Objective To analyze the effect of Callicarpa nudiflora on wound healing and phos-phatidylinositol-3-kinase/protein kinase B/mammalian target of rapamycin(PI3K/AKT/mTOR)path-way by regulating M2 macrophage polarization in rats with diabetic foot ulcer.Methods A total of 40 rats were selected,with 10 rats in control group(topical application of saline),and the remaining 30 were used to establish rat model of diabetic foot ulcer.Ultimately,27 rats were successfully mod-eled and divided into model group(topical application of saline),Callicarpa nudiflora group(topi-cal application of Callicarpa nudiflora),and Callicarpa nudiflora combined with inhibitor group(topical application of Callicarpa nudiflora combined with CD206 inhibitor,a marker protein of M2 macrophages),with 9 rats in each group.The wound healing rate,levels of basic fibroblast growth factor(bFGF)and vascular endothelial growth factor(VEGF),relative expression levels of induc-ible nitric oxide synthase(iNOS),CD16/32,CD206,PI3K,AKT and mTOR as well as mRNA ex-pression levels of PI3K,AKT and mTOR were compared among groups.Results On the 3rd,7th and 14th days after intervention,compared with the control group,the wound healing rate,VEGF,bFGF,relative expression level of CD206,relative expression of PI3K,AKT and mTOR at mRNA and protein levels were significantly decreased while the relative expression levels of iNOS and CD16/32 were significantly increased in all other groups(P＜0.05);compared with the model group,the Callicarpa nudiflora group and the Callicarpa nudiflora combined with inhibitor group showed significant increased wound healing rate,VEGF,bFGF,relative expression level of CD206,and relative expression of PI3K,AKT and mTOR at mRNA and protein levels,and significant de-creased relative expression levels of iNOS and CD16/32(P＜0.05);compared with the Callicarpa nudiflora group,the Callicarpa nudiflora combined with inhibitor group showed significant decreased wound healing rate,VEGF,bFGF,relative expression level of CD206,and relative expression of PI3K,AKT and mTOR at mRNA and protein levels,and significant increased relative expression levels of iNOS and CD16/32(P＜0.05).Conclusion Callicarpa nudiflora can promote M2 mac-rophage polarization,increase wound healing rate and levels of VEGF and bFGF in rats with diabetic foot ulcer,and activate the PI3K/AKT/mTOR signaling pathway.

Objective:To investigate clinical characteristics of bullous pemphigoid (BP) developing after the treatment with dipeptidyl peptidase-Ⅳ inhibitors (DPP4i) in patients with diabetes mellitus.Methods:A total of 116 inpatients with BP complicated by diabetes mellitus were collected from the Seventh People′s Hospital of Shenyang between January 2014 and December 2020, and divided into 2 groups: DPP4i-BP group treated with DPP4i before the onset of BP, and general BP group receiving no treatment with DPP4i. General clinical data, skin lesion area, laboratory indicators, treatment regimens, and prognosis were analyzed and compared between the above 2 groups, the time interval from the administration of DPP4i to the diagnosis of BP was recorded in the DPP4i-BP group. One-way analysis of variance was used to compare measurement data among multiple groups, two-independent-sample t test was used for comparisons between two groups, and paired t-test for intra-group comparisons before and after treatment; chi-square test was used to compare enumeration data between groups. Results:There were 32 patients aged 77.17 ± 15.32 years in the DPP4i-BP group, with a male-to-female ratio being 15∶17; there were 84 patients aged 76.65 ± 19.32 years in the general BP group, with a male-to-female ratio being 43∶41. The time interval from the administration of DPP4i to the diagnosis of BP was 14.61 ± 3.93 months in the DPP4i-BP group. The time interval for vildagliptin was the shortest (5.42 ± 2.84 months) , and there was a significant difference in the time interval among vildagliptin, sitagliptin, linagliptin and saxagliptin ( F= 8.93, P < 0.001) . The proportion of patients with severe BP was significantly higher in the DPP4i-BP group (16 cases, 50%) than in the general BP group (25 cases, 29.76%; Z= 2.63, P= 0.008) . There was no significant difference in the positivity rate of anti-BP180 antibody between the two groups ( χ2= 0.03, P= 0.870) . However, the level of anti-BP180 antibody was significantly higher in the DPP4i-BP group than in the general BP group before and after treatment ( P= 0.015, < 0.001, respectively) , and the decrease in the level of anti-BP180 antibody was significantly less in the DPP4i-BP group than in the general BP group after treatment ( t= 5.11, P < 0.001) . There was no significant difference in the average effective dose of glucocorticoids required to control the disease between the two groups ( t= 1.00, P= 0.322) . However, the DPP4i-BP group showed a significant increase in the average time required to control the disease and in the proportion of patients requiring combined treatment with immunosuppressants or other drugs compared with the general BP group ( t= 6.72, 10.05, P < 0.001,= 0.002, respectively) . Within 6 months after the start of systemic treatment, the recurrence rate was significantly higher in the general BP group (17 cases, 27.86%) than in the DPP4i-BP group (2 cases, 7.69%; χ2= 4.35, P= 0.037) ; at 6 months, the average dose of glucocorticoids was also significantly higher in the general BP group than in the DPP4i-BP group ( t= 7.04, P < 0.001) . Conclusions:Among the DPP4i hypoglycemic drugs, vildagliptin was the most common drug administrated by patients before the onset of BP, with the shortest interval from the administration to the onset of BP. DPP4i-BP may be difficult to control at the early stage, but the prognosis is good.

