Objective To investigate the risk factors and establish a line graph model for diabetic retinopathy(DR)and diabetic macular edema(DME)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 446 patients with T2DM admitted to our hospital from June 2017 to January 2020 were selected and divided into DR/DME group(n=80)and T2DM group(n=366)according to whether they were complicated with DR and DME.Univariate and multivariate analysis were performed on the clinical data to obtain the influencing factors,and a nomogram model was constructed to evaluate the model.Results The DM duration,proportion of short axial length,FPG,HbA1c,TC and LDL-C in the DR/DME group were higher than those in the T2DM group,and the age and eGFR were lower than those in the T2DM group(P<0.05).DM duration(OR 16.380,95%CI 10.697～29.133),eGFR(OR 13.510,95%CI 5.393～33.863),HbA1c(OR 2.820,95%CI 1.064～5.610)and short axial length(OR 7.062,95%CI 1.153～43.265)were the influencing factors of DR and DME in T2DM patients.The AUC of the nomogram model was 0.906.The consistency index(0.957)and calibration curve showed that the model had good discrimination and consistency.Conclusions The DM duration,eGFR,HbA1c and short eye axis are closely related to DR and DME in T2DM patients,and the column line graph model based on this analysis has high predictive efficacy.

Objective To investigate the risk factors and establish a line graph model for diabetic retinopathy(DR)and diabetic macular edema(DME)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 446 patients with T2DM admitted to our hospital from June 2017 to January 2020 were selected and divided into DR/DME group(n=80)and T2DM group(n=366)according to whether they were complicated with DR and DME.Univariate and multivariate analysis were performed on the clinical data to obtain the influencing factors,and a nomogram model was constructed to evaluate the model.Results The DM duration,proportion of short axial length,FPG,HbA1c,TC and LDL-C in the DR/DME group were higher than those in the T2DM group,and the age and eGFR were lower than those in the T2DM group(P<0.05).DM duration(OR 16.380,95%CI 10.697～29.133),eGFR(OR 13.510,95%CI 5.393～33.863),HbA1c(OR 2.820,95%CI 1.064～5.610)and short axial length(OR 7.062,95%CI 1.153～43.265)were the influencing factors of DR and DME in T2DM patients.The AUC of the nomogram model was 0.906.The consistency index(0.957)and calibration curve showed that the model had good discrimination and consistency.Conclusions The DM duration,eGFR,HbA1c and short eye axis are closely related to DR and DME in T2DM patients,and the column line graph model based on this analysis has high predictive efficacy.

ChuanWu (CW), the dried mother root of Aconitum carmichaelii Debx., is a well-known traditional Chinese medicine (TCM) recognized for its potent efficacy but inherent toxicity, primarily due to its alkaloid content. Traditional and modern detoxification methods for CW include proper processing, rational compatibility, and specialized decoction techniques, among which honey-boiled CW is particularly distinctive. However, research on the detoxification mechanism of honey-boiled CW remains limited. This study investigated this mechanism by analyzing alkaloid transformation and supramolecular aggregation. Honey-boiled and water-boiled CW preparations were compared. Ultra-high-performance liquid chromatography-tandem mass spectrometry was used to analyze CW alkaloids, specifically diester alkaloids (DDAs), monoester alkaloids (MDAs), and non-esterified diterpenoid alkaloids (NDAs). Transmission electron microscopy was employed to observe and identify supramolecular aggregates in the honey-boiled CW decoction. In vivo absorption of water-boiled, honey-boiled, and NADES-boiled CW was compared. Median lethal dose (LD₅₀) tests assessed toxicity, including hepatotoxicity and nephrotoxicity. In vitro experiments evaluated the safety, anti-inflammatory, and analgesic effects of CW-medicated serum on RAW264.7 cells, with in vivo validation in mice. Results showed that honey promoted the conversion of highly toxic DDAs to less toxic MDAs and prevented MDAs from hydrolyzing into NDAs. Honey-boiled CW formed approximately 250 nm supramolecular aggregates that encapsulated MDAs, inhibiting their conversion to NDAs. These encapsulated MDAs acted as a stable delivery system with higher bioavailability than free benzoylmesaconine. Subsequent mouse experiments confirmed that honey-boiled CW significantly increased the LD₅₀ of CW while reducing hepatotoxicity and nephrotoxicity. Additionally, honey-boiled CW significantly improved cell safety and enhanced anti-inflammatory and analgesic effects. Our findings reveal that honey-boiled CW exhibits a potent detoxification mechanism by influencing alkaloid transformation and facilitating the formation of supramolecular aggregates. This study lays the groundwork for developing detoxification or synergistic strategies within honey-boiled TCM.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

