Objective To evaluate the efficacy and safety of dupilumab combined with 2％cleboride ointment in the treatment of moderate to severe atopic dermatitis,as well as its impact on serological indica-tors.Methods A retrospective analysis was conducted on the clinical data of 67 patients with moderate to se-vere atopic dermatitis(AD)admitted to the Department of Dermatology of Shaoxing University Affiliated Hospital from March 2021 to December 2024.The study subjects were divided into an experimental group(n=35)and a control group(n=32)according to the treatment method.The experimental group was treated with Dupilumab injection and 2％Cleboride ointment,while the control group was treated with ebastine tab-lets and 2％cleboride ointment.Clinical and related serological indicators of patients after 16 weeks of treat-ment were collected,and the itch digital scale score,eczema area and severity(EASI)score,IL-4,IL-13 levels,and incidence of local skin adverse reactions were analyzed before and after treatment in both groups.Results The total effective rate of the experimental group after treatment was 94.29％(33/35),which was higher than the control group[53.13％(17/32)],and the difference was statistically significant(x2=12.862,P＜0.001).There was no statistically significant difference in symptom scores,IL-4,and IL-13 levels between the two groups before treatment(P＞0.05).After treatment,the symptom scores of the experimental group were lower than those of the control group,and the difference was statistically significant(P＜0.05).The lev-els of IL-4 and IL-13 in the experimental group were lower than those in the control group,and the difference was statistically significant(P＜0.05).The incidence of adverse reactions in the experimental group was 2.86％(1/35),significantly lower than the 34.38％(11/32)in the control group,and the difference was sta-tistically significant(x2=9.252,P=0.002).Conclusion The combination of dupilumab injection and 2％cleboride ointment is effective in relieving skin symptoms,regulating cellular immune function,reducing in-flammatory reactions,and minimizing local skin adverse reactions in patients with moderate to severe AD.It is worthy of clinical promotion and use.

Objective To investigate the value of serum long noncoding RNA small nucleolar RNA host gene 7(lncRNA SNHG7)and microRNA(miR)-34a-5p expression in the diagnosis and prognostic evaluation of bloodstream infection(BSI).Methods A total of 193 suspected BSI patients admitted to the emergency department of Guangxi Wuzhou Red Cross Hospital from March 2022 to March 2023 were collected as the study subjects.After diagnosis,BSI patients were included as the infection group(n=100),and non BSI patients were included as the non infection group(n=93).After 28 days of treatment,BSI patients were separated into a death group(n=32)and a survival group(n=68)based on their prognosis.The real time fluorgenic quantitative PCR(qRT-PCR)method was applied to detect the expression levels of serum lncRNA SNHG7 and miR-34a-5p.The Target Scan Human website was applied to predict the targeting relationship between miR-34a-5p and lncRNA SNHG7.Pearson method was applied to analyze the correlation between serum lncRNA SNHG7 level and miR-34a-5p level.Multivariate Logistic regression was applied to analyze the influencing factors of prognosis in patients with BSI.Receiver operating characteristic(ROC)curve was applied to analyze the prognostic value of serum lncRNA SNHG7 and miR-34a-5p.Results The serum lncRNA SNHG7 level(1.47±0.35)in the infection group was obviously higher than that in the non infection group(1.03±0.15),and the miR-34a-5p level(0.85±0.21)was obviously lower than that in the non infection group(1.02±0.13),and the differences were statistically significant(t=11.203,6.703,all P<0.05).Compared with survival group,the serum lncRNA SNHG(1.68±0.21 vs 1.37±0.19),C-reactive protein(CRP)(85.74±9.16mg/L vs 63.18±7.68mg/L),procalcitonin(PCT)levels(56.37±8.72ng/ml vs 34.69±5.54ng/ml),albumin(92.51±10.18g/L vs 65.27±7.24g/L),Acute Physiological and Chronic Health Evaluation(APACHE II)scores(28.15±5.12scores vs 16.35±4.31scores)of the death group were obviously higher,and serum miR-34a-5p level(0.67±0.14 vs 0.93±0.16)was obviously lower,the differences were statistically significant.(t=7.357～15.340,all P<0.05).LncRNA SNHG7 had a targeted binding site with miR-34a-5p,and lncRNA SNHG7 was negatively correlated with miR-34a-5p(r=-0.568,P<0.05).Serum lncRNA SNHG7 and miR-34a-5p were prognostic factors for BSI patients(all P<0.05).The area under the curve(AUC)of serum lncRNA SNHG7,miR-34a-5p,and their combined evaluation of prognosis in BSI patients was better than that of serum lncRNA SNHG7 and miR-34a-5p detected sepatately(Z=0.001,2.304,all P<0.05),with sensitivity and specificity of 78.12%and 97.06%,respectively.Conclusion The serum lncRNA SNHG7 level in BSI patients is obviously elevated,while the serum miR-34a-5p level is obviously reduced.The two are closely related to the prognosis of BSI patients,and the combination of the two has good evaluation value for the prognosis of BSI patients.

