Objective This study aimed to explore the effect of the combined Danzhi Jiangtang Capsule with dapagliflozin on the blood lipid profile and related inflammatory markers in patients with type 2 diabetes mellitus with peripheral vascular disease. Methods 72 patients with type 2 diabetes mellitus with peripheral vascular disease who met the inclusion criteria were admitted to the Department of Endocrinology,The First Affiliated Hospital of Anhui University of Chinese Medicine,from April 2021 to April 2023. The patients were assigned to the experimental group and the control group using the random number table method (36 cases in each group). The control group was treated with dapagliflozin in addition to standard treatment,while the experimental group received the Danzhi Jiangtang Capsule for 12 weeks. Clinical efficacy,glucose and lipid metabolism indicators,hypersensitive C-reactive protein (hs-CRP),body mass index (BMI) levels,and traditional Chinese medicine (TCM) syndrome scores were observed pre-and post-treatment.Results In post-treatment,the clinical efficacy was higher in the experimental group than in the control group. Significant reductions in fasting blood glucose (FPG),2 h postprandial glucose (2 hPG),triglycerides (TG),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),hs-CRP,BMI,and increased high-density lipoprotein cholesterol (HDL-C) were observed. Scores for TCM syndrome and individual items also decreased (P<0.05). Comparisons within the groups for pre-and post-treatment showed reductions in FPG,2 hPG,TG,TC,LDL-C,hs-CRP,and an increase in HDL-C,along with a decrease in total scores of TCM syndrome (P<0.05). Conclusion The Danzhi Jiangtang Capsule combined with dapagliflozin in the treatment of type 2 diabetes mellitus with peripheral vascular disease can regulate the blood lipid profile,reduce inflammatory factors,and improve patient's symptoms. Integrated traditional Chinese and Western medicine treatment are more conducive to controlling the disease,and TCM can be used in clinical practice as a combination treatment.

Objective:To evaluate changes in operational effectiveness after the implementation of ambulatory surgical management in pars plana vitrectomy (PPV).Methods:A retrospective clinical study. 17 528 surgeries in 10 895 eyes of 10 895 patients who underwent minimally invasive PPV on an ambulatory and/or inpatient basis at Tianjin Medical University Eye Hospital from August 2015 to June 2023 were included in this study. Among them, 5 346 eyes in 5 346 cases were male; 5 549 eyes in 5 549 cases were female. The age ranged from 0 to 95 years, with the mean age of (57.74±13.15) years. 6 381 surgeries in 3 615 eyes from August 2015 to December 2018 (the initial period of day surgery) were used as the control group; 11 147 surgeries in 7 280 eyes from January 2019 to June 2023 (the expanded period of day surgery) were used as the observation group. According to the management mode of ambulatory surgery, the observation group was subdivided into the decentralized management group (January 2019 to December 2020) and the centralized management group (January 2021 to June 2023), with 2 905 and 4 375 eyes and 4 646 and 6 501 surgeries, respectively. Changes in the percentage of day surgery, average hospitalization days, and average unplanned reoperation rate were compared. The Mann-Whitney U test was used to compare numerical variables between groups; the chi-square test or Fisher's exact test was used to compare categorical variables. Results:The number of cases of daytime PPV performed in the observation group and control group was 7 852 (70.44%, 7 852/11 147) and 24 (0.38%, 24/6 381) cases, respectively, and the average hospitalization days were 1 (1) and 5 (3) d. Compared with the control group, the observation group had a significantly higher percentage of day surgery ( χ2=8 051.01) and a considerably lower mean hospitalization day ( Z=4 536 844.50), and the differences were statistically significant ( P<0.000 1). The mean hospitalization days in the decentralized and centralized management groups were 2 (3) and 1 (0) d, respectively, and unplanned reoperations were 34 (0.73%, 34/4 646) and 171 (2.63%, 171/6 501) eyes, respectively. Compared with the decentralized management group, average hospitalization days was significantly lower ( Z=1 436.94) and unplanned reoperation rate was significantly higher ( χ2=54.10) were significantly lower in the centralized management group, both of which were statistically significant ( P<0.000 1). Conclusion:PPV ambulatory management model can significantly reduce the average hospitalization day, but also results in higher rates of unplanned reoperations.

