The hypoxia-inducible factor is a significant regulator of adaptive transcriptional response in hypoxia or hypoxia. Hypoxia-inducible factor (hypoXIA-inducible factor) loses its activity after hydroxylation by proline hydroxylase in a normoxic environment. Proline hydroxylase inhibitor is a kind of new small molecule oral preparation by inhibiting the proline hydroxylase, reducing the degradation of HIF, activating the hypoxia-induced way, adjusting including stimulates erythropoiesis, iron absorption and mobilization, angiogenesis, lipid, and glucose metabolism, inflammation, energy metabolism, cell growth and differentiation, and other physiological reaction, Showed more clinical benefits. In recent years, the application of proline hydroxylase inhibitors in the field of renal anemia has achieved apparent efficacy, and the research in the field of ischemic heart disease has also made significant progress in the future in the treatment of ischemic heart disease and other aspects of good application prospects.

Objective To systematically evaluate the effect of exercise therapy on body structure,function,and activity and partici-pation in patients with chronic nonspecific neck pain(CNSNP)based on the International Classification of Func-tioning,Disability and Health(ICF)framework. Methods A PICO framework was constructed,and randomized controlled trials(RCTs)on the intervention of different types of exercise therapy for patients with CNSNP were retrieved from databases of CBM,Wanfang data,VIP,CNKI,Cochrane Library,Embase,PubMed and Web of Science,from the establishment to March,2024.The quality of the literature was evaluated with Cochrane Risk of Bias Tool and Physiotherapy Evidence Database(PEDro)scale,and the evidence quality of the outcome indicators was evaluated using GRADE.Data were syn-thesized and analyzed using RevMan 5.3,and the risk of bias was evaluated using Stata 18.0. Results A total of eleven RCTs involving 668 subjects were included.The scores of PEDro scale were five to eight.The types of interventions included muscle strength training,stability training,proprioception training,Yoga and Pi-lates.The control groups received placebo,physical factor therapy and health education.Exercise therapy could increase the craniovertebral angle(SMD=0.84,95%CI 0.42 to 1.26,P<0.001),reduce the Visual Analogue Scale score(SMD=-2.05,95%CI-2.58 to-1.52,P<0.001),increase the pressure pain threshold(MD=112.27,95%CI 75.03 to 149.50,P<0.001),increase the range of motion of cervical forward(SMD=1.24,95%CI 0.34 to 2.15,P=0.007)and lateral(SMD=1.52,95%CI 0.40 to 2.65,P=0.008)flexion,and improve the endurance of the deep cervical flexors(SMD=1.02,95%CI 0.10 to 1.94,P=0.03)and position sense of the cervical spine(SMD=-1.00,95%CI-1.47 to-0.53,P<0.001);however,it was not significant in improving the range of motion of backward flexion(SMD=0.85,95%CI-1.04 to 2.75,P=0.38)and rotation(SMD=1.65,95%CI-0.35 to 3.65,P=0.11).Exercise therapy could also reduce the Neck Disability Index score(MD=-11.88,95%CI-16.09 to-7.68,P<0.001),and it was no significant in the Short-Form-36 score(MD=19.04,95%CI-3.00 to 41.08,P=0.09). Conclusion Exercise therapy can improve head posture,pain,motion of forward flexion and lateral flexion,endurance of the cervical flexors and joint position sense,and the overall function in patients with CNSNP.However,fur-ther researches are needed to verify the effects on cervical backward flexion and rotation,and quality of life.

