Dacryocystorhinostomy through nasal endoscope with extended bone window and high ostomy in the treatment of chronic dacryocystitis / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the efficacy and safety of dacryocystorhinostomy(DCR)through nasal endoscope with extended bone window and high ostomy in the treatment of chronic dacryocystitis.METHODS: Retrospective clinical study. A total of 50 patients(59 eyes)diagnosed with chronic dacryocystitis in our hospital from January 2018 to January 2020 were selected. They were divided into two groups according to the operation method, with 23 cases(29 eyes)in the simple stoma group and 27 cases(30 eyes)in the improved group. Patients in the simple stoma group were treated with transnasal endoscopic flat middle turbinate axillary DCR(simple stoma), and patients in the improved group were treated with transnasal endoscopic extended bone window with high-level stoma DCR. The total clinical efficiency, postoperative complication rate and satisfaction of the two groups were compared.RESULTS: The effective rate of the simple stoma group was 79% at 12mo after surgery, while that of the improved group was 97%(P=0.039). The total incidence of complications in the simple stoma group was 28%, while that in the improved group was 7%(P=0.042). The satisfaction rate of the simple stoma group was 65%, while that of the improved group was 93%(P=0.030).CONCLUSION: The treatment of chronic dacryocystitis with transnasal endoscopic extended bone window and high-level ostomy DCR further improved the efficiency of surgery and reduced the incidence of complications.

Genome-wide analysis of AP2/ERF superfamily in Isatis indigotica / 中西医结合学报

OBJECTIVE@#AP2/ERF (APETALA2/ethylene-responsive factor) superfamily is one of the largest gene families in plants and has been reported to participate in various biological processes, such as the regulation of biosynthesis of active lignan. However, few studies have investigated the genome-wide role of the AP2/ERF superfamily in Isatis indigotica. This study establishes a complete picture of the AP2/ERF superfamily in I. indigotica and contributes valuable information for further functional characterization of IiAP2/ERF genes and supports further metabolic engineering.@*METHODS@#To identify the IiAP2/ERF superfamily genes, the AP2/ERF sequences from Arabidopsis thaliana and Brassica rapa were used as query sequences in the basic local alignment search tool. Bioinformatic analyses were conducted to investigate the protein structure, motif composition, chromosome location, phylogenetic relationship, and interaction network of the IiAP2/ERF superfamily genes. The accuracy of omics data was verified by quantitative polymerase chain reaction and heatmap analyses.@*RESULTS@#One hundred and twenty-six putative IiAP2/ERF genes in total were identified from the I. indigotica genome database in this study. By sequence alignment and phylogenetic analysis, the IiAP2/ERF genes were classified into 5 groups including AP2, ERF, DREB (dehydration-responsive element-binding factor), Soloist and RAV (related to abscisic acid insensitive 3/viviparous 1) subfamilies. Among which, 122 members were unevenly distributed across seven chromosomes. Sequence alignment showed that I. indigotica and A. thaliana had 30 pairs of orthologous genes, and we constructed their interaction network. The comprehensive analysis of gene expression pattern in different tissues suggested that these genes may play a significant role in organ growth and development of I. indigotica. Members that may regulate lignan biosynthesis in roots were also preliminarily identified. Ribonucleic acid sequencing analysis revealed that the expression of 76 IiAP2/ERF genes were up- or down-regulated under salt or drought treatment, among which, 33 IiAP2/ERF genes were regulated by both stresses.@*CONCLUSION@#This study undertook a genome-wide characterization of the AP2/ERF superfamily in I. indigotica, providing valuable information for further functional characterization of IiAP2/ERF genes and discovery of genetic targets for metabolic engineering.

Effects of hospital elderly life program to prevent the ICU-acquired delirium and weakness in patients after cardiac surgery / 中国实用护理杂志

