AIM:To investigate the effect of paeoniflorin on the inflammatory response of diabetic retinopathy rats by regulating phosphatidylinositol-3 kinase/protein kinase B(PI3K/Akt)signaling pathway.METHODS: A total of 70 SPF male SD rats were selected, and 12 rats were randomly selected as the control group(normal saline gavage). The remaining 58 rats were fed with high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin(STZ)to establish diabetic rat models. Rats with diabetic retinopathy were randomly divided into model group(normal saline), paeoniflorin low-dose group(100 mg/kg paeoniflorin), paeoniflorin high-dose group(200 mg/kg paeoniflorin)and metformin group(100 mg/kg metformin), with 12 rats in each group. The body mass of the rats in each group were compared. HE staining was used to observe the pathological changes of the rat retina. Automatic biochemical analyzer was used to detect the levels of fasting blood glucose, glycosylated hemoglobin, serum high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), total cholesterol and triglyceride in the rats. Enzyme-linked immunosorbent assay was used to detect the levels of serum superoxide dismutase(SOD), reactive oxygen species(ROS), malondialdehyde(MDA), glutathione peroxidase(GSH-PX), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6)and interleukin-1β(IL-1β)in the rats. Western blot was used to detect the expressions of Occludin, p-PI3K, tight junction protein-1(ZO-1), p-Akt and VE-Cadherin in the rat retina.RESULTS: The expression levels of Occludin, ZO-1 and VE-cadherin in low-dose and high-dose paeoniflora groups were higher than those in the model group, while the expression levels of TNF-α, IL-6, IL-1β, p-PI3K and p-Akt in serum were lower than those in the model group. The high-dose group of paeoniflorin was significantly better than the low-dose group of paeoniflorin(all P<0.05).CONCLUSION: Paeoniflorin may reduce inflammatory response in diabetic retinopathy rats by inhibiting PI3K/Akt signaling pathway.

AIM:To investigate the effect of paeoniflorin on the inflammatory response of diabetic retinopathy rats by regulating phosphatidylinositol-3 kinase/protein kinase B(PI3K/Akt)signaling pathway.METHODS: A total of 70 SPF male SD rats were selected, and 12 rats were randomly selected as the control group(normal saline gavage). The remaining 58 rats were fed with high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin(STZ)to establish diabetic rat models. Rats with diabetic retinopathy were randomly divided into model group(normal saline), paeoniflorin low-dose group(100 mg/kg paeoniflorin), paeoniflorin high-dose group(200 mg/kg paeoniflorin)and metformin group(100 mg/kg metformin), with 12 rats in each group. The body mass of the rats in each group were compared. HE staining was used to observe the pathological changes of the rat retina. Automatic biochemical analyzer was used to detect the levels of fasting blood glucose, glycosylated hemoglobin, serum high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), total cholesterol and triglyceride in the rats. Enzyme-linked immunosorbent assay was used to detect the levels of serum superoxide dismutase(SOD), reactive oxygen species(ROS), malondialdehyde(MDA), glutathione peroxidase(GSH-PX), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6)and interleukin-1β(IL-1β)in the rats. Western blot was used to detect the expressions of Occludin, p-PI3K, tight junction protein-1(ZO-1), p-Akt and VE-Cadherin in the rat retina.RESULTS: The expression levels of Occludin, ZO-1 and VE-cadherin in low-dose and high-dose paeoniflora groups were higher than those in the model group, while the expression levels of TNF-α, IL-6, IL-1β, p-PI3K and p-Akt in serum were lower than those in the model group. The high-dose group of paeoniflorin was significantly better than the low-dose group of paeoniflorin(all P<0.05).CONCLUSION: Paeoniflorin may reduce inflammatory response in diabetic retinopathy rats by inhibiting PI3K/Akt signaling pathway.

