Objective:To evaluate the clinical efficacy of transmural follicle-activating herbal medicine combined with electroacupuncture in luteinized unruptured follicle syndrome (LUFS).Methods:A randomized controlled trial (RCT) was conducted. Totally 90 LUFS patients in our hospital from November 2018 to January 2021 were selected as the observation subjects, and were divided into three groups using a random number table method, with 30 patients in each group. The Chinese materia medica group was treated with transmural follicle-activating herbal medicine, the acupuncture-medicine combination group was treated with transmural follicle-activating herbal medicine + electroacupuncture, and the Western medicine group was treated with injection of chorionic gonadotropin (hCG). The ovarian blood flow pulsatility index (PI) and resistance index (RI) of patients before and after treatment were observed. Chemiluminescence was used to detect the levels of estradiol (E 2), progesterone (P), and LH. Ovulation, pregnancy, and LUFS recurrence and adverse reactions after treatment were observed, and clinical efficacy was evaluated. Results:The total effective rate of the acupuncture-medicine combination group was 86.67% (26/30), the Chinese materia medica group was 63.33% (19/30), and the Western medicine group was 60.00% (18/30). There was a statistical significance among the three groups ( χ2=6.03, P=0.049). After treatment, there was a statistical significance in ovarian blood flow PI (1.57 ± 0.51 vs. 1.85 ± 0.56 vs. 1.90 ± 0.61, F=2.03), RI (0.48 ± 0.14 vs. 0.57 ± 0.18 vs. 0.62 ± 0.20, F=2.16) ( P<0.05); the serum E 2 [(322.60 ± 62.31) ng/L vs. (289.58 ± 55.45) ng/L vs. (291.17 ± 63.69) ng/L, F=2.26], P [(16.36 ± 4.14) μg/L vs. (13.45 ± 3.68) μg/L vs. (13.71 ± 3.50) μg/L, F=3.58], LH [(27.19 ± 5.04) IU/ml vs. (21.52 ± 4.66) IU/ml vs. (22.58 ± 4.80) IU/ml, F=3.68] levels were compared, and the differences were statistically significant ( P<0.05, P<0.01). The ovulation rate [93.33% (28/30) vs. 66.67% (20/30) vs. 63.33% (19/30), χ2=13.01] and pregnancy rate [53.33% (16/30) vs. 30.00% (9/30) vs. 26.67% (8/30), χ2=6.11], the recurrence rate of LUFS [19.23% (5/26) vs. 47.37% (9/19) vs. 55.56% (10/18), χ2=6.94] in the needle-medicine combination group, the Chinese materia medica group and the Western medicine group after treatment were significantly different ( P<0.05). During the treatment period, there was no statistical significance in the occurrence of adverse reactions among the three groups ( χ2=2.02, P=0.364). Conclusion:The transmural follicle-activating herbal medicine combined with electroacupuncture demonstrates superior efficacy in LUFS management by improving ovarian perfusion and endocrine function, with higher ovulation/pregnancy rates and lower recurrence.

Objectives:Analyze the clinical characteristics of patients with primary antiphospholipid syndrome (PAPS) progressing to systemic lupus erythematosus (SLE).Explore the risk factors for the progression from PAPS to SLE.Methods:The clinical data of 262 patients with PAPS enrolled in Peking Union Medical College Hospital from February 2005 to September 2021 were evaluated. Assessments included demographic data, clinical manifestations, laboratory tests (serum levels of complement, anti-nuclear antibodies, anti-double-stranded DNA antibodies), treatment, and outcomes. Kaplan-Meier analysis was used to calculate the prevalence of SLE in patients with PAPS. Univariate Cox regression analysis was employed to identify the risk factors for PAPS progressing to SLE.Results:Among 262 patients with PAPS, 249 had PAPS (PAPS group) and 13 progressed to SLE (5.0%) (PAPS-SLE group). Univariate Cox regression analysis indicated that cardiac valve disease ( HR=6.360), positive anti-double-stranded DNA antibodies ( HR=7.203), low level of complement C3 ( HR=25.715), and low level of complement C4 ( HR=10.466) were risk factors for the progression of PAPS to SLE, whereas arterial thrombotic events ( HR=0.109) were protective factors ( P<0.05 for all). Kaplan-Meier analysis showed that the prevalence of SLE in patients suffering from PAPS with a disease course>10 years was 9%-15%. Hydroxychloroquine treatment had no effect on the occurrence of SLE in patients with PAPS ( HR=0.753, 95% CI 0.231-2.450, P=0.638). Patients with≥2 risk factors had a significantly higher prevalence of SLE compared with those with no or one risk factor (13-year cumulative prevalence of SLE 48.7% vs. 0 vs. 6.2%, P<0.001 for both). Conclusions:PAPS may progress to SLE in some patients. Early onset, cardiac-valve disease, positive anti-dsDNA antibody, and low levels of complement are risk factors for the progression of PAPS to SLE (especially in patients with≥2 risk factors). Whether application of hydroxychloroquine can delay this transition has yet to be demonstrated.

