As the population ages,the incidence of diabetes continues to climb.Diabetic peripheral neuropathy(DPN)occurs in about half of diabetic patients.DPN is characterized by the loss of peripheral nerve function from distal to proximal,with the main symptom of diffuse and persistent spontaneous intractable pain,which is one of the most common chronic complications of diabetes.DPN has a high mortality rate and poor prognosis,and the pathogenesis is not fully clear.The current focus of clinical treatment for DPN is to alleviate the clinical symptoms,as well as to control blood glucose and reduce the risk of adverse cardiovascular events.This study investigated the pathogenesis,diagnosis,and treatment of DPN and summarized the latest research progress to provide new ideas for clinical diagnosis and treatment of DPN.

Objective To investigate the expression of the ubiquitination enzyme UBE2S in different cell types in hepatocellular carcinoma(HCC)microenvironment and its impact on proliferation and stemness of HCC cells.Methods TCGA and CPTAC database were used to analyze the transcriptional and promoter methylation levels and protein expressions of UBE2S in HCC.Specific expression patterns of UBE2S,intercellular communication and key transcription factors in different cell types were analyzed based on single-cell sequencing data from TISCH website.We further examined UBE2S expressions in clinical samples of HCC tissues,HCC cells and T cells using immunohistochemistry and immunofluorescence staining.We also tested the effects of UBE2S knockdown on stemness of HCC-LM3 and HepG2 cells using clone formation experiments and sphere formation assay.Results Analysis based on TCGA database suggested significant overexpression of UBE2S in both paired and non-paired tumor tissues(P<0.001),and its transcriptional level increased with tumor grades.The methylation level of UBE2S promoter was significantly decreased in HCC(P<0.001),and its transcription level increased obviously in HCC with TP53 mutation(P<0.001).Analysis of CPTAC database also demonstrated overexpression of UBE2S protein in HCC tissues(P<0.001).Three prognostic models suggested that HCC patients with high UBE2S expression had poorer prognosis(P<0.001).Single-cell sequencing data analysis revealed high expressions of UBE2S in T cells and high intensities of interaction between endothelial cells,epithelial cells and fibroblasts in HCC microenvironment.Immunohistochemistry and immunofluorescence staining demonstrated high UBE2S expressions in clinical samples of HCC tissues,HCC cells and T cells.In HCC-LM3 and HepG2 cells,UBE2S knockdown significantly inhibited cell clone formation and tumor sphere formation(P<0.05).Conclusion UBE2S is highly expressed in T cells in HCC microenvironment in close correlation with a poor prognosis.High UBE2S expression promotes the stemness of HCC cells.

Objective To investigate the expression of the ubiquitination enzyme UBE2S in different cell types in hepatocellular carcinoma(HCC)microenvironment and its impact on proliferation and stemness of HCC cells.Methods TCGA and CPTAC database were used to analyze the transcriptional and promoter methylation levels and protein expressions of UBE2S in HCC.Specific expression patterns of UBE2S,intercellular communication and key transcription factors in different cell types were analyzed based on single-cell sequencing data from TISCH website.We further examined UBE2S expressions in clinical samples of HCC tissues,HCC cells and T cells using immunohistochemistry and immunofluorescence staining.We also tested the effects of UBE2S knockdown on stemness of HCC-LM3 and HepG2 cells using clone formation experiments and sphere formation assay.Results Analysis based on TCGA database suggested significant overexpression of UBE2S in both paired and non-paired tumor tissues(P<0.001),and its transcriptional level increased with tumor grades.The methylation level of UBE2S promoter was significantly decreased in HCC(P<0.001),and its transcription level increased obviously in HCC with TP53 mutation(P<0.001).Analysis of CPTAC database also demonstrated overexpression of UBE2S protein in HCC tissues(P<0.001).Three prognostic models suggested that HCC patients with high UBE2S expression had poorer prognosis(P<0.001).Single-cell sequencing data analysis revealed high expressions of UBE2S in T cells and high intensities of interaction between endothelial cells,epithelial cells and fibroblasts in HCC microenvironment.Immunohistochemistry and immunofluorescence staining demonstrated high UBE2S expressions in clinical samples of HCC tissues,HCC cells and T cells.In HCC-LM3 and HepG2 cells,UBE2S knockdown significantly inhibited cell clone formation and tumor sphere formation(P<0.05).Conclusion UBE2S is highly expressed in T cells in HCC microenvironment in close correlation with a poor prognosis.High UBE2S expression promotes the stemness of HCC cells.

