Objective To evaluate the effect of levamlodipine intervention in diabetic nephropathy patients which accompanied with hypertension, using the technology of diffusion-weighted imaging (DWI) of functional magnetic resonance (fMRI).Methods A controlled prospective method was taken , and fifty diabetic nephropathy ( phase III) patients which accompanied with hypertension were randomized assigned to two groups of A ( n =26) and B ( n =24).Levamlodipine (2.5 mg qd) was taken by patients of group A and amlodipine (5 mg qd) was taken by patients of group B for 24 weeks, respectively.Two groups both took angiotensinⅡreceptor blockers (ARBs) as the first line antithypertensive agents , their urinary albumin excretion rate (UAER), serum creatinine (sCr), cystatin C (Cys C) , and DWI scanning were detected before and after intervention .The levels of UAER, apparent diffusion coeffi-cient (ADC) value were compared between two groups before and after intervention .During the 24th week, two groups'adverse reac-tion to the medicines and the levels of blood pressure were recorded in each follow-up visit.Results The levels of UAER, systolic blood pressure(SBP), and diastolic blood pressure(DBP) were Significantly lower in group A after 24-week intervention compared to baseline [42.5 (25.3~91.0)μg/min vs 49.2(29.7~96.8)μg/min,(112.6 ±6.4)mmHg vs (135.3 ±7.6)mmHg, (71.4 ± 10.7)mmHg vs (80.3 ±11.6)mmHg, P <0.05, respectively].DWI scanning showed that ADC value of renal parenchyma was sig-nificantly improved than that of baseline [(2.45 ±0.12)vs(2.17 ±0.09), P <0.05].In Group B, the level of SBP was also signifi-cantly lower than that of baseline [(121.5 ±11.6)mmHg vs (134.8 ±9.2)mmHg, P <0.05], and ADC value of renal parenchyma was significantly improved than that of baseline [(2.28 ±0.15) vs (2.14 ±0.09), P <0.05].No difference was found in DBP and UAER before and after intervention ( P >0.05).Group A had a better improvement of SBP (ΔSBP) and ADC (ΔADC) after inter-vention compared to group B ( P =0.02,0.01, respectively).The overall adverse reaction incidence was 15.4%(4/26) in group A and 41.7%(10/24)in group B, respectively (χ2 =4.27, P =0.0387).Conclusions For the diabetic nephropathy (phase III) pa-tients accompanied with hypertension , levamlodipine likely showed better effects on reducing comprehensive blood pressure and UAER , improving renal microcirculation , with less overall adverse reaction compared to amlodipine .

Aim To investigate the effects of diterpene ginkgolides meglumine injection (DGMI ) on amino acids and monoamine neurotransmitters in rats with cerebral ischemia/reperfusion injury.Methods In-traluminal suture was applied to establish middle cere-bral artery occlusion (MCAO/R)model with ischemia for 1.5 h and reperfusion for 24 h.After the adminis-tration of DGMI (i.v.),the levels of amino acid and monoamine neurotransmitters in brain tissue were de-tected through HPLC-ECD.Results DGMI down-reg-ulated the concentrations of aspartic acid, glutamic acid,glycine and γ-aminobutyric acid which were in-creased in MCAO/R group.DGMI also reduced the levels of norepinephrine epinephrine,glyoxylic acid, serotonin and 5-HIAA in cortex and hippocampus,and increased adrenaline content compared to the model group.Conclusion DGMI exhibits a protective role in rats with cerebral ischemia /reperfusion injury through regulating amino acids and monoamine neuro-transmitters.

Shegan Mahuang Decoction is a classic formula for the treatment of asthma, which has the efficacy of dissipating cold and reducing phlegm, relieving cough and relieving asthma, and can be used clinically alone to control acute attacks, or to assist Western medical methods to improve the efficacy, and can also to combine with other classical prescriptions for the pathogenesis, which can improve the symptoms of cough and asthma, expectoration, and lung function indexes. The mechanism of Shegan Mahuang Decoction in the treatment of asthma is mainly related to reducing inflammatory response and inhibiting airway remodeling, and it mainly regulates immune inflammatory pathways to play a role.

