Objective:To detect the expression of autophagy-associated genes (ATGs) involved in the early stage of autophagy in peripheral blood mononuclear cells (PBMCs) of patients with ankylosing spondylitis (AS) and analyze the results with clinical data. To explore the association between the early stage of autophagy and AS and the clinical significance of ATGs involved in the early stage of autophagy in assessing the disease and inflammatory status of AS.Methods:①Clinical data and peripheral blood samples of 90 patients with AS (AS group) who were admitted to the Rheumatology and Immunology Department of the Affiliated Hospital of North Sichuan Medical College from March 2021 to August 2022 were collected, including 32 patients in the active stage (ASA group) and 58 patients in the stable stage (ASS group). In addition, clinical data and peripheral blood samples of 30 patients who were treated with secuchiumab for 24 weeks were also collected. The clinical data and peripheral blood samples of 45 healthy control (HC group) who underwent physical examination at the Affiliated Hospital of Sichuan Northwest Medical University at the same time served as controls for clinical data and peripheral blood specimens were used as controls. RT-qPCR was used to detect the mRNA expression levels of 8 ATGs (ATG13, ATG14, ATG17, ATG18, ATG101, Beclin1, ULK1, mTOR) involved in the early stage of autophagy in all PBMCs of peripheral blood samples, and compared between different groups. Data that follows a normal distribution is tested using the t-test, while data that does not follow a normal distribution is tested using the Wilcoxon rank sum test. Correlation analysis is performed using Spearman's rank correlation coefficient.②Receiver operating curve (ROC) was used to evaluate the value of ATGs with differential expression between AS group and HC group in detecting AS disease.Results:①Compared with HC group, the level of ATG13, ATG14, ATG17, ATG18, ATG101 and Beclin1 mRNA in AS group were significantly lower than those in HC group[ATG3:3.52(1.95, 5.09)×10 -3, 7.21(5.49, 9.16)×10 -3, Z=-5.64, P<0.001; ATG14:2.48(1.85, 3.64)×10 -3, 6.16(4.27, 7.80)×10 -3, Z=-6.44, P<0.001; ATG17: 6.45(3.29, 9.48)×10 -3, 18.52(12.30, 22.51)×10 -3, Z=-6.18, P<0.001;ATG18:2.97(1.77, 4.37)×10 -3, 4.61(3.27, 5.59)×10 -3, Z=-3.88, P<0.001; ATG101: 2.07(1.11, 3.33)×10 -3, 3.65(2.41, 5.20)×10 -3, Z=-3.87, P<0.001; Beclin1: 3.50(0.63, 6.14)×10 -3, 4.17(2.82, 7.93)×10 -3, Z=-1.82, P=0.027]. ②Comparison between ASA and ASS groups: The levels of ATG17, ATG 101 and Beclin1 mRNA in ASA group were significantly lower than those in ASS group[ATG17: 4.61(2.75, 7.85)×10 -3, 6.86(3.85, 11.28)×10 -3, Z=-2.16, P=0.030; ATG101:0.93(0.40, 1.67)×10 -3, 2.15(1.17, 3.20)×10 -3, Z=-3.94, P=0.002; Beclin1: 1.24(0.52, 3.94)×10 -3, 3.86(1.55, 5.45)×10 -3, Z=-2.26, P=0.024]. ③Spearman correlation analysis showed that the mRNA expression levels of ATG13 and Beclin1 in AS were negatively correlated with ESR and hs-CRP, respectively ( r=-0.22, P=0.038; r=-0.30, P=0.006; r=-0.34, P=0.004; r=-0.241, P=0.037), ATG18 mRNA expression ESR was positively correlated ( r=0.22, P=0.041). ④ROC curve showed that ATG13, ATG14, and ATG17 had a good ability to predict AS, and their area under the curve (AUC) was 0.821, 0.866, and 0.851, respectively. The mRNA expression levels of ATG13, ATG14, and ATG18 in AS were significantly increased after 24 weeks of secuchiumab treatment[ATG13: 3.09(0.17, 4.48)×10 -3, 3.50(3.42, 3.57)×10 -3, Z=-3.45, P=0.001; ATG14: 2.49(1.43, 4.03)×10 -3, 5.62(2.28, 6.77)×10 -3, Z=-3.01, P=0.003; ATG18: 2.91(1.61, 4.37)×10 -3, 4.53(2.91, 5.73)×10 -3, Z=-3.34, P=0.001]. Conclusion:①The different expressions of ATG13, ATG14, ATG17, ATG18, ATG101, and Beclin1 between HC and AS suggest that these 6 genes may related to the pathogenesis of AS, among which Beclin1 and ATG13 are closely related to the levels of inflammatory indicators ESR and hs-CRP in patients. It may affect the inflammatory state in AS. ②IL-17Ai may be a potential regulator of autophagy, which can play a therapeutic role by affecting the early autophagy process in AS, but the specific mechanism needs to be further explored. ③ Genes related to the early stage of autophagy are expected to be biological indicators for monitoring the occurrence of AS.

