Objective  To introduce and evaluate the practice of ^“Internet Plus^” new technology for health management of chronic diseases in community in Yichang, and to provide reference for chronic disease patients' health management in community. Methods  Data of hypertensive patients were collected from the national basic public health service system, the big data intelligent sorting system for chronic disease patients in Yichang City, and the basic public health service system in urban areas in Yichang from 2016 to 2020. Data on the discovery, sorting and filing, standardized management rate and blood pressure control of urban hypertension patients were analyzed. The application effect of ^“Internet Plus^” new technology in chronic disease community health management was evaluated. Results  From 2016 to 2020, 15 934 patients with hypertension were found and their health records were established through big and intelligent data in Yichang City, accounting for 93.54% (15 934 / 17 035) of the total. The rate of standardized management in each district increased year by year, with an increase of 8.71% in 2020 compared with 2016, and the difference was statistically significant (χ²=1273.30, P<0.001). The blood pressure control rate of hypertensive patients increased year by year, with the control rate being 11.64% higher in 2020 than that in 2016, and the difference was statistically significant (χ²=867.14, P<0.001). Conclusion  Data exchange and sharing among medical institutions at all levels can strengthen the health management of chronic diseases in the community. The “Internet Plus” new technology, integrating the Internet, big data, cloud computing and intelligent terminal technology, can effectively improve the detection, management and treatment rate of chronic diseases, and provide a new direction for the health management of chronic diseases.

Objective To analyze the level, constituent ratio, and change trend of death caused by chronic non-communicable diseases （NCDs）in Yichang from 2015 to 2020. Methods The death monitoring data of residents in Yichang from 2015 to 2020 were collected from the National Mortality Surveillance System, and the crude mortality rate, standardized mortality rate and death composition ratio of Yichang residents in different seasons, genders, ages and regions were analyzed. The standardized mortality was calculated using the data of the sixth national census in 2010. The Joinpoint regression model (Joinpoint Regression Program 4.9.0.0 software) was used to analyze the trend of time variation. The annual change percentage (APC), and 95% CI were calculated. Results In 2020, the age-standardized mortality of NCDs in Yichang was 399.20 per 100 000. From 2015 to 2020, the age-standardized mortality rate of chronic diseases among residents in Yichang showed a significant downward trend (APC=-3.42%, P<0.05). The standardized mortality of NCDs decreased rapidly in urban areas (APC=-3.52%, P<0.05）and in women（APC=-4.23%, P<0.05）. The standardized mortality of NCDs in most groups (except age 40-year-old and 70-year-old groups) decreased significantly (APC=-12.31%∽-3.13%, P<0.05). The standardized mortality of NCDs in the first and fourth quarters decreased year by year（APC=-3.83%, -4.02%, P<0.05）. The constituent ratio of death caused by NCDs in urban areas and in female residents in Yichang declined slowly (APC=-0.39%, -0.54%, P<0.05）. After the outbreak of infectious diseases in 2020, the crude mortality in the first quarter changed from an upward trend in the past 5 years（APC=3.71%, P<0.05） to no statistical significance, and the rude mortality in 2020 was lower than all other years. The constituent ratios of deaths from NCDson the way to the hospital and deaths in the elderly care service institutions changed from no statistical significance in the past to a downward trend (APC=-14.65%, P<0.05) and an upward trend (APC=8.03% , P<0.05), respectively. Conclusions From 2015 to 2020, the age-standardized mortality rate of chronic non-communicable diseases among residents in Yichang has decreased, and the proportion of urban and female deaths has declined. Epidemic situation of infectious disease has changed the time trend of mortality of NCDs in stages, and partially affected the choice of place of death. It is recommended to implement the whole population strategy for the prevention and control of NCDs, focusing on rural and male residents, and optimize the management of chronic diseases.

