Objective To investigate the relationship between serum mannan binding lectin(MBL),histi-dine rich glycoprotein(HRG),interleukin(IL)-23/IL-17 inflammatory axis and cerebral vasospasm(CVS)and prognosis in patients with aneurysmal subarachnoid hemorrhage(aSAH)after interventional emboliza-tion.Methods A total of 195 patients with aSAH who underwent interventional embolization treatment in the hospital from March 2019 to February 2022 were selected and were divided into no CVS group(126 cases),mild CVS group(18 cases),moderate CVS group(39 cases),and severe CVS group(12 cases)according to the occurrence and severity of CVS detected by digital subtraction angiography at the 4th postoperative day.The levels of serum MBL,HRG,IL-23 and IL-17 among the four groups before and 3 d after surgery were compared.The patients were followed up for 6 months and divided into good prognosis group(137 cases)and poor prognosis group(58 cases)according to their prognosis.Factors influencing poor prognosis in aSAH pa-tients were analyzed by multivariate Logistic regression model.The predictive value of serum MBL,HRG,IL-23,IL-17 levels and their combined application models for poor prognosis in patients with aSAH was analyzed by receiver operating characteristic(ROC)curve.Results The incidence rate of CVS after interventional em-bolization was 35.38%in 195 patients with aSAH.3 d after surgery,the serum levels of MBL,IL-23 and IL-17 in the mild,moderate,and severe CVS groups were higher than those in the no CVS group,those in the severe CVS group were higher than those in the moderate CVS group,those in the moderate CVS group were higher than those in the mild CVS group(P<0.05).The serum HRG levels in the mild,moderate,and severe CVS groups were lower than those in the non CVS group,those in the severe CVS group were lower than those in the moderate CVS group,those in the moderate CVS group were lower than those in the mild CVS group(P<0.05).3 d after surgery,the levels of serum MBL,IL-23 and IL-17 in the four groups were higher than that before surgery,while the levels of serum HRG were lower than that before surgery(P<0.05).The pro-portions of patients with aneurysm diameter≥6 mm,number of aneurysms>1,surgery time>24 h,Hunt-Hess grade Ⅲ/Ⅳ and postoperative CVS,and serum levels of MBL,IL-23,and IL-17 on the 3rd day after sur-gery in the good prognosis group were lower than those in the poor prognosis group,and serum HRG levels at 3 d after surgery in the good prognosis group were higher than that in the poor prognosis group(P<0.05).Multivariate Logistic regression analysis showed that aneurysm diameter≥6 mm,Hunt-Hess grade Ⅲ/Ⅳ and postoperative CVS,elevated serum levels of MBL,IL-23,and IL-17 and decreased HRG level at 3 d after sur-gery were independent risk factors for poor prognosis in aSAH patients(P<0.05).ROC results showed that serum levels of MBL,HRG,IL-23,and IL-17 at 3 d after surgery had certain predictive power for poor progno-sis in patients with aSAH.The predictive model with the combined application of four indicators had relatively high efficiency(the area under the curve was 0.853).Conclusion Elevated levels of MBL,IL-23,IL-17,and decreased HRG levels in aSAH patients after interventional embolization could increase the risk of CVS and are associated with poor prognosis in aSAH patients after interventional embolization.The above indicators have a certain predictive power for poor prognosis in aSAH patients.

