Objective To investigate the role of high mobility group box 1 protein(HMGB1) and the receptor for advanced glycation end products (RAGE) in the pathogenesis of primary gouty arthritis (GA).Methods Enzyme-linked immunosorbent assay(ELISA) was used to determine the level of plasma HMGB1 in 68 acute gout (AG),48 quiescent gout (QG) and 45 healthy control(HC).Real-time quantitative polymerase chain reaction (RT-qPCR) was employed to measure the expression of HMGB1 and RAGE mRNA in the peripheral blood mononuclear cells (PBMCs) in 68 AG,48 QG and 94 HC.One way ANOVA or Wilcoxon test and Spearman's correlations were used for statistical analysis.Results The level of plasma HMGB1,PBMCs HMGB1 and RAGE mRNA were significantly higher in GA than that in HC [(24±34) ng/ml,0.019±0.029,0.000 5±0.000 3] (P＜0.05),while the level of plasma HMGB1 and PBMCs HMGB1 mRNA were significantly higher in AG [(222±178) ng/ml,0.235±0.954,0.001 5±0.003 5] than that in QG [(107±176) ng/ml,0.044±0.117,0.001 3±0.000 9] (P＜0.05),and the level of PBMCs RAGE mRNA was higher in AG than that in QG (P＞0.05).In the GA patients,the level of plasma HMGB1 was positively correlated with white blood cell count,neutrophile granulocytes count,mononuclear cells and erythrocyte sedimentation rate (r=0.34,0.44,0.39,0.33; P＜0.05),while negatively correlated with apolipoprotein A1 (r=-0.28,P＜0.05); the level of PBMCs HMGB1 mRNA was positively correlated with RAGE mRNA,white blood cell counts,neutrophil counts,lymphocyte counts,serum total cholesterol level,low density lipoprotein level and apolipoprotein B100 level (r=0.29,0.36,0.26,0.28,0.29; P＜0.05),while negatively correlated with high density lipoprotein (r=-0.30,P＜0.01); the level of PBMCs RAGE mRNA was positively correlated with lymphocyte counts,total cholesterol and apolipoprotein B100 (r=0.35,0.35,0.44; P＜0.05).Conclusion HMGB1 and its signaling pathway may play important role in the pathogenesis of gouty arthritis,which may also be involved in the regulation of the lipid metabolism of gout.

ObjectiveTo evaluate the effect of large-spot and low-energy Q switched Nd:YAG laser on melasma,and to observe the changes of melasma lesions with confocal laser scanning microscopy (CLSM) before and after the laser treatment.MethodsTotally,45 patients aged from 24 to 48 years and diagnosed with facial melasma were included in this study,and treated with large-spot and low-energy Q switched Nd:YAG once a week for 10 or more sessions.CLSM was used to estimate the melanin content in melasma lesions before each irradiation and after the last irradiation.ResultsAmong the 45 patients,8 ( 17.78％ ) were nearly cured,25 (55.56％) markedly improved,11 (24.44％) improved,and only 1 (2.22％) unimproved after the laser irradiation.The total response rate was 73.33％.As CLSM showed,there was an increment in melanin granules in melasma lesions compared with the normal skin surrounding melasma lesions,but a reduction in melanin granules was induced by the laser treatment in melasma lesions.ConclusionsLarge-spot and lowenergy Q switched Nd∶YAG laser is substantially effective and highly safe for the treatment of melasma,and CLSM can be used to evaluate the therapeutic effect of laser on melasma.

