Anti-CD20 monoclonal antibodies for the treatment of refractory nephrotic syndrome （RNS） in children. The first- generation rituximab is the most widely used in clinical practice； it shows definite efficacy in children with RNS， is recommended by guidelines， particularly for achieving a high remission rate in minimal change nephrosis， and can significantly reduce the cumulative use of glucocorticoids and immunosuppressants. The second-generation ofatumumab has potential as an alternative treatment for patients who are intolerant or resistant to rituximab， while the third-generation obinutuzumab has shown efficacy in complex cases such as rituximab resistance or post-transplant recurrence. However， there is still controversy regarding the optimization of rituximab treatment dosage and whether ofatumumab and obinutuzumab offer greater advantages than rituximab for the treatment of RNS in children. The most common adverse reaction induced by anti-CD20 monoclonal antibodies is infusion reactions， and long-term adverse events mainly include increased risks of sustained immunosuppression and infections. Rituximab has significant economic advantages for the treatment of RNS， but additional pharmacoeconomic research based on China’s healthcare environment is needed to evaluate the cost-effectiveness of ofatumumab and obinutuzumab in this population. Given that the current use of ofatumumab and obinutuzumab in this field is considered off-label use， clinical application should only proceed after a rigorous evaluation of the patient’s benefits and risks.

Objective To investigate the clinical efficacy of CT-guided drilling,hematoma aspiration and drainage for senile cerebellar hemorrhage.Methods A retrospective analysis was performed on 89 very old patients(75-89 years old)with cerebellar hemorrhage admitted to our hospital from January 2016 to December 2022.According to their wishes,different surgical treatments were adopted,and thus they were divided into puncture group(42 cases,CT-guided drilling,aspi-ration and drainage for hematoma)and craniotomy group(47 cases,craniotomy).GCS,preopera-tive hematoma volume,length of ICU stay,postoperative complications,mortality rate and the mRS score in 3 months postoperatively in the survival were compared between the 2 groups.Re-sults There were no significant differences in age,male ratio,GCS score,preoperative hematoma volume,recurrence rate at 24 h postoperatively and mortality rate at 3 months postoperatively be-tween 2 groups(P＞0.05).The puncture group had significantly shorter length of ICU stay(7.10±1.43 dvs 8.87±1.39 d,P=0.000)and lower intracranial infection rate(4.76％vs 19.15％,P=0.040)than the craniotomy group.In 3 months of follow-up after surgery,the rate of good mRS score was higher in the puncture group than the craniotomy group,and the mRS score was lower in the former group than the latter one(P＜0.05).Conclusion CT-guided drilling,aspiration and drainage for hematoma can reduce the infection rate and improve the prognosis,and is an effective approach in the treatment of patients over 75 years old with cerebellar hemorrhage.

Objective:To investigate the effects of brace masks on controlling facial hypertrophic scars. Method:Totally 63 patients with 286 post-bum facial hypertrophic scars samples were recruited for the study.And they were divided into the brace mask group with 28 cases(152 scars),cloth mask group with 26 cases(100 scars),and control group with 9 cases(34 scars).Patients in the brace mask group and cloth mask group received eight weeks of pressure therapy,while the control group did not receive pressure therapy interven-tion.Pre-and post-treatment,chromatography was used to evaluate the scar color(lightness,redness and yel-lowness).An ultrasonic measuring instrument was used to evaluate the scar thickness.The Vancouver scar scale(VSS)was used.Patient satisfaction with eight weeks of treatment was evaluated with satisfaction scale. Result:①Pre-and post-treatment comparison:The brightness decreased in control group and increased in mask group(P＜0.001).The redness increased in control group and decreased in mask group(P＜0.001).The thick-ness and VSS score increased in three groups bu more in control group(P=0.001).There was no change in yel-lowness for all the three groups(P=0.981).②compared the two mask groups,there was no significant differ-ence for all parameters(P＞0.05).③satisfaction:the overall satisfaction of the brace mask group and the cloth mask group are 75％and 69.2％respectively.The comfort and appearance satisfaction of the brace mask group is better than the cloth mask group.The price satisfaction of the mask group is lower. Conclusion:For the facial hypertrophic scars,this short-term efficacy study showed that the brace mask and cloth mask could improve the lightness and redness and inhibit the thickness of it.The overall satisfaction of patients is high after using brace masks and cloth masks.

