Background::There is a need for effective and safe therapies for psoriasis that provide sustained benefits. The aim of this study was to assess the efficacy and safety of tildrakizumab, an anti-interleukin-23p19 monoclonal antibody, for treating moderate-to-severe plaque psoriasis in Chinese patients.Methods::In this multi-center, double-blind, phase III trial, patients with moderate-to-severe plaque psoriasis were enrolled and randomly assigned (1:1) to receive subcutaneous tildrakizumab 100 mg or placebo at weeks 0 and 4. Patients initially assigned to placebo were switched to receive tildrakizumab at weeks 12, 16, and every 12 weeks thereafter. Patients in the tildrakizumab group continued with tildrakizumab at week 16, and every 12 weeks until week 52. The primary endpoint was the Psoriasis Area and Severity Index (PASI 75) response rate at week 12.Results::At week 12, tildrakizumab demonstrated significantly higher PASI 75 response rates (66.4% [73/110] vs. 12.7% [14/110]; difference, 51.4% [95% confidence interval (CI), 40.72, 62.13]; P <0.001) and Physician’s Global Assessment (60.9% [67/110] vs. 10.0% [11/110]; difference, 49.1% [95% CI, 38.64, 59.62]; P <0.001) compared to placebo. PASI 75 response continued to improve over time in both tildrakizumab and placebo-switching to tildrakizumab groups, reaching maximal efficacy after 28 weeks (86.8% [92/106] vs. 82.4% [89/108]) and maintained up to 52 weeks (91.3% [95/104] vs. 87.4% [90/103]). Most treatment-emergent adverse events were mild and not related to tildrakizumab. Conclusion::Tildrakizumab demonstrated durable efficacy through week 52 and was well tolerated in Chinese patients with moderate-to-severe plaque psoriasis.Trial registration::ClinicalTrials.gov, NCT05108766.

Objective:To understand the development of extracurricular activities among students majoring in preventive medicine in a medical college and explore the impact of perception of extracurricular activities on major courses and extracurricular performances.Methods:A self-made questionnaire on the extracurricular perception was conducted, involving such aspects as organizational support, teacher guidance, student participation, etc. In August 2019, all senior students from Department of Preventive Medicine of a medical college were investigated by the questionnaire. At the same time, we had the extracurricular performances of the students from the Communist Youth League Committee and the major courses performances from the Academic Affairs Section of the Department. The Pearson test was conducted on the dimensions and total score of extracurricular perception, extracurricular performance and major courses performance to verify the impact of extracurricular perception on major courses and extracurricular performances. SPSS 19.0 was used for normality test, chi-square test and correlation analysis.Results:A total of 95 valid questionnaires were distributed and collected. It was noted that the total score of students' extracurricular perception was higher (66.23 points), among which, the highest score of teacher guidance was 73.10, while the lowest score of students' participation was 61.85. Extracurricular perception had a significant impact on major courses and extracurricular activities, especially in organizational support and teacher's guidance.Conclusion:Teachers play an important role in extracurricular activities, and students' participation is influenced by students and school factors. It is suggested that the school should pay attention to extracurricular activities in the process of cultivating college students, education environment should be optimized, funds should be guaranteed, the extracurricular courses should be improved, and the management system should be improved. For the teachers, teachers' professional level should be improved. Teachers should provide helpful guidance for students. At the same time, teachers should learn to use new technologies to build a better environment for students' learning. In addition, teachers should provide students with opportunities to be involved in extracurricular activities and create platforms. Finally, students should actively participate in all kinds of activities both inside and outside the school.

