Objective:To investigate the inhibitory effect of ferulic acid on the retina of diabetic mice and high glucose-induced human retinal pigment epithelium (RPE) cell injury and the mechanism.Methods:Thirty 8-week-old SPF male type 2 diabetic db/db mice were selected and divided into a model group and a ferulic acid group by the random number table method, with 15 mice in each group.Another 15 db/m mice of the same age were selected as a control group.The model and control groups received normal saline (5 ml/kg) by gavage daily, and the ferulic acid group received ferulic acid solution (0.05 g/kg) by gavage daily.After two months of treatment, the mice were sacrificed and the eyeballs were removed.The morphological changes of mouse retinal tissues were observed by hematoxylin-eosin staining.The fluorescence intensity and expression levels of mitochondrial calcium uniporter (MCU), p38 mitogen-activated protein kinase (p38 MAPK) and phosphorylated p38 MAPK (p-p38 MAPK) in mouse retinal tissues were detected by immunofluorescence staining and Western blot.Human RPE cells were divided into control group, dimethyl sulfoxide (DMSO) group, high glucose group and high glucose+ ferulic acid group.The control group received no treatment, and the other cell groups were cultured with the corresponding reagents for 24 hours.The reactive oxygen (ROS) level of RPE cells in each group was detected with the ROS detection kit.The mitochondrial membrane potential level of RPE cells was detected with the a mitochondrial membrane potential detection kit (JC-1).The MCU and microfilament fluorescence intensity of RPE cells were detected with the a microfilament green fluorescent probe.To explore the regulatory relationship between MCU, p38 MAPK and p-p38 MAPK, the MCU protein level was silenced and overexpressed by lentivirus transfection technology.The fluorescence intensity and expression levels of MCU, p38 MAPK and p-p38 MAPK proteins in RPE cells were detected by immunofluorescence staining and Western blot.The use and feeding of experimental animals followed the 3R principle and the Statement of the Association for Research in Vision and Ophthalmology on the Use of Animals in Ophthalmology and Vision Research.This study protocol was approved by the Ethics Committee of Ningxia Eye Hospital, People's Hospital of Ningxia Hui Autonomous Region (No.2019085).Results:The intercellular space of the outer nuclear layer, inner nuclear layer and ganglion cell layer of the retinal tissue in the model group was increased and the cell arrangement was disordered compared with the control group, and the retinal tissue in the ferulic acid group was significantly improved.Compared with the control group, the fluorescence intensity of MCU, p-p38 MAPK and MCU+ p-p38 MAPK protein of mouse retinal tissue in model group and ferulic acid group was significantly increased (all at P<0.05).Compared with the model group, the fluorescence intensity of MCU, p-p38 MAPK and MCU+ p-p38 MAPK protein of mice retinal tissue in ferulic acid group was significantly decreased (all at P<0.05).Compared with the control group, the relative expression levels of MCU, p38 MAPK and p-p38 MAPK proteins of mouse retinal tissue in model group were significantly increased (all at P<0.05).Compared with the model group, the relative expression levels of MCU, p38 MAPK and p-p38 MAPK proteins of mice retinal tissue in ferulic acid group were significantly decreased (all at P<0.05).The ROS fluorescence intensities in the control group, DMSO group, high glucose group and high glucose+ ferulic acid group were 0.22±0.02, 0.22±0.03, 0.30±0.02 and 0.24±0.02, respectively, and the overall difference was statistically significant ( F=7.845, P<0.01).The ROS fluorescence intensity was significantly higher in the high glucose group than in the control and DMSO groups, and it was significantly lower in the high glucose+ ferulic acid group than in the high glucose group (all at P<0.05).The mitochondrial membrane potential was significantly lower in high glucose group and high glucose+ ferulic acid group than in control and DMSO groups, and significantly higher in high glucose+ ferulic acid group than in high glucose group (all at P<0.05).Compared with the control group and DMSO group, the fluorescence intensity of MCU was higher in the high glucose group, accompanied by the decrease and thinning of cell microfilaments, and the fluorescence intensity of MCU protein was significantly decreased in high glucose+ ferulic acid group, with the number of microfilaments increased significantly.Compared with the control group and DMSO group, the fluorescence intensity and relative expressions of MCU, p38 MAPK and p-p38 MAPK proteins were significantly increased in the high glucose group (all at P<0.05).Compared with the high glucose group, the fluorescence intensity and relative expressions of MCU, p38 MAPK and p-p38 MAPK proteins were significantly decreased in the high glucose+ ferulic acid group (all at P<0.05).Compared with the control group and the empty vector group, the relative expressions of MCU, p38 MAPK and p-p38 MAPK proteins were significantly increased in the MCU overexpression group and significantly decreased in the MCU shRNA group and the MCU overexpression+ ferulic acid group (all at P<0.05).Compared with MCU overexpression group, the relative expressions of MCU, p38 MAPK and p-p38 MAPK proteins were significantly decreased in MCU shRNA group and MCU overexpression+ ferulic acid group, and the differences were statistically significant (all at P<0.05). Conclusions:Ferulic acid can regulate oxidative stress and mitochondrial dysfunction, thereby ameliorating retinal damage and high glucose-induced RPE cell injury in diabetic mice, which may play a protective role through MCU and p38MAPK signaling pathways.