Objective To investigate the mRNA and protein expression levels of telomeric-repeat binding factor-1 (TRF1) and TRF2 in the peripheral blood mononuclear cells (PBMCs) of patients with systemic lupus erythematosus (SLE),and the relations between these gene expression levels and clinical data of SLE patients were explored.Methods According to disease activity,these SLE patients were divided into the active group (40 cases) and the stable group (67 cases).These patients were also grouped as renal damage group (46 cases) and renal damage-free group (61 cases) based on their renal conditions.Healthy individuals (41 cases) were also included as control.Real-time quantitative polymerase chain reaction (RT-qPCR) was employed to study the mRNA expression of TRF1 and TRF2.The protein levels of TRF1 and TRF2 were measured by Western Blot (WB).Independent-Samples t test or one-way analysis of variance (ANOVA) in conjunction with the Least-Significant Difference method (LSD method) wasperformed if the data were in normal distributions;otherwise,the Kruskal-Wallis test was applied.Spearman's correlation analysis was also used for statistical analysis.Results The mRNA and protein expression levels of TRF1 and TRF2 in the PBMCs of the active group (TRF1:0.003 1±0.003 3;TRF2:0.010 5±0.064 8) and renal damage group (TRF1:0.002 3 ±0.002 6;TRF2:0.004 3 ±0.003 3) were significantly increased compared to the stable group (TRF1:0.001 2±0.001 1;TRF2:0.004 2±0.008 6),the renal damage-free group (TRF1:0.001 3±0.001 8;TRF2:0.003 4±0.007 2) and healthy (TRF1:0.001 2±0.003 0;TRF2:0.003 4±0.002 7) individuals respectively (P＜0.05).In SLE patients,the expression levels of TRF1 mRNA were correlated with erythrocyte sedimentation rate (r=0.365,P＜0.05);the expression levels of TRF2 mRNA were correlated with SLEDAI score (r=0.270,P＜0.05),erythrocyte sedimentation rate (r=0.304,P＜0.05),creatinine (r=0.258,P＜0.05) and 24-hour urinary protein (r=0.344,P＜0.05).Conclusion Altered expression of TRF1 and TRF2 might be involved in the pathogenesis of Systemic lupus erythematosus.The positive correlation between TRF2 and SLEDAI score,24-hour urinary protein suggest that TRF2 might be usedas a biomarker for disease activity or renal damage in

Objective To investigate the possible role of high mobility group box 1 protein (HMGB1) and its advanced gly‐cation end products receptor (RAGE) in the pathogenesis of systemic lupus erythematosus (SLE) .Methods The enzyme‐linked immunosorbent assay (ELISA) was used to determine the level of plasma HMGB1 in 52 cases of SLE (SLE group) and 40 healthy females undergoing physical examination (HC group) ,at the same time real time quantitative polymerase chain reaction (RT‐qPCR) was employed to detect the expression of HMGB1 and RAGE mRNA in peripheral blood mononuclear cells (PBMCs) .The correlation between plasma HMGB1 ,PBMCs HMGB1 and RAGE mRNA levels with clinical indicators was analyzed .Results The levels of plasma HMGB1 ,PBMCs HMGB1 mRNA in the SLE group were significantly higher than those in the HC group ,the differences were statistically significant (P< 0 .05) ,while the level of PBMCs RAGE mRNA had no statistical difference (P>0 .05);the Spearman correlation analysis showed that the level of plasma HMGB1 was positively correlated with antinuclear anti‐bodies titers and SLEDAI score in the SLE patients (P<0 .01) ,while had no obvious correlation with the other clinical and labora‐tory indicators(P>0 .05);the HMGB1 mRNA expression level was positively correlated with the RAGE mRNA expression level and SLEDAI scores(P<0 .01 ,P<0 .05) ,and had no obvious correlation with other clinical and laboratory indicators (P>0 .05) . Conclusion The abnormal expression of plasma HMGB1 and PBMCs HMGB1 mRNA in SLE patients prompts that which might be involved in the occurrence and development of SLE ,might participate in the immune and inflammatory regulation of SLE .

Effective referral management of health and clinical services in maternal and child health hospitals plays an important role in enhancing patients′ medical experience, improving the efficiency and quality of maternal and child health services. A tertiary grade A maternal and child health hospital has carried out a practice of health and clinical service referral management based on information technology construction. A referral information module embedded in the hospital information system has been designed and constructed, and started to be applied in outpatient clinics in July 2021. At the same time, corresponding system and process construction, as well as quality control management and continuous improvement, have been carried out. The outpatient referral rate from July to December 2021 was 2.8% (11 466/412 808), from January to June 2022 it was 5.6% (22 705/402 586), from July to December 2022 it was 5.5% (22 233/402 959), and from January to June 2023 it was 6.7% (23 373/347 898). The referral rate has continued to improve and can provide reference for the referral management of other maternal and child health institutions.

