Bioinformatics analysis and identification to immune-related markers of osteoporosis / 细胞与分子免疫学杂志

Objective To identify immune-related dysregulation mechanisms and potential diagnostic predictive biomarkers in osteoporosis. Methods Gene expression data for both osteoporosis and control populations were retrieved from the GSE35958 and GSE56815 datasets. Immune-related differentially expressed genes (DEGs) were obtained by screening DEGs and were compared with the immunology database and analysis portal (ImmPort) database. Enrichment analysis of these immune-related DEGs was conducted using the Clusterprofiler software package. A protein-protein interaction network was built with the STRING database, which is a search tool for finding interacting genes/proteins, and the top 10 genes with the highest network connectivity were identified as candidate genes. Subsequently, the diagnostic predictive effect of candidate genes was evaluated using receiver operating characteristic (ROC) curves, logistic regression, and column plots. Finally, PCR and Western blot analysis were applied to detect the differential expression of these genes in bone marrow tissue of patients with osteoporosis. Results A total of 138 immune-related DEGs were obtained through intersection analysis. The results of the enrichment analysis indicated that these genes were involved in biological functions such as immune inflammation and signaling pathways including T cell receptors, mitogen activated protein kinase (MAPK), rat sarcoma virus oncogene homologs (Ras), osteoclast differentiation, and B cell receptors. In addition, among the candidate genes, upregulated vascular endothelial growth factor A (VEGFA) and epidermal growth factor receptor (EGFR) and downregulated AKT1, SRC, and JUN in osteoporosis showed the highest connectivity. Among them, VEGFA, EGFR, JUN, and AKT1 demonstrated the best diagnostic predictive value. Conclusion The screening of immune-related DEGs will enhance the understanding of osteoporosis and facilitate the development of immunotherapy targets.

Histone deacetylase 6 promotes skin wound healing by regulating fibroblast migration and differentiation in aged mice / 生理学报

Skin wound healing tends to slow down with aging, which is detrimental to both minor wound recovery in daily life and the recovery after surgery. The aim of current study was to explore the effect of histone deacetylase 6 (HDAC6) on wound healing during aging. Cultured human dermal fibroblasts (HDFs) and mouse full-thickness skin wound model were used to explore the functional changes of replicative senescent dermal fibroblasts and the effect of aging on skin wound healing. Scratch wound healing assay revealed significantly decreased migration speed of senescent HDFs, and BrdU incorporation assay indicated their considerably retardant proliferation. The protein expression levels of collagen and HDAC6 were significantly decreased in both senescent HDFs and skin tissues from aged mice. HDAC6 activity inhibition with highly selective inhibitor tubastatin A (TsA) or HDAC6 knockdown with siRNA decreased the migration speed of HDFs and considerably suppressed fibroblast differentiation induced by transforming growth factor-β1 (TGF-β1), which suggests the involvement of HDAC6 in regulating fundamental physiological activities of dermal fibroblasts. In vivo full-thickness skin wound healing was significantly delayed in young HDAC6 knockout mice when compared with young wild type mice. In addition, the wound healing was significantly slower in aged wild type mice than that in young wild type mice, and became even worse in aged HDAC6 knockout aged mice. Compared to the aged wild type mice, aged HDAC6 knockout mice exhibited delayed angiogenesis, reduced collagen synthesis, and decreased collagen deposition in skin wounds. Together, these results suggest that delayed skin wound healing in aged mice is associated with impaired fibroblast function. Adequate expression and activity of HDAC6 are required for fibroblasts migration and differentiation.

