Efferocytosis refers to the process that phagocytes recognize and remove the apoptotic cells, which is essential for maintaining tissue homeostasis both in physiological and pathological conditions. Numerous studies have demonstrated that efferocytosis can prevent secondary necrosis and proinflammatory factor release, leading to the resolution of inflammation and tissue immunological tolerance in numerous diseases such as stroke. Stroke is a leading cause of death and morbidity for adults worldwide. Persistent inflammation triggered by the dead cells or cell debris is a major contributor to post-stroke brain damage. Effective efferocytosis might be an efficient strategy to minimize inflammation and restore brain homeostasis for neuronal regeneration and function recovery. In this review, we will discuss the phagocytes in the brain, the molecular mechanisms underlying efferocytosis, the role of efferocytosis in inflammation resolution, and the potential therapeutic applications targeting efferocytosis in stroke.
Humans ; Stroke ; Phagocytosis/physiology* ; Inflammation ; Apoptosis/physiology* ; Animals ; Phagocytes/physiology* ; Brain/metabolism* ; Efferocytosis

Objective:To investigate the prevalence and risk factors of hypertensive retinopathy (HRP) in a non-diabetic population over 30 years old during routine health examinations.Methods:This was a cross-sectional study of a non-diabetic population over 30 years of age. The study was conducted during routine health examinations at the Tongren Hospital, Beijing, from January to December 2020. Fundus photographs were taken, and data including medical history, height, weight, and blood pressure were collected. Routine laboratory examinations were performed. The study population was divided into hypertension, transient hypertension, and non-hypertension groups. The prevalence of HRP was compared among the three groups. OR and 95% CI of HRP risk factors was estimated by binary logistic regression, adjusted for age and gender. Results:The prevalence of HRP was 4.3% in the non-diabetic population over 30 years old. Adjusted for age, gender, and systolic blood pressure, the prevalence of HRP in hypertension and transient hypertension groups, was both higher than in the non-hypertension group [ OR(95% CI) of 3.11(2.25-4.30) and 1.72(1.21-2.45), respectively]. The proportion of grade 1-2 HRP was higher (76.2%). There was no significant difference in the prevalence of grade 3 HRP among the three groups. Adjusted for age and gender, systolic blood pressure and creatinine clearance rate were independent risk factors for HRP in the hypertension group [ OR(95% CI): 1.22(1.01-1.48) and 1.66(1.12-2.46)] and transient hypertension group [ OR(95% CI): 1.48(1.10-2.06) and 1.95(1.03-3.46)]. SBP and DBP were independent risk factors for HRP in the non-hypertension group [ OR(95% CI): 1.68(1.07-2.63) and 1.61(1.06-2.44)]. Conclusions:There was a high prevalence of HRP among the non-diabetic population over the age of 30 and there was still relatively high risk of grade 3 HRP among the normotensive population.

