Chromatin binding protein HMGN1 promotes HBV cccDNA transcription and replication by regulating the phosphorylation of histone 3.

BACKGROUND AND AIMS: Direct elimination of cccDNA remains a formidable obstacle due to the persistent and stable presence of cccDNA in hepatocyte nuclei. The silencing of cccDNA transcription enduringly is one of alternative strategies in the treatment of hepatitis B. Protein binding to cccDNA plays an important role in its transcriptional regulation; thus, the identification of key factors involved in this process is of great importance. APPROACHES AND RESULTS: In the present study, high mobility group nucleosome binding domain 1 (HMGN1) was screened out based on our biotin-avidin enrichment system. First, chromatin immunoprecipitation and fluorescent in situ hybridization assays confirmed the binding of HMGN1 with cccDNA in the nucleus. Second, functional experiments in HBV-infected cells showed that the promoting effect of HMGN1 on HBV transcription and replication depended on the functional region of the nucleosomal binding domain, while transfection of the HMGN1 mutant showed no influence on HBV compared with the vector. Third, further mechanistic exploration revealed that the silencing of HMGN1 increased the level of phosphorylase CLK2 and promoted H3 phosphorylation causing the reduced accessibility of cccDNA. Moreover, silenced HMGN1 was mimicked in HBV (r) cccDNA mouse model of HBV infection in vivo. The results showed that silencing HMGN1 inhibited HBV replication in vivo. CONCLUSIONS: In summary, our study identified that a host protein can bind to cccDNA and promote its transcription, providing a candidate strategy for anti-HBV targeting to interfere with the transcriptional activity of cccDNA microchromosomes.

A neonate with filamin A gene-associated periventricular nodular heterotopia / 中华围产医学杂志

This paper reported a neonate with periventricular nodular heterotopia associated to filamin A ( FLNA) gene mutation. The female patient was born at 29 +6 weeks of gestation to a mother who had intractable seizures and a history of two adverse pregnancy outcomes. Postnatal cranial ultrasound showed multiple hypoechoic masses on the walls of bilateral ventricles, which presented as "sawtooth pattern". MRI revealed gray matter displacement, unclear edge of gray and white matter, wavy bilateral ventricles and multiple nodular signals. Whole exon sequencing showed that the patient carried a maternally-inherited and likely pathogenic heterozygous mutation of chrX:153579307 in the FLNA gene (NM_00111 0556; p.Glu2376fsTer9), which caused the periventricular nodular heterotopia in the neonate. The patient was followed up until eight months of age and no convulsion or obvious abnormality in her growth or development was reported.

Design and application of flipped classroom combined with micro-lectures in the teaching of pediatric infectious diseases / 中华医学教育探索杂志

Objective:To investigate the application effect of flipped classroom combined with micro-lectures in the teaching of pediatric infectious diseases.Methods:A total of 199 five-year students in the class of 2019 from Department of Pediatrics of Chongqing Medical University were divided into 14 groups. Each group selected a micro-lecture theme targeting the key and difficult points of the course and produced an original micro-lecture video through flipped classroom, which was then uploaded to Chaoxing platform for evaluation by teachers and students. At the end of the course, a questionnaire survey was performed to investigate the teaching effect, and final examination score and department examination score during internship were compared between the students in the class of 2019 and those in the class of 2018. SPSS 22.0 was used to perform the t-test, the Wilcoxon rank-sum test, the chi-square test, and the Fisher's exact test. Results:A total of 14 flipped micro-lecture works were completed by the students. The questionnaire survey showed that 98.47% (193/196) of the students thought that this model was helpful to master the key and difficult points; 93.88% (184/196) of the students thought that the flipped micro-lecture works had better originality and quality than reading reports and literature reviews in the past; 94.90% (186/196) of the students were more willing to accept the mode of flipped classroom combined with micro-lectures. Compared with the students in the class of 2018, the students in the class of 2019 had significantly higher final examination score (79.32±7.53 vs. 76.06±12.01, P<0.001), theoretical score of department examination (88.68±4.87 vs. 87.15±4.09, P<0.001), and operation score of department examination (84.93±7.56 vs. 82.08±9.10, P<0.001). Conclusion:Flipped classroom combined with micro-lectures can effectively solve the key and difficult points in the teaching of pediatric infectious diseases, and it can also stimulate the interest in independent learning and help to improve learning performance among students. Therefore, it holds promise for clinical application.

