Objective To systematically evaluate the efficacy and safety of plum-blossom needle therapy for vitiligo by using the systematic review and meta analysis.Methods The randomized controlled trials(RCT)on plum-blossom needle for treating vitiligo were systematically retrieved from the databases of the PubMed,China Biological Medicine Database,CNKI,Wanfang Data and VIP database from the database estab-lishment to June 2,2022.The literatures were screened according to the inclusion and exclusion criteria.The finally included literatures conducted the data extraction.The RevMan 5.4 software was used for conducting the data analysis.The methodological quality evaluation on the included trials was performed by the ROB tool.The GRADE method was used to assess the evidence level.Results A total of 7 trials involving 469 pa-tients were finally included.The meta analysis results showed that the plum-blossom needle combined with other therapies(including laser or ultraviolet irradiation,tacrolimus ointment,compound Kaliziran tincture)was superior to the other therapies alone in the aspects of improving vitiligo skin lesion including reducing the of white spot skin lesion area(MD=-1.11,95％CI:-1.92 to-0.30,P=0.007),increasing the repigment-ation rate of vitiliginous lesions(MD=18.09,95％CI:1.55 to 34.63,P=0.030)and enhancing the pigment deposition in vitiligo lesions(MD=0.92,95％CI:0.32 to 1.52,P=0.003),and improving the patients'quali-ty of life(MD=-7.48,95％CI:-8.04 to-6.92,P＜0.001),and the differences were statistically signifi-cant.In terms of safety,there was no statistically significant difference in adverse events between plum blos-som acupuncture combined with other therapies and other therapies alone(RR=1.20,95％CI:0.77 to 1.84,P=0.420).Conclusion Low or very low evidence shows that plum-blossom needle combined with other therapies for treating vitiligo may enhance the effect in the aspects of improving the white spot skin lesions and quality of life in the patients with vitiligo,moreover which is relatively safe.

Polyphenolic compounds have received tremendous attention in biomedicine because of their good biocompatibility and unique physicochemical properties.In recent years,phenolic-enabled nanotechnology(PEN)has become a hotspot of research in the medical field,and many promising studies have been reported,especially in the application of central nervous system(CNS)diseases.Polyphenolic compounds have superior anti-inflammatory and antioxidant properties,and can easily cross the blood?brain barrier,as well as protect the nervous system from metabolic damage and promote learning and cognitive functions.However,although great advances have been made in this field,a comprehensive review regarding PEN-based nanomaterials for CNS therapy is lacking.A systematic summary of the basic mechanisms and synthetic strategies of PEN-based nanomaterials is beneficial for meeting the demand for the further development of novel treatments for CNS diseases.This review systematically introduces the fundamental physicochemical properties of PEN-based nanomaterials and their applications in the treatment of CNS diseases.We first describe the different ways in which polyphenols interact with other substances to form high-quality products with controlled sizes,shapes,compositions,and surface chemistry and functions.The application of PEN-based nanomaterials in the treatment of CNS diseases is then described,which provides a reference for subsequent research on the treatment of CNS diseases.

Radiotherapy plays a key role in the treatment of head and neck tumors, which can not only serve as a curative treatment, but also as an adjuvant treatment after surgery to improve the local control rate. In addition, radiotherapy also helps preserve important organ functions, such as laryngeal function or facial appearance, which is of great significance for the treatment and rehabilitation of patients. Despite advances in radiotherapy technology, some patients still experience resistance to radiation therapy, resulting in treatment failure. Non-coding RNA (ncRNA) is considered to be the main type of RNA transcription, which is usually not translated into proteins, and mainly functions through the interaction with proteins, chromatins and mRNAs, and is a molecular marker for a variety of tumors, involving tumor proliferation, apoptosis, invasion and migration, etc. Many studies have shown that dysregulated ncRNA play an important role in radiotherapy resistance in head and neck tumors. Therefore, this article reviews the research progress of ncRNA in radiotherapy resistance in head and neck tumors, aiming to better understand the role of ncRNA in the occurrence and development of radiotherapy resistance, and provide reference for formulating more effective strategies for preventing radiotherapy resistance.