Objective:To investigate the effect of drug metabolism related gene polymorphism on the efficacy of clopidogrel in patients with acute coronary syndrome (ACS).Methods:The medical records and follow-up records of ACS patients, who were hospitalized in the People′s Hospital of Daxing District between 2017 and 2019, received standardized treatment with aspirin (100 mg/day)+clopidogrel (75 mg/day), and underwent testing for genetic polymorphisms related to clopidogrel absorption/metabolism, were collected. The patients were divided into thrombotic event group and non-thrombotic event group according to whether they experienced thrombotic events such as myocardial infarction, stent thrombosis, and cerebral infarction within 1 year of treatment. The age, gender, smoking history and drinking habits, underlying diseases, drug combination, and alleles related to clopidogrel absorption/metabolism in patients in the 2 groups were compared. The factors affecting the clinical efficacy of clopidogrel was analyzed using logistic regression model.Results:A total of 342 patients were included in the analysis, including 274 males and 68 females, aged (58±9) years; of them, 78 (22.8%) developed thrombotic events. The differences in age, gender, smoking history, drinking history, hypertension, diabetes mellitus, hyperlipidemia, percutaneous coronary intervention history, proportion of combined with calcium channel antagonists, cytochrome P450 (CYP) 2C19*3, paraoxonase-1 Q192R, and adenosine triphosphate binding cassette transporter B1 C3435T between the thrombotic event group and the non-thrombotic event group were not statistically significant (all P>0.05), but the body mass index (BMI), the proportion of CYP2C19*2 GG type and CYP2C19*17 CT type in patients in the thrombotic event group were lower than those in the non-thrombotic event group (all P<0.05), and the proportion of patients with proton pump inhibitor and CYP2C19*17 CC type in the thrombotic event group was higher than that in the non-thrombotic event group (all P<0.05). Multivariate logistic regression analysis showed that high BMI ( OR=0.915, 95 %CI: 0.847-0.989, P=0.026), CYP2C19*2 GG type ( OR=0, 95 %CI: 0-0.008, P<0.001), and GA type ( OR=0.028, 95 %CI: 0.003-0.296, P=0.003) were independent protective factors for thrombotic events after clopidogrel treatment; CYP2C19*17 CC type ( OR=2 856.665, 95 %CI: 87.337-93 436.810, P<0.001) was an independent risk factor for thrombotic events after clopidogrel treatment. Conclusion:CYP2C19*2 and CYP2C19*17 mutations are important factors affecting the efficacy of clopidogrel and the occurrence of thrombotic events after treatment in ACS patients.

Objective:To investigate the effect of drug metabolism related gene polymorphism on the efficacy of clopidogrel in patients with acute coronary syndrome (ACS).Methods:The medical records and follow-up records of ACS patients, who were hospitalized in the People′s Hospital of Daxing District between 2017 and 2019, received standardized treatment with aspirin (100 mg/day)+clopidogrel (75 mg/day), and underwent testing for genetic polymorphisms related to clopidogrel absorption/metabolism, were collected. The patients were divided into thrombotic event group and non-thrombotic event group according to whether they experienced thrombotic events such as myocardial infarction, stent thrombosis, and cerebral infarction within 1 year of treatment. The age, gender, smoking history and drinking habits, underlying diseases, drug combination, and alleles related to clopidogrel absorption/metabolism in patients in the 2 groups were compared. The factors affecting the clinical efficacy of clopidogrel was analyzed using logistic regression model.Results:A total of 342 patients were included in the analysis, including 274 males and 68 females, aged (58±9) years; of them, 78 (22.8%) developed thrombotic events. The differences in age, gender, smoking history, drinking history, hypertension, diabetes mellitus, hyperlipidemia, percutaneous coronary intervention history, proportion of combined with calcium channel antagonists, cytochrome P450 (CYP) 2C19*3, paraoxonase-1 Q192R, and adenosine triphosphate binding cassette transporter B1 C3435T between the thrombotic event group and the non-thrombotic event group were not statistically significant (all P>0.05), but the body mass index (BMI), the proportion of CYP2C19*2 GG type and CYP2C19*17 CT type in patients in the thrombotic event group were lower than those in the non-thrombotic event group (all P<0.05), and the proportion of patients with proton pump inhibitor and CYP2C19*17 CC type in the thrombotic event group was higher than that in the non-thrombotic event group (all P<0.05). Multivariate logistic regression analysis showed that high BMI ( OR=0.915, 95 %CI: 0.847-0.989, P=0.026), CYP2C19*2 GG type ( OR=0, 95 %CI: 0-0.008, P<0.001), and GA type ( OR=0.028, 95 %CI: 0.003-0.296, P=0.003) were independent protective factors for thrombotic events after clopidogrel treatment; CYP2C19*17 CC type ( OR=2 856.665, 95 %CI: 87.337-93 436.810, P<0.001) was an independent risk factor for thrombotic events after clopidogrel treatment. Conclusion:CYP2C19*2 and CYP2C19*17 mutations are important factors affecting the efficacy of clopidogrel and the occurrence of thrombotic events after treatment in ACS patients.