Objective: To analyze the treatment and clinical prognosis of lower extremity arterial injury caused by trauma. Methods: The clinical data of 77 patients with traumatic lower extremity arterial injury admitted to Department of Vascular Surgery,Yichang Central People's Hospital from January 2013 to June 2021 were collected retrospectively. There were 65 males and 12 females, with an average age of 47.4 years (range: 7 to 75 years). Among the 77 patients, 56 cases (72.7%) had open injury and 21 cases (27.3%) had closed injury. Iliac artery was injured in 9 cases (11.7%), common femoral artery in 7 cases (9.1%), superficial femoral artery in 1 case (1.3%), popliteal artery in 11 cases (14.3%) and inferior knee artery in 49 cases (63.6%). The treatment methods and clinical effects were analyzed. Results: One case with pelvic fracture combined the internal iliac artery injury and 1 case with multiple injuries involving the common femoral artery died of circulatory failure before surgery. Seventy-five cases received vascular-related operations, including arterial ligation in 24 cases, arterial reconstruction in 40 cases, stent graft implantation in 1 case, primary amputation in 2 cases, and arterial embolization in 8 cases. The overall mortality rate was 6.5% (5/77), all of which were closed injuries. Except for 2 cases who died before surgery, 3 cases with pelvic fracture combined the internal iliac artery injury died of multiple organ failure after internal iliac artery embolization. There were 8 cases received amputation (10.4%, 8/77), 5 cases with closed injury and 3 cases with open injury. In addition to 2 cases with primary amputation, 6 cases underwent secondary amputation due to ischemia-reperfusion injury after revascularization (4 cases with popliteal artery injury and 2 cases with subpatellar artery injury). The average followed-up time was 17 months (range: 2 months to 8 years). One patient with femoral artery injury underwent autologous great saphenous vein bypass, and lower limb artery CT angiography was re-examined 6 months after the operation, and 30% distal anastomotic stenosis was found. Ankle brachial index<0.8 was found in two patients 1 year after popliteal artery repair, but none of the patients had intermittent claudication symptoms, and no further intervention was performed. Five patients suffered delayed healing due to severe lower limb injury, fracture and skin injury. Among them, 2 cases had poor wound healing at the stump of amputation, which gradually healed 3 to 5 months after several debridements. The other 3 vascular injury combined with tibial fracture patients had delayed tibial healing after surgery, but no symptoms of vascular ischemia occurred. All the other patients recovered well and no other serious complications occurred. Conclusions: The proportion of death and disability in patients with lower limb artery injury caused by trauma is high. Active and orderly surgical repair according to the site and type of injury can reduce the mortality, save the function of the affected limb, and promote the healing of injury.
Amputation ; Female ; Femoral Artery ; Humans ; Lower Extremity ; Male ; Middle Aged ; Popliteal Artery/surgery* ; Retrospective Studies ; Treatment Outcome ; Vascular System Injuries/surgery*

The aim of this paper was to investigate the effect of total saponins from Panax japonicus( SPJ) on cognitive decline of natural aging rats and its mechanism. Thirty male SD rats of eighteen month old were randomly divided into three groups: aged group,10 mg·kg~(-1) SPJ-treated group and 30 mg·kg~(-1) SPJ-treated group. The SPJ-treated groups were given SPJ at the dosages of 10 mg·kg~(-1) and 30 mg·kg~(-1),respectively,from the age of 18 to 24 months. Aged group were lavaged the same amount of saline,10 six-month-old rats were used as control group,with 10 rats in each group. The open field test,novel object recognition and Morris water maze were performed to detect the changes of cognitive function in each group. The changes of synaptic transmission of long-term potentiation( LTP) in hippocampal CA1 region were detected by field potential recording. Western blot was used to detect the protein levels of NLRP3,ASC,caspase-1 and the changes of Glu A1,Glu A2,CAMKⅡ,CREB and phosphorylation of CAMKⅡ,CREB in each group.The results showed that SPJ could improve the decline of cognitive function in aging rats,reduce the damage of LTP in the hippocampal CA1 region of aged rats,and decrease the expression of NLRP3,ASC,caspase-1 in aging rats. At the same time,SPJ could enhance the membrane expression of AMPA receptor( Glu A1 and Glu A2),and increase the expression of p-CAMKⅡand p-CREB in aging rats.SPJ could improve cognitive decline of natural aging rats,and its mechanism may be related to regulating NLRP3 inflammasome,thus regulating the membrane expression of AMPA receptor,and enhancing the expression phosphorylation of CAMKⅡ and CREB.
Aging ; Animals ; CA1 Region, Hippocampal ; physiology ; Cognition ; drug effects ; Inflammasomes ; metabolism ; Long-Term Potentiation ; Male ; NLR Family, Pyrin Domain-Containing 3 Protein ; metabolism ; Panax ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Saponins ; pharmacology