Objective:To detect the expression of autophagy-associated genes (ATGs) involved in the early stage of autophagy in peripheral blood mononuclear cells (PBMCs) of patients with ankylosing spondylitis (AS) and analyze the results with clinical data. To explore the association between the early stage of autophagy and AS and the clinical significance of ATGs involved in the early stage of autophagy in assessing the disease and inflammatory status of AS.Methods:①Clinical data and peripheral blood samples of 90 patients with AS (AS group) who were admitted to the Rheumatology and Immunology Department of the Affiliated Hospital of North Sichuan Medical College from March 2021 to August 2022 were collected, including 32 patients in the active stage (ASA group) and 58 patients in the stable stage (ASS group). In addition, clinical data and peripheral blood samples of 30 patients who were treated with secuchiumab for 24 weeks were also collected. The clinical data and peripheral blood samples of 45 healthy control (HC group) who underwent physical examination at the Affiliated Hospital of Sichuan Northwest Medical University at the same time served as controls for clinical data and peripheral blood specimens were used as controls. RT-qPCR was used to detect the mRNA expression levels of 8 ATGs (ATG13, ATG14, ATG17, ATG18, ATG101, Beclin1, ULK1, mTOR) involved in the early stage of autophagy in all PBMCs of peripheral blood samples, and compared between different groups. Data that follows a normal distribution is tested using the t-test, while data that does not follow a normal distribution is tested using the Wilcoxon rank sum test. Correlation analysis is performed using Spearman's rank correlation coefficient.②Receiver operating curve (ROC) was used to evaluate the value of ATGs with differential expression between AS group and HC group in detecting AS disease.Results:①Compared with HC group, the level of ATG13, ATG14, ATG17, ATG18, ATG101 and Beclin1 mRNA in AS group were significantly lower than those in HC group[ATG3:3.52(1.95, 5.09)×10 -3, 7.21(5.49, 9.16)×10 -3, Z=-5.64, P<0.001; ATG14:2.48(1.85, 3.64)×10 -3, 6.16(4.27, 7.80)×10 -3, Z=-6.44, P<0.001; ATG17: 6.45(3.29, 9.48)×10 -3, 18.52(12.30, 22.51)×10 -3, Z=-6.18, P<0.001;ATG18:2.97(1.77, 4.37)×10 -3, 4.61(3.27, 5.59)×10 -3, Z=-3.88, P<0.001; ATG101: 2.07(1.11, 3.33)×10 -3, 3.65(2.41, 5.20)×10 -3, Z=-3.87, P<0.001; Beclin1: 3.50(0.63, 6.14)×10 -3, 4.17(2.82, 7.93)×10 -3, Z=-1.82, P=0.027]. ②Comparison between ASA and ASS groups: The levels of ATG17, ATG 101 and Beclin1 mRNA in ASA group were significantly lower than those in ASS group[ATG17: 4.61(2.75, 7.85)×10 -3, 6.86(3.85, 11.28)×10 -3, Z=-2.16, P=0.030; ATG101:0.93(0.40, 1.67)×10 -3, 2.15(1.17, 3.20)×10 -3, Z=-3.94, P=0.002; Beclin1: 1.24(0.52, 3.94)×10 -3, 3.86(1.55, 5.45)×10 -3, Z=-2.26, P=0.024]. ③Spearman correlation analysis showed that the mRNA expression levels of ATG13 and Beclin1 in AS were negatively correlated with ESR and hs-CRP, respectively ( r=-0.22, P=0.038; r=-0.30, P=0.006; r=-0.34, P=0.004; r=-0.241, P=0.037), ATG18 mRNA expression ESR was positively correlated ( r=0.22, P=0.041). ④ROC curve showed that ATG13, ATG14, and ATG17 had a good ability to predict AS, and their area under the curve (AUC) was 0.821, 0.866, and 0.851, respectively. The mRNA expression levels of ATG13, ATG14, and ATG18 in AS were significantly increased after 24 weeks of secuchiumab treatment[ATG13: 3.09(0.17, 4.48)×10 -3, 3.50(3.42, 3.57)×10 -3, Z=-3.45, P=0.001; ATG14: 2.49(1.43, 4.03)×10 -3, 5.62(2.28, 6.77)×10 -3, Z=-3.01, P=0.003; ATG18: 2.91(1.61, 4.37)×10 -3, 4.53(2.91, 5.73)×10 -3, Z=-3.34, P=0.001]. Conclusion:①The different expressions of ATG13, ATG14, ATG17, ATG18, ATG101, and Beclin1 between HC and AS suggest that these 6 genes may related to the pathogenesis of AS, among which Beclin1 and ATG13 are closely related to the levels of inflammatory indicators ESR and hs-CRP in patients. It may affect the inflammatory state in AS. ②IL-17Ai may be a potential regulator of autophagy, which can play a therapeutic role by affecting the early autophagy process in AS, but the specific mechanism needs to be further explored. ③ Genes related to the early stage of autophagy are expected to be biological indicators for monitoring the occurrence of AS.

