AIM: To analyze the changes of retinal structure and function before and after panretinal photocoagulation(PRP)in patients with proliferative diabetic retinopathy(PDR).METHODS: Prospective study. Totally 98 cases(98 eyes)of PDR patients who underwent PRP in Eye Hospital of Wenzhou Medical University from January 2022 to May 2023 were included. Optical coherence tomography angiography(OCTA)was used to detect central retinal thickness(CRT), central macular thickness(CMT), subfoveal choroidal thickness(SFCT), foveal avascular zone(FAZ), deep vascular complex(DVC)blood flow density, superficial vascular complex(SVC)blood flow density before and at 1 wk, 1 and 3 mo after PRP. During the follow-up, 1 eye underwent vitrectomy, 2 eyes were lost to follow-up, and finally 95 eyes completed 1 a follow-up, with a loss rate of 3%. According to the visual prognosis at 1 a after treatment, the patients were divided into two groups: 73 eyes in good prognosis group and 22 eyes in poor prognosis group(including 9 eyes of visual disability and 13 eyes of visual regression). The changes in retinal structure and function before and after PRP treatment were compared between the two groups of patients, and the receiver operating characteristic(ROC)curve and decision curve were used to analyze the predictive value of retinal structure and function for PDR treatment.RESULTS: There were statistical significant differences in PDR staging, CRT, CMT, SFCT, DVC blood flow density, and SVC blood flow density between the two groups of patients before treatment(all P<0.05). At 1 wk, 1 and 3 mo after treatment, the FAZ area of both groups decreased compared to before treatment, while the blood flow density of DVC and SVC increased compared to before treatment(both P<0.05). However, there was no significant difference in the blood flow density of FAZ, DVC, and SVC between the two groups at 1 wk, 1 and 3 mo after treatment(all P>0.05). The CRT, CMT and SFCT of the two groups at 1 wk after treatment were higher than those before treatment(all P<0.05), but there were no significant differences between the two groups(all P>0.05). The CRT, CMT and SFCT at 1 and 3 mo after treatment were lower than those at 1 wk after treatment and before treatment in both groups. The CRT, CMT and SFCT in the poor prognosis group at 3 mo after treatment were higher than those at 1 mo after treatment, and were higher than those in the good prognosis group(all P<0.05). ROC analysis showed that, at 3 mo after laser treatment in PDR patients, the area under the curve of the CRT, CMT, and SFCT alone or in combination after treatment for 1 a was 0.788, 0.781, 0.783, and 0.902, respectively, and the combined prediction value was better(P<0.05). Decision curve analysis showed that the combined detection of CRT, CMT, and SFCT in PDR patients at 3 mo after treatment can improve the predictive value of visual prognosis.CONCLUSION: The optimal time for retinal structure and function recovery in PDR patients after PRP treatment is between 1 wk and 1 mo. OCTA measurement of CRT, CMT, and SFCT at 3 mo after treatment can predict the visual prognosis during the 1 a treatment period.

OBJECTIVES: The gut microbiota plays a crucial role in the pathophysiology of various types of diabetes. However, the causal relationship between them has yet to be systematically elucidated. This study aims to explore the potential causal associations between gut microbiota and diabetes using a two-sample Mendelian randomization (MR) analysis, based on multiple taxonomic levels. METHODS: Eligible instrumental variables were extracted from the selected genome-wide association study (GWAS) data on gut microbiota. These were combined with GWAS datasets on type 1 diabetes (T1D), type 2 diabetes (T2D), and gestational diabetes mellitus (GDM) to conduct forward MR analysis, sensitivity analysis, reverse MR analysis, and validation of significant estimates. Microbial taxa with causal effects on T1D, T2D, and GDM were identified based on a comprehensive assessment of all analytical stages. RESULTS: A total of 2 179, 2 176, and 2 166 single nucleotide polymorphisms (SNP) were included in the MR analyses for gut microbiota with T1D, T2D, and GDM, respectively. MR results indicated causal associations between: Six microbial taxa (Eggerthella, Lachnospira, Bacillales, Desulfovibrionales, Parasutterella, and Turicibacter) and T1D; 9 microbial taxa (Verrucomicrobia, Deltaproteobacteria, Actinomycetales, Desulfovibrionale, Actinomycetaceae, Desulfovibrionaceae, Actinomyces, Alcaligenaceae, and Lachnospiraceae NC2004 group) and T2D; 10 microbial taxa (Betaproteobacteria, Coprobacter, Ruminococcus2, Tenericutes, Clostridia, Methanobacteria, Mollicutes, Methanobacteriales, Methanobacteriaceae, and Methanobrevibacter) and GDM. CONCLUSIONS This study identified specific gut microbial taxa that may significantly increase or decrease the risk of developing diabetes. Some findings were fully replicated in independent validation datasets. However, the underlying biological mechanisms of these causal relationships warrant further investigation through mechanistic studies and population-based research.
Gastrointestinal Microbiome/genetics* ; Humans ; Mendelian Randomization Analysis ; Genome-Wide Association Study ; Diabetes Mellitus, Type 2/genetics* ; Diabetes Mellitus, Type 1/genetics* ; Female ; Polymorphism, Single Nucleotide ; Diabetes, Gestational/genetics* ; Pregnancy

