BACKGROUND:The pathogenesis of diabetic peripheral neuropathy has not yet been clarified,and TAM(Tyro3,Axl,and MerTK)receptor tyrosine kinases can control apoptotic cells and suppress inflammatory responses in the central nervous system. OBJECTIVE:To investigate the difference of Mer receptor tyrosine kinase(MerTK)levels in plasma and sciatic nerve tissue of Sprague-Dawley rats with type 2 diabetes and diabetic peripheral neuropathy,and to study the correlation between MerTK and diabetic peripheral neuropathy. METHODS:Forty male Sprague-Dawley were randomly divided into control group with 15 rats,type 2 diabetes group with 10 rats,and diabetic peripheral neuropathy group with 15 rats.The control group was fed with ordinary diet,while the experimental groups were fed with high-fat and high-sugar diet.After 6 weeks,intraperitoneal injection of streptozotocin at the minimum dose of 35 mg/kg was administered in the two experimental groups.After 14 days,tail vein blood was collected to detect blood glucose.If blood glucose≥16.7 mmol/L,the model of type 2 diabetes was successfully established.Rats in the diabetic peripheral neuropathy group continued to be fed with a high-sugar and high-fat diet for 8 weeks.The sciatic nerve conduction velocity of rats was detected through live isolation under anesthesia.Blood samples were collected from the abdominal aorta,and the sciatic nerve tissue was collected.Histological changes of nerve fibers in each group were observed under a light microscope to confirm the success of diabetic peripheral neuropathy modeling.ELISA was used to detect peripheral blood glucose,blood lipids and serum MerTK levels in rats;hematoxylin-eosin staining was used to observe the histological changes in the sciatic nerve;immunofluorescence,immunohistochemistry and western blot were used to detect the expression of MerTK in the sciatic nerve tissue. RESULTS AND CONCLUSION:The Sprague-Dawley rat models of type 2 diabetes and type 2 diabetes peripheral neuropathy were successfully constructed,and the modeling rate of diabetic peripheral neuropathy was 80%.Compared with the control group,the blood glucose levels of rats in the type 2 diabetes and diabetic peripheral neuropathy groups were significantly higher(P<0.000 1),while the blood glucose level in the diabetic peripheral neuropathy group was higher than that in the type 2 diabetes group;and the sciatic nerve conduction velocity was significantly decreased(P<0.05),which was lower in the diabetic peripheral neuropathy group than the type 2 diabetes group.Histological examination:Compared with the control group,the sciatic nerve nuclei were reduced in the type 2 diabetes group,with some vacuolar degeneration and phagocytosis;in the diabetic peripheral neuropathy group,the cell body was swollen,the nuclear spacing was increased,vacuolar degeneration was observed,and the myelin sheath was partitioned and unsmooth,and lattice-like axons appeared.Serum MerTK levels were significantly higher in the diabetic peripheral neuropathy group than the control group.Expression of MerTK in the sciatic nerve tissue was significantly upregulated in the diabetic peripheral neuropathy group compared with the control group(P<0.05).To conclude,elevated levels of MerTK in plasma and sciatic nerve tissue of rats with diabetic peripheral neuropathy are presumably related to its anti-inflammatory and immunomodulatory effects.

