Objective To evaluate the safety and immunogenicity of pre-exposure prophylaxis of the approved freeze-dried rabies vaccine(Vero cell)(rabies vaccine in brief)for human use in adults ≥18 years of age.Methods Participants aged ≥18 years in Guizhou and Shanxi provinces from June 2022 to September 2022 were enrolled,vaccinated with 1 dose of rabies vaccine at 0,7,28 d respectively,and collected for 5. 0 mL of venous blood before the first dose and 14 d after the third dose. Immunofluorescence foci assay was used to detect rabies virus neutralizing antibodies,and adverse events were collected 0～7 d after each dose of vaccine.Results A total of 120 participants were enrolled,120 participants received the first dose of rabies vaccine,119 participants received the second dose and 118 participants received the third dose.Before the first dose of rabies vaccine,the seropositive rate of antibody was 2. 54% and the geometric mean concentration(GMC)was 0. 40 IU/mL. After the third dose of rabies vaccine,the seropositive rate and seroconversion rate were 100%,the GMC was 9. 68 IU/mL,and the geometric mean increase(GMI)was 23. 99. The incidence of adverse events 0～7 d after the first,second and third doses of rabies vaccine were 22. 50%,13. 45% and 4. 24%,respectively. The local adverse events were mainly pain,and the systemic adverse events were mainly fever,fatigue/weakness,dizziness,joint pain,and diarrhea.Conclusion Approved rabies vaccine showed good safety and immunogenicity in pre-exposure prophylaxis of people ≥ 18 years old.

Objective:To compare clinical characteristics of acute and chronic central serous chorioretinopathy (CSC).Methods:41 patients with CSC in the First Affiliated Hospital of Soochow University were studied, according to the course, they were divided into acute central serous chorioretinopathy group (A group, 29 eyes of 29 cases) and chronic central serous chorioretinopathy group (B group, 12 eyes of 12 cases). All patients underwent the best corrected visual acuity (BCVA), subretinal fluid thickness (SRF) and subfoveal choroidal thickness (SFCT) examination. The imaging characteristics of fundus fluorescein angiography (FFA) and optical coherence tomography angiography (OCTA) were compared between the two groups.Results:The BCVA, SRF and SFCT in A group were higher than those in B group ( P<0.05). FFA in group A showed that the leakage of ink diffusion or smoke type fluorescein leakage. FFA in group B showed that the fluorescein leakage was single or multiple in macular area, and atrophy of retinal pigment epithelium (RPE) cells was observed. OCTA of group A showed that the choroidal capillary layer showed high blood flow signal, low blood flow signal around the outside, or coarse granular high signal, and no choroidal neovascularization (CNV) was found. OCTA in group B showed that the image of choroidal capillary layer was similar to that of group A, but in group B, 2 eyes (2/12) had CNV with obvious morphology. Conclusions:Clinical characteristics of acute and chronic central serous chorioretinopathy are different. OCTA has definite application value in follow-up and detection of CNV.

Objective To observe the clinical efficacy of Wenjing Shexue Recipe ( WSR) in treating polycystic ovarian syndrome ( PCOS) with liver-kidney deficiency, and to explore the possible therapeutic mechanism. Methods Seventy-four PCOS patients were randomized into observation group ( N=38) and control group ( N=36). The observation group was given oral use of WSR and the control group was treated with Ethinylestradiol and Cyproterone Acetate Tablets orally. Both groups received treatment for 6 months, and were followed up for 3 moths after drug withdrawal. After treatment, the therapeulic effect was evaluated , and the changes of body mass index ( BMI) , hairiness. acne, and sexual hormone levels were monitored before and after treatment. Results ( 1) The total effective rate of the observation gorup was 92.11% and that of the control group was 75.00%, the difference being significant ( P<0.05). ( 2) After treatment for 6 months, body mass index (BMI), the scores of hairiness and acne, and serum levels of testosterone (T) and luteotrophic hormone (LH) were decreased in the observation group (P<0.05 compared with those before treatment). The control group had lower scores of hairiness and acne and serum levels of T and LH than those before treatment ( P<0.05) , but BMI showed no obvious decrease (P>0.05) . The results of follow-up showed that BMI, the scores of hairiness and acne, and serum levels of T and LH were still lower in the observation group than those before treatment (P<0.05), but the above indexes except acne scores were increased in the control group (P>0.05 compared with those before treatment) and were higher than those of the observation group (P<0.05). Conclusion WSR exerts better effect for the treatment of PCOS with liver-kidney deficiency than Ethinylestradiol and Cyproterone Acetate Tablets, and the possible mechanism is probably related with the regulation of endocrine disturbance by decreasing serum T and LH levels.

