Neovascular eye diseases,with highly complicated and refractory,are one group of the most difficult problems for domestic and overseas clinical oculists in recent years.Angiogenesis is a complex process participating with multiple factors and various ways,and its exact pathogenesis is unclear yet.Ocular neovascularization is the dynamic balance result between proangiogenic factors and antiangiogenic factors provided that intraocular microenvironment be under a physiological condition.Some pathological factors including ischemia,hypoxia and inflammation destroy the dynamic balance between cytokines leading to neovascularization.Currently studies indicated that numerous cytokines containing vascular endothelial growth factor (VEGF) and pigment epithelium derived factor (PEDF) are closely linked to ocular neovascularization,while it is more crucial to elucidate the molecular mechanism of numerous cytokines involved in ocular neovascularization,which can recognize the pathogenesis of neovascular eye disease more clearly.Research progress of pathological relevant cytokines of neovascular eye diseases,including VEGF,insulin-like growth factor 1 (IGF-1),angiogenin-2 (Ang-2),stromal cell derived factor 1 (SDF-1) and PEDF were reviewed in this paper.

Background Clinical work found that triamcinolone acetonide (TA)bleeding during vitrectomy in proliferative diabetic retinopathy (PDR),but its mechanism is not clear.Objective This study was to explore the anastalsis of TA in vitrectomy for PDR.Methods A prospective study was performed.Twelve eyes of 12 patients who received vitrectomy combined with the intraocular use of TA for PDR were in cluded in Tianjin Medical University General Hospital from 2011 to 2014 and served as TA group.Thirty-two eyes of 32 patients who underwent vitrectomy for epimacular membrane or macular hole were enrolled as control group.The vitreous specimens of 0.6 ～0.8 ml was collected during the surgery.The concentrations of urokinase plasminogen activator (u-PA),tissue plasminogen activator (t-PA) and plasminogen activator inhibitors 1 (PAI-1) in vatreous were measured by ELISA.Results The mean contents u-PA,t-PA and PAI-1 in the vatreous were 25.45,127.44 and 0.42 ng/ml respectively in the TA group,and those the mean contents in the control group were 22.94,142.37 and 0.27 ng/ml respectively,shouwing a significant difference between the TA group and the control group (Z=-2.268,P＜0.05).NO significant difference was found in vitreous t-PA and PAI-1 between TA and control groups (Z =-0.092,-1.847,both at P＞0.05).Conclusions Vitreous u-PA content is increased in PDR eyes,which is more likely to lead bleeding.Anastalsis of TA during vitrectomy for PDR may be relatived to decreasing vitreous t-PA and u-PA contents as well as increasing PAI-1 contents.

This study was aimed to explore clinical functions of consensus-based clinical practice guidelines (CB CPGs) in traditional Chinese medicine (TCM). Under the guidance of the State Administration of TCM, 42 TCM hospitals in China had conducted a questionnaire survey for 73 CB CPGs and 2993 questionnaires had been included and analyzed. According to the category of good, general and bad, the proportion of the good in improving safety performance was 69.43%, controlling cost was 58.57%, regulating medical behavior was 55.50%, improving clinical effectiveness was 46.74%. It was concluded that the CB CPGs had played a good role in improving safety performance and controlling cost in TCM clinical practice.

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease characterized by neuro-ophthalmic intercross and humoral immunity.Neuromyelitis optica related optic neuritis (NMO-ON) is often the initial symptom of NMOSD patients, with a high blinding rate, which brought a heavy blow to the quality of life, study, work and other aspects of patients.The discovery of aquaporin-4 immunoglobulin G (AQP4-IgG) has brought significant progress in the pathogenesis, diagnosis and treatment of NMOSD.However, AQP4-IgG is not a universal biomarker of NMOSD.The role of CD4 + T helper (Th) cell related cytokines in the pathogenesis of NMOSD has been increasingly emphasized.This paper reviewed the research results of CD4 + Th cell-related cytokines closely related to the occurrence of NMOSD in recent years, including Th17 cell-related cytokines such as interleukin-6 (IL-6), IL-17, IL-21, Th2 cell-related cytokines such as IL-4, IL-5, IL-13, IL-31, IL-33, and regulatory T cell-related cytokines, etc.to provide new insights for the pathogenesis, diagnosis and treatment strategies of NMOSD or NMO-ON.