Purpose To investigate the 18F-FDG PET/CT metabolic characteristics and the accuracy of diagnosis in post-traumatic osteomyelitis. Materials and Methods A total of 64 patients with post-traumatic fracture nonunion and suspected infection in Beijing Jishuitan Hospital were retrospectively analyzed. The PET/CT examinations were performed from May 2019 to April 2020. Qualitative and semi-quantitative evaluation methods were used to evaluate the diagnostic accuracy of 18F-FDG PET/CT in post-traumatic osteomyelitis. The diagnostic efficiency was compared among different laboratory indexes,such as erythrocyte sedimentation rate,C-reactive protein and leukocyte. Logistic regression was used to analyze parameters with diagnostic significance. Results Among 64 patients with post-traumatic fracture nonunion,37 were ultimately diagnosed with post-traumatic osteomyelitis. Among them,23 were confirmed through positive microbial cultures during surgery,and 14 were diagnosed based on clinical symptoms and follow-up results. The remaining 27 patients showed no signs of infection based on intraoperative microbial cultures (n=10) or clinical follow-up of more than six months (n=17). PET/CT correctly identified infections in 34 of the 37 infected cases and accurately ruled out infections in 23 of the 27 non-infected cases. The sensitivity,specificity,positive predictive value,negative predictive value and overall diagnostic accuracy of PET/CT were 91.89％,85.19％,89.47％,88.46％ and 89.06％,respectively. The maximum standardized uptake value (SUVmax) of PET/CT semi-quantitative parameter in the infection group (6.23±2.16) was higher than that in the non-infection group (4.24±1.86),showing a statistically significant difference (t=3.864,P<0.01). Logistic regression analysis revealed that SUVmax and C-reactive protein had diagnostic significance for distinguishing between groups,and SUVmax demonstrated higher diagnostic accuracy than C-reactive protein (x2=27.245,P<0.001). Conclusion The metabolic imaging features provided by 18F-FDG PET/CT imaging help to provide a more accurate reference for the diagnosis of post-traumatic osteomyelitis,which is worthy of clinical application.

Objective To observe the correlations of quantitative parameters of contrast-enhanced ultrasound(CEUS),micro-flow imaging(MFI)and shear wave elastography(SWE)with tumor microenvironment(TME)acidification in nude mice MCF7 breast cancer.Methods MCF7 human breast cancer cells were injected subcutaneously into 20 BALB/c-nu nude mice,and modeling was regarded as successful when tumor grew to 150-200 mm3.Then,CEUS,MFI and SWE were performed to obtain relevant parameters,including time-intensity curve(TIC)parameters(peak intensity[PI],area under the curve[AUC]),vessel index(VI)and maximum,median and mean Youngs modulus(Emax,Emed,Emean).Tumor pH value was measured using fluorescence quenching method,and its correlation with CEUS,MFI and SWE parameters were analyzed.Results pH value of MCF7 breast cancer tissue in nude mice was 6.05-6.43,with an average of 6.27±0.05,which in high perfusion area was significantly higher than in low perfusion area(P＜0.001).PI and AUC of TIC and VI were all positively correlated with pH value(r=0.661,0.611,0.768,all P＜0.001),while Emax,Emed and Emean were negatively correlated with pH value(r=-0.490,-0.562,-0.571,all P＜0.001).Conclusion TIC parameters and VI of MCF7 breast cancer in nude mice were positively correlated with TME acidification,while Emax,Emed and Emean were negatively correlated with TME acidification.