Objective To observe the therapeutic effect of Wenyang Huayu Sanjie Decoction ( WHSD) for the treatment of adenomyosis with the syndrome of blood deficiency and cold stagnation. Methods Seventy qualified patients were evenly randomized into observation group and control group. The control group was treated with Mirena intrauterine contraceptive device, and the observation group was treated with WHSD ( composed of Danggui Sini San, Wuzhuyu Shengjiang Tang, Shixiao San and Rhizoma Sparganii, Rhizoma Curcumae). The clinical outcomes included the menstrual blood volume, menstrual cycle, menstruation, degrees of dysmenorrhea, uterine volume, and serum CA125 level in the two groups before treatment and 3, 6 months after treatment. Results ( 1) After treatment for 6 months, the total effective rate of the observation group was 94.29%, significantly higher than 85.71% in the control group ( P<0.05). ( 2) After treatment, dysmenorrheal degrees, menstrual blood volume, menstrual cycle, menstruation, uterine volume, and serum CA125 level were improved in both groups ( P<0.05) , and the observation group had better effect on relieving dysmenorrhea, improving menstruation, and decreasing CA125 level than the control group ( P<0.05). ( 3) No obvious adverse reaction was found in the observation group, but most of the cases in the control group had menstrual disorder such as vaginal irregular bleeding and prolongation of menstruation. Conclusion WHSD has certain therapeutic effect on adenomyosis with the syndrome of blood deficiency and cold stagnation, and can also obviously improve the quality of life of the patients.

Background The pathogenesis and mechanism research of corneal neovascularization is of important significance for the prevention and management of corneal neovascularization.Some relative researches are being performed on non-corneal neovascularization-derived vascular endothelial cells, so the results are affected to a certain extent.Objective This study was to isolate and culture vascular endothelial cells from experimental corneal neovascularization tissue and detect the expression of chemokine receptors in vitro.Methods Corneal neovascularization models were established on 10 SPF male BALB/c mice with the age of 7-8 weeks by sticking the filter papers with NaOH on the central corneas, and then the immunofluorescence technique was use to assay the CD31 expression in corneal flatmount 2 weeks after modeling.Corneal pieces were made in 2 weeks after alkali burn and then were digested by collagenase type D.Vascular endothelial cells were isolated from neovascularized tissue by affinity purification using magnetic beads coated with anti-CD31.The cells were cultured on fibronectin-coated walls and then identified by immunocytochemistry.Reverse transcription-PCR was employed to detect the expressions of chemokine receptors in the cells.The use and care of the animals complied with ARVO Statement and this experimental procedure was approved by Soochow University Animal Care Committee.Results Corneal neovascularization occurred at 7 days and peaked at 2 weeks after modeling, and immunofluorescence exhibited the green network-like fluorescence for CD31 antibody in corneas.The cells grew against the wall 2 hours after culture with the polygon shape and large dimension, and the growth obviously quickened after passage.The cultured cells showed the positive response for CD31 antibody, showing the brown dye in cytoplasm,in contrast,the expression of CD31 was absent in corneal stromal cells.Chemokine receptors were positively expressed in the cells with the strongest expression levels in CCR1 ,CCR2,CCR3 and CCR4 mRNA and the weakest expression levels in CCR9,CXCR4 and CXCR5 mRNA,while CXCR3, CCR6, CCR10 and CX3CR1 mRNA were expressed with the moderate intensity.Conclusions Vascular endothelial cells can be obtained from experimental neovascularized corneas by affinity purification and express chemokine receptors,which facilitate the study of their biological properties.

Objective To investigate the release and intracellular localization of high mobility group box chromosomal protein 1(HMGBl)in the peripheral blood monocytes of rheumatoid arthritis(RA) patients and the inhibitive effect of thaiidomide.Methods 19 RA patients and 20 healthy controls were included in the study.Monocytes were separated from peripheral blood with Ficoll density gradient centrifugation.Monocytes were treated with 100 ng/ml tumor necrosis factor α(TNFa)or 100 ng/ml TNFα plus 40 μg/ml thalidomide and grown in an incubator at 37℃ with 5%CO,for 24 hours.The cuIture supernatants of the monocytes were collected.HMGB1 level in the culture medium was detected with Western blot.In addition,the intraceUular localization of HMGB1 in the fflonocytes was investigated with immunocytochemical analysis. Results Without stimulation. the release of HMGBl protein was significantly increased in the culture supernatants of peripheral blood monocytes from RA patients as compared with that from healthy controls(P<0.05).TNFα(100 ng/ml)did not further increase the release of HMGBl in the monocytes from the patients with RA.Thalidomide(40 μg/ml)could inhibit the release of HMGB1 in the monocytes from RA patients stimulated with TNFα(P<0.05).In the monocytes from RA patients,HMGBl was mainly localized in the nucleus.Treatment with TNFOL(100 ng/ml)for 24 hour resulted in a cytoplasmic translocation of HMGB1,which was inhibited significantly by thalidomide. Conclusion TNFα induces the release and cytoplasmic translocation of HMGBI in the peTipheral blood monocytes of RA patients and thalidomide inhibits the release and translocation of HMGB1.

