Objective:To investigate the impacts of fatty acid binding protein 4(FABP4)silencing on endoplasmic reticulum stress(ERS)and insulin resistance(IR)in gestational diabetes mellitus(GDM)rats by regulating protein kinase R-like endoplasmic reticulum kinase(PERK)/eukaryotic initiation factor 2α(eIF2α)/transcription factor 4(ATF4)/C/EBP homologous protein(CHOP)signaling pathway.Methods:GDM rat model was established by intraperitoneal injection of streptozotocin(STZ).Rats were injected with FABP4 siRNA plasmid(si-FABP4),negative control plasmid(NC)and PERK activator(CCT020312)via tail vein,and were randomly grouped into Normal group,GDM group,GDM+NC group,GDM+si-FABP4 group and GDM+si-FABP4+CCT020312 group.The levels of FABP4,blood lipids,inflammatory markers and oxidative stress markers in pancreatic tissue were detected,the expres-sions of PERK/eIF2α/ATF4/CHOP signaling pathway-related proteins in pancreatic tissue were detected.HTR-8/SVneo cells were divided into 5 groups:Control group,high glucose(HG)group,HG+NC group,HG+si-FABP4 group,HG+si-FABP4+CCT020312 group.After 24 h,the expressions of FABP4 and PERK/eIF2α/ATF4/CHOP signaling pathway related proteins were detected.Results:Compared with Normal group,the level of FABP4 in the serum and pancreatic tissue of the GDM group were obviously up-regu-lated(P<0.05).FABP4 silencing obviously reduced FBG and IR,decreased the levels of blood lipids,CRP,TNF-α,IL-6 and MDA,and increased the levels of SOD and CAT(P<0.05).Furthermore,FABP4 silencing attenuated pancreatic and placental tissue damages.After CCT020312 up-regulated the phosphorylation levels of PERK and eIF2α and the protein expressions of ATF4 and CHOP,the inhibitory effects of FABP4 silencing on IR,inflammation,oxidative stress,and pancreatic and placental damages in GDM rats were reversed(P<0.05).FABP4 was up-regulated in HTR-8/SVneo cells induced by HG,and silencing FABP4 inhibited the protein ex-pression of the PERK/eIF2α/ATF4/CHOP pathway,while CCT020312 reversed this change(P<0.05).Conclusion:FABP4 silencing improves IR and ERS in GDM rats by inhibiting inflammation and oxidative stress,and the mechanism is related to the inhibition of PERK/eIF2α/ATF4/CHOP signaling pathway.

OBJECTIVE To understand the current status of research on traditional Chinese medicine（TCM） human resources， and to provide a reference for expanding research ideas on TCM human resources and promoting the construction of TCM talents. METHODS From January 1， 2000 to December 31， 2022， literature related to TCM human resources was collected from the three major databases of CNKI， Wanfang and VIP. Using CiteSpace 5.8 R3 software， visualization analysis was performed for the literature in terms of publication time， journal sources， authors， institutions and areas， funding， research content， keywords， etc. RESULTS A total of 324 literature related to TCM human resources in China were included， and the number of literature issued showed an upward trend， with an annual average of 14.09 literature； 161 kinds of journals were involved， core journals accounted for 18.21% of the total publication volume； a total of 23 authors had published 2 or more literature， with a total of 55 literature published （16.98%）； a total of 416 institutions were involved， mainly schools （66.83%）； 60.49% of the literature were supported by the fund. The majorities of 324 literature were survey studies （170 literature）， and most of them used self-designed questionnaires （55 literature）； the high-frequency keywords included talent training， human resources， TCM， etc. The keywords were clustered into 7 categories， such as “human resources“”talent training“”TCM industry“”TCM services“”talent training models” “fairness” and “TCM talents”. The main problems described in the literature included insufficient talent， lack of reasonable distribution of regional structure， lack of reasonable plans for talent training， and insufficient professional knowledge and abilities. Continuously cultivating high-level talents and improving employment conditions in areas with severe human resource loss were the corresponding countermeasures proposed in the literature. CONCLUSIONS The research on TCM human resources starts late but has developed rapidly overall， and the quality of research needs to be improved； the structure of research team is single and unevenly distributed geographically； there is a structural imbalance in the allocation of human resources， as well as problems such as a shortage of professional talents， low levels of education and training and incomplete development systems.

