Objective To discuss the intraoperative and postoperative effects of conbercept combined with pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR) patients.Methods From January 2016 to December 2016,123 PDR patients (149 eyes) aged 41-65 years old with nonclearing vitreous hemorrhage (VH) and/or tractional retinal detachment (TRD) were enrolled in this study.According to whether preoperative intravitreal injection conbercept,the patients were divided into two groups:Conbercept group (64 cases,78 eyes),Control group (59 cases,71 eyes).Conbercept group was treated with intravitreal injection of Conbercept 0.50 mg (0.05 mL) at 3 days before PPV.Then the standard 23G minimally invasive sclera three-channel vitrectomy was performed if no significant complications after the injection of conbercept.The operation time,intraoperative bleeding,iatrogenic retinal hole,use of endodiathermy and silicone oil,and postoperative complications were recorded and analyzed.The visual acuity and macuiar thickness were compared before and 1 month after the surgery.Results Two groups had no difference on age,sex,HbA1 C,duration,VH ≥ three degree(56/78,45/71),TRD.Conbercept pretreatment could significantly reduce the bleeding during PPV (43/78,49/71),the probability of iatrogeuic retinal holes (11/78,21/71),reduce intraocular electrocoagulation using (57/78,62/71) and silicone oil (43/78,51/71),and then shorten the operation time (58.63 ± 21.66)s and (72.69 ± 22.48)s,and it could significantly improve the postoperative visual acuity (0.23 ± 0.15,0.16 ± 0.11) and macular edema thickness (260.95 ± 27.44) μm and (330.81 ± 36.62)μm,while reduce the incidence of second bleeding (3/78,10/71).Conclusion Conbercept pre-treatment combined with PPV for PDR is a positive and effective treatment,which has good clinical application significance.

Objective To investigate the effect of different noise index (NI) combined with iterative recombination on the image quality and radiation dose of CT scan in patients with different body mass index (BMI). Method One hundred and sixty patients who had a liver CT enhanced scan were divided into group A (18 kg/m2≤BMI<24 kg/m2 ) and group B (24 kg/m2≤BMI<31 kg/m2) according to BMI, and each group had 80 patients. The two groups were randomly divided into 4 subgroups which NI value was 11, 13, 15 and 17 respectively. All images were restructured with 50% adaptive statistical iterative reconstruction. Subjective evaluation, objective evaluation [signal noise ratio (SNR) and contrast noise ratio (CNR)] and the effective dose of each group were recorded and calculated after the scan. ANOVA and Kruskal-Wallis test were used to evaluated the difference of imaging quality and radiation dose. Results In group A, the SNR, CNR and the subjective score of the later arterial phase images showed a statistical difference between NI=17 group and other subgroups (P<0.05), while there was no statistical differences among the other three subgroups during three CT enhanced phase. The average ED of NI=15, 17 group were decreased by 57.56%(2.17/3.77) and 61.54% (2.32/3.77) compared with NI=11 group, respectively. In group B, the SNR, CNR and the subjective image scores of the later arterial phase showed a significant difference between NI=15 and NI=11, 13 group (P<0.05). There was a statistically difference of image quality in group NI=17 compared with the other three subgroups in the later arterial phase, portal venous phase and equilibrium phase (P<0.05). The average ED of NI= 13, 15 group was decreased by 26.41% (1.69/6.40) and 45.31%(2.90/6.40) compared with NI=11 group, respectively. Conclusion Upon maintaining diagnostic imaging quality, setting different NI according to BMI and applying the iterative reconstruction algorithm can effectively reduce the radiation dose of liver CT enhanced scanning.

Objective To detect the influence of rapamycin on the expression of 4 kinds of miRNAs and the effect cell autophagy.To study the relationship of miR-144 and Beclin-1 gene.Methods SKOV-3 cells were treated with 50 ng/mL rapamycin 2 hours and 10 nmol/L 3-methyl adenine 12 hours,the expression of miR-17,miR-20a,miR-144 and miR-155 was detected by RT-qPCR in SKOV-3 cell of different groups,the protein expression of Beclin-1 was detected by Western blot.The targeting effect of miR-144 on Beclin-1 gene was verified by the dual-luciferase reporter assay,Western blot and RT-qPCR.Results The expression of miR-17,miR-144 and miR-155 were in creased compared with NC groups in rapamycin group (P＜0.05);miR-17,miR-20a and miR-144 were down regulated compared with NC group in 3-MA group(P＜0.05);the protein of Beclin-1 was down expression compared with NC group in rapamycin group.miR-144 could suppress Beclin-1 expression by targeting the specific 3'untranslated region sequence of Beclin-1 gene.Conclusions miR-144 can inhibit the autophagy-related gene Beclin-1 expression and regulate the autophagy process in SKOV-3 cells.