OBJECTIVE Human beings possess the ability to indirectly acquire the emotions of others.This also known as emotional contagion or empathy,enables us to rapidly perceive the emotions of others.However,an excessive empathy may result in heightened fear and sensitivity to pain.Therefore,the establishment of appropri-ate animal models for analyzing neural mechanisms underlying empathy would contribute to pharmacological research on pain sensitivity caused by psychological sus-ceptibility.METHODS We used the observed fear para-digm for assessing contagion of negative emotions in mice.To minimize the impact of emotional contagion dif-ferences caused by the subject change,we established a bilateral observation area and the two mice were trained to observe fear simultaneously.First,two observer(OB)mice were placed on either side of the observational area.Next,a demonstrator(DM)mouse was introduced into the cylindrical shock cage located at the center of the apparatus.The shock cage is made of transparent organic plastic with air holes and has provided ample space for free movement by the DM mouse.During the shock stage,DM mice were subjected to electric stimulation while the behaviors of OB mice on both sides was observed,including freezing,the side and corner time,social interaction behavior.Additionally,c-Fos staining was utilized to confirm distinct local brain activities.RESULTS In the habituation stage,OB mice on both sides showed more social preference for DM mouse,as evidenced by an increase in duration time in the designat-ed interaction zone.During the shock phase,OB mice observed the DM mouse receiving electric shocks and displayed significantly higher levels of fear contagion;however,their fear behavior was not entirely consistent.Some mice exhibited a significant increase in freezing time,while others demonstrated a significant increase in corner and side exploration time.We utilized Z-normal-ization to evaluate changes in emotionality across vari-ous behaviors and identified mice with distinct susceptibil-ities.Fos-positive neurons exhibited higher expression levels in susceptible OB mice,primarily concentrated within brain regions associated with the ascending path-ways of pain perception,such as thalamus,the anterior insular cortex,and anterior cingulate cortex.CONCLU-SION In this study,we have developed an innovative experimental facility that integrates various behavioral tests to evaluate empathic behavior in mice.Our findings highlight the robustness of emotionality measures obtained from individual mice by combining this experi-mental model with the Z-scoring method,facilitating screening for empathic fear or pain-susceptible mice and will helpful for pharmacological evaluation.

Objective:To investigate the application of artificial intelligence based on the neural network radiation field in repair of soft tissue defects at lower limbs.Methods:A retrospective analysis was performed of the 23 patients who had been admitted to Department of Orthopedic Surgery, Renmin Hospital of Wuhan University from June 2020 to May 2022 for soft tissue defects at lower limbs. There were 14 males and 9 females, aged (38.6±6.7) years. Causes for soft tissue defects: traffic injury in 9 cases, benign or malignant primary soft tissue tumor in 6 cases, mechanical injury in 4 cases, crush injury in 2 cases, and chronic ulcer in 2 cases. Defect locations: the thigh in 3 cases, the lower leg in 7 cases, and the ankle and distal foot in 13 cases. The areas of soft tissue defect ranged from 6.0 cm×3.8 cm to 14.7 cm×12.8 cm. The defects were repaired and reconstructed by transplantation of an anterolateral femoral free flap in 7 cases and a pedicled flap in 16 cases with the assistance of artificial intelligence based on the neural network radiation field, a cutting-edge artificial intelligence algorithm that can quickly construct and process three-dimensional model images through volume rendering under the radiation field. The flap survival rate, aesthetic satisfaction before and after treatment, time for skin flap harvesting and transplantation, functional recovery of lower limbs and incidence of complications were recorded.Results:All the 23 patients were followed up for 32(28, 36) weeks. All the flaps were harvested smoothly and survived. The time for flap harvesting and transplantation was 65.8(50.0, 76.0) min. The aesthetic satisfaction scored (2.3±0.7) points before treatment and (8.4±1.6) points 4 weeks after treatment, showing a statistically significant difference ( P<0.05). The skin flaps healed well with no complications such as hematoma or infection in all but one patient who suffered from superficial necrosis at the distal skin flap due to venous crisis but healed with a scar. On average, the functional recovery of lower limbs scored 23.7(22.0, 25.0) points at 12 weeks after operation according to the Enneking evaluation system, and the functional recovery of lower limbs was 79% (23.7/30.0). Conclusion:Application of artificial intelligence based on the neural network radiation field can achieve ideal results in repair of soft tissue defects at lower limbs, due to its advantages of rapid and accurate surgical procedures, limited damage to the donor site, and a short learning curve.

