ObjectiveTo observe the clinical efficacy and safety of Tangning Tongluo tablets in the treatment of nonproliferative diabetic retinopathy （DR）. MethodsFourteen research centers participated in this study， which spanned a time interval from September 2021 to May 2023. A total of 240 patients with nonproliferative DR were included and randomly assigned into an observation group （120 cases） and a control group （120 cases）. The observation group was treated with Tangning Tongluo tablets， and the control group with calcium dobesilate capsules. Both groups were treated for 24 consecutive weeks. The vision， DR progression rate， retinal microhemangioma， hemorrhage area， exudation area， glycosylated hemoglobin （HbA1c） level， and TCM syndrome score were assessed before and after treatment， and the safety was observed. ResultsThe vision changed in both groups after treatment （P<0.05）， and the observation group showed higher best corrected visual acuity （BCVA） than the control group （P<0.05）. The DR progression was slow with similar rates in the two groups. The fundus hemorrhage area and exudation area did not change significantly after treatment in both groups， while the observation group outperformed the control group in reducing the fundus hemorrhage area and exudation area. There was no significant difference in the number of microhemangiomas between the two groups before treatment. After treatment， the number of microhemangiomas decreased in both the observation group （Z=-1.437， P<0.05） and the control group （Z=-2.238， P<0.05）， and it showed no significant difference between the two groups. As the treatment time prolonged， the number of microhemangiomas gradually decreased in both groups. There was no significant difference in the HbA1c level between the two groups before treatment. After treatment， the decline in the HbA1c level showed no significant difference between the two groups. The TCM syndrome score did not have a statistically significant difference between the two groups before treatment. After treatment， neither the TCM syndrome score nor the response rate had significant difference between the two groups. With the extension of the treatment time， both groups showed amelioration of TCM syndrome compared with the baseline. ConclusionTangning Tongluo tablets are safe and effective in the treatment of nonproliferative DR， being capable of improving vision and reducing hemorrhage and exudation in the fundus.

GPR126, also known as ADGRG6, is one of the most deeply studied aGPCRs. Initially, GPR126 was thought to be a receptor associated with muscle development and was primarily expressed in the muscular and skeletal systems. With the deepening of research, it was found that GPR126 is expressed in multiple mammalian tissues and organs, and is involved in many biological processes such as embryonic development, nervous system development, and extracellular matrix interactions. Compared with other aGPCRs proteins, GPR126 has a longer N-terminal domain, which can bind to ligands one-to-one and one-to-many. Its N-terminus contains five domains, a CUB (complement C1r/C1s, Uegf, Bmp1) domain, a PTX (Pentraxin) domain, a SEA (Sperm protein, Enterokinase, and Agrin) domain, a hormone binding (HormR) domain, and a conserved GAIN domain. The GAIN domain has a self-shearing function, which is essential for the maturation, stability, transport and function of aGPCRs. Different SEA domains constitute different GPR126 isomers, which can regulate the activation and closure of downstream signaling pathways through conformational changes. GPR126 has a typical aGPCRs seven-transmembrane helical structure, which can be coupled to Gs and Gi, causing cAMP to up- or down-regulation, mediating transmembrane signaling and participating in the regulation of cell proliferation, differentiation and migration. GPR126 is activated in a tethered-stalk peptide agonism or orthosteric agonism, which is mainly manifested by self-proteolysis or conformational changes in the GAIN domain, which mediates the rapid activation or closure of downstream pathways by tethered agonists. In addition to the tethered short stem peptide activation mode, GPR126 also has another allosteric agonism or tunable agonism mode, which is specifically expressed as the GAIN domain does not have self-shearing function in the physiological state, NTF and CTF always maintain the binding state, and the NTF binds to the ligand to cause conformational changes of the receptor, which somehow transmits signals to the GAIN domain in a spatial structure. The GAIN domain can cause the 7TM domain to produce an activated or inhibited signal for signal transduction, For example, type IV collagen interacts with the CUB and PTX domains of GPR126 to activate GPR126 downstream signal transduction. GPR126 has homology of 51.6%-86.9% among different species, with 10 conserved regions between different species, which can be traced back to the oldest metazoans as well as unicellular animals.In terms of diseases, GPR126 dysfunction involves the pathological process of bone, myelin, embryo and other related diseases, and is also closely related to the occurrence and development of malignant tumors such as breast cancer and colon cancer. However, the biological function of GPR126 in various diseases and its potential as a therapeutic target still needs further research. This paper focuses on the structure, interspecies differences and conservatism, signal transduction and biological functions of GPR126, which provides ideas and references for future research on GPR126.