ObjectiveTo observe the clinical effectiveness and safety of Xiaozhong Zhitong Mixture （消肿止痛合剂） combined with antibiotic bone cement in the treatment of diabetic foot ulcer （DFU） with damp-heat obstructing syndrome. MethodsA total of 72 DFU patients with damp-heat obstructing syndrome were randomly assigned to treatment group （36 cases） and the control group （36 cases）. Both groups received standard treatment and topical antibiotic bone cement for ulcer wounds， while the treatment group received oral Xiaozhong Zhitong Mixture （50 ml per time， three times daily） in additionally. Both groups underwent daily wound dressing changes for 21 consecutive days. Ulcer healing rate， serum levels of tumor necrosis factor-alpha （TNF-α）， interleukin-1 beta （IL-1β）， malondialdehyde （MDA）， superoxide dismutase （SOD）， C-reactive protein （CRP）， and white blood cell （WBC） count were observed before and after treatment， and visual analog scale （VAS） scores for wound pain， traditional Chinese medicine （TCM） syndrome scores， and the DFU Healing Scale （DMIST scale） were also compared. Liver and kidney function were evaluated before and after treatment， and adverse events such as allergic reactions， worsening ulcer pain were recorded. ResultsTotally 35 patients in the treatment group and 33 in the control group were included in the final analysis. The ulcer healing rate in the treatment group was （87.93±9.34）%， significantly higher than （81.82±12.02）% in the control group （P = 0.035）. Compared to pre-treatment levels， both groups showed significant reductions in serum CRP， WBC， MDA， IL-1β， and TNF-α levels， with an increase in SOD level （P＜0.05）. TCM syndrome scores， VAS， and DMIST scores also significantly decreased in both groups （P＜0.05）， with greater improvements in the treatment group （P＜0.05）. No significant adverse reactions were observed in either group during treatment. ConclusionXiaozhong Zhitong Mixture combined with antibiotic bone cement has significant advantages in promoting DFU healing， reducing inflammatory response， and alleviating oxidative stress in DFU patients with damp-heat obstructing syndrome， with good safety for DFU patients with damp-heat obstructing syndrome.

The incidence of falls, as well as the consequent fear of falling among aged hemodialysis patients, is notably high. Such fear contributes to both psychosomatic damage and a diminished quality of life, constituting a significant risk factor for mortality in this demographic. This article comprehensively reviews the overview of fear of falling in aged hemodialysis patients, its effects on these individuals, the current prevalence, influencing factors, and intervention measures. It aims to provide a scientific foundation for formulating effective strategies to counteract the fear of falling in aged hemodialysis patients.

The aim of this study was to establish a laboratory research model for the desiccation tolerance of Coxiella bur-netii(C.burnetii),based on an axenic culture system.The conditions for osmotic pressure in the axenic culture system of C.burnetii were set via a gradient.Quantitative PCR was used to determine the C.burnetii genome equivalents during the culture cycle under different osmotic pressures,and the growth curves were recorded.In addition,the bacterial manifestations of C.burnetii obtained from eukaryotic cell cultures or cell-free cultures were analyzed with phase contrast microscopy and transmis-sion electron microscopy(TEM).The bacterial infection levels and vacuole forming units(VFU)were measured by infection of BGMK cells.C.burnetii showed as many as 7 days of adaptive survival in osmotic axenic medium under high osmotic condi-tions.The bacteria shrank by dehydration under extremely high osmotic pressure and appeared primarily as hypo-hydrated small cell variants(SCVs).The VFUs were significantly diminished 24 hours after infection,as compared with the parallel contrasts.The method for researching desiccation tolerance was thus successfully established.This method provides a basis for further investigation of the genetic mechanisms of the anti-desiccation properties of C.burnetii in the natural environment,through proteomics and other methods.

