Rosacea is a chronic facial inflammatory skin disease. It has been proved that heredity, immunity, neurovascular disorders, microorganisms, skin barrier damage and ultraviolet rays are closely related to the occurrence of rosacea. However, the exact pathogenesis of rosacea has not been fully elucidated. This review summarizes recent advances in the pathogenesis of rosacea in the past 5 years.

Objective:The study aimed to analyze the risk variables influencing the prognosis of patients with sepsis-associated delirium (SAD) in the Intensive Care Unit (ICU) and build a prediction nomogram.Methods:This was a retrospective cohort study that includes patients with SAD in the Medical Information Mart for Intensive CareⅢ database (MIMIC-Ⅲ) database as training cohort, and patients who were hospitalized in the First Hospital of Jiaxing from January 2021 to September 2022 as validation cohort. Inclusion criteria: (1) age≥18 years old; (2) being admitted to the ICU for the first time; (3) the length of ICU stay≥24 h; (4) consistent with the diagnosis of sepsis; (5) the diagnosis of delirium was identified by CAM-ICU questionnaire. The general information, vital signs, past medical history and laboratory examination results of the patients were collected, and the outcome was 28-day mortality. Multiple logistic regression was used to identify independent influencing factors and the nomogram was constructed. The validity of the prediction model was determined using multiple indicators, including calibration curve, the area under the receiver operating characteristic curve (AUC), decision curve analysis (DCA), and Hosmer-Lemeshow test.Results:A total of 250 patients were included in the training cohort and 154 patients were in the validation cohort. The multiple logistic regression demonstrated that age ( OR=1.057, 95% CI: 1.030-1.084, P<0.001), respiratory frequency ( OR=1.117, 95% CI: 1.037-1.202, P=0.003), lactic acid ( OR=1.137, 95% CI:1.011-1.279, P=0,032), hemoglobin ( OR=0.983, 95% CI: 0.970-0.997, P=0.020), SOFA score ( OR=1.184, 95% CI: 1.070-1.309, P=0.001) were independent risk factors associated with the 28-day mortality of patients with SAD. The AUC of the nomogram created by the five factors above was 0.773 (95% CI: 0.705-0.841), and the Hosmer-Lemeshow test showed that the model was a good fit ( P=0.875). The DCA curve indicates that the model has potential net benefit. The AUC was 0.864 (95% CI: 0.799-0.928) in the validation cohort, and the Hosmer-Lemeshow test showed that the model was a good fit ( P=0.488). The DCA curve indicates that the model of the validation cohort had potential net benefit. Conclusion:The prediction model based on age, respiratory frequency, lactate, hemoglobin, and SOFA scores shows valuable capability of predicting the prognosis of patients with SAD, which could help clinicians identify risk factors at first time and make earlier intervention.

Objective:To investigate the disability status of patients with inflammatory bowel disease (IBD) in China and to identify the influencing factors of the inflammatory bowel disease disability index (IBD-DI).Methods:From October 1 to December 31, 2021, a total of 1 170 IBD patients were recruited from 7 IBD centers and WeChat public platforms in China. All the patients were surveyed by the IBD-DI questionnaire, which included demographic information, disease activity, medication history, treatment and surgical history. Demographic information included gender, age, income status, etc. Multiple linear regression was used to analyze the influencing factors of IBD-DI.Results:Among the 1 170 IBD patients, 746 patients (63.76%) were male and 424 patients (36.24%) were female; there were 871 cases (74.44%) of Crohn′s disease(CD), 277 cases (23.68%) of ulcerative colitis (UC) and 22 cases (1.88%) of inflammatory bowel disease undassified (IBDU). The age was 36.00 years old (29.00 years old, 45.00 years old), and the IBD-DI score was 9.00 (5.00, 15.00). The results of multiple linear regression analysis revealed that the disease activity ( β=0.65, t=22.33, P<0.001), current treatment with enteral nutrition ( β=0.09, t=3.06, P<0.001), and history of perianal surgery ( β=0.06, t=2.12, P=0.034) were influencing factors of IBD-DI in the CD patients. Disease activity ( β=0.65, t=14.37, P<0.001), household per capita annual income ( β=-0.16, t=-3.59, P<0.001), current usage of immunosuppressants ( β=0.12, t=2.66, P=0.008), current treatment with enteral nutrition ( β=0.12, t=2.57, P=0.011), and the duration of each exercise ( β=-0.12, t=-2.67, P=0.008) were influencing factors of IBD-DI in UC patients. Conclusions:Disability is common in Chinese IBD patients, and their IBD-DI were different. Disease activity is the most important factor affecting IBD-DI. The IBD-DI is higher in IBD patients receiving enteral nutrition treatment, CD patients with a history of perianal surgery and UC patients with current usage of immunosuppressants. However, household per capita annual income and the duration of each exercise are negatively correlated with IBD-DI in UC patients.

