Objective:To investigate the changes of macular region structure before and after operation in patients with macular epiretinal membrane,and its relationship with the visual function of patients.Methods:The clinical data of 60 patients with macular epiretinal membrane (60 eyes) in our hospital from February 2014 to August 2016 were retrospectively analyzed.All patients were examined with optical coherence tomography (OCT) examination,and observed the changes ofmacula central fovea and retinal each azimuth thickness,and the best corrected visual acuity (BCVA) was recorded before and after operation,and the correlations of them were analysised.Results:The visual acuity was improved in 53 patients (53 eyes) after operation,accounting for 88.33％,and the visual acuity was unchanged in 7 patients (7 eyes),accounting for 11.67％.The preoperative BCVA of patients was (0.18± 0.07),and it was (0.38± 0.12) at 3 months after operation,which was significantly higher than before operation (P＜0.05).Postoperative macular central thickness,inner side of the inner ring thickness,nasal side of the inner ring thickness,above the inner ring thickness,below the inner ring thickness,outer ringtemporal side thickness,external ring nasal side thickness,above the outer ring thickness,below the outer ring thickness in patients compared with the preoperative were significantly lower,the difference was statistically significant (P＜0.05).The Pearson correlation analysis showed that preoperative macular central thickness,preoperative inner side of the inner ring thickness,preoperative outer ring temporal side thickness,the difference of macular fovea thickness before and after operation,the difference of the medial temporal before and after operationwas,the difference of outer ring temporal side before and after operation were negatively correlated with postoperative BCVA (P＜0.05).Conclusion:Vitrectomy can significantly reduce macular retinal thickness in patients with macular epiretinal membrane,and it can improve the visual function of patients,and the shape ofmacular region before operation had some influence on postoperative visual acuity.

AIM: To investigate the changes of the redox status and the antioxidative capability in the tissue of malignant tumors. METHODS: The carcinoma tissues collected from 42 patients with primary cancer in digestive tract (13 cases of esophageal cancer, 14 cases of gastric cancer and 15 cases of colorectal cancer),the corresponding paratumor mucosa tissues were taken as the control samples. The content of oxidized and reduced glutathion (GSSG and GSH), oxidized and reduced coenzyme II (NADP+ and NADPH) were measured, the GSH/GSSG, NADPH/NADP+ ratios, and the GSH/GSSG, NADPH/NADP+ redox potentials were calculated according to Nernst formula. RESULTS: The levels of GSH and NADPH in cancer tissues were significantly higher than those in corresponding paratumor tissues (P0.05). CONCLUSIONS: The significant increase in GSH and NADPH contents in cancer tissues indicates a notable enhancement of its antioxidative capability compared with the corresponding paratumor tissues. Based on this changes, the redox potential in the cancer tissues has only slightly reductive shift, which may suggest an apparent oxidative stress existed in the cancer tissues.

Background: The dietary agent sulforaphane (SFN) has been reported to reduce diabetes-induced renal fibrosis, as well as inhibit histone deacetylase (HDAC) activity. Bone morphologic protein 7 (BMP-7) has been shown to reduce renal fibrosis induced by transforming growth factor-beta1. The aim of this study was to investigate the epigenetic effect of SFN on BMP-7 expression in diabetes-induced renal fibrosis. Methods: Streptozotocin (STZ)-induced diabetic mice and age-matched controls were subcutaneously injected with SFN or vehicle for 4 months to measure the in vivo effects of SFN on the kidneys. The human renal proximal tubular (HK11) cell line was used to mimic diabetic conditions in vitro. HK11 cells were transfected to over-express HDAC2 and treated with high glucose/palmitate (HG/Pal) to explore the epigenetic modulation of BMP-7 in SFN-mediated protection against HG/Pal-induced renal fibrosis. Results: SFN significantly attenuated diabetes-induced renal fibrosis in vivo. Among all of the HDACs we detected, HDAC2 activity was markedly elevated in the STZ-induced diabetic kidneys and HG/Pal-treated HK11 cells. SFN inhibited the diabetes-induced increase in HDAC2 activity which was associated with histone acetylation and transcriptional activation of the BMP-7 promoter. HDAC2 over-expression reduced BMP-7 expression and abolished the SFN-mediated protection against HG/Pal-induced fibrosis in vitro. Conclusion Our study demonstrates that the HDAC inhibitor SFN protects against diabetes-induced renal fibrosis through epigenetic up-regulation of BMP-7.

