Objective:To analyze factors influencing repigmentation patterns in patients with vitiligo treated with phototherapy.Methods:Clinical data were retrospectively collected from patients with vitiligo treated with 308-nm excimer laser or 308-nm excimer lamp at the Department of Dermatology, Xijing Hospital, Air Force Medical University from June 2013 to May 2022. The treatment frequency was thrice weekly, and skin lesions were evaluated via photographs once every 5 sessions of phototherapy. Chi-square test or Fisher′s exact test was used to analyze associations between clinical characteristics and vitiligo repigmentation patterns.Results:A total of 223 patients with vitiligo were included in this study, including 109 males (48.9%) and 114 females (51.1%), and their ages ( M [ Q1, Q3]) were 20 (10, 28) years. Among the 223 patients, 170 (76.2%) were treated with 308-nm excimer laser, and 53 (23.8%) with 308-nm excimer lamp. The repigmentation patterns included the perifollicular pattern in 63 cases (28.3%), marginal pattern in 97 (43.5%), diffuse pattern in 36 (16.1%), and mixed pattern in 27 (12.1%). Analysis of the associations between clinical characteristics and vitiligo repigmentation patterns showed no significant differences in the repigmentation patterns among vitiligo patients of different genders or different Fitzpatrick skin types (both P > 0.05) ; however, the diffuse repigmentation pattern more frequently occurred in the patients aged ≤ 12 years compared with those aged > 12 years ( χ2 = 7.71, P = 0.005), in the patients with vitiligo in the progressive stage compared with those in the stable stage ( χ2 = 4.59, P = 0.030), and in lesions without white hair compared with those with white hair ( χ2 = 6.75, P = 0.009) ; the mixed repigmentation pattern more frequently occurred in the patients with segmental vitiligo compared with those with non-segmental vitiligo ( χ2 = 11.76, P = 0.001) ; the marginal repigmentation pattern more frequently occurred in lesions on the face and neck ( χ2 = 15.82, P<0.001) and extremities ( χ2 = 11.85, P = 0.001) compared with lesions on the trunk; the perifollicular repigmentation pattern more frequently occurred in the patients with stable vitiligo compared with those with progressive vitiligo ( χ2 = 4.70, P = 0.030), and in skin lesions on the trunk compared with those on face and neck ( χ2 = 13.73, P < 0.001) and extremities ( χ2 = 5.49, P = 0.035) ; after 308-nm excimer laser treatment, the proportions of patients with the marginal repigmentation pattern ( χ2 = 12.30, P < 0.001) and those with the diffuse repigmentation pattern ( χ2 = 5.64, P = 0.018) were significantly higher than those after 308-nm excimer lamp treatment, while the proportions of patients with the perifollicular repigmentation pattern ( χ2 = 7.87, P = 0.005) and those with the mixed repigmentation pattern ( χ2 = 17.13, P < 0.001) were significantly higher after 308-nm excimer lamp treatment than those after 308-nm excimer laser treatment. Conclusion:Patients′ age, clinical types and stages of vitiligo, presence or absence of concomitant white hair, skin lesion sites, and phototherapy modalities were factors influencing the repigmentation patterns of vitiligo.

Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment.However,irrigant selection or irrigation procedures are far from clear.The vapor lock effect in the apical region has yet to be solved,impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes.Additionally,ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified.Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes.Indeed,clinicians have been aware of these concerns for years.Based on the current evidence of studies,this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions.The evolution of different kinetic irrigation methods,their effects,limitations,the paradigm shift,current indications,and effective operational procedures regarding intracanal medication are also discussed.This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication,thus facilitating a better understanding of infection control,standardizing clinical practice,and ultimately improving the success of endodontic therapy.

