ObjectiveTo evaluate the effectiveness of stone needle thermocompression and massage compared to flurbiprofen gel patch in relieving chronic musculoskeletal pain in the shoulder and back， and to explore the potential mediating mechanism through muscle elasticity. MethodsA total of 120 patients with chronic musculoskeletal pain in the shoulder and back were randomly assigned to either stone needle group or flurbiprofen group， with 60 patients in each. The stone needle group received stone needle thermocompression and massage for 30 minutes， three times per week； the flurbiprofen group received flurbiprofen gel patch twice daily. Both groups were treated for 2 weeks. Pain improvement， as the primary outcome， was assessed using the Global Pain Scale （GPS） at baseline， after 2 weeks of treatment， and again 2 weeks post-treatment. To explore potential mechanisms， a mediator analysis was conducted by measuring changes in superficial and deep muscle elasticity using musculoskeletal ultrasound at baseline and after the 2-week treatment period. ResultsThe stone needle group showed significantly greater pain relief than the flurbiprofen group 2 weeks post-treatment. After adjusting for confounders related to pain duration， the between-group mean difference was -8.8 ［95% CI （-18.2， -0.7）， P＜0.05］. Part of the therapeutic effect was mediated by changes in deep muscle elasticity， with a mediation effect size of -1.5 ［95% CI （-2.0， -0.9）， P = 0.024］， accounting for 17.9% of the total effect. ConclusionStone needle thermocompression and massage can effectively relieve chronic musculoskeletal pain in the shoulder and back， partly through a mediating effect of improved deep muscle elasticity.

OBJECTIVE To study the toxicity-reducing effects and mechanisms of Niuhuang Jiedu Tablets(NHJDT)by gas chromatography-mass spectrometry(GC-MS)metabolomics.METHODS 24 mice were randomly divided into control,realgar(1.0 g·kg-1)and NHDJT(1.0 g·kg-1)groups with 8 mice in each group.The liver and kidney of mice were collected for patho-logic examination after 14 d oral administration to mice.The content of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in liver and creatinine(Cr)and uric acid(UA)in kidney was also determined.The differences of endogenous metabolites in liver and kidney were further analyzed by GC-MS metabolomics.RESULTS The contents of ALT and AST in the liver as well as the Cr and UA in kidney of mice were significantly changed after NHJDT intervention(P<0.05).NHJDT alleviated the pathological dam-age of liver and kidney in mice.A total of 17 biomarkers related to detoxification were screened,including citric acid,ascorbic acid,asparagine,levodopa and phenylalanine.The changes of metabolites mainly involved in glutamine and glutamate metabolism,arginine biosynthesis,tryptophan metabolism,tyrosine and tryptophan biosynthesis,and phenylalanine metabolism.CONCLUSION NHJDT with compound compatibility could reduce the hepatorenal toxicity of realgar.The detoxification mechanism may be related to the regu-lation of amino acid metabolism.

Objective To analyze the characteristics of visceral leishmaniasis cases in Henan Province, so as to provide insights into formulation of the visceral leishmaniasis control srtrategy. Methods All epidemiological data of reported visceral leishmaniasis cases in Henan Province from 2021 to 2023 were retrieved from the National Notifiable Disease Report Information Management System of Chinese Center for Disease Control and Prevention, and the epidemiological features and diagnosis of visceral leishmaniasis cases were descriptively analyzed. Results A total of 93 visceral leishmaniasis cases were reported in Henan Province from 2021 to 2023, with a male to female ratio of 2.58∶1, and including 2 imported cases from other provinces and 91 local cases. The number of visceral leishmaniasis cases peaked during the period between March and May, and between July and October. The reported visceral leishmaniasis cases had ages of 7 months to 74 years, with the largest number of cases found at ages of 0 to 9 years (26 cases, 27.96%), followed by at ages of 60 to 70 years (24 cases, 25.81%). Farmer (47 cases, 50.54%) and diaspora children (19 cases, 20.43%) were predominant occupations, and 91 local visceral leishmaniasis cases were found in 6 cities of Zhengzhou, Luoyang, Anyang, Hebi, Sanmenxia and Xuchang. The median duration from onset of visceral leishmaniasis to diagnosis was 20 days, and there were 25.81% (24/93) cases with 10 days and less duration from onset to diagnosis, 38.71% (36/93) cases receiving diagnosis at 11 to 30 days following onset, and 35.48% (33/93) cases receiving diagnosis for more than 30 days following onset. All cases were predominantly diagnosed in province- (60.00%) and city-level (28.89%) medical institutions. Conclusions The number of visceral leishmaniasis is on the rise in Henan Province, with a gradually expanding coverage. Intensified monitoring of visceral leishmaniasis cases, dogs, and vectors, dog management, sandflies control and improved individual protection are recommended to prevent the spread of visceral leishmaniasis.