Humans ; Otitis Media, Suppurative ; Chronic Disease ; Biofilms ; Otitis Media

Objective: To compare clinical efficacy between laparoscopic radical proximal gastrectomy with double-tract reconstruction (LPG-DTR) and laparoscopic radical total gastrectomy with Roux-en-Y reconstruction (LTG-RY) in patients with early upper gastric cancer, and to provide a reference for the selection of surgical methods in early upper gastric cancer. Methods: A retrospective cohort study method was carried out. Clinical data of 80 patients with early upper gastric cancer who underwent LPG-DTR or LTG-RY by the same surgical team at the Department of General Surgery, the First Affiliated Hospital of Xi'an Jiaotong University from January 2018 to January 2021 were retrospectively analyzed. Patients were divided into the DTR group (32 cases) and R-Y group (48 cases) according to surgical procedures and digestive tract reconstruction methods. Surgical and pathological characteristics, postoperative complications (short-term complications within 30 days after surgery and long-term complications after postoperative 30 days), survival time and nutritinal status were compared between the two groups. For nutritional status, reduction rate was used to represent the changes in total protein, albumin, total cholesterol, body mass, hemoglobin and vitamin B12 levels at postoperative 1-year and 2-year. Non-normally distributed continuous data were presented as median (interquartile range), and the Mann-Whitney U test was used for comparison between groups. The χ(2) test or Fisher's exact test was used for comparison of data between groups. The Mann-Whitney U test was used to compare the ranked data between groups. The survival rate was calculated by Kaplan-Meier method categorical, and compared by using the log-rank test. Results: There were no statistically significant differences in baseline data betweeen the two groups, except that patients in the R-Y group were oldere and had larger tumor. Patients of both groups successfully completed the operation without conversion to laparotomy, combined organ resection, or perioperative death. There were no significant differences in the distance from proximal resection margin to superior margin of tumor, postoperative hospital stay, time to flatus and food-taking, hospitalization cost, short- and long-term complications between the two groups (all P>0.05). Compared with the R-Y group, the DTR group had shorter distal margins [(3.2±0.5) cm vs. (11.7±2.0) cm, t=-23.033, P<0.001], longer surgery time [232.5 (63.7) minutes vs. 185.0 (63.0) minutes, Z=-3.238, P=0.001], longer anastomosis time [62.5 (17.5) minutes vs. 40.0 (10.0) minutes, Z=-6.321, P<0.001], less intraoperative blood loss [(138.1±51.6) ml vs. (184.3±62.1) ml, t=-3.477, P=0.001], with significant differences (all P<0.05). The median follow-up of the whole group was 18 months, and the 2-year cancer-specific survival rate was 97.5%, with 100% in the DTR group and 95.8% in the R-Y group (P=0.373). Compared with R-Y group at postoperative 1 year, the reduction rate of weight, hemoglobin and vitamin B12 were lower in DTR group with significant differences (all P<0.05); at postoperative 2-year, the reduction rate of vitamin B12 was still lower with significant differences (P<0.001), but the reduction rates of total protein, albumin, total cholesterol, body weight and hemoglobin were similar between the two groups (all P>0.05). Conclusions: LPG-DTR is safe and feasible in the treatment of early upper gastric cancer. The short-term postoperative nutritional status and long-term vitamin B12 levels of patients undergoing LPG-DTR are superior to those undergoing LTG-RY.