Objective:To explore the applications value of hospital elderly life program in cardiac surgery patients in intensive care unit, and provide reference for improving the prognosis of patients.Methods:This was a prospective study. A total of 84 cardiac surgery patients in intensive care unit from April 2020 to February 2022 in the People′s Hospital of Leshan by convenient sampling method, they were enrolled and divided into the observation group and the control group according to the admission time, each group was 42 cases. Routine nursing care was carried out in both groups, the control group implemented delirium and debility prevention nursing, the observation group adopted hospital elderly life program. The incidence of ICU-acquired delirium and weakness, mechanical ventilation time, duration of ICU stay, the total length of stay and intensive care experience were assessed between the two groups.Results:The 42 cases were included in the final control group and 39 cases in the observation group. The incidence of ICU-acquired delirium and weakness were 17.95% (7/39) and 7.69% (3/39) in the observation group, lower than in the control group 38.10%(16/42) and 23.81%(10/42), the differences were statistically significant ( χ2 = 4.04, 3.90, both P<0.05); the duration of ICU delirium were (1.71 ± 0.95) d in the observation group, shorter than in the control group (2.81 ± 1.05) d, the difference was statistically significant ( t = 2.38, P<0.05); the mechanical ventilation time, duration of ICU stay, the total length of stay, the total score of intensive care experience in hospital in the observation group were (193.54 ± 21.67) h, (9.49 ± 2.11) d, (18.10 ± 3.12) d, (2.72 ± 0.26) points, lower than those in the control group (214.50 ± 27.25) h, (10.90 ± 1.97) d, (20.59 ± 4.07) d, (3.15 ± 0.35) points, the differences were statistically significant ( t values were 3.11-6.35, all P<0.05). Conclusions:Hospital elderly life program can decrease the incidence of ICU-acquired delirium and weakness of cardiac surgery patients in intensive care unit, shorten mechanical ventilation time and hospitalization time, alleviate discomfort in the intensive care experience.

Effect of T helper 1 to T helper 2 ratio on the prognosis of patients with multiple myeloma / 白血病·淋巴瘤

Objective:To investigate the effect of T helper 1 (Th1) to T helper 2 (Th2) ratio (Th1/Th2) on the prognosis of patients with multiple myeloma (MM).Methods:The clinical data of 168 MM patients who were newly diagnosed in the Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2016 to January 2021 were retrospectively analyzed. Disease staging was defined according to the Chinese guidelines for diagnosis and treatment of MM (2020 edition). Risk stratification was based on the Mayo stratification of myeloma and risk-adapted therapy (mSMART) 3.0. The levels of Th1 and Th2 in peripheral blood of patients were detected by flow cytometry. Th1/Th2 was compared among patients with different disease staging and risk stratification. Using mSMART 3.0 risk stratification as the gold standard, the receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value of Th1/Th2 for determining high-risk MM. According to the optimal cut-off value, patients were divided into high Th1/Th2 group (≥ optimal cut-off value) and low Th1/Th2 group (< optimal cut-off value). The progression-free survival (PFS) of the two groups was analyzed by Kaplan-Meier method. Multivariate Cox proportional hazards model was used to analyze the influencing factors of PFS.Results:There were 40, 62 and 66 patients with international staging system (ISS) stages Ⅰ, Ⅱ and Ⅲ, respectively, with Th1/Th2 [ M ( IQR)] of 19.20 (18.98), 15.93 (14.40) and 14.47 (12.01), respectively ( H = 6.68, P = 0.036). There were 31,102 and 35 patients with revised international staging system (R-ISS) stages Ⅰ, Ⅱ and Ⅲ, respectively, with Th1/Th2 of 19.67 (21.92), 14.87 (11.36) and 13.50 (12.80), respectively ( H = 7.26, P = 0.027). There were 99 and 69 patients with mSMART 3.0 high-risk and standard-risk, respectively, and the Th1/Th2 of high-risk patients was lower than that of the standard-risk patients [14.70 (11.93) vs. 17.72 (16.80), U = 2 612.00, P = 0.009]. ROC curve analysis showed that the area under the curve for Th1/Th2 to determine high-risk MM was 0.618 (95% CI 0.531-0.705, P = 0.010), and the optimal cut-off value was 16.55 and there were 81 and 87 cases in the high Th1/Th2 group and low Th1/Th2 group. With a median follow-up of 28 months (1-70 months), the median PFS time for all patients was 36 months (95% CI 29-43 months); PFS in high Th1/Th2 group was better than that in low Th1/Th2 group [median PFS time: 39 months (95% CI 26-51 months) vs. 28 months (95% CI 21-34 months), P = 0.040]. Multivariate Cox regression analysis showed that renal impairment (with vs. without: HR = 2.340, 95% CI 1.350-4.053, P = 0.002) and low Th1/Th2 (high vs. low: HR = 0.551, 95% CI 0.344-0.882, P = 0.013) were independent risk factors for PFS in MM patients. Conclusions:The imbalance between Th1 and Th2 is associated with the prognosis of MM patients, and patients with low Th1/Th2 are at high risk of progression. Th1/Th2 can be used as a prognostic indicator for MM.