Objective To explore the clinical efficacy of anterior superior malleolus flap and second toe transplantation for thumb reconstruction and soft tissue defect repair or first web reconstruction.Methods A total of 13 cases were underwent anterior superior malleolus flap and second toe transplantation for thumb reconstruction and soft tissue defect repair from June,2008 to January,2016.There were 9 males and 4 females.The average age was 25 years old,ranging from 18 to 52.There were 3 cases of Ⅲ-degree thumb defect with soft tissue defect of hand,6 cases of Ⅳ-degree thumb defect with soft tissue defect of hand,3 cases of single Ⅴ-degree thumb defect and 1 Ⅴ-degree thumb defect with soft tissue defect.There were 5 patients accompanied with injury of other fingers of the affected hand.And the thenar muscles were also damaged to a varied degree.There were 10 patients with soft tissue defect before surgery,with the wound surface ranging from 3 cm × 5 cm-6 cm × 13 cm.And the wound of other 3 cases was closed.After the surgery,follow-up visit was conducted on the appearance,sensation,function,daily life and working condition of reconstructed thumb,the appearance and function condition of donor site.Results The reconstructed thumbs and anterior superior malleolus flaps in 13 cases survived and healed primarily.The average post-operative followed-up time was 5.5 years,ranging from 2.5 to 10.0 years.The appearance of reconstructed thumb was satisfactory,and the temperature sensation,pain sensation and touch sensation were recovered.The two-points discrimination was 8-18 mm.Moreover,the flexion and extension function,opposing function and finger-to-thumb function was recovered,which could meet the demand of daily life and work.The appearance of donor site was satisfactory,without claudication,pain or dysfunction.The survival of transplanted skin area in the calf was good,with no ulcer noticed.According to the Trial Standard for Thumb and Finger Reconstitution Functional Assessment of Hand Surgery Society of Chinese Medical Association,there were 10 cases excellent results,2 good and 1 fair.Conclusion Application of anterior superior malleolus flap and second toe transplantation for first-stage thumb reconstruction and soft tissue defect repair or thenar muscles and first web reconstruction is an effective therapeutic approach.

Objective Based on MRI m-Dixon-Quant technique to quickly quantify bone marrow fat content in the vertebral body of middle-aged and elderly patients,and provide a scientific basis for the diagnosis of osteoporosis(OP).Methods A total of 74 middle-aged and elderly patients who were admitted to our hospital from July 2016 to July 2017 were collected.The age,sex and body mass index (BMI)of the patients were collected.All subjects were evaluated for bone mineral density (BMD)and fat fraction (FF)and other indicators of measurement.According to the guidelines for bone mineral density measurement by the American College of Radiology(ACR),the subject was classified by the bone mineral density value,and receiver operating characteristic(ROC)curve was used for the diagnosis and analysis of FF.Results The average age of the subjects was (59.50±8.72)years.There was a positive correlation between MRI m-Dixon-Quant FF and age(r=0.436),which was highly negatively correlated with the average bone density(r=-0.739).By ROC analysis,the sensitivity and specificity were 74.2% and 83.3% for normal and low bone mass groups,92.0% and 88.9% for the normal and OP groups,and 72.0% and 87.1% for the low bone mass and OP groups.FF could be used for the evaluation of OP.If FF<54.60,normal bone mass was considered.If 54.60≤FF≤65.20,low bone mass was considered,if FF>65.20,OP was considered.Conclusion The MRI m-Dixon-Quant FF index can be rapidly and quantitatively used for the diagnosis of OP,which provides a new reference for the diagnosis of OP.

