Aim To investigate the effect of exogenous growth differentiation factor 11(GDF11)on vascular re-modeling in hypertensive rats through regulating the endoplasmic reticulum stress pathway mediated by lectin-like oxidized low density lipoprotein receptor-1(LOX-1).Methods Rats were randomly divided into control group,model group(Ang Ⅱ-induced hypertension rat model group),r-GDF11 group,Ab-LOX-1 group,r-GDF11+r-LOX-1 group,with 10 rats in each group.The changes of caudal arterial blood pressure in rats were detected by animal non-invasive blood pres-sure meter;the morphology of aortic vessels was evaluated by hematoxylin-eosin(HE)staining;the collagen deposition in aortic tissue was evaluated by Masson staining;the expression of GDF11,LOX-1 and endoplasmic reticulum(ER)stress related proteins in aortic tissues were detected by Western blot.Results Compared with the control group,the blood pressure of rats in the model group was increased,the media thickness(MT)and MT/lumen diameter(LD)of aortic tis-sue were increased,and the LD of aortic tissue was decreased(all P＜0.05);Collagen volume fraction(CVF)value,the expression of glucose regulated protein 78(GRP78)and activating transcription factor 6(ATF6)protein,the ratio of phosphorylated PKR-like endoplasmic reticulum regulating kinase(p-PERK)/PERK and phosphorylated inositol requiring enzyme 1α(p-IRE1α)/IRE1α in aortic tissue were increased(all P＜0.05).Compared with the model group,the blood pressure of rats in the r-GDF11 group and Ab-LOX-1 group was decreased,the MT and MT/LD of aortic tissue were de-creased,and the LD of aortic tissue was increased(all P＜0.05);CVF value,the expression of GRP78 and ATF6 protein,p-PERK/PERK and p-IRE1α/IRE1α in aortic tissue were decreased(all P＜0.05).Compared with the r-GDF11 group,the blood pressure of rats in the r-GDF11+r-LOX-1 group was increased,the MT and MT/LD of aortic tissue were increased,and the LD of aortic tissue was decreased(all P＜0.05);CVF value,the expression of GRP78 and ATF6 protein,the p-PERK/PERK and p-IRE1α/IRE1α in aortic tissue were increased(all P＜0.05).Conclusion Exogenous GDF11 im-proves vascular remodeling in hypertensive rats through inhibiting LOX-1-mediated endoplasmic reticulum stress pathway.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.

Diabetic keratopathy is a chronic complication of diabetes caused by abnormal metabolites accumulation, oxidative stress, abnormal inflammation and corneal neuropathy.It can result in delayed corneal epithelial healing and decreased corneal sensitivity under the stimulation of ocular trauma or surgery which bring great challenges to clinicians.Activation of nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammatory is one of the factors that cause chronic complications of diabetes, and is also an important factor for delaying the healing of diabetic wounds.The NLRP3 inflammatory signaling pathway is closely related to corneal oxidative stress, delayed epithelium healing and development of corneal neuropathy.In this paper, the research status and prospects of NLRP3 inflammatory signaling pathway and diabetic keratopathy were reviewed to provide new ideas for studying the mechanism and treatment of diabetic keratopathy.

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

  Objective  This study aimed at describing the frequency of rare variants of monogenic cerebral small vessel diseases (CSVD) in a cohort of patients with CSVD, and to explore its clinical relevance.  Methods  This study included CSVD patients visiting the Neurology Department of Peking Union Medical College Hospital(PUMCH) from March 2017 to January 2022, collecting their demographic and clinical information and DNA samples for whole-exome sequencing. Descriptive analysis and statistical analysis were conducted exploring the differences between monogenic CSVD-related gene mutation carriers and noncarriers.  Results  A total of 292 patients were included, 51.03% of whom carried one or more rare variants of monogenic CSVD-related genes. The most common rare low-frequency variants were located in the NOTCH3 gene (70 patients, 23.97%), followed by HTRA1 and COL4A1/COL4A2 (22 patients, 7.53%) respectively. Among the subgroup of patients without a family history of stroke (n=176), the frequency of rare variants was as high as 47.16%. Compared with non-carriers, the carriers were diagnosed at a younger age (58.76±13.71 vs. 63.46±13.21, P=0.003). No difference was found in phenotypes among single-SNP carriers, multiple-SNPs carriers, and noncarriers.  Conclusions  The frequency of rare mutation of monogenic CSVD-related genes were relatively high in Chinese CSVD cohort. The most common rare variant was within the NOTCH3, followed by HTRA1 and COL4A1/COL4A2 genes. For CSVD patients of unknown causes, genetic screening should not be neglected even if there is not a family history of the disease.

Objective: To analyze the clinical data of 153 patients with novel coronavirus pneumonia (COVID-19) in chongqing ,and provide reference and thinking for the diagnosis and treatment. Methods: Analyze the clinical data, laboratory examination and chest imaging characteristics of 153 COVID-19 patients in Chongqing Public Health Medical Center from January 26 to February 5, 2020. According to the relevant diagnostic criteria ,patients were divided into non-severe group(n=132) and severe group(n=21),and analyze the correlation between serum index changes and disease severity. Results: Combined with diabetes and chronic respiratory diseases, the severity of the disease was statistically significant (χ²=11.04和6.94, P<0.05). No symptoms were found in patients with mild illness (χ²=4.09, P<0.05) .The proportion of fever and muscle soreness in the severe group was higher than that in the non-severe group (χ²=4.40 and 22.67,P<0.05).Among the concomitant symptoms, the proportion of cough and shortness of breath in the severe group was higher than that in the non-severe group (χ²=8.46 and 4.80,P<0.05).C-reactive protein and d-dimer were higher in the severe group than in the non-severe group (t=43.44 and 37.13, P<0.05), and the number of CD₃⁺T lymphocyte cells, CD₄⁺T lymphocyte cells and CD₈⁺T lymphocyte cells in the severe group was lower than that in the non-severe group (Z=27.25, 20.60 and 17.36, P<0.05).Compared with the non-severe group, both lungs and the right lung lower lobe were more susceptible to involved (χ²=6.95和20.39, P<0.05) . Conclusion Severity of COVID-19 was associated with underlying disease, symptoms, site of involvement, C-reactive protein, d-dimer, CD₃⁺T lymphocyte count, CD₄⁺T lymphocyte count, and CD₈⁺T lymphocyte count. 

