OBJECTIVES: To investigate the role of activating transcription factor 3 (ATF3) in atherosclerotic plaques for regulating inflammatory responses during atherosclerosis (AS) progression. METHODS: Human coronary artery specimens from autopsy cases were examined for ATF3 protein expression and localization using immunofluorescence staining and Western blotting. Apolipoprotein E-deficient (ApoE^-/-) mouse models of AS induced by high-fat diet (HFD) feeding for 12 weeks were subjected to tail vein injection of adeno-associated virus serotype 9 (AAV9) to knock down ATF3 expression. After an additional 5 weeks of HFD feeding, the mice were euthanized for analyzing structural changes of the aortic plaques, and the expression levels of ATF3, inflammatory factors (CD45, CD68, IL-1β, and TNF-α), and NF-κB pathway proteins (P-IKKα/β and P-NF-κB p65) were detected. In the cell experiment, THP-1-derived foam cells were transfected with an ATF3-overexpressing plasmid or an ATF3-specific siRNA to validate the relationship between ATF3 and NF‑κB signaling. RESULTS: In human atherosclerotic plaques, ATF3 expression was significantly elevated and partially co-localized with CD68. ATF3 knockout in ApoE^-/- mice significantly increased aortic plaque volume, upregulated the inflammatory factors, enhanced phosphorylation of the NF‑κB pathway proteins, and increased the expressions of VCAM1, MMP9, and MMP2 in the plaques. In THP-1-derived foam cells, ATF3 silencing caused activation of the NF‑κB pathway, while ATF3 overexpression suppressed the activity of the NF-κB pathway. CONCLUSIONS AS promotes ATF3 expression, and ATF3 deficiency exacerbates AS progression by enhancing plaque inflammation via activating the NF-κB pathway, suggesting the potential of ATF3 as a therapeutic target for AS.
Animals ; Activating Transcription Factor 3/metabolism* ; Signal Transduction ; NF-kappa B/metabolism* ; Humans ; Mice ; Plaque, Atherosclerotic/metabolism* ; Inflammation/metabolism* ; Apolipoproteins E ; Atherosclerosis/metabolism* ; Diet, High-Fat

OBJECTIVE To study the effect of Runzao zhiyang capsule （RZZY） on gut microbiota and its metabolites short- chain fatty acids （SCFA） in eczema rats， in order to reveal the improvement effect and possible mechanism of RZZY on eczema. METHODS The rats were divided into normal group， model group， desloratadine group （1.5 mg/kg）， and RZZY low-dose and high-dose groups （0.6， 1.2 g/kg）. Except for the normal group， the eczema model was established in other groups by applying the 2，4-dinitrochlorobenzene solution to the hair removal area to sensitize it； they were given relevant drugs intragastrically， once a day， for consecutive 2 weeks. After medication， the skin thickness of rats was measured， and the eczema area and severity index （EASI） scoring and pathology scoring were performed； the structure of gut microbiota was analyzed by 16S rDNA sequencing. The contents of SCFA （including acetic acid， propionic acid， and butyric acid） in feces were determined by gas phase-mass spectrometry. The expressions of signal transduction and activator of transcription 3 （STAT3） in the colon and skin were detected. RESULTS RZZY significantly alleviated skin swelling and ulceration and reduced EASI， skin thickness and pathological score in eczema rats （P＜0.05）. RZZY significantly increased ACE， Sobs and Shannon indexes （P＜0.05） and promoted the microbiota of eczema rats to return to normal structure. RZZY increased the abundance of Firmicutes and Lachnospira， Lactobacillus and Alistipes， while decreased the abundance of Bacteroidetes and Bacteroides. RZZY significantly increased the contents of propionic acid and butyric acid in the feces of eczema rats （P＜0.05）， while significantly down-regulated the expressions of STAT3 protein in the colon and skin （P＜0.05）. C ONCLUSIONS RZZY can improve SCFA levels by regulating gut microbiota， thereby inhibiting STAT3 expression， playing an anti- inflammatory role， and improving skin inflammation in eczema rats.