Objective To investigate the feasibility and efficacy of mindfulness-based stress reduction (MBSR) in the management of chronic pain among military personnel stationed in plateau area of China. Methods Military personnel who had been stationed at an altitude ranging from 3 300 to 3 500 meters for over four months and suffered from chronic pain were selected as the study subjects by the judgment sampling method. A total of 51 individuals were assigned to the control group, and 53 individuals were assigned to the MBSR group using the random number table method. Individuals of the control group received conventional pain management, while the MBSR group received an additional eight-week MBSR training alongside conventional management. Pain, mindfulness levels, mood state, and psychological resilience of individuals were assessed before and 12 weeks after the intervention using the Brief Pain Inventory (BPI), the Five Facet Mindfulness Questionnaire-Short Form, the Profile of Mood States, and the Connor-Davidson Resilience Scale. Results After the intervention, the BPI scores, and the scores of the pain intensity and pain impact dimensions of individuals in the MBSR group were lower than those in the control group (all P<0.01). The reductions in these three scores were greater in the MBSR group than those in the control group (all P<0.01). Meanwhile, individuals in the MBSR group showed superior improvements in the mindfulness level score, the total mood disturbance, and the psychological resilience score compared with the control group (all P<0.05). The multiple linear regression analysis results showed that the pre-intervention BPI score, post-intervention changes in mindfulness levels, headache and lower back pain were influencing factors for the improvement of the BPI score in the MBSR group individuals (all P<0.05). Conclusion Conducting MBSR in military units in plateau areas is an effective approach for alleviating chronic pain. The pain relief effect is more pronounced in individuals with higher initial pain scores, a greater increase in mindfulness scores after training, and those with headache and low back pain.

OBJECTIVE To analyze the correlation of the peak blood concentration （cmax） of compound sulfamethoxazole （TMP/SMZ） and its metabolite N-acetyl sulfamethoxazole （NSMZ） with clinical efficacy and adverse reactions in critically ill patients. METHODS The data of critically ill patients treated with TMP/SMZ in various ICU of Hainan General Hospital from December 2023 to January 2025 were retrospectively collected. The patients were divided into success group and failure group based on the treatment outcome. Simple linear regression and Spearman correlation analysis were used to analyze the correlation of TMP cmax， SMZ cmax， and NSMZ cmax with clinical efficacy and adverse reactions. The receiver operating characteristic curve （ROC） was used to determine the cutoff values of cmax for predicting the occurrence of adverse reactions. RESULTS Among critically ill patients with an acute physiology and chronic health evaluation Ⅱ （APACHE-Ⅱ） ≥15 points 24 h of check-in at ICU， SMZ cmax of success group was significantly higher than failure group （P＜0.05）. The daily total dose of TMP/SMZ was positively correlated with TMP cmax and SMZ cmax（ P＜0.05）. TMP cmax was significantly correlated with hepatotoxicity and nephrotoxicity， SMZ cmax with hepatotoxicity， and NSMZ cmax with nephrotoxicity （P＜0.05）. The cutoff values of TMP cmax for predicting nephrotoxicity and hepatotoxicity were 7.25 μg/mL and 6.63 μg/mL， respectively. The cutoff value of SMZ cmax for predicting hepatotoxicity was 138.00 μg/mL， and that of NSMZ cmax for predicting nephrotoxicity was 60.76 μg/mL. CONCLUSIONS Among critically ill patients with an APACHE-Ⅱ ≥15 points 24 h of check-in at ICU， SMZ cmax is associated with treatment success. Hepatotoxicity risk significantly increases when TMP cmax ≥6.63 μg/mL or SMZ cmax ≥138.00 μg/mL； nephrotoxicity risk significantly increases when TMP cmax ≥7.25 μg/mL or NSMZ cmax ≥60.76 μg/mL.