Objective:In this study, the role of IL-17 in the pathogenesis of idiopathic myositis (IIM) was preliminarily investigated by detecting the expression of IL-17 in the muscle tissues of patients with idiopathic inflammatory myositis (IIM) and normal controls.Methods:Twenty-eight patients (20 in DM group with dermatomyositis and 8 in ASS group with anti-synthase syndrome) who were diagnosed with IIM after muscle biopsy and autoantibody detection in our hospital for the first time from October 2019 to August 2021 were included. Twelve cases with normal muscle tissue matched for age and sex were included as the control group. Western blot and immunohistochemical techniques were used to detect the expression level of IL-17 in muscle tissue, and enzyme-linked immunosorbent assay (ELISA) was used to detect serum IL-6. Mann-Whitney U rank sum test was used to compare the difference of IL-17 expression in muscle tissue between the two groups, and non-parametric test was used for comparison between multiple groups. Chi-square test and Spearman rank correlation analysis were used, and P<0.05 was considered statistically significant. Results:① The expression level of IL-17 in IIM muscle tissue[1.63(1.30, 2.05)pg/ml was higher than that in control group[1.00(0.96, 1.00)pg/ml, and the difference was statistically significant ( Z=-3.52, P<0.001). The difference be-tween DM[1.94(1.58, 2.14)pg/ml] and ASS[1.22(1.04,1.55)pg/ml was statistically significant ( Z=-3.20, P=0.001). ② Compared with healthy control group [4.08(3.01, 5.67)pg/ml, the expression of IL-6 in ⅡM serum[8.88(4.93, 13.64) was high ( Z=-3.01, P=0.003), which was positively correlated with the expression of IL-17 ( r=0.42, P=0.027). ③ The ex-pression of IL-17 in muscle tissue was higher in IIM associated with muscle weakness[1.91(1.56, 2.14) pg/ml vs 1.50(1.04, 2.00)pg/ml] ( Z=-1.38, P=0.020), dysphagia [2.06(1.99, 2.14)pg/ml vs 1.62(1.52, 2.04)pg/ml] ( Z=-2.74, P=0.010) and skin involvement[1.98(1.57, 2.14)pg/ml vs 1.04(0.86, 1.61)pg/ml] ( Z=-3.20, P<0.010), and the differences were statistically significant ( P<0.05). ④IL-17 was positively correlated with Myoact-total activity ( r=0.51, P=0.006), Myoact-muscle symptom ( r=0.45, P=0.016), erythrocyte sedimen tation ( r=0.48, P=0.020), and myoenzyme increase ( r=0.56, P=0.002). Conclusion:IL-17 and IL-6 are synergistically involved in the pathogenesis of IIM, suggesting that IL-17 is the therapeutic target of IIM.

