Dry eye disease(DED)refers to a condition characterized by reduced stability of the tear film or an imbalance in the microenvironment of the ocular surface, resulting from abnormalities in quality, quantity and kinetics of tear. This condition leads to various ocular discomforts and even visual impairment. The pathogenesis of DED is multifactorial and current treatment mainly focuses on symptom relief and preservation of visual function. Acupuncture has shown effectiveness in treating dry eye, although its underlying mechanism remains incompletely understood. Proteomics technology offers a comprehensive and systematic approach to studying the functions, structures and interactions of proteins. Its application in DED research can provide valuable insights into the dynamic changes in protein levels associated with different etiology or the course of DED and facilitate the identification of potential biomarkers. Furthermore, proteomics can systematically explore the regulatory mechanisms underlying acupuncture treatment for DED, providing a theoretical basis for acupuncture treatment research and contributing to the understanding of its effects at a fundamental level. This paper aims to explore the potential application of proteomics in both clinical and basic research on DED. Ultimately, it strives to offer scientific and effective strategies for the diagnosis and treatment of DED and advance our knowledge of the mechanisms underlying acupuncture therapy.

Objective To evaluate the effectiveness and safety of inferior oblique transposition combined with medial and lateral rectus surgery in the treatment of inferior oblique hyperfunction combined with V-type strabismus.Methods Thirty-nine patients with inferior oblique hyperfunction combined with V-type strabismus admitted to Jiaxing Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University from November 2020 to September 2021 were selected as study objects,and were divided into combined operation group(n=28)and multiple operation group(n=11)according to different surgical programs.The visual acuity,eye position,cure rate of V sign,correction rate of inferior oblique hyperfunction,oculocardiac reflex,oculogastric reflex and complications were compared between two groups.Results One month after surgery,patients of two groups recovered the first eye position,and there were no statistical significances in the number of V sign cured and the number of inferior oblique hyperfunction corrected(P>0.05).Visual acuity returned to preoperative level in both groups.There were no significant differences in oculocardiac reflex and oculogastric reflex between two groups(P>0.05).There were no inflammatory reaction,massive subconjunctival hemorrhage,subcutaneous hematoma of eyelid,retrobulbar hemorrhage and other complications in two groups.Conclusion The effect of inferior oblique transposition combined with medial and lateral rectus surgery in the treatment of inferior oblique hyperfunction combined with V-type strabismus is not inferior to that of conventional divided operation,but it can reduce the number of operations and avoid the pain caused by the second operation,which is worthy of clinical application.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.

Objective:To investigate the protective effect of human umbilical cord mesenchymal stem cell conditioned medium (HucMSC-cm) against lipopolysaccharide (LPS)-induced acute lung injury (ALI) and relevant mechanism of action.Methods:Forty 6-week-old male C57BL/6 mice were selected and randomized (random number) into the sham group, LPS group, LPS + HucMSC-cm (LPS+cm) group, and LPS+HucMSC-cm+Compound C (LPS+cm+cc) group, with 10 mice in each group. Mice were intratracheally injected with LPS (5 mg/kg) to establish ALI model, and intratracheally injected with hucMSC-CM (50 μL) 4 h after LPS treatment. Mice in the LPS+cm+cc group were intraperitoneally treated with Compound C (15 mg/kg) prior to LPS treatment. Neutrophils in peripheral blood were counted with the automated hematology analyzer 72 h after LPS administration. After that, mice were sacrificed, and the lung tissue pathology was observed using hematoxylin eosin (HE) staining. Besides, the expressions of IL-6, ICAM-1, VCAM-1 and P-AMP-activated protein kinase (P-AMPK) in the lung tissues were analyzed by Western blot and immunohistochemical assay. In vitro, human lung microvascular endothelial cells (HuLEC-5a) were cultured and divided into three groups: control group, LPS group (10 μg/ mL), and LPS + HucMSC-cm group. After 24 h of treatment, the expressions of p-AMPK and AMPK were detected by Western blot, and the expressions of IL-6 and IL-8 were detected by real-time fluorescence quantitative PCR. Oneway analysis of variance was used to compare the mean values of normally distributed measurement data between groups. Comparisons between two groups were performed using the Tukey’s multiple comparison test. Results:Compared with the sham group, the LPS group showed lungs with congestion and swelling, thickened pulmonary septum, and inflammatory cell infiltration. Moreover, in the LPS group, the protein expressions of IL-6 ( P=0.003), ICAM-1 ( P<0.001) and VCAM-1 ( P=0.001) were increased significantly, while the expression of p-AMPK was decreased ( P=0.013), accompanied by an increase in the proportion of neutrophils in peripheral blood ( P<0.001). Compared with the LPS group, the LPS+HucMSC-cm group demonstrated eased congestion, edema and pathological injury of lung tissue, reversed protein expressions of IL-6 ( P=0.003), ICAM-1 ( P=0.002), VCAM-1 ( P=0.006) and P-AMPK ( P=0.002), as well as decreased proportion of neutrophils in peripheral blood ( P<0.005). Compared with the LPS+HucMSC-cm group, the LPS+cm+cc group exhibited more severe lung histopathological injury, significantly increased protein expressions of IL-6, ICAM-1 and VCAM-1 in lung tissues, as well as decreased expression of P-AMPK protein. The results of immunohistochemistry were consistent with those of protein. In vitro experiment, after LPS treatment, the mRNA expressions of IL-6 ( P<0.001) and IL-8 ( P=0.027) were increased and p-AMPK protein expression ( P=0.005) was decreased as compared with the control group. In comparison with the LPS group, the LPS+HucMSC-cm group showed decreased mRNA expression levels of IL-6 ( P=0.003) and IL-8 ( P=0.002), but increased protein level of p-AMPK ( P=0.003). Conclusions:HucMSC-cm has a protective effect against LPS-induced acute lung injury, which is mainly attributed to the inhibited expression of adhesion molecules and inflammatory factors under the activation of AMPK.

