BACKGROUND:In the initial stage of growth plate injury inflammation,platelet-derived growth factor BB promotes the repair of growth plate injury by promoting mesenchymal progenitor cell infiltration,chondrogenesis,osteogenic response,and regulating bone remodeling. OBJECTIVE:To elucidate the action mechanism of platelet-derived growth factor BB after growth plate injury. METHODS:PubMed,VIP,WanFang,and CNKI databases were used as the literature sources.The search terms were"growth plate injury,bone bridge,platelet-derived growth factor BB,repair"in English and Chinese.Finally,66 articles were screened for this review. RESULTS AND CONCLUSION:Growth plate injury experienced early inflammation,vascular reconstruction,fibroossification,structural remodeling and other pathological processes,accompanied by the crosstalk of chondrocytes,vascular endothelial cells,stem cells,osteoblasts,osteoclasts and other cells.Platelet-derived growth factor BB,as an important factor in the early inflammatory response of injury,regulates the injury repair process by mediating a variety of cellular inflammatory responses.Targeting the inflammatory stimulation mediated by platelet-derived growth factor BB may delay the bone bridge formation process by improving the functional activities of osteoclasts,osteoblasts,and chondrocytes,so as to achieve the injury repair of growth plate.Platelet-derived growth factor BB plays an important role in angiogenesis and bone repair tissue formation at the injured site of growth plate and intrachondral bone lengthening function of uninjured growth plate.Inhibition of the coupling effect between angiogenesis initiated by platelet-derived growth factor BB and intrachondral bone formation may achieve the repair of growth plate injury.

OBJECTIVE To solve the problem of insolubility of itraconazole, improve its dissolution in vitro, and provide a reference for further industrial scale-up of the itraconazole multiparticle system. METHODS Itraconazole multiparticle system pellets were dissolved in an organic solvent and prepared in a fluidized bed by bottom spraying. Itraconazole and hydroxypropyl methylcellulose were sprayed onto the surface of the sucrose pellet core to form a uniform solid dispersion. The preparation parameters of the fluidized bed bottom spray coating were investigated by single factor method. The mass ratio of drug to carrier and core weight gain of the itraconazole multiparticle system were optimized by central composite design and response surface methodology with accumulative dissolution rate, application efficiency and adhesion rate as response values. Samples were prepared to verify the optimized prescription, the microscopic hierarchical structure of the itraconazole multiparticle system was observed by scanning electron microscope, and the solid dispersion in the itraconazole multiparticle system pellets was characterized by differential scanning calorimetry(DSC) and X-ray diffraction(XRD). The dissolution curves of itraconazole pellets and the physical mixture in 0.1 mol·L−1 HCl dissolution medium were compared to verify the solubilization effect. RESULTS Single factor method was used to determine the bottom spray coating parameters of the fluidized bed. The pumping speed was set as 3.0−5.0 mL·min−1, the atomization pressure was set as 1.5 bar, the inlet air volume was set as 110 m3·h−1, and the material temperature was set as 35 ℃. According to the central composite design and response surface methodology, the mass ratio of drug to carrier of the optimized prescription was 1∶1.5 and the core weight of the pill was 75%, and the response values reached the expected value. The result of scanning electron microscopy showed that the diameter of the itraconazole multiparticle system pellet was about 910 µm, the diameter of the sucrose pellet core was about 570 µm, the thickness of the drug loading layer was about 110 µm, and the thickness of encapsulation layer was about 11 µm. The results of DSC and XRD showed that itraconazole formed a uniform solid dispersion in the itraconazole multiparticle system pellets, which was amorphous. In the dissolution medium of 0.1 mol·L−1 HCl, the accumulative dissolution rate of the multiparticle system after 90 min was about 10 times that of the physical mixture, which showed that the solubilization effect was remarkable. CONCLUSION The dissolution of itraconazole in vitro can be significantly improved by processing itraconazole into pellets with multiparticle system and forming solid dispersion.

