BACKGROUND:Grape seed extract has been shown to be effective in inhibiting the growth of androgen-dependent tumors(e.g.,breast cancer),and thus grape seed extract could theoretically inhibit epiphyseal closure induced by estrogen in late adolescence. OBJECTIVE:To screen the effects of grape seed extract on apoptosis of growth plate chondrocytes and epiphyseal closure in rats. METHODS:(1)In vitro experiment:Growth plate chondrocytes from rat large tibia and femur at logarithmic growth stage were obtained and cultured in groups:normal control group,model control group(adding 17β-estradiol to induce apoptosis),positive control group(adding letrozole and 17β-estradiol),grape seed extract group(adding 17β-estradiol and 10 μg/mL grape seed extract),Caspase-9 inhibitor group(adding 17β-estradiol and Caspase-9 inhibitor),Caspase-9 agonist group(adding 17β-estradiol and Caspase-9 agonist).Cell apoptosis was detected by flow cytometry after 48 hours of culture.(2)In vivo experiment:Thirty 3-month-old Sprague-Dawley rats were randomly divided into model control group,positive control group and low-,medium-and high-dose groups,with five rats in each group.All rats were injected subcutaneously with 17β-estradiol(3 times per week)to establish epiphyseal closure models,followed by intragastric administration of letrozole in positive control group and 0.05,0.2 and 0.8 g/kg grape seed extract in low-,medium-and high-dose groups,respectively,once a day until over 2/3 of the epiphyseal plate in the model control group was closed.The length of the tibia was then observed.Another 18 Sprague-Dawley rats were randomly divided into model control group,positive control group,and medium-dose group,with 6 rats in each group,treated as above for 1.5 continuous months.The expression of Caspase-9 protein in rat growth plate cartilage was detected by western blot. RESULTS AND CONCLUSION:(1)In vitro experiment:17β-estradiol could induce apoptosis in growth plate chondrocytes,and letrozole,grape seed extract,and caspase-9 inhibitors could all inhibit apoptosis in growth plate chondrocytes.(2)In vivo experiment:When more than 2/3 of the epiphyseal plate in the model control group was closed,the number of rats with epiphysis closure in the positive control and medium-dose groups was less than that in the model control group(P＜0.05),and the tibial length was longer than that in the model control group(P＜0.05),and the Caspase-9 protein expression in the tibial growth plate was lower than that in the model control group(P＜0.05).To conclude,the appropriate dose of grape seed extract can effectively inhibit the apoptosis of growth plate chondrocytes and delay epiphyseal closure,which has the potential to promote bone growth.

Objective:To investigate the factors contributing to in-hospital mortality among elderly patients aged 80 and above with gastrointestinal bleeding(GIB).Additionally, it seeks to assess the predictive ability of the electronic frailty index(eFI)in determining the risk of in-hospital mortality in GIB patients.Methods:A retrospective analysis was performed among 624 patients aged 80 and above with GIB who were admitted to Beijing Hospital between July 2013 and September 2019.The patients were categorized into two groups based on their discharge outcomes: those who survived and those who did not.The eFI was developed using a cumulative deficit model utilizing data from the hospital's electronic medical records.The study examined the clinical features and risk factors associated with in-hospital mortality among these elderly patients.The effectiveness of eFI in predicting in-hospital mortality in elderly patients with gastrointestinal bleeding was evaluated by calculating the area under the curve(AUC)of the receiver operating characteristic(ROC)curve.Results:Among a total of 624 patients aged between 80 and 102 years, the average age was(83.0±6.4)years, with 339 being male.A majority of the patients, 581 cases(93.1%), had an eFI ≥ 0.15.A comparison between the survival group(380 cases)and the death group(244 cases)revealed that the latter had higher eFI values(0.39±0.09 vs.0.29±0.11, t=-11.452, P<0.001), along with higher rates of heart failure, chronic kidney disease, and malignant tumors, as well as lower body mass index, hemoglobin, albumin, and total cholesterol levels, and higher alanine aminotransferase and D-dimer levels(all P<0.05).Logistic regression analysis indicated that eFI( OR=2.322, 95% CI: 1.840-2.929, P<0.001), malignant tumor( OR=1.833, 95% CI: 1.141-2.860, P<0.001), and albumin<35 g/L( OR=1.826, 95% CI: 1.200-2.777, P<0.001)were independent risk factors for in-hospital death in elderly patients aged 80 and over with gastrointestinal bleeding.With every 0.1 increase in eFI, the risk of in-hospital death rose by 1.322 times.The AUC of eFI for predicting in-hospital mortality was 0.751(95% CI: 0.713-0.789, P<0.001).An eFI of ≥0.33 demonstrated a sensitivity of 77.9% and a specificity of 60.3% in predicting in-hospital mortality in elderly patients aged 80 and over with GIB. Conclusions:The eFI serves as an important independent risk factor for in-hospital mortality among patients aged 80 and above who experience GIB.It can effectively assess the prognosis of elderly individuals facing GIB.