OBJECTIVETo investigate the effects of exposure to aluminum (Al) on Zn, Fe, Cu and Ca contents in hippocampus of rats.

METHODSAlCl(3).6H(2)O was administered orally through diet (8% of body weight) to SD rats at doses of 0 (A), 11.2 (B), 55.9 (C), 111.9 (D) mg Al(3+)/kg BW for successive 90 days. Then Al, Zn, Fe, Cu and Ca contents in hippocampi of rats were determined by atomic absorption spectrophotometry.

RESULTSAfter oral exposure to Al, the Al content in hippocampus of rat increased significantly with a remarkable dose-effect relationship (r = 0.731, P < 0.001), The Zn, Fe, Ca and Cu contents in these four groups are as follows: Group A (18.29 +/- 2.48, 24.86 +/- 1.97, 48.69 +/- 22.08, 4.53 +/- 0.99) mg/g, Group B (17.22 +/- 2.06, 27.54 +/- 2.87, 42.79 +/- 14.42, 4.06 +/- 0.41) mg/g, Group C (14.46 +/- 1.90, 20.18 +/- 2.79, 29.95 +/- 7.33, 3.98 +/- 0.25) mg/g, Group D (15.85 +/- 2.54, 20.96 +/- 2.83, 36.14 +/- 12.66, 4.53 +/- 0.58) mg/g. Compared with the control group A, the Zn and Fe contents in group B and group C decreased significantly (P < 0.05), and the Ca content in group C also decreased significantly.

CONCLUSIONOral exposure to Al may result in accumulation of Al in hippocampus of brain and thus affect some essential elements (Zn, Fe, Cu and Ca) contents in the hippocampus at different degrees.

Aluminum ; metabolism ; pharmacology ; toxicity ; Animals ; Calcium ; metabolism ; Copper ; metabolism ; Dose-Response Relationship, Drug ; Hippocampus ; drug effects ; metabolism ; Iron ; metabolism ; Male ; Metals ; metabolism ; Rats ; Rats, Sprague-Dawley ; Zinc ; metabolism

Polyamines (putrescine, spermidine, and spermine) are essential polycations that play important roles in various physiological and pathophysiological processes in mammalian cells. The study was to investigate their role in cardioprotection against ischemia/reperfusion (I/R) injury and the underlying mechanism. Isolated hearts from male Sprague-Dawley rats were Langendorff-perfused and cardiac I/R was achieved by 30 min of global ischemia followed by 120 min of reperfusion. Different concentrations of polyamines (0.1, 1, 10, and 15 μmol/L of putrescine, spermidine, and spermine), cyclosporin A (0.2 μmol/L), or atractyloside (20 μmol/L) were given 10 min before the onset of reperfusion. The hemodynamics were monitored; the lactate dehydrogenase (LDH) levels in the coronary effluent were measured spectrophotometrically; infarct size was determined by the 2,3,5-triphenyltetrazolium chloride staining method; and mitochondrial permeability transition pore (MPTP) opening was determined spectrophotometrically by the Ca-induced swelling of isolated cardiac mitochondria. The results showed that compared to I/R alone, 0.1 and 1 μmol/L polyamines treatment improved heart function, reduced LDH release, decreased infarct size, and these effects were inhibited by atractyloside (MPTP activator). In isolated mitochondria from normal rats, 0.1 and 1 μmol/L polyamines treatment inhibited MPTP opening. However, 10 and 15 μmol/L polyamines treatment had the opposite effects, and these effects were inhibited by cyclosporin A (MPTP inhibitor). Our findings showed that polyamines may have either protective or damaging effects on hearts suffering from I/R by inhibiting or activating MPTP opening.
Animals ; Cyclosporine ; pharmacology ; Male ; Mitochondria, Heart ; physiology ; Mitochondrial Membrane Transport Proteins ; physiology ; Myocardial Reperfusion Injury ; physiopathology ; Polyamines ; metabolism ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate the effect of protease-activated receptor 2 (PAR-2) on rat apoptotic cardiomyocytes underwent ischemia reperfusion (I/R) injury.

