Objective To investigate the mechanism of effects of histone deacetylase 3(HDAC3)on re-nal fibrosis in mice with unilateral ureteral obstruction(UUO)by regulating CIC-5.Methods A UUO mouse model was constructed,and intervention was performed on the expression of HDAC3 and CIC-5 in mice.A UUO mouse model was constructed and the mice were divided into the following groups:sham-operated group(Sham group),UUO group(UUO model mice without any treatment),sh-NC group(UUO model mice injec-ted with sh-NC via tail vein),sh-HDAC3 group(UUO model mice injected with sh-HDAC3 via tail vein),HDAC3 overexpression group(UUO model mice injected with HDAC3 overexpression vector via tail vein),and HDAC3+CIC-5 overexpression group(UUO model mice injected with HDAC3 and CIC-5 overexpression vectors via tail vein),with 5 mice in each group.Intervention was performed on the expression of HDAC3 and CIC-5 in the mice.HE staining and Masson staining were used to detect the pathological changes of mouse kidney tissue.The expression of renal fibrosis markers(α-SMA,Collagen-Ⅰ,MMP2)in mouse kidney tissue was detected by RT-qPCR and Western blot.The levels of blood urea nitrogen(BUN)and creatinine(Cr)in the serum of mice were detected by an automatic biochemical analyzer.Results UUO mice showed obvious renal tissue damage and increased fibrosis.The mRNA and protein expression levels of CIC-5 in the renal tis-sue of the UUO group were lower than those in the Sham group,while the mRNA and protein expression lev-els of HDAC3 were higher(P<0.05).The BUN,Cr levels,and the mRNA and protein expression levels of α-SMA,Collagen-I,and MMP2 were higher in the UUO group than in the Sham group(P<0.05).The BUN,Cr levels,and the mRNA and protein expression levels of α-SMA,Collegan-Ⅰ,and MMP2 were lower in the sh-HDAC3 group than in the sh-NC group(P<0.05).The BUN,Cr levels,and the mRNA and protein ex-pression levels of α-SMA,Collegan-Ⅰ,and MMP2 were higher in the HDAC3 group than in the Sham group and UUO group(P<0.05).The BUN,Cr levels,and the mRNA and protein expression levels of α-SMA,Col-legan-Ⅰ,and MMP2 were lower in the HDAC3+CIC-5 group than in the HDAC3 group(P<0.05).Conclu-sion HDAC3 inhibits the expression of CIC-5 by regulating its acetylation,thereby promoting renal fibrosis in UUO mice.Inhibiting the expression of HDAC3 is expected to be an effective way to improve UUO renal fibrosis.

Objective:To explore the diagnostic value of serum cystatin C (CysC) and C1q tumor necrosis factor-related protein 9 (CTRP9) levels for diabetic retinopathy (DR) and diabetic macular edema (DME) in patients with type 2 diabetes.Methods:A cross-sectional study was conducted.A total of 135 patients with type 2 diabetes, aged 45-75 years, who were treated in Gansu Provincial Hospital from April 2021 to April 2022 were included.According to DR grading standard, patients were divided into non-DR (NDR) group, non-proliferative DR (NPDR) group and proliferative DR (PDR) group, with 45 patients in each group.The DR patients were subdivided into DME group (51 cases) and non-DME group (39 cases).A total of 45 healthy subjects were selected as the normal control group.Fasting peripheral venous blood was collected to detect serum glycosylated hemoglobin, fasting blood glucose, triacylglycerol, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, CysC and CTRP9 levels.The expression of CysC and CTRP9 levels among different groups were compared.The independent influencing factors of DR and DME were evaluated by multivariate logistic regression analysis model.The diagnostic value of serum CysC and CTRP9 in DR and DME were evaluated by receiver operating characteristic (ROC) curve.This study adhered to the Declaration of Helsinki and the study protocol was approved by the Ethics Committee of Gansu Provincial Hospital (No.2021-301).All patients were informed about the purpose and methods of the study and signed an informed consent form.Results:Serum CysC levels in normal control group, NDR group, NPDR group and PDR group were 0.74(0.67, 0.83), 1.03(0.85, 1.22), 1.40(0.98, 1.63) and 1.66(1.31, 1.85)mg/L, respectively, showing a gradually increasing trend, and the serum CTRP9 levels were (136.90±14.95), (120.23±16.31), (109.50±14.71) and (90.99±13.88)pg/ml, respectively, showing a gradually decreasing trend, with statistically significant overall comparison differences among groups ( Z=89.430, P<0.001; F=74.242, P<0.001), the comparison