Rosacea is a chronic recurrent inflammatory skin disease, and correct assessment of clinical symptoms and severity may facilitate treatment options. This review summarizes a range of subjective, semi-subjective and objective methods currently used in the assessment of rosacea severity, in order to provide useful tools for clinical assessment of rosacea severity and give guidance on treatment modification according to the therapeutic effect.

Objective This study aimed to systematically compare the effects of flapless and flapped implantations on the surrounding soft tissues of dental implants.Methods Nine databases were searched,including PubMed,Em-base,Cochrane Library,Web of Science,Clinical Trials,OpenGrey,OpenDoar,Scopus,and Ovid,from January 1,2013,to August 27,2023.Randomized controlled trials comparing flapless implantation with flapped implantation for restora-tion of missing teeth were included.Meta-analysis was conducted on studies that met the inclusion criteria by using Rev-Man 5.3 and Stata 14.0.Results A total of 1 245 articles were retrieved,and 17 studies were ultimately included.The results of Meta-analysis showed that flapless implanta-tion resulted in better healing of the soft tissues around the dental implants than flapped implantation.Moreover,flapless implantation showed superior changes in implant success rate[mean difference(MD)=1.06,95%confi-dence interval(CI)(1.02,1.10),P=0.004],the width of keratinized gingival changes[MD=0.10,95%CI(0.00,0.20),P= 0.04],and probing depth[MD=-0.60,95%CI(-0.67,-0.53),P<0.000 01],with statistically significant differences.The final combined results of modified plaque index[standardized mean difference(SMD)=-0.41,95%CI(-0.81,0.00),P= 0.05]and modified sulcus bleeding index[SMD=-0.44,95%CI(-0.78,-0.10),P=0.01]showed superiority over flapped implantation.The papillary presence index was higher in the flapless implantation group than in the flapped implantation group.No statistically significant differences were observed in plaque index and gingival indices changes between the two groups.Conclusion Flapless implantation can achieve higher implant success rate,smaller changes in the width of keratinized gingival,and smaller probing depths than flapped implantation.It also has advantages in terms of modified plaque index,modified sulcus bleeding index,and papillary presence index.

Purpose/Significance To explore the changes,challenges,key application scenarios and future development directions of generative artificial intelligence(AI)represented by ChatGPT in the field of hospital management,and to provide references for the ap-plication of AI natural language processing(NLP)technology in the field of hospital management in China.Method/Process Through literature review and analysis,the changes and challenges brought about by the rapid development of generative AI in the field of hospital management are sorted out,its key application scenarios and future development directions in the field of hospital management are empha-sized and explored.Result/Conclusion AI has broad application prospects in the field of hospital management,and it should focus on exploring its practical application scenarios and strategic directions to provide reference and guidance for promoting the high-quality de-velopment of public hospitals.

Bluetongue virus is an arbovirus that seriously harms ruminants such as sheep,this study aims to investigate the molecular mechanism of bluetongue virus infection and host cell interferon antiviral immune response.The study was conducted to characterize the mRNA expression of inter-feron pathway genes by real-time fluorescence quantitative PCR,as well as Western blot analysis of MDA5,TRAF3,RIG-Ⅰ,and TBK1 protein expression in BHK-21 cells induced by BTV with a multiplicity of infections(MOI)of 1 for 18,24,and 36 h.The results showed that the most pro-nounced changes in the expression of interferon signaling pathway genes were observed at 24 h of induction,the gene mRNA expression levels of the IFN-α,IFN-β,RIG-Ⅰ,TBK1,MDA5,VISA,and TRAF3 genes were upregulated.However,the mRNA expression levels of IKKε and TRAF6 genes were downregulated.At the protein level,MDA5 and TBK1 proteins were upregulated while RIG-1 and TRAF3 proteins were downregulated,which showed that BTV infection induces a typeⅠ interferon immune response in BHK-21 cells.This study lays the foundation for further exploring the antiviral immunity mechanism of IFN-Ⅰ signaling pathway regulatory genes in host cells infected with BTV infection.

