AIM: To investigate the distribution characteristics of pathogens in patients with post-traumatic infectious endophthalmitis(PTIE)and their relationship with serum levels of macrophage inflammatory protein 1α(MIP-1α), heat shock protein 70(HSP70), and soluble triggering receptor expressed on myeloid cells 1(sTREM-1).METHODS:A total of 157 patients with PTIE from the Handan City Eye Hospital(The Third Hospital of Handan)from May 2023 to May 2025 were selected as the study group. They were divided into a good prognosis group and a poor prognosis group based on their uncorrected visual acuity at discharge. Meanwhile, 157 patients with ocular trauma but without endophthalmitis during the same period were selected as control group 1, and 157 healthy volunteers who underwent physical examinations during the same period were selected as control group 2. Aqueous humor and vitreous fluid samples were collected from the study group to detect the distribution of pathogens. The levels of serum MIP-1α, HSP70, and sTREM-1 were measured using the enzyme-linked immunosorbent assay. Multivariate Logistic regression analysis was performed to identify risk factors for poor prognosis. The predictive value of serum MIP-1α, HSP70, and sTREM-1 levels for poor prognosis was evaluated using receiver operating characteristic(ROC)and decision curve analysis(DCA).RESULTS: The general data of the participants in the three groups was comparable. A total of 173 pathogens were detected in the 157 patients with PTIE, with Gram-positive bacteria being the predominant type. The levels of serum MIP-1α and sTREM-1 in the study group were higher than those in control groups 1 and 2, while the level of HSP70 was lower than those in control groups 1 and 2(all P<0.05). There were no significant differences in the levels of serum MIP-1α, HSP70, and sTREM-1 between control groups 1 and 2(all P>0.05). In the poor prognosis group, the time of wound suture was ≥24 h, the wound location was in zones II/III, the type of trauma was rupture, the proportion of rupture injuries, and the levels of serum C-reactive protein, MIP-1α, and sTREM-1 were higher than those in the good prognosis group, while the level of HSP70 was decreased(all P<0.001). Multivariate Logistic regression analysis showed that the time of wound suture, wound location, type of trauma, C-reactive protein, MIP-1α, HSP70, and sTREM-1 were risk factors for poor visual prognosis in patients with PTIE(all P<0.05). The ROC curve results showed that the combined prediction of serum MIP-1α, HSP70, and sTREM-1 for poor visual prognosis in PTIE patients had an AUC value of 0.965, which was significantly higher than that of individual predictions(ZMIP-1α, ZHSP70, ZsTREM-1=3.628, 4.705, 3.930, all P<0.05). Additionally, the DCA curve showed that the combined prediction had a higher net benefit rate than individual predictions in the high-risk threshold range of 0.03-0.97.CONCLUSION:Gram-positive bacteria are the predominant type of pathogenic bacteria in patients with PTIE, with elevated levels of serum MIP-1α and sTREM-1 and decreased levels of HSP70. The combined detection of these three factors has a high predictive efficacy for visual prognosis in patients.

