ObjectiveTo analyze the clinical data of 126 patients with hepatic myelopathy （HM）， to summarize their clinical manifestations and prognostic features， and to provide a reference for clinical diagnosis and treatment. MethodsRelated clinical data were collected from 126 HM patients who attended The First Hospital of Lanzhou University from January 1， 2016 to June 30， 2025， and according to their muscle strength on admission， they were divided into grade<3 group， grade 3 group， and grade 4 group. The three groups were compared in terms of the clinical data including etiology， symptoms， clinical signs， past history， personal history， laboratory test results， imaging findings， treatment， and outcome. An analysis of variance was used for comparison of normally distributed continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups； the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups， and the Bonferroni correction method was used for further comparison between two groups； the chi-square test was used for comparison of categorical data between multiple groups. ResultsAll 126 patients with HM were comorbid with liver cirrhosis， with a male/female ratio of 2.7∶1， an age of 23 — 73 years， a mean age of 53.9±9.3 years， and a median age of 54 years. The top three etiologies of liver cirrhosis were hepatitis B in 78 patients （61.9%）， hepatitis C in 9 patients （7.1%）， and alcoholic hepatitis in 8 patients （6.3%）. During the course of the disease， all 126 patients with HM showed weakness in both lower limbs， among whom 9 patients （7.1%） also had the symptoms of lower limb pain and numbness. Among the 126 patients， 3 （2.4%） had grade 0 muscle strength， 4 （3.2%） had grade 1 muscle strength， 9 （7.1%） had grade 2 muscle strength， 39 （31.0%） had grade 3 muscle strength， and 71 （56.3%） had grade 4 muscle strength. Comparison of related data between the three groups of patients with varying grades of muscle strength showed that as for comorbidities， there were significant differences between the three groups in the constituent ratios of overt hepatic encephalopathy （OHE） （χ²=6.254， P=0.044）， ascites （χ²=6.248， P=0.044）， and liver failure （χ²=7.704， P=0.029）； as for laboratory markers， there were significant differences between the three groups in red blood cell count （RBC） （F=5.334， P=0.006）， hemoglobin （HGB） （F=4.627， P=0.012）， aspartate aminotransferase （AST） （H=6.866， P=0.032）， alanine aminotransferase （H=6.444， P=0.040）， albumin （Alb） （F=6.331， P=0.002）， cholinesterase （ChE） （H=11.064， P=0.004）， total cholesterol （TC） （F=4.843， P=0.009）， prothrombin activity （PTA） （F=3.937， P=0.022） and international normalized ratio （INR） （H=6.448， P=0.040）. Compared with the grade 4 group， the grade<3 group had significantly lower levels of RBC， HGB， and ChE （all P<0.05） and a significantly higher level of AST （P<0.05）； compared with the grade 3 group， the grade<3 group had significant reductions in Alb， TC， and PTA （all P<0.05） and a significant increase in INR （P<0.05）. At discharge， 27 patients （21.4%） achieved improvement， and 99 patients （78.6%） showed no response， among whom 2 patients died. ConclusionHM has the main clinical manifestation of symmetrical spastic paraplegia of both lower limbs， and it is more common in men. The main causes of HM include hepatitis B， hepatitis C， and alcoholic hepatitis. Muscle strength in HM patients is associated with the comorbidity of OHE， ascites， or liver failure， and patients with weak muscle strength tend to have low levels of RBC， HGB， Alb， ChE， TC， and PTA and high levels of AST and INR， suggesting that the changes in these indicators may be correlated with the degree of muscle strength impairment. HM often has a poor prognosis， and there are currently no effective treatment methods.

