AIM: To investigate the efficacy of Yangyin Yiqi Decoction combined with polyethylene glycol eye drops on dry eye disease after cataract surgery and its effect on inflammatory factors in tears.METHODS:Prospective study. A total of 104 patients(104 eyes)with dry eye disease after cataract surgery admitted to our hospital from April 2022 to March 2024 were selected and randomly divided into two groups: 52 cases(52 eyes)in the control group were treated with polyethylene glycol eye drops; 52 cases(52 eyes)in the combined group were treated with Yangyin Yiqi Decoction combined with polyethylene glycol eye drops. The dry eye symptom score, tear film stability index, tear inflammatory factor level, ocular surface disease index score(OSDI)and clinical efficacy of the two groups were compared before and after treatment.RESULTS:There were 6 cases(6 eyes)lost to follow-up, and 3 cases(3 eyes)were lost to follow-up in each group, with a loss to follow-up rate of 5.8%. The total effective rate of treatment in the combination group was significantly higher than that in the control group(94% vs 80%, P=0.037), and the Schirmer I test(SIt)and tear film break-up time(BUT)were higher than those in the control group(all P<0.05), and the dry eye symptom score, corneal fluorescein staining(FL)score, IL-1β, TNF-α, hs-CRP levels in tears and OSDI score were lower than those in the control group(all P<0.05).CONCLUSION:The combination of Yangyin Yiqi Decoction and polyethylene glycol eye drops provides an effective treatment plan for patients with dry eye disease after cataract surgery. It can effectively alleviate dry eye symptoms, reduce eye discomfort, improve tear film stability and ocular surface status, and reduce inflammatory factors in tears.

Background With the aging of China's population, cognitive impairment in the elderly is receiving increasing public attention. Screening and intervention of people with mild cognitive impairment (MCI) are of great significance to prevent and reduce the occurrence of cognitive impairment. Objective To understand the prevalence and explore potential influencing factors of MCI in the elderly in Songjiang District, Shanghai, and to provide scientific basis for promoting early screening of cognitive impairment and precise intervention of MCI in the elderly in this area. Methods A cross-sectional study design was adopted. From August to October 2022, using multi-stage random sampling, 1800 elderly residents aged 60 years and above were screened for cognitive impairment in 6 neighborhood/village committees in 6 towns in Songjiang District. The survey questionnaires included a sociodemographic questionnaire, a health status and lifestyle questionnaire, the Instrumental Activities of Daily Living (IADL), the Patient Health Questionnaire (PHQ-9), and the Mini-Mental State Examination (MMSE). Prevalence rates of MCI among the elderly by selected social demographic characteristics, health status, and lifestyle were estimated, and potential influencing factors of MCI were evaluated by binary logistic regression. Results A total of 209 elderly residents with MCI and 1591 healthy elderly residents were detected, and the prevalence of MCI in the elderly aged 60 and above was 11.6% in Songjiang District. Being physically active (OR=0.556, 95%CI: 0.399, 0.774) reduced the risk of MCI. Illiteracy (OR=1.810, 95%CI: 1.239, 2.644), primary school education level (OR=3.454, 95%CI: 2.342, 5.092), non-participation in social activities (OR=1.945, 95%CI: 1.360, 2.781), IADL damaged (OR=3.173, 95%CI: 2.137, 4.712), and depression (OR=1.957, 95%CI: 1.112, 3.443) increased the risk of MCI (P＜0.05). Conclusion The prevalence of MCI among the elderly in Songjiang District is lower than the national average. Educational level, physical activity, participation in social activities, IADL, and depression may be the influencing factors of MCI in the elderly. It is recommended to carry out early screening, early detection, and early intervention for cognitive impairment in the elderly. Improving involvement in physical exercise and increasing participation in social activities are encouraged. Special attention should be paid to the needs of vulnerable groups such as low education level and disabled elderly during a community MCI intervention program.

