It is necessary to improve the stability of human serum albumin in response to the complex temperature, light and other conditions during the manufacture and storage. In this paper, the stabilization effect and simple stabilization mechanism of ligands on albumin were described from the perspective of ligand binding to albumin.Through review and comparison, it can be concluded that the common ligand sodium octanoate mainly plays a role in improving thermal stability, and the common ligand N-acetyl-L-tryptophan mainly plays a role in improving antioxidant activity, N-acetyl-L-methionine has better antioxidant and anti-photooxidation than N-acetyl-L-tryptophan.

OBJECTIVE To compare the influence of age on the recovery of sudden sensorineural hearing loss.METHODS Detailed medical data of patients were reviewed.The patients were diagnosed as sudden sensorineural hearing loss from Jan 2010 to June 2018 and accepted treatments with neurotrophic drugs,steroid or hyperbaric oxygen.Age grouping was performed by every 5 years'interval.The treatment efficacy and hearing improvement were compared according to the age.RESULTS There were one hundred and sixty-three patients in this study.The majority of patients had moderate or above hearing loss,and most of the hearing curve was flat and profound type.The overall recovery rate was 56.44%,hearing gain was averaged 21.88 dB.55-60 years group had largest number of patients in the 11 age groups.Even with different treatment,the patients aged 57-66 years had the bad recovery,including the hearing gain data and total effective rate.CONCLUSION Ages has influence on the recovery of sudden sensorineural hearing loss,it maybe correlated with the etiology and patients'condition.

TGF-β1 is considered a key mediator in the formation of hepatic fibrosis and mainly acts by activating the downstream Smad signaling pathway.Smad2 and Smad3 are two major downstream regulators that promote TGF-β1-mediated tissue fibrosis,while Smad7 is a negative-feedback regulator of the TGF-β1/Smad pathway and inhibits TGF-β1-mediated hepatic fibrosis.A growing number of studies are showing that natural products can delay the progression of hepatic fibrosis by regulating the TGF-β1/Smad pathway,inhibiting HSC activation,and reducing ECM deposition.This article reviews the molecular mechanism of the TGF-β1/Smad signaling pathway in hepatic fibrosis,and summarizes the natural products that target the regulation of this pathway,providing a reference for research into the treatment of hepatic fibrosis.

Objective:To evaluate modified Lanza score (MLS) of gastric mucosa for predicting the prognosis of geriatric patients with sepsis.Methods:Data of 50 patients with sepsis, who were over 60 years old and underwent gastroscopy for suspected gastrointestinal bleeding in the Department of Geriatric Critical Care Medicine of Guangdong Provincial People's Hospital from January 2019 to April 2022, were retrospectively analyzed. Patients were divided into the death group ( n=32) and the survival group ( n=18) according to their regression within 28 days after gastroscopy. Their gastric mucosa was scored by using MLS system, and the mortality of patients with MLS≥1 was calculated, then the patients were further divided into 2 groups, MLS=0-2 ( n=23, less than 2 regions of lesions ) and MLS=3-5 ( n=27, two or more regions of lesions). The relationship between MLS and acute physiology and chronic health status evaluation (APACHE) Ⅱ score, risk factor of death and mortality in each group were compared. The correlation between MLS and mortality was analyzed. The influence of geriatric sepsis risk factors affecting the prognosis of patients within 28 days were analyzed by using logistic regression. Results:Among the 50 geriatric patients with sepsis, those with gastric mucosal lesions, i.e., MLS ≥1, accounted for 68.00% (34/50), including 84.38% (27/32) patients with MLS≥1 in the death group, which was significantly higher than the 38.89% (7/18) patients with MLS≥1 in the survival group ( χ 2=10.593, P<0.001). Patients with MLS=3-5 had significantly higher APACHE Ⅱ scores (26.09±6.47 VS 18.57±7.66, t=3.527, P=0.001) and higher mortality [85.19% (23/27) VS 39.13% (9/23), χ 2=11.434, P=0.001] compared with MLS=0-2. Correlation analysis showed a significant correlation between MLS and mortality ( r=0.886, P=0.019). Multivariate logistic regression analysis showed that MLS=4-5 was an independent risk factor for death in geriatric patients with sepsis ( OR=17.055, 95% CI: 1.387-209.744, P=0.027). Conclusion:MLS presents high sensitivity in predicting 28-day outcomes for geriatric patients with sepsis. Two or more than 2 regions of gastric mucosal lesions can significantly increase the risk of death in geriatric patients with sepsis.

Frontal fibrosing alopecia is a primary lymphocytic cicatricial alopecia, and is generally considered to be a subtype of lichen planopilaris due to similar histopathological changes. Its etiology is still unclear. With the deepening of research on this disease, more and more cases of frontal fibrosing alopecia have been reported in China and other countries. This review summarizes research progress in pathogenesis, clinical and pathological characteristics, and treatment of frontal fibrosing alopecia.

