BackgroundPerceived discrimination has been identified as a main risk factor for depression in maintenance hemodialysis patients. Chronic Illness Rejection and Discrimination Scale （CIRDS） is a measure for assessing perceived discrimination in individuals with chronic disease. However， the Chinese version of CIRDS for maintenance hemodialysis patients has not yet been established. ObjectiveTo translate CIRDS into Chinese version and evaluate its reliability and validity in maintenance hemodialysis patients， so as to provide an effective tool for assessing the perceived discrimination among maintenance hemodialysis patients. MethodsThe Brislin's model for translation， back-translation， cross-cultural adaptation and pre-experimentation was utilized to develop a Chinese version of CIRDS. A coherent of 250 maintenance hemodialysis patients attending Taihe Hospital Affiliated to Hubei Medical College， from July to October 2023 were selected as the research subjects. The formal scale was refined by employing item analysis， exploratory factor analysis and confirmatory factor analysis. The validity of the scale was evaluated using content validity and construct validity. The reliability of the scale was evaluated using Cronbach's α coefficient， test-retest reliability and split-half reliability. ResultsThe Chinese version of CIRDS consisted of 11 items， including 2 factors （perceived discrimination and perceived rejection）. The scale-level content validity index （S-CVI） value was 0.898 and the item-level content validity index （I-CVI） values ranged from 0.875 to 1.000. Two common factors were extracted by exploratory factor analysis and explained 65.41% of the total variance. Confirmatory factor analysis also indicated that the model provided a good fit for the data. The Cronbach's α coefficient of the scale was 0.910， with Cronbach's α coefficients of 0.835 and 0.912 for the perceived discrimination and perceived rejection， respectively. The split-half reliability of the scale was 0.803， and the test-retest reliability was 0.920. ConclusionThe Chinese version of CIRDS has excellent reliability and validity， which can be used to evaluate the perceived discrimination in maintenance hemodialysis patients.

[摘 要] 目的：探讨扁蒴藤素（Pris）调节Shh/Gli1信号通路对宫颈癌HeLa细胞增殖、凋亡和血管生成拟态（VM）的影响及其机制。方法：采用MTT法检测不同浓度Pris对宫颈癌HeLa细胞增殖的抑制作用，以选取合适的干预浓度。将HeLa细胞分为对照组、环巴胺组、Pris组、Pris+pc-NC组和Pris+pc-Shh组。采用MTT法、EdU法检测各组细胞的增殖能力，Transwell小室法、流式细胞术检测各组细胞的迁移及侵袭能力和细胞凋亡率，体外血管生成实验观察VM形成情况，qPCR法检测各组细胞中Shh和Gli1 mRNA表达水平，WB法检测细胞中血管内皮生长因子A（VEGF-A）、血管内皮钙黏素（VE-cadherin）、Ki-67、caspase-3及与Shh/Gli1信号通路相关蛋白表达水平。结果：0.25~2.5 mmol/L的Pris对HeLa细胞增殖均有显著抑制作用，选择1.5 mmol/L的Pris进行后续实验。对照组细胞形成良好的管腔结构，与对照组相比，环巴胺组、Pris组和Pris+pc-NC组HeLa细胞管腔结构被明显破坏，细胞增殖活力和增殖率、迁移及侵袭细胞数目、Shh和Gli1 mRNA、VEGF-A、VE-cadherin、Ki-67、Shh、Gli1蛋白表达均显著降低（均P<0.05），细胞凋亡率和caspase-3表达均显著升高（均P<0.05）；环巴胺组与Pris组HeLa细胞各项检测指标比较差异均无统计学意义（均P>0.05）；与Pris+pc-NC组相比，Pris+pc-Shh组细胞管腔结构形成明显改善，细胞增殖活力和增殖率、迁移及侵袭细胞数、Shh和Gli1 mRNA、VEGF-A、VE-cadherin、Ki-67、Shh、Gli1蛋白表达均显著升高（均P<0.05），细胞凋亡率和caspase-3表达均显著降低（均P<0.05）。结论：Pris抑制宫颈癌HeLa细胞的增殖、迁移与侵袭和VM的形成并促进细胞凋亡，可能与阻断Shh/Gli1信号通路有关。