Objective To realize real-time monitoring and evaluation of muscle strength,this study designed and validated a wearable muscle strength monitoring system based on muscle perimeter changes.Methods Six healthy college students who are not sports majors wore the monitoring gear based on the change of muscle perimeter to perform the isokinetic muscle strength test,the real-time data of the change of muscle perimeter during the isokinetic exercise was obtained.After analyzing and processing the curve of muscle perimeter change overtime,namely,the peak muscle perimeter change(PP),the peak velocity of muscle perimeter change(PVP)and the accumulation of muscle perimeter change(AP)over time in a single exercise,Pearson correlation analysis was conducted with the peak torque(PT),the peak torque to body weight ratio(PT/BW),the torque at 0.18 s(T0.18)and the endurance ratio(ER)obtained by the isokinetic muscle strength test.The reliability of wearable system for real-time muscle strength monitoring was verified.The muscle perimeter changes were sampled with the arm and leg wearable protectors,and the muscle perimeter monitoring positions corresponded to the largest muscle perimeter changes when the strength of biceps in the upper arm was applied,as well as the largest muscle perimeter changes when the strength of quadriceps above the knee was applied.The isokinetic muscle strength test was performed on elbow and knee joints using the Biodex System 4 pro device.Results Dynamic muscle perimeter changes could be used to monitor the muscle strength level of the human body.There was a significant correlation between arm muscle perimeter and elbow muscle strength index(P≤0.01),and the maximum correlation coefficient was 0.91.Leg muscle perimeter was significantly correlated with knee muscle strength(P≤0.01),and the maximum correlation coefficient was 0.99.Conclusions The wearable muscle strength monitoring system has a high reliability and can be used for real-time monitoring of the elbow and knee muscle strength during isokinetic exercise.

Objective:To evaluate the impact of implementing a regional hierarchical medical management model based on the medical internet of things (medical IoT) on the frequency of emergency department visits and hospitalizations, as well as related medical expenses, in patients with chronic obstructive pulmonary disease (COPD).Methods:This retrospective study included COPD patients enrolled in the regional hierarchical medical management system based on Medical IoT across 21 community health service centers in Songjiang District, Shanghai, between July 2017 and May 2018. Utilizing patient data from the year prior to enrollment as the baseline, changes in the number of emergency visits, hospitalizations, and associated medical costs during the first and second years of management were compared. Changes for patients receiving drug treatment were also analyzed.Results:A total of 973 COPD patients were enrolled. The mean age was 75.2±17.0 years, and 64.34% (626/973) were male. Compared to baseline, all COPD patients in the first year of management showed significant reductions: emergency visits decreased by 33.67%, total emergency costs by 45.60%, hospitalizations by 27.15%, and total hospitalization costs by 25.42%. In the second year, reductions were: emergency visits by 28.08%, total emergency costs by 36.10%, hospitalizations by 35.26%, and total hospitalization costs by 18.13% (all P<0.05). Among patients receiving drug therapy, reductions in the first year were: emergency visits by 39.66%, total emergency costs by 47.54%, hospitalizations by 25.19%, and total hospitalization costs by 28.40%. In the second year, reductions were: emergency visits by 46.98%, total emergency costs by 45.99%, hospitalizations by 41.98%, and total hospitalization costs by 24.94% (all P<0.05). No significant differences were observed before and after management for patients without drug treatment. Conclusion:The implementation of the regional hierarchical medical management model based on Medical IoT significantly reduced the frequency of emergency visits and hospitalizations, as well as related costs, for COPD patients.

