Infantile hemangioma (HEM) is the most common benign vascular tumor in infancy and is characterized by a unique progression pattern involving rapid proliferation followed by spontaneous involution. Increasing evidence suggests that the tumor microenvironment plays a critical role in regulating endothelial cell behavior during HEM development. In this study, we investigated how fibroblast (FB) phenotypic remodeling influences hemangioma endothelial cell (HemEC) function. Through single-cell RNA sequencing analysis, we identified extensive communication between FBs and ECs within HEM tissues. Functional experiments revealed that adipogenically differentiated FBs markedly suppressed HemEC proliferation, migration, invasion, and tube formation while promoting apoptosis. Transcriptomic analysis further demonstrated that this inhibitory effect was mediated by activation of the Hippo-YAP/TAZ signaling pathway in ECs. Mechanistically, adipogenic differentiation significantly upregulated PPARG expression in FBs, which in turn triggered Hippo pathway activation in ECs, leading to YAP/TAZ phosphorylation and nuclear exclusion. Importantly, PPARG silencing in FBs or pharmacological inhibition of the Hippo pathway reversed these effects. Collectively, our findings reveal a previously unrecognized microenvironmental regulatory mechanism in which PPARγ-driven fibroblast adipogenesis suppresses HEM progression through activation of the Hippo-YAP/TAZ pathway in endothelial cells. This study provides new insights into stromal-endothelial communication in HEM and suggests that the PPARγ-Hippo signaling axis may represent a potential therapeutic target. Proposed molecular mechanism by which PPARγ-mediated FB adipogenic differentiation regulates Hippo-YAP/TAZ signaling activity in HemECs. Note: Created in Biorender.

Aims: In this study, we aimed to decipher the impact of enhancer of zeste homolog 2 (EZH2) in psoriasis as well as the underlying mechanism. Methods: A mouse model of psoriasis was developed by means of imiquimod induction, with the expression of EZH2, microRNA-125a-5p (miR-125a-5p), and SFMBT1 determined. The role of EZH2, miR-125a-5p, and SFMBT1 in malignant phenotypes of HaCaT cells and the development of psoriasis in vivo was subsequently investigated through gain- and loss-of-function experiments. Chromatin immunoprecipitation assay and dual-luciferase reporter assay were conducted to explore the relationship between EZH2 or SFMBT1 and miR-125a-5p. Finally, the effects of EZH2 and miR-125a-5p on the transforming growth factor β (TGFβ)/SMAD pathway were analyzed. Results: Overexpressed SFMBT1 and EZH2 was detected while miR-125a-5p were downregulated in psoriasis tissues and human keratinocyte (HaCaT) cells. EZH2 increased the levels of IL-17A-induced cytokines and promoted the malignant phenotypes of HaCaT cells. Functionally, EZH2 reduced miR-125a-5p expression while miR-125a-5p targeted SFMBT1 to activate the TGFβ/SMAD pathway in vitro . Knockdown of EZH2 or up-regulation of miR-125a-5p inhibited cell proliferation and the levels of IL-17A-induced cytokines, but increased the expression of TGFβ1 and the extent of smad2 and smad3 phosphorylation in HaCaT cells. Notably, EZH2 contributed to the development of psoriasis in vivo by inhibiting the TGFβ/SMAD pathway via impairment of miR-125a-5p-mediated SFMBT1 inhibition. Conclusion: Taken together, the results of the current study highlight the ability of EZH2 to potentially inactivate the TGFβ/SMAD pathway via upregulation of miR-125a-5p-dependent SFMBT1during the progression of psoriatic lesions.

Chronic idiopathic urticaria (CIU) is an unfavorable skin condition which could be maintained for six weeks or longer time. Gremlin1 (GREM1) was recently applied in treatments of many diseases. However, the possible regulatory mechanism of GREM1 in CIU remained unclear. This study aimed to explore the regulatory effects of GREM1 on the inflammatory response and vascular permeability mediated by mast cells of CIU via TGF-β signaling pathway. Initially, microarray analysis was used to identify CIU-related differentially expressed genes and the potential mechanism of this gene. A mouse model of CIU was established. To explore the functional role of GREM1 in CIU, the modeled mice were then injected with GREM1-siRNA, SRI-011381 (the activator of TGF-β signaling pathway), or both, followed by serum test, and immunoglobulin detection. The levels of inflammatory factors and tryptase, β-hexosaminase, histamine in the serum were detected. Besides, vascular endothelial cell permeability and the target relation between GREM1 and TGF-β were also examined. Mice injected with SRI-011381 exhibited higher levels of tryptase, β-hexosaminase, histamine, inflammation-related factors and increased vascular endothelial cell permeability, while GREM1-silenced mice yet expressed opposite tendency. Silencing of GREM1 was demonstrated to inhibit the TGF-β signaling pathway. Taken together, our results demonstrated that down-regulation of GREM1 could potentially impede inflammatory response and vascular permeability by suppressing TGF-β signaling pathway. GREM1 may promote the development of prognosis management and therapeutic treatment in CIU.