Glaucoma is one of the most common optic neuropathies, featuring progressive retinal ganglion cell damage and visual field loss (Tham et al., 2014; Xu et al., 2020). Currently, the only effective treatment for this condition is the reduction of intraocular pressure (IOP) (Palmberg, 2001; Heijl et al., 2002). Canaloplasty is a proven bleb-independent surgery with good efficacy and safety profiles in primary open-angle glaucoma (POAG) (Gołaszewska et al., 2021). However, early transient postoperative IOP elevation has been reported in up to 30% of cases (Riva et al., 2019), similar to that commonly observed in other internal drainage glaucoma surgeries such as implantation using iStent (0%-21.0%), CyPass (10.8%), and Hydrus (4.8%-6.5%) (Lavia et al., 2017). This complication may be a predictor of poor reserve in the outflow system and is potentially associated with surgical failure. Nonetheless, the exact pathophysiology of glaucoma remains unknown, and studies clarifying the risk factors for postoperative IOP elevation have been scarce.
Humans ; Intraocular Pressure ; Glaucoma, Open-Angle/surgery* ; Incidence ; Treatment Outcome ; Risk Factors

Objective: To improve the social skills of children with ASD by using Program for the Education and Enrichment of Relational Skills(PEERS ), and to reduce the uncertainty towards ASD and negative emotions for mothers of ASD children. Methods: From September to October 2017, 30 dyads of autistic mother and child were recruited and divided into intervention group and control group (15 mother child dyads each). Based on the content of PEERS social skill, cognitive behavior therapy was delivered in group format, through demonstration, role play and group exercise. At the same time, mother child dyads were trained using parallel social technology. Mothers and children with ASD were investigated using Parents Perception of Uncertainty Scale (PPUS), Patient Health Questionnaire 9 (PHQ-9), Chinese Version of the Beck Depression Inventory II(BDI-Ⅱ-C), Beck Anxiety Inventory (BAI), State Trait Anxiety Inventory(STAI-Form Y), and Autism Behavior Checklist (ABC), Cildhood Autism Rating Scale (CARS), and Social Communication Questionnaire (SCQ). Results: Changes in ASD symptom score in children and emotional score of mothers in the intervention group were less than 0. The total score of mother disease uncertainty(74.93±13.58, 90.40± 9.21 ), ambiguity(31.13±7.07, 38.93±4.73), lack of clarity information(11.93±2.09, 13.80±2.54), unpredictability(9.60±1.99, 12.07±2.89), significantly changed after intervention( t =-3.65, -3.55, -2.20, -2.72, P <0.05). Conclusion Social PEERS group intervention can enhance the social skills of children with ASD, reduce uncertainty of illness among mother of ASD children. Timely disease related information, guidance for mothers to actively participate in child care and training, might help to reduce cognitive bias, depressive and anxiety symptoms among mothers.

Objective To evaluate the efficacy of the new treatment regimen versus the standardized scheme for the initial treatment of smear-positive tuberculosis in the elderly.Methods A total of 302 elderly patients meeting the inclusion and exclusion criteria were selected from 14 tuberculosis-designated medical institutions in Beijing.The patients received the initial treatment of smear-positive tuberculosis from January 2014 to August 2016 in the combined prospective and retrospective study.All patients were divided into observation group(n=63)receiving treatment with 6L2 HELfx regimen from August 1,2015 to August 31,2016,and control group (n =239) receiving treatment with 6L2HELfx regimen from January 1,2014 to January 31,2015.The nation-unified standard chemotherapy regimen 2RHZE/4RH was used in tuberculosis medical service institutions for all patients.The differences between the two groups were analyzed and compared in the completion of treatment,negative conversion of sputum culture or smear,adverse drug reactions and treatment outcome.Results The completion rate of long-course therapy was significantly higher in the observation group than in control group [90.5％ (57/63) vs.79.5％ (190/239),x2 =4.034,P =0.045].The rate of negative conversion of sputum culture or smear at the end of the 2nd month was higher in the observation group than in control group,but had no significant difference[87.0％ (47/54)vs.81.6％(155/190),x2 =0.879,P=0.349].The incidence of adverse reactions was much lower in observation group than in control group[46.0％ (29/63) vs.65.3％ (156/239),x2 =7.777,P =0.005].The success rate of treatment(cure or completion of long-course therapy)was higher in observation group than in control group [90.5％ (57/63) vs.77.4％ (185/239),x2 =5.350,P =0.021].ConclusioNS As compared with the standard chemotherapy regimen,the L and Lfxcontaining treatment regimen has better effects,higher success rate of treatment and less adverse reactions in elderly patients with the initial treatment of smear-positive tuberculosis.

