Diabetic retinopathy(DR)is one of the most common microvascular complications of diabetes and has become one of the leading causes of blindness and visual impairment in diabetes patients.The pathogenesis of DR is multifaceted,involving inflammation,oxidative stress,neurovascular abnormalities,and other factors that present potential targets for disease management interventions.Currently,anti-vascular endothelial growth factor(VEGF)drugs serve as the primary treatment for advanced stages of DR when irreversible neurovascular damage and visual impairment have occurred.Additionally,some patients show poor or no response to anti-VEGF treatment.There is a lack of early intervention options for the initial phases of the disease.Therefore,there is an urgent need to develop novel local or systemic therapies based on the underlying mechanisms of DR to enable early prevention and treatment with the aim of preserving patients' vision.Medications targeting various pathways including anti-inflammatory agents(corticosteroids and nonsteroidal anti-inflammatory drugs),neurotrophic and neuroprotective drugs,drugs modulating biochemical pathways,antioxidant phytochemicals,and gene therapy can complement each other in terms of therapeutic effects to benefit a larger number of individuals affected by DR.This article reviews previous research reports on the pathogenesis,drug treatment methods,and potential therapeutic targets associated with DR in order to provide guidance for clinical practice.

Objective:To analyze the risk factors for ankle varus deformity after McFarland fracture surgery in children.Methods:A total of 48 children with McFarland fracture who underwent surgical treatment in the Second General Hospital of Fuzhou from January 2015 to December 2022 were retrospectively analyzed, including 24 males and 24 females, aged 11.2±3.2 years (range, 2-14 years), 19 cases on the left side and 29 cases on the right side. Salter-Harris classification: 34 cases of type III and 14 cases of type IV. Causes of injuries: 28 cases of sports injuries, 15 cases of fall injuries, and 5 cases of car accident injuries. The time from injury to operation was 2.6±1.7 d (range, 1-7 d). The reduction methods included closed reduction in 38 cases and open reduction in 10 cases. Tibial internal fixation: 42 cases of hollow screws, 6 cases of Kirschner pins. There were 30 cases of combined fibula fracture, 20 cases were fixed with plate, 8 cases were fixed with Kirschner's pin, and 2 cases were not treated with internal fixation. The internal fixation survival time was 6.4±2.8 months (range, 1-12 months). The lateral distal tibial angle (LDTA) was used to determine whether the child had ankle varus deformity. The general data and perioperative indicators of the two groups were compared, and the indicators with statistically significant differences were included in binary logistic regression analysis to determine the independent risk factors for ankle varus deformity after McFarland fracture surgery in children. The receiver operating characteristic curve was drawn and the area under the curve of each independent risk factor was calculated.Results:All patients successfully completed the operation and were followed up for 39.2±21.8 months (range, 15-98 months). At the last follow-up, all the 48 children with McFarland fracture had bone union and the internal fixation was successfully removed, and 5 of them had ankle varus deformity. The LDTA of the affected side was 98.6°±4.8° (range, 94°-106°) in the ankle varus deformity group and 89.0°±0.8° (range, 87°-91°) in the non-ankle varus deformity group. The age of children in the ankle varus deformity group was 6.6±5.1 years, which was younger than that in the non-ankle varus deformity group (11.7±2.5 years), and the difference was statistically significant ( t=3.772, P<0.001). The survival time of internal fixation in the ankle varus deformity group was 4.4±2.2 months, which was shorter than that in the non-ankle varus deformity group (6.6±2.8 months), and the difference was statistically significant ( t=1.750, P=0.087). There was no significant difference in gender, side, cause of injury, fracture type, initial displacement distance, fibular fracture, time from injury to operation, reduction method, or fixation method between the two groups ( P>0.05). Age and duration of internal fixation were included in binary logistic regression analysis. The results showed that age ( OR=0.717, 95% CI: 0.543, 0.945, P=0.018) was an independent risk factor for postoperative ankle varus deformity in children with McFarland fracture. The receiver operating characteristic curve of independent risk factors predicting postoperative ankle varus deformity in children with McFarland fracture was drawn and the area under the curve was calculated. The results showed that the best cut-off value of age was 5.5 years, and the area under the curve was 0.807, and the prediction efficiency of the prediction model was good. Conclusion:Age<5.5 years is an independent risk factor for postoperative varus ankle deformity in children with McFarland fracture.