Anti-CoVid19 plasmid DNA vaccine induces a potent immune response in rodents by Pyro-drive Jet Injector intradermal inoculation

There is an urgent need to limit and stop the worldwide coronavirus disease 2019 (COVID-19) pandemic via quick development of efficient and safe vaccination methods. Plasmid DNA vaccines are one of the most remarkable vaccines that can be developed in a short term. pVAX1-SARS-CoV2-co, which is a plasmid DNA vaccine, was designed to express severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) spike protein. The produced antibodies lead to Immunoreactions against S protein, anti-receptor-binding-domain, and neutralizing action of pVAX1-SARS-CoV2-co, as confirmed in a previous study. To promote the efficacy of the pVAX1-SARS-CoV2-co vaccine, a pyro-drive jet injector (PJI) was employed. PJI is an injection device that can adjust the injection pressure depending on various target tissues. Intradermally-adjusted PJI demonstrated that pVAX1-SARS-CoV2-co vaccine injection caused a strong production of anti-S protein antibodies, triggered immunoreactions and neutralizing actions against SARS-CoV-2. Moreover, a high dose of pVAX1-SARS-CoV2-co intradermal injection via PJI did not cause any serious disorders in the rat model. Finally, virus infection challenge in mice, confirmed that intradermally immunized (via PJI) mice were potently protected from COVID-19 infection. Thus, pVAX1-SARS-CoV2-co intradermal injection via PJI is a safe and promising vaccination method to overcome the COVID-19 pandemic.

Risk factors of portal vein thrombosis in cirrhotic patients with esophageal varices / 临床肝胆病杂志

ObjectiveTo investigate the risk factors for portal vein thrombosis (PVT) in cirrhotic patients with esophageal varices, and to establish a nomogram for predicting the risk of PVT. MethodsA retrospective analysis was performed for the clinical data of 283 cirrhotic patients with esophageal varices who attended Shandong Provincial Hospital Affiliated to Shandong University from December 2013 to December 2018, and according to imaging findings, the patients were divided into PVT group with 119 patients and non-PVT group with 164 patients. The t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. A multivariate logistic regression analysis was used to screen out independent risk factors; a nomogram was established and validated based on the results of the multivariate logistic regression analysis, and C-index and calibration curve were used to evaluate its performance. ResultsThe univariate analysis showed that compared with the non-PVT group, the PVT group had significantly higher Child-Pugh class (χ2=9.388, P=0.009), proportion of patients with a history of splenectomy (χ2=26.805, P＜0.001), white blood cell count (Z=-2.248, P=0.025), platelet count (Z=-3.323, P=0.001), D-dimer(Z=-6.236, P＜0.001), and spleen thickness (Z=-2.432, P=0.015) and a significantly lower level of triglyceride (TG) (Z=-4.150, P＜0.001). The multivariate logistic regression analysis showed that a reduction in TG (odds ratio ［OR］=0.441, 95% confidence interval ［CI］: 0.190-0.889), an increase in D-dimer (OR=1.151, 95%CI: 1.041-1.272), prolonged prothrombin time (PT) (OR=1160, 95%CI: 1.025-1.313), and a history of splenectomy (OR=2.933, 95%CI: 1.164-7.389) were independent risk factors for PVT in cirrhotic patients with esophageal varices. In addition, a nomogram was established based on the results of the multivariate regression analysis, with a C-index of 0.745, and the calibration curve showed good consistency between the observed and predicted values for the development of PVT. ConclusionA reduction in TG, an increase in D-dimer, prolonged PT, and a history of splenectomy are independent risk factors for PVT in cirrhotic patients with esophageal varices, and the nomogram developed based on these results can provide a quantitative and intuitive tool for clinicians to assess the risk of PVT.

Preclinical study of DNA vaccines targeting SARS-CoV-2

To fight against the worldwide COVID-19 pandemic, the development of an effective and safe vaccine against SARS-CoV-2 is required. As potential pandemic vaccines, DNA/RNA vaccines, viral vector vaccines and protein-based vaccines have been rapidly developed to prevent pandemic spread worldwide. In this study, we designed plasmid DNA vaccine targeting the SARS-CoV-2 Spike glycoprotein (S protein) as pandemic vaccine, and the humoral, cellular, and functional immune responses were characterized to support proceeding to initial human clinical trials. After intramuscular injection of DNA vaccine encoding S protein with alum adjuvant (three times at 2-week intervals), the humoral immunoreaction, as assessed by anti-S protein or anti-receptor-binding domain (RBD) antibody titers, and the cellular immunoreaction, as assessed by antigen-induced IFN{gamma} expression, were up-regulated. In IgG subclass analysis, IgG2b was induced as the main subclass. Based on these analyses, DNA vaccine with alum adjuvant preferentially induced Th1-type T cell polarization. We confirmed the neutralizing action of DNA vaccine-induced antibodies via two different methods, a binding assay of RBD recombinant protein with angiotensin-converting enzyme 2 (ACE2), a receptor of SARS-CoV-2, and pseudovirus assay. Further B cell epitope mapping analysis using a peptide array showed that most vaccine-induced antibodies recognized the S2 and RBD subunits, but not the S1 subunit. In conclusion, DNA vaccine targeting the spike glycoprotein of SARS-CoV-2 might be an effective and safe approach to combat the COVID-19 pandemic.

