BACKGROUND: 1,25(OH)2D3 plays an important regulatory role in the development of diabetic nephropathy. OBJECTIVE: To explore the effect of 1,25(OH)2D3 on the expression of microRNA-130b and transforming growth factor pi in kidney of diabetic nephropathy rats. METHODS: The study was approved by the Laboratory Animal Ethical Committee of Laboratory Animal Center of Xinjiang Medical University. Twenty-five clean Sprague-Dawley rats were randomly divided into normal control group, diabetic nephropathy+1,25(OH)2D3 group and diabetic nephropathy+peanut oil group. The latter two groups were given calcitriol (1,25(OH)2D3, active vitamin D3, 0.03 jg/kg^d) treatment and peanut oil control treatment, respectively. After 37 days, the samples were collected and the expression of transforming growth factor pi in rat kidney tissue was detected by RT-PCR, western blot assay and immunohistochemical staining. The expression level of microRNA-130b in kidney was detected by RT-PCR. Morphological structure and degree of fibrosis of rat kidney were analyzed by hematoxylin-eosin staining and Masson staining. RESULTS AND CONCLUSION: (1) RT-PCR results showed that the expression levels of microRNA-130b in the diabetic nephropathy+ 1,25(OH)2D3 group and diabetic nephropathy+peanut oil group were significantly lower than those in the normal control group (P < 0.01). The level of microRNA-130b in the diabetic nephropathy+1,25(OH)2D3 was significantly higher than that in the diabetic nephropathy+peanut oil group (P < 0.01). (2) RT-PCR, western blot assay and immunohistochemical staining and pathological findings showed that the expression level of transforming growth factor pi mRNA protein and renal tissue structure disorder and degree of fibrosis in the diabetic nephropathy+1,25(OH)2D3 group and diabetic nephropathy+peanut oil group were significantly higher than those in the normal control group (P < 0.01). The level of transforming growth factor mRNA protein and renal tissue structure disorder and degree of fibrosis in the diabetic nephropathy+1,25(OH)2D3 group were significantly lower than those in the diabetic nephropathy+peanut oil group (P < 0.01). (3) These results suggest that the expression level of microRNA-130b is decreased and transforming growth factor pi mRNA and protein levels are increased in renal tissue of diabetic nephropathy rats and the renal tissue structure is disordered and the degree of fibrosis is severe. 1,25(OH)2D3 can up-regulate the expression of microRMA-130b and also down-regulate the expression of transforming growth factor pi in the kidney of diabetic nephropathy rats, thus improving the degree of renal tissue structure disorder and fibrosis.

Atherosclerosis is usually the underlying cause of cardiovascular diseases. With the change in diet structure and living environment, it has become an increasingly serious global health problem, posing a huge challenge to public health. Berberine, also known as flavonidol, is an isoquinoline-type quaternary alkaloid with purgative and detoxifying effects. Berberine and its derivatives have antibacterial, antiviral, anti-inflammatory, antioxidant, hypoglycemic, hypolipidemic, and atherosclerosis prevention effects, etc. Recent research results showed that berberine and its derivatives can play an important role in atherosclerosis prevention through a hypolipidemic effect, anti-oxidative stress and anti-inflammatory activity, improvement of vascular endothelial dysfunction, and regulation of intestinal microbiota. In this review paper, the research progress on the mechanism of action of berberine and its derivatives in the prevention of atherosclerosis was reviewed from the perspectives of a lipid-regulating effect, inhibition of oxidative stress and the inflammatory response, improvement of vascular endothelial dysfunction, and regulation of intestinal microbiota. The aim of this paper is to provide a theoretical basis for reducing the occurrence of atherosclerosis, improving the clinical symptoms of patients, and further developing berberine-based drugs.

