BACKGROUND:Dysfunction of macrophage efferocytosis can induce local and systemic inflammatory damage and is associated with a variety of obesity-related metabolic diseases.Moreover,compounds targeting efferocytosis have shown good therapeutic effects. OBJECTIVE:By reviewing the effects of obesity on macrophage efferocytosis,to analyze the key mechanism by which obesity inhibits efferocytosis,to summarize the research progress in compounds targeting efferocytosis to treat obesity-related metabolic diseases,so as to provide new ideas for fully understanding efferocytosis and its relationship with metabolic diseases,aiming to provide new strategies for disease prevention and treatment. METHODS:The English search terms were"efferocytosis,metabolism,obesity,obese,atherosclerosis,non-alcoholic steatohepatitis,neurodegeneration,tumor,osteoarthritis,diabetes,compound,medicine,treatment,"which were used for literature retrieval in PubMed and Web of Science.The Chinese search term was"efferocytosis,"which was used for literature retrieval in CNKI,VIP and WanFang datebases.Ninety-nine papers were finally included in the review analysis after a rigorous screening process. RESULTS AND CONCLUSION:In the process of efferocytosis,the"Find me"and"Eat me"processes involving a large number of apoptotic cell derived factors are mainly regulated by apoptotic cells.The efferocytosis factor involved in cytoskeletal remodeling and digestion are mainly derived from macrophages,which are crucial for efferocytosis activity.These results suggest that the"Find me"and"Eat me"factors mainly reflect the condition of apoptosis,and it is more scientific to select the expression of factors involved in cytoskeletal remodeling and digestion when evaluating the efferocytosis activity of macrophages.Obesity inhibits efferocytosis,and shows an inhibitory effect on most digestive factors,but has a stress-induced activation effect on most"Find me,""Eat me"and cytoskeletal recombination factors,which further indicates the decisive effect of digestive stage on efferocytosis and suggests that it is not reliable for some studies to evaluate the efferocytosis based on the increased expression of"Find me"and"Eat me"factors.Targeting cytokines in the digestive phase may be more effective when discussing future intervention strategies targeting macrophages efferocytosis.The efferocytosis activators of macrophages are effective in the treatment of various metabolic diseases,but the efferocytosis inhibitors in tumor tissue show good anticancer effects,suggesting that the role of efferocytosis should be rationally evaluated according to the characteristics of tissue inflammation.Efferocytosis is a relatively new concept proposed in 2003,with a short research history and complex efferocytosis factors.Current studies on obesity and efferocytosis only involve a tip of the iceberg and most of them are at a superficial level and a large number of scientific experiments are needed to further validate the mechanisms.

Objective To analyze the short-term clinical efficacy and influencing factors of ustekinumab monoclonal antibody(UST)in the treatment of Crohn′s disease(CD).Methods Retrospective cohort study was used to collect the clinical data of CD patients treated with UST in the 10th People′s Hospital affiliated to Tongji University from December 2020 to October 2022.The main analysis is the short-term clinical efficacy and influencing factors of UST treatment for CD at weeks 8 and 16,And analyze the endoscopic response rate of some patients.Results A total of 91 CD patients who first used UST were included.The 8-week clinical response rate of UST treat-ment for CD was 61.5%,and the clinical response rate was 45%;The clinical response rate at 16 weeks was 71.4%,and the clinical response rate was 54.9%.56 cases underwent endoscopic re-examination in our hospital,and the endoscopic response rate at 16 weeks was 41.1%.Univariate analysis showed that fistula(including anal fistula,personal history of anal fistula,and intestinal skin fistula)is associated with clinical remission in Crohn′s disease patients at 8/16 weeks.Further multivariate COX regression analysis showed that the presence of a history of anal fistula surgery was an independent protective factor affecting clinical remission in CD patients treated with UST at 8 weeks(HR = 0.04,95%CI:0.00～0.38;P = 0.005)and 16 weeks(HR = 0.04,95%CI:0.01～0.34;P = 0.003)compared to those without fistula;Narrow lesions are an independent risk factor for 16 week clinical remission in CD patients compared to non-narrow and non-penetrating lesions(HR = 1.75,95%CI:1.08～2.84;P = 0.023).No patients were found to have stopped medication due to serious adverse reactions.Conclusions UST can improve the clinical remission and response of CD patients at 8/16 weeks,and has good short-term clinical efficacy.CD patients with a personal history of anal fistula are recommended to use UST monoclonal antibodies,while patients with stenotic lesions should be cautious in using UST monoclonal antibodies.Whether the patient has undergone surgical treatment in the past,as well as whether UST has been used on the first or non-first line,has no significant impact on clinical remission.