Objective:To investigate the association of total sleep time (TST) and oxygen desaturation index (ODI) with hypertension in patients with obstructive sleep apnea/hypopnea syndrome (OSA).Methods:A total of 440 OSA patients admitted to Yixing Hospital from January 2017 to December 2022 were consecutively enrolled, including 236 patients with hypertension (OSA+hypertension group) and 204 patients without hypertension (OSA group). The clinical data and polysomnograpic parameters were collected. Univariate and multivariate logistic regression was used to analyze the related factors of OSA complicated with hypertension. The multiplicative interaction between TST and ODI on OSA with hypertension was analyzed. A two-factor cross-over analysis of TST and ODI was performed and the additive interaction model was used to analyze the additive interaction between TST and ODI on OSA with hypertension.Results:Univariate logistic regression showed that male sex, smoking, diabetes, coronary heart disease, TST <7 h, age, body mass index, neck circumference, waist circumference, Epworth Sleepiness Scale (ESS) score, TST, AHI, ODI>16 times/h, triglyceride, high density lipoprotein cholesterol and fasting blood glucose were positively correlated with hypertension in OSA patients (all P<0.05). Multivariate logistic regression analysis showed that smoking ( OR=4.327, 95% CI: 2.499-2.499, P<0.001), TST<7 h ( OR=1.748, 95% CI: 1.079-2.832, P=0.023) and ODI>16 times/h ( OR=3.482, 95% CI: 2.016-6.014, P<0.001) were independently associated with hypertension in OSA patients. After introducing a multiplicative term and adjusting for confounding factors, there was a positive multiplication interaction between TST <7 h and ODI>16 times/h ( OR=2.958, 95% CI: 1.079-8.113, P<0.050). Multivariate logistic regression analysis showed that the risk of hypertension in OSA patients with TST<7 h and ODI>16 times/h was 7.196 times (95% CI: 3.421-15.137) higher than that in patients with TST≥7 h and ODI≤16 times/h. The additive interaction model showed a synergistic effect between TST<7 h and ODI>16 times/h, with S value of 4.302 (95% CI: 1.566-11.815), RERI value of 4.756 (95% CI: 0.642-8.869) and API value of 66.10% (95% CI: 43.10%-89.10%). Conclusion:Shortened sleep duration and increased ODI are independent risk factors for hypertension in OSA patients, and when they coexist, the risk of hypertension in OSA patients is further increased.

Objective To investigate the role of RNA-binding motif protein X-linked(RBMX)in regulating the proliferation,migration,invasion and glycolysis in human bladder cancer cells.Methods A lentivirus vectors system and RNA interference technique were used to construct bladder cancer 1376 and UC-3 cell models with RBMX overexpression and knockdown,respectively,and successful cell modeling was verified using RT-qPCR and Western blotting.Proliferation and colony forming ability of the cells were evaluated using EdU assay and colony-forming assay,and cell migration and invasion abilities were determined using Transwell experiment.The expressions of glycolysis-related proteins M1 pyruvate kinase(PKM1)and M2 pyruvate kinase(PKM2)were detected using Western blotting.The effects of RBMX overexpression and knockdown on glycolysis in the bladder cancer cells were assessed using glucose and lactic acid detection kits.Results RT-qPCR and Western blotting confirmed successful construction of 1376 and UC-3 cell models with RBMX overexpression and knockdown.RBMX overexpression significantly inhibited the proliferation,clone formation,migration and invasion of bladder cancer cells,while RBMX knockdown produced the opposite effects.Western blotting results showed that RBMX overexpression increased the expression of PKM1 and decreased the expression of PKM2,while RBMX knockdown produced the opposite effects.Glucose consumption and lactate production levels were significantly lowered in the cells with RBMX overexpression(P<0.05)but increased significantly following RBMX knockdown(P<0.05).Conclusion RBMX overexpression inhibits bladder cancer progression and lowers glycolysis level in bladder cancer cells by downregulating PKM2 expression,suggesting the potential of RBMX as a molecular target for diagnosis and treatment of bladder cancer.

