Objective:Acute kidney injury(AKI) is a common complication after cardiac surgery, and associated with increased risk of development of chronic kidney disease and mortality in the long term. Neutrophil percentage-to-albumin ratio(NPAR) is a new inflammatory marker that has been used to predict the poor prognosis of patients with cardiovascular disease or shock. However, the relationship between NPAR and AKI in patients with cardiac surgery has not been established. The aim was to evaluate the relationship between NPAR and AKI after cardiac surgery.Methods:Data of all adult patients underwent cardiac surgery with cardiopulmonary bypass from January 1, 2006 to December 31, 2018 were extracted from electronic medical record system of the Guangdong Provincial People's Hospital and retrospectively analyzed. The outcome of interest was AKI diagnosed by using the criteria of Kidney Disease Improving Global Outcomes. Logistic regression was used to assess the relationship between NPAR and postoperative AKI while adjust for potential confounders. In addition, restricted cubic spline(RCS) was utilized to provide a flexible description of the association of the preoperative NPAR and AKI. Results:Totally, 24 178 patients were analyzed. The incidence of AKI was 30.1%. Compared with patients without AKI, those with AKI were older and had higher rates of males, left ventricular ejection fraction(LVEF) less than or equal to 0.60, estimated glomerular filtration rate less than 90 ml·min -1·1.73 m -2, hypertension, diabetes, emergency surgery, preoperative critical illness, and reoperation. The baseline serum creatinine, serum uric acid, cardiopulmonary bypass time and postoperative mechanical ventilation time were higher or longer in AKI patients than those in none AKI patients. Then, patients were divided into four groups based on NPAR quartiles. After adjusting for confounding factors using logisitc regression, compared with patients with NPAR in group 3(1.551.97), respectively. The RCS showed a U-shaped nonlinear relationship( P for nonlinear less than 0.001) between NPAR and AKI after adjusting for potential confounding factors. RCS indicated the NPAR of 1.77 was the lowest risk for AKI. When NPAR less than 1.77, per 1-standard deviation(SD) increase in NPAR, the risk of AKI decreased by 23.2%( OR=0.768, 95% CI: 0.687, 0.859). Conversely, when NPAR above 1.77, per one SD increase in NPAR, the risk of AKI increased by 25.9%( OR=1.259, 95% CI: 1.166, 1.36). Conclusion:A U-shaped relationship between NPAR and AKI after cardiac surgery was shown. The appropriate value for NPAR might be 1.77. The risk of AKI might be increased, when less or above this value. NPAR might be used as an effective and economical tool to identify AKI risk among individuals with cardiac surgery, as well as to formulate individualized prevention and intervention strategy.

Objective:Acute kidney injury(AKI) is a common complication after cardiac surgery, and associated with increased risk of development of chronic kidney disease and mortality in the long term. Neutrophil percentage-to-albumin ratio(NPAR) is a new inflammatory marker that has been used to predict the poor prognosis of patients with cardiovascular disease or shock. However, the relationship between NPAR and AKI in patients with cardiac surgery has not been established. The aim was to evaluate the relationship between NPAR and AKI after cardiac surgery.Methods:Data of all adult patients underwent cardiac surgery with cardiopulmonary bypass from January 1, 2006 to December 31, 2018 were extracted from electronic medical record system of the Guangdong Provincial People's Hospital and retrospectively analyzed. The outcome of interest was AKI diagnosed by using the criteria of Kidney Disease Improving Global Outcomes. Logistic regression was used to assess the relationship between NPAR and postoperative AKI while adjust for potential confounders. In addition, restricted cubic spline(RCS) was utilized to provide a flexible description of the association of the preoperative NPAR and AKI. Results:Totally, 24 178 patients were analyzed. The incidence of AKI was 30.1%. Compared with patients without AKI, those with AKI were older and had higher rates of males, left ventricular ejection fraction(LVEF) less than or equal to 0.60, estimated glomerular filtration rate less than 90 ml·min -1·1.73 m -2, hypertension, diabetes, emergency surgery, preoperative critical illness, and reoperation. The baseline serum creatinine, serum uric acid, cardiopulmonary bypass time and postoperative mechanical ventilation time