Objective:To observe the effect of warm needling plus oral administration of rosuvastatin calcium tablets on blood lipids in cerebral infarction patients. Methods:A total of 125 eligible cases were randomly allocated into group A (n=42), group B (n=40) and group C (n=43). Cases in group A received warm needling plus oral administration of rosuvastatin calcium tablets, cases in group B received warm needling, whereas cases in group C received oral administration of rosuvastatin calcium tablets. Results:After treatment, the total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) all dropped obviously in the three groups, with significant differences (allP<0.05), modified Barthel index (BI) scores all significantly rise (allP<0.05), and high-density lipoprotein cholesterol (HDL-C) remained unchanged (allP>0.05). After treatment, the changes of TC, TG and LDL-C in group A were significantly different from those in group B and group C (allP<0.05), while the changes showed no statistical significance between group B and group C (P>0.05). There were no between-group differences in HDL-C among the three groups (allP>0.05); the modified BI scores in groupA and groupB were significantly higher than that in group C (bothP<0.05), while there was no significant difference between group A and group B (P>0.05).After treatment, the total effective rate was significantly higher in group A than that in group B and group C (bothP<0.05), there was no significant difference between group B and group C (P>0.05). Conclusion:Warm needling and oral administration of rosuvastatin calcium tablets both can adjust blood lipids effectively in cerebral infarction patients with a similar therapeutic efficacy, while the effect gets better based upon combining both methods; acupuncture-moxibustion plays an important role in the recovery of nerve functions in cerebral infarction patients.

Objective To compare the clinical outcomes between two different femur rotating osteotomy methods for kneeling ability recovery after total knee arthroplasty (TKA).Methods From January 2012 to December 2014,88 patients underwent TKA were selected for a retrospective study and were divided into two groups based on the methods to determine femoral rotation.Forty-eight patients were in measured resection group,while 40 patients in gap balancing group.The patients in both groups underwent fixed-bearing tibia prosthesis.There were no statistical significance between the two groups in gender,age,BMI and knee varus angle (P＞0.05).The knee varus angle,ROM,Oxford knee score (OKS) and American Knee Society (KSS) knee score were collected to assess malformation correction,kneeling ability and functions at pre-operation,one and two years postoperatively.Results The operation duration and blood loss in measured resection group were 80±19 min and 348±121 ml,while these data in gap balancing group were 82±23 min and 315 ± 100 ml respectively (P＞0.05).Patients in measured resection group were followed up 24-59 months (mean 43± 11 months),while the followed-up duration in gap balancing group was 25-58 months (mean 47±10 months).No major complications such as infection loosen and instability were occurred.Varus angles in measured resection group at postoperative 1 year and 2 year postoperative were 1.2°±0.4° and 1.0°±0.2° respectively,while those in gap balancing group were 0.9°±0.2° and 0.8°±0.3° (P＞0.05).The scores of the seventh item of OKS in measured resection group at 1 year and 2year follow-ups were 2.79±1.02 and 2.75± 1.03 respectively,while those in the gap balancing group were 1.90±0.85 and 1.80±0.83 (P＜0.01).ROM in the measured resection group at 1 year and 2 year postoperative were 102.08°± 15.60° and 102.08°±15.60° respectively,while those in the gap balancing group were 112.50°±18.32° and 113.00°±18.09° (P＜0.05).KSS in measured resection group at postoperative 1 year and 2 years were 154.63±31.12 and 154.63±31.26 respectively,while those in the gap balancing group were 170.55±22.67 and 173.45±22.52 (P＜0.05).Conclusion The method of measured resection and gap balancing to confirm femoral rotation during TKA can both achieve favorable kneeling ability and clinical outcomes,while gap balancing show superiority on kneeling ability recovery,ROM and clinical outcomes at 2-year postoperative improvement.