Objective To assess the effectiveness and safety of CYP2C19 genotype test to guide clopi-dogrel individualized therapy in treating ischemic stroke.Methods The databases of PubMed,Embase,Co-chrane Library,Web of Science,Clinical Trail,CBM,CNKI,Wanfang database and VIP database were compre-hensively retrieved.The retrieval time was from the database establishment to August 2023.The randomized controlled trials (RCT) of CYP2C19 gene guiding clopidogrel anti-platelet therapy in the patients with ische-mic stroke were collected.The meta analysis was conducted by adopting the RevMan 5.3 software.Results A total of eleven RCT and 8729 patients with ischemic stroke were included.The meta analysis results showed that there was statistically significant difference in the recurrence rate risk of stroke (OR=0.48,95％CI:0.28-0.83,P=0.008),cardiovascular events incidence rate (OR=0.52,95％CI:0.33-0.82,P=0.005) and incidence rate of all-cause death (OR=0.57,95％CI:0.31-1.06,P=0.070) between clopidogrel individ-ualized anti-platelet treatment based on CYP2C19 genotype detection guidance and conventional anti-platelet treatment.In terms of safety,there were no statistically significant difference in the incidence rate of bleeding between the two groups (OR=1.16,95％CI:0.53-2.50,P=0.710).Conclusion CYP2C19 genotype detec-tion guided clopidogrel personalized anti-platelet therapy could significantly reduce the recurrent rate of stroke and incidence rate of vascular events compared with conventional anti-platelet treatment based on the existing evidence,moreover without increasing the risk of bleeding event occurrence

【Objective】 To compare the efficacy and safety between partial tubeless and standard percutaneous nephrolithotomy in the treatment of upper urinary tract calculi. 【Methods】 The clinical data of 802 patients with upper urinary tract calculi treated at our hospital during Jun.2018 and Dec.2021 were retrospectively analyzed. The patients were divided into the partial tubeless group and standard group, and 60 cases in either group were selected by a simple random method. Clinical data, complications and stone-free rate were compared between the two groups. 【Results】 All 120 patients completed the operation successfully. The postoperative hospital stay, pain score and postoperative recovery of the partial tubeless group were significantly superior to those of the standard group (P<0.05). There were no significant differences in operation time, blood loss, complications and stone clearance rate between the two groups (P>0.05). 【Conclusion】 In the treatment of upper urinary tract calculi, partial tubeless percutaneous nephrolithotomy can achieve satisfactory surgical results, and has obvious advantages in postoperative recovery and patients’ experience. It is worthy of clinical application.

PURPOSE: To investigate the clinical effects of arthroscopically artificial ligament reconstruction with tensional remnant-repair in patients who are obese, and/or with demand for highly intensive sports, and/or with poor-quality ligament remnants. METHODS: A retrospective case series study was performed on patients treated by arthroscopically anterior talofibular ligament (ATFL) reconstruction with tensional remnant repair technique from January 2019 to August 2021. General data, including demographics, surgical time, and postoperative adverse events, were recorded. The American Orthopaedic Foot and Ankle Society score (AOFAS), foot and ankle ability measure (FAAM), visual analog scale (VAS), and anterior talar translation were measured preoperatively and at 6 weeks, 3 months, and 2 years postoperatively. Ultrasonography examination was performed preoperatively and 2 years postoperatively to evaluate the ATFL. Data were analyzed using SPSS 19.0. F test was used to analyze the pre- and postoperative VAS, FAAM, and AOFAS scores. The significance was set at p < 0.05. RESULTS: There were 20 males and 10 females among the patients with a mean age of (30.71 ± 5.81) years. The average surgical time was (40.21 ± 8.59) min. No adverse events were observed after surgery. At 2 years postoperatively, the anterior talar translation test showed grade 0 laxity in all patients. VAS score significantly decreased from preoperatively to 6 weeks, 3 months, and 2 years postoperatively (p < 0.001). Improvement of FAAM score and the AOFAS score from preoperatively to 6 weeks, 3 months, and 2 years postoperatively was statistically significant (p < 0.001). At 3 months postoperatively, most patients (23/30) could return to their pre-injured activities of daily living status. At 2 years postoperatively, all patients were able to return to their pre-injured activities of daily living status, and almost every patient (18/19) who expected highly intensive sports returned to sports with only 1 obese patient failing to achieve the goal. The ultrasonography examination at 2 years postoperatively showed that there was a linear band structure of soft tissue on the tension-rich fiber tape image from the fibular to the talar attachment sits of ATFL. CONCLUSION The novel arthroscopically artificial ligament reconstruction with tensional remnant-repair technique for ATFL achieved satisfactory clinical outcomes in the short and medium term after operation, and allowed early return to pre-injured activities, which could be a reliable option for patients with chronic lateral ankle instability.
Male ; Female ; Humans ; Young Adult ; Adult ; Ankle Joint/surgery* ; Retrospective Studies ; Activities of Daily Living ; Ankle Injuries/surgery* ; Lateral Ligament, Ankle/surgery* ; Joint Instability/surgery* ; Ligaments ; Obesity ; Arthroscopy/methods*