were higher or longer in AKI patients than those in none AKI patients. Then, patients were divided into four groups based on NPAR quartiles. After adjusting for confounding factors using logisitc regression, compared with patients with NPAR in group 3(1.551.97), respectively. The RCS showed a U-shaped nonlinear relationship( P for nonlinear less than 0.001) between NPAR and AKI after adjusting for potential confounding factors. RCS indicated the NPAR of 1.77 was the lowest risk for AKI. When NPAR less than 1.77, per 1-standard deviation(SD) increase in NPAR, the risk of AKI decreased by 23.2%( OR=0.768, 95% CI: 0.687, 0.859). Conversely, when NPAR above 1.77, per one SD increase in NPAR, the risk of AKI increased by 25.9%( OR=1.259, 95% CI: 1.166, 1.36). Conclusion:A U-shaped relationship between NPAR and AKI after cardiac surgery was shown. The appropriate value for NPAR might be 1.77. The risk of AKI might be increased, when less or above this value. NPAR might be used as an effective and economical tool to identify AKI risk among individuals with cardiac surgery, as well as to formulate individualized prevention and intervention strategy.

Objective:To explore the cause of inconsistency between the results of trisomy 7 by expanded non-invasive prenatal testing (NIPT-PLUS) and trisomy 18 by prenatal diagnosis.Methods:A pregnant woman who received genetic counseling at Jiaozuo Maternal and Child Health Care Hospital on July 5, 2020 was selected as the study subject. NIPT-PLUS, systematic ultrasound and interventional prenatal testing were carried out. The middle segment and root of umbilical cord, center and edge of the maternal and fatal surface of the placenta were sampled for the validation by copy number variation sequencing (CNV-seq).Results:The result of NIPT-PLUS indicated that the fetus has trisomy 7. Systematic ultrasound has shown multiple malformations including atrioventricular septal defect, horseshoe kidney, and rocker-bottom feet. However, QF-PCR, chromosomal karyotyping analysis, and CNV-seq of amniotic fluid samples all showed that the fetus was trisomy 18. Validation using multiple placental samples confirmed that the middle segment of the umbilical cord contains trisomy 18, the center of the placenta contained trisomy 7, and other placental sites were mosaicism for trisomy 7 and trisomy 18. Notably, the ratio of trisomy 18 became lower further away from the umbilical cord.Conclusion:The false positive results of trisomy 7 and false negative trisomy 18 by NIPT-PLUS was probably due to the existence of placental mosaicism. Strict prenatal diagnosis is required needed aneuploidy is detected by NIPT-PLUS to exclude the influence of placental mosaicisms.

Objective To determine the chemical constituents in BSLYT by ultra-high performance liquid chromatography-mass spectrometry(UHPLC-MS/MS),and to establish a high-performance liquid chromatographic fingerprint of the material basis of BSLYT and the content determination of its six main constituents,mononoside,loganin,oroxin A,oroxin B,baicalein and astilbin,providing a reference for the quality control.Methods The mass spectrometry data were used to establish the fingerprints.The content of the main components in the BSLYT samples was calculated by using the external method,and the discrepency between different batches of samples were analyzed by combining with chemometric methods.Results A total of 69 compounds were identified by mass spectrometry,and 13 compounds were identified after comparison with high-performance liquid chromatography(HPLC).The similarity of the baseline characterization profiles of the 15 batches of BSLYT substances was above 0.90,and a total of 27 common peaks were identified.Cluster analysis(CA)classified the substance benchmarks into 2 classes,S1,S2,S5,S8,S9,S13,and S15 were clustered into one class,and S3,S4,S6,S7,S10-S12,and S16 were clustered into one class.By combining PCA and OPLS-DA,the chemical components affecting the baseline classification of the substances were screened and attributed to wood butterfly,cornelian cherry and cocos nigra,respectively.The contents of six components were determined by MICS,which ranged from 0.31%-0.51%,0.12%-0.22%,0.09%-0.19%,0.09%-0.24%,0.07%-0.18%,and 0.08%-0.29%for mononoside,loganin,oroxin A,oroxin B,baicalein and astilbin respectively.Conclusion The fingerprint and multi-indicator content determination method established in this paper are accurate and stable,which provide a basis for the quality control of the material benchmark of Kidney and Pharynx Formula and its related preparations.