目前,我国已步入老龄社会[1],随着人口老龄化速度的加剧,老龄化所带来的公共健康问题也成为政府及研究学者所关注的热门问题。随着年龄的增长,老年人许多器官和系统逐渐退化[2],研究显示[3],从40岁开始肌力以每10年5%的速度退化,65岁以后下肢肌力每年下降1%～2%。老年人下肢肌肉力量与活动能力和姿势稳定性密切相关,下肢肌肉力量对维持身体姿势的稳定具有很重要的作用,肌肉力量薄弱导致人体姿势不稳,增加老年人发生跌倒的危险系数[2,4]。

目的 分析选择性心理干预对老年女性乳腺癌术后康复效果的影响.方法 选择100例乳腺癌患者,采用随机分配方法划分研究对象为对照组和研究组,对照组给予常规健康教育护理,观察组在对照组基础上给予选择性心理干预,治疗时间为4个月,观察两组术后4个月内并发症发生率、免疫功能指标、焦虑抑郁指标及生存质量指标.结果 观察组发生术后并发症的人数远远小于对照组(P<0.05),观察组术后4个月的CD3+、CD4+值明显高于对照组(P<0.05),观察组患者汉密尔顿焦虑自评量表(HAMA)及汉密尔顿抑郁自评量表(HAMD)得分分别约为对照组的1/3和1/2,观察组躯体化、强迫、人际关系敏感、焦虑、抑郁评分均显著小于对照组各项评分(P<0.05).结论 选择性心理干预可以减少老年女性乳腺癌患者并发症发生率,提升免疫力,改善焦虑、抑郁情绪,提高生存质量,对老年女性乳腺癌术后康复效果有着积极影响.

Congenital muscular torticollis (CMT) is typically characterized by lateral flexion of the head to one side and cervical rotation to the opposite side due to unilateral shortening of the sternocleidomastoid muscle. Infants with CMT under the age of 1 year old are frequently treated with physical therapy, such as manual stretching and mass massage, and are evaluated by visual or angular measurement. However, there are no consensus on the techniques to perform the physical therapy examination and intervention. The International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY) is an international tool for recording and describing the functions, disability, and health status of children and adolescents, emphasizing that the condition of the disease or health is determined by the combination of body structure and function, activity, participation, and environmental factors, and the treatment of this disease requires overall analysis and integrated intervention. This article applies the ICF-CY framework to review the physical therapy examination and intervention of CMT. Key words: Congenital muscular torticollis; International Classification of Functioning, Disability and Health-Children and Youth Version; Physical therapy examination; Therapy

The aim of this study is to evaluate serum 25-hydroxyvitamin D[25(OH)D] levels in children with tic disorders and to explore the relationship between serum 25(OH)D level and tic severity. Children (n = 179, 31 females, 148 males, mean age at diagnosis: 8.0 ± 2.7 years old, age ranged from 3 to 14.5 years old) who were diagnosed with a tic disorder were enrolled as case group, 189 healthy children were recruited as control group. Serum level of 25(OH)D of each child was measured by high performance liquid chromatography and tandem mass spectrometry (HPLC-MS/MS). Yale Global Tic Severity Scale (YGTSS) was used to assess tic severity. Mean serum level of 25(OH)D in the case group was significantly lower than that of the control group. The serum 25(OH)D level was significantly associated with tic severity after adjusting for age and body mass index (BMI). This study identified a high prevalence of vitamin D insufficiency or deficiency in children with tic disorders, and there was a negative correlation between the serum 25(OH)D level and tic severity. In the future, large sample size studies are urgently needed to further clarify this correlation.