Prognostic Analysis of Socioeconomic Factors in Multiple Myeloma Patients and Construction of A Myeloma-specific Survival Prediction Model / 肿瘤防治研究

Objective To investigate the effects of socioeconomic factors on the prognosis of multiple myeloma (MM) patients and construct a prediction model for evaluating myeloma-specific survival (MSS) rates. Methods A total of 32625 patients diagnosed with MM between January 2007 and December 2016 were included through the SEER database. Cox regression model was used to analyze the predictive indicators of MSS. The results of the multivariate subgroup analysis were presented as forest plots. The significant factors identified in the multivariate Cox analysis were used to construct a nomogram. The predictive performance of the nomogram was assessed using the AUC and calibration plots. A nomogram score-based risk stratification system was constructed using a restricted cubic spline. Results Patients were divided into five groups according to their socioeconomic status (SES). Groups with higher SES had relatively higher proportions of those part of the White, insured, married, and urban populations. Age, gender, race, marital status, insurance status, and SES were independent prognostic factors of MSS (all P < 0.001). The linear trend of increased MSS risk with decreasing SES was most pronounced among the White, married, insured, and urban patients (all P < 0.001). The nomogram exhibited good discrimination and accuracy in both training and validation sets, showing AUC values of 0.701, 0.709, and 0.722 for predicting 3-, 5-, and 8-year MSS, respectively. A risk stratification model was established based on the nomogram total points and the HR, which then divided patients into three different risk levels with substantial survival disparities (all P < 0.001). Conclusion Socioeconomic factors, such as marital status, insurance status, and SES, have a significant impact on the survival outcomes of MM patients. The nomogram and the risk stratification model based on these factors can accurately and reliably predict MSS.

Analysis of the effects of low/intermediate dose of coagulation factor Ⅷ on 30 adult patients with severe hemophilia A in a single center / 中华血液学杂志

Objective: To evaluate the clinical effects of low- and intermediate-dose factor Ⅷ (F Ⅷ) prophylaxis in Chinese adult patients with severe hemophilia A. Methods: Thirty adult patients with severe hemophilia A who received low- (n=20) /intermediate-dose (n=10) F Ⅷ prophylaxis at Nanjing Drum Tower Hospital affiliated with Nanjing University Medical College were included in the study. The annual bleeding rate (ABR), annual joint bleeding rate (AJBR), number of target joints, functional independence score of hemophilia (FISH), quality of life score, and health status score (SF-36) before and after preventive treatment were retrospectively analyzed and compared. Results: The median follow-up was 48 months. Compared with on-demand treatment, low- and intermediate-dose prophylaxis significantly reduced ABR, AJBR, and the number of target joints (P<0.05) ; the improvement in the intermediate-dose prophylaxis group was better than that in the low-dose prophylaxis group (P<0.05). Compared with on-demand treatment, the FISH score, quality of life score, and SF-36 score significantly improved in both groups (P<0.05), but there was no significant difference between the two groups (P>0.05) . Conclusion: In Chinese adults with severe hemophilia A, low- and intermediate-dose prophylaxis can significantly reduce bleeding frequency, delay the progression of joint lesions, and improve the quality of life of patients as compared with on-demand treatment. The improvement in clinical bleeding was better with intermediate-dose prophylaxis than low-dose prophylaxis.

A novel mesenchymal stem cell-based regimen for acute myeloid leukemia differentiation therapy

Currently the main treatment of acute myeloid leukemia (AML) is chemotherapy combining hematopoietic stem cell transplantation. However, the unbearable side effect of chemotherapy and the high risk of life-threatening infections and disease relapse following hematopoietic stem cell transplantation restrict its application in clinical practice. Thus, there is an urgent need to develop alternative therapeutic tactics with significant efficacy and attenuated adverse effects. Here, we revealed that umbilical cord-derived mesenchymal stem cells (UC-MSC) efficiently induced AML cell differentiation by shuttling the neutrophil elastase (NE)-packaged extracellular vesicles (EVs) into AML cells. Interestingly, the generation and release of NE-packaged EVs could be dramatically increased by vitamin D receptor (VDR) activation in UC-MSC. Chemical activation of VDR by using its agonist 1α,25-dihydroxyvitamin D3 efficiently enhanced the pro-differentiation capacity of UC-MSC and then alleviated malignant burden in AML mouse model. Based on these discoveries, to evade the risk of hypercalcemia, we synthetized and identified sw-22, a novel non-steroidal VDR agonist, which exerted a synergistic pro-differentiation function with UC-MSC on mitigating the progress of AML. Collectively, our findings provided a non-gene editing MSC-based therapeutic regimen to overcome the differentiation blockade in AML.