Osteochondral lesion of the talus(OLT)is a localized cartilage and subchondral bone injury of the talus trochlea.OLT is caused by trauma and other reasons,including osteochondritis dissecans of the talus(OCD)and talus osteochondral tangential fracture.OLT can develop from being asymptomatic to subchondral bone cysts accompanied by deep ankle pain.OLT tends to occur on the medial and lateral sides of the talar vault.OLT seriously affects the patients'life and work and may even lead to disability.Herein,we reviewed advances in the treatment of OLT and the strengths and weaknesses of various treatments.Different treatment methods,including conservative treatments and surgical treatments,can be adopted according to the different subtypes or clinical symptoms of OLT.Conservative treatments mostly relieve symptoms in the short term and only slow down the disease.In recent years,it has been discovered that platelet-rich plasma injection,microfracture,periosteal bone grafting,talar cartilage transplantation,allograft bone transplantation,reverse drilling under robotic navigation,and other methods can achieve considerable benefits when each of these treatment methods is applied.Furthermore,microfracture combined with platelet-rich plasma injections,microfracture combined with cartilage transplantation,and various other treatment methods combined with anterior talofibular ligament repair have all led to good treatment outcomes.

Objective To investigate the clinical efficacy of modified arthroscopic revision release for patients who have gluteal muscle contracture and who have poor outcomes after traditional open surgery.Methods The data of patients who underwent modified arthroscopic revision release for residual symptoms of gluteal muscle contracture after traditional open surgery were retrospectively collected and analyzed.All subjects underwent the procedure between December 2015 and December 2022.The surgical efficacy was assessed by evaluating improvements in specific symptoms,including bilateral lower extremity inequality,hip internal rotation and adduction mobility,squatting with both knees pressed together,and the ability to cross one's legs in supine position,as well as the preoperative and postoperative results for the gluteal muscle contracture functionality scale.Paired t-test was performed to examine whether the differences between preoperative and postoperative measurements were statistically significant.Results A total of 36 patients were followed up systematically,with the mean follow-up period being(22.4±4.9)months.All patients had significantly higher scores for assessment with the gluteal muscle contracture functionality scale at the last follow-up than their preoperative assessment results,showing an increase from the preoperative scores of 40.2±5.5 to 78.4±4.9(P＜0.05).At the follow-up,all patients showed improvement in hip adduction and internal rotation mobility compared with their preoperative status and all patients were able to squat with both knees pressed together.Moreover,only 1 patient still had difficulty in crossing his legs.A total of 27 cases(75%)had preoperative leg length inequality,all of which improved to varying degrees at follow-up.Among all the patients(72 hips/cases),8 cases had subcutaneous hematomas and incisional ecchymosis,which were resolved after conservative treatments such as hot compresses.3 cases showed decreased hip abductor strength,but the muscle strength gradually recovered after postoperative exercise and rehabilitation.There were no complications such as subcutaneous exudate,neurovascular injury,or surgical site infection.Conclusion Modified arthroscopic revision release of gluteus muscle contracture is suitable for cases with poor outcomes after conventional open surgery.

Esophageal squamous cell carcinoma (ESCC) is one of the most common malignant tumors with a poor prognosis. 4-nitroquinoline-1-oxide (4NQO) is a water-soluble quinoline derivative that can successfully induce the production of squamous cell carcinoma in vivo. Establishing and optimizing experimental methods for 4NQO induced ESCC formation in mice can provide a more suitable in situ model for the study of ESCC.

Background: Acne vulgaris (AV) is a common adolescent skin condition which is mainly caused by Cutibacterium acnes overcolonization and subsequent inflammation. Objective: Our previous studies demonstrated that ethanol extracts of Meconopsis quintuplinervia Regel (EMQ) possess significant antimicrobial properties. However, their protective effects and potential mechanisms against AV remain unclear. Methods: In the present study, the EMQ treatment potential for AV was evaluated in a C.acnes-induced mouse ear edema model, and the EMQ anti-inflammatory mechanism was evaluated in lipopolysaccharide (LPS)-induced RAW264.7 macrophage cells. Results: The results showed that EMQ alleviated edema formation and inflammatory cell infiltration in an acne mouse model by suppressing inflammatory cytokines interleukin (IL)-6, IL-1β, and tumor necrosis factor α expression. Moreover, EMQ inhibited the phosphorylation of MAP kinases (MAPKs) such as p38, JNK, and ERK, the phosphorylation and degradation of IκB-α and the nuclear translocation of nuclear factor kappa B (NF-κB) p65 in LPS-induced RAW264.7 cells. Conclusion These findings suggest the potent anti-inflammatory activity of EMQ is possibly through the regulation of the MAPKs and NF-κB signaling pathways. Inhibition of C. acnes activity combined with a powerful anti-inflammatory effect of EMQ indicated its potential as a novel therapeutic option for AV.