Adipose progenitor cells(APCs) represent a prominent stromal cellular component of adipose tissue and are now identified as highly heterogenous populations. However, the role of APCs in regulating systemic metabolism remains unknown. Using single cell RNA-sequencing, we investigated the role of the APC subpopulations in regulating development of type 2 diabetes. CD9 + CD55 low APCs are the novel subset identified in this study, which is significantly increased in type 2 diabetic patients. Transplantation of these cells from type 2 diabetic patients into adipose tissue caused glycemic disturbance in mice. Depletion of pathogenic APCs improved obesity-related glycemic disturbance. Collectively, our data provide deeper insights into human APC functionality and highlights APCs as a potential therapeutic target to combat type 2 diabetes. This study has been published in Nature Communications, 2024, 15(1): 4827.

Objective To investigate the clinical efficacy of the anchor suture bridge technique in treating avulsion fractures at the tibial insertion point of the posterior cruciate ligament(PCL)in the knee joint.Methods In this study,we reviewed 80 patients with PCL tibial avulsion fractures treated using the anchor suture bridge technique in our department from February 2010 to December 2023.Follow-ups were conducted starting at 3 months post-surgery,then every 3 months until 12 months post-surgery.Clinical and follow-up data of each patient were analyzed.The Lysholm and Hospital for Special Surgery Knee-Rating Scale(HSS)scores of knee function before surgery and at the last follow-up were compared to assess the surgical treatment outcome.Results The 80 patients were followed up for an average of(12.16±1.08)months post-surgery.Re-examination X-rays showed that all fractures had healed,with an average healing time of(3.66±0.51)months.All patients recovered well,with primary healing of surgical incisions and no complications such as neurovascular injury,skin necrosis,incision infection,fracture displacement,or ligament laxity.Postoperative knee Lysholm and HSS scores were significantly higher than preoperative scores.At the last follow-up,the Lysholm score increased from(46.30±6.10)preoperatively to(90.85±3.27),and the HSS score increased from(45.30±5.80)to(91.15±2.66),with statistically significant differences(P＜0.025).Conclusion The anchor suture bridge technique is effective in treating avulsion fractures of the PCL tibial insertion point in the knee joint.It has a high safety profile and leads to good postoperative knee function recovery,with no serious postoperative complications,demonstrating excellent clinical efficacy.