Background::Scleroderma is characterized by inflammation and fibrosis, predominantly occurring in the skin and extending to various parts of the body. The pathophysiology of scleroderma is multifaceted, with the current understanding including endothelial damage, inflammatory cell infiltration, and fibroblast activation in its progression. Nonetheless, the mechanism of cellular interactions and the precise spatial distribution of these cellular events within the fibrotic tissues remain elusive, highlighting a critical gap in our comprehensive understanding of scleroderma’s pathogenesis.Methods::In this study, we administered bleomycin intradermally to the dorsal skin of four individual murine models. Subsequently, skin tissues were harvested at predetermined intervals for comprehensive spatial transcriptomic analysis to determine the spatial dynamics influencing scleroderma pathogenesis. To validate the possible results from bioinformatic analysis, further in vitro and in vivo experiments were conducted. Results::Analysis of the spatial transcriptome revealed significant alterations in cell clusters during the progression of scleroderma. Gene Ontology analysis identified disruptions in lipid metabolism as the disease advanced. Pseudotime analysis provided evidence for a phenotypic transition from adipocytes to fibroblasts. In vitro studies demonstrated increased expression of Col1a1 and α-SMA as the disease progressed. These fibroblasts have been identified as key contributors to the increasing inflammation. Co-culturing TGF-β induced adipocytes with RAW264.7 cells resulted in overexpression of pro-inflammatory cytokines in the RAW264.7 cells. Both in vitro and in vivo experiments confirmed adipocyte loss and fibroblast formation, with transformed fibroblasts showing pronounced pro-inflammatory characteristics, highlighting their crucial role in the disease mechanism. Conclusions::Our study showed the spatial distribution and dynamic alterations of various cell types during scleroderma progression. Crucially, we identified the transformation of adipocytes into fibroblasts as a key factor promoting disease advancement. These emergent fibroblasts intensify inflammation, indicating that research on these cell clusters could reveal key scleroderma mechanisms and guide future therapies.

Objective:To investigate the changes of inflammation and immune function in children with chronic tonsillitis after tonsillotomy. Methods:Prospectively collected 60 children with obstructive sleep apnea （OSA） diagnosed as chronic tonsillitis with adenoids and tonsillar hypertrophy from January to June 2021. Two groups were divided, the experimental group （n=30） underwent bilateral partial tonsillectomy + adenoidectomy by hypothermia plasma ablation, and the control group （n=30） underwent adenoidectomy by using the same hypothermia plasma ablation method. The number of tonsillitis attacks before surgery and within one year after surgery was recorded, and the serum immunoglobulin IgM, IgG, IgA, complement C3 and complement C4 levels before operation, one month and three months after operation were measured. Results:The number of tonsillitis attacks in the experimental group and the control group at one year after surgery was lower than that before surgery（P<0.05）; The number of inflammatory attacks in the experimental group was （0.50±0.63） times/year, which was lower than that of （1.33±0.80） times/year in the control group. There was no significant difference in the five immunization results of the two groups at one month and three months after operation compared with before operation, and there was also no significant difference between the experimental and the control groups. Conclusion:Partial tonsillectomy can be applied to children with chronic tonsillitis, which can effectively reduce the number of tonsillitis attacks and has no effect on the immune function of children.
Child ; Humans ; Tonsillectomy/methods* ; Hypothermia ; Tonsillitis/surgery* ; Adenoidectomy ; Palatine Tonsil/surgery* ; Inflammation ; Chronic Disease ; Immunity

