G protein-coupled estrogen receptor(GPER), as a newly discovered estrogen membrane protein-coupled receptor, has attracted much attention in endocrine metabolism research in recent years.Abnormal glucose and lipid metabolism and imbalance of inflammatory response mediated by GPER is one of the pathogenesis mechanisms of various endocrine and metabolic diseases.GPER is expected to become a new drug target for the treatment of coronary atherosclerosis, obesity and diabetes.This article briefly reviews the progress of GPER-mediated estrogen signaling pathway in terms of glucose metabolism, lipid metabolism and inflammation.

Objective To probe the etiology and management of restenosis after artificially grafting bypass for chronic ischemia of the lower extremities. Methods In this study 52 cases suffering from postoperative restenosis and obliteration were compared with 32 cases whose artificial grafts remain patent during the same postoperative follow-up period of 3～62 months.Possible risk factors that lead to restenosis were evaluated.Resuits FIB(4.48±1.68)g/L,CRP(9.5±2.6)mg/L and LDL(4.5±1.7)mmol/L were significantly higher in the restenosis group than FIB(3.50±0.72)g/L,CRP(4.0±3.2)mg/L and LDL(2.8±0.9)mmol/L in the patent group(P＜0.01).There were no significant difference between HDL(1.02±0.32)mmol/L in the restenosis group and HDL(1.12±0.28)mmol/L in the patent group (P＞0.05).Reoperation in these 52 cases found severe intima hyperplasia and secondary thrombosis within anastomosis in 42 cases and the remaining 10 cases were found with artificial vessel primary thrombosis.After reoperation,artificial graft remain patent in 28 cases,limb amputation was performed in 10 cases,the grafted bypass were removed due to infection in 3 cases. Five patients died postoperatively.Conclusion The main reason for restenosis after artificially grafting bypass is intima hyperplasia in vascular anastomosis.Higher levels of FIB,CRP and LDL maybe the major high risk factors that lead to intima hyperplasia and artificial graft obliteration.

Background:The reproductive health addresses the reproductive processes,functions and system at all stages of life.Enhancing the level of global reproductive health is the goal of sustained attention and struggle by the international community.The social and economic development in Southeast Asia is lagging behind,and its female reproductive health is worrying,while the differences of female reproductive health among different regions are significant.Objective:To obtains the necessity and urgency of strengthening the reproductive health level of Southeast Asian countries,so as to provide the basis for the priorities and target to policy-makers and health administrators to improve reproductive health.Methods:Literature review were searched in PubMed,Web of Science databases,Google scholar database,and WHO's webpages.Maternal mortality ratio,contraceptive rates,unmet need for family planning,antenatal and postnatal care coverage,and sexually transmitted disease were the five key indicators and the influence factors for female reproductive health status in Southeast Asian countries.Results:The reproductive health of Southeast Asian women were still at a lower level overall and varied in different regions and conntries.Women's education and attitude,accessibility of service,socioeconomic and cultural factors,etc.were the potential influencing factors.Conclusion:There is left quite large space for improvement to the reproductive health in Southeast Asian countries and efficient interventions can be achieved for the key and easier-improved risk factors such as education and in high-risk areas.

Objective:To analyze the changes of relevant indicators in reproductive health status among Bangladeshi women from 1999 to 2018 and to assess whether the 2030 Sustainable Development Goals (SDGs) can be achieved.Methods:Data were obtained from both the Bangladesh Demographic and Health as well as from the Maternal Mortality and Health Care Surveys. The trends of SDGs indicators related to reproductive health from 1999 to 2018 were analyzed and compared, and the average annual rate of change was calculated. Development index was used to assess the difficulty of achieving the SDGs.Results:The maternal mortality rate increased first and then leveled off from 2001 to 2016. From 1999 to 2018, the coverage of reproductive health care services and the proportion of women who had the right to make the decision on their own health care service, were generally increasing. Proportion of the following areas as: "contraceptive needs, women who consider that partner violence is justified, the rate of early marriage, and the rate of early childbearing etc.", were declining at various degrees. Development index of the antenatal care coverage, rate of delivery in medical facilities, percentage of live births attended by medically trained providers and the rate of postnatal care etc., were less than 1. The development indices of the maternal mortality rates were close to 1, while all the other indicators were greater than 1. Conclusions:The reproductive health-related SDGs indicators in Bangladesh appeared somehow degrees of progress from 1999 to 2018. However, for most indicators, the average annual rate of change was still lower than the expected to achieve the 2030 target which called for acceleration in the next few years.

40 IU/ml were used as cut-off points.(4) TSH level was higher in subjects with positive thyroid autoantibodies than those without antibodies (P

In recent years, studies have shown that transplanted neural stem cells (NSCs) help neural tissues regenerate and return to normal through paracrine action rather than just replacing cells. Exosomes are essential paracrine mediators that can participate in cell communication through substance transmission. This review focuses on NSCs regulated by exosomes and their application in treatment of nervous system diseases, in order to provide important references for further research and clinical application of NSCs exosomes..

