Objective:To observe the correlation between the level of advanced glycosylation end products (AGE) in skin and diabetic retinopathy (DR), and establish and preliminatively verify the nomogramolumbaric model for predicting the risk of DR.Methods:A clinical case-control study. A total of 346 patients with type 2 diabetes mellitus (T2DM) who were admitted to the Department of Endocrinology and Ophthalmology of the First Affiliated Hospital of Zhengzhou University from January 2023 to June 2024 were included in the study. Among them, 198 were males and 148 were females. The mean age was (54.77±10.92). According to whether the patients were accompanied by DR, the patients were divided into the non-DR group (NDR group) and the DR group (DR group), 174 and 172 cases, respectively. All patients underwent skin AGE detection using a noninvasive diabetes detector. Diabetes duration, hemoglobin A1c (HbA1c), fasting plasma glucose, Urea, creatinine (Crea), uric acid, total cholesterol, triglyceride, estimated glomerular filtration rate (eGFR), urinary albumin concentration (UALB), and body mass index (BMI) were collected in detail. Univariate analysis and multivariate logistic regression analysis were used to determine the independent risk factors for T2DM concurrent DR, and to construct a nomogram prediction model for DR risk. Receiver operating characteristic curve (ROC curve), calibration curve and decision curve (DCA) were used to evaluate the model.Results:Hypertension prevalence rate ( χ2=3.892), Diabetes duration ( Z=?7.708), BMI ( Z=?2.627), HbA1c ( Z=?4.484), Urea ( Z=?4.620), Crea ( Z=?3.526), UALB ( Z=?6.999), AGE ( Z=?8.097) in DR group were significantly higher than those in NDR group, with statistical significance ( P<0.05); eGFR was lower than that in NDR group, the difference was statistically significant ( Z=?6.061, P<0.05). Logistic regression analysis showed that AGE, diabetes duration, HbA1c, UALB and eGFR were independent risk factors for DR ( P<0.05). Based on the results of multi-factor regression analysis, a nomogram prediction model was constructed. The area under ROC curve of the model was 0.843, 95% confidence interval was 0.802-0.884, sensitivity and specificity were 79.1% and 75.9%, respectively. The calibration curve was basically consistent with the ideal curve. The results of DCA analysis showed that when the model predicted the risk threshold of patients with DR between 0.17 and 0.99, the clinical net benefit provided by the nomogram model was> 0. Conclusions:Skin AGE level is an independent risk factor for DR. The nomogram prediction model based on AGE, diabetes duration, HbA1c, eGFR and UALB can accurately predict the risk of DR, and has good clinical practicability.

Objective:To construct an exosome (EXO)-based nanosystem co-loaded with bovine serum albumin and isoquercitrin (BSA@ISO), and to investigate its protective mechanism against high glucose-induced damage in human retinal pigment epithelial cells (ARPE-19).Methods:EXO was extracted from ARPE-19 cells via ultracentrifugation, and the structure was observed using transmission electron microscopy (TEM). EXO markers were detected by Western blot.BSA@ISO nanoparticles were prepared using the oscillating synthesis method.A ROS-responsive EXO-based nanosystem co-loaded with BSA@ISO (BSA@ISO@EXO) was constructed using a membrane extruder.The particle size and zeta potential of BSA@ISO@EXO were measured and its morphology was observed by TEM.Chemical structure was analyzed using a spectrophotometer and infrared spectroscopy.Encapsulation efficiency and drug loading capacity were calculated using the differential method.Cells were divided into control group, model group, low-dose ISO nanosystem group (5 μmol/L ISO), medium-dose ISO nanosystem group (10 μmol/L ISO), high-dose ISO nanosystem group (20 μmol/L ISO), and pure ISO group.Cell viability at different time points was assessed using the CCK-8 assay.Apoptosis rate after 48 hours of culture was measured by flow cytometry.Levels of inflammatory factors tumor necrosis factor (TNF)-α and interleukin (IL)-1β in the cell supernatant were determined by ELISA, while activities of antioxidant enzymes glutathione peroxidase (GSH-PX) and superoxide dismutase (SOD) and the level of oxidative stress marker malondialdehyde (MDA) in the supernatant were measured using biochemical kits.Results:The BSA@ISO@EXO nanosystem exhibited a uniform spherical shape with an average particle size of approximately 39.6 nm.UV-visible and IR spectra showed characteristic absorption peaks of BSA, ISO and EXO.The encapsulation efficiency of the nanosystem was (76.6±5.0)%, the drug loading capacity was (10.3±0.6)%, and the 24-hour drug release rate reached 75.1%.CCK-8 assay showed that cell viability in all ISO nanosystem groups after 48-hour culture was significantly higher than that in the pure ISO group (all P<0.05). The ROS level was significantly lower in the medium-dose ISO group than in the pure ISO group ( P<0.01). The levels of TNF-α, IL-1β, and MDA were significantly lower and GSH-PX and SOD activities were significantly higher in the medium-dose ISO nanosystem group than those in the model and high-dose ISO nanosystem groups (all P<0.05). Conclusions:A stable BSA@ISO@EXO nanosystem was successfully constructed.This system enhances the antioxidant and anti-inflammatory effects by improving the bioavailability of ISO, offering a new strategy for the treatment of diabetic retinopathy.