Objective To explore the value of prenatal MRI in the diagnosis of fetal simple expansion of lateral ventricle(ventriculomegaly), and follow up the nervous system development status after birth. Methods Simple expansion of the lateral ventricle fetus by prenatal MRI examination were collected in Huzhou Maternal and Child Care Hospital from May 2013 to June 2015, 126 cases of live births in expansion group, 50 normal cases were recruited in the same period as the control group. In expansion group, fetal subgroup analysis was done:(1) unilateral or bilateral lateral ventricle expasion:one group was 98 cases was lateral ventricle expansion (77.8%, 98/126), expansion of bilateral ventricle group was 28 cases (22.2%, 28/126). (2) Prenatal MRI in the diagnosis of the lateral ventricle of expansion: expansion of the lateral ventricle width was greater than 10.0 mm, if both sides were expanding, the expand width was the heavier one side, divided into 3 subgroups: ①Expansion in group A (lateral ventricle width 10.0-12.0 mm) were 88 cases (69.8%, 88/126).②Expansion in group B (lateral ventricle width 12.1-15.0 mm) were 29 cases (23.0%, 29/126). ③Expansion of group C (lateral ventricle width> 15.0 mm) were 9 cases (7.12%, 9/126). All 176 cases were followed up after birth at the 3rd, 6th, 12th, 18th month (corrected age was used for premature babies), and Gesell developmental schedules (GDS) were used to evaluate the neurobehavioral development. Results (1) The MRI results after birth:21 cases were followed up by MRI after birth. In group A, 11 cases had MRI and 9 were normal (the ventricular width<10.0 mm after birth) , the other 2 cases were stable (the ventricular width measured first time after birth was ≥10.0 mm, but the difference was within 2.0 mm from the MRI before birth). In group B, 4 cases had MRI, 1 was normal, 1 was stable, and 2 cases were getting better (the ventricular width measured first time after birth was ≥10.0 mm, but the width decreased more than 2.0 mm from the MRI before birth). In group C, 6 cases had MRI. 3 cases were getting better and 3 cases were stable. (2) Overall GDS results:expansion group after the birth of the 3rd, 6th, 12th, 18th month GDS evaluation results compared with control group, respectively, the differences were not statistically significant (all P>0.05). (3) The GDS results among the subgroups:in each evaluation after birth, there were no statistically significant differences between group A and the control group (all P>0.05). The GDS results of group B at the 3rd and 6th month were lower than those of the control group (P<0.05); while there were no statistically significant differences between the 2 goups at the 12th and 18th month (P>0.05). And for group C, statistically significant differences were found compared to the control group at each follow-up time (all P<0.05). (4) GDS results at different times after birth in the expansion group:there was no statistically significant difference between the results at the 3rd and 6th month (P>0.05). But when the result at the 3rd month was compared to the results of the 12th or 18th month, the differences were statistically significant (P<0.05). GDS result of 6th months after birth compared with 12th and 18th months, respectively, there were no statistically significant differences (P>0.05). There was no statistically significant difference between the results at the 12th and 18th month (P>0.05). (5) The GDS results in unilateral and bilateral ventricle expansion:at the 18th month, among the 98 unilateral cases, 86 (87.8%, 86/98) had normal GDS results(>85 scores);8 (8.2%, 8/98) had borderline results (75-85 scores);4 (4.1%, 4/98) had delayed results (<75 scores). Among the 28 bilateral cases, 23 (82.1%, 23/28) had normal GDS results;3 (10.7%, 3/28) had borderline results; 2 (7.1%, 2/28) had delayed results. There was no statistically significant difference (P>0.05). Conclusions Among the simple expansion of lateral ventricle, those whose ventricular width are≤12.0 mm may not need clinical treatment. If the width is between 12.1 to 15.0 mm, closely follow-up and targeted rehabilitation training after birth are recommended. When the width is more than 15.0 mm, the risk of the central nervous system function delay is significantly increased, and early intervention might improve the prognosis.

Objective To investigate intradermal injection and subcutaneous injection of Gadodiamide MR lymphangiography (MRL) in evaluation on the central conducting lymphatics in rabbits.Methods T1 weighted three-dimendional fast low angle shot (fl3d) sequence was used before and after administration of Gadodiamide to undertake MRL.Gadodiamide was administed intrademally in the left and right footpad in 8 rabbits,and then undertake MRL in 1.5T MRI system (intradermal injection group).Three days later,Gadodiamide was administered subcutaneously in the left and right footpad in 8 rabbits,and MRL were underdone with the same sequence (subcutaneous injection group).The degree of contrast enhancement within the lumbar lymphatic trunk and thoracic duct were evaluated using a 3-point scoring system.Results Intradermal injection group showed the popliteal lymph nodes,sacral lymph node and inferior aortic lymph node enhanced obviously in all 8 rabbits,and the enhancement duration time was about 30 90 mini the lumbar lymphatic trunk and cisterna chyli were detected in 6 rabbits,and part of the thoracic duct were detected in 5 rabbits.Subcutaneous injection group showed the popliteal lymph nodes enhanced obviously in all 8 rabbits,but the lumbar lymphatic trunk and the thoracic duct were not detected.The score of contrast enhancement within the lymphatic system of intradermal injection group and subcutaneous injection group had statistical difference (t=100.00,P=0.0002).Conclusion MRL with intradermal injection Gadodiamide are better than subcutaneous injection in evaluation of the lumbar lymphatic trunk.

Purpose Dual-energy coronary artery CT angiography (CTA) is a very promising one-stop examine, but the radiation dose is too high to hinder the development of the technology. The aim of this article is to explore the feasibility of low tube current combined with sonogram-affirmed iterative reconstruction (SAFIRE) technology in dual energy coronary artery CTA scan. Materials and Methods One hundred and twenty patients were randomly divided into four groups according to the tube current of A ball:conventional group (180 mAs) and low-dose groups (150 mAs, 120 mAs, 90 mAs). The SAFIRE 3 reconstruction method was used in the low-dose groups. The differences of mean CT values, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), image quality score and effective dose (ED) of the four groups were compared. Results The coronary artery segment display and the mean CT value of the four groups showed no statistic difference (P>0.05), while the image quality score, noise, SNR, and CNR showed statistic difference (P<0.05). The image quality score, SNR, and CNR was highest in the 150 mAs group, but noise was the lowest. There were no statistic difference of the image quality score, SNR, and CNR between the 180 mAs group and 90 mAs group (P>0.05). The ED was (5.50±1.47) mSv, (4.55±1.16) mSv, (3.41±0.77) mSv and (2.44±0.67) mSv, respectively for the four groups, and there was statistical difference (P<0.05). ED of 90 mAs group decreased 55.62% than that of 180 mAs group. Conclusion Coronary artery CTA using 90 mAs combined with SAFIRE can significantly reduce the radiation dose without losing image quality, thus it has a good prospect of clinical application.

