ObjectiveTo investigate the potential mechanism of Danggui Shaoyaosan （DSS） in ameliorating renal injury in db/db mice. MethodsThirty 8-week-old specific pathogen-free （SPF）-grade male db/db mice and six db/m mice were acclimated for one week. Urinary microalbumin and blood glucose levels were measured weekly in both db/db and db/m mice. Successful modeling was determined by significantly higher microalbuminuria in db/db mice compared to db/m mice and a fasting blood glucose ≥16.7 mmol·L^-1. The 30 db/db mice were randomly divided into five groups： the model group， the irbesartan （IBN） group， and three DSS dose groups （low-， medium-， and high-dose DSS groups， administered at 16.77， 33.54， 67.08 g·kg^-1·d^-1， respectively）. Additionally， the six db/m mice served as the normal control group. The IBN group received irbesartan at 0.025 g·kg^-1·d^-1 by gavage， while the three DSS groups received DSS at 16.77， 33.54， and 67.08 g·kg^-1·d^-1 by gavage， respectively. The normal and model groups were administered with an equivalent volume of normal saline by gavage. All interventions lasted for 8 consecutive weeks. After intervention， serum creatinine （SCr）， blood urea nitrogen （BUN）， urinary total protein （UTP）， triglyceride （TG）， and low-density lipoprotein cholesterol （LDL-C） were measured to evaluate the therapeutic efficacy of the treatments. Renal histopathological changes were observed with hematoxylin-eosin （HE） staining. Western blot was used to detect the protein expression of silencing information regulator 1 （SIRT1）， hypoxia-inducible factor-1α （HIF-1α）， very low-density lipoprotein receptor （VLDLr）， and cluster of differentiation 31 （CD31）. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect the mRNA levels of HIF-1α and VLDLr. Immunohistochemistry was used to observe the expression and distribution of HIF-1α and Caspase-3. ResultsCompared to the normal group， the model group showed significantly increased SCr， BUN， UTP， TG， and LDL-C. HE staining revealed glomerulosclerosis， mesangial matrix hyperplasia， capillary loop distortion and thickening， with extensive inflammatory cell infiltration. Protein expression of SIRT1 and CD31 significantly decreased （P<0.05）， while HIF-1α and VLDLr protein and mRNA levels increased （P<0.05）. Immunohistochemistry showed increased expression of HIF-1α and Caspase-3 （P<0.05）， indicating hypoxia and apoptosis in renal cells. In all treatment groups， SCr， BUN， TG， and LDL-C were significantly reduced compared to the model group （P<0.05）， and UTP was significantly improved in the medium-dose DSS group （P<0.05）. Renal tissue structure and morphology were improved， inflammatory cells were reduced， and no vascular hyaline degeneration was observed. SIRT1 and CD31 protein expression was elevated to varying degrees compared to the model group （P<0.05）， while HIF-1α and VLDLr protein and mRNA levels decreased （P<0.05）. Immunohistochemistry showed reduced expression of HIF-1α and Caspase-3 in all treatment groups （P<0.05）， with the most significant improvement observed in the IBN group and medium-dose DSS group （P<0.05）. ConclusionDSS can effectively ameliorate glomerulosclerosis and lipid deposition in db/db mice， and its mechanism may involve the SIRT1/HIF-1α/VLDLr signaling pathway.