Objective To investigate the clinical characteristics and therapeutic method in the eldly patients with recurrent fever after coronavirus disease 2019(COVID-19)infection.Methods The data of 4 eldly patients with recurrent fever after COVID-19 infection was collected and their clinical characteristics and efficacy of glucocorticoid therapy were analyzed.Results Three patients were male and 1 was female,their ages were 82-86 years old,fever time was 24-37 days.Lung lesions in 3 patients were mild and 1 was severe.Low dose glucocorticoid was used in 2 cases(the initial dose of methylprednisolone tablets was 20 mg daily).The higher initial dose was used in 2 other cases(methylprednisolone,40 mg daily).The duration of fever reduction was 2-4 days.The treatment course of glucocorticoid was as short as 3-6 weeks for the 3 patients with mild lung lesions,and as long as 23 weeks for the patient with severe lung lesion.Conclusion For eldly patients with recurrent fever after COVID-19 infection,if the lung lesion was mild,a small dose of glucocorticoid and a short course of treatment may be used;if the lung lesion was severe,the dose can be increased appropriately and the course of treatment prolonged.

Objective To observe the effects of ritodrine hydrochloride,phloroglucinol and magnesium sulfate on serum sex hormones and fetal protection effect in patients with threatened abortion after 20 gestational weeks.Methods Patients with threatened abortion(after 20 gestational weeks)underwent fetal protection treatment were retrospectively enrolled.According to cohort method,they were divided into group A(ritodrine hydrochloride injection 100 mg+5％glucose injection 500 mL for intravenous drip,continued infusion after uterine contraction inhibition for 12-18 h,oral ritodrine hydrochloride tablets),group B(of phloroglucinol injection 40 mg+5％glucose injection 500 mL for intravenous drip,drug withdrawal after uterine contraction inhibition)and group C(magnesium sulfate injection 20 mL+5％glucose injection 100 mL,magnesium sulfate injection 40 mL+5％glucose injection 500 mL for intravenous drip after rapid intravenous drip,continued infusion after uterine contraction inhibition for 12 h).The onset time,disappearance time of uterine contraction,levels of serum sex hormones[progesterone(P),estradiol(E2),human chorionic gonadotrophin β-subunit(β-hCG)],adverse drug reactions and response rate of fetal protection in the three groups were observed.Results There were 40 cases in group A,38 cases in group B and 42 cases in group C.The onset time in group A,group B and group C were(1.71±0.34),(2.29±0.23)and(4.51±1.12)h,and the difference was statistically significant(P＜0.05).The disappearance time of uterine contraction in groups A,B and C were(1.34±0.32),(2.24±0.26)and(2.36±0.28)d,and the difference between group B and group A,between group C and group A were statistically significant(all P＜0.05).After 3 d of treatment,levels of serum P in group A,group B and group C were(78.64±10.34),(69.35±10.52)and(68.76±11.13)ng·mL-1;E2 levels were(672.25±85.63),(623.25±92.31)and(624.12±93.65)pg·mL-1;β-hCG levels were(6.95×104±1 258.65),(6.75×104±1 274.43)and(6.70×104±1 327.59)mU·mL-1;the difference between group B and group A,between group C and group A were statistically significant(all P＜0.05).The incidence rates of palpitation in groups A,B and C were 25.00％,0 and 9.52％,the difference between group A and group B was statistically significant(P＜0.05).The incidence rates of headache in groups A,B and C were 2.50％,2.63％and 26.19％;the difference between group A and group C,and between group B and group C was statistically significant(P＜0.05).The incidence rates of fatigue in groups A,B and C were 5.00％,0 and 19.05％,and the difference between group B and group C was statistically significant(P＜0.05).The incidence rates of gastrointestinal discomfort were 5.00％,0 and 11.90％,and the difference between group B and group C was statistically significant(all P＜0.05).The response rates of fetal protection in groups A,B and C were 92.50％,94.74％and 73.81％,and the difference between group A and group C,between group B and group C was statistically significant(all P＜0.05).Conclusion The onset time of ritodrine hydrochloride is short,which can be the first choice for disease control.Phloroglucinol is comparable to ritodrine hydrochloride in terms of fetal protection effect,which has better advantages in adverse drug reactions.Clinically,phloroglucinol can be considered for patients with poor tolerance to ritodrine hydrochloride.