African swine fever(ASF),caused by the African swine fever virus(ASFV),is a highly contagious infectious disease of pigs.This disease has been spread rapidly in China since 2018,po-sing a huge threat to China's pig farming industry.To rapid detect the ASFV,a loop-mediated iso-thermal amplification(LAMP)combined with the disposable nucleic acid visualization test strip was established for visual detection of the nucleic acid of ASFV B646L gene.The method was easy to operate without special instruments and equipment,while it effectively avoided the disadvantage of false positives caused by aerosol contamination.The method was able to detect 1.16 copies/μL of the recombinant plasmid in 50 min at 65 ℃.In addition,the method was specific with no cross-re-action with classical swine fever virus,porcine reproductive and respiratory syndrome virus,por-cine parvovirus,transmissible gastroenteritis virus.The results in this study provides a rapid,con-venient,sensitive and reliable method for early diagnosis and screening for ASFV suspected infec-tion cases.

Minimal residual disease (MRD) is termed as the small numbers of remnant tumor cells in a subset of patients with tumors. Liquid biopsy is increasingly used for the detection of MRD, illustrating the potential of MRD detection to provide more accurate management for cancer patients. As new techniques and algorithms have enhanced the performance of MRD detection, the approach is becoming more widely and routinely used to predict the prognosis and monitor the relapse of cancer patients. In fact, MRD detection has been shown to achieve better performance than imaging methods. On this basis, rigorous investigation of MRD detection as an integral method for guiding clinical treatment has made important advances. This review summarizes the development of MRD biomarkers, techniques, and strategies for the detection of cancer, and emphasizes the application of MRD detection in solid tumors, particularly for the guidance of clinical treatment.

Objective To compare the effect and safety of stenting versus directional atherectomy (DA) in the treatment of TASCⅡ A and B superficial femoral artery lesions.Methods 100 patients with TASC Ⅱ A and B lesions were divided into percutaneous transluminal stenting(PTS) group (n =50) and DA group (n =50).Patients were compared in terms of technical success rate,treatment success rate,first operation cost,postoperative ankle brachial index (ABI),limb salvage rate,survival,and patency.Results The technical success rate in both PTS and DA group was 100％.The treatment success rate was 98％ vs.86％,P＞0.05.Postoperative ABI:0.82 ±0.19 vs.0.80 ±0.27,P＞0.05.First operation cost:(34 820 ± 1 051) yuan vs.(45 635 ± 1 358) yuan,P ＜0.001;All patients were followed-up for up to 2-year,the cumulative patency rate was 81.6％ vs.72.9％ (P＞0.05).Limb salvage rate was 97.9％ vs.93.8 ％,P ＞ 0.05.Conclusion There were no significant differences in the effect and safety of PTS versus DA in the treatment of TASCⅡ A and B superficial femoral artery lesions.

Objective:To investigate the clinical, pathological and genetic characteristics of neonatal alveolar capillary dysplasia with misalignment of the pulmonary veins (ACDMPV).Methods:The clinical manifestations, radiographic examinations, pathology and parental genetic analysis of a newborn with FOXF1 variation induced ACDMPV, who was hospitalized in the Department of Neonatology of Shenzhen Children′s Hospital in January 2020, were extracted and analyzed. Related literature up to March 2020 with the key words of “Alveolar capillaries dysplasia” “Alveolar capillary dysplasia with misalignment of the pulmonary veins” “FOXF1” in PubMed, CNKI, Wanfang, CQVIP database and Leiden Open Variation database (LOVD) were searched.Results:A full-term male newborn （1 hour of age） was admitted due to anal atresia. Surgical repair of anal atresia and omphalocele was performed on the first day of life, and gallbladder absence and Meckel′s diverticulum were identified during the operation. Respiratory distress with hypoxemia developed at about 6 hours of life, and persistent pulmonary hypertension developed and progressed after surgery, with poor response to mechanical ventilation and pulmonary vasodilators. This infant passed away at 26 days of life. Lung biopsy showed decreased alveolar units and thickened interalveolar septa, reduced alveolar capillary density and thickened walls of peripheral pulmonary arteries, and misaligned pulmonary veins adjacent to the pulmonary arterioles, which were consistent with ACDMPV. The whole exome sequencing revealed a heterozygous novel frameshift of FOXF1 gene located in chromosome 16q24.1 c376_377insT; p.(Pro126fs). According to the bioinformatics analysis, this variation was likely to be pathogenic as it was associated with coding disorder of FOXF1 Pro126, resulting in truncation of the encoded protein. This novel variation had not been reported in the human gene mutation database (HGMD), ESP6500siv2_ALL, 1000g2015aug_ALL or dbSNP147 database. Previous 6 literatures reported 54 variants, including 28 missense, 10 nonsense, 11 frameshift, 2 deletion, 1 synonymous, and 2 extensions. Only three of the reported 45 cases （24 males, 21 females） were still alive as of the time of this study.Conclusions:Typically, ACDMPV is a catastrophic disease in neonatal period with high mortality. Lung biopsy and genetic testing should be considered in infants who present with persistent pulmonary hypertension and refractory hypoxemia, especially when combined with extrapulmonary abnormalities.