Effect of ligustrazine on hypoxic-ischemic encephalopathy in neonatal rats by regulating autophagy through the PINK1/Parkin pathway / 中国当代儿科杂志

OBJECTIVES@#To study the effect of ligustrazine injection on mitophagy in neonatal rats with hypoxic-ischemic encephalopathy (HIE) and its molecular mechanism.@*METHODS@#Neonatal Sprague-Dawley rats, aged 7 days, were randomly divided into a sham-operation group with 8 rats, a model group with 12 rats, and a ligustrazine group with 12 rats. The rats in the model group and the ligustrazine group were used to establish a neonatal rat model of HIE by ligation of the left common carotid artery followed by hypoxia treatment, and blood vessels were exposed without any other treatment for the rats in the sham-operation group. The rats in the ligustrazine group were intraperitoneally injected with ligustrazine (20 mg/kg) daily after hypoxia-ischemia, and those in the sham-operation group and the model group were intraperitoneally injected with an equal volume of normal saline daily. Samples were collected after 7 days of treatment. Hematoxylin and eosin staining and Nissl staining were used to observe the pathological changes of neurons in brain tissue; immunohistochemical staining was used to observe the positive expression of PINK1 and Parkin in the hippocampus and cortex; TUNEL staining was used to measure neuronal apoptosis; Western blotting was used to measure the expression levels of the mitophagy pathway proteins PINK1 and Parkin and the autophagy-related proteins Beclin-1, microtubule-associated protein 1 light chain 3 (LC3), and ubiquitin-binding protein (P62).@*RESULTS@#Compared with the sham-operation group, the model group had a significant reduction in the number of neurons, an increase in intercellular space, loose arrangement, lipid vacuolization, and a reduction in Nissl bodies. The increased positive expression of PINK1 and Parkin, apoptosis rate of neurons, and protein expression levels of PINK1, Parkin, Beclin1 and LC3 (P<0.05) and the decreased protein expression level of P62 in the hippocampus were also observed in the model group (P<0.05). Compared with the model group, the ligustrazine group had a significant increase in the number of neurons with ordered arrangement and an increase in Nissl bodies, significant reductions in the positive expression of PINK1 and Parkin, the apoptosis rate of neurons, and the protein expression levels of PINK1, Parkin, Beclin1, and LC3 (P<0.05), and a significant increase in the protein expression level of P62 (P<0.05).@*CONCLUSIONS@#Ligustrazine can alleviate hypoxic-ischemic brain damage and inhibit neuronal apoptosis in neonatal rats to a certain extent, possibly by inhibiting PINK1/Parkin-mediated autophagy.

Effects of dexmedetomidine on pulmonary function in patients receiving one-lung ventilation: a meta-analysis of randomized controlled trial / 대한마취과학회지

Background@#Mechanical ventilation, particularly one-lung ventilation (OLV), can cause pulmonary dysfunction. This meta-analysis assessed the effects of dexmedetomidine on the pulmonary function of patients receiving OLV. @*Methods@#The Embase, PubMed, MEDLINE, Cochrane Library, ClinicalTrials.gov, and Chinese Clinical Trial Registry databases were systematically searched. The primary outcome was oxygenation index (OI). Other outcomes including the incidence of postoperative complications were assessed. @*Results@#Fourteen randomized controlled trials involving 845 patients were included in this meta-analysis. Dexmedetomidine improved the OI at 30 (mean difference [MD]: 40.49, 95% CI [10.21, 70.78]), 60 (MD: 60.86, 95% CI [35.81, 85.92]), and 90 min (MD: 55, 95% CI [34.89, 75.11]) after OLV and after surgery (MD: 28.98, 95% CI [17.94, 40.0]) and improved lung compliance 90 min after OLV (MD: 3.62, 95% CI [1.7, 5.53]). Additionally, dexmedetomidine reduced the incidence of postoperative pulmonary complications (odds ratio: 0.44, 95% CI [0.24, 0.82]) and length of hospital stay (MD: −0.99, 95% CI [−1.25, −0.73]); decreased tumor necrosis factor-α, interleukin (IL)-6, IL-8, and malondialdehyde levels; and increased superoxide dismutase levels. However, only the results for the OI and IL-6 levels were confirmed by the sensitivity and trial sequential analyses. @*Conclusions@#Dexmedetomidine improves oxygenation in patients receiving OLV and may additionally decrease the incidence of postoperative pulmonary complications and shorten the length of hospital stay, which may be related to associated improvements in lung compliance, anti-inflammatory effects, and regulation of oxidative stress reactions. However, robust evidence is required to confirm these conclusions.

Huanglian Jiedutang Treats Acute Gouty Arthritis via NLRP3 Inflammasome and TLR4/NF-κB Signaling Pathway / 中国实验方剂学杂志