OBJECTIVE To investigate the anti-inflammatory effect of electroacupuncture in mice with chronic obstructive pul-monary disease(COPD)and its underlying mechanisms.METHODS Forty C57BL/6 mice were randomly divided into normal group,model group,electroacupuncture(EA)group,vagotomy group,and vagotomy+EA group,with 8 mice in each group.Except for the normal group,all groups were exposed to cigarette smoke for 12 weeks to establish a COPD model.After model establishment,the vagotomy group and the vagotomy+EA group underwent left cervical vagotomy before EA.EA treatment was performed at the Feishu(BL13)and Zusanli(ST36)acupoints once daily for 20 minutes for a total of 14 days.After EA,the pulmonary ventilation function of the mice was detected by a pulmonary function analysis system;lung tissue pathology was observed by HE staining;the levels of inter-leukin(IL)-6,tumor necrosis factor-α(TNF-α),IL-10,and transforming growth factor-β(TGF-β)in lung tissue were detected by ELISA;the expression of CD86 and CD206 proteins in lung tissue was detected by Western blot;the distribution of F4/80+CD86+(M1 type)and F4/80+CD206+(M2 type)cells in lung tissue was determined by flow cytometry;the expression of CD86 and CD206 in lung tissue was observed by immunofluorescence.RESULTS Compared with the normal group,the model group showed significantly decreased lung function(P<0.01),obvious lung pathological damage,increased M1 proportion,IL-6,TNF-α,CD86 content and expression(P<0.05,P<0.01),and decreased M2 proportion,IL-10,TGF-β,CD206 content and expression(P<0.01).Compared with the model group,the EA group showed varying degrees of improvement in lung function and pathology;the M1 proportion,IL-6,TNF-α,and CD86 were reduced(P<0.05,P<0.01),while the M2 proportion,IL-10,TGF-β,and CD206 were increased(P<0.05,P<0.01).The vagotomy group showed worsened lung function and pathology,increased IL-6,TNF-α,and CD86 content and expression(P<0.05,P<0.01),and decreased IL-10,TGF-β,and CD206 content and expression(P<0.05,P<0.01).Compared with the EA group,the vagotomy+EA group showed increased M1 proportion,IL-6,TNF-α,and CD86 content and expression(P<0.01),and decreased M2 proportion,IL-10,TGF-β,and CD206 content and expression(P<0.05,P<0.01).CONCLUSION EA at Feishu(BL13)and Zusanli(ST36)acupoints can improve lung function and pulmonary inflammation in COPD mice,promoting the polarization of alveolar macrophages from M1 to M2,which is mediated by the vagus nerve.

Under the background of breaking the " five only" evaluation criteria, continuously optimizing the scientific research performance evaluation system of hospitals to mobilize the enthusiasm and creativity of scientific researchers and guide the direction of scientific research development plays an important role in enhancing the overall scientific research capability of hospitals. Through literature analysis and expert consultation, a certain hospital has constructed a personal scientific research performance evaluation index system for medical staff in tertiary public hospitals, oriented towards innovation quality and member contributions, and began to implement it throughout the hospital in 2021. This index system included four categories of scientific research performance: vertical scientific research projects, academic influence, science and technology awards, and transformation of achievements, with a total of 20 indicators. The annual scientific research performance score of an individual would serve as the basis for the distribution of year-end scientific research performance and an important reference for applying for key and major projects within the hospital. After the application of this evaluation index system, the enthusiasm of medical staff for scientific research has been effectively stimulated. The average individual scientific research performance score increased from 0.974 in 2020 to 1.220 in 2023. All scientific research indicators involved in the evaluation system have shown growth, with a significant increase in high-quality results. This evaluation system can provide a reference for the scientific research performance evaluation of public hospitals under the background of breaking the " five only" evaluation criteria.