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic is a global public health crisis, which elicits psychological problems in different population This study is to investigate the impact of COVID-19 on mental health in the front-line staff. METHODS: Patient Health Questionnare-9 (PHQ-9), Self-Rating Anxiety Scale (SAS), and Fatigue Self-assessment Scale (FSAS) were used to assess the depression, anxiety, and fatigue in front-line staff. RESULTS: The detection rates of depression, anxiety, and fatigue were 49.1%, 21.8%, and 76.0% among the front-line staff. The rates of depression, anxiety, and fatigue in community workers were higher than those in medical workers and other occupational staff (<0.01). The PHQ-9 of front-line staffs was negatively correlated with age, family income, family members' support, satisfaction of service objects, and sleep quality (all <0.01), while positively correlated with education level, fatigue, fear of pneumonia, and the duration of daily attention to the COVID-19 (all <0.01). SAS was negatively correlated with age, family income, family support, satisfaction of objects service, and sleep quality (all <0.01), while positively correlated with gender, fatigue, fear of pneumonia, and duration of daily attention to the COVID-19 (all <0.01). CONCLUSIONS The front-line workers should manage work and rest time reasonably to adjust their negative mood and fatigue. The government and the society should pay more attention to the psychological state of the front-line staff, particularly for the staff working in the community or villages and towns in preventing the COVID-19 pandemic. Thus, front-line staff can be obtained mental intervention or be taken a rest from the high-intensive work.
Anxiety ; diagnosis ; Betacoronavirus ; Coronavirus Infections ; prevention & control ; psychology ; Depression ; diagnosis ; Fatigue ; diagnosis ; Health Personnel ; psychology ; Humans ; Mental Health ; Pandemics ; prevention & control ; Pneumonia, Viral ; prevention & control ; psychology

Objective To observe the inhibitory effect of lentiviral vector miR-191 (LV-191) on retinal neovascularization (RNV) in mice model of oxygen-induced retinopathy (OIR).Methods Eighty healthy 7-day-old C57BL/6J mice were randomly divided into 5 groups including normal group, non-intervention group, normal saline (NS) group, LV-191 group and LV-green fluorescent protein (GFP) group, 16 mice in each group. The OIR model was established in the non-intervention group, NS group, LV-191 group and LV-GFP group. NS group, LV-191 group and LV-GFP group were given an intravitreal injection of 1 μl of NS, LV-191 and LV-GFP at the age of 12 days. No injection was performed in the non-intervention group. In normal group,newborn mouse were maintained in room air form P0 to P17, and no treatment was performed. Mice in all five groups were euthanized at P17. Retinal neovasculation (RNV) was evaluated by counting the number of pre-retinal neovascular cells and analysis of non-perfusion area area by immunofluorescent staining of the mouse retina. Real-time quantitative PCR (RT-PCR) to detect miR -191 and P21 expression of retinal tissue.Results In the LV-191 group, the non-perfusion area were both significantly smaller than those in non-intervention group, NS group and LV-GFP group (F=127.20,P<0.001). The number of pre-retinal neovascular cell nuclei in retinas from LV-191 group were obviously lower than those in the retinas from non-intervention group, NS group and LV-GFP group (F=31.71,P<0.05). RT-PCR showed that the LV-191 and P21 level of LV-191 group increased significantly than other groups (F=10.95, 15.60;P<0.05).Conclusion Intravitreal injection of LV-191 inhibits RNV in mice model of OIR possibly through up-regulating p21.

Objective: To investigate the application of Symptom Checklist-90 (SCL-90) in Chinese nurses. Methods: We performed a literature search for articles in Chinese on the mental health of nurses investigated using the SCL-90 that were published from January 2007 to December 2016. A total of 129 articles were included, involving 178 groups of valid samples as well as 36316 subjects in 27 provinces or cities in China. The metafor package of R 3.2.1 software and Excel were used for meta-analysis and data statistics. Results: Heterogeneity was identified for the nine factors included in the literature data (Q test: P<0.05; I² test >40%) , so a random effects model was used. For all factors except interpersonal relationship factor, the 95% confidence intervals of the pooled effect sizes did not include 0. For all factors except interpersonal relationship factor (Egger test: P<0.05) , no significant asymmetry or incompleteness appeared in the funnel plots. The fail-safe number of each factor was much larger than 5k+10. The merger scores and mean values of nine factors were higher than the national norm. Conclusion The SCL-90 is widely used in the study of mental status of Chinese nurses, but the SCL-90 norm for nurses is lacking.

Objective: To investigate the status of abnormal menstruation in female nurses in a comprehensive hospital in Beijing, China and related influencing factors. Methods: In July 2016, a cross-sectional survey was performed, and a self-administered questionnaire was used to investigate the status of menstruation and occupation in female nurses in a comprehensive hospital in Beijing. The chi-square test and a multivariate logistic regression analysis were used for statistical analysis. Results: A total of 892 female nurses were investigated, and among them, 485 experienced abnormal menstruation within the past three months, resulting in an abnormal menstruation rate of 54.37%. The female nurses who were exposed to harmful factors during work, negative life events, or high workload had a significantly higher abnormal menstruation rate than those who were not exposed to such factors (χ²=5.199, 16.186, and 10.227, P<0.05 or P<0.01) . Negative life events (odds ratio [OR]=1.813, 95% confidence interval[CI]: 1.317-2.496) and high workload (OR=1.461, 95%CI: 1.112-1.918) were risk factors for abnormal menstruation. Conclusion Nurses have an abnormal menstruation rate as high as 54.37%, and high workload and negative life events were risk factors for abnormal menstruation in nurses.