OBJECTIVE:To provide reference for clinical individual medication of voriconatole. METHODS:The distribution of MIC of voriconazole to Aspergillus fumigatus and Candida albicans were summarized as well as the pharmacokinetic parameters of voriconazole in different populations. Using probability of target attainment(PTA)and cumulative fraction of response(CFR)as indexes,crystal ball software 11.1.2.4 was used for Monte Carlo simulation of different dosage regimens of same population and same dosage regimen of different populations. RESULTS:For children with impaired immunity,when the drug doses of were 4,6 mg/kg and MIC was lower than 0.125 mg/L,PTA was higher than 90%;when the drug doses was increased to 8 mg/kg and MIC was lower than 0.125 mg/L,PTA was higher than 90%. For different populations receiving same dosage regimens(4 mg/kg),MIC of teenagers with impaired immunity was lower than 0.25 mg/L and those of healthy adults,patients underwent hematopoietic stem cell transplantation and adults with impaired immunity were all lower than 0.5 mg/L,PTA was higher than 90%. CFR to A. fumigatus were 42.53%,58.41%,77.74%,70.16%,89.40%,93.72%,95.42% and CFR to C. albicans were 96.68%,97.13%,97.94%, 97.54%,98.07%,98.28%,98.35%among children with impaired immunity receiving different drug doses(4,6,8 mg/kg)and dif-ferent populations receiving drug dose of 4 mg/kg(teenagers with impaired immunity,healthy adults,patients underwent hemato-poietic stem cell transplantation,adults with impaired immunity). CONCLUSIONS:Various dosage regimens of different popula-tions included in this study could effectively control C. albicans infection. It is necessary to increase the drug dose of children and teenagers with impaired immunity in order to meet the needs of A. fumigatus infection treatment.

Objective To explore the cognitive status of amyotrophic lateral sclerosis (ALS) patients, and to explore the involved cognitive domains, subtypes and risk factors of mild cognitive impairment in ALS ( ALS-MCI).Methods Twenty-nine cases of ALS and 58 healthy volunteers were included.The severity of the bulbar and spinal functions of the patients was evaluated by the Improved Norris Scale.According to the Diagnostic and Statistical Manual of Mental Disorders 4th Edition-Revised( DSM-Ⅳ-R) criteria of dementia, ALS cases were classified as demented and non-demented.For non-demented ALS cases, the common cognitive batteries evaluating mental state, verbal memory, executive, attentional and visuospatial abilities were performed.Hamilton Anxiety Scale ( HAMA) and Hamilton Depression Scale (HAMD) were evaluated too.They were further classified into ALS-cognitively normal (ALS-CogNL) and ALS-MCI groups according to Petersen criteria of MCI.Risk factors possibly correlated with ALS-MCI were analyzed by comparing the differences in age, age of onset, duration of the disease, sites of onset, symptoms of bulbar and limb function between ALS-CogNL and ALS-MCI groups.Results Among 29 ALS cases, 14 (48.3% ) cases with cognitively normal( ALS-CogNL), 15 cases (51.7% ) with ALS-MCI,and none with dementia were identified.Among 15 ALS-MCI cases, 12 cases with executive dysfunction, 8 cases with memory deficits,9 cases with attention impairment and none with visuospatial impairment were found.ALSMCI cases could be further classified into three subtypes; 1 case with amnestic MCI (aMCI) ,6 cases with single domain non-memory MCI ( sdMCI), and 8 cases with multiple domains slightly impaired MCI (mdMCI).Between ALS-MCI and ALS-CogNL groups, there were significant differences (t = -2.435,- 2.576, both P ＜ 0.05) in education ((8.7 ± 2.8) years vs (11.3 ± 3.0) years) and Improved Norrisscale (bulbar score: (28.4 ± 7.7) scores vs ( 34.0 ± 3.4) scores) , however, no significant differences in sex, age, age of onset, duration,site of onset,HAMA or HAMD scores,and Improved Norris scale( spinal score) were found.Conclusions Cognitive deficits commonly exist in ALS patients.For the involved domains, executive dysfunction is the most common, deficits of attention and memory are also common, and deficit in visuospatial function is not found.The most common subtype of ALS-MCI is mdMCI.Severe bulbar symptoms and lower education may be the risk factors of ALS-MCI.