OBJECTIVE: To analyze the factors related to spontaneous re-eruption after intruded injury in permanent anterior teeth in children and adolescents. METHODS: Clinical data from 5- to 17-year-old patients who sustained intrusive luxation of permanent anterior teeth and treated in the Department of Pedia-tric Dentistry of Peking University School and Hospital of Stomatology from June 2015 to August 2024 were reviewed. Information of age, gender, degree of intrusion, direction of intrusion, tooth development, concomitant injuries, luxation and post-osteoclastic eruption of the adjacent teeth were recorded. The patients were divided into two groups based on whether they showed spontaneous re-eruption during advised observation after intrusion. Univariate and multifactor analysis were performed using Logistic regression. RESULTS: Data from 170 teeth in 139 patients whose age ranging from 5.3-16.3 years [mean age (9.0± 2.1) years] were examined. A gender disparity was observed among the patients, with 84 being male and 55 being female. Among the 170 teeth, 112 were categorized as successfully spontaneous re-eruption during advised observation after intrusion, while 58 were not. In terms of the degree of intrusion, 45 teeth (26.47%) had intrusion less than 3 mm, 102 teeth (60.00%) experienced intrusion between 3-7 mm, and 23 teeth (13.53%) were faced with intrusion exceeding 7 mm. As for the direction of intrusion, 117 teeth (68.82%) were straight intrusion while mesial-distal and buccal-lingual intrusion respectively accounting for 17 (10.00%) and 23 (13.53%). Multivariate Logistic regression analysis showed that mesial-distal intrusion (OR=0.167, 95%CI: 0.031-0.9048, P=0.038), intrusion of >7 mm (OR=0.065, 95%CI: 0.014-0.299, P < 0.001) and luxation of adjacent teeth (OR=0.369, 95%CI: 0.144-0.944, P=0.037) were independent risk factors for spontaneous re-eruption of traumatically intruded permanent anterior teeth in children and adolescents during advised observation after intrusion, while intrusion of < 3 mm (OR=9.860, 95%CI: 2.430-40.009, P=0.001) and post-osteoclastic eruption of adjacent teeth (OR=4.712, 95%CI: 1.528-14.531, P=0.007) were independent protective factors. The possibility of spontaneous re-eruption in permanent anterior teeth during advised observation after intrusion was decreased by 61.1% with the increase of root development using Cvek' s classification (OR=0.611, 95%CI: 0.408-0.914, P=0.017). Age (OR=1.077, 95%CI: 0.763-1.521, P=0.673) and laceration of gingival (OR=0.865, 95%CI: 0.290-2.578, P=0.794) didn't significantly affect the spontaneous re-eruption during advised observation after intrusion. CONCLUSION In this study, mesial-distal intrusion, intrusion of >7 mm and luxation of adjacent teeth were independent risk factors for spontaneous re-eruption of traumatically intruded permanent anterior teeth in children and adolescents during advised observation, while intrusion of < 3 mm and post-osteoclastic eruption of adjacent teeth were served as independent protective factors.
Humans ; Adolescent ; Child ; Female ; Male ; Tooth Eruption/physiology* ; Child, Preschool ; Tooth Avulsion/therapy* ; Dentition, Permanent ; Incisor/injuries* ; Remission, Spontaneous

OBJECTIVES: Intracranial aneurysm (IA) has an insidious onset, and once ruptured, it carries high rates of mortality and disability. Cardiometabolic factors may be associated with the formation and rupture of IA. This study aims to summarize the application of Mendelian randomization (MR) methods in research on cardiometabolic factors and IA, providing insights for further elucidation of IA etiology and pathogenesis. METHODS: Literature about MR-based IA studies published up to February 21, 2024, was retrieved from PubMed, Embase, Web of Science, CNKI, and Wanfang. Two researchers independently performed literature screening, data extraction, and quality assessment. A narrative synthesis approach was used to conduct a qualitative systematic review of the included studies. RESULTS: A total of 11 MR-based studies on IA published between 2017 to 2024 were included, of which 4 were rated as high quality. These studies investigated the associations between blood pressure, blood lipids, blood glucose, obesity-related indicators, and inflammatory cytokines with IA and its subtypes, though issues of duplication were noted. Four MR studies based on the same European population but using different instrumental variable selection criteria, as well as another MR study in a different European cohort, consistently identified blood pressure as a risk factor for IA and its subtypes. Findings for blood lipids, blood glucose, obesity-related indicators, and inflammatory cytokines were inconsistent across MR studies. CONCLUSIONS Blood pressure appears to increase the risk of IA and its subtypes. Associations between other cardiometabolic factors and IA/subtypes require further in-depth investigation. Given the inherent limitations of MR studies, causal inferences should be made cautiously in combination with other lines of evidence.
