Objective To investigate the association between serum magnesium levels,serum phosphorus concentrations,vascular calcification,and cardiovascular disease mortality in maintenance hemodialysis patients.Methods This study enrolled 200 hemodialysis patients admitted to Nanjing Drum Tower Hospital from May 2020 to May 2022 as subjects,with an additional 200 healthy individuals from the same period selected as a control group.The biochemical indicators between the two groups were compared;their correlations were analyzed.Binary logistic regression was used to investigate the independent factors of serum magnesium and phosphorus levels in relation to vascular calcification and cardiovascular events in maintenance hemodialysis patients.ROC curve analysis was employed to assess the predictive value of serum magnesium and phosphorus for vascular calcification and cardiovascular events.Results The research group's patients exhibited significantly elevated levels of blood phosphorus,calcium-phosphorus product,iPTH,AACS,and 25-(OH)-VitD compared to the control group.In contrast,their blood magnesium and BMP-7 levels were notably lower than those of the control group,with statistical significance(P<0.05).Pearson correlation showed positive correlations between serum magnesium and serum calcium,phosphorus,calcium-phosphorus product,25-(OH)-VitD3,and BMP-7(r=0.385,0.183,0.141,0.131,0.458,P<0.05);between serum calcium and serum phosphorus,calcium-phosphorus product,iPTH,AACS,25-(OH)-VitD3,and BMP-7(r=0.318),correlation(r=0.318,0.311,0.098,0.170,0.277,0.485,P<0.05);between serum phosphorus and calcium-phosphorus product,iPTH,AACS,25-(OH)-VitD3(r=0.362,0.506,0.367,0.461,P<0.05);between calcium-phosphorus product and iPTH,AACS,25-(OH)-VitD3(r=0.542,0.373,0.434,P<0.05);between iPTH and AACS,25-(OH)-VitD3 showing positive correlations(r=0.553,0.616,P<0.05)and a negative correlation with BMP-7(r=-0.373,P<0.05);between AACS and 25-(OH)-VitD3 showing a positive correlation(r=0.402,P<0.05),and a negative correlation with BMP-7(r=-0.155,P<0.05),with statistically significant differences(P<0.05).Statistically significant differences were noted between the two groups in age,diabetes,serum magnesium,serum calcium,serum phosphorus,calcium-phosphorus product,25-(OH)-VitD3,and hs-CRP(P<0.05).Logistic regression analysis showed that age,serum magnesium,serum calcium,serum phosphorus,calcium phosphate product,25-(OH)-vitamin I were all risk factors for cardiovascular disease(CVD)mortality in maintenance hemodialysis(MHD)patients(P<0.05).ROC curve analysis showed that serum magnesium,serum calcium,and serum phosphorus had predictive areas under the curve(AUC)of 0.895,0.802,and 0.851 for CVD mortality in MHD patients,with sensitivities and specificities of 87.5%/98.7%,66.7%/90.8%,and 72.9%/100%,respectively.The combined prediction for CVD mortality in MHD patients showed an AUC of 0.921,with a sensitivity of 81.3%and specificity of 93.4%.Conclusion MHD patients exhibit low blood magnesium levels,elevated serum phosphorus concentrations,and increased calcium-phosphorus product,with complex correlations among these biomarkers.Age,magnesium,calcium,and phosphorus levels were all associated with CVD mortality.ROC curve analysis demonstrates that magnesium,calcium,and phosphorus,both individually and in combination,have high predictive value for CVD mortality risk.

Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.

Objective:To investigate the role of dendritic cells (DC) in Chlamydia muridarum ( Cm) respiratory infection and their effect on adaptive immune response. Methods:C57BL/6 mice were exposed to 1×10 3 inclusion-forming units (IFU) of Cm through inhalation to establish the mouse model of Cm respiratory infection. The proportion of CD11c + MHCⅡ + DC and the expression of costimulatory molecules (CD40, CD80 and CD86) in spleen tissues were detected by flow cytometry on 0, 3 and 7 d after infection. The expression of IL-12p40, IL-10 and IL-6 at mRNA level in spleen tissues was detected by qPCR. Mouse splenic DC isolated on 7 d after Cm infection were sorted by magnetic beads and then transferred to recipient mice. Th1 response in the recipient mice was measured using intracellular cytokine staining 14 d after infection. Results:Cm respiratory infection induced massive infiltration of DC and promoted the expression of costimulatory molecules on splenic DC. The expression of IL-12 and IL-10 at mRNA level in splenic DC reached the peak on 3 d after infection. Transferring the splenic DC of Cm-infected mice into the recipient mice could alleviate the disease condition in the recipient mice after Cm infection with reduced Cm inclusion-forming units in lung tissues and significantly increased proportion of Th1 cells in lung and spleen tissues. Conclusions:Cm respiratory infection could induce the maturation and activation of DC, which promoted Th1 immune response. DC played an important role in Cm infection.