Carcinoma of the esophagus is one of the common malignant tumors, and surgical treatment is still the main method for the treatment of esophageal cancer. With the development of thoracoscopic and laparoscopic instruments, minimally invasive esophagectomy is more and more widely used in the treatment of esophageal cancer. At present, minimally invasive esophagectomy mainly includes thoracoscopic and laparoscopic esophagectomy, mediastinoscopic esophagectomy, robot assisted esophagectomy, etc. At present, there are many studies on the comparison between minimally invasive esophagectomy and open esophagectomy. Although it is not clear which minimally invasive surgical method is more superior, each method may be superior to open esophagectomy in terms of blood loss, pulmonary complications and hospital stay. No matter what method is used, surgeons must be trained in a structured system to improve the level of experience required for independent operation. Ultimately, with the implementation of experienced doctors, the minimally invasive method in esophagectomy is superior to open esophagectomy in technically feasible cancer cases.

Objective:To investigate the status of hypoglycemia fear, diabetes distress, self-regulatory fatigue and self-management in type 2 diabetes patients. The chain mediating effects of self-regulated fatigue and psychological distress on hypoglycemic fear and self-management were investigated.Methods:The Hypoglycemia Fear Survey-Worry Subscale (CHFSII-WS), Diabetes Distress Scale (DDS), Self-Regulatory Fatigue Scale (SRF-S) and Summary of Diabetes Self-Care Activities (SDSCA) were used to investigate the type 2 diabetes patients from the department of Endocrinology of the First Affiliated Hospital in Jinzhou Medical University. And constructed the structural equation model.Results:The scores of fear of hypoglycemia in type 2 diabetes patients were positively correlated with psychological pain and self-regulating fatigue ( r=0.739, 0.625, P<0.05), but negatively correlated with self-management level ( r=-0.602, P<0.05). The psychological pain score was positively correlated with the self-regulating fatigue score ( r=0.669, P<0.05) and negatively correlated with the self-management level score ( r=-0.609, P<0.05). The score of self-regulation fatigue was negatively correlated with the score of self-management ( r=-0.596, P<0.05). Pathway analysis showed that hypoglycemia fear could directly affect self-management behavior, indirectly predict self-management level through self-regulation fatigue and psychological pain respectively, and negatively affect self-management behavior through chain mediation of self-regulation fatigue and psychological pain ( χ2/ df=3.079, GFI=0.920, CFI=0.961, NFI=0.943, IFI=0.961, RMSEA=0.078). Conclusions:The Self-regulated fatigue and psychological distress acts as the chain mediators of hypoglycemic fear and self-management in patients with type 2 diabetes.

OBJECTIVE:Chronic ankle instability is mainly characterized by symptoms such as muscle weakness,intermittent pain,and repeated sprains,which seriously affect exercise and daily life.Loss of proprioception,prolongation of fibular reaction time,and weakening of valgus force may be the main symptoms of chronic ankle instability,so exercise intervention can effectively improve the symptoms related to ankle instability.Meta-analysis was used to quantitatively evaluate the effect of balance training on the rehabilitation intervention of chronic ankle instability,providing a reliable theoretical basis and practical basis for chronic ankle instability patients to scientifically formulate exercise prescriptions. METHODS:The randomized controlled trial of balance training on symptom rehabilitation and dynamic equilibrium of patients with chronic ankle instability was retrieved on CNKI,VIP,Web of Science,and PubMed.The literature was published from the inception to November 23,2022.Two reviewers were included to evaluate the quality of the included literature based on the physical therapy evidence scale.The primary outcome measure is the Self Functional Rating Scale,and the secondary outcome measure is the Star Shift Balance Test,both of which are continuous variables.Forest mapping,meta-regression,subgroup analysis,sensitivity analysis,and publication bias evaluation were performed on the included literature using RevMan 5.3 and Stata-SE 15 software. RESULTS:(1)A total of 18 articles of randomized controlled trials were screened and 641 patients with chronic ankle instability were included in the study.Overall,the methodological quality of the literature was relatively high.(2)Meta-analysis results showed that balance training improved the functional rehabilitation effect of chronic ankle instability patients(SMD=0.82,95%CI:0.41-1.23,P<0.000 1).Meta-regression exhibited that intervention time might be the main reason for heterogeneity(P=0.008).(3)The subgroup analysis results revealed that 6 weeks of intervention(SMD=0.98,95%CI:0.31-1.65,P=0.03),more than 3 interventions per week(SMD=0.87,95%CI:0.30-1.44,P=0.003),and each intervention time less than 20 minutes(SMD=0.89,95%CI:0.61-1.66,P<0.000 1)were the best rehabilitation plans to improve the functional rehabilitation effect of chronic ankle instability patients.(4)Meta-analysis results also showed that balance training improved the stretching degree of the anterior side(SMD=0.56,95%CI:0.31-0.80,P<0.05),posterior inner side(SMD=0.88,95%CI:0.45-1.32,P<0.05),and posterior outer side(SMD=0.84,95%CI:0.22-1.46,P<0.05)of the star shift balance test. CONCLUSION:Current clinical evidence shows that balance training can improve ankle instability symptoms and elevate dynamic equilibrium ability in chronic ankle instability patients.It is recommended to intervene more than 3 times a week,with each intervention lasting less than 20 minutes,to achieve better rehabilitation effects.

