OBJECTIVES: Papular dermatoses commonly affecting the female vulva, such as molluscum contagiosum, syringoma, lymphangioma, folliculitis, verruca vulgaris, ectopic sebaceous glands, and bowenoid papulosis, often present with similar clinical appearances and are frequently misdiagnosed. This study aims to explore the clinical diagnostic value of reflectance confocal microscopy (RCM) in differentiating these conditions. METHODS: A retrospective analysis was conducted on RCM imaging and histopathological findings from lesion sites in 172 female patients with vulval papular dermatoses. RCM characteristics confirmed by biopsy were summarized and diagnostic clues were explored. RESULTS: RCM diagnosis was consistent with histopathological diagnosis in 147 out of 172 cases (85.47%). Molluscum contagiosum, syringoma, lymphangioma, and folliculitis all exhibited cystic-like structures under RCM, differing in the location of the structures, wall characteristics, internal contents, and reflectivity. Verruca vulgaris, ectopic sebaceous glands, and bowenoid papulosis lacked such structures. Verruca vulgaris showed distinctive low-refractive vacuolated cells in the spinous layer; bowenoid papulosis exhibited mild cytologic atypia in the spinous layer; ectopic sebaceous glands were characterized by moderately to low-refractive, fish roe-like sebaceous lobules within the dermis. CONCLUSIONS RCM enables noninvasive, real-time, and dynamic visualization of key diagnostic and differential features of common vulvar papular dermatoses in women, offering high diagnostic value.
Humans ; Female ; Microscopy, Confocal/methods* ; Retrospective Studies ; Adult ; Vulvar Diseases/diagnosis* ; Middle Aged ; Young Adult ; Aged ; Adolescent ; Diagnosis, Differential ; Child ; Skin Diseases/pathology* ; Molluscum Contagiosum/diagnosis*

Objective To investigate the incidence of functional bowel disease(FBD)and its relationship with depression,anxiety and sleep in navy submarine forces.Methods A questionnaire survey on the incidence of FBD was conducted on 364 naval soldiers who were enrolled according to Rome Ⅳ classification and diagnostic criteria.The risk factors of FBD were analyzed.The incidence of specific diseases of FBD was compared among soldiers with different jobs.The depression,anxiety,and sleep quality were investigated in FBD patients.Results In the 364 participants,132(36.3%)were diagnosed with FBD according to Roman Ⅳcriteria.Military rank and marital status might be risk factors for FBD.There was no significant difference in the overall incidence of FBD among the participants with various jobs(P>0.05).The incidence of functional constipation in the submariners was significantly higher than that in the land soldiers,while the incidence of functional diarrhea in the land soldiers was higher than that in the submariners(all P<0.05).The incidences of depression,anxiety and sleep disorder in the participants with FBD were higher than those in the participants without FBD.Conclusion There is a high incidence of FBD in submariners,which may be related to their psychological states.

Objective:To investigate the efficacy and influencing factors of iodine-125 seed implantation in the treatment of recurrent radioiodine refractory differentiated thyroid carcinoma (RAIR-DTC) .Methods:Retrospective analysis of 18 patients with recurrent RAIR-DTC treated with iodine-125 particle implantation at Ward One, Department of Oncology, Hebei General Hospital from Sept. 2015 to Mar. 2022 was performed. A total of 35 lesions were involved, all permanently implanted with iodine-125 particles under image guidance, with particle activity ranging from 0.3mCi to 0.8mCi, and prescription doses ranging from 80 to 140 Gy. The study observed the objective response rate, local control rate, survival rate, adverse reactions, and factors influencing treatment efficacy.Results:After a follow-up period of 8 to 115 months,according to the objective efficacy evaluation criteria of solid tumors 1.1,the objective response rates were 51.4% (18/35) ,80.0% (28/35) ,68.6% (24/35) ,60.0% (21/35) ,42.9% (15/35) at 3,6,12,24,36 months postoperatively,respectively.The local control rates were 100% (35/35) ,100% (35/35) ,80.0% (28/35) ,62.9% (22/35) ,51.4% (18/35) at 3,6,12,24,36 months postoperatively,respectively.The 1-,2-, and 3-year postoperative survival rates were 83.3% (15/18) ,72.2% (13/18) ,61.1% (11/18) ,respectively.During the follow-up period,4 patients developed progressive lesions in the target area.One grade I radioactive skin injury,one grade Ⅱ radioactive skin injury,and no residual particle-related adverse reactions.The results of multivariate analysis showed that D90,tumor involvement of the esophagus were the factors influencing the recent efficacy.The area under the ROC curve for D90 was 0.804 with the best bound of 106.5Gy.Conclusion:Iodine-125 particle implantation is safe and effective for recurrent RAIR-DTC.D90,tumor involvement of the esophagus are the influencing factors of the recent efficacy,and the D90≥106.5Gy treatment effect is better.