Objective: To investigate the effect of Ginsenoside Rg1 (GsRg1) on proliferation , migration and osteogenic differentiation of human gingival fibroblasts (HGFs) and its molecular mechanism. Methods: Human gingival fibroblasts (HGFs) were isolated and cultured by tissue block method , and identified by morphology and immunofluorescence. The effect of six concentrations of GsRg1 (0 , 6. 25 , 12. 5 , 25 , 50 , 100 mg/L) on the proliferation of HGFs was detected by CCK⁃8 method. Transwell assay was used to detect the effects of different concentrations of GsRg1 on the migration ability of HGFs. Alkaline phosphatase (ALP) staining was used to detect osteogenic ability. Alizarin red staining was used to observe and quantify calcium nodules. The expression of COL⁃ Ⅰ , OCN and OPN osteogenic genes was detected by qRT⁃PCR. Western blot was used to detect the protein expression of OCN ,OPN , COL⁃ Ⅰ and PI3K/AKT signaling pathway. Results: Compared with the control group , the proliferation ability of HGFs was significantly improved at the concentrations of 12. 5 ,25 ,50 and 100 mg/L GsRg1 (P < 0. 05) , and the proliferation promotion effect of 100 mg/L GsRg1 was the strongest. There was no significant difference between the 6. 25 mg/L GsRg1 group and the control group. After GsRg1 treatment , the migration ability of HGFs was enhanced and showed concentration dependence. Compared with the control group , the activity of ALP in 100 mg/L GsRg1 group significantly increased (P < 0. 01) . Alizarin red staining showed a significant increase in the number of calcium nodules(P < 0. 01) . The mRNA and egg white expression levels of osteogenic genes OCN , OPN and COL⁃ Ⅰ increased (P < 0. 05 ) . The expression levels of p ⁃PI3K and p ⁃Akt were significantly up⁃regulated with time ( P <0. 05) ,while the expression levels of PI3K and AKT had no significant changes. Conclusion GsRg1 can promote the proliferation and migration of HGFs , and 100 mg/L GsRg1 can promote the osteogenic differentiation of HGFs ,which may be related to the activation of PI3K/AKT signaling pathway.

Objective:To investigate the clinical effect of "ladder reduction method" in the treatment of iliac fracture combined anterior dislocation of sacroiliac joint.Methods:The retrospective analysis was performed on 10 cases of iliac fracture combined anterior sacroiliac joint dislocation admitted to the Affiliated Hospital of Yunnan University from February 2010 to January 2022, among which 5 cases were males and 5 cases were females, aged ranging from 22 to 52 years, with an average age of 38.8 years. All patients were injured in car accidents including 5 cases of C1.2, 3 cases of C2, and 2 cases of C3 fractures according to Tile classification. All patients were treated with the "ladder reduction method" with plate and screw fixation. In the first step, 1-2 Schanz pins were inserted into the iliac crest to control the ilium, and the Schanz pins were appropriately pulled laterally; in the second step, the periosteal stripper was used to pry the reduction between the sacrum and ilium; in the third step, for the patients who still could not be reduced, a 2.5 mm diameter Kirschner wire was placed on the sacrum close to the iliac crest, and a periosteal stripper was inserted between the sacrum and iliac crest, with its tip against the Kirkner wire, and the iliac crest as the fulcrum for pry pulling to separate the two. In the fourth step, the pry was maintained, and then another 2.5 mm diameter Kirschner wire was placed on the sacrum close to the internal margin of the iliac bone. The periosteal stripper was continued to pry between the sacrum and the iliac bone, and the operation was repeated. At the same time, the anterior dislocation of the sacroiliac joint was reduced with traction of the lower limb. Postoperatively, the quality of reduction was evaluated by the Matta score, and the degree of functional recovery after pelvic fracture was evaluated by the Majeed score.Results:Four patients completed the reduction through the first and second steps, and 6 cases of refractory sacroiliac joint anterior dislocation were successfully reduced through the first to fourth steps. The fracture reduction time of 6 patients with refractory anterior sacroiliac joint dislocation was 39.67±3.09 min (range, 35-44 min), with intraoperative blood loss of 300.00±141.42 ml (range, 150-600 ml); in the other 4 cases, the fracture reduction time was 36.75±4.38 min (range, 30-42 min), and the intraoperative blood loss was 225.00±44.30 ml (range, 200-300 ml). All 10 patients were followed up for 12.9±3.7 months (range, 9-20 months). The anterior and posterior pelvic ring fractures were healed in all patients, and the fracture healing time was 12.77±1.62 weeks (range, 10.71-15.28 weeks). At the last follow-up, Matta evaluation was excellent in 5 cases, good in 1 case, and excellent in the other 4 cases. The Majeed scores of 6 cases were 86.50±6.08 points (range, 74-92 points), of which 5 cases were excellent and 1 case was good. The other 4 cases were 81.5±9.39 scores (range, 71-94), of which 2 were excellent and 2 were good.Conclusion:The "ladder reduction method" is a safe, effective and easy-to-operate method for the treatment of iliac fracture combined anterior dislocation of the sacroiliac joint, especially for refractory anterior dislocation of the sacroiliac joint, which can still obtain satisfactory curative effects.