ObjectiveTo observe the effect of Huanglian Jiedutang on the inflammatory injury in the mouse model of acute gouty arthritis （AGA） and to explore the mechanism of Huanglian Jiedutang in treating AGA. MethodForty male C57BL/6J mice were randomized into blank， model， colchicine （0.83 mg·kg-1）， and Huanglian Jiedutang （5 g·kg-1） groups. The mouse model of AGA was established by injecting monosodium urate （MSU） crystals into the ankle joint. The swelling degree of the right ankle joint of each mouse was measured every day for 7 days， and the pathological changes of the ankle joint were detected by hematoxylin-eosin （HE） staining after 7 days. The other 40 C57BL/6J mice were grouped as above. After 18 hours of modeling， the right ankle joint was collected， and real-time polymerase chain reaction was employed to measure the mRNA levels of interleukin （IL）-1β， tumor necrosis factor （TNF）-α， IL-6， NOD-like receptor protein 3 （NLRP3）， apoptosis-associated speck-like protein containing a CARD （ASC）， and Caspase-1. The expression levels of IL-1β， TNF-α， and IL-6 were measured by the enzyme-linked immunosorbent assay. Western blot was employed to determine the protein levels of NLRP3 inflammasome， Toll-like receptor 4 （TLR4）， and nuclear factor-κB （NF-κB）. ResultCompared with the blank group， the model group showed swelling right ankle joint （P<0.01）， obvious foreign body granuloma in the ankle joint with inflammatory cell infiltration. After the treatment with Huanglian Jiedutang， the ankle joint swelling was relieved （P<0.05， P<0.01）， and the size of foreign body granuloma was reduced. Compared with the blank group， the model group showed up-regulated mRNA levels of IL-1β， TNF-α， and IL-6 in the ankle joint tissue （P<0.01）， up-regulated mRNA levels of NLRP3 and Caspase-1 in the NLRP3 inflammasome （P<0.05， P<0.01）， and up-regulated protein levels of NLRP3， Caspase-1， TLR4， and NF-κB （P<0.05， P<0.01）. Huanglian Jiedutang down-regulated the mRNA levels of IL-1β， TNF-α， IL-6， NLRP3， and Caspase-1 （P<0.05， P<0.01） and the protein levels of IL-1β， TNF-α， IL-6， NLRP3， Caspase-1， TLR4， and NF-κB （P<0.05 or P<0.01）. ConclusionInjecting MSU crystal resulted in local inflammatory injury of the joints in the mouse model of AGA. The treatment with Huanglian Jiedutang may alleviate the inflammatory injury by regulating the NLRP3 inflammasome and TLR4/NF-κB signaling pathway.

The optimal anti-phospholipase A2 receptor cutoff for the diagnosis of idiopathic membranous nephropathy: a single-center retrospective study

Background/Aims@#Anti-phospholipase A2 receptor (PLA2R) autoantibody is the main biomarker of idiopathic membranous nephropathy (IMN). We aimed to find a new cutoff value of anti-PLA2R for patients with IMN and to explore the relevance between this antibody and baseline clinical parameters. @*Methods@#A total of 670 subjects including 374 IMN cases and 296 non-IMN controls were included between January 2017 and January 2020. All clinical parameters were collected at the time of renal biopsy. The levels of anti-PLA2R were detected by a commercial enzyme-linked immunosorbent assay (ELISA) kit. The optimal cutoff value was calculated by a receiver operating characteristic curve and compared in diagnostic efficiency. @*Results@#The optimal cutoff value of anti-PLA2R for IMN was 7.45 RU/mL with the highest Youden index, and the corresponding sensitivity, specificity, positive predictive value and negative predictive value were 80.75%, 97.97%, 98.05% and 80.11%, respectively. Anti-PLA2R levels in IMN patients demonstrated a significant positive correlation with serum creatinine and 24-hour urinary protein, while they showed a negative correlation with serum albumin and estimated glomerular filtration rate. @*Conclusions@#The recommended cutoff value of anti-PLA2R is 7.45 RU/mL using ELISA detection for distinguishing IMN from non-IMN nephropathy. The level of anti-PLA2R is related to baseline renal function in IMN. This new threshold can improve the diagnostic efficiency and facilitate early diagnosis of IMN.

A case report of ligamentum flavum cyst in the lumbar vertebral canal and literature review / 中华老年医学杂志

Ligamentum flavum cysts in the spinal canal are rare space-occupying lesions.They usually occur in the middle-aged and people over 50 years old, without obvious sex or regional differences, and mostly involve the cervical, thoracic and lumbar vertebrae, especially the lumbar vertebrae(L4/5 and L5/S1). There are no characteristic manifestations for ligamentum flavum cysts.They can cause neurological symptoms due to compression of nerve roots or the dural sac.For example, patients with lumbar ligamentum flavum cysts may complain of symptoms of lumbar disc herniation-related sciatica, which can easily lead to misdiagnosis.Surgical excision of the cyst is the most effective method.Recently, one patient with this disease was admitted to our department.After surgical fenestration, the ligamentum flavum cyst in the lumbar canal was resected and its diagnosis was eventually confirmed histologically.After 17 months of follow-up, the patient recovered well.