Objective To investigate the diagnostic and prognostic value of neutrophil-to-lymphocyte rate ( NLR) in acute pancreatitis related acute kidney injury patients .Methods Peripheral blood specimens and clinical information of 98 acute pancreatitis patients in Wenzhou Center Hospital were collected .The WBC, neutrophils , lymphocytes were detected and NLR were calculated when they were admitted .The patients were divided into two groups by their NLR and whether they were with AKI respectively .Besides, ALT, Hct, TC, TG, blood calcium concentration , serum creatine and urea nitrogen , C reactive protein were detected and patients′APACHEⅡ score were also recorded to analyze the difference between the two groups .Results There is no significance in the age , BMI, Hct, TG, TC, ALT and blood calcium between AP patients with and without AKI.The blood creatinine, BUN, CRP, APACHEⅡscore were (395 ±122)μmol/L, (28.2 ±5.2) mmol/L, (34.0 ±8.2)mg/L, (11.5 ±3.8) score, respectively in AP patients with AKI, and which were (79 ±17 )μmol/L, ( 7.3 ±2.0 ) mmol/L, ( 14.8 ±2.9 ) mg/L, ( 6.9 ±2.4 ) score, respectively in AP patients without AKI.The blood ALT, blood creatinine, BUN, CRP, APACHEⅡscore were (257 ±76)U/L, (159 ±62)μmol/L, (20.5 ±6.6)mmol/L, (24.8 ±5.5)mg/L and (12.4 ±4.6) score in the patients with higher NLR respectively , and which were ( 165 ±30 ) U/L, ( 98 ±23 )μmol/L, ( 14.3 ±5.2 ) mmol/L, (19.5 ±3.0)mg/L and (5.4 ±2.1) score in the patients with lower NLR respectively .NLR was 4.97 ±0.19 in AP patients with AKI, and was 9.62 ±0.81 in AP patients without AKI.The difference between the two groups was significant(P=0.0001).The area under ROC curve of diagnosing AP by NLR was 0.895 (95%CI 5.75).the sensitivity was 89.5%and the specificity was 77.2% when using 5.75 as the cut-off value to diagnose AP related AKI with NLR .Conclusions NLR can be a potential predictive index of the severity and relate to renal function in acute pancreatitis related acute kidney injury patients .

Objective To investigate the protective effect of protocatechuic acid(PCA)on the PC12 cell model of Alzheimer’s disease(AD)and to explore its mechanism . Methods Amyloid beta peptide 1-42(Aβ1-42)fiber polymers were identified by immunofluorescence. After PC12 cells were stimulated with the Aβ1-42 fiber polymers, the cellular morphology was observed at different time points of hour 0, 3, 6, 9, 12, 24 , and the cellular viability was tested by methyl thiazolyl tetrazolium(MTT)assay to monitor the modeling condition. The effect of PCA on PC12 cells was detected after PC12 cells were pretreated with the different contentions of PCA. Autophagy-related marker Beclin1 protein level was detected by Western blotting method to investigate the protective mechanism of PCA. Results Aggregated white Aβ1-42 mass was stable at hour 12 and 24, and showed no significant difference between the two time points, the cell damage rate being 40%. Therefore, we defined culturing time being 12 and 24 hours as the modeling condition of AD model. The cell viability was increased with 200-800 μmol/L of PCA after culturing for 24 hours(P<0.01) , and the Western blotting results showed that the Beclin1 protein expression was up-regulated by PCA. Conclusion PCA prevents PC12 cells from Aβ1-42-induced toxicity, the mechanism being related with the increase of cellular autophagy.