Cordyceps sinensis extract protects against the ovariectomy-induced bone loss via the action on osteoclasts / 药学实践杂志

Objective To explore the effects of Cordyceps sinensis extract (CSE) on osteoporosis and RANKL-mediated osteoclastogenesis. Methods Bone marrow-derived macrophages (BMMs) was isolated from the bone marrow of C57BL/6 mice. CSE was added in osteoclast differentiation. Osteoclasts were stained by tartrate-resistant acid phosphatase (TRAP). The nearly mature osteoclasts were planted on hydroxyapatite plates and the area of bone lacunae was observed by microscope. The F-actin belt was stained by DAPI and phylloeptide and the number of nuclei was observed by confocal microscopy. The expressions of DC-STAMP, ATP6V0D2, TRAP, CTSK, and NFATC1 were detected by q-PCR. The protein expression of the MAPK pathway was detected by Western Blot. The in vivo experiments were carried out by administering CSE to the ovariectomized mice daily through gavage. After 6 weeks of intervention, mouse femurs were taken for morphological analysis. Peripheral blood was taken for ELISA. Results CSE represses osteoclastogenesis, bone resorption, F-actin belts formation, osteoclast specific gene expressions and MAPK signaling pathways in vitro. In vivo study indicated that CSE prevents OVX-induced osteoporosis and preserves bone volume by repressing osteoclast activity and function. It also increases the serum ALP, BGP content, and reduces TRAP content. Conclusion CSE can attenuate osteoclast formation and OVX-induced osteoporosis, suggesting potential clinical therapeutic effects for osteoporosis.

Customized maxillary incisor position relative to dentoskeletal and soft tissue patterns in Chinese women: A retrospective study / 대한치과교정학회지

Objective@#To provide reliable prediction models based on dentoskeletal and soft tissue variables for customizing maxillary incisor positions and to optimize digitalized orthodontic treatment planning. @*Methods@#This study included 244 Chinese women (age, 18–40 years old) with esthetic profiles after orthodontic treatment with fixed appliances (133 in group I: 1° ≤ The angle between the nasion [N]-A point [A] plane and the N-B point [B] plane [ANB] ≤ 4°; 111 in group II: 4° < ANB ≤ 7°). Dental, skeletal, and soft tissue measurements were performed on lateral cephalograms of the participants. Correlation and multiple linear regression analyses were used to determine the influence of dentoskeletal and soft tissue variables on maxillary incisor position. @*Results@#The ideal anteroposterior position of the maxillary incisor varied between sagittal skeletal patterns. The position of the maxillary incisor correlated with the sagittal discrepancy between the maxilla and the mandible (ANB), protrusion of the midface, nasal tip projection, development of the chin, and inclination of both the maxillary and mandibular incisors. Distance from the maxillary central incisor to nasion-pogonion plane predicted using multiple linear regression analysis was accurate and could be a practical measurement in orthodontic treatment planning. @*Conclusions@#Instead of using an average value or norm, orthodontists should customize a patient’s ideal maxillary incisor position using dentoskeletal and soft tissue evaluations.

Optimization and Validation of a Novel Three-Dimensional Co-Culture System in Decellularized Human Liver Scaffold for the Study of Liver Fibrosis and Cancer.