Objective To investigate the mechanism of action of Dingchuan granules in intervening respiratory syncytial virus pneumonia based on network pharmacology and animal experiments.Methods The potential active ingredients and targets of each traditional Chinese medicine in Dingchuan granules were obtained from TCMSP and TCMID databases,and the active ingredients of the drugs in Dingchuan granules were screened according to ADME pharmacokinetic parameters;the potential disease targets of respiratory syncytial virus pneumonia were obtained from Genecards,OMIM,and DisGeNet databases;the protein-interaction networks of intersecting targets were visualized by using String platform;the key core targets were visualized by using David database;and the intersection targets were visualized by using David database.Interaction networks were constructed using the String platform to visualize the intersecting targets;GO functional enrichment and KEGG pathway enrichment analyses of the key core targets were performed using the David database;and then the relevant networks for the intervention of Respiratory Syncytial Virus Pneumonia in the Dingchuan particles were constructed using the Cytoscape software(3.9.1).Respiratory syncytial virus(RSV)-induced respiratory syncytial virus pneumonia in young rats was selected for experimental validation.Results The results of the network pharmacology showed that the 177 potential active ingredients of Dingchuan granules acted on 144 targets,and there were 1075 targets related to respiratory syncytial virus pneumonia,and 55 drug-disease intersecting targets were obtained,of which 25 core targets were ALB,IL6,CASP3,EGFR,VEGFA,etc.The GO function of Dingchuan granules was also investigated,and the GO function of Dingchuan was investigated.The results of GO function enrichment analysis showed that the biological processes involved mainly include positive regulation of transcription,positive regulation of RNA polymerase II promoter transcription,positive regulation of gene expression,negative regulation of apoptosis,etc.The KEGG pathway enrichment mainly involves the PI3K-Akt signaling pathway,the cancer pathway,the tumor necrosis factor signaling pathway,the IL-17 signaling pathway and so on.The KEGG pathway enrichment mainly involves PI3K-Akt signaling pathway,tumor necrosis factor signaling pathway,IL-17 signaling pathway,etc.Animal experiments initially showed that the fixed wheezing granules can play a role in inflammation and immune response by regulating the PI3K-Akt signaling pathway,thus participating in the inflammatory and immune response.Compared with the normal group,the ratios of p-PI3K/PI3K and p-Akt/Akt in the lung tissues of young rats in the model group were significantly higher(P<0.05),the viral load was significantly higher(P<0.05),the pathological score of lung tissue damage was significantly higher(P<0.05),and the content of inflammatory factors IL-6 and TNF-α in alveolar lavage fluid(BALF)was significantly higher(P<0.05).Compared with the model group,the expression of p-PI3K/PI3K and p-Akt/Akt proteins in the lung tissues of young rats in each dose group and the positive control group was reduced(P<0.05),the viral load was significantly reduced(P<0.05),the pathological scores of lung tissue injury were significantly reduced(P<0.05),and the contents of inflammatory factors IL-6 and TNF-α in BALF were significantly reduced(P<0.05).Conclusion The study revealed the synergistic mechanism of multi-component,multi-target,and multi-pathway action of Dingchuan granules for the treatment of respiratory syncytial virus pneumonia.It was verified by animal experiments that RSV infection in young rats probably activated the PI3K-Akt signaling pathway,which caused the release of inflammatory factors IL-6 and TNF-α.Dingchuan granules could effectively down-regulate the PI3K-Akt signaling pathway,inhibit the release of inflammatory factors IL-6 and TNF-α,and thus achieve the anti-inflammatory effect.