Objective To observe the clinical efficacy of olaparib maintenance therapy combined with gemcitabine+cisplatin(GP)chemotherapy regimen and thermal therapy in the treatment of advanced ovarian cancer and analyze the prognosis.Methods Patients with advanced ovarian cancer were divided into control group and treatment group according to the random number table method.The control group was treated with GP chemotherapy regimen and thermal therapy,and given intravenous infusion of 1 250 mg·in-2 of gemcitabine on the 1st day and 8th day and 40 mg·m-2of cisplatin on the 1st day and 3rd day,and given 60 min of local deep thermal therapy(qod)with temperature at 42 ℃ on the 1st day of chemotherapy,and the patients were treated for 4 courses with 21 days as a course.The treatment group was additionally given olaparib maintenance therapy on the basis of the control group,and given continuously oral administration of olaparib 200 mg(bid)during chemotherapy,and the patients were treated for 4 courses with 21 days as a course of treatment.The clinical efficacy,peritoneal carcinomatosis index(PCI),peripheral blood lymphocyte subsets,serum tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 72-4(CA72-4),human epididymal protein 4(HE4)],progressive-free survival time(PFS),overall survival(OS)and occurrence of adverse drug reactions were compared between both groups of patients.Results There were 37 cases in treatment group and 36 cases in control group.After treatment,the total effective rates in treatment group and control group were 54.05％(20 cases/37 cases)and 30.56％(11 cases/36 cases);the PCI scores were(10.79±2.56)and(12.54±3.17)scores,with significant difference(all P＜0.05).After treatment,the proportions of peripheral blood CD4+cell in treatment group and control group were(33.63±3.17)％and(30.06±3.24)％;the ratios of CD4+/CD8+were 0.78±0.16 and 0.67±0.13;serum CEA levels were(33.17±6.82)and(39.35±7.51)ng·mL-1;CA125 levels were(47.64±8.56)and(55.84±10.02)U·mL-1;CA72-4 levels were(6.35±1.27)and(8.59±1.64)U·mL-1;HE4 levels were(124.62±20.14)and(141.62±21.43)pmol·mL-1,all with significant difference(all P＜0.05).PFS values in treatment group and control group were 9.00 months(95％CI:7.79-10.21)and 8.00 months(95％CI:7.20-8.80),and OS values were 13.00 months(95％CI:12.35-13.65)and 11.00 months(95％CI:10.46-11.54),all with significant difference(all P＜0.05).The adverse drug reactions in treatment group mainly included nausea and vomiting,hypertension and constipation,the adverse drug reactions in control group mainly included nausea and vomiting and stomatitis.The total incidence rates of adverse drug reactions in treatment group and control group were 32.43％and 22.22％,with no significant difference(P＞0.05).Conclusion Olaparib maintenance therapy combined with GP chemotherapy regimen and thermal therapy has a significant effect in the treatment of patients with advanced ovarian cancer,and it can prolong the survival time of patients without increasing adverse drug reactions.

Objective To understand the respiratory protection competency of staff in hospitals.Methods Staff from six hospitals of different levels and characteristics in Beijing were selected,including doctors,nurses,medical technicians,and servicers,to conduct knowledge assessment on respiratory protection competency.According to exposure risks of respiratory infectious diseases,based on actual cases and daily work scenarios,content of respira-tory protection competency assessment was designed from three aspects:identification of respiratory infectious di-seases,transmission routes and corresponding protection requirements,as well as correct selection and use of masks.The assessment included 6,6,and 8 knowledge points respectively,with 20 knowledge points in total,all of which were choice questions.For multiple-choice questions,full marks,partial marks,and no mark were given respective-ly if all options were correct,partial options were correct and without incorrect options,and partial options were correct but with incorrect options.Difficulty and discrimination analyses on question of each knowledge point was conducted based on classical test theory.Results The respiratory protection competency knowledge assessment for 326 staff members at different risk levels in 6 hospitals showed that concerning the 20 knowledge points,more than 60％participants got full marks for 6 points,while the proportion of full marks for other questions was relatively low.Less than 10％participants got full marks for the following 5 knowledge points:types of airborne diseases,types of droplet-borne diseases,conventional measures for the prevention and control of healthcare-associated infec-tion with respiratory infectious diseases,indications for wearing respirators,and indications for wearing medical protective masks.Among the 20 knowledge questions,5,1,and 14 questions were relatively easy,medium,and difficult,respectively;6,1,4,and 9 questions were with discrimination levels of ≥0.4,0.30-0.39,0.20-0.29,and ≤0.19,respectively.Conclusion There is still much room for hospital staff to improve their respiratory protection competency,especially in the recognition of diseases with different transmission routes and the indications for wearing different types of masks.