Humans ; Mendelian Randomization Analysis ; Intracranial Aneurysm/etiology* ; Risk Factors ; Blood Pressure ; Blood Glucose ; Obesity/complications* ; Cardiometabolic Risk Factors ; Lipids/blood*

[This corrects the article DOI: 10.1016/j.apsb.2021.07.004.].

Objective To explore the effects of Tepp-46, a pyruvate kinase M2 (PKM2) agonist, on the skin fibrosis of patients with systemic scleroderma (SSc) and its therapeutic effect on the SSc mouse models. Methods Full-thickness skin tissues of SSc patients and healthy controls were taken, and the expression levels of PKM2 and α-smooth muscle actin (α-SMA) were detected using immunohistochemical staining. The skin primary fibroblasts were isolated from the tissues, and the PKM2 protein expression was detected using Western blotting. SSc fibroblasts were stimulated with Tepp-46 of different concentrations, and Western blotting was used to measure the expression of PKM2, collagen type Ⅰα1 (ColⅠα1) and α-SMA protein after the stimulation. The C57BL/6 mice were randomly divided into three groups: control group, bleomycin (BLM) group and Tepp-46 group. BLM was injected subcutaneously to establish the SSc mouse model, at the same time, Tepp-46 treatment initiated in the Tepp-46 group. At 21 d after modeling, the mice were executed and their skins were taken. HE staining and Masson staining were used to analyze morphological changes of the skin. The immunohistochemical staining was used to examine the expression of PKM2 and α-SMA protein in the mouse skin. Western blotting was used to analyze the expression of ColⅠα1 and PKM2 in the mouse skin. Results Compared with the healthy controls, α-SMA protein expression in the dermis of SSc patients was higher, and PKM2 protein expression in the epidermis and dermis of SSc patients increased (P＜0.000 1). PKM2 protein expression in primary fibroblasts of SSc skin was higher than that of healthy controls (P＜0.01); after Tepp-46 stimulation, the levels of ColⅠα1 and α-SMA in SSc fibroblasts decreased (P＜0.01), but PKM2 protein was not affected. In the mice, HE and Masson stainings showed that compared with BLM group, the pathological changes of skin were alleviated in the Tepp-46 group. The immunohistochemical staining results showed the levels of PKM2 and α-SMA in the skin of Tepp-46 group were lower than those of the BLM group (P＜0.000 1). Western blotting results showed the level of ColⅠα1 in the Tepp-46 group was lower than that in the BLM group (P＜0.001). Conclusions The expression of PKM2 protein in SSc skin tissue and primary fibroblasts is up-regulated, and PKM2 agonist Tepp-46 can inhibit SSc skin fibrosis.

Objective To investigate the effects of modified Simiao San combined with Metronidazole Tablets on immune factors,inflammatory factors,and oxidative stress in patients with bacterial vaginosis(BV).Methods Eighty BV patients treated at Dongguan Hospital of Guangzhou University of Chinese Medicine(Dongguan Traditional Chinese Medicine Hospital)from March 2023 to April 2024 were equally randomly divided into a control group(40 cases,treated with Metronidazole Tablets)and a study group(40 cases,treated with modified Simiao San plus Metronidazole Tablets).The treatment for the two groups lasted for 7 days.Serum immunologic factors[immunoglobulin(Ig)A,IgG,and IgM],inflammatory factors[C-reactive protein(CRP),tumor necrosis factor α(TNF-α),and interleukin-6(IL-6)],and oxidative stress markers[superoxide dismutase(SOD),malondialdehyde(MDA),and glutathione peroxidase(GSH-Px)]in the two groups were measured before and after treatment.After treatment,symptom resolution time,clinical efficacy,and the incidence of total adverse reactions were compared between the two groups.Results(1)After 7 days,the total effective rate was 95.00%(38/40)in the study group versus 77.50%(31/40)in the control group(tested by chi-square test,P＜0.05).(2)The study group showed significantly shorter time to the resolution of profuse or scanty leukorrhea,odor of leukorrhea,vulvar itching,vaginal pain,and vaginal mucosal hyperemia(all P＜0.01)than the control group.