AIM:To investigate the changes of aryl hydrocarbon receptor (AhR) in the process of cardiomyo-cyte hypertrophy induced by high glucose , and to explore its potential mechanisms .METHODS: The rat cardiomyocytes (H9c2 cells) were divided into normal glucose group , high glucose group, DMSO group and resveratrol (an AhR antago-nist) group.The content and distribution of AhR were observed with immunofluorescence staining .The myocardial cells were stained with rhodamine-labeled phalloidin to visualize cytoskeleton , and the cell surface area were determined after im-aging by fluorescence microscopy .The generation of reactive oxygen species ( ROS) in the cardiomyocytes was measured u-sing a fluorescent probe DCFH-DA.The mRNA expression of AhR , CYP1A1, atrial natriuretic peptide ( ANP) and brain natriuretic peptide ( BNP) were evaluated by real-time quantitative PCR ( RT-qPCR).The protein levels of AhR, CYP1A1, ANP and BNP were assessed by Western blot .RESULTS:AhR was constitutively presented in the cytosol un-der normal-glucose condition and was translocated to the nuclei under high-glucose condition .High glucose induced cardiac hypertrophy , and increased ROS generation .Significant reductions in the cell size and ROS generation were observed after treated with resveratrol.The expression of AhR, CYP1A1, ANP and BNP at mRNA and protein levels in high glucose group was increased as compared with normal glucose group and resveratrol group , and the above-mentioned indexes signifi-cantly decreased in resveratrol group as compared with DMSO group .CONCLUSION: High glucose-induced cardiac hy-pertrophy increases AhR expression , which may be involved in the maintenance of glucose homeostasis in the cardiomyo-cytes.AhR translocation to the nucleus induced by high glucose results in the increases in CYP 1A1 expression and ROS generation, which may be an important mechanism of high glucose-induced cardiomyocyte hypertrophy .

Objective To study the expression and significance of Th17 and Tc17 cells in the peripheral blood,skin and lung in a murine model of bleomycin (BLM)-induced systemic sclerosis (SSc).Methods Thirty female BALB/c mouse were randomly divided into 3 groups,including a control group ( A group),a injected with BLM 4 week without pulmonary fibrosis(PF) group( B group) and with obviously PF group(C group).Pathological changes of skin and lung were detected.The proportion of CD4+,CD8+,CD4+IL-17+(Th17),CD8+IL-17+(Tc17) cells in the peripheral blood,skin and lung of mouse was determined by flow cytometry.The mRNA expressions of RORγt,IL-17A in skin and lung of mouse were evaluated by real-time PCR.Enzyme linked immunosorbent assay(ELISA) was used to measure the levels of IL-17 in serum.Results Dermal hydroxyproline(HYP) contents and the score of PF were significantly increased in C group [ (3.07±1.26) μg/mg,4.0±1.41 ]and B group [ (2.43±0.61) μμg/mg,1.50±0.76]as compared with A group [ (1.45±0.40) μg/mg,0.60±0.70 ],and pulmonary HYP contents was obviously increased in C group than in A and B groups,all P＜0.05.Compared with the A group,the percentage of CD4+ and Th17 cells in the peripheral blood,skin and lung of B and C groups,Tc17 cells of C group was significantly increased,and CD8+ cells was significantly decreased(all P＜0.05).The ratio of Th17/CD4+CD8+ in the peripheral blood,skin and lung of B and C groups [ ( 1.41 ±0.36)％,( 1.79±0.77)％ ],[ (2.58±1.07)％,(5.23±2.34)％ ]and [ (3.50±1.20)％,(4.02±1.32) ％ ]was significantly increased compared with A group (0.71±0.25)％,(1.15±0.59)％,(0.99±0.46)％.The ratio of Tc17/CD4+CD8+ in the lung of C groups( 1.62±0.53) ％ and in the skin of B and C groups [ (1.70±0.70) ％,( 1.63±0.63 ) ％ ]was significantly increased compared with A group [ ( 1.00±0.47 ) ％,( 1.1 1 ±0.34 ) ％ ],all P＜0.05.Compared with the A group,the mRNA levels of IL-17A,RORγt in skin of B and C groups,and in lung of C group were higher and the levels of IL-17 in serum was significantly increased,all P＜0.05.Th17 cells and the levels of IL-17 in blood were positive correlation with dermal and pulmonary inflammation,fibrosis and H YP contents,all P＜0.01.The frequency of Th17 and Tc17 cells in skin and lung respectively had a positive correlation with dermal and pulmonary inflammation,the score of fibrosis,and HYP contents of skin and lung,all P＜0.01.Conclusion Th17 and Tc17 cells were significantly increased in the peripheral blood,skin and lung of a murine model of SSc,and Th17 cells is dominated.They correlated with the inflammation and fibrosis of skin and lung,and may participate in the pathogenesis of SSc through secrete IL-17.