Objective:To construct an exosome (EXO)-based nanosystem co-loaded with bovine serum albumin and isoquercitrin (BSA@ISO), and to investigate its protective mechanism against high glucose-induced damage in human retinal pigment epithelial cells (ARPE-19).Methods:EXO was extracted from ARPE-19 cells via ultracentrifugation, and the structure was observed using transmission electron microscopy (TEM). EXO markers were detected by Western blot.BSA@ISO nanoparticles were prepared using the oscillating synthesis method.A ROS-responsive EXO-based nanosystem co-loaded with BSA@ISO (BSA@ISO@EXO) was constructed using a membrane extruder.The particle size and zeta potential of BSA@ISO@EXO were measured and its morphology was observed by TEM.Chemical structure was analyzed using a spectrophotometer and infrared spectroscopy.Encapsulation efficiency and drug loading capacity were calculated using the differential method.Cells were divided into control group, model group, low-dose ISO nanosystem group (5 μmol/L ISO), medium-dose ISO nanosystem group (10 μmol/L ISO), high-dose ISO nanosystem group (20 μmol/L ISO), and pure ISO group.Cell viability at different time points was assessed using the CCK-8 assay.Apoptosis rate after 48 hours of culture was measured by flow cytometry.Levels of inflammatory factors tumor necrosis factor (TNF)-α and interleukin (IL)-1β in the cell supernatant were determined by ELISA, while activities of antioxidant enzymes glutathione peroxidase (GSH-PX) and superoxide dismutase (SOD) and the level of oxidative stress marker malondialdehyde (MDA) in the supernatant were measured using biochemical kits.Results:The BSA@ISO@EXO nanosystem exhibited a uniform spherical shape with an average particle size of approximately 39.6 nm.UV-visible and IR spectra showed characteristic absorption peaks of BSA, ISO and EXO.The encapsulation efficiency of the nanosystem was (76.6±5.0)%, the drug loading capacity was (10.3±0.6)%, and the 24-hour drug release rate reached 75.1%.CCK-8 assay showed that cell viability in all ISO nanosystem groups after 48-hour culture was significantly higher than that in the pure ISO group (all P<0.05). The ROS level was significantly lower in the medium-dose ISO group than in the pure ISO group ( P<0.01). The levels of TNF-α, IL-1β, and MDA were significantly lower and GSH-PX and SOD activities were significantly higher in the medium-dose ISO nanosystem group than those in the model and high-dose ISO nanosystem groups (all P<0.05). Conclusions:A stable BSA@ISO@EXO nanosystem was successfully constructed.This system enhances the antioxidant and anti-inflammatory effects by improving the bioavailability of ISO, offering a new strategy for the treatment of diabetic retinopathy.