Comparison of gastrointestinal adverse events with different doses of metformin in the treatment of elderly people with type 2 diabetes.

WHAT IS KNOWN AND OBJECTIVE: Gastrointestinal discomfort is the most common adverse event of metformin treatment for type 2 diabetes, especially in elderly patients. The aim of this study was to compare gastrointestinal adverse events resulting from different doses of metformin used for the treatment of elderly people with type 2 diabetes. METHODS: A total of 361 elderly patients with newly diagnosed diabetes were randomly divided into three groups: metformin 1000 mg/d (N = 120), metformin 1500 mg/d (N = 121) and metformin 2000 mg/d (N = 120). Glycaemic control and gastrointestinal adverse events (abdominal pain, diarrhoea, nausea, vomiting, bloating and anorexia) were assessed and compared among the three groups after 12 weeks of treatment. RESULTS AND DISCUSSION: At baseline, there was no significant difference in gastrointestinal symptoms among the three groups. After 12 weeks of treatment with metformin, the change in HbA1c level was -0.7%, -0.9% and -1.0% for the 1000 mg/d, 1500 mg/d and 2000 mg/d groups, respectively (P < .0001). There was no significant difference in gastrointestinal adverse events among the three groups after treatment with metformin. In total, 62 people (17.2%) could not tolerate the adverse effects of metformin, and most of them stopped treatment in the first 4 weeks. Logistic regression analysis shows that female sex (OR = 2.660, 95%CI 1.692-4.183, P < .0001) and the concurrent use of organic cation transporter 1-inhibiting drugs (OR = 1.874, 95%CI 1.076-3.265, P = .027) are independent risk factors for adverse events. WHAT IS NEW AND CONCLUSIONS: Our data demonstrate that metformin doses of 1000 mg/d-2000 mg/d have similar adverse events but that 2000 mg/d of metformin yields the best glycaemic control in elderly people with diabetes. If elderly people can tolerate 1000 mg/d of metformin, we could gradually increase the dose to 2000 mg/d to achieve better glycaemic control.

Guilingji Capsules reduce 900 MHz collphone electromagnetic radiation-induced testicular oxidative damage and downregulate Prdx2 protein expression in the rat testis / 中华男科学杂志

Objective@#To investigate the relationship of electromagnetic radiation (EMR) from 900 MHz cellphone frequency with testicular oxidative damage and its influence on the Prdx2 protein expression in the rat testis, and to explore the mechanism of Guilingji Capsules (GC) alleviating oxidative damage to the testis tissue.@*METHODS@#Fifty healthy SD male rats were randomly divided into five groups of equal number, sham-EMR, 4-h EMR, 8-h EMR, 4-h EMR+GC and 8-h EMR+GC and exposed to 900 MHz EMR (370 μW/cm2) for 0, 4 or 8 hours daily for 15 successive days. The rats of the latter two groups were treated intragastrically with GC suspension and those of the first three groups with pure water after exposure to EMR each day. After 15 days of exposure and treatment, all the rats were sacrificed and their testis tissue collected for observation of the histomorphological and ultrastructural changes by HE staining and transmission electron microscopy, measurement of the levels of serum glutathione (GSH), superoxide dismutase (SOD) and malondialdehyde (MDA) with thiobarbiuric acid and determination of the Prdx2 protein expression by immunohistochemistry and Western blot.@*RESULTS@#Compared with the rats in the sham-EMR group, those in the 4-h and 8-h EMR groups showed different degrees of histomorphological and ultrastructural changes in the testis tissue, significantly decreased levels of GSH (［80.62 ± 10.99］ vs ［69.58 ± 4.18］ and ［66.17 ± 8.45］ mg/L, P < 0.05) and SOD (［172.29 ± 10.98］ vs ［158.92 ± 6.46］ and ［148.91 ± 8.60］ U/ml, P < 0.05) and increased level of MDA (［7.51 ± 1.73］ vs ［9.84 ± 1.03］ and ［11.22 ± 2.13］ umol/ml, P < 0.05), even more significantly in the 8-h than in the 4-h EMR group (P < 0.05). In comparison with the sham-EMR group, the expression of the Prdx2 protein was markedly downregulated in the 4-h and 8-h EMR groups (0.56 ± 0.03 vs 0.49 ± 0.03, 0.21 ± 0.01, P < 0.05), but again upregulated in the 4-h and 8-h EMR+GC groups (0.55±0.03 and 0.37±0.04) (P < 0.05).@*CONCLUSIONS@#Electromagnetic radiation from cellphones can cause ultrastructural damage to the testis tissue of male rats, while Guilingji Capsules can alleviate it, presumably by upregulating the Prdx2 protein expression in the testis tissue and reducing testicular oxidative damage.