Mild encephalitis/encephalopathy with reversible splenial lesion has special clinical-imaging features. According to the extent of lesion involvement, it can be divided into type Ⅰ and type Ⅱ. Clinically, type Ⅰ is more common, and type Ⅱ is rare. A rare case of recurrent type Ⅱ mild encephalitis/encephalopathy with reversible splenial lesion is reported. The patient presented with typical type Ⅱ mild encephalitis/encephalopathy with reversible splenial lesion for the first time, involving the corpus callosum and the deep white matter, and the lesions disappeared after a short-term reexamination. Two years later, the lesions recurred, and the scope of the lesions was similar to that of the first time, and the lesions disappeared after a short-term reexamination. The clinical and imaging findings are analyzed in combination with relevant literatures review in order to deepen the understanding of the disease and improve the level of diagnosis and treatment.

Objective? To explore the effects of health education based on "information-motivation-behavioral skills" (IMB) model on health behavior among soldiers with urolithiasis in the plateau. Methods? From January 2016 to May 2017, we selected 160 soldiers with urolithiasis providing logistic services in the plateau with altitude of more than 3 000 m at the 940th Hospital of Logistic Services Troops of the Chinese People's Liberation Army as subjects by convenience sampling. All of the patients were divided into experimental group and control group with the random number table, 80 cases in each group. Control group carried out routine health education, while experimental group implemented health education based on IMB model. After intervention, we compared the health belief, health behavior and recurrence rate of calculi of soldiers between two groups. Results? Six months after intervention, the total scores of health belief and health behavior of experimental group were (140.22±12.90) and (149.44±14.18) higher than those of control group with statistical differences (P＜0.05). The recurrence rates of calculi of experimental group in 6 and 12 months were lower than those of control group with statistical differences (χ2=7.761,P＜0.05). Conclusions? Health education based on IMB model makes soldiers change healthy perception into actual behavior and maintain healthy behavior in daily life to reduce the recurrence rate of urinary calculus and improve the combat capability of troops.

Objective To investigate the morphological differences of proximal femoral medullary cavity in elderly patients with intertrochanteric fracture and its effect on the treatment efficacy of proximal femoral nail antirotation (PFNA). Methods A retrospective case series study was conducted on the clinical data of 112 elderly patients with intertrochanteric fracture of the femur from December 2012 to January 2017, including the preoperative and postoperative hip joints orthotopic X ray (including the proximal femur), lateral X ray, and pelvic orthotopic X ray films. The proximal femoral canal flare index (CFI) and the metaphyseal canal flare index (MCFI) were measured. The proportion of patients with different types of medullary cavity and the gender difference were analyzed according to Dorr typing. The fractures were classified according to the modified Evans classification. Operation time, fracture reduction quality, tip apex distance (TAD), incidence of intraoperative split fracture around the rotors, postoperative fracture reduction loss rate, weight bearing time, and fracture healing time were recorded. Results The proximal femoral canal flare index (CFI) was significantly correlated with the intramedullary diameter above the lesser trochanter, the inner diameter of the affected side medullary cavity isthmus, and metaphyseal canal flare index (MCFI) (P ＜0.01). There was clear difference in gender in terms of the medullary cavity diameter 20 mm above the middle point of lesser trochanter, medullary isthmus internal diameter, the medullary cavity diameter 20 mm below the middle point of lesser trochanter, CFI, and MCFI. Thereinto, there was significant difference in the medullary cavity diameter 20 mm above the middle point of lesser trochanter [male (52.6 ± 6.4) mm, female: (49.9 ± 5.4) mm], the medullary cavity diameter 20 mm below the middle point of lesser trochanter [male: (26.5 ± 3.7) mm, female: (23.1 ±2.8)mm], and MCFI (male:2.0 ±0.3, female:2.2 ±0.2). No significant difference between the medullary isthmus internal diameter and CFI was found (P＞0.05). In this group, the medullary cavity of proximal femur was classified by Dorr: the proportion of funnel type, normal type, and chimney type was 5.4％ (6/112), 73.2％ (82/112), and 21.4％ (24/112), respectively. There was no significant difference in the modified Evans fracture stability among different morphological types of the proximal femoral medullary cavity. The difference of weight bearing time between normal group and chimney group was statistically significant [normal type: (21.4±16.9)d, chimney type: (45.5 ± 11.2)d] (P ＜ 0.05), but there were no significant differences in operation time, reduction quality, TAD, intraoperative incidence of cleavage fracture incidence, reduction loss rate, and healing time between the two groups (P＞0.05). Conclusions The occurrence and development of osteoporosis can cause significant changes in the morphology of proximal femoral medullary cavity, mainly manifesting as the gradual increase of the proportion of chimney type. The efficacy of PFNA in treatment of the intertrochanteric fracture is satisfactory. However, the risk of intraoperative cleavage fracture and postoperative reduction loss should be taken seriously.