Objective:To analyze the prevention and treatment of Kaschin-Beck disease in Fu County, Shaanxi Province, so as to provide basis for consolidating the results of Kaschin-Beck disease prevention and control and the treatment of patients with Kaschin-Beck disease.Methods:The epidemiological investigation of data and clinical data Kaschin-Beck disease from 1954 to 2022 were collected from the Fu County Institute for Endemic Disease Prevention and Control and People's Hospital of Fu County in Shaanxi Province, respectively. The retrospective study was used to investigate the prevention and control of Kaschin-Beck disease in Fu County through the adoption of comprehensive measures such as relocation, grain exchange, water improvement, conversion of farmland to forest and so on.Results:In 1954, there were 6 endemic townships and 127 endemic villages of Kaschin-Beck disease in Fu County, with a total population of 78 781. A total of 16 327 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 20.72%, including 5 434 patients without clinical symptoms. There were 5 850 patients with clinical grade Ⅰ, 3 725 patients with clinical grade Ⅱ and 1 318 patients with clinical grade Ⅲ. In 1975, the first general survey of Kaschin-Beck disease was conducted in the whole county, with a total population of 101 341. A total of 9 575 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 9.45%, including 3 247 cases without clinical symptoms. Among the patients with symptoms, there were 3 704 cases of clinical grade Ⅰ, 2 006 cases of clinical grade Ⅱ and 618 cases of clinical grade Ⅲ. The patients with Kaschin-Beck disease were mainly local residents, accounting for 93.92% (8 993/9 575). In 1997, 27 320 students aged 7 to 16 years in 342 schools of 15 townships were examined and found that there were 169 cases without clinical symptoms with X-ray changes, only 2 cases with clinical grade Ⅰ, and the detection rate decreased to 0.63%. In 1997, Fu County began to encourage relocation and grain exchange to prevent Kaschin-Beck disease. The relocation targets were mainly the seriously ill villages with new cases among children and poor living conditions. By 1999, a total of 100 households and 469 people were relocated, and by 2020, 1 569 households and 5 334 people were relocated. In 1997 and 1998, measures were taken to improve water quality in 43 natural villages in 6 townships, with 1 591 households and 7 375 people benefiting. In 2010, a general survey of Kaschin-Beck disease was conducted in 15 townships of Fu County, with a total population of 135 858, and 3 424 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 2.52%. There were 2 885 cases with clinical symptoms, including 1 584 cases with clinical grade Ⅰ, 1 024 cases with clinical grade Ⅱ and 277 cases with clinical grade Ⅲ. Among them, 32 561 minors under 16 years old were examined, and 49 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 0.15%, and all of them were clinical gradeⅠ patients. In 2014, a total of 73 600 people were surveyed in 170 endemic villages of Fu county, and 2 885 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 3.92%. Compared with 2010, the number of patients with Kaschin-Beck disease increased zero, and there were no underage patients under the age of 16 for 4 consecutive years. By the end of 2016, 666.67 hm 2 of farmland had been converted to forest in Fu County, involving 9 townships (including communities), 33 administrative villages and 1 993 households. In 2018, another general survey of Kaschin-Beck disease was conducted in Fu County, with a total population of 157 362. A total of 2 308 patients were detected by X-ray examination, with a detection rate of 1.47%. Among them, there were 1 270 cases of clinical grade Ⅰ, 870 cases of clinical grade Ⅱ and 168 cases of clinical grade Ⅲ, and there were no patients with Kaschin-Beck disease under 16 years old in the county for 8 consecutive years (2011-2018). In the same year, 22 cases of Kaschin-Beck disease joint replacement were completed in Fu County, and by January 2022, about 60 cases had completed joint replacement. Conclusion:The prevention and control of Kaschin-Beck disease in Fu County has achieved remarkable results through comprehensive measures such as relocation, grain exchange, water improvement and conversion of farmland to forest.

