Objective To investigate the relationship between serum forkhead box F1(FOXF1)and Ape-lin-13 levels and carotid atherosclerosis(CAS)in elderly patients with type 2 diabetes mellitus(T2DM).Methods From January 2022 to March 2024,207 elderly T2DM patients admitted to the hospital(T2DM group)and 52 healthy elderly patients underwent physical examination(control group)were selected as the study objects.The elderly T2DM patients were divided into CAS group(128 cases)and non-CAS group(79 cases)according to the occurrence of CAS.Serum FOXF1 and Apelin-13 levels were detected by real-time flu-orescent quantitative PCR and enzyme-linked immunoadsorption assay.The influencing factors of CAS in eld-erly T2DM patients were determined by multivariate unconditional Logistic regression,and the predictive effi-cacy of serum FOXF1 and Apelin-13 levels was analyzed by receiver operating characteristic curve.Results The levels of FOXF1 and Apelin-13 in T2DM group were lower than those in control group(P＜0.05).The inci-dence of CAS in 207 elderly T2DM patients was 61.84％(128/207).The levels of serum FOXF1 and Apelin-13 in CAS group were lower than those in non-CAS group(P＜0.05).The independent risk factors of CAS in elderly T2DM patients were the duration of T2DM,glycosylated hemoglobin and low density lipoprotein cho-lesterol(P＜0.05),and the independent protective factors were FOXF1 and Apelin-13(P＜0.05).The com-bined prediction of serum FOXF1 and Apelin-13 levels for CAS in elderly T2DM patients was 0.882,which was larger than 0.782 and 0.791 predicted by serum FOXF1 and Apelin-13 levels alone(P＜0.05).Conclu-sion The decrease of serum FOXF1 and Apelin-13 levels in elderly T2DM patients is closely related to CAS,and the combined detection of serum FOXF1 and Apelin-13 levels has a high predictive effect on CAS in elder-ly T2DM patients.

AIM: To analyze the causes of blindness and low vision in patients with visual disability in Yangpu District of Shanghai from 2019 to 2022.METHODS:Cross-sectional study. A total of 1 604 patients who participated in the evaluation of visual disability in Shanghai Yangpu District Kongjiang Hospital, from April 2019 to December 2022 were selected for the study. The grade of visual disability and the main causes of blindness and low vision were determined by trained doctors.RESULTS:A total of 804 patients with visual disabilities were identified, with 87.31% aged 60 and above. The causes of visual disability were high myopic retinopathy(30.47%), age-related macular degeneration(23.26%), glaucoma(17.04%), and diabetic retinopathy(11.07%). Glaucoma(36.96%)is the leading cause of blindness.CONCLUSION: The majority of patients with visual disability are aged 60 years and above. More attention should be paid to the elderly population. Comprehensive prevention, treatment and rehabilitation measures should be applied in different diseases based on classification, so as to early reduce the occurrence of visual disability.