Objective:To investigate the clinical application value of commonly used preoperative indicators of sarcopenia in predicting postoperative pneumonia in patients aged 70 years and above with esophageal cancer.Methods:A retrospective analysis was conducted on the clinical data of 398 elderly patients(≥70 years old)with esophageal squamous cell carcinoma who underwent thoracic laparoscopic radical resection of esophageal cancer in our hospital from January 2020 to December 2021.The study aimed to investigate the correlation between clinical pathological indicators and commonly used measurement indicators of sarcopenia and postoperative pneumonia.Statistical analysis was performed to analyze the data.Results:The study found that the proportion of postoperative pneumonia in esophageal squamous cell carcinoma patients aged 70 years and above was 27.9%(111 out of 398). The pneumonia group had significantly lower preoperative BMI and peak expiratory flow(PEF)measurements compared to the non-pneumonia group, with statistically significant differences( t=2.799, 2.674, both P<0.05). Logistic multivariate analysis revealed that low PEF, low psoas major muscle index(PMI), and low psoas muscle density(PMD)were the primary risk factors for postoperative pneumonia in esophageal cancer patients aged 70 years and above(Wald χ2 values were 7.577, 6.091, 6.845, all P<0.05). The risk of postoperative pneumonia in esophageal cancer patients aged 70 years and above with low PEF, low PMI, and low PMD was found to be 1.969 times higher(95% CI: 1.215-3.185, P=0.006), 1.912 times higher(95% CI: 1.143-3.205, P=0.014), and 1.832 times higher(95% CI: 1.164-2.882, P=0.009)respectively, compared to patients with high PEF, high PMI, and high PMD. Conclusions:Low PEF, low PMI, and low PMD are significant risk factors for postoperative pneumonia in esophageal cancer patients aged 70 years and older.Preoperative PEF, PMI, and PMD, which are commonly utilized measurement indicators for sarcopenia, can be utilized as early screening indicators for postoperative pneumonia.

Objective:To analyze the effects of paroxetine combined with aniracetam on the treatment of senile depression and the levels of 5-hydroxytryptamine (5-HT), cortisol and cystatin C(CysC).Methods:A total of 80 patients admitted to the psychiatric Department of Psychiatry, Suzhou City Guangji Hospital from January 2020 to January 2023 were selected and divided into two groups by random number table method: control group (40 cases) and observation group (40 cases). The control group was treated with oral paroxetine hydrochloride tablets, and the observation group was treated with oral paroxetine hydrochloride combined with aniracetam tablets. Negative emotions were assessed by Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) before and after treatment, and sleep quality was assessed by Pittsburgh Sleep Quality Scale (PSQI). Serum levels of central neurotransmitters [norepinephrine (NE) and 5-HT], neurotrophic factor (BDNF), oxidative stress [cortisol and malondialdehyde (MDA)] and amino acid metabolism [cysteine (Hcy) and CysC] were measured before and after treatment.Results:After treatment, SAS and SDS scores in both groups were significantly decreased (all P<0.05), and SAS and SDS scores in the observation group were significantly lower than those in the control group (all P<0.05). After treatment, the sleep quality, sleep time, sleep time, sleep efficiency, sleep disorders, hypnotic drugs, daytime function scores and PSQI total scores of the two groups were significantly decreased (all P<0.05), and the above scores of the observation group were significantly lower than those of the control group ( P<0.05). After treatment, the serum levels of NE, 5-HT and BDNF in 2 groups were significantly increased, and the serum levels of NE, 5-HT and BDNF in the observation group were significantly higher than those in control group (all P<0.05). After treatment, the levels of serum cortisol and MDA in both groups were significantly decreased, and the levels of serum cortisol and MDA in the observation group were significantly lower than those in the control group (all P<0.05). After treatment, the serum Hcy and CysC levels in 2 groups were significantly decreased, and the serum Hcy and CysC levels in the observation group were significantly lower than those in the control group (all P<0.05). Conclusions:Paroxetine combined with aniracetam is more effective than paroxetine alone in the treatment of senile depression, which can effectively relieve anxiety and depression symptoms, improve sleep quality, and have positive effects on serum neurotransmitters, neurotrophic factors, oxidative stress and amino acid metabolism levels of patients.