Hypersplenism is an important complication of cirrhotic portal hypertension, and splenectomy is an important means to treat hypersplenism in cirrhosis. It is realized that hypersplenism played a pathological role in the course of cirrhosis. This article analyzes and compares the changes in the condition of patients with cirrhosis between splenectomy with and without hyperfunction, and comprehensively discusses the pathological role and mechanism of hypersplenism in the course of cirrhosis, in order to strengthen the clinical prevention and treatment of hypersplenism in cirrhosis and to better improve the condition and prognosis of patients with cirrhosis.

Objective:To investigate the epidemiological characteristics of lower extremity deep vein thrombosis (DVT) in patients with femoral fracture.Methods:Retrospectively analyzed were the data of 2,571 patients with femoral fracture who had been treated at the Third Hospital of Hebei Medical University from January 2019 to December 2019. There were 1,079 males and 1,492 females, aged from 14 to 96 years (average, 67.1 years). There were 1,158 femoral neck fractures, 951 femoral intertrochanteric fractures, 309 femoral shaft fractures, and 153 femoral condylar fractures. 2,414 patients were treated surgically while 157 patients non-surgically. Color Doppler ultrasonography of both lower extremities was performed to determine the occurrence of DVT before operation and every week after operation for patients undergoing surgical treatment, and within 48 hours after admission and every week during hospitalization for those undergoing non-surgical treatment. The incidence and location of DVT were recorded for different femoral fractures.Results:The incidence of DVT in this cohort was 35.5%(913/2,517), that of proximal DVT 5.3%(135/2,571), and that of distal DVT 30.3% (778/2,571). In patients with femoral neck fracture, femoral intertrochanteric fracture, femoral shaft fracture and femoral condylar fracture, the incidence of DVT was respectively 28.8% (334/1,158), 44.7% (425/951), 30.7% (95/309) and 38.6% (59/153), the incidence of proximal DVT was respectively 2.7% (31/1,158), 5.6%(53/951), 9.7% (30/309) and 13.7% (21/153), and the incidence of distal DVT was respectively 26.2% (303/1,158), 39.1% (372/951), 21.0% (65/309) and 24.8%(38/153). The incidence of DVT in the femoral vein and above, popliteal vein, tibiofibular vein and intermuscular vein in this cohort was respectively 2.3%(60/2,571), 2.9%(75/2,571), 6.4%(165/2,571) and 23.8%(613/2,571).Conclusions:The incidence of DVT may be high in patients with femoral fracture, and the proximal DVT with a high risk of pulmonary embolism may occur more in patients with femoral condylar fracture.

Objective: To investigate the effect of nimodipine combined with cerebrospinal fluid replacement on hemoglobin concentration, Toll-like receptor 4 (TLR4) expression level and cerebral vasospasm (CVS) in patients with CVS after aneurysmal subarachnoid hemorrhage (aSAH). Methods: One hundred and twenty patients with CVS after aSAH admitted to the Department of Neurosurgery, the Sixth Medical Center of PLA General Hospital from May 2013 to May 2015 were selected. They were randomly divided into control group and observation group (n=60 in each group). The control group received conventional treatment and nimodipine infusion after embolization of