Diabetic kidney disease(DKD)is one of the serious complications of diabetes.Ferroptosis causes pathological damage and is involved in the progression of DKD.How to inhibit ferroptosis and delay DKD is a new academic hotspot.The author's team further enriched and proposed the core pathogenesis theory of"internal heat induced disease"on the basis of the traditional DKD"yin deficiency and dryness-heat"theory,and explained the general development law of DKD.In this article,"internal heat"and"Zhengjia"in the theory of DKD"internal heat induced diseases"are used as the starting point to explore the relationship of the main pathological damage of ferroptosis such as activating inflammatory response,enhancing oxidative stress,promoting fibrosis and so on with the internal mechanism of the theory of"internal heat induced diseases",further explained the scientific connotation of DKD"internal heat induced diseases",in order to provide ideas and theoretical basis for the TCM prevention and treatment of DKD.

Diabetic kidney disease （DKD） is one of the main causes of chronic kidney disease. Both traditional Chinese medicine （TCM） and western medicine have their own advantages in the prevention and treatment of DKD， but there are also many difficulties. By analysis of the difficulties faced by TCM and western medicine in the differentiation and treatment of DKD， based on the theory of "miniature masses in the renal collaterals"， combined with long-term clinical practice， "internal heat leading to mass" is proposed as the core pathogenesis of DKD. Therefore， a trinity model of "disease-syndrome-symptom" for differentiation and treatment of DKD based on the core pathogenesis has been proposed. This model highlights the status of the core pathogenesis of "internal heat leading to mass" in DKD， and conducts a three-dimensional identification from the perspectives of disease， syndrome and symptom， so as to inspire clinical practice.

Objective To investigate the clinical features,diagnosis,treatment and prognosis of sinon-asal mucosal melanoma(SNMM).Methods The clinical data of 16 cases of SNMM without cervical lymph node metastasis admitted to this hospital from June 2014 to July 2021 were retrospectively analyzed.Results The mean age of all 16 cases was(70.00±7.02)years.The mean survival period was 22.87 months in the treated group and 9.42 months in the untreated group,with significant difference in outcome(P=0.01).There was no significant difference in long-term prognosis between patients with bone destruction and those without bone destruction after treatment(P=0.085).There was also no significant difference in prognosis between T3 group and T4a group after treatment(P=0.119).Conclusion SNMM usually presents with mi-nor nasal bleeding as the initial symptom,and the overall prognosis is poor due to its propensity for metasta-sis.Surgical resection and postoperative individualized comprehensive therapy are the main treatments,and immunotherapy may improve survival.

Diabetic kidney disease(DKD)is one of the serious complications of diabetes.Ferroptosis causes pathological damage and is involved in the progression of DKD.How to inhibit ferroptosis and delay DKD is a new academic hotspot.The author's team further enriched and proposed the core pathogenesis theory of"internal heat induced disease"on the basis of the traditional DKD"yin deficiency and dryness-heat"theory,and explained the general development law of DKD.In this article,"internal heat"and"Zhengjia"in the theory of DKD"internal heat induced diseases"are used as the starting point to explore the relationship of the main pathological damage of ferroptosis such as activating inflammatory response,enhancing oxidative stress,promoting fibrosis and so on with the internal mechanism of the theory of"internal heat induced diseases",further explained the scientific connotation of DKD"internal heat induced diseases",in order to provide ideas and theoretical basis for the TCM prevention and treatment of DKD.

Objective To investigate the correlation between different grade glioma and MRI image texture parameters and the guiding value of texture analysis for postoperative prognosis.Methods A total of 107 glioma patients were selected,and the texture parameters of MRI images were recorded.The correlation between the grade of glioma and the texture parameters of MRI images was analyzed.The risk factors affecting postoperative adverse effects of glioma patients were analyzed,and the diagnostic efficacy of each texture parameter in predicting glioma grade and postoperative good condition was evaluated.Results Comparison of MRI image tex-ture parameters between patients with low-grade glioma and patients with high-grade glioma showed no significant differences in kur-tosis,skewness,standard deviation,contrast and uniformity,but significant differences in correlation,entropy,consistency and gap distance.Correlation,entropy,consistency and gap distance were significantly correlated with glioma grade.The diagostic efficiency of entropy in predicting glioma grade was significantly higher than that of correlation,consistency and gap distance.The combination of the four predicted glioma patients with good postoperative diagnostic efficacy was the highest.Conclusion The correlation,entropy,consistency and gap distance of MRI image texture parameters can effectively diagnose the grade of glioma,and the combination of the four parameters is more beneficial to the postoperative evaluation of glioma patients.