BACKGROUND:Hypoxic exercise can promote the degradation of body fat,and changes in the external environment can affect the circadian rhythm of animals,but the mechanisms by which changes in circadian rhythm regulate adipose tissue browning and fat degradation are unclear. OBJECTIVE:To elucidate the mechanism of clock gene regulation on epididymal adipose tissue Browning in obese rats undergoing hypoxia exercise. METHODS:Forty obese rats were randomly selected and divided into four groups(n=10 per group):normoxic sedentary group,hypoxic sedentary group,normoxic exercise group,and hypoxic exercise group for 4 weeks of intervention.The rats in the sedentary groups were not intervened,while those in the hypoxic groups lived in a hypoxic chamber with an oxygen concentration of 13.6%for the whole day.In the exercise groups,adaptive training was performed in the 1st week,and the speed and length of training remained unchanged for the last 3 weeks.The body mass,body length and perirenal fat mass of obese rats were measured.Serum levels of triacylglycerol,total cholesterol,low-density lipoprotein cholesterol,and high-density lipoprotein cholesterol in obese rats were detected by a biochemical assay kit.Liver fat content was observed by oil red O staining.Hematoxylin-eosin staining was used to evaluate the browning of epididymal adipose tissue of rats in different groups.RNA sequencing combined with bioinformatics analysis was used to analyze transcriptome changes in adipose tissue.The mRNA expressions of PGC-1α,Beclin 1,KLF 2 and Perilipin 1 in epididymal adipose tissue were detected by RT-PCR. RESULTS AND CONCLUSION:Hypoxic exercise intervention significantly decreased body mass,body fat percentage,Lee's index,serum triacylglycerol,total cholesterol,and low-density lipoprotein cholesterol levels(P＜0.01),and significantly increased high-density lipoprotein cholesterol level(P＜0.01).Oil red O staining and hematoxylin-eosin staining results showed that hypoxic exercise was more effective in promoting fat mobilization in liver tissue and promoting the browning of parepididymal adipose tissue compared with normoxic sedentary group,hypoxic sedentary group,and normoxic exercise group.RNA-seq results showed that hypoxic exercise significantly upregulated the expression of clock genes Dbp,Nr1d1,Sik1 and adipose tissue browning gene Ppargc1a(PGC-1α)and downregulated the expression of Arntl(Bmal1),accompanied by the enhanced expression of genes related to substance metabolism.qRT-PCR indicated that hypoxic exercise significantly increased the mRNA expression levels of PGC-1α and Perilipin1(P＜0.01).Therefore,these findings indicate that clock genes play an important role in promoting adipose tissue browning during hypoxic exercise.