Objective:To observe the pathological changes of levator palpebrae superiors muscle in patients with different severities of simple congenital ptosis (SCP).Methods:Levator palpebrae superiors muscle specimens from 102 eyes of 68 patients with SCP who received levator palpebrae superiors muscle shortening surgery at Wuhan Aier Hankou Eye Hospital from August 2018 to October 2019 were collected as the observation group.According to the severity of ptosis, the specimens were divided into three groups, coverage ≤4 mm group (n=35), coverage >4 mm to ≤6 mm group (n=30), and coverage >6 mm group (n=37). Fresh levator palpebrae superiors muscle tissues from 8 normal donors in Aier Eye Bank of Wuhan Red Cross were selected as the control group.All specimens were performed with Masson trichrome staining and immunohistochemical staining for α-smooth muscle actin (α-SMA), and ImageJ software was used to measure the collagen fiber area ratio, skeletal muscle fiber area ratio and the integrated absorbance (IA) value of α-SMA.Seventeen specimens (2 from the control group, 5 from coverage ≤4 mm group/coverage >4 mm to ≤6 mm group/coverage >6 mm group) were observed with a transmission electron microscope (TEM). This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Wuhan Aier Hankou Eye Hospital (No.HKAIER2018IRB-005-01). All patients and their legal guardians were well informed about the treatment method and the purpose of sampling and voluntarily signed informed consent.Results:Compared with the control group, the skeletal muscle fiber was reduced in number and was in disordered arrangement, and the striation of some muscle fibers disappeared, and hyperplastic fibrous connective tissue was found in intercellular substances in the observation group.The collagen fiber area ratio of the coverage ≤4 mm group, coverage >4 mm to ≤6 mm group, coverage >6 mm group were significantly higher than that of the control group, and the skeletal muscle fiber area ratio of the three groups was significantly lower than that of the control group (all at P<0.008 3). There were more smooth muscle fibers and positive expression of α-SMA found in the specimens of the observation group.The IA value of α-SMA of the coverage ≤4 mm group, coverage >4 mm to ≤6 mm group, coverage >6 mm group was 7 195.28(5 935.69, 14 058.29), 55 584.18(33 861.88, 80 419.32), 166 507.76(119 121.95, 187 890.86), respectively, which were all higher than 5 543.03(4 867.67, 8 312.02) of the control group, among which, there were statistically significant differences between the control group and the coverage >4 mm to ≤6 mm group, coverage >6 mm group (both at P<0.008 3). Abundant organelles and some damaged mitochondria were found in smooth muscle cytoplasm in the observation group with a TEM.But no characteristic structure of smooth muscle cells such as dense patch and dense body was detected.Conclusions:There are abnormal smooth muscle cells in the levator palpebrae superiors muscle of SCP patients, and the dysgenesis of the levator palpebrae superiors muscle may be related to this abnormal muscle cell.

Objective:To explore the effect of sliding tarso-conjunctival flap combined with allogeneic scleral transplantation for one-stage reconstructing posterior eyelid defect.Methods:The clinical data of eyelid tumor patients who admitted to Hankou Aier Eye Hospital from January 2015 to March 2019 were selected. The lesions crossed the gray line and the tarsal plates were involved. The benign tumor was removed from the margin by 1—2 mm and the pathological examination was performed. Mohs method (intraoperative delivery of frozen sections to control the cut edge) resection was performed for malignant tumor. The residual tarsal plate in the vertical direction after tumor was removed (upper eyelid≥3 mm, lower eyelid ≥2 mm) . The posterior defect reconstruction was performed by sliding the residual tarsal conjunctival flap to the eyelid margin, and the posterior tarsal defect area was repaired with allogeneic sclera. The anterior defect was reconstructed with sliding flaps, rotating flaps and free skin grafts.Results:A total of 8 cases were selected, including 3 males and 5 females, aged 31—76 years, with an average of 42 years old. 2 cases of eyelid intradermal nevi, 1 case of eyelid basal cell carcinoma, 4 cases of eyelid adenocarcinoma, and 1 case of eyelid squamous cell carcinoma. All patients were followed up for 6 to 24 months. All of the 8 patients had no tumor recurrence. Except for the absence of eyelashes in the reconstructed area, the eyelids were in good shape. Patients did not complain about foreign body sensation. No allogeneic sclera dissolution or rejection.Conclusions:For the residual tarsal plate in the vertical direction after tumor resection (upper eyelid≥3 mm, lower eyelid≥2 mm). The use of the sliding tarso-conjunctival flap combined with allogeneic scleral transplantation to reconstruct the posterior layer of the eyelid defect can achieve satisfactory result in both appearance and function.

Objective:To explore the effect of sliding tarso-conjunctival flap combined with allogeneic scleral transplantation for one-stage reconstructing posterior eyelid defect.Methods:The clinical data of eyelid tumor patients who admitted to Hankou Aier Eye Hospital from January 2015 to March 2019 were selected. The lesions crossed the gray line and the tarsal plates were involved. The benign tumor was removed from the margin by 1—2 mm and the pathological examination was performed. Mohs method (intraoperative delivery of frozen sections to control the cut edge) resection was performed for malignant tumor. The residual tarsal plate in the vertical direction after tumor was removed (upper eyelid≥3 mm, lower eyelid ≥2 mm) . The posterior defect reconstruction was performed by sliding the residual tarsal conjunctival flap to the eyelid margin, and the posterior tarsal defect area was repaired with allogeneic sclera. The anterior defect was reconstructed with sliding flaps, rotating flaps and free skin grafts.Results:A total of 8 cases were selected, including 3 males and 5 females, aged 31—76 years, with an average of 42 years old. 2 cases of eyelid intradermal nevi, 1 case of eyelid basal cell carcinoma, 4 cases of eyelid adenocarcinoma, and 1 case of eyelid squamous cell carcinoma. All patients were followed up for 6 to 24 months. All of the 8 patients had no tumor recurrence. Except for the absence of eyelashes in the reconstructed area, the eyelids were in good shape. Patients did not complain about foreign body sensation. No allogeneic sclera dissolution or rejection.Conclusions:For the residual tarsal plate in the vertical direction after tumor resection (upper eyelid≥3 mm, lower eyelid≥2 mm). The use of the sliding tarso-conjunctival flap combined with allogeneic scleral transplantation to reconstruct the posterior layer of the eyelid defect can achieve satisfactory result in both appearance and function.