Albumins ; Anastomosis, Roux-en-Y/adverse effects* ; Cholesterol ; Gastrectomy/methods* ; Hemoglobins ; Humans ; Laparoscopy/methods* ; Postoperative Complications/etiology* ; Retrospective Studies ; Stomach Neoplasms/pathology* ; Treatment Outcome ; Vitamin B 12

AIM: To systematically evaluate the effects of 0.01%, 0.025% and 0.05% ophthalmic atropine on the change of spherical equivalent(SE)degree and axial length(AL)of myopic children. METHODS: PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Database, VIP and CBM were searched for all publications related to 0.01%, 0.025% and 0.05% atropine to control myopia simultaneously. The publication time is from the database construction to May 2022. The Cochrane handbook was used to evaluate the risk of bias and quality of the included literature, STATA12.0 was used to detect publication bias and Revman5.4 software was used for Meta-analysis. RESULTS: A total of 6 literatures(1 239 eyes)were included, with 5 randomized controlled trials and 1 case-control study. Meta-analysis results showed that 0.025% atropine had better inhibitory effect on SE and AL than 0.01% atropine(SE: WMD=-0.15, 95%CI: -0.23--0.06, P<0.001; AL: WMD=0.07, 95%CI: 0.03-0.10, P<0.001). The inhibitory effect of 0.05% atropine on SE and AL was better than 0.01% atropine(SE: WMD=-0.35, 95%CI: -0.44--0.26, P<0.001; AL: WMD=0.16, 95%CI: 0.12-0.20, P<0.001). The inhibitory effect of 0.05% atropine on SE and AL increase was better than 0.025% atropine(SE: WMD=-0.20, 95%CI: -0.28--0.11, P<0.001; AL: WMD=0.09, 95%CI: 0.06-0.12, P<0.001). CONCLUSION: The concentration of 0.05% atropine is superior to 0.01% and 0.025% atropine in the control of SE and AL. However, the side effects of long-term use remain to be observed.

Objective: To investigate the effect of visceral fat area (VFA) on the surgical efficacy and early postoperative complications of radical gastrectomy for gastric cancer. Methods: A retrospective cohort study method was used. Clinicopathological data and preoperative imaging data of 195 patients who underwent D2 radical gastric cancer surgery at the First Affiliated Hospital of Xi'an Jiaotong University from January 2014 to December 2017 were analyzed retrospectively. Inclusion criteria: (1) complete clinicopathological and imaging data; (2) malignant gastric tumor diagnosed by preoperative pathology, and gastric cancer confirmed by postoperative pathology; (3) no preoperative complications such as bleeding, obstruction or perforation, and no distant metastasis. Those who had a history of abdominal surgery, concurrent malignant tumors, poor basic conditions, emergency surgery, palliative resection, and preoperative neoadjuvant therapy were excluded. The VFA was calculated by software and VFA ≥ 100 cm² was defined as visceral obesity according to the Japan Obesity Association criteria . The patients were divided into high VFA (VFA-H, VFA≥100 cm², n=96) group and low VFA (VFA-L, VFA<100 cm², n=99) group . The clinicopathological characteristics, surgical outcomes and early postoperative complications were compared between the two groups. Univariate and multivariate Logistic regression models were used to analyze the risk factors of early complications. Receiver operating characteristic (ROC) curve was used to analyze predictive values of VFA for early complications. Pearson's χ² test was used to analyze the correlation between BMI and VFA. Results: There were no significant differences in terms of gender, age, American Society of Anesthesiologists physical status classification, preoperative comorbidities, preoperative anemia, tumor TNM