Objective:To study the dosimetry effects of differently selected values of control point(CP)in Monaco radiotherapy planning system on dynamic intensity modulated radiation therapy(dIMRT)for esophageal cancer of middle and lower segment.Methods:Thirteen patients with esophageal cancer at middle and lower segment who received dIMRT in Shangluo Central Hospital from January to June 2023 were selected.In the Monaco radiotherapy planning system,nine groups of dIMRT plans were designed for each patient according to the 9 kinds of CP limit values(10,20,30,40,50,60,70,80 and 90).There were not changes in other optimized parameters except CP parameter.The differences of the dosimetry between target region and organs at risk(OAR)included lung,heart and spinal cord were analyzed.Results:With the increase of the CP limit value,the maximum dose of the target region which was radiation dose(D2%)of 2%volume of target region,the mean dose,which was radiation dose(D50%)of 50%volume of target region,and the homogeneity index(HI)appeared a trend of gradual stability after reduction,and the radiation dose(D98%)of 98%volume of target region which was the minimum dose of target region and the conformance index(CI)appeared a trend of gradual stability after increase.There was not significant in each dose indicator of OAR(P>0.05).The variation ranges of lung at 5,10,20,30 Gy dose(V5,V10,V20 and V30)were respectively 1.13%,0.75%,0.29%and 0.19%,and the maximum deviation of mean dose(Vmean)of lung was 18.7 cGy.The variation ranges of V10,V20,V30 and V40 in the heart were respectively 2.2%,1.23%,1.39%and 1.12%,and the maximum deviation of Vmean in the heart was 63.85 cGy,and the maximum deviation of Dmax in the spinal-cord was 70.78 cGy.There were statistically significant differences in the actual CP number(CPs),execution time(DT)of plan,and ratio value of machine unit(MU)of the complexity of plan to CPs(MU/CPs)among the plans of 9 groups(F=2.857,25.145,135.467,P<0.05),respectively.Conclusion:In the dIMRT plan of esophageal cancer of middle and lower segment,the maximum CP value is set at between 40-50,which can reduce the optimization time of the plan,the number of subfields and the treatment time of patients under the premise of meeting the dose of the target region and the OAR.

Objective:To explore the effect of aspirin resistance(AR)on the recurrence of cerebral infarction and to analyze risk factors related to the development of AR in such patients.Methods:A retrospective study was conducted to analyze the data of 202 cerebral infarction patients admitted to Shangqiu First People's Hospital between January 2020 and January 2022.All patients were given continuous treatment in accordance with their conditions for more than one week.The AR status of the patients was examined by the turbidimetric platelet aggregation test.Based on AR status, 202 patients were divided into an AR group(63)and an aspirin-sensitive(AS)group(139).General data of the two groups were compared concerning sex, age, hypertension, diabetes, coronary heart disease, hyperlipidemia, smoking, drinking, atrial fibrillation, AR, triglycerides, total cholesterol(TC), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, C-reactive protein, homocysteine, compliance with antiplatelet drug therapy, and oxidized low-density lipoprotein(ox-LDL), among others.Parameters showing statistical significance in the comparison were further examined in multivariate logistic regression analysis to identify independent risk factors for the occurrence of AR in patients with cerebral infarction.The 2-year recurrence rates between the two groups were compared.Results:There were statistically significance differences in cerebral infarction recurrence, TC and ox-LDL between patients in the AR group and in the AS group( P<0.05).Subsequent multivariate logistic regression analysis showed that cerebral infarction recurrence( OR=15.410, 95% CI: 5.504-43.146, P<0.001)and TC( OR=0.454, 95% CI: 0.313-0.660, P<0.001)were independent risk factors affecting AR in patients with cerebral infarction.The 2-year recurrence rate in the AR group(11.11% or 7/63)was significantly higher than in the AS group(3.60% or 5/139)( P<0.05). Conclusions:Cerebral infarction recurrence and TC are independent risk factors for AR in patients with cerebral infarction, and AR will further increase the risk of cerebral infarction recurrence.Therefore, monitoring the presence of AR in patients has practical value in preventing cerebral infarction recurrence.