Objective To make a preliminary investigation of the effect of the immune pathway mediated by live Lacticaseibacillus paracasei N11 15 on the development of primary hippocampal neurons cultured in vitro.Methods Live Lacticaseibacillus paracasei N1115 suspension of an appropriate concentration was used as the experimental group.Peptidoglycan(PGN)and lipopolysaccharide(LPS)were used as positive controls,and RPMI1640 medium served as the blank control.These were co-cultured with RAW264.7 cells to obtain the co-culture mediums and the total cellular RNA,and to measure the expression and secretion of cytokines.After centrifugation,the supernatants were co-cultured with primary hippocampal neurons at appropriate ratios.The co-culture mediums were collected,and the total cellular RNA was extracted to measure the expression of genes related to synaptic development in neurons.Following immunofluorescence staining of the primary hippocampal neurons,the presynaptic and presynaptic membrane-associated proteins,including synaptophysin(SYP)and the postsynaptic density protein 95(PSD95),and neuronal cell maturation markers,including microtubule-associated protein 2(MAP-2),and doublecortin(DCX)were quantitatively analyzed.Additionally,the morphological development of the neurons were measured.Results Compared with the blank control,the mRNA expression levels of interleukin(IL)-6 and tumor necrosis factor-α(TNF-α)increased by 7471％and 926％,respectively,after the RAW264.7 cells were treated with live Lacticaseibacillus paracasei N1115,while their secretion levels increased by 184.16 pg/mL and 12320.76 pg/mL,respectively,all showing statistically significant differences(P＜0.05).The activation ability of N1115 live bacteria was stronger than that of PGN but weaker than that of LPS,showing statistically significant differences(P＜0.05).Compared with the blank control,following the intervention with the supernatant from the co-culture of N1115 live bacteria and RAW264.7 cells,the viability of primary hippocampal neurons in the 10％supernatant intervention group increased by 19.25％,showing statistically significant differences(P＜0.05),and the mRNA expression of SYP and PSD95 increased by 137％and 159％,respectively,showing statistically significant differences(P＜0.05).The total neurite length(489.88 μm)of the neurons of the group intervened with the supernatant of N11 15 live bacteria was increased compared to that of the blank control group(381.51 μm),and the cell body area(2092.22 μm2),maximum neurite length(184.78 μm),total neurite length,average neurite length(108.38 μm),and branching points(4.84 s)were higher than those in the two positive control groups,showing statistically significant differences(P＜0.05).Conclusion Lacticaseibacillus paracasei N1115 can significantly activate the immune regulatory function of macrophages,thereby promoting the morphological development and synaptic function of nerve cells.

Objective:To investigate the effect of gene polymorphism of β1 adrenergic receptor (β1-AR) G1165C and A145G locus on myocardial hypertrophy and the efficacy in patients with hypertension.Methods:Two hundred and twenty-seven cases of patients with hypertension admitted to Binhai County People′s Hospital from January to December 2019 were enrolled. Among them, there were 113 cases of hypertension with myocardial hypertrophy and 114 cases of hypertension without myocardial hypertrophy. In addition, 115 patients with normal physical examination during the same period were selected as the control group. DNA in the peripheral blood leukocytes was extracted, polymerase chain reaction-restriction fragment length polymorphism method was used to detect β1-AR G1165C and A145G locus gene polymorphism, and the differences in the efficacy of β blockers in hypertensive patients with different genotypes were compared.Results:There was no statistically significant differences in the distribution of β1-AR A145G genotypes among the three groups ( P>0.05). Compared with the healthy control group, the frequency of Gly/Gly genotype carrying β1-AR G1165C locus was higher in hypertension with myocardial hypertrophy group, and the frequency of Gly/Arg and Arg/Arg gene were lower; compared with hypertension without myocardial hypertrophy group, the frequency of Gly/Arg+Gly/Gly gene in hypertension with myocardial hypertrophy group was higher; taking Arg/Arg genotype as the control group, carrying Gly/Gly genotype could increase the risk of cardiac hypertrophy in hypertensive patients by 3.159 times ( OR = 3.159, 95% CI 1.240 - 7.412, P<0.05).The frequency of G1165C allele Arg in the hypertension with myocardial hypertrophy group was significantly lower than that in the control group and the hypertension without myocardial hypertrophy group ( P<0.05); the frequency of G1165C allele Gly was significantly higher than that in the control group and the hypertension without myocardial hypertrophy group ( P<0.05); taking Arg/Arg genotype as the control, carrying Gly/Gly genotype could increase the risk of cardiac hypertrophy in hypertensive ( OR = 3.417, 95% CI 1.357 - 7.965, P<0.05). The left ventricular mass index of Gly/Gly genotype patients was (120.38 ± 28.41) g/m 2, which was significantly higher than (99.76 ± 25.16) g/m 2 and (90.30 ± 19.54) g/m 2 of Gly/Arg and Arg/Arg, with statistically significant differences ( F = 10.89, P<0.01). After the treatment, the resting heart rate, systolic blood pressure, diastolic blood pressure and mean arterial blood pressure of patients with G1165C allele Arg hypertension with myocardial hypertrophy were lower than those with G1165C allele Gly, with statistically significant differences ( P<0.05). Conclusions:β1-AR G1165C gene polymorphism is related to the risk of myocardial hypertrophy in hypertensive patients. Carrying the G1165C allele Gly may increase the risk of susceptibility to cardiac hypertrophy, and β-blockers are more effective in hypertensive patients with myocardial hypertrophy who carry the G1165C allele Arg.