Purpose To investigate the 18F-FDG PET/CT metabolic characteristics and the accuracy of diagnosis in post-traumatic osteomyelitis. Materials and Methods A total of 64 patients with post-traumatic fracture nonunion and suspected infection in Beijing Jishuitan Hospital were retrospectively analyzed. The PET/CT examinations were performed from May 2019 to April 2020. Qualitative and semi-quantitative evaluation methods were used to evaluate the diagnostic accuracy of 18F-FDG PET/CT in post-traumatic osteomyelitis. The diagnostic efficiency was compared among different laboratory indexes,such as erythrocyte sedimentation rate,C-reactive protein and leukocyte. Logistic regression was used to analyze parameters with diagnostic significance. Results Among 64 patients with post-traumatic fracture nonunion,37 were ultimately diagnosed with post-traumatic osteomyelitis. Among them,23 were confirmed through positive microbial cultures during surgery,and 14 were diagnosed based on clinical symptoms and follow-up results. The remaining 27 patients showed no signs of infection based on intraoperative microbial cultures (n=10) or clinical follow-up of more than six months (n=17). PET/CT correctly identified infections in 34 of the 37 infected cases and accurately ruled out infections in 23 of the 27 non-infected cases. The sensitivity,specificity,positive predictive value,negative predictive value and overall diagnostic accuracy of PET/CT were 91.89％,85.19％,89.47％,88.46％ and 89.06％,respectively. The maximum standardized uptake value (SUVmax) of PET/CT semi-quantitative parameter in the infection group (6.23±2.16) was higher than that in the non-infection group (4.24±1.86),showing a statistically significant difference (t=3.864,P<0.01). Logistic regression analysis revealed that SUVmax and C-reactive protein had diagnostic significance for distinguishing between groups,and SUVmax demonstrated higher diagnostic accuracy than C-reactive protein (x2=27.245,P<0.001). Conclusion The metabolic imaging features provided by 18F-FDG PET/CT imaging help to provide a more accurate reference for the diagnosis of post-traumatic osteomyelitis,which is worthy of clinical application.

Objective To observe the correlations of quantitative parameters of contrast-enhanced ultrasound(CEUS),micro-flow imaging(MFI)and shear wave elastography(SWE)with tumor microenvironment(TME)acidification in nude mice MCF7 breast cancer.Methods MCF7 human breast cancer cells were injected subcutaneously into 20 BALB/c-nu nude mice,and modeling was regarded as successful when tumor grew to 150-200 mm3.Then,CEUS,MFI and SWE were performed to obtain relevant parameters,including time-intensity curve(TIC)parameters(peak intensity[PI],area under the curve[AUC]),vessel index(VI)and maximum,median and mean Youngs modulus(Emax,Emed,Emean).Tumor pH value was measured using fluorescence quenching method,and its correlation with CEUS,MFI and SWE parameters were analyzed.Results pH value of MCF7 breast cancer tissue in nude mice was 6.05-6.43,with an average of 6.27±0.05,which in high perfusion area was significantly higher than in low perfusion area(P＜0.001).PI and AUC of TIC and VI were all positively correlated with pH value(r=0.661,0.611,0.768,all P＜0.001),while Emax,Emed and Emean were negatively correlated with pH value(r=-0.490,-0.562,-0.571,all P＜0.001).Conclusion TIC parameters and VI of MCF7 breast cancer in nude mice were positively correlated with TME acidification,while Emax,Emed and Emean were negatively correlated with TME acidification.

Objective To compare the value of Child-Pugh score, Model for End-Stage Liver Disease (MELD) score, MELD combined with serum sodium concentration (MELD-Na) score, CLIF Consortium Acute Decompensation (CLIF-C AD) score, and Freiburg index of post-transjugular intrahepatic portosystemic shunt (TIPS) survival (FIPS) score in predicting the survival of patients undergoing TIPS. Methods A retrospective analysis was performed for the clinical data of 447 patients with liver cirrhosis who underwent TIPS in several hospitals in southwest China, among whom there were 306 patients in the survival group and 62 in the death group. The scores of the above five models were calculated, and a survival analysis was performed based on these models. The independent samples t -test was used for comparison of normally distributed continuous data between groups, and the non-parametric Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the Pearson chi-square test was used for comparison of categorical data between groups; a multivariate Cox regression analysis was used for correction analysis of known influencing factors with statistical significance which were not included in the scoring models; the Kaplan-Meier method was used to evaluate the discriminatory ability of each model in identifying risks in the surgical population, and the log-rank test was used for analysis. The area under the receiver operating characteristic curve (AUC), C-index at different time points, and calibration curve were used to evaluate the predictive ability of each scoring model. Results Compared with the death group, the survival group had significantly lower age ( Z =2.884, P < 0.05), higher albumin ( t =3.577, P < 0.05), and Na + ( Z =-3.756, P < 0.05) and significantly lower proportion of patients with alcoholic cirrhosis ( χ 2 =22.674, P < 0.05), aspartate aminotransferase ( Z =2.141, P < 0.05), prothrombin time ( Z =2.486, P < 0.05), international normalized ratio ( Z =2.429, P < 0.05), total bilirubin ( Z =3.754, P < 0.05), severity of ascites ( χ 2 =14.186, P < 0.05), and scores of the five models (all P < 0.05). Survival analysis showed that all scoring models effectively stratified the prognostic risk of the patients undergoing TIPS. Comparison of the C-index of each scoring model at different time points showed that Child-Pugh score had the strongest ability in predicting postoperative survival, followed by MELD-Na score, MELD score, and CLIF-C AD score, and FIPS score had a relatively poor predictive ability; in addition, the prediction efficiency of each score gradually decreased over time. Child-Pugh score had the largest AUC of 0.832 in predicting 1-year survival rate after surgery, and MELD-Na score had the largest AUC of 0.726 in predicting 3-year survival rate after surgery, but FIPS score had a poor ability in predicting 1- and 3-year survival rates. Conclusion All five scoring models can predict the survival of patients with liver cirrhosis after TIPS and can provide effective stratification of prognostic risk for such patients. Child-Pugh score has a better ability in predicting short-term survival, while MELD-Na score has a better ability in predicting long-term survival, but FIPS score has a relatively poor predictive ability in predicting both short-term and long-term survival.

Objective:We investigated the incidence of surgical site infection (SSI) following emergency abdominal surgery (EAS) in China and further explored its risk factors, providing a reference for preventing and controlling SSI after EAS.Methods:This was an observational study. Data of patients who had undergone EAS and been enrolled in the Chinese SSI Surveillance Program during 2018–2021were retrospectively analyzed. All included patients had been followed up for 30 days after surgery. The analyzed data consisted of relevant patient characteristics and perioperative clinical data, including preoperative hemoglobin, albumin, and blood glucose concentrations, American Society of Anesthesiologists (ASA) score, grade of surgical incision, intestinal preparation, skin preparation, location of surgical site, approach, and duration. The primary outcome was the incidence of SSI occurring within 30 days following EAS. SSI was defined as both superficial and deep incisional infections and organ/space infections, diagnoses being supported by results of microbiological culture of secretions and pus. Secondary outcomes included 30-day postoperative mortality rates, length of stay in the intensive care unit (ICU), duration of postoperative hospitalization, and associated costs. The patients were classified into two groups, SSI and non-SSI, based on whether an infection had been diagnosed. Univariate and multivariate logistic regression analyses were performed to identify risk factors associated with SSI following EAS.Results:The study cohort comprised 5491 patients who had undergone EAS, comprising 3169 male and 2322 female patients. SSIs were diagnosed in 168 (3.1%) patients after EAS (SSI group); thus, the non-SSI group consisted of 5323 patients. The SSIs comprised superficial incision infections in 69 (41.1%), deep incision infections in 51 (30.4%), and organ or space infections in 48 (28.6%). Cultures of secretions and pus were positive in 115 (68.5%) cases. The most frequently detected organism was Escherichia coli (47/115; 40.9%). There were no significant differences in sex or body mass index between the SSI and non-SSI groups (both P>0.05). However, the proportion of individuals aged 60 years or older was significantly greater in the SSI than in the non-SSI group (49.4% [83/168] vs. 27.5% [1464/5323), χ 2=38.604, P<0.001). Compared with the non-SSI group, the SSI group had greater proportions of patients with diabetes (11.9% [20/168] vs. 4.8% [258/5323], χ 2=16.878, P<0.001), hypertension (25.6% [43/168] vs. 12.2% [649/5323], χ 2=26.562, P<0.001); hemoglobin <110 g/L (27.4% [46/168] vs. 13.1% [697/5323], χ 2=28.411, P<0.001), and albuminemia <30 g/L (24.4% [41/168] vs. 5.9% [316/5323], χ 2=91.352, P<0.001), and a reduced rate of preoperative skin preparation (66.7% [112/168] vs. 75.9% [4039/5323], χ 2=7.491, P=0.006). Furthermore, fewer patients in the SSI group had preoperative ASA scores of between one and two (56.0% [94/168] vs. 88.7% [4724/5323], χ 2=162.869, P<0.001) in the non-SSI group. The incidences of contaminated and infected incisions were greater in the SSI group (63.1% [106/168] vs. 38.6% [2056/5323], χ 2=40.854, P<0.001). There was a significant difference in surgical site distribution between the SSI and non-SSI groups (small intestine 29.8% [50/168] vs. 10.6% [565/5323], colorectal 26.2% [44/168] vs. 5.6% [298/5 323], and appendix 24.4% [41/168] vs. 65.1% [3465/5323]) χ 2=167.897, P<0.001), respectively. There was a significantly lower proportion of laparoscope or robotic surgery in the non-SSI group (24.4 % [41/168] vs. 74.2% [3949/5323], χ 2=203.199, P<0.001); the percentage of operations of duration less than 2 hours was significantly lower in the SSI than non-SSI group (35.7% [60/168] vs. 77.4% [4119/5323], χ 2=155.487, P<0.001). As to clinical outcomes, there was a higher 30-day postoperative mortality rate (3.0%[5/168] vs. 0.2%[10/5323], χ 2=36.807, P<0.001) and higher postoperative ICU occupancy rate (41.7% [70/168] vs. 19.7% [1046/5323], χ 2=48.748, P<0.001) in the SSI group. The median length of stay in the ICU (0[2] vs. 0[0] days, U=328597.000, P<0.001), median total length of stay after surgery (16[13] vs. 6[5] days, U=128146.000, P<0.001), and median hospitalization cost (ten thousand yuan, 4.7[4.4] vs. 1.7[1.8], U=175965.000, P<0.001) were all significantly greater in the SSI group. Multivariate logistic regression analysis revealed that the absence of skin preparation before surgery (OR=2.435,95%CI: 1.690–3.508, P<0.001), preoperative albuminemia <30 g/L (OR=1.680, 95%CI: 1.081–2.610, P=0.021), contaminated or infected incisions (OR=3.031, 95%CI: 2.151–4.271, P<0.001), and laparotomy (OR=3.436, 95% CI: 2.123–5.564, P<0.001) were independent risk factors of SSI. Operative duration less than 2 hours (OR=0.465, 95%CI: 0.312–0.695, P<0.001) and ASA score of 1–2 (OR=0.416, 95% CI: 0.289–0.601, P<0.001) were identified as independent protective factors for SSI. Conclusions:It is important to consider the nutritional status in the perioperative period of patients undergoing EAS. Preoperative skin preparation should be conducted and, whenever possible, laparoscope or robot-assisted surgery. Duration of surgery should be as short as possible while maintaining surgery quality and improving patient care.