OBJECTIVE To prepare a self-microemulsifying drug delivery system(SMEDDS) for the oral administration of nebivolol hydrochloride(NBH) and to conduct in vitro evaluation. METHODS The solubility of NBH was determined using various oil phases, surfactants, and co-surfactants. The composition of the blank self-microemulsifying formulation was determined using pseudo-ternary phase diagrams. A centralcomposite design-response surface method was employed to screen and optimize the formulation variables, and an excess amount of NBH raw material was incorporated to determine the drug loading capacity. RESULTS The optimized composition of the NBH-SMEDDS formulation consisted of medium-chain glycerides, capryl caproyl macrogol glycerides, and 2-(2-ethoxyethoxy) ethyl acetate at a ratio of 20∶48∶32, with a drug loading capacity of 20.05 mg. The particle size, self-emulsification time, and particle size distribution range of the formulation were in agreement with the predicted values. Dissolution testing demonstrated that the overall dissolution trend of NBH-SMEDDS in the medium was higher than that of NBH powder and NBH ordinary tablet. The stability of NBH-SMEDDS was found to be satisfactory under accelerated conditions for 1, 2, and 3 months. CONCLUSION The SMEDDS shows potential for enhancing the in vitro dissolution of NBH and demonstrates good stability.

The rapid development of artificial intelligence(AI)technology has driven the intelligentization of medicine.In recent years,due to the continuous improvement of machine learning and deep learning technologies,AI technology has made rapid progress in the diagnosis and treatment of ocular fundus diseases,including retinal vascular disease,macular disease,retinal detachment,and retinal pigment degeneration.Early diagnosis and treatment are of great significance for the prognosis of ocular fundus diseases.This article gives a guide for the application of AI in automatic segmentation of ret-inal images and disease diagnosis,providing a reference for further research and appIication of AI in this field.

Objective:To explore the relationship among suicide risk,distress tolerance,and resilience in pa-tients with depression.Methods:A total of 130 patients with depression who met the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)diagnostic criteria were included.The Chinese version of the Mini International Neuropsychiatric Interview(MINI)suicide module was used to assess suicide risk.According to the interview results,the patients with depression were divided into suicide risk group(98 cases)and non-suicide risk group(32 cases).The Hamilton Depression Rating Scale(HAMD),Distress Tolerance Scale(DTS),10-item Connor-Davidson Resilience Scale(CD-RISC-10)were used to assess severity of depressive symptoms,level of distress tolerance and resilience,respectively.Results:The DTS total scores were positively correlated with the CD-RISC-10 total scores(r=0.50,P＜0.01).The total scores of MINI suicide module were negatively correlated with the total scores of DTS and CD-RISC-10(r=-0.34,-0.34,Ps＜0.01).Distress tolerance had a direct effect on suicide risk(β=-0.26,P＜0.05),and resilience played a mediating effect on the relationship between distress tolerance and suicide risk(β=-0.13,P＜0.05),and the mediating effect accounted for 33.5％of the total effect.Conclusion:Patients with depression with lower levels of distress tolerance may have higher suicide risk,and resilience may play a partially mediating role in the relationship between distress tolerance and suicide risk.

Objective:To evaluate the clinical effectiveness and safety of fractional microneedle radiofrequency (RF), subsequently followed by narrowband intense pulsed light (IPL), in the treatment of facial photoaging.Methods:A retrospective analysis was performed on 50 female patients who underwent facial photodamage treatment at the Fifth People＇s Hospital of Suzhou from January to December 2021, with an average age of (40±8) years. Each patient received fractional microneedle RF therapy, subsequently followed by two sessions of narrowband IPL therapy at 500-600 nm, with a 4-week interval between treatments. Before and 4 weeks after the final treatment, skin parameters including wrinkles, redness, and sunspots were quantitatively assessed using the Visia skin image analyzer. Patients self-reported their satisfaction levels, and any adverse reactions were recorded.Results:All patients completed the prescribed treatment regimen. Post-treatment evaluations revealed marked improvements in facial skin, characterized by reduced wrinkles, enhanced skin smoothness, tighter contours, and lighter pigmentation spots. Specifically, the pre-treatment scores for wrinkles, sunspots, and redness were (25.6±10.2), (312.6±75.9), and (162.0±68.6) scores, respectively, which significantly decreased to (18.3±7.4), (261.2±82.7), and (129.7±60.1) scores four weeks post-treatment (all P<0.001). The patients＇ satisfaction levels were (6.6±1.2) scores. During treatment, all patients experienced mild erythema and edema, which resolved within 3-4 days. No serious adverse reactions, such as blistering, hyperpigmentation, or scarring, were observed. Conclusions:Fractional microneedle RF therapy, followed by narrowband IPL therapy, emerges as an effective and safe treatment option for facial photodamage, with minimal adverse reactions.