Objective:To explore the relationship between cardiac discomfort symptoms, fear of disease progress and post-traumatic stress disorder (PTSD) in patients with acute myocardial infarction(AMI) after discharge, and to clarify main intervention direction of PTSD in patients with AMI.Methods:Patients with AMI who were discharged from Tangshan Gongren Hospital between 1 month and 1 year were selected from November 2019 to November 2020.The cardiac discomfort symptoms scale, fear of progress questionnaire(FoP-Q-SF) and post-traumatic stress disorder self-rating scale(PTSD-SS) were used to investigate cardiac discomfort symptoms, fear of disease progress level and post-traumatic stress disorder status.Spearman rank correlation analysis was used to analyze the relationship between cardiac discomfort symptoms, fear of disease progress and post-traumatic stress disorder by SPSS 24.0 software. The mediating effect of fear of disease progress was analyzed by AMOS 24.0 software.Results:The PTSD score was (32.78±12.38) of patients with AMI discharged from hospital for 1 month to 1 year and the incidence of PTSD was 12.3%.Spearman correlation test showed cardiac discomfort symptoms and fear of disease progress were positively correlated with PTSD( r=0.530, 0.723, both P<0.01) and cardiac discomfort symptoms was positively correlated with fear of disease progress( r=0.518, P<0.01). Mediating effect test showed that fear of disease progress was a complete mediator between cardiac discomfort symptoms and PTSD. Conclusion:Cardiac discomfort symptoms can affect PTSD through a complete mediator of fear of disease progress.

OBJECTIVE: To study the effects of Wuzhi capsule/schisantherin A (SchA) combined with cyclophosphamide on the pharmacokinetics of cyclophosphamide (CTX) in rats. METHODS: A total of 36 rats were randomly divided into CTX group (via tail vein, iv, CTX solution 300 mg/kg), CTX+WZC group (ig, Wuzhi capsule 300 mg/kg+via tail vein, iv, CTX solution 300 mg/kg), CTX + SchA low-dose, medium-dose, high-dose and excessive high-dose groups (ig, SchA 30, 300, 3 000, 30 000 μg/kg+via tail vein, iv, CTX solution 300 mg/kg) with 6 rats in each group. Blood samples were collected from orbital venous plexus of rats before medication and 0.083, 0.25, 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48 h after medication.UPLC-MS/MS method was applied for concentration determination of CTX and its metabolites [de-chloroethyl CTX (DC-CTX), 4-ketone CTX (4-keto CTX), carboxyl phosphamide (CPM)] in plasma of rats. The plasma concentration-time curve was obtained. The pharmacokinetic parameters were fitted by using DAS 2. 0 software. RESULTS: The maximum plasma concentration (cmax) of DC-CTX in CTX group, CTX+WZC group, CTX+SchA low-dose, medium-dose, high-dose and excessive high-dose groups were (22 167. 85 ±2 844. 93), (10 920. 53 ± 1 490. 89), (18 951. 29 ± 1 558. 81), (18 622. 08 ± 791. 19), (18 515. 20 ± 2 560. 61), (15 133. 21 ± 1 305. 07) μg/mL, respectively; the area under the curves (AUCo-48 h) were (173 864. 01 ± 65 342. 21), (100 996. 98 ± 33 530. 02), (137 028. 16 ± 45 975. 19), (131 650. 18 ± 53 196. 41), (113 699. 40 ± 34 131. 36), (110 773. 27 ± 30 307. 15) μg·mL/h, respectively. Compared with CTX group, cmax of DC-CTX in CTX group, CTX+SchA low-dose, medium-dose, high-dose and excessive high-dose groups were decreased by 50. 74％, 14. 51％, 16. 10％, 16. 48％, 31. 73％, respectively. AUC0-48 h were decreased by about 42. 23％, 21. 45％, 24. 63％, 33. 37％, 36. 55％, respectively; with statistical significance (P<0. 05). The pharmacokinetic indexes as t1/2, tmax had no significant change. CONCLUSIONS: To some degree, both WZC and SchA can reduce the generation of DC-CTX, which indicates both of them can inhibit CTX toxicity metabolism pathway so as to reduce the generation of toxic metabolite chloroacetaldehyde. The inhibitory effect of SchA on toxicity metabolism pathway is weaker than that of WZC, and does not have a dose-dependent inhibitory effect.

