Objective To explore the therapeutic mechanism of maggot for psoriasis-like lesions in mice from the perspective of immune stress and complement activation regulation.Methods Thirty-six male C57BL/6 mice were randomly divided into control group,model group,maggot(1.25%,2.5%,and 5%)groups,and Benvitimod(1%)group.Psoriasis-like lesions were induced by application of imiquimod cream,and the severity of skin lesions was assessed using the modified Psoriasis Area and Severity Index(MPASI)score.Auricular swelling of the mice was observed,and histopathological changes of the skin lesions were examined with HE staining.Scratching behavior of the mice was observed and the spleen index was calculated.Toluidine blue staining was used to detect mast cells in the skin lesions,and serum levels of IgG,IgM,the complements CH50,C1s,C3,C3a,C5 and C5a,and the inflammatory factors IL-23,IL-17A and TNF-α were determined with ELISA.Results In mice with imiquimod-induced psoriasis-like skin lesions,treatment with the maggot at the 3 doses significantly decreased MPASI score,alleviated auricular swelling and pathologies in the skin lesions,reduced scratching behaviors,spleen index,and the number of mast cells in the lesions.Treatment with high-dose maggot significantly lowered serum levels of IgG,C1s,C3a,C5a,IL-23,IL-17A and TNF-α and the levels of C1s,C3,C3a,C5 and C5a in the lesion tissue,and increased serum levels of CH50,C3,and C5.The therapeutic effect of maggot showed a dose-effect dependence.Conclusion Maggot can alleviate psoriasis-like skin lesions in mice by inhibiting immune stress and complement activation.

Objective To investigate the expression of serum CC chemokine ligand 2(CCL2),CX3C chemokine ligand 1(CX3CL1)and CXC chemokine ligand 10(CXCL10)in postmenopausal osteoporosis(PMOP)patients and the value of combination with fracture risk assessment tool(FRAX)in predicting fracture occurrence.Methods A total of 120 patients with PMOP admitted to Hainan West Central Hospital from January 2022 to June 2023 were selected,and they were divided into fracture group(n=52)and non-fracture group(n=68).According to the FRAX score examination,they were divided into a high-risk fracture group(n=73)and a low-risk fracture group(n=47).The levels of serum CCL2,CX3CL1 and CXCL10 in each group were compared.Multivariate Logistic regression was used to analyze the fracture risk factors in PMOP patients.ROC curve was drawn to analyze the value of CCL2,CX3CL1 and CXCL10 combined with FRAX score in predicting fracture of PMOP.Results The levels of serum CCL2(134.98±32.24 pg/ml),CX3CL1(186.25±41.60 pg/ml)and CXCL10(223.47±56.43 pg/ml)in the fracture group were higher than those in the non-fracture group(82.26±17.30 pg/ml,105.23±23.78 pg/ml,151.47±43.14 pg/ml),and the differences were statistically significant(t=11.503,13.452,7.923,all P＜0.001).The levels of serum CCL2(119.70±37.56 pg/ml),CX3CL1(161.43±53.79 pg/ml)and CXCL10(204.06±61.41pg/ml)in the high-risk group for fractures were higher than those in the low-risk group(82.43±17.23 pg/ml,107.55±24.75 pg/ml,149.45±42.50pg/ml),and the differences were statistically significant(t=6.377,6.436,5.327,all P＜0.001).Multivariate Logistic regression analysis showed that elevated levels of serum CCL2,CX3CL1 and CXCL10 were risk factors for fractures in PMOP patients.The ROC curve showed that the combination of CCL2,CX3CL1 and CXCL10 combined with FRAX scores predicted the highest AUC(95％CI)for PMOP fractures[0.951(0.892～0.993)],with sensitivity and specificity of 98.2％and 85.6％,respectively.Conclusion The increased levels of serum CCL2,CX3CL1 and CXCL10 are risk factors for fracture in PMOP patients,and the combination with FRAX score has a good predictive value for fracture.

Objective To explore the therapeutic mechanism of maggot for psoriasis-like lesions in mice from the perspective of immune stress and complement activation regulation.Methods Thirty-six male C57BL/6 mice were randomly divided into control group,model group,maggot(1.25%,2.5%,and 5%)groups,and Benvitimod(1%)group.Psoriasis-like lesions were induced by application of imiquimod cream,and the severity of skin lesions was assessed using the modified Psoriasis Area and Severity Index(MPASI)score.Auricular swelling of the mice was observed,and histopathological changes of the skin lesions were examined with HE staining.Scratching behavior of the mice was observed and the spleen index was calculated.Toluidine blue staining was used to detect mast cells in the skin lesions,and serum levels of IgG,IgM,the complements CH50,C1s,C3,C3a,C5 and C5a,and the inflammatory factors IL-23,IL-17A and TNF-α were determined with ELISA.Results In mice with imiquimod-induced psoriasis-like skin lesions,treatment with the maggot at the 3 doses significantly decreased MPASI score,alleviated auricular swelling and pathologies in the skin lesions,reduced scratching behaviors,spleen index,and the number of mast cells in the lesions.Treatment with high-dose maggot significantly lowered serum levels of IgG,C1s,C3a,C5a,IL-23,IL-17A and TNF-α and the levels of C1s,C3,C3a,C5 and C5a in the lesion tissue,and increased serum levels of CH50,C3,and C5.The therapeutic effect of maggot showed a dose-effect dependence.Conclusion Maggot can alleviate psoriasis-like skin lesions in mice by inhibiting immune stress and complement activation.