The introduction of new preclinical models for in vitro drug discovery and testing based on 3D tissue-specific extracellular matrix (ECM) is very much awaited. This study was aimed at developing and validating a co-culture model using decellularized human liver 3D ECM scaffolds as a platform for anti-fibrotic and anti-cancer drug testing. Decellularized 3D scaffolds obtained from healthy and cirrhotic human livers were bioengineered with LX2 and HEPG2 as single and co-cultures for up to 13 days and validated as a new drug-testing platform. Pro-fibrogenic markers and cancer phenotypic gene/protein expression and secretion were differently affected when single and co-cultures were exposed to TGF-ß1 with specific ECM-dependent effects. The anti-fibrotic efficacy of Sorafenib significantly reduced TGF-ß1-induced pro-fibrogenic effects, which coincided with a downregulation of STAT3 phosphorylation. The anti-cancer efficacy of Regorafenib was significantly reduced in 3D bioengineered cells when compared to 2D cultures and dose-dependently associated with cell apoptosis by cleaved PARP-1 activation and P-STAT3 inhibition. Regorafenib reversed TGF-ß1-induced P-STAT3 and SHP-1 through induction of epithelial mesenchymal marker E-cadherin and downregulation of vimentin protein expression in both co-cultures engrafting healthy and cirrhotic 3D scaffolds. In their complex, the results of the study suggest that this newly proposed 3D co-culture platform is able to reproduce the natural physio-pathological microenvironment and could be employed for anti-fibrotic and anti-HCC drug screening.

Progress on the left-right asymmetry patterning in amphioxus.

The mechanisms underlying the establishment of left-right (L-R) asymmetry in bilaterians is one of the central enigmas in developmental biology. Amphioxus is an important model in studying the mechanisms of animal asymmetry specification due to its particular phylogenetic position, vertebrate-like embryogenesis and body plan. Recently, with the establishments of artificial breeding technology, high-efficiency microinjection method and gene knockout technology, researchers have successfully dissected the mechanisms of amphioxus L-R asymmetry development. In this review, we summarize the major progress in understanding L-R asymmetry specification in amphioxus and propose a model of regulation of L-R asymmetry in this species. Hh protein is transported dominantly to the right side by cilia movement, leading to R>L Hh signaling andCerexpression. Cer inhibits expression of Nodal, leading to the asymmetric expression of Nodal-dependent genes. The L-R differences in the propagation of the Nodal pathway result in the correct morphological L-R asymmetry development in amphioxus embryo. BMP signaling probably does not provide the asymmetric cue, but is necessary for correct expression ofCer andNodal.

Association Between Osteogenic Differentiation in Soft Tissue Lump and Clinicopathological Characteristics of Osteosarcoma Patients / 肿瘤防治研究

Objective To investigate the association between the osteogenic differentiation in the soft tissue lump and the clinicopathological characteristics of osteosarcoma patients. Methods We retrospectively reviewed the clinical data of conventional osteosarcoma patients with soft tissue lumps, including Enneking stages, chemotherapy sensitivity, overall survival and post-metastatic survival time. The ossification level in soft tissue lumps was assessed by imaging and the proportion of osteoid matrix was assessed by pathological examination. Results A total of 189 cases were included in this study. In patients with Enneking IIIB, non-osteoblastic, partially osteoblastic and osteoblastic types accounted for 30.2%, 9.6% and 6.3%, respectively. Non-osteoblastic osteosarcoma patients had a higher rate of initial metastasis (P < 0.05); Chemotherapy efficiency of non-osteoblastic, partially osteoblastic and osteoblastic types were 60.5%, 59.6% and 31.3%, respectively. The osteoblastic osteosarcoma held the worst rate of chemotherapy sensitivity (P < 0.05). The overall survival of non-osteoblastic osteosarcoma was shorter than those of partially osteoblastic and osteoblastic types (P < 0.05). Post-metastatic survival time of osteoblastic osteosarcoma was longer than that of non-osteoblastic osteosarcoma (P=0.078). Conclusion For conventional osteosarcoma, the osteogenesis level in soft tissue lumps is related to the surgical stage, chemotherapy sensitivity and prognosis of tumors, which may provide guidance for the individual decision regarding chemotherapy and surgery timing on patients.