Third-line treatment for metastatic colorectal cancer(mCRC)refers to subsequent therapeutic interventions following the failure or intolerance of first-and second-line treatments.This represents a critical challenge in clinical practice and a core focus of translational medicine research in recent years.With advancements in molecular typing technologies and the emergence of novel therapies,the third-line treatment strategy has evolved from traditional chemotherapy toward precision targeting and immunotherapy.A comprehensive literature search was conducted across PubMed,ClinicalTrials.gov database and American Society of Clinical Oncology(ASCO),European Society for Medical Oncology(ESMO)conference abstracts.Phase Ⅲ randomized controlled trials,phase Ⅰ/Ⅱ frontier clinical studies,and authoritative reviews were included,with an emphasis on data related to survival benefits,drug resistance mechanisms,and biomarkers.This review provided an in-depth analysis of significant progress in third-line treatment strategies for mCRC,encompassing standard therapies[regorafenib,fruquintinib,trifluridine/tipiracil,anti-epidermal growth factor receptor(EGFR)rechallenge therapy],targeted therapies(e.g.,BRAF V600E inhibitors,ERBB2 amplification inhibitors,KRAS G12C inhibitors)and immunotherapies[microsatellite instability-high(MSI-H)/deficient mismatch repair(dMMR),microsatellite stable(MSS)/proficient mismatch repair(pMMR)and target-immune combination therapies].Notable breakthroughs have been achieved in targeted therapies.Anti-EGFR rechallenge therapy extended the median overall survival(OS)to 17.3 months in RAS/BRAF wild-type patients identified through dynamic circulating tumor DNA(ctDNA)monitoring.However,drug resistance remains complex,with high secondary mutation rates necessitating further optimization of dynamic monitoring systems.For BRAF V600E mutations,triple therapy(encorafenib+binimetinib+cetuximab)demonstrated a median OS of 9.3 months[hazard ratio(HR)=0.52],surpassing conventional treatments.The combination of KRAS G12C inhibitor adagrasib with cetuximab achieved an objective response rate(ORR)of 34%and a median OS of 15.9 months,though tumor resistance continued to pose challenges.In the realm of immunotherapy,dual immunotherapy(nivolumab+ipilimumab)yielded a 4-year OS rate of 71%in MSI-H/dMMR patients.For MSS patients,immune-targeted combination strategies(e.g.,cabozantinib+atezolizumab)increased the ORR to 27.6%.Emerging therapies include artificial intelligence platforms for precision medicine,gut microbiota-based biomarkers and fecal microbiota transplantation,as well as advancements in chimeric antigen receptor-T(CAR-T)cell therapy.By summarizing the current status and progress of third-line treatment for mCRC,this review aims to inform clinical decision-making and guide future research directions.

Objective To realize real-time monitoring and evaluation of muscle strength,this study designed and validated a wearable muscle strength monitoring system based on muscle perimeter changes.Methods Six healthy college students who are not sports majors wore the monitoring gear based on the change of muscle perimeter to perform the isokinetic muscle strength test,the real-time data of the change of muscle perimeter during the isokinetic exercise was obtained.After analyzing and processing the curve of muscle perimeter change overtime,namely,the peak muscle perimeter change(PP),the peak velocity of muscle perimeter change(PVP)and the accumulation of muscle perimeter change(AP)over time in a single exercise,Pearson correlation analysis was conducted with the peak torque(PT),the peak torque to body weight ratio(PT/BW),the torque at 0.18 s(T0.18)and the endurance ratio(ER)obtained by the isokinetic muscle strength test.The reliability of wearable system for real-time muscle strength monitoring was verified.The muscle perimeter changes were sampled with the arm and leg wearable protectors,and the muscle perimeter monitoring positions corresponded to the largest muscle perimeter changes when the strength of biceps in the upper arm was applied,as well as the largest muscle perimeter changes when the strength of quadriceps above the knee was applied.The isokinetic muscle strength test was performed on elbow and knee joints using the Biodex System 4 pro device.Results Dynamic muscle perimeter changes could be used to monitor the muscle strength level of the human body.There was a significant correlation between arm muscle perimeter and elbow muscle strength index(P≤0.01),and the maximum correlation coefficient was 0.91.Leg muscle perimeter was significantly correlated with knee muscle strength(P≤0.01),and the maximum correlation coefficient was 0.99.Conclusions The wearable muscle strength monitoring system has a high reliability and can be used for real-time monitoring of the elbow and knee muscle strength during isokinetic exercise.