Objective To investigate the types and frequency of gene mutations of β‐thalassemia in south of Sichuan area ,so as to provide basis for β‐thalassemia prevention plan and to help drop β‐thalassemia incidence effectively .Methods Polymerase chain reaction(PCR)and reverse dot blot(RDB)techniques were employed to perform diagnostic analysis for β‐thalassemia genes in sus‐pected thalassemia patient in south of Sichuan region.Results The detection rate of β‐thalassemia was 60 .1% among 319 cases ;9 genes mutation types was found among 17β‐thalassemia genes mutation types .Three types of gene mutations had highest frequency of occurrence ,followed by CD17 41 .3% ,CD41‐42 27 .39% ,IVS‐Ⅱ‐654 24 .35% .Conclusion The gene mutation rate of β‐thalasse‐mia are higher in south of Sichuan region .In order to prevent the birth of children with intermedial and major thalassemia ,the sig‐nificance is important to strengthen hematology screenings and genetic diagnosis for β‐thalassemia.

Objective: To establish a dissolution determing method for the two primary ingredients atenolol and nifedipine in YakepingⅡcapsules. Methods:A small glass method was adopted with the rotation rate of 50 r·min-1 . According to the dissolution conditions in Japan “quality of medical drugs information set” with appropriate adjustments in accordance with the actual situation of the samples, different YakepingⅡ capsules were determined by HPLC respectively in pH 1. 2 artificial gastric solution ( containing 0. 5% sodium dodecyl sulfate), pH 4. 0 acetate buffer(containing 0. 5% sodium dodecyl sulfate), pH 6. 8 phosphate buffer(contai-ning 0. 25% sodium dodecyl sulfate) and water(containing 0. 25% sodium dodecyl sulfate). Results:The assay displayed a good lin-earity over the concentration range of 10-30 μg·ml-1 for atenolol and nifedipine(r=0. 999 6 and r=0. 999 8), and the recovery of the two components in the different medium was 99. 64%(RSD=0. 73%), 99. 55%(RSD=0. 65%), 99. 53%(RSD=0. 47%)and 99.54% (RSD=0.51%), 99.52%(RSD=0.67%), 99.52%(RSD=0.72%), 99.51%(RSD=0.63%)and 99.61%(RSD=0. 59%)(n=9). The dissolution of different batches of YakepingⅡcapsules in the four media showed the similar behavior. Conclu-sion:The method is simple, accurate and reproducible in the dissolution determination of atenolol and nifedipine in YakepingⅡ cap-sules.

Objective To analyze the effects of achievement motivation and family environ-ment of undergraduates majoring in preventive medicine on creativity tendency. Methods The self-administered questionnaire was used to survey the general characteristics , achievement motivation , family environment, and Williams creativity tendency of undergraduates (n=243) from grade 1 to grade 5 majoring in preventive medicine in a medical college. The effects of achievement motivation and family environment on creativity tendency were tested with multiple linear regression analysis. SPSS 17.0 software was used for statistical analysis. The indexes between boys and girls was compared with group t test, and single factor analysis of variance was made for comparison between grades, SNK method was used to test and compare two groups; linear correlation analysis was made to inspect the correlation between the two indicators, and multiple linear regression analysis method was used for further analysis. Results The survey recycled 226 copies of effective questionnaires. The scores of achievement motivation, family environment, and Williams creativity tendency and all dimen-sions had no statistically significant difference among the five grades, or between the male and female (P>0.05). The positive influence factors of creativity tendency and its dimensions were pursuing success, the in-formative property, the entertaining property and organizational property, the negative influence factor was avoiding failure. R2 was 0.094-0.265 (P=0.000-0.048). Conclusion Achievement motivation and family environment of undergraduates majoring in preventive medicine may have posi-tive effects on creativity tendency. Various comprehensive measures should be taken to improve family environment and enhance achievement motivation, and to promote to increase creativity tendency, and to cultivate students' creativity and improve students' scientific research ability.