Objective:To observe the clinical characteristics of patients with familial vitreous amyloidosis (FVA) and the efficacy of vitrectomy (PPV) and the occurrence of complications.Methods:A retrospective clinical study. From June 2009 to March 2020, 32 eyes of 18 patients from 3 FVA families who were diagnosed and treated by PPV at Department of Ophthalmology of Jiaxing TCM Hospital were included in the study. Among them, there were 12 males with 22 eyes and 6 females with 10 eyes. The average age of onset was 42.28±3.25 years; the average duration of disease was 3.75±3.93 years. All the affected eyes underwent best corrected visual acuity (BCVA) and B-mode ultrasound examination. A logarithmic visual acuity chart was used in the BCVA examination, which was converted to the logarithmic minimum angle of resolution (logMAR) visual acuity when recorded. The average logMAR BCVA of the affected eye was 1.72±0.53; the intraocular pressure was less than 21 mm Hg (1 mm Hg=0.133 kPa). The vitreous body of the affected eye was obviously cloudy. All the affected eyes underwent standard three-channel PPV through the flat part of the ciliary body, and vitreous specimens were collected for pathological examination during the operation. Peripheral venous blood of probands from 3 families was collected, and the whole exome gene sequencing was performed. The follow-up time after surgery was ≥6 months. The patient's clinical characteristics, fundus lesions in PPV, changes in BCVA after surgery, and complications was observed. One-way analysis of variance or t test was performed for measurement data comparison; χ2 test was performed for count data comparison. Results:The vitreous body of the affected eye showed gray-white dense and thick flocculent changes, and the posterior capsule attached to the lens showed "foot disc-like" turbidity; later the lens was mainly cystic opacity. Pathological examination of the vitreous body showed positive staining of Congo red; under a polarized light microscope, it showed apple green dots and sheet-like birefringence. The genetic test results showed that there was a c.307G>C (p.Gly103Arg) missense mutation in the TTR gene of the proband in Family 2. Peripheral retinal hemorrhages in 4 eyes (12.5%, 4/32), retinal tears in 5 eyes (15.6%, 5/32), retinal degeneration in 4 eyes (12.5%, 4/32), retinal detachment were found in PPV 3 eyes (9.4%, 3/32). The vitreous body was filled with C 3F 8 and silicone oil respectively for 2, 1 eye. Six months after the operation, the logMAR BCVA of the affected eye was 0.39±0.32, which was significantly higher than that before the operation, and the difference was statistically significant ( t=15.131, P=0.000). After the operation, high intraocular pressure occurred in 2 eyes (6.3%, 2/32), secondary glaucoma in 1 eye (3.1%, 1/32), retinal detachment in 2 eyes (6.3%, 2/32), neovascular glaucoma (NVG) in 2 eyes (6.3%, 2/32), cataract in 10 eyes (31.3%, 10/32). Conclusion:The vitreous body of FVA eyes are gray-white dense, thick and flocculent, attached to the posterior lens capsule, showing "foot disc-like" turbidity; PPV treatment can effectively improve the BCVA of the FVA eyes; secondary glaucoma, secondary retinal detachment, NVG can occur after surgery.