BACKGROUND:Parkinson's disease is a neurodegenerative disease,and its pathogenesis involves mitochondrial dysfunction.Exercise has a potential ameliorative effect on mitochondrial dysfunction related to Parkinson's disease,but there is no comprehensive review and in-depth analysis in this field. OBJECTIVE:To comprehensively review and analyze mitochondrial dysfunction related to Parkinson's disease and the potential ameliorative effect of exercise,thereby providing new ideas and methods for the treatment and prevention of Parkinson's disease. METHODS:We searched the Web of Science,PubMed,CNKI,WanFang,and VIP databases with the keywords of"mitochondria,mitochondrial function,mitochondrial disease,mitochondrial dysfunction,Parkinson's disease,Parkinson,exercise,physical activity,exercise training,exercise therapy,mitochondrial impairment,mitochondrial damage,mitochondrial defects"in Chinese and"mitochondria,Parkinson's disease,Parkinson disease,physical exercise,exercise,physical activity,mitochondrial dysfunction,mitochondrial damage,mitochondrial impairment,athletic training,exercise training,rehabilitation"in English.A total of 89 articles were included for review and analysis. RESLUTS AND CONCLUSION:Parkinson's disease is closely related to mitochondrial dysfunction,including mitochondrial biogenesis inhibition,reduced autophagy,increased apoptosis,abnormal elevation of Ca2+ concentration,and increased oxidative stress in Parkinson's disease patients.Exercise has a positive effect on mitochondrial dysfunction related to Parkinson's disease,by promoting mitochondrial biogenesisand autophagy,regulating mitochondrial morphology,altering the plasticity of the mitochondrial respiratory chain,and reducing oxidative stress,thus helping to improve the development and progression of Parkinson's disease.However,the detailed mechanism between mitochondrial dysfunction and the ameliorative effect of exercise is still not fully understood,and future clinical studies can be conducted to validate the results of animal models and gain insights into the benefits and mechanisms of exercise in patients with Parkinson's disease.

【Objective】 To investigate the clinical value of transrectal contrast-enhanced ultrasound (CEUS) in the diagnosis of prostate cancer in different total prostate specific antigen (tPSA) intervals. 【Methods】 According to serum tPSA levels, 96 patients meeting the inclusion criteria were divided into 3 groups:4-10 ng/mL, >10-20 ng/mL and >20 ng/mL groups. All patients underwent transrectal CEUS. With pathological results as reference, the diagnostic value of transrectal CEUS in different tPSA intervals was evaluated. 【Results】 Of the 96 cases, 62 were confirmed by pathology as prostate cancer and 34 as benign prostatic hyperplasia (BPH). The main perfusion characteristics of prostate cancer under CEUS were rapid enhancement (64.52%), rapid clearance (70.97%), uneven enhancement (83.87%) and high enhancement (61.29%);the main characteristics of BPH were non-rapid enhancement (70.59%), non-rapid clearance (73.53%), uniform enhancement (76.47%) and non-high enhancement (52.94%). There were significant differences in terms of enhancement speed, clearance speed and enhancement uniformity between prostate cancer and BPH (P<0.05), but no significant difference in the enhancement intensity. The sensitivity of transrectal CEUS in the diagnosis of prostate cancer in low, medium and high tPSA groups were 58.33%, 70.37% and 95.65%, the specificity were 83.33%, 76.92% and 66.67%, and the accuracy were 73.33%, 72.50% and 92.31%, respectively. Transrectal CEUS showed consistency at different serum tPSA levels for the diagnosis of prostate cancer, with statistical significance. Moreover, in the 4.0 ng/mL ≤tPSA<10.0 ng/mL group, the diagnostic specificity was the highest. 【Conclusion】 Transrectal CEUS is helpful in the differential diagnosis of benign and malignant prostatic lesions, especially for patients with different serum tPSA levels.

The incidence of solitary fibroma of seminal vesicle is low, and the source of seminal vesicle is rare. A 38-year-old patient was admitted to hospital because of intermittent gross hematuria for more than one month. Seminal vesicle space occupying lesions can be seen in pelvic MRI. Laparoscopic resection of right seminal vesicle tumor was performed, and the pathological diagnosis tended to solitary fibroma. During the 5-month follow-up, the symptoms of hematuria disappeared and no recurrence.

