Objective To explore the effects of metformin on the proliferation,migration,and epithelial-mesenchy-mal transition(EMT)of human lens epithelial cells(LEC)induced by transforming growth factor-β2(TGF-β2).Methods Immortalized human LEC(HLEB-3 cells)was selected as the cell source.Human LEC with a cell fusion degree of 80％was cultured in DMEM low-glucose medium containing 10 mg·L-1 TGF-β2 for 24 hours as the control group.The cells treated with TGF-β2 and then further treated with different concentrations of metformin were used as the experimental group.After treatment,the morphological changes of cells in each group were observed under an inverted microscope.The cytotoxicity was detected by CCK-8 assay,and the cell survival rate was calculated.The expression levels of Yes-associated protein 1(YAP1),large tumor suppressor 1(LATS1),and Vimentin in cells were detected by Western blot.The mRNA ex-pression levels of YAP1,LATS1,mammalian STE20-like kinase 1(MST1),Vimentin,and E-cadherin were detected by re-al-time quantitative polymerase chain reaction.Results The cytotoxicity test of metformin showed that when the concen-tration of metformin was greater than 15 mmol·L-1,the survival rate of human LEC significantly decreased,indicating that the concentration of metformin had a significant impact on the survival of LEC.Therefore,15 mmol·L-1 was selected for subsequent experiments.Metformin significantly inhibited the proliferation of human LEC induced by TGF-β2 in a dose-dependent manner(P＜0.001).After 24 hours of treatment with 15 mmol·L-1 metformin,the relative expression levels of YAP1 and Vimentin proteins in human LEC were lower than those in the control group(both P＜0.05),while the relative expression level of LATS1 protein was higher than that in the control group(P＜0.05).After 24 hours of treatment with 15 mmol·L-1 metformin,the relative expression levels of YAP1 and Vimentin mRNA in human LEC were lower than those in the control group,while the relative expression levels of LATS1,MST1,and E-cadherin mRNA were higher than those in the control group,with statistically significant differences(all P＜0.05).Conclusion Metformin can inhibit the prolifer-ation,migration and EMT of human LEC induced by TGF-β2 in vitro,downregulate the expression of YAP1 and Vimentin mRNA,and upregulate the expression of LATS1,MST 1 and E-cadherin.The mechanism of action may be related to its ac-tivation of the Hippo signaling pathway.

OBJECTIVE Exploring the TNC gene mutations in a family with hereditary hearing loss and their relationship with clinical phenotypes.METHODS Draw the family pedigree chart,analyze the inheritance pattern,and assess the clinical phenotypes of family members using audiologic,imaging,and vestibular function tests.Perform whole exome sequencing on six members of the family to identify candidate mutations potentially related to hearing loss,and validate the distribution of these candidate mutations within the family and in normal controls using Sanger sequencing.RESULTS A heterozygous mutation c.5110G>T(p.Ala1704Ser)in exon 17 of the TNC gene on chromosome 9 was identified in the family.This mutation is associated with hereditary hearing loss.Carriers of this gene mutation all presented with normal hearing at birth and hearing decline during childhood;imaging examinations showed no abnormalities in the middle ear or inner ear structures.CONCLUSION This study reports for the first time the association between the heterozygous mutation c.5110G>T(p.Ala1704Ser)in the TNC gene and hereditary hearing loss,providing new evidence for molecular diagnosis and genetic counseling in cases of hereditary hearing loss.

Objective:To explore the factors affecting the management of medical devices in the COVID-19 pandemic, and to provide guidance for the management of medical devices in public health emergencies.Methods:A total of 184 hospitals caring COVID-19 patients in Jiangsu, Zhejiang, Shanghai, Anhui and Shandong were selected, and clinical engineers were randomly sampled. A self-compiled questionnaire was used to conduct an online survey on factors affecting medical device management during the COVID-19 pandemic from August to December 2021.The index system of influencing factors of medical device management during the COVID-19 pandemic was determined through an exploratory factor analysis, and then the structural equation model was used to verify the rationality and scientificity of the index system, while the relative weight method was used to calculate the weight of the index system.Results:277 valid questionnaires were recovered. Through the exploratory factor analysis, an index system of influencing factors of medical device management was established, which consisted of such level-indexes as the human factor, device factor, material factor, method factor, and environment factor, as well as 17 level-2 indexes. The fitness-indexes of the second-order structural equation model were finally fitted as follows: the chi-square to freedom ratio was 2.606, the approximate root mean square error was 0.076, and the value of value-added adaptation index, non-standard adaptation index and comparative adaptation index were 0.921, 0.903 and 0.920, respectively. The weights of the method factor, human factor, device factor, material factor and environment factor of the level-1 indexes were 0.216, 0.191, 0.175, 0.274 and 0.144, respectively. Such factors as manpower, regulations and institutional processes, and information technology ranked top three among the 17 level-2 indexes, which were 0.090, 0.082 and 0.080 respectively.Conclusions:The influencing factor model of medical device management during the COVID-19 pandemic in this study is ideal; human factors and method factors are the influencing factors deserving high priority in medical device management during the COVID-19 pandemic. Ensuring sufficient human resources, improving laws, regulations and processes, as well as enhancing information management level are breakthroughs expected in medical device management.

