Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.

Color is an important indicator for evaluating the ornamental traits of horticultural plants, and plant pigments is a key factor affecting the color phenotype of plants. Plant pigments and their metabolites play important roles in color formation of ornamental organs, regulation of plant growth and development, and response to adversity stress. It has therefore became a hot topic in the field of plant research. Virus-induced gene silencing (VIGS) is a vital genomics tool that specifically reduces host endogenous gene expression utilizing plant homology-dependent defense mechanisms. In addition, VIGS enables characterization of gene function by rapidly inducing the gene-silencing phenotypes in plants. It provides an efficient and feasible alternative for verifying gene function in plant species lacking genetic transformation systems. This paper reviews the current status of the application of VIGS technology in the biosynthesis, degradation and regulatory mechanisms of plant pigments. Moreover, this review discusses the potential and future prospects of VIGS technology in exploring the regulatory mechanisms of plant pigments, with the aim to further our understandings of the metabolic processes and regulatory mechanisms of different plant pigments as well as improving plant color traits.
Plant Viruses/genetics* ; Plants/genetics* ; Gene Silencing ; Plant Development ; Gene Expression Regulation, Plant ; Genetic Vectors

Myocardial dysfunction is the most serious complication of sepsis. Sepsis-induced myocardial dysfunction (SMD) is often associated with gastrointestinal dysfunction, but its pathophysiological significance remains unclear. The present study found that patients with SMD had higher plasma gastrin concentrations than those without SMD. In mice, knockdown of the gastrin receptor, cholecystokinin B receptor (Cckbr), aggravated lipopolysaccharide (LPS)-induced cardiac dysfunction and increased inflammation in the heart, whereas the intravenous administration of gastrin ameliorated SMD and cardiac injury. Macrophage infiltration plays a significant role in SMD because depletion of macrophages by the intravenous injection of clodronate liposomes, 48 h prior to LPS administration, alleviated LPS-induced cardiac injury in Cckbr-deficient mice. The intravenous injection of bone marrow macrophages (BMMs) overexpressing Cckbr reduced LPS-induced myocardial dysfunction. Furthermore, gastrin treatment inhibited toll-like receptor 4 (TLR4) expression through the peroxisome proliferator-activated receptor α (PPAR-α) signaling pathway in BMMs. Thus, our findings provide insights into the mechanism of the protective role of gastrin/CCKBR in SMD, which could be used to develop new treatment modalities for SMD.

Chronic hepatitis B (CHB) is a major global public health issue, and although direct-acting antiviral agents can control hepatitis B virus (HBV) replication, it is difficult to achieve the cure of CHB. Host adaptive immune response plays a key role in eliminating HBV, and it is expected to achieve the functional cure of CHB by rebuilding the patient’s adaptive immunity. Great progress has been made in therapeutic vaccines, cellular immunotherapy, immune checkpoint blockade, T cell metabolic reprogramming, and strategies of neutralizing antibody targeting adaptive immunity for the treatment of hepatitis B. This article summarizes the above-mentioned therapies for hepatitis B in recent years.

Objective To investigate the diagnostic value of B7-H3 and carcinoembryonic antigen (CEA) on diagnosis of malignant pleural effusion (MPE).Methods We collected and analysed the expression of B7-H3 and CEA in 40 MPE cases and 22 cases of benign pleural effusion (BPE) using enzyme-linked immunosorbent assay (ELISA).Receiver operator characteristic curves (ROC) were drawn according to the expression of B7-H3 and CEA, calculated diagnosis sensitivity, specificity and the area under curve (AUC).Results The diagnosis sensitivity of B7-H3 was 62.5％, specificity 81.0％, with the AUC of 0.777;similarly, The diagnosis sensitivity of CEA was 72.5％, specificity 81.0％, with the AUC of 0.850.Higher AUC of 0.910 was gained in combination ROC, with sensitivity and specificity of 72.5％, 81.0％, respectively.Conclusion B7-H3 and CEA could be available diagnosing markers for MPE.Combined applications of B7-H3 and CEA have higher AUC.They may be widely applied in future clinical practice.