ObjectiveTo investigate the therapeutic efficacy of Danggui Shaoyaosan （DSS） on renal injury in db/db mice and its impact on endoplasmic reticulum stress （ERS） in renal tissues. MethodsThirty 8-week-old male db/db mice and six db/m mice were acclimated for one week， after which urinary microalbumin and blood glucose levels were monitored to establish a diabetic kidney disease （DKD） model. The model mice were randomly divided into a model group， an irbesartan group， and three DSS treatment groups with different doses （16.77， 33.54， and 67.08 g·kg^-1·d^-1）. A normal group was set as control. Each group was intragastrically administered with the corresponding drugs or saline for 8 weeks. After the intervention， general conditions were observed. Serum cystatin C （Cys-C）， 24-hour urinary total protein （24 h-UTP）， 24-hour urinary microalbumin （24 h-UMA）， urinary creatinine （Ucr）， and urea nitrogen （UUN） were measured. Transmission electron microscopy （TEM） was used to observe glomerular basement membrane （GBM） and ultrastructural changes of the endoplasmic reticulum （ER） in glomerular endothelial cells. Western blot， real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）， and immunohistochemistry were used to analyze renal tissue structure and the expression of GRP78， CHOP， and related markers. ResultsCompared with the normal group， the mice in the model group showed curled posture， sluggish response， poor fur condition， increased levels of Cys-C， 24 h-UTP， 24 h-UMA， and UUN （P<0.05）， while Ucr decreased （P<0.05）. The GBM was significantly thickened， with podocyte and foot process fusion. The protein expressions of GRP78， CHOP， and ATF6 were significantly upregulated （P<0.05）， the mRNA levels of GRP78 and CHOP increased （P<0.05）， and immunohistochemistry showed an enhanced GRP78 signal （P<0.05）. After treatment， the mice exhibited improved behavior， normalized GBM and podocyte structure， improved ER morphology and markedly better biochemical indicators. Western blot， Real-time PCR， and immunohistochemistry indicated that the ERS-related markers were downregulated in the DSS treatment groups （P<0.05）， suggesting alleviated ERS and improved renal function. ConclusionDSS can effectively ameliorate renal pathological damage in db/db mice， possibly by regulating ERS in glomerular endothelial cells， although the underlying signaling mechanisms require further investigation.

Objective:To explore the interaction between pediatric sleep-disordered breathing（SDB）, the intestinal microbiota, and pediatric non-alcoholic fatty liver disease（NAFLD）. Methods:A total of 63 non-obese children（47 children with SDB in the experimental group and 16 without SDB in the control group） were enrolled in this study. The liver function and degree of SDB were assessed in both groups. High-throughput 16S rRNA sequencing was conducted to detect the composition and functional variations of the intestinal microbiota in the two groups of children. Results:Compared with children in the experimental group, serum ALT and AST levels were higher in the control group. and the relative proteobacteria abundance of intestinal flora increased, and the relative abundance of Bacteroidetes decreased significantly. Function including membrane transport, carbohydrate metabolism and lipid metabolism, were enriched in the intestinal microbiota of children with SDB. Conclusion:The composition and functional annotation of the pediatric liver functional status and gut microbiota were significantly different between the two groups of children with and without SDB. Changes in SDB-associated intestinal bacterial abundance may be related to the pathogenesis of pediatric NAFLD.
Humans ; Non-alcoholic Fatty Liver Disease/microbiology* ; Gastrointestinal Microbiome ; Child ; Male ; Sleep Apnea Syndromes/microbiology* ; Female ; RNA, Ribosomal, 16S/genetics* ; Bacteroidetes ; Proteobacteria/isolation & purification* ; Lipid Metabolism

Objective:To explore the clinical effect and safety of modified composite labia minora and clitoral hood reduction using modified curved linear method.Methods:A retrospective analysis was carried out focusing on the case data of patients with congenital hypertrophy of labia minora combined with redundant clitoral hood who were treated by the author’s operation group after admission to the Department of Plastic Cosmetic Surgery in Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, from September 2018 to August 2020. All patients received composite labia minora and clitoral hood reduction using modified curved linear method, which permits improving the appearance of labia minora and clitoral hood during one operation. Further analysis was made on the preoperative symptoms and the surgical demands of the patients. Postoperative follow-up was performed in the aspects of complications, symptom improvement, perceived appearance improvement, sexual satisfaction improvement, and overall satisfaction after operation. Descriptive statistics were used for statistical analysis.Results:Sixty subjects undergoing labia minora and clitoral hood reduction were enrolled. The ages of the patients ranged from 19 to 44 years with an average of (30.0±8.6) years. In terms of preoperative symptoms and surgical demands, there were 35 cases (58.3%) of irritation during friction, 22 cases (36.7%) of increased secretion, 5 cases (8.3%) of chronic genitourinary infection, 20 cases (33.3%) of discomfort during sexual intercourse and 55 cases (91.7%) of appearance influence. Fifty-three patients re-visited the hospital for follow-up after the operation, with a follow-up rate of 88.3%. Over a mean follow-up of 4.5 months (ranged from 2 to 15 months), wound dehiscence occurred in 1 case (1.9%), postoperative asymmetry or redundancy occurred in 3 cases (5.7%). In addition, according to postoperative investigation, 48 patients (90.6%) had relieved preoperative symptoms in varying degrees, 50 cases (94.3%) had perceived improved appearance, and 26 cases (49.1%) had increased sexual satisfaction. Besides, the total satisfaction survey revealed that 48 cases were very satisfied and satisfied with the outcomes, accounting for 90.6%.Conclusions:The modified composite labia minora and clitoral hood reduction using modified curved linear method can adjust the appearance of labia minora and clitoral hood in a single operation, with satisfactory aesthetic effect. Besides, the proposed method is simple and safe in operation, exhibiting a wide range of application.