Objective To investigate the image quality,radiation dose and iodine intake of CT pulmonary angiography (CTPA) in patients using low tube voltage (100 kVp) combination of different noise indexes (NI) and low concentration contrast agent.Methods A total of 80 patients with suspected pulmonary embolism (PE) and other pulmonary diseases who had undergone CTPA were divided into four groups (A,B,C and D),with 20 patients in each group.Group A underwent 120 kVp CT scan protocol in combination with NI=25 and 370 mg iodine/ml contrast agent,while groups B,C and D underwent 100 kVp CT scan protocol in combination with NI=30,35,40,and 320 mg iodine/ml contrast agent,respectively.All images were restructured using 60％ adaptive statistical iterative algorithm 2.0.Objective image quality evaluation included CT values of pulmonary artery,noise values of pulmonary artery,signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR).Subjective image evaluation used a 5-point scoring method and was conducted by two independent radiologists.The CT dose index of volume (CTDIvol),dose-length product (DLP) and iodine intake was recorded,and the mean value was calculated.The DLP was converted to the effective dose (ED).Analysis of Variance or Kruskal-Wallis test was used to evaluate the differences among the four groups in terms of image quality,radiation dose and iodine intake.Results There was a significant difference in CT values of pulmonary artery among the groups A,B,C and D (P＜0.05),and the CT values of pulmonary artery of group A was the lowest.There was no significant differences in noises of pulmonary artery,SNR,CNR and subjective indexes scores among the groups A,B,C and D (P＞0.05).There was a significant difference in iodine intake among the groups A,B,C and D,iodine intake of the group A was the highest,iodine intake of the group D was the lowest.The iodine intake of groups B,C and D decreased by 12.4％ (42/340),13.2％ (45/340) and 15.0％ (51/340) relative to group A,respectively.There was a significant difference in radiation dose among the groups A,B,C and D,The CTDIvol,DLP and ED of group D decreased by 45.3％ (3.9/8.6),48.6％ (120/247) and 48.3％ (2.02/4.18) relative to group A,respectively (P＜0.01).Conclusion Low tube voltage combination with high NI value and low concentration contrast agent can more effectively reduce the radiation dose and iodine intake for CTPA while maintaining diagnostic image quality.

Objective To compare the image quality and radiation dose of CTA of the kidney in patients using routine CT and the spectral imaging combination of different scanning protocols with the adaptive statistical iterative reconstruction 2.0 algorithm (ASIR 2.0). Methods A total of 90 patients who had undergone a CTA of the kidney were divided into three groups (A, B and C), with 30 patients in each group. Group A underwent a routine CT examination, and the scan parameters are:120 kVp, 30 to 650 mA, rotation time 0.5 s/r, scan FOV 50 cm × 50 cm;while groups B and C underwent spectral imaging protocol 1 and 2, the scan parameters of spectral imaging protocol 1 and 2 are:rapid dual kVp (80-140 kVp) switching in 0.25 ms, 375 mA and 360 mA, rotation time 0.7 s/r and 0.6 s/r, scan FOV 36 cm × 36 cm and 32 cm × 32 cm, respectively. All images were reconstructured using ASIR 2.0. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of all images were calculated when the kidney CTA was completed. Each subjective image evaluation used a 5-point scoring method and was conducted by two independent radiologists. The CT dose index (CTDIvol) and dose-length product (DLP) were recorded, and the mean value was calculated. The DLP was converted to the effective dose (ED). All data were compared with Kruskal-Wallis test and one-way ANOVA. Results The energy level of 49 to 56 keV was found to provide the best CNR for displaying CTA of the kidney. There were significant differences in CT values, noise, SNR, CNR and subjective score between groups B, C and A (P<0.05), and there was no significant differences in CT values, noise, SNR, CNR and subjective score between groups B and C (P>0.05). There were significant differences in ED among groups A, B and C (P<0.05), and the ED of groups A, B and C were (8.2±1.2), (5.2± 0.9) and (4.4 ± 0.7) mSv, respectively. Conclusion Spectral imaging with different scanning protocols can more effectively reduce the radiation dose than the routine CT scan mode for a kidney CTA while still maintaining diagnostic image quality, and protocol 2 of spectral imaging in our study is recommended.