Objective:To evaluate the relationship between early postoperative recovery and frailty after digestive endoscopy-assisted minimally invasive surgery under intravenous anesthesia in the elderly.Methods:This study retrospectively selected hospitalized patients, aged ≥65 yr, scheduled for elective gastrointestinal endoscopic treatment.Early postoperative recovery time was defined as the period from the end of propofol administration to the achievement of a modified Aldrete score of 9.All the patients were divided into 2 groups according to whether the early recovery time after operation was less than 75%: normal early postoperative recovery time group and delayed early postoperative recovery time group.Frailty was assessed using the frailty phenotype (FP score 0-5), and the patient was diagnosed as frail (FP ≥3) or non-frail (FP 0-2). The age, sex, height, weight, smoking history, American Society of Anesthesiologists (ASA) Physical Status classification, type of operation, and baseline mean arterial pressure and heart rate were recorded.Logistic regression analysis was used to identify the risk factors for delayed early postoperative recovery time after minimally invasive digestive endoscopy under intravenous anesthesia in elderly patients.Results:A total of 214 patients were enrolled and divided into normal early postoperative recovery time group ( n=169) and delayed early postoperative recovery time group ( n=45). There were significant differences in frailty, age, drinking history of more than 10 yr, preoperative ASA Physical Status classification and propofol administration time between delayed early postoperative recovery time group and normal early postoperative recovery time group ( P<0.05). The results of logistic regression analysis indicated that frailty, age, ASA Physical Status classification Ⅲ, and propofol administration time were independent risk factors for the occurrence of delayed early postoperative recovery ( P<0.05). Conclusions:Frailty, age, ASA Physical Status classification Ⅲ and propofol administration time are independent risk factors for delayed early postoperative recovery time following digestive endoscopy-assisted minimally invasive surgery under intravenous anesthesia in elderly patients.

The German ( Kooperation für Transoarenz und Qualit?t im Gesundheitswesen, KTQ) certification system was officially launched in Germany in December 2001. Over ten years′ development proves that the KTQ certification system as a high standard medical management system. The authors introduced its background, the update of certification content and procedures, and explained its characteristics and advantages.These insights provide valuable references for establishing a professional and efficient quality certification system, suitable for China′s social and economic development level.

Objective:To develop the methods for the determination of calcined calamine and borneol in Jinniu ophthalmic remedy. Methods:The content of zinc oxide in calcined calamine was determined by an EDTA coordination titration method. A DB-WAX capillary column (30 m ×0.32 mm,0.5 μm) was used with an FID as the detector and ethylacetate as the solvent to determine the content of borneol. The column temperature was 150 ℃, the injection port temperature was 180 ℃, the detector temperature was 200 ℃, the split ratio was 5 :1,and the flow rate was 1 ml·min-1. Results:The recovery of zinc oxide was 101.5% with the RSD was 1.2%(n = 9). The linear range of borneol was 0.1-5.0 μg(r = 0.999 9). The recovery of borneol was 98.18% with the RSD was 0.8%(n = 9). The content of zinc oxide and borneol in the samples was 0.38-0.59 g·g-1and 0.13-0.21 g·g-1,respectively. Conclusion:The method is simple and accurate with high reproducibility and promising stability, which can be used for the quality control of Jinniu ophthalmic remedy.