Origin and relationship of -well points and Shixuan (EX-UE 11) / 中国针灸

Both the twelve -well points and Shixuan (EX-UE 11) are the commonly used first-aid points. These two kinds of acupoints are located closely and similar in function, hence, they are often confused in application. In order to explore the origin of their location and theory as well as their relationship, the relevant data were retrieved. It has been found that the relationship between -well points and Shixuan (EX-UE 11) is traced at the earliest time to (). It is believed that the -well points refer to the starting points or the ending points of the twelve regular meridians and Shixuan (EX-UE 11) are located at the crossing sites of - related meridians of the regular meridians. These two kinds of acupoints are interconnected, share the same source and are also different from each other. Qiduan (EX-LE 12) is also named as foot-Shixuan. Shixuan (EX-UE 11) and Qiduan (EX-LE 12) can be regarded as the same category, just like -well points. In clinical practice, the -well points are generally selected in treatment of internal diseases, local diseases and those on the running course of meridians. They can be used separately in treatment. Shixuan (EX-UE 11) is the first option, or combined with Qiduan (EX-LE 12) in the emergent treatment of tense syndrome and syncope. The -well points and Shixuan (EX-UE 11) are different even though sharing the same origin. They are mutually benefited and supplemented with each other in clinical practice.

Research progress on morphology and associations of peripapillary atrophy / 中华眼底病杂志

Through the different image technologies, peripapillary atrophy can be classified into four types: α zone, β zone, γ zone and δ zone. Each type of them has different imaging and histological features. Peripapillary atrophy is a common structure in peoples' eyes and it is correlated with many factors and diseases such as age, myopia, glaucoma, non-arteritic anterior ischemic optic neuropathy and age-related macular degeneration which bring difficulties to our diagnosis and antidiastole. Classifying and qualifying peripapillary atrophy properly, which can evaluate the changes and degrees, can benefit our studies about their mechanism and offer the clinical biological indictors and research basis.

Exploration into the simplex reinforcing-reducing manipulation of acupuncture / 中国针灸

Four controversial types of simplex reinforcing-reducing manipulation of acupuncture and their possible meanings were summarized to explore several key elements of reinforcing-reducing manipulation of acupuncture, in addition, the simplex reinforcing-reducing manipulation of acupuncture was classified by single factor. It is concluded that the definition of simplex reinforcing-reducing manipulation of acupuncture should try not to include other non-manipulative elements. According to single factor, it can be divided into: needle-oriented reinforcing-reducing manipulation, twisting reinforcing-reducing manipulation, lifting and interpolating reinforcing-reducing manipulation, fast and slow reinforcing-reducing manipulation, breathing reinforcing-reducing manipulation, opening and closing reinforcing-reducing manipulation. In addition, after considering the effect and principle of number reinforcing-reducing manipulation, it can be considered.

