OBJECTIVE To investigate the mechanism by which Qiaobai cold compress solution （QBCS） improves acne vulgaris （AV） based on transcriptomics and animal experiments. METHODS Rats were randomly divided into a blank control group （ n ＝6） and a modeling group （ n ＝30）. AV models were established in the modeling group by topical application of oleic acid to the inner surface of both ears， combined with subcutaneous injection of Cutibacterium acnes suspension into the auricle. Successfully modeled rats were further divided into the model group， positive control group （Tretinoin cream， 0.045 g/kg）， and QBCS low-， medium-， high-dose groups [3.55， 7.11， 14.22 g/kg （calculated by the amount of crude drug） ] ， with 6 rats in each group. Rats in each d rug group were treated with the corresponding drugs once daily for 14 consecutive days. After the final administration， changes in the appearance of the ears and histopathological changes in the ear tissues were observed， and serum levels of inflammatory factors， including tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6） and IL-1β， were measured. Auricular tissues from the blank control group， model group and QBCS medium-dose group were collected for transcriptome sequencing. Differential expressed genes （DEGs） were screened and subjected to Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis， followed by validation using real-time quantitative polymerase chain reaction and Western blot assay. RESULTS Compared with the model group， rats in all QBCS groups showed alleviated auricular acne symptoms， with reduced epidermal thickening， sebaceous gland hyperplasia， and inflammatory cell infiltration. Serum levels of TNF-α （except for the QBCS low-dose group）， IL-6 （except for the QBCS low-dose group） and IL-1β were significantly decreased （ P ＜0.05）. A total of 590 DEGs were identified （blank control group vs. model group）， and 596 DEGs were identified （model group vs. QBCS medium-dose group）. Above DEGs （blank control group vs. model group） were mainly enriched in Toll-like receptor （TLR） and nuclear factor-kappa B （NF-κB） signaling pathways， etc. Validation experiments showed that， compared with model group， low-， medium- and high-dose of QBCS reduced， to varying degrees， the mRNA expression of TNF-α， TLR2， interferon-γ and CXC chemokine ligand 8 in the auricular tissues of AV rats， increased the mRNA expression of peroxisome-proliferator-activated receptor gamma and tumor protein 53， and inhibited the phosphorylation of NF-κB p65 protein as well as the expressions of TLR2 and myeloid differentiation primary response protein 88（MyD88） （ P ＜0.05）. CONCLUSIONS QBCS can alleviate auricular inflammation and skin lesions in AV rats. This effect may be related to inhibition of the TLR/MyD88/NF-κB signaling pathway， thereby suppressing the expression of downstream inflammatory factors such as TNF-α.

Objective To analyze the influence of clinical indicators and PPARD gene polymorphism on the hypoglycemic efficacy of dapagliflozin(DAPA)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 102 patients with T2DM who visited the Affiliated Hospital of Jiangnan University and the Affiliated Hospital of Xuzhou Medical University from June 2021 to December 2023 were selected as the study subjects,an observational cohort of T2DM patients treated with DAPA was established,and DAPA tablets of 10 mg were administered orally once a day for 12 weeks,the venous blood and clinical data of the patients were col-lected.PPARD gene polymorphism typing was performed by using the Snapshot method.The differences in clinical indicators among patients with different genotypes were compared and the influencing factors of DA-PA in improving insulin resistance index(HOMA-IR)were analyzed.Results Eighty-two patients completed the 12-week follow-up.Before DAPA treatment,the differences in the clinical indicators of patients with dif-ferent PPARD rs3777744 genotypes were not statistically significant(P＞0.05).After 12 weeks of DAPA treatment,compared with patients with AA genotype,patients carried of G allele(GG+AG genotype)had lower levels of fasting blood glucose(FPG),HOMA-IR and its decrease,and the differences were statistically significant(P＜0.05).The results of multiple linear regression analysis showed that the genotype of PPARD rs3777744 locus and baseline HOMA-IR were correlated with the improvement of HOMA-IR after 12 weeks of DAPA treatment,and the improvement of HOMA-IR in G allele carriers was not as significant as that in AA genotype patients,and the higher the baseline HOMA-IR,the more significant the improvement of HO-MA-IR.Conclusion Different genotypes of PPARD rs3777744,baseline HOMA-IR are important influencing factors for DAPA to improve insulin resistance of T2DM patients.

AIM:To establish a nomogram model to predict the effect of serum ferritin on diabetic retinopathy and evaluate the model.METHODS:A total of 21 variables, including ferritin, were screened by univariate and multivariate regression analysis to determine the risk factors of diabetic retinopathy. A nomogram prediction model was established for evaluation and calibration.RESULTS:Ferritin, duration of diabetes, hemoglobin, urine microalbumin, regularity of medication and body mass index were included in the nomogram model. The consistency index of the prediction model with serum ferritin was 0.813(95%CI: 0.748-0.879). The calibration curves of internal and external verification showed good performance, and the probability of the threshold suggested by the decision curve was in the range 10% to 90%. The model had a high net profit value.CONCLUSIONS:Serum ferritin is an important risk factor for diabetic retinopathy. A new nomogram model, which includes body mass index, duration of diabetes, ferritin, hemoglobin, urine microalbumin and regularity of medication, has a high predictive accuracy and could provide early prediction for clinicians.