staging, N staging, T staging and tumor differentiation, surgical method, extent of resection, and tumor location between the VFA-L group and the VFA-H group (all P>0.05). However, patients in the VFA-H group had higher BMI, larger tumor, lower rate of hypoalbuminemia and greater subcutaneous fat area (SFA) (all P<0.05). The VFA-H group presented significantly longer operation time and significantly less number of harvested lymph nodes as compared to the VFA-L group (both P<0.05). However, there were no significant differences in intraoperative blood loss, conversion to laparotomy and postoperative hospital stay (all P>0.05). Complications of Clavien-Dindo grade II and above within 30 days after operation were mainly anastomosis-related complications (leakage, bleeding, infection and stricture), intestinal obstruction and incision infection. The VFA-H group had a higher morbidity of early complications compared to the VFA-L group [24.0% (23/96) vs 10.1% (10/99), χ²=6.657, P=0.010], and the rates of anastomotic complications and incision infection were also higher in the VFA group [10.4% (10/96) vs. 3.0% (3/99), χ²=4.274, P=0.039; 7.3% (7/96) vs. 1.0% (1/99), P=0.033]. Multivariate logistic analysis showed that high BMI (OR=3.688, 95%CI: 1.685-8.072, P=0.001) and high VFA (OR=2.526, 95%CI: 1.148-5.559,P=0.021) were independent risk factors for early complications. The area under the ROC curve (AUC) of VFA for predicting early complications was 0.645, which was higher than that of body weight (0.591), BMI (0.624) and SFA (0.626). Correlation analysis indicated that there was a significantly positive correlation between BMI and VFA (r=0.640, P<0.001). Conclusion: VFA ≥ 100 cm² is an independent risk factor for early complications after radical gastrectomy for gastric cancer.It can better predict the occurrence of above early postoperative complications.
Gastrectomy/methods* ; Humans ; Laparoscopy/methods* ; Lipids ; Obesity/surgery* ; Obesity, Abdominal/surgery* ; Postoperative Complications/epidemiology* ; Retrospective Studies ; Stomach Neoplasms/pathology*

As an effective antipyretic medicine,Indigo Naturalis has a long history of application in the field of Chinese medicine.The content of organics,mainly indigo and indirubin,is about 10%. However,the active ingredients and mechanism of its antipyretic effect have not yet been fully elucidated. In view of this,they were investigated in this study with the rectal temperature change as an indicator and 2,4-dinitrophenol-induced fever rats as subjects. The content of PGE2 and c AMP in the hypothalamus and the serum levels of TNF-α,IL-1β and IL-6 were determined by ELISA. Moreover,the plasma samples of fever rats were analyzed by metabonomics in combination with UPLC-Q-TOF-MS for the exploration of potential biomarkers and the discussion on the antipyretic mechanism of Indigo Naturalis and its active ingredients. The results showed that the rising trend of rectal temperature in rats was suppressed 0. 5 h after the treatment with Indigo Naturalis,organic matter,indigo or indirubin as compared with the rats of model group( P < 0. 05),among which Indigo Naturalis and organic matter had better antipyretic effect. ELISA results showed that organic matter and indigo can inhibit the expression of PGE2 and c AMP( P<0. 01),while Indigo Naturalis and organic matter were effective in curbing the increase in TNF-α( P<0. 05). A total of 21 endogenous metabolites were identified from the plasma samples of the Indigo Naturalis,organic matter,indigo and indirubin groups,which were mainly involved in glycerophospholipid metabolism.