Objective To verify whether β-arrestin-2 inhibits autophagy by up-regulating PI3K/Akt signal to protect the liver from ischemia-reperfusion injury (IRI) in mice. Methods Twelve β-arrestin-2 knockout (KO) and twelve wild-type (WT) C57BL/6 mice were randomly divided into the KO+sham group, KO+IRI group, WT+sham group and WT+IRI group, six mice in each group. The mouse models with 70% liver IRI were established or sham operation was performed. Relevant experiments were carried out at 6 h after liver reperfusion or operation. The expression levels of apoptosis signal protein cleaved Caspase-3, proliferation signal protein Ki-67 and the PI3K/Akt signal protein p-Akt were detected by immunohistochemical staining. Results Immunohistochemical staining demonstrated that compared with the corresponding sham group, the positive cell count for cleaved Caspase-3, Ki-67 and p-Akt in liver tissues of mice was significantly increased in the KO+IRI and WT+IRI groups (all P < 0.01). Compared with the WT+IRI group, the positive cell count for cleaved Caspase-3 in liver tissues of mice was significantly increased, whereas the positive cell count forKi-67 and p-Akt was significantly decreased in the KO+IRI group (both P < 0.05). Conclusions β-arrestin-2 can mitigate the liver cell apoptosis and promote the repair of injury after IRI in mice. Moreover, β-arrestin-2 inhibits autophagy by up-regulating the PI3K/Akt signal to alleviate liver IRI in mice.

The prevalence of heart failure(HF) is increasing worldwide, and mitral regurgitation(MR) is a common manifestation in patients with end-stage HF. Currently, the indications for concomitant surgical intervention of significant preoperative MR during left ventricular assist device(LVAD) implantation are still controversial. Based on discussing the etiology, classification, and pathophysiology of functional MR in patients with end-stage HF, this paper reviews the relevant factors affecting the prognosis of such patients and the progress of research related to whether to perform mitral valve surgery to intervene in significant MR during LVAD implantation, to provide a further reference for clinical practice.

Objective:To investigate the prevalence of albuminuria in Chinese residents aged >35 years and its potential association with cardiovascular disease (CVD).Methods:A total of 34 647 Chinese subjects aged ≥35 years were selected by stratified multi-stage random sampling from 2012 to 2015. Data were collected through questionnaires, physical examinations, and laboratory tests. Albuminuria was categorized into 3 types according to urinary albumin-to- creatinine ratio: normal (<30 mg/g), microalbuminuria (MAU, 30-300 mg/g), and macroalbuminuria (≥300 mg/g). Measurement data were expressed as xˉ±s, and t-tests were used for comparisons between indicators. Qualitative data were expressed as rate or constituent ratio, and the χ2 test or Kruskal-Wallis test was used to examine differences. Logistic regression was used for multivariate analyses. SAS 9.4 software was used for statistical analyses, and P<0.05 was considered statistically significant. Results:The prevalence of abnormal albuminuria was 19.1%; the prevalence was 17.2% for MAU and lower in males (13.8%) than females (20.1%, P<0.01). The risk of CVD was higher among subjects with MAU ( OR=1.23, 95% CI 1.12-1.35) and macroalbuminuria ( OR=1.86, 95% CI 1.50-2.32). When MAU was complicated by hypertension and diabetes mellitus, the CVD risk was 1.76 times higher. Conclusions:The prevalence of MAU is high among Chinese subjects aged 35 years and over. Those with MAU have higher CVD risk, especially those with hypertension and diabetes mellitus.

OBJECTIVE: To characterize the silver in chitosan antibacterial gel, and to establish a method for the determination of silver content in samples. METHODS: The silver in the samples was analysed by scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS) and single particle inductively coupled plasma mass spectrometry (SP-ICP-MS). Microwave digestion was adopted to digest the chitosan antibacterial gel, and then the content of silver was determined by flame atomic absorption spectrometry. RESULTS: The analysises showed that the particle size of silver in chitosan antibacterial gel was about 150~ 200 nm. The silver showed good linearity in the concentration range of 25~250 μg/L (y=0.000 35x+0.001 7, r=0.999 9). The recovery rate (n=9) was 98.5%. CONCLUSIONS SEM, EDS and SP-ICP-MS can be used for the characterization of silver particles in chitosan antibacterial gel. Microwave digestion-flame atomic absorption spectrophotometry method is simple, practicable, high precision and high quantitative accuracy, which is suitable for the quantitative analysis of silver in chitosan antibacterial gel.
Anti-Bacterial Agents/pharmacology* ; Chitosan/chemistry* ; Microwaves ; Particle Size ; Silver

OBJECTIVETo summarize the disposal methods and the reasons of complications in operation of totally implantable central venous port (TICVP).