Progress of the application of PET technology in acupuncture research / 中国针灸

To further investigate the application of positron emission tomography (PET) technology in acupuncture research field, with "PET" and "acupuncture" as keywords, the related literature published from 1997 to 2018 was searched in PubMed, CNKI and WANFANG database; then the literature was classified and analyzed. The results showed that in clinical and experimental studies, whether in physiological or pathological conditions, PET technology has verified the specificity of acupoints, bidirectional regulation of acupoints, and the clinical effect of -arrival from the level of brain functional activity. It has deeply revealed the central mechanism underlying that acupuncture has multi-target, multi-channel and multi-level overall effects. The purpose of this study is to provide objective scientific basis for acupuncture research, and then potentially guide the clinical practice.

Association between dawn phenomenon and sleep disorders in elderly patients with type 2 diabetes / 中华全科医师杂志

Objective To investigate the association between dawn phenomenon and sleep disorders in elderly patients with type 2 diabetes mellitus (T2DM).Methods Three hundred and ninety-six T2DM patients aged 60-80 years were recruited from Department of Endocrinology,Huadong Hospital from January 2014 to January 2017.All cases used oral hypoglycemic drug more than 3 months,their glycosylated hemoglobin (HbA1c) was lower than 8.5％ and underwent continuous glucose monitoring for 72 h.The Pittsburgh sleep quality index (PSQI) scale was applied to evaluate sleep quality,and the PSQI＞7 was defined as the sleep disorder.There was dawn phenomenon in 165 cases (group Ⅰ) and no dawn phenomenon in 231 cases(group Ⅱ).The clinical data,blood glucose related indicators,homeostasis model assessment of insulin resistance (HOMA-IR) and PSQI scores were compared between two groups.The correlation between dawn phenomenon and sleep disorder was analyzed with Logistic regression.Results There were no significant differences in age,BMI,blood lipids,liver and kidney function,hypersensitive CRP(hCRP),serum cystatin and serum cortisol between the two groups (all P＞0.05).Patients in group Ⅰ presented a higher ratio of urinary protein/creatinine [1.3 (0.7,5.4) mg/mmol vs.1.1 (0.5,3.4) mg/mmol,t=-2.105,P=0.04],PSQI scores [(7.3±3.3) vs.(5.4±2.7),t=3.587,P＜0.01] and the incidence of sleep disorders [57.0％ (94/165) vs.25.1％ (58/231),x2=3.765,P＜0.01] than those in group Ⅱ.The HbA1c [(7.4±0.9)％ vs.(7.0±1.0)％,t=3.384,P＜0.01] and fasting glucose [(8.3±1.6) mmol/L vs.(7.0± 1.4) mmol/L,t=8.778,P＜0.01] were significantly higher in group Ⅰ than those in group Ⅱ;while the fasting insulin [(8.2±7.2) mU/L vs.(10.3±10.2) mU/L,t=-2.286,P=0.02] and nocturnal nadir [(5.7± 1.3) mmol/L vs.(6.6± 1.4) mmol/L,t =-6.331,P＜0.01] were lower than those in group Ⅱ.Pearson correlation analysis showed that dawn phenomenon was positively correlated with sleep disorders (r=0.323,P＜0.01).Logistic regression analysis showed that sleep disorders were associated with increased risk of dawn phenomenon (OR=4.143,95％CI:1.69-10.16,P＜0.0 1).Conclusion Sleep disorders may play a relevant pathological role in the occurrence of dawn phenomenon in elderly T2DM patients.

Arginine Vasopressin-Aquaporin-2 Pathway-Mediated Dehydration Effects of Electroacupuncture in Guinea Pig Model of AVP-Induced Eendolymphatic Hydrops / 中国结合医学杂志