Objective To investigate the role of RNA-binding motif protein X-linked(RBMX)in regulating the proliferation,migration,invasion and glycolysis in human bladder cancer cells.Methods A lentivirus vectors system and RNA interference technique were used to construct bladder cancer 1376 and UC-3 cell models with RBMX overexpression and knockdown,respectively,and successful cell modeling was verified using RT-qPCR and Western blotting.Proliferation and colony forming ability of the cells were evaluated using EdU assay and colony-forming assay,and cell migration and invasion abilities were determined using Transwell experiment.The expressions of glycolysis-related proteins M1 pyruvate kinase(PKM1)and M2 pyruvate kinase(PKM2)were detected using Western blotting.The effects of RBMX overexpression and knockdown on glycolysis in the bladder cancer cells were assessed using glucose and lactic acid detection kits.Results RT-qPCR and Western blotting confirmed successful construction of 1376 and UC-3 cell models with RBMX overexpression and knockdown.RBMX overexpression significantly inhibited the proliferation,clone formation,migration and invasion of bladder cancer cells,while RBMX knockdown produced the opposite effects.Western blotting results showed that RBMX overexpression increased the expression of PKM1 and decreased the expression of PKM2,while RBMX knockdown produced the opposite effects.Glucose consumption and lactate production levels were significantly lowered in the cells with RBMX overexpression(P<0.05)but increased significantly following RBMX knockdown(P<0.05).Conclusion RBMX overexpression inhibits bladder cancer progression and lowers glycolysis level in bladder cancer cells by downregulating PKM2 expression,suggesting the potential of RBMX as a molecular target for diagnosis and treatment of bladder cancer.

Objective:To analyze the antimicrobial resistance and genomic characteristics of Salmonella enterica serovar Derby strains isolated from human and food sources in Hangzhou. Methods:A total of 60 Salmonella enterica serovar Derby strains isolated in Hangzhou during the period from 2015 to 2020 were subjected to antimicrobial susceptibility testing, pulsed field gel electrophoresis (PFGE) typing and whole-genome sequencing. Multilocus sequence typing (MLST), core genome multilocus sequence typing (cgMLST) and the identification of antimicrobial resistance genes were performed using the sequencing data. Phylogenetic tree based on the single nucleotide polymorphism (SNP) sites in the 60 genomes from Hangzhou and 379 genomes from public databases was constructed. Results:No significant difference was observed in the drug resistance rates between the clinical strains and food strains in Hangzhou. The multidrug resistance (MDR) rate was 76.7% (46/60). All of the 60 Salmonella Derby strains were positive for the antimicrobial resistance genes aac(6′)- Iaa and fosA7. The 60 strains were subtyped into 46 molecular types by PFGE and 53 molecular types by cgMLST(HC2). Except for one strain belonging to ST3220, the other Salmonella Derby strains were ST40. The phylogenetic analysis showed that some strains isolated in Hangzhou were close to the strains in Southeast Asia, suggesting the possibility of cross-border transmission of ST40 strains, with the main food sources being pork and fish; other strains were close to those circulating in Beijing, Guangzhou, Hubei, Chongqing and other provinces, suggesting the possibility of cross-province transmission of the strains, with the main food sources being pork, beef and chicken. Conclusions:The epidemic of Salmonella Derby in Hangzhou was mainly caused by the spread of ST40 strains and MDR was common. Clinical infections might be closely related to the consumption of pork, beef, chicken and fish. There was the possibility of cross-border transmission of Salmonella Derby between Hangzhou and Southeast Asia and cross-province transmission in China.