Objective To investigate the relationship between different body position fixation tech-niques,umbilical plane volume change(ΔV),body weight change rate(ΔW%),and radiotherapy setup errors in cervical cancer patients,and to provide recommendations for determining the margin of planning target vol-ume(MPTV).Methods A retrospective analysis was performed on the clinical data of 57 cervical cancer pa-tients who underwent radiotherapy at this hospital from June 2022 to May 2023.Patients were divided into the observation group(fixed with body membrane+thermoplastic pad,n=24)and the control group(fixed with body membrane alone,n=33)based on different positioning fixation methods.They were also further strati-fied by median BMI into BMI≥23.82 kg/m2 and BMI<23.82 kg/m2 patients.Setup errors in the left-right(X),cranio-caudal(Y),and anterior-posterior(Z)directions were recorded.Meanwhile,the umbilical plane volume on the first CT positioning image and the patient's body weight before positioning were recorded,as well as umbilical plane volume of cone-beam CT(CBCT)verification images during weekly radiotherapy and body weight before scan,the ΔV and ΔW%were calculated.Setup errors were compared between two groups,and correlations between ΔV,ΔW%and setup errors were analyzed in all patients,in two groups(the obser-vation group and the control group)and in two BMI subgroups.MPTV values in X,Y,and Z directions were calculated,and receiver operating characteristic(ROC)curve determined the cut off values of ΔV and ΔW%when setup errors met the department's MPTV criteria.Results Compared with the control group,the ob-servation group showed significantly smaller setup errors in X,Y,and Z directions(P<0.05).Both ΔV and ΔW%were positively correlated with setup errors in X and Y direction in all patients,patients in the control group,and patients with BMI≥23.82 kg/m2(P<0.05).In the observation group,ΔW%was positively corre-lated with setup errors in Z direction in patients with BMI<23.82 kg/m2(P<0.05);In the control group,ΔV and ΔW%were positively correlated with setup errors in X and Y direction in patients with BMI≥23.82 kg/m2.ROC curve analysis showed that when setup errors in Y direction reached the department's MPTV criteria(8.41 mm),the cutoff values ΔV and ΔW%were 8.045 cm2 and 4.12%,respectively.Conclusion The body membrane+thermoplastic pad fixation technique reduces setup errors and mitigates the impact of ΔV and ΔW%on setup errors in X and Y directions.When ΔV or ΔW%exceeds the cutoff values,increasing CBCT verification frequency and re-fabricating the body membrane are recommended.

Objective To investigate the status quo of pain catastrophizing(PC)in the patients with di-abetic peripheral neuropathic pain(DPNP),and to analyze the influencing factors to provide reference for for-mulating clinical preventive intervention strategies.Methods A total of 206 patients with DPNP admitted and treated in the People's Hospital of Guangxi Zhuang Autonomous Region were selected as the research sub-jects by convenience sampling method.The general data questionnaire,Numerical Rating Scale(NRS),Pain Catastrophizing scale(PCS),Perceived Social Support Scale(PSSS)and diabetes distress scale(DDS)were used to conduct the investigation.Results The incidence rate of PC in 206 cases of DPNP patients was 44.66％(92/206),and the total score of PCS was(30.10±5.16)points.The results of multiple linear regres-sion analysis showed that the gender,duration of diabetes(≥10 years),multiple drug use,number of compli-cations(＞5),NRS score,PSSS score and scores of DDS dimensions were the main influencing factors of PC(all P＜0.05),which could explain 92.3％of the total variation of PC.Conclusion The PC incidence rate in the patients with DPNP is high.Clinical healthcare workers should pay attention to the evaluation of PC in these patients,and formulate the scientific and effective targeted intervention measures according to the main influen-cing factors to help the patients to reduce the pain burden in order to reduce the level of PC.

Objective To explore the regulatory effect of Mertk expression level on NF-κb pathway in rat Schwann cells and its possible mechanism.Methods Rat Schwann cells were cultured in vitro,and the expression of Mertk in Schwann cells exposed to high glucose was detected by Western blot.Co-immunoprecipitation was used to detect the interaction between endogenous Mertk and Ikbkb.Western blot was used to detect the expression levels of Ikbkb,P65 and tumor necrosis factor-α in Schwann cells after Mertk silencing.The protein expressions of Mertk,Ikbkb and P65 after silencing Mertk were detected by immunofluorescence.Results Mertk was expressed in Schwann cells,and the expression level increased with the increase of glucose concentration.Co-immunoprecipitation assay showed that Mertk interacted with Ikbkb in rat Schwann cells.Compared with the control group,the expression level of Mertk was significantly decreased(P<0.05),while Ikbkb,P65 and TNF-α were significantly increased(P<0.05)after knock down expression of Mertk in Schwann cells.Immunofluorescence experiments showed that the fluorescence of Mertk was decreased,and the fluorescence of Ikbkb and P65 was increased in the silenced Schwann cells.Conclusion After the expression of Mertk is decreased,it can mediate the regulation of NF-κb pathway in Schwann cells through interaction with Ikbkb,and up-regulate the expression of P65 and inflammatory factor TNF-α.