Objective: To analyze the prevalence and related factors of pediatric flexible flatfoot (PFF) among 7-8 year old children in Changzhou, so as to provide a feasible basis for the prevention and treatment of PFF. Methods: From December 2023 to February 2024, a total of 1 685 children aged 7-8 from 10 primary schools in Changzhou were selected by stratified cluster random sampling method, and screened for PFF by using a foot optical assessment recording device. Information including sex, body mass index (BMI), diet, exercise and shoe wearing habits were collected. The valgus angle of the hindfoot was measured on the body surface by using an orthopedic measuring ruler in the standing position. Pain levels were evaluated by using visual analogue score (VAS) for children with flatfoot syndrome. Multivariate Logistic analysis was used to analyze related factors of PFF. Results: The overall detection rate of PFF was 27.4%, and there was a significant difference in the detection rate of PFF between boys and girls, with 30.3% and 24.1% respectively ( χ 2=7.96, P < 0.01 ). Most cases of PFF were mild flatfoot (60.8%) and bilateral ( 60.4% ). Approximately 13.2% of children with PFF had flatfoot syndrome, with a mean VAS of (2.86±0.73). About 56.1% of children with PFF had a normal valgus angle of the hindfoot. Sex, high BMI and preference for shoe last with front upturned shoe shape were positively correlated with the detection of PFF ( OR= 1.74, 1.54, 1.13, P <0.05). After stratified by sex, regular exercise in boys and age in girls were negatively correlated with the detection of PFF ( OR=0.40, 0.64, P <0.05). Conclusions The detection rate of PFF in 7-8 year old children is high. Additionally, PFF combined with flatfoot syndrome or valgus hindfoot is relatively rare and is likely to be underestimated, which emphasizes the importance of early detection and intervention for PFF.

Objective:To explore the curative efficacy of pelvic reconstruction plate and T-plate elastic fixation in the treatment of acetabular fractures with comminuted posterior wall.Methods:A retrospective analysis was conducted of the 21 patients who had been treated at Department of Orthopaedics, Affiliated Hospital to the Second Mongolia Medical University for acetabular fractures with comminuted posterior wall from January 2017 to June 2019. They were 15 males and 6 females, aged from 29 to 55 years (average, 41.5 years). According to the Letournel-Judet classification, there were 15 cases of simple posterior wall fracture with dislocation of the femoral head, 4 cases of posterior wall and posterior column fracture, and 2 cases of double-column and posterior wall fracture. The time from injury to surgery averaged 3 days (from 2 to 5 days). The posterior acetabulum was treated by pelvic reconstruction plate combined with T-plate elastic fixation through the posterior acetabular Kocher-Langenbeck approach. Postoperative fracture reduction, fracture union time, function of the affected hip and complications at the last follow-up were evaluated.Results:This group of 21 patients were followed up for 6 to 24 months (average, 15 months). By the Matta imaging scoring, the postoperative reduction of the posterior wall fracture was evaluated as excellent in 18 cases and as good in 3, giving an excellent to good rate of 100%. The fracture union time averaged 10 weeks (from 8 to 12 weeks) for this group. By the improved Merle d'Aubigné & Postel evaluation at the last follow-up, the affected hips scored from 12 to 18 points (average, 16 points), yielding 18 excellent, 2 good and one poor cases, giving an excellent to good rate of 95.2%. There was no major hemorrhage, nerve injury or deep vein thrombosis intraoperatively. During the follow-up, mild ectopic ossification occurred in one case, and subluxation of the femoral head and traumatic arthritis were observed in another, but no patient had other complications like avascular necrosis of the femoral head.Conclusion:In the treatment of acetabular fracture with comminuted posterior wall, pelvic reconstruction plate and T-plate elastic fixation through the posterior acetabular Kocher-Langenbeck approach can lead to fine short-term outcomes.

