Objective To summarize the clinical diagnosis and treatments of 55 reflux laryngitis (RL) pa-tients, and to study the relationship between gastroesophageal reflux disease (GERD) and RL. Methods The pa-tients went through the following diagnostic process consisting of the collection of medical history, laryngoscopy, gastroscope, X-ray barium meal examination, vocal evaluation, therapy of anti-acid and anti-reflux. Results The laryngeal manifestations of RL mainly consisted of laryngeal discomfort or foreign body sensation (89. 1%), chronic cough (36.4 % ), hoarseness (20 % ), laryngeal pain (18. 2 %), even severe aspiration or laryngismus (10.9%) and so on. With the laryngoscopy we could see congestion in arytenoids area (67.3%), swelling or pachynsis of a mucosal fold in interarytenoid area (43.6%), edema of true or false vocal cord(40%), a little dropsy staying in piriform sinus (32.70% ), contact ulcer or granuloma on posterior extremity of a vocal cord (20 % ), artificial sulcus under vocal cords (16.4 %). RL patients might have mild voice disorder, among whom 65.5 percent displayed ten-sion dysphonia. Fundamental frequency (F0), jitter, shimmer and normalized noise energy (NNE) of RL patients increased. Compared with the controls, there were significant differences (P<0. 05) except for the F0 of female pa-tients. The manifestation and physical symptoms were improved or disappeared after the treatment with proton pump inhibitor (PPI). Conclusion RL is one of the important manifestations of GERD out of digestive tract. Typi-cal RL manifestation is mainly a pathological process in the postero-glottis. Clinically, PPI can be used as not only a treatment but also a tentative diagnosis of RL.

AIM: To provide a basis for appraising quality standard of Baohe Pill (Fructus Gataegi, Massa medicata fermentata, Rhizoma pinelliae, Pericapium citr reticulatae, Fructus forsythiae, Semen raphani, Fructus Mordei germinatus, Poria) inclusive of its RP-HPLC fingerprint chromatogram. METHODS: The chromatographic column was Kromasil C_ 18 column (4.6 mm?250 mm, i.d, 5-?m particle size). The mobile phase was 0.5% solution of ammonium dihydrogen phosphate (NH_4H_2PO_4), and the flow rate was 0.8 mL/min with UV detector at 214 nm. RESULTS: The RP-HPLC fingerprint chromatogram of Baohe Pill was established. In the experiment, for precision and repeatability, the RSD of each area of common peak was less than 3%. CONCLUSION: This method is simple and reliable.

Background and purpose:Cancer is a major public health issue in China and worldwide, which se-riously threatens human beings as well as social and economic development. This study explored the relationships between the cancer distribution characteristics and cancer prevalences in Chinese cancer surveillance regions to provide scientific evidence for cancer prevention and management.Methods:The data were obtained from the book named“Prevalence and Mortality of Cancer in China from 2003-2007” including incidence of 23 cancer types in 32 regions of China published by the Academy of Military Medical Sciences of the Chinese PLA in 2012. Correspondence analysis was used to gain the relation between the prevalence and area distribution. Cluster analysis was used to obtain the classifications with special significance by putting the cancers or regions with similar characteristics into a cluster.Results:Esophageal cancer, gastric cancer, liver cancer, lung cancer, colorectal and anal cancer have high incidence and mortality in both genders. The districts with high incidence of esophageal cancer and gastric cancer were grouped together. The counties or cities (Shexian, Yangcheng, Linzhou, Yanting, Yangzhong and Jianhu) with high incidence of esophageal cancer and gastric cancer were classified into same cluster frequently. Fusui was grouped along because of the lower incidence of various cancers than the national average except for liver cancer. Guangzhou, Sihui and Zhongshan were the districts with high incidence of nasopharyngeal carcinoma in both genders. Rural areas in Qidong and Haimen were classified into a cluster in male and total data for the high incidence of liver cancer. Colorectal cancer, anal cancer and breast cancer in women also had high incidence in urban areas. Cervical cancer had the second level high incidence in women following diseases of digestive system, breast cancer and lung cancer.Conclusion:Similar pathogenic factors may exist in counties or cities of Shexian, Cixian, Yangcheng,etc, because of the high prevalence of esophageal cancer. Similar pathogenic factors may also exist in other districts or cancers that were classified into the same cluster.

