Objective To systematically evaluate the effects of liraglutide combined with metformin on glucose and lipid metabolism,sex hormones,reproductive function,and gastrointestinal reactions in patients with polycystic ovary syndrome(PCOS).Methods We searched databases such as PubMed,WanFang Medical Network,WanFang Database,China National Knowledge Infrastructure(CNKI),and VIP Journals to collect randomized controlled trials published from January 2011 to August 2022 on the treatment of polycystic ovary syndrome with liraglutide combined with metformin,using Revman 5.4 for the meta-analysis.Results A total of 16 case-control studies were included,involving 1436 patients.Compared to metformin alone,the combination of liraglutide and metformin significantly lowered fasting blood sugar,postprandial blood glucoseafter 2 hours,HbA1c,HOMA-IR,FINS,BMI,as well as LH,FSH,and total testosterone in patients with PCOS.It improved lipid levels,helped establish menstrual cycles,and increased the normal ovulation rate and natural conception rate in these patients.However,there was a significantly higher incidence of gastrointestinal reactions in the liraglutide plus metformin group,and the difference was statistically significant(P＜0.05).Conclusion The combination of liraglutide and metformin can improve glucose and lipid metabolism in patients with polycystic ovary syndrome(PC OS),reduce levels of LH,FSH,and total testosterone,help establish regular menstrual cycles,and increase ovulation and pregnancy rates,but it significantly increases gastrointestinal side effects.

Aim To investigate the inhibition role and mechanism of adipose derived mesenchymal stem cell(ADMSC)exosomes(Exo)on adverse ventricular remodeling after myocardial infarction(MI).Methods The chan-ges of autophagy and inflammasomes phenotype of cardiac fibroblasts after H2O2 treatment were observed.MI rats were in-jected with an equal volume of normal saline,adipose derived mesenchymal stem cell exosomes(MSC-Exo)or fibroblast exosomes(MEF-Exo)via a tail vein.The expression of autophagy related 16 like protein 1(ATG16L1),autophagy re-lated protein 7(ATG7)and NOD-like receptor protein 3(NLRP3),inflammatory response,the degree of myocardial fi-brosis,and the cardiac function were observed in different groups.Results After treatment with H2O2 on cardiac fi-broblasts,the expressions of ATG16L1 and ATG7 were significantly decreased(P＜0.001),NLRP3 was significantly in-creased(P＜0.001),and the levels of inflammatory cytokines interleukin-1β(IL-1β)and IL-18 were significantly elevated(P＜0.001).After MI rats were intervened with MSC-Exo,the expressions of autophagy related proteins ATG16L1 and ATG7 were significantly up-regulated(P＜0.001),NLRP3 was significantly down-regulated(P＜0.001),serum IL-1β and IL-18 levels were significantly decreased(P＜0.001),fibrosis-related proteins collagen Ⅰ and Ⅲ were significantly reduced(P＜0.001),myocardial fibrosis was significantly relieved(P＜0.001),and cardiac function was sig-nificantly improved(P＜0.001).Conclusion Adipose derived MSC-Exo play a role in inhibiting adverse ventricular remodeling after MI by regulating the balance of autophagy and NLRP3 inflammasomes.

Purpose To explore the feasibility of prenatal MRI as a supplementary imaging examination of fetal multicystic dysplastic kidney(MCDK),and to improve the accuracy of imaging diagnosis.Materials and Methods The MR images of 104 fetuses diagnosed as MCDK by prenatal fetal MRI in Hubei Maternal and Children's Hospital from January 2018 to December 2021 were retrospectively analyzed.The results of fetal MRI were compared with those of autopsy or postnatal surgery,ultrasound and MRI,and the diagnostic accuracy of MRI and ultrasound was compared,respectively,the advantages of MRI combined with ultrasound in the diagnosis of MCDK was also analyzed.Results Among 104 fetuses diagnosed as MCDK by MRI,there were 102 cases with MCDK and 2 cases with misdiagnoses.Amniotic fluid was obviously reduced or absent in 4 cases.Among the 102 cases of MCDK,58 cases(56.9％)were correctly diagnosed as MCDK by ultrasound,40 cases(39.1％)were identified with polycystic alterations,without diagnosed as MCDK,and 4 cases(3.9％)were misdiagnosed as other diseases(1 case with adult polycystic kidney,1 case with multiple renal cyst and 2 cases with renal absence).Conclusion Compared with prenatal ultrasound,prenatal MRI can obtain more information,especially in oligohydramnios and maternal obesity affecting the quality of ultrasound image.MRI can be used as a reliable supplementary method of prenatal ultrasound.

