Diabetic retinopathy is one of the most common and specific chronic complications of diabetes mellitus,which is a serious and irreversible progressive blinding eye disease.The visual im-pairment caused by the progression of the disease and the economic burden caused by the treatment of the disease lead to psychological problems such as anxiety and depression,affecting the quality of life and physical and mental health,and increasing the burden on the family and society.This article re-viewed the current status of epidemiological research on DR,discussed the correlation of DR with anxiety and depression and its influencing factors,analyzed the research progress of evaluation and in-tervention methods,aiming to provide assistance for improving patients'treatment compliance and quality of life.

Objectives:To quantitatively evaluate the relationship between triglyceride-glucose index and stroke risk by a dose-response meta-analysis.Methods:Prospective cohort studies on the association between triglyceride-glucose(TyG)index and stroke risk were searched by computer in China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform,VIP,China Biomedical Literature Database,PubMed,Embase and Web of Science.The retrieval time was from the self-established database to November 7,2024.Two researchers used the Newcastle-Ottawa Scale(NOS)to evaluate literature quality and then extract relevant data for the included literatures.Stata 17.0 software was used for statistical analysis.Results:A total of 17 prospective literatures were included,involving 449 210 subjects,including 28 506 patients with stroke.The results of meta-analysis showed that the TyG index was positively correlated with the risk of stroke(HR=1.60,95%CI:1.45-1.76,P<0.05).The results of dose-response meta-analysis showed that there was a positive correlation between the TyG index and the risk of stroke,and every 1 unit increase of the TyG index,the risk of stroke increased by 20.2%.According to Egger's test,the P value is 0.962,and the P value of Begg's test is 0.967,indicating that there was no publication bias in the literature included in this study.Conclusions:There is a linear dose-response relationship between TyG index and stroke risk,and higher TyG index can increase the risk of stroke.

Objective To explore the effect of the pneumatic and electric hand training system with multiple sensory stimulation mo-dalities combined with low-frequency repetitive transcranial magnetic stimulation on hand movement and tactile pressure sensation in patients with stroke.Methods From May,2023 to October,2024,62 stroke patients from the First Affiliated Hospital of University of South China were randomly divided into control group(n=31)and experimental group(n=31).Both groups received conventional rehabilitation,and 1 Hz low-frequency repetitive transcranial magnetic stimulation in the primary cerebral motor cortex on the unaffected side,while the experimental group received the pneumatic and electric hand training system with multiple sensory stimulation modalities in addition,for four weeks.They were as-sessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE),Motor Assessment Scale(MAS),Semmes Weinstein Monofilament Test(SWMT)and modified Barthel index(MBI)before and after treatment.Results One case dropped out in control group and one in the experimental group.After treatment,the scores of FMA-UE,MAS,SWMT and MBI increased in both groups(|t|>5.464,P<0.001),expect the score of SWMT in the control group(P>0.05),and all scores were better in the experimental group than in the control group(|t|>2.195,P<0.05).Conclusion The pneumatic and electric hand training system with multiple sensory stimulation modalities combined with low-frequency repetitive transcranial magnetic stimulation can improve the motor and tactile pressure func-tion of stroke patients,and improve their activity of daily living.

Objectives:To quantitatively evaluate the relationship between triglyceride-glucose index and stroke risk by a dose-response meta-analysis.Methods:Prospective cohort studies on the association between triglyceride-glucose(TyG)index and stroke risk were searched by computer in China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform,VIP,China Biomedical Literature Database,PubMed,Embase and Web of Science.The retrieval time was from the self-established database to November 7,2024.Two researchers used the Newcastle-Ottawa Scale(NOS)to evaluate literature quality and then extract relevant data for the included literatures.Stata 17.0 software was used for statistical analysis.Results:A total of 17 prospective literatures were included,involving 449 210 subjects,including 28 506 patients with stroke.The results of meta-analysis showed that the TyG index was positively correlated with the risk of stroke(HR=1.60,95%CI:1.45-1.76,P<0.05).The results of dose-response meta-analysis showed that there was a positive correlation between the TyG index and the risk of stroke,and every 1 unit increase of the TyG index,the risk of stroke increased by 20.2%.According to Egger's test,the P value is 0.962,and the P value of Begg's test is 0.967,indicating that there was no publication bias in the literature included in this study.Conclusions:There is a linear dose-response relationship between TyG index and stroke risk,and higher TyG index can increase the risk of stroke.