BACKGROUND: Plasma epidermal growth factor receptor (EGFR) mutation tests are less invasive than tissue EGFR mutation tests. We determined which of two kits is more efficient: cobas EGFR Mutation test v2 (cobasv2; Roche Molecular Systems, Pleasanton, CA, USA) or PANAMutyper-R-EGFR (Mutyper; Panagene, Daejeon, Korea). We also evaluated whether pleural effusion supernatant (PE-SUP) samples are assayable, similar to plasma samples, using these two kits. METHODS: We analyzed 156 plasma and PE-SUP samples (31 paired samples) from 116 individuals. We compared the kits in terms of accuracy, assessed genotype concordance (weighted κ with 95% confidence intervals), and calculated Spearman's rho between semi-quantitatively measured EGFR-mutant levels (SQIs) measured by each kit. We also compared sensitivity using 47 EGFR-mutant harboring samples divided into more-dilute and less-dilute samples (dilution ratio: ≥ or <1:1,000). RESULTS: cobasv2 tended to have higher accuracy than Mutyper (73% vs 69%, P=0.53), and PE-SUP samples had significantly higher accuracy than plasma samples (97% vs 55–71%) for both kits. Genotype concordance was 98% (κ=0.92, 0.88–0.96). SQIs showed strong positive correlations (P<0.0001). In less-dilute samples, accuracy and sensitivity did not differ significantly between kits. In more-dilute samples, cobasv2 tended to have higher sensitivity than Mutyper (43% vs 20%, P=0.07). CONCLUSIONS: The kits have similar performance in terms of EGFR mutation detection and semi-quantification in plasma and PE-SUP samples. cobasv2 tends to outperform Mutyper in detecting less-abundant EGFR-mutants. PE-SUP samples are assayable using either kit.
Epidermal Growth Factor ; Genotype ; Plasma ; Pleural Effusion ; Receptor, Epidermal Growth Factor

Objective·To examine the expression level of protein arginine methyltransferase 6(PRMT6)in breast carcinoma tissues and to assess its impact on the proliferative and migratory behaviors of breast cancer cells.Methods·The PRMT6 transcriptome sequencing data between 33 tumor tissues and normal tissues from The Cancer Genome Atlas(TCGA)database was analyzed through the R language.The gene expression profile interactive analysis(GEPIA2)online database was used to analyze the difference of PRMT6 expression in normal breast tissues and breast cancer tissues.By using the immunohistochemistry(IHC)data of human normal breast tissues and breast cancer tissues from Human Protein Atlas(HPA)database to analyze the protein expression of PRMT6.IHC was used to detect the expression of PRMT6 in breast cancer tissues and paired para-tumor tissues from 27 clinical samples.After PRMT6 was knocked down with small interfering RNA(siRNA)in MDA-MB-231 and MCF-7 cells,the expression of PRMT6 was detected by qRT-PCR and Western blotting.The proliferation ability of breast cancer cells was measured with cell counting kit-8(CCK-8)assay and colony formation assay.The effect of PRMT6 on the migration ability of breast cancer cells was detected by wound healing assay and Transwell assay.By using the RNA-sequence data from GSE210948 of Gene Expression Omnibus(GEO)database,differentially expressed genes were analyzed in control and low expression groups of PRMT6.Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis was performed to reveal the signaling pathways associated with PRMT6.Cell cycle analysis was detected by flow cytometry.The expressions of cyclin D1 and EMT-related proteins(E-cadherin,N-cadherin and Vimentin)were detected by Western blotting after knocking down PRMT6.Results·Bioinformatics analysis and IHC results showed that PRMT6 was highly expressed in breast cancer tissues compared with normal tissues(P=0.000)and para-tumor tissues(P=0.001).qRT-PCR and Western blotting results verified that the siRNA significantly reduced the expression level of PRMT6 in MDA-MB-231 and MCF-7 cell lines compared with the control group(mRNA:P=0.006,P=0.004;P=0.001,P=0.043.Protein:P=0.035,P=0.001;P=0.003,P=0.002).After knocking down PRMT6,the proliferation(P=0.014,P=0.000;P=0.003,P=0.003)and migration(P=0.000,P=0.000;P=0.000,P=0.002)ability of breast cancer cells were inhibited significantly.The KEGG pathway enrichment analysis showed that the expression of PRMT6 affected the cell cycle pathway.After knocking down PRMT6,the expression of cyclin D1 decreased in protein level(P=0.021,P=0.000;P=0.034,P=0.014)and transcription level(P=0.036,P=0.001;P=0.044,P=0.000).Knock down of PRMT6 increased the number of cells in G0/G1 phase(P=0.000;P=0.003)and decreased the number of cells in G2/M phase of the cell cycle.The expression level of E-cadherin increased(P=0.002,P=0.012;P=0.043,P=0.003),while the expression levels of N-cadherin(P=0.004,P=0.041;P=0.032,P=0.034)and Vimentin(P=0.028,P=0.005;P=0.024,P=0.001)decreased in PRMT6 knockdown cells.Conclusion·PRMT6 is highly expressed in breast cancer,which can promote the proliferation and migration of breast cancer cells.