Objective To analyze the distribution characteristics of injuries among students in Songjiang district, Shanghai, and to provide data support for preventing injuries among students. Methods Data of injury cases among school students in Songjiang from 2017 to 2019 were collected from the National Injury Surveillance System (NISS), and the demographic characteristics, injury occurrence and clinical characteristics of injuries were analyzed. Results A total of 13 877 cases of injuries in school students were reported from 2017-2019, with a sex ratio of 1.94:1. The education level of the injured students was mainly primary school. The peak incidence months of student injuries were May (9.97%) and November (9.67%). Falls (50.83%) were the leading cause of student injuries, and the top three places of student injuries were at home (30.08%), in schools and public places (28.11%) and on roads/streets (22.97%). The top three activities at the time of the injury were leisure activities (34.62%), sports activities (18.50%), and taking transportation（17.68%）. The top three injury types were bruise/scratch (42.94%), sprain/strain (28.67%) and sharps/bite/open injury (13.53%). The common injury parts were lower limbs (38.39%), head (27.82%) and upper limbs (24.88%). Conclusion The prevention of injuries in school students in Songjiang should focus on male students and low age students, and targeted injury prevention and control work for students of different ages should be carried out.

We aimed to evaluate the effectiveness and safety of single-course initial regimens in patients with low-risk gestational trophoblastic neoplasia (GTN). In this trial (NCT01823315), 276 patients were analyzed. Patients were allocated to three initiated regimens: single-course methotrexate (MTX), single-course MTX + dactinomycin (ACTD), and multi-course MTX (control arm). The primary endpoint was the complete remission (CR) rate by initial drug(s). The primary CR rate was 64.4% with multi-course MTX in the control arm. For the single-course MTX arm, the CR rate was 35.8% by one course; it increased to 59.3% after subsequent multi-course MTX, with non-inferiority to the control (difference -5.1%,95% confidence interval (CI) -19.4% to 9.2%, P = 0.014). After further treatment with multi-course ACTD, the CR rate (93.3%) was similar to that of the control (95.2%, P = 0.577). For the single-course MTX + ACTD arm, the CR rate was 46.7% by one course, which increased to 89.1% after subsequent multi-course, with non-inferiority (difference 24.7%, 95% CI 12.8%-36.6%, P < 0.001) to the control. It was similar to the CR rate by MTX and further ACTD in the control arm (89.1% vs. 95.2%, P =0.135). Four patients experienced recurrence, with no death, during the 2-year follow-up. We demonstrated that chemotherapy initiation with single-course MTX may be an alternative regimen for patients with low-risk GTN.
Antineoplastic Combined Chemotherapy Protocols/adverse effects* ; Dactinomycin/adverse effects* ; Female ; Gestational Trophoblastic Disease/drug therapy* ; Humans ; Methotrexate/therapeutic use* ; Pregnancy ; Retrospective Studies