within groups was statistically significant (all at P<0.05).Compared with non-DME group, the serum CysC level was significantly increased and serum CTRP9 level was significantly decreased in DME group (both P<0.05).Multivariate logistic regression analysis showed that serum CysC (odds ratio [ OR]=19.742, 95% confidence interval [ CI]: 4.515-86.316, P<0.001) was the independent risk influencing factors for the occurrence of DR, and CTRP9 ( OR=0.937, 95% CI: 0.908-0.966, P<0.001) was a protective factor for the occurrence of DR.Serum CTRP9 level ( OR=0.838, 95% CI: 0.778-0.903, P<0.001) was a protective factor for DME.The ROC curve showed that the area under ROC curve (AUC) for serum CysC and CTRP9 levels alone and in combination for the diagnosis of DR in patients with type 2 diabetes mellitus complicated by DR were 0.798, 0.802 and 0.870, respectively.The cutoff values of serum CysC and CTRP9 levels to obtain the best diagnostic efficacy were 1.34 mg/L and 110.12 pg/ml, respectively.The AUC for serum CysC and CTRP9 level alone and in combination for the diagnosis of DME in DR patients were 0.682, 0.923 and 0.923, respectively.The cutoff value of serum CTRP9 level to obtain optimal diagnostic efficacy was 104.68 pg/ml. Conclusions:The enhanced expression of serum CysC level and reduced expression of serum CTRP9 level are the risk factors for the development of DR in type 2 diabetes patients.The decrease of serum CTRP9 level is one of the risk factors for the development of DME in DR patients.

BACKGROUND:Our previous studies found that adding barium sulfate could improve the mechanical and radiopaque properties of calcium phosphate cement.However,with the degradation of calcium phosphate,the remaining radiopaque agent is difficult to degrade,and the space-occupying and osteoclast effects at the implantation site affect the bone repair process.Therefore,it is necessary to develop a new biodegradable radiopaque material. OBJECTIVE:To discuss the radiopaque ability of bioactive degradable material strontium polyphosphate(SrPP)and its impact on the physicochemical properties and osteogenic effect of calcium phosphate cement. METHODS:(1)Calcium phosphate cement(CPC),starch modified calcium phosphate cement(CPS)and starch modified calcium phosphate cement(20%SrPP-CPN)containing SrPP(20%mass fraction of bone cement powder)were prepared respectively,and the physicochemical properties of the three groups of bone cements were characterized.(2)The three groups of bone cement extracts were co-cultured with rat bone marrow mesenchymal stem cells,respectively,to detect cell proliferation,energy metabolism,and osteogenic differentiation.(3)Bone defects with a diameter of 5 mm were made on each side of the top of the skull of 24 SD rats,and they were randomly divided into control group(without any intervention),CPC group,CPS group,and 20%SrPP-CPN group for intervention,with 6 rats in each group.Relevant tests were performed after 4 and 12 weeks of intervention. RESULTS AND CONCLUSION:(1)Compared with the other two groups of bone cement,20%SrPP-CPN had enhanced radiopaque ability,increased compressive strength and degradation rate,and prolonged curing time,and 20%SrPP-CPN could release Sr2+ stably during degradation.(2)CCK-8 assay showed that 20%SrPP-CPN did not affect the proliferation of bone marrow mesenchymal stem cells.Cell starvation test(serum-free culture)showed that 20%SrPP-CPN could promote the proliferation of bone marrow mesenchymal stem cells compared with the other two groups of bone cement.Compared with the other two groups of bone cements,20%SrPP-CPN increased adenosine triphosphate concentration in bone marrow mesenchymal stem cells.Alkaline phosphatase and alizarin red staining showed that 20%SrPP-CPN could promote osteogenic differentiation of bone marrow mesenchymal stem cells compared with the other two groups of bone cement.(3)In the rat skull defect experiment,Micro-CT scanning and histological observation(hematoxylin-eosin and Masson stainings)showed that bone cement in 20%SrPP-CPN group was significantly degraded compared with that in CPC and CPS groups,and a large number of new bone tissues were dispersed in degraded bone cement.Immunohistochemical staining showed that Runx2 protein expression was increased in 20%SrPP-CPN group compared with CPC group and CPS group(P＜0.01).(4)These results show that 20%SrPP-CPN has good radiopaque ability and osteogenic properties.