Objective:To explore the clinicalfactors related to allograft fibrosis after pediatric liver transplantation.Methods:The clinical data were respectively analyzed for 94 pediatric recipients from January 2013 to December 2016 at Tianjin First Central Hospital.The Patients were assigned into fibrotic and non-fibrotic groups based upon the results of protocol liver biopsies. Univariate and multivariate Logistic regression analyses were performed for examining the risk factors of fibrosis after pediatric livertransplantation. Then Logistic regression model was established to obtain the predicted value of combined predictive factors.Thereceiver operating characteristic curve (ROC) was conducted to evaluate the predictive value of combined predictive factors.Results:A total number of 54(57.5%) patients occurred fibrosis among the 94 patients. There weresignificant differences in cold ischemia time (Z=2.094), warm ischemia time (Z=2.421), biliary stricture( χ2=4.560), drug-induced liver injury ( χ2=7.389), hepatic artery thrombosis and rejection ( χ2=6.955)between two groups ( P<0.05). Logistic regression analysis showed that cold ischemia time (OR=1.003, 95%CI: 1.000~1.007, P=0.044), biliary stricture(OR=6.451, 95%CI: 1.205~33.295), rejection(OR=2.735, 95%CI: 1.057~7.077)and drug-induced liver injury (OR=4.977, 95%CI: 1.207~20.522, P=0.026) were independent risk factors for fibrosis 5 years after liver transplantation. The area under the ROC curve was 0.786(95%CI: 0.691~0.881), for predicting patient outcome.If using 0.311as a cutoff Value, the sensitivity was 90.70%, and the specificity was 60.00%. However, through the ROC curve comparison, there was statistical significance between combined predictive factors and the other independent risk factors ( P>0.05). Conclusions:The incidence of fibrosis 5 years after pediatricliver transplantation is 57.5%. Prolonged cold ischemia time, biliarystricture, rejectionand drug-induced liver injury after liver transplantation are independent risk factors for fibrosis 5 years after pediatric liver transplantation.And the combined predictive factors have a high predictive value forallograftfibrosis.

Objective: To analyze the molecular characteristics of Listeria monocytogenes strains from ready-to eat food in China. Methods: A total of 239 Listeria monocytogenes strains isolated from ready-to-eat food in 2017, all strains underwent whole-genome sequencing (WGS) , and comparisons uncovered population structure derived from lineages, clonal complex, serogroups, antimicrobial susceptibility and virulence, which were inferred in silico from the WGS data. Core genome multilocus sequence typing was used to subtype isolates. Results: All strains were categorized into three different lineages, lineage Ⅱ was the predominant types in food, and IIa was the main serogroups. CC8, CC101 and CC87 were the first three prevalent CCs among 23 detected CCs, accounting for 49.4%. Only 4.6% (11 isolates) of tested strains harbored antibiotic resistance genes, which were mostly trimethoprim genes (7 isolates, 2.9%). All strains were positive for LIPI-1, and only a part of strains harbored LIPI-3 and LIPI-4, accounting for 13.8% (33 isolates) and 14.2% (34 isolates), respectively. ST619 carried both LIPI-3 and LIPI-4. 51.5% (123 isolates) of strains carried SSI-1, and all CC121 strains harbored SSI-2. Different lineages, serogroups and CCs can be separated obviously through cgMLST analysis, and 24 sublineages were highly concordant with CCs. Conclusion Ⅱa was the main serogroups in ready-to-eat food isolates in China; CC8, CC101 and CC87 were the prevalent CCs, and CC87 isolates was hypervirulent isolates, cgMLST method can be adopted for prospective foodborne disease surveillance and outbreaks detection.

Objective:This study aimed to investigate the functional and aesthetical outcomes after index pollicization for severe congenital thumb hypoplasia.Methods:From June 2010 to November 2018, 26 patients (29 hands) with Manske modified Blauth type ⅢB-V thumb hypoplasia who were admitted to Department of Hand Surgery, Beijing Ji Shui Tan Hospital were treated with index pollicization. Thumb abduction angles, Kapandji score, pinch forces, interphalangeal and metacarpophalangeal ranges of motion were measured. The stability of carpometacarpal joint was checked. Goldfarb function score and Likert scale score were used to evaluate overall function of thumb. Whether new first metacarpal’s physeal closure presence was observed on X-ray film. Postoperative complications were recorded. The patients’guardian’s and follow-up doctor’s subjective satisfactions on thumb appearance and function were surveyed. The correlation between guardian’s satisfaction and objective indicators, the differences between guardian’s and doctor’s satisfactions, the difference between operation satisfaction before and after 3 years old were analyzed.Results:Among 26 patients(4 type ⅢB, 16 type Ⅳ, and 9 type V), there were 19 males and 7 females with an average age of 37 months (range: 15-89 months) during surgery, including 8 left hands, 15 right hands and 3 bilateral hands. The average follow-up was 42 months. Average thumb radial abduction was 46.2°, average palmar abduction was 34.1°, and average Kapandji score was 7.1. Average angle of interphalangeal joint extension was 3.4°, flexion 40.7°, metacarpophalangeal joint extension 4.1°, flexion 38.6°. The average pinching forces (key pinch, tip pinch and tripod pinch) were 0.5 kg, 0.8 kg and 1.2 kg respectively. All carpometacarpal joints were stable. The average Goldfarb score was 4. The average Likert scale was 22. All epiphyses were open. First web contracture and superficial skin necrosis were respectively observed in 1 and 6 cases. There was no correlation between the guardian’s satisfaction and the objective indicators. The guardian’s satisfaction on thumb appearance and function was significantly lower than that of doctors’. There was no significant difference in guardian’s and physician’s satisfaction between patients before and after 3 years old.Conclusions:Satisfactory functional outcomes can be obtained after index pollicization for patients with Manske modified Blauth ⅢB-V thumb hypoplasia, with weak strength of thumb opposition and flexion. The subjective satisfaction of doctors was higher and that of guardians was lower.