Third-line treatment for metastatic colorectal cancer(mCRC)refers to subsequent therapeutic interventions following the failure or intolerance of first-and second-line treatments.This represents a critical challenge in clinical practice and a core focus of translational medicine research in recent years.With advancements in molecular typing technologies and the emergence of novel therapies,the third-line treatment strategy has evolved from traditional chemotherapy toward precision targeting and immunotherapy.A comprehensive literature search was conducted across PubMed,ClinicalTrials.gov database and American Society of Clinical Oncology(ASCO),European Society for Medical Oncology(ESMO)conference abstracts.Phase Ⅲ randomized controlled trials,phase Ⅰ/Ⅱ frontier clinical studies,and authoritative reviews were included,with an emphasis on data related to survival benefits,drug resistance mechanisms,and biomarkers.This review provided an in-depth analysis of significant progress in third-line treatment strategies for mCRC,encompassing standard therapies[regorafenib,fruquintinib,trifluridine/tipiracil,anti-epidermal growth factor receptor(EGFR)rechallenge therapy],targeted therapies(e.g.,BRAF V600E inhibitors,ERBB2 amplification inhibitors,KRAS G12C inhibitors)and immunotherapies[microsatellite instability-high(MSI-H)/deficient mismatch repair(dMMR),microsatellite stable(MSS)/proficient mismatch repair(pMMR)and target-immune combination therapies].Notable breakthroughs have been achieved in targeted therapies.Anti-EGFR rechallenge therapy extended the median overall survival(OS)to 17.3 months in RAS/BRAF wild-type patients identified through dynamic circulating tumor DNA(ctDNA)monitoring.However,drug resistance remains complex,with high secondary mutation rates necessitating further optimization of dynamic monitoring systems.For BRAF V600E mutations,triple therapy(encorafenib+binimetinib+cetuximab)demonstrated a median OS of 9.3 months[hazard ratio(HR)=0.52],surpassing conventional treatments.The combination of KRAS G12C inhibitor adagrasib with cetuximab achieved an objective response rate(ORR)of 34%and a median OS of 15.9 months,though tumor resistance continued to pose challenges.In the realm of immunotherapy,dual immunotherapy(nivolumab+ipilimumab)yielded a 4-year OS rate of 71%in MSI-H/dMMR patients.For MSS patients,immune-targeted combination strategies(e.g.,cabozantinib+atezolizumab)increased the ORR to 27.6%.Emerging therapies include artificial intelligence platforms for precision medicine,gut microbiota-based biomarkers and fecal microbiota transplantation,as well as advancements in chimeric antigen receptor-T(CAR-T)cell therapy.By summarizing the current status and progress of third-line treatment for mCRC,this review aims to inform clinical decision-making and guide future research directions.

Objective To investigate the value of serum long noncoding RNA small nucleolar RNA host gene 7(lncRNA SNHG7)and microRNA(miR)-34a-5p expression in the diagnosis and prognostic evaluation of bloodstream infection(BSI).Methods A total of 193 suspected BSI patients admitted to the emergency department of Guangxi Wuzhou Red Cross Hospital from March 2022 to March 2023 were collected as the study subjects.After diagnosis,BSI patients were included as the infection group(n=100),and non BSI patients were included as the non infection group(n=93).After 28 days of treatment,BSI patients were separated into a death group(n=32)and a survival group(n=68)based on their prognosis.The real time fluorgenic quantitative PCR(qRT-PCR)method was applied to detect the expression levels of serum lncRNA SNHG7 and miR-34a-5p.The Target Scan Human website was applied to predict the targeting relationship between miR-34a-5p and lncRNA SNHG7.Pearson method was applied to analyze the correlation between serum lncRNA SNHG7 level and miR-34a-5p level.Multivariate Logistic regression was applied to analyze the influencing factors of prognosis in patients with BSI.Receiver operating characteristic(ROC)curve was applied to analyze the prognostic value of serum lncRNA SNHG7 and miR-34a-5p.Results The serum lncRNA SNHG7 level(1.47±0.35)in the infection group was obviously higher than that in the non infection group(1.03±0.15),and the miR-34a-5p level(0.85±0.21)was obviously lower than that in the non infection group(1.02±0.13),and the differences were statistically significant(t=11.203,6.703,all P<0.05).Compared with survival group,the serum lncRNA SNHG(1.68±0.21 vs 1.37±0.19),C-reactive protein(CRP)(85.74±9.16mg/L vs 63.18±7.68mg/L),procalcitonin(PCT)levels(56.37±8.72ng/ml vs 34.69±5.54ng/ml),albumin(92.51±10.18g/L vs 65.27±7.24g/L),Acute Physiological and Chronic Health Evaluation(APACHE II)scores(28.15±5.12scores vs 16.35±4.31scores)of the death group were obviously higher,and serum miR-34a-5p level(0.67±0.14 vs 0.93±0.16)was obviously lower,the differences were statistically significant.(t=7.357～15.340,all P<0.05).LncRNA SNHG7 had a targeted binding site with miR-34a-5p,and lncRNA SNHG7 was negatively correlated with miR-34a-5p(r=-0.568,P<0.05).Serum lncRNA SNHG7 and miR-34a-5p were prognostic factors for BSI patients(all P<0.05).The area under the curve(AUC)of serum lncRNA SNHG7,miR-34a-5p,and their combined evaluation of prognosis in BSI patients was better than that of serum lncRNA SNHG7 and miR-34a-5p detected sepatately(Z=0.001,2.304,all P<0.05),with sensitivity and specificity of 78.12%and 97.06%,respectively.Conclusion The serum lncRNA SNHG7 level in BSI patients is obviously elevated,while the serum miR-34a-5p level is obviously reduced.The two are closely related to the prognosis of BSI patients,and the combination of the two has good evaluation value for the prognosis of BSI patients.