METHODSHealthy male Sprague-Dawley rats were randomly divided into five groups (n = 8 each): sham-operation group, I/R (ligating the left coronary artery for 30 minutes and followed by 120 minutes reperfusion) group and three SLIGRL-NH2 groups treated with intravenous PAR-2 agonist SLIGRL-NH2 at different doses (0.5, 1, 3 mg/kg) 5 minutes before reperfusion. Apoptic cardiomyocytes was detected by TUNEL staining and by DNA ladder on agarose gel electrophoresis. Bax and Bcl-2 expression in myocardium was analyzed by immunohistochemical technique. The mRNA expression of PAR-2 was determined by Real-time quantitative polymerase chain reaction (RT-PCR).

RESULTS(1) The apoptosis index and the expression of Bcl-2 and Bax were significantly increased in IR group and SLIGRL-NH2 groups than those in sham group (P < 0.05-0.01). (2) Compared with I/R group, the apoptosis index and the expression of Bax were significantly reduced while the expression of Bcl-2 and PAR-2 mRNA were significantly upregulated by SLIGRL-NH2 in a dose-dependent manner. (3) DNA Agarose gel electrophoresis demonstrated that DNA ladder existed in I/R and 0.5 mg/kg SLIGRL-NH2 group, but not in 1, 3 mg/kg SLIGRL-NH2 groups.

CONCLUSIONSPAR-2 agonist SLIGRL-NH2 could reduce myocardial apoptosis by upregulating the Bcl-2 and PAR-2 mRNA level and downregulating Bax expression in a dose-dependent manner in this rat I/R model.

Animals ; Apoptosis ; drug effects ; Male ; Myocytes, Cardiac ; metabolism ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Sprague-Dawley ; Receptor, PAR-2 ; agonists ; metabolism ; Reperfusion Injury ; metabolism ; pathology ; bcl-2-Associated X Protein ; metabolism

Juvenile open angle glaucoma(JOAG)is a subtype of primary open angle glaucoma(POAG)that severely affects the quality of life of young patients and has a high disability rate. While JOAG is commonly considered an autosomal dominant disease, it has been found to have a diverse mode of inheritance, including autosomal recessive inheritance in specific populations. The variable genetic predisposition of JOAG may be attributed to the co-regulation of several key disease-causing genes, such as MYOC, CYP1B1, and CPAMD8. Mutations in these genes are closely associated with various biological processes in ocular tissues, including cellular metabolic regulation, oxidative stress response, and abnormal induction of programmed death. Therefore, a comprehensive study of the causative genes associated with JOAG is crucial to understanding the specific genetic background of disease onset, progression, and clinical phenotype. This knowledge will provide a strong foundation for early identification and screening of high-risk populations. The objective of this review is to focus on the genetic characterization and genetic studies of JOAG. Through a systematic review of the relevant literature, we summarize the causative genes and their mutations associated with JOAG and explore their potential applications and value in advancing research in the field, aiming to provide valuable insights for the diagnosis and treatment of JOAG.