Objective:To evaluate the effect of dexmedetomidine on Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) signaling pathway in lung tissues in a rat model of cardiopulmonary bypass (CPB).Methods:Twenty-four clean-grade healthy male Sprague-Dawley rats, weighing 320-350 g, aged 12-16 weeks, were randomly divided into sham operation group (group S), CBP group, and dexmedetomidine group (group Dex), with 8 rats in each group.In group Dex, dexmedetomidine was intravenously infused in a dose of 5 μg/kg starting from 15 min before CPB followed by infusion of 5 μg·kg -1·h -1 during CPB.Blood samples were collected at 2 h after the end of CPB for blood gas analysis, and oxygenation index (OI) and respiratory index (RI) were calculated.Then the rats were sacrificed by bloodletting.The lung tissues were removed for microscopic examination of the pathological changes which were scored and for determination of wet/dry weight ratio (W/D ratio), contents of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6)(by enzyme-linked immunosorbent assay), and expression of JAK2, STAT3, phosphorylated JAK2 (p-JAK2) and phosphorylated STAT3 (p-STAT3) (by Western blot). The p-JAK2/JAK2 and p-STAT3/STAT3 ratios were calculated. Results:Compared with group S, the lung injury score, W/D ratio and RI were significantly increased, OI was decreased, the contents of TNF-α and IL-6, p-JAK2/JAK2 ratio and p-STAT3/STAT3 ratio were increased in the other two groups ( P<0.05). Compared with group CPB, the lung injury score, W/D ratio and RI were significantly decreased, OI was increased, the contents of TNF-α and IL-6, p-JAK2/JAK2 ratio and p-STAT3/STAT3 ratio were decreased in group Dex ( P<0.05). Conclusion:The mechanism by which dexmedetomidine attenuates CPB-induced lung injury may be related to inhibiting JAK2/STAT3 signaling pathway and reducing inflammatory responses in lung tissues of rats.

Objective:To investigate the application effect of preoperative prerehabilitation in elderly patients with knee arthroplasty combined with sarcopenia.Methods:A total of 164 elderly patients who were hospitalized and underwent artificial knee arthroplasty combined with sarcopenia in Department of Orthopedics of the First Affiliated Hospital of Zhengzhou University from July 2020 to December 2021 were included by the convenient sampling method. According to random number table method, they were divided into the control group and the observation group, with 82 cases in each group. The control group received routine preoperative nursing, and the observation group received preoperative pre-rehabilitation intervention on the basis of the control group. Knee range of motion, Hospital for Special Surgery Knee Score (HSS) , skeletal muscle mass index and grip strength were evaluated before intervention and 1 month after operation. Length of stay and postoperative complications were recorded and compared between the two groups.Results:Knee range of motion, HSS of two groups at 1 month after operation were higher than those before intervention, and the differences were statistically significant ( P<0.05) . One month after surgery, the knee range of motion, HSS and grip strength of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . The skeletal muscle mass index of the observation group was higher one month after surgery than before intervention, but the difference was not statistically significant ( P>0.05) . The hospitalization time of observation group was shorter than control group, and the difference was statistically significant ( P<0.05) . The incidence of complications in the observation group and control group was respectively 15.85% (13/82) and 39.02% (32/82) , and the difference was statistically significant ( P<0.05) . Conclusions:Preoperative rehabilitation can effectively improve the knee range of motion and joint function of elderly patients with sarcopenia after knee rarthroplasty, alleviate sarcopenia, shorten the length of hospital stay and reduce postoperative complications.

Objective:To explore the effect of nurse-patient cooperative rehabilitation model based on rapid recovery concept on the rehabilitation effect of patients with avascular necrosis of the femoral head undergoing artificial hip replacement.Methods:Convenience sampling was used to select 104 patients with avascular necrosis of the femoral head who were treated in the First Affiliated Hospital of Zhengzhou University from September 2019 to October 2021 and underwent artificial hip replacement. The patients were divided into control group and observation group according to the random number table method, with 52 cases in each group. The control group was given routine nursing, and the observation group was given nurse-patient cooperative rehabilitation model based on the concept of rapid recovery. The Visual Analogue Score and Harris Hip Score were compared between the two groups before and after the intervention.Results:Pain scores of the observation group were lower than those of the control group five and ten days after operation and one month after discharge, and the differences were statistically significant ( P<0.05) . After intervention, the joint pain, functional changes, deformity and joint range of motion of the observation group were better than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The nurse-patient cooperative rehabilitation model based on the concept of rapid recovery for patients with avascular necrosis of the femoral head can improve the hip joint function of patients, alleviate pain and promote rehabilitation.

Objective:To investigate the effects and mechanism of metformin on the wound healing of full-thickness skin defects in diabetic rats.Methods:This study was an experimental study. Eighteen 8-week-old male Sprague Dawley rats were divided into control group, diabetes group, and diabetes+metformin group according to complete random grouping method, with 6 rats in each group. The latter two groups of rats were used to create diabetic models, and then four circular full-thickness skin defect wounds with a diameter of 5 mm were made on the back of 18 rats. Metformin F-127 hydrogel was applied only to the wounds of rats in diabetes+metformin group. The wound healing status on post injury day (POD) 7 and 13 was observed and the wound healing rate was calculated. The wound tissue on POD 7 and 13 was collected for hematoxylin-eosin staining to measure the length of re-epithelialized epidermis and calculate the change rates in diameters of epidermal and dermal wounds, for immunohistochemical staining to detect the relative expressions of keratin 10 and proliferating cell nuclear antigen (PCNA), and for Western blotting to detect the protein expressions of keratin 10 and PCNA. The sample size in all the above experiments was 8 except that in the last experiment was 3. The correlations between the relative expressions of keratin 10 and PCNA in wound tissue in three groups of rats and their wound healing rates, and the correlation between the relative expressions of keratin 10 and PCNA in wound tissue were analyzed.Results:On POD 7, the wound healing rates of rats in diabetes group and diabetes+metformin group were 81.48% (77.89%, 85.53%) and 93.04% (92.51%, 94.24%), which were significantly lower than 100% (97.17%, 100%) in control group (with Z values of 2.37 and -3.36, respectively, P<0.05); the wound healing rate of rats in diabetes+metformin group was significantly higher than that in diabetes group ( Z=3.45, P<0.05). On POD 13, the wound healing rates of rats in control group and diabetes+metformin group were both 100% (100%, 100%), which were significantly higher than 94.47% (90.68%, 99.82%) in diabetes group (with Z values of 2.90 and -2.90, respectively, P<0.05). On POD 7, the change rates in epidermal wound diameter of rats in control group and diabetes+metformin group were significantly higher than that in diabetes group (with Z values of 3.36 and -2.74, respectively, P<0.05). The change rates in dermal wound diameter of rats in the three groups were similar on POD 7 and 13 ( P>0.05). The lengths of re-epithelialized epidermis of rats in control group and diabetes+metformin group on POD 13 were significantly longer than that in diabetes group (with Z values of 3.34 and -2.64, respectively, P<0.05). The relative expressions of keratin 10 in wound tissue of rats in diabetes group on POD 7 and 13 were significantly higher than those in control group (with Z values of -3.36 and -3.26, respectively, P<0.05) and diabetes+metformin group (with Z values of 3.36 and 3.15, respectively, P<0.05), and the relative expression of keratin 10 in wound tissue of rats in diabetes+metformin group on POD 7 was significantly lower than that in control group ( Z=3.05, P<0.05); the relative expressions of PCNA in wound tissue of rats in diabetes group on POD 7 and 13 were significantly lower than those in control group (with both Z values of 3.36, P<0.05) and diabetes+metformin group (with both Z values of -3.36, P<0.05). The protein expressions of keratin 10 in wound tissue of rats in control group and diabetes+metformin group on POD 7 as well as that in diabetes+metformin group on POD 13 were significantly lower than those in diabetes group ( P<0.05), and the protein expressions of PCNA in wound tissue of rats in control group and diabetes+metformin group on POD 7 were significantly higher than that in diabetes group ( P<0.05). There was a significant positive correlation between the relative expression of keratin 10 in wound tissue and the wound healing rate in control group and diabetes+metformin group of rats (with r values of 0.78 and 0.71, respectively, P<0.05), there was a significant negative correlation between the relative expression of PCNA in wound tissue and the wound healing rate in diabetes+metformin group of rats ( r=-0.60, P<0.05), and there was a significant negative correlation between the relative expressions of PCNA and keratin 10 in wound tissue of rats in diabetes group and diabetes+metformin group (with r values of -0.41 and -0.49, respectively, P<0.05). Conclusions:The diabetic rats with full-thickness skin defect wound exhibit delayed healing, accompanied by up-regulation of keratin 10 and down-regulation of PCNA in keratinocytes in the wound tissue. Metformin can promote wound healing in diabetic rats with full-thickness skin defects by down-regulating keratin 10 expression and up-regulating PCNA expression in keratinocytes in the wound tissue, and the wound healing rate was positively correlated with the expression of keratin 10 and negatively correlated with the expression of PCNA.

According to the general goal of long term development of basic science from 2021 to 2035 and the "14th Five-Year Plan" in China, starting from the reasearch characteristics and the basic situation of endemiology, this study discusses the strategic position, development law, development trend, development status and layout, development goals and realization ways of endemiology, combined with the strategic needs of the discipline, the important interdisciplinary research areas of endemiology are put forward. The purpose of this study is to promote the rapid development of basic research on endemic diseases, to provide reference for the scientific and technological layout and policy formulation of the endemiology, to provide reference for the "14th Five-Year Plan" in China, and to provide guarantee for the people in the sick area to seek health.