Objective: To investigate the characteristics of HIV-1 molecular transmission network among HIV/AIDS patients in Zhoushan City, Zhejing Province. Methods: The newly reported HIV/AIDS cases in Zhoushan City from 2020 to 2022 were selected. Basic information was collected and whole blood samples were obtained at the initial follow-up. The pol gene sequences of HIV-1 were amplified by RT-PCR and nested-PCR. HIV-1 subtypes were identified by Neighbor-Joining phylogenetic trees. The HIV-1 molecular transmission network was built and analyzed using Cytoscape 3.6.1 software. Results: A total of 222 HIV/AIDS cases were reported in Zhoushan City from 2020 to 2022, 200 whole blood samples were collected, and 152 sequences were obtained successfully, including 122 males (80.26%), 75 cases aged 50 years and above (49.34%), 109 cases with a junior high school education or below (71.71%), and 63 cases with commercial heterosexual contact (41.45%). The main subtypes were CRF07_BC and CRF01_AE, accounting for 45.39% and 21.05%, respectively. When the threshold of genetic distance was set to 1%, 20 molecular clusters were formed in 69 cases, with a clustering rate of 45.39%. Using the molecular network constituted by reported HIV/AIDS cases in 2020 as the baseline network, there were 2 active molecular clusters with ≥5 new cases in 2022, each with 9 cases, characterized mainly by individuals aged 50 or above, with a junior high school education or below, and transmission through commercial heterosexual sex. Conclusions The predominant HIV-1 subtypes among HIV/AIDS cases in Zhoushan City are CRF07_BC and CRF01_AE. Transmission through commercial heterosexual contact among middle-aged and elderly people is a main mode of HIV transmission.

Intrauterine adhesion (IUA) can occur after trauma to the basal layer of the endometrium, contributing to severe complications in females, such as infertility and amenorrhea. To date, the proposed therapeutic strategies are targeted to relieve IUA, such as hysteroscopic adhesiolysis, Foley catheter balloon, and hyaluronic acid injection have been applied in the clinic. However, these approaches showed limited effects in alleviating endometrial fibrosis and thin endometrium. Mesenchymal stem cells (MSCs) can offer the potential for endometrium regeneration owing to reduce inflammation and release growth factors. On this basis, MSCs have been proposed as promising methods to treat intrauterine adhesion. However, due to the drawbacks of cell therapy, the possible therapeutic use of extracellular vesicles released by stem cells is raising increasing interest. The paracrine effect, mediated by MSCs derived extracellular vehicles (MSC-EVs), has recently been suggested as a mechanism for their therapeutic properties. Here, we summarizes the main pathological mechanisms involved in intrauterine adhesion, the biogenesis and characteristics of extracellular vesicles, explaining how these vesicles could provide new opportunities for MSCs.

Objective:To evaluate the clinical efficacy of microfat on neck wrinkles and its structure and viability.Methods:A retrospective analysis was conducted to review the clinical data of 23 patients with neck wrinkles corrected by microfat injection from June 2018 to June 2021 at the Body Contouring and Fat Grafting Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, aged (38.1±10.7) years old. A blunt cannula with multiple side holes of 0.8 mm was used to obtain fat particles under low negative pressure and to prepare the microfat by washing and soft centrifugation. A 26-gauge sharp needle was used to inject microfat with small amount and at multiple points into the intradermal and subdermal layer where the neck lines were linearly depressed. Regular follow-ups were carried out after the operation, and the efficacy of the operation was evaluated from routine neck examinations, third-party doctor′s grade scoring and patient′s scoring towards satisfaction. To clarify the structure and viability of microfat, scanning electron microscope was used to observe the structure of fat particles, Calcein-AM/propidium iodide (Calcein-AM/PI) staining to detect tissue viability and Musecell counting to count SVF cells.Results:All of the 23 patients successfully completed the operation without complications such as infection and fat liquefaction. After a follow-up of 3 to 30 months, the neck wrinkles were effectively improved. The postoperative grade scores of third-party doctor was significantly reduced ( P<0.05). And the satisfaction of patients was high, with 20 cases (87.0%) satisfied. Scanning electron microscopy showed that the fat granule cells were tightly arranged and the structure remained intact. Calcein-AM/PI staining showed that most cells in the granules survived. The number of viable SVF cells in fat particles was (9.34±2.68)×10 5/ml. Conclusions:Microfat is easy to obtain with high tissue activity, which is suitable for neck wrinkle filling. Good effects can be achieved with high patients′ satisfaction. It is worthy of clinical application.

