AIM:To explore the effectiveness of predictive models based on quantitative characteristics of multimodal fundus images in assessing the risk of progression of non-proliferative diabetic retinopathy(NPDR).METHODS:A single-center retrospective cohort study was conducted. Patients diagnosed with moderate to severe NPDR between January 2021 and December 2023 in Wuhan Ninth Hospital were selected. Baseline color fundus photography(CFP), optical coherence tomography(OCT), and fundus autofluorescence(FAF)images were collected. Microaneurysm count, hard exudate area, central retinal thickness, retinal nerve fiber layer thickness, and total area of hyperautofluorescent spots were extracted and quantified. All patients were followed up regularly. The primary endpoint was the progression to treatment-requiring proliferative diabetic retinopathy(PDR)or clinically significant diabetic macular edema(DME)during the follow-up period. According to the occurrence of endpoint events during follow-up, the patients were divided into the progression group and the non-progression group. Combined with clinical significance and inter-group comparison results, candidate quantitative imaging parameters were included in the multivariate logistic regression analysis to construct a prediction model. The model was visualized using a Nomogram. The discriminative ability and calibration degree of the model were evaluated via receiver operating characteristic(ROC)curves and calibration curves.RESULTS:A total of 300 patients(300 eyes)completed follow-up, with 93 in the progression group, including 47 males and 46 females, with an average age of 59.02±8.21 y. There were 207 cases in the non-progression group, including 105 males and 102 females, with an average age of 58.01±8.10 y. Multivariate logistic regression showed that the total area of FAF hyperautofluorescent spots(OR=1.580, 95%CI: 1.061-1.718, P=0.002),OCT retinal nerve fiber layer thickness(OR=1.520, 95%CI: 1.307-6.212, P=0.013), and CFP microaneurysm count(OR=1.459, 95%CI: 1.089-2.095, P=0.015)were risk factors for DR progression. The AUC of the Nomogram for predicting progression risk during the follow-up period was 0.889(95%CI: 0.826-0.952), and the calibration curve showed good consistency between predicted probability and actual risk.CONCLUSION: The prediction model integrating quantitative imaging features of CFP, OCT and FAF can effectively identify NPDR patients with high progression risk and exhibits good predictive efficacy, which can serve as a quantitative tool for individualized clinical risk management.

Perifoveal exudative vascular anomalous complex (PEVAC) is a very rare macular vascular disease characterized by an isolated large aneurysmal lesion in the fovea, with accompanied by small retinal hemorrhage and exudation. The main clinical symptoms of the patients are various degree of impaired vision. Clinically, it is often confused with type 1 macular telangiectasia and type 3 macular neovascularization. A thorough understanding of the clinical features of PEVAC is particularly important for its differential diagnosis. Due to the unclear pathogenesis of PEVAC, there is no specific treatment for the cause of disease. Most scholars use intravitreal injection against vascular endothelial growth factor drugs for treatment, but can not improve patients' visual acuity. At present, many attempts have been made to eliminate abnormal exudation of the lesion, maintain visual function and achieve a good prognosis by simple or combined laser photocoagulation. At present, it is still necessary to explore the pathogenesis of PEVAC, improve the understanding of the disease, and find a better treatment plan.

Humans ; Asthma/drug therapy* ; Biological Therapy

The adjacent anatomy of the pelvis is complicated, with digestive, urinary, reproductive and other organs as well as important blood vessels and nerves. Therefore, accurate resection of pelvic tumors and precise reconstruction of defects after resection are extremely difficult. The development of medical 3D printing technology provides new ideas for precise resection and personalized reconstruction of pelvic tumors. The “triune” application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis in pelvic tumor limb salvage reconstruction treatment has achieved good clinical results. However, the current lack of normative guidance standards such as preparation and application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis restricts its promotion and application. The formulation of this consensus provides normative guidance for 3D printing personalized pelvic tumor limb salvage reconstruction treatment.

[Abstract] Objective: To investigate the effect of metformin on the senescence-associated secretory phenotype (SASP) of doxorubicin-induced gastric cancer BGC823 cells. Methods: Human gastric cancer BGC823 cells were cultured in vitro and treated with doxorubicin at gradient concentrations (50, 100, 150 and 200 nmol/L). Cell senescence was detected by SA-β-gal staining, and SASP factor expression was detected by ELISA. The effects of metformin on cell senescence and SASP factor secretion induced by doxorubicin (100 nmol/L) were observed by adding gradient concentrations of metformin (0, 5, 10 and 20 mmol/L). Results: With the increase of doxorubicin concentration and treatment time, the senescence rate of gastric cancer BGC823 cells increased first and then decreased. At 96 h after 100 nmol/L doxorubicin treatment, the peak aging rate reached 68.7%, accompanied with significantly increased expressions of SASP factors IL-1a, IL-6, IL-8 and CXCL1. The proportion of senescent cells was (55.2±1.9)%, (48.7±2.2)% and (40.8±2.3)% respectively under the effects of 5, 10 and 20 mmol/L metformin, which was significantly lower than that in the non-metformin treatment group (P< 0.01). At the same time, with the increase of metformin concentration, the production of SASP factors IL-1α, IL-6, IL-8 and CXCL1 showed a gradient decline. Compared with the non-metformin treatment group, IL-6 and IL-8 decreased significantly under the effect of metformin above 10 mmol/L (P<0.05 or P<0.01), while IL-1α and CXCL1 decreased significantly under the effect of 20 mmol/L metformin (all P<0.05). Conclusion: Metformin can inhibit the senescence and SASP production of gastric cancer cells induced by doxorubicin.

