Atopic dermatitis (AD) is a prevalent inflammatory skin disorder in which patients experience recurrent eczematous lesions and intense itching. The colonization of Staphylococcus aureus (S. aureus) is correlated with the severity of the disease, but its role in AD development remains elusive. Using single-cell RNA sequencing, we uncovered that keratinocytes activate a distinct immune response characterized by induction of Il24 when exposed to methicillin-resistant S. aureus (MRSA). Further experiments using animal models showed that the administration of recombinant IL-24 protein worsened AD-like pathology. Genetic ablation of Il24 or the receptor Il20rb in keratinocytes alleviated allergic inflammation and atopic march. Mechanistically, IL-24 acted through its heterodimeric receptors on keratinocytes and augmented the production of IL-33, which in turn aggravated type 2 immunity and AD-like skin conditions. Overall, these findings establish IL-24 as a critical factor for onset and progression of AD and a compelling therapeutic target.
Dermatitis, Atopic/genetics* ; Interleukins/metabolism* ; Animals ; Methicillin-Resistant Staphylococcus aureus/immunology* ; Mice ; Keratinocytes/microbiology* ; Humans ; Interleukin-33/immunology* ; Inflammation/microbiology* ; Staphylococcal Infections/microbiology* ; Disease Models, Animal ; Hypersensitivity/microbiology* ; Mice, Inbred C57BL

Objective:To conduct signal detection and analysis of cardiovascular-related adverse events associated with second-generation H1 antihistamines(sgAH)in the elderly population, utilizing the Food and Drug Administration adverse event reporting system(FAERS)database.The findings provide a reference for assessing the clinical drug safety of sgAH in the elderly.Methods:A cross-sectional study was conducted.Four methods were utilized to detect signals of cardiovascular-related adverse events associated with sgAHs in the FAERS database, covering the period from the first quarter of 2004 to the first quarter of 2024.These methods included the reporting odds ratio, the Medicines and Healthcare Products Regulatory Agency method, the Bayesian Confidence Propagation Neural Network method, and the multi-item gamma Poisson shrinker method.Subgroup analyses were performed on both the overall population and the elderly population(aged ≥65).Results:A total of 1 065 reports of cardiovascular-related adverse events involving sgAHs such as loratadine, desloratadine, cetirizine, levocetirizine, and fexofenadine were collected.In the overall population, palpitations were identified as a positive signal, while desloratadine also demonstrated positive signals for tachycardia and prolonged electrocardiogram QT interval.In the elderly population, both palpitations and prolonged electrocardiogram QT interval were recognized as positive signals, exhibiting higher information component(IC)values and empirical Bayesian geometric mean(EBGM)values compared to the overall population.Furthermore, loratadine and desloratadine were also identified as positive signals for prolonged electrocardiogram QT interval in the elderly.Conclusions:Palpitations have been identified as a significant indicator of cardiovascular-related adverse events associated with sgAHs.Elderly patients should be particularly vigilant regarding the risk of prolonged QT intervals on electrocardiograms.

OBJECTIVE To observe the clinical efficacy of Ziyu Prescription in the treatment of polycystic ovary syndrome relat-ed infertility of kidney deficiency and its effect on endometrial receptivity.METHODS A total of 120 patients with polycystic ovary syndrome related infertility of kidney deficiency were enrolled and randomly divided into a control group and a treatment group,with 60 cases in each group.After excluding dropout cases and excluded cases,56 cases were completed in each group.The control group was treated with letrozole and placebo,while the treatment group was treated with letrozole and Ziyu Prescription.The treatment course of both groups was 3 menstrual cycles.The clinical pregnancy rate and ultrasound Salle score during the implantation window were the main outcome indicators.The traditional Chinese medicine(TCM)syndrome score and serum estradial(E2),testosterone(T),anti-Müllerian hormone(AMH),luteinizing hormone(LH),follicle-stimulating hormone(FSH),homeostatic model assessment of insulin resistance(HOMA-IR),serum E2 and progesterone(P)levels during the implantation window were used as secondary outcome indica-tors.Multivariate Logistic regression and ROC curve analysis were used to evaluate the effect and predictive ability of ultrasound Salle score on pregnancy outcome.Multiple linear regression was used to evaluate the effect of estrogen and progesterone levels during the implantation window on ultrasound Salle score.RESULTS After treatment,the clinical pregnancy rate and ultrasound Salle score during the implantation window in the treatment group were significantly higher than those in the control group(P＜0.05,P＜0.01).The total TCM syndrome score of the treatment group was significantly lower than that of the control group(P＜0.01);the ser-um T,LH/FSH,and HOMA-IR levels of the treatment group were significantly lower than those of the control group(P＜0.05,P＜0.01);the serum E2 and P levels of the treatment group were significantly higher than those of the control group during the implanta-tion window period(P＜0.01).Multivariate Logistic regression analysis and ROC curve analysis showed that ultrasound Salle score was significantly positively correlated with pregnancy rate and had a high predictive value for pregnancy outcome.Multiple linear regression analysis found that there was a linear relationship between the ultrasound Salle score and E2 and P during the implantation window peri-od,and the P level had a greater impact.CONCLUSION Ziyu Prescription can improve the clinical pregnancy rate of patients with polycystic ovary syndrome related infertility of kidney deficiency,effectively improve their endometrial receptivity,regulate the levels of sex hormones and glucose metabolism,reduce the TCM syndrome score,and improve the reproductive quality of patients.