Objective:To observe the correlation between the level of advanced glycosylation end products (AGE) in skin and diabetic retinopathy (DR), and establish and preliminatively verify the nomogramolumbaric model for predicting the risk of DR.Methods:A clinical case-control study. A total of 346 patients with type 2 diabetes mellitus (T2DM) who were admitted to the Department of Endocrinology and Ophthalmology of the First Affiliated Hospital of Zhengzhou University from January 2023 to June 2024 were included in the study. Among them, 198 were males and 148 were females. The mean age was (54.77±10.92). According to whether the patients were accompanied by DR, the patients were divided into the non-DR group (NDR group) and the DR group (DR group), 174 and 172 cases, respectively. All patients underwent skin AGE detection using a noninvasive diabetes detector. Diabetes duration, hemoglobin A1c (HbA1c), fasting plasma glucose, Urea, creatinine (Crea), uric acid, total cholesterol, triglyceride, estimated glomerular filtration rate (eGFR), urinary albumin concentration (UALB), and body mass index (BMI) were collected in detail. Univariate analysis and multivariate logistic regression analysis were used to determine the independent risk factors for T2DM concurrent DR, and to construct a nomogram prediction model for DR risk. Receiver operating characteristic curve (ROC curve), calibration curve and decision curve (DCA) were used to evaluate the model.Results:Hypertension prevalence rate ( χ2=3.892), Diabetes duration ( Z=?7.708), BMI ( Z=?2.627), HbA1c ( Z=?4.484), Urea ( Z=?4.620), Crea ( Z=?3.526), UALB ( Z=?6.999), AGE ( Z=?8.097) in DR group were significantly higher than those in NDR group, with statistical significance ( P<0.05); eGFR was lower than that in NDR group, the difference was statistically significant ( Z=?6.061, P<0.05). Logistic regression analysis showed that AGE, diabetes duration, HbA1c, UALB and eGFR were independent risk factors for DR ( P<0.05). Based on the results of multi-factor regression analysis, a nomogram prediction model was constructed. The area under ROC curve of the model was 0.843, 95% confidence interval was 0.802-0.884, sensitivity and specificity were 79.1% and 75.9%, respectively. The calibration curve was basically consistent with the ideal curve. The results of DCA analysis showed that when the model predicted the risk threshold of patients with DR between 0.17 and 0.99, the clinical net benefit provided by the nomogram model was> 0. Conclusions:Skin AGE level is an independent risk factor for DR. The nomogram prediction model based on AGE, diabetes duration, HbA1c, eGFR and UALB can accurately predict the risk of DR, and has good clinical practicability.

Bone is a dynamic tissue undergoing continuous regeneration and reconstruction， and its metabolic activities are mainly regulated by bone formation mediated by osteoblasts and bone resorption mediated by osteoclasts. In addition， a variety of cells such as adipocytes， inflammatory cells， endothelial cells， and nerve cells can affect bone metabolism by changing the bone marrow microenvironment. The incidence of bone metabolic diseases caused by bone metabolism disorders is increasing with aging of the population. At present， the clinical treatment of bone metabolic diseases has the disadvantages of long cycle， high cost and many side effects. Therefore， there is an urgent need for safe and effective prevention and treatment drugs. Corylin is an isoflavonoid extracted from Psoraleae Fructus， which has a variety of pharmacological effects such as anti-inflammatory， anti-oxidation， anti-tumor， anti-atherosclerosis， attenuating obesity and improving insulin resistance. Studies have shown that corylin not only exerts osteoprotective effects by promoting osteoblast differentiation and inhibiting osteoclast differentiation， but also plays a positive role in bone metabolism by regulating lipid metabolism， inflammatory response， angiogenesis and anti-aging. The current review overviews the effects and mechanisms of corylin on regulating bone metabolism directly or indirectly， hoping to open up a new perspective for the prevention and treatment of osteoporosis， fracture， osteoarthritis and other related diseases.