Objective:To investigate the diagnostic value of serum CircRNA_0048211 expression level in postmenopausal osteoporosis (PMOP) and its correlation with bone-specific alkaline phosphatase (BALP), osteopontin (OPN), procollagen type I N-terminal propeptide (PINP) and β-crosslaps (β-CTX). Methods:Data of postmenopausal women who underwent physical examination in our hospital from January 2019 to December 2021 were collected. All subjects were measured bone mineral density (BMD) by dual-energy X-ray absorptiometry and divided into PMOP group, decreased bone mass group and normal bone mass group according to BMD level. The serum CircRNA_0048211, BALP, OPN, PINP and β-CTX levels were compared in each group. Binary logistic regression was used to analyze the risk factors of PMOP, the receiver operating characteristic curve (ROC) was drawn to analyze the diagnostic value of CircRNA_0048211, BALP, OPN, PINP and β-CTX on PMOP. The correlation between CircRNA_0048211 expression level and BALP, OPN, PINP and β-CTX was analyzed by Pearson correlation analysis. Results:A total of 218 patients were included in this study. Age is 60.52±6.83 years (range, 47-76 years), body mass index is 24.27±2.28 kg/m 2 (range, 22.18-25.73 kg/m 2) and menopausal time is 10.16±4.25 years (range, 2.30-21.80 years). There were 40 cases in PMOP group, 97 cases in osteopenia group and 81 cases in normal bone mass group. The serum CircRNA_ 0048211, BALP, OPN, PINP and β-CTX was significantly different between PMOP group, osteopenia group and normal group ( F=21.15, P<0.001; F=12.52, P<0.001; F=17.86, P<0.001; F=14.32, P<0.001; F=15.52, P<0.001). The serum CircRNA_0048211 level in PMOP group (0.37±0.08) were significantly lower than that of osteopenia group (1.05±0.46) and normal bone mass group (1.73±0.81), the difference was statistically significant ( P<0.05). The levels of BALP (28.42±7.35 μg/L), OPN (17.28±7.30 ng/ml), PINP (58.40±14.37 ng/ml) and β-CTX (1.52±0.28 μg/L) in PMOP group were significantly higher than those in osteopenia group (22.61±5.93 μg/L, 11.95±5.64 ng/ml, 49.16±11.24 ng/ml, 0.81±0.17 μg/L) and normal bone mass group (16.30±4.18 μg/L, 7.62±3.25 ng/ml, 35.48±7.12 ng/ml, 0.37±0.10 μg/L), the difference was statistically significant ( P<0.05). Binary logistic regression analysis showed that decreased CircRNA_0048211 expression level [ OR=3.53, 95% CI (2.73, 10.32)] was a risk factor for the occurrence of PMOP ( P<0.001). ROC curve showed that CircRNA_0048211≤0.76 has a diagnostic significance on PMOP, and its combination of BALP, OPN, PINP and β-CTX has the highest AUC [0.95, 95% CI (0.89, 1.00)] in diagnosing PMOP. Correlation analysis showed that CircRNA_0048211 expression level were negatively correlated with BALP, OPN, PINP and β-CTX ( r=-0.46, P<0.001; r=-0.80, P<0.001; r=-0.81, P<0.001; r=-0.69, P<0.001). Conclusion:The CircRNA_0048211 showed low expression in PMOP, which was negatively correlated with BALP, OPN, PINP and β-CTX. The combination of these five factors has certain clinical value in the diagnosis of PMOP.