Objective:To observe and summarise the clinical effect of free groin flap in repairing of soft tissue defects in extremities, and to explore the selection of main vessel in a flap.Methods:From January 2018 to January 2021, 146 patients with soft tissue defects in extremities were treated with free groin flaps in the Department of Hand and Microsurgery, Guangxi Guilin Xing'an Jieshou Orthopaedic Hospital. There were 126 patients with traumatic wound and 20 with chronic ulcer. In addition, 86 of the patients with bone fracture and exposure of internal fixator, 18 with tendon, nerve or artery injuries or defects. There were 6 patients with severe infection and other 3 with deep dead space. The sizes of wound ranged from 2.0 cm×3.0 cm to 25.0 cm×6.0 cm. The flap was the same size as the wound and not enlarged. Firstly, the superficial branch of superficial iliac circumflex artery was explored as the axial artery for all the flaps, then the blood supply vessels of the flap were selected according to the availability of the axial artery. The size, course, adjacent and possible length to be freed of the axial artery and the accompanying veins of a flap were recorded. The donor sites were directly sutured and closed. All patients were included in the postoperative follow-up at outpatient clinic.Results:Free groin flap were used to repair the wounds in all patients. However, the main blood supply vessel of the flap was not constant, and it was often required to adjust the way of flap harvesting. Superficial circumflex iliac artery was taken as the axial vessels in 141 patients (96.6%), among them, 133 cases(94.3%) had the superficial branch as the axis and 5 cases (3.6%) had deep branch as the axis. Three patients (2.1%) had the bone and soft tissue defects reconstructed with vascularised iliac mosaic osteocutaneous flap with superficial circumflex iliac artery as axial vessel and 5 cases(3.4%) had the superficial epigastric artery as axial vessel. The axial arteries were measured as follow: the superficial branch of the superficial circumflex iliac artery was 0.5-0.9 mm in diameter and 7.0-9.0 cm in length, the outer diameter of the deep branch was 1.2-1.4 mm and 9.0-11.0 cm in length, and the outer diameter of superficial epigastric artery was 1.0-1.6 mm and 8.0-11.3 cm in length. All the flaps survived smoothly after surgery and the follow-up period ranged 6-40 (mean 26) months. The texture of the flaps was soft with good function.Conclusion:Free groin flap can be used to repair soft tissue defects in extremities. The main axial vessel is the superficial branch of the superficial circumflex iliac artery, followed by the deep branch or the trunk. The superficial abdominal artery can also be used as an axial vessel. Under the circumstances, the flap design needs to be adjusted without changing the supply area

Objective:To understand the current situation of robot-assisted patient rehabilitation training in neurological disease-related departments of ClassⅢ medical institutions across the country, so as to provide guidance and basis for promoting the improvement of robot-assisted training.Methods:In September 2021, convenience sampling was used to select neurological disease-related departments in Class Ⅲ hospitals from all provinces and cities across the country to conduct a survey on the status of robot-assisted rehabilitation training. A self-designed Hospital Robot-Assisted Training Questionnaire was used for investigation. The survey was conducted using an electronic questionnaire. A total of 250 questionnaires were distributed, and 236 valid questionnaires were recovered, with a valid recovery rate of 94.4%.Results:Among the 236 neurological disease-related departments, a total of 93 (39.4%) departments used robot-assisted rehabilitation training. The robot type was mainly wearable robot, which was mainly used to train lower limb motor function, upper limb motor function, gait ability and so on. A total of 55.9% (52/93) of departments believed that robot-assisted rehabilitation training was more effective than conventional rehabilitation training. Hospital type, department bed turnover times, and daily training time were the main factors affecting the effectiveness of robot-assisted training, and the differences were statistically significant ( P<0.05) . Among the 93 departments that had used robots, 22.6% (21/93) of the departments had not experienced any negative events in the robot-assisted rehabilitation training. The 143 departments that had not yet used robots had a positive attitude towards robots, and the main reasons for not using robots were that robots were too expensive, lacked the guidance of technicians, and were afraid to use them without professional training. Conclusions:Robot-assisted training has been concerned and tried to use by neurological disease-related departments, but the safety still needs to be further enhanced. Medical institutions should formulate robot-assisted rehabilitation training guidelines as soon as possible to guide the application and development of robot-assisted training.