Objective To explore the clinical characteristics, etiology and prognosis of orbit apex syndrome. Methods Clinical data of 18 patients with orbit syndrome was summarized and analyzed. Results All patients developed vision loss, ptosis and diplopia, such as a headache or sore eyes forehead performance. However, the onset symptoms varied including vision decline or loss in 8 cases, headache in 7 cases, eye pain in 1 case, toothache in 1 case, stuffy nose and runny nose in 1 case and exophthalmos in 1 cases. The Causes included trauma in 6 cases (33％), mass lesion in 5 cases (28％), nonspecific inflammation in 1 cases (22％), infection in 3 cases (17％). Vision and eye movements disorder were improved in 5 cases of 6 patients with trauma in which 3 mild cases recovered better and one severe case did not recovered. Of 5 patients with mass lesion, the vision and eye movement were improved in one patients with sphenoid sinus mucocele receiving surgical operation. but not in the rest 4 cases with orbital adenoid cystic carcinoma or osteosarcoma patients receiving either surgical operation or radiotherapy. Of 4 patients with nonspecific inflammatory disease, eye movements were improved in 2 mild cases but not in 2 severe cases. Of 3 infectious diseases, eye movements were improved in 1 mild case. Conclusion Orbital apex syndrome is a heterogeneous disorder with multiple etiologies, presenting with a variety of initial symptoms. The prognosis depends on causes, timely diagnosis, early diagnosis and early treatment.

Objective:To screen the endoplasmic reticulum stress (ERS) signature-related differentially expressed genes (DEG) in gastric cancer and to construct a prognostic risk model based on a bioinformatics.Methods:Transcriptome sequencing data (RNA-seq) of 375 gastric cancer and 32 paracancerous tissue samples downloaded from The Cancer Genome Atlas (TCGA) database and the corresponding clinical information were obtained as training set samples; data of 387 gastric cancer patients (GSE84437) from Gene Expression Omnibus (GEO) database were downloaded as validation set samples. All data were obtained on December 25, 2021. A total of 785 ERS signature-related genes (ERS-RG) were obtained from the GeneCards database. DEG between gastric cancer tissues and paracancerous tissues in the TCGA database was analyzed. The identified gastric cancer DEG were intersected with ERS-RG from the GeneCards database to obtain gastric cancer ERS signature-related DEG, which were analyzed for gene ontology (GO) function and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment. Univariate Cox proportional risk model was used to screen ERS signature-related DEG with prognostic value in gastric cancer, and LASSO regression analysis was performed to construct a polygenic prognostic risk model, and to calculate the prognostic risk score. The patients in training set and validation set were divided into high-risk group and low-risk group according to the median of the prognostic risk score (2.369); Kaplan-Meier survival analysis was used to compare the overall survival (OS) and to draw time-dependent receiver operating characteristic (ROC) curves of patients in the two groups; nomogram was drawn based on the prognostic independent influencing factors of gastric cancer. The characteristic immune cell infiltration abundance between the two groups was analyzed by using the inverse convolution-based CIBERSORT algorithm. Cytolytic activity scores were calculated by using the geometric mean of granzyme A and perforin 1 expression. According to the median prognostic risk score (2.369) and median tumor mutation burden (TMB) (3.000), all patients with gastric cancer were divided into high risk score-high TMB group, high risk score-low TMB group, low risk score-high TMB group and low risk score-low TMB group to compare the OS of patients in each group.Results:A total of 444 ERS signature-related DEG in gastric cancer including 168 down-regulated genes and 276 up-regulated genes were obtained, which were mainly enriched in biological processes such as protein processing in the endoplasmic reticulum, extracellular matrix (ECM) receptor interactions and unfolded protein responses (all P < 0.05). Univariate Cox regression analysis showed that 12 prognostic-related ERS signature-related DEG in gastric cancer were screened out. LASSO regression analysis was performed to obtain a prognostic risk score = 0.052×NOS3+0.137×PON1+0.067×CXCR4+0.131×MATN3+0.116×ANXA5+0.090×SERPINE1. The results of Kaplan-Meier analysis showed that the OS of the low-risk group in both the training and validation sets was better than that of the high-risk group (all P < 0.01). The results of the time-dependent ROC curve analysis showed that the AUC for the 3-year, 5-year, 8-year OS rates was 0.695, 0.786, 0.698, respectively in the training set, while the AUC for the 3-year 5-year, 8-year OS rates was 0.580, 0.625, 0.627, respectively in the validation set. Multivariate Cox regression analysis showed that prognostic risk score ( HR = 3.598, 95% CI 2.290-5.655, P < 0.001) and tumor stage ( HR = 1.344, 95% CI 1.057-1.709, P < 0.05) were independent factors influencing the prognosis of gastric cancer. Among 375 gastric cancer patients in the TCGA database, the expression levels of ATF6, HSPA5, XBP1 and ATF4 in the high-risk group were higher than those in the low-risk group (all P < 0.05); CIBERSORT results showed that the abundance of activated CD4 memory T cells in the high-risk group was lower than that in the low-risk group, and the abundance of both M0 and M2 macrophages in the high-risk group was higher than that in the low-risk group (all P < 0.05). The expression levels of common immune checkpoints (CD274, CTLA4, TNFRSF9, TIGIT, PDCD1, LAG3) in the high-risk group were all higher than those in the low-risk group (all P < 0.05). Cytolytic activity score in the high-risk group was higher than that in the low-risk group ( P < 0.05). The prognostic risk score was negatively correlated with TMB ( r = -0.20, P < 0.001). Patients in the low-risk score-high TMB group had the best OS and those in the high-risk score-low TMB group had the worst OS (both P < 0.001). Conclusions:The prognostic risk score model is established based on 6 ERS signature-related DEG in gastric cancer and its prognostic risk score may be effective as an independent prognostic factor to predict the prognosis of gastric cancer patients.