Progress in diagnosis and treatment of congenital tuberculosis / 国际儿科学杂志

Congenital tuberculosis is a tuberculosis disease caused by the fetus infected with Mycobacterium tuberculosis in the womb or during delivery, which is a kind of special and rare tuberculosis in children.The clinical manifestation of congenital tuberculosis is lack of specificity, difficulty in early diagnosis, rapid progress, easy misdiagnosis and high mortality.At present, there are few studies on congenital tuberculosis.In this review, we will discuss the epidemiology and clinical features of congenital tuberculosis.Importantly, we will further introduce the rapid etiological detection and treatment to strengthen clinicians′ understanding of congenital tuberculosis.

Effect of dapagliflozin on metabolic markers and autonomic function in patients with type 2 diabetes mellitus and metabolic associated fatty liver disease / 临床肝胆病杂志

Objective To investigate the effect of dapagliflozin on metabolic markers, hepatic fat content, and autonomic nervous function in patients with type 2 diabetes mellitus (T2DM) and metabolic associated fatty liver disease (MAFLD). Methods A total of 90 patients with T2DM and MAFLD who were admitted to The Second Affiliated Hospital of Zhengzhou University from October 2019 to October 2020 were enrolled and randomly divided into control group and dapagliflozin group, with 45 patients in each group. All patients were given conventional treatment before enrollment; the patients in the control group were treated with the original hypoglycemic regimen, and those in the dapagliflozin group were given dapagliflozin in addition to the treatment in the control group. The treatment cycle was 24 weeks. General information was collected before and after treatment, and the two groups were compared in terms of the changes in body mass index (BMI), glycosylated hemoglobin (HbA1c), fasting blood glucose (FPG), blood lipids, serum uric acid (SUA), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), liver function, liver fat content, and heart rate variability after treatment. The paired t -test was used for comparison of normally distributed continuous data within each group, and the independent samples t -test was used for comparison between groups; the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data within each group, and the Mann-Whitney U test was used for comparison between groups. The Chi-square test was used for comparison of categorical data between two groups. Results A total of 43 patients in the dapagliflozin group and 40 patients in the control group completed the study. After 24 weeks of treatment, the dapagliflozin group had significant reductions in BMI, HbA1c, FBG, triglyceride (TG), SUA, alanine aminotransferase (ALT), aspartate aminotransferase (AST), HOMA-IR, and liver fat content ( t =8.781, 8.765, 8.813, 3.485, 6.199, 5.694, 3.428, 6.492, and 4.925, all P < 0.05) and significant increases in high-density lipoprotein cholesterol, standard deviation of all normal R-R intervals (SDNN), standard deviation of average NN intervals (SDANN), root mean square of successive differences, percent of the number whose difference between adjacent NN interval are more than 50 ms (pNN50), high frequency (HF), and low frequency (LF) ( t =-2.055, -6.307, -7.696, -3.388, and -7.928, Z =-3.339 and -3.309, all P < 0.05), while the control group had significant reductions in HbA1c, FBG, and HOMA-IR ( t =9.220, 7.214, and 3.340, all P < 0.05). Compared with the control group after treatment, the dapagliflozin group had significantly lower levels of BMI, HbA1c, TG, SUA, HOMA-IR, ALT, AST, and liver fat content ( t =-4.055, -2.670, -2.056, -2.496, -3.976, -3.703, -2.123, and -5.184, all P < 0.05) and significantly higher levels of SDNN, SDANN, pNN50, LF, and HF ( t =4.136, 5.433, and 5.971, Z =-2.333 and -2.010, all P < 0.05). Conclusion For patients with T2DM and MAFLD, dapagliflozin can reduce BMI, HbA1c, TG, SUA, and liver fat content, improve insulin resistance and liver function, reduce the activity of sympathetic nerve, and regulate autonomic nerve function.

