AIM: To study the protective effect of fenofibrate on diabetic retinal neurodegeneration and observe its effect on miR-26a-5p and its target gene PTEN in the retinal of diabetic mice.METHODS: Diabetic mice models were established and they were gavaged by fenofibrate. H& E staining and transmission electron microscopy were used to observe the impairments of retinal neurons. Real-time PCR was used to examine the expression of miR-26a-5p, and Western blotting was employed to measure the expression of phosphatase and tensin homologue(PTEN)in the retina of diabetic mice. The expression level of nuclear factor-κB(NF-κB), interleukin-1β(IL-1β)and the morphology of neural tissues were observed.RESULTS: When compared with the diabetic mice, fenofibrate significantly attenuated the damage to retinal ganglion cells and the atrophy of retinal nerve fiber layer. While the level of miR-26a-5p was increased and the levels of PTEN and inflammatory mediators were significantly decreased in the retina of fenofibrate treated diabetic mice, with significant statistical significance(P<0.05).CONCLUSIONS: Fenofibrate protects against diabetic retinal neurodegeneration by upregulating miR-26a-5p and inhibiting PTEN, attenuating the inflammatory response and alleviating retinal cell injury.

Objective To investigate the effects of microRNA-26a-5p(miR-26a-5p)on high glucose-induced retina Müller activation and apoptosis by regulating PTEN/PI3K/Akt signaling pathway,and the potential mechanism of diabetic retinal neurodegeneration.Methods Various concentrations of high glucose were added into rMC-1 culture.CCK-8 and flow cytometry was used to examine cell proliferation and apoptosis respectively.The regulatory effects of miR-26a-5p on the expressions of PTEN,PI3K and Akt were observed by real-time PCR;the expression levels of IL-1β and IL-6 in Müller cells were examined by ELISA.The data were processed by Graphpad 8.0 software.Results Müller cells grew actively in high-glucose stimulation culture.Compared with the control group,the activity of Müller cells stimulated by 50 mmol/L glucose increased gradually at 12 h and 24 h,but decreased at 48 h after stimulation,when Müller cells apoptosis increased.The difference between the groups was statistically significant(P＜0.05).The expression of miRNA-26a-5p decreased,that of PTEN increased,and those of PI3K and Akt decreased.Meanwhile,IL-1β and IL-6 levels were significantly increased in Müller cells.miR-26a-5p over-expression alleviated injuries to high glucose stimulated retinal Müller cells by inhibiting PTEN,which upregulated the expression of PI3K/Akt and downregulation of IL-1β and IL-6(P＜0.01).Conclusion Upregulating miR-26a-5p protects Müller cells against apoptosis,probably through regulation of PTEN/PI3K/Akt and affecting the production of inflammatory factors.

In recent years,with the development of the bio-psycho-social medical model,more and more attention has been paid to the relationship between psycho-emotional factors and liver.According to traditional Chinese medicine theory,the liver is mainly responsible for catharsis and regulating emotion,which is closely related to emotion.Epidemiological studies have shown that all kinds of liver diseases are accompanied by different degrees of mental disorders,and mental and emotional abnormalities may promote the occurrence of liver diseases and affect the prognosis.Liver and emotion have a common pathogenesis in pathology,involving the dysfunction of nervous,endocrine and immune systems.Based on the basic theory of traditional Chinese medicine and modern medical research,this review analyzes the correlation between emotions and liver.At the same time,neurotransmitters,inflammatory cytokines,brain-derived neurotrophic factor(BDNF),soluble epoxide hydrolase(sEH),intestinal microecology,hypothalamic-pituitary-adrenal(HPA)axis and hypothalamic-pituitary-thyroid(HPT)axis,which summarizes the potential mechanisms of liver disease complicated with emotional disorders,and provides certain reference value for future theoretical research and clinical treatment.