Objective To investigate the effect of Danshen Baoxin Cha (DBC) on a rat model of coronary heart disease combined with cognitive impairment. Methods Male Sprague-Dawley(SD) rats were randomly assigned to two groups:normal group and model group. Streptozotocin was injected into the bilateral ventricles of rats in the model group to establish cognitive impairment model,then isoproterenol hydrochloride was injected subcutaneously to model myocardial ischemia. Behavioral experiments were conducted to verify the success of the model of cognitive dysfunction. The rats of the model group were randomly divided into five groups:model control group,Tongxinluo Capsule group (TXL group,1.6 g·kg-1),and low-(4 g·kg-1),medium-(8 g·kg-1),and high-(16 g·kg-1) dose DBC groups. These groups were received the respective treatments continuously for two weeks. Subsequently,the Y-maze,novel object recognition and Morris water maze experiment were employed to assess the learning and memory abilities of rats. A kit was utilized to quantify the level of oxidative stress in the brain and the adenosine triphosphate (ATP) content in the brain and mitochondria. Hematoxylin-eosin (HE) staining and Nissl staining were employed to observe the pathological changes of neurons in hippocampus CA1 region. Electron microscopy was utilized to observe the pathological changes of mitochondria in hippocampal CA1 region. The expression levels of peroxisome proliferator-activated receptor γ coactivator-1α(PGC-1α),glucose transporter type 4(GLUT4),and optic atrophy 1(OPA1) were quantified by real-time fluorescence quantitative polymerase chain reaction (PCR),and the expression of proteins related to the AMPK/OPA1 signaling pathway was determined by Western Blot analysis. Results Compared with the normal group,the spontaneous alternating reaction rate,the novel object recognition index,number of crossing the original platform,and distance ratio in the model group were obviously decreased (P<0.01). Neuronal density in the CA1 region of the hippocampus was decreased,Nissl bodies were decreased,and nucleus consolidation was increased. The ATP level in mitochondria,and the levels of ATP,SOD,and GSH-PX in brain were significantly decreased(P<0.05,P<0.01),as well as the content of ROS and MDA were significantly increased (P<0.05,P<0.01). The mitochondria of hippocampus in CA1 region were swollen,with sparse and vacuolated cristae. The mRNA expression levels of GLUT4,PGC-1α,and OPA1 were significantly decreased (P<0.01). The protein expression levels of GLUT4,SIRT1,PGC-1α and OPA1,and p-AMPK/AMPK ratio were significantly decreased (P<0.05,P<0.01). Compared with the model group,the behavioral indexes of rats in the DBC groups were significantly improved (P<0.05,P<0.01),the number of neurons in the hippocampal CA1 area,Nissl bodies and nucleus consolidation were improved. The ATP level in mitochondria and the levels of ATP,SOD,and GSH-PX in brain were significantly increased (P<0.05,P<0.01). The levels of ROS and MDA were significantly decreased (P<0.05,P<0.01). The structure of mitochondrial cristae in hippocampal CA1 region were relatively intact. The mRNA expression levels of GLUT4,PGC-1α and OPA1 were increased (P<0.05,P<0.01),and the expression of proteins related to the AMPK/OPA1 signaling pathway was significantly increased(P<0.05,P<0.01). Conclusion DBC can enhance learning and memory abilities,reduce neuronal damage in a rat model of coronary heart disease combined with cognitive impairment. The mechanism may be related to the reduction of oxidative stress damage in the brain,the activation of the AMPK/OPA1 signaling pathway,and the restoration of energy levels.

Objective Comprehensively analyzing the epilepsy-related genes by bioinformatics methods,and to explore their functions based on network and pathway analysis.Methods I Collected epilepsy-related genes through OMIM,DisGeNET,GeneCards databases and literatures deposited in PUBMED.Performed gene ontology(GO)and pathway enrichment analysis using"ClusterProfiler"R package,and the correlation between pathways was identified through pathway crosstalk analysis.Epilepsy-related genes were then mapped to human protein-protein interaction network(PPIN)to obtain epilepsy-specific PPIN,and extracted the hub and potential genes based on network topology.Results A total of 572 epilepsy-related genes were collected,642 significant GO biological process items and 80 Kyoto Encyclopedia of Genes and Genomes(KEGG)pathways,including learning,memory and cognition,were obtained by enrichment analysis.Based on PPIN analysis,10 hub genes of the epilepsy were extracted and most of them are gamma-aminobutyric acid(GABA)receptor genes.By integrating PPIN and WGCNA analysis,17 potential genes were extracted,involving heat shock protein,growth factor receptor binding protein,etc.Conclusion Epilepsy is a complex process,involving the abnormality of multiple functional genes,multiple biological processes and pathways are closely contact through multiple functional genes,and collectively lead to the occurrence of epilepsy.