Objective:This study investigates the influence of the apolipoprotein E ε4(APOE ε4)genotype on the relationship between glucose-lipid metabolism disorders and diabetes-related cognitive impairment(DCI).Methods:A case-control study was conducted involving 891 patients with type 2 diabetes mellitus(T2DM)with a mean age of(62.1±13.8)years, all of whom underwent elective surgery at the First Hospital of Shanxi Medical University between January 2017 and December 2022.Among these participants, 229 were diagnosed with DCI(case group), while 662 were cognitively normal(control group).Routine clinical information was collected, and peripheral venous blood samples were analyzed for glycated hemoglobin(HbA1c)and blood lipid levels.The single nucleotide polymorphisms rs429358 and rs7412 were analyzed to determine the presence of the APOE ε4 genotype.Stepwise Logistic regression was employed to identify independent risk factors for DCI, and subgroup analyses were performed to evaluate the effect of the APOE ε4 genotype on the relationship between HbA1c and blood lipid levels in relation to DCI risk. Results:Among all patients, female gender( OR=1.915, 95% CI: 1.393-2.631, P<0.001), longer duration of T2DM( OR=1.169, 95% CI: 1.087-1.257, P<0.001), elevated triglycerides( OR=1.161, 95% CI: 1.041-1.294, P=0.007), and being an APOE ε4 carrier( OR=1.638, 95% CI: 1.115-2.405, P=0.012)were identified as independent risk factors for developing DCI.High levels of low-density lipoprotein(LDL)were found to be independently associated with an increased risk of DCI specifically in APOE ε4 carriers( OR=1.408, 95% CI: 1.060-1.870, P=0.018), but not in non-APOE ε4 carriers( P>0.05).In contrast, elevated HbA1c was independently associated with a higher risk of DCI in non-APOE ε4 carriers( OR=1.220, 95% CI: 1.040-1.430, P=0.014), but not in APOE ε4 carriers( P>0.05).Additionally, elevated triglycerides were independently linked to an increased risk of DCI across the entire sample and within each APOE ε4 genotype subgroup. Conclusions:The APOE genotype plays a significant role in modulating the relationship between dyslipidemia and the risk of developing DCI.This highlights the critical importance of lipid metabolism disorders and APOE risk genes in both the development and progression of DCI.These findings offer valuable insights for future clinical and mechanistic studies focused on DCI.

Objective:To explore the characteristics and data related to the degradation and biocompatibility of the domestically procuded polyglycolic acid (PGA) nerve conduit.Methods:This study was conducted in the Department of Burns and Plastic Surgery, the Northern Theater General Hospital between January and August 2022. PGA nerve conduits were immersed in 15 ml normal saline for in vitro experiments of degradation. The experimental period was 12 weeks. The pH of the immersion solution were tested weekly and the rates of mass loss were calculated. The in vitro experiments for biocompatibility were conducted in both of the experimental group and the control group. In the experimental group, a DMEM solution containing 10% of fetal bovine serum was used as the extraction medium, and domestically produced PGA nerve conduit was immersed in the extraction medium in the control group. An extraction medium was firstly prepared for a controlled extraction time of 72 hours±2 hours at 37 ℃±1 ℃. The pH of both experimental and control groups were tested at 24, 48 and 72 hours. The 72-hour extracts of both experimental and control groups were used to prepare the single cell suspension. The single cell suspension containing the cultured RSC 96 were separately seeded into 96-well plates for Methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay, to observe the effect of PGA nerve conduits on the proliferation of RSC 96. Then RSC 96 were incubated for 24 hours with the extracts of both experimental and control groups. The effect of PGA nerve conduits on the migration of RSC 96 was observed with Transwell assay. Twenty-four adult male SD rats were used and divided into experimental group and control group, with 12 rats per group, for the in vivo study of degradation and biocompatibility. Rats in the experimental group were implanted with domestically produced PGA nerve conduits, and Neurotubes, a US made nerve conduit, were implanted in the rats of control group. The PGA nerve conduits were implanted in a bluntly prepared gap between the biceps femoris muscle and the gluteus maximus muscle of the right hind limb of rats for the in vivo degradative experient. The degradation and biocompatibility of the PGA nerve conduit were evaluated by means of gross observation, tests of blood routine, liver and kidney functions and histological examinations at 2, 4, 8 and 12 weeks after implantation. SPSS 19.0 software was used for statistical analysis of the experimental data, and the results were expressed as Mean±SD. T test was used for inter-group comparison and Turkey method was used for intra-group and inter-group comparison. P<0.05 was used to determine whether the difference was statistically significant. Results:The rate of in vitro degradation was found at 1.470%±0.026% in week 4, and thereafter, a gradually accelerated degradation rate was observed and at a 32.180%±0.040% of degradation rate in week 12. The pH of the immersion solution decreased slowly in the first 2 weeks, with the pH at 6.200±0.061 in week 2. The pH then suddenly dropped to 3.930±0.118 in week 3, and then decreased slowly, with a pH 2.560±0.003 in week 12. Both MTT and Transwell experiments showed that the extract of PGA nerve conduits had no effect on the proliferation and migration of RSC 96, nor a significant difference existed in comparison with the corresponding control groups ( P>0.05). The experiments of in vivo degradation of PGA nerve conduits showed that the nerve conduits in both experimental and control groups had good support at week 2 after implantation. At weeks 4-12 after implantation, the nerve conduits in both groups gradually softened and collapsed, but the conduits were in one piece and not broken. The blood routine, liver and kidney functions showed no statistically significant difference between the 2 groups over the same period, and between each time point within the groups and the groups before implantation ( P>0.05). No obvious abnormal appearance of livers and kidneys was found in the rats sacrificed at each observation time point. Also, there was no obvious degeneration and necrosis of the muscle tissue around the conduits in the 2 groups, and no obvious inflammatory cells infiltration was found from the histological examinations. Morphology of the muscle tissue remained normal. Conclusion:Domestically produced PGA nerve conduit is fund good in both of biocompatibility and biodegradability. It is safe and reliable, and it provides a basis for the further experients in repair of nerve defects.