Ovarian cancer has become the most lethal gynecological tumor due to the difficulty in early diagnosis,the late stage when diagnosed and the high recurrence rate.Resistance to platinum-based anti-tumor chemotherapy drugs is an important reason for the poor prognosis of ovarian cancer.circular RNA(circRNA)is more stable than mRNA in cells due to its special structure,and it is involved in the regulation of the occurrence,development and chemotherapy resistance of a variety of tumors.circRNA can be used as a competing endogenous RNA(ceRNA)of miRNA to bind to proteins,and regulates the phenotypic polarization of macrophages,it can also be used as an exosomal circRNA to regulate the sensitivity of platinum resistance in ovarian cancer.circRNA is expected to be a new marker of platinum resistance and a new target for the treatment of platinum resistance.In order to further explore the relationship between circRNA and platinum resistance in ovarian cancer,this article summarizes the recent literature related to circRNA and platinum resistance in ovarian cancer.

Objective To investigate the biological function and main molecular mechanism of long noncoding RNA RMRP(lncRNA RMRP)in endometrial carcinoma.Methods The specimens of carcinoma tissues and adjacent tissues of 30 patients with endometrial carcinoma who received surgical treatment in our hospital were collected.RT-qPCR was used to detect the expression of lncRNA RMRP in endometrial carcinoma tissues and adjacent tissues,and HESC cells and HEC-1-A cells.The endometrial carcinoma cell line HEC-1-A was cultured in vitro,and the Vector,pcDNA-RMRP,NC-siRNA,RMRP-siRNA,NC mimic,miR-580-3p mimic,pcDNA-RMRP+NC mimic,pcDNA-RMRP+ miR-580-3p mimic,RMRP-siRNA+Vector,RMRP-siRNA+pcDNA-JAK2,NC inhibitor,and miR-580-3p inhibitor were transfected into HEC-1-A cells as the Vector group,the pcDNA-RMRP group,the NC-siRNA group,the RMRP-siRNA group,the NC mimic group,the miR-580-3p mimic group,the pcDNA-RMRP+NC mimic group,the pcDNA-RMRP+miR-580-3p mimic group,the RMRP siRNA+Vector group,the RMRP-siRNA+pcDNA-JAK2 group,the NC inhibitor group,and the miR-580-3p inhibitor group respectively.RT-qPCR was used to detect the expression of lncRNA RMRP and miR-580-3p in cells.CCK-8 was used to detect cell proliferation rate.The apoptosis rate was detected by flow cytometry analysis.Bioinformatics software and dual luciferase reporter gene experiment were used to predict and verify the targeted relationships between miR-580-3p and lncRNA RMRP,as well as miR-580-3p and JAK2.Western blot was used to detect the protein expression of JAK/STAT signaling pathway.Results Compared with adjacent tissues,lncRNA RMRP was highly expressed in endometrial carcinoma tissues(P<0.05).Compared with HESC cells,the expression of lncRNA RMRP in HEC-1-A cells was significantly increased(P<0.05).pcDNA-RMRP significantly promoted cell proliferation and inhibited cell apoptosis,while RMRP-siRNA significantly inhibited cell proliferation and promoted cell apoptosis,with statistically significant diferences(P<0.05).miR-580-3p was the downstream target miRNA of lncRNA RMRP,and lncRNA RMRP could negatively regulate the expression of miR-580-3p.JAK2 was the downstream target gene of miR-580-3p,and miR-580-3p could negatively regulate the expression of JAK2 protein.pcDNA-RMRP significantly increased the protein levels of JAK2,p-JAK2 and p-STAT3 in the cells,while co-transfection of pcDNA-RMRP and miR-580-3p mimic significantly decreased the protein levels of JAK2,p-JAK2 and p-STAT3,with statistically significant diferences(P<0.05).RMRP-siRNA could signifi-cantly reduce the protein levels of JAK2,p-JAK2 and p-STAT3 in cells.After co-transfection of RMRP-siRNA and pcDNA-JAK2,the protein levels of JAK2,p-JAK2 and p-STAT3 were significantly increased,with statistically significant diferences(P<0.05).In addition,co-transfection of RMRP-siRNA and pcDNA-JAK2 increased cell proliferation and decreased cell apoptosis,with statistically significant diferences(P<0.05).Conclusion Knockdown of lncRNA RMRP could inhibit endometrial carcinoma cell proliferation and promote cell apoptosis by regulating JAK2/STAT3 signaling pathway,which might be a potential therapeutic target for endometrial carcinoma.