OBJECTIVE@#To investigate the effects of electroacupuncture (EA) on endolymphatic hydrops (EH) and the regulation of arginine vasopressin (AVP)-aquaporin-2 (AQP2) pathway in guinea pigs.@*METHODS@#EH was induced in male guinea pigs by an intraperitoneal injection of AVP. For the treatment, EA was delivered to Baihui (GV 20) and Tinggong (SI 19) acupoints, once per day for 10 consecutive days. In histomorphological studies, cochlear hydrops degree was evaluated by hematoxylin-eosin (HE) staining, and then the ratio of scala media (SM) area to SM + scala vestibuli (SV) area (R value) was calculated. In mechanical studies, a comparison of plasma AVP (p-AVP) concentrations, cyclic adenosine monophosphate (cAMP) levels, vasopressin type 2 receptor (V2R) and AQP2 mRNA expressions in the cochlea were compared among groups.@*RESULTS@#EA significantly reduced cochlear hydrops in guinea pigs (P=0.001). EA significantly attenuated the AVPinduced up-regulation of p-AVP concentrations (P=0.006), cochlear cAMP levels (P=0.003) and AQP2 mRNA expression (P=0.016), and up-regulated the expression of V2R mRNA (P=0.004) in the cochlea.@*CONCLUSIONS@#The dehydrating effect of EA might be associated with its inhibition of AVP-AQP2 pathway activation.

HPLC fingerprint of Lomatogonium rotatum / 中草药

Objective To study the fingerprints of 15 batches of Mongolian medicinal materials of Lomatogonium rotatum collected from different places by HPLC, and to evaluate the quality of the medicinal materials of L. rotatum by similarity calculation. Methods A total of 15 batches of ribbed flowers were collected by HPLC. Chromatographic column: YMC C18 column (250 mm × 4.6 mm, 5 μm), mobile phase: acetonitrile-0.4% phosphoric acid-methanol, gradient elution, flow rate was 0.8 mL/min, detection wavelength was 254 nm, column temperature was 30 ℃. The similarity of fingerprints was evaluated by using the “Similarity Evaluation System of Chromatographic Fingerprints of Traditional Chinese Medicine 2004A Edition”. Results The fingerprints of L. rotatum of Mongolian medicine were established, 15 common peaks were identified, five common peaks were identified, and the similarity among 15 batches of L. rotatum and the fingerprints of control was in the range of 0.881—0.997. The fingerprints of erect column flowers have good precision, stability and reproducibility. Conclusion The characteristic fingerprint of L. rotatum was established for the first time, which not only provides a new scientific basis for the identification and quality control of L. rotatum, but also has important significance for the quality evaluation of L. rotatum.

Toxic effects of combination of Aconiti Lateralis Radix Praeparata with Trichosanthis Fructus on inflammatory response and myocardial fibrosis in pressure overload rats based on β2-AR/PKA signal / 中国中药杂志

To study the effects of combination of Aconiti Lateralis Radix Praeparata( Fuzi) with Trichosanthis Fructus( Gualou) on cardiac function,electrocardiogram,inflammatory response and myocardial fibrosis in pressure overload( PO) rats,and further explore the mechanism based on β2-AR/PKA signaling. PO rat model was established by constricting the abdominal aorta. Twelve weeks after the operation,these rats were randomly divided into model goup( PO),low dose Fuzi group( FL,5. 4 g·kg-1·d-1),Gualou group( GL,5. 4 g·kg-1·d-1),Fuzi and Gualou combination group( FG,5. 4 g·kg-1·d-1+5. 4 g·kg-1·d-1) and high dose Fuzi group( FH,10. 8 g·kg-1·d-1). At the same time,sham operation group was set. After intervention for 6 weeks,carotid blood pressure,cardiac function,electrocardiogram and heart mass index were measured. HE staining was used to observe the inflammatory response in the rat heart and kidney. Masson staining was used to determine the myocardial fibrosis. Western blot was used to detect the protein expression of β2-AR and PKA. As compared with sham operation group,the blood pressure and heart mass index were obviously increased in PO model group,but there was no significant difference in various treatment groups in the above indexes. As compared with PO model group,FH treatment significantly increased the ejection fraction( EF) and GL treatment effectively enhanced the cardiac output( CO),but other treatment groups had no significant effect on these parameters. Moreover,FG treatment can synergistically attenuate QT and QTc internal prolongation,but it also aggravated inflammatory response in the heart and kidney tissues and promoted myocardial fibrosis as compared to FZ or GL alone treatment,with toxic effects equivalent to FH treatment group. Following FG and FH treatment,simultaneously,β2-AR and PKA protein levels were significantly elevated,indicating that the increasing toxicity of FG could be associated with activation of β2-AR/PKA signaling. These results suggested that combination of FZ and GL could synergistically enhance toxicity of FZ in special pathological states such as pressure overload,and caution should be taken in clinical application.