Objective:To investigate the correlations of dynamic iodine nutrition status and thyroid function in pregnant women and newborns in Lingang of Shanghai, so as to provide an evidence for whether urine iodine testing and iodine supplementation should be carried out.Methods:A prospective study was conducted by randomly selecting pregnant women from October 2017 to October 2018 in Shanghai Sixth People’s Hospital East Affiliated to Shanghai University of Medicine & Health Sciences. The pregnant women were divided into early (5-12 weeks), middle (22-24 weeks), late pregnancy (36-37 weeks). Samples of serum and 24 hours urine were collected to test on thyrotropin (TSH), free thyroxine (FT 4), free triiodothyronine (FT 3), anti-thyroid peroxidase (TPOAb), anti-thyroglobulin (TgAb) and urinary iodine. TSH in neonatal heel blood was analyzed 72 h after birth (newborns from pregnant women in the late pregnancy). The differences of thyroid function of pregnant women with different pregnant periods and different urinary iodine levels were analyzed, as well as the neonatal TSH levels of pregnant women with different urinary iodine levels. Results:A total of 109, 90 and 54 cases of pregnant women in early, middle and late pregnancy were investigated and the medians of urinary iodine were 120.95, 136.30 and 116.80 μg/L, respectively. There was no significant difference in urinary iodine content among different pregnant periods( P > 0.05). The proportions of urinary iodine level less than 150 μg/L in early, middle and late pregnancy were 75.2% (82/109), 61.1% (55/90) and 59.3% (32/54), respectively. The median values of serum TSH in early, middle and late pregnancy were 1.81, 1.95 and 2.29 mU/L, mean values of FT 3 were (5.21 ± 0.84), (4.79 ± 0.72) and (4.13 ± 0.56)pmol/L, and means of FT 4 were (16.48 ± 2.58), (15.02 ± 2.78) and (13.31 ± 1.87) pmol/L, respectively. The FT 3 and FT 4 levels in the late pregnancy were lower than those in the early and middle pregnancy, while the TSH levels in the late pregnancy were higher than those in the early and middle pregnancy. There were no significant difference in serum FT 3, FT 4 and TSH levels among early, middle and late pregnancy under different urinary iodine levels. The median TSH of newborn heel blood was 1.48 mU/L. There was no statistically significant difference between the neonatal heel blood TSH level of pregnant women with urinary iodine < 150 μg/L [1.45(1.09, 2.23)mU/L] in late pregnancy and those with urinary iodine ≥150 μg/L [1.42 (1.14, 2.61) mU/L, Z=- 0.354, P > 0.05]. Conclusions:There is mild iodine deficiency in pregnant women in Lingang of Shanghai. However, due to the compensatory regulation, it has no significant effect on the thyroid function of mother and newborn. Monitoring of iodine nutrition of pregnant women should be carried out and iodine supplementation should be done scientifically and reasonably.