Objective To observe the thickness changes in the peripapillary retinal nerve fiber layer(RNFL)and the ganglion cell-inner plexiform layer(GC-IPL)in the macular region,so as to analyze the pathological rules of retinal nerve injury in diabetes retinopathy(DR)patients and explore the related risk factors.Methods A total of 164 patients(164 eyes)with type 2 diabetes who visited the Department of Ophthalmology and Department of Endocrinology of Shaanxi Pro-vincial People's Hospital from January 1,2017 to January 1,2018 were selected as the subjects.According to the condition of concomitant DR,these subjects were divided into three groups:non-DR(NDR)group(56 eyes of 56 patients),mild non-proliferative DR(NPDR)group(53 eyes of 53 patients)and moderate NPDR group(55 eyes of 55 patients).Healthy individuals who underwent physical examinations in the same period were selected as the control group(50 eyes of 50 pa-tients).Optical coherence tomography and optical coherence tomography angiography were used to measure the peripapil-lary RNFL,macular GC-IPL,and macular vessel density(VD)of all subjects.Comparison among groups and correlation analysis were conducted on the above retinal nerve injury indicators.Results Compared with the control group and NDR group,the average,upper and lower peripapillary RNFL in the mild NPDR group and moderate NPDR group were signifi-cantly thinner,and the differences were statistically significant(all P＜0.05).The differences in macular GC-IPL thickness at the average,upper,upper temporal,lower temporal,lower,lower nasal,and upper nasal regions in all groups were sta-tistically significant(all P＜0.05);pairwise comparisons showed that compared with the control group,the GC-IPL thick-ness in each quadrant of the macular area of patients in the NDR group,mild NPDR group and moderate NPDR group de-creased significantly(all P＜0.05),with the upper GC-IPL thinning being the most significant;compared with the NDR group,the GC-IPL thickness in the upper,average,and upper temporal macular area of patients with mild NPDR decreased significantly(all P＜0.05);compared with the mild NPDR group,the GC-IPL thickness in the upper macular area was thin-ner in the moderate NPDR group,and the difference was statistically significant(P＜0.05).There were statistically signifi-cant differences in the average and inner ring VDs in the macular area among the groups(both P＜0.05).The correlation analysis results showed that there was a significantly positive correlation between the peripapillary RNFL thickness and the average VD in the macular area(r=0.517,P＜0.01),while the average GC-IPL thickness in the macular area was weakly positively correlated with the average VD in the macular area(r=0.279,P＜0.01).Conclusion The peripapillary RNFL thickness objectively reflects the degree of retinal neuron injury,and is a key index to evaluate the degree of retinal nerve injury in diabetes patients.

Background: Domestic yaks are the most important livestock species on the Qinghai-Tibetan Plateau. Adult female yaks normally breed in the warm season (July to September) and enter anestrous in the cold season (November to April). Nevertheless, it is unclear how ovarian activity is regulated at the molecular level. Objectives: The peculiarities of yak reproduction were assessed to explore the molecular mechanism of postpartum anestrus ovaries in yaks after pregnancy and parturition. Methods: Sixty female yaks with calves were observed under natural grazing in Haiyan County, Qinghai Province. Three yak ovaries in pregnancy and postpartum anestrus were collected. RNA sequencing and quantitative proteomics were employed to analyze the pregnancy and postpartum ovaries after hypothermia to identify the genes and proteins related to the postpartum ovarian cycle. Results: The results revealed 841 differentially expressed genes during the postpartum hypoestrus cycle; 347 were up-regulated and 494 genes were down-regulated. Fifty-seven differential proteins were screened: 38 were up-regulated and 19 were down-regulated. The differential genes and proteins were related to the yak reproduction process, rhythm process, progesterone-mediated oocyte maturation, PI3K/AKT signaling pathway, and MAPK signaling pathway categories. Conclusions Transcriptome and proteomic sequencing approaches were used to investigate postpartum anestrus and pregnancy ovaries in yaks. The results confirmed that BHLHE40, SF1IX1, FBPX1, HSPCA, LHCGR, BMP15, and ET-1R could affect postpartum hypoestrus and control the state of estrus.

Objective:To investigate the relationship between self-management ability and self-efficacy in coronary heart disease (CHD) patients, and the influential factors.Methods:From April to June 2016, a questionnaire survey was conducted among 236 patients with coronary heart disease selected by simple random sampling method in the outpatient clinic of Pengpu Community Health Service Center; and the Coronary Artery Disease Self-management Scale and self-efficacy questionnaire were used in the survey. The correlation between scores of the two scales was analyzed; the scores were compared between patients with percutaneous coronary intervention (PCI) and those without PCI, between patients with myocardial infarction (MI) and those without MI. Multiple linear regression was performed to elucidate the influencing factors of self-management ability and self-efficacy of CHD patients.Results:The mean scores of self-management ability and self-efficacy were (75.5±15.5) and (24.8±10.8), respectively. The self-management ability was significantly correlated with self-efficacy in CHD patients(r=0.398-0.683, P<0.05). The self-management score of patients with PCI was higher than those without PCI[ (80.4±14.9) vs.(72.5±15.1), t=3.38, P<0.01]. The scores of self-management[(85.0±16.4) vs.(72.9±14.2), t=5.14, P<0.01]and self-efficacy[(29.3±12.0) vs. (23.6±10.2), t=3.39, P<0.01] of patients with MI were higher than those without MI. Multiple linear stepwise regression analysis indicated that age over 65, history of MI, history of PCI, history of smoking and self-efficacy score were all factors influencing self-management behavior in patients with CHD ( R=0.735; R2=0.540; F=26.451, P<0.01). Smoking history and self-management score were the influencing factors of self-efficacy in patients with CHD ( R=0.690; R2=0.476; F=20.425, P<0.01). Conclusion:The self-efficacy of patients with CHD is closely related to their self-management behavior, so we should strengthen their self-efficacy and improve their self-management level by comprehensive measures, particularly for patients without PCI.