Objective To investigate the mechanism of Zuogui Pills (ZGP) on improving the stemness of ovarian germline stem cells (OSCs) in ovarian aging rats through the gap junction protein connexin 43 (Cx43) phosphorylation based on the phosphoinositide 3-kinase/protein kinase B (PI3K/AKT) pathway. Methods Eight-week-old female SD rats were randomly divided into control(CON),model(cyclophosphamide,CTX),ZGP and dehydroepiandrosterone(DHEA) groups,six rats in each group. CTX was injected intraperitoneally for 15 days to establish a model for ovarian aging,and then ZGP (1.85 g·kg-1) or DHEA (8.1 mg·kg-1) was administered by gavage once daily for 30 days. Follicle count at different stages and pathological changes of ovarian tissues were observed by HE staining. ELISA was used to detect serum levels of anti-mullerian hormone (AMH),follicle-stimulating hormone (FSH),and estradiol(E2). The expression levels of related proteins (PCNA,MVH,Oct4,Cx43,p-Cx43,EGFR,AKT、p-AKT) in ovarian tissue were detected by Western Blot. Results Compared with the CON group,rats in CTX group had significantly reduced body mass(P<0.05) and ovarian mass(P<0.05). The number of primordial follicles decreased significantly(P<0.01). Serum FSH level increased remarkably(P<0.01),while AMH and E2 levels showed a downward trend (P>0.05). The protein expressions of Oct4,MVH,PCNA,EGFR,p-AKT/AKT,p-Cx43(Ser368)/Cx43 and Cx43 in ovarian tissue were obviously decreased(P<0.05,P<0.01). Compared with the model group,the body mass of rats in ZGP group was significantly increased (P<0.05),as well as ovarian mass and ovarian coefficient were remarkably increased (P<0.01). The number of primordial follicles were increased significantly (P<0.01),and E2 level increased significantly (P<0.05). The protein expressions of Oct4,MVH,PCNA,EGFR,p-AKT/AKT,p-Cx43(Ser368)/Cx43 and Cx43 in ovarian tissue were all increased significantly (P<0.05,P<0.01). Conclusion ZGP may ameliorate ovarian aging by maintaining the stemness of OSCs. Its mechanism of actions is related to the PI3K/AKT signaling pathway and gap junction protein phosphorylation.

Bluetongue virus (BTV) usually infects sheep, cattle, deer and other domesticated and wild ruminants through the bite of the vector insects, Culicoide, causing bluetongue (BT). BT in subtropical and even temperate regions poses a serious threat to the development and international trade of the livestock industry. This article introduced the structure and cellular invasion, and summarized the mechanisms of anti-BTV immune response of host cells and antagonism of host cell innate immune response by the non-structural proteins (e.g., NS3 and NS4) and structural proteins (e.g., VP3 and VP4) of BTV. This review provided a basis for understanding the antagonism mechanisms of BTV against the interferon (IFN) immune response in the host cell and the pathogenesis of BTV as well as for developing novel vaccines against this virus.
Bluetongue virus/immunology* ; Animals ; Bluetongue/prevention & control* ; Immunity, Innate ; Interferons/immunology* ; Sheep ; Viral Nonstructural Proteins/immunology* ; Cattle

[摘 要] 目的：采用基于中国人群单核苷酸多态性位点开发的同源重组缺陷（HRD）检测工具评估云南地区卵巢癌患者的HRD状态和BRCA1/2基因突变频率并探讨其临床意义。方法：共纳入2021年1月至2023年5月间在云南省肿瘤医院收治的卵巢癌患者248例，HRD状态采用基因组瘢痕评分法（GSS）（主要依据拷贝数的长度、类型、位置及基因组断片）或HRD评分法（杂合性缺失、端粒等位基因失衡及大片段移位等基因组不稳定事件的总和）进行评估，当组织样本的GSS≥50分或HRD评分≥42分者或检测到有害的BRCA1/2基因突变时HRD被定义为阳性。分析患者HRD状态与临床病理特征的关系。结果：248名卵巢癌患者中70.97%的患者HRD呈阳性，其中BRCA1/2基因突变率为30.65%。Ⅲ~Ⅵ期、高级别浆液腺癌的卵巢癌患者具有更高的HRD阳性率（均P<0.01），HRD评分更高的患者其合并其他基因突变的频率也越高（P<0.05）。HRD状态与卵巢癌的病理类型、临床分期和其他基因突变均有关联（均P<0.01）。结论：云南地区卵巢癌患者HRD阳性率较高，HRD阳性的卵巢癌患者可以从聚ADP核糖聚合酶（PARP）抑制剂治疗中获得更大的收益。

Humans ; Skin ; Rosacea ; Patients