Objective: To explore the associations between exposure to chlorination disinfection by-products (CDBPs) during gestation and newborns' small for gestational age (SGA). Methods: During April 2010 to July 2012, a total of 3 903 pregnant women who lived in a district with the same water treatment plant in Wuhan, China were recruited to this perspective study. Information about demographic characteristics of pregnant women and their newborns was collected. The tap water samples were monthly collected for 28 months in 3 different sites, with 84 samples, and 4 kinds of trihalomethanes (THMs)(chloroform (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM), and bromoform (TBM)) and 2 kinds of chlorohaloacetic acids (HAAs) (trichloroacetic acid (TCAA), dichloroacetic acid (DCAA)) were determined. The pregnant women were divided into 4 groups(Q1 to Q4) by quartile method according to their exposure level of CDBPs. Binary Logistic regression models were used to assess the associations between exposure to CDBPs during gestation and newborns' small for gestational age. Results: The average weight of all the newborns was (3 310.19±389.91) g, of which 169 (4.33%) were SGA. The median concentrations of TCM, BDCM, bromo-THMs, total THMs, TCAA, and DCAA during the whole pregnancy were 18.07, 4.93, 8.51, 26.74, 10.65, and 13.77 μg/L, respectively. Binary Logistic regression analysis showed dose-response relationships between elevated TCM and total THMs during the whole gestation and compared with Q1 group, while there was a increased risk of SGA in Q4 group, and OR(95%CI) was 1.87 (1.01-3.49) , 2.30 (1.22-4.35) , respectively (P for trend equaled to 0.044, 0.015). Compare with Q1 group, there also be positive associations between exposure to TCAA (Q4 group) during first-trimester and the whole gestation and SGA, while OR(95%CI) was 2.16 (1.19-3.91) (P for trend equaled to 0.015). Conclusion Exposure to CDBPs during gestation might increase the risk of newborns' SGA.

Objective To explore the effectiveness of 12-week exercises with different intensities on cardiorespiratory fitness(CRF)of rats,so as to provide theoretical evidences for evaluating effective exercise loads.Methods Forty male Wistar rats were randomly divided into a low intensity group(50％ VO2max),a moderate intensity group(65％VO2max),a high intensity group(80％VO2max)and a sedentary group,each of 10.All rats were measured the VO2max after three-day adaptive training,then they were repeated the VO2max test every two weeks on the non-training days and the load of the next two weeks was adjusted according to the test result.The treadmill speed was controlled to maintain the specific exercise intensity of each group in the training period.The rats in the exercise groups were trained 5 days per week and 60 minutes per day.After 12 weeks of exercise intervention,the ultrasonic cardiogram tests were conducted.Results After 12 weeks of exercise,compared with the sedentary group,the average weight of the low and high intensity groups decreased significantly(P＜0.05,P＜0.01).After the 12-week exercise intervention,the average VO2max of the three exercise groups were significantly higher than the sedentary group (P＜0.01).The average CRF of the moderate and high intensity group improved faster,with their peak value at the 6th and 8th week respectively.However,in the low intensity group significant improvement in the average CRF was observed from the 10th week,with the peak value appearing at the 12th week.The average left ventricular internal dimension systole of the high intensity group was lower than the low intensity group(P＜0.05),while the ejection fraction and left ventricular shortening fraction increased significantly (P＜0.05).Conclusions Exercises with different intensity can improve the CRF.However,compared with moderate and high intensity exercise,it requires longer time to improve CRF with low intensity exercise.Only exercise with 80％VO2max can significantly improve the cardiac pumping function.

Objective To explore the effects of bundle care on preventing deep vein thrombosis (DVT) in elderly patients with gastrointestinal carcinoma in the perioperative period. Methods The elderly patients who received surgery for gastrointestinal carcinoma in the Department of Oncological Surgery of the Affiliated Hospital of Jiangnan University were selected as subjects in this study according to quasi-experimentation. Totally 220 patients admitted between January and December 2016 were divided into an observation group, who received bundle care as planned, while another 216 patients admitted from January to December 2015 were divided into a control group, who received conventional nursing for patients with gastrointestinal carcinoma in the perioperative period. The incidence of DVT, duration of hospital stays and satisfaction were then compared between the patients in the two groups. Results Totally 13 patients in the control group, while only 4 in the observation group, showed DVT (χ2=5.132,P<0.05). The average duration of hospital stays of the patients in the observation group was (17.27±6.17) days, shorter than that of the patients in the control group (t=34.924, P<0.01). The patients in the observation group scored (9.75±0.24) in satisfaction with nursing, higher than that of the patients in the control group (t=11.155,P<0.01). Conclusions Bundle care can help to reduce the incidence of DVT in elderly patients with gastrointestinal carcinoma in the perioperative period, shorten their average duration of hospital stays, and improve their satisfaction.