Objective? To understand the self-management status among elderly chronic heart failure (CHF) patients and to compare the regional differences of self-management. Methods? By random cluster sampling, we investigated 6 124 elderly CHF patients from 102 hospitals in five regions, East China (Jiangxi Province, Shanghai Municipality, Zhejiang Province), West China (Qinghai Province, Xinjiang Uygur Autonomous Region, Shaanxi Province, Gansu Province, Ningxia Hui Autonomous Region, Yunnan Province), South China (Hainan Province, Guangxi Zhuang Autonomous Region), North China (Heilongjiang Province, Inner Mongolia Autonomous Region), Central China (Henan Province, Hubei Province, Hunan Province). The investigation result statistics were carried out and regional differences were compared. Results? The self-management of elderly CHF patients had a low to medium level with 61.25% (49/80) ＜80% for the scoring rate. The scores of East China and Central China were higher and the score of West China was low; the regional differences were statistical (H=59.07, P＜0.01). The score of diet management was highest with 66.67% for the scoring rate (8/12); East China had the highest score, and West China had the lowest score; the regional differences were statistical (H=92.49, P＜0.01). The scoring rate of medication management was 65.00% (13/20) with the highest in East China and low in North China and West China; the regional differences were statistical (H=351.10, P＜0.01). Mental/social adjustment management was poor with 60.00% (12/20) for the scoring rate; the scores of Ease China were higher than those of North and West China; the regional differences were statistical (H=8.84, P＜0.01). Symptom management was the worst with 57.14% (16/28) for the scoring rate; the scores of East and Central China were high;the regional differences were also statistical (H=17.62,P＜0.01). Conclusions? Self-management of elderly CHF patients needs to be improved. Systematic and targeted health education for different regions should be carried out to improve patients' self-management and to reduce the disease burden.

Objective To intervene and appraise the health literacy of diabetic patients entering contracts with family doctors in pilot communities,and learn the effect and feasibility of health literacy management by family doctors for diabetic patients.Methods By means of community intervention study and questionnaire survey,560 diabetic patients as mentioned above in Shanghai were subject to a baseline assessment on their health literacy,followed by management and routine follow-up on their diabetic health literacy.At the end of six months of comprehensive intervention,their health literacy was appraised again to observe the effects of such management.Results Six months of guidance and management found the average scoring of the health literacy of these patients 23.46 over the baseline,an increase of 36.8% of the patients in their compliance of the four basic diabetic diet behaviors,and an increase of 27.8% of them in regular and quantitative exercises.Conclusions It is feasible for community family doctors to carry out the health literacy management for diabetic patients contracted,and health literacy management can change the awareness and behaviors of such patients to some extent.

OBJECTIVE:To provide reference for the realization of normalization and standardization of quality control and management of Pharmacy intravenous admixture service(PIVAS). METHODS:The management and effectiveness of PIVAS quali-ty control in our hospital were introduced from aspects of the establishment of internal quality control system,the key indicators and effects of quality control. RESULTS:According to checking items from aspects of examining once in a month,on prescription checking,preparation,infection control,equipments,drugs,consumable materials,sanitation;holding 1 monthly quality control reviews;and analyzing unqualified indexes and existing security risks,the quality control of PIVAS had achieved good results. The qualified percentage of quality control index was increased from 84%(Jan. 2016)to 90%(Jun. 2016),error rate in the same peri-od was decreased from 0.579‰ to 0.099‰. CONCLUSIONS:Developing quality control of the implementation of detailed quality control key indexes for the whole process of intravenous infusion in PIVAS can effectively regulate the position working process,re-duce preparation error and ensure the quality of infusion preparation.

Objective To establish a polymerase spiral reaction (PSR) method for rapid detection of influenza A/H1N1 virus.Methods Six sets of primers were designed for influenza A/H1N1 virus HA gene, and the results were determined with real time kinetic turbidimetric assay and colorimetry method.Results and Conclusion The best primers were selected from six sets of primers, and the best temperature was determined as 65 degrees Celsius.Further experiments showed that the best primer had good specificity for detection of influenza A/H1N1 virus,without cross reactions with 14 other respiratory tract pathogenic nucleic acids.The sensitivity was up to 100 copies,and consistent with that of PCR.So a PSR method is established for rapid detection of the influenza A/H1N1 virus, which is simple, quick, highly specific and sensitive,and especially applicable to field and grass-roots units.