OBJECTIVE Fear can be learned indi-rectly,but excessive transmission of fear is essential for the development of mental illness.Previous research has indicated that the anterior insular cortex(AIC)may play a crucial role in the process of fear transmission,and abnormal AIC activity is a possible mechanism under-lying various affective disorders.Inhibitory neurons are crucial for maintaining local microcircuit homeostasis.With the support of novel specific neuroregulatory tech-niques,it is now possible to monitor and regulate differ-ent types of neurons in real-time.Therefore,investigating distinct subtypes of inhibitory neurons in the AIC that are involved in fear contagion may provide valuable insights into potential mechanisms underlying mental disorders.METHODS We established a modified observational fear(OF)model.A demonstrator(DM)mouse was placed in an acrylic cup at the center of the apparatus,and two observer(OB)mice were allowed to explore the DM mouse simultaneously from separate areas on either side.During the OF training,electric foot shocks were administered to the DM mouse and freezing,the side and corner time,and social interaction behavior were scored.Next,we characterized the activity patterns of distinct neuronal subtypes in the AIC using GCaMP-based calcium recording.Finally,we employed a Cre-dependent optogenetic approach to selectively modulate excitatory or inhibitory neurons in the AIC,and investigat-ed empathic fear behavior across different Cre transgenic mouse lines(CK2-Cre,PV-Cre,SOM-Cre,VIP-Cre).RESULTS During the training phase,the OB mice exhib-ited significantly higher levels of fear compared to the control group(which did not observe a traumatic event),as evidenced by increased freezing time,decreased interaction time,and increased corner zone time.Calcium fiber recording results suggested that CK2 neurons are involved in risk prediction,while PV and VIP neurons exert inhibitory control on this behavior.Optogenetic silencing of CK2-positive neurons in the AIC through injection of AAV-DIO-NpHR-mCherry in mice demon-strated a significant reduction in empathic fear.Similarly,activation of PV or VIP inhibitory neurons expressing ChR2-eYFP also resulted in a similar effect.However,activation of SOM neurons led to a significant increase in empathic fear.CONCLUSION Our study demonstrated that VIP and PV neuron activity in the AIC attenuates empathetic fear,while SOM and CK2 neuron activity enhances fear expression.These findings shed light on the distinct contributions of various inhibitory interneu-rons in the AIC to fear contagion,indicating their mutual interaction for maintaining local microcircuit homeostasis that regulates empathetic fear behaviors.

Objective : To study the clinical periodontal status of patients with desquamative gingivitis (DG) and analyze the factors that influence clinical periodontal indicators. Methods : A purposive sampling method was used to obtain 42 subjects for a DG case group and a control group. Periodontal clinical indicators were detected, and related factors were analyzed. Results : The DG patients were primarily middle-aged women. Periodontal clinical indicators were more prevalent in individuals with oral lichen planus (OLP) and mucous membrane pemphigoid (MMP) than in the control group. Probing depth (PD) (χ2=53.058, P<0.001; χ2=32.989, P<0.001), clinical attachment (χ2=30.292, P<0.001; χ2=32.470, P<0.001) and the positive rate of bleeding on probing (BOP) (χ2=50.003, P<0.001; χ2=36.236, P<0.001) were higher in the OLP and MMP group than in the control group. The time interval between the onset and treatment of DG was correlated with PD (rs=0.523, P<0.001) and the rate of positive BOP sites (rs=0.377, P=0.014). Conclusion Patients with DG have obvious periodontal lesions. Early medical intervention is helpful for diagnosing and treating DG-related oral and systemic disease.

