Diabetic kidney disease （DKD） is one of the common microvascular complications of diabetes mellitus （DM） and a primary cause of chronic kidney disease （CKD） and end-stage renal disease （ESRD）. Inflammation is currently a hot topic in exploring the pathogenesis of DKD. Macrophages， T cells， interleukins， tumor necrosis factor， NOD-like receptor protein 3 （NLRP3） inflammasome， Janus kinase/signal transducer and activator of transcription （JAK/STAT） signaling pathway， and nuclear factor-kappa B （NF-κB）-related signaling pathway all play a role in regulating the inflammation of DKD and accelerating its progression. Astragali Radix， a Chinese herbal medicine， is widely used in the treatment of DKD and possesses strong anti-inflammatory effects. Studies have revealed that active ingredients of Astragali Radix， including polysaccharides， astragaloside Ⅳ， total flavonoids， calycosin， and quercetin， can regulate multiple signaling pathways to ameliorate the microinflammatory state and alleviate kidney damage， thereby slowing down the progression of DKD. This article systematically reviews the factors influencing the inflammation in DKD and analyzes recent research findings and mechanisms concerning active ingredients of Astragali Radix in the management of DKD inflammation， aiming to offer novel insights and directions for the prevention， treatment， and research of DKD.

Objective To systematically analyze the medical radiation exposure levels in a district of Ningbo City and to provide a scientific basis for the reasonable and effective control of medical radiation exposure. Methods Based on the radiological diagnosis frequency and dose information system, basic medical radiation exposure data were collected, such as radiation doses received by patients in various X-ray diagnostic examinations, from all 13 public medical institutions in a district of Ningbo City from January 1 to December 31, 2020. The data were analyzed for the percentage and collective effective dose of various diagnostic examinations, the distribution of examinations by sex and age, and the number of patients undergoing two or more examinations and their cumulative doses within multiple time intervals. Results Among medical X-ray diagnostic examinations in the district, the percentages of CT examination and routine photography examination were 50.88% and 47.93%, respectively, and the collective effective dose of CT examination accounted for 97.75%. By age and sex, the frequency of examination was the highest in the age group of 45-54 years, and the frequency of examination in the male was higher than that in the female before age 55. The annual effective dose for two patients exceeded 100 mSv. Conclusion In this study, CT examination accounted for up to 50.88% of all medical X-ray diagnostic examinations, and contributed 97.75% of the collective effective dose, highlighting the need for particular attention to the justification of medical radiation exposure from CT.

Chronic cerebral hypoperfusion leads to white matter injury (WMI), which plays a significant role in contributing to vascular cognitive impairment. While 13-docosenamide is a type of fatty acid amide, it remains unclear whether it has therapeutic effects on chronic cerebral hypoperfusion. In this study, we conducted bilateral common carotid artery stenosis (BCAS) surgery to simulate chronic cerebral hypoperfusion-induced WMI and cognitive impairment. Our findings showed that 13-docosenamide alleviates WMI and cognitive impairment in BCAS mice. Mechanistically, 13-docosenamide specifically binds to cannabinoid receptor 1 (CNR1) in oligodendrocyte precursor cells (OPCs). This interaction results in an upregulation of ubiquitin-specific peptidase 33 (USP33)-mediated CNR1 deubiquitination, subsequently increasing CNR1 protein expression, activating the phosphorylation of the AKT/mTOR pathway, and promoting the differentiation of OPCs. In conclusion, our study suggests that 13-docosenamide can ameliorate chronic cerebral hypoperfusion-induced WMI and cognitive impairment by enhancing OPC differentiation and could serve as a potential therapeutic drug.
Animals ; Oligodendrocyte Precursor Cells/metabolism* ; Mice ; Cell Differentiation/drug effects* ; Male ; Receptor, Cannabinoid, CB1/metabolism* ; Mice, Inbred C57BL ; Ubiquitin Thiolesterase/metabolism* ; Ubiquitination/drug effects* ; Carotid Stenosis/complications* ; Cognitive Dysfunction/drug therapy*