Objective To investigate the predictive value of serum soluble tumor necrosis factor-like weak inducer of apoptosis(sTWEAK)and Netrin-1 combined with acute physiology and chronic health evaluationⅡ(APACHE Ⅱ)score for poor prognosis in patients with severe craniocerebral injury after surgery.Methods Totally 120 patients with severe craniocerebral injury admitted to a hospital from June 2020 to June 2022 were divided into good prognosis group and poor prognosis group according to the prognosis 30 days af-ter surgery.The serum levels of sTWEAK,Netrin-1 and APACHE Ⅱ score were compared between the two groups.Univariate and multivariate Logistic regression were used to analyze the influencing factors of poor prognosis in patients with severe craniocerebral injury,and the prediction model of serum sTWEAK,Netrin-1 and APACHE Ⅱ score combined was constructed.The predictive value of serum sTWEAK,Netrin-1 level and APACHE Ⅱ score in patients with severe craniocerebral injury after surgery was analyzed by receiver operat-ing characteristic(ROC)curve.Results The duration of intensive care unit stay in the poor prognosis group was longer than that in the good prognosis group,and the albumin level,Glasgow Coma scale and serum Ne-trin-1 level at admission were lower than those in the good prognosis group.The proportion of multiple brain contusion and laceration,the proportion of mechanical ventilation,APACHE Ⅱ score at admission and the lev-els of serum sTWEAK,blood creatinine and blood urea nitrogen were higher than those in the group with good prognosis,and the differences were statistically significant(P＜0.05).Multivariate Logistic regression analysis showed that multiple brain contusion and laceration,decreased Netrin-1 level,increased APACHE Ⅱscore and increased sTWEAK level at admission were risk factors for poor prognosis in patients with severe craniocerebral injury(P＜0.05).ROC curve analysis showed that the area under the curve and 95％CI of ser-um sTWEAK,Netrin-1 and APACHE Ⅱ scores were 0.742(0.552-0.925),0.731(0.488-0.963),0.714(0.502-0.911)and 0.882(0.795-0.947)respectively when the three indexes were used alone and in com-bination.Conclusion Serum sTWEAK and Netrin-1 combined with APACHE Ⅱ score have good predictive value for the poor prognosis of patients with severe craniocerebral injury after surgery,and can provide refer-ence for the formulation of clinical treatment.

Objective:To analyze and predict the future trend of the premature mortality of major chronic and non-communicable diseases in Anhui Province, evaluate the implementation of the "Healthy China 2030" Plan, and explore its influencing factors.Methods:Using data from death-cause surveillance and statistical yearbooks in Anhui, the trend prediction and analysis on influencing factors were conducted by using methods such as time series accumulation and logarithmic linear Joinpoint regression, principal component regression.Results:In Anhui, 28.10% of the deaths were premature ones, of which 84.40% were attributed to chronic and non-communicable diseases. In premature deaths attributed to chronic and non-communicable diseases, the deaths caused by malignant tumor and cardiovascular disease accounted for 45.88% and 41.65% respectively. The prediction results showed that the premature mortality of major chronic and non-communicable diseases would decrease in Anhui in the future, and by 2030, the goal in the "Healthy China 2030" Plan would be reached only in rural area. To reduce premature death, it is necessary to pay attention to the prevention and control of malignant tumor and cardiovascular disease. Men in urban area are the key population. Factors that reflect urban infrastructure had a significant impact on premature mortality of major chronic non-communicable diseases, such as garden and green space area per capita. Factors such as concentration of PM 2.5 had a negative impact on premature mortality of chronic non-communicable diseases, while factors such as garden and green space area per capita had a positive impact. Conclusions:Disease burden caused by chronic and non-communicable diseases, such as malignant tumor, exits in Anhui. Men in urban area are key population in the prevention and control of chronic and non-communicable diseases in the future.

OX40 is a costimulatory receptor that is expressed primarily on activated CD4⁺, CD8⁺, and regulatory T cells. The ligation of OX40 to its sole ligand OX40L potentiates T cell expansion, differentiation, and activation and also promotes dendritic cells to mature to enhance their cytokine production. Therefore, the use of agonistic anti-OX40 antibodies for cancer immunotherapy has gained great interest. However, most of the agonistic anti-OX40 antibodies in the clinic are OX40L-competitive and show limited efficacy. Here, we discovered that BGB-A445, a non-ligand-competitive agonistic anti-OX40 antibody currently under clinical investigation, induced optimal T cell activation without impairing dendritic cell function. In addition, BGB-A445 dose-dependently and significantly depleted regulatory T cells in vitro and in vivo via antibody-dependent cellular cytotoxicity. In the MC38 syngeneic model established in humanized OX40 knock-in mice, BGB-A445 demonstrated robust and dose-dependent antitumor efficacy, whereas the ligand-competitive anti-OX40 antibody showed antitumor efficacy characterized by a hook effect. Furthermore, BGB-A445 demonstrated a strong combination antitumor effect with an anti-PD-1 antibody. Taken together, our findings show that BGB-A445, which does not block OX40-OX40L interaction in contrast to clinical-stage anti-OX40 antibodies, shows superior immune-stimulating effects and antitumor efficacy and thus warrants further clinical investigation.
Mice ; Animals ; Receptors, Tumor Necrosis Factor/physiology* ; Receptors, OX40 ; Membrane Glycoproteins ; Ligands ; Antibodies, Monoclonal/pharmacology* ; Antineoplastic Agents/pharmacology*