Objective:To investigate the characteristics of anxiety and depression of postgraduates in military medical university under public health emergencies.Methods:By means of self-rating anxiety scale (SAS) and self-rating depression scale (SDS), 944 postgraduate students of a military medical university were investigated to analyze their characteristics of anxiety and depression. SPSS 25.0 was used to statistically analyze the collected data.Results:①The positive rates of anxiety and depression were respectively 8.03% and 8.25%. ②The positive rate of anxiety of male postgraduates was significantly higher than that of female postgraduates ( P=0.035). ③The positive rate of anxiety of serviceman students was significantly higher than that of civilian students ( P=0.022). ④There was no statistical difference in the positive rates of anxiety and depression among postgraduates in different areas ( P > 0.05). ⑤The levels of anxiety and depression of left-behind children were significantly higher than those of unleft-behind children ( P=0.000, P=0.018). ⑥The levels of anxiety and depression of postgraduate students were lower than those of undergraduate students ( P=0.000, P=0.002). Conclusion:Under the outbreak of public health emergencies, anxiety and depression occur in the postgraduates. To strengthen the mental health maintenance of postgraduates in military medical university during the outbreak, it is necessary to pay more attention on the mental health of military students, males and who were left-behind children before.

Objective:To investigate the role of IL-21/IL-21R-mediated CD4 + T cells in Chlamydia muridarum ( Cm) respiratory infection. Methods:C57BL/6 mice (WT mice) and IL-21R -/- mice were used to establish the models of Cm respiratory infection through intranasal inhalation of Cm. Flow cytometry was used to detect the proportion, number, activity and function of CD4 + T cells in lung and spleen tissues at 0, 3, 7 and 14 d after Cm respiratory tract infection. IFN-γ and IL-4 levels in spleen cell culture supernatants were detected by ELISA. Na?ve WT mice were transferred with CD4 + T cells in the spleen tissues of IL-21R -/- mice or WT mice on 7 d after infection and given Cm intranasally 2 h later. Then the mice were weighed daily and sacrificed on 14 d after infection. The bacterial load and pathological changes in lung were analyzed. Flow cytometry was performed to detect the proportions and numbers of neutrophils (CD45 + CD11b + Gr-1 high) and alveolar macrophages (CD45 + F4/80 + CD11c high)as well as the proportions of Th1 (IFN-γ + CD4 + ) and Th2 (IL-4 + CD4 + ) cells. ELISA was also performed to measure IFN-γ and IL-4 levels in spleen cell culture supernatants. Results:Compared with WT mice, IL-21R -/- mice showed elevated numbers and enhanced activation of CD4 + T cells, increased proportion of Th1 cells and decreased proportion of Th2 cells in spleen and lung tissues after Cm respiratory infection. Besides, IFN-γ levels increased, while IL-4 levels decreased in spleen cell culture supernatants of IL-21R -/- mice. After Cm infection, the na?ve WT transferred with CD4 + T cells from IL-21R -/- mice showed less body weight loss, reduced bacterial load and alleviated pathological changes in lung tissues, increased proportion of Th1 cells in lung tissue and higher IFN-γ level in spleen cell culture supernatants. Conclusions:IL-21/IL-21R-mediated CD4 + T cells could aggravate Cm respiratory infection by suppressing Th1 cell immune responses.