Objective:To discuss the composition and connotation of practical training objectives for nurses specialized in intravenous therapy, and provide guidance and reference for standardizing the practical training of nurses specialized in intravenous therapy.Methods:In this phenomenological analysis in qualitative research, 13 intravenous treatment and nursing experts from Shandong, Zhejiang, Sichuan, and Shaanxi provinces were selected from May to July 2021 for semi-structured interviews. Colaizzi's 7-step method and Nvivo 12.0 were used to organize data and analyze and refine themes.Results:Three themes and 12 subthemes were extracted for the practical training of intravenous therapy nurses, including knowledge objectives, ability objectives, and well-rounded objectives.Conclusions:Attention should be paid to the setting of clinical professional knowledge, skills and comprehensive quality goals for nurses specialized in intravenous therapy, so as to improve the pertinence and timeliness of training, promote the quality of training and the professional development of specialized training for intravenous therapy.

We report a neonate with transaldolase deficiency caused by compound heterozygous variation of the TALDO1 gene. A pregnant woman, who had an adverse pregnancy history, was found with multiple fetal abnormalities on prenatal ultrasound and the following whole exon sequencing indicated a likely pathogenic heterozygous variation of c.462-2A>G and c.574C>T(p.R192C) in TALDO1 gene in the fetus. A body was born at 38 +1 weeks and presented dysmorphic features (cutis laxa/wrinkled skin and low-set ears, etc.), splenomegaly, anemia, abnormal liver function and coagulation. In combination with the prenatal testing results, transaldolase deficiency was diagnosed. The patients still had cutis laxa/wrinkled skin on the back of both hands and neck at one year and three months old. Therefore, for babies with hepatosplenomegaly, anemia, thrombocytopenia, coagulation dysfunction, at the same time with dysmorphic features such as cutis laxa, low-set ears, attention should be paid to the investigation of transaldolase deficiency.

Objective:To evaluate the relationship between serum folate and the prognosis of cervical intraepithelial neoplasia grade I (CIN1) and the interaction between folate and high risk human papillomavirus (HR-HPV) infection.Methods:From a community-based married women cohort established in Jiexiu and Yangqu County of Shanxi Province from June to December 2014, a total of 564 eligible women with CIN1 by pathologically diagnosed were recruited. The pathological examination was performed again 12 months later. According to the prognosis of CIN1, participants were divided into CIN1 regression group, persistence and progression group, respectively. Nested case-control study was used to explore the relationship between serum folate and CIN1 prognosis, and additive model was used to analyze the interaction between serum folate and HR-HPV infection.Results:Among 564 CIN1 patients, 479 cases underwent pathological examination again, 331 were divided in CIN1 regression group and other 148 in persistence and progression group. The levels of serum folate in CIN1 regression group and persistence and progression group were (18.890±8.360) and (15.640±5.550) nmol/L, respectively, and the difference was statistically significant ( Z=-6.937, P<0.001). HPV infection was detected in 154 patients, including 148 cases of HR-HPV infection and 6 cases of low risk human papillomavirus (LR-HPV) infection. Univariate analysis showed that there were significant differences in the age, passive smoking, frequency of pudendal cleaning, frequency of cleaning after sex, frequency of changing underwear, serum folate and HR-HPV infection between regression group and persistence and progression group ( P<0.05). Multivariate logistic regression analysis showed that the frequency of pudendal cleaning ( OR=0.422, 95% CI: 0.238-0.750), frequency of changing underwear ( OR=0.574, 95% CI: 0.355-0.928), serum folate (13.06-16.78nmol/L: OR=4.806, 95% CI: 2.355-9.810; ≤13.05nmol/L: OR=8.378, 95% CI: 4.024-17.445), HR-HPV infection ( OR=1.852, 95% CI: 1.170-2.933) were the independent influencing factors of CIN1 prognosis. Interaction analysis showed that the relative excess risk of low serum folate level and HR-HPV infection for the CIN1 persistence and progression was 4.992 (95% CI: 0.189-9.796), attributable proportion due to interaction was 0.552 (95% CI: 0.279-0.824), synergy index was 2.632 (95% CI: 1.239-5.588), a OR of serum folate≤16.78 nmol/L and HR-HPV infection positive was 9.055 (95% CI: 4.878-16.807). Conclusion:Low serum folate level could increase the risk of CIN1 persistence and progression, and might enhance the risk when combined with HR-HPV infection.