Objective:To investigate the current status of endoscopic treatment for gastroesophageal varices in portal hypertension in China, and to provide supporting data and reference for the development of endoscopic treatment.Methods:In this study, initiated by the Liver Health Consortium in China (CHESS), a questionnaire was designed and distributed online to investigate the basic condition of endoscopic treatment for gastroesophageal varices in portal hypertension in 2022 in China. Questions included annual number and indication of endoscopic procedures, adherence to guideline for preventing esophagogastric variceal bleeding (EGVB), management and timing of emergent EGVB, management of gastric and isolated varices, and improvement of endoscopic treatment. Proportions of hospitals concerning therapeutic choices to all participant hospitals were calculated. Guideline adherence between secondary and tertiary hospitals were compared by using Chi-square test.Results:A total of 836 hospitals from 31 provinces (anotomous regions and municipalities) participated in the survey. According to the survey, the control of acute EGVB (49.3%, 412/836) and the prevention of recurrent bleeding (38.3%, 320/836) were major indications of endoscopic treatment. For primary [non-selective β-blocker (NSBB) or endoscopic therapies] and secondary prophylaxis (NSBB and endoscopic therapies) of EGVB, adherence to domestic guideline was 72.5% (606/836) and 39.2% (328/836), respectively. There were significant differences in the adherence between secondary and tertiary hospitals in primary prophylaxis of EGVB [71.0% (495/697) VS 79.9% (111/139), χ2=4.11, P=0.033] and secondary prophylaxis of EGVB [41.6% (290/697) VS 27.3% (38/139), χ2=9.31, P=0.002]. A total of 78.2% (654/836) hospitals preferred endoscopic therapies treating acute EGVB, and endoscopic therapy was more likely to be the first choice for treating acute EGVB in tertiary hospitals (82.6%, 576/697) than secondary hospitals [56.1% (78/139), χ2=46.33, P<0.001]. The optimal timing was usually within 12 hours (48.5%, 317/654) and 12-24 hours (36.9%, 241/654) after the bleeding. Regarding the management of gastroesophageal varices type 2 and isolated gastric varices type 1, most hospitals used cyanoacrylate injection in combination with sclerotherapy [48.2% (403/836) and 29.9% (250/836), respectively], but substantial proportions of hospitals preferred clip-assisted therapies [12.4% (104/836) and 26.4% (221/836), respectively]. Improving the skills of endoscopic doctors (84.2%, 704/836), and enhancing the precision of pre-procedure evaluation and quality of multidisciplinary team (78.9%, 660/836) were considered urgent needs in the development of endoscopic treatment. Conclusion:A variety of endoscopic treatments for gastroesophageal varices in portal hypertension are implemented nationwide. Participant hospitals are active to perform emergent endoscopy for acute EGVB, but are inadequate in following recommendations regarding primary and secondary prophylaxis of EGVB. Moreover, the selection of endoscopic procedures for gastric varices differs greatly among hospitals.