Objective: The Chinese version of the Multidimensional Bullying Victimization Scale (MBVS) was revised, and its reliability, validity and cross gender equivalence were tested in Chinese adolescents. Methods: A total of 2 279 adolescents were investigated by using convenient cluster sampling method from April to May 2021, 1 500 adolescents were followed to complete the retest of Chinese version of MBVS after 4-6 weeks. Olweus Bully/Victim Questionnaire Victim (OBVQ-V) and Center for Epidemiologic Studies Depression Scale (CES-D) were used as the criterion related validity instrument. Results: Exploratory factor analysis extracted 4 factors with a cumulative variance interpretation rate of 58.34%. Results of CFA supports the hypothesis of 4 factor model( χ 2/df=8.64, CFI=0.93, TLI=0.92, RMSEA =0.06), and the 4 dimensions included direct bullying, indirect bullying, evaluative bullying and relationship bullying. The correlation coefficient between MBVS and OBVQ-V was 0.59, between MBVS and CES-D was 0.32. The internal consistency reliability was 0.92 and the test retest reliability was 0.72. The cross gender equivalence hypothesis of the scale was valid. Conclusion The Chinese version of MBVS has good reliability and validity, as well as gender equivalence and could be recommended for adolescent bullying screening.

Objective:To detect the serum level of chitinase-3-like protein 1 (YKL-40) in patients with pemphigus vulgaris, and to analyze its correlation with the severity of pemphigus vulgaris.Methods:From January 2017 to May 2018, serum samples were collected from 38 patients with pemphigus vulgaris in Department of Dermatology, the Affiliated Hospital of Southwest Medical University, and those collected from 14 age-, gender- and body mass index-matched healthy volunteers served as controls. Serum levels of YKL-40 and Th1/Th2/Th17-related cytokines were detected by using Luminex ? 200 TM system. Mann-Whitney U test was used to compare serum levels of cytokines between the patient group and control group; binary logistic regression was used to investigate factors independently related to the severity of pemphigus vulgaris; a receiver operating characteristic (ROC) curve was drawn, and the area under the curve, sensitivity and specificity were calculated to evaluate the ability of YKL-40 to predict the severity of pemphigus vulgaris. Results:Compared with the control group, the patient group showed significantly increased serum levels of YKL-40 (expressed as median[ Q1, Q3]: 15.22 [14.19, 15.93] vs. 13.64 [13.21, 14.63]μg/L, z=-3.88, P < 0.05) , interleukin (IL) -6 (2.05 [1.49, 4.21] vs. 1.57[1.38, 1.75]ng/L, z=-2.44, P < 0.05) , IL-7 (7.45[5.63, 11.63] vs. 3.77[2.21, 5.97]ng/L, z=-3.26, P < 0.05], IL-8 (6.59[3.60, 14.73] vs. 4.36[2.96, 6.53]ng/L, z=-1.96, P < 0.05) , IL-2R-α (509.08 [386.36, 757.67] vs. 336.44[309.86, 458.71]ng/L, z=-2.35, P < 0.05) , and C5a (100.35 [78.31, 140.84] vs. 72.08 [37.23, 82.08] ng/L, z = -3.04, P < 0.05) . The concentration of serum YKL-40 gradually decreased along with the reduction of lesion areas ( r = 0.63, P < 0.001) , and YKL-40 was independently correlated with the severity of pemphigus vulgaris ( P = 0.025, OR = 46.54, 95% CI: 1.61, 1 347.19) . The area under the curve of YKL-40 was 0.783 (95% CI: 0.613, 0.953) for distinguishing between patients with severe to extremely severe pemphigus vulgaris and those with mild to moderate pemphigus vulgaris. Conclusion:The serum level of YKL-40 is strongly correlated with the severity of pemphigus vulgaris, and has a potential value in predicting the severity of this disease.