Objectives:This study aimed to assess the efficacy and safety of bendamustine in combination with rituximab (BR regimen) for the treatment of newly diagnosed indolent B-cell non-Hodgkin's lymphoma (B-iNHL) and elderly mantle cell lymphoma (eMCL) .Methods:From December 1, 2020 to September 10, 2022, a multi-center prospective study was conducted across ten Grade A tertiary hospitals in Shandong Province, China. The BR regimen was administered to evaluate its efficacy and safety in newly diagnosed B-iNHL and eMCL patients, and all completed at least four cycles of induction therapy.Results:The 72 enrolled patients with B-iNHL or MCL were aged 24-74 years, with a median age of 55 years. Eastern Cooperative Oncology Group (ECOG) performance status scores of 0-1 were observed in 76.4% of patients, while 23.6% had scores of 2. Disease distribution included follicular lymphoma (FL) (51.4% ), marginal zone lymphoma (MZL) (33.3% ), eMCL (11.1% ), and the unknown subtype (4.2% ). According to the Ann Arbor staging system, 16.7% and 65.3% of patients were diagnosed with stage Ⅲ and stage Ⅳ lymphomas, respectively. Following four cycles of BR induction therapy, the overall response rate was 98.6%, with a complete response (CR) rate of 83.3% and a partial response (PR) rate of 15.3%. Only one eMCL patient experienced disease progression during treatment, and only one FL patient experienced a relapse. Even when evaluated using CT alone, the CR rate was 63.9%, considering the differences between PET/CT and CT assessments. The median follow-up duration was 11 months (range: 4-22), with a PFS rate of 96.8% and an OS rate of 100.0%. The main hematologic adverse reactions included grade 3-4 leukopenia (27.8%, with febrile neutropenia observed in 8.3% of patients), grade 3-4 lymphopenia (23.6% ), grade 3-4 anemia (5.6% ), and grade 3-4 thrombocytopenia (4.2% ). The main non-hematologic adverse reactions such as fatigue, nausea/vomiting, rash, and infections occurred in less than 20.0% of patients.Conclusion:Within the scope of this clinical trial conducted in China, the BR regimen demonstrated efficacy and safety in treating newly diagnosed B-iNHL and eMCL patients.

Objective:To investigate the relationship between NOD-like receptors 3 (NLRP3) inflammasomes mediated inflammatory response and the pathogenesis of depression, and to investigate the effect of fluoxetine on this process.Methods:120 male C57BL/6J (wild-type) mice were randomly divided into control group 1, control group 2, chronic unpredictable mild stress (CUMS) group, and CUMS plus fluoxetine group. Another 30 male C57BL/6J (NLRP3-/-) mice were selected as NLRP3-/- group. Control group 1 and control group 2 had No treatment; CUMS group, CUMS plus fluoxetine group, and NLRP3-/- group were given chronic unpredictable mild stimulation for six weeks. After modeling, mice in control group 2 and CUMS plus fluoxetine group were intraperitoneally injected with fluoxetine (10 mg/(kg·d)). In contrast, mice in the other three groups were injected with the same amount of normal saline every day for four weeks. Behavioral tests were performed once a week before and after stress stimulation. Tail venous blood was drawn immediately before stress stimulation, three weeks later and six weeks after stress stimulation and was centrifuged at 3000 r/min for 10 min. The supernatant was kept and frozen for future use. Serum levels of interleukin-1β(IL-1β) and interleukin-18 (IL-18) were detected by enzyme-linked immunosorbent assay. After drug intervention (10 mg/(kg·d) fluoxetine or the same volume of normal saline), the mice in each group underwent behavioral tests once a week. The results included the sugar water preference test, forced swimming test (FST), and tail suspension test (TST). Tail venous blood was drawn from mice in each group at 1, 3, and 4 weeks after fluoxetine administration, and the supernatant was centrifuged and stored for later use. Serum levels of IL-1β and IL-18 were detected by enzyme-linked immunosorbent assay. At the above time points, 5 mice in each group were sacrificed each time, and fresh hippocampal tissues were collected and stored at a low temperature. NLRP3, urinary winter peptidase (caspase-1), the induction of transcription factors-KB (nuclear factor-κB, NF-κB), IL-1β and the IL-18 in the hippocampus brain regions were detected by using Western Blot.Results:(1) Model establishment: After six weeks of CUMS, compared with control group 