Objective:To explore the current situation of family hardiness of breast cancer patients and analyze its influencing factors, so as to provide a basis for the development of intervention measures.Methods:This study adopted a cross-sectional survey method. Using the convenient sampling method, a total of 110 patients with breast cancer who received surgical treatment in Department of Thyroid Breast Vascular Surgery in the First Affiliated Hospital of Air Force Medical University from January to September 2022 were selected as the research objects. Breast cancer patients were investigated with general information questionnaire, Chinese version of Family Hardiness Index (FHI) and Social Support Rating Scale (SSRS) . Pearson correlation analysis, independent sample t-test, and one-way ANOVA were used for one-way analysis. Multiple linear regression analysis was used for multivariate analysis. A total of 110 questionnaires were distributed in this study, and 106 valid questionnaires were collected, with an effective response rate of 96.4% (106/110) . Results:The total scores of the Chinese version of FHI and SSRS in 106 patients with breast cancer were (58.77±7.49) and (33.99±6.85) , respectively. Pearson correlation analysis showed that there was a positive correlation between the total score of the Chinese version of FHI and SSRS for breast cancer patients ( r=0.485, P<0.01) . Multiple linear regression analysis showed that the influencing factors of family hardiness of breast cancer patients were education level, family economic situation, religious belief, main caregivers (spouses) and social support level ( P<0.05) . Conclusions:The family hardiness of breast cancer patients is at a medium level. Education level, family economic situation, religious belief, main caregivers (spouses) and social support level are the influencing factors of family hardiness of breast cancer patients. In the next step, intervention measures should be formulated for the influencing factors.

Objective:To comprehensively and systematically measure and analyze deaf children's gray matter cortex and white matter fibers by surface-based morphometry (SBM) and tract-based spatial statistics(TBSS).Methods:Twenty-seven deaf children aged 9-13 years old and twenty-seven age and sex matched normal controls were selected. T1 structural images and diffusion tensor imaging data were collected and analyzed by SBM and TBSS to calculate the cortical thickness, back index and anisotropic index (fractional anisotropy, FA). The SPSS 20.0 software and FSL software were used for data analysis.Results:Compared with the control group, the thickness of the cortex in the left cerebral hemisphere central posterior gyrus, the superior lobule, the central lateral lobule, and the anterior lobe were significantly reduced(cluster size 4 150, P<0.05), and in the right cerebral hemisphere squats and the middle sacral region reduced(cluster size 2 592, P<0.05). The local regression index of the left anterior wedge region was significantly increased(cluster size 3 225, P<0.05). The DTI results showed a decrease in FA values in the areas of radiation crown, cortical bundle, cingulate gyrus, corpus callosum, thalamus radiation, and sub-occipital bundle( P<0.05, TFCE corrected). Conclusion:There are different degrees of damage in the cerebral cortex and white matter microstructure of deaf children, and the brain structure remodeling and compensatory reconstruction appeared in the anterior wedge, which provide strong evidence for in-depth study of relationship between the loss of auditory function and changes in the brain structure.

Objective:To investigate the prevalence of Escherchia albertii in Shanxi province. Methods:The chicken intestines were enriched in EC broth. The eae gene was detected by PCR, and the eae-positive EC enrichments were inoculated in MacConkey agar plate. The eae-positive lactose non-fermenting isolates were presumed as Escherchia albertii, and then analyzed by triplex-PCR, 16S rDNA sequencing and MLST. Results:Two suspected Escherchia albertiiwere isolated from 250 samples of chicken intestines. It was identified as Escherchia albertii by phenotypic, specific genes,16S rDNA sequencing, and MLST analyses . The cytolethal distending toxin B ( cdtB) showed positive by PCR,and they were clusted to Ⅱ/Ⅲ/Ⅴ group by sequencing. Conclusion:This study showed that the Escherchia albertii was existed in Shanxi province, China.