Objective:To evaluate the impact of implementing a regional hierarchical medical management model based on the medical internet of things (medical IoT) on the frequency of emergency department visits and hospitalizations, as well as related medical expenses, in patients with chronic obstructive pulmonary disease (COPD).Methods:This retrospective study included COPD patients enrolled in the regional hierarchical medical management system based on Medical IoT across 21 community health service centers in Songjiang District, Shanghai, between July 2017 and May 2018. Utilizing patient data from the year prior to enrollment as the baseline, changes in the number of emergency visits, hospitalizations, and associated medical costs during the first and second years of management were compared. Changes for patients receiving drug treatment were also analyzed.Results:A total of 973 COPD patients were enrolled. The mean age was 75.2±17.0 years, and 64.34% (626/973) were male. Compared to baseline, all COPD patients in the first year of management showed significant reductions: emergency visits decreased by 33.67%, total emergency costs by 45.60%, hospitalizations by 27.15%, and total hospitalization costs by 25.42%. In the second year, reductions were: emergency visits by 28.08%, total emergency costs by 36.10%, hospitalizations by 35.26%, and total hospitalization costs by 18.13% (all P<0.05). Among patients receiving drug therapy, reductions in the first year were: emergency visits by 39.66%, total emergency costs by 47.54%, hospitalizations by 25.19%, and total hospitalization costs by 28.40%. In the second year, reductions were: emergency visits by 46.98%, total emergency costs by 45.99%, hospitalizations by 41.98%, and total hospitalization costs by 24.94% (all P<0.05). No significant differences were observed before and after management for patients without drug treatment. Conclusion:The implementation of the regional hierarchical medical management model based on Medical IoT significantly reduced the frequency of emergency visits and hospitalizations, as well as related costs, for COPD patients.

Objective The aim of this study was to analyze the predictive value of an immune scoring model based on im-mune cell infiltration for the efficacy and prognosis of immunotherapy in early gastric cancer.Methods The gene expression data and related clinical parameters of 167 early gastric cancer patients were downloaded from the Cancer Genome Atlas(TCGA)as the training set.The clinical information of 92 early gastric cancer patients who first visited our hospital from January 2017 to January 2020 was collected as a validation set.The infiltration of 22 immune cells in tumor tissues was calculated by the Cibersort software.The key pre-dictive factors for early gastric cancer patients were further screened and determined by lasso analysis and multivariate Cox regression analysis.The eligible immune cells were used to construct the prognostic risk scoring model and verify it.Based on the risk model,a nomograph model was established to predict the probability of death and treatment failure in early gastric cancer patients,and evaluate the differentiation,accuracy,and reliability of the model.Results There was no statistically significant difference in the general infor-mation of patients between the training set and the validation set(P＞0.05).Compared with normal tissues,the content of CD8+T cells,activated memory CD4+T cells,M0 macrophages,M1 macrophages,resting dendritic cells,and activated dendritic cells in early gastric cancer tumor tissues decreased.The contents of regulatory T cells(Treg cells)and eosinophils increased,and the difference was statistically significant(P＜0.05).The LASSO analysis further screened five types of infiltrating immune cells,including activated memory CD4+T cells,M1 macrophages,Treg cells,activated dendritic cells and eosinophils.The survival curve results showed that the immune scoring model could effectively distinguish the survival time of patients.The total score of the prognostic nomogram model was 274,corresponding to risk of death of 72%.The total score of the treatment effect nomograph model was 307,corresponding to a 75%risk of ineffective treatment.The model validation results showed that the nomograph model has high discrimination,accuracy and reli-ability.Conclusion The immune scoring model based on immune cell infiltration has a certain predictive value for the efficacy and prognosis of immunotherapy in patients with early gastric cancer.