Objective To investigate the relationship between serum levels of vitamin D(VD)and brain derived neurotrophic factor(BDNF)and restless leg syndrome(RLS)in maintenance hemodialysis patients.Methods A total of 168 end-stage renal disease patients admitted to the hospital for maintenance hemodialy-sis treatment from May 2021 to May 2022 were regarded as the observation group.According to whether they had concurrent RLS,they were separated into concurrent RLS group and non concurrent RLS group.In addi-tion,121 healthy volunteers who came to the hospital for physical examination were regarded as the control group.Enzyme-linked immunosorbent assay(ELISA)was applied to detect the levels of VD and BDNF in ser-um,multivariate Logistic regression was applied to analyze the influencing factors of RLS in maintenance he-modialysis patients.Receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of single and combined detections of VD and BDNF for RLS in maintenance hemodialysis patients.Results Compared with the control group,the serum levels of VD and BDNF in the observation group were reduced(P<0.05).Compared with the non concurrent RLS group,the continuous dialysis time and serum ferritin level in the non concurrent RLS group were increased,while serum VD and BDNF levels were reduced(P<0.05).Multivariate Logistic regression analysis showed that VD and BDNF were protective factors for RLS in maintenance hemodialysis patients,while continuous dialysis time and ferritin were risk factors for RLS in maintenance hemodialysis pa-tients(P<0.05).The area under the curve of the combined prediction of VD and BDNF for RLS in mainte-nance hemodialysis patients was 0.889,which was superior to those of single detection(Zcombination-VD=3.748,Zcombination-BDNF=2.245,P<0.05),and the sensitivity of the combined detection was 86.11%,and the specificity was 79.55%.Conclusion The levels of VD and BDNF in serum are protective factors for RLS in maintenance hemodialysis patients.The combination of the two could effectively predict RLS in maintenance hemodialysis patients.

The stenosis and embolization of internal fistula vessels directly affect the clinical treatment effect of maintenance hemodialysis patients, and the study of the mechanism of internal fistula stenosis has become a research hotspot in recent years. Previous studies mainly focused on the hemodynamics and pathophysiology of blood vessel wall, and there were few studies on molecular biology and its related signaling pathways. This paper reviews the hemodynamics of the vascular pathway of internal arteriovenous fistula (AVF), the pathophysiological mechanism, molecular biology, and changes in various signaling pathways of AVF dysfunction at home and abroad, in order to provide references for the study of AVF dysfunction.

This study aims to establish a rat model of renal ischemia reperfusion injury (RIRI) to observe the alterations in the expression of phosphatidylinositol-3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) signaling pathway following various exosome treatments. Additionally, differential miRNA expression analysis will be conducted to elucidate the molecular mechanisms underlying the effects of exosomes derived from ischemic preconditioned (IPC) renal tubular cells in mitigating RIRI in rats. Initially, ten SD rats were subjected to bilateral nephrectomy under general anesthesia to prepare primary renal tubular cells. The second-generation renal tubular cells were then subjected to the following treatments for 12 hours: normoxia (38% O 2, 5% CO 2), hypoxia (1% O 2, 5% CO 2), and hypoxia plus inactivation (heated at 65 ℃ for 30 minutes). Following these treatments, exosomes were extracted, yielding normoxic exosomes, IPC exosomes, and inactivated exosomes, respectively. A subsequent cohort of 50 SD rats was randomly divided into five groups: Sham group, RIRI group, RIRI + normoxic exosome group (NC group), RIRI + IPC exosome group (IPC group), and RIRI + inactivated exosome group (INA group). RIRI model was established in the latter four groups. Twenty-four hours after RIRI modeling, the NC, IPC, and INA groups received intravenous injections of 200 μg of normoxic exosomes, IPC exosomes, and inactivated exosomes via the tail vein, respectively. Six days later, venous blood samples were collected, and both kidneys were excised to observe renal function, histopathological changes in kidney tissue, and alterations in the PI3K/AKT/mTOR signaling pathway among the five groups. Furthermore, differential miRNA expression analysis [ P<0.05, |log 2(Fold Change)|≥1] was conducted between the NC and IPC groups to investigate the changes in the miRNA expression profile. Subsequently, GO analysis and KEGG pathway enrichment analysis were performed. The results revealed that: (1) Compared with the Sham group, the RIRI and INA groups exhibited elevated levels of serum creatinine and urea nitrogen (all P<0.01). Histopathological examination of kidney tissues showed substantial inflammatory cell infiltration in the interstitium accompanied by varying degrees of edema, degenerative swelling of tubular structures, necrosis, and detachment of tubular epithelial cells. Notably, the number of TUNEL-positive cells was significantly increased, while the number of Ki67-stained positive cells was markedly decreased. Additionally, the mRNA and protein expression of PI3K/AKT/mTOR signaling pathway in RIRI group and INA group were down-regulated. (2) Compared to the NC group, the IPC group demonstrated lower levels of serum creatinine and urea nitrogen (both P<0.01). Notably, there was a significant decrease in the accumulation of inflammatory cells in the renal interstitium, and tissue edema was markedly improved. Moreover, the number of TUNEL-positive cells was reduced, while the number of Ki67-stained positive cells was significantly increased. Additionally, the mRNA and protein expressions of PI3K, PDK1, AKT, and mTOR were all up-regulated (all P<0.05). (3) Compared to the NC group, 56 miRNAs were up-regulated and 42 miRNAs were down-regulated in the IPC group. The target genes of GO enrichment analysis were PIK3C2A, PIK3CA, PIK3CB, PIK3CD, PIK3C2G, AKT1, mTOR, Rheb, and KEGG enrichment analysis revealed significant enrichment in PI3K/AKT signal pathway and mTOR signal pathway. In conclusion, this study reveals that during the course of RIRI, exosomes derived from IPC renal tubular cells induce differential miRNA expression in kidney tissues, resulting in enhanced expression of the PI3K/AKT/mTOR signaling pathway, which plays a pivotal role in mitigating RIRI in rats.

Objective To observe the clinical effect of single urokinase and urokinase pump combined with low-molecular-weight Heparin in the treatment of autogenous arteriovenous fistula thrombolysis,and the influence on inflammatory factors [interleukin (IL)-1,IL-6,tumor necrosis factor-α (TNF-α)] and CD62p.Methods 20 hemodialysis patients hospitalized in our hospital for the treatment of thrombosis in fistula were selected.They were randomly divided into group A (n =10) and group B (n =10).The group A was treated by urokinase infusion,and the group B was treated with urokinase pump combined with low-molecular heparin respectively.Results Compared with that before thrombolysis,the blood flow rate was increased significantly while the IL-1,TNF-oα and CD62p decreased significantly in the two groups after thrombolytic treatment,with statistically significant difference (P ＜ 0.05).Compared with the group A,the IL-1,IL-6 and CD62p in group B were decreased after thrombolytic therapy,with statistically significant difference (P ＜ 0.05).Conclusions Urokinase combined with low-molecular-weight heparin is better than single urokinase in the treatment of arteriovenous fistula thrombolysis,providing a theoretical basis for clinical fistula thrombolysis treatment.

Objective To observe the level of CD4+CD25+ regulatory T cells (CD4+CD25+ Treg cells) with positive fork head transcription factor 3 (Foxp3) and changes of T-box transcription factor TBX1 (TBX1) and myocyte specific enhancer 2D (MEF2D) expression in peripheral blood of rats with acute rejection after renal transplantation,and to investigate its regulatory mechanisms by combined with renal function,plasma interleukin-10 (IL-10),interferon-γ (IFN-γ) and renal histopathological changes.Methods Rat renal transplantation model was established and divided into two groups:acute rejection group (AR group) and non-acute rejection group (non-AR group).Their renal function including serum creatinine (Scr) and blood urea nitrogen (BUN) in plasma was measured.The renal histopathology was observed by HE staining.Levels of IL-10 and IFN-γ in plasma were detected by ELISA.The proportion of CD4+CD25+ Treg cells was measured by flow cytometry.The mRNA expressions of Foxp3,TBX1 and MEF2D in CD4+CD4+Treg cells were detected by real-time PCR,and their protein expressions were tested by Western blotting.Results Compared with these in the non-AR group,the levels of BUN,Scr and IFN-γ significantly increased in AR group (all P ＜ 0.05),while IL-10 decreased (P ＜ 0.05).Renal histopathology in the acute rejection group showed glomerular hypertrophy and mesangial cell proliferation,capillary proliferation and neutrophil infiltration;renal interstitial edema and tubular necrosis,accompanied by lymphocytes,plasma cells and neutrophils infiltration.Compared with that in the non-AR group,the percentage of CD4+CD25+ Treg cells in peripheral blood was notably lowered in AR group (4.50％±0.50％ vs 5.74％±1.96％,P ＜ 0.05).The mRNA and protein expressions of Foxp3 and MEF2D were lower in AR group than those in non-AR group,while the expressions of TBX1 was elevated (all P ＜ 0.05).Conclusions In rats with acute renal allograft rejection,the percentage of CD4+CD25+ Treg cells and expressions of Foxp3,MEF2D and IL-10 decrease,while the expressions of TBX1 and IFN-γ enhance.These participate in the development of acute rejection after renal transplantation,and aggravate the renal damage.

Objective:To establish a mouse model of intra-jugular arteriovenous fistula (AVF) to screen differentially expressed genes in the process of intimal stenosis of AVF for investigating the abnormal expression signaling pathways and the mechanisms.Methods:Forty-six male C57BL/6 mice were randomly divided into AVF group ( n=23) and sham-operated group ( n=23). The AVF group underwent internal jugular arteriovenous fistuloplasty, and the sham-operated group separated the right external jugular vein and common carotid artery and then sutured the incision. The whole-genome sequences of mice with AVF stenosis were determined by transcriptomic reversible chain terminator and synthetic sequencing. The microarray data set was established, and the Benjamini & Hochberg method of gene microarray data analysis was applied to screen the differentially expressed genes. The differentially expressed genes were screened by R-language enrichment analysis. Then, gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) were performed. The subcellular localization of the differentially expressed genes was performed by BUSCA software. The protein network interaction of differentially expressed genes was analyzed by using STRING database and Cytoscape software. Results:In the AVF group, 21 mice were successfully modeled and 2 mice failed. Therefore, there were 21 mice in the AVF group and only 21 mice in the sham-operated group. This mouse internal jugular AVF model was innovated using the continuous-interrupted suture method, which improved the success rate of modeling this model. The differential gene sequencing analysis showed that there were 2 514 differentially expressed genes in the AVF process, including 1 323 up-regulated genes and 1 191 down-regulated genes. GO functional enrichment analysis showed that the differential genes were mainly enriched in metabolic process, activation, redox, mitochondria and so on. KEGG pathway enrichment analysis showed that the differential genes were enriched in metabolism, energy substance synthesis, diabetes, oxidative stress and so on. Statistical analysis of subcellular localization showed that the differences were mainly in mitochondrial proteins (24.24%), cytoplasmic proteins (17.51%), nuclear proteins (13.13%), cell membrane proteins (11.45%), and extracellular proteins (10.77%).Conclusions:Mitochondrial oxidative stress injury may be involved in the pathological damage process of endothelial proliferation stenosis in the AVF.

Objective:To observe the proteomic changes in vitreous fluid samples from patients with rhegmatogenous retinal detachment combined with choroidal detachment (RRDCD).Methods:A prospective cross-sectional clinical study. Vitreous fluid samples were collected from 35 patients with RRDCD (RRDCD group) and 40 patients with rhegmatogenous retinal detachment (RRD group) who were diagnosed at Wuhan Aier Eye Hospital between November 2021 and December 2023. Prior to vitrectomy, 0.3-0.5 ml of vitreous fluid was collected from the affected eyes. Differentially expressed proteins were analyzed using Data-Independent Acquisition (DIA). Three of these proteins were randomly selected for validation using enzyme-linked immunosorbent assay (ELISA). Bioinformatics analyses, including gene ontology functional enrichment and kyoto encyclopedia of genes and genomes pathway enrichment, were performed to explore the functions of the differentially expressed proteins.Results:Significant differences were observed between the RRDCD and RRD groups in intraocular pressure ( t=-12.795), the number of retinal tears ( t=4.601), the extent of retinal detachment ( χ2=39.642), axial length ( t=0.840), postoperative proliferative vitreoretinopathy incidence ( χ2=4.730), single-surgery reattachment rate ( χ2=7.717), and best-corrected visual acuity ( t=7.033) at 6 months postoperatively ( P<0.05). A total of 237 differentially expressed proteins were identified between the RRDCD and RRD groups, with 63 upregulated and 174 downregulated. These proteins were involved in pathways such as extracellular matrix-receptor interaction, complement activation, coagulation, and lysosomal pathways. ELISA validation results showed that the expression trends of the three selected proteins in the RRDCD and RRD groups were consistent with the DIA proteomic analysis. Compared to the RRD group, proteins such as fibrin, coagulation factors, cathepsins, and trypsin inhibitors were significantly upregulated in the RRDCD group. Conclusions:The protein expression profile in vitreous fluid samples from RRDCD patients show significant alterations compared to the RRD group. These differential changes suggest that RRDCD is closely associated with complement and coagulation cascade activation, lysosomal pathways, and extracellular matrix remodeling.