OBJECTIVE To investigate the anti-inflammatory effect of electroacupuncture in mice with chronic obstructive pul-monary disease(COPD)and its underlying mechanisms.METHODS Forty C57BL/6 mice were randomly divided into normal group,model group,electroacupuncture(EA)group,vagotomy group,and vagotomy+EA group,with 8 mice in each group.Except for the normal group,all groups were exposed to cigarette smoke for 12 weeks to establish a COPD model.After model establishment,the vagotomy group and the vagotomy+EA group underwent left cervical vagotomy before EA.EA treatment was performed at the Feishu(BL13)and Zusanli(ST36)acupoints once daily for 20 minutes for a total of 14 days.After EA,the pulmonary ventilation function of the mice was detected by a pulmonary function analysis system;lung tissue pathology was observed by HE staining;the levels of inter-leukin(IL)-6,tumor necrosis factor-α(TNF-α),IL-10,and transforming growth factor-β(TGF-β)in lung tissue were detected by ELISA;the expression of CD86 and CD206 proteins in lung tissue was detected by Western blot;the distribution of F4/80+CD86+(M1 type)and F4/80+CD206+(M2 type)cells in lung tissue was determined by flow cytometry;the expression of CD86 and CD206 in lung tissue was observed by immunofluorescence.RESULTS Compared with the normal group,the model group showed significantly decreased lung function(P<0.01),obvious lung pathological damage,increased M1 proportion,IL-6,TNF-α,CD86 content and expression(P<0.05,P<0.01),and decreased M2 proportion,IL-10,TGF-β,CD206 content and expression(P<0.01).Compared with the model group,the EA group showed varying degrees of improvement in lung function and pathology;the M1 proportion,IL-6,TNF-α,and CD86 were reduced(P<0.05,P<0.01),while the M2 proportion,IL-10,TGF-β,and CD206 were increased(P<0.05,P<0.01).The vagotomy group showed worsened lung function and pathology,increased IL-6,TNF-α,and CD86 content and expression(P<0.05,P<0.01),and decreased IL-10,TGF-β,and CD206 content and expression(P<0.05,P<0.01).Compared with the EA group,the vagotomy+EA group showed increased M1 proportion,IL-6,TNF-α,and CD86 content and expression(P<0.01),and decreased M2 proportion,IL-10,TGF-β,and CD206 content and expression(P<0.05,P<0.01).CONCLUSION EA at Feishu(BL13)and Zusanli(ST36)acupoints can improve lung function and pulmonary inflammation in COPD mice,promoting the polarization of alveolar macrophages from M1 to M2,which is mediated by the vagus nerve.

Objective:To observe the expression of genes related to hereditary retinal diseases (IRD) in human microglia (hMG).Methods:A experimental study. Efficient differentiation of human induced pluripotent stem cells (iPSC) into hMG. Identification of octamer-binding transcription factor 4 (OCT4), sex-determining transcription factor 2 (SOX2), Nanog homeobox (NANOG), stage-specific embryonic antigen-4 (SSEA4), alpha-fetoprotein (AFP), α-smooth muscle actin (α-SMA) as markers associated with iPSC dryness and pluripotency by immunofluorescence staining Glial fibrillary acidic protein (GFAP); hMG associated marker transmembrane protein 119 (TMEM119), purinergic receptor P2Y12 (P2RY12), and allograft inflammatory factor 1 (IBA1). The proportion of CD11b + and CD45 + cells was detected by flow cytometry. Mature hMG was collected and stimulated with lipopolysaccharide for 0, 4, 8 and 12 h, and were divided into groups 0 h, 4 h, 8 h and 12 h, respectively. Total RNA samples from the 4 groups were extracted for transcriptome sequencing, and the persistently significant differentially expressed genes (DEG) were screened. Real-time quantitative polymerase chain reaction (qPCR) was used to verify and analyze the expression of DEG mRNA. The two-tailed Student t test was used for comparison between the two groups. Results:iPSC expressed the dry related markers OCT4, SOX2, NANOG and SSEA4, and differentiated into endoderm, mesoderm and ectoderm, expressing the corresponding markers AFP, α-SMA and GFAP, respectively. iPSC formed embryoid bodies under specific culture conditions, and then differentiated into hMG, and hMG expressed related markers TMEM119, P2RY12 and IBA1 by immunofluorescence staining. The double positive ratio of CD11b + and CD45 + was > 95%. Transcriptomic analysis showed that the expression of 18 DEG in hMG stimulated by LPS was changed. qPCR test results showed that compared with group 0 h, mRNA expressions of Toll-like receptor 4 (TLR4), phosphoglycerate kinase 