Objective:To discuss the effects of Buzhong Yiqi Decoction medicated serum combined with cisplatin on the expression of Nrf2 and its effects of downstream antioxidant proteins in human pulmonary adenocarcinoma A549/DDP cells.Methods:Totally 60 rats were divided into blank group, low-dosage group, medium-dosage group, and high-dosage group using a random number table method, with 15 rats in each group. The low-, medium-, and high-dosage groups were orally administered with 3.29, 6.57, and 13.13 g/kg Buzhong Yiqi Decoction for gavage, once a day, for 7 days. 1 hour after the last administration, blood was collected from the abdominal aorta to prepare the serum containing Buzhong Yiqi Decoction. A549/DDP cells were divided into 5 groups: blank group (rat serum), model group (rat serum+cisplatin), low-dosage group (low-dosage Buzhong Yiqi Decoction medicated serum+cisplatin), medium-dosage group (medium-dosage Buzhong Yiqi Decoction medicated serum +cisplatin), and high-dosage group (high-dosage Buzhong Yiqi Decoction medicated serum+cisplatin). And 24 h after the Buzhong Yiqi Decoction intervention, CCK-8 method was used to detect the IC 50 of cisplatin in each group. The fluorescence expression intensity of p-Nrf2 in A549/DDP cells of each group was determined by confocal fluorescence localization method. The mRNA relative expression of Nrf2 in A549/DDP cells of each group was detected by RT-qPCR. The relative expressions of Nrf2, p-Nrf2, GPX4, PRX1 and SOD in A549/DDP cells of each group were detected by Western blot. Results:Compared with the model group, the IC 50 of A549/DDP cells to cisplatin decreased in the low-, medium-, and high-dosage groups ( P<0.01); the fluorescence intensity of p-Nrf2 decreased ( P<0.01); the level of Nrf2 mRNA decreased ( P<0.01); the protein expressions of Nrf2, p-Nrf2, SOD, PRX1, and GPX4 were down-regulated ( P<0.01), with the effect being more significant in the medium- and high-dosage groups ( P<0.05). Conclusion:Buzhong Yiqi Decoction medicated serum can improve cisplatin resistance in human pulmonary adenocarcinoma cancer by inhibiting the active expression of Nrf2 in A549/DDP cells and down-regulating the target genes of SOD, PRX1 and GPX4 in vivo.