OBJECTIVE Cognitive deficit is a com-mon comorbidity in temporal lobe epilepsy(TLE)and that is not well controlled by current therapeutics.Currently,how epileptic seizure affects cognitive performance remains largely unclear.The subiculum is the major out-put of the hippocampus,which projects to entorhinal cor-tex and other more distinct brain regions.Physiologically,the subiculum codes spatial working memory and naviga-tion information including place,speed,and trajectory.Importantly,prior studies have noted the importance of the subiculum in the beginning,spreading,and generaliz-ing process of hippocampal seizure.How seizure-activated neurons in subiculum participate in cognitive impairment remains largely elusive.METHODS In this study,we sought to label the subicular seizure-activated c-fos+ neu-rons with a special promoter with enhanced synaptic activity-responsive element E-SARE in the subiculum,combined with chemogenetics and designer receptors exclusively activated by designer drugs(DREADDs),Ca2+ fiber photometry approaches,and behavioral tasks,to reveal the role of these neurons in cognitive impairment in epilepsy.RESULTS We found that chemogenetic inhibi-tion of subicular seizure-tagged c-fos+ neurons(mainly CaMK Ⅱ α+ glutamatergic neurons)alleviates seizure generalization and improves cognitive performance in the hippocampal CA3 kindling TLE model.While inhibition of seizure-labeled c-fos+ GABAergic interneuron shows no effect on seizure and cognition.As a comparison,che-mogenetic inhibition of the whole subicular CaMK Ⅱ α+ neuron impairs cognitive function in na?ve mice in basal condition.Notably,inhibition of subicular seizure-tagged c-fos+ neurons enhances the recruitment of cognition-responsive c-fos+ neurons via increasing neural excitability during cognition tasks.CONCLUSION Our results dem-onstrate that subicular seizure-activated c-fos+ neurons contribute to cognitive impairment in TLE,suggesting sei-zure-tagged c-fos+ neurons as the potential therapeutic target to alleviate cognitive impairment in TLE.