Objective To explore the value of low-dose CT in assessment of neonatal pneumothorax.Methods Low-dose CT and chest radiographys were performed in 98 neonates with clinically suspected of pneumothorax.Results Pneumothorax was detected in 98 neonates by low-doseCT, compared with 84 neonates by chest radiography.The sensitivity of low-dose CT was higher than that of chest radiography (P =0.026<0.05). Conclusion Low-dose CT provides a reliable assessment of neonatal pneumothorax and a guide for clinical diagnosis and treatment.

Objective To investigate the effect of erythropoietin on hemorrhage in hip replacement surgery .Methods 48 cases undergoing elective hip replacement surgery in our hospital From June 2014 to October 2016 were selected and devided into control group and experimental group according to the conditional similarity, 24 cases in each group, then the application of erythropoietin in hip replacement surgery was explored.For the experimental group, erythropoietin was injected subcutaneously at three, five and seven days before operation, the dose was 250 U/(kg· times).The control group received 0.9%sodium chloride injection of the same volume of saline, and the other treatments were the same as in the experimental group.Preoperative situation, hemoglobin (Hb) levels, blood pressure (diastolic pressure and systolic blood pressure) at one day before surgey and three, seven and 14 days after surgey were compared and analyzed.Results There were no significant difference in body weight, hemoglobin (Hb), and age between the two groups before operation.The levels of Hb in the experimental group and the control group at 3 and 7 days after operation were compared, the difference was statistically significant (P<0.05), 14 days after the surgey, Hb returned to normal in the experimental group, while the Hb level in the control group was still significantly lower than that in the control group before surgey, the difference was statistically significant (P<0.05).There was no significant difference in diastolic blood pressure and systolic blood pressure between the two groups.Conclusion Preoperative erythropoietin mobilization in patients with hip replacement surgery can reduce the amount of bleeding during and after operation , and the adverse reactions are not obvious.

Objective To investigate the clinical curative effect and the influence on knee joint function of knee osteoarthritis treating with sodium hyaluronate combined with compound salvia injection.Methods 78 patients with osteoarthritis treated in our hospital from June 2015 to August 2016 were randomly divided into three groups: sodium hyaluronate group, compound salvia injection group and sodium hyaluronate plus compound salvia injection combination therapy group, 26 cases each group.The levels of serum inflammatory cytokines (IL-6,TNF-αand IL-1β) were measured by ELISA before and after treatment in the three groups, and the improvement of knee joint function and the change of pain score before and after treatment were analyzed as well.Results The total effective rate of sodium hyaluronate combined with compound salvia injection was significantly higher than that of sodium hyaluronate and compound salvia injection alone ( P <0.05 ); after treatment, patients VAS pain score was significantly decreased ( P <0.05), and the VAS pain scores in the combination group were significantly lower than those of the group treated with sodium hyaluronate and the compound salvia injection (P<0.05).The levels of IL-6, TNF-αand IL-1βin the three groups were significantly lower than those before treatment (P<0.05),and the inflammatory factors in the combination group were significantly lower than those in the alone treatment group (P <0.05). Conclusion Sodium hyaluronate combined with compound salvia injection has good clinical curative effect on knee osteoarthritis,improving the function of knee joint, reducing pain and so on.

Objective To study on the factors of countercurrent occured in hysterosalpingography to improve the understanding of countercurrent.Methods 180 patients who underwent hysterosalpingography due to infertility were recruited,and 63 of them who were involved in countercurrent in the process of hysterosalpingography were analyzed statistically.Results The single factor analy-sis demonstrated that such four factors of primary/secondary infertility,menstrual clean days,tubal obstruction or not,and depth of cannula were associated with countercurrent,while Logistic regression analysis indicated that the factors of menstrual clean days, tubal obstruction or not,and depth of cannula during the hysterosalpingography operation were closely related.Conclusion Counter-current are caused by the comprehensive impact of several comprehensive factors like menstrual clean day,tubal obstruction or not, and cannula operation.Therefore adequate preparation should be made before and during the operation,to reduce the occurrences of countercurrent.