1 and control group 2, the sugar water consumption of mice in CUMS group and CUMS+fluoxetine group was significantly reduced, and the immobility time of FST and TST was significantly prolonged, which proved that the model establishment was successful. After CUMS, NLRP3-/- group mice did not show depression-like changes in FST, sugar water preference test, and TST, which indicated that the model failed to be established. (2) After intraperitoneal fluoxetine injection, there were no significant differences in sugar water consumption, FST and TST immobility time between control group 2 and control group 1 ( P>0.05), and the sugar water consumption of mice in CUMS plus fluoxetine group was significantly increased, compared with CUMS group ( P<0.05). The immobility time of FST and TST was significantly shortened ( P<0.05). (3) The results of the enzyme-linked immunosorbent assay showed that after stimulation of CUMS, compared with control group 1 and control group 2, the serum levels of IL-1β and IL-18 in CUMS group and CUMS plus fluoxetine group were significantly increased ( P<0.05), while NLRP3-/- group had no significant change ( P>0.05). After fluoxetine administration, the serum levels of IL-1β and IL-18 in CUMS plus fluoxetine group were significantly lower than those in CUMS group ( P<0.05). (4) Western blotting results showed that after stimulation of CUMS, compared with control group 1 and control group 2, mice brain hippocampus NLRP3 expression, caspase-1 activation and induction of transcription factors-κB (nuclear factor-κB, NF-κB), IL-1β, IL-18 expression significantly increased ( P<0.05) in CUMS and CUMS plus fluoxetine group. After fluoxetine treatment, mice brain hippocampus NLRP3 expression, caspase-1 activation, NF-κB, IL-1β, and IL-18 expression in CUMS plus fluoxetine group had a significant reduction (restored to control 1 group by 99%, 91%, 97%, 95%, and 97% respectively). Conclusion:(1) CUMS may bring more NLRP3, caspase-1, NF-κB, IL-1β, and IL-18 expression in mice hippocampus, which cannot be seen, in the NLRP3 gene knockout mice; (2) The fluoxetine treatment may significantly decrease the NLRP3, caspase-1, NF-κB, IL-1β, IL-18 expression on depressive model mice, and improve depressive behavior.

Objective:To investigate the relationship between NOD-like receptors 3 (NLRP3) inflammasomes mediated inflammatory response and the pathogenesis of depression, and to investigate the effect of fluoxetine on this process.Methods:120 male C57BL/6J (wild-type) mice were randomly divided into control group 1, control group 2, chronic unpredictable mild stress (CUMS) group, and CUMS plus fluoxetine group. Another 30 male C57BL/6J (NLRP3-/-) mice were selected as NLRP3-/- group. Control group 1 and control group 2 had No treatment; CUMS group, CUMS plus fluoxetine group, and NLRP3-/- group were given chronic unpredictable mild stimulation for six weeks. After modeling, mice in control group 2 and CUMS plus fluoxetine group were intraperitoneally injected with fluoxetine (10 mg/(kg·d)). In contrast, mice in the other three groups were injected with the same amount of normal saline every day for four weeks. Behavioral tests were performed once a week before and after stress stimulation. Tail venous blood was drawn immediately before stress stimulation, three weeks later and six weeks after stress stimulation and was centrifuged at 3000 r/min for 10 min. The supernatant was kept and frozen for future use. Serum levels of interleukin-1β(IL-1β) and interleukin-18 (IL-18) were detected by enzyme-linked immunosorbent assay. After drug intervention (10 mg/(kg·d) fluoxetine or the same volume of normal saline), the mice in each group underwent behavioral tests once a week. The results included the sugar water preference test, forced swimming test (FST), and tail suspension test (TST). Tail venous blood was drawn from mice in each group at 1, 3, and 4 weeks after fluoxetine administration, and the supernatant was centrifuged and stored for later use. Serum levels of IL-1β and IL-18 were detected by enzyme-linked immunosorbent assay. At the above time points, 5 mice in each group were sacrificed each time, and fresh hippocampal tissues were collected and stored at a low temperature. NLRP3, urinary winter peptidase (caspase-1), the induction of transcription factors-KB (nuclear factor-κB, NF-κB), IL-1β and the IL-18 in the hippocampus brain regions were detected by using Western Blot.Results:(1) Model