Hip fracture is considered as the most severe osteoporotic fracture characterized by high disability and mortality in the elderly. Improved surgical techniques and multidisciplinary team play an active role in alleviating prognosis, which places higher demands on perioperative nursing. Dysfunction, complications, and secondary impact of anaesthesia and surgery add more difficulties to clinical nursing. Besides, there still lack clinical practices in perioperative nursing for elderly patients with hip fracture in China. In this context, led by the Orthopedic Nursing Committee of Chinese Nursing Association, the Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture ( version 2023) is developed based on the evidence-based medicine. This consensus provides 11 recommendations on elderly patients with hip fracture from aspects of perioperative health education, condition monitoring and inspection, complication risk assessment and prevention, and rehabilitation, in order to provide guiding advices for clinical practice, improve the quality of nursing and ameliorate the prognosis of elderly patients with hip fracture.

Objective: To explore the action mechanism of electroacupuncture (EA) in improving the gastric motility of rats with diabetic gastroparesis (DGP). Methods: Forty-eight healthy Sprague-Dawley (SD) rats were randomly assigned into four groups: a normal group (group A), a model group (group B), a group of EA at acupoints (group C), and a group of EA at non-acupoints (group D), 12 rats in each group. The animal model of DGP was established by intraperitoneal injection of streptozotocin (STZ) plus high glucose and fat diet. The blood glucose, urine glucose and gastric emptying rate (GER) were observed. The content of insulin (INS) in serum and ghrelin in gastric antrum tissue were detected by enzyme linked immunoassay (ELISA). The expression of growth hormone secretagogue receptor mRNA (GHSR mRNA) in gastric antrum tissue was detected by real-time fluorescent quantitative polymerase chain reaction (PCR). Results:Compared with group A, blood glucose and urine glucose increased significantly (P<0.01), GER, content of serum insulin, the content of ghrelin and expression of GHSR mRNA in gastric antrum tissue decreased significantly (P<0.05 orP<0.01) in group B. Compared with group B, blood glucose and urine glucose decreased significantly (P<0.05), GER, the content of insulin in serum, the content of ghrelin and expression of GHSR mRNA in gastric antrum tissue increased significantly (P<0.05 orP<0.01) in group C. Conclusion: EA at acupoints can down-regulate the content of blood and urine sugar, and promote gastric emptying, which is possibly related to the regulation of serum insulin, and the expressions of ghrelin and GHSR mRNA in gastric antrum.

Objective: To determine possible relations between early adiposity rebound and adolescent development. Methods: Prospective children cohort from 2 kindergartens selected through clustering convenience sampling method in Anhui Province was established since Sep. 2010. Participants were classified as Cohort 1 (2010), Cohort 2 (2011) and Cohort 3 (2012) according to the recruiting year. Till Sep. 2015, a toal of 802 girls were included in this study, and received follow-up till primary school. During kindergarten period, physical examination was carried out every 3 months, 8 times in total. In primary school, physical examination was carried out annually; till Sep.2015, the cohort 1, 2, 3 took physical examination for 12, 11, 10 times, respectively. Information on household economic status and child physical activity was acquired through parents questionnaire survey, and breast development were assessed through visual inspection and palpation. Adiposity rebound was determined according to Rolland-Cachera's method for each girl. Differences between early adiposity rebound and normal adiposity rebound groups were compared by using t test and χ² test. Multivariate regression analysis was applied to explore the association between early adiposity rebound and breast development. Results: The average age of participants was (8.90±0.87) years old and the BMI was (17.48±2.70) kg/m². The average age at adiposity rebound was (6.16±0.90) years old and the BMI was (15.33±1.82) kg/m². Premature breast development was found significantly higher in girls in early adiposity rebound group (27.8%, 54/802) than it in normal adiposity rebound group (13.7%) (P<0.001). After current adiposity, age, household economic status, childhood physical activity adjusted, the OR of premature beast development in early adiposity rebound group was 2.41(95%CI: 1.41-4.12). Conclusion Early adiposity rebound increases the risk of premature puberty in girls.