Clinical value of synthetic MRI and dynamic contrast-enhanced MRI in the differentiation of benign and malignant breast lesions / 中华放射学杂志

Objective:To explore the value of synthetic MRI and dynamic contrast-enhanced MRI (DCE-MRI) in differentiating benign and malignant breast lesions.Methods:Totally 116 patients (female, aged 22-80 years) with suspicious breast lesions found by clinical examination in General Hospital of Ningxia Medical University from September 2020 to March 2021 were retrospectively analyzed. All patients received synthetic MRI and DCE-MRI scans, and the quantitative parameters of synthetic MRI [T 1, T 2, proton density (PD) value before enhancement of breast lesions (T 1pre, T 2pre, PD pre) and T 1, T 2, PD value after enhancement of breast lesions (T 1Gd, T 2Gd, PD Gd)] were measured. The difference before and after enhancement (?T 1, ?T 2, ?PD) and the ratio before and after enhancement(T 1ratio, T 2ratio, PD ratio) were calculated. All lesions were confirmed by biopsy or surgery. Independent sample t test was used to compare the differences of parameters between benign and malignant lesions, and parameters with statistically significant differences were analyzed by multivariate logistic regression to screen out independent predictors for the diagnosis of breast malignant lesions. The efficacy of quantitative parameters alone and in combination with DCE-MRI, was evaluated by the receiver operating characteristic (ROC) curve. Results:Of 116 patients, 27 patients were benign and 89 patients were malignant. T 2pre, PD pre, T 2Gd, PD Gd, ?T 2, T 1ratio and T 2ratio values of malignant patients were lower than those of benign lesions ( P<0.05). Multivariate logistic regression analysis showed that T 2pre (OR=0.961,95%CI 0.926-0.993, P=0.022)and PD pre(OR=0.945, 95%CI 0.908-0.979, P=0.003) were independent predictors of breast malignant lesions. The area under ROC curve (AUC) of T 2pre+PD pre in differentiating benign and malignant breast lesions was 0.77, and the accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 0.84, 0.87, 0.68, 0.92 and 0.56, respectively. The AUC of T 2pre+PD pre combined with DCE-MRI in differentiating benign and malignant breast lesions was 0.95, indicating the best diagnostic efficiency, and higher than that of DCE-MRI alone (0.92)( Z=2.20, P<0.05). Conclusions:T 2pre and PD pre values of synthetic MRI can be used as reference parameters for differentiating benign and malignant breast lesions. Synthetic MRI combined with DCE-MRI can effectively improve the diagnostic efficiency of breast malignant lesions.

Fiberoptic endoscopic evaluation of swallowing for evaluation of dysphagia after stroke / 中国基层医药

Objective:To investigate the application value of fiberoptic endoscopic evaluation of swallowing (FEES) in patients with dysphagia after stroke.Methods:A total of 200 patients with dysphagia who received treatment in Wenzhou Hospital of Traditional Chinese Medicine from January 2019 to December 2020 were included in this study. All patients underwent videofluoroscopic swallowing study (VFFS) and FEES. Examination results and the incidence of adverse reactions were compared between VFFS and FEES.Results:VFFS results revealed that oral food residue occurred in 122 patients, food leakage in 168 patients, food aspiration in 170 patients, epiglottis valley residue in 179 patients, pyriform sinus residue in 184 patients, cricopharyngeus muscle dysfunction in 61 patients, and abnormal esophageal peristalsis in 58 patients. FEES results revealed that food leakage occurred in 173 patients, food penetration in 151 patients, food aspiration in 180 patients, food retention in 166 patients, and vocal neoplasm in 21 patients. The incidence of adverse reactions generated in FEES was lower than that in VFFS (5.5% vs. 12.0%, χ2 = 5.29, P < 0.05). Conclusion:FEES has high sensitivity and safety in the detection of dysphagia after stroke, and it has important guiding significance for the treatment of dysphagia.

Correlation and protective effect of diabetes mellitus in aortic aneurysm disease / 国际外科学杂志

Diabetes mellitus is a metabolic disease characterized by hyperglycemia. It is found that the incidence and mortality of abdominal aortic aneurysm (AAA) in diabetes mellitus patients are lower than that in non-diabetes mellitus patients. This review will present the protective role of diabetes mellitus and its treatment on the aortic disease process, aiming to provide more support for the clinical treatment of AAA.