OBJECTIVE: To detect receptor activator of nuclear factor kappa B ligand (RANKL) expressed on B10 cells in rheumatoid arthritis (RA) and to evaluate the correlation between RANKL-producing B10 cells in RA and clinical features and laboratory parameters, trying to reveal the possible role of B10 cells in the pathogenesis of RA and the potential mechanism of impaired immunosuppressive capacities. METHODS: 25 RA patients and 20 healthy volunteers were enrolled. These RA patients did not received treatment with glucocorticoids, disease-modifying anti-rheumatic drug and biologics during the recent half of a year. The levels of RANKL-producing B10 cells were measured by flow cytometry (FCM) and polymerase chain reaction (PCR). The correlation between the frequencies of RANKL-producing B10 cells in RA and clinical data, laboratory parameters were analyzed. The role of tumor necrosis factor α (TNF-α) and interleukin 1β (IL-1β) in inducing RANKL expression in B10 cells was evaluated by in vitro stimulation assay. Independent samples t test, Pearson and Spearman correlation were used for statistical analysis. RESULTS: B10 cells were capable of producing RANKL at a low level in health controls. The frequencies of RANKL-producing B10 cells were markedly higher in RA patients than in health controls (3.65%±1.59% vs. 2.25%±0.68%, P<0.01). The frequencies of these cells correlated positively with RA tender joint counts, swollen joint counts and disease activity score in 28 joints (DAS28) (r=0.479, P=0.035; r=0.519, P=0.008; r=0.526, P=0.019). However, no correlation was found between these cells and RA patient age, disease duration, or the levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF) and anti-citrullinated peptide antibody (ACPA). After in vitro stimulation by TNF-α, but not IL-1β, B10 cells isolated from healthy donors demonstrated fundamentally upregulated expression of RANKL. CONCLUSION Our studies showed the frequencies of RANKL-producing B10 cells were markedly higher in RA patients, and their frequencies were positively correlated with RA tender joint counts, swollen joint counts and DAS28. These findings suggested that B10 cells might be involved in RA bone destruction.
Antirheumatic Agents ; Arthritis, Rheumatoid/metabolism* ; Autoantibodies/metabolism* ; B-Lymphocytes, Regulatory/metabolism* ; Humans ; RANK Ligand/metabolism* ; Rheumatoid Factor

OBJECTIVETo explore the role of TLR4 in myocardial ischemia reperfusion injury (MI/RI) by observing the dynamic TLR4 expression changes at mRNA and protein levels early after myocardial ischemia reperfusion.

METHODSMale SD rats were randomly divided into Sham and IR group and the rats were killed according to different reperfusion time (0, 0.5, 1, 2, 4 and 8 hours). Myocardial changes under light microscope and transmission electronic microscope were observed. TLR4 expressions at protein and mRNA levels were detected by immunohistochemistry and realtime RT-PCR respectively. Myocardial TNF-alpha was determined by ELISA.

RESULTS(1) Myocardial injury was observed in IR but not in Sham group and histopathological and ultrastructural changes in IR group remained unchanged up to 8 hours after reperfusion. (2) Positive TLR4 protein staining was visualized in both Sham and IR groups and significantly increased and peaked at 1 hour of reperfusion in IR group. (3) Compared to Sham group, TLR4 mRNA level was upregulated in myocardium in IR group and peaked at 1 hour of reperfusion. (4) Concentration of TNF-alpha in IR group was significantly higher than that of Sham group at corresponding time points (all P < 0.05), and myocardial TLR4 mRNA level correlated positively with myocardial TNF-alpha (r = 0.728, P < 0.01).

CONCLUSIONExpression of TLR4 in myocardium during early after myocardial ischemia reperfusion was upregulated and actived TLR4 might play an important role in MI/RI through promoting myocardial TNF-alpha excretion.

Animals ; Disease Models, Animal ; Male ; Myocardial Reperfusion Injury ; metabolism ; pathology ; Myocardium ; pathology ; Rats ; Rats, Sprague-Dawley ; Toll-Like Receptor 4 ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism