Objective To investigate the effect of NOD-like receptor family pyrin domain containing 3(NLRP3)knockdown on a mouse model of nonalcoholic steatohepatitis(NASH)induced by high-fat high-carbohydrate(HFHC)diet.Methods A total of 44 mice were randomly divided into normal diet group(CON group)with 20 mice and HFHC group with 24 mice.At the end of week 14 of modeling,4 mice were randomly selected from the HFHC group for the pre-experiment of adeno-associated virus(AAV)by tail vein injection,and NLRP3 knockdown was verified after 4 weeks.After NLRP3 knockdown was verified at the end of week 18,the remaining 40 mice were given a single tail vein injection of AAV,and then they were divided into CON+NLRP3 knockdown negative control group(CON+NLRP3-NC group),CON+NLRP3 knockdown group(CON+NLRP3-KD group),HFHC+NLRP3-NC group,and HFHC+NLRP3-KD group,with 10 mice in each group.At the end of week 24,the activation of NLRP3 inflammasome was observed;related indicators were measured,including body weight,liver weight,liver index,and glucose metabolism(fasting blood glucose,fasting insulin,and Homeostasis Model Assessment of Insulin Resistance[HOMA-IR]index);the indicators of liver lipid content(liver triglyceride[TG]and oil red O staining),liver inflammation(serum alanine aminotransferase[ALT]activity,HE staining,and inflammation-related genes),and liver fibrosis(Sirius Red staining and fibrosis-related genes)were measured.A one-way analysis of variance was used for comparison of continuous data between multiple groups,and the least significant difference t-test was used for further comparison between two groups.Results Compared with the CON+NLRP3-NC group based on the results of Western Blot,the HFHC+NLRP3-NC group had significant increases in the protein expression levels of NLRP3,pro-Caspase1,Caspase1,ASC,and IL-1β,while the HFHC+NLRP3-KD group had significant reductions in these levels(all P<0.05).The HFHC+NLRP3-NC group showed varying degrees of increase in body weight,liver weight,liver index,and glucose metabolism indicators,while the HFHC+NLRP3-KD group showed significant improvements in these indicators(all P<0.05).As for hepatic fat deposition,compared with the CON+NLRP3-NC group,the HFHC+NLRP3-NC group had a significant increase in liver TG,with a large number of red lipid droplets shown by oil red O staining,and the HFHC+NLRP3-KD group had significant reductions in liver TG and the number of lipid droplets in the liver(all P<0.01).In terms of liver inflammation,compared with the CON+NLRP3-NC group,the HFHC+NLRP3-NC group had significant increases in serum ALT,NAFLD activity score,and inflammation-related genes,while the HFHC+NLRP3-KD group had significant reductions in these indicators(all P<0.01).As for liver fibrosis,compared with the CON+NLRP3-NC group,the HFHC+NLRP3-NC group had significant increases in collagen fiber area and fibrosis-related genes,and the HFHC+NLRP3-KD group had significant reductions in fibrosis-related genes(all P<0.05)and a tendency of reduction in collagen fiber area(P>0.05).Conclusion NLRP3 knockdown can significantly improve hepatic fat deposition and inflammation in a mouse model of HFHC-induced NASH.