Background p21 is a cyclin-dependent kinase inhibitor,and it can prevent cells from going through the G1/S phase checkpoint and inhibit cell proliferation.Stuies determined that the expression level of p21 WAF1/CIP1 is associated with proliferative diseases.Traumatic proliferative vitreoretinopathy (PVR) is a proliferative response of eye.Understaining the relationship of dynamic expression levels of p21 WAF1/CIP1 in PVR is of significance for the prevention and management of PVR.Objective This study was to investigate the expression of p21 WAF1/CIP1 during the course of experimental traumatic PVR in rabbits.Methods Fifty-four pigmented rabbits were randomized into the normal control group and different experimerital groups,and one lateral eye of each rabbit served as experimental eye.PVR models were established by intravitreal injection of human platelet-rich plasma (PRP) (0.4 ml)combined with cryotherapy for 5 seconds,and vitreous and retinas were examined with B type sonography.The rabbits were sacrificed in 7,14,21 and 28 days after operation,and histopathological examination of the retinas was performed by haematoxylin and eosin stain.The expression levels of p21WAF1/CIP1 protein and gene were detected by immunohistochemistry,Western blot and reverse transcription-PCR (RT-PCR).The use and care of the rabbits complied with Statement of ARVO.Results B type sonography showed that the retinal morphology was normal in the normal control group.However,the proliferative membrane was gradually thickened 1 to 7 days after operation.Retinal folds of rabbits were seen in 7 days,and tractional retinal detachment was found in 14 days and 28 days after operation.The histopathological examination of the retinas showed epiretinal membrane and infiltration of inflammatory cells 7 days and fixed ruffle 28 days after operation.The p21WAF1/CIP1 was strongly expressed in the cell nucleus of retinal ganglion cell layer (GCL) and inner nuclear layer (INL) in the normal control group,and the expression was gradually weakened after modeling,with the weakest expression in the retinas in 14 days after modeling.The relative expression levels of p21 WAF1/CIP1 protein was 0.74±0.08,0.60±0.05,0.56±0.03,0.74±0.02 and 0.65 ±0.04 in the normal control group,postoperative 7-day group,postoperative 14-day group,postoperative 21-day group and postoperative 28-day group,respectively,showing a significant difference among the groups (F =20.55,P =0.00),and the expression levels of p21WAF1/CIP1 protein were significantly lower in the postoperative 7-day group and postoperative 14-day group than those of the normal control group,postoperative 21-day group and postoperative 28-day group (all at P＜0.05).The relative expression levels of p21 WAF1/CIP1 mRNA was 0.65 ± 0.09,0.57 ± 0.05,0.45 ±0.04,0.46±0.02 and 0.47±0.04 in the normal control group,postoperative 7-day group,postoperative 14-day group,postoperative 21-day group and postoperative 28-day group,respectively,with a significant difference among the groups (F =18.06,P =0.00),and the expression levels were significantly lower in the postoperative 14-day group,postoperative 21-day group and postoperative 28-day group than those of the normal control group and postoperative 7-day group (all at P＜0.05).Conclusions The dynamic expression of p21WAF1/CIP1 in the retinas is consistant with the prograssion of traumatic PVR,and the reduce tendency of p21 WAF1/CIP1expression is similar to cell prolieration change,indicating that reduce of p21WAF1/CIP1 expression in the retinas may promote the development of traumatic PVR.

Objective To investigate the connection between sex hormones and gender differences and cognitive func-tion in patients with schizophrenia. Methods A total of 80 eligible patients including 60 female and 20 male with schizophrenia conducted general information collection and Digit Span Task(DST) and Trial Making Test (TMT) mea-surement. The data o f the schizophrenic patients were collected and analyzed with sex hormones. Results There were significant differences between male and female schizophrenic patients in the age of first onset, course of disease,degree of education and antipsychotic treatment effects(P<0.05). The digit span-forward Task(DSF) score of female patients was higher than that of male patients, TMTA and TMTB were lower than those of male patients (P<0.05). In both male and female schizophrenic patients, E2 level was positively related to the age of first onset, and degree of education, oth-erwise,it was negatively related to the course of disease and antipsychotic treatment effects. In male patients,there was no connection between T level and the age of first onset, course of disease,degree of education and antipsychotic treat-ment effects. The estrogen level of male and female patients was positively correlated with the DSF and was negatively related to the TMTA and TMTB. The testosterone level of male patients was negatively correlated with the TMTand TMTB. Conclusion Estrogen may be related to gender differences in schizophrenia. Estrogen and testosterone have a certain correlation with cognitive function.