(3)After treatment,both groups exhibited increased IgA,IgG,and IgM(P＜0.05)compared to those before treatment,with greater improvements in the study group(P＜0.01).(4)After treatment,serum levels of inflammatory factors of CRP,TNF-α,and IL-6 in both groups decreased(P＜0.05),with superior reductions in the study group(P＜0.01).(5)After treatment,serum levels of oxidative stress markers of SOD and GSH-Px levels rose(P＜0.05),while MDA declined(P＜0.05)in both groups,and the study group demonstrated more pronounced improvements(P＜0.01).(6)Adverse reaction rates were 5.00%(2/40)and 15.00%(6/40)in the study group and control group,respectively,the differentce being no statistical significance between the two groups(P＞0.05).Conclusion Modified Simiao San combined with Metronidazole Tablets significantly alleviates BV symptoms,improves immune function,and inhibits inflammatory response and oxidative stress,demonstrating satisfactory efficacy and high safety.

Objective To explore the medication rules and therapeutic principles of Zhang Jingyue's miscarriage prevention therapies based on data mining technique and literature analysis.Methods The prescription data recorded in the chapter about pregnancy and fetal development from the volume of Women's Diseases in Jing Yue Quan Shu(Jingyue's Complete Works)were collected to establish a database.Frequency analysis,association analysis,and cluster analysis of the herbal medicines from the prescriptions for preventing miscarriage were performed using SPSS Modeler 18.0 and SPSS Statistics 26.0 to investigate Zhang's medication rules.Additionally,discussions on miscarriage prevention in the chapter about pregnancy and fetal development were systematically reviewed to summarize his therapeutic principles.Results A total of 76 miscarriage-prevention prescriptions involving 102 herbal medicinals were analyzed.Among them,26 high-frequency herbal medicinals(used≥5 times)were identified,and primarily belonged to the tonifying deficiency category(11 medicinals).Association analysis revealed 10 association rules with high support,such as"Atractylodis Macrocephalae Rhizoma→Ginseng Radix et Rhizoma"and"Glycyrrhizae Radix et Rhizoma Praeparata cum Melle→Ginseng Radix et Rhizoma,Atractylodis Macrocephalae Rhizoma".The network graph of drug association presented high-correlation herbs including Glycyrrhizae Radix et Rhizoma Praeparata cum Melle,Atractylodis Macrocephalae Rhizoma,Poria,Ginseng Radix et Rhizoma,and Angelicae Sinensis Radix.Cluster analysis yielded four core prescription groups:(1)Ziziphi Spinosae Semen,Polygalae Radix,Dioscoreae Rhizoma,and Corni Fructus;(2)Paeoniae Radix Alba,Chuanxiong Rhizoma,Rehmanniae Radix Praeparata,Atractylodis Macrocephalae Rhizoma,Ginseng Radix et Rhizoma,Glycyrrhizae Radix et Rhizoma Praeparata cum Melle,Angelicae Sinensis Radix,Poria,and Citri Reticulatae Pericarpium;(3)Rehmanniae Radix,Glycyrrhizae Radix et Rhizoma,and Scutellariae Radix;(4)Pinelliae Rhizoma,Magnoliae Officinalis Cortex,Zingiberis Rhizoma Recens,and Jujubae Fructus.Zhang's therapeutic principles for preventing miscarriage were as follows:(1)treating primary diseases together by preventing miscarriage;(2)monthly-specific cultivation of the fetus to preemptively address deficiencies;(3)emphasis on maternal health to consolidate fetal vitality;(4)strict adherence to medication and dietary contraindications and lifestyle management during pregnancy.Conclusion Zhang Jingyue's miscarriage-prevention principles emphasize etiological diagnosis with dual focus on treating primary diseases and preventing miscarriage.His therapies prioritize replenishing qi and blood,skillfully regulating spleen-stomach function and qi movement by employing special and mild herbs and prescribing simplified and flexible formulas.These medication rules and therapeutic principles may provide valuable references for modern miscarriage-prevention strategies.