the aneurysms, and the observation group underwent cerebrospinal fluid replacement by lumbar puncture on this basis. The clinical efficacy, Glasgow Coma Scale (GCS) scores, hemoglobin concentration and TLR4 expression levels before and after treatment, and adverse reactions were compared between the two groups. Results: One month after treatment, the improvement rate of vasospasm in the observation group was significantly higher than that in the control group (86.7% vs. 60.0%; χ²=9.590, P=0.002). Three months after the treatment, the good rate of clinical outcome (the modified Rankin Scale score 0-2) was significantly higher than that of the control group (88.3% vs. 58.3%; χ² =13.807, P<0.001). Before treatment, there were no significant differences in hemoglobin concentration and TLR4 expression levels between the two groups; after treatment, the hemoglobin concentration and TLR4 expression levels of both groups were significantly reduced (P<0.05). Compared with the control group, the hemoglobin concentration (119.9±19.8 g/L vs. 137.6±17.8 g/L; t=3.270, P=0.001) and TLR4 expression level (2.5±1.2 vs. 4.5±1.5; t=8.060, P<0.001) in the observation group decreased more significantly. Multivariate logistic regression analysis showed that hypertension (odds ratio [OR] 5.19, 95% confidence interval [CI] 2.31-6.71), hyperlipidemia (OR 2.70, 95% CI 1.93-4.86), previous history of stroke or transient ischemic attack (OR 6.29, 95% CI 3.23-7.32), smoking (OR 4.80, 95% CI 2.18-6.19), and the TLR4 expression level before treatment (OR 3.28, 95% CI 2.87-6.93) were independently correlated with the lack of improvement in CVS, and cerebrospinal fluid replacement was independently correlated with CVS improvement (OR 0.40, 95% CI 0.14-0.89). There was no significant difference in the incidence of adverse reactions such as blood pressure drop, obstructive hydrocephalus and gastrointestinal hemorrhage between the observation group and the control group, but the incidence of delayed CVS (13.3% vs. 36.7%; χ²=7.510, P=0.006) and secondary cerebral infarction (8.3% vs. 31.7%; χ²=8.800, P=0.003) in the observation group were significantly lower than those of the observation group. Conclusion Nimodipine infusion combined with cerebrospinal fluid replacement by lumbar puncture affected the hemoglobin concentration and TLR4 expression levels, improved the CVS improvement rate, and significantly improved the clinical outcome in patients with CVS after aSAH.

目的：探讨成纤维细胞生长因子 13（fibroblast growth factor 13，FGF13）对非小细胞肺癌 A549 细胞活性氧（reactive oxygen species，ROS）的生成和凋亡的影响及其调控机制。方法：WB 法检测 FGF13 在人正常肺上皮细胞 BEAS-2B 和肺癌 A549、H460 细胞中的本底表达量。采用 FGF13 过表达载体转染 BEAS-2B 和 A549 细胞；设计两组靶向 FGF13 的 shRNA 序 列，构建慢病毒干扰载体，包装病毒后侵染 A549 细胞，采用 qPCR 和 WB 法检测干扰效果，DCFH-DA 探针结合荧光酶标仪分 析敲减 FGF13 对 A549 细胞内 ROS 水平的影响，MitoSOX 与 WB 法检测对线粒体 ROS 水平及烟酰胺腺嘌呤二核苷酸磷酸氧 化酶 4（nicotinamide adenine dinucleotide phosphate oxidase 4，NOX4）蛋白表达量的影响，Annexin V-FITC-PI 双染法检测对细胞 凋亡和 Caspase-3 及 Cleaved Caspase-3 蛋白表达的影响。结果：与 BEAS-2B 细胞相比，FGF13 蛋白在两种肺癌细胞中均高表 达（均 P<0.05）。成功构建 FGF13 过表达、低表达的 A549 细胞系。过表达 FGF13 后，BEAS-2B 和 A549 细胞内 ROS 水平显著 降低（P<0.05）；敲减 FGF13 表达后，A549 细胞内 ROS 水平显著升高（P<0.05）；然而过表达及干扰 FGF13 对 A549 细胞内线粒 体 ROS 水平无显著影响，但 NOX4 蛋白表达量显著下调（P<0.05）及显著上调（P<0.05）。FGF13 干扰后 A549 细胞凋亡率显著 升高（P<0.01），Caspase-3 及 Cleaved Caspase-3 蛋白表达量显著上调（P<0.05）。结论：FGF13 可能通过 NOX 家族途径调控 ROS 的生成，并通过 ROS/Caspase-3 通路调控 A549 细胞凋亡。