Objective:To simulate the spot characteristics of light emitting diode (LED) array light sources used in non-invasive phototherapy at different distances and to provide reference for the formulation of clinical non-invasive phototherapy treatment schemes.Methods:The ray tracing module in Comsol software was used to simulate the spot characteristics of LED light sources with different power and arrays at different distances, and the fitting curve was analyzed. The model was verified by the actual LED spot measurement, and the feasibility of the treatment scheme was verified by the mouse back wound model.Results:Under the irradiation of 2×2 LED light source array, with the increase of the vertical distance from the light source, the area of the effective area and the treatment area gradually increased, the power density value in the area gradually decreased, and the uniformity gradually increased. These changes showed a linear or binomial correlation with the vertical distance. The model was improved based on the actual LED light spot, and the new model consisted of an array of 18 LEDs as the light source, and the treatment area showed better uniformity and power density values. The simulated optical parameters were used to treat mice’s wounds with light, and the results showed that light treatment could promote wound healing.Conclusions:The established medical LED array light source spot characteristics simulation can provide a reference for the development of clinical non-invasive phototherapy protocols, thus helping the clinic select the appropriate LED power and array distribution according to the treatment needs and also providing a basis for the development of medical LED array light sources.

Gastric cancer is one of the most common malignant tumors in the world, and its incidence and mortality are among the top of malignant tumors in China. Since Kitano et al com-plete the first laparoscopic radical gastrectomy for gastric cancer in the world in 1992, the laparos-copic technology has developed rapidly. After more than 30 years of exploration and practice, the clinical diagnosis and treatment of gastric cancer in China has also made considerable progress. A large number of clinical studies at home and abroad have confirmed that laparoscopic radical gas-trectomy is no less effective than traditional open surgery in the short and long term. Laparoscopic radical gastrectomy has the characteristics of less trauma, faster recovery of gastrointestinal func-tion, less postoperative pain, and shorter average hospital stay. It has gradually replaced open surgery as the mainstream surgical method for gastric cancer. As the concept of surgical treatment for gastric cancer continues to update, emerging minimally invasive technologies continue to emerge, including robotic surgery systems and indocyanine green tracing technology, which are increasingly used in gastric cancer surgery, making gastric cancer surgery more minimally invasive and accurate, the quality of perigastric lymph node dissection and the domestic gastric cancer surgery technology further improving. Based on the relevant research at home and abroad, the authors review and summarize the latest progress in recent years with the topic of minimally invasive surgery for gastric cancer, aiming to systematically describe the current situation and future prospects of gastric cancer surgery. It is believed that in the future, the clinical diagnosis and treatment of gastric cancer in China will be more standardized, minimally invasive and accurate, more high-quality multicenter clinical research will be carry out and the diagnosis and treatment of gastric cancer will be further improved in China.

ObjectiveTo evaluate the overall demand for rehabilitation services from the perspective of the groups with disabilities, diseases, injuries and older adults, and explore the causes of the supply and demand gap of rehabilitation services. MethodsThe literatures in the field of rehabilitation were collected, summarized and analyzed, including policy documents issued by World Health Organization and relevant departments in China, surveys, and researches. ResultsThe demand for rehabilitation services caused by disabilities, chronic diseases, injuries and population ageing were vast in China, but many were still unmet. The main reasons leading to the gap included those population trend and health situation, the insufficient reserve of rehabilitation resources coming from incomplete development of rehabilitation service system early, and inadequate construction of disability reporting system, which could not efficiently meet rehabilitation demand with supply. ConclusionThe strategies to optimize the rehabilitation services system and promote the quality of the services based on the disability reporting system are warranted.

To investigate the clinical and genetic characteristics of patients with idiopathic hypogonadotropic hypogonadism (IHH), the clinical data of 23 patients with IHH were retrospectively analyzed. Gene analyses were accomplished with whole-exome sequencing (WES) and Sanger sequencing. Functional prediction of mutation sites was conducted using two bioinformatics platforms, SIFT and Polyphen. Among the 23 patients with IHH, 9 patients carried prokinin 2 (PROKR2) gene mutations including 4 missense mutations (p.W178S, p.Y113H, p.A103V, p.R164Q), and 1 frameshift mutation (p.D42delinsDED), the remaining 14 cases were found negative in gene sequencing. Functional prediction showed that the above mutations may affect protein function suggestive of a pathogenic role of PROKR2 mutation in the patients. There were no significant differences in the levels of follicle-stimulating hormone, luteinizing hormone, testosterone, and estradiol between the IHH patients with PROKR2 gene mutation and those without. PROKR2 gene mutation might associated with IHH, and the mutations reported in the present study could enrich the pathogenic spectrum of genes.