Objective: To explore the effects of different concentrations of glucose solution on the survival of Aedes albopictus and Culex pipiens pallens larvae, the attraction to mosquitoes and egg-laying behaviors, so as to provide the reference for developing mosquito control technology based on sugar bait. Methods: White porcelain bowls were filled with 100 mL of 3%, 5%, 8%, 10% and 15% glucose solutions. Ten of fourth instar larvae of Aedes albopictus or Culex pipiens pallens were added to each bowl, and the survival of larvae was recorded after 2, 4, 6, 24, 48 and 72 hours. Egg-laying cups containing 5%, 8% and 15% glucose solution were put in mosquito cages containing fully blooded female mosquitoes of Aedes albopictus and Culex pipiens pallens (50 mosquitoes each), and the total number of eggs laid in 72 hours was observed. The analogous site room was filled with fully blooded and starved female mosquitoes of Aedes albopictus and Culex pipiens pallens (100 mosquitoes each), and simple mosquito control buckets containing 5% and 8% glucose solution and black sticky insect plates. The number of mosquitoes and eggs was observed after 6 days. All the above experiments were repeated 3 times using dechlorinated water as the control. Results: The 72 hour corrected mortality rates of Aedes albopictus and Culex pipiens pallens larvae gradually increased with the increase of glucose concentration. The glucose solution with 5% and higher concentrations was not suitable for mosquito larvae to survive. The attraction of egg-laying behaviors to Aedes albopictus and Culex pipiens pallens gradually decreased with the increase of glucose concentration. The effects were similar between 5% and 8% glucose solution, with the averages of 686.67 and 682.33 eggs for Aedes albopictus, and 3.00 and 2.33 egg rafts for Culex pipiens pallens. In analogous site room, there were 93.33, 105.00 and 130.33 adult mosquitoes captured on average in the control group, 5% and 8% glucose solution groups, respectively, with 8% glucose solution group more attractive to adult mosquitoes than the control group (F=3.283, P=0.030); there were 70.33, 55.33 and 63.00 Aedes albopictus eggs (eggs counts+larvae counts) on average, respectively, with statistically significant differences among the three groups (H=6.761, P=0.034). Conclusion Glucose solution with concentration of 5% or higher can effectively inhibit the survival of Aedes albopictus and Culex pipiens pallens larvae, and attractive to adult mosquitoes and egg-laying behavoirs.

Objective:To observe the change of retinal artery angle in eyes with idiopathic epiretinal membrane (ERM) and to analyze the relationship between retinal artery angle, ERM classification based on optical coherence tomography (OCT), and visual acuity.Methods:A retrospective cross-sectional clinical study. A total of 187 eyes in 187 patients diagnosed with monocular idiopathic ERM (IERM group) in Department of Ophthalmology of Zhejiang Provincial People's Hospital and the Affiliated Eye Hospital of Wenzhou Medical University at Hangzhou from November 2018 to January 2023 were included in the study. The contralateral healthy eyes were included as the control group. All patients underwent best corrected visual acuity (BCVA), fundus photography, spectral-domain OCT, OCT angiography (OCTA) and axial length (AL) measurement. BCVA examination was performed using the standard logarithmic visual acuity chart, which was converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity. The foveal avascular zone (FAZ) area was measured by OCTA. The central macular thickness (CMT) was measured by spectral domain OCTaccording to the grading criteria of ectopic inner foveal layer (EIFL) was divided into stages 1 to 4 with 42, 45, 62, and 38 eyes, and the IERM group was subdivided into stage 1, stage 2, stage 3, and stage 4 groups accordingly. Image J was used to measure the retinal artery angle and the 1/2 retinal artery angle on fundus images. Multiple linear regression analysis was used to analyze the correlation between BCVA and artery angle, 1/2 artery Angle, CMT, FAZ area and AL.Results:Compared with the control group, eyes in IERM group had worse BCVA ( t=9.727), thicker CMT ( t=12.452), smaller FAZ area ( t=-14.329), smaller artery angle ( t=-9.165) and smaller 1/2 artery angle ( t=-9.549). The differences were statistically significant ( P<0.001). With the increase of IERM stage, the artery angle and 1/2 artery angle decreased significantly ( F=21.763, 12.515; P<0.001). There was no significant difference in artery angle and 1/2 artery angle between stage 1 group and stage 2 group, and 1/2 arterial angle between stage 2 group and stage 3 group ( P>0.05). There were significant differences in artery angle and 1/2 artery angle between the other groups ( P<0.05). There were significant differences in CMT and logMAR BCVA among different classification subgroups in IERM groups ( P<0.05). There was no significant difference in FAZ area between grade 3 group and grade 4 group ( P>0.05). There were significant differences in FAZ area between the other groups ( P<0.05). Correlation analysis showed that decreased artery angle ( P=0.013) and increased CMT ( P<0.001) were associated with decreased BCVA. Conclusions:Compared with healthy eyes, the artery angle decreases significantly with the increase of ERM stage. Decreased retinal artery angle is associated with decreased visual acuity in IERM eyes.