METHODSA total of 2 007 patients were enrolled in this observational, single-center study between December 2008 and March 2013. TICVP implantation was performed with one small skin incision and subcutaneous puncture of subclavian or jugular vein. Patient's profiles, indications of port system, early and delayed complications, and disposal methods were evaluated. There were 38 male and 1 969 female patients, aged from 21 to 85 years, with a mean of 47.6 years.

RESULTSThe mean duration of the TICVP system was (242 ± 12) days, ranging from 9 to 1 243 days. The achievement rate of puncture in the right jugular vein (99.76%) was the highest. Sonographic approach using the internal jugular vein were better than the external landmark-guided technique (99.80% vs. 96.34%, χ² = 29.905, P = 0.000). The rate of immediate complication was 0.80%, which included pneumothorax, hemothorax, lymphatic fistula and thrombosis. Early complications rate was 0.10%, which included pocket hematoma, catheter migration, venous thrombosis, port pocket infection, fibrin sheath formation. Late complications rate was 7.87%, which included catheter fracture, pinch-off syndrome, catheter-related bloodstream infection, fibrin sheath formation, catheter migration, extravasation, port inversion and port reveal. The rate of removal due to complications was 1.34% (27/2 007), and the early complication was higher (χ² = 8.053, P = 0.011).

CONCLUSIONSThe low incidence of complications suggests that TICVP is safe and reliable for long term intermittent venous access. The results support the use of TICVP in the oncology patients and patients requiring long-term intravenous therapy.

Adult ; Aged ; Aged, 80 and over ; Catheterization, Peripheral ; adverse effects ; methods ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Prostheses and Implants ; Retrospective Studies ; Young Adult

OBJECTIVE: To investigate the effect of electroacupuncture on osteoarthritis in rats and explore the possible mechanism. METHODS: Thirty SD rats were randomly divided into osteoarthritis model group, electro-acupuncture group and control group (n=10), and in the former two groups, early osteoarthritis was induced using a modified DMM surgical modeling method. After successful modeling, the rats in the electro-acupuncture group were treated with electro-acupuncture at bilateral "Housanli" and "Anterior knee point". Behavioral tests of the rats were performed and scored using the LequesneMG scale. Subchondral bone degeneration was observed in each group, and serum levels of IL-1β, ADAMTS-7, MMP-3 and COMP were measured using ELISA. The mRNA and protein expressions of IL-1β, Wnt-7B, β-catenin, ADAMTS-7, and MMP-3 in the cartilage tissue of the knee joints were detected using RT-PCR and Western blotting. RESULTS: In behavioral tests, the rats in the model and electroacupuncture groups had significantly higher LequesneMG scores after modeling than those in the control group (P < 0.05). After 20 days of treatment, LequesneMG scores were significantly lowered in rats in the electroacupuncture as compared with the model rats (P < 0.05). Imaging examination revealed obvious subchondral bone damage in both the electroacupuncture group and the model group, but the damages were significantly milder with former group. Compared with the model rats, the rats receiving electroacupuncture had significantly lower serum levels of IL-1β, ADAMTS-7, MMP-3 and COMP (P < 0.05) with also lower expressions of IL-1β, Wnt-7B, β-catenin, ADAMTS-7 and MMP-3 in the cartilage tissues at both the mRNA and protein levels (P < 0.05). CONCLUSION Electroacupuncture can alleviate joint pain and improve subchondral bone damage in rats with osteoarthritis by reducing IL-1β levels in the joint cartilage tissue and serum to alleviate joint inflammation and by reducing such cytokines as ADAMTS-7 and MMP-3 via regulating the Wnt-7B/β-catenin signaling pathway.
Rats ; Animals ; Electroacupuncture ; Matrix Metalloproteinase 3/metabolism* ; Rats, Sprague-Dawley ; beta Catenin/metabolism* ; Osteoarthritis/metabolism* ; Wnt Signaling Pathway ; Cartilage, Articular ; Inflammation/metabolism*

To explore the impact of an airway stepwise management strategy in the treatment of hospital acquired pneumonia (HAP) in the ultra elderly critically ill patients.