Objective:To investigate the effects of Buzhong Yiqi Decoction on the expressions of multidrug resistance-related protein (MRP), lung resistance-related protein (LRP), and P-glycoprotein (P-gp) in transplantation tumor of A549 tumor-bearing nude mice.Methods:A549 cells were cultured to establish xenograft models of tumor-bearing nude mice. According to the random number table method, they were divided into blank control group, cisplatin group, cisplatin + Buzhong Yiqi Decoction low-dosage group, cisplatin + Buzhong Yiqi Decoction medium-dosage group, cisplatin + Buzhong Yiqi Decoction high-dosage group. After 25 days of corresponding drug intervention, the mRNA expressions of MRP, LRP and P-gp in transplantation tumors were detected by Real-Time PCR, and Western blot was used to detect the expressions of MRP, LRP and P-gp proteins in xenograft tissues in each group.Results:Compared with blank control group, the mRNA and protein expressions of MRP, LRP and P-gp in cisplatin group were significantly down-regulated ( P<0.05). Compared with cisplatin group, the mRNA and protein expressions of MRP, LRP and P-gp in the cisplatin + Buzhong Yiqi Decoction low-dosage group, cisplatin + Buzhong Yiqi Decoction medium-dosage group, cisplatin+Buzhong Yiqi Decoction high-dosage group decreased ( P<0.05). Conclusion:Buzhong Yiqi Decoction can inhibit the expressions of MRP, LRP and P-gp in transplantation tumor of A549 tumor-bearing nude mice and without dosage dependence.

Autoinflammatory diseases are a group of inherited disorders characterized by dysregulation of the immune system,periodic fever and reccurrence of inflammation.The common rashes of autoinflammatory diseases include acne,pyoderma gangrenosum,erysipelas,urticaria,ichthyosis,pustulosis,while vasculitis is rare.This review summarizes autoinflammatory diseases accompanied by vasculitis.Familial Mediterranean fever mainly manifests as small-and medium-vessel vasculitis such as Henoch-Sch(o)nlein purpura and polyarteritis nodosa,while large-vessel vasculitis is common in Blau syndrome.Small-and medium-artery vasculitis can occur in patients with deficiency of adenosine deaminase 2 as well,so it should be differentiated from polyarteritis nodosa in clinical practice.Stimulator of interferon gene-associated vasculopathy with onset in infancy mainly presents as cutaneous small-vessel vasculitis and vasculopathy.

As an effective treatment method of tumors and other diseases,radiotherapy has been widely applied to clinical practices.After radiotherapy,about 95％ of patients suffer from skin injuries to different extents,including acute and/or chronic radiodermatitis,or radiotherapy-related skin diseases,including cutaneous fibrosis,morphea,sclerosing panniculitis,bullous skin diseases,eosinophilic polymorphic and pruritic eruption,lichen sclerosus et atrophicus,angiosarcoma,atypical vascular lesions and radiation recall dermatitis.These skin injuries greatly affect the quality of life and treatment compliance of patients.This review briefly summarizes common and rare skin diseases induced by radiotherapy,so as to improve the understanding of radiotherapy-related skin diseases in clinicians.

On November 30th,2017,a 62-year-old female patient was admitted to the hospital because of multiple depigmented patches all over the body for 16 years,as well as erythema and blisters on the scalp,trunk and upper extremities for more than 8 years,which had been aggravated for 1 year.The patient underwent surgical resection of thymoma in 1996,and developed myasthenia gravis in 2004.Skin examination showed scattered erythemas of various sizes on the scalp,face,chest and upper extremities,with crusts on the surface of some erythemas and positive Nikolsky's sign.Hypopigmented macules mingled with depigmentated macules of various sizes were scattered all over the body.A large area of depigmentation was observed on both hands,and the nail plates were atrophic.Hairs,eyebrows,eyelashes,axillary and pubic hairs were abscent.Laboratory examination showed the presence of homogeneous IgG antinuclear antibody with a titer of 1:640,anti-double stranded DNA antibody (276 IU/ml),lupus anticoagulant (1.62),anti-Dsg1 antibody (＞ 150 U/ml) and anti-Dsg3 antibody (91 U/ml).Histopathological examination of dorsal blister tissues and hematoxylin-eosin staining showed fissured blisters and acantholytic cells in the epidermis,monolayer basal cells on the basilar membrane,and perivascular infiltration of a few lymphocytes in the superficial dermis.The patient successively developed thymoma,vitiligo,myasthenia gravis,systemic lupus erythematosus,pemphigus vulgaris and alopecia universalis,so a diagnosis of autoimmune polyglandular syndrome type Ⅳ was made.Since autoimmune-mediated endocrinopathies are prone to occur successively,changes of related hormones and antibodies in the patient should be monitored for early diagnosis and treatment of newly emerging autoimmune diseases.