Objective To explore the effect of the pneumatic and electric hand training system with multiple sensory stimulation mo-dalities combined with low-frequency repetitive transcranial magnetic stimulation on hand movement and tactile pressure sensation in patients with stroke.Methods From May,2023 to October,2024,62 stroke patients from the First Affiliated Hospital of University of South China were randomly divided into control group(n=31)and experimental group(n=31).Both groups received conventional rehabilitation,and 1 Hz low-frequency repetitive transcranial magnetic stimulation in the primary cerebral motor cortex on the unaffected side,while the experimental group received the pneumatic and electric hand training system with multiple sensory stimulation modalities in addition,for four weeks.They were as-sessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE),Motor Assessment Scale(MAS),Semmes Weinstein Monofilament Test(SWMT)and modified Barthel index(MBI)before and after treatment.Results One case dropped out in control group and one in the experimental group.After treatment,the scores of FMA-UE,MAS,SWMT and MBI increased in both groups(|t|>5.464,P<0.001),expect the score of SWMT in the control group(P>0.05),and all scores were better in the experimental group than in the control group(|t|>2.195,P<0.05).Conclusion The pneumatic and electric hand training system with multiple sensory stimulation modalities combined with low-frequency repetitive transcranial magnetic stimulation can improve the motor and tactile pressure func-tion of stroke patients,and improve their activity of daily living.

Purpose To study the association between ultrasonography signs of midurethral sling(MUS)and postoperative bladder neck mobility,and urethral segmental mobility,to explore ultrasound parameters that measure the biomechanical effects of MUS and to analyze the relationship between them and the clinical outcomes.Materials and Methods This was a retrospective analysis of the clinical material and ultrasound imaging data of the patients who underwent MUS surgery and had postoperative clinic follow-up in the Second Xiangya Hospital,Central South University,from September 2017 to July 2022.According to the surgical outcome,all patients were divided into three groups:stress urinary incontinence(SUI)cure group,SUI recurrence group and postoperative voiding dysfunction(VD)group.Bladder neck mobility,urethral segmental mobility,MUS position,and sling-pubic gap(SPG)during maximal Valsalva manoeuvre were measured by pelvic floor ultrasound.Ultrasound results among the three groups were compared,respectively.The relationships between ultrasound signs of the sling(MUS position and SPG),bladder neck and urethral mobility,and the surgical outcomes were analyzed,respectively.Results A total of 117 women had valid data.The median follow-up interval was 10(6,18)months.On clinical examination and diagnosis,44 women(37.6％)had cured SUI,46(39.3％)had recurrence SUI,and 27(23.1％)had postoperative VD.The mean SPG of the 117 slings was(12.0±3.5)mm(range 4.7 to 23.0 mm),and the mean position of the MUS was the 53％(range 33％-75％).There was no significant difference in MUS position and SPG between the SUI cured group and the postoperative VD group(P＞0.05).The SUI recurrence group had farther MUS position[(56±11)％vs.(49±10)％,P=0.003]relative to the bladder neck and wider SPG[(13.9±3.7)mm vs.(11.2±2.7)mm,P＜0.001]than SUI cure group.No significant correlation was found between the ultrasound signs of MUS(MUS position and SPG)and bladder neck mobility(r=-0.138-0.205,all P≥0.05).MUS position and SPG were correlated with midurethral mobility(MUS position vs.point 2 and 3,r=0.322,0.322,both P＜0.01;SPG vss.point 3 to 6,r=0.288-0.434,all P＜0.01):the closer the MUS position was relative to the distal urethra,the higher the midurethral mobility.The wider the SPG,the higher the midurethral mobility.Logistic regression showed a positive correlation between SPG and SUI recurrence with an odds ratio(OR)of 1.401(95％CI 1.189-1.652,P＜0.001),and a negative correlation with postoperative VD with an OR of 0.755(95％CI 0.627-0.909,P=0.003).Conclusion SPG during the Valsalva manoeuvre can be used to measure the tightness of MUS.The larger the measured value of SPG,with the looser the MUS,the greater the likelihood of postoperative SUI recurrence,and the lower the risk of postoperative VD.