Objective To explore the effect of decreased air pollutants concentrations on the incidence of Type 2 Diabetes Mellitus (T2DM). Methods A prospective cohort was designed in Tianjin where the air quality gradually improved from 2014 to 2018. A total of 5 077 community residents (18-90 years old) were recruited as the baseline population from 2013 to 2014. From 2014 to 2018 follow-up was carried out year by year to observe the new incidence of T2DM in the cohort. The HR and 95%CI (95% confidence interval) were calculated with the multiple Cox proportional hazard regression model to evaluate the effect of the decrease in the concentrations of SO₂, NO₂, and particulate matters with diameters <10μm and <2.5μm (PM₁₀, PM_2.5) on the incidence of T2DM. Results The cohort was followed up year by year from 2014 to 2018, with a cumulative follow-up of 25 385 person-years over the 5 years. At the same time, the air quality of Tianjin was significantly improved. Statistical analysis results after covariate adjustment revealed that the risk of T2DM in the population decreased by 0.172, 0.124, and 0.210 times, for a decrease of 10 μg/m³ in the annual average concentrations of SO₂, PM₁₀, and PM_2.5 each, respectively (SO2：HR=0.828，95%CI=0.757-0.907；PM₁₀：HR=0.876，95%CI=0.816-0.941；PM_2.5：HR=0.790，95%CI=0.694-0.899). Conclusion The implementation of environmental protection measures to improve air pollution could reduce the risk of T2DM in the population and control the increasing prevalence.

Objective To investigate the effects of glucocorticoid combined with spleen aminopeptide on immune function and pulmonary function in children with combined allergic rhinitis and asthma syndrome (CARAS).Methods A total of 166 cases of CARAS were divided into observation group (84 cases) and control group (82 cases),the patients in the control group were treated by nasal inhalation of Budesonide Aerosol,in addition to the treatment of control group the observation group was given spleen aminopeptide oral lyophilized powder for treatment,and two groups were treated continuously for 3 months.The effect of 2 groups of children,and the changes of immune and lung function before and after treatment were compared.Results Rhinitis and asthma were significantly reduced in two groups of children after treatment,and the reductions of the score of rhinitis symptoms and the asthma score in the observation group were more significant than those in the control group(P＜0.05).The humoral immunity index (IgG,IgM and IgA) of the 2 groups increased significantly after treatment.CD3+,CD4+ and the ratio of CD4+/CD8+ in the cellular immune indexes increased significantly,and CD8+ decreased significantly.The immune indexes in the observation group were significantly improved compared with those in the control group (P＜0.05).After treatment,the forced expiratory volume in one second(FEV1) and maximal expiratory flow rate (PEFR) of the 2 groups increased significantly compared with those before treatment,and the degree of increase in the observation group was significantly higher than that in the control group(P＜0.01).Conclusion Glucocorticoid combined with spleen aminopeptide could not only improve the symptoms and signs of children with CARAS,but also significantly enhance cellular immunity,humoral immunity and pulmonary function.

Objective To investigate the biomechanical properties of human calcaneus by finite element method. Methods Through CT scanning, Mimics, Geomagic and other software, the finite element model of calcaneus was established. The stress distribution and displacement tendency of calcaneus under normal standing and external force were analyzed. Results Under normal standing, the calcaneal stress was uniformly distributed and small. Under external force, the entire calcaneus stress increased significantly, and the stress on calcaneocuboid articular surface also obviously increased. Conclusions The analysis of the stress and strain distribution on calcaneus in neutral position under different loading, and the investigation on biomechanical properties of calcaneus and mechanism of calcaneal fracture will provide theoretical basis for clinical treatment of calcaneal fractures.