AIM:To investigate the impact of Kir2.1 channels on abnormal spontaneous pacemaker activities induced by hypokalemia and to elucidate the underlying mechanisms.METHODS:Human induced pluripotent stem cell-derived cardiomyocytes(hiPSC-CMs)were transfected with lentiviral particles containing sequences for human Kir2.1,the Kir2.1-E224G mutant,or Kir4.1.Patch clamp techniques were employed to examine the effects of low extracellular potassium concentration([K+]e)of 1 mmol/L on the resting membrane potentials and whole-cell currents of the cells in each group,assessed via both current and voltage clamp modes.RESULTS:Under conditions of 1 mmol/L[K+]e,cur-rent clamp data revealed that hiPSC-CMs overexpressing Kir2.1 channels exhibited both hyperpolarized and depolarized resting membrane potentials,with the depolarized state triggering abnormal pacemaker activities.In contrast,cells overex-pressing the Kir2.1-E224G mutant or Kir4.1 channels displayed only hyperpolarized resting membrane potentials.Voltage clamp analysis indicated that hiPSC-CMs overexpressing Kir2.1 channels produced"N"-shaped whole-cell currents,whereas cells expressing the Kir2.1-E224G mutant or Kir4.1 exhibited typical K+currents.CONCLUSION:Kir2.1 channels play a crucial role in mediating hypokalemia-induced abnormal spontaneous pacemaker activities in human car-diomyocytes through their inward rectification properties.

AIM:To investigate the impact of Kir2.1 channels on abnormal spontaneous pacemaker activities induced by hypokalemia and to elucidate the underlying mechanisms.METHODS:Human induced pluripotent stem cell-derived cardiomyocytes(hiPSC-CMs)were transfected with lentiviral particles containing sequences for human Kir2.1,the Kir2.1-E224G mutant,or Kir4.1.Patch clamp techniques were employed to examine the effects of low extracellular potassium concentration([K+]e)of 1 mmol/L on the resting membrane potentials and whole-cell currents of the cells in each group,assessed via both current and voltage clamp modes.RESULTS:Under conditions of 1 mmol/L[K+]e,cur-rent clamp data revealed that hiPSC-CMs overexpressing Kir2.1 channels exhibited both hyperpolarized and depolarized resting membrane potentials,with the depolarized state triggering abnormal pacemaker activities.In contrast,cells overex-pressing the Kir2.1-E224G mutant or Kir4.1 channels displayed only hyperpolarized resting membrane potentials.Voltage clamp analysis indicated that hiPSC-CMs overexpressing Kir2.1 channels produced"N"-shaped whole-cell currents,whereas cells expressing the Kir2.1-E224G mutant or Kir4.1 exhibited typical K+currents.CONCLUSION:Kir2.1 channels play a crucial role in mediating hypokalemia-induced abnormal spontaneous pacemaker activities in human car-diomyocytes through their inward rectification properties.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

