BACKGROUND:Collagen combined with microneedling therapy has gradually become an important means of improving skin photoaging.OBJECTIVE:To summarize and explore the main mechanism and clinical application status of collagen combined with microneedle therapy.METHODS:PubMed,China National Knowledge Infrastructure,and ScienceDirect databases were searched for Chinese and English literature published before August 2024.Chinese and English search terms were"ultraviolet radiation,photoaging,collagen,microneedling,clinical applications."Finally,74 articles were included for summary.RESULTS AND CONCLUSION:Collagen treats skin photoaging through mechanisms such as inhibiting matrix metalloproteinase expression,retaining skin moisture,and reducing melanin formation.Microneedles can better promote the penetration of collagen into deep layers of the skin,breaking down the skin's barrier and increasing the absorption rate.Collagen combined with microneedles has various beneficial effects for treating skin photoaging,such as whitening,anti-wrinkle,improving skin elasticity,shrinking pores,and repairing skin barriers.It also has the advantages of easy operation,significant effects,and high safety.Currently,the research on collagen combined with microneedling therapy is still in its early stages,and achieving clinical application may become a key research direction in the future.The clinical application of collagen combined with microneedles for the treatment of photoaging still faces many challenges,such as exploring the optimal mechanical structure and materials of microneedles,selecting appropriate microneedle types,and insufficient clinical evidence that collagen combined with microneedles can further delay the treatment of skin photoaging.

BACKGROUND:Collagen combined with microneedling therapy has gradually become an important means of improving skin photoaging.OBJECTIVE:To summarize and explore the main mechanism and clinical application status of collagen combined with microneedle therapy.METHODS:PubMed,China National Knowledge Infrastructure,and ScienceDirect databases were searched for Chinese and English literature published before August 2024.Chinese and English search terms were"ultraviolet radiation,photoaging,collagen,microneedling,clinical applications."Finally,74 articles were included for summary.RESULTS AND CONCLUSION:Collagen treats skin photoaging through mechanisms such as inhibiting matrix metalloproteinase expression,retaining skin moisture,and reducing melanin formation.Microneedles can better promote the penetration of collagen into deep layers of the skin,breaking down the skin's barrier and increasing the absorption rate.Collagen combined with microneedles has various beneficial effects for treating skin photoaging,such as whitening,anti-wrinkle,improving skin elasticity,shrinking pores,and repairing skin barriers.It also has the advantages of easy operation,significant effects,and high safety.Currently,the research on collagen combined with microneedling therapy is still in its early stages,and achieving clinical application may become a key research direction in the future.The clinical application of collagen combined with microneedles for the treatment of photoaging still faces many challenges,such as exploring the optimal mechanical structure and materials of microneedles,selecting appropriate microneedle types,and insufficient clinical evidence that collagen combined with microneedles can further delay the treatment of skin photoaging.