ObjectiveTo investigate the impact of yang deficiency syndrome on the progression to end-point events of diabetic kidney disease （DKD）. MethodsA retrospective study among patients with stage Ⅳ DKD admitted to Dongzhimen Hospital of Beijing University of Chinese Medicine from September 1st， 2016 to September 30th， 2021 was conducted. Data on the patients' general information， clinical indicators including duration of diabetes， duration of proteinuria， history of smoking and drinking， hemoglobin （HGB）， fasting blood glucose （FBG）， albumin （ALB）， serum creatinine （Scr）， urea nitrogen （BUN）， uric acid （UA）， cholesterol （TC） ， triglycerides （TG）， low-density lipoprotein （LDL）， 24-hour urine protein quantification （24h-UTP） and estimated glomerular filtration rate （eGFR）， and TCM syndromes including symptoms， tongue and pulse， and syndrome scores were collected. The patients were divided into exposure group （yang-deficiency group） and non-exposure group （non-yang-deficiency group）. The general information， clinical indicators and incidence rates of end-point events were compared， and the impact of yang deficiency syndrome on the end-point events of stage Ⅳ DKD was analyzed. Survival analysis was performed using Kaplan-Meier method， and multivariate Cox proportional risk models were used to identify independent predictors of end-point events. ResultsA total of 160 patients with stage Ⅳ DKD were included in the study， including 43 cases of yang deficiency syndrome and 117 cases of non-yang deficiency syndrome. Compared to those in the non-yang deficiency group， the waist circumference， BUN and the incidence of end-point events in the yang deficiency group were significantly higher （P＜0.05 or P＜0.01）. Spearman correlation analysis showed that yang deficiency syndrome was positively correlated with incidence of end-point events of stage Ⅳ DKD （r = 0.167， P = 0.035）. Furthermore， 24h-UTP and BUN levels were also positively correlated with end-point events in stage Ⅳ DKD patients （P＜0.01）， while ALB and HGB levels were negatively correlated （P＜0.01）. Kaplan-Meier survival curves showed that yang deficiency syndrome was associated with an increased risk of end-point events （Log Rank P = 0.011）. Moreover， 24h-UTP levels ≥3500 mg， BUN level ≥8 mmol/L， ALB level ＜30 g and HGB level ＜11 g were all associated with the increase of the risk of end-point events （P＜0.05 or P＜0.01）. Multivariate Cox regression analysis showed that yang deficiency syndrome was an independent risk factor for patients with stage Ⅳ DKD to progress into end-point events （HR = 2.36， 1.32 to 4.21； P = 0.004）， as well as 24h-UTP ≥ 3500 mg， BUN ≥ 8 mmol/L， HGB＜11 g and ALB＜30 g （P＜0.05 or P＜0.01）. ConclusionsFor stage Ⅳ DKD， patients with yang deficiency syndrome are more likely to have end-point events， which is an independent risk factor for the progression into end-point events.

Objective:To analyze the relationship between the gastric diseases classification under endoscopy and infection and antibiotic resistance of Helicobacter pylori ( H. pylori) based on the data of gastric diseases classification under endoscopy, H. pylori isolation and antibiotic resistance. Methods:From January 1, 2015 to December 31, 2019, endoscopic diagnosis and the data of drug susceptibility of H. pylori of 5 441 patients with benign gastric diseases along with gastrointestinal symptoms who visited The First People′s Hospital of Putuo District of Zhoushan were retrospectively collected. The H. pylori infection in patients with different genders and different types of gastric diseases and the drug resistance rates of H. pylori among different antibiotic types were analyzed. Chi-square test was used for statistical analysis. Results:The positive rate of H. pylori in 5 441 patients with benign gastric diseases was 51.37% (2 795/5 441). The drug resistance rates of clarithromycin, levofloxacin, metronidazole, amoxicillin, tetracycline and furazolidone were 26.73% (747/2 795), 43.22% (1 208/2 795), 98.68% (2 758/2 795), 0.32% (9/2 795), 0 and 0, respectively. Among the 2 795 cases of H. pylori-positive patients, only 23 cases (0.82%) were sensitive to all six antibiotics; 1 263 cases (45.19%) were resistant to single antibiotic; 1 072 cases (38.35%) were resistant to combination of two antibiotics, and 433 cases (15.49%) were resistant to combination of three antibiotics. The drug resistance rate to three antibiotics, clarithromycin, levofloxacin and metronidazole simultaneously was the highest (15.31%, 428/2 795). And only four patients (0.14%) were simultaneously resistant to four antibiotics clarithromycin, levofloxacin, metronidazole and amoxicillin. H. pylori infection rate in men was higher than that in women (55.23%, 1 615/2 924 vs. 46.88%, 1 180/2 517), and the difference was statistically significant ( χ2=37.76, P<0.01). However there were no statistically significant differences in the drug resistance rates of six antibiotics between different gender among H. pylori-positive patients (all P>0.05). There was statistically significant difference in the positive rate of H. pylori among patients with different types of gastric diseases ( χ2=909.07, P<0.01). The positive rate of H. pylori was the highest in patients with duodenal ulcer (97.53%, 79/81), and the lowest in patients with bile reflux gastritis (19.79%, 37/187). There were statistically significant differences in the drug resistance rates of metronidazole, clarithromycin, levofloxacin and amoxicillin among 9 types of gastric diseases ( χ2=24.75, 38.62, 80.54 and 7.01, all P<0.01). Conclusions:The positive rate of H. pylori and antibiotic resistance rate are different in patients with different types of gastric diseases. It is necessary to pay attention to the selection of drugs for ulcerative diseases in the process of clinical treatment. Individualized treatment is recommended according to the results of antibiotic susceptibility test.