Background Corneal neovascularization (CNV) is one of the causes of corneal blindness.Studies showed that ADP-ribosylation factor (ARF) can regulate the growth of tumor cells,and inhibiting ARF will decrease angiogenesis.However,whether ARF antagonist plays an action on CNV is unclear.Objective The aim of this study was to explore the effect and mechanism of ARF inhibitor on alkali-burn induced CNV.Methods Sixty clean male BABL/c mice aged 7-8 weeks were divided into PBS group and ARF antagonist group according to randomized number table.CNV models were induced by NaOH burn method in all the mice.ARF at the concentration of 0.5 g/L(0.5 ml) was intraperitoneally injected 3 times per week for 1 week followed the induction of CNV in the ARF antagonist group,and 0.5 ml PBS was used in the PBS group.CNV was examined 2,4,7,14 days after injection by the slit lamp microscope and the CNV related area in the cornea was calculated.Betore modeling(0 day) and 4,7,14 days after modeling,real-time PCR and Western blot were used to analyze the expressions of ARF mRNA and protein in the corneas.Forteen days after modeling,the expression of the CD31 in the CNV was detected using immnofluorescence of corneal whole mount;the expression of vascular endothelial growth factor(VEGF) in the cornea was assayed by Western blot.Cellular wound scratch test was employed to evaluate the effects of ARF antagonist on proliferation and migration of human retinal vascular endothelial cells (RECs).All animal experiments were done in accordance with the ARVO Statement for the Use of Animals in Ophthalmic and Vision Research and Guideline for the Care and Use of Laboratory Animals on the the Soochow University Animal Care Committee.Results ARF mRNA and protein were expressed in the mice corneas in both the PBS group and the ARF antagonist group at various time points.The expression of ARF mRNA in mice corneas was enhanced with the lapse of the time (Ftime =65.17,P =0.00),but no significant difference was found among the groups (Fsroup =1.98,P=0.18).There was also significant difference in the expression of ARF protein in mice corneas at different time points in the ARF antagonist group (F =10.77,P =0.00).The related CNV area was 0.45±0.05 in the ARF antagonist group,and that in the PBS group was 0.72±0.11,with significant difference between them (t =-3.87,P ＜ 0.05).The green fluorescence area of C D31 expression in the cornea was smaller in the ARF antagonist group than that of the PBS group.Expression level of VEGF in the ARF antagonist group was 1.20±0.21,and that in the PBS group was 2.47±0.33,showing a significant difference (t =-5.62,P ＜ 0.05).As the increase of ARF antagonist concentration,the inhibiting rate of cell proliferation was reinforced among 10,100 and 1 000 μg/L ARF antagonist groups (F=8.47,P =0.02).Twenty-four hours after scratch test,the migrating distance of human RECs was (5.46±1.32) μm and (5.04±1.68) μm in the 100 μg/L and 1 000 μg/L ARF antagonist groups,respectively,which were shorter than (8.49± 1.18) μm of the PBS group (t=-2.94,-2.91,both at P＜0.05).Conclusions ARF inhibitor can reduce CNV by down-regulating the expression of VEGF in alkaline burn cornea and inhibiting the proliferation and migration of vascular endothelial cells.