Objective:To investigate the efficacy and influencing factors of iodine-125 seed implantation in the treatment of recurrent radioiodine refractory differentiated thyroid carcinoma (RAIR-DTC) .Methods:Retrospective analysis of 18 patients with recurrent RAIR-DTC treated with iodine-125 particle implantation at Ward One, Department of Oncology, Hebei General Hospital from Sept. 2015 to Mar. 2022 was performed. A total of 35 lesions were involved, all permanently implanted with iodine-125 particles under image guidance, with particle activity ranging from 0.3mCi to 0.8mCi, and prescription doses ranging from 80 to 140 Gy. The study observed the objective response rate, local control rate, survival rate, adverse reactions, and factors influencing treatment efficacy.Results:After a follow-up period of 8 to 115 months,according to the objective efficacy evaluation criteria of solid tumors 1.1,the objective response rates were 51.4% (18/35) ,80.0% (28/35) ,68.6% (24/35) ,60.0% (21/35) ,42.9% (15/35) at 3,6,12,24,36 months postoperatively,respectively.The local control rates were 100% (35/35) ,100% (35/35) ,80.0% (28/35) ,62.9% (22/35) ,51.4% (18/35) at 3,6,12,24,36 months postoperatively,respectively.The 1-,2-, and 3-year postoperative survival rates were 83.3% (15/18) ,72.2% (13/18) ,61.1% (11/18) ,respectively.During the follow-up period,4 patients developed progressive lesions in the target area.One grade I radioactive skin injury,one grade Ⅱ radioactive skin injury,and no residual particle-related adverse reactions.The results of multivariate analysis showed that D90,tumor involvement of the esophagus were the factors influencing the recent efficacy.The area under the ROC curve for D90 was 0.804 with the best bound of 106.5Gy.Conclusion:Iodine-125 particle implantation is safe and effective for recurrent RAIR-DTC.D90,tumor involvement of the esophagus are the influencing factors of the recent efficacy,and the D90≥106.5Gy treatment effect is better.

Objective:The aim of this study is to explore the correlation among serum hepcidin,ferritin,and q-Dioxn MRI with upgrading,upstaging and biochemical recurrence in prostate cancer(PCa)patients.Methods:A total of 103 PCa patients di-agnosed by biopsy were selected for this study.All patients underwent q-Dixon MRI prior to biopsy for T2*value measurement.Then serum hepcidin and ferritin were measured before receiving radical prostatectomy.Pathological grading and staging were conducted both preoperatively and postoperatively.The correlations among hepcidin,ferritin,T2*values,and postoperative upgrading,upstaging,biochemical recurrence were subsequently analyzed.Results:The hepcidin level of PCa patients was measured at(123.51±23.03)ng/mL,while the ferritin level was recorded at(239.80±79.59)ng/mL,and the T2* value was(41.07±6.37)ms.A total of 49 and 36 cases were observed with upgrading and upstaging in postoperative pathology,respectively.The median follow-up duration was 28.0 months(6.0-38.0 months),during which biochemical recurrence was observed in 12 cases.For upgrading,hep-cidin and ferritin demonstrated the predictive efficacy,with areas under the ROC curve of 0.777 and 0.642,respectively,whereas T2*values did not show sufficient predictive power.For upstaging,hepcidin,ferritin,and T2*exhibited predictive efficacy,with areas under the ROC curve of 0.806,0.696,and 0.655,respectively.Multivariate Logistic regression analysis indicated that hepcidin served as an independent risk factor for both upgrading(OR 1.055,95％CI 1.027-1.085,P＜0.001)and upstaging(OR 1.094,95％CI 1.040-1.152,P＜0.001).Cox regression analysis showed that hepcidin(95％CI 1.000-1.052,P=0.049)was a sig-nificant risk factor for predicting biochemical recurrence.Conclusion:Hepcidin could serve as a predictor for pathological upgra-ding,upstaging and biochemical recurrence after radical prostatectomy,which provides a novel potential index for risk stratification and prognostic evaluation of PCa patients.