Clinical data on the ultra eldely(≥80 years old) HAP patients at the department of Critied Care Medicine, Peking Union Medical College Hospital from January 2021 to April 2023 was retrospective collected, and the enrolled patients were divided into an observation group (January 2022-April 2023) and control group (January 2021-December 2021) according to the airway stepwise management strategy. In the control group, conventional airway manage- ment was used, and in the observation group, an airway stepwise management strategy from simple to complex and from noninvasive to invasive was used. The oxygenation indices before and after airway interventiont, tracheal intubation/tracheostomy rate, and invasive ventilator usage rate was compared in both groups.

A total of 61 HAP patients who met the inclusion and exclusion criteria were selected, including 31 in the observation group and 30 in the control group. Compared with before airway intervention, the arterial partial pressure of carbon dioxide gradually decreased, arterial partial pressure of oxygen and oxygenation index gradually increased at 12 h, 48 h and 72 h of airway intervention(all P < 0.05). Compared with the control group, the observation group had lower arterial partial pressure of carbon dioxide, and higher arterial partial pressure of oxygen and oxygenation index(all P < 0.05), and the rate of tracheal intubation/incision (35.5% vs. 66.7%, P=0.015) and the rate of invasive ventilator use (41.9% vs. 73.3%, P=0.013) were lower in the observation group at 48 h of airway intervention.

The application of an airway stepwise management strategy in the ultra elderly HAP patients can significantly improve oxygenation status and reduce iatrogenic trauma.

Long noncoding RNAs (lncRNAs) are expressed in different species and different tissues, and perform different functions, but little is known about their involvement in the synthesis or secretion of follicle-stimulating hormone (FSH). In general, we have revealed lncRNA‍‒‍microRNA (miRNA)‍‒‍‍messenger RNA (mRNA) interactions that may play important roles in rat primary pituitary cells. In this study, a new lncRNA was identified for the first time. First, we analyzed the gene expression of lncRNA-m18as1 in different tissues and different stages by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and observed the localization of lncRNA-m18as1 with fluorescence in situ hybridization, which indicated that this lncRNA was distributed mainly in the cytoplasm. Next, we used RT-qPCR and enzyme-linked immunosorbent assay (ELISA) to analyze the regulation of FSH synthesis and secretion after overexpression or knockdown of lncRNA-m18as1 and found that lncRNA-m18as1 was positively correlated with FSH synthesis and secretion. In addition, mothers against decapentaplegic homolog 2 (Smad2) was highly expressed in our sequencing results. We also screened miR-18a-5p from our sequencing results as a miRNA that may bind to lncRNA-m18as1 and Smad2. We used RNA immunoprecipitation-qPCR (RIP-qPCR) and/or dual luciferase assays to confirm that lncRNA-m18as1 interacted with miR-18a-5p and miR-18a-5p interacted with Smad2. Fluorescence in situ hybridization (FISH) showed that lncRNA-m18as1 and miR-18a-5p were localized mainly in the cytoplasm. Finally, we determined the relationship among lncRNA-m18as1, miR-18a-5p, and the Smad2/3 pathway. Overall, we found that lncRNA-m18as1 acts as a molecular sponge of miR-18a-5p to regulate the synthesis and secretion of FSH through the Smad2/3 pathway.
Animals ; Cell Line, Tumor ; Cell Proliferation ; Follicle Stimulating Hormone/metabolism* ; Gene Expression Regulation, Neoplastic ; In Situ Hybridization, Fluorescence ; MicroRNAs/metabolism* ; RNA, Long Noncoding/metabolism* ; Rats