Background The signal pathway of mammalian target of rapamycin (mTOR) plays an important role in the regulation of cell cycle.Rapamycin(RAPA) can inhibit the proliferation of cells by regulating of cell cycle.Objective This study was to investigate the effect of RAPA on the proliferation of Rhesus retinal vascular endothelial cells (RF/6A).Methods RF/6A cell strains were cultured in vitro,and PBS,10 μg/L RAPA or 5 μg/L RAPA was added into the medium respectively.The expression of cyclin D1 protein in the RF/6A cells (absorbancy) were detected by Western blot.The cell cycle distribution after RAPA action was analyzed by flow cytometry.Matrigel was used in endothelial-cell tube formation to evaluate the effect of RAPA on angiogenesis.Results Western blot assay showed that the expressions of cyclin D z protein were 0.92±0.04,0.58±0.02 and 0.73±0.02 in the PBS group,10 μg/L RAPA group and 5 μg/L RAPA group,showing a significant difference among the three groups (F =246.320,P =0.000),and the relative expressing level of cyclin D1 protein in the l0 μg/L RAPA group and 5 μg/L RAPA group was significantly lower than that of the PBS group (both at P＜0.05).The proportion of G0/G1 cells were (42.13±0.57)％,(65.15±0.64)％ and (54.09± 0.78)％ respectively in the PBS group,10 μg/L RAPA group and 5 μg/L RAPA group,which was significantly different among the three groups (F=887.815,P=0.000).The number of endothelial-cell tubes were (9.67 ± 1.53)/field,(4.33 ± 0.58)/field and (6.33 ±0.58)/field respectively in the PBS group,10 μg/L RAPA group and 5 μg/L RAPA group,and the number of endothelial-cell tubes in 10 μg/L RAPA group and 5 μg/L RAPA group was less than that in the PBS group,with a significant difference among the three groups (F =21.778,P =0.002).Conclusions RAPA can inhibit the proliferation of RF/6A cells in vitro by down-regulating the expression of cyclin D1.

Objective To observe the clinical features and outcomes of vitrectomy for diabetic retinopathy (DR) with central retinal vein occlusion (CRVO) in type 2 diabetes mellitus (T2DM).Methods A total of 192 patients (241 eyes) with proliferative DR (PDR) who underwent vitrectomy were enrolled in this study.All the patients were diagnosed as vitreous hemorrhage (VH) because of suddenly decreased vision.There were 93 eyes with tractional retinal detachment (TRD) and six eyes with neovascularization of iris (NVI).The patients were divided into PDR with CRVO group (group A,41 eyes) and PDR group (group B,200 eyes) according to the results of fundus examination.All patients received vitrectomy with silicone oil and C3F8 gas tamponade.There were 138 eyes with silicone oil tamponade which including 30 eyes in group A and 108 eyes in group B.The difference of number in silicone oil-filled eyes in two groups was statistically significant (x2=5.110,P＜0.05).There were 38 eyes with C3F8 gas tamponade which including six eyes in group A and 32 eyes in group B.There was no difference in C3F8 gas-filled eyes numbers in two groups (x2 =0.048,P＞0.05).The follow-up ranged from one to 60 months,with the mean of (28.69± 17.28) months.The corrected vision,retinal reattachment,persisting macular edema (ME),neovascular glaucoma (NVG) and repeated VH after surgery were comparatively analyzed.Results Of 241 eyes,there were 41 eyes (17.0％) with CRVO.Before surgery,the differences of corrected vision (Z=-0.138),intraocular pressure (t=0.966),whether there was TRDor not (x2=0.412),whether underwent panretinal photocoagulation or not (x2 =1.416) were not statistically significant (P＞0.05),but the difference of whether NVI were present or not was statistically significant (x2=31.724,P＜0.05)between two groups.After surgery,the corrected vision improved in both two groups (Z=2.319,4.589;P＜0.05).There was no difference of corrected vision after surgery between two groups (Z=0.782,P＞0.05).Postoperative complications occurred in 94 eyes,including 26 eyes in group A and 68 eyes in group B.The differences of incidence of reoperation (x2 =0.498),retinal reattachment (x2 =0.818),persisting ME (x2 =2.722) between two groups after surgery were not statistically significant (P ＞ 0.05).The incidence of repeated VH (x2 =5.737) and NVG (x2 =6.604) in group A were higher than those in group B (P＜ 0.05).Conclusions CRVO is commonly found to coexist with DR in T2DM patients with VH.Combined with CRVO patients are more likely to suffer NVI.Vitrectomy can improve the visual function in PDR with CRVO patients.