Objective: To explore the clinical phenotype, immunological features, pathogenesis and gene variation of a case with A20 haploinsufficiency (HA20). Methods: A patient diagnosed with tumor necrosis factor α-induced protein 3 (TNFAIP3) mutated HA20 was admitted into Shenzhen Children′s Hospital in May,2019.The clinical data was analyzed. Flow cytometry was used to detect the patient′s peripheral blood lymphocyte subsets, and also, the percentage of follicular helper T cell (TFH) cells in the patient and thirteen healthy controls. After the construction of empty vector, wild-type and mutant plasmid vectors, a wild-type or mutant overexpression system of the TNFAIP3 gene was established in 293T cells and Hela cells. Then, the expression level of A20 in 293T cells and the expression of inhibitor K binding α (IKBα) in green fluorescent protein (GFP)+Hela cells before and after tumor necrosis factor α (TNF-α) stimulation were measured, to verify the pathogenicity of this variation. Results: A 5 years and 11 months old boy, presented with recurrent oral ulcer, abdominal pain, joint swelling and arthralgia. Oral ulcer, chronic skin rashes, knee joint swelling were observed. The levels of inflammatory markers were increased. Colonoscopy showed congestion of mucosa and multiple ulcers in terminal ileum and ileocecus. The absolute number of naive B cells was 124×10⁶ cells/L (reference range 147×10⁶-431×10⁶ cells/L), accounting for 0.430 of the total B cells (reference range 0.484-0.758). Compared to healthy controls (0.016-0.071), the percentage of TFH cells in CD4⁺T cells was much lower (0.008).A heterozygous mutation of TNFAIP3 gene (c.909_913 del, p.L303fs) was identified by genetic analysis. In vitro study showed that truncated A20 protein was expressed in TNFAIP3 mutant overexpressed 293T cells, which verified the pathogenicity of this variation. Besides, after TNF-α stimulation, the degradation rate of IkBα protein in mutant overexpressed Hela cells (35%) was between the other two groups (15% in the wild-type group and 57% in the non-loaded group). Conclusions This case with HA20 due to a de novo TNFAIP3 gene mutation presents with early onset Behcet-like autoinflammatory syndrome. This variation leads to expression of truncated A20 protein, enhanced degradation of IkBα, and further activation of nuclear factor κB signaling pathway.

Objective The aim of this study was to investigate the expression of miR-320a and cephalospermoma syndrome protein(CYLD)in patients with gastric cancer and its relationship with clinicopathological characteristics and prognosis. Methods A total of 460 patients with gastric cancer underwent tumor resection in our hospital from March 2013 to November 2014 were enrolled. Tumor tissues,non-tumor gastric mucosa tissues and normal tissues were collected. The expression of miR-320a and CYLD at levels of mRNA and protein were detected by Real-Time PCR,immunohistochemistry and Western blotting. The relationship between the expression of miR-320a and CYLD,and the clinicopathological features&prognosis of gastric cancer patients was analyzed. Results The relative expression of miR-320a and CYLD at the mRNA level in tumor tissues was(0. 37 ± 0. 09),(0. 91 ± 0. 23),and the relative expression in non-tumor tissues was(0. 86 ± 0. 15),(1. 56 ± 0. 42),respectively. The relative expression of miR-320a and CYLD mRNA in tumor tissues was significantly different from non-tumor tissues(t=60. 078,29. 113,P=0. 000),the positive ex-pression rate of CYLD protein in tumor tissues was 43. 48% when compared to 73. 91% in non-tumor tissues. The difference was statistically significant(χ2=86. 624,P=0. 003). The expression level of miR-320a was significantly associated with the diameter of the tumor and lymph node metastasis(χ2=25. 859 and 13. 742,P<0. 05). The expression of CYLD was also significantly associated with the TNM stage and degree of tumor differentiation(χ2=37. 725 and 59. 323,P<0. 05). The median survival of patients with low miR-320a expression(20. 36 months,95% CI:19. 252 ~21. 462 months) and those with high miR -320a expression(28. 29 months,95% CI:27.158~29.412 months)were statistically significant(χ2=87.967,P<0.001).The median survival of patients with CYLD negative expression(17. 70 months,95% CI:16. 599~18. 796 months)and those with CYLD positive expression(26. 74 months,95% CI:25. 474~27. 997 months)were statistically significant(χ2=109. 887,P<0. 001);The median survival of patients with the co-expressed miR-320a and CYLD was(29. 01 months,95% CI:26. 831~28. 946 months)and those with the non-co-expressed miR-320a and CYLD(17. 13 months,95% CI:17. 214~19. 568 months)were statistically significant(χ2=117. 680,P<0. 001). There showed a positive correlation between the expression of miR-320a and CYLD at mRNA level(r=0. 607,P<0. 001);miR-320a at the low expression,CYLD at the negative expression,TNM staging,lymph node metastasis and degree of tumor differen-tiation were independent risk factors for the prognosis of gastric cancer(HR=1. 939,2. 180,1. 561,1. 719,1. 608,95% CI:1. 141~3.295,1.252~3.796,1.014~2.403,1.115~2.650,1.097~2.357,respectively)(P<0.05).Conclusion The expressions of miR-320a and CYLD in tumor tissues of patients with gastric cancer is significantly decreased,which is related to the occurrence and development of diseases,and poor prognosis. It is a potential target for diagnosis and treatment of gastric cancer.