Objective:To study the agreements between transperineal ultrasound (TPUS) and endoanal ultrasound in assessing obstetrics anal sphincter injury (OASI), and to analyse the diagnostic efficacy of OASI in predicting AI relationship between OASI and anal incontinence (AI).Methods:A total of 217 women were prospectively recruited from the clinic in the Second Xiangya Hospital of Central South University from January 2021 to May 2022. Symptoms of AI were determined using the St Mark′s Incontinence Score (SMIS). TPUS and EAUS were performed by the same operator with the same machine on every participant for detecting OASI: OASI grades 3a, 3b, 3c, and 4 were performed according to the extent of the injuries in the anal sphincter complex. The angle of the defect in the external anal sphincter (EAS) was measured. A "significant EAS defect" was diagnosed as a defect affecting at least 2/3 of the length of the EAS with a defect angle of ≥30° in each slice.Ultrasound findings were compared between the two methods. The diagnostic efficacy of "ultrasound OASI" in predicting AI was analysed by logistic regression.Results:Of 217 women, twenty-eight (12.9%) suffered from AI with SMIS ranging from 5~20(11.9±4.5). On TPUS, 79 (36.4%) cases were suspected of OASI, that was 50 OASI 3a, 13 OASI 3b, and 16 OASI 3c/4. On EAUS, 78 (35.9%) cases were suspected of OASI that was 23 OASI 3a, 22 OASI 3b, 15 OASI 3c, and 18 OASI 4. Twenty-four "significant EAS defects" were diagnosed by TPUS and twenty-eight by EAUS, TPUS had excellent agreement with EAUS (weighted Kappa=0.91, P<0.001). Logistic regression analysis showed that "ultrasound OASI" was associated with AI symptoms. ROC curve analysis showed that the area under the curve (AUC) was 0.92, 0.87, 0.89, 0.92 for TPUS OASI 3b+ , EAUS OASI 3b+ , TPUS "Significant EAS defect" , and EAUS "Significant EAS defect" for predicting AI, respectively. Conclusions:TPUS has good agreement with EAUS in detecting OASI. OASI 3b+ and "significant EAS defect" on TPUS and EAUS had good performance in predicting AI symptoms.

Objective:To investigate the effect and molecular mechanism of tumor necrosis factor-α-inducible protein 8-like 2(TIPE2)on lipopolysaccharide(LPS)or interleukin-4(IL-4)-induced phenotypic switch of adipose tissue macrophages(ATM).Methods:The expression levels of TIPE2, inducible nitric oxide synthase(iNOS), monocyte chemoattractant protein 1(MCP-1), CD206, and arginase 1(Arg-1)in the visceral adipose tissue of obese mice, TIPE2-knockout(KO)mice, and control mice were detected by immunohistochemistry, Western blotting, and real-time PCR(RT-qPCR). Peritoneal macrophages isolated from KO and wild-type mice and RAW 264.7 mouse macrophage cell line were cultured, and then stimulated with LPS(100 ng/mL)or IL-4(20 ng/mL)for 6 hours. The expression levels of TIPE2, iNOS, MCP-1, CD206, and Arg-1 were detected by Western blotting and RT-qPCR.Results:Obese mice showed down-regulated TIPE2 expression, up-regulated pro-inflammatory markers iNOS and MCP-1 expressions, and down-regulated anti-inflammatory markers CD206 and Arg-1 expressions. LPS decreased the expression of TIPE2 in RAW 264.7 cells and peritoneal macrophages from mice, increased the expression of the classically activated macrophages(M1 phenotype)markers iNOS and MCP-1, and decreased the expression of the substituting activated macrophages(M2 phenotype)markers CD206 and Arg-1. IL-4 increased the expression of TIPE2 in RAW 264.7 cells and peritoneal macrophages, decreased the expression of iNOS and MCP-1, and increased the expression of CD206 and Arg-1. During the M1 polarization of macrophages, LPS increased toll-like receptor(TLR4)expression as well as nuclear transcription factor κBα suppressor protein(IκBα) and NF-κB phosphorylations in macrophages. Knockout of TIPE2 further increased the expression of the TLR4/IκBα/NF-κB signaling pathway and M1 macrophage markers, and further reduced the expression of the M2 macrophage markers.Conclusion:TIPE2 regulates ATM phenotypic transformation through inhibition of the TLR4/IκBα/NF-κB signaling pathway, which ameliorates adipose tissue inflammation in obese states.