Objective:To explore the efficacy of adjusting the dose of imatinib dose in the context of therapeutic drug monitoring (TDM) in patients with gastrointestinal stromal tumors (GISTs) who are receiving adjuvant therapy after complete resection of their tumors.Methods:This was a descriptive study. Inclusion criteria were (1) complete surgical resection with a pathological diagnosis of GIST, (2) postoperative adjuvant therapy with imatinib and dosage adjustment, (3) multiple TDM of imatinib, and (4) complete clinical, pathological, and follow-up data. The data of 70 patients with GISTs treated at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between January 2015 and December 2023 were collected retrospectively. The study cohort comprised 15 (21.4%) men and 55 (78.6%) women of median age 60 years (range: 25–82). Of the eligible patients, 49 (70.0%) were at high-risk, 14 (20.0%) at intermediate-risk, six (8.6%) at low-risk, and one (1.4%) at very low risk. Patients were followed up by the gastrointestinal stromal tumor clinic every 2–3 months and their plasma concentrations of imatinib were checked. The dose was adjusted to 300 mg/d or 200 mg/d depending on whether they had had ≥ grade III adverse reactions, and whether the first plasma concentration of imatinib was ≥ 1,500 μg/L or between the expected range of 760 μg/L–1,100 μg/L. Studied indicators included adverse reactions, quality of life before and after dose adjustment, and overall survival and recurrence-free survival (RFS) after dose adjustment.Results:Before dose adjustment, all 70 patients received 400 mg of imatinib daily, with initial TDM values of 1,900 ± 568 μg/L, for a median duration of 8.3 months. After dose adjustment, 60 patients received 300 mg daily, with a TDM of 1,216 ± 350 μg/L, whereas 10 received 200 mg daily, with a TDM of 1,023 ± 269 μg/L. The median duration of treatment after dose adjustment was 23.4 months. Compared with those whose dosages were not adjusted, the incidence of bone marrow suppression was significantly lower (74.3% [52/70] vs. 51.4% [36/70], χ 2=9.202, P=0.010); as were the incidences of edema (95.7% [67/70] vs. 50.0% [35/70], χ 2=40.526, P<0.001); skin reactions (70.0% [49/70] vs. 32.9% [23/70), χ 2=22.495, P<0.001); and gastrointestinal reactions (38.6% [27/70] vs. 10.0% [7/70], χ 2=15.899, P<0.001) in those whose dosages were adjusted. The average total scores for physical health before and after dose adjustment were 76 ± 5 and 88 ± 4, respectively; whereas the mental health scores were 75 ± 6 and 89 ± 4, respectively. The median follow-up period was 36 months (range 6–126). During the first 3 years of follow-up, five high-risk patients with non-gastric GISTs developed recurrences. The 3-year overall survival rate was 100%, and the 3-year RFS rate was 92.8%, high-risk patients having a 3-year RFS rate of 89.8%. Conclusion:The adverse reactions and quality of life of GIST patients with severe adverse reactions to adjuvant imatinib therapy after complete resection can be mitigated by appropriately reducing the dosage of imatinib under the guidance of TDM.

Objective:To explore the efficacy of adjusting the dose of imatinib dose in the context of therapeutic drug monitoring (TDM) in patients with gastrointestinal stromal tumors (GISTs) who are receiving adjuvant therapy after complete resection of their tumors.Methods:This was a descriptive study. Inclusion criteria were (1) complete surgical resection with a pathological diagnosis of GIST, (2) postoperative adjuvant therapy with imatinib and dosage adjustment, (3) multiple TDM of imatinib, and (4) complete clinical, pathological, and follow-up data. The data of 70 patients with GISTs treated at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between January 2015 and December 2023 were collected retrospectively. The study cohort comprised 15 (21.4%) men and 55 (78.6%) women of median age 60 years (range: 25–82). Of the eligible patients, 49 (70.0%) were at high-risk, 14 (20.0%) at intermediate-risk, six (8.6%) at low-risk, and one (1.4%) at very low risk. Patients were followed up by the gastrointestinal stromal tumor clinic every 2–3 months and their plasma concentrations of imatinib were checked. The dose was adjusted to 300 mg/d or 200 mg/d depending on whether they had had ≥ grade III adverse reactions, and whether the first plasma concentration of imatinib was ≥ 1,500 μg/L or between the expected range of 760 μg/L–1,100 μg/L. Studied indicators included adverse reactions, quality of life before and after dose adjustment, and overall survival and recurrence-free survival (RFS) after dose adjustment.Results:Before dose adjustment, all 70 patients received 400 mg of imatinib daily, with initial TDM values of 1,900 ± 568 μg/L, for a median duration of 8.3 months. After dose adjustment, 60 patients received 300 mg daily, with a TDM of 1,216 ± 350 μg/L, whereas 10 received 200 mg daily, with a TDM of 1,023 ± 269 μg/L. The median duration of treatment after dose adjustment was 23.4 months. Compared with those whose dosages were not adjusted, the incidence of bone marrow suppression was significantly lower (74.3% [52/70] vs. 51.4% [36/70], χ 2=9.202, P=0.010); as were the incidences of edema (95.7% [67/70] vs. 50.0% [35/70], χ 2=40.526, P<0.001); skin reactions (70.0% [49/70] vs. 32.9% [23/70), χ 2=22.495, P<0.001); and gastrointestinal reactions (38.6% [27/70] vs. 10.0% [7/70], χ 2=15.899, P<0.001) in those whose dosages were adjusted. The average total scores for physical health before and after dose adjustment were 76 ± 5 and 88 ± 4, respectively; whereas the mental health scores were 75 ± 6 and 89 ± 4, respectively. The median follow-up period was 36 months (range 6–126). During the first 3 years of follow-up, five high-risk patients with non-gastric GISTs developed recurrences. The 3-year overall survival rate was 100%, and the 3-year RFS rate was 92.8%, high-risk patients having a 3-year RFS rate of 89.8%. Conclusion:The adverse reactions and quality of life of GIST patients with severe adverse reactions to adjuvant imatinib therapy after complete resection can be mitigated by appropriately reducing the dosage of imatinib under the guidance of TDM.