Objective:To investigate the prevalence of Escherchia albertii in Shanxi province. Methods:The chicken intestines were enriched in EC broth. The eae gene was detected by PCR, and the eae-positive EC enrichments were inoculated in MacConkey agar plate. The eae-positive lactose non-fermenting isolates were presumed as Escherchia albertii, and then analyzed by triplex-PCR, 16S rDNA sequencing and MLST. Results:Two suspected Escherchia albertiiwere isolated from 250 samples of chicken intestines. It was identified as Escherchia albertii by phenotypic, specific genes,16S rDNA sequencing, and MLST analyses . The cytolethal distending toxin B ( cdtB) showed positive by PCR,and they were clusted to Ⅱ/Ⅲ/Ⅴ group by sequencing. Conclusion:This study showed that the Escherchia albertii was existed in Shanxi province, China.

Objective To explore the role of forkhead box F2 (FoxF2) in the extracellular matrix of trabecular meshwork.Methods The cultured human trabecular meshwork cells (HTMCs) were divided into Scramble control group and FoxF2 small hairpin RNA (shRNA) group,then FoxF2 shRNA,the FoxF2 restructuring interference carrier was built,HTMCs were infected with FoxF2 shRNA lentivirus.Western blot assay was used to detect the expression of FoxF2 protein and extracellular matrix.Furthermore,Transwell counting experiment was used to analyze the migration ability of HTMCs.Results The cultured HTMCs grew well and showed a long spindle shape.The growth status of HTMCs was well,and their morphological characteristics were consistent with the HTMCs in vivo.The relative expression level of FoxF2 protein in the FoxF2 shRNA group was lower than that in the Scramble control group,with a significant difference between them (0.72 ± 0.02 vs.1.27 ± 0.05;t =16.68,P ＜ 0.01).The relative expression level of fibronectin (FN),collagen type Ⅰ (COL Ⅰ) and α-smooth muscle actin (α-SMA) were 0.43±0.03,0.53 ±0.08 and O.86±0.15 in the FoxF2 shRNA group,and 0.87±0.04,1.66±0.06 and 1.73 ±0.13 in the Scramble control group,respectively,the relative expression levels of FN,COL Ⅰ and α-SMA in the FoxF2 shRNA group were significantly lower than those in the Scramble control group (t =15.08,18.81,7.50,all at P＜0.01).The migration number of HTMCs in the FoxF2 shRNA group was significantly lower than that in the Scramble control group (117.30±11.41 vs.251.00±10.37;t =8.72,P＜0.01).Conclusions The FoxF2 shRNA lentivirus are successfully constructed,which can decrease the expression of FoxF2 in HTMCs.Low expression of FoxF2 can reduce the expression level of extracellular matrix protein in HTMCs and inhibit the migration ability of HTMCs.

Objective To study the protective effect of trimetazidine pretreatment on myocardial I/R in a rat I/R model and its mechanism.Methods One hundred and twenty SD rats were divided into control group,I/R group,HSP70 inhibitor group,trimetazidine treatment group and combined treatment group (24 in each group).The rats in each group were further divided into 30 min reperfusion group,4 h reperfusion group and 8 h reperfusion group (8 in each group).Their HSP70-positive myocardial cells were calculated,their serum CK,CK-MB,MDA,SOD levels and their myocardial infarction size were measured.Results The serum CK and CK-MB levels were significantly higher in I/R group,HSP70 inhibitor group,trimetazidine treatment group and combined treatment group than in control group and were significantly lower in trimetazidine treatment group than in combined treatment group and I/R group after reperfusion for 4 and 8 h (P＜0.01).The serum levels of HSP70 and SOD were significantly higher,the MDA levels were significantly lower in trimetazidine treatment group than in combined treatment group and I/R group after reperfusion for 30 min,4 and 8 h (P＜0.01).The infraction size was significantly smaller in trimetazidine treatment group than in combined treatment group and I/R group after reperfusion for 4 and 8 h (P＜0.05).Conclusion Trimetazidine can increase the serum HSP70 level in myocardial cells,reduce the infarction size,and protect the myocardium against I/R in rats.

