This report described a case of eclampsia complicated by hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome with refractory hepatic impairment. The patient presented at 34 +6 weeks' gestation with convulsions and impaired consciousness for over 3 hours, accompanied by severe hypertension [240/120 mmHg (1 mmHg=0.133 kPa)]. Emergency cesarean delivery was performed at a local hospital. On postoperative day 2, the patient was transferred to our institution due to sharp transaminase elevation, hepatic failure, and coagulopathy. Although treated with artificial liver support, anti-infection therapy, and organ protection measures, hepatic parameters showed intermittent rebounds. Subsequent detection of cytomegalovirus in bronchoalveolar lavage fluid and blood prompted targeted antiviral therapy, which significantly improved hepatic injury. Through multidisciplinary management, the patient recovered and was discharged 43 days postpartum. Although multiple artificial liver sessions provided limited hepatic function improvement, this case offers valuable insights for managing refractory hepatic impairment in pregnant women, regardless of whether viral infection represented a primary etiology or secondary complication.

Objective To investigate the protective effect of LncRNA MEG3 on the retina in early-stage diabetic rats through regulation of the COX-2/PGE2/VEGF signaling pathway.Methods 50 male SD rats of SPF grade were selected for the study.Among them,10 rats were assigned to the control group,while 40 rats were used to establish diabetic retinopathy models.A total of 32 rats successfully underwent modeling and were subsequently divided into four groups(n=8 per group):model group,negative control group,MEG3 overexpression group,and MEG3 overexpression+COX-2 inhibitor group.Histopathological changes,vascular permeability,glucose and lipid metabolism,inflammatory factors,oxidative stress indices,PGE2 levels,as well as the relative mRNA and protein expression levels of COX-2 and VEGF were evaluated in each group.Results Compared with the control group,HDL-C,CAT,GSH-PX,and SOD levels were significantly decreased,whereas the mRNA and protein expression levels of vascular permeability,TG,TC,LDL-C,IL-6,IL-1β,TNF-α,MDA,PGE2,COX-2,and VEGF were significantly increased in the model group(P<0.05).Compared with the negative control group,HDL-C,CAT,GSH-PX,and SOD levels were significantly increased in the MEG3 overexpression group,while the mRNA and protein expression levels of vascular permeability,TG,TC,LDL-C,IL-6,IL-1β,TNF-α,MDA,PGE2,COX-2,and VEGF were significantly decreased(P<0.05).Compared with the MEG3 overexpression group,HDL-C,CAT,GSH-PX,and SOD levels were further increased in the MEG3 overexpression+COX-2 inhibitor group,and the mRNA and protein expression levels of vascular permeability,TG,TC,LDL-C,IL-6,IL-1β,TNF-α,MDA,PGE2,COX-2,and VEGF were further decreased(P<0.05).Conclusion LncRNA MEG3 is capable of regulating the COX-2/PGE2/VEGF pathway,enhancing glucose and lipid metabolism in rats,suppressing the expression of inflammatory factors,attenuating stress responses,and alleviating diabetic retinopathy.