OBJECTIVE: Current clinical evidence on the effects of home blood pressure telemonitoring (HBPT) on improving blood pressure control comes entirely from developed countries. Thus, we performed this randomized controlled trial to evaluate whether HBPT plus support (patient education and clinician remote hypertension management) improves blood pressure control more than usual care (UC) in the Chinese population. METHODS: This single-center, randomized controlled study was conducted in Beijing, China. Patients aged 30-75 years were eligible for enrolment if they had blood pressure [systolic (SBP) ≥ 140 mmHg and/or diastolic (DBP) ≥ 90 mmHg; or SBP ≥ 130 mmHg and/or DBP ≥ 80 mmHg with diabetes]. We recruited 190 patients randomized to either the HBPT or the UC groups for 12 weeks. The primary endpoints were blood pressure reduction and the proportion of patients achieving the target blood pressure. RESULTS: Totally, 172 patients completed the study, the HBPT plus support group ( n = 84), and the UC group ( n = 88). Patients in the plus support group showed a greater reduction in mean ambulatory blood pressure than those in the UC group. The plus support group had a significantly higher proportion of patients who achieved the target blood pressure and maintained a dipper blood pressure pattern at the 12th week of follow-up. Additionally, the patients in the plus support group showed lower blood pressure variability and higher drug adherence than those in the UC group. CONCLUSION HBPT plus additional support results in greater blood pressure reduction, better blood pressure control, a higher proportion of dipper blood pressure patterns, lower blood pressure variability, and higher drug adherence than UC. The development of telemedicine may be the cornerstone of hypertension management in primary care.
Humans ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Hypertension/therapy* ; Telemedicine/methods* ; Hypotension

Objective:To investigate the infiltration and polarization of macrophages in mice during Chlamydia muridarum ( Cm) respiratory infection. Methods:C57BL/6 mice were intranasally infected with 1×10 3 inclusion-forming units (IFU) of Cm to establish the mouse model of Cm respiratory tract infection. The percentages of CD45 + F4/80 + cells and the macrophages expressing CD86, major histocompatibility complex Ⅱ (MHC), inducible nitric oxide synthase (iNOS) and CD206 were detected by flow cytometry. Expression of iNOS, CD206 and CCL2 at mRNA level was detected by real-time quantitative PCR. Results:Cm respiratory tract infection induced the increase of macrophages in mouse lung tissues. Compared with uninfected group, CD45 + F4/80 + macrophages were increased significantly from day 3 and reached the peak on day 7 after Cm infection. Moreover, the expression of CD86, MHCⅡ and CCL2 was increased, and the macrophages were polarized to M1 phenotype. However, the expression of M2 macrophage marker CD206 was decreased gradually. Further studies showed that iNOS expression, the indicator of M1 macrophage activation, was increased after Cm infection and reached to the top on day 7. Conclusions:Cm respiratory infection could induce the infiltration of macrophages in lung tissues and promote the polarization of macrophages to M1 phenotype.

Objective:To analyze clinical characteristics of patients of Tibetan nationality with vitiligo in the Tibet autonomous region.Methods:Clinical data were collected from 527 patients of Tibetan nationality with vitiligo, who visited Department of Dermatology, People′s Hospital of Tibet Autonomous Region from January 2018 to December 2019, including age, gender, seasons at onset, involved body sites, classification and stages of vitiligo, concomitant diseases and laboratory test results.Results:Among the 527 patients of Tibetan nationality with vitiligo, the ratio of male to female was 0.97∶1, and vitiligo usually occurred at 10 - 30 years of age. As for clinical staging, 335 (63.6%) patients were diagnosed with progressive vitiligo, and 192 (36.4%) with stable vitiligo; as for clinical classification, there were 97 (18.4%) patients with segmental vitiligo, 293 (55.6%) with vitiligo vulgaris, 79 (15%) with mixed vitiligo and 58 (11%) with unclassified vitiligo; vitiligo lesions were mainly located on the face and neck (253 cases, 48%) , followed by the trunk (148 cases, 28%) , upper limbs (64 cases, 12%) , lower limbs (46 cases, 9%) , and perineal and perianal mucosa (16 cases, 3%) ; vitiligo usually occurred in summer (198 cases, 37.6%) and spring (154 cases, 29.2%) , followed by autumn (98 cases, 18.6%) and winter (77 cases, 14.6%) ; 140 (26.6%) patients suffered from other diseases such as thyroid diseases (85 cases, 16.1%) , and 74 (14.0%) suffered from subclinical thyroid diseases; one or more serological abnormalities were observed in 22 patients, including 18 with progressive vitiligo. Compared with the patients with stable vitiligo, those with progressive vitiligo showed significantly increased thyroid stimulating hormone (TSH) levels ( P = 0.004) . Spearman rank correlation analysis showed that altitude was weakly correlated with the stage of vitiligo ( rs = -0.18, P < 0.001) , the stage of vitiligo was weakly negatively correlated with the TSH level ( rs = -0.12, P = 0.005) and complement C3 level ( rs = -0.09, P = 0.041) , and the classification of vitiligo was weakly correlated with the TSH level ( rs = -0.11, P = 0.011) . Conclusion:In this study, the patients of Tibetan nationality with vitiligo were mostly aged at 10 - 30 years, vitiligo lesions were mainly located on the face and neck, and usually occurred in spring and summer, and the prevalence of comorbid thyroid dysfunction was relatively high.