Objective:To investigate the relationships between severe, diffuse decrease in global brain 18F-fluorodeoxxglucose(FDG)uptake, whole-body total lesion glycolysis(TLG)and short-term death in elderly patients with newly diagnosed stage Ⅳ cancer. Methods:Clinical and 18FFDG PET/CT data of 24 elderly patients newly diagnosed stage Ⅳ cancer showing marked diffuse decrease in global brain FDG uptake(the decreased brain uptake group)were retrospectively enrolled.Sixteen elderly patients with newly diagnosed stage Ⅳ cancer but without decreased global brain FDG uptake(the no decreased brain uptake group)and 25 healthy subjects were enrolled as the control groups.Correlations between brain FDG uptake and whole-body TLG were analyzed.We followed up the final outcomes of all patients and analyzed the short-term prognostic value of these manifestations. Results:The decreased brain uptake group included 17 patients with stage Ⅳ lymphoma and 7 patients with stage Ⅳ malignant tumor of other types[15 males, age: (73±9)years], while the no decreased brain uptake group included 8 patients with stage Ⅳ lymphoma and 8 patients with stage Ⅳ malignant tumor of other types[12 males, age: (65±5)years]and the healthy control group included 25 subjects[13 males, age: (65±6)years]. Patients were older in the decreased brain uptake group than in the no decreased brain uptake group( t=3.8, P=0.001). The global brain SUV means of the decreased brain uptake group and the no decreased brain uptake group were 4.9±1.8 and 10.9±2.0, respectively( t=-9.8, P=0.000). The global brain total glycolysis(TG)values of the two groups were 1786.5±1162.5 and 2868.4±1424.5, respectively( t=-2.6, P=0.012). The whole-body TLG values of the two groups were 6825.5±4776.9 and 2919.5±2031.7, respectively( t=3.6, P=0.001). Pearson correlation analysis showed that brain FDG uptake was adversely correlated with whole-body TLG.We followed up the survival outcomes of the two groups.The median follow-up lengths of the two groups were 6 months and 10 months, respectively( χ2=3.7, P=0.054). Fourteen(14/24)patients died in the decreased brain uptake group while 9(9/16)died in the no decreased brain uptake group( χ2=0.017, P=0.896). However, 8 cases died within 1 month post PET/CT scan in the decreased brain uptake group while none died in the no decreased brain uptake group( χ2=4.7, P=0.029). Conclusions:Severe, diffuse decrease in 18F-FDG PET/CT uptake in the whole cerebral cortex is more common in elderly patients with newly diagnosed stage Ⅳ cancer, whose total tumor load is significantly higher than that of cancer patients without decrease in whole cerebral cortex FDG uptake.This uptake reduction may indicate poor short-term outcome and the probability of short-term death may be high.

Objective:To explore the effect of recombinant human syntaxin-4(STX4) on lipopolysaccharide(LPS)-induced injury in islet β-cells(INS-1).Methods:Pancreatic islet β-cells(INS-1) were divided into Control (blank control), LPS (LPS treatment), LPS+ NC (transfection of negative control vector, LPS treatment), and LPS+ STX4 (transfection of pcDNA-STX4, LPS treatment) groups. RT-qPCR and Western blot were used to detect STX4 mRNA and protein expression, flow cytometry to detect apoptosis, DCFHDA method to detect reactive oxygen species(ROS) level, xanthine oxidation method to detect superoxide orgotein dismutase(SOD) level, colorimetric method to detect glutathione peroxidase(GSH-Px) level, ammonium molybdate colorimetric method to detect catalase(CAT) level, thiobarbituric acid method to detect malonaldehyde(MDA) level, ELISA method to detect the level of interleukin-1β(IL-1β), tumor necrosis factor-α(TNF-α), and insulin secretion levels under glucose conditions secreted by cells, Western blot method to detect Cleared Caspase-3, Bcl-2 Associated X Protein(Bax), p65 protein expression. After treatment with NF-κB signaling pathway activator, STX4 up-regulated islet β-cell INS-1 was given LPS stimulation, and the same method was used to measure apoptosis, ROS, SOD, GSH-Px, CAT, MDA levels and secreted IL-1β, TNF-α, insulin levels and Cleaved Caspase-3, Bax, p65 protein levels.Results:Compared with the Control group, the expression of STX4 mRNA and protein in islet β cells of the LPS group decreased, the apoptosis rate, ROS level, and MDA levels increased, and the levels of SOD, GSH-Px, and CAT decreased, the levels of IL-1β, TNF-α increased, the level of insulin secreted by the cells decreased, and the expression levels of Cleaved Caspase-3, Bax, and p65 also increased. NF-κB pathway activator treatment reversed the effect of up-regulated STX4 on islet β-cell apoptosis, ROS, SOD, GSH-Px, CAT, MDA levels and secreted IL-1β, TNF-α levels, and Cleaved Caspase-3 , Bax and p65 protein levels.Conclusion:Up-regulation of STX4 alleviated LPS-induced islet β cell oxidative damage, apoptosis and inflammatory factor release. The underlying mechanism might be related to the inhibition of activated NF-κB signaling pathway.