Objective To explore the therapeutic effect of cornuside on diabetic retinopathy(DR)in rats and ana-lyze the acting mechanism of the reactive oxygen species(ROS)/thioredoxin interacting protein(TXNIP)/NOD-like recep-tor thermal protein domain associated protein 3(NLRP3)signaling pathway in this process.Methods A total of 56 suc-cessfully modeled DR rats were randomly divided into the model group,the cornuside 20 mg·kg-1 group,the cornuside 40 mg·kg-1 group,the calcium dobesilate 5.8 mg·kg-1 group,with 14 rats in each group;while,meanwhile another 14 healthy rats were selected as the control group.After the corresponding intervention of rats in each group,retinal tissue in-flammation,oxidative stress indicators,fasting blood glucose(FBG),and angiogenic factor levels were detected by the en-zyme-linked immunosorbent assay(ELISA).The hematoxylin-eosin(HE)staining and terminal deoxynucleotidyl transfer-ase dUTP nick end labeling(TUNEL)staining were used to observe retinal histopathology and retinal cell apoptosis,re-spectively.The mRNA expression of ROS,TXNIP,and NLRP3 in the retinal tissue was detected by the quantitative fluores-cence polymerase chain reaction(PCR).The apoptosis of retinal cells and the protein expression of the ROS/TXNIP/NL-RP3 signaling pathway were detected by Western blotting.Results Compared with the control group,the model group showed disordered arrangement of retinal cells and a significant decrease in the cell number,accompanied by nuclear con-densation and edema;interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),malondialdehyde(MDA),FBG,angiopoie-tin-1(Ang-1),vascular endothelial growth factor(VEGF),retinal cell apoptosis rate,ROS,and the mRNA and protein ex-pression levels of TXNIP and NLRP3 increased significantly,while superoxide dismutase(SOD)and B cell lymphoma-2(Bcl-2)protein expression levels decreased significantly(all P＜0.05).Compared with the model group,the arrangement of retinal cells in the cornuside 20 mg·kg-1 group,the cornuside 40 mg·kg-1 group,and the calcium dobesilate 5.8 mg·kg-1 group gradually became normal,the number of retinal cells increased,and the nuclear condensation and edema were relieved;IL-6,TNF-α,MDA,FBG,Ang-1,VEGF,retinal cell apoptosis rate,ROS,and the mRNA and protein expression level of TXNIP and NLRP3 decreased significantly,while the protein expression level of SOD and Bcl-2 increased signifi-cantly(all P＜0.05).In the intergroup comparison of the pathological damage of retinal tissue and the improvement degree of the above quantitative indexes in DR rats,the cornuside 40 mg·kg-1group was superior to the cornusin 20 mg·kg-1 group(all P＜0.05);the calcium dobesilate 5.8 mg·kg-1 group was superior to the cornusin 20 mg·kg-1 group,but infe-rior to the cornuside 40 mg·kg-1 group(all P＜0.05).Conclusion Cornuside can mitigate retinal inflammation,oxi-dative stress,and pathological damage in DR rats and inhibit blood glucose,retinal angiogenesis,and cell apoptosis.The acting mechanism of cornuside may be related to the inhibition of the ROS/TXNIP/NLRP3 signaling pathway.

Objective To investigate the protective effect of LncRNA MEG3 on the retina in early-stage diabetic rats through regulation of the COX-2/PGE2/VEGF signaling pathway.Methods 50 male SD rats of SPF grade were selected for the study.Among them,10 rats were assigned to the control group,while 40 rats were used to establish diabetic retinopathy models.A total of 32 rats successfully underwent modeling and were subsequently divided into four groups(n=8 per group):model group,negative control group,MEG3 overexpression group,and MEG3 overexpression+COX-2 inhibitor group.Histopathological changes,vascular permeability,glucose and lipid metabolism,inflammatory factors,oxidative stress indices,PGE2 levels,as well as the relative mRNA and protein expression levels of COX-2 and VEGF were evaluated in each group.Results Compared with the control group,HDL-C,CAT,GSH-PX,and SOD levels were significantly decreased,whereas the mRNA and protein expression levels of vascular permeability,TG,TC,LDL-C,IL-6,IL-1β,TNF-α,MDA,PGE2,COX-2,and VEGF were significantly increased in the model group(P<0.05).Compared with the negative control group,HDL-C,CAT,GSH-PX,and SOD levels were significantly increased in the MEG3 overexpression group,while the mRNA and protein expression levels of vascular permeability,TG,TC,LDL-C,IL-6,IL-1β,TNF-α,MDA,PGE2,COX-2,and VEGF were significantly decreased(P<0.05).Compared with the MEG3 overexpression group,HDL-C,CAT,GSH-PX,and SOD levels were further increased in the MEG3 overexpression+COX-2 inhibitor group,and the mRNA and protein expression levels of vascular permeability,TG,TC,LDL-C,IL-6,IL-1β,TNF-α,MDA,PGE2,COX-2,and VEGF were further decreased(P<0.05).Conclusion LncRNA MEG3 is capable of regulating the COX-2/PGE2/VEGF pathway,enhancing glucose and lipid metabolism in rats,suppressing the expression of inflammatory factors,attenuating stress responses,and alleviating diabetic retinopathy.