Objective To explore the therapeutic effects of different doses of radioactive iodine-131 on patients with hyperthyroidism.Methods A total of 574 patients with hyperthyroidism treated in the First Affiliated Hospital of Xinxiang Medical University from April 2020 to April 2023 were sampled for this study and were divided evenly into the observation group and the control group by a random number table,with 287 patients in each group.The control group was treated with high-dose radioactive iodine-131(＞10-15 mCi),while the observation group was provided with low-dose radioactive iodine-131(5-10 mCi).The therapeutic effects were estimated six months after treatment.Data of the two groups of patients before treatment and 3 and 6 months after treatment were compared,including the levels of thyroid hormone(FT4),free triiodothyronine(FT3),and thyroid-stimulating hormone(TSH),which were measured through the fluorescence immunochromatography of serum(obtained by centrifugation of 3 mL fasting venous blood),and the tumor necrosis factor-α(TNF-α),transforming growth factor-β1(TGF-β1),interleukin-6(IL-6),and IL-1,which were measured through the enzyme-linked immunosorbent assay of serum.The salivary gland uptake index and salivary gland secretion index of the patients before treatment and 3 and 6 months after treatment were measured through radionuclide imaging.The incidence of adverse reactions during treatment was documen-ted.The incidence of hypothyroidism in both groups was evaluated 6 months after treatment.Results The total effective rate of the observation group and the control group was 83.27％(234/281)and 92.88％(261/281),respectively,and that of the observation group was significantly higher(x2=12.353,P＜0.05).The FT4,FT3,and TSH levels of the two groups before treatment showed no statistical discrepancy(P＞0.05).According to data collected 3 and 6 months after treatment,FT4 and FT3 levels of both groups significantly decreased,while TSH increased(P＜0.05)compared to corresponding pre-treatment levels;FT4 and FT3 levels of both groups observed 6 months after treatment were significantly lower than those observed 3 months before,in contrast to the growing TSH trend(P＜0.05).At 3 and 6 months after treatment,FT4 and FT3 levels of the observation group were significantly lower than those of the control group,while TSH levels were significantly higher(P＜0.05).The salivary gland uptake index and salivary gland secretion index between the two groups before treatment showed no statistical discrepancy(P＞0.05).At 3 and 6 months after treatment,such indexes of both groups obviously decreased(P＜0.05).However,those observed 6 months after treatment were higher than three months before(P＜0.05).At 3 months after treatment,the salivary gland uptake index and salivary gland secretion index of the observation group were notably higher than the control group(P＜0.05);at 6 months after treatment,no statistical discrepancy was observed between the two groups in terms of the two indexes(P＞0.05).Before treatment,there was no statistical difference in TNF-α,TGF-β1,IL-6,and IL-1 levels between the two groups(P＞0.05).At 3 and 6 months after treatment,the TNF-α,TGF-β1,IL-6,and IL-1 levels of both groups decreased significantly from pre-treatment levels(P＜0.05),and the data observed 6 months after treatment were still lower than those observed 3 months after treatment(P＜0.05).At 3 months after treatment,the TNF-α,TGF-β1,IL-6,and IL-1 levels of the observation group were significantly lower than those of the control group(P＜0.05);at 6 months after treatment,no statistical difference was observed between the two groups(P＞0.05).The incidence of adverse reactions during treatment in the control group and the observation group was 16.38％(47/287)and 8.01％(23/287),respectively,and that of the observation group was significantly lower than the other group(x2=8.457,P＜0.05).At 6 months after treatment,the incidence of hypothyroidism in the control group and the observation group was 12.46％(35/281)and 3.56％(10/281),respectively,and that of the observation group was significantly lower than that in the control group(x2=15.098,P＜0.05).Conclusion Low doses of radioactive iodine-131 work better in the treatment of hyperthyroidism and can effectively alleviate inflammation and salivary gland dysfunction,with less risk of inducing hypothyroidism and adverse reactions.