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Objective:To investigate the effects and mechanism of Qiangjin Zhuanggu Capsules in bone remodeling in ovariectomized osteoporotic mice.Methods:Totally 75 8-week-old C57BL/6 female mice were divided into a sham-operation group of 15 mice and a modeling group of 60 mice. The model was created using bilateral ovariectomy (OVX) to replicate a postmenopausal osteoporosis mouse model. The successfully modeled mice were divided into model group, estradiol group, and Qiangjin Zhuanggu Capsules low-, medium-, and high-dosage groups using a random number table method, with 10 mice in each group. The estradiol group was given a 0.013 mg/ml solution of estradiol valerate tablets by gavage; Qiangjin Zhuanggu Capsules low-, medium-, and high-dosage groups were orally administered with Qiangjin Zhuanggu Capsule solution at dosages of 46.0, 92.0, and 184.0 mg/ml. The sham-operation group and model group were orally administered with equal volumes of physiological saline once a day for 8 consecutive weeks. After the intervention, the femoral trabecular bone structure, bone mineral density (BMD), bone volume/total volume (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th), bone surface area/bone volume (BS/BV), and trabecular separation (Tb.Sp) were assessed using Micro-CT. Serum levels of bone metabolism markers such as calcium (Ca), phosphorus (P), bone alkaline phosphatase (BALP), osteocalcin (OCN), and cathepsin K (CTSK) were measured by ELISA. Hematoxylin and eosin (HE) and Masson staining were used to observe the morphological changes in femoral trabecular bone structure and collagen fibers. Western blot analysis was employed to detect the protein expression of Runt-related transcription factor 2 (Runx2), alkaline phosphatase (ALP), and bone morphogenetic protein-2 (BMP-2), .Results:Compared with the model group, the levels of BMD, BV/TV, Tb. N, and Tb.Th ( P<0.01 or P<0.05) in estradiol group and Qiangjin Zhuanggu Capsule medium- and high-dosage groups increased ( P<0.01, P<0.05), and BS/BV and Tb.Sp decreased ( P<0.01, P<0.05)serum levels of Ca, P, BALP, and OCN were elevated ( P<0.01, P<0.05), while CTSK was reduced ( P<0.01); the expression of Runx2, ALP and BMP-2 proteins significantly increased ( P<0.01, P<0.05). Conclusion:Qiangjin Zhuanggu Capsules exhibit preventive and therapeutic effects on postmenopausal osteoporosis, potentially through the regulation of Runx2, ALP and BMP-2.

Objective Observe the impact of Qang Gu Kang Wei extraction(KW)on skeletal muscle atrophy in simulated weightlessness rats by regulating endoplasmic reticulum stress and mitochondrial fusion.Methods SD rats were randomy divided the control group(Control),the simulated weightlessness group(TS),and the KW group(TS+KW).Rats were treated with KW with or without tail suspension(TS)for 28 days,and the cross-sectional areas of the gastrocnemius muscle were compared with a control group.The expression levels of endoplasmic reticulum stress(ERS)and key proteins involved in mitochondrial fusion were also analyzed.Results KW treatment reduced the loss of muscle cross-sectional area caused by TS.TS increased the protein expression of glucose-regulated Protein 78(GRP78)and components of the ERS signaling pathways,while KW treatment reduced this increase.TS also inhibited the expression of mitofusin 2(MFN2),which was increased by KW treatment.Additionally,KW treatment promoted the interaction between GRP78 and the endoplasmic reticulum protein sigma-1 receptor(Sig-1R).Conclusion KW may attenuate muscle atrophy caused by simulated weightlessness by regulating ERS and mitochondrial fusion fusion.