OBJECTIVE To investigate the inhibitory effect and mechanism of 5,6-dimethylxanthe-none-4-acetic acid(DMXAA)on metastasis of Lewis lung cancer(LLC)in mice.METHODS The inhibi-tory effect of DMXAA on tumor metastasis was analyzed via an LLC xenograft tumor model and LLC metastatic tumor model.The mice of LLC xenograft tumor model were randomly divided into three groups:model group(physiological saline containing 1%DMSO,ip,once every two days),model+suni-tinib group(30 mg·kg-1,ip,once every two days),and model+DMXAA group(25 mg·kg-1,ip,once).Tumor volume and body mass were measured once every two days after administration.Two and five days after administration,tumor mass was measured by sacrificing the mice,followed by immunofluores-cence staining of tumor tissues.Platelet/endothelial cell adhesion molecule-1(CD31)and α-smooth muscle actin(α-SMA)were used to analyze the vascular structure of tumor tissues.The tumor hypoxia level was detected using the hypoxia probe pimonidazole staining.The mice of LLC metastatic tumor model were randomly divided into three groups:model group(physiological saline containing 1%DMSO,ip,twice a week),model+sunitinib group(60 mg·kg-1,ip,twice a week),and model+DMXAA group(25 mg·kg-1,ip,once).At the Two and five weeks after administration,the in vivo tumor growth and metastasis were observed and quantified using a small animal live imaging system.RESULTS Compared with the model group,the tumor volume and mass of the model+sunitinib group and model+ DMXAA group were significantly reduced(P<0.05,P<0.01),and DMXAA took effect faster and more significantly than sunitinib.At the same time,compared with the model group,the body mass in the model+sunitinib group decreased significantly(P<0.05),but there was no significant difference in body mass the model+DMXAA group.Compared with the model group,model+sunitinib had no effect on tumor metastasis,but model+DMXAA significantly reduced tumor metastasis two weeks after administration(P<0.01).Compared with the model group,the coverage rate of α-SMA/CD31 in the model+sunitinib group and model+DMXAA group increased significantly(P<0.05).Compared with the model group,there was no significant change in the tumor hypoxia area in the model+sunitinib group,but this in the model+DMXAA group decreased significantly(P<0.01).CONCLUSION DMXAA significantly inhibits the growth and metastasis of LLC in mice,and its mechanism may be related to its improvement of tumor vascular normalization and hyposic microenvironments.

Objective: To suggest strategies for emergency diagnosis and treatment of trauma orthopedics in the epidemic period of Corona Virus Disease 2019(COVID-19). Methods: In the epidemic of COVID-19 from January 21 to February 15, 2020, 128 patients with orthopaedic trauma sought emergency treatment at Department of Orthopedic Surgery, The People’s Hospital of Wuhan University. They were 71 males and 57 females with an average age of 48.7 years (from 5 to 88 years).Of them, 107 cases were treated at the outpatient department and 21 hospitalized. Emergency operations were carried out for 4 cases and selective operationsfor 17 cases. COVID-19 infections were recorded in the patients and medical staff as well. Measures taken and experiences learned were summarized since the epidemicoutbreak of COVID-19. Results: Of the 107 cases treated at the outpatient department, 3 had a definite diagnosis of COVID-19 and 3 a suspected diagnosis of COVID-19. Of the 4 cases undergoing emergency surgery, one was suspected of having COVID-19. Of the 17 cases undergoing selective surgery, one was diagnosed definitely as COVID-19and 2 were suspected of COVID-19. Two nurses were diagnosed definitely as having mildCOVID-19.One doctor and one nurse were suspected of COVID-19. Since the COVID-19 infections in medical staff occurred all before the preventive and control measures for COVID-19 had been implemented,is was not ruled out that their infections might have come from communities. Conclusions It is particularly important for medical institutions of all levels to maintain safe and effective routine services while doing well in COVID-19 prevention. In the epidemic of COVID-19, front-line medical staff in emergency traumatic orthopedics is faced with great challenges in the process of diagnosing and treating patients. High-quality and safe medical services can be provided as long as nosocomial COVID-19infection is effectively controlled by rigid screening of patientsnewly admitted, classified management of inpatients, optimal management of inpatient wards, standard preventive measures in perioperative period, a perfect system for medical protection, and medical education for patients and their carers.