Objective To evaluate the characteristics of arterial elasticity changes of abdominal aorta atherosclerosis in type 2 diabetic rats by using velocity vector imaging(VVI).Methods A rat model of diabetes mellitus(DM)were successfully established by a high-fat diet combined with the streptozotocin injection in thirty healthy male sprague-dawley rats.DM rats were randomly divided into five groups (n =6,each):0-week group (rats before treatment),4-week group (rats treated for 4 weeks),8-week group(rats treated for 8 weeks),the 12-week group(rats treated for 12 weeks),the 16-week group(rats treated for 16 weeks).The intima-media thickness(IMT)of abdominal aorta,the difference of end-systolic and end-diastolic vessel diameter(△D),resistance index(RI),pulsatility index (PI)and peak systolic velocity(Vs)were detected by ultrasound every 4 weeks.Peak radial velocity (PRy),PCs rate (PCs),peak circumferential strain (PCsr) and peak radial displacement (PRd) of abdominal aorta in short axis view were determined by VVI technique.Rats were sacrificed in different stages.Then,the specimens of abdominal aorta were collected,and observed by light microscope and electron microscope for the histopathological and ultrastructural changes in the atherosclerosis,respectively.Results Compared with 0-week group(0.25±0.03) mm and 4-week group(0.26 ±0.02)mm,IMT was thickened in the 16 weeks group(0.30±0.03)mm,(F=3.718,P=0.017).PRv,PCs,PCsr and PRd were lower after 8 weeks of treatment than in 0-week group.PRy,PCs,PCsr and PRd were lower in 16-week group than 0-week,4-week and 8-week groups (F =15.565,14.754,25.015 and 19.326,P＜0.01).Under the light microscope in abdominal aorta of rats in 12-week group and 16-week group,the stromal layer was thickened,smooth muscle cells were deformed and migrated to the tunica intima,and foam cells were formed.And under electron microscope,endothelial cells had a large amount of lipid attachment,and smooth muscle cells had vacuolar degeneration.Conclusions As compared with the two-dimensional ultrasound,velocity vector imaging can earlier find the elasticity change and intimal damage in abdominal aortic wall of diabetic rat,and can better analyze a motor function of the vascular wall.

Objective To evaluate the effect of transversus abdominis plane (TAP) block on postoperative cognitive function in elderly patients undergoing laparoscopic surgery under general anesthesia.Methods Forty-eight male patients undergoing laparoscopic tension-free repair of inguinal hernia under general anesthesia,aged 65-75 yr,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,with body mass index of 20-28 kg/m2,were divided into 2 groups (n =24 each) using a random number table method:TAP block combined with general anesthesia group (group TG) and general anesthesia group (group G).Anesthesia was induced with midazolam,cisatracurium besylate,sufentanil and etomidate,and the patients were mechanically ventilated after laryngeal mask airway insertion.TAP block was performed through the anterior superior iliac spine approach,and 0.25％ ropivacaine 30 ml was injected in group TG.Anesthesia was maintained by target-controlled infusion of propofol and remifentanil and muscle relaxation by intravenously injecting cisatracurium.The occurrence of cerebral regional oxygen saturation (rSO2) and low rSO2 events (rSO2 ＜60％) was recorded at 1 min before anesthesia induction (T0),5 min after inserting the laryngeal mask airway (T1),at skin incision (T2),30 min after skin incision (T3),and at the end of surgery (T4).The consumption of propofol and remifentanil was recorded during surgery.Montreal Cognitive Assessment (MoCA) was used to evaluate the cognitive function of patients at 1 day before surgery and 7 days after surgery,and the development of postoperative cognitive dysfunction (POCD,MoCA scores＜ 26) was recorded.Results Compared with group G,the intraoperative consumption of propofol and remifentanil was significantly reduced,rSO2 was increased at T2~,and the incidence of low rSO2 events was decreased,MoCA scores were increased at 7 days after surgery,and the incidence of POCD was decreased in group TG (P＜0.05).Conclusion TAP block can reduce the incidence of POCD in elderly patients undergoing laparoscopic surgery under general anesthesia.