Scleroderma is a rare disease which requires multidisciplinary treatment. Drug-based therapy can partially alleviate or end the progression of the disease, but cannot reverse the lesions that have occurred. Scleroderma patients who seek care in plastic surgery has gradually increased in recent years. With the understanding of the regenerative role of fat and adipose stem cells, physicians have found that surgical treatment of scleroderma can improve morphology while reversing the state of the diseased tissue, acting as a local treatment or slowing progression. This paper briefly described the etiology and classification of scleroderma, analyzed the current status of scleroderma treatment and focused on the surgical treatment strategy of scleroderma, providing guidelines for the surgical management of scleroderma.

Scleroderma is a rare disease which requires multidisciplinary treatment. Drug-based therapy can partially alleviate or end the progression of the disease, but cannot reverse the lesions that have occurred. Scleroderma patients who seek care in plastic surgery has gradually increased in recent years. With the understanding of the regenerative role of fat and adipose stem cells, physicians have found that surgical treatment of scleroderma can improve morphology while reversing the state of the diseased tissue, acting as a local treatment or slowing progression. This paper briefly described the etiology and classification of scleroderma, analyzed the current status of scleroderma treatment and focused on the surgical treatment strategy of scleroderma, providing guidelines for the surgical management of scleroderma.

Objective:To analyze the consistency and correlation between the Chinese Version of Swanson Nolan and Pelham, Version Ⅳ Scale (SNAP-Ⅳ) and the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT) in the assessment of attention deficit hyperactivity disorder (ADHD), thus providing a reliable basis for the diagnosis of ADHD, and reducing the misdiagnosis rate and missed diagnosis rate.Methods:Clinical data of children to be diagnosed as ADHD in the Department of Children′s Rehabilitation, Yuying Children′s Hospital of the Second Affiliated Hospital of Wenzhou Medical University from October 2019 to July 2020 were collected.A total of 282 SNAP-Ⅳ and IVA-CPT profiles were collected, and the Kappa test and Pearson test were used to retrospectively analyzed for their consistency and correlation in the diagnosis of ADHD. Results:SNAP-Ⅳ and IVA-CPT were consistent in the diagnosis of ADHD (Kappa value=0.514, total coincidence rate=65.6%, P<0.000 1). Inattention subset scores of SNAP-Ⅳ were consistent with the assessment of ADHD by IVA-CPT (Kappa value=0.485, total coincidence rate=75.5%, P<0.000 1). Inattention subset scores of SNAP-Ⅳ were negatively correlated with the Full Scale Attention Quotient (FAQ) in IVA-CPT ( r=-0.71, P<0.000 1). Hyperactivity-impulsive subscale in the SNAP-Ⅳ and IVA-CPT were consistent in the assessment of hyperactivity-impulsive behavior (Kappa value=0.585, total coincidence rate=81.6%, P<0.000 1). Hyperactivity-impulse subset scores were negatively correlated with the Full Scale Response Control Quotient (FRCQ) in IVA-CPT ( r=-0.74, P<0.000 1). Conclusions:Both SNAP-Ⅳ and IVA-CPT have certain diagnostic potential of ADHD, showing good consistency and correlation.They can be both used to provide a more comprehensive diagnosis basis, thereby reducing the misdiagnosis rate and missed diagnosis rate of ADHD.