【Objective】 To evaluate the screening efficacy and practical value of the portable microfluidic biochemical analyzer in the detection of blood donors before blood donation. 【Methods】 Blood donor samples, clinical blood samples and constant quality control products were collected. Referring to the documents of ISO15189 and National Health Industry Standard, the precision and accuracy of hemoglobin (Hb) and alanine aminotransferase (ALT) were verified and compared with other detection systems. 【Results】 The MS200 biochemistry instrument has an intra-batch precision of 1.40% to 1.46%, inter-batch precision of 1.91% to 1.94%, and correctness bias of -0.9% to -1.3% for Hb test, and an intra-batch precision of 3.77% to 4.86%, inter-batch precision of 4.92% to 6.02%, and correctness bias of -3.0% to -4.8% for ALT test, which were within the range of quality requirements of industry standard. Comparison of Hb test results between MS200 biochemistry and Hb201 analyser on 1 189 peripheral blood samples from donors showed no statistically significant difference (P>0.05). 65 samples showed positive correlation between MS200 biochemistry and XS-900i automated hematology analyzer on Hb test results (R²=0.986, P=0.000). Correlation analysis of all the results of ALT detection by MS200 biochemical analyzer and AU480 biochemical analyzer in 1 065 samples showed a positive correlation (R²=0.965, P=0.000). The elevated ALT samples did not affect the Hb test results, and the samples with abnormal Hb value did not affect the ALT test results, with no interference between the two items in the detection. 【Conclusion】 The MS200 biochemical analyzer based on microfluidic technology has reliable methodological performance and can meet the need of pre-donation testing.

Objective To compare the efficacies and adverse reactions of palonosetron hydrochloride with tropisetron and ondansetron in the prevention of nausea and vomiting after transcatheter arterial chemoembolization.Methods A total of 120 patients with postoperative liver metastasis of colorectal cancer who underwent transcatheter arterial chemoembolization were randomly divided into three groups.One hour before surgery,tropisetron hydrochloride(5 mg)was intravenously dripped in group A,ondansetron hydrochloride capsule(8 mg)was orally administered in group B,and palonosetron hydrochloride(0.25 mg)was intravenously injected in group C.No other antiemetics were used after surgery,and if necessary,intramuscular injection of metoclopramide(10 mg)was given for rescue.Results The complete response rates in preventing acute vomiting were 67.5%in group A,65.0%in group B,and 70.0%in group C,with no statistically significant difference(P>0.05).The complete response rate in preventing delayed vomiting was 87.5%in group C,which was significantly higher than those in group A(70.0%)and group B(60.0%)(P<0.05).The main adverse reactions in the three groups were mild constipation and abdominal distension.Conclusion Palonosetron,tropisetron,and ondansetron have satisfactory effects on preventing postoperative nausea and vomiting caused by transcatheter arterial chemoembolization,with mild and controllable adverse reactions.Palonosetron hydrochloride has a better effect on delayed vomiting.