Objective To investigate the clinical value of real-time shear wave elastography( SWE) in early diagnosis of diabetic nephropathy ( DN ) . Methods One hundred and fifty-five patients with type 2 diabetes mellitus (DM) in our hospital were selected as DN group and 54 healthy volunteers with matched age-sex were selected as control group . According to the criteria of Mogensen staging ,patients of DN group were divided into 3 subgroups according to urine protein/creatinine ( ACR) :group A ( DM or DN Ⅰ ,Ⅱ ) , ACR＜30 mg/g ;group B ( DN Ⅲ ) ,ACR 30 －300 mg/g ;group C ( DN Ⅳ ,Ⅴ ) ,ACR＞ 300 mg/g . All subjects were examined by SWE technique to detect the maximum ,mean and minimum Young′s modulus values ( Emax ,Emean ,Emin) of the middle of left renal parenchyma ,the values of Young′s modulus in the control group and DN patients were compared . The relationship between Young′s modulus and ACR in patients with DN was analyzed . Results The Emax ,Emean and Emin in DN patients were all greater than those in control group ( P ＜0 .05) . In group A ,B and C ,Emax ,Emean and Emin gradually increased ( P＜0 .05) . Spearman correlation analysis showed that there was a positive correlation between Young′s modulus and ACR in patients with DN ( r ＝ 0 .817 ,0 .764 ,0 .609 ;all P＝ 0 .000) . ROC curve analysis showed that the area under the curve of Emax diagnosis DN Ⅲ stage was 0 .810 ,the cut-point value was 6 .65 kPa ,the sensitivity was 79 .0% ,and the specificity was 81 .7% ;the area under the curve of Emean diagnosis DN Ⅲ stage was 0 .785 ,and the cut-off value was 3 .69 kPa ,sensitivity 62 .8% ,specificity 78 .3% . Conclusions SWE technique can quantitatively analyze renal parenchyma hardness in patients with different stages of DN ,which may provide new diagnostic information for early diagnosis of DN .

Objective:To explore the rule of CD8+CD25+FoxP3+ regulator T cells(Treg) in the pathogenesis of pre-eclampsia (PE) in peripheral blood.Methods:This study included 24 gestational-age-matched healthy pregnant women and 46 pregnant women diagnosed with mild PE (MPE,n=24) or severe PE (SPE,n=22) during the third trimester of gestation.An 3 ml sample of peripheral blood was drawn from each subject and anti-coagulated with heparin sodiurm The percentage of CD8 + CD25 + FoxP3 + Treg cells was detected by flow cytometry.The cytokines IL-6,IL-17A,IL-10,IL-1,IL-33 and TGF-β31 were detected using Luminex200.Peripheral blood mononuclear cells (PBMCs) were isolated frum healthy controls and treated with IL-33,the percentages of CD8+ CD25+ FoxP3 + Treg cell were measured by flow cytometric detection.Results:Compared to that of healthy pregnant controls [0.48(0.21-0.96)％],MPE patients [0.32(0.19-0.63)％] and SPE patients [0.13(0.02-0.41)％] had lower percentages of CD8+CD25+FoxP3+Treg cells (P＜0.05).Compared to HP controls,higher levels of IL-6 and IL-17A were found in MPE and SPE patients(P＜0.05) and even higher in SPE patients.The levels of IL-10,IL-1[β and IL-33 were similar in all three groups (P＞0.05).Compared to HP contruls,the levels of TGF-[β1 was significantly increased in SPE and MPE patients(P＜0.05),but no significant differences were found between these two groups (P ＞ 0.05).The percentage of CD8+ CD25+ FoxP3+ Treg cells showed a negative correlation with the serum concentrations of IL-17A (r =-0.338,P =0.338),and a positive correlation with the serum concentrations of IL-33 (r =0.548,P =0.548).After PBMCs were treated with IL-33 for five days,the percentages of CD8+CD25+FoxP3+ Treg were significantly higher than those of the contruls (P＜0.05).Conclusion:These findings suggested that the reduced CD8+ CD25 + FoxP3 + Treg cells may play a role in the pathogenesis of ore-eclamosia.