OBJECTIVE To observe the clinical efficacy of Ziyu Prescription in the treatment of polycystic ovary syndrome relat-ed infertility of kidney deficiency and its effect on endometrial receptivity.METHODS A total of 120 patients with polycystic ovary syndrome related infertility of kidney deficiency were enrolled and randomly divided into a control group and a treatment group,with 60 cases in each group.After excluding dropout cases and excluded cases,56 cases were completed in each group.The control group was treated with letrozole and placebo,while the treatment group was treated with letrozole and Ziyu Prescription.The treatment course of both groups was 3 menstrual cycles.The clinical pregnancy rate and ultrasound Salle score during the implantation window were the main outcome indicators.The traditional Chinese medicine(TCM)syndrome score and serum estradial(E2),testosterone(T),anti-Müllerian hormone(AMH),luteinizing hormone(LH),follicle-stimulating hormone(FSH),homeostatic model assessment of insulin resistance(HOMA-IR),serum E2 and progesterone(P)levels during the implantation window were used as secondary outcome indica-tors.Multivariate Logistic regression and ROC curve analysis were used to evaluate the effect and predictive ability of ultrasound Salle score on pregnancy outcome.Multiple linear regression was used to evaluate the effect of estrogen and progesterone levels during the implantation window on ultrasound Salle score.RESULTS After treatment,the clinical pregnancy rate and ultrasound Salle score during the implantation window in the treatment group were significantly higher than those in the control group(P＜0.05,P＜0.01).The total TCM syndrome score of the treatment group was significantly lower than that of the control group(P＜0.01);the ser-um T,LH/FSH,and HOMA-IR levels of the treatment group were significantly lower than those of the control group(P＜0.05,P＜0.01);the serum E2 and P levels of the treatment group were significantly higher than those of the control group during the implanta-tion window period(P＜0.01).Multivariate Logistic regression analysis and ROC curve analysis showed that ultrasound Salle score was significantly positively correlated with pregnancy rate and had a high predictive value for pregnancy outcome.Multiple linear regression analysis found that there was a linear relationship between the ultrasound Salle score and E2 and P during the implantation window peri-od,and the P level had a greater impact.CONCLUSION Ziyu Prescription can improve the clinical pregnancy rate of patients with polycystic ovary syndrome related infertility of kidney deficiency,effectively improve their endometrial receptivity,regulate the levels of sex hormones and glucose metabolism,reduce the TCM syndrome score,and improve the reproductive quality of patients.

Objective:To conduct signal detection and analysis of cardiovascular-related adverse events associated with second-generation H1 antihistamines(sgAH)in the elderly population, utilizing the Food and Drug Administration adverse event reporting system(FAERS)database.The findings provide a reference for assessing the clinical drug safety of sgAH in the elderly.Methods:A cross-sectional study was conducted.Four methods were utilized to detect signals of cardiovascular-related adverse events associated with sgAHs in the FAERS database, covering the period from the first quarter of 2004 to the first quarter of 2024.These methods included the reporting odds ratio, the Medicines and Healthcare Products Regulatory Agency method, the Bayesian Confidence Propagation Neural Network method, and the multi-item gamma Poisson shrinker method.Subgroup analyses were performed on both the overall population and the elderly population(aged ≥65).Results:A total of 1 065 reports of cardiovascular-related adverse events involving sgAHs such as loratadine, desloratadine, cetirizine, levocetirizine, and fexofenadine were collected.In the overall population, palpitations were identified as a positive signal, while desloratadine also demonstrated positive signals for tachycardia and prolonged electrocardiogram QT interval.In the elderly population, both palpitations and prolonged electrocardiogram QT interval were recognized as positive signals, exhibiting higher information component(IC)values and empirical Bayesian geometric mean(EBGM)values compared to the overall population.Furthermore, loratadine and desloratadine were also identified as positive signals for prolonged electrocardiogram QT interval in the elderly.Conclusions:Palpitations have been identified as a significant indicator of cardiovascular-related adverse events associated with sgAHs.Elderly patients should be particularly vigilant regarding the risk of prolonged QT intervals on electrocardiograms.