Objective:To explore the relationship and underlying mechanism between exosomes derived from doxorubicin-resistant osteosarcoma cells and MDR1 and miRNAs. Methods:MG63 and U2OS cell lines were selected to construct doxorubicin-resistant strains, and the 50% inhibitory concentration (half maximal inhibitory concentration, IC 50) of drug-resistant and sensitive strains was detected by MTT, and fluorescence staining was performed at intervals of 15 min between 15 and 120 min to detect the change of fluorescence intensity. RT-PCR and Western Blot were used to detect the expression levels of MDR1 P-gp to verify the drug resistance of osteosarcoma cells. Exosomes were identified by particle size analysis and Western Bolt detection. The endocytosis of PKH26-labeled exosomes from doxorubicin-resistant cells was observed, and the proliferation level and migration of exosomes from doxorubicin-resistant cells co-cultured with osteosarcoma cells were detected by MTT assay and cell scratch assay. The differential expression levels of miRNAs in osteosarcoma-sensitive and drug-resistant cells were verified by sequencing and bioinformatics analysis and RT-PCR assay. Tumor growth, serum exosome identification and mRNA expression level of miR-21-5p in tumor-bearing nude mice between normal osteosarcoma cell group and drug-resistant group, drug-resistant+normal exosome group, drug-resistant+drug-resistant+drug-resistant exosome group were observed. MDR1 expression level in tumor tissue was detected by RT-PCR, Western Blot and immunohistochemistry. Results:The IC 50 of two adriamycin resistant strains were 2.21 vs. 11.81 μg/ml and 0.93 vs. 11.81 μg/ml, respectively, and the fluorescence intensity decreased faster than that of normal strains. The relative mRNA expression levels of MDR1 in two cell lines were normal 1.12±0.16, 1.02±0.11 and drug-resistant 2.15±0.10, 2.127±0.12, respectively. The relative protein expression of P-gp was normal 0.92±0.11, 0.73±0.10 and drug-resistant 0.46±0.03, 0.30±0.04, the differences were statistically significant ( P<0.05). Drug-resistant exosomes can enter osteosarcoma cells through endocytosis and concentrate in the cytoplasm when co-cultured with normal strains. Osteosarcoma cells were co-cultured with drug-resistant exosomes at 2, 4, 6, and 8 μg/ml adriamycin, respectively. Compared with normal group, the proliferation level in drug-resistant group was significantly increased. Compared with the normal cell group 35.95±3.92, 6.72±3.55 and the normal exosome group 51.22±5.55, 19.31±1.93, the drug-resistant cell group 54.20±9.32, 19.24±2.88 and drug-resistant exosome group 76.40±5.41, 30.26±4.87, all had significantly higher cell mobility, the difference was statistically significant ( P<0.05). Exosome sequencing and biogenic analysis of 10 highly upregated miRNAs to validate mRNA expression differences between normal and drug-resistant strains by RT-PCR, showing a significant increase in miR-21-5p expression level of drug-resistant strains (5.89±0.26 vs. 0.99±0.06; 1.05±0.07 vs. 8.80±0.93, P<0.05), the difference was statistically significant ( P<0.05). In MG63 and U2OS, the normal cell group and drug-resistant cell group, and the normal exosome group and drug-resistant exosome group were compared, the tumor volume and the terminal tumor weight of nude mice were increased to varying degrees. MRNA relative expression levels of miR-21-5p in serum exosomes of nude mice after drug intervention were 0.86±0.07 and 0.86±0.05 in normal cell group, respectively. The values were 1.13±0.12, 1.14±0.12 in drug-resistant cell group, 0.71±0.05, 0.75±0.03 in normal exosome group, and 0.90±0.07, 0.93±0.04 in drug-resistant exosome group. Compared with normal and drug-resistant strains, the expression levels of normal and drug-resistant exosome groups were increased, with statistical significance ( P<0.05). Conclusion:The exosomes of drug-resistant cells in osteosarcoma could enhance the proliferation level and migration ability of cells through intercellular transfer of MDR1 and miRNAs. The expression of MDR1 and miR-21-5p in drug-resistant cells and tumor-forming nude mouse serum and tumor tissues were up-regulated which suggested that it might be involved in regulating the drug resistance process of osteosarcoma.

Objective To monitor the cumulative terrestrial γ radiation dose around Shidaowan nuclear power plant, Shandong, China before operation, to analyze the dose levels and influencing factors, and to estimate the annual effective dose to local residents. Methods Fifty-six monitoring sites were selected within 30 km around the nuclear power plant. The environmental γ radiation dose was measured by the thermoluminescence dosimeter monitoring method. The γ radiation dose levels were investigated for 369 days in four monitoring periods (January 16 to April 14, April 15 to July 20, July 21 to October 21, 2021, and October 22, 2021 to January 20, 2022 for periods I to IV, respectively). Relations between γ radiation and monitoring time, altitude, distance from the nuclear power plant were analyzed, and the annual effective dose of terrestrial γ radiation to residents was estimated to reflect the background terrestrial γ radiation level in the area. Results The average values of terrestrial γ radiation dose rate in the four monitoring periods in the area were (76.196 ± 3.366), (81.773 ± 6.144), (93.554 ± 7.449), and (97.604 ± 9.396) nGy/h, respectively, and the terrestrial γ radiation dose rate in the whole year was (87.282 ± 6.589) nGy/h. The effective dose to residents was 0.428 mSv. The terrestrial γ radiation level was high from July 2021 to January 2022. There was no significant difference in the γ radiation dose rate at the monitoring sites with different distance from the nuclear power plant. No impact upon the terrestrial γ radiation dose by the altitude was observed in this study. Conclusion The terrestrial γ radiation level around Shidaowan nuclear power plant in 2021 was at the background level.