Objective:To study the short-term (≤3 months) efficacy and safety of esophageal triamcinolone acetonide filling combined with short-course oral methylprednisolone for the prevention of esophageal stenosis after large-area endoscopic submucosal dissection (ESD) (≥3/4 circumference).Methods:A total of 14 patients with 15 early esophageal lesions who received ESD after evaluation from June 2021 to September 2022 in Jiangsu Province Hospital of Chinese Medicine were enrolled. All received regular esophageal triamcinolone acetonide filling combined with oral methylprednisolone for 7 weeks until the lesions completely recovered by regenerated squamous epithelium (>95%). Patients with esophageal stricture were treated with additional endoscopic dilatation. The stenosis rate, the interval between the first endoscopic dilation and the completion of ESD, the number of esophageal triamcinolone acetonide filling, the healing time after ESD, and the speed and method of squamous epithelium regeneration were observed. The secondary observations were adverse events such as bleeding and perforation after ESD and adverse events related to steroid hormone.Results:No adverse events occurred after ESD in 14 patients. Only 1 patient developed esophageal stenosis, the incidence of stenosis was 7.1% (1/14). The interval between the first dilation and ESD was 39 days. Thirteen patients achieved squamous epithelium regeneration without stenosis or adverse events related to steroid hormone. The median number of esophageal triamcinolone acetonide filling was 6.5 times (4.0-14.0 times), the median healing time was 40 days (32-94 days), and the median healing speed was 0.61 cm2/d (0.30-1.55 cm2/d).Conclusion:Esophageal triamcinolone acetonide filling combined with short-course oral methylprednisolone for the prevention of esophageal stenosis after large-area ESD is effective and safe in the short-term follow-up.

ObjectiveTo observe the effect of the enhanced external counterpulsation （EECP） combined with drug on social function and efficacy in patients with depressive episodes， so as to provide references for the treatment of depressive episodes. MethodsA total of 66 hospitalized patients who was in hospital at department of psychiatry of the Second Xiangya Hospital of Central South University， met the criteria of Diagnostic and Statistical Manual of Mental Disorders，fifth edition（DSM-5） diagnosis of depressive episode or bipolar disorder depressive episode from May 2019 to March 2020 were included by simple random sampling. The participants were divided into study group （n=36） and control group （n=30） according to the random number table method. Both groups received conventional drug treatment， and the study group recieved the EECP intervention at same time. The Depression symptoms and social function were assessed before and after treatment by using Hamilton Depression Scale-24 item （HAMD-24） and Sheehan Disability Scale （SDS）. Treatment efficacy of the two groups was compared. ResultsAfter the intervention， the HAMD-24 and SDS scores in both groups were lower than those before treatment， the differences were statistically significant （t=8.149， 5.791， 8.016， 3.488， P˂0.01）. And the SDS score of the study group was siginficantly lower than that of the control group （t=-3.008， P<0.05）. The total effective rate of treatment in the study group was higher than that of the control group， and the difference was statistically significant （90.63% vs. 63.33%， χ²=8.725， P˂0.05）. ConclusionEECP therapy combined with drug has better efficacy on the patients with depressive episodes， and it can improve social function effectively.