Objective To explore the distribution ofchoroidal thickness and its influence factors in university students.Methods A cross-sectional study.A total of 896 eyes of 896 college students were included in the study.Among them,there were 350 males (350 eyes) and 546 females (546 eyes).All the eyes were right eyes.The average age was 19.18 ± 1.36 years old.According to the spherical equivalent refraction (SER),the eyes were divided into non-myopia group,low myopia group,moderate myopia group and high myopia group,which were 59,251,356 and 230 eyes,respectively.The subfoveal ChT (SFCT) was measured using a swept-frequency source optical coherence tomography scanner.According to the ETDRS,the choroid within 6 mm of the fovea was divided into three concentric circles centered on the fovea of the macula,which were the central area with a diameter of 1 mm,the inner ring area of 1-3 mm and the outer ring area of 3-6 mm.The outer ring area of 3-6 mm has a total of 9 zones.The inner ring and outer ring 4 regions were superior,inferior,nasal and temporal,respectively.The distribution characteristics of ChT in different regions,genders and diopter groups were observed.Bivariate correlation analysis were used to analyze the correlation of ChT and SER,axial length (AL).Results The average SFCT of 896 eyes was 221.28± 67.35 μm.The mean SFCT of males and females were 227.20 ± 69.38 and 217.50± 65.80 μm,respectively.The difference of SFCT between different genders was statistically significant (t=2.075,P=0.038).Compared with the central region ChT,there was no significant difference in ChT between the outer ring and the outer region (t=0.086,P=0.932).The difference of ChT in other regions was statistically significant (t=-21.973,-5.818,36.328,-3.065,-18.017,-10.595,57.007;P＜0.001,＜0.001,＜0.001,＜0.002,＜0.001,＜0.001,＜0.001).In the horizontal direction,ChT gradually thickens from nasal to temporal (F=2 251.558,P＜0.001);in the vertical direction,ChT gradually decreases from superior to the central,but have a little increased from central to inner inferior,then decreased to outer inferior again (F=45.425,P＜0.05).Correlation analysis showed that SFCT was negatively correlated with AL (r=0.478,P＜0.01) and a negative correlation with axial length (r=-0.395,P＜0.01),and positively correlated with SER (r=0.478,P＜0.01).SFCT decreased by 12.29 μm for every in myopic refractive error of 1 D,or by 20.14 μm for every increase in AL of 1 mm.Conclusions ChT is changed by different location.The horizontal direction is gradually thickened from nasal to temporal.The vertical direction is thicker than the center.The inferior inner ring area is thicker than the outer ring area.Gender,SER and AL are the influencing factors of SFCT.

Intestinal flora can participate in and influence the physiological function and disease process of the organism as part of the host .The symbiotic relationship between intestinal flora and the host is the result of species′evolution over millions of years .Immunity system , which is complex and includes multiple influencing factors , is the necessary defense system that runs through human life .Among them, the intestinal flora plays an important role in maintaining the steady state of human immunity system .In this paper, the relationship between intestinal flora and immune system disease is briefly described , in order to deepen the understanding for medical workers and researchers , and provide references for the prevention , treatment and prognosis of the disease .

Objective To evaluate he significance of the Neutrophil-Lymphocyte Ratio(NLR)and the red blood cell(erythrocyte)distribution width(RDW)in distinguishing between simple and complex febrile seizures and evaluate the diagnostic values of NLR and RDW in febrile seizures. Methods Totally,100 patients aged between 6 months and 5 years diagnosed with febrile seizure were admitted to the emergency department of the hospital.Complete blood count obtained from the peripheral blood samples collected from the patients at admis-sion were evaluated. Results The average values of NLR for simple and complex seizure groups were 2.16 ± 1.26 and 3.62 ± 1.51 respectively.The average values of RDW for simple and complex seizure groups were 15.04 ± 1.73 and 16.89 ± 1.44,respectively.Using receiver operating characteristic curve(ROC),the sensitivity and specificity were 65.5% and 66.2%,respectively,with the area under the curve[AUC]of 0.670 when the cut-off value was 2.52 for NLR,and they were 62.1% and 59.3%,respectively,with AUC of 0.619 when the cut-off value was 16.47 for RDW. Conclusion NLR and RDW may provide clinicians with an insight into differentiation between simple and complex febrile seizures,however,we need much better diagnostic value to classify the febrile seizures

Objective To establish a high performance liquid chromatography (HPLC) method for the determination of baicalin and naringin inQinbei mixture.Methods The HPLC system consisted of the Fortis-C18(4.6 mm × 250 mm, 5μm) column, and the mobile phase consisted of MeOH:0.4% H3PO4 (42:58), and the flow rate was 1.0 ml/min, and the UV detector was set at 280 nm, and the column temperature was 30℃.Results The linear response range of baicalin was 0.062-0.930μg. The linear response range of naringin was 0.033-0.492μg. The average recovery of baicalin was 98.11% (RSD=1.62%). The average recovery of naringin was 96.78% (RSD=1.74%).Conclusions The method is simple, rapid, accurate and repeatable. It can be applied in determination of baicalin and naringin inQinbei mixture.

Objective To explore the diagnostic value of C‐reactive protein(CRP) for diagnosing chronic obstructive pulmonary disease(COPD) to dig a new marker for COPD diagnosis .Methods A total of 199 cases of COPD ,159 cases of pulmonary malig‐nant tumor and 115 individuals undergoing the physical examination were collected .The whole blood CRP level was detected in 3 groups and the detection results were compared among 3 groups .The receiver operating characteristic(ROC) curve was drawn . Then the sensitivity ,specificity and Youden′s index(YI) were calculated to find the cut‐off value of diagnosis .Results Compared with the individuals undergoing healthy physical examination ,the CRP level in the COPD patients and the patients with pulmonary malignant tumor was significantly increased ,the difference was statistically significant(P<0 .05);the area under ROC curve(AUC) was 0 .768 ,the maximal YI was 0 .418 ,the sensitivity and specificity were 64 .7% and 77 .1% respectively ,the corresponding cut‐off value was 49 .75 mg/L .Conclusion CRP has a certain diagnostic value and can serve as a new index of COPD diagnosis .