Subcutaneous panniculitis-like T-cell lymphoma (SPTL) is an extremely rare, indolent skin malignancy that can be difficult to distinguish from autoimmune disease-associated panniculitides. Here, we describe a 12-year-old boy who was diagnosed at age 7 years with dermatomyositis with classical manifestations, including poikiloderma, Gottron’s sign, and symmetric muscle weakness. Recently, the boy presented multiple subcutaneous nodules and fever. Histopathological examination and immunohistochemical staining revealed coexistence of SPTL. To our knowledge, this is the first case of dermatomyositis accompanied with SPTL. This case alert clinical physicians of the possibility of SPTL should be considered when a patient with dermatomyositis has new lesions presenting as nodules and unknown fever.

In recent years, the number of guidelines/consensus in the field of dermatology has increased in China, but the quality is variable. This article proposes to describe the specific process of guideline/consensus development in 10 steps, focusing on the initiation phase, advancement phase, as well as dissemination, implementation and update phases, with the aim to improve the quality of guidelines/consensus in the field of dermatology.

In order to further standardize the diagnosis and treatment of atopic dermatitis by health-care professionals, as well as to enhance the awareness of atopic dermatitis among patients and promote doctor-patient communication, Chinese Society of Dermatology and China Dermatologist Association jointly initiated the development of guidelines on the diagnosis and treatment of atopic dermatitis (specialist version, general practitioner version and patient version). The development working group had planned the development process of the 3 versions of guidelines with reference to relevant development manuals and methodological articles. It is also intended to expound the details of registration, working group establishment, clinical question collection, evidence search and grading, recommendation formation and consensus through this protocol, aiming to enhance the transparency of guideline development.

The purpose of this article is to review the research progress on fear of dementia， and to provide references for clinical treatment and nursing care. Fear of dementia is a widespread problem for adults， and adults with high degrees of fear were more likely to develop adverse psychological consequences， including aggravation of anxiety and depression， decreased inclination toward health-promoting behaviours， avoidance of medical treatment， and suicidal ideation. At present， domestic and foreign studies have mainly focused on the current situation and influencing factors of fear of dementia. Therefore， this article gives a review on the fear of dementia in terms of its concept， incidence， impact， influencing factors， assessment tools and intervention measures， with a view to provide a reference for the subsequent studies.