OBJECTIVE To study the chemical constituents in S henfu injection and the anti-inflammatory activities of its polyacetylene compounds. METHODS Shenfu injection was separated and purified by macroporous adsorption resin ，medium pressure liquid chromatography ，preparative thin layer chromatography and reversed-phase semi-preparative high-performance liquid chromatography，and the compound structure was identified according to the physicochemical properties and spectral data. RAW 264.7 cell inflammation model was used to evaluate the anti-inflammatory activities of polyacetylene compounds . The effects of active polyacetylene compounds on the expressions of cyclooxygenase- 2（COX-2）protein were evaluated by Western blot assay. RESULTS Twelves compounds were isolated and identified from Shenfu injection ，including 8 ginsenoside compounds ，i.e. ginsenoside Rg 1（1），ginsenoside Re （2），ginsenoside Rb 1（3），ginsenoside Rk 1（4），20（R）-ginsenoside Rh 1（5），20（S）-ginsenoside Rg3 （6），notoginsenoside R 1（7），panaxatriol（8）；4 polyacetylene compounds ，i.e.（3R，9R，10R）-panaxytriol（9），panaxydol（10）， heptadeca-1，8-dien-4，6-diyne-3，10-diol（11）and panaxynol （12）. Among 4 polyacetylene compounds ，only compound 10 had anti-inflammatory activity. Compound 10 was not toxic to normal RAW 264.7 cells；when the concentration of compound 10 ranged 12.5-50.0 μmol/L，it could significantly reverse the lipopolysaccharide-induced NO content increase in cell supernatant （P＜0.05 or P＜0.01）；when the concentration of co mpound 10 was 50.0 μmol/L，it could significantly reverse the lipopolysaccharide-induced protein expression increase of COX- 2 in cells （P＜0.05）. CONCLUSIONS Compounds 4，7，10-12 are identified and reported in Shenfu injection for the first time ，and panaxydol possesses a certain anti-inflammatory effect.

Objective:To investigate the application value of pelvic floor ultrasound in screening early postpartum stress urinary incontinence (SUI).Methods:A total of 220 postpartum women, who were admitted by the Department of Gynecology and Obstetrics of The People's Hospital of Hechi from January 2018 to June 2019, were selected for this study. These women were divided into SUI ( n = 52) and no SUI ( n = 168) groups according to whether SUI occurred within 42 days after delivery. Pelvic floor ultrasound parameters and clinical data were compared between the two groups. The effects of each ultrasound parameter on postpartum SUI were assessed. The receiver operating characteristic (ROC) curve was plotted for each parameter. The area under the ROC was calculated. The risk factors for postpartum SUI were investigated using the logistic regression analysis. Results:The number of deliveries (≥ 2 times), the proportion of women subjected to vaginal delivery, and neonatal weight in the SUI group were significantly higher than those in the no SUI group [ χ2 = 4.13, 3.30, t = 4.43, all P < 0.05]. There were significant differences in the bladder neck position and levator hiatus area in the resting state between the two groups ( t = 2.29, 3.09, both P < 0.05). There were significant differences in the bladder neck position, levator hiatus area, urethral rotation angle, and bladder neck mobility during the Valsalva movement between the two groups ( t = 13.14, 4.27, 15.64, 8.54, all P < 0.05). The areas under the ROC of bladder neck position and levator hiatus area in the resting state and the areas under the ROC of bladder neck position, levator hiatus area, urethral rotation angle, and bladder neck mobility during the Valsalva movement were 0.707, 0.725, 0.730, 0.771, 0.813, and 0.836, respectively. The area under the ROC of parameters used in combination was 0.849. Logistic regression analysis results revealed that the number of deliveries (≥ 2 times), bladder neck position (> 27.286 mm) and levator ani hiatus area in resting state (> 16.663 cm 2), and bladder neck position (< -2.774 mm), levator hiatus area (> 21.915 cm 2), urethral rotation angle (> 80.445°), and bladder neck mobility (> 30.501°) during the Valsalva movement were the risk factors for postpartum SUI. Conclusion:Combined use of pelvic floor ultrasound parameters is valuable for the diagnosis of postpartum SUI. Abnormal changes in the bladder neck position, levator ani hiatus area, urethral rotation angle, and bladder neck mobility are closely related to the occurrence of postpartum SUI. Therefore, combined use of pelvic floor ultrasound parameters can be preferred to screen early postpartum SUI.