1, disintegrin and metallopeptidase domain 9 (ADAM9) in LPS stimulated group 4 h were significantly increased ( t=25.43, 15.54, 6.26; P<0.01). The mRNA expression levels of MER proto-oncogene tyrosine kinase (MERTK), non-hydrolase domain containing lysophospholipase 12 (ABHD12), retinal dehydrogenase 11 (RDH11), DNA damage autophagic regulator 2 (DRAM2) decreased ( t=5.94, 14.14, 8.21, 6.97; P<0.01), and the differences were statistically significant. Compared with group 0 h, mRNA expressions of RDH11, MERTK, ABHD12, DRAM2 and ADAM9 in group 8 h stimulated by LPS were significantly decreased, with statistical significance ( t=25.97, 5.47, 43.97, 38.40, 3.84; P<0.05). Compared with the group 0 h, the mRNA expressions of TLR4, ADAM9, MERTK, ABHD12, RDH11 and DRAM2 in the 12 h stimulated group were significantly decreased, and the differences were statistically significant ( t=6.39, 46.11, 5.34, 14.14, 25.97, 25.65; P<0.05). Conclusion:IRD-related genes may be involved in the occurrence and development of IRD by regulating the function of hMG.

Under the background of breaking the " five only" evaluation criteria, continuously optimizing the scientific research performance evaluation system of hospitals to mobilize the enthusiasm and creativity of scientific researchers and guide the direction of scientific research development plays an important role in enhancing the overall scientific research capability of hospitals. Through literature analysis and expert consultation, a certain hospital has constructed a personal scientific research performance evaluation index system for medical staff in tertiary public hospitals, oriented towards innovation quality and member contributions, and began to implement it throughout the hospital in 2021. This index system included four categories of scientific research performance: vertical scientific research projects, academic influence, science and technology awards, and transformation of achievements, with a total of 20 indicators. The annual scientific research performance score of an individual would serve as the basis for the distribution of year-end scientific research performance and an important reference for applying for key and major projects within the hospital. After the application of this evaluation index system, the enthusiasm of medical staff for scientific research has been effectively stimulated. The average individual scientific research performance score increased from 0.974 in 2020 to 1.220 in 2023. All scientific research indicators involved in the evaluation system have shown growth, with a significant increase in high-quality results. This evaluation system can provide a reference for the scientific research performance evaluation of public hospitals under the background of breaking the " five only" evaluation criteria.

Objective:To observe the expression of genes related to hereditary retinal diseases (IRD) in human microglia (hMG).Methods:A experimental study. Efficient differentiation of human induced pluripotent stem cells (iPSC) into hMG. Identification of octamer-binding transcription factor 4 (OCT4), sex-determining transcription factor 2 (SOX2), Nanog homeobox (NANOG), stage-specific embryonic antigen-4 (SSEA4), alpha-fetoprotein (AFP), α-smooth muscle actin (α-SMA) as markers associated with iPSC dryness and pluripotency by immunofluorescence staining Glial fibrillary acidic protein (GFAP); hMG associated marker transmembrane protein 119 (TMEM119), purinergic receptor P2Y12 (P2RY12), and allograft inflammatory factor 1 (IBA1). The proportion of CD11b + and CD45 + cells was detected by flow cytometry. Mature hMG was collected and stimulated with lipopolysaccharide for 0, 4, 8 and 12 h, and were divided into groups 0 h, 4 h, 8 h and 12 h, respectively. Total RNA samples from the 4 groups were extracted for transcriptome sequencing, and the persistently significant differentially expressed genes (DEG) were screened. Real-time quantitative polymerase chain reaction (qPCR) was used to verify and analyze the expression of DEG mRNA. The two-tailed Student t test was used for comparison between the two groups. Results:iPSC expressed the dry related markers OCT4, SOX2, NANOG and SSEA4, and differentiated into endoderm, mesoderm and ectoderm, expressing the corresponding markers AFP, α-SMA and GFAP, respectively. iPSC formed embryoid bodies under specific culture conditions, and then differentiated into hMG, and hMG expressed related markers