Objective:To observe the changes in acromiaohumeral distance(AHD) in patients undergoing the modified arthroscopic double-button Latarjet procedure for recurrent anterior shoulder dislocation complicated with glenoid bone defect.Methods:A retrospective study was performed of the 52 patients who had undergone the modified arthroscopic double-button Latarjet procedure from October 2014 to October 2016 at Department of Sports Medicine, The First Affiliated Hospital to Shenzhen University for recurrent anterior shoulder dislocation complicated with glenoid bone defect. They were 33 males and 19 females, having 30 left and 22 right shoulders affected. Their ages ranged from 19 to 45 years(mean, 29.6 years). Their glenoid bone defects ranged from 17% to 30%(mean, 23.4%). CT scans were performed on the surgery side to observe the healing and reshaping of the bone grafts and to measure the AHDs of healthy shoulder, immediately, 6, 18 and 36 months after operation. Their American Shoulder and Elbow Surgeons(ASES), Rowe and Walch-Duplay scores were recorded before operation and at the final follow-up for comparison.Results:The follow-up time for this series ranged from 37 to 44 months (mean, 40.6 months). The AHDs at immediate postoperation(9.6 mm ± 0.7 mm), 6 months postoperation(8.6 mm ± 0.9 mm), 18 months postoperation (8.0 cm ± 0.8 cm) and 36 months postoperation(7.9 cm ± 0.8 cm) were significantly wider than the healthy side value (7.8 mm ± 0.8 mm)( P<0.05). The ASES, Rowe and Walch-Duplay scores at the final follow-up (93.9±3.2, 94.5±2.7 and 95.7±3.6) were significantly improved than the preoperative values (67.3±9.1, 40.1±4.2 and 63.5±9.0) ( P<0.05). The final follow-ups observed no symptoms or signs of chronic shoulder pain, rotator cuff injury or acromion impingement. Conclusion:As the AHD becomes wider rather than narrower after arthroscopic double-button Latarjet procedure for recurrent anterior shoulder dislocation complicated with glenoid bone defect, no subsequent rotator cuff injury may happen due to the uplift of the humeral head after the modified arthroscopic double-button Latarjet procedure.

Objective To investigate the impact of diabetic cardiovascular autonomic neuropathy (DCAN) on heart rate and blood pressure during position change in patients with diabetes mellitus . Methods From January to June 2003 ,54 patients with diabetes mellitus were divided into diabetes mellitus group (n=31) and DCAN group (n= 23) according to the presence or absence of DCAN .22 healthy adults were selected as control group (n= 22 ) . The blood pressure and heart rate were measured continuously by digital arterial blood pressure monitoring system in the process of standing ,squatting and standing up .The changes of blood pressure and heart rate were observed at different time points and posture . Results Compared to NC group ,there were significant increased rangeability of changes in blood pressure [squatting diastolic pressure :(17.9 ± 9.5)vs(24.1 ± 18.1) ,P< 0.05 ;standing systole pressure:(-49.4 ± 20.4)vs(-73.5 ± 21.3)mmHg ,P<0.01 ;standing diastolic pressure :(-32.2 ± 7.1) vs(-43.1 ± 15.8)mmHg ,P<0.05 or P<0.01] and significant decreased rangeability of changes in heart rate [squatting(-21.3 ± 13.0)vs(-6.5 ± 7.8)bpm ,P<0.05 or P<0.01 ;standing(34.6 ± 10.8)vs(11.4 ± 9.8)bpm ,P<0.05 or P<0.01] and remarkable longer recovery time especially in DCAN group (P<0.05 or P<0.01) during standing-squatting-standing test .There was no significant correlation between rangeability of blood pressure changes and heart rate in patients with diabetes . Conclusion There is impaired regulation of blood pressure and heart rate during postural changes in patients with diabetes , especially DCAN .

BACKGROUND:Extensive studies have shown that transcutaneous electrical nerve stimulation (TENS) plays a positive role in relieving the pain caused by a variety of diseases. However, its exact effect to manage pain in patients with knee osteoarthritis is stil controversial. TENS is classified into h-TENS and l-TENS, but currently its respective role in relieving the pain caused by knee osteoarthritis is not clear yet. OBJECTIVE: To compare the efficacy of h-TENS and l-TENS on pain relieving among patients with knee osteoarthritis. METHODS: A computer-based search was performed on PubMed, Embase and Cochrane database for randomized controled trials on TENS for the treatment of knee pain in patients with knee osteoarthritis which were reported before February 2014. Methodology quality of the trials was criticaly assessed and relative data were extracted. These studies were selected independently by two reviewers according to the inclusion and exclusion criteria. Meta-analysis was performed using Revman5.2 software. RESULTS AND CONCLUSION:A total of 10 randomized controled trials involving 519 cases were included. The results of meta-analysis showed that the h-TENS group had significant effects on pain relief in knee osteoarthritis patients in comparison to the control group [MD=-0.56, 95%CI(-0.98,-0.15),P=0.008]; the l-TENS group had no significant effect on pain relief in knee osteoarthritis patients in comparison to the control group [MD=-0.13, 95%CI(-1.63, 1.38),P=0.87]; the h-TENS group had significant effect on pain relief in knee osteoarthritis patients in comparison to the l-TENS group [MD=-0.85, 95%CI(-1.32, -0.37), P=0.000 5]. These findings indicate that h-TENS performs something positive to reduce pain in knee osteoarthritis patients that l-TENS cannot do. Owing to the limitations of this study, further work is needed to determine the role of TENS in pain management among patients with knee osteoarthritis.