Tic disorders (TD) are a group of neurodevelopmental disorders that are characterized by motor and/or vocal tics in children and adolescents. The etiology and pathogenesis of TD remain unclear, and it is believed to be caused by a combination of genetic, biological, psychological, and environmental factors. The major treatment for TD includes psychoeducation, behavioral intervention, and drug treatment. To further explore the management of TD, this article reviews the research advances in psychoeducation and behavioral intervention for patients with TD.

Objective The amyloid β-protein precursor contains a domain highly homologous to Kunitz-type serine protease inhibitors. We have successfully established and characterized the recombinant human rhKD/APP in vitro. The aim of this study is to investigate the potential neuroprotective role of rhKD/APP on cerebral ischemia/reperfusion injury in rats. Methods Rats pretreated with rhKD/APP (4, 8, 16 mg/kg) were subjected to prepare models of cerebral ischemia/reperfusion (I/R) injury and those rats treated with Nimodipine were used as positive control. Comparison of the scores of neurological deficits, TTC-stained infarct volume and cerebral water content between the groups was performed. The activities of SOD, Na+-K+-ATPase and the content of MDA in the cortex tissues were measured and the activities of serum myeloperoxidase ( MPO) enzyme were also compared. The expressions of adhesion molecules ( ICAM-1 and E-selectin) were compared by immunohistochemistry. End-labeling of nuclear DNA fragmentation (TUNEL) and qualification of caspase-3, Bcl-2 and Bax were also employed to evaluate the local apoptosis in cortex tissues. Results By pretreatment with the rhKD/APP at three doses, cerebral infarct volume, water content and neurological deficits were all reduced. The activities of SOD, and Na+-K+-ATPase were increased, the contents of MDA were decreased in the cortex tissues, and the serum MPO activity was reduced. The expressions of adhesion molecules were downregulated and the apoptotic signaling of neurons were inhibited. All the changes induced by rhKD/APP treatment in the ischemia/reperfusion injury models showed statistical significance compared with the control rats. However, no significant difference was shown between the rhKD/APP group and Nimodipine group excepted for the reduced MPO in sera. Conclusions The result of this study suggest that rhKD/APP has neuroprotective effect on the cerebral ischemia/reperfusion injury through inhibiting multiple signaling pathways and is promising to be a potential neuroprotective drug.

患者男,55岁,因全身多发丘疹、脓疱、溃疡1月余,加重10 d就诊.患者自述1个多月前于阴阜部出现一个米粒大红色丘疹伴明显瘙痒,当地医院皮肤科诊断为丘疹性荨麻疹,给予对症治疗后皮损逐渐消退,3d后全身散发米粒至黄豆大小红色丘疹,迅速发展为脓疱、结节,数天内中央发生破溃,形成溃疡,出现脓性分泌物,患者自觉轻度头痛及全身肌肉酸痛,病程中伴发热,最高可达38.7℃,为求进一步诊治,于我院住院治疗.自述半年前有过非婚性接触史,否认其他慢性病史及手术外伤史.体检:一般情况较好,各系统检查无明显异常,浅表淋巴结未触及肿大.皮肤科检查:面部、头皮、躯干、四肢及阴阜部可见散在的多发黄豆至鹌鹑蛋大小红色丘疹结节伴脓疱、溃疡,溃疡呈圆形或类圆形,大小不等,伴脓性分泌物,边缘隆起,呈穿凿样,周围伴红晕,部分溃疡表面结黑色痂,呈蛎壳状(图1A);口腔黏膜未受累.患者左小腿伸侧的溃疡性皮损内可见数条1 cm长的白色蛆虫(图1B),但全身其余皮损内未见蛆虫.实验室检查:白细胞13.0 × 109/L,中性粒细胞0.79,淋巴细胞0.09,单核细胞0.12,中性粒细胞计数10.23 × 109/L,单核细胞计数1.6 × 109/L;肝肾功能等未见明显异常,梅毒螺旋体明胶凝集试验(TPPA) (+),快速血浆反应素环状卡片试验(RPR)1:32(+),HIV (-),丙型肝炎病毒抗体(+).分泌物细菌培养出表皮葡萄球菌,药敏试验提示对头孢类药物较敏感.