Objective:To observe the clinical curative effects of sequential therapy of estrogen and progesterone in the patient after second curettage with residual uterine cavity. Methods:Totally 60 patients after second curettage with residual uterine cavity were ran-domly divided into the treatment group (30 cases) and the control group (30 cases). The treatment group was treated by sequential therapy of estrogen and progesterone,while the control group was selected curettage and treated with Xinshenghua granules, and the treatment course was 21 days. The serum level ofβ-human chorionic gonadotropin (β-HCG) , stop time of vaginal bleeding, menstrual restore time and clinical curative effect were evaluated and compared between the two groups. Results:After the treatment, the serum level of β-HCG, stop time of vaginal bleeding and menstrual restore time in the treatment group were lower than those in the control group (P<0. 05, P<0. 01). The clinical effective rate of the treatment group was 90%, while that of the control group was 93. 33%, and there was no statistically significant difference between the two groups (P>0. 05). Conclusion:The sequential therapy of estro-gen and progesterone can improve clinical symptoms and promote the functional recovery of uterus, which is worthy of clinical promo-tion.

Objective To evaluate the value of MicroPure imaging system of ultrasonography in display of breast calcification,and explore its clinical application value.Methods One hundred and forty-one patients underwent by mammography,conventional ultrasound imaging and MicroPure imaging,the mammography results were reference standard,observing the display rate of MicroPure imaging for calcification,and the value of MicroPure imaging in the display of calcification with different shapes on mammography.As the pathologic diagnosis was golden standard,the accuracy of diagnosis of conventional ultrasound,conventional ultrasound combined with MicroPure imaging,conventional ultrasound combined with mammography were evaluated with receiver operating characteristic(ROC) curve.Results The display case of calcifications within breast masses:the specificity of MieroPure imaging was lower than conventional ultrasound(88.14％ vs 100％,P ＜ 0.05),the sensitivity and accuracy were higher than conventional ultrasound(100％ vs 62.79％,93.14％ vs 84.31 ％,P ＜0.05).The display case of microcalcifications within normal breast tissue:the specificity and accuracy of MicroPure software system were lower than conventional ultrasound(9.26％ vs 100％,43.87％ vs 65.96％,P ＜0.05),the sensitivity was higher than conventional ultrasound (100％ vs 20.00％,P ＜0.05).The punctate calcification,amorphous calcification,rough uneven,pleomorphic calcifications on mammography were all hyperechoic spots on MicroPure software system.The area under the ROC curve of the conventional ultrasound,conventional ultrasound combined with MicroPure imaging,conventional ultrasound combined with MicroPure imaging was 0.881,0.858,0.932,respectively.Conclusions MicroPure imaging has some clinical value on microcalcifications within breast masses,which can improve its sensitivity and accuracy.The specificity of MicroPure imaging diagnostic ultrasound imaging of microcalcifications were lower,and it can not distinguish between different shapes of calcifications.Compared with conventional ultrasound,MicroPure imaging system can not improve the accuracy of diagnosis of benign and malignant breast lesions.