Objective To investigate the effect of electroacupuncture on serum insulin (INS) levels and gastric antral cholecystokinin (CCK) content in rats with diabetic gastroparesis (DGP).Methods Sixty SD rats were randomized into groups A, B, C, D and E, 12 rats each. Group A is a normal control. A DGP model was made by an intraperitoneal injection of 2% streptozocin (STZ) plus an irregular high sugar and fat diet in groups B, C, D and E. group B is a model one and did not receive treatment. Group C received electroacupuncture at points Zusanli, Sanyinjiao and Liangmen; group D, electroacupuncture at the control points of Zusanli, Sanyinjiao and Liangmen. Group C, an oral gavage of metoclopramide tablet solution. Blood sugar and urine sugar were determined using a OneTouch lood glucose meter and Tes-Tape, respectively. The gastric emptying rate and the intestinal migration rate were measured by an oral gavage of phenol red. Serum INS levels and gastric antral CCK content were measured by ELISA in every group of rats before and after treatment.Results There were statistically significant differences in blood and urine sugar values between group B, C, D or E rats and group A (P<0.01) and between group C rats and group B or E (P<0.05). There was a statistically significant difference in the gastric emptying rate between group B, C, D or E rats and group A (P<0.01) and between group C rats and group B or D (P<0.01,P<0.05). There was a statistically significant difference in the intestinal migration rate between group B or D rats and group A (P<0.01) and between group C rats and group B or D (P<0.01). There were statistically significant differences in serum INS levels and gastric antral CCK content between groups B and A rats (P<0.05,P<0.01). There was a statistically significant difference in gastric antral CCK content between groups D and A rats (P<0.01). There were statistically significant differences in serum INS levels and gastric antral CCK content between groups C or E rats and group B (P<0.05,P<0.01). There was a statistically significant difference in gastric antral CCK content between groups C and D rats (P<0.05).Conclusions Electroacupuncture can markedly improve gastrointestinal functions and promote gastric emptying in DGP rats. Its therapeutic effect may be related to electroacupuncture raising serum INS levels and reducing gastric antral CCK content.

Objective To explore whether Helq deletion affect the pluripotency of stem cells. Methods Helq knockout embryonic stem cells were obtained by CRISPR?Cas9 gene editing technique. Results The results of immunoflu?orescence analysis showed that the expression of Oct4 and Nanog had no obvious difference to that of the control cells. The Helq-/ - embryonic stem cells could produce viable pups by tetraploid complementation, indicating that their pluripotency was not affected. Meanwhile, we found that day 2 epiblast?like cells also were obtained through differentiation of the Helq-/ - embryonic stem cells in vitro. Immunostaining and real?time PCR analysis showed that the gene expression of Helq-/ - epiblast cells were similar to the wild type cells. Conclusions Taken together, it is proved that the genomic in?stability caused by Helq deletion does not affect the pluripotency of pluripotent stem cells.

Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Oximetry ; Pneumoconiosis ; blood ; complications ; Prognosis ; Respiratory Insufficiency ; blood ; etiology

Objective To detect epidermal growth factor receptor (EGFR) 19, 21 exon gene mutation and gene copy number in lung adenocarcinoma tissue, and to analyze the relationship of EGFR 19, 21 mutation with copies number. MethodsEGFR mutations and gene copy number in the tissue samples embedded by paraffin and fixed by for marlin from 58 cases of lung adenocarcinoma were detected by RT-PCR and FISH. The statistical data were analyzed by chi-square test.ResultsOf 58 cases, the overall single mutation rate of EGFR exon 19, 21 was 43.1% (25/58), and 2 cases contained both types of the mutation.The overall FISH positive rate of EGFR was 51.7 % (30/58), including 8 positive amplification and 22 highly ploidy amplification. The testing results showed that there had no statistically differences in FISH positive rates of EGFR mutation among different differentiation lung adenocarcinoma tissues(P ＞0.05), and the FISH positive rates of EGFR mutation in poorly differentiated cancer were lower than those in moderatedly differentiated and well-differentiated cancer (P ＜0.05). EGFR mutation was closely related to EGFR gene copies (P ＜0.01). ConclusionThere are high EGFR mutation frequencies and FISH positive rates in lung adenocarcinoma tissue; Combined detection of EGFR mutation and gene copy number may provide a better approach in selecting patients who may benefit from anti-EGFR target therapy.