Objective:To investigate the effect of low density lipoprotein cholesterol (LDL-C) on the progression of retinal arteriosclerosis by using a deep learning model.Methods:A cohort study was performed.Data of 1 928 individuals who underwent the medical examination at Beijing Yijiandian Clinic between January 2016 and August 2023 were reviewed, including baseline demographics, physical examination, serological test and fundus photography.Retinal arteriosclerosis was identified using a deep learning model.Five groups were divided according to LDL-C levels, including 389 subjects in group 1 (0.64-1.90 mmol/L), 387 subjects in group 2 (1.91-2.26 mmol/L), 384 subjects in group 3 (2.27-2.57 mmol/L), 385 subjects in group 4 (2.58-2.95 mmol/L), and 383 subjects in group 5 (2.96-6.06 mmol/L).The association between LDL-C levels and progression of retinal arteriosclerosis and the dose-response relationship were analyzed by logistic regression analysis and restricted cubic spline (RCS) regression model.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Peking University People's Hospital (No.2021PHB058-001).Written informed consent was obtained from each subject.Results:The incidence of retinal arteriosclerosis progression was 22.10% (426/1 928) during the mean follow-up (66.84±6.58) months.The proportions of fundus progression in groups 1, 2, 3, 4, and 5 were 15.68%(61/389), 21.71%(84/387), 21.35%(82/384), 25.71%(99/385), and 26.11%(100/383), respectively, with statistical significant differences among them ( χ2=15.97, P=0.003).Using group 1 as a reference, LDL-C 2.58-2.95 mmol/L was an independent risk factor for progression of retinal arteriosclerosis ( OR=1.52, 95% CI: 1.04-2.22), and RCS analysis showed an " L" shaped association.The effect of LDL-C on retinal arteriosclerosis showed a threshold effect, with the risk of retinal arteriosclerosis progression increasing with increasing LDL-C when LDL-C was <2.34 mmol/L ( OR=1.97, 95% CI: 1.10-3.62), and stabilizing when LDL-C was ≥2.34 mmol/L. Conclusions:LDL-C has a threshold effect on the impact of retinal arteriosclerosis progression, and the threshold is 2.34 mmol/L.

Objective:To estimate and analyze the levels of occupational exposure of aircrews in China, and to provide scientific basis for strengthening occupational health management.Methods:Through the FlightAware website, the flight data were collected of a total of 104 routes flying between airports with large passenger volume in China. Four kinds of cosmic radiation dose estimation programs CARI, SIEVERT, PCAIRE, and JISCARD-EX were compared and analyzed from the aspects of covering the number of airports in China, program user experience and example calculation of airline effective dose. Based on route logs, CARI-7A was applied to estimate the levels of occupational exposure of Chinese aircrews to cosmic radiation.Results:The difference in the effective doses calculated by use of these four cosmic radiation dose estimation programs for the routes with different solar activity levels was statistically significant ( M=7.52-180.98, P<0.05). The annual effective dose estimated by PCAIRE for 68 routes from 2014 to 2021 was significantly higher than that estimated by CARI-7A ( Z=2.52, P<0.05). Based on CARI-7A, the annual effective doses from cosmic radiation to aircrews in China from 2014 to 2021 were estimated, being 1.26 (0.57-2.35) mSv for flight attendants and 1.03 (0.47-1.92) mSv for pilots. The effective dose from cosmic radiation to aircrews on a single flight on some high-frequency routes in China ranged from 0.57 to 6.88 μSv. Conclusions:The level of occupational exposure of Chinese aircrews to cosmic radiation meets the requirements of national standards, but is higher than that of occupational exposure from medical and industrial applications of radiation, so it is still necessary to further strengthen the mamagememt of occupational exposure and occupational health of aircrews.

Objective To develop a Psychological Birth Trauma Assessment Scale and to test its reliability and validity.Methods Through literature review,semi-structured interview,expert conference,Delphi expert enquiry and preliminary investigation,a pre-test scale was formed.From March to May 2023,postpartum women from 38 hospitals of different levels in 15 provinces(Jiangsu,Anhui,Zhejiang,Fujian,Tibet,and Shanghai,etc.)were conveniently selected for investigation.The sample size of the first-round survey was 547,which was used for reliability and validity test.The sample size of the second-round survey was 550,which was used for confirmatory factor analysis.Results The psychological birth trauma assessment scale consisted of 2 parts,with a total of 29 items in 6 dimensions.The intrapartum feeling part included 4 dimensions,with a cumulative variance contribution rate of 63.992％,and the postpartum effect part included 2 dimensions,with a cumulative variance contribution rate of 68.208％.The content validity index of the scale was 0.947,and the content validity index of each item was 0.809～1.000.The total score of the scale and the scores of each dimension were significantly negatively correlated with the total score of the calibration scale(r=-0.784～-0.533,P＜0.001).The total Cronbach's α coefficient was 0.941,and the split-half reliability coefficient was 0.883.Confirmatory factor analysis showed that the main evaluation indicators were all within the acceptable range.Conclusion The Psychological Birth Trauma Assessment Scale has good reliability and validity,and it can be used as an assessment tool for the degree of maternal psychological birth trauma.