Objective:To investigate the clinical efficacy of distal tibiofibular screw fixation combined with ligament repair for the treatment of ankle fracture accompanied with distal tibiofibular syndesmosis injuries.Methods:A retrospective cohort analysis was made on clinical data of 72 patients with ankle fracture accompanied with distal tibiofibular syndesmosis injuries admitted to 909th Hospital of Joint Service Support Force of PLA from September 2017 to September 2020, including 38 males and 34 females, aged 19-65 years [(42.5±12.2)years]. The fracture was type B in 30 patients, type C 1 in 29 and type C2 in 13 according to Danis-Weber classification. A total of 36 patients were treated by distal tibiofibular screw fixation combined with ligament repair (fixation+repair group) and 24 patients by distal tibiofibular screw fixation (fixation group). Operation time, intraoperative blood loss and hospital stay were recorded. Visual analogue scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) ankle hindfoot score and ankle range of motion (ROM) were determined at 1, 3 months postoperatively and at the final follow-up. Complications were documented. Results:All patients were followed up for 12-22 months [(15.9±2.2)months]. There were no significant differences in operation time, intraoperative blood loss and hospital stay between the two groups (all P>0.05). VAS in fixation+repair group was (3.1±1.0)points and (2.1±0.6)points at 1, 3 months postoperatively, significantly lower than (3.9±0.8)points and (2.6±0.8)points in fixation group (all P<0.05), but the score showed no significant difference between the two groups at the final follow-up ( P>0.05). AOFAS score in fixation+repair group was (64.7±4.0)points, (73.2±3.4)points and (87.2±3.4)points at 1, 3 months postoperatively and at the final follow-up, significantly higher than (60.1±4.9)points, (70.2±1.9)points and (84.1±2.6)points in fixation group (all P<0.05). There was no significant difference in the ROM between the two groups at 1 month postoperatively ( P>0.05), but the ROM at 3 months postoperatively and at the final follow-up in fixation+repair group [(44.4±2.9)° and (52.3±2.5)°, respectively] was significantly higher than that in fixation group [(41.4±2.7)° and (50.1±2.7)°, respectively] (all P<0.05). There was 1 patient with internal fixation loosening in fixation+repair group, with the incidence of complications of 3% (1/36). While the incidence of complications was significantly lhigher in fixation group [17%(6/36)], including 2 patients with re-separation of distal tibiofibular syndesmosis, 2 with internal fixation loosening and 2 with internal fixation breakage ( P<0.05). Conclusion:Compared with distal tibiofibular screw fixation, distal tibiofibular screw fixation combined with ligament repair for the treatment of ankle fracture accompanied with distal tibiofibular syndesmosis injuries is effective to early relieve ankle pain, improve ankle function and ROM, and reduce occurrence of complications.

In recent years, with the increasing incidence of diabetes, diabetic keratopathy has gradually attracted more attention from clinicians.Diabetic keratopathy is mainly manifested as delayed corneal epithelial healing, corneal edema, decreased corneal sensitivity, and neurotrophic corneal ulcer.There are many mechanisms of diabetic keratopathy, including the abnormal accumulation of metabolites, an inflammatory reaction, oxidative stress, the lack of neurotrophic factors, corneal limbal stem cell abnormalities, etc.At present, most of the research on diabetic keratopathy at home and abroad has mainly focused on epithelial damage repair and changes in nerve function, and the pathological mechanism is mainly inflammatory response and apoptosis.Nuclear factor kappa B(NF-κB) is an important transcription regulatory factor, and is involved in regulating the expression of inflammatory factors, chemokines, cell adhesion molecules, apoptosis-related genes, growth factors, and other target genes.Studies have reported that chronic inflammation and epithelial cell apoptosis of the diabetic corneal epithelium are involved in the regulation of the NF-κB signaling pathway, which is also involved in the regulation of diabetic peripheral neuropathy, and diabetic corneal neuropathy belongs to the category of diabetic peripheral neuropathy.The NF-κB signaling pathway is closely related to the occurrence and development of diabetic keratopathy, and this article summarizes its mechanism.

Xylanase is a high-profile glycoside hydrolase with applications in brewing, feed, pharmacy and bioenergy industries, but most of xylanases are in active below 30 ℃. In order to obtain low temperature active xylanase, a xylanase gene, XYN11A, was cloned from Penicillium sp. L1 and expressed in Pichia pastoris GS115. After purification and enzyme assay, optimal pH and temperature were determined to be 3.5 to 4.0 and 55 ℃. This enzyme was stable at acid and neutral condition (pH 1.0 to 7.0) or under the treatment of 40 ℃ for 1 hour. This xylanase displayed strong resistance to all tested ions and chemicals. Noteworthily, XYN11A maintained a higher activity of 6 700 U/mg than a lot of GH11 xylanase, and demonstrated higher activity (24% to 58%) at lower temperature from 20 to 40 ℃. After beechwood xylan hydrolysis for 16 h, the hydrolysates consisted mainly of xylobiose, xylotriose and xylotetraose and barely of xylose, thus XYN11A could be used for the production of prebiotic xylooligosaccharide. Possessing the features of acidophilic, highly active at lower temperature and oligosaccharide production, XYN11A demonstrated great potential in food and feed industrials.