Objective:To investigate the effect of deacylase Sirtuin 5 in the recovery of hematopoietic stem cells(HSCs)after treated by 5-FU in mouse.Methods:Flow cytometry was used to analyze the effect of SIRT5 deletion on the proportion of hematopoietic stem/progenitor cells(HSPCs)in bone marrow(BM),the proportion of T cells,B cells and myeloid cells(TBM)in peripheral blood(PB)and spleen,and the development of T cells in thymus.Mouse were treated with 5-FU to study the effect of SIRT5 deletion on the cell cycle,apoptosis and the proportion of HSPCs in BM.The effect of SIRT5 deletion on the proliferation of HSCs was analyzed by flow sorting in vitro.Results:SIRT5 deletion did not affect the development of T cells in thymus and the proportion of TBM cells in PB and spleen compared with wild type mice.SIRT5 deletion increased proportion of HSPCs in BM.After 5-FU treatment,the proportion of HSCs in SIRT5 deletion mice was significant decreased(P＜0.05),the HSPC in SIRT5 deletion mice was activated from G0 to G1 phase(P＜0.05),and the proportion of early apoptosis increased(P＜0.05).By monoclonal culture in vitro,the ability of HSCs to form clones in SIRT5 deletion mice was decreased significantly(P＜0.05).Conclusion:SIRT5 deletion lead to a decreased the ability of HSCs to clone in vitro.SIRT5 deletion is not conducive to the recovery of HSPCs injury in mice under hematopoietic stress.

OBJECTIVE: To evaluate the effectiveness and safety of Chinese medicine (CM) in the treatment of coronavirus disease 2019 (COVID-19) in China. METHODS: A multi-center retrospective cohort study was carried out, with cumulative CM treatment period of ⩾3 days during hospitalization as exposure. Data came from consecutive inpatients from December 19, 2019 to May 16, 2020 in 4 medical centers in Wuhan, China. After data extraction, verification and cleaning, confounding factors were adjusted by inverse probability of treatment weighting (IPTW), and the Cox proportional hazards regression model was used for statistical analysis. RESULTS: A total of 2,272 COVID-19 patients were included. There were 1,684 patients in the CM group and 588 patients in the control group. Compared with the control group, the hazard ratio (HR) for the deterioration rate in the CM group was 0.52 [95% confidence interval (CI): 0.41 to 0.64, P<0.001]. The results were consistent across patients of varying severity at admission, and the robustness of the results were confirmed by 3 sensitivity analyses. In addition, the HR for all-cause mortality in the CM group was 0.29 (95% CI: 0.19 to 0.44, P<0.001). Regarding of safety, the proportion of patients with abnormal liver function or renal function in the CM group was smaller. CONCLUSION This real-world study indicates that the combination of a full-course CM therapy on the basic conventional treatment, may safely reduce the deterioration rate and all-cause mortality of COVID-19 patients. This result can provide the new evidence to support the current treatment of COVID-19. Additional prospective clinical trial is needed to evaluate the efficacy and safety of specific CM interventions. (Registration No. ChiCTR2200062917).
Humans ; Retrospective Studies ; Male ; Female ; Middle Aged ; COVID-19/epidemiology* ; COVID-19 Drug Treatment ; Aged ; Medicine, Chinese Traditional/methods* ; Drugs, Chinese Herbal/adverse effects* ; SARS-CoV-2 ; Treatment Outcome ; China/epidemiology* ; Adult