Objective:To explore the effect of sliding tarso-conjunctival flap combined with allogeneic scleral transplantation for one-stage reconstructing posterior eyelid defect.Methods:The clinical data of eyelid tumor patients who admitted to Hankou Aier Eye Hospital from January 2015 to March 2019 were collected. The lesions crossed the gray line and the tarsal plates were involved. The benign tumor was removed from the margin by 1-2 mm and the pathological examination was performed. Mohs method (intraoperative delivery of frozen sections to control the cut edge) resection was performed for malignant tumor. The residual tarsal plate in the vertical direction after tumor was removed (upper eyelid≥3 mm, lower eyelid ≥2 mm). The posterior defect reconstruction was performed by sliding the residual tarsal conjunctival flap to the eyelid margin, and the posterior tarsal defect was repaired with allogeneic sclera. The anterior defect was reconstructed with sliding flaps, rotating flaps and free skin grafts. The postoperative follow-up was performed to observe the morphology of the eyelid margin, the repair of the eyelid defect area, the degree of movement of the eyelid and the function of opening and closing, and lifting.Results:A total of 8 cases were included, 3 males and 5 females, aged 31-76 years, with an average of 42 years old. 2 cases of eyelid intradermal nevi, 1 case of eyelid basal cell carcinoma, 4 cases of eyelid adenocarcinoma, and 1 case of eyelid squamous cell carcinoma. All patients were followed up for 6 to 24 months. All of the 8 patients had no tumor recurrence. Aside from the absence of eyelashes in the reconstructed area, the eyelids were in good shape. The movement of eyelid was good, the functions of opening and closing and lifting were normal. Patients did not complain about foreign body sensation. No allogeneic sclera dissolution or rejection.Conclusions:For the residual tarsal plate in the vertical direction after tumor resection (upper eyelid≥3 mm, lower eyelid≥2 mm). The use of the sliding tarso-conjunctival flap combined with allogeneic scleral transplantation to reconstruct the posterior layer of the eyelid defect can achieve satisfactory result in both appearance and function.

Objective:To explore the effect of sliding tarso-conjunctival flap combined with allogeneic scleral transplantation for one-stage reconstructing posterior eyelid defect.Methods:The clinical data of eyelid tumor patients who admitted to Hankou Aier Eye Hospital from January 2015 to March 2019 were selected. The lesions crossed the gray line and the tarsal plates were involved. The benign tumor was removed from the margin by 1—2 mm and the pathological examination was performed. Mohs method (intraoperative delivery of frozen sections to control the cut edge) resection was performed for malignant tumor. The residual tarsal plate in the vertical direction after tumor was removed (upper eyelid≥3 mm, lower eyelid ≥2 mm) . The posterior defect reconstruction was performed by sliding the residual tarsal conjunctival flap to the eyelid margin, and the posterior tarsal defect area was repaired with allogeneic sclera. The anterior defect was reconstructed with sliding flaps, rotating flaps and free skin grafts.Results:A total of 8 cases were selected, including 3 males and 5 females, aged 31—76 years, with an average of 42 years old. 2 cases of eyelid intradermal nevi, 1 case of eyelid basal cell carcinoma, 4 cases of eyelid adenocarcinoma, and 1 case of eyelid squamous cell carcinoma. All patients were followed up for 6 to 24 months. All of the 8 patients had no tumor recurrence. Except for the absence of eyelashes in the reconstructed area, the eyelids were in good shape. Patients did not complain about foreign body sensation. No allogeneic sclera dissolution or rejection.Conclusions:For the residual tarsal plate in the vertical direction after tumor resection (upper eyelid≥3 mm, lower eyelid≥2 mm). The use of the sliding tarso-conjunctival flap combined with allogeneic scleral transplantation to reconstruct the posterior layer of the eyelid defect can achieve satisfactory result in both appearance and function.