Objective To explore the changes of hepatic and pancreatic fat content in patients with type 2 diabetes mellitus(T2DM)using quantitative MRI,and to discuss the relationship with pancreatic β-cell function and bone mineral density(BMD).Methods A total of 118 patients with T2DM(T2DM group)were selected as the research subjects.At the same time,100 healthy control(HC)(HC group)who received physical examination were selected.All patients were examined with MRI.Hepatic fat fraction(HFF)and pancreatic fat fraction(PFF)were detected using the iterative decomposition of water and fat with echo asymmetry and least square estimation quantitation(IDEAL-1Q)technology.The homeostasis model assessment of β-cell function(HOMA-β)and homeostasis model assessment of insulin resistance(HOMA-IR)were performed.BMD of L2-L4,femoral neck and total hip were measured by dual-energy X-ray absorptiometry.The correlations among HFF,PFF and HOMA-β,HOMA-IR and BMD of L2-L4,femoral neck and total hip were analyzed by Pearson method.Results HFF and PFF in the T2DM group[(14.12±2.19)％and(8.23±1.60)％]were higher than those in the HC group[(5.30±0.83)％and(4.36±0.85)％],with statistically significant differences(P＜0.05).HOMA-βand BMD of L2-L4,femoral neck and total hip in the T2DM group[14.50±3.63,(0.92±0.13)mg/cm3,(0.77±0.10)mg/cm3 and(0.83±0.12)mg/cm3]were lower than those in the HC group[25.22±5.43,(1.05±0.23)mg/cm3,(0.85±0.18)mg/cm3 and(0.91±0.20)mg/cm3].HOMA-IR in the T2DM group(3.56±1.22)was higher than that in the HC group(1.90±0.45).The differences were statistically significant(P＜0.05).Pearson correlation analysis found that HFF and PFF were negatively correlated with HOMA-β and BMD of L2-L4,femoral neck and total hip,and were positively correlated with HOMA-IR(P＜0.05).Conclusion MRI can be used to quantitatively evaluate hepatic and pancreatic fat content in patients with T2DM.In addition,hepatic and pancreatic fat content are closely related to pancreatic HOMA-β,HOMA-IR and BMD.

ObjectiveTo observe the clinical efficacy of Qiju Dihuangtang combined with Chinese medicine fumigation in the treatment of dry eye and its effect on the levels of interleukin-6 （IL-6） and matrix metalloproteinase-9 （MMP-9） in tears. MethodA total of 120 patients with dry eye of liver-kidney Yin deficiency syndrome who were treated in the Department of Ophthalmology， The Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine（TCM） from october 2019 to october 2021 were randomized into the observation group and control group. The control group was given sodium hyaluronate eye drops， and the observation group was treated with sodium hyaluronate eye drops， Qiju Dihuangtang， and Chinese medicine fumigation. The treatment lasted 30 days for both groups. The changes of ocular surface disease index （OSDI）， TCM syndrome score， tear secretion （SIT）， tear film breaking up time （BUT）， corneal fluorescein staining （FL）， and tear interleukin-6 （IL-6） and matrix metalloproteinase-9 （MMP-9） were observed. ResultAfter the treatment， the total effective rate was 90.0% （54/60） in the observation group and 75.0% （45/60） in the control group （χ²=4.675， P<0.05）. After treatment， the OSDI score and TCM syndrome score were lower than those before treatment in both groups （P<0.05）， and lower in the observation group than in the control group （P<0.05）. After treatment， the SIT and BUT were higher （P<0.05） and FL score was lower （P<0.05） than those before treatment in both groups. After treatment， the improvement of the above indicators in the observation group was better than that in the control group （P<0.05）. After treatment， the levels of IL-6 and MMP-9 were lower than those before treatment in both groups （P<0.05）， and lower in the observation group than in the control group （P<0.05）. ConclusionQiju Dihuangtang combined with Chinese medicine fumigation can effectively improve subjective symptoms， promote tear secretion， prolong BUT， enhance corneal epithelial repair， and reduce the levels of tear IL-6 and MMP-9 in the treatment of dry eye.