Objective:To analyze the epidemic status and characteristics of human brucellosis in Ordos City, and to provide basis for formulating perfect prevention and control countermeasures of brucellosis.Methods:The data of reported human brucellosis cases in Ordos City from 2016 to 2020 were collected through the Chinese Disease Prevention and Control Information System. Descriptive epidemiological method was used to analyze the distributions of time, region and population.Results:Totally 2 861 cases of human brucellosis were reported in Ordos City from 2016 to 2020. The average annual incidence rate was 27.68/100 000 and no deaths. The incidence rate of human brucellosis decreased year by year from 2016 to 2018 (24.11/100 000, 20.82/100 000, 20.11/100 000). But the incidence rate began to pick up in 2019 (24.59/100 000) and rose to 48.53/100 000 in 2020. The incidence peak was from March to August (1 882 cases). The cases had been reported in all over 9 banners (districts) of the city. The cumulative number of reported cases from more to less was Hangjin Banner, Dalat Banner, Otog Front Banner, Jungar Banner, Otog Banner, Dongsheng District, Wushen County, Ejin Horo Banner and Kangbashi District. The cases were predominantly male, and the sex ratio of male to female was 2.23∶1.00 (1 974 ∶ 887). The onset was mainly young and middle-aged adults, and the age was mainly 30-69 years old (2 541 cases). Farmers accounted for 65.26% (1 867 cases) in all reported cases, followed by herdsmen, accounting for 18.98% (543 cases).Conclusions:There is an obvious upward trend of human brucellosis in Ordos City in recent years, mainly among young and middle-aged male farmers. Health education for key populations should be strengthened, as well as personal protection during high-risk operations.

Objective: To investigate the ameliorative effects of Mushroom on adipose tissue inflammation and glucolipid metabolism in mice fed a high-fat diet, and to provide a theoretical basis for the mechanisms of Mushroom regulating glucolipid metabolism and inflammatory responses. Methods: C57 BL/6 J mice were fed with normal diet(LF) group, high-fat diet(HF)group and high-fat diet + Mushroom(HF+Mushroom) group for 15 weeks.Then, body weight subcutaneous and epididymal white adipose tissue weight were measured. The morphological changes of adipose tissues were compared by HE staining, and the expression of genes related to inflamation, glycolysis and fatty acid oxidation pathways were detected by RT-PCR and Western blot. Results: Compared with the LF group, the HF group had increased body weight, increased subcutaneous and epididymal white fat weight and adipocyte size, and upregulated expression of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), monocyte chemoattractant protein-1(MCP-1), CD68, inducible nitric oxide synthase(iNOS), pyruvate kinase(PK), phosphofructokinase(PFK), hypoxia inducible factor-1α(HIF-1α) and peroxisome proliferator activated receptor alpha(PPARα) in adipose tissues, while the expression of carnitine palmitoyl transferase-1 A(CPT-1 A), cytochrome P450 4 a10(CYP4 a10) and medium-chain acyl-coenzyme a dehydrogenase(MCAD) were downregulated(P<0.05). Compared with the HF group, Mushroom supplementation reduced body weight, adipose tissue weight and adipocyte size, and downregulated the expression of pro-inflammatory factors and glycolytic pathway-related factors in adipose tissues, while the expression of fatty acid oxidation pathway-related factors were upregulated(P<0.05). Conclusion Mushroom can ameliorate inflammation and disorders of glycolipid metabolism in adipose tissues of obese mice.

Objective:To explore clinical evaluation and genetic analysis of patients with idiopathic hypogonadotropic hypogonadism (IHH).Methods:The clinical data and phenotypes of 22 patients with IHH diagnosed and treated in our department were reviewed and analyzed. Whole-exome sequencing(WES)and Sanger method were used for variant analysis and verification.Results:Among the 22 cases of IHH probands, 12 cases of Kalman syndrome (KS) and 10 cases of IHH (nIHH) with normal sense of smell. On physical examination, males showed short penis, small testicles, small or inconspicuous laryngeal knots, and a sharp voice. Mammary gland development, mammary gland dysplasia, primary amenorrhea, etc. in women. Sex hormone examination: Follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), estradiol (E2) levels are reduced or at the lower limit of normal. There were nine missense variants of CHD7 gene in 8 patients. Based on the American College of Medical Genetics and Genomics guidelines, the c. 307T>A(p.Ser103Thr), c.3143G>A(p.Gly1048Glu), c.6956G>T(p.Arg2319Leu) and c. 3145A>T(p.Ser1049Cys) variants of CHD7 gene were predicted to be likely pathogenic (PS1+ PP1+ PM2, PM2+ PM6+ PP2+ PP3, PM2+ PM5+ PM6+ PP2+ PP3 and PM2+ PM6+ PP2+ PP3), the remaining 14 cases of IHH patients had negative genetic screening. Conclusion:CHD7 gene variants may be related to IHH disease.