Advances of optical coherence tomography angiography in myopia / 中华眼底病杂志

Optical coherence tomography angiography (OCTA) is an noninvasive, rapid and reproducible technology which can provide high resolution view of the vascular structures and quantifies the vessel densities in retina and choroid. Myopia can be divided into simple myopia and pathologic myopia. The mechanism of myopia is not clear while it is closely related to the vessel density. For simple myopia, OCTA can monitor the course and deepen the understanding of myopia by quantifying the vessel densities in each layers and sectors and the foveal avascular zone. For pathologic myopia, OCTA has an advantage of observing the choroidal neovascularization, chorioretinal atrophy and Zinn-Haller arterial circle which can contribute to the early diagnosis and management and follow-up to estimate the prognosis. However, there are several limitations of OCTA which need to be improved, including in the process of acquiring high-quality images, accurate layering and dynamic observation.

Observation of choroidal blood flow and morphology in patients with severe stenosis of internal carotid artery / 中华眼底病杂志

Objective To observe the choroidal blood flow and morphological changes in patients with severe stenosis of internal carotid artery stenosis (ICAS).Methods A retrospective case-control study. Forty-six patients (46 eyes) with ICAS were enrolled in this study. There was severe stenosis in one side (the eyes in this side were set as case group) and mild or no stenosis in other side (the eyes in this side were set as control group). Color doppler ultrasound (CDI) was used to observe the changes of hemodynamic parameters of the ophthalmic artery (OA) and posterior ciliary artery (PCA),the main parameters of ultrasound Doppler imaging are peak systolic velocity (PSV), end diastolic velocity (EDV), resistance indices (RI) and the calculation of the pulsation indices (PI) through the use of a formula. Enhanced binarization of deep imaging coherence tomography (EDI-OCT) was used to measure the subfoveal choroidal thickness (SFCT). The total subfoveal choroidal area (TCA), luminal (LA), stromal (SA) and choroidal vascularity index (CVI) were obtained by modified image binarization technique.Results In the case group, the PSV in the OA and PCA was significantly lower than that of the control group (t=?2.200, ?2.612;P=0.030, 0.011). There were no significant differences in EDV, RI, PI of OA (t=0.337, ?1.810, ?1.848;P=0.737, 0.074, 0.068) and PCA (t=?1.160, 1.400, 0.815;P=0.249, 0.165, 0.417). The SFCT (t=?3.711,P<0.001), TCA (t=?2.736,P=0.007), LA (t=?3.188, P=0.002) and CVI (t=?2.096,P=0.039) of the case group was significantly lower than that of the control group. There were no significant differences in SA (t=?1.262,P=0.210) and LA/SA (t=?1.696,P=0.093).Conclusion In severe stenosis ICAS eyes, the PSV in the PCA and SFCT, TCA, LA, CVI are decreased.

Correlations between the levels of serum Wnt5a, Sfrp5, and glycemic control in elderly male patients with type 2 diabetes mellitus / 中华内分泌代谢杂志