Objective To optimize in vitro amplification of human γδ T cells with cytokines for tumor adoptive immunotherapy.Methods On the basis of the immobilized anti-TCR γδ antibody plus IL-2 system, other γ chain receptor family cytokines, including IL-7, IL-15 and IL-21, were tested to amplify human peripheral blood γδ T cells either alone or in diversity combination.The percentage of γδ T cells was measured by flow cytometry, and the proliferation efficiency of γδ T cells was calculated.The expression of proliferation-or cytotoxicity-related molecules on γδ T cells was examined by flow cytometry in order to explore the relevant mechanisms.The cytotoxicity of γδ T cells to Daudi cells was detected by lactate dehydrogenase.Results IL-15 alone but not IL-7 or IL-21 increases the γδ T cell purity, amplification efficiency and cytotoxicity to reach comparable levels to those of IL-2.IL-2 plus IL-15 up-regulates the expression of CD69 on γδ T cells and significantly increases their amplificationefficiency (P<0.05).IL-2 plus IL-21 enhanced the cytotoxicity of γδ T cells against Daudi cells by increasing the expression of granzyme A (P<0.001).The combination of IL-2, IL-15 and IL-21 significantly improves cytotoxicity of γδ T cells but reduces their amplification efficiency.In addition, when IL-21 was applied for a short time, it also enhanced the cytotoxicity of γδ T cells (P<0.05).Conclusions The combination of IL-2 and IL-15 as well as a short time addition of IL-21 is the best cytokine recipe to amplify human peripheral blood γδ T cells in vitro with immobilized anti-TCR γδ antibody, which can increase both the proliferation efficiency and the cytotoxicity to tumor cells of γδ T cells.

Medical nutrition therapy (MNT)is the basic and long-term treatment of diabetes patients. At present,the dietary structure of type 2 diabetes mellitus(T2DM)patients in China has yet to be further improved. This article focused on the effect,dietary structure,food selection and guarantee of compliance of MNT in T2DM.We recommended that the dietary pattern should be designed based on the traditional dietary habits around the country,combined with people living and working reality. The rational utilization of network platform can improve the efficiency and compliance of nutrition education.