OBJECTIVE To systematically evaluate the efficacy and safety of fondaparinux versus low molecular weight heparin（nadroparin，enoxaparin）in the treatment of non-ST-elevation acute coronary syndrome （NSTE-ACS）. METHODS The computer searched PubMed ，Medline，Embase，EBSCO，CNKI，Wanfang medical network ，VIP Chinese Journal Full-text Database and relevant clinical trial registration network for the clinical retrospective cohort study （RCS）of fondaparinux （as trial group）and low molecular weight heparin （natroparin，enoxaparin）（as control group ）in the treatment of NSTE-ACS. The retrieval time limit was from the establishment of the database to August 2021. Newcastle Ottawa scale （NOS）was used to evaluate the quality of literature. Outcome indicators included primary efficacy indicators （incidence of acute myocardial infarction and recurrent angina pectoris during hospitalization ），secondary efficacy indicators [revascularization of target vessels during 话：0835-2862024。E-mail：xiexingxing07@163.com hospitalization， prothrombin time （PT）， activated partial thromboplastin time （APTT）]，safety indicators （incidence of serious cardiovascular events ，severe bleeding ，slight bleeding and severe puncture site co mplications during hospitalization ），combined endpoint indicators （30 and 180 days combined endpoint）. RevMan 5.3 software was used for Meta-analysis of each effect index. RESULTS Finally，17 RCS articles were included，involving 4 946 patients with NSTE-ACS ，including 2 507 in the trial group and 2 439 in the control group.The results of NOS literature quality evaluation showed that there were 8 high-quality studies ，accounting for 47.06％ . The results of Meta-analysis showed that there was no significant difference in the incidence of acute myocardial infarction ，recurrent angina pectoris，revascularization of target vessels ，PT and serious cardiovascular events between 2 groups （P＞0.05）；there was significant difference in the APTT （MD＝1.34，95％CI of 0.22-2.45，P＜0.05），the incidence of severe bleeding （RR＝0.47， 95％CI of 0.30-0.74，P＜0.05），the incidence of slight bleeding （RR＝0.48，95％CI of 0.32-0.71，P＜0.05），the incidence of severe puncture site complications （RR＝0.48，95％CI of 0.25-0.95，P＜0.05），30 day combined endpoint （RR＝0.57，95％CI of 0.46-0.72，P＜0.05），180 days combined endpoint （RR＝0.73，95％CI of 0.54-0.98，P＜0.05）. CONCLUSIONS Fondaparinux in the treatment of NSTE-ACS in China has the same efficacy as low molecular weight heparin （nadroparin，enoxaparin），and has more obvious advantages in drug safety such as bleeding ，severe puncture site complications.

The European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines showed us venous thrombosis management in January 2022. In terms of iliac vein diseases, it retained some guiding views, upgraded some guiding views, and added some new views compared with the version 2015. It has good guidance and reference significance for medical staff and patients. The part of the guidelines about iliac vein disease is worth our interpretation.

[Abstract] Objective To investigate whether levosimendan (Lev) affects hypoxia / reoxygenation (H / R) - induced cardiomyocyte proliferation, apoptosis and fibrosis by regulating the molecular axis of long chain noncoding RNA (LncRNA) eosinophil granule ontogeny transcript (EGOT) / microRNA (miR) -641. Methods Rat cardiomyocytes H9C2 were cultured in vitro, and H / R-treated cells were used to establish cell damage models, which were randomly divided into control group, H / R group, H / R + Lev 1 μmol / L (H / R + Lev-L) group, H / R + Lev 5 μmol / L (H / R + Lev-M) group, and H / R + Lev 10 μmol / L (H / R + Lev-H) group, 9 samples per group. MTT method was used to detect cell proliferation. Flow cytometry was used to detect the apoptosis rate. Real-time P CR was used to detect the expression levels of EGOT and miR-641 mRNA. P cDNA-EGOT and EGOT small interfering RNA (si-EGOT) were transfected into H9 C2 cells respectively, and the cell proliferation and apoptosis rates were detected by the above method. The dual luciferase report experiment verified the targeting relationship between EGOT and miR-641. Western blotting was used to detect the expression levels of Bax, Bcl-2, collagen I (colI), collagen Ⅲ (col Ⅲ), tissue inhibitor of matrix metalloproteinase 2 (TIMP 2), matrix metalloproteinase-2 (MMP -2) . Results Compared with the control group, the cell survival rate of the H / R group reduced significantly (P < 0. 05), the apoptosis rate increased significantly (P < 0. 05), and the protein levels of Bax, c I, col Ⅲ, TIMP 2, and MMP -2 increased significantly (P < 0. 05), the level of Bcl-2 protein reduced significantly (P < 0. 05), the expression level of EGOT reduced significantly (P < 0. 05), the expression level of miR-641 increased significantly (P < 0. 05) . Compared with the H / R group, the cell survival rate of the H / R + Lev-L group, H / R + Lev-M group, and H / R + Lev-H group increased significantly (P < 0. 05), and the apoptosis rate decreased significant (P < 0. 05), the protein levels of Bax, colI, colⅢ, TIMP 2, MMP -2 reduced significantly (P < 0. 05), the level of Bcl-2 protein increased significantly (P < 0. 05), the expression level of EGOT increased significantly (P < 0. 05), the expression level of miR-641 reduced significantly (P < 0. 05), and each index of H / R + Lev-L group, H / R + Lev-M group, H / R + Lev-H group, the difference was statistically significant (P < 0. 05) . The dual luciferase report experiment confirmed that EGOT ccould target and bind to miR-641. The effect of transfecting pcDNA-EGOT and Lev was similar. Transfection of si-EGOT could reduce the effect of Lev on H / R-induced proliferation, apoptosis and fibrosis of H9 C2 cells. Conclusion Levosimendan may promote H / R-induced H9 C2 cell proliferation and inhibit apoptosis and fibrosis by up-regulating EGOT expression and down-regulating miR-641 expression.