The long non-coding RNAs (lncRNAs) regulating encoding transcripts/genes involved in Wnt signalling pathway in keloids is largely unclear. We used a pathway-focused lncRNA microarray to detect the differentiated expression profiles of both lncRNAs and genes involved in Wnt pathway, thus a total of 116 Wnt-targeted genes and 69 Wnt-related lncRNAs aberrantly expressed in keloids were initially identified. A stepwise bioinformatics was further performed to find skin-related lncRNA/gene pairs in Wnt pathway in keloids. Firstly, an lncRNA/gene co-expression network with clustered functional modules was constructed; simultaneously, 114 Wnt-genes regarding to dermis were online enriched using Phenotype Enrichment. Secondly, 17 skin-related keloid-aberrant Wnt-genes were acquired by overlapping the 114 skin-related Wnt-genes with the 116 keloid-aberrant Wnt-genes. Thirdly, after co-expression coefficient of each lncRNA/gene profile being ranked respectively, 11 top co-expressed lncRNAs characterized with the highest co-expression coefficients to the 17 genes were identified. Fourthly, seven of the 11 top co-expressed lncRNAs exhibiting array-detected aberrant expression in keloids, together with their 12 most interactive Wnt-genes, were selected to undergo in-pair intracellularly quantitative PCR validation in keloids. As a result, four lncRNAs including CACNA1G-AS1, HOXA11-AS, LINC00312 and RP11-91I11.1 with their six paired Wnt-genes undergoing both array-and-qPCR as well as lncRNA-and-gene double validation were finally identified as skin-related lncRNA/gene pairs that involved in Wnt signalling pathway in keloids. In conclusion, in-depth exploration on these easily-accessible lncRNAs in keloids might aid to find the novel target on how to maintain highly recurrent tumours benign via Wnt-involved network regulation.

目的:了解脑瘫患儿家庭康复的现状.方法:采用"家庭康复现状调查问卷表"对我市两家康复机构长期康复治疗的99例脑瘫患儿家长进行问卷调查.结果:(91.92%)的脑瘫患儿缺少有效家庭康复的参与,且家庭康复中,(69.70%)的家长仅重视功能的训练,而忽视了对患儿的教育、心理康复.结论:可从家长培训、制定家庭康复方案及监测康复效果等方面给予家庭康复支持,走医院与家庭相结合的康复模式,从而促进脑瘫患儿全面康复.

目的:比较双节段前路椎问盘切除减压融合术(anterior cervical discectomy and fusion,ACDF)和单节段前路椎体次全切除减压融合术(anterior cervical corpectomy and fusion,ACCF)对邻近双节段脊髓型颈椎病的治疗结果.方法:对2010年09月～2013年7月应用双节段椎间盘切除减压聚醚醚酮融合器(Polyetherether-ketone cage,PEEK cage)植骨融合术及单节段椎体次全切减压钛网植骨融合术进行治疗的54例邻近双节段脊髓型颈椎病患者进行回顾性分析,ACCF组23例,ACDF组31例.比较两组患者基线资料、住院天数、手术时间、出血量、日本骨科协会(Japanese Orthopaedic Association,JOA)评分及疼痛视觉模拟评分(visual analogue score,VAS)的不同.通过测量术前、术后3d、术次随访时的影像学图片,分析两组患者颈椎曲度、融合节段高度及融合率的变化.结果:年龄、性别、病变节段、矢状位序列、植骨材料、住院天数和手术时问两组问差异无统计学意义,ACDF组的出血量显著少于ACCF组(175.4±12.1ml VS 201.3±80.4ml).ACDF组JOA及VAS评分在术前(13.06±0.81、6.48±1.43)与末次随访时(15.45±1.06、2.97±1.28)比较均有显著统计学意义(P=0.000),ACCF组JOA及VAS评分同ACDF组,术后与术前比较均有统计学意义(P＜0.05);但组间比较未发现明显差别(P＞0.05).两组颈椎曲度和融合节段高度术后3d时较术前均有增加(P＜0.05),而末次随访时轻度下降(P＜0.05),ACDF组改善程度明显大于ACCF组(P＜0.05).两组均获得了100％的融合率.结论:在邻近双节段脊髓型颈椎病的手术治疗中,ACDF出血量相对较少,能更好地改善颈椎曲度和维持融合节段高度.