Colorectal tumors often create an immunosuppressive microenvironment that prevents them from responding to immunotherapy.Cannabidiol(CBD)is a non-psychoactive natural active ingredient from the cannabis plant that has various pharmacological effects,including neuroprotective,antiemetic,anti-inflammatory,and antineoplastic activities.This study aimed to elucidate the specific anticancer mechanism of CBD by single-cell RNA sequencing(scRNA-seq)and single-cell ATAC sequencing(scATAC-seq)technologies.Here,we report that CBD inhibits colorectal cancer progression by modulating the suppressive tumor microenvironment(TME).Our single-cell transcriptome and ATAC sequencing results showed that CBD suppressed M2-like macrophages and promoted M1-like macrophages in tumors both in strength and quantity.Furthermore,CBD significantly enhanced the interaction between M1-like macrophages and tumor cells and restored the intrinsic anti-tumor properties of macrophages,thereby preventing tumor progression.Mechanistically,CBD altered the metabolic pattern of macro-phages and related anti-tumor signaling pathways.We found that CBD inhibited the alternative acti-vation of macrophages and shifted the metabolic process from oxidative phosphorylation and fatty acid oxidation to glycolysis by inhibiting the phosphatidylinositol 3-kinase-protein kinase B signaling pathway and related downstream target genes.Furthermore,CBD-mediated macrophage plasticity enhanced the response to anti-programmed cell death protein-1(PD-1)immunotherapy in xenografted mice.Taken together,we provide new insights into the anti-tumor effects of CBD.

Objective:To investigate the effects of matrine on proliferation, apoptosis and radiotherapy sensitivity of uveal melanoma cells.Methods:An animal experiment study. In vitro experiment: MuM2B cells of human choroidal melanoma were randomly divided into control group and matrine 0.25, 0.50, 1.00, 2.00 g/L groups. The cell morphology was observed by transmission electron microscope. Cell proliferation was detected by thiazole blue colorimetry. The mRNA and relative expression levels of CyclinD D (CyclinD), B lymphoblastoma-2 (Bcl-2) and Bcl2-associated X protein (Bax) were detected by real-time polymerase chain reaction and Western blot. In vivo experiment: BALB/C mice were injected with MuM2B cell suspension subcutaneously on the back of forelimb to prepare transplanted tumor model. After successful modeling, they were randomly divided into blank group and matrine treatment group with different concentrations. Mice in blank group were injected with phosphate buffer subcutaneously. Mice in different matrine treatment groups were injected with 15, 25, 50, 100 mg/kg matrine subcutaneously, respectively, for 7 consecutive days. The tumor was weighed and its volume was measured after the last administration. Single factor analysis of variance was used to compare different groups. The t test was used for pairwise comparison between groups. Results:In the control group, the cell structure was normal, the distribution was uniform, and no or rare nuclear pyknosis was seen. With the increase of matrine dosage, the nuclear pyretosis increased gradually and cell morphology changed obviously. Compared with the control group, the cell survival rate in 0.50, 1.00 and 2.00 g/L groups gradually decreased with matrine concentration increasing and treatment time prolongating, the relative expression levels of CyclinD and Bcl-2 mRNA and protein gradually decreased, and the relative expression levels of Bax mRNA and protein gradually increased. Under the same radiation dose X-ray irradiation, the cell survival rate of 0.50, 1.00 and 2.00 g/L groups gradually decreased, and the differences were statistically significant ( P<0.05). Compared with blank group, the tumor weight and volume of mice in different doses of matrine group were significantly decreased, and the differences were statistically significant ( P<0.05). Conclusion:Matrine can down-regulate the expression of CyclinD and Bcl-2, up-regulate the expression of Bax, promote the apoptosis of MuM2B human melanoma cells, inhibit cell proliferation, and enhance cell radiosensitivity.

Breast milk contains a variety of bioactive components, which play a vital role in disease prevention and treatment.Among them, circular RNA(circRNA), which is a closed ring structure formed by covalent bonds, has aroused interest because of its conservation and stability.Pediatric researchers should attach importance to studies on circRNA in breast milk, as they may bring new inspiration for breast milk functions.In this article, characteristics and functions of circRNA in breast milk will be investigated, and its research and prospects will be discussed.