OBJECTIVE：To systematically evaluate therapeutic efficacy and safety of Breviscapine injection combined with routine treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD），and to provide evidence-based reference for clinical drug use. METHODS ：Retrieved from Cochrane Library ，PubMed，Embase，CBMdisc，CNKI，VIP and Wanfang database ，randomized controlled trials （RCTs）about Breviscapine injection combined with routine treatment （trial group ） versus routine treatment （control group ）in the treatment of AECOPD were collected. After literature screening and data extraction ， the qualities of literatures were evaluated with modified Jadad scale ；Meta-analysis was performed by using Rev Man 5.2 statistical software. RESULTS ：A total of 19 RCTs were included ，involving 1 930 patients. Results of Meta-analysis showed that total response rate [OR ＝2.80，95％ CI （1.96，4.01），P＜0.000 01]，FEV1[MD＝0.65，95％ CI（0.57，0.72），P＜0.000 01]， FEV1％[MD＝5.33，95％CI（0.31，10.35），P＝0.04]，FVC[MD＝0.69，95％CI（0.23，1.16），P＝0.004]， FEV1/FVC [MD ＝ 4.83，95％CI（0.98，8.67），P＝0.01]，PEF [M D＝0.95，95％CI （0.57，1.33），P＜0.001]，PaO2 [MD＝4.70，95％CI（2.02， No.81402991） + 7.37），P＜0.001]，CD3 level [MD ＝5.11，95％ CI（3.04， 7.18），P＜0.001] and CD 4+ level [MD ＝2.62，95％CI（1.78， qq.com 3.47），P＜0.001] of trial group were significantly higher than those of control group ；PaCO2 [MD＝－3.33，95％CI（－5.02， －1.65），P＜0.001]，CD8+ level [MD ＝－2.55，95％CI（－4.28，－0.82），P＜0.004]，cough relief time [MD ＝－1.93，95％CI （－2.24，－1.63），P＜0.001]，sputum remission time [MD ＝－2.19，95％CI（－2.48，－1.89），P＜0.001]，wheezing remission time [MD ＝－1.59，95％CI（－1.86，－1.32），P＜0.001] and hospital stay [MD ＝－1.73，95％CI（－2.06，－1.39），P＜0.001] of trial groups were significantly lower or shorter than those of control group ；there was no statistical significance in CD 4+/CD8+ between 2 groups [MD ＝－0.11，95％CI（－0.23，0.01），P＝0.06]. In terms of safety ，3 studies reported the occurrence of ADR ， and no serious ADR occurred. CONCLUSIONS ：Breviscapine injection can improve clinical efficacy and lung function ，enhance immunity in patients with AECOPD with good safety.

Objective To discuss the value of joint detection in patients with progressive cerebral infarction (PCI) on high sensi‐tivity c‐reactive protein(hs‐CRP) ,and homocysteine(Hcy) ,D‐Dimer ,Fibrinogen(Fib) ,ferritin(SF) .Methods According to the de‐velopment and evolution of the 156 patients with acute cerebral infarction were divided into progressive cerebral infarction group and non‐progressive cerebral infarction group ,to determine the level of serum hs‐CRP ,Hcy ,one or two D‐Dimer ,Fib ,SF .Results hs‐CRP ,Hcy ,D‐D ,Fib ,SF in the PCI group were higher than those in the control group ,the difference was statistically significant (P<0 .05) .Conclusion Between the development of the PCI with hs‐CRP ,Hcy ,D‐D ,Fib and SF ,there is a close relationship ,to detect the level has a certain significance to the prediction of progressive ischemic stroke .