Effects of parental involvement on children s eye use behavior / 中国学校卫生

Objective@#To analyze the correlation between parental involvement and the formation of good eye use behavior in children,and to provide theoretical basis for more accurate prevention and control of myopia.@*Methods@#A total of 2 726 children and their parents from 3 primary schools were selected from April to May 2021 by clustering sampling method. Children s ocular parameters, eye use behavior, general characteristics of parents, and parental involvement were collected through ocular measurements and questionnaires, respectively.@*Results@#Parental involvement was associated with family economic, parental education level, and parental myopic status( P <0.05). Children s myopia risk was associated with parental involvement: lower myopia risk was associated with frequent parental involvement in behavioral management of child sleep and child outdoor activities( P <0.01). Parents who always/frequently participate in the management of children s eye behavior have an average daily screen time of <2 h ( OR= 1.95 , 95%CI =1.31-2.90), and daily outdoor activity time>2 h ( OR=0.78, 95%CI =0.65-0.93), daily sleep time >8 h ( OR= 0.52 , 95%CI =0.40-0.68), daily continuous reading and writing time <1 h ( OR=1.33, 95%CI =1.30-1.56), reading and writing The distance from the desktop > 30 cm ( OR=0.57, 95%CI =0.34-0.95) had a statistically significant effect ( P <0.05).@*Conclusion@#High parental involvement may help school age children develop good eye habits and reduce the risk of childhood myopia. Parental involvement is higher among those who had myopia themselves, and parental involvement is positively associated with total household income and parental literacy.

A long-term ischemic stroke risk score model in patients aged 60 years and older with obstructive sleep apnea: a multicenter prospective cohort study / 南方医科大学学报

OBJECTIVE@#To analyze the independent risk factors of long-term ischemic stroke and establish a nomogram for predicting the long-term risks in elderly patients with obstructive sleep apnea (OSA).@*METHODS@#This multicenter prospective cohort study was conducted from January, 2015 to October, 2017 among consecutive elderly patients (≥60 years) with newly diagnosed OSA without a history of cardio-cerebrovascular diseases and loss of important clinical indicators. The follow-up outcome was the occurrence of ischemic stroke. The baseline demographic and clinical data, sleep parameters, laboratory and ultrasound results were collected from all the patients, who were randomized into the modeling group (n=856) and validation group (n=258) at a 3∶1 ratio. LASSO regression was used for variable reduction and dimension screening, and the risk score prediction model of ischemic stroke was established based on Cox proportional hazard regression.@*RESULTS@#In the total of 1141 patients enrolled in this study, 58 (5.08%) patients experienced ischemic stroke during the median follow-up of 42 months (range 41-54 months). The cumulative incidence of ischemic stroke was 5.14% in the model group and 4.91% in the verification group (P < 0.05). Age (HR=3.44, 95% CI: 2.38- 7.77), fasting blood glucose (FPG) (HR=2.13, 95% CI: 1.22-3.72), internal diameter of the ascending aorta (HR=2.60, 95% CI: 1.0- 4.47), left atrial anteroposterior diameter (HR=1.98, 95% CI: 1.75-2.25) and minimum oxygen saturation (LSpO2) (HR=1.57, 95% CI: 1.20-1.93) were identified as independent risk factors for ischemic stroke (P < 0.05 or 0.01). A long-term ischemic stroke risk score model was constructed based the regression coefficient ratios of these 5 risk variables. Before and after the application of the Bootstrap method, the AUC of the cohort risk score model was 0.84 (95% CI: 0.78- 0.90) and 0.85 (95% CI: 0.78- 0.89) in the model group and was 0.83 (95% CI: 0.73-0.93) and 0.82 (95%CI: 0.72-0.90) in the verification group, respectively, suggesting a good prediction efficiency and high robustness of the model. At the best clinical cutoff point, the cumulative incidence of ischemic stroke was significantly higher in the high-risk group than in the low-risk group (P=0.021).@*CONCLUSION@#This model can help to identify high-risk OSA patients for early interventions of the risks of ischemic stroke associated with OSA.

Identification of onco-miRNAs in hepatocellular carcinoma and analysis of their regulatory network / 南方医科大学学报