Bardet-Biedl syndrome (BBS) is an autosomal recessive hereditary rare disease with high heterogeneity in clinical phenotypes, which can affect multiple systems, such as six fingers/digits deformity, mental impairment, retinopathy, polycystic kidney, etc, and is easily diagnosed according to a single system disease, resulting in misdiagnosis. The paper reports a case of BBS, diagnosed with "renal cyst, developmental delay, chondrosis, and left foot hexadactylism" at 5 years old, "anemia, renal insufficiency, distal renal tubule poisoning, renal osteodystrophy" at 7 years old. At 10 years old, the patient received hemodialysis treatment for uremia. Cloudy vision appeared in both eyes at 14 years old. Because of the prominent manifestation of kidney damage, the patient was misdiagnosed as "polycystic kidney" for a long time, and other systemic damages were ignored. The result of gene sequencing showed that chromosome 16 NM_031885.5 exon17 had one homozygous nonsense mutation. Therefore, the patient was accurately diagnosed as BBS. This paper is the first report of BBS in Li nationality in China. The relevant literature of BBS were reviewed to strengthen clinicians' understanding of the disease and improve patients' prognosis.

OBJECTIVES: To study the correlation of intestinal dominant flora with hyperuricemia, and to explore influencing factors of hyperuricemia. METHODS: Data of gut dominant microbiota were collected from subjects who underwent health check-up in Shulan (Hangzhou) Hospital from January 2018 to April 2020. Subjects with high uric acid and normal uric acid were matched by propensity score matching method according to age, gender and body mass index (BMI). This resulted in 178 pairs as hyperuricemia group and control group. The gut dominant microbiota between hyperuricemia and normal control group were compared. Pearson or Spearman correlation coefficient method was used to analyze the correlation between blood uric acid and intestinal dominant flora. Univariate and multivariate logistic regression were used to analyze the influencing factors of hyperuricemia. RESULTS: The abundance of Atopobium, Lactobacillus, Bacteroides, Enterococcus, Clostridium leptum, Fusobacterium prausnitzii, Bifidobacterium, Clostridium butyricum and the ratio of Bifidobacterium to Enterobacter (B/E) in the hyperuricemia group were significantly lower than those in the control group (all P<0.01). The correlation analysis showed that serum uric acid were negatively correlated with the abundance of Atopobium (r=－0.224, P<0.01), Bacteroides (r=－0.116, P<0.05), Clostridium leptum (r=－0.196, P<0.01), Fusobacterium prausnitzii (r=－0.244, P<0.01), Bifidobacterium (r=－0.237, P<0.01), Eubacterium rectale (r=－0.125, P<0.05), Clostridium butyricum (r=－0.176, P<0.01) and B/E value (r=－0.127, P<0.05). Multivariate logistic regression analysis showed that glutamyl transpeptidase was an independent risk factor for hyperuricemia (OR=1.007, 95%CI: 1.002-1.012, P<0.05), and the Atopobium was an independent protective factor for hyperuricemia (OR=0.714, 95%CI: 0.605-0.842, P<0.01). CONCLUSIONS There are alterations in abundance of gut dominant microbiota in patients with hyperuricemia, and Atopobium abundance appears as a protective factor for hyperuricemia.
Humans ; Uric Acid ; Hyperuricemia ; Body Mass Index ; Risk Factors ; Microbiota