Objective:To investigate the correlation between mild cognitive impairment(MCI)and abnormal glucose metabolism and thus to provide a basis for MCI prevention.Methods:A total of 1 074 elderly outpatients with normal cognitive function and without confirmed diabetes mellitus, hyperlipoidemia or gout were enrolled.During a five-year follow-up period, 121 subjects were diagnosed with MCI based on the mini mental state examination(MMSE)and the Montreal cognitive assessment(MoCA). Furthermore, annual blood glucose and glycated hemoglobin monitoring was carried out to examine the long-term effects of abnormal glucose metabolism on MCI risk.Results:According to cognitive function, 1 074 subjects were divided into the MCI group and the non-MCI group.Compared with the non-MCI group, the mean values of fasting blood glucose(FBG), glycosylated hemoglobin(HbA1c), triglycerides(TG)and total cholesterol(TC)in the MCI group were elevated( P<0.05). The receiver operating characteristic(ROC)curve showed that the cut-off value of FBG was 6.2 mmol/L for the hyperglycemia group(sensitivity: 84.1%, specificity: 90.9%, area under curve: 0.875, P<0.001)and 4.5mmol/L for the hypoglycemic group(sensitivity: 77.4%, specificity: 87.3%, area under curve: 0.823, P<0.001); the cut-off value of HbA1c was 5.5%(sensitivity: 76.0%, specificity: 87.0%, area under curve: 0.815, P<0.001). Multiple Logistic regression analysis showed that increased risk of MCI was associated with the mean values of fasting blood glucose <4.5 mmol/L( RR: 1.69, 95% CI: 1.11-2.59)or ≥6.2 mmol/L( RR: 1.81, 95% CI: 1.15-2.86)and of glycosylated hemoglobin ≥ 5.5%( RR: 2.13, 95% CI: 1.51-2.99). Conclusions:Impaired fasting glucose tolerance and low fasting blood glucose are independent risk factors for MCI in the elderly.

Objective To investigate the application of PBL and LBL teaching in medical imag-ing teach-ing. Methods Totally 124 five-year clinical students were divided into two groups:PBL teaching (n=57)and LBL teaching(n=67). Teaching in PBL group was conducted through the following 6 proce-dures:grouping-giving cases-asking questions-establishing hypothesis-collecting data-hypoth-esis testing-team summarizing. Teaching in LBL group was conducted mainly by teachers with multime-dia, course-ware,wall charts,models,samples,etc and finally summarized by teachers. Effect was eval-uated by reading test,closed-book exam and questionnaire survey. t test was employed to do statically analysis,with P≤0.05 being statistical differences. Results Reading test score ((82.4±14.8)vs (74.5±9.7))and case analysis score((13.9±5.1)vs (10.2±6.1))were higher in PBL group than in LBL group(P≤0.05). Most students in PBL group appreciated the teaching method. Conclusions PBL teaching can help improve the clinical analysis of students and is welcomed by students. Moreover, PBL,as a supplement of traditional teaching,can initiate the learning interests and enhance the innova-tion of students.

Background Researches showed that ADP-ribosylation factor (ARF) promotes intracorneal secretion of multiple angiogenesis-related factors,such as vascular endothelial growth factor (VEGF) and nitricoxide synthase (NOS) etc., and therefore results in corneal neovascularization.However, whether ARF affects the tube formation of human retinal endothelial cells(HRECs) is unelucidated.Understanding the effect of ARF tube formation of HRECs is important for the target treatment of retinal vascular diseases.Objective The aim of this study was to explore the effect and mechanism of ARF inhibitor on tube formation of HRECs in vitro.Methods HRECs (HREC line) were cultured and passaged.The growth-well cells were harvested and divided into two groups.The cells were regularly cultured in the control group,and ARF antagonist (lml) was added in the culture medium in the ARF antagonist group.The expression levels of ARFmRNA and protein in the cells were examined by reverse transcription (RT)-PCR and Western blot.The morphology and number of HREC tube formation were detected by using three-dimensional Matrigel assay.The relative expression levels of VEGF, NOS, focal adhesion kinase (FAK) and heat shock protein 90 (HSP90) at gene level and protein level were examined by RT-PCR and Western blot in vitro.Results The relative expression levels of ARFmRNA in the cells were 0.65 ±0.14 and 0.32±0.10, and those of ARF protein were 0.85±0.15 and 0.24±0.17 in the control group and ARF antagonist group,showing significant differnces between the two groups (t =7.32, P =0.00;t =5.15, P =0.00).The number of HREC tube formation was (34.66±8.57)/field in the ARF antagonist group, which was significantly lower than (51.46±7.12)/field in the control group (t=2.99 ,P=0.04).The relative expression levels of VEGF mRNA, NOSmRNA and their proteins in the cells were significantly lower than those of the control group (t =3.02, P =0.04;t =3.68, P =0.02;t =3.33,P=0.03;t=2.89 ,P=0.04).The relative expression levels of FAKmRNA and HSP90mRNA in the ARF antagonist group were 0.65±0.18 and 0.28±0.05 ,which were significantly lower than 0.76±0.25 and 0.46±0.09 in the control group (all at P＜0.05).Conclusions ARF antagonist appears to have an inhibitory effect on the tube formation ability of HRECs propably by down-regulating the expressions of VEGF, NOS and the downstream signal transduction factors FAK and HSP90 in HRECs in vitro.