Objective:In the process of fat grafting, there is no good solution to achieve delicate filling while retaining the viability of fat particle. There was still no research on the composition and activity of delicate fat particle. In this study, two different methods for delicate fat process were established to explore the feasibility and clinical efficacy.Methods:From December 2015 to June 2016, 5 patients (22-31 years old, with average 26.2 years) with abdominal liposuction in Shanghai Ninth People's Hospital were inclueded. The fat particles were obtained by floating method and filtration method respectively, and compared with emulsified fat/nanofat and traditional fat grafts. The cell viability and composition of adipose tissue were compared in each group through cell viability test, flow analysis and tissue staining.Results:The fat particles obtained by floating and filtration methods, emulsified fat could pass through OT needle. Cell viability test revealed the presence of living cells in the fat obtained by both methods, but not in the emulsified fat. Flow analysis showed that the expression of CD90 in floating group was higher than that in control group ( P=0.048). Conclusions:The delicate fat particle can be obtained by floating or filtration method, which can preserves the tissue integrity and cell viability; meanwhile it can achieve fine needle injection and clinical application.

Objective:To explore the effectiveness of autologous fat grafting in the treatment of undesirable skin expansion.Methods:Patients' data were reviewed from 2011 to 2016, including the expanded regions with early signs of skin complications in face and neck. The effects of fat grafting group and control group were evaluated by follow-up records of expansion volume, skin thickness, skin texture and local capillary reaction.Results:Fat grafting could increase the thickness of expanded skin. It also improved the texture of expanded skin, with 0.83± 0.71 points before treatment and 1.30±0.66 points after treatment ( P=0.04). The local capillary reaction was also improved from 1.06±0.54 points before treatment and 1.45±0.51 points after treatment ( P=0.03). The expansion in the fat grafting group was 2.21±0.57 times before treatment and 2.94±0.83 times after treatment. In the control group, the expansion was 2.19 times when it showed early signs, and no obvious changes were observed during the follow-up period. Conclusions:Autologous fat grafting can effectively treat complications of skin expansion, prolong expansion process and promote tissue regeneration.

Objective:To investigate the impact of the destruction of dorsal motor nucleus of the vagus(DMV)on lower esophageal sphincter pressure in a rat model of acute esophagitis.Methods:A total of 40 male Sprague-Dawley(SD)rats were randomly divided into four groups: the control group, sham group, DMV destruction group, DMV destruction + vagal stimulation group.Two weeks after DMV destruction or sham operation, hydrochloric acid with pepsin was perfused into the esophagogastric junction of rats for 90 min, and lower esophageal sphincter pressure was measured before and after operation and 60 min after acid perfusion.Rats in the control group received assessment of lower esophageal sphincter pressure directly.Rats in the DMV destruction + vagus stimulation group were given electric current stimulation for 30 minutes before and after 15 min of esophageal acid perfusion.Rats were sacrificed after 60 min of the acid perfusion.The esophagus was prepared for hematoxylin and eosin(HE)staining, and the degree of inflammation and the expression of inflammatory cytokines were examined.Results:In the DMV destruction group, lower esophageal sphincter pressure decreased 2 weeks after DMV destruction compared with pre-destruction levels(25.9±8.8 cmH 2O vs.34.0±8.9 cmH 2O, P<0.05), and lower esophageal sphincter pressure decreased after 60 min of acid perfusion compared with pre-destruction levels(18.6±3.6 cmH 2O vs.25.9±8.8 cmH 2O, P<0.01). In the DMV destruction + vagus stimulation group, lower esophageal sphincter pressure increased after vagus nerve stimulation(22.3±2.9 cmH 2O vs.18.6±3.6 cmH 2O, P<0.05). There was no significant difference in lower esophageal sphincter pressure in the sham group before and after sham operation, while the pressure increased after acid perfusion(30.0± 9.5 cmH 2O vs.37.8±5.8 cmH 2O, P<0.05). The degree of inflammation in the lower esophagus was aggravated and the expression of tumor necrosis factor-α, interleukin(IL)-6, IL-1β and prostaglandin E2 in esophageal tissues increased in the DMV destruction group compared with the sham group( P<0.01). The inflammation degree and the expression of inflammatory factors in the lower esophagus improved after vagal nerve stimulation compared with pre-stimulation levels( P<0.01). Conclusions:DMV destruction decreases lower esophageal sphincter pressure and aggravates esophageal inflammation and injury in a rat model of acute esophagitis.Vagus nerve stimulation can strengthen the pressure of the lower esophageal sphincter and improve the inflammation of the lower esophageal segment.