OBJECTIVE: To explore the effect of small interfering RNA (siRNA)-mediated CEP55 gene silencing on the proliferation of mouse spermatogonia. METHODS: Six patients with azoospermia diagnosed to have maturation arrest (3 cases) or normal spermatogenesis (3 cases) based on testicular biopsy between January 1 and December 31, 2017 in our center were examined for differential proteins in the testicular tissue using isobaric tags for relative and absolute quantitation (iTRAQ), and CEP55 was found to differentially expressed between the two groups of patients. We constructed a CEP55 siRNA for transfection in mouse spermatogonia and examined the inhibitory effects on CEP55 expressions using Western blotting and qPCR. The effect of CEP55 gene silencing on the proliferation of mouse spermatogonia was evaluated with CCK8 assay. RESULTS: In the testicular tissues from the 6 patients with azoospermia, iTRAQ combined with LC/MS/MS analysis identified over two hundred differentially expressed proteins, among which CEP55 showed the most significant differential expression between the patients with maturation arrest and those with normal spermatogenesis. The cell transfection experiment showed that compared with the cells transfected with the vehicle or the negative control sequence, the mouse spermatogonia transfected with CEP55 siRNA showed significantly lowered expressions of CEP55 mRNA and protein ( < 0.05) and significantly decreased proliferation rate as shown by CCK8 assay ( < 0.05). CONCLUSIONS CEP55 may play a key role in spermatogenesis and may serve as a potential therapeutic target for non-obstructive azoospermia with maturation arrest.
Animals ; Azoospermia ; congenital ; genetics ; Cell Cycle Proteins ; genetics ; Gene Silencing ; Humans ; Male ; Mice ; Nuclear Proteins ; genetics ; Spermatogenesis ; Spermatogonia ; Tandem Mass Spectrometry ; Transfection

OBJECTIVE: To explore the causes of oocyte vitrification and its application in assisted reproduction. METHODS: We retrospectively analyzed the data of 26 patients with 27 cycles of oocyte vitrification cryopreservation undergoing intracytoplasmic sperm injection (ICSI) and embryo transfer between January, 2008 and October, 2018. The causes of oocyte vitrification and the outcomes of ICSI and clinical pregnancy were analyzed. RESULTS: The causes of oocytes vitrification included mainly azoospermia or severe spermatogenesis disorder of the husband, failure to obtain sperms from the husband, failure of the husband to be present on the day of oocyte retrieval and acute diseases of the husband to not allow sperm collection. A total of 274 oocytes were frozen in 27 oocyte retrieval cycles, and 217 eggs were thawed in 19 cycles with a survival rate of 81.11% (176/217). The normal fertilization rate, cleavage rate and high-quality embryo rate was 74.81% (98/131), 89.80% (88/98) and 36.73% (36/98), respectively. Fifteen patients underwent embryo transfer, and the clinical pregnancy rate and live birth rate was 53.33% (8/15) and 33.33% (5/15), respectively. Compared with patients below 35 years of age, the patients aged above 35 years had significantly lower oocyte survival rate after thawing (82.76% 74.42%, =0.211), clinical pregnancy rate (77.78% 16.67%, =0.041) and live birth rate (55.56% 0, =0.044). CONCLUSIONS Oocytes vitrification can be used as a remedy for infertile couples who fail to provide sperms due to male factors on the day of oocyte retrieval. Vitrification of the oocytes does not significantly affect the fertilization rate or the clinical pregnancy rate. The survival rate of the thawed oocytes is related to the age of the wife, and an age younger than 35 years can be optimal for achieving favorable clinical pregnancy outcomes after oocyte vitrification.
Adult ; Cryopreservation ; Embryo Transfer ; Female ; Humans ; Male ; Oocytes ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Vitrification

Objective: To explore the application of septoplasty and cheiloplasty in complete unilateral cleft lip repairment, and evaluate the effect on nasal shape correction. Methods: Twenty-four infants with complete unilateral cleft lip were divided into two groups: the correction group and the control group. Both groups underwent cheiloplasty by Mohler′s technique, septoplasty was performed in the correction group during the primary cheiloplasty. Six-month follow-up was taken to evaluate the nasal shape with the three dimensional images. Independent-samples t Test was performed using SPSS 21.0, to compare the nasal morphology between two groups. Results: All patients healed in the first stage, and were followed for 6 months after operations. There were no complication, including nasal septum perforation, occurred in either group.There were statistically significant differences in nasal parameters between the correction group and controls (P<0.05). The columellar width, nostril width on the affected side, and columella deviation of the correction group were smaller, than those of controls. The nose tip height, columellar height and nostril height on the affected side of the correction group were greater than those of the control group. Conclusions Septoplasty associated with the primary cheiloplasty in complete unilateral cleft lip repairment, shows better results in the elongation of the nasal columella, and the correction of septum deviation, and provides a stable nasal structure.