Objective: To investigate the predictive effect of interleukin-27clinical pathological factors on local tumor progression after microwave ablation of liver cancer. Methods: Collection of blood samples from 102 patients with hepatic malignancies treated with microwave ablation from January 2014 to December 2016 in Department of General Surgery, Lianyungang Oriental Hospital of Xuzhou Medical University. There were 80 males and 22 females, aged 24 to 83 years old, mean (58.7±11.4) years old. Patient age, gender, hepatitis, tumor diameter, tumor number, tumor boundary, tumor type, tumor blood perfusion degree, liver Child-Pugh classification, whether liver cirrhosis and peripheral blood IL-27 concentration and tumor local progression relationship were analyzed.Detection of IL-27 concentration in peripheral blood using ELISA.The Youden index was calculated using the receiver operating characteristic curve (ROC) to obtain the best cutoff value for IL-27 levels.Patients were divided into 61 patients with high IL-27 (>498.45 pg/L) and 41 patients with low IL-27 (≤ 498.45 pg/L) with optimal cut-off value.Measurement data were expressed as mean ± standard deviation (Mean±SD), and comparison between groups was evaluated by t test; Comparison of count data was evaluated by chi-square test. Survival curves were plotted by Kaplan-Meier method and survival rates were calculated; Cox proportional hazard regression model was used for multivariate analysis. Results: The total incidence of local tumor progression was 35.3% (36/102). The IL-27 value of 102 patients ranged from(34.92-1 014.87) pg/L.The ROC curve of IL-27 value was plotted based on 2-year tumor-free survival as the endpoint. The area under the curve was AUC of 0.714 (P=0.017). When the IL-27 value was 498.45 pg/L, the Youden index was the largest, the sensitivity was 0.682, and the specificity was 0.556.The 2-year disease-free survival rate of all patients was 64.2%.The 2-year disease-free survival rates of patients with high IL-27 and low IL-27 were 72.7% and 50.5%, respectively. Survival analysis by Kaplan-Meier method showed that the prognosis of patients with high IL-27 group was better than that of patients with low IL-27 group (χ²=5.991, P=0.014). Univariate analysis of tumor local progression was associated with tumor >3 cm (χ²=7.170, P=0.007), tumor adjacent to large vessels (χ²=9.301, P=0.002), and high degree of tumor perfusion (χ²=5.599, P=0.018), IL-27 high level (χ²=5.460, P=0.019). Cox proportional hazard model analysis of tumor>3 cm, tumor adjacent to large blood vessels, low IL-27 level was an independent risk factor for tumor progression. Conclusions The level of IL-27, tumor ≥3 cm and tumor adjacent large blood vessels are predictor of local tumor progression after microwave ablation of liver cancer. Patients with low IL-27 levels have a high rate of local tumor progression.

Objective To explore the effects of systematic nursing intervention on calcium and phosphorus metabolism and pruritus in hemodialysis patients. Methods A total of 60 patients undergoing hemodialysis in the Department of Nephrology at Wuxi Second Hospital Affiliated to Nanjing Medical University from February to August 2017 were selected and divided into control group and observation group by random number method, with 30 cases in each group. The control group was given routine care. Dietary guidance, psychological care and comprehensive health education were implemented in the observation group on the basis of routine nursing. Diet, skin pruritus and calcium and phosphorus metabolism were compared between the two groups. Results The dietary compliance rate in the observation group (83.33%) was higher than that in the control group (60.00%) after the intervention, and the difference was statistically significant (P＜0.05). There was no significant difference in serum calcium levels between the two groups (P＞0.05). The differences in the total parathyroid hormone and serum phosphorus levels between the two groups were statistically significant (P＜ 0.05). The degree of pruritus, the distribution of the skin and the score of sleep disturbance in the observation group were significantly lower than those in the control group, with statistical difference (P＜0.05). Conclusions Systematic nursing plays a positive role in calcium and phosphorus metabolism and pruritus in hemodialysis patients and is worthy of promotion and application.

The aim of this study was to identify antigens for a vaccine or drug target to control rabbit coccidiosis. A combination of 2-dimensional electrophoresis, immunoblotting, and mass spectrometric analysis were used to identify novel antigens from the sporozoites of Eimeria stiedae. Protein spots were recognized by the sera of New Zealand rabbits infected artificially with E. stiedae. The proteins were characterized by matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF/TOF-MS) analysis in combination with bioinformatics. Approximately 868 protein spots were detected by silver-staining, and a total of 41 immunoreactive protein spots were recognized by anti-E. stiedae sera. Finally, 23 protein spots were successfully identified. The proteins such as heat shock protein 70 and aspartyl protease may have potential as immunodiagnostic or vaccine antigens. The immunoreactive proteins were found to possess a wide range of biological functions. This study is the first to report the proteins recognized by sera of infected rabbits with E. stiedae, which might be helpful in identifying potential targets for vaccine development to control rabbit coccidiosis.
Coccidiosis* ; Computational Biology ; Eimeria ; Electrophoresis ; HSP70 Heat-Shock Proteins ; Immunoblotting ; Mass Spectrometry ; Rabbits ; Sporozoites