OBJECTIVE@#To construct the regulatory network of survival-related onco-miRNAs and their target genes in hepatocellular carcinoma (HCC) and verify the interactions between the key miRNAs and their targets.@*METHODS@#We screened survival-related miRNAs in HCC in OncomiR and Oncolnc databases, predicted their target genes using miRNet, and conducted survival and expression analysis using GEPIA2 and Ualcan, respectively. The miRNA-target gene co-expression analysis was performed and the miRNA-target network was constructed. Enrichment analysis was performed in Enrichr and protein-protein interaction analysis in STRING database. We tested the effects of transfection with the mimic or inhibitor of hsa-miR-1226-3p or hsa-miR-221-5p on proliferation of HepG2 cells using CCK8 assay and examined the changes in the expressions of the target genes using RT-qPCR. The effect of transfection with hsa-miR-221-5p mimic or inhibitor on protein expressions of the target genes was examined using Western blotting in. A dual luciferase reporter assay was used to test the interaction between hsa-miR-221-5p and its potential target gene GCDH. We further examined the effect of transfection with hsa-miR-221-5p mimic and pEGFP N1-GCDH, alone or in combination, on proliferation, migration and invasion of HepG2 cells.@*RESULTS@#We identified 223 survival-related miRNAs in HCC from OncomiR and 146 miRNAs from Oncolnc with an intersection of 131 miRNAs, and 48 miRNAs were identified as onco-miRNAs in HCC after survival and expression analysis. Twenty-seven eligible target genes were identified after miRNA-mRNA co-expression analysis. The constructed miRNA-target gene network consisted of 25 miRNAs and 27 target genes. The most enriched term was fatty acid metabolism for the target genes. In HepG2 cells, transfection with the mimic or inhibitor of hsa-miR-1226-3p or hsa-miR-221-5p caused significant changes of the mRNA and protein levels of their respective target genes (P < 0.05). The results of dual luciferase reporter assay confirmed the targeting relationship between hsa-miR-221-5p and GCDH gene (P < 0.05). Transfection with hsa-miR-221-5p mimic significantly suppressed the proliferation, migration and invasion of HepG2 cells, but this effect was obviously relieved by co-transformation with pEGFP N1-GCDH (P < 0.05).@*CONCLUSION@#Fatty acid metabolism might be one of the most crucial pathways that mediate the effect of the oncomiRNAs in HCC, and the hsa-miR-221-5p/GCDH axis is an important molecular mechanism for HCC progression.

Molecular mechanism of Ganoderma against gastric cancer based on network pharmacology and experimental test / 中国中药杂志

This study aims to explore the molecular mechanism of Ganoderma against gastric cancer based on network pharmacology, molecular docking, and cell experiment. The active components and targets of Ganoderma were retrieved from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP), and gastric cancer-related targets from GeneCards and Online Mendelian Inheritance in Man(OMIM). The protein-protein interaction(PPI) network of the common targets was constructed with STRING, followed by Gene Ontology(GO) term enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analysis of the common genes based on Bioconductor and R language. The medicinal-disease-component-target network and medicinal-disease-component-target-pathway network were established by Cytoscape. Molecular docking was performed between β-sitosterol(the key component in Ganoderma) and the top 15 targets in the PPI network. Cell experiment was performed to verify the findings. A total of 14 active components and 28 targets of Ganoderma were retrieved, and the medicinal and the disease shared 25 targets, including caspase-3(CASP3), caspase-8(CASP8), caspase-9(CASP9), and B-cell lymphoma-2(BCL2). The common targets involved 72 signaling pathways and apoptosis and p53 signaling pathway may play a crucial role in the effect of Ganoderma against gastric cancer. β-sitosterol had strong binding activity to the top 15 targets in the PPI network. The in vitro cell experiment demonstrated that β-sitosterol inhibited gastric cancer AGS cell proliferation by inducing cell apoptosis and cell cycle arrest in the S phase, which might be related to the regulation of the p53 pathway. This study shows the multi-component, multi-target, and multi-pathway characteristics of Ganoderma against gastric cancer, which lays a scientific basis for further research on the molecular mechanism.

Mechanism of Prunellae Spica Against Breast Diseases： A Review / 中国实验方剂学杂志

Prunellae Spica is the dry ear of the labiaceae plant Prunella vulgaris， which is a traditional medicine and food plant with many functions. Prunellae Spica can clear liver-fire， improve eyesight， disperse knot detumescence. It owns hot and bitter flavors and cold property. It goes to the liver， gallbladder meridian， and is a kind of commonly-used antifebric. Prunellae Spica has been used in the treatment of mammary gland diseases since ancient times.The mammary abscess， mammary nodules， mammary carcinoma of traditional Chinese medicine all belong to breast disease， and the liver meridian is most closely related to these diseases. With the development of social life， breast disease has gradually become the most primary health problem for women. Modern pharmacological studies show that Prunellae Spica contains terpenoids， phenolic acids， flavonoids and other biological active components， which have anti-inflammatory， antibacterial， hormone regulation， anti-tumor and other effects. Prunellae Spica inhibits the p38 mitogen-activated protein kinase （p38 MAPK）/nuclear factor kappa-B （NF-κB） pathway to play an anti-mastitis role， interferes with the effects of estrogen receptors or regulates lipid levels to treat breast hyperplasia， and treats breast cancer through promoting the apoptosis of breast cancer cells， inhibiting the migration of breast cancer cells， regulating the division of breast cancer cells and other ways. While referring to the relevant literature， it was found that Prunellae Spica often exerted pharmacological effects through multi-channels and multi-target regulation， but most of the studies did not specify the specific target of its effect， which needs further study. In this review， the effects and mechanisms of Prunellae Spica in the treatment of various breast diseases were summarized， so as to provide a reference for further research on the wider clinical therapeutic effects of Prunella subtilis and its therapeutic effects on breast diseases.