Objective:To analyze the clinical features of patients with COVID-19 in Chongqing Municipality.Methods:The clinical data, laboratory tests and chest imaging findings of 153 patients COVID-19 admitted in Chongqing Public Health Medical Center from January 26 to February 5, 2020 were retrospectively reviewed. According to the relevant diagnostic criteria, patients were divided into non-severe group (n=132) and severe group (n=21). The correlation between serum index changes and disease severity was analyzed.Results:The proportion of patients with underlying diabetes or chronic respiratory diseases in severe group was significantly higher than that in non-severe group ( χ2=11.04 and 6.94, P<0.05). The proportion of symptom-free patients in non-severe group was significantly higher than that in severe group ( χ2=4.09, P<0.05). The symptoms of fever, fatigue and muscle soreness in the severe group were more common than those in the non-severe group ( χ2=4.40, 14.42 and 22.67, P<0.05). Among the concomitant symptoms, the proportion of cough and shortness of breath in the severe group was higher than that in the non-severe group ( χ2=8.46 and 4.80, P<0.05). C-reactive protein and D-Dimer levels were higher in the severe group than those in the non-severe group ( Z=-4.39 and -1.96, P<0.05), and the number of CD3 + T lymphocyte cells, CD4 + T lymphocyte cells and CD8 + T lymphocyte cells in the severe group was lower than that in the non-severe group ( Z=27.25, 20.60 and 17.36, P<0.05). Compared with the non-severe group, both lungs and the right lung lower lobe were more susceptible to be involved( χ2=9.71和23.61, P<0.05). Conclusions:There are significant differences in underlying diseases, clinical symptoms, imaging manifestations and laboratory findings between severe and non-severe patients with COVID-19.

Objective:To understand application value of pathogen detection in elderly patients with respiratory infection by using multiple RT-PCR to detect 13 common pathogens of respiratory tract infection.Methods:This is a retrospective study, which included 317 elderly patients, aged 60 to 98 years with respiratory symptoms, who visited Geriatrics of the First Hospital of Shijiazhuang between June 2016 and May 2017. Sputum of each patient was collected. After the viral DNA/RNA was extracted, 13 respiratory pathogens were detected by multiplex RT-PCR and capillary electrophoresis. The clinical performance of the assay was evaluated in comparison to direct sequencing and Real-time PCR.Results:Compared with the direct sequencing and Real-time PCR, the accuracy of multiple RT-PCR was 99.93% (95% CI: 99.79%-99.98%), positive predictive value was 99.24% (95% CI: 97.78%-99.74%), negative predictive value was 100% (95% CI: 99.9%-100%), and Cohen’s kappa was 0.9958 (95% CI: 0.9652-1.026). Among the 317 elderly patients, the positive rate of respiratory infection was 75.7% (240/317). The highest was influenza A, 20.2% (64/317), mainly H3N2, 70.3% (45/64), followed by rhinovirus, adenovirus, Mycoplasma pneumoniae and influenza B, with the positive rates 15.5% (49/317), 13.6% (43/317), 11.0% (35/317) and 10.1% (32/317), respectively. In addition, 81 (25.6%) elderly patients were infected with two or more pathogens. Conclusions:Multiple RT-PCR meet the needs of clinical detection of respiratory pathogens and provide information for the prevention and treatment of respiratory system Infection.

Objective: To investigate the effect of early-stage training combined with the ultrashort wave therapy on the functional recovery of rats after a spinal cord injury, and to observe the expression of aquaporin protein-4 (AQP-4) and glial fibrillary acidic protein (GFAP). Methods: Fifty female Sprague-Dawley rats had spinal cord injury (SCI) induced using the modified Allen′s method. After successful modeling, 40 were randomly divided into a sham operation group, a control group, an ultrashort wave group, a treadmill group and a combined group, each of 8. Motor function in their hind limbs was evaluated 4 weeks after the operation using BBB scoring. GFAP and AQP-4 immunohistochemical staining were used to determine the integral optical density (IOD) of the protein expression. Results: The average BBB score of the sham operation group was 21, while the other four groups averages were all less than 1 on the 1st day after the operation. They gradually increased with time, and by 4 weeks the increases were significant. Compared with the control group at the same time point, the average BBB scores of the treadmill and the combined groups were significantly higher. Compared with the ultrashort wave group, the average BBB score of the treadmill group was higher after 4 weeks, and the combined group′s average was significantly higher at 2, 3 and 4 weeks after the operation. Four weeks after the SCI modeling, the average AQP-4 IOD and GFAP IOD levels of the ultrashort wave group, the treadmill group and the combined group were lower than that of the control group, while the average AQP-4 and GFAP IOD levels of the combined group were significantly lower than those of the ultrashort wave group. Compared with the treadmill group, the combined group had a significantly lower average GFAP level. Conclusions Both treadmill training and ultrashort wave treatment promote motor function recovery after a spinal cord injury. The mechanism may be related to downregulation of AQP-4 and GFAP expression at the injured site. Combining the two treatments gives better effects.