Objective:To construct the prediction model for the prolonged length of postoperative hospital stay in the patients undergoing thoracoscopic lobectomy.Methods:The patients of both sexes, aged ≥18 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ, who received elective thoracoscopic lobectomy with general anesthesia from March 2016 to February 2019 in our hospital, were selected, their clinical data were collected, and the patients were pathologically diagnosed with non-small-cell lung cancer after operation.Basic information (sex, age, smoking history), previous history (dyslipidemia, hypertension, diabetes, cardiovascular and cerebrovascular diseases, peripheral vascular diseases, chronic obstructive pulmonary diseases), allergy history, other tumor history, surgical resection site, anesthetic factors (intraoperative use of non-steroidal anti-inflammatory drugs and glucocorticoids, duration of anesthesia, intraoperative epidural anesthesia + postoperative epidural analgesia) and postoperative complications (pleural effusion, pneumothorax, atelectasis) was collected.The patients were divided into 2 groups according to whether the length of postoperative hospital stay was prolonged: normal group (≤ 7 days) and prolonged group (>7 days).Logistic regression analysis was used to identify the predictors for prolonged length of postoperative hospital stay.The regression model for prediction of prolonged length of postoperative hospital stay was constructed based on the TensorFlow deep learning framework, and the efficacy of prediction was evaluated.A deep neural network was further established based on the TensorFlow framework to construct a classification prediction model for prolonged length of postoperative hospital stay, and the efficacy of prediction was assessed, further comparing it with the prediction model constructed by the traditional machine learning method.Results:A total of 428 patients were finally enrolled in the study.The results of multivariate logistic regression analysis showed that age and anesthesia duration were the risk factors for the prolonged length of postoperative hospital stay, and female, other tumor history and resection of right middle lobe were the protective factors ( P<0.05).The performance of the regression model proved ineffective, getting 2.16 mean absolute error and 11.05 mean square error on the training set, 2.14 mean absolute error and 11.73 mean square error on the test set.The classification model achieved better score with accuracy 75.58%, F1-measure 0.553 and area under the receiver operating characteristic curve 0.702 on the test set, however, it showed no better performance than that of 4 other prediction models established by 4 traditional machine learning methods, specifically Logistic Regression, Random Forest, Gradient Boosting and Support Vector Machine. Conclusions:Sex, age, surgical resection site, other tumor history and duration of anesthesia can serve as the predictors, and a classification prediction model for prolonged length of postoperative hospital stay is constructed based on a deep neural network in the patients undergoing thoracoscopic lobectomy.

Objective:To study the risk of refracture after osteoporotic vertebral fracture with changes in blood calcium and bone metabolism.Methods:260 patients with osteoporotic vertebral fracture treated in our hospital from Feb. 2018 to Feb. 2020 were selected for study. All patients were treated with kyphoplasty. The clinical curative effect, blood calcium, PINP, and β-CTX level changes were observed, postoperative recurrence was followed up. Clinical data of fracture patients were collected, risk factors of osteoporotic vertebral fractures in patients with postoperative recurrence of fracture were analyzed, receiver-operating characteristic curve was drawn to analyze the predictive value of blood calcium, PINP, andβ-CTX in postoperative recurrence of osteoporotic vertebral fracture.Results:The total clinical response rate was 95.77% (249/260) after treatment. After treatment, serum calcium, PINP, and β-CTX decreased with time, and the difference was significant ( P<0.05) . All patients were followed up for 6 months. There were 81 cases (31.15%) suffering postoperative fracture and 179 cases (68.85%) without fracture. According to univariate analysis, there were no statistically significant differences in age, sex, BMI, history of trauma, underlying disease, site of surgical vertebral body, segment of surgical vertebral body, correction angle of sagittal kyphosis, or amount of bone cement injection between the two groups ( P>0.05) . Long-term history of glucocorticoid use, preoperative fractured vertebra number, surgical vertebra number, blood calcium, PINP, β-CTX, fracture compression rate, vertebra height recovery rate, reinforced vertebra number, and bone cement leakage were correlated with postoperative recurrence of fracture in patients with osteoporotic vertebral fracture ( P<0.05) . Multivariate Logistic analysis showed that long-term history of glucocorticoid use, preoperative number of fractured vertebrae, surgical vertebra number, fracture compression rate, vertebral height recovery rate, enhanced vertebral body number, bone cement leakage, blood calcium, PINP, and β-CTX were all independent risk factors for postoperative recurrence of osteoporotic vertebral fracture ( P<0.05) . ROC curve results showed that AUC, 95%CI and truncation value were 0.820, 0.770-0.871 and 2.12mmol/L vs 0.915, 0.873-0.957 and 45.51 ng/mL vs 0.973, 0.957-0.988, and 463.29 for serum calcium, PINP, and β-CTX respectively in predicting the recurrence of osteoporotic vertebral fracture. Conclusion:Kyphoplasty has a significant effect on osteoporotic vertebral fracture, and it can effectively improve the serum calcium, PINP, and β-CTX, which have a certain monitoring value for postoperative recurrence of fracture.