Clinical and endoscopic data of 6 patients with colorectal mucosa associated lymphoid tissue (MALT) lymphoma who were diagnosed by endoscopy in the Digestive Endoscopy Center of Jiangsu Province Hospital of Chinese Medicine from January 2015 to June 2021 were retrospectively analyzed. There were 2 males and 4 females with aged from 62 to 87 years. The lesions were located in rectum in 3 cases, transverse colon in 1 case, sigmoid colon in 1 case, and sigmoid colon and rectum in 1 case. There were 1 case of polyposis type, 2 cases of inflammation type, and 3 cases of submucosal tumor type. The "tree-like appearance (TLA)" found in 5 cases. Endoscopic resection, surgery combined with chemotherapy, Helicobacter pylori eradication and follow-up were performed on 2, 1, 1 and 2 cases, respectively. Five cases had a good prognosis after 21-73 months follow-up, and 1 case had lost to follow-up. No recurrence was found in endoscopic and imaging review. Colorectal MALT lymphoma should be considered when colonoscopy detects a submucosal lesion with TLA sign on the left colon. Endoscopic resection has the potential to be a first-line treatment in the context of early diagnosis.

Objective:To investigate the molecular mechanism of rabbit ear cartilage remodeling induced by 1064 nm Nd∶YAG laser irradiation.Methods:Thirty-three rabbits were divided into 6 groups according to a random number table, and were used in the following experiments respectively: screening the optimal laser energy (6 rabbits), observing the changes of ear cartilage tissue immediately (6 rabbits), 1 week (6 rabbits), 3 weeks (6 rabbits), and 6 weeks after irridiation (6 rabbits), as well as transcriptome sequencing and verification (3 rabbits). The left ears of rabbits were used as untreated self-controls, while the right ears were irradiated. (1) Laser energy screening: the right ear cartilages of 6 rabbits were irradiated with 1064 nm Nd∶YAG laser at different energy densities (50, 60, 70, 80, 90, 100 J/cm 2). Cartilages without skin and perichondrium were cut into the same thickness and size for HE staining, in order to observe the changes of chondrocytes and to determine the optimal laser energy density for shaping (hereinafter referred to as the optimal energy density). (2) Histological observation of rabbit ear cartilage: the right ears of 24 rabbits were irradiated with laser under the optimal energy density. Bilateral cartilage samples were collected immediately after surgery and at 1, 3 and 6 weeks after surgery for histological observation (HE, Masson and Sirius red staining). (3) Transcriptome sequencing and sample verification: the right ears of 3 rabbits were irradiated with laser under the optimal energy density, and the cartilages were harvested and mixed within 6 hours after irradiation, which was set as the laser irradiation group. Cartilages of the same region and size on the left ears were set as blank control group. Transcriptome RNA sequencing was performed, and the expression levels of related genes and proteins were detected by quantitative polymerase chain reaction (qPCR) and Western blotting. Results:(1) After laser irradiation with different energy density of 50-100 J/cm 2, HE staining showed that the chondrocytes could be changed at the laser energy density of 80 J/cm 2, without causing vacuolar deformation and coagulation necrosis, indicating that the damage degree was suitable.(2) After 80 J/cm 2 laser irradiation, histological observation revealed that there was an irradiated zone immediately after the operation. The overall morphology of chondrocytes in the radiation zone was elongated and exhibited spindle cell-like changes, with deep matrix staining and obvious refraction, as well as a relative increase of type Ⅱ collagen. At 1 week after irradiation, the radiation zone became shallower and the cell size recovered. From 3 weeks to 6 weeks, the matrix staining around the radiation zone gradually deepened and the overall cellular morphology was stretched again. (3) Transcriptome RNA sequencing revealed that there were 198 differentially expressed genes (70 up-regulated and 128 down-regulated) in the laser irradiated group compared with the blank control group. Through further screening and study, CREB3L2 gene expression was up-regulated in the laser irradiation group. qPCR results showed that the relative expression level of CREB3L2 mRNA in laser irradiation group was significantly higher than that in the blank control group, the difference was statistically significant( P<0.01). Western blotting showed that the relative expression level of CREB3L2 protein was higher than that of control group in a time-dependent manner, and the difference was statistically significant( P<0.01). Conclusions:After irradiation with long-pulsed 1064 nm Nd∶YAG laser, the expression level of CREB3L2 gene is up-regulated, which then induced chondrocyte rearrangement and proliferation, resulting in morphological and biomechanical changes of ear cartilage.