TMEM119, P2RY12 and IBA1 by immunofluorescence staining. The double positive ratio of CD11b + and CD45 + was > 95%. Transcriptomic analysis showed that the expression of 18 DEG in hMG stimulated by LPS was changed. qPCR test results showed that compared with group 0 h, mRNA expressions of Toll-like receptor 4 (TLR4), phosphoglycerate kinase 1, disintegrin and metallopeptidase domain 9 (ADAM9) in LPS stimulated group 4 h were significantly increased ( t=25.43, 15.54, 6.26; P<0.01). The mRNA expression levels of MER proto-oncogene tyrosine kinase (MERTK), non-hydrolase domain containing lysophospholipase 12 (ABHD12), retinal dehydrogenase 11 (RDH11), DNA damage autophagic regulator 2 (DRAM2) decreased ( t=5.94, 14.14, 8.21, 6.97; P<0.01), and the differences were statistically significant. Compared with group 0 h, mRNA expressions of RDH11, MERTK, ABHD12, DRAM2 and ADAM9 in group 8 h stimulated by LPS were significantly decreased, with statistical significance ( t=25.97, 5.47, 43.97, 38.40, 3.84; P<0.05). Compared with the group 0 h, the mRNA expressions of TLR4, ADAM9, MERTK, ABHD12, RDH11 and DRAM2 in the 12 h stimulated group were significantly decreased, and the differences were statistically significant ( t=6.39, 46.11, 5.34, 14.14, 25.97, 25.65; P<0.05). Conclusion:IRD-related genes may be involved in the occurrence and development of IRD by regulating the function of hMG.

A case of giant liquid tophus in both lower legs was reported. The patient was a 41-year-old man with a history of gout for more than 10 years. The patient had hyperlipidemia and prediabetes, and the long-term use of hormone cortisol drugs was suspected. After standardized treatment for lowering uric acid, reducing blood lipids, and correcting glucose intolerance, the patient lost 12 kg over six months. The patient was admitted to the hospital upon discovering symmetrical enlargement of both calves. Ultrasound showed subcutaneous masses with clear boundaries behind the gastrocnemius muscle, approximately 14.9 cm×6.7 cm on the left and 13.6 cm×4.6 cm on the right. Based on the clinical information and morphological features, a diagnosis of gouty tophus was made. Following ultrasound-guided puncture drainage, aspirate about 200 mL fluid from the subcutaneous masses of each lower legs. The patient continued to receive standardized uric acid-lowering treatment and the patient′s condition improved. For such atypical giant liquid tophus, clinical practitioners should remain vigilant, differentiating them from tumors, infections, autoimmune diseases, and promptly perform pathological examinations through puncture to be diagnosed. After a definitive diagnosis, surgical excision can be performed concurrently with standardized uric acid-lowering treatment to achieve a favorable prognosis.

Objective:To investigate the risk factors of diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM) patients in plain-sand areas and loess hilly areas of Gansu province.Methods:A total of 1 599 T2DM patients who participated in chronic disease and risk factors monitoring and basic public health service management were selected by multi-stage stratified random sampling method in the sandy plain areas and loess hilly areas of Gansu province. Questionnaire survey, physical measurement and laboratory tests were performed. Multivariate binary logistic model was used to analyze the influencing factors.Results:The prevalence of DKD was 22.1% (174/787) among T2DM patients in the sandy plain areas and 19.1%(155/812) in the loess hilly area, respectively. Hypertension ( OR=3.022), hyperuricemia ( OR=2.114) and HbA1c≥7%( OR=2.231) were the risk factors for DKD in the plain-sand areas, and the risk of DKD increased with age. In the loess hilly areas, female sex ( OR=0.379) was the protective factor for DKD; while duration of disease≥10 years ( OR=2.476), hyperuricemia ( OR=1.907), HbA1c≥7% ( OR=1.927) were the risk factors for DKD; and the risk of DKD increased with the increase of age, and decreased with the increase of per capita monthly income. Conclusions:The prevalence of DKD and its influencing factors are different between sandy plain areas and loess hilly areas in Gansu province. The prevention and treatment of hypertension should be given more attention in sandy plain areas. In addition, the screening of DKD should be conducted among T2DM patients, particularly for those with old age, hyperuricemia and HbA1c≥7% in both areas of the province.