establishment: After six weeks of CUMS, compared with control group 1 and control group 2, the sugar water consumption of mice in CUMS group and CUMS+fluoxetine group was significantly reduced, and the immobility time of FST and TST was significantly prolonged, which proved that the model establishment was successful. After CUMS, NLRP3-/- group mice did not show depression-like changes in FST, sugar water preference test, and TST, which indicated that the model failed to be established. (2) After intraperitoneal fluoxetine injection, there were no significant differences in sugar water consumption, FST and TST immobility time between control group 2 and control group 1 ( P>0.05), and the sugar water consumption of mice in CUMS plus fluoxetine group was significantly increased, compared with CUMS group ( P<0.05). The immobility time of FST and TST was significantly shortened ( P<0.05). (3) The results of the enzyme-linked immunosorbent assay showed that after stimulation of CUMS, compared with control group 1 and control group 2, the serum levels of IL-1β and IL-18 in CUMS group and CUMS plus fluoxetine group were significantly increased ( P<0.05), while NLRP3-/- group had no significant change ( P>0.05). After fluoxetine administration, the serum levels of IL-1β and IL-18 in CUMS plus fluoxetine group were significantly lower than those in CUMS group ( P<0.05). (4) Western blotting results showed that after stimulation of CUMS, compared with control group 1 and control group 2, mice brain hippocampus NLRP3 expression, caspase-1 activation and induction of transcription factors-κB (nuclear factor-κB, NF-κB), IL-1β, IL-18 expression significantly increased ( P<0.05) in CUMS and CUMS plus fluoxetine group. After fluoxetine treatment, mice brain hippocampus NLRP3 expression, caspase-1 activation, NF-κB, IL-1β, and IL-18 expression in CUMS plus fluoxetine group had a significant reduction (restored to control 1 group by 99%, 91%, 97%, 95%, and 97% respectively). Conclusion:(1) CUMS may bring more NLRP3, caspase-1, NF-κB, IL-1β, and IL-18 expression in mice hippocampus, which cannot be seen, in the NLRP3 gene knockout mice; (2) The fluoxetine treatment may significantly decrease the NLRP3, caspase-1, NF-κB, IL-1β, IL-18 expression on depressive model mice, and improve depressive behavior.

Objective: To observe the effect of 25G pars plana vitrectomy (PPV) combined with or without internal limiting membrane (ILM) flap and sterile air or perfluoropropane (C₃F₈) tamponade in the treatment of idiopathic macular hole (IMH). Methods: A retrospective case analysis. From December 2015 to December 2016 in Tianjin Eye Hospital, 101 eyes of 98 consecutive IMH patients who underwent 25G PPV combined with or without ILM flap and sterile air or C₃F₈ tamponade, were included in this study. All patients underwent BCVA and OCT examination. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logMAR visual acuity. The patients were divided into three groups according to preoperative minimum liner diameter of Hole (MLD) and surgical methods: MLD<400 μm for the group A, 41 eyes of 39 patients, MLD more than 400 μm without ILM flap surgery as the group B, 39 eyes of 38 patients, including 16 eyes tamponaded with air and 23 eyes tamponaded with C₃F₈, MLD more than 400 μm with ILM flap as the group C, a total of 21 patients of 21 eyes, including 7 eyes tamponaded with air and 14 eyes tamponaded with C₃F₈. The logMAR BCVA of group A, B and C were 0.82±0.39, 1.11±0.42, 1.25±0.50, respectively. The follow-up times were 1 week, 1 month, 3 month, 6 month and 1 year post operation, BCVA and OCT were performed at each follow-up time. The hole closure rate and BCVA improvement were observed. Results: The postoperative BCVA of group A, B and C was improved obviously,the differences were statistically significant (t=−11.66, −7.52, −4.99; P<0.01). There was no significant difference in improvement of visual acuity between the three groups (A and B, A and C, B and C group: t=0.77, −0.41, 0.28; P=0.44, 0.72, 0.76). 96.94% macular hole closure occurred in 7 days post operation. The postoperative visual acuity improved significantly in 3 mouth after operation, Conclusions The macular hole closure occurred mainly in 1 week after operation, postoperative visual acuity increased mostly in the 3rd month post operation. There is no advantage of ILM flap in improve postoperative visual acuity of IMH patients with MLD more than 400 μm.