Objective To report single-center experience on CBA combined with LAAC in treat-ment of AF.Methods A retrospective study was conducted on 27 AF patients undergoing one-stop surgery of CBA combined with LAAC in Department of Cardiovascular Diseases of the People's Hospital of Liaoning Provincie from August 2020 to November 2022.The efficacy and safety of the surgery were analyzed.Results There were 22 patients(81.5％)with LAmbre and 5 patients with Watchman(18.5％,including one case of 24 mm Watchman FLX).All the patients achieved complete pulmonary vein isolation,and conversion to sinus rhythm during operation.During a mean follow-up of 30.0±9.2 months,24 patients(88.9％)maintained sinus rhythm at 12-month follow-up,and 22 patients(81.5％)maintained sinus rhythm at 24-month follow-up.TEE at 3 months after operation displayed that all the devices were in good positions and no PDL or DRT was observed.In the 11 patients undergoing cardiac enhanced CT in 12-36 months after surgery,PDL was detected in one patient(9.1％),and uncomplete endothelialisation of the device was observed in another one(9.1％)using the Watchman device.TEE at 26 months revealed one patient(3.7％)of DRT.Conclusion One-stop surgery of CBA combined with LAAC is a feasible treatment option for patients with NVAF and at high risk of stroke.

Objective To investigate the in vitro anti-inflammatory effects of Sophora davidii Hance leaves total alkaloids(SDLTAs)and possible molecular mechanisms.Methods The lipopolysaccharide(LPS)-induced inflammation model of RAW264.7 cells was used,and different concentrations of SDLTAs(50,100 and 200 μg/mL)were administered,and the effect of SDLTAs on cellular NO expression was detected by the Griess method;ELISA method was used to detect the effect of SDLTAs on the expression of IL-6,TNF-α and IL-1β;The expression of iNOS,NF-κB p65 and IκBα mRNA was detected by RT-qPCR;Western blotting was used to detecte the expres-sion of p-p38,p-p65 and p-JNK in the cells and NF-κB p65 in the nucleus.Results SDLTAs could significantly inhibit the LPS-induced inflammatory response in RAW264.7 cells.SDLTAs significantly decreased the secretion of NO,IL-6,TNF-α and IL-1β in cells(P<0.01),and significantly decreased the mRNA expressions of iNOS,NF-κB p65 and IκBα in cells(P<0.01).Significantly decreased the protein expression of p-p38,p-p65 and p-JNK in cells and NF-κB p65 in nucleus(P<0.01).Conclusion SDLTAs can exert anti-inflammatory effects by regulating the MAPK/NF-κB signalling pathway.

Objective To explore the effect and mechanism of Shenqi Jieyu Formula(SQJYF)on depression and anxiety-like behavior in adult offspring rats after maternal separation(MS).This was done by observing the levels of metabolites in the hippocampus and prefrontal cortex of the Papez circuit through magnetic resonance spectroscopy(MRS).Methods Twenty-four Sprague-Dawley rats at 16 days of pregnancy were divided into the normal,model,SQJYF,and fluoxetine groups using the random number table method,with six rats per group.MS was performed 4 h a day from the first to the 21st day afterbirth.Starting from the 15th day,the corresponding medications(SQJYF group:12.5 g/kg,fluxetine group:2.33 mg/kg)were administered to mother rats once a day for 7 consecutive days.Normal breastfeeding was performed during the gavage.The offspring rats were weaned on the 22nd day.According to the experimental grouping of mother rats,one male and one female offspring rat of each mother rat were randomly selected using the random number table method,with six rats per group.They were divided into normal,model,SQJYF,and fluoxetine female and male rat groups,respectively.After 8 weeks of feeding,the offspring rats in each group were subjected to forced swimming test(FST),the sucrose water consumption test,and open field tests(OFT),and the elevated plus maze(EPM)test was conducted.The relative values of N-acetyl-aspartate(NAA),choline(Cho),glutamic acid(Glu),myo-inositol(mI),and creatine(Cr)in the hippocampus and prefrontal cortex were detected using MRS.Results Compared with that of the normal female and male rat groups,the weight of the rats in the model group was decreased as well as sucrose water consumption and the horizontal and vertical scores of OFT,whereas the immobility time of FST increased.Compared with the normal female and male rat group,the NAA/Cr and Glu/Cr values in the bilateral hippocampus and prefrontal cortex of the female and male rats in the model group decreased(all P＜0.01).The proportion of rats entering the open arm and open arm residence time of the model female rat group in the EPM test decreased,whereas the Cho/Cr value of the right hippocampus of the female rats in the model group increased(P＜0.05).Compared with the model female and male rat group,the weight of the rats in the SQJYF and fluoxetine groups increased,the immobility time of FST decreased,but the sucrose water consumption and the horizontal and vertical OFT scores increased(P＜0.01).The proportion of rats entering the open arm and open arm residence time in the EPM increased in the SQJYF and fluoxetine female rat groups compared to those of the model female rat group(P＜0.01).Compared with the model female rat group,the NAA/Cr and Glu/Cr values in the bilateral hippocampus and prefrontal cortex of female rats in the SQJYF and fluoxetine groups increased.The NAA/Cr and Glu/Cr values in the right hippocampus and prefrontal cortex of male rats in the SQJYF and fluoxetine groups were higher than those in the model group(P＜0.05),whereas the Cho/Cr value in the right hippocampus of female and male rats in the SQJYF and fluoxetine groups decreased(P＜0.05).Conclusion MS in early life can lead to depression and anxiety-like behavior in adult offspring.However,SQJYF may exert antidepressant and anti-anxiety effects by regulating the metabolite levels in related brain regions of the Papez circuit.