Objective:To explore the effect of sliding tarso-conjunctival flap combined with allogeneic scleral transplantation for one-stage reconstructing posterior eyelid defect.Methods:The clinical data of eyelid tumor patients who admitted to Hankou Aier Eye Hospital from January 2015 to March 2019 were selected. The lesions crossed the gray line and the tarsal plates were involved. The benign tumor was removed from the margin by 1—2 mm and the pathological examination was performed. Mohs method (intraoperative delivery of frozen sections to control the cut edge) resection was performed for malignant tumor. The residual tarsal plate in the vertical direction after tumor was removed (upper eyelid≥3 mm, lower eyelid ≥2 mm) . The posterior defect reconstruction was performed by sliding the residual tarsal conjunctival flap to the eyelid margin, and the posterior tarsal defect area was repaired with allogeneic sclera. The anterior defect was reconstructed with sliding flaps, rotating flaps and free skin grafts.Results:A total of 8 cases were selected, including 3 males and 5 females, aged 31—76 years, with an average of 42 years old. 2 cases of eyelid intradermal nevi, 1 case of eyelid basal cell carcinoma, 4 cases of eyelid adenocarcinoma, and 1 case of eyelid squamous cell carcinoma. All patients were followed up for 6 to 24 months. All of the 8 patients had no tumor recurrence. Except for the absence of eyelashes in the reconstructed area, the eyelids were in good shape. Patients did not complain about foreign body sensation. No allogeneic sclera dissolution or rejection.Conclusions:For the residual tarsal plate in the vertical direction after tumor resection (upper eyelid≥3 mm, lower eyelid≥2 mm). The use of the sliding tarso-conjunctival flap combined with allogeneic scleral transplantation to reconstruct the posterior layer of the eyelid defect can achieve satisfactory result in both appearance and function.

Objective:To explore the effect of sliding tarso-conjunctival flap combined with allogeneic scleral transplantation for one-stage reconstructing posterior eyelid defect.Methods:The clinical data of eyelid tumor patients who admitted to Hankou Aier Eye Hospital from January 2015 to March 2019 were collected. The lesions crossed the gray line and the tarsal plates were involved. The benign tumor was removed from the margin by 1-2 mm and the pathological examination was performed. Mohs method (intraoperative delivery of frozen sections to control the cut edge) resection was performed for malignant tumor. The residual tarsal plate in the vertical direction after tumor was removed (upper eyelid≥3 mm, lower eyelid ≥2 mm). The posterior defect reconstruction was performed by sliding the residual tarsal conjunctival flap to the eyelid margin, and the posterior tarsal defect was repaired with allogeneic sclera. The anterior defect was reconstructed with sliding flaps, rotating flaps and free skin grafts. The postoperative follow-up was performed to observe the morphology of the eyelid margin, the repair of the eyelid defect area, the degree of movement of the eyelid and the function of opening and closing, and lifting.Results:A total of 8 cases were included, 3 males and 5 females, aged 31-76 years, with an average of 42 years old. 2 cases of eyelid intradermal nevi, 1 case of eyelid basal cell carcinoma, 4 cases of eyelid adenocarcinoma, and 1 case of eyelid squamous cell carcinoma. All patients were followed up for 6 to 24 months. All of the 8 patients had no tumor recurrence. Aside from the absence of eyelashes in the reconstructed area, the eyelids were in good shape. The movement of eyelid was good, the functions of opening and closing and lifting were normal. Patients did not complain about foreign body sensation. No allogeneic sclera dissolution or rejection.Conclusions:For the residual tarsal plate in the vertical direction after tumor resection (upper eyelid≥3 mm, lower eyelid≥2 mm). The use of the sliding tarso-conjunctival flap combined with allogeneic scleral transplantation to reconstruct the posterior layer of the eyelid defect can achieve satisfactory result in both appearance and function.