Objective To explore the therapeutic effect of cornuside on diabetic retinopathy(DR)in rats and ana-lyze the acting mechanism of the reactive oxygen species(ROS)/thioredoxin interacting protein(TXNIP)/NOD-like recep-tor thermal protein domain associated protein 3(NLRP3)signaling pathway in this process.Methods A total of 56 suc-cessfully modeled DR rats were randomly divided into the model group,the cornuside 20 mg·kg-1 group,the cornuside 40 mg·kg-1 group,the calcium dobesilate 5.8 mg·kg-1 group,with 14 rats in each group;while,meanwhile another 14 healthy rats were selected as the control group.After the corresponding intervention of rats in each group,retinal tissue in-flammation,oxidative stress indicators,fasting blood glucose(FBG),and angiogenic factor levels were detected by the en-zyme-linked immunosorbent assay(ELISA).The hematoxylin-eosin(HE)staining and terminal deoxynucleotidyl transfer-ase dUTP nick end labeling(TUNEL)staining were used to observe retinal histopathology and retinal cell apoptosis,re-spectively.The mRNA expression of ROS,TXNIP,and NLRP3 in the retinal tissue was detected by the quantitative fluores-cence polymerase chain reaction(PCR).The apoptosis of retinal cells and the protein expression of the ROS/TXNIP/NL-RP3 signaling pathway were detected by Western blotting.Results Compared with the control group,the model group showed disordered arrangement of retinal cells and a significant decrease in the cell number,accompanied by nuclear con-densation and edema;interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),malondialdehyde(MDA),FBG,angiopoie-tin-1(Ang-1),vascular endothelial growth factor(VEGF),retinal cell apoptosis rate,ROS,and the mRNA and protein ex-pression levels of TXNIP and NLRP3 increased significantly,while superoxide dismutase(SOD)and B cell lymphoma-2(Bcl-2)protein expression levels decreased significantly(all P＜0.05).Compared with the model group,the arrangement of retinal cells in the cornuside 20 mg·kg-1 group,the cornuside 40 mg·kg-1 group,and the calcium dobesilate 5.8 mg·kg-1 group gradually became normal,the number of retinal cells increased,and the nuclear condensation and edema were relieved;IL-6,TNF-α,MDA,FBG,Ang-1,VEGF,retinal cell apoptosis rate,ROS,and the mRNA and protein expression level of TXNIP and NLRP3 decreased significantly,while the protein expression level of SOD and Bcl-2 increased signifi-cantly(all P＜0.05).In the intergroup comparison of the pathological damage of retinal tissue and the improvement degree of the above quantitative indexes in DR rats,the cornuside 40 mg·kg-1group was superior to the cornusin 20 mg·kg-1 group(all P＜0.05);the calcium dobesilate 5.8 mg·kg-1 group was superior to the cornusin 20 mg·kg-1 group,but infe-rior to the cornuside 40 mg·kg-1 group(all P＜0.05).Conclusion Cornuside can mitigate retinal inflammation,oxi-dative stress,and pathological damage in DR rats and inhibit blood glucose,retinal angiogenesis,and cell apoptosis.The acting mechanism of cornuside may be related to the inhibition of the ROS/TXNIP/NLRP3 signaling pathway.

This report described a case of eclampsia complicated by hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome with refractory hepatic impairment. The patient presented at 34 +6 weeks' gestation with convulsions and impaired consciousness for over 3 hours, accompanied by severe hypertension [240/120 mmHg (1 mmHg=0.133 kPa)]. Emergency cesarean delivery was performed at a local hospital. On postoperative day 2, the patient was transferred to our institution due to sharp transaminase elevation, hepatic failure, and coagulopathy. Although treated with artificial liver support, anti-infection therapy, and organ protection measures, hepatic parameters showed intermittent rebounds. Subsequent detection of cytomegalovirus in bronchoalveolar lavage fluid and blood prompted targeted antiviral therapy, which significantly improved hepatic injury. Through multidisciplinary management, the patient recovered and was discharged 43 days postpartum. Although multiple artificial liver sessions provided limited hepatic function improvement, this case offers valuable insights for managing refractory hepatic impairment in pregnant women, regardless of whether viral infection represented a primary etiology or secondary complication.