Objective To investigate the natural changes of high-risk HPV (HR-HPV) in women with negative for intraepithelial lesion or malignancy (NILM) for regulating HR-HPV screening.Methods Four hundred and thirty-three newly-diagnosed women were enrolled from January 1st,2015 to December 31,2015 in Beijing Obstetrics and Gynecology Hospital.The ages of these patients were between 22 and 74 years,the average age was (45±21) years old.Two hundred and sixty-three cases were less than 50 years old,170 cases were more and equal to 50 years old.One hundred and fifty-six cases were HR-HPV positive,277 cases were HR-HPV negative.Follow up tests were conducted for all 433 patients,who were screened by ThinPrep cytologic test (TCT) combined with HR-HPV and were diagnosed with NILM,for a period of 1 year (at the 3,6,9 and 12 months intervals respectively),if the TCT results are abnormal and the HR-HPV test results are positive,will follow up colposcopy directed cervical biopsy.Results (1) HR-HPV natural changes:of 156 NILM cases with HR-HPV infection,42 cases (26.9％,42/156) turned negative within 3 months,88 cases (56.4％,88/156) turned negative within 6 months,99 cases (63.5％,99/156) turned negative within 9 months,and 100 cases (64.1％,100/156) turned negative within 12 months.The negative conversion ratio at 3,6,9 and 12 months for women at childbearing age (＜50 years) were significantly higher than those at non-childbearing age (≥50 years old;all P＜0.05).Of 277 NILM cases without HR-HPV infection,35 cases (12.6％,35/277) had new HR-HPV positive infections within 3 months,70 cases (25.3％,70/277) had new infections within 6 months,80 cases (28.9％,80/277) had new infections within 9 months,and 83 cases (30.0％,83/277) had new infections within 12 months.The new infections rate at 3,6,9 and 12 months for women at childbearing age (＜50 years old) were slightly higher than those at non-childbearing age (≥50 years old;all P＞0.05).(2) The progress of cervical leision:of 156 NILM cases with HR-HPV positive,no case progressed during 12 months follow-up.Of 277 NILM cases with HR-HPV negative,4 cases progressed to cervical intraepithelial neoplaisa (CIN) with HR-HPV infection and TCT abnormal during 12 months follow-up,including 2 cases pathology diagnosed with CIN Ⅰ,1 case with CIN Ⅱ,and 1 case with CIN Ⅲ.The progression rate was 1.4％ (4/277),which accounts for 4.8％ (4/83) of new HR-HPV infections cases in women.Conclusions The results of cytology combined with HR-HPV screenings suggest every 6 months for simple HR-HPV positive women,colposcopy directed cervical biopsy is recommended to assess cervical lesions if necessary.Cytology combined with HR-HPV screenings suggest every 12 months for simple HR-HPV negative women to early detection of cervical leision.

Objective To investigate the prevalence of hyperuricemia in health check-up population of Beijing suburb.Methods Total 1 336 rural residents in Nankou Township of Beijing received health check-up from July to Aug 2014,including 686 subjects aged 20-59 years (young/middle-aged group) and 650 subjects aged 60-96 years (elderly group).The blood pressure and body mass index (BMI) were measured;serum uric acid (SUA),fasting blood glucose (FBG) and blood lipids (TG,TC,HDL-C,LDL-C) were determined.The SUA levels ＞ 420 μmol/L for male and ＞ 360 μmol/L for female were defined as hyperuricemia.Results The four quartiles of SUA levels were 27.00-254.59 μmol/L (Q1),254.60-302.35 μmol/L (Q2),302.36-359.78 μmol/L(Q3) and 359.79-702.0 μmol/L (Q4).The prevalence of hyperuricemia was significantly higher in young/middle-aged group than that in elderly group [20.41％ (140/686) vs.13.85％ (90/650),x2 =10.08,P =0.001 5],the systolic blood pressure [SBP,(126.8±15.7) vs.(116.7±12.0)mmHg(1 mmHg=0.133 kPa),t=2.76,P=0.008],FBG [(7.40±4.10) vs.(6.11 ±2.03)mmol/L,t=2.12,P=0.036],TC [(5.52±1.10) vs.(5.23±1.00)mmol/L,t =2.04,P =0.045],LDL-C [(3.5 ±0.7) vs.(2.4 ±0.9)mmol/L,t =2.21,P =0.029]in young/middle-aged group were significantly higher than those in elderly group.BMI,FBG were significantly higher in Q4 than those in other quartiles [BMI:(26.44 ± 3.88) vs.(24.19 ± 3.37),(25.49±3.42) and (25.61 ±3.49)kg/m2,t =2.78,P=0.008;FBG:(8.19 ±1.52) vs.(6.34±1.34),(6.09 ± 1.51) and (6.40 ± 1.98) mmol/L,t =2.80,P =0.007].The triglyceride (TG) levels in group Q3 and Q4 [(1.85 ± 0.90) and (1.92 ± 0.44) mmol/L] were higher than those in Q1 and Q2 [(1.37 ±0.76) and (1.70 ±0.84) mmol/L,t =2.1,P =0.035].Only 9.57％ subjects (22/230)with hyperuricemia was not combined with metabolic disorder;subjects combined with one and two metabolic disorders accounted for 20.87％ (48/230) and 69.57％ (160/230),respectively.Conclusion Screening for hyperuricemia is important for comprehensiye treatment and management of hyperuricemia in rural residents,especially in the young and middle-aged population.