Objective:To explore the clinical effect and safety of modified composite labia minora and clitoral hood reduction using modified curved linear method.Methods:A retrospective analysis was carried out focusing on the case data of patients with congenital hypertrophy of labia minora combined with redundant clitoral hood who were treated by the author’s operation group after admission to the Department of Plastic Cosmetic Surgery in Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, from September 2018 to August 2020. All patients received composite labia minora and clitoral hood reduction using modified curved linear method, which permits improving the appearance of labia minora and clitoral hood during one operation. Further analysis was made on the preoperative symptoms and the surgical demands of the patients. Postoperative follow-up was performed in the aspects of complications, symptom improvement, perceived appearance improvement, sexual satisfaction improvement, and overall satisfaction after operation. Descriptive statistics were used for statistical analysis.Results:Sixty subjects undergoing labia minora and clitoral hood reduction were enrolled. The ages of the patients ranged from 19 to 44 years with an average of (30.0±8.6) years. In terms of preoperative symptoms and surgical demands, there were 35 cases (58.3%) of irritation during friction, 22 cases (36.7%) of increased secretion, 5 cases (8.3%) of chronic genitourinary infection, 20 cases (33.3%) of discomfort during sexual intercourse and 55 cases (91.7%) of appearance influence. Fifty-three patients re-visited the hospital for follow-up after the operation, with a follow-up rate of 88.3%. Over a mean follow-up of 4.5 months (ranged from 2 to 15 months), wound dehiscence occurred in 1 case (1.9%), postoperative asymmetry or redundancy occurred in 3 cases (5.7%). In addition, according to postoperative investigation, 48 patients (90.6%) had relieved preoperative symptoms in varying degrees, 50 cases (94.3%) had perceived improved appearance, and 26 cases (49.1%) had increased sexual satisfaction. Besides, the total satisfaction survey revealed that 48 cases were very satisfied and satisfied with the outcomes, accounting for 90.6%.Conclusions:The modified composite labia minora and clitoral hood reduction using modified curved linear method can adjust the appearance of labia minora and clitoral hood in a single operation, with satisfactory aesthetic effect. Besides, the proposed method is simple and safe in operation, exhibiting a wide range of application.

Objective To explore the relationship between syncope and risk of death in patients with cardiovascular emergencies including acute myocardial infarction(AMI), arrhythmia, acute heart failure(AHF), pulmonary thromboembolism(PTE) and aortic dissection(AD) rupture. Methods Data from 2 789 patients with cardiovascular emergency admitted from June 2010 to June 2016 in the Emergency Department, Air Force General Hospital, PLA was retrospectively analyzed. Difference in gender, age and motality were compared between patients with syncope and those without syncope. Among fi ve kinds of cardiovascular emergency events with syncope, difference in mortality were compared. Difference in mortality were also analyzed by the CHM corrected chi square test when difference of disease, gender and age were taken into consideration. Syncope, the type of cardiovascular emergency, gender and age were analyzed as potential risk/protective factors for death by the multiple logistic regression analysis. Results The mortalities of the fi ve diseases accompanied with syncope were 50%, 30.43%, 26.53%, 20% and 7.04% respectively in arterial dissection, pulmonary embolism, acute myocardial infarction, acute heart failure and arrhythmia.There was a statistically signifi cant difference in mortality among the fi ve kinds of cardiovascular emergencies accompanied with syncope(P<0.05).The mortalities of patients with syncope were significantly higher than those without syncopein AMI patients(26.53% vs.11.20%,P<0.05) and cardiac arrhythmias patients(7.04% vs.0.36%,P<0.05).The results of the CHM corrected chi square test showed that there was signifi cant difference in mortality between the syncope group and non-syncope group, when the differences in disease type, age and gender were adjusted (χ2=35.876, P<0.01). The mortality of syncope group was higher than that of non-syncope group.When age, gender and disease type were considered as covariates, the multiple logistic regression analysis showed that syncope signifi cantly increased the risk of mortality(OR=3.876,95% CI:2.362-6.359,P<0.01).Conclusion Syncope is an independent risk factor of death in patients with cardiovascular emergencies.