Objective:To provide references for finding an objective, accurate, highly repeatable and operable measurement method of the resting energy expenditure (REE) for flying personnel by taking the indirect calorimetry measured REE as the gold standard and establishing the formula for predicting REE combined with body composition indexes.Methods:Fourteen normal-size male volunteers were chosen as the subjects. The hypobaric hypoxia environment was constructed in the hypobaric chamber. The subjects were asked to complete single task (flight control) and dual task (flight control and calculation). The body weight, fat free mass (FFM), muscle mass (MM), fat mass (FM), waist-to-hip ratio (WHR), visceral fat mass (VFM) and body fat percentage (BF%) were directly measured by body composition analyzer. The respiratory frequency (RF), volume of CO 2 (VCO 2), maximal volume of O 2 (VO 2max), volume of tidal (VT), minute ventilation volume (VE), metablic equivalent (MET), REE and REE/kg/d were measured by gas metabolizer. The correlation between REE and body composition indexes was analyzed and a linear regression equation was obtained. Results:In the simulated hypobaric hypoxia environment, the RF, VCO 2, VO 2max, VE, VT, REE, REE/kg/d, MET and heart rate of the subjects increased slightly in the dual task, but there were no significant differences between the dual task and the single task (all P>0.05). REE was positively correlated with FFM and MM ( r=0.566, 0.570, P=0.035, 0.033), but not with height, FM and heart rate (all P>0.05). The prediction formula of REE in hypobaric hypoxia environment was Model A: REE=60.34×MM-1 121 ( r=0.570, P=0.033), or Model B: REE=55.34×FFM-1 073 ( r=0.566, P=0.035). There was a positive correlation between the predicted REE and the measured REE ( r=0.570, P=0.033) for Model A, and the error value was (0.032±358.170) kcal/d, P=1.00>0.05. Conclusions:FFM and MM are the main determinants of REE in normal-size subjects under hypobaric hypoxia environment. Either MM or FFM shows a good prediction effect to REE.

Objective:To provide references for finding an objective, accurate, highly repeatable and operable measurement method of the resting energy expenditure (REE) for flying personnel by taking the indirect calorimetry measured REE as the gold standard and establishing the formula for predicting REE combined with body composition indexes.Methods:Fourteen normal-size male volunteers were chosen as the subjects. The hypobaric hypoxia environment was constructed in the hypobaric chamber. The subjects were asked to complete single task (flight control) and dual task (flight control and calculation). The body weight, fat free mass (FFM), muscle mass (MM), fat mass (FM), waist-to-hip ratio (WHR), visceral fat mass (VFM) and body fat percentage (BF%) were directly measured by body composition analyzer. The respiratory frequency (RF), volume of CO 2 (VCO 2), maximal volume of O 2 (VO 2max), volume of tidal (VT), minute ventilation volume (VE), metablic equivalent (MET), REE and REE/kg/d were measured by gas metabolizer. The correlation between REE and body composition indexes was analyzed and a linear regression equation was obtained. Results:In the simulated hypobaric hypoxia environment, the RF, VCO 2, VO 2max, VE, VT, REE, REE/kg/d, MET and heart rate of the subjects increased slightly in the dual task, but there were no significant differences between the dual task and the single task (all P>0.05). REE was positively correlated with FFM and MM ( r=0.566, 0.570, P=0.035, 0.033), but not with height, FM and heart rate (all P>0.05). The prediction formula of REE in hypobaric hypoxia environment was Model A: REE=60.34×MM-1 121 ( r=0.570, P=0.033), or Model B: REE=55.34×FFM-1 073 ( r=0.566, P=0.035). There was a positive correlation between the predicted REE and the measured REE ( r=0.570, P=0.033) for Model A, and the error value was (0.032±358.170) kcal/d, P=1.00>0.05. Conclusions:FFM and MM are the main determinants of REE in normal-size subjects under hypobaric hypoxia environment. Either MM or FFM shows a good prediction effect to REE.

The experimental class is a very important part of teaching process for medical students. Relying on the medical virtual simulation experiment center of Henan University, in this study, we select the appropriate experimental items and related knowledge content of the medical virtual simulation experiment center and post them to the students. Students are required to log in to the experimental center to strengthen the study of basic medical experimental knowledge by watching experimental videos and learning experimental principles, and then carry out virtual experimental operations. In terms of the teaching content, the required experimental virtual operation are required to complete, and in terms of teaching form, we adopt the combination of online experimental teaching course and webcast course teaching. This experimental teaching method is easy for students to accept, stimulates high enthusiasm for learning, and inspires curiosity for basic medical knowledge for the students, which significantly improves the teaching effect.