Objective:To investigate the molecular mechanism of rabbit ear cartilage remodeling induced by 1064 nm Nd∶YAG laser irradiation.Methods:Thirty-three rabbits were divided into 6 groups according to a random number table, and were used in the following experiments respectively: screening the optimal laser energy (6 rabbits), observing the changes of ear cartilage tissue immediately (6 rabbits), 1 week (6 rabbits), 3 weeks (6 rabbits), and 6 weeks after irridiation (6 rabbits), as well as transcriptome sequencing and verification (3 rabbits). The left ears of rabbits were used as untreated self-controls, while the right ears were irradiated. (1) Laser energy screening: the right ear cartilages of 6 rabbits were irradiated with 1064 nm Nd∶YAG laser at different energy densities (50, 60, 70, 80, 90, 100 J/cm 2). Cartilages without skin and perichondrium were cut into the same thickness and size for HE staining, in order to observe the changes of chondrocytes and to determine the optimal laser energy density for shaping (hereinafter referred to as the optimal energy density). (2) Histological observation of rabbit ear cartilage: the right ears of 24 rabbits were irradiated with laser under the optimal energy density. Bilateral cartilage samples were collected immediately after surgery and at 1, 3 and 6 weeks after surgery for histological observation (HE, Masson and Sirius red staining). (3) Transcriptome sequencing and sample verification: the right ears of 3 rabbits were irradiated with laser under the optimal energy density, and the cartilages were harvested and mixed within 6 hours after irradiation, which was set as the laser irradiation group. Cartilages of the same region and size on the left ears were set as blank control group. Transcriptome RNA sequencing was performed, and the expression levels of related genes and proteins were detected by quantitative polymerase chain reaction (qPCR) and Western blotting. Results:(1) After laser irradiation with different energy density of 50-100 J/cm 2, HE staining showed that the chondrocytes could be changed at the laser energy density of 80 J/cm 2, without causing vacuolar deformation and coagulation necrosis, indicating that the damage degree was suitable.(2) After 80 J/cm 2 laser irradiation, histological observation revealed that there was an irradiated zone immediately after the operation. The overall morphology of chondrocytes in the radiation zone was elongated and exhibited spindle cell-like changes, with deep matrix staining and obvious refraction, as well as a relative increase of type Ⅱ collagen. At 1 week after irradiation, the radiation zone became shallower and the cell size recovered. From 3 weeks to 6 weeks, the matrix staining around the radiation zone gradually deepened and the overall cellular morphology was stretched again. (3) Transcriptome RNA sequencing revealed that there were 198 differentially expressed genes (70 up-regulated and 128 down-regulated) in the laser irradiated group compared with the blank control group. Through further screening and study, CREB3L2 gene expression was up-regulated in the laser irradiation group. qPCR results showed that the relative expression level of CREB3L2 mRNA in laser irradiation group was significantly higher than that in the blank control group, the difference was statistically significant( P<0.01). Western blotting showed that the relative expression level of CREB3L2 protein was higher than that of control group in a time-dependent manner, and the difference was statistically significant( P<0.01). Conclusions:After irradiation with long-pulsed 1064 nm Nd∶YAG laser, the expression level of CREB3L2 gene is up-regulated, which then induced chondrocyte rearrangement and proliferation, resulting in morphological and biomechanical changes of ear cartilage.