Objective:To explore the mediating effect of rumination between self-perceived burden (SPB) and stigma in stroke patients, so as to provide theoretical basis for the development of targeted nursing interventions in clinical practice.Methods:In September 2022, cluster sampling was used to select 1 126 stroke patients admitted to Department of Neurology of five ClassⅢ Grade A hospitals in Henan Province as subjects. General Information Questionnaire, Self-Perceived Burden Scale (SPBS), Stroke Stigma Scale (SSS), and Chinese Version of Event Related Rumination Inventory (C-ERRI) were used to investigate stroke patients. Pearson correlation analysis was used to explore the correlation between SPB, rumination, and stigma. AMOS 28.0 software was used to establish the structural equation model, and Bootstrap method was used to test the mediating effect.Results:A total of 1 126 questionnaires were distributed, and 1 026 valid questionnaires were collected, with a valid response rate of 91.12% (1 026/1 126). SPBS score of 1 026 stroke patients was (28.68±8.32), the SSS score was (40.53±9.48) and the C-ERRI score was (25.43±12.62). Pearson correlation analysis showed that SPB in stroke patients was positively correlated with stigma and rumination ( P<0.01), and rumination was positively correlated with stigma ( P<0.01). Bootstrap mediating effect test showed that rumination partially mediated the relationship between SPB and stigma in stroke patients, accounting for 55.15% of the total effect. Conclusions:SPB of stroke patients both directly affect stigma and indirectly affect stigma through rumination. Clinical nursing workers should promptly evaluate patients' SPB, pay attention to the mediating role of rumination, develop effective psychological intervention programs, implement personalized and targeted nursing measures, relieve patients' stigma, and improve treatment and rehabilitation compliance.

Objective:To understand the research status and hotspots in the field of stroke health management at home and abroad, and to provide insights for stroke health management research in China.Methods:Relevant literature on stroke health management published between 2013 and 2023 was retrieved from the Web of Science Core Collection and China National Knowledge Infrastructure databases. CiteSpace 6.1.R6 was used for the visual analysis of the number of publications, authors, institutions, countries, and keywords.Results:A total of 382 relevant articles were included, with 169 in English and 213 in Chinese. The number of publications on stroke health management showed a fluctuating upward trend. Research hotspots and frontiers in stroke health management mainly focused on telemedicine, big data and "Internet+", primary and secondary prevention, risk prediction models, quality of life, and swallowing disorders. Future research trends may focus on management models for post-stroke swallowing disorders, risk identification, and the role of caregivers in remote rehabilitation interventions.Conclusions:Researchers can refer to the research hotspots and trends shown by the visual analysis, with particular attention to health management models for patients with post-stroke swallowing disorders and issues related to remote intervention rehabilitation.