Objective:To explore impacts of remifentanil on neuroinflammation in rats with cerebral infarction by regulating CC chemokine macrophage inflammatory protein-1α(MIP-1α)/CC chemokine receptor 1(CCR1)signaling pathway.Methods:Rats were randomly grouped into sham group,model group,remifentanil group,MIP-1α Ab group(MIP-1α neutralizing antibody,10 μg)and HY-U00350 group(CCR1 antagonist,100 μg),improved Longa suture method was applied to prepare a rat cerebral infarction model.Neural function scoring method was applied to evaluate neural function of rats;ELISA was applied to detect serum levels of TNF-α,IL-6 and IL-1β;HE staining was applied to observe pathological changes in rat hippocampal tissue,TTC staining method was applied to detect area of cerebral infarction in rats,TUNEL staining was applied to detect apoptosis rate of rat brain cells;RT-qPCR was applied to detect expressions of MIP-1α mRNA and CCR1 mRNA;Western blot was applied to detect expressions of MIP-1α and CCR1 proteins in rat brain tissue.Results:Compared with sham group,hippocampal neuron structure was seriously damaged in model group,neurological function score,levels of TNF-α,IL-6 and IL-1β,apoptosis rate,percentage of cerebral infarction area,expres-sions of MIP-1α,CCR1 gene and protein were obviously increased(P<0.05);compared with model group,morphological damage of neurons in remifentanil group,MIP-1α Ab group and HY-U00350 group was obviously reduced,neurological function score,levels of TNF-α,IL-6 and IL-1β,apoptosis rate,percentage of cerebral infarction area,expressions of MIP-1α,CCR1 gene and protein were obviously reduced(P<0.05);compared with remifentanil group,indicators of rats in MIP-1α Ab group had no statistical significance(P>0.05),levels of MIP-1α gene and protein obviously increased in HY-U00350 group,other indicators were also not statistically obvious(P>0.05).Conclusion:Remifentanil can reduce neuroinflammation in rats with cerebral infarction,which may be related to inhibition of MIP-1α/CCR1 signaling pathway.

To perform the phylogenetic characterization of an isolated porcine rotavirus(PoRV)and investigate its pathogenicity in suckling mice and piglets.A G4P[23]genotype PoRV strain JSJR2023 was successfully isolated from the diarrheic piglet feces through propagation in MA104 cells.The viral proliferation kinetics were analyzed using TCID50 assays,followed by complete genome sequencing through Sanger sequencing platforms.Comprehensive genotyping and phylogenetic reconstruction were conducted using MEGA7.0 with maximum likelihood algorithms.Pathogenicity was assessed in the following animal models:5-day-old C57BL/6 mice and 3-day-old piglets.Multidimensional evaluation included clinical monitoring(diarrhea scoring,growth parameters),virological detection,and histopathological analysis of intestinal tissues.The virus strain JSJR2023 could replicate efficiently in MA104 cells,achieving peak titers of 107.5 TCID50/mL.Whole genome genotype analysis showed that the strain belonged to G4-P[23]-I5-R1-C1-M1-A8-N1-T1-E1-H1.Phylogenetic analysis indicated that the VP3 and NSP4 genes of JSJR2023 strain were most closedrelated to human species rotaviruses,suggesting genetic reassortment between human and porcine RV strains.The animal experiments in suckling mice showed that the JSJR2023 strain infection caused diarrhea symptoms,intestinal edema and congestion,and shedding of intestinal villus epithelial cells.The pathogenicity experiments in piglets showed that compared with the control group,the challenged group of pig-lets had severe diarrhea symptoms,accompanied by reduced appetite and listlessness.Post-mortem examination revealed that the intes-tines were significantly thinner,congested,and filled with yellow watery contents.The challenged piglets showed typical pathological changes such as thinning of the intestinal wall and shortening and shedding of intestinal villi.In conclusion,this study successfully iso-lated a human-porcine recombinant G4P[23]PoRV strain and established the infection models in suckling mice and piglets,providing important tools for investigating the pathogenic mechanism of PoRV,evaluating vaccines and developing antiviral drug.