Objective:This study aimed to investigate the functional and aesthetical outcomes after index pollicization for severe congenital thumb hypoplasia.Methods:From June 2010 to November 2018, 26 patients (29 hands) with Manske modified Blauth type ⅢB-V thumb hypoplasia who were admitted to Department of Hand Surgery, Beijing Ji Shui Tan Hospital were treated with index pollicization. Thumb abduction angles, Kapandji score, pinch forces, interphalangeal and metacarpophalangeal ranges of motion were measured. The stability of carpometacarpal joint was checked. Goldfarb function score and Likert scale score were used to evaluate overall function of thumb. Whether new first metacarpal’s physeal closure presence was observed on X-ray film. Postoperative complications were recorded. The patients’guardian’s and follow-up doctor’s subjective satisfactions on thumb appearance and function were surveyed. The correlation between guardian’s satisfaction and objective indicators, the differences between guardian’s and doctor’s satisfactions, the difference between operation satisfaction before and after 3 years old were analyzed.Results:Among 26 patients(4 type ⅢB, 16 type Ⅳ, and 9 type V), there were 19 males and 7 females with an average age of 37 months (range: 15-89 months) during surgery, including 8 left hands, 15 right hands and 3 bilateral hands. The average follow-up was 42 months. Average thumb radial abduction was 46.2°, average palmar abduction was 34.1°, and average Kapandji score was 7.1. Average angle of interphalangeal joint extension was 3.4°, flexion 40.7°, metacarpophalangeal joint extension 4.1°, flexion 38.6°. The average pinching forces (key pinch, tip pinch and tripod pinch) were 0.5 kg, 0.8 kg and 1.2 kg respectively. All carpometacarpal joints were stable. The average Goldfarb score was 4. The average Likert scale was 22. All epiphyses were open. First web contracture and superficial skin necrosis were respectively observed in 1 and 6 cases. There was no correlation between the guardian’s satisfaction and the objective indicators. The guardian’s satisfaction on thumb appearance and function was significantly lower than that of doctors’. There was no significant difference in guardian’s and physician’s satisfaction between patients before and after 3 years old.Conclusions:Satisfactory functional outcomes can be obtained after index pollicization for patients with Manske modified Blauth ⅢB-V thumb hypoplasia, with weak strength of thumb opposition and flexion. The subjective satisfaction of doctors was higher and that of guardians was lower.

The bursa of Fabricius (BF) is a central humoral immune organ unique to birds. Four bursal peptides (BP-I, BP-II, BP-III, and BP-IV) have been isolated and identified from the BF. In this study, the immunoadjuvant activities of BPs I to IV were examined in mice immunized with H9N2 avian influenza virus (AIV) vaccine. The results suggested that BP-I effectively enhanced cell-mediated immune responses, increased the secretion of Th1 (interferon gamma)- and Th2 (interleukin-4)-type cytokines, and induced an improved cytotoxic T-lymphocyte (CTL) response to the H9N2 virus. BP-II mainly elevated specific antibody production, especially neutralizing antibodies, and increased Th1- and Th2-type cytokine secretion. BP-III had no significant effect on antibody production or cell-mediated immune responses compared to those in the control group. A strong immune response at both the humoral and cellular levels was induced by BP-IV. Furthermore, a virus challenge experiment followed by H&E staining revealed that BP-I and BP-II promoted removal of the virus and conferred protection in mouse lungs. BP-IV significantly reduced viral titers and histopathological changes and contributed to protection against H9N2 AIV challenge in mouse lungs. This study further elucidated the immunoadjuvant activities of BPs I to IV, providing a novel insight into immunoadjuvants for use in vaccine design.
Adjuvants, Immunologic ; Animals ; Antibodies, Neutralizing ; Antibody Formation ; Birds ; Bursa of Fabricius ; Cytokines ; Immunity, Cellular ; Immunity, Humoral ; Influenza A Virus, H9N2 Subtype ; Influenza in Birds ; Lung ; Mice ; Peptides ; T-Lymphocytes, Cytotoxic