Objective To explore the constitute and antimicrobial susceptibility of pathogenic fungi causing candidemia in Nanchang City of Jiangxi Province.Methods Candida spp.isolated from blood specimens of patients at a hospital in Nanchang in March-October 2015 were collected, fungal strains were identified by amplifying the internal transcribed spacer (ITS) and large ribosomal subunit (D1/D2 region of 26rRNA), antifungal susceptibility of fungi was detected.Results A total of 1 332 positive blood culture specimens were collected, including 74 fungal positive specimens, accounting for 5.56％, 52 strains of Candida spp.were obtained, most were Candida tropicalis (n=17,32.69％),followed by Candida albicans(n=16, 30.77％) and Candida parapsilosis complex (n=16, 30.77％).Identification results of ITS and D1/D2 region were identical.52 strains of Candida spp.were sensitive to both micafungin and caspofungin, epidemiological cutoff value(ECV) of amphotericin B showed that 52 strains were all wild type.Resistance rates of Candida tropicalis to fluconazole and voriconazole were 29.41％ and 17.64％ respectively, ECV of itraconazole and posaconazole showed that wild type accounted for 82.35％ and 94.12％ respectively;resistance rates of Candida albicans to fluconazol and voriconazole were 93.75％ and 81.25％ respectively, ECV of itraconazole and posaconazole showed that wild type accounted for 75.00％ and 81.25％ respectively;Candida parapsilosis complex strains were sensitive to both fluconazole and voriconazole, ECV of itraconazole and posaconazole showed that all were wild type;all Candida glabrata strains had intermediate resistance rates to fluconazole, ECV of voriconazole, itraconazole, and posaconazole showed that wild type accounted for 66.67％, 100.00％, and 100.00％ respectively.Conclusion Candida tropicalis is the most common pathogenic fungus causing candidemia in Nanchang of Jiangxi, followed by Candida albicans and Candida parapsilosis complex.Azole, echinocandin, and amphotericin B are still first-line antifungal agents.

The fine structure of enoxaparin sodium samples with different degree of 1,6-anhydro derivatives were analyzed with polyacrylamide gel electrophoresis, high performance liquid chromatography, ultraviolet spectroscopy, infrared spectroscopy and nuclear magnetic resonance spectroscopy. A further study of anticoagulation activity of enoxaparins was performed, including those on their inhibition activities of coagulation factor Xa (FXa) and thrombin (FIIa). The results showed that the anti-FXa and -FIIa activities of enoxaparins with different degree of 1,6-anhydro derivatives (20.0%-39.7%) with similar structure characteristics, had decreasing tendency when the degree of 1,6-anhydro derivatives increased. Especially, the anti-FXa activity was sensitive to the change of the degree of 1,6-anhydro derivatives.

The aim of the present study is to investigate the effects of sequoyitol (Seq) on expression of eNOS and NOX4 in aortas of type 2 diabetic rats. Type 2 diabetic rats induced by high fat and high sugar diet and low dose of streptozotocin (STZ, 35 mg x kg(-1)) and were administered Seq (12.5, 25 and 50 mg x kg(-1) x d(-1)) for 6 weeks. The fasting blood glucose (FBG) and body weight were tested. Acetylcholine (Ach) induced endothelium-dependent relaxation and sodium nitroprusside (SNP) induced endothelium-independent relaxation were measured in aortas for estimating endothelial function. Aortic morphological change was observed with HE staining. The level of serum insulin was measured by radioimmunoassay. The total antioxidative capacity (T-AOC), malondialdehyde (MDA) and NO levels in aortas were determined according to the manufacturer's instructions. In addition, the expressions of eNOS and NOX4 in aortas were measured by immunohistochemisty, real-time PCR or Western blotting. The results showed that Seq significantly decreased FBG and insulin resistance, and improved aortic endothelium-dependent vasorelaxation function. The expressions of NOX4 and MDA content were obviously decreased, while the expression of eNOS, the levels of NO and T-AOC increased significantly in aortas of diabetic rats with Seq treatment. In conclusion, Seq protects against aortic endothelial dysfunction of type 2 diabetic rats through down-regulating expression of NOX4 and up-regulating eNOS expression.

This study is to observe the effects of sequoyitol on the expression of NADPH oxidase subunits p22 phox and p47 phox in rats with type 2 diabetic liver diseases. The model of high fat and high sugar diet as well as intraperitoneal injection of small dose of streptozotocin (STZ, 35 mg x kg(-1)) induced diabetic rat liver disease was used. After sequoyitol (50, 25 and 12.5 mg x kg(-1)) was administrated for 6 weeks, the contents of blood glucose (BG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total antioxidant capacity (T-AOC), hydrogen peroxide (H2O2), NO and insulin (Ins) were measured, liver p22 phox and p47 phox mRNA content was determined with real-time PCR and the expression of p22 phox and p47 phox protein was examined by Western blotting. In addition, pathological changes in liver were observed with HE staining. Sequoyitol could reduce the content of fasting blood glucose, ALT, AST, Ins and H2O2, restore insulin sensitive index (ISI) and weight, elevate liver tissue T-AOC and NO content, reduce the NADPH oxidase subunit liver tissue p22 phox and p47 phox mRNA and protein expression, as well as ameliorate liver pathologic lesions. The results showed that sequoyitol can ease the type 2 diabetic rat liver oxidative stress by lowering NADPH oxidase expression.