Objective: To compare diagnostic performance of traditional vertical section technique, horizontal section technique and modified Ho-Vert technique for classical lichen planopilaris. Methods: Clinical data were collected from patients with classical lichen planopilaris in Department of Dermatology, The Affiliated Wuxi People′s Hospital of Nanjing Medical University from January 1st 2015 to January 1st 2019. With the help of dermoscopy, 2 scalp specimens were obtained from each patient and sliced horizontally and vertically respectively by using modified Ho-Vert technique. The horizontal and vertical sections were read separately or simultaneously, and histopathological changes were observed. Results: Totally, 21 patients with classical lichen planopilaris were enrolled into this study, including 15 males and 6 females. Their age was 50.0 ± 13.6 years, and the average course of disease was 18 months. The patients mainly presented with multifocal or confluent patchy hair loss, and scalp atrophy, perifollicular hyperkeratosis, loss of follicular ostia, fibrous white dots and orbit sign were observed. On the horizontal sections, lichenoid lymphocytic infiltration around the infundibulum and isthmus of hair follicles and follicular micro-scars could be observed in all patients, and the dermo-epidermal interface could be seen in 7 patients. On the vertical sections, lichenoid lymphocytic infiltration around the infundibulum and isthmus of hair follicles only could be observed in 9 patients, follicular micro-scars could be seen in 4, and the dermo-epidermal interface could be observed in all patients. Moreover, the detection rates of interfollicular interface dermatitis, follicular keratotic plugs, lymphocytic infiltration around sebaceous glands, atrophy or disappearance of sebaceous glands and inflammatory infiltration around hair follicle bulbs were significantly different between the horizontal and vertical sections. In combination with clinical manifestations, 7 patients could be exactly diagnosed with lichen planopilaris according to findings from horizontal sections, and 9 could be diagnosed exactly according to findings from vertical sections, while 21 could be diagnosed exactly according to histopathological findings from both horizontal and vertical sections. Conclusion With the help of dermoscopy, modified Ho-Vert technique can improve the efficacy of pathological diagnosis of classical lichen planopilaris, by multidimensionally showing histopathological changes.

Objective:To investigate the expression of microRNA-155 (miR-155) in serum and kidney of C57BLKS/db (db/db) mice and its role in the pathogenesis of diabetic kidney disease (DKD).Methods:The db/db mice ( n=24) were divided into 6, 8, and 10 weeks old groups ( n=8) with age increasing according to the random number table, and C57BL/6 mice of the same age were used as control group. The expression of miR-155 in mouse serum and kidney tissue was determined using real-time quantitative PCR. The mRNA and protein expression of Ets-1, eNOS, AGTR1 in renal tissues was verified by real-time quantitative PCR, Western blotting and immunohistochemistry. Results:Compared with the control group, the expression of miR-155 in serum of db/db mice at 6, 8 and 10 weeks of age were significantly increased (all P<0.01), and the increase of miR-155 was most obvious at 10 weeks of age ( P<0.01). Meanwhile the expression of miR-155 in kidney tissues of 6, 8 and 10 weeks old db/db mice was significantly up-regulated (all P<0.01), and the highest expression of miR-155 was at 10 weeks of age ( P<0.01). Immunohistochemistry showed that Ets-1, eNOS and AGTR1 were localized in glomerular endothelial cells. The results of real-time quantitative PCR showed that the mRNA expression of Ets-1, eNOS and AGTR1 were down-regulated in the kidney tissues of db/db mice at 6, 8 and 10 weeks of age compared to the control(all P<0.05), and the level of down-regulation was the most obvious at 10 week. Western blotting results showed that there was no significant change in Ets-1, eNOS and AGTR1 in 6-week-old db/db mice compared to the control group; the eNOS protein expression was down-regulated at 8 weeks of age ( P<0.05); the expression of AGTR1 protein was down-regulated ( P<0.05), and the protein expression of Ets-1 and eNOS were significantly down-regulated at 10-week age (both P<0.01). Conclusions:The expression of miR-155 in serum and kidney tissues of db/db mice increases during the progression of DKD, while the expression of miR-155 target genes Ets-1, eNOS and AGTR1 decreases with the progression of DKD. MiR-155 may participate in the development and progression of DKD by inhibiting its target genes Ets-1, eNOS and AGTR1, affecting endothelial cell function.

Objective To analyze the differences in the treatment patterns,clinical characteristics,treatment outcomes and prognostic factors between breast cancer patients with ductal carcinoma in situ (DCIS) and ductal carcinoma in situ with microinvasion (DCIS-MI).Methods Clinical data of 866 female patients including 631 DCIS cases and 235 DCIS-MI cases treated in our institution between 1999 and 2013 were retrospectively analyzed.The local control (LC),disease-free survival (DFS) and overall survival (OS) rates were calculated by Kaplan-Meier survival analysis.The prognostic factors were identified by Log-rank test.Results Similar LC,DFS and OS rates were obtained between two groups (all P＞ O.05).The univariate analysis demonstrated that Her-2-positive patients had worse OS and DFS than Her-2-negative counterparts.Patients undergoing breast-conserving surgery without radiotherapy had lower LC and DFS rates compared with those receiving radical mastectomy.Conclusions DCIS and DCIS-MI patients have similar clinical prognosis in terms of OS,LC and DFS.Her-2 positive is an unfavorable prognostic factor for DFS and OS.The LC and DFS rates in the breast-conserving surgery alone group are worse than those in the mastectomy group.