Objective:To explore our self-designed classification system of irreducible intertrochanteric fractures based on reduction stage and bone block position and to evaluate the reduction techniques guided by the classification system.Methods:A retrospective study was conducted to analyze the data of 115 patients with irreducible intertrochanteric fracture who had been admitted to Department of Orthopedics, Beijing Hospital from September 2014 to November 2022. There were 24 males and 91 females with a mean age of (80.9±11.0) years. The reduction for the fractures was divided into a diaphysis reduction stage (Phase Ⅰ) and a cortical reduction stage (Phase Ⅱ). Based on the relative positions of the intraoperative bone blocks, Phase Ⅰ was divided into an anterior and posterior interlocking type (Phase Ⅰa) and a distal bone block sinking displacement type (Phase Ⅰb) while Phase Ⅱ into a proximal lifting type (Phase Ⅱa), a posterior angulation type (Phase Ⅱb), a positive support type (Phase Ⅱc), and a negative support type (Phase Ⅱd). Depending on the difficulties encountered in different reduction stages, corresponding close reduction strategies (such as top rod support, percutaneous prying, and Joystick technique) were adopted to restore the proximal femoral neck shaft angle, anteversion angle, anterior medial cortex, and length of the affected limb before fixation with intramedullary nails. Recorded were the patient's surgical time, intraoperative bleeding, quality of postoperative reduction, fracture union time, and complications.Results:The surgical time for this group of patients was 70.0(60.0, 92.0) minutes, and the intraoperative blood loss 200.0 (170.0, 200.0) mL. According to the standards by Baumgaertner et al., the quality of postoperative reduction was evaluated as excellent in 103 cases and as good in 12 cases, with an excellent and good rate of 100.0% (115/115). Of the 115 patients, 86 were followed up for more than 6 months to reveal fracture union in all after a duration of 6.0 (4.0, 8.0) months. One patient died of an acute cardiovascular event in the hospital 5 days after surgery. Two patients lost their mobility within 3 months after surgery due to acute cerebral infarction. There was no internal fixation failure requiring secondary surgery or no incision infection.Conclusion:Guided by our self-designed classification system of irreducible intertrochanteric fractures based on the intraoperative reduction stage and the relative position of bone block, real time intraoperative fluoroscopy images can be used to effectively clarify the difficulty of fracture reduction in stages so that corresponding reduction strategies can be adopted, leading to fine clinical efficacy.

Objective:To explore the latent profile types of capability-opportunity-motivation-behavior in stroke patients and analyze the influencing factors of different latent profiles.Methods:From January to October 2023, totally 596 stroke patients from the Neurology Department of five ClassⅢ Grade A hospitals in Henan Province were selected by stratified random sampling. The patients were surveyed using a general information questionnaire, the Stroke Prevention Knowledge Questionnaire (SPKQ), the Social Support Rating Scale (SSRS), the WHO's Quality of Life Questionnaire- Brief Version (WHOQOL-BREF), the Short Form Health Belief Model Scale (SF-HBMS), and the Health Promoting Lifestyle ProfileⅡ (HPLPⅡ). Latent profile analysis was used to classify the capability-opportunity-motivation-behavior characteristics of stroke patients, and multiple logistic regression was conducted to explore the influencing factors of different latent profiles.Results:Three latent profiles of capability-opportunity-motivation-behavior in stroke patients were identified, including low capability-opportunity-motivation-behavior with high health beliefs (32.4%, 193/596), moderate capability-opportunity-motivation-behavior with insufficient health beliefs (47.5%, 283/596), and high capability-opportunity-motivation-behavior with lack of social support (20.1%, 120/596). Multiple logistic regression analysis showed that educational level, smoking history, family history, body mass index, and Charlson Comorbidity Index score were influencing factors of different latent profiles ( P<0.05) . Conclusions:Stroke patients exhibit distinct classifications of capability-opportunity-motivation-behavior. Targeted interventions should be conducted based on the characteristics of each category to improve health behavior management outcomes in patients.