Objective To study the clinical characteristics,treatment and prognosis of neonatal VACTERL association.Method The clinical data of newborns diagnosed with VACTERL association from January 2010 to December 2015 were collected and retrospectively analyzed.Result A total of 33 patients diagnosed with VACTERL association were included,including 23 males and 10 females.Among them,17 cases were term infants,15 cases premature infants and 1 case of overdue birth,with an admission age of 1 to 24 days.The most common deformities were cardiac anomalies (C) in 27 cases (81.8％),followed by anal atresia/anorectal malformation (A) in 25 cases (75.8％),renal deformity (R) in 24 cases (72.7％),limb abnormalities (L) in 20 cases (60.6％),Tracheoesophageal fistula (TEF) in 8 cases (24.2％) and vertebral abnormalities (V) in 3 cases (9.1％).11 cases (33.3％) had other deformities.Among these 33 patients,24 cases had 3 types of malformations and 9 cases had 4 types of malformations.The most common combination was ACR (n =8).20 patients had no abnormalites on chromosome karyotype test including 2 patients had normal gene microarray results.16 patients received surgical treatment during neonatal period and 13 of them recovered and discharged.Among the other 17 cases received no surgery,only 1 patient improved and discharged.A telephone follow-up was proceeded in 14 discharged cases at 1 year old.Among them,13 cases had good prognosis,however,the remaining one was dead.Conclusion VACTERL association is a rare non-random combination of multiple malformations.The early discovery and appropriately treatment after diagnosis will improve the prognosis and prevent death.Doctors should reinforce the ability to detect various types of deformities and examine the chromosome and gene properly.

This study was aimed to evaluate the clinical effect and safety of Qing-Fei Tong-Luo (QFTL) ointment for treating children with pneumonia.Randomized controlled trial (RCT) was conducted among 460 cases of children with pneumonia.The observation group was given QFTL ointment combined with basic treatment.And the control group was only treated by basic treatment.Evaluation was given on the total clinical efficacy,disappeared time of fever,cough,expectoration,shortness of breath,and medication safety.The incidence of respiratory diseases was followed up on the 30th days after drug withdrawal.The results showed that in the aspect of clinical efficacy between two groups,the cure rate of the observation group was 98.26％,and that of the control group was 93.89％,with statistic significance (P ＜ 0.05).The cure rate of the observation group was better than that of the control group.There was statistical difference on expectoration disappeared time (P ＜ 0.05).There was no statistical difference on disappeared time of fever,cough and shortness of breath (P ＞ 0.05).There was statistical difference on the incidence of respiratory diseases on the 30th days followed-up after drug withdrawal (P ＜ 0.05).There was no statistical difference on the incidence of upper respiratory tract infection,pneumonia and asthma (P ＞ 0.05).No adverse reactions occurred in the observation group.It was concluded that QFTL ointment combined with basic therapy on the treatment of pneumonia in children was significantly better than the control group in the aspect of clinical efficacy,expectoration disappeared time and the incidence of bronchitis.It is safe and effective.The prognosis is good and worthy of promotion in the clinical practice.

Objective To study the effect of microRNA-204 (miR-204) on the biological characteristics of breast cancer cells.Methods Real-time PCR was used to detect the expression of miR-204 in human breast cancer cell MDA-MB-231 after transfection of miR-204 mimics and inhibitor for 48 h.Flow cytometry was used to analyse the effect of miR-204 on the proliferation and apoptosis of MDA-MB-231 cells.The effect of miR-204 on the migration of MDA-MB-231 cells was detected by Transwell migration assay.Results Real-time PCR analysis showed that miR-204 mimics and inhibitors had significant effect compared with normal control group(P<0.01).Flow cytometry analysis showed that compared with normal control group,the number of G1 phase cells of miR-204 mimics group was significantly decreased(P<0.01),while the number of G2/M cells of miR-204 mimics group was significantly increased(P<0.01).In contrast,the number of G1 phase cells of miR-204 inhibitor group was significantly increased(P<0.01),while the number of G2/M cells of miR-204 inhibitor group was significantly decreased(P<0.01).miR-204 mimics group significantly promoted apoptosis,while the inhibitor group significantly inhibited apoptosis(P<0.01).Transwell migration analysis showed that the number of cells of miR-204 mimics group were significantly reduced,while the number of cells was significantly increased in the inhibitor group(P<0.01).Conclusion We find miR-204,which can promote cell apoptosis and inhibit cell proliferation and migration,is a negative factor in the breast cancer cell line MDA-MB-231.