Objective To develop and explore the clinical application effect of orthopedic protective trestle for post-operative patients with lower limb fracture.Methods Totally 60 patients with lower limb fracture that hospitalized in Osteopathic Department from March to June 2015 were randomly divided into the observation group(n=30) and the control group(n=30). Patients in the control group were given Thomas trestle for the fixation while patients in the observation group were given orthopedic protective trestle for the fixation. The pain score, average hospitalization days and patients′satisfaction degree in two groups were compared. Results The pain score of patients in the observation group after 48 h was (3.50±0.63) points, which was significantly lower than the score in the control group (5.53±0.82) points (t=10.78,P<0.05);the average hospitalization days in the observation group was (16.47±2.68) d, which was significantly lower than that in the control group (22.47± 7.32) d (t=4.22,P<0.05);the satisfaction score of patients in the observation group was (8.80±0.61) points, which was significantly higher than the score in the control group (6.93±1.36) points (t=-6.85,P<0.05). Conclusions Orthopedic protective trestle for patients with lower limb fracture can relieve the pain of patients, reduce the length of average hospitalization days and improve the satisfaction of patients.

Objective To observe the effects of short-term withdrawal of thyroxine on lipid level and the protective effect of atorvastatin.Methods The study included 60 rabbits which were randomly divided into treatment experiment group 1 (near-total thyroidectomy + 131 I ablative therapy),treatment experiment group 2 (near-total thyroidectomy + 131I ablative therapy + Atorvastatin intervention) and control group(sham thyroidectomy).Compared the thyroid functions and lipid levels among different groups at the points of before surgery.three weeks after surgery and five weeks after surgery.Results (1) Compared to before surgery,the thyroid function at the points of three weeks and five weeks after surgery were obvious reduced both in treatment group.(2) The leves of TG,TC,LDL-C in EG1 were increased gradually with the extension of time after surgery.Compared with the point of before surgery,the level of HDL-C at the point of five weeks after surgery was significantly declined in EG1.Compared with the point of before surgery,the level of TG at the ponts of three weeks and five weeks after surgery was significantly declined in EG2.Compared with the point of before surgery,the level of LDL-C at the point of three weeks after surgery was significantly declined in EG2.Conclusions (1) Short-term hypothyroidism can increase the levels of TG,TC,LDL-C in plasma.(2) Atorvastatin can maintain the stability of blood lipids during Short-term hypothyroidism.

Objective To analyze the outcome and prognostic factors in breast cancer at high-risk of recurrence and evaluate the role of radiotherapy. Methods 381 breast cancer patients treated with mastec-tomy and axillary dissection were retrospectively analyzed. The including criterias were pathologic diagnosis of invasive breast cancer, T_3-T_4 and/or four or more positive axillary nodes. The survival rates was calculat-ed by Kaplan-Meier method, and compared by Logrank test. Cox regression model was used to select poten-tial prognostic variables. Results The median follow up was 48 months. The 5-year overall survival (OS) and locoregional recurrence-free survival (LRFS) rates were 76.8% and 89.7%, respectively. Radiothera-py significantly improved the OS (80.9% vs. 62.3%, χ~2=15.47, P=0.001) and LRFS (93.4% vs. 77.1% χ~2=19.95,P=0.000). The use of ipsilateral chest wall and supraclavicular nodal radiation was associated with increased 5-year chest wall recurrence free survival (96.8% : 86.2%, χ~2= 12.66, P=0.001) and 5-year supraclavicular node recurrence free survival (97.7% : 90.7 %, χ~2= 9.98, P=0.002).However, axillary irradiation had no impact on 5-year axillary recurrence free survival (98.4% : 96.1% ,χ~2=0.74, P=0.389). In multivariate analysis, absence of radiotherapy (χ~2=14.42, P=0.000), 10 or more positive axillary nodes (χ~2=21.60, P=0.000), and T_4 stage (χ~2=10.79, P=0.001) were inde-pendent unfavorable prognostic factors for overall survival. Conclusions Radiotherapy improves the overall survival of breast cancer patients with T_3, T_4 and/or four or more positive axillary nodes. The chest wall and supraclavicular nodal radiation should be given to this group of patients.