OBJECTIVE: To explore the genetic basis for a child with Rothmund-Thomson syndrome (RTS). METHODS: The child has featured poikeloderma, short stature, cataract, sparse hair and skeletal malformation. Peripheral blood samples of the child and her family members were collected and subjected to whole exome sequencing. Candidate variants were verified by Sanger sequencing. RESULTS: The child was found to harbor compound heterozygous variants of the RECQL4 gene, namely c.1048_1049delAG and c.2886-1G>A, among which c.2886-1G>A was unreported previously. According to the ACMG guidelines, the c.1048_1049delAG was predicted to be pathogenic (PVS1+PM3_Strong+PM2), while the c.2886-1G>A was predicted to be likely pathogenic (PVS1+PM2). CONCLUSION The compound heterozygous variants of the RECQL4 gene probably underlay the pathogenesis of RTS in this patient. Above finding has enriched the mutational spectrum of the RECQL4 gene.
Child ; Family ; Female ; Humans ; Mutation ; RecQ Helicases/genetics* ; Rothmund-Thomson Syndrome/genetics* ; Whole Exome Sequencing

Objective: To investigate the intake of liquid dairy products and identify its influencing factors among the fourth grade students in Nanjing City. Methods: The fourth grade students were selected as the study subjects in Nanjing City using a multi-stage random cluster sampling method in September 2020. Their general information, frequency of liquid dairy product intake one week prior to survey and mean intake amount per time were collected. According to the 2016 Dietary Guidelines for Chinese Residents, weekly intake of liquid dairy products of 2 100 g and greater was defined eligible. Factors affecting the frequency and amount of liquid dairy product intake were identified using multivariable logistic regression analysis. Results: A total of 2 268 questionnaires were allocated and 2 216 valid questionnaires were recovered, with an effective recovery rate of 97.71%. The respondents included 1 199 boys ( 54.11% ) and 1 017 girls ( 45.89% ). The frequency of liquid dairy product intake was (6.41±4.86) times per week, and the median intake amount was 1 250.00 g per week (interquartile range, 1 750.00 g per week). There were 607 students ( 27.39% ) consuming liquid dairy products of 2 100 g and greater a week, and 1 016 students ( 45.85% ) consumed liquid dairy products for 7 times and more a week. Multivariable logistic regression analysis showed that living in urban areas ( OR=1.204, 95%CI: 1.005-1.443 ), knowing nutrition labels ( OR=1.221, 95%CI: 1.021-1.460 ), periodical measurement of body weight (OR=1.486, 95%CI: 1.098-2.011) and restricted intake of sugar-containing drinks ( OR=1.264, 95%CI: 1.005-1.590 ) facilitated the intake of liquid dairy products for 7 times and more a week, and students with periodical measurement of body weight were more likely to consume liquid dairy products for 2 100 g and greater a week ( OR=1.821, 95%CI: 1.240-2.676 ). Conclusions Inadequate intake of liquid dairy products is found among the fourth grade students in Nanjing City. Residence, awareness of nutrition labels, periodical measurement of body weight, and parental restriction of sugar-containing drink intake affect the intake of liquid dairy products.