Objective:To observe the clinical characteristics and treatment prognosis of patients with ocular toxocariasis (OT).Methods:A retrospective clinical trial. From March 2018 to September 2021, 40 eyes of 40 OT patients diagnosed by ophthalmic examination in the First Affiliated Hospital of Zhengzhou University were included in the study. All patients underwent best corrected visual acuity (BCVA) and scanning laser ophthalmoscope (SLO) examination. Color Doppler ultrasound flow imaging (CDFI), fluorescein fundus angiography (FFA) and optical coherence tomography (OCT) were performed in 25, 26 and 26 eyes, respectively. Among the 40 patients, there were 23 males (57.5%, 23/40) and 17 females (42.5%, 17/40). All patients were monocular. Thirty patients (75.0%, 30/40) were younger than 18 years old, with the mean age of (9.60±0.60) years. Ten patients (25.0%, 10/40) were great than or equal to 18 years old, with the mean age of (34.60±4.52) years. Thirty-three patients (82.5%, 33/40) lived in rural areas for a long time. There were 27 patients (67.5%, 27/40) with a history of contact with dogs and cats. In 40 eyes, peripheral granuloma (peripheral type), posterior pole granuloma (posterior pole type), vitreous opacity similar to endophthalmitis (turbid type) and hybrid type were 18(45.0%, 18/40), 11(27.5%, 11/40), 6(15.0%, 6/40) ang 5(12.5%,5/40), respectively. All patients were treated with drugs and/or surgery after definite diagnosis. There were 28 eyes of peripheral type, posterior pole type and hybrid type, 17 eyes were treated with surgery and 11 eyes with drug treatment, respectively. Five eyes with turbid type were only treated with drugs. In 40 patients, 33 patients participated in follow-up. The follow-up time after treatment was (18.78±9.44) months. The improvement of BCVA was observed. The number of eyes with different BCVA before and after treatment was compared by χ2 test or Fisher's test. Results:At the first visit, the BCVA ranged from light perception to 0.6, including 20 eyes with BCVA <0.1, 13 eyes with BCVA 0.1-0.3, and 7 eyes with BCVA >0.3. The posterior vitreous anterior limiting membrane was thickened in 24 eyes (60.0%, 24/40). There were 27 eyes (67.5%, 27/40) with lamellar vitreous opacity and 22 eyes (55.0%, 22/40) with peripheral/posterior pole granulomas. Among 25 eyes examined by CDFI, 14 eyes (56.0%, 14/25) showed characteristic stratified or diffuse opacity in vitreous body. Of the 26 eyes examined by FFA, 15 eyes (57.7%, 15/26) had "fern-like" leakage of retinal capillaries, and the lesion had a patchy non-perfused area. In 26 eyes examined by OCT, epiretinal membrane, cystoid macular edema and vitreoretinal traction were 8 (30.8%, 8/26), 5 (19.2%, 5/26) and 2 (7.7%, 2/26) eyes, respectively. At the last follow-up, compared with before treatment, the BCVA of 5 eyes with turbid type increased, and the difference was statistically significant ( P<0.05). In 28 eyes with peripheral type, posterior pole type and hybrid type, 17 eyes with surgical treatment improved BCVA, and the difference was statistically significant ( χ2=6.258, P<0.05). In 11 eyes only treated with drugs, BCVA remained unchanged, and the difference was not statistically significant ( χ2=0.594, P>0.05). Conclusions:OT patients are mostly children; retinal granulomas, gray-white hyperplastic membrane behind lens or vitreous stratified opacity are specific characteristics. OT is mainly treated by glucocorticoid drugs and vitrectomy.

Objective To investigate the clinical effect of pars plana vitrectomy combined with segmental scleral buckling(PPV-SSB)in the treatment of inferior rhegmatogenous retinal detachment(RRD).Methods Totally 87 eyes of 87 patients with inferior RRD who attended the Ophthalmology Department Ⅱ,the First Affiliated Hospital of Zhengzhou University from October 2020 to April 2022 were retrospectively included.Among them,45 patients(45 eyes)were treated with PPV-SSB(PPV-SSB group),and 42 patients(42 eyes)were treated with PPV(PPV group).The retinal reattachment rate,best corrected visual acuity(BCVA)and complications of patients who underwent single surgery in the two groups were compared.Results After a single surgery,the retinal reattachment rate was 95.56％(43/45)in the PPV-SSB group and 80.95％(34/42)in the PPV group,with a statistically significant difference(P=0.033).At 3 months and 6 months af-ter surgery,there were significant differences in BCVA between the PPV-SSB group and the PPV group(P=0.010,0.004).The incidence of postoperative phacoscotasmus in the PPV-SSB group and the PPV group was 28.89(13/45)and 54.76％(23/42),respectively,with a significant difference(P=0.018),while there were no significant differences in the inci-dence of the remaining few complications(all P＞0.05).Conclusion PPV-SSB has a higher retinal reattachment rate,better visual effect and fewer complications in the treatment of inferior RRD.