Objective To explore the effect and mechanism of Shenqi Jieyu Formula(SQJYF)on depression and anxiety-like behavior in adult offspring rats after maternal separation(MS).This was done by observing the levels of metabolites in the hippocampus and prefrontal cortex of the Papez circuit through magnetic resonance spectroscopy(MRS).Methods Twenty-four Sprague-Dawley rats at 16 days of pregnancy were divided into the normal,model,SQJYF,and fluoxetine groups using the random number table method,with six rats per group.MS was performed 4 h a day from the first to the 21st day afterbirth.Starting from the 15th day,the corresponding medications(SQJYF group:12.5 g/kg,fluxetine group:2.33 mg/kg)were administered to mother rats once a day for 7 consecutive days.Normal breastfeeding was performed during the gavage.The offspring rats were weaned on the 22nd day.According to the experimental grouping of mother rats,one male and one female offspring rat of each mother rat were randomly selected using the random number table method,with six rats per group.They were divided into normal,model,SQJYF,and fluoxetine female and male rat groups,respectively.After 8 weeks of feeding,the offspring rats in each group were subjected to forced swimming test(FST),the sucrose water consumption test,and open field tests(OFT),and the elevated plus maze(EPM)test was conducted.The relative values of N-acetyl-aspartate(NAA),choline(Cho),glutamic acid(Glu),myo-inositol(mI),and creatine(Cr)in the hippocampus and prefrontal cortex were detected using MRS.Results Compared with that of the normal female and male rat groups,the weight of the rats in the model group was decreased as well as sucrose water consumption and the horizontal and vertical scores of OFT,whereas the immobility time of FST increased.Compared with the normal female and male rat group,the NAA/Cr and Glu/Cr values in the bilateral hippocampus and prefrontal cortex of the female and male rats in the model group decreased(all P＜0.01).The proportion of rats entering the open arm and open arm residence time of the model female rat group in the EPM test decreased,whereas the Cho/Cr value of the right hippocampus of the female rats in the model group increased(P＜0.05).Compared with the model female and male rat group,the weight of the rats in the SQJYF and fluoxetine groups increased,the immobility time of FST decreased,but the sucrose water consumption and the horizontal and vertical OFT scores increased(P＜0.01).The proportion of rats entering the open arm and open arm residence time in the EPM increased in the SQJYF and fluoxetine female rat groups compared to those of the model female rat group(P＜0.01).Compared with the model female rat group,the NAA/Cr and Glu/Cr values in the bilateral hippocampus and prefrontal cortex of female rats in the SQJYF and fluoxetine groups increased.The NAA/Cr and Glu/Cr values in the right hippocampus and prefrontal cortex of male rats in the SQJYF and fluoxetine groups were higher than those in the model group(P＜0.05),whereas the Cho/Cr value in the right hippocampus of female and male rats in the SQJYF and fluoxetine groups decreased(P＜0.05).Conclusion MS in early life can lead to depression and anxiety-like behavior in adult offspring.However,SQJYF may exert antidepressant and anti-anxiety effects by regulating the metabolite levels in related brain regions of the Papez circuit.