Objective:To evaluate the effect of individualized blood pressure management on postoperative delirium in elderly hypertensive patients undergoing radical resection for gastrointestinal tumor.Methods:One hundred and sixty elderly hypertensive patients of both sexes, aged 60-80 yr, with body mass index of 19-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, scheduled for elective radical resection for gastrointestinal tumor under general anesthesia, were divided into 2 groups ( n=80 each) using a random number table method: standardized blood pressure management group (group S) and individualized blood pressure management group (group I). Combined intravenous-inhalational anesthesia was performed, and BIS values were maintained at 40-60 and heart rate at 50-100 times/min during surgery in both groups. In group S, intraoperative systolic blood pressure was maintained above 90 mmHg with a decrease of less than 30% of the baseline value, while intraoperative fluctuation of systolic blood pressure was maintained less than 10% of the baseline value in group I. The use of vasoactive agents, numerical rating scale scores within 3 days after operation, and length of hospital stay were recorded. Postoperative delirium was evaluated by Confusion Assessment Method within 5 days after surgery. Results:Compared with group S, the intraoperative usage rate of norepinephrine was significantly increased, the incidence of postoperative delirium was reduced( P<0.05), and no significant change was found in the numerical rating scale scores and length of hospital stay in group I ( P>0.05). Conclusions:Individualized blood pressure management can reduce the development of postoperative delirium in elderly hypertensive patients undergoing radical resection for gastrointestinal tumor.

Objective: To investigate the diagnostic value of serum complement level and lipid metabolism level detection in senile osteoporosis. Methods: A total of 215 elderly people who underwent physical examination and bone mineral density test in Beijing Jishuitan Hospital from January 2016 to June 2016 were divided into osteoporotic group(74) and non-osteoporotic group (141) according to bone mineral density classification. The relationship between serum complement C3, complement C4, low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL), triglyceride (TG), total cholesterol (CHO) and bone mineral density were analyzed. The data were analyzed by t-test, non-parametric test, binary Logistic regression and the receiver operating characteristic (ROC) curve. Results: The age and CHO,LDL, HDL, complement C3 and C4 in the osteoporosis group[(80.6±8.2)years, (4.43±1.25)mmol/L, (2.27±0.73) mmol/L, (1.33±0.39) mmol/L, (1.12±0.22) g/L, (0.29±0.09)g/L], were significantly higher than those in the non-osteoporosis group[(77.5±8.3)years,(4.04±1.02)mmol/L,(1.97±0.59)mmol/L,(1.19±0.32)mmol/L,(0.86±0.25)g/L,(0.21±0.06)g/L,t-value were 2.571,-3.848,-4.483,-3.951,-1.249,-1.185,P<0.05], and the the BMI bone mineral density T-Score value of DXA and in the osteoporosis group were significantly lower than those in the non-osteoporosis group[(22.33±3.8)kg/m², -2.74±0.78 and (25.03±4.2)kg/m², 0.14±0.9, while the t value was 6.151 and 4.624, respectively, P<0.05]. The level of TG in osteoporotic group was significantly lower than that in non-osteoporotic group[the median (quartile) was 1.21(0.67,1.44)mmol/L and 1.37(0.86,1.67)mmol/L, respectively, Z=-2.51, P<0.01].Gender and serum levels of HDL, LDL, C3 and C4 were independent risk factors for senile osteoporosis(OR=2.476,P=0.004;OR=1.305,P=0.038;OR=1.564,P=0.028; OR=1.018, P=0.025; OR=1.023, P=0.015, respectively). The risk of osteoporosis in women was 2.476 times higher than that in men of the same age. The corresponding risk of osteoporosis increased by1.305,1.564, 1.018 and 1.023 times as HDL, LDL, C3 and C4 increased by one unit. The areas under the ROC curve detected separately by HDL, LDL, C3 and C4 were 0.623,0.595,0.673 and 0.731 respectively, and the area under the ROC curve of the four items was 0.864. Conclusions The levels of blood lipids and complements play a great role in bone metabolism. The combined detection of blood lipid metabolism and complement can improve the diagnostic efficacy of senile osteoporosis.

Objective To find the rational selection of specimens for the detection of Epstein-Barr virus ( EBV ) DNA.Methods A total of 117 patients were diagnosed with EBV infection at Beijing Friendship Hospital from January to June 2017, including 44 patients with infectious mononucleosis (IM), 36 patients with EBV-associated hemophagocyticlymphohistiocytosis ( HLH ) and 37 patients with post-transplant lymphoproliferative disorders (PTLD).Patients were aged from 6 months to 28 years.EBV DNA loads (median and quartile) in peripheral blood mononuclear cells (PBMC) and plasmawere detected by real-time quantitative PCR.The viral loads of different specimen types were compared by nonparametric rank sum test ( Mann-Whitney test, M-W test) .Spearman correlation analysis was performed for correlation analysis.Results TheEBV DNA loads in PBMC of IM and PTLD were 53600 (7875,626500) copies/ml and 114000 (3396,590500) copies/ml, which were significantly higher than those in plasma [4500 (675, 8600)copies/ml and 0(0, 0)copies/ml, respectively].The M-W values were 372.5 and 30.5 respectively (both P<0.001), which indicated statistically significant differences .However, the EBV DNA loads in PBMC and plasma of HLH were 5100 (1425, 170000) copies/ml and 13500 (1303, 152500) copies/ml.The M-W value was 646.5 (P=0.991), which indicated no statistically significant difference . Spearman correlation analysis showed good correlations of EBV DNA loads between PBMC and plasmain IM and HLH, and the r values were 0.548 and 0.400, respectively (both P<0.05), while the correlation of EBV DNA loads between PBMC and plasma in PTLD was poor , and the r value was 0.308 ( P>0.05 ) . Conclusions For the diagnosis and monitoring of EBV infection , the types of specimens recommended by different diseases are different .Plasma or serum specimens are recommended for quantitative detection of EBV DNA in IM and HLH, while PBMC and plasma specimens are recommended in PTLD .Clinically, the type of specimen should be chosen reasonably according to the type of disease .