Objective To investigate the clinical utility of SonoVue,a microbubble-enhancing contrast agent,in the treatment of uterine fibroids carrying different signal intensities on T2WI with high-intensity focused ultrasound (HIFU).Methods Based on the preoperative MRI signal intensity on T2WI,a total of 64 patients with uterine fibroids,who were scheduled to receive HIFU,were divided into low-intensity group (n =24),iso-intensity group (n =22) and high-intensity group (n =18).MRI check-up examination was performed one day after HIFU treatment to evaluate the ablation effect.The parameters related to HIFU,including therapeutic power,irradiation time and therapeutic dose,and the indexes related to therapeutic effect,including volume ablation rate (non-perfusion volume ratio,NPVR),energy-efficiency factor,treatment time,were recorded,and the results were compared between each other among the three groups.Results In the low-intensity group,iso-intensity group and high-intensity group,the volume ablation rates were (84.83±18.49)％,(8.72±17.76)％ and (71.11±23.87)％ respectively,the energy-efficiency factors were (6.87±7.77) J/mm3 (7.99±6.58) J/mm3 and (12.93±9.38) J/mm3 respectively,the treatment time were (102.12±54.45) min,(153.86±66.04) min and (141.50±69.56) min respectively.Single factor analysis indicated that statistically significant differences in volume ablation rate,energy-efficiency factor and treatment time existed between each other among the three groups.Among the total 64 patients,3 patients developed lower abdominal pain (6/64,9.4％),3 patients complained of general aches with numb (3/64,4.7％),and no severe complications,such as skin burn in treatment area,etc.,occurred in all patients.Conclusion The curative effect of SonoVue combined with HIFU for low-intensity and iso-intensity uterine fibroids is better than that for high-intensity uterine fibroids;the treatment time for low-intensity uterine fibroids is shorter than that for iso-intensity and high-intensity uterine fibroids.SonoVue is a safe and effective synergist for HIFU treatment.

Objective To investigate the regulating effects of Krüppel-like factor 6 (KLF6) on the apoptosis of human lens epithelial cells (HLECs) by activating transcription factor 4 (ATF4) pathway and explore the bio-molecular mechanism of KLF6/ATF4-induced HLECs apoptosis.Methods HLECs (HLE-B3) were cultured using high glucose DMEM medium.The eukaryotic expression plasmid pEGFP-C2-ATF4 was transfected into the cells by liposome 2000 in the ATF4-transfected group,and pEGFP-C2 was transfected in the empty plasmid group.Then the cells were exposed to 20 mJ/cm2 ultraviolet ray B (UVB) for 200 seconds,The morphological changes of the cells were observed by hematoxylin & eosin staining and Hoechst33258 fluorescein staining.Cultured cells were transfected using pEGFP-C2-KLF6 and pEGFP-C2 plasmid and pSilencer-KLF6 (siKLF6) and pSilencer plasmid,respectively,and the expression of ATF4 protein in the cells was detected by Western blot assay.Culture cells were divided into four groups.pEGFP-C2 and pSilencer plasmids were co-transfected into the cells in the empty plasmid group;pEGFP-C2-KLF6 and pSilencer empty plasmid were co-transfected into the cells of the KLF6 + pSilencer group;pEGFP-C2 empty plasmid and pSilencer-ATF4 were co-transfected in the cells of the siATF4 + pEGFP-C2 group;pEGFP-C2-KLF6 and pSilencer-ATF4 plasmids were co-transfected in the cells of the KLF6 + siATF4 group,and then the cells were exposed to UVB.The apoptosis of the cells were detected by ELISA assay.Results Cultured cells grew well in the normal control group with the uniform morphology and regular arrangement.The karyopyknosis,karyorrhexis and enlargement of intercellular space were found in the cells exposed to UVB.In the ATF4 transfected group,the number of cells was decreased.The relative expression level of the ATF4 protein in the cells was 0.99±0.06 and 0.13±0.02 in the UVB+ATF4 transfected group and UVB+pEGFP-C2 plasmid group,respectively,with a significant difference between them (t =23.13,P＜0.01).The relative expression levels of KLF6 and ATF4 proteins in the KLF6 transfected group were higher than those in the empty plasmid group,and the relative expression levels of KLF6 and ATF4 proteins in the siKLF6 group were significantly lower than those in the empty plasmid group (all at P＜0.01).ELISA assay showed that the apoptotic rate in the ATF4 transfected group was 1.37± 0.11,which was significantly higher than 0.31 ±0.11 in the normal control group (t =8.034,P =0.001);the apoptotic rate of the cells was increased in the KLF6+pSilencer group and decreased in the siATF4+pEGFP-C2 group in comparison with the empty plasmid group (P＜0.01,P=0.02).In addition,the apoptotic rate in the KLF6+ siATF4 group was remarkably lower than that in the KLF6 + pSilencer group (P＜ 0.01).Conclusions KLF6 promotes the apoptosis of HLECs induced by UVB radiation.Silence of ATF4 gene reduces the apoptotic rate of the cells.ATF4 is probably a target factor in the regulating oathwav of KLF6 to apoptosis.