Objective To investigate the levels of serum Wnt5a and Sfrp5 in elderly male patients with type 2 diabetes mellitus (T2DM), and identify associations between their levels and glycemic control. Methods A total of 67 elderly male T2DM patients and 65 nondiabetic subjects were studied. Participants were divided into four groups:normal control (NC group), T2DM patients were categorized by HbA1C quartile(Group Ⅰ: HbA1C<7％, Group Ⅱ:7％≤HbA1C < 9％, Group Ⅲ: HbA1C ≥9％). The serum Wnt5a and Sfrp5 concentrations were measured through ELISA. Influencing factors for Wnt5a and Sfrp5 were analyzed. Results Compared with the NC group, Wnt5a levels of elderly T2DM were decreased in groups Ⅱ and Ⅲ, in contrast, Sfrp5 levels were elevated in groups Ⅱ and Ⅲ than NC group(all P<0.05). Spearman correlation analysis suggested that Wnt5a levels were negatively correlated with HbA1C , GA, FPG, and 2hPG(r were -0.277, -0.298, -0.185, and -0.254 respectively, all P<0.05);Sfrp5 levels were positively correlated with HbA1C , GA, and FPG(r were 0.311, 0.247, and 0.200 respectively, all P<0.05) while negatively correlated with BMI and LDL-C( r were - 0.193 and - 0.190, both P< 0.05). Multivariate linear regression analysis showed that HbA1C was an independent association factor for Wnt5a, and FPG was an independent association factor for Sfrp5. Conclusions In the elderly male T2DM with worse glycemic control, Wnt5a levels were more decreased, and in contrast, Sfrp5 levels were elevated. This result indicated that Wnt5a and Sfrp5 may be associated with the level of glycemic control in elderly male T2DM patients.

Regular exercise behavior stage and its influencing factors in young and middle-aged patients with type 2 diabetes / 医学研究生学报

Objective Young and middle-aged people have become the fastest growing group of diabetes, but the compliance of regular exercise is poor. It is urgent to formulate effective intervention strategies or measures to promote the change of their behavior. The article is Objective ly based on the attitude-social influence-self efficacy model, to investigate the stages distribution and influencing factors of regular exercise behavior in young and middle-aged patients with type 2 diabetes.Methods A convenience sampling was used to select 430 young and middle-aged type 2 diabetic patients from the department of endocrinology in two Nanjing 3A grade hospitals. A cross-sectional survey was conducted with a general questionnaire, a regular exercise behavioral stage questionnaire, a diabetes behavioral attitude and social impact scale, and a diabetes self-efficacy scale.Results The proportion of regular exercise behavior in young and middle-aged patients with type 2 diabetes is as follows. There were 14.9% patients at the precontemplation, 25.8% at the contemplation,15.8% at the preparation, 12.3% at the action, 31.2% at the maintenance. Logistic regression analysis showed that on-the-job (OR=1.77), accepting health education (OR=0.49), HbA1c level (OR=0.78), attitude (OR=5.32), subjective norm (OR=2.43), social support (OR=1.87) and self-efficacy (OR=1.28) are main factors to affect the stages of physical activity (P<0.05) .Conclusion Most of the young and middle-aged patients with type 2 diabetes are in the pre-action stages of regular exercise behavior, which needs to be improved, and many factors can affect the stages of regular exercise behavior. Clinical medical staff should provide individualized interventions for these patients with reference to the characteristics of different behavioral stages of patients.

Effect of Aurora protein kinase inhibitor VX-680 on homogeneity adhe-sion and migration in human hepatoma HepG2 cell / 中国病理生理杂志

AIM:To study the effect of Aurora protein kinase inhibitor VX-680 on homogeneous adhesion and migration ability in human hepatocellular carcinoma cell line HepG 2.METHODS:The HepG2 cell were divided into ex-perimental group and control group, respectively.VX-680 was used in experimental groups at 3 concentrations(3.125 μmol/L group,6.25 μmol/L group and 12.5 μmol/L group).DMSO was used in the control group.The effects of VX-680 at different concentrations on the adhesion ability of human hepatocellular carcinoma HepG 2 cells were observed by cell slow aggregation test and separation experiment.The effects of VX-680 at different concentrations on the migration ability of HepG2 cells was detected by wound healing assay.The expression of E-cadherin in HepG2 cells was detected by Western blot.RESULTS:The results of the slow aggregation test showed that compared with the control group,the number of cell clumps formed in experimental groups was significantly decreased(P<0.01).The results of separation experiment showed that the ratio of NTC/NTEgradually decreased with the increased concentration of VX-680.The results of wound healing as-say showed that as the concentration of VX-680 increased, the cell scratch healing ability gradually weakened compared with control group.The results of Western blot showed that the protein expression of E-cadherin in the HepG2 cells in-creased with the increased concentration of VX-680(P<0.05).CONCLUSION:VX-680 increases the homogeneous ad-hesion and inhibits the migration of HepG 2 cells.