Establishment of evaluation index system for training effect of rural oriented clinical students based on Delphi method / 中华医学教育探索杂志

Objective:To establish an evaluation index system for training effect of order-oriented clinical medical students in Xinjiang by employers, so as to lay a foundation for training effect evaluation.Methods:On the basis of questionnaires and interviews with the training requirements of employers, Delphi method was used to determine the index system and weight.Results:The training requirements of employing units for the ability of free and directional medical students in autonomous regions were in turn competent for work, knowledge and practical ability, and good moral quality. The cultivation requirements for students' personal qualities of free and directional medical students were good interpersonal communication and moral quality. After three rounds of Delphi expert consultation, the evaluation index system was established, and three dimensions (knowledge, professional ability, professional ethics literacy), nine secondary indicators and 33 tertiary indicators were screened out, and the weights were determined.Conclusion:The evaluation index of training effect of directional clinical medical students established by Delphi expert consultation method needs further validation. Through the follow-up empirical application in directional clinical students, the evaluation index system can be constantly improved, which can also provide reference for the establishment of evaluation index system for other positions.

Risk factors for blood transfusion in very low birth weight infants / 中国小儿急救医学

Objective:To evaluate the characteristics and risk factors for blood transfusion in very low birth weight infants(VLBWI).Methods:Clinical data of one hundred VLBWI, hospitalized from July, 2016 to June, 2019, were studied retrospectively.The infants were divided into two groups according to whether they received blood transfusion.The general information, incidence of diseases and treatment measures were compared between two groups.The risk factors influencing the blood transfusion were analyzed.Results:Of the one hundred VLBWI, sixty-nine cases needed blood transfusion.The first time of blood transfusion ranged from one to four weeks after birth, and average number of transfusions was 6 times.Maternal anemia during pregnancy, birth weight, gestational age, hemoglobin and hematocrit at birth, volume of blood taking within two weeks after birth, duration of hospitalization, duration of paraenteral nutrition, delivery method, need for intubation and neonatal respiratory distress syndrome, apnea, bronchopulmonary dysplasia, patent ductus arteriosus showed significant differences between the two groups( P<0.05). Logistic regression analysis revealed that lower gestation( OR=0.386, 95% CI 0.212-0.704, P=0.002), longer duration of hospital stay( OR=2.177, 95% CI 1.170-4.049, P=0.014), prolonged parenteral nutrition( OR=1.195, 95% CI 1.083-1.319, P<0.001), greater volume of blood taking within two weeks after birth ( OR=1.269, 95% CI 1.083-1.487, P=0.003)and cesarean delivery( OR=5.513, 95% CI 1.056-28.770, P=0.043) were associated with increasing risk of blood transfusion in VLBWI. Conclusion:The gestational age, length of hospital stay, blood intake within two weeks after birth, duration of paraenteral nutrition and delivery method all affected the risk of blood transfusion to varying degrees.

The influence of intelligent hand hygiene monitoring system on reducing the incidence of catheter-related bloodstream infections / 中国实用护理杂志

Objective:To investigate the effects of intelligent hand hygiene monitoring system on hand washing compliance and the incidence of catheter-related bloodstream infections.Methods:A retrospective analysis was conducted on the hand hygiene compliance of medical staff and works at different seasons in 2018. The daily doses of hand sanitizer patients in each quarter of 2017 and 2018, the microbial contamination of the hands before the medical staff contacted the patients, the overall hospital infection rate and the incidence of catheter-related bloodstream infections were calculated and compared.Results:The hand-washing compliance rate of medical staff and workers were increased in 2018. Compared with daily doses of hand sanitizer patients in 2017 and 2018, there was significant difference ( F value was 4.99, P<0.05). In 2018, the qualified rate of microbial contamination in the hands of medical staff before contacting patients was higher than in 2017: 91.5%(43/47) vs. 51.1%(23/45), there was significant difference ( χ2 value was 92, P<0.05) . The rate of hospital infection and catheter-related bloodstream infections were 1.57%(30/1 907), 0.5%(6/1 158) in 2018 and 3.11%(57/1 843), 1.6%(17/1 095) in 2017, there was significant difference ( χ2 values were 9.551, 5.959, P<0.05). Conclusions:The intelligent control hand hygiene monitoring system can improve the hand-washing compliance of medical staff and workers, reduce microbial contamination in the hands of medical staff, thereby reducing the incidence of catheter-related bloodstream infections.