Objective: To observe the effects of electroacupuncture (EA) pretreatment on M1 polarization of alveolar macrophages (AMs) in rats with acute lung injury (ALI) induced by lipopolysaccharide (LPS), and to explore the potential protective mechanism of EA.Methods: Forty Sprague-Dawley rats were randomly divided into a normal group, a model group, and three groups of EA pretreatment [including a Chize (LU5) group, a Zusanli (ST36) group and a Chize (LU5) plus Zusanli (ST36) group], with eight rats in each group. The model rats of ALI were established by instilling LPS [2 mg/(kg·bw)] into the trachea of rats for 3 h. The rats in each EA pretreatment group were pretreated with EA for 30 min per day at the corresponding bilateral acupoints 6 d before instilling LPS. Three hours after modeling, the pulmonary function of the rats was tested, and the lung tissue was taken to calculate the ratio of lung wet weight to dry weight (W/D). The pathological lung changes and the injury score were observed by hematoxylin-eosin staining. The contents of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and myeloperoxidase (MPO) in rat's bronchoalveolar lavage fluid (BALF) were detected by enzyme-linked immunosorbent assay. The mRNA and protein expression levels of M1 macrophage markers clusters of differentiation 86 (CD86), inducible nitric oxide synthase (iNOS), and its signaling pathway factor Toll-like receptor (TLR) 4, and nuclear factor-κB (NF-κB) p65 in the alveoli were detected by fluorescence quantitative polymerase chain reaction and Western blot, respectively. Results: After being induced by LPS, the pulmonary function of the model rats showed that the forced expiratory volume in 0.1 s (FEV0.1), forced expiratory volume in 0.3 s (FEV0.3), and their respective ratios of FEV to forced vital capacity (FVC) (including FEV0.1/FVC and FEV0.3/FVC) were significantly decreased (P<0.01), while the W/D of lung tissue was increased (P<0.01). The score of lung injury was significantly higher (P<0.01). The contents of TNF-α, IL-1β, and MPO in the BALF and the mRNA and protein expression levels of CD86, iNOS, TLR4, and NF-κB p65 in the lung tissue were significantly increased (P<0.01). After EA pretreatment, the FEV0.1, FEV0.3, FEV0.1/FVC, and FEV0.3/FVC were significantly increased, the lung injury score decreased significantly, and the contents of TNF-α, IL-1β, and MPO in the BALF and the expression levels of CD86, iNOS, TLR4, and NF-κB p65 mRNAs and proteins in the alveoli decreased significantly (P<0.05 or P<0.01). Compared with the other two single acupoint groups, the contents of TNF-α, IL-1β, and MPO in the BALF and the expression levels of CD86, iNOS, TLR4, and NF-κB p65 mRNAs in the alveoli in the Chize (LU5) plus Zusanli (ST36) group were significantly lower (P<0.01). Conclusion: EA pretreatment at Chize (LU5) and Zusanli (ST36) can inhibit inflammation and reduce pulmonary injury in ALI rats induced by LPS. The effect of the combination of Chize (LU5) and Zusanli (ST36) is better than that of using these two acupoints separately, and its mechanism may be related to the inhibition of AMs' M1 polarization by down-regulation TLR4/NF-κB signaling pathway.