The stem and branch extract of Tripterygium wilfordii (Celastraceae) afforded seven new dihydroagarofuran sesquiterpene polyesters [tripterysines A-G (1-7)] and eight known ones (8-15). The chemical structures of these new compounds were established based on combinational analysis of HR-ESI-MS and NMR techniques. The absolute configurations of tripterysines A-C (1-3) and E-G (5-7) were determined by X-ray crystallographic analysis and circular dichroism spectra. All the compounds were screened for their inhibitory effect on inflammation through determining their inhibitory effect on nitric oxide production in LPS-induced RAW 264.7 cells and the secretion of inflammatory cytokines TNF-α and IL-6 in LPS-induced BV2 macrophages. Compound 9 exhibited significant inhibitory activity on NO production with an IC₅₀ value of 8.77 μmol·L^-1. Moreover, compound 7 showed the strongest inhibitory effect with the secretion of IL-6 at 27.36%.
Tripterygium/chemistry* ; Esters/pharmacology* ; Interleukin-6 ; Lipopolysaccharides/pharmacology* ; Plant Leaves/chemistry* ; Anti-Inflammatory Agents/chemistry* ; Nitric Oxide/analysis* ; Sesquiterpenes/chemistry* ; Molecular Structure

To investigate the clinical features and influencing factors for new-onset atrial fibrillation (AF) early after coronary artery bypass grafting. Methods    The clinical data of 339 patients undergoing coronary artery bypass grafting in our hospital from January 2012 to January 2019 were retrospectively analyzed. There were 267 males and 72 females with an average age of 37-83 (58.03±8.90) years. The clinical features and influencing factors for new-onset AF after surgery were investigated. Results    There were 234 patients of off-pump coronary artery bypass grafting (OPCABG), with 36 (15.4%) new-onset AF patients after operation, among whom 16.1% were males and 12.5% were females. There were 105 patients of on-pump coronary artery bypass grafting (CABG), with 39 (37.1%) new-onset AF patients, among whom 40.7% were males and 25.0% were females. The incidence was higher after the CABG surgery than that after the OPCABG surgery (37.1% vs. 15.4%, P<0.05). There was no statistical difference in the incidence rate between males and females (P>0.05). The incidence of new-onset AF after surgery was higher in ≥60 years patients for both  operations (18.9% and 45.8%), which was significantly higher than that in <45 years patients (P<0.05). For both operations, the incidence of new-onset AF after surgery was high on the second day (24-48 h) after surgery, and most of the AF lasted for 1 day (P<0.05). The hypertension (OR=4.983, P=0.036), frequent premature atrial contraction or atrial tachycardia (OR=17.682, P=0.002), postoperative creatine kinase isoenzyme MB (CKMB) (OR=0.152, P=0.042), left anterior and posterior diameters (OR=17.614, P<0.001) and preoperative ejection fraction (OR=7.094, P=0.011) were influencing factors for new-onset AF after OPCABG. Diabetes (OR=11.631, P=0.020), other cardiac malformations (OR=29.023, P=0.002), frequent premature ventricular contraction or ventricular tachycardia (OR=0.047, P=0.001), and postoperative CKMB (OR=3.672, P=0.040) were influencing factors for new-onset AF after CABG. Conclusion    The incidence of new-onset AF after CABG is higher than that after OPCABG, and it increases with age increasing. There is no difference in the incidence between males and females. The influencing factors for the two operations are different.