To summarize the nursing experience of a patient with cardiac resynchronization therapy defibrillator(CRT-D)implantation who was about to deplete battery due to repeated discharge after implantation and underwent left ventricular assist device implantation combined with cryoablation.Key points of care were as follows.To begin with,we actively managed arrhythmias and electric storm.Secondly,we carried refined capacity management to avoid water and sodium retention.Thirdly,we formulated personalized anticoagulation programs to reduce the risk of bleeding and thrombosis.Then,the pump line infection should be prevented as early as possible.At the whole stage,we provided psychological counseling to improve emotional state.After discharge,regular follow-up was carried out through online and offline method to ensure quality of life in the long term.After careful treatment and nursing care,23 days after surgery,the patient was discharged smoothly,and good follow-up after discharge.

Sarcopenia is one of the most common diseases of elderly patients which can affect the physical function and quality of life.Elderly patients not only have high prevalence of type 2 diabetes mellitus, but also have complex polypharmacy.As a result, the risk of antidiabetic agents related skeleton muscle damage and sarcopenia will increase significantly.Therefore, it is extremely important to identify and try to avoid the use of related drugs in the elderly.This article reviewed the types of antidiabetic drugs and mechanism likely leading to sarcopenia, as well as the intervention methods and drug management, to promote the prevention and control of the morbidity of sarcopenia in the elderly and improve the level of rational drug use.

Liver failure is a common clinical syndrome of severe liver disease with rapid progression and high mortality. Therefore， early intervention in pre-liver failure or “golden window” is of great significance in improving the prognosis of patients. Hepatitis B virus-related acute-on-chronic liver failure and alcohol-related acute-on-chronic liver failure are the main topics of studies on pre-liver failure. This article discusses the pathogenesis of pre-liver failure and artificial liver support therapy， so as to guide the reasonable and affective applications of artificial liver technology in clinical practice， promote related studies， and thereby reduce the mortality rate of patients with liver failure.

AIM: To evaluate the changes in corneal epithelial thickness(CET)and corneal optical density(CD)after smart pulse technology(SPT)-assisted transepithelial photorefractive keratectomy(TPRK)and analyze their correlation.METHODS: The prospective study included 60 patients(120 eyes)with myopia and myopic astigmatism who underwent SPT-TPRK in the ophthalmology department at the First Affiliated Hospital of Xinxiang Medical University between February and August 2023. Changes in CET and CD were evaluated preoperatively and at 1 wk, 1 and 3 mo postoperatively.RESULTS: A total of 14 cases(28 eyes)were lost to follow-up, and 3 patients(6 eyes)with postoperative haze were excluded from this study, resulting in a final inclusion of 43 patients(86 eyes). At 1 wk after SPT-TPRK, CET had statistically significantly thickened compared to preoperative levels(P<0.05), particularly in the CET at 0-2 mm central corneal area(P<0.05). At 1 mo after SPT-TPRK, the CET at 0-2 mm area had statistically significantly decreased(P<0.05). At 3 mo after SPT-TPRK, the CET at 0-2 mm had essentially reached preoperative levels. Postoperative CD values increased, with a positive correlation between CET in the 0-2 mm area and CD in the whole 0-2 mm area(r=0.256, P<0.05), and a positive correlation between CET in the 2-5 mm area and CD in the anterior 2-6 mm area(r=0.319, P<0.05).CONCLUSION: Corneal epithelial remodeling takes 3 mo in areas within 2 mm of the central cornea; areas with thinner CET have faster postoperative corneal epithelial remodeling and greater thickening in the early postoperative period; CD increases in the early postoperative period compared to the preoperative value, and in some areas, there is a positive correlation between CET and CD value.

Sarcopenia is one of the most common diseases of elderly patients which can affect the physical function and quality of life.Elderly patients not only have high prevalence of type 2 diabetes mellitus, but also have complex polypharmacy.As a result, the risk of antidiabetic agents related skeleton muscle damage and sarcopenia will increase significantly.Therefore, it is extremely important to identify and try to avoid the use of related drugs in the elderly.This article reviewed the types of antidiabetic drugs and mechanism likely leading to sarcopenia, as well as the intervention methods and drug management, to promote the prevention and control of the morbidity of sarcopenia in the elderly and improve the level of rational drug use.