To perform the phylogenetic characterization of an isolated porcine rotavirus(PoRV)and investigate its pathogenicity in suckling mice and piglets.A G4P[23]genotype PoRV strain JSJR2023 was successfully isolated from the diarrheic piglet feces through propagation in MA104 cells.The viral proliferation kinetics were analyzed using TCID50 assays,followed by complete genome sequencing through Sanger sequencing platforms.Comprehensive genotyping and phylogenetic reconstruction were conducted using MEGA7.0 with maximum likelihood algorithms.Pathogenicity was assessed in the following animal models:5-day-old C57BL/6 mice and 3-day-old piglets.Multidimensional evaluation included clinical monitoring(diarrhea scoring,growth parameters),virological detection,and histopathological analysis of intestinal tissues.The virus strain JSJR2023 could replicate efficiently in MA104 cells,achieving peak titers of 107.5 TCID50/mL.Whole genome genotype analysis showed that the strain belonged to G4-P[23]-I5-R1-C1-M1-A8-N1-T1-E1-H1.Phylogenetic analysis indicated that the VP3 and NSP4 genes of JSJR2023 strain were most closedrelated to human species rotaviruses,suggesting genetic reassortment between human and porcine RV strains.The animal experiments in suckling mice showed that the JSJR2023 strain infection caused diarrhea symptoms,intestinal edema and congestion,and shedding of intestinal villus epithelial cells.The pathogenicity experiments in piglets showed that compared with the control group,the challenged group of pig-lets had severe diarrhea symptoms,accompanied by reduced appetite and listlessness.Post-mortem examination revealed that the intes-tines were significantly thinner,congested,and filled with yellow watery contents.The challenged piglets showed typical pathological changes such as thinning of the intestinal wall and shortening and shedding of intestinal villi.In conclusion,this study successfully iso-lated a human-porcine recombinant G4P[23]PoRV strain and established the infection models in suckling mice and piglets,providing important tools for investigating the pathogenic mechanism of PoRV,evaluating vaccines and developing antiviral drug.

Objective:To explore impacts of remifentanil on neuroinflammation in rats with cerebral infarction by regulating CC chemokine macrophage inflammatory protein-1α(MIP-1α)/CC chemokine receptor 1(CCR1)signaling pathway.Methods:Rats were randomly grouped into sham group,model group,remifentanil group,MIP-1α Ab group(MIP-1α neutralizing antibody,10 μg)and HY-U00350 group(CCR1 antagonist,100 μg),improved Longa suture method was applied to prepare a rat cerebral infarction model.Neural function scoring method was applied to evaluate neural function of rats;ELISA was applied to detect serum levels of TNF-α,IL-6 and IL-1β;HE staining was applied to observe pathological changes in rat hippocampal tissue,TTC staining method was applied to detect area of cerebral infarction in rats,TUNEL staining was applied to detect apoptosis rate of rat brain cells;RT-qPCR was applied to detect expressions of MIP-1α mRNA and CCR1 mRNA;Western blot was applied to detect expressions of MIP-1α and CCR1 proteins in rat brain tissue.Results:Compared with sham group,hippocampal neuron structure was seriously damaged in model group,neurological function score,levels of TNF-α,IL-6 and IL-1β,apoptosis rate,percentage of cerebral infarction area,expres-sions of MIP-1α,CCR1 gene and protein were obviously increased(P<0.05);compared with model group,morphological damage of neurons in remifentanil group,MIP-1α Ab group and HY-U00350 group was obviously reduced,neurological function score,levels of TNF-α,IL-6 and IL-1β,apoptosis rate,percentage of cerebral infarction area,expressions of MIP-1α,CCR1 gene and protein were obviously reduced(P<0.05);compared with remifentanil group,indicators of rats in MIP-1α Ab group had no statistical significance(P>0.05),levels of MIP-1α gene and protein obviously increased in HY-U00350 group,other indicators were also not statistically obvious(P>0.05).Conclusion:Remifentanil can reduce neuroinflammation in rats with cerebral infarction,which may be related to inhibition of MIP-1α/CCR1 signaling pathway.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.