Objective:To assess the safety and efficacy of mammaplasty with autologous fat grafting(AFG).Methods:A retrospective analysis was conducted to review cases of mammaplasty with AFG from December 2010 to December 2020 in Department of Body Contouring and Fat Grafting Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences. Liposuction was performed using low negative pressure (-60 kPa) by liposuction machine. After lipoaspirate was washed with normal saline, cotton pad or low-speed centrifugation method was utilized to process fat. A blunt cannula with a diameter of 2.5 mm was used for multi-layer injection into the breast. The efficacy of surgery was evaluated from routine breast examinations, ultrasound examinations, third-party evaluations of pre- and post-operative photos, and patient’s scoring on breast appearance and the quality of life. The score interval is 0-100 points, and the higher the score, the better the effect. The Mann-Whitney U test was applied to compare the differences between groups, and the paired t-test was used to compare the difference of chest circumferences before and after surgery and the doctors’ scores. P<0.05 indicates statistically significant difference. Results:449 patients with 829 breasts were enrolled, aged (37.6±9.4) years old with a body mass index of (21.4±2.8) kg/m 2, including 372 patients with breast dysplasia, 42 patients underwent total mastectomy due to breast cancer, 8 patients with breast deformity after breast-conserving surgery, and 27 cases with breast implants for augmentation. Of the 449 cases, 37 cases used Brava before surgery, including 25 patients with breast dysplasia and 12 patients who underwent total mastectomy. All patients successfully completed the operation. Patients with breast dysplasia required (2.0±0.7) times of AFG for breast augmentation, with a unilateral injection volume of (244.4±58.1) ml per session. Patients who underwent total mastectomy required (2.9±1.1) times of AFG, with a unilateral injection volume of (223.2±62.4) ml per session. Patients with breast deformity after breast-conserving surgery required (1.5±0.5) times of AFG, with a unilateral injection volume of (204.0±29.5) ml per session. And for patients with breast implants for augmentation, it takes (2.2±0.8) times of AFG after removal of implants. The postoperative follow-up time was (14.0±6.8) months. Cystic nodules and benign calcifications with a diameter of 0.1-0.3 cm was found in 34 patients in ultrasound, 5 patients had palpable nodules and 3 patients had intramammary infections. No serious complications occurred. The breast circumference of 353 patients with bilateral breast dysplasia increased by (4.8±1.0) cm ( P<0.01) compared with that before operation. Breast circumference of the 27 patients who underwent implant removal and AFG for augmentation reduced by (1.2±1.7) cm ( P<0.01) after operation. The scores of third-party after operation in each group were significantly higher than those before operation ( P<0.05). The doctor’s score of patients with breast reconstruction after total mastectomy for breast cancer increased the most, which was 15.4±4.9 points ( P<0.01). In this group, the scores of patients who underwent radiotherapy increased by (19.3±2.3) points, which was higher than those without radiotherapy 13.4±5.5 points ( P<0.01). Patients with breast reconstruction after total mastectomy for breast cancer had the lowest breast satisfaction and quality of life scores, which were 84.6±2.9 and 84.7±3.2 points respectively, while those with breast deformity correction after breast conserving surgery had the highest scores, 88.8±4.0 and 90.6±3.7 points respectively. Conclusions:The application of AFG to mammaplasty is both safe and effective, with fewer complications, and high satisfaction rate.