Objective To investigate the prevalence and risk factors of diabetic retinopathy (DR) in a Beijing population during routine medical examinations. Methods This was a cross-sectional study during a routine health examination at the Tongren Hospital of Beijing,from March 2014 to February 2015. Fundus photography was conducted by experienced ophthalmologists.Medical history,height,weight,waist and hip circumference,and blood pressure were recorded.Routine laboratory examinations were performed. Logistic regression models were used to estimate the odds ratio (OR) and 95% confidence interval (CI) of diabetic retinopathy for each risk factor,adjusted for age and gender. Results The prevalence of DR was 7.0% among diabetic individuals.The multivariate analysis showed that disease durations[OR(95% CI),2.1 (1.564-2.752),P<0.001],fasting plasma glucose[1.2(1.093-1.273),P<0.001],body mass index[1.8(1.010-3.100),P=0.046],and triglyceride[0.794(0.638-0.987),P=0.038]were independently associated with DR. The prevalence of diabetes mellitus (DM) and DR significantly increased in populations aged>30 years. Conclusion Fundus photography (nonmydriatic) should be recommended as a routine screening method for people 30 years and elder to effectively prevent occurrence of visual impairment and blindness.

Objective To evaluate the effects of nurse-led team management on self-management and hyperten-sion control for community-dwelling hypertensive patients. Methods A quasi-experimental study design was adopt-ed,two communities were elected as the intervention group and the control group in Wuhou District,Chengdu,and 102 hypertensive patients were recruited from each group. The intervention group received nurse-led team manage-ment for 2 years,and intervention methods included individual management,phone or home follow-up,collective inter-vention and so on. While the control group received doctor-led hypertension management. The patients' self-man-agement behaviors and hypertension control were evaluated before the intervention and 6,12,24 months after the intervention. Results After 24-month nurse-led team management,scores of self-management behaviors and hyper-tension control rate of patients in the intervention group were significantly higher than those of patients in the con-trol group(P<0.05). Conclusion Nurse-led team management could significantly improve self-management behaviors and the rate of hypertension control for hypertensive patients.

Xeroderma pigmentosum (XP) is a group of genetic disorders caused by mutations of XP-associated genes, resulting in impairment of DNA repair. XP patients frequently exhibit neurological degeneration, but the underlying mechanism is unknown, in part due to lack of proper disease models. Here, we generated patient-specific induced pluripotent stem cells (iPSCs) harboring mutations in five different XP genes including XPA, XPB, XPC, XPG, and XPV. These iPSCs were further differentiated to neural cells, and their susceptibility to DNA damage stress was investigated. Mutation of XPA in either neural stem cells (NSCs) or neurons resulted in severe DNA damage repair defects, and these neural cells with mutant XPA were hyper-sensitive to DNA damage-induced apoptosis. Thus, XP-mutant neural cells represent valuable tools to clarify the molecular mechanisms of neurological abnormalities in the XP patients.
DNA Damage ; DNA Repair ; DNA-Binding Proteins ; genetics ; metabolism ; Female ; Humans ; Induced Pluripotent Stem Cells ; metabolism ; pathology ; Male ; Models, Biological ; Mutation ; Neural Stem Cells ; metabolism ; pathology ; Xeroderma Pigmentosum ; genetics ; metabolism ; pathology