Objective To explore the effect of regional synergistic treatment system on the treatment time and short-term prognosis of patients with ST-segment elevation myocardial infarction (STEMI).Methods A retrospective analysis of the clinical data of STEMI patients who admitted to emergency center of Suzhou Kowloon Hospital Affiliated to Shanghai Jiaotong University School of Medicine and underwent primary percutaneous coronary intervention (PPCI) from January 2013 to January 2017 were conducted. All patients were divided into two groups, group A was the patients who underwent the PPCI before the establishment of the acute chest pain area co-treatment system (from January 2013 to December 2014), and group B was the patients who received the treatment after the establishment of the area co-treatment system (from January 2015 to January 2017). The length of time from onset of symptoms to the balloon dilatation (S2B), the length of time from the first medical contact to the balloon dilatation (FMC2B), the length of time from entering the gate of hospital to the balloon dilatation (D2B), and the incidence of 90-day end point events (including heart failure, all-cause death, and other related adverse events) were collected. The relations of the establishment of the acute chest pain area co-treatment system and the incidence of 90-day end point events were analyzed by multivariable Logistic regression analysis.Results Among the 221 enrolled patients with STEMI, 83 patients were in group A and 138 patients were in group B respectively. Compared with group A, S2B time [minutes: 180 (140, 210) vs. 201 (154, 225)], FMC2B time [minutes: 89 (78, 100) vs. 94 (83, 107)] and D2B time [minutes: 66 (62, 70) vs. 85 (72, 99)] were significantly shortened in group B (allP < 0.05), the incidence of 90-day end point events were significantly decreased (heart failure:20.3％ vs. 32.5％, all-cause death: 1.4％ vs. 7.2％, other related adverse events: 23.2％ vs. 36.1％, allP < 0.05). It was shown by multivariable Logistic regression analysis that the establishment of the acute chest pain area co-treatment system could lower the incidence of 90-day end point events [heart failure: odds ratio (OR) = 1.904, 95％ confidence interval (95％CI) = 0.968-1.004, P = 0.048; all-cause death:OR = 11.724, 95％CI = 0.955-1.048,P = 0.013; other related adverse events:OR = 1.925, 95％CI = 1.049-3.530,P = 0.034].Conclusion The construction of regional synergistic treatment system can shorten the emergency treatment time of STEMI patients and reduce the incidence of 90-day end point events including heart failure and death.

Objective To explore the effect of cisterna magna plastic repairing (posterior vertebral column resection and cerebella tonsillectomy and reconstruction of the cisterna magna by artificial dura) on cerebrospinal fluid dynamics in Chiari malformation type Ⅰ with syringomyelia and evaluate the efficacy of this surgical method.Methods Forty patients with Chiari malformation type Ⅰ with syringomyelia (CMI-SM),admitted to and diagnosed by MRIin our hospital from January 2011 to December 2013,were selected.All patients were treated with cistema magna plastic repairing.Phase-contrast MR imaging (PC-MRI) was performed,changes of cerebrospinal fluid dynamics indicators of cerebral aqueduct,pons ventral side and C3 ventral side were detected and compared and Japanese Orthopaedic Association (JOA) scale scores were evaluated 24 h before operation and 12 months after operation.Results No neurological deterioration or death was noted;JOA scores in all patients were increased from 7.89±3.52 to 12.53±4.32,with significant difference (P＜0.05);post-operated PC-MRI indicated that the cistema magna formed well,spinal subarachnoid space was clear,syringomyelia in 30 patients was significantly reduced;as compared with those before operation,the stroke volume and mean flux were significantly increased,but maximum peak velocity was significantly reduced (P＜0.05).Conclusion Cisterna magna plastic repairing can reduce syringomyelia,increase cerebrospinal fluid flow,and reduce peak flow of cerebrospinal fluid,which is an effective surgical procedure for Chiari malformation type I with syringomyelia.

Objeetive To evaluate the relationship between aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT ratio) and metabolic syndrome in college students.Methods Anthropometric and metabolic measurements including fasting plasma glucose (FPG),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C),true insulin (TI),(AST and ALT) were assessed in a crosssectional study of 425 college students aged 19 to 24 years old (male 216,female 209) in 2009.The participants were then assigned to the AST/ALT ratio ＜ 1 group or the AST/ALT ratio ≥ 1 group.Metabolic syndrome was defined as Adult Treatment Panel Ⅲ criteria.Results AST/ALT ratio ＜ 1 was found in 146 subjects (34.4％).After adjustment for age and sex,AST/ALT ratio showed a positive correlation with HDLC (r=0.125) and negative correlations with body mass index (BMI,r=-0.281),waist circumtance (WC,r =-0.264),TG (r =-0.134),TI (r =-0.118) and HOMA-insulin resistance (HOMA-IR,r =-0.121) (all P ＜0.05).The prevalence of metabolic syndrome was 2.1％ and was similar in males and females (2.3％ vs.1.9％,P =0.774).Those with AST/ALT ratio ＜ 1 had a significantly higher prevalence of metabolic syndrome (4.8％ vs.0.7％,P =0.016).After adjustment for age,gender and BMI,the prevalence of metabolic syndrome of subjects with AST/ALT ratio ＜ 1 was nearly 7 (95％ CI:1.430 to 34.019,P =0.016) times of those with AST/ALT ratio ≥ 1.Conclusion AST/ALT ratio may be related with metabolic syndrome in college students.