Multiple mediation effect on perceived stress and abnormal eating behavior through different emotion regulation strategies among medical students / 中国学校卫生

Objective@#To explore the relationships among perceived stress, emotion regulation strategies, and abnormal eating behavior among medical students, in order to provide healthy eating behavior reference for medical students, especially under pressure.@*Methods@#Chinese Perceived Stress Questionnaire, Emotion Regulation Questionnaire, and Dutch Eating Behavior Questionnaire were administered among 777 students from three medical universities in Shanxi seleceted by a stratified random cluster sampling method.@*Results@#There were significant differences in unhealthy eating behavior by gender and major. Abnormal eating problem score of clinical medicine students was significantly higher than that of non-clinical medicine students (t=3.56,P<0.01); Scores of restrained eating behavior, emotional eating behavior, and exogenic eating behavior of clinical medicine students were all significantly higher than those of non-clinical medicine students (t=3.45, 3.04, 4.19, P<0.01). Abnormal eating behavior, and restrained eating behavior and exogenic eating behavior in female students were significantly higher than those of male students (t=2.28, 2.58, 2.46, P<0.05). The perceived stress significantly and positively correlated with the abnormal eating behavior (P<0.01); Cognitive reappraisal and expressive inhibition significantly and negatively correlated with abnormal eating behavior respectively (P<0.01); No significant association was found between expressive inhibition and abnormal eating behavior. Cognitive reappraisal mediated the association between abnormal eating behavior with perceived stress which accounted for 36.89%, mediating effect in boys was higher than that of girls. However, expressive inhibition showed no similar effect and gender difference.@*Conclusion@#Perceived stress can influence abnormal eating behavior of medical students through cognitive reappraisal directly or indirectly, while expressive inhibition shows no such mediating effect. For medical students under pressure, the skill of emotion regulation through cognitive reappraisal, emotion expression as well as appropriate coping style under pressure should be developed.

Orthognathic surgical treatment of secondary maxillary deformities following the cleft lip and palate repair / 中华整形外科杂志

Objective@#The aim of this study is to summarize the experience of the orthognathic surgical treatment forsecondary maxillary deformities following the cleft lip and palate repair.@*Methods@#Twenty-two patients with secondary maxillary deformities following the cleft lip and palate repairment(orthognathic approach), were retrospectively analyzed.All the cases were treated in the Hospital of Stomatology, China Medical University from January 2007 to December 2016. There were 9 males and 13 females, ranging from 18 to 24 years in age. Only 3 of those cases were not undergone preoperative and postoperative orthodontic treatments. The anteroposterior maxilla and mandible discrepancy was 6-11 mm preoperatively. The modified surgical procedures are as follows: One-stage alveolar bone graftand maxillary osteotomy were performed for unilateral cleft patients; Internal fixation with micro-plate at the alveolar cleft region was performed to stabilize the maxillary dental arch intraoperatively; Intermolar wire ligation and palatal arch were used to control the width of maxilla intraoperatively and 1 month after operation; 2-3 mm overcorrection for the Le Fort Ⅰ advancement was produced to reduce relapse in sagittal direction. Mandibular set back was performed using bilateral sagittal split osteotomy at the same time. Rigid internal fixation with titanium palates and screws was applied for all the cases. All patients had been followed up for 1 to 2 years postoperatively.@*Results@#Most of the patients had satisfactory facial proportion, and good and stable occlusion relationship, with only one patient developed severely uncontrollable relapse to class Ⅲ malocclusion, and 3 patients experienced relapse resulted in edge to edge incisor relationship.@*Conclusions@#Le Fort Ⅰ osteotomy combined with bilateral sagittal split osteotomy was effective to correct the secondary maxillary deformities following the cleft lip and palate repair. The treatment plan should be individualized, depending on the patients′ occlusion relationship, skeletal deformity, and facial appearance as well. It is necessary to modify the surgical techniques of Le Fort Ⅰ osteotomy for the cleft patients.