Objective: To investigate the diagnostic values of separated renal multi-locular cystic lesions color Doppler ultra-sound and contrast-enhanced ultrasound performance in multi-locular cystic renal cell carcinoma and cysts. Methods:A total of 53 pa-tients (54 lesions) with multi-locular cystic renal cell carcinoma and cysts were included in the study. The presence of carcinoma and cysts was confirmed via histopathology and tested using ultrasound. Contrast-enhanced ultrasound was applied in 24 (24 lesions) of the total number of patients, and the receiver operating characteristic (ROC) curve was used to analyze the numbers of separation, thick-ness, and type of blood flow patterns of the lesions. The contrast-enhanced ultrasound characteristics were also analyzed. We analyzed the diagnostic value of the color Doppler ultrasound in the separated renal multilocular cystic lesions and the contrast-enhanced ultra-sound performance in multi-locular cystic renal cell carcinoma and cysts. Results:Based on the analysis of the ROC curves of the sepa-ration number, thickness, and type of the blood flow of the lesions in 53 patients (54 lesions), the diagnostic specificity was relatively higher in the lesions where the separation number was≥5 strips (86%), the thicknesses were>3 and≤4 mm (95%), and blood flow was band-like (86%). The areas under the curve of the three indexes were 0.7621, 0.8331, and 0.7962, respectively, which indicate high diagnostic values. The separation number of 4 strips, the thicknesses of>2 and≤3 mm, and the point-like blood flow could be used as critical values for the diagnosis. The contrast enhancement, enhancement peak, and disappearance were (11.2 ± 3.4), (21.7 ± 3.8), and (32.1±4.0) s in 14 patients with multi-locular cystic renal cell carcinoma and (18.4±4.5), (37.8±8.0), and (51.3±9.0) s in 10 patients with multi-locular renal cysts, with statistically significant differences (t=4.47, t'=5.90, t'=6.31, respectively;P<0.05). Conclusion:The sepa-ration number, thickness, and type of blood flow of lesions have relatively higher specificity in multi-locular renal cysts than in multi-locular cystic renal cell carcinoma. The ROC curves show a high diagnostic value. Contrast-enhanced ultrasound of the lesions helped in the differential diagnosis of multi-locular cystic renal cell carcinoma and renal cysts.

Objective To study the influence of sole massage on children’s analepsia from general anesthesia.Methods One hundred children in analepsia period were divided into the test group(50 cases)and the control group(50 cases).The routine nursing and monitoring during recovery stage were done in the control group.Based on the routine monitoring and nursing care as in the control group,the test group received sole massage for 10 minutes.The two groups were compared in terms of declining percentage of SpO2, rate of nausea,blood pressure,heart-rate variability,and post-analepsia dysphoria scores.Result The test group was significantly lower than the control one in all the indexes of the declining percentage of SpO2,rate of nausea,blood pressure,heart-rate variability,and post-analepsia dysphoria scores(all P<0.05).Conclusions Sole massage during children’s analepsia from general anesthesia is effective not only in lessening their declining percentage of SpO2,rate of nausea,blood pressure,heart-rate variability, and recovery dysphoria mark,but also easing their dysphoria,anxiety and fear.It may create a good condition for children to live through analepsia period successfully and safely.

Objective To develop a nested PCR for the detection of early syphilis and genotyping of Treponema pallidum (TP), and to investigate the distribution of genotypes of TP in Guangzhou. Methods Specimens were consecutively collected from genital ulcers of patients with suspected chancre during 2002-2004, and were detected by dark-field microscopy and nested PCR. The acidic repeat protein (arp) gene and the T. pallidum repeat (tpr) gene family were amplified with the positive specimens above. The number of repeats presented in the arp gene and the restriction fragment length polymorphism by Mse I in the tpr gene were analyzed by electrophoresis. The strains were genotyped according to Pillay's criteria. Results Out of 62 patients with suspected chancre, 33 cases (53.2%) were positive by dark-field microscopy and 54 cases (87.1%) by nested PCR. Of 47 TP-positive specimens genotyped by arp gene, 36 (76.6%) were type 14, while of 49 cases genotyped by tpr gene 39 (79.6%) were type d. By combining genotypes of arp and tpr genes, 7 genotypes were found, including 14d (31, 66.0%), 13d (5, 10.6%), 14b (4, 8.5%), 12b (3, 6.4%), 12d (2, 4.3%), 15d(l, 2.2%) and 14i (1, 2.2%). Conclusions Nested PCR shows a high sensitivity in early detection of TP. Genotype 14d seems the predominant type of TP in Guangzhou.