Objective:To investigate the effects of Chlamydia muridarum ( Cm) respiratory tract infection on the infiltration and polarization of alveolar macrophages (AMs) and pulmonary interstitial macrophages (IMs). Methods:A C57BL/6 mouse model of Cm respiratory tract infection was established through nasal inhalation. Flow cytometry was used to detect AMs (CD45 + F4/80 + CD11c + ) and IMs (CD45 + F4/80 + CD11c -) in lung tissues at 0, 3, 7 and 14 d after Cm respiratory tract infection. The proportions of M1 (CD80 + , CD86 + , MHCⅡ + , iNOS + ) and M2 (CD206 + , Arg1 + ) macrophages in AMs and IMs were also detected. Results:(1) Cm respiratory tract infection induced the infiltration of AMs and IMs. Compared with the uninfected group (0 d), the proportions and the numbers of AMs and IMs of were significantly increased 3 d after infection ( P<0.05, P<0.01). The numbers of AMs and IMs reached the peak 7 d after infection ( P<0.001). (2) Compared with the uninfected group, the proportions of CD80 + and CD86 + cells in AMs were significantly up-regulated 3 d after infection ( P<0.05, P<0.01); the proportion of MHCⅡ + cells in AMs increased after infection and reached the peak at 14 d ( P<0.05), while the proportion of CD206 + cells decreased after infection ( P<0.05). (3) Compared with the uninfected group, the proportions of CD80 + and CD86 + cells in IMs were increased 3 d after infection ( P<0.05, P<0.001) and the proportion of MHCⅡ + cells was significantly increased 14 d after infection ( P<0.01), while there was no significant change in the proportion of CD206 + cells. (4) In AMs, the proportion of iNOS + cells increased continuously after infection ( P<0.01), while the proportion of Arg1 + cells decreased continuously after infection, especially at 7 d and 14 d ( P<0.05). In IMs, the proportion of iNOS + cells reached the peak at 7 d ( P<0.001), but the proportion of Arg1 + cells showed no significant change after infection. Conclusions:Cm respiratory tract infection induced the infiltration of AMs and IMs, stimulated the polarization of AMs and IMs towards the M1 phenotype and weakened the polarization of AMs to M2 macrophages, but had no significant influence on the polarization of IMs towards the M2 phenotype.

ObjectiveTo study the value of pedicled orbital septum fat flap secured fixation in lower eyelid blepharoplasty. MethodsIn this retrospective study， 81 patients diagnosed as bulgy lower eyelid with tear trough deformity who underwent this procedure at the Department of Plastic Surgery of the Third Affiliated Hospital of Sun Yat-sen University between January 2018 and March 2021 were reviewed. Through a percutaneous or transconjunctival incision， the orbicularis oculi were completely released over tear trough deformity. And orbital septum fat was released and firmly sutured to deep fat pat or periosteum as a flap. Extra orbital septum fat， and extra skin for percutaneous approach was excised to correct bulgy lower eyelid. ResultsThe follow-up was three to twelve months. Bulgy lower eyelid and tear trough deformity were significantly improved. Among them， two patients had hematoma， one patient had eyelid ectropion， one patient had palsy of one side of the middle and lower face， three patients who underwent transconjunctival incision had foreign body sensation， and all of them recovered after two weeks to three months. No other complications were reported. ConclusionPedicled orbital septum fat flap secured fixation in lower eyelid blepharoplasty shows great effect for bulgy lower eyelid with tear trough deformity， and maintains low restoration rate and low complication.