Objective To investigate the gender differences of glucose metabolic network in brains of healthy adults at resting state by 18F-FDG PET.Methods A total of 204 dextromanual,healthy individuals (104 males,average age:(53.45±11.51) years;100 females,average age:(54.11±12.09) years) were enrolled from June 2011 to June 2016 to construct brain metabolic networks.The nodal and global parameters,including clustering coefficient (Cp),characteristic path length (Lp) and betweenness centrality (Cb),were analyzed by graph theory.Permutation test with 1 000 repetitions was used.Results The brain metabolic networks derived from 18F-FDG PET data were with small-world properties in both male group and female group.Compared with Cb in females,Cb in males was significantly reduced in left postcentral gyrus,right angular gyrus and left temporal pole/middle temporal gyrus (permutation test,all P<0.05);and it was increased in left amygdala,left precuneus,right temporal pole/middle temporal gyrus and left inferior temporal gyrus (permutation test,all P<0.05).Comparing with the females,the male group had higher Cp and longer absolute Lp but without significant difference (permutation test,all P>0.05).Conclusions There are gender-related differences of topological structure in whole-brain metabolic networks.Gender should be considered as a covariate while designing experiments,accounting for cerebral metabolic data from normal control and experimental patients as well as making clinical decisions.

Objective To explore the pressure ulcer incidence and nutrition evaluation of 102 hospitalized super aging patients (80-90 year-old) by the subjective comprehensive nutrition evaluation method (SGA),the micro-nutrition evaluation method (MNA-SF),and nutritional risk screening 2002 (NRS 2002).Methods A total of 102 hospitalized super aging patients had been selected by the convenient sampling method and documented the incidence pressure ulcer according to three methods of nutritional screening from August 2012 to December 2014.We combined with the traditional measurement methods and laboratory index to compare the correlation between them,and combined with the ROC to evaluate the sensitivity and specificity of different pressure ulcers.The evaluation of the advantages and disadvantages were also discussed.Results In elderly patients,the incidence of pressure ulcers was 35.29％,the detection rate of MNA-SF,NRS 2002,SGA evaluation methods in malnutrition were 74.5％,54.9％ and 29.4％.The MNA-SF detection rate of malnutrition was higher than the other two methods.All three nutrition detection methods had negative correlation with traditional nutrition measurement and indexes results of laboratory (P ＜ 0.05),and had statistical significance at assessment of nutrition risk,malnutrition,normal nutrition with incidence rate of pressure ulcer (P ＞ 0.05).While we assessed the sensitivity of pressure ulcer,the MNA-SF was 86.1％,NRS 2002 61.0％,SGA 33.3％,and the three specificity were 68.2％,51.5％,27.3％.Conclusions MNA-SF has a better effect than SGA and NRS 2002 at detection of malnutrition and the effect of pressure ulcer.

Objective To analyze the clinical characteristic of Chinese autoimmune pancreatitis (AIP) patients.Methods All clinical data of 81 patients with a diagnosis of AIP in Shanghai Changhai Hospital from February 2005 to May 2012 were analyzed.Results The sex ratio was 7.1∶1 and the mean age was (57± 12) years old in 81 patients with AIP.Obstructive jaundice was the initial symptom in 51.9％ (42/81) patients.In patient receiving CT,focal and diffuse type accounted for 45 and 35 patients.respectively,and pseudocyst was the main manifestation in 1 patient,biliary tract was involved in 59(72.8％ ) patients,dilatation of main pancreatic duct was observed in 5 ( 11.1％ ) patients.In patients receiving PET-CT,diffuse increased Flourine-18 FDG uptake by the pancreas was found in 11 patients,focal increased uptake in 2patients,and significant extra-pancreatic uptake was found in 5 patients.The positive rate of serum IgG4,CA19-9,ss DNA,anti-nuclear antibody and ds-DNA antibody was 94.6％ (53/81),54.4％ (37/68),14.3％ (4/28),10.7％ (3/28),7.1％ (2/28),respectively.The pathological findings of H-E staining and IgG4 immunohistochemical analysis in 20 patients were consistent with lymphoplasmacytic sclerosing pancreatitis.Conclusions Type 1 AIP is the main subtype of AIP in China.Combining clinical symptoms,extra-pancreatic manifestations,imaging or nuclear medicine findings,serology,cytology or histology can effectively increase the correct diagnosis rate of AIP.