PURPOSE: Details of patients hospitalized for asthma exacerbation in mainland China are lacking. To improve disease control and reduce economic burden, a large sample survey among this patient population is indispensable. This study aimed to investigate the clinical characteristics and outcomes of such patients.METHODS: A retrospective study was conducted on patients hospitalized for asthma exacerbation in 29 hospitals of 29 regions in mainland China during the period 2013 to 2014. Demographic features, pre-admission conditions, exacerbation details, and outcomes were summarized. Risk factors for exacerbation severity were analyzed.RESULTS: There were 3,240 asthmatic patients included in this study (57.7% females, 42.3% males). Only 28.0% used daily controller medications; 1,287 (39.7%) patients were not currently on inhaled corticosteroids. Acute upper airway infection was the most common trigger of exacerbation (42.3%). Patients with severe to life-threatening exacerbation tended to have a longer disease course, a smoking history, and had comorbidities such as hypertension, chronic obstructive pulmonary disease (COPD), and food allergy. The multivariate analysis showed that smoking history, comorbidities of hypertension, COPD, and food allergy were independent risk factors for more severe exacerbation. The number of patients hospitalized for asthma exacerbation varied with seasons, peaking in March and September. Eight patients died during the study period (mortality 0.25%).CONCLUSIONS: Despite enhanced education on asthma self-management in China during recent years, few patients were using daily controller medications before the onset of their exacerbation, indicating that more educational efforts and considerations are needed. The findings of this study may improve our understanding of hospital admission for asthma exacerbation in mainland China and provide evidence for decision-making.
Adrenal Cortex Hormones ; Asthma ; China ; Comorbidity ; Disease Progression ; Education ; Female ; Food Hypersensitivity ; Hospitalization ; Humans ; Hypertension ; Inpatients ; Medication Adherence ; Mortality ; Multivariate Analysis ; Pulmonary Disease, Chronic Obstructive ; Retrospective Studies ; Risk Factors ; Seasons ; Self Care ; Smoke ; Smoking

[Abstract] Objective: To investigate the effect of Xihuang (XH) extract on the proliferation of gastric cancer SGC-7901 cells and its underlying mechanism. Methods: Gastric cancer cell line SGC-7901 was conventionally cultured. CCK-8 assay and flow cytometry were used to detect the effect of different concentrations of XH extracts (3.2, 6.4, 12.8, and 25.6 mg/ml) on proliferation and apoptosis of SGC-7901 cells after treatment for different time periods (24, 48, and 72 h); The effect of different concentrations of XH extracts on the mRNA expression of apoptosis-related genes (Bax and Bcl-2) was detected by qPCR; Western blotting was used to detect the effect of XH extracts on the expression of apoptosis-associated proteins (caspase 3, caspase 9, Bax and Bcl-2). Results: XH extracts (3.2, 6.4, 12.8, and 25.6 mg/ml) could effectively inhibit proliferation of gastric cancer SGC-7901 cells (P<0.05 or P<0.01) in a concentration-depend manner (P<0.01). XH extract could significantly up-regulate Bax mRNAand down-regulate Bcl-2 mRNAexpression (P<0.05 or P <0.01); Meanwhile, XH extract ouldincrease protein expressions of caspase 3, caspase 9, Bax but reduce Bcl-2 protein expression (P< 0.05 or P<0.01). Conclusion: XH extract can inhibit the proliferation of gastric cancer SGC-7901 cells by triggering apoptosis, which may become a potential method of adjuvant treatment of gastric cancer.

There are some problems such as difficulty of pressure control, inconvenience of use and carry, congested easily and dredged hardly in clinical application of vacuum extractor in common use. For solving the above problems, researchers have designed a new portable and pressure stabilized abdominal drainage system which was composed of integral double spherical aspirator and separated double cannula. The new apparatus has achieved good effects in drainage which is suitable for not only rescuing of abdominal trauma and war wound, but also abdominal surgery that manifested as sucking safe and effective, using easily and convenient, that was verified by testing.

Objective To evaluate the general level of asthma management in urban areas of China and further promote the national asthma management plan. Methods A multi-center, cross-sectional survey was carried out in 30 provinces of China (except for Tibet) during Oct 2015 to May 2016. It's a questionnaire-based face-to-face survey which included asthma management using peak flow meter (PFM) and pulmonary function test,medication choice of maintenance therapy and asthma education.Results A total of 3 875 asthmatic outpatients were recruited including 2 347(60.6%)females and 1 528(39.4%)males. The mean age was(50.7±16.7)years ranging from 14 to 99.Only 10.1%(388/3 837)patients used PFM as monitoring, whereas 62.1%(2 405/3 874) patients underwent pulmonary function test during the past year. There were 57.4%(2 226/3 875) patients treated with inhaled cortical steroid plus long-acting β2-agonist combinations (ICS+LABA) as daily medication. 43.3%(1 661/3 836) patients were followed up by physicians. Among this population, 1 362 asthmatic outpatients were recruited, who also took part in the asthma control survey in 2007-2008 in 10 cities.In this subgroup,17.9%(244/1 360)were tested by PFM and 66.6%(907/1 362)by pulmonary function test during last year.As to the medication,63.1%(860/1 362) selected ICS+LABA for daily control. There were 50.4%(685/1 359) patients in the follow-up cohort by physicians.Compared to the similar survey conducted in 2007-2008,the proportion of patients with ICS+LABA regimen and follow-up by physicians were markedly higher,while the rate of PFM use did not have significant improvement. Conclusion Although the present level of asthma management in China is still far from ideal, asthma management has improved compared to 8 years ago. Yet the use of PFM does not significantly improve.Asthma action plan and application of PFM should be further promoted to improve the level of asthma management.