Rheumatoid arthritis(RA)is an autoimmune disease with the basic pathological manifestation of synovial inflammation.Symmetric poly-articular pain and swelling are the main symptoms in clinical practice,and even extra-articular manifestations and comorbidities such as interstitial fibrosis and coronary artery disease are triggered,which seriously affect the quality of life of patients.Traditional Chinese medicine(TCM)has achieved good clinical efficacy in the prevention and treatment of RA with the advantages of multi-pathway,multi-target,multi-component,and less toxic side effects,and plays an important role in the treatment of RA.Recently,many studies have demonstrated that Chinese medicine monomers and Chinese herbal compound can control inflammation,reduce angiogenesis,induce apoptosis of synovial fibroblasts,and inhibit their proliferation,invasion and migration by regulating the PI3K/Akt signaling pathway,so as to play a key role in the treatment of RA.For this reason,the article summarizes current knowledge regarding the PI3K/Akt signaling pathway and its role in RA,as well as summarizes the current research progress of TCM in the treatment of RA by regulating the PI3K/Akt signaling pathway.The aim of this review is to provide theoretical bases for the prevention and treatment of RA and the development of new drugs.

Objective To explore the current status of H.pylori infection in the natural population of Sanya City,analyze its influencing factors,and provide a reference basis for the prevention and control of H.pylori infection.Methods A total of 677 residents from four districts of Sanya City were selected by overall stratified random sampling method,and were subjected to urea 14C breath test and questionnaire survey to calculate the positive rate of H.pylori in the natural population and analyze the influencing factors of H.pylori infection.Results A total of 606 residents were included,and the number of H.pylori positive detections was 261,with a positive detection rate of 38.5％.Among them,different ethnicity,marital status,smoking,eating vegetables and fruits,and literacy level were associated with H.pylori infection(P＜0.05);gender,age,BMI,alcohol consumption,drinking water source,betel quid chewing,and the number of cohabitants were not significantly associated with H.pylori infection(P＞0.05).Family infection was an independent risk factor for H.pylori infection in the natural population of Sanya City,and Li ethnicity,frequent consumption of fruits and vegetables,and college and higher education level were independent protective factors for H.pylori infection in the natural population of Sanya City.Conclusion The rate of H.pylori infection in the natural population of Sanya City is lower than the national average.Consuming more fruits and vegetables and improving the awareness of hygiene protection are conducive to the prevention of H.pylori infection;and the promotion of the family and related members with the same examination and treatment is important to avoid aggregation of infection within the family.

With the innovation of obesity treatment concepts and surgical equipmentes, the procedures of metabolic and bariatric surgery have become more and more diversified. In addition to the widely used laparoscopic surgery, robot-assisted surgery, endoscopic therapy, and implantable weight loss devices have been constantly emerging and apply to clinical treatment, and achieved remarkable therapeutic effects. As a young branch of surgery, the ability to quickly absorb new technologies is a major feature of metabolic and bariatric surgery. Through the data support of various clinical studies with standardized, large sample sizes, and multiple centers, more effective, minimally invasive, and convenient treatment methods will surely evolve in the near future, which will meet the diverse needs of more obese patients while ensuring safety and weight loss effects. The authors review and look forward to the innovative surgical methods and techniques in metabolic and bariatric surgery, in order to provide reference and inspiration for the academic community.