[Objective]To evaluate the role of mature cumulus cells from oocyte-cumulus complex(OCC)in in-vitro maturation(IVM)and establish a new culture technique which is convenient to carry out.[Methods]The cumulus cells of OCC were cut off and dispersed by 1 mL syringe.The cumulus cells were co-cultured with the immature oocytes retrieved from the COH cycles after they adherent to the bottom of the dish.The immature oocytes were experienced IVM procedures in different culture media.They were divided into 3 groups(the oocytes at germinal vesicle stage from one woman were allotted to the same group randomly).Group 1(solution A):basic culture medium+human follicular fluid(hFF);Group 2(solution B):solution A+ cumulus cells(OCC);Group 3(solution C):solution A+ OCC+ follicle stimulating hormone(FSH)+ epidermal growth factor (EGF).Then,the maturation rate,fertilization rate and formation rate of available embryo were observed.[Results]In 113 treatment cycles,298 immature oocytes were performed IVM with solution A,B,and C.The difference for 24 hour maturation rates among 3 groups wag statistically significant(A:45.2%,B:61.7%,C:78.2%,P＜0.05).There was no statistical difference for 25～48 hour maturation rates and normal fertilization rates of mature oocytes.The differences of cleavage rates and rescued embryo rates between group 1 and 2,group 1 and 3 were statistically significant(P＜0.05).The formation rates of available embryo showed an increasing trend from group 1,2,to 3.[Conclusion]After being dispersed by simply beat upon with syringe and adherent culture,the mature cumulus eells from mature OCCs in COH cycles,together with growth factors in the follicular fluid or extraneously supplemented,could promote the IVM of immature oocyte.

The Workers' Hospital of Huangmian Group in our city, which succeeded in separating from the enterprise and becoming commercially oriented through reforming the property right system, has made some worthwhile attempts at transforming the property right system of enterprise-owned hospitals. The experience accumulated includes: commercialization of enterprise-owned hospitals through reforming the property right system is a must in adapting to the system of the socialist market economy and setting up the system of modern enterprises; it is also a must in the current reform of the health system; reform of the property right system of enterprise-owned hospitals gave strong impetus to the reform of operational mechanisms of personnel matters, distribution and management within the hospitals; appropriate policies are the key to ensuring the success of the reform; and hospitals with transformed ownership ought to maintain their original functions and continue to undertake such social tasks as medical treatment, prevention of diseases, healthcare and supervision of public hygiene.

Objective To evaluate the relationship between intraocular pressure (IOP) and anterior chamber angle in patients with different types of acute angle-closure glaucoma after phacoemulsification and intraocular lens implantation. Design Retrospective case series. Participants 173 cases of acute angle-closure glaucoma coexisting cataract (173 eyes) in Mingren Eye Hospital from January, 2005 to June, 2007. Methods All patients with acute angle-closure glaucoma underwent phacoemulsification and intraocular lens implantation, and were examined with high-frequency ultrasound biomicroscopy (UBM). Anterior chamber depth (ACD), intraocular pressure (IOP) and anterior chamber angle (ACA) were measured. Follow-up was 1-48 weeks after surgery. Main Outcome Measures Intraocular pressure, phacoemulsification complications, re-open rate of anterior chamber angle. Results At 8th week after surgery, the rate of IOP control in pupillary block group, non-pupillary blocking group, and multimechanism group was 88.9%, 52.0%, 83.4%, respectively and there was a statistically significant between these groups (?2=7.13, P=0.022). At 48th week, the rate of IOP control was 54.2%, 33.3%, 35.8%, respectively(?2=12.56, P=0.003). Fifty patients were follow up with UBM, and 66.7% in pupillary block group, 33.3% in non-pupillary blocking group and 33.3% in multimechanism group in 48 weeks postoperatively showed evidence of the widened anterior chamber angle. No specific postoperative complications were found in this study compared with those with phacoemulsification without glaucoma. Conclusions The use of phacoemulsification and intraocular lens implantation for acute angle-closure glaucoma coexsiting cataract can get best IOP-controlled rates in pupillary block group. It is related to the degree of widened anterior chamber angle.

AIM: To investigate the effect of Gengnianle Granule on hypothalamic-pituitary-ovarian(HPO) axis in climacteric rats.METHODS: 12-15 months SD female rats were randomized into climacteric group and young control group was selected additionally.After being administrated for thirty days,the level of E_2、P、Te、FSH、LH in serum were examined by the radio-immunity method,the expression of GnRH in hypothalame,the expression of ER in hypothalame and pituitary appendage were examined by the immunohistochemical method. RESULTS: Compared with climacteric group,Gengnianle Granule could increase the level of E_2、P in serum(P