目的 原核表达人膜联蛋白(annexin,ANX)A3(ANX A3),并进行纯化.方法 提取人胎盘样品总RNA,反转录建立cDNA文库,用KOD-Plus高保真DNA聚合酶扩增anx A3基因编码区全长,连接至克隆载体pEASY-Blunt上,测序鉴定.用primix extaq酶重新扩增anx A3基因,与表达载体pEASY-E1连接,构建重组表达质粒pEASY-anx A3,转化E.coli Transetta DE3,IPTG诱导表达.表达的重组蛋白经6×His纯化介质及Bio-Rad BioLogic DuoFlowChromatography Systems纯化后,经SDS-PAGE及Western blot鉴定.结果 重组表达质粒经菌落PCR鉴定,阳性克隆可扩增出972 bp的目的片段,与NCBI中GenBank上报道的anx A3序列完全一致.纯化的重组蛋白相对分子质量约为36 000,可与鼠Anti 6×His-Tag单克隆抗体特异性结合,浓度为400 μg/ml.结论 成功构建了重组原核表达质粒pEASY-anxA3,并在E.coli Transetta DE3中表达了重组蛋白,为进一步研究ANX A3在哮喘病的起因和形成中的作用及机制奠定了基础.

Vitamin D is not only an important biological regulatory factor of calcium and phosphate metabolism, but also an important modulator of immune function. Study has found that vitamin D deficiency rickets in addition to bone lesions, also can affect the nerves, muscles, blood and immune organ function. One of the most striking is the vitamin D immune function. Now the progress of immunomodulatory effects of vitamin D and its relationship with autism were reviewed in this article.

Objective To investigate the effects of extracorporeal shock wave therapy on foot dorsiflexion angle of children with spastic cerebral palsy. Methods The children with spastic cerebral palsy were randomly divided into two groups, control group and treatment group. The control group only accepted conventional comprehensive rehabilitation and the treatment group accepted extracorporeal shock wave therapy during comprehensive rehabilitative training. Evaluating children with passive foot dorsiflexion angle after the first month and the third month, comparing the difference of improvement in passive foot dorsiflexion angle between two groups, respectively comparing the difference of improvement in passive foot dorsiflexion angle between pre-therapy and post-treatment every time in the beginning, the first month and the third month in treatment group, to observe the effects of extracorporeal shock wave therapy. Results The reducing of passive foot dorsiflexion angle in the treatment group was better than the control group after treatment with one and three months(P<0.05). The reducing of passive foot dorsiflexion angle in post-treatment every time was better than pre-therapy in the beginning, the first month and the third month in treatment group(P<0.05). Conclusion Extracorporeal shock wave therapy can effectively improve foot dorsiflexion angle of children with spastic cerebral palsy. And immediate effect is obvious sustainably appearing within three months.

<正>Sweet综合征又名急性发热性嗜中性皮病,以发热,四肢、面、颈部有疼痛性红色丘疹、斑块或结节,组织病理见真皮有密集的中性粒细胞浸润,末梢血中中性粒细胞增多为最突出的特点,女性较为多发。

<正>脑性瘫痪是指自受孕开始至婴儿期非进行性脑损伤和发育缺陷所导致的综合征,主要表现为运动障碍及姿势异常[1],综合康复训练[2]是目前主要的治疗方法。物理疗法(physical therapy,PT)是脑瘫治疗的基础,对于约占脑瘫60%~70%的痉挛型脑瘫,PT可不同程度地改善患儿的粗大运动功能[1]。但患儿能保持直立体位后,对平衡及协调能力的需求增加,故如何提高这部分患儿的立位平衡能力是随后临床工作中的重点[3]。感觉统合理论(Sensory Integration Theory)创立于1972年,多应用于感觉统合失常、自闭症、注意力缺陷、精神发育迟滞等患儿的康复[4-10][11]

Objective To observe of integrated traditional Chinese and Western medicine without operation method in the treatment of adhesive intestinal obstruction.Methods With simple Western medicine treatment and configure decoction by nasogastric tube,treating combined with fasting,gastrointestinal decompression,anti-inflammatory rehydration vein nutrition method of traditional Chinese medicine and Western Medicine.Results 45 cases were cured among 60 cases of integrated traditional Chinese and Western medicine.Effective 11 cases,invalid 4 cases,the effective rate was 75%,the total efficiency of 93%.Invalid 4 cases converted to laparotomy.Significant efficiency.The two groups after treatment the total efficiency were compared with statistical significance(P 0.05).Conclusion Curative effect is better than pure Western medicine conservative treatment of adhesive intestinal obstruction with integrated traditional Chinese and Western medicine,greatly reduces the probability of operation,so as to alleviate the suffering of patients.It is worthy of popularization in clinical practice.