2,4-Dinitrophenol ; Animals ; Antipyretics ; Drugs, Chinese Herbal ; Indigo Carmine ; Indigofera ; Rats

There have been many clinical trials, systematic reviews/Meta-analysis proving that Xingnaojing Injection has a good clinical efficacy in treatment of cerebral ischaemic stroke, but with fewer comprehensive descriptions. In this study, an overview of systematic reviews/Meta-analysis of Xingnaojing Injection in treating cerebral ischaemic stroke was performed to provide current situation of evidences and basis for clinical practice. CNKI, Wanfang, VIP, CBM, EMbase, PubMed, Cochrane Library, Web of Science were retrieved through computers. A total of 6 literatures were included in this study. By AMSTAR-2 checklist and GRADE, the quality of included systematic reviews and the efficacy of Xingnaojing Injection were evaluated. The results of AMSTAR-2 checklist showed an extremely low quality for all of the 6 systematic reviews. According to the results of GRADE evaluation, among 55 outcomes, there were 2 outcomes with a medium quality, 4 outcomes with a low quality and 49 outcomes with an extremely low quality. The 6 systematic reviews reached a consistent conclusion that Xingnaojing Injection was effective in the treatment of cerebral ischaemic stroke. This therapy could improve the total efficacy, neurological deficit scores, hemodynamic and hemodynamic parameters. However, the methodolo-gical quality of all literatures was extremely low. The evidence levels of outcomes were between extremely low to medium. The effectiveness of Xingnaojing Injection in the treatment of cerebral ischaemic stroke still needs to be further verified by more high-quality studies. In the future, relevant clinical studies and systematic reviews/Meta-analysis shall be carried out in a strict accordance with relevant regulations.
Brain Ischemia/drug therapy* ; Drugs, Chinese Herbal ; Humans ; Ischemic Stroke ; Stroke/drug therapy* ; Systematic Reviews as Topic

The efficacy of gastrodin as a Chinese herbal medicine extract in the treatment of tension-type headache has been confirmed. This paper systematically reviewed the efficacy and safety of gastrodin in the treatment of tension-type headache, aiming to provide a new choice for the treatment of this disease. In this study, four Chinese databases, four English databases and two trial registries were searched from the date of establishment to September 2020. The related randomized controlled trials(RCTs) were screened out according to the predetermined criteria. The bias risk assessment tool developed by Cochrane collaboration was used to evaluate the quality of the reports. RevMan 5.4.1 was used for Meta-analysis, and GRADE system for the evidence-based evaluation on the quality of outcome indicators. A total of 177 articles were retrieved and 8 articles were finally included for analysis, with a total sample size of 1 091 cases, which included 565 cases in the treatment group and 526 cases in the control group. The overall quality of included stu-dies was not high. The results of Meta-analysis are as follows:(1)In terms of headache frequency, gastrodin group was better than wes-tern medicine group(MD=-2.90, 95%CI[-3.76,-2.03], P<0.000 01).(2)In terms of number of abnormal blood vessels in TCD, gastrodin group was better than western medicine group(MD=-88.96, 95%CI[-102.36,-75.55], P<0.000 01).(3)In terms of effective rate, gastrodin group was better than western medicine group(RR=1.47, 95%CI[1.29, 1.68], P<0.000 01). The results of subgroup analysis are as follows:(1)Effective rate based on age, for the patients upper age limit 40-46 years old, gastro-din group was better than western medicine group(RR=1.69, 95%CI[1.50, 1.90], P<0.000 01); for the patients upper age limit 55-60 years old, gastrodin group was better than western medicine group(RR=1.27, 95%CI[1.16, 1.38], P<0.000 01).(2)Effective rate based on dosage form, both the gastrodin capsules and injection groups were better than western medicine group(RR_(capsules)=1.42, 95%CI[1.08, 1.88], P=0.01; RR_(injection)=1.50, 95%CI[1.26, 1.77], P<0.000 01). GRADE evaluation showed that the above outcomes had low quality of evidence. Only one article detailed the occurrence of adverse reactions and thus the present study cannot make a positive conclusion on the safety of gastrodin in the treatment of tension-type headache. The small number and low quality of the included reports affected the reliability of the results. In the future, more high-quality randomized controlled trails are needed to improve the evaluation on the efficacy and safety of gastrodin in the treatment of tension-type headache.
Adult ; Benzyl Alcohols/therapeutic use* ; Drugs, Chinese Herbal/adverse effects* ; Glucosides ; Humans ; Middle Aged ; Reproducibility of Results ; Tension-Type Headache

Adult ; Anti-Bacterial Agents/therapeutic use* ; COVID-19/drug therapy* ; Catheter-Related Infections/microbiology* ; China ; Drug Resistance, Multiple, Bacterial ; Drugs, Chinese Herbal/therapeutic use* ; Humans ; Intubation, Intratracheal ; Male ; Pneumonia, Viral/drug therapy* ; Prosthesis-Related Infections/microbiology* ; SARS-CoV-2