OBJECTIVE:To standardize the ward rescue and essential drugs quality management in wards,and reduce the med-ication risk of patients. METHODS:Failure mode and effect analysis(FMEA)was used to analyze the inspection items and failure modes of quality management of ward rescue and essential drugs. According to scoring the possibility,severity and detectability de-gree of the failure modes and calculating the risk priority number(RPN),failure modes that should be given priority improvement were quantified and determined,improvement measures were developed and conducted,and management effects were evaluated af-ter 6 months. RESULTS:12 failure modes were determined,including the residue treatment of narcotic and the first-class psycho-tropic drugs was not recorded,drug storage temperature was not up to standard and drug expired,etc. Improving related systems, enhancing the inspection management,cold chain management,daily management and other measures were implemented and con-ducted. After 6 months,the top 3 items with the highest RPNs were dropped from 320,240,216 score to 16,16,27 scores,re-spectively,all in a relatively low risk area. Numbers of failure mode event were dropped from 1869 to 218,dropping by 88.3%. CONCLUSIONS:According to qualifying the failure modes in ward rescue and essential drugs quality management by using FMEA in our hospital,the management items with the highest risk has determined and improved,the medication risk of patients has significantly reduced.

Objective Comparison the corrective effect of plasma exchange method and formula method for chylemia on hematology analysis.Methods A total of 10 samples without hemolysis,jaundice and lipemia were set as control group,each sample was divided into 4 parts,then 5,10,20 and 40 μl lipid emulsion was added.Each chylous samples was treated by plasma exchange method for two times,and routine blood test was reanalyzed with hematology analyzer.The comparisons before and after the exchange was made,while the test results on each exchange were analyzed.For another part,the HGB of chylous plasma was tested,the value was substituted into HGBcorrected value =HGBbefore correction-(HGBchylous plasma-HGBchylous plasma ×HCTbefore correction).Results The chylemia could lead significant increase of HGB,MCH and MCHC (P＜0.05).After plasma exchanging for two times,the three parameters returned to normal and the count of WBC,RBC and PLT decline slightly with no significance.There were no differences between plasma exchange method and formula calibration method.Conclusion Plasma exchange method and formula calibration method could significantly reduce the impact of chylemia on routine blood analysis,which facilitate the clinical work with correct analysis of routine blood test.

Objective To understand the prevalence and genotype distribution of human papillomavirus among male patients attending to venereal outpatient department and provide basic data for prevention and treatment of HPV.Methods Retrospective analysis method was used to analyze 1 074 patients from venereal outpatient department of Beijing Friendship Hospital during January to August in 2015.Swab specimen were analyzed by flow-through hybridization and gene chip to detect the type of HPV.Chi-square test was used to compare the distribution of CA and suspected patients.Results Among the 434 CA samples, the positive rate was 72.6%(315/434).The 58.1%(252/434) samples were high risk HPV positive and 14.5%(63/434) samples were low risk HPV positive.In high risk HPV infection, multiple infection accounted for 40.4%(175/434) and single infection was 17.7%(77/434), while in low risk HPV infection, single infection accounted for 12.9%(56/434).HPV-11, HPV-6, HPV-16, HPV-52, HPV-58 and HPV-51 were common.The positive rate among suspected CA patients was 36.6%(234/640) , and dominated in high risk HPV infection 25.3%( 162/640 ) .The positive rates of high risk HPV in CA patients [ 40.4%( 175/434 ) and 17.7%( 77/434 ) ] were obviously higher than that of suspected ones [12.9%(56/434) and 1.6%(7/434)], χ2 =95.956 and 9.122, both P<0.05.Conclusions Male patients from venereal outpatient department have a high prevalence of HPV, and common genotype are HPV-11, HPV-6, HPV-16, HPV-52, HPV-58 and HPV-51.The intensity of HPV screening should be strengthened in order to provide the vital basis for the prevention and treatment HPV related diseases.