Objective To investigate the current status and influencing factors of nurses'missed nursing care in infection prevention and control,and provide reference for establishing targeted programs to improve nursing care situation in clinical infection prevention and control.Methods From October to November 2023,369 nurses from two tertiary first-class hospitals in Zhejiang Province were selected as surveyed subjects by convenience sampling methods.General information questionnaire,missed nursing care in infection prevention and control survey,hospi-tal ethical climate survey,and safety attitudes questionnaire were used for questionnaire survey.Univariate analy-sis,Pearson correlation analysis,and multiple linear regression analysis were adopted to analyze the influencing fac-tors.Results A total of 364 valid questionnaires were collected,with a respond rate of 98.64％.The scores of 364 nurses'missed nursing care in infection prevention and control survey B and C were(48.94±15.06)and(47.88±14.54)points,respectively.The score of hospital ethical climate was(103.00±16.01)points,and the score of safety attitude was(128.50±17.00)points.Multiple linear regression analysis showed that the influencing factors for missed nursing care in infection control and prevention were temporary employment modes,work at pre-hospital emergency departments,and low scores in hospital ethical climate(all P＜0.05).Conclusion Nurses'missed nursing care in infection prevention and control is at a lower-middle level,there is still room for improvement.Nur-sing managers should reduce missed nursing care in infection prevention and control by improving the hospital ethical climate and taking appropriate intervention measures for nurses in different departments and employment styles.

Diabetic retinopathy(DR)is one of the common chronic complications of diabetes,which can lead to irreversible damage of vision and seriously affect the quality of life of patients.In recent years,with its unique theoretical system and rich practical experience,traditional Chinese medicine(TCM)has gradually become an important choice for the treatment of DR.Based on the literature review of TCM monomer and compound intervention in DR,this paper focused on the application and mechanism of TCM monomer from animal and plant,prescription composition and combined medicine in DR treatment,in order to provide reference for the clinical treatment of DR And the research and development of new drugs.

Purpose To explore the influence of different spin-locking frequencies on T1ρ values based on a 3.0T MR system.Materials and Methods Thirty-eight healthy adult volunteers underwent cardiac magnetic resonance imaging at the First Affiliated Hospital of Anhui Medical University from July to September 2023.T1ρ mapping and short-axis cine imaging with steady-state free precession sequences were performed with 3.0T MR system.T1ρ mapping sequence in three short-axis slices with three spin-lock frequencies at the amplitude of 5 Hz,300 Hz,400 Hz,and 500 Hz was scanned,respectively.T1ρ relaxation times and myocardial fibrosis index were quantified for each slice and each myocardial segment,the difference in T1ρ of different spin-locking frequencies and myocardial fibrosis index was analyzed using one-way repeated-measures analysis of variance method.Results T1ρ of 5 Hz,300 Hz,400 Hz,and 500 Hz were(33.9±2.8)ms,(43.4±2.1)ms,(45.4±2.6)ms and(46.5±2.4)ms,respectively;and T1ρ values showed a significant progressive increase from the low spin-lock frequency to the high spin-lock frequency of the heart(300 Hz vs.400 Hz:P<0.001;300 Hz vs.500 Hz:P<0.001;400 Hz vs.500 Hz:P=0.043).In addition,the measured myocardial fibrosis index at 300 Hz,400 Hz and 500 Hz were(9.4±2.2)ms,(11.3±2.9)ms and(12.6±2.7)ms,respectively.Statistical analysis underscored significant variations among these measurements(300 Hz vs.400 Hz:P<0.001;300 Hz vs.500 Hz:P<0.001;400 Hz vs.500 Hz:P=0.033).Conclusion In this prospective study,myocardial T1ρ values for the specific cardiac magnetic resonance setting are provided,and we found that spin-lock frequency can affect the T1ρ values.