Objective:To deeply understand the causes of poor compliance with out-of-hospital disease self-management behaviors in patients with deep vein thrombosis (DVT) of lower extremities, and provide a scientific basis for targeted interventions.Methods:Totally 14 patients who were diagnosed with DVT of the lower extremities, self-managed for 6 months outside the hospital and showed poor compliance in a ClassⅢ Grade A hospital in Beijing from August 2018 to April 2019 were selected for semi-structured interviews using phenomenological methods. The data were analyzed using Colaizzi's 7-step analysis.Results:The two themes of medical behavior management and health behavior management were refined; the causes of poor compliance were: lack of knowledge on systematic prevention and treatment of thrombosis, poor communication between doctors and patients and weak family and social support.Conclusions:The out-of-hospital disease self-management of patients with DVT of the lower extremities is poor. Doctors and nurses should strengthen health education from systematic knowledge of thrombosis treatment, enhance communication between doctors and patients, strengthen family social support, implement re-examination and non-compliance behavior supervision, and improve self-management behavior compliance outside the hospital.

Motabolic bariatric surgery is a fast and effective method for the treatment of obesity and obesity-associated diseases. In order to maintain weight loss and prevent complications, self-management of bariatric and metabolic surgery patients undergoing metabolic bariatric surgery is very important. This paper summarizes the research status, assessment tools and influencing factors of self-management of patients undergoing metabolic bariatric surgery. This paper also puts forward the problems to be solved in current research and practice, aiming to provide a reference for future research and improving the self-management ability of patients undergoing metabolic bariatric surgery.

Body image is a common concept in the field of psychology and an important indicator for evaluating the quality of life of patients after bariatric and metabolic surgery. This paper reviews the concept of body image, the measurement tools, influencing factors and the intervention of the body image after bariatric and metabolic surgery, so as to provide a reference for domestic research on the body image of patients after bariatric and metabolic surgery.

Objective:To construct and test the reliability and validity of an assessment scale for self-management of patients with dry eye, so as to help patients establish dry eye related health behaviors.Methods:Based on the knowledge attitude and practice theory, the initial scale was constructed on the basis of literature review and qualitative interview, and revised through Delphi expert consultation and expert argumentation. After the preliminary investigation, 211 dry eye patients treated in the dry eye nursing outpatient department of Beijing Tongren Hospital from August 2023 to January 2024 were selected by convenience sampling method for questionnaire investigation to test the reliability and validity of the scale.Results:Among 211 dry eye patients, there were 58 males and 153 females, aged (39.31 ± 12.81) years old. The scale of self-management of patients with dry eye included 27 items in 3 dimensions: knowledge, attitude and behavior. The authority coefficient of the two rounds of expert consultation was 0.86, and the Kendall coordination index increased from 0.175 to 0.223 (both P < 0.01). The cumulative variance contribution rates of the three dimensions were 41.843%, 54.219% and 44.273%, respectively. The Cronbach α coefficient of the scale was 0.787, and the Spearman-Brown coefficient was 0.641. Conclusions:The scale of self-management of patients with dry eye has good reliability and validity and can be used in the assessment of dry eye patients to provide a reference basis for targeted guidance and intervention.

Objective:To evaluate and summarize the best evidence for exercise scheme after bariatric and metabolic surgery in obese patients at home and abroad.Methods:We used "obesity" " bariatric and metabolic surgery" "sleeve gastrectomy" "gastric bypass surgery" "banding surgery" "exercise" "physical activity" "exercise therapy" "guideline" "expert consensus" "systematic review" "Meta-analysis" and "evidence summary" as keywords, and searched databases such as UpToDate, Cochrane Library, PubMed, China National Knowledge Infrastructure (CNKI) , Wanfang Data, and the guide network and professional association platforms by computer. Literature retrieved included guidelines, expert consensus, best clinical practice, clinical decision-making, systematic reviews, and the search time limit was from the database establishment to July 18, 2020. Two researchers evaluated the quality of literature and extracted evidence, and the evidence was revised and perfected through expert consultation.Results:A total of 4 systematic reviews and Meta-analysis articles, 2 clinical decision-making articles, 4 guidelines, and 1 expert consensus were included. The evidence was collected from 7 aspects, namely the importance of exercise, pre-exercise evaluation, exercise style, exercise intensity and duration, exercise safety, exercise follow-up, exercise effect evaluation, and finally 33 best evidences were summed up.Conclusions:Evidence of exercise scheme after bariatric and metabolic surgery in obese patients is comprehensive. Medical institutions and clinical medical and nursing staff can combine the institutional environment to transform and apply the evidence.