BACKGROUND:N6-methyladenosine(m6A)is a hot research topic in the mechanism of pathological cardiac remodeling and plays an important role in the development of cardiovascular diseases. OBJECTIVE:To summarize the possible mechanism by which m6A modification in non-coding RNAs regulates the main processes of pathological cardiac remodeling,such as pathological cardiac hypertrophy,cardiomyocyte death,myocardial fibrosis and vascular remodeling. METHODS:"m6A,non-coding RNA,pathological cardiac hypertrophy,cardiomyocyte apoptosis,cardiomyocyte pyroptosis,cardiomyocyte ferroptosis,myocardial fibrosis,vascular remodeling"were used as search terms in Chinese and English.Relevant literature from CNKI,PubMed and Web of Science databases published from January 1974 to April 2023 was retrieved,and finally 86 eligible articles were reviewed. RESULTS AND CONCLUSION:m6A modification is a highly dynamic and reversible modification.Pathological cardiac remodeling mainly involves pathological cardiac hypertrophy,cardiomyocyte apoptosis,cardiomyocyte pyroptosis,cardiomyocyte ferroptosis,myocardial fibrosis and vascular remodeling.m6A-related enzymes can regulate pathological cardiac remodeling processes through various non-coding RNAs and different signaling pathways,which can be used as a new potential intervention for cardiovascular diseases.In pathological cardiac remodeling,research on the regulatory relationship between m6A modification and non-coding RNAs is still in its infancy.With the development of epigenetics,m6A modification in non-coding RNAs is expected to have a new development in the regulation of pathological cardiac remodeling.

Alternative polyadenylation (APA), a phenomenon that RNA molecules with different 30 ends originate from distinct polyadenylation sites of a single gene, is emerging as a mechanism widely used to regulate gene expression. In the present review, we first summarized various methods prevalently adopted in APA study, mainly focused on the next-generation sequencing (NGS)-based techniques specially designed for APA identification, the related bioinformatics methods, and the strategies for APA study in single cells. Then we summarized the main findings and advances so far based on these methods, including the preferences of alternative polyA (pA) site, the biological processes involved, and the corresponding consequences. We especially categorized the APA changes discovered so far and discussed their potential functions under given conditions, along with the possible underlying molecular mechanisms. With more in-depth studies on extensive samples, more signatures and functions of APA will be revealed, and its diverse roles will gradually heave in sight.