Objective: Neuronal apoptosis is considered to be a critical process in spinal cord injury (SCI). Despite growing evidence of the antiapoptotic, anti-inflammatory, and modulation of ischemic injury tolerance effects of extracellular ubiquitin (eUb), existing studies have paid less attention to the impact of eUb in neurological injury disorders, particularly in SCI. This study aimed to investigate whether eUb can play a protective role in neurons, both in vitro and in vivo, and explores the underlying mechanisms. Methods: By utilizing an oxygen glucose deprivation cellular model and a SCI rat model, we firstly investigated the therapeutic effects of eUb on SCI and further explored its effects on neuronal autophagy and mitochondria-dependent apoptosis-related indicators, as well as the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mechanical target of rapamycin (mTOR) signaling pathway. Results: In the SCI models both in vivo and in vitro, early intervention with eUb enhanced neuronal autophagy and inhibited mitochondrial apoptotic pathways, significantly mitigating SCI. Further studies had shown that this protective effect of eUb was mediated through its receptor, CXC chemokine receptor type 4 (CXCR4). Additionally, eUb-enhanced autophagy and antiapoptotic effects were possibly associated with inhibiting the PI3K/Akt/mTOR pathway. Conclusion In summary, the study demonstrates that early eUb intervention can enhance autophagy and inhibit mitochondrial apoptotic pathways via CXCR4, protecting neurons and promoting SCI repair.

Objective: Neuronal apoptosis is considered to be a critical process in spinal cord injury (SCI). Despite growing evidence of the antiapoptotic, anti-inflammatory, and modulation of ischemic injury tolerance effects of extracellular ubiquitin (eUb), existing studies have paid less attention to the impact of eUb in neurological injury disorders, particularly in SCI. This study aimed to investigate whether eUb can play a protective role in neurons, both in vitro and in vivo, and explores the underlying mechanisms. Methods: By utilizing an oxygen glucose deprivation cellular model and a SCI rat model, we firstly investigated the therapeutic effects of eUb on SCI and further explored its effects on neuronal autophagy and mitochondria-dependent apoptosis-related indicators, as well as the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mechanical target of rapamycin (mTOR) signaling pathway. Results: In the SCI models both in vivo and in vitro, early intervention with eUb enhanced neuronal autophagy and inhibited mitochondrial apoptotic pathways, significantly mitigating SCI. Further studies had shown that this protective effect of eUb was mediated through its receptor, CXC chemokine receptor type 4 (CXCR4). Additionally, eUb-enhanced autophagy and antiapoptotic effects were possibly associated with inhibiting the PI3K/Akt/mTOR pathway. Conclusion In summary, the study demonstrates that early eUb intervention can enhance autophagy and inhibit mitochondrial apoptotic pathways via CXCR4, protecting neurons and promoting SCI repair.

Objective: Neuronal apoptosis is considered to be a critical process in spinal cord injury (SCI). Despite growing evidence of the antiapoptotic, anti-inflammatory, and modulation of ischemic injury tolerance effects of extracellular ubiquitin (eUb), existing studies have paid less attention to the impact of eUb in neurological injury disorders, particularly in SCI. This study aimed to investigate whether eUb can play a protective role in neurons, both in vitro and in vivo, and explores the underlying mechanisms. Methods: By utilizing an oxygen glucose deprivation cellular model and a SCI rat model, we firstly investigated the therapeutic effects of eUb on SCI and further explored its effects on neuronal autophagy and mitochondria-dependent apoptosis-related indicators, as well as the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mechanical target of rapamycin (mTOR) signaling pathway. Results: In the SCI models both in vivo and in vitro, early intervention with eUb enhanced neuronal autophagy and inhibited mitochondrial apoptotic pathways, significantly mitigating SCI. Further studies had shown that this protective effect of eUb was mediated through its receptor, CXC chemokine receptor type 4 (CXCR4). Additionally, eUb-enhanced autophagy and antiapoptotic effects were possibly associated with inhibiting the PI3K/Akt/mTOR pathway. Conclusion In summary, the study demonstrates that early eUb intervention can enhance autophagy and inhibit mitochondrial apoptotic pathways via CXCR4, protecting neurons and promoting SCI repair.

Objective: Neuronal apoptosis is considered to be a critical process in spinal cord injury (SCI). Despite growing evidence of the antiapoptotic, anti-inflammatory, and modulation of ischemic injury tolerance effects of extracellular ubiquitin (eUb), existing studies have paid less attention to the impact of eUb in neurological injury disorders, particularly in SCI. This study aimed to investigate whether eUb can play a protective role in neurons, both in vitro and in vivo, and explores the underlying mechanisms. Methods: By utilizing an oxygen glucose deprivation cellular model and a SCI rat model, we firstly investigated the therapeutic effects of eUb on SCI and further explored its effects on neuronal autophagy and mitochondria-dependent apoptosis-related indicators, as well as the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mechanical target of rapamycin (mTOR) signaling pathway. Results: In the SCI models both in vivo and in vitro, early intervention with eUb enhanced neuronal autophagy and inhibited mitochondrial apoptotic pathways, significantly mitigating SCI. Further studies had shown that this protective effect of eUb was mediated through its receptor, CXC chemokine receptor type 4 (CXCR4). Additionally, eUb-enhanced autophagy and antiapoptotic effects were possibly associated with inhibiting the PI3K/Akt/mTOR pathway. Conclusion In summary, the study demonstrates that early eUb intervention can enhance autophagy and inhibit mitochondrial apoptotic pathways via CXCR4, protecting neurons and promoting SCI repair.

Objective: Neuronal apoptosis is considered to be a critical process in spinal cord injury (SCI). Despite growing evidence of the antiapoptotic, anti-inflammatory, and modulation of ischemic injury tolerance effects of extracellular ubiquitin (eUb), existing studies have paid less attention to the impact of eUb in neurological injury disorders, particularly in SCI. This study aimed to investigate whether eUb can play a protective role in neurons, both in vitro and in vivo, and explores the underlying mechanisms. Methods: By utilizing an oxygen glucose deprivation cellular model and a SCI rat model, we firstly investigated the therapeutic effects of eUb on SCI and further explored its effects on neuronal autophagy and mitochondria-dependent apoptosis-related indicators, as well as the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mechanical target of rapamycin (mTOR) signaling pathway. Results: In the SCI models both in vivo and in vitro, early intervention with eUb enhanced neuronal autophagy and inhibited mitochondrial apoptotic pathways, significantly mitigating SCI. Further studies had shown that this protective effect of eUb was mediated through its receptor, CXC chemokine receptor type 4 (CXCR4). Additionally, eUb-enhanced autophagy and antiapoptotic effects were possibly associated with inhibiting the PI3K/Akt/mTOR pathway. Conclusion In summary, the study demonstrates that early eUb intervention can enhance autophagy and inhibit mitochondrial apoptotic pathways via CXCR4, protecting neurons and promoting SCI repair.

Objective:To observe the change of retinal artery angle in eyes with idiopathic epiretinal membrane (ERM) and to analyze the relationship between retinal artery angle, ERM classification based on optical coherence tomography (OCT), and visual acuity.Methods:A retrospective cross-sectional clinical study. A total of 187 eyes in 187 patients diagnosed with monocular idiopathic ERM (IERM group) in Department of Ophthalmology of Zhejiang Provincial People's Hospital and the Affiliated Eye Hospital of Wenzhou Medical University at Hangzhou from November 2018 to January 2023 were included in the study. The contralateral healthy eyes were included as the control group. All patients underwent best corrected visual acuity (BCVA), fundus photography, spectral-domain OCT, OCT angiography (OCTA) and axial length (AL) measurement. BCVA examination was performed using the standard logarithmic visual acuity chart, which was converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity. The foveal avascular zone (FAZ) area was measured by OCTA. The central macular thickness (CMT) was measured by spectral domain OCTaccording to the grading criteria of ectopic inner foveal layer (EIFL) was divided into stages 1 to 4 with 42, 45, 62, and 38 eyes, and the IERM group was subdivided into stage 1, stage 2, stage 3, and stage 4 groups accordingly. Image J was used to measure the retinal artery angle and the 1/2 retinal artery angle on fundus images. Multiple linear regression analysis was used to analyze the correlation between BCVA and artery angle, 1/2 artery Angle, CMT, FAZ area and AL.Results:Compared with the control group, eyes in IERM group had worse BCVA ( t=9.727), thicker CMT ( t=12.452), smaller FAZ area ( t=-14.329), smaller artery angle ( t=-9.165) and smaller 1/2 artery angle ( t=-9.549). The differences were statistically significant ( P<0.001). With the increase of IERM stage, the artery angle and 1/2 artery angle decreased significantly ( F=21.763, 12.515; P<0.001). There was no significant difference in artery angle and 1/2 artery angle between stage 1 group and stage 2 group, and 1/2 arterial angle between stage 2 group and stage 3 group ( P>0.05). There were significant differences in artery angle and 1/2 artery angle between the other groups ( P<0.05). There were significant differences in CMT and logMAR BCVA among different classification subgroups in IERM groups ( P<0.05). There was no significant difference in FAZ area between grade 3 group and grade 4 group ( P>0.05). There were significant differences in FAZ area between the other groups ( P<0.05). Correlation analysis showed that decreased artery angle ( P=0.013) and increased CMT ( P<0.001) were associated with decreased BCVA. Conclusions:Compared with healthy eyes, the artery angle decreases significantly with the increase of ERM stage. Decreased retinal artery angle is associated with decreased visual acuity in IERM eyes.

Objective To explore the diagnostic value of musculoskeletal ultrasound in patients with limb pain.Methods A total of 80 patients with limb pain admitted to the First Hospital of Nanchang from January 2021 to December 2022 were included in the study.All patients received magnetic resonance imaging(MRI)and musculoskeletal ultrasound on admission.The consistency and coincidence rate of musculoskeletal ultrasound and MRI in diagnosing the cause of limb pain were compared.Results In the 80 patients,MRI and musculoskeletal ultrasound detected positive results in 78 cases,accounting for 97.50%,and 2 cases had no clear disease type.According to the results of MRI,there were 75 cases in which musculoskeletal ultrasound diagnosis of the cause of limb pain was consistent with the MRI results,and total coincidence rate was 96.15%(75/78),with excellent consistency(Kappa=0.907).Conclusion Musculoskeletal ultrasound can clearly display the fine tissue structure,and the diagnosis accuracy of limb pain is high,and the diagnosis consistency with MRI is excellent.

Objective To investigate the changes and clinical significance of serum pro-gastrin-releasing peptide (ProGRP), squamous cell carcinoma-related antigen (SCC), and carbohydrate antigen 72-4 (CA72-4) levels in patients with gastric cancer. Methods A total of 68 patients with gastric cancer (gastric cancer group), 37 patients with benign gastric lesions (benign gastric lesion group), and 30 healthy subjects (non-gastric disease group) were selected as the study participants. Serum ProGRP, SCC, and CA72-4 levels were compared among the three groups on admission. The relationships of serum ProGRP, SCC, and CA72-4 levels with pathological parameters were analyzed in the gastric cancer group. Patients in the gastric cancer group were followed up for 24-month after discharge. Multivariate Logistic regression analysis was used to identify the influencing factors of prognosis in gastric cancer patients. Receiver operating characteristic (ROC) curves were plotted and the area under the curve (AUC) was calculated to analyze the predictive value of serum ProGRP, SCC, and CA72-4 for death during follow-up in gastric cancer patients. Results The serum levels of ProGRP, SCC, and CA72-4 in the gastric cancer group were higher than those in the benign gastric lesion group and the non-gastric disease group, and the serum levels of ProGRP and CA72-4 in the benign gastric lesion group were higher than those in the non-gastric disease group (P < 0.05). In the gastric cancer group, patients with TNM stage Ⅲ to Ⅳ, moderately-lowly differentiated histological grade, and lymph node metastasis had higher serum levels of ProGRP and CA72-4 than those with stage Ⅰto Ⅱ, high differentiation, and no lymph node metastasis. Patients with moderately-lowly differentiated histological grade had higher serum levels of SCC than those with high differentiated histological grade (P < 0.05). After 24 months of follow-up, 49 patients survived (survival group) and 19 patients died (death group) in the gastric cancer group. The serum levels of ProGRP, SCC, and CA72-4 in the death group were higher than those in the survival group on admission (P < 0.05). Multivariate Logistic regression analysis showed that serum ProGRP, SCC, and CA72-4 were independent influencing factors for the prognosis of gastric cancer patients (P < 0.05). Serum ProGRP, SCC, and CA72-4 had good predictive efficacy for death during follow-up in gastric cancer patients (AUC=0.766, 0.705, 0.828), and their combined predictive efficacy was better (AUC=0.899). Conclusion The serum levels of ProGRP, SCC, and CA72-4 that are related to TNM stage, histological grade, and lymph node metastasis in patients with gastric cancer are abnormally elevated, and their combined detection has good predictive efficacy for death during follow-up.

Objective:To study a deep learning-based dual-modality fundus camera which was used to study retinal blood oxygen saturation and vascular morphology changes in eyes with branch retinal vein occlusion (BRVO).Methods:A prospective study. From May to October 2020, 31 patients (31 eyes) of BRVO (BRVO group) and 20 healthy volunteers (20 eyes) with matched gender and age (control group) were included in the study. Among 31 patients (31 eyes) in BRVO group, 20 patients (20 eyes) received one intravitreal injection of anti-vascular endothelial growth factor drugs before, and 11 patients (11 eyes) did not receive any treatment. They were divided into treatment group and untreated group accordingly. Retinal images were collected with a dual-modality fundus camera; arterial and vein segments were segmented in the macular region of interest (MROI) using deep learning; the optical density ratio was used to calculate retinal blood oxygen saturation (SO 2) on the affected and non-involved sides of the eyes in the control group and patients in the BRVO group, and calculated the diameter, curvature, fractal dimension and density of arteriovenous in MROI. Quantitative data were compared between groups using one-way analysis of variance. Results:There was a statistically significant difference in arterial SO 2 (SO 2 -A) in the MROI between the affected eyes, the fellow eyes in the BRVO group and the control group ( F=4.925, P<0.001), but there was no difference in the venous SO 2 (SO 2-V) ( F=0.607, P=0.178). Compared with the control group, the SO 2-A in the MROI of the affected side and the non-involved side of the untreated group was increased, and the difference was statistically significant ( F=4.925, P=0.012); there was no significant difference in SO 2-V ( F=0.607, P=0.550). There was no significant difference in SO 2-A and SO 2-V in the MROI between the affected side, the non-involved side in the treatment group and the control group ( F=0.159, 1.701; P=0.854, 0.197). There was no significant difference in SO 2-A and SO 2-V in MROI between the affected side of the treatment group, the untreated group and the control group ( F=2.553, 0.265; P=0.088, 0.546). The ophthalmic artery diameter, arterial curvature, arterial fractal dimension, vein fractal dimension, arterial density, and vein density were compared in the untreated group, the treatment group, and the control group, and the differences were statistically significant ( F=3.527, 3.322, 7.251, 26.128, 4.782, 5.612; P=0.047, 0.044, 0.002, <0.001, 0.013, 0.006); there was no significant difference in vein diameter and vein curvature ( F=2.132, 1.199; P=0.143, 0.321). Conclusion:Arterial SO 2 in BRVO patients is higher than that in healthy eyes, it decreases after anti-anti-vascular endothelial growth factor drugs treatment, SO 2-V is unchanged.

Objective    To evaluate the prognosis of interventional treatment with covered stent graft for retrograde Stanford type A aortic dissection and intramural hematoma by single-arm meta-analysis. Methods    Related studies on treating retrograde Stanford type A aortic dissection and intramural hematoma with covered stent graft were retrieved from the databases by computer, including PubMed, EMbase, The Cochrane Library, Wanfang Data, VIP, CNKI and CBM, from inception to January 2020. Literatures were screened by researchers step by step according to the predefined inclusion and exclusion criteria. Quality of the enrolled literatures was evaluated, and data were extracted from the included studies. Afterwards, single-arm meta-analysis was carried out by the R3.6.3 software. Results    A total of 12 English and 5 Chinese studies were included, which were all case series, and the quality of all literatures was moderate evaluated by Newcastle-Ottawa Scale (NOS). After analyzing the clinical prognosis of 260 patients, the 30-day mortality was 6% (95%CI 0.04 to 0.11, P=0.97), the late mortality was 8% (95%CI 0.05 to 0.14, P=0.78), the incidence of endoleak was 21% (95%CI 0.16 to 0.29, P=0.06), the incidence of stroke was 5% (95%CI 0.03 to 0.09, P=0.99), the incidence of new aortic dissection was 7% (95%CI 0.04 to 0.11, P=0.96), the incidence of dissection progression was 10% (95%CI 0.07 to 0.16, P=0.24), and the absorption rate of intramural hematoma was 84% (95%CI 0.37 to 1.00, P<0.01). Conclusion    Interventional treatment with covered stent graft for retrograde Stanford type A aortic dissection and intramural hematoma can obtain good early treatment results for some patients, and can be used as a safe and effective treatment for aged patient with high risk who cannot tolerate surgery. Endoleak, stroke and new aortic dissection are the early serious complications of this method.