Natural killer cells(NK)are important innate immune cells that do not require prior antigen exposure and can directly recognize and attack virus-infected cells and tumor cells.The activation and effector functions of NK cells are regulated by a balance of signals delivered through their surface activating receptors and inhibitory re-ceptors,which bind to ligands on target cells to achieve cytotoxicity via"induced self"and"missing self"recogni-tion models.The killing mechanisms of NK cells primarily include release of cytotoxic granules such as perforin and granzymes to induce target cell lysis,death receptor-mediated apoptosis,secretion of various cytokines,chemokines and growth factors to coordinate with other immune cells in killing tumor cells,thereby generating secondary im-mune responses and antibody-dependent cellular cytotoxicity(ADCC).

ObjectiveTo evaluate the clinical efficacy and safety of Tongluo Mingmu capsules in the treatment of diabetic retinopathy with blood stasis， collateral obstruction， and Qi and Yin deficiency syndrome. MethodA randomized， double-blind， positive-control， and multi-center clinical trial design method was used. 416 patients with diabetic retinopathy with blood stasis， collateral obstruction， and Qi and Yin deficiency syndrome in four test centers were included （the ratio of the treatment group to the control group was 3∶1）. On the basis of standardized hypoglycemic treatment， the treatment group was given both four Tongluo Mingmu capsules and two Calcium Dobesilate capsule agents three times a day， while the control group were given both two Calcium Dobesilate capsules and four Tongluo Mingmu capsule agents three times a day. The course of treatment was 12 weeks. The curative effect of Tongluo Mingmu capsules was evaluated by comparing the comprehensive curative effect of diabetic retinopathy， traditional Chinese medicine（TCM） syndrome score， corrected visual acuity， fundus changes， fundus fluorescence angiography， and other curative effect indexes before and after treatment in the two groups. At the same time， general examination， laboratory examination， and adverse events were performed to evaluate the safety of the drug. ResultThe baseline demographic data and disease characteristics of the treatment group and the control group were balanced and comparable， with the difference not statistically significant. After 12 weeks of treatment， the total effective rate of the comprehensive curative effect of diabetic retinopathy in the treatment group （61.0%， 189/310） was better than that in the control group （44.1%， 45/102）， and the difference was statistically significant （χ²=8.880， P<0.01）. The total effective rate of TCM syndromes in the treatment group （88.4%， 259/293） was better than that in the control group （69.9%， 65/93）， and the difference was statistically significant （χ²=17.927， P<0.01）. The disappearance rate of dry eyes （χ²=8.305）， dull complexion （χ²=4.053）， lassitude （χ²=10.267）， shortness of breath （χ²=8.494）， and dry stool （χ²=8.657） in the treatment group was higher than that in the control group， and the difference between the groups was statistically significant （P<0.05， P<0.01）. In terms of improving corrected visual acuity （χ²=8.382）， fundus changes （χ²=6.026） ， the treatment group was significantly better than the control group （P<0.05）. During the trial， the incidence of adverse events in the treatment group and the control group was 1.3% and 2.9%， respectively. There was no significant difference between the two groups. In addition， there were no serious adverse events and adverse events leading to withdrawal in both groups. ConclusionTongluo Mingmu capsules can improve the comprehensive curative effect of diabetic retinopathy and enhance the efficacy of TCM syndromes， visual acuity， fundus changes， and fundus fluorescein angiography， with great safety. Therefore， it can provide a new alternative therapeutic drug for patients with diabetic retinopathy.