One case of severe subcutaneous soft tissue infection caused by nonstandard insulin injection / 中华烧伤杂志

On January 1st 2018, a male 44 years old diabetic patient with subcutaneous soft tissue infection in right thigh was admitted to our hospital. The patient repeatedly used the same needle to inject insulin subcutaneously in the unsterilized right thigh, and his blood glucose was badly controlled in the long term. Severe subcutaneous soft tissue infection of the right thigh occurred after his fatigue, accompanied with ketoacidosis. Then he received conservative treatment in the local hospital for one month, but the infection persisted. After being transferred to our hospital, we highly suspected the diagnosis of necrotizing fasciitis according to previous test indicators and local B-ultrasound results, but suggestion of aggressive surgery was refused. So we treated him with conservative therapies using sensitive antibiotics and supportive remedies. The patient was basically healed after treatment of 1 month and he was recovered well during the follow-up 2 months after discharged from our hospital. This case emphasizes the importance of standard injection of insulin and early diagnosis of severe subcutaneous soft tissue infection.

Comparison of different doses streptozotocin-induced mouse models for the research of type 1 diabetic keratopathy / 中华实验眼科杂志

Objective To compare the rates and pathological features of diabetic keratopathy in mice induced by single high dose or multiple low dose streptozotocin (STZ) injections.Methods Eighty male C57BL/6 mice (6-8 weeks old) were randomly divided into 4 groups with each group contain 20 mice:normal control group,multiple low dose 1 month group and multiple low dose 3 months group (injected with 60 mg/kg STZ for 5 consecutive times),single high dose 1 month group (injected with 150 mg/kg STZ).The survival rate,model success rate,body weight,glycosylated hemoglobin (HbA1c) content were compared among different modeling group.The percentages of residual epithelial defect area were examined by fluorescein sodium staining after removal of central corneal epithelium.The expression of p-Akt,Sirt1 and Ki67 were evaluated by immunofluorescent staining.The corneal sensitivity were compared among different groups before corneal epithelial curettage,3,7,10 and 14 days after corneal epithelial curettage.The corneal subbasal nerve density at 14 days after corneal epithelial curettage were compared among different groups.This study complied with the declaration of ARVO Results The success rate of diabetic modeling in multiple low dose 1 month group,multiple low dose 3 months group and single high dose 1 month group was 90％,80％ and 70％,respectively.The HbA1c levels in the diabetic modeling groups were significantly higher than that in the normal control group (all at P＜0.05).The percentage of residual epithelial defect area 24 and 48 hours after corneal epithelial curettage in the multiple low dose 3 months group and single high dosc 1 month group were significantly higher than those in the normal control group (all at P＜0.05).The fluorescence intensity of p-Akt,Sirt1 and Ki67 in the multiple low dose 3 months group and single high dose 1 month group were stronger than those in the normal control group.There were no significant differences on corneal sensitivity and corneal nerve density between normal control and multiple low dose 3 months group before and 14 days after the corneal epithelial removal (all at P＞0.05).However,the corneal sensitivity and corneal nerve density were dramatically decreased in the multiple low dose 3 months group and single high dose 1 month group before and 14 days after the corneal epithelial removal,and there were significant differences compared with normal control group (all at P＜0.05).Conclusions The injection of 60 mg/kg STZ can not induce the features of diabetic keratopathy in mice within 1 month.However,the mice of both 1 month after 150 mg/kg STZ injection and 3 months after 60 mg/kg STZ injection appear the typical epithelial and nerve features of diabetic keratopathy,therefore can be the ideal animal models for research.