Objective To explore the molecular mechanism of lipopolysaccharide(LPS)on the contraction of pregnant uterine smooth muscle at tissue and cellular levels.Methods C57BL/6J mice at 16 days of gestation were randomly divided into control group and LPS group.The mice in LPS group were intraperitoneally injected with 20 μg in LPS solution to establish the model of preterm birth,and the mice in control group were intraperitone-ally injected with the same amount of normal saline.Isolated uterine muscle strips were used to detect changes in the contractile function of the tissue,as well as changes in the expression and function of the contraction key signa-ling molecule TWIK-related K+channel 1(TREK-1).Primary cultured pregnant mouse uterine smooth muscle cells were used to detect the expression of TREK-1 under the regulation of LPS.Results The contractility of mouse u-terine tissues was significantly enhanced by LPS,and the protein expression of TREK-1,a key signal for contrac-tion,was significantly reduced,and activation of TREK-1 resulted in a significant down-regulation of the enhanced contractility of mouse uterine tissues in the LPS group.However,there was no significant difference in the expres-sion of TREK-1 protein,which was highly expressed in the smooth muscle of pregnant mice,when LPS acted on the primary uterine smooth muscle cells of pregnant mice.Conclusion Uterine contractility is enhanced in pregnant mice uterine tissues by inhibiting TREK-1 expression and function in response to LPS,and it may be one of the mechanisms by which LPS induces preterm labor.However,the effect of LPS on TREK-1 on mouse pregnant uter-ine smooth muscle cells may be realized through intercellular signaling and not directly on uterine smooth muscle cells.This further suggests that the animal and histological experiments cannot be completely replaced by isolated cell experiments in the study of inflammatory preterm labor.

Objective:To understand the current research status of master of professional degree students in clinical medicine in provincial teaching hospitals with moderate scientific research level under the " dual-track" training system.Methods:Sojump online survey was conducted to investigate the cognition, current situation and self-evaluation of all clinical master degree students in three grades in a provincial teaching hospital, and the research status of professional degree and scientific degree students was compared and analyzed respectively.Results:The proportion of scientific degree students participating in scientific research projects was significantly higher than that of professional degree students. The proportion of professional degree students participating in scientific research projects was still not high even in the third year of graduate students. However, there was no difference between scientific degree and professional degree students in the publication of scientific research papers. The scientific degree of scientific research knowledge is significantly higher than that of professional degree students. Although scientific degree students receive more scientific research guidance from their supervisors, professional degree students communicate more with their supervisors, and the results show that professional degree students are significantly more satisfied with their supervisors, graduate policies and scientific research policies than scientific degree students. In addition, the results of graduate students found that the degree of research stress of both scientific and professional degrees exceeded 50%.Conclusions:Scientific degree is better than professional degree in research status because of professional characteristics and more research guidance from their supervisors. However, through the reform of professional degree training mode based on scientific research project management in recent years, professional degree students have been able to communicate more with their supervisors, and their satisfaction with their supervisors and colleges has significantly increased. In addition, sufficient attention should be paid to high scientific research pressure of medical graduate students.

OBJECTIVE:To study the inhibition effects of tranilast on hypertrophic scar tissue of rabbits and its mechanism. METHODS:Rabbits were selected to induce hypertrophic scar(HS)model,the HS model rats were randomly divided into model control group (normal saline),tranilast low-dose,medium-dose,high-dose groups (0.3,0.5,0.7 mg/kg),6 rabbits in each group,local intradermaly injected corresponding drugs. Scar thickness 1 h before injection and the first,third,fifth week after in-jection in each group were measured,pathological changes of scar(fifth week after injection)were observed,transforming growth factor β1 (TGF-β1),α-smooth muscle actin(α-SMA)mRNA and protein expression were detected. RESULTS:Compared with 1 h before injection,scar thickness of rabbits in other groups were decreased after injection except for model control group. In fifth week after injection,compared with model control group,scar thickness of rabbits in other groups were decreased,pathological changes were improved;TGF-β1,α-SMA mRNA and protein expression were decreased (P<0.05),showing positive correlation with tranilast dose. CONCLUSIONS:Tranilast can inhibit the formation of hypertrophic scar,and the mechanism may be related to inhibiting the TGF-β1,α-SMA mRNA and protein expression.

Infection is a catastrophiccomplication in total knee arthroplasty.Reported a case of Nocardiafarcinica infection which appeared after application of cemented total knee replacement.A 64-year-old male patient was admitted to hospital 1 months after knee surgery,with a 2-week history of pain,swelling,and restricted mobility.As no improvement could be a-chieved after synovectomy and antibiotherapy,the prosthesis were removed from him.Although improvement could not be a-chieved in the knee of the patient at the end of 10-month therapy,the case has still being followed-up.