Objective:To explore the influencing factors of unqualified bowel preparation before colonoscopy in patients with chronic constipation, in order to propose corresponding countermeasures.Methods:Using the convenient sampling method, a total of 146 patients with chronic constipation who underwent colonoscopy in Gastroenterology Department of Shanxi Provincial People's Hospital from February 2018 to April 2020 were selected as the research subjects, and the unqualified conditions of them were counted. Single factor analysis and multivariate Logistic regression analysis were used to screen out the influencing factors of unqualified intestinal preparation and propose the corresponding nursing countermeasures.Results:Among 146 patients with chronic constipation, 15 cases (10.27%) were unqualified in intestinal preparation before colonoscopy, including 7 cases (4.79%) in left colon, 5 cases (3.42%) in transverse colon and 3 cases (2.05%) in right colon. Univariate analysis showed that there were statistically significant differences in intestinal preparation qualification among patients of different ages, whether they had insufficient activity during medication, whether they had a history of diabetes, whether they had a history of abdominal or pelvic surgery and different courses of chronic constipation ( P<0.05). Multivariate Logistic regression analysis showed that age older than 60 years, insufficient activity during medication and history of diabetes were independent risk factors for unqualified bowel preparation before colonoscopy in patients with chronic constipation ( P<0.05) . Conclusions:Old age, insufficient activity during medication and history of diabetes are all risk factors for unqualified bowel preparation before colonoscopy in patients with chronic constipation. And targeted nursing programs should be developed according to the actual conditions of patients to increase the pass rate of bowel preparation.

Objective:To explore the role of interleukin (IL)-9 and other T helper (Th) cell-related cytokines in the pathogenesis of acute anterior uveitis.Methods:A cross-sectional study was conducted.Thirty-six patients (36 eyes) with acute anterior uveitis who were treated at Gansu Provincial Hospital from May 2018 to May 2019 and 40 matched healthy subjects (40 eyes) who had no eye diseases or systemic diseases in the same period were enrolled as the acute anterior uveitis group and healthy control group, respectively.The disease severity of the subjects in the acute anterior uveitis group was graded and the subjects were divided into mild, moderate and severe groups according to the grading.Serum of all subjects was collected to determine the concentration of serum IL-9, IL-17, transforming growth factor-β 1 (TGF-β 1), interferon-γ (IFN-γ), IL-4, IL-35 and IL-22 by enzyme linked immunosorbent assay (ELISA) method.Spearman rank correlation analysis was used to evaluate the relationship between IL-9 concentration and other Th cell-related cytokines.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Gansu Provincial Hospital (No.2019-204). Written informed consent was obtained from each subject prior to any medical examination. Results:The serum levels of IL-9, IFN-γ, IL-4, TGF-β 1, IL-35 and IL-22 in the acute anterior uveitis group were significantly higher than those in the healthy control group, and the differences were statistically significant (all at P<0.05). There was no statistically significant difference in the concentration of IL-17 between the two groups ( U=704.500, P=0.872). The IL-9 concentration of patients with acute anterior uveitis in the mild, moderate and severe groups was 57.24 (47.47, 65.10), 71.68 (67.55, 78.91) and 114.01 (74.78, 139.30) ng/L, respectively, and the overall difference was statistically significant ( Z=8.766, P=0.012), and the IL-9 concentration of the mild group and the moderate group was significantly lower than that of the severe group (both at P<0.05). The concentration of IL-9 in the patients with acute anterior uveitis was positively correlated with the concentration of IL-17, TGF-β 1 and IL-35 ( rs=0.449, 0.517, 0.400; all at P<0.05), and no significant correlations were found between the concentration of IL-9 and the concentration of IFN-γ, IL-4 and IL-22 ( rs=0.293, 0.286, 0.316; all at P>0.05). Conclusions:IL-9 plays a role in promoting the immune inflammatory response in the occurrence and development of acute anterior uveitis, and it is closely related to Th17 and Treg cell-related cytokines (TGF-β 1, IL-35).