Effect of hyperandrogenism on obstetric complications of singleton pregnancy from in vitro fertilization in women with polycystic ovary syndrome / 中华妇产科杂志

Objective To compare the difference in risks of obstetric complications of singleton pregnancy between women with hyperandrogenic polycystic ovary syndrome (PCOS) and women with normoandrogenic PCOS. Methods Prospective cohort study. This study was a secondary analysis of data collected during a multicenter randomized controlled clinical trial. Women who got clinical singleton pregnancy were grouped according to whether they were diagnosed with hyperandrogenism at baseline. There were 118 women with hyperandrogenism and 366 women without hyperandrogenism. The incidences of obstetric complications and birth weight were compared between the two groups. Results Women with hyperandrogenic PCOS had a significantly higher risk of preterm delivery than women with normoandrogenic PCOS [12.7％ (15/118) versus 3.6％ (13/366); OR=3.94, 95％CI: 1.82-8.56]. After adjustment of age, duration of infertility, body mass index, and fresh or frozen embryo transfer group, hyperandrogenism was still associated with an increased risk of preterm delivery (OR=3.67, 95％CI: 1.67-8.07). Compared with women with normoandrogenic PCOS, women with hyperandrogenic PCOS had similar risks of pregnancy loss, gestational diabetes mellitus, pre-eclampsia, placenta previa, and postpartum hemorrhage (all P>0.05). Birth weight as well as the risks of being small for gestational age and large for gestational age were also comparable between the two groups (all P>0.05). Conclusion In women with PCOS and singleton pregnancy, those with preconceptional hyperandrogenism have a higher risk of preterm delivery than those without hyperandrogenism.

Characteristics and influencing factors of cognitive function in young and middle-aged hospitalized patients with type 2 diabetes mellitus / 中华护理杂志

Objective To investigate the characteristics of cognitive impairment and its influential factors in young and middle-aged hospitalized patients with T2DM.Methods Totally 140 young and middle-aged T2DM patients were recruited in 4 hospitals using convenience sampling method and were evaluated by Montreal Cognitive Assessment Scale (MoCA).Results The prevalence of cognitive impairment in 140 young and middle-aged T2DM patients in this study was 37.9％.The delayed memory (85.0％) was most common,followed by language(73.6％),and impaired visuospatial and executive function(50.7％).Attention,abstraction,and orientation were rarely affected,and naming was not impaired.Logistic regression showed that older individuals,women,poor blood glucose control could be important independent risk factors for cognitive impairment in young and middle-aged T2DM patients.Conclusion The prevalence of cognitive impairment in young and middle-aged T2DM patients was relatively high,and the delayed recall was mostly common.The older individuals,women,poor blood glucose control are associated with cognitive impairment.

Relationship between fibrosis and M2 macrophages in endometriosis / 实用医学杂志

Objective To investigate the relationship between fibrosis and M2 macrophages in endometriosis. Methods BALB/c mice model of endometriosis was established by intraperitoneal injection. The growth of ectopic lesions in mice was observed on the 7th,14th and 21th day after modeling. Masson staining was used to observe the degree of fibrosis and immunohistochemical method to detect the expression of CD206 and CD68 of mice. Image-Pro-Plus 6.0 was used for semi quantitative analysis of staining and the correlation between the degree of fibrosis and the expression of M2 macrophages was explored. Results The success rate of the establishment of endometriosis model by intraperitoneal injection was 100%. There was a positive correlation between fibrosis and the expression of M2 macrophages in endometriosis mice model. Conclusions The mice model of endometriosis can be established successfully by intraperitoneal injection and M2macrophages may promote fibrosis in endometriosis.