Objective:To construct the continuous nursing need index system based on discharge readiness for patients with spinal cord injury so as to guide the clinical nursing practice.Methods:From January 2017 to July 2018, this study selected 115 spinal cord injury inpatients of Spine Surgery Department at a ClassⅢ Grade A hospital in Qingdao as subjects by convenience sampling. The Readiness for Hospital Discharge Scale (RHDS) was used to investigate those patients. According to the investigation results, this study primarily built the continuous nursing need index system for spinal cord injury patients. Delphi method was used to select 25 experts for two rounds of consultation so as to establish the final the continuous nursing need index system for spinal cord injury patients.Results:Among 115 spinal cord injury patients, the total score and item average score of RHDS were (60.39±22.12) points and (5.27±2.75) points respectively. Among two rounds of consultation, the authoritative coefficients of experts were 0.78 and 0.81 respectively, and the coordination coefficients were 0.343 and 0.423. In the second round of consultation, the variation coefficients ranged from 0.09 to 0.18. The final the continuous nursing need index system for spinal cord injury patients included 5 first-level indexes and 33 second-level indexes.Conclusions:The continuous nursing need index system for spinal cord injury patients has a high level of authoritative coefficients and is scientific practical which can provide a basis for discharge health instruction in spinal cord injury patients and promote the safe transition in hospital-community-family as well as comprehensive rehabilitation.

Objective To evaluate the effectiveness of mild hypothermia and the intra-aortic balloon pump (IABP) in postcardiac surgical patients with severe heart failure. Methods Twelve patients took combination therapy of IABP and mild hypothermia after cardiac surgery, which did not improve the low cardiac output with massive doses of catecholamine, were included in this study. The values of cardiac index (CI), mixed venous oxygen saturation (SvO2), urine volume and creati-nine (Cr) were measured before and after treatment. Results After combination therapy of IABP and mild hypothermia, the value of CI was improved obviously [L/(min·m2):2.4±0.5 vs 1.6±0.2], the value of SvO2 increased (0.65±0.07 vs 0.52±0.05 ), urine output increased obviously [mL/(kg·h):2.9±1.9 vs 1.2±0.9 ] and the value of Cr decreased obviously (mmol/L:95±10 vs 282±25 ). Conclusion The combination therapy of mild hypothermia and IABP is an effective and simple procedure for the postcardiac surgical patients with severe heart failure.

Objective To explore the relationship between folic acid levels of cord blood and birth weight, hyaline membrane disease in newborns. Methods Eighty-seven newborns were divided into premature infant group(42 cases) and term infant group(45 cases),intrauterine growth retardation group( 28cases) and control group (59 cases), hyaline membrane disease of premature infant group ( 13 cases) and premature infant control group(15 cases) according to the gestational age, birth weight, clinical manifestation and chest X-ray, respectively. Folic acid levels of cord blood were measured. Results The folic acid level of cord blood in premature infant group was lower than that in term infant group [(10.87 ±4.31) nmol/L vs.( 13.56 ± 5.07) nmol/L,P ＜0.05 ]. The folic acid level of cord blood in intrauterine growth retardation group was lower than that in control group [(11.01±4.29)nmol/L vs.( 14.87 ± 5.14)nmol/L,P＜0.05]. The folic acid level of cord blood in hyaline membrane disease of premature infant group was lower than that in premature infant control group [(9.15 ±4.02) nmol/L vs.(12.91±4.51) nmol/L,P＜0.05]. The positively correlation was found between the folic acid level of cord blood and birth weight in newborns (r =0.1825).Conclusion The folic acid level of cord blood is correlated with the occurrence of premature infants,intrauterine growth retardation and hyaline membrane disease in newborns.

Objective To investigate the diagnostic value of endoscopic ultrasonography (EUS) for duodenal cysts.Methods Clinical manifestations, results of conventional gastroscopy and EUS, as well as follow-up, of patients with duodenal cysts were retrospectively analyzed.Results A total of 105 patients with duodenal cysts presented with no lesion-related symptoms, but displayed characteristic imaging changes under EUS, which could reveal the origin, size and nature of duodenal cysts, and differentiate it from other submucosal lesions.A maximum follow-up of 5 years showed no changes in duodenal cysts.Conclusion Duodenal cyst is a benign disease, and EUS plays a very important role in diagnosis of the disease.