Formins are widely distributed in eukaryotes such as fungi, plants and animals. They play crucial roles in regulating the polymerization of actin, coordinating the synergistic interactions between actin and microtubules, and determining cell growth and morphology. Unlike formins from fungi and animals, plant formins have been evolved into two plant-specific types. Generally, type Ⅱ formins are believed to regulate the polarized growth of cells, and type Ⅰ formins may regulate the cell expansion and division processes. Recent studies on the function of plant formins suggest it is inappropriate to classify the function of formins purely based on their structures. This review summarizes the domain organization of formins and their corresponding functions, as well as the underpinning mechanisms. Furthermore, the unsolved or unexplored issues along with future perspectives on plant formins are proposed and discussed.
Actins ; Formins ; Microfilament Proteins ; Plant Cells ; Plant Development ; Plants

OBJECTIVE：To investiga te main risk factors for adverse drug reactions （ADR）of skin by intravenous injection of iodine contrast agent. METHODS ：From Jan. 2009 to Apr. 2020，the patients suffering from skin ADR after enhanced CT with iodine contrast agent were collected from our hospital. The basic information ，laboratory test results before using iodine contrast agent and ADR related information were collected through hospital information system （HIS）. The use of iodine contrast agent ，main manifestations of skin ADR and drug combination were analyzed statistically. Taking the sex ，age，body mass index （BMI），the dosage of iodine contrast agent ，length of stay ，laboratory examination ，tumor history ，basic disease ，allergy history ，drinking history as independent variables ，the incidence of skin ADR related to iodine contrast agent was analyzed by single factor analysis ，and the variables with statistically significant were selected for multivariate Logistic stepwise regression analysis. RESULTS ：There were 157 cases of skin ADR ，involving 79 males（50.3％）and 78 females（49.7％）. The age ranged from 19 to 86 years old ，being（52.68± 18.73）years old in average. BMI was 14.6-40.7 kg/m2，being（22.5±3.7） kg/m2. 67 cases（42.68％）were treated with iprodione ，34 cases（21.66％）with iodixanol ，31 cases（19.74％）with iohexol and 25 cases（15.92％）with iopamidol ；the dose of iodine contrast agent were 50-100 mL，being（73.06±13.29）mL in average. There was no significant difference among different dosage of 4 kinds of iodine contrast agents （P≤0.05）. Among 4 kinds of iodine contrast agents ，the incidence of skin ADR induced by iopromide was the highest（0.197％）. The skin ADR related to iodine contrast agent was mainly acute （89.2％），the severity was mild （75.2％），and urticaria（38.9％）was the most common. After symptomatic treatment ，135 cases were cured ，13 cases were improved and 9 cases were not improved. Among the patients with iodine contrast agent related skin ADR ，the incidence of ADR induced by combined use of anti infective drugs was the highest （33.1％）；however，the combined use of anti-tumor drugs was the main cause of severe skin ADR. The length of stay ｛11～20 d[OR＝1.21，95％CI（1.07，1.20），P＝0.042]、21～30 d[OR＝1.39，95％CI（1.12，1.52），P＝0.035]、31～40 d[OR＝1.15，95％CI（1.03，1.37），P＝0.008]、＞40 d[OR＝1.33，95％CI（1.28，1.53），P＝0.003]｝，respitatory and circulatory system tumor history[OR ＝1.51，95％CI（1.35，1.61），P＝0.037]，injection allergy history[OR ＝1.50，95％CI（1.37，1.59），P＝0.005] can significantly increase the incidence of iodine contrast agent related skin ADR. CONCLUSIONS ：The main manifestation of skin ADR related to iodine contrast agent was urticaria. The main risk factors of skin ADR related to iodine contrast agent were length of stay （＞ 10 d），respiratory and circulatory system tumor history and injection allergy history.