This study aimed to investigate the protective effects of Baibu Tang on bleomycin-induced pulmonary fibrosis in mice. After intratracheally giving bleomycin(3. 5 mg/kg), mice were orally administered Baibu Tang once a day for 14 consecutive days, takingnintedanib as a positive control. The anti-fibrotic effects were assessed by the hydroxyproline level and the histopathological changes in H&E or Masson stained lung tissues. The results revealed that the lung coefficient, hydroxyproline content, inflammation and collagen deposition were increased significantly in the lung tissue of the model mice. Both ethanol and water extracts of Baibu Tang significantly improved all the pathological indexes in mice, but the effect of the ethanol extract was better than that of the water extract. Baibu Tang with Baibu(root of Stemona tuberosa)containing different components(neotuberostemonine, tuberostemonine and stemoninine, respectively)could significantly reduce hydroxyproline level and collagen deposition in the lung tissue of bleomycin-induced mice, and there was no significant difference in their activity. This result showed that the changes in the chemical composition of Stemona tuberosa(Baibu, monarch drug for Baibu Tang)have little effect on the anti-fibrosis activity of Baibu Tang, and its mechanism and material basis need further investigation.

Objective To explore the effects of individualized comprehensive intervention on complications during indwelling implantable venous access port (IVAP), so as to provide reasonable suggestion and theory evidence for reducing the incidence of IVAP complications. Methods We selected 400 breast cancer patients with IVAP. All of the patients were completely randomized divided into control group and experimental group. Patients of control group (n=200) received routine intervention including education before implanting IVAP and discharge instruction. On this basis of routine intervention, patients of experimental group (n=200) were treated with the individualized comprehensive intervention and enhancing continuous intervention out hospital aiming at common complications of IVAP. We compared patients' incidences of complications during IVAP between two groups. Results Patients' incidences of complications during IVAP in control group and experimental group were 27.0% and 7.5% respectively with a significant difference (P＜ 0.01). There were 12 patients with unplanned port drawing due to complications in control group and 3 in the experimental group with a significant difference (P＜ 0.05). Conclusions Individualized comprehensive intervention can effectively reduce the incidences of complications during IVAP, improve the utilization time and ratio of IVAP. Enhancing continuous intervention out hospital is also the important measure to decrease the incidence of severe complications.

Objective To investigate the clinical efficacy of acupuncture in treating subhealth.Methods One hundred and fifty-four patients with subhealth were allocated, using a random number table, to observation and control groups, 77 cases each. The control group received basic treatment by diet, exercise, rest and rest and psychological intervention and the observation group, acupuncture therapy in addition. Subhealth scale subscores and the 36-Item Short-Form Health Survey (SF-36) subscore were recorded and blood biochemical indicators were measured in the two groups before and after treatment. the clinical therapeutic effects were compared between the two groups.Results The total efficacy rate was 96.1% in the observation group and 83.1% in the control group; there was a statistically significant difference between the two groups (P<0.05). There were statistically significant pre-/post-treatment differences in subhealth scale subscores in the two groups (P<0.05). After treatment, sleep, digestion, urination, positive emotion, ability and social relation subscores were higher, and fatigue, discomfort and negative emotion subscores were lower in the observation group than in the control group (both P<0.05). There were statistically significant pre-/post-treatment differences in blood biochemical indicators in the two groups (P<0.05). After treatment, blood uric acid (UA), total cholesterol (TC), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) were significantly lower and high-density lipoprotein cholesterol (HDL-C) was significantly higher in the observation group than in the control group (both P<0.05). The 36-Item Short-Form Health Survey (SF-36) subscore were higher in thetwo groups after treatment than before treatment (P<0.05). After treatment, physiological function, role-physical, role-emotional, body pain and general health subscore were significantly higher in the observation group than in the control group (P<0.05).Conclusions Acupuncture helps to improve subhealth status in population, regulate blood biochemical indicators and enhance the clinical therapeutic effect to raise the quality of life in the patients.

Objective To study the real world of bicyclol tablets in the treatment of viral hepatitis and its influence on platelets.Methods The hospital information system (HIS) was selected from 18 Triple-A hospitals in China on patients with bicyclol tablets information as exposed group (2 690 cases),patients with unused bicyclol tablet (2 690 cases) as an exposed group,an exception occurs of platelet as an index of the ending.Results The incidence of abnormal platelet difference in two groups before the treatment were not statistically significant.The incidence of abnormal platelet reduce between two groups have statistical significance,can be thought of exposure of abnormal lower rate (11.75%)lower than that of non exposed group(15.17%) (P<0.01).Conclusion Bicyclol piece have signficantly curative effect on the treatment of viral hepatitis.It shows more safety,and less impact on platelets.It is worth to be used in clinical practice.