OBJECTIVE To evaluate the quality of evidence in the systematic evaluation/meta-analysis of traditional Chinese medicine （TCM） for diabetes retinopathy （DR） based on the GRADE system. METHODS Chinese and English databases were searched to obtain the relevant studies of systematic evaluation/meta-analysis of traditional Chinese medicine in the treatment of DR. The search time was from the establishment of each database to January 13th， 2024. According to the inclusion and exclusion criteria， literature screening was conducted. After extracting relevant information from the included literature， the GRADE system was used to evaluate the quality level of the evidence body in the included studies， and the evidence of the outcome indicators was integrated and summarized. RESULTS A total of 51 studies were ultimately included， encompassing 135 outcome indexes. Among these， 19 indicators （14.1%） were of high quality， 87 （64.4%） were of medium quality， 26 （19.3%） were of low quality， and 3 （2.2%） were of very low quality. Overall， the evidence quality of the outcome indicators in the included studies was medium to low quality. The integrated results of evidence on the efficacy of outcome indexes showed that compared with conventional Western medicine， calcium dobesilate or placebo， TCM had significant advantages in improving overall efficacy， reducing bleeding spot area， reducing macular foveal thickness， and increasing visual improvement rate. In addition，the combination of TCM and conventional Western medicine or calcium dobesilate was significantly more effective than using conventional Western medicine or calcium dobesilate alone. CONCLUSIONS The overall quality of the evidence in the systematic evaluation/meta-analysis study on the treatment of DR with TCM is medium to low quality. Based on existing research findings， TCM demonstrates good clinical efficacy in the treatment of DR.

Objective To observe the efficacy and safety of Morinda officinalis oligosaccharides in the continuation treatment of mild and moderate depression.Methods An open,single-arm,multi-center design was adopted in our study.Adult patients with mild and moderate depression who had received acute treatment of Morinda officinalis oligosaccharides were enrolled and continue to receive Morinda officinalis oligosaccharides capsules for 24 weeks,the dose remained unchanged during continuation treatment.The remission rate,recurrence rate,recurrence time,and the change from baseline to endpoint of Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),Clinical Global Impression-Severity(CGI-S)and Arizona Sexual Experience Scale(ASEX)were evaluated.The incidence of treatment-related adverse events was reported.Results The scores of HAMD-17 at baseline and after treatment were 6.60±1.87 and 5.85±4.18,scores of HAMA were 6.36±3.02 and 4.93±3.09,scores of CGI-S were 1.49±0.56 and 1.29±0.81,scores of ASEX were 15.92±4.72 and 15.57±5.26,with significant difference(P＜0.05).After continuation treatment,the remission rate was 54.59％(202 cases/370 cases),and the recurrence rate was 6.49％(24 cases/370 cases),the recurrence time was(64.67±42.47)days.The incidence of treatment-related adverse events was 15.35％(64 cases/417 cases).Conclusion Morinda officinalis oligosaccharides capsules can be effectively used for the continuation treatment of mild and moderate depression,and are well tolerated and safe.

To investigate the protective effect of hirudin on kidneys of diabetic rats and its molecular mechanism.

To investigate the protective effect of hirudin on kidneys of diabetic rats and its molecular mechanism.

Objective To investigate the distribution of traditional Chinese medicine(TCM)constitution in chronic hepatitis B(CHB)patients complicated with metabolism associated fatty liver disease(MAFLD),and to explore the correlation of the complication of MAFLD with TCM constitution and body composition,thus to determine their predictive values for the complication of MAFLD in CHB patients.Methods A retrospective study was adopted.The study started from the collection of the clinical data of 235 outpatients who attended the Department of Hepatology of Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to December 2023,and was diagnosed as CHB following the diagnostic criteria.According to the controlled attenuation parameter(CAP)value,134 cases of CHB patients were allocated to the non-MAFLD group(CAP＜238 dB/m)and 101 cases were allocated to the MAFLD group(CAP≥238 dB/m).And then the distribution of TCM constitution in the two groups was observed.In addition,according to the body mass index(BMI)value,the patients were divided into the non-obese group(141 cases,BMI＜24.0 kg/m2)and the overweight/obese group(94 cases,BMI≥24.0 kg/m2).And then the logistic regression was used to analyze the independent risk factors for the complication of MAFLD in CHB patients,multivariate logistic regression was used to analyze the influencing factors,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of the influencing factors for the complication of MAFLD in CHB patients and to determine their optimal cut-off values.Results(1)The constitutions of CHB patients in the MAFLD group were predominated by balanced constitution(36.6%),damp-heat constitution(20.8%),and phlegm-damp constitution(14.9%),which accounted for 72.3%in total.(2)In CHB patients complicated with MAFLD,the overweight/obese group had higher levels of γ-glutamyl-transpeptidase(γ-GT),BMI,total body fat mass(TBFM),total muscle mass(TMM),total body water(TBW),interacel1ular water(ICW),extracellular water(ECW),body fat ratio(BFR),visceral fat area(VFA),basal metabolism(BM),and trunk fat mass(TFM)than the non-obese group,and the differences were statistically significant(P＜0.05 or P＜0.01).(3)The results of multivariate logistic regression analysis showed that the white blood cell(WBC)count,blood uric acid(UA),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and VFA were the influencing factors for the complication of MAFLD in the CHB patients in clinic.(4)The results of ROC curve analysis showed that in CHB patients,the areas under the ROC curve(AUC)for age,TG,UA,and VFA were 0.532,0.680,0.738,and 0.859 respectively;the optimal cut-off values of VFA in CHB patients,non-obese CHB patients,and overweight/obese CHB patients were 74.98,66.5 and 112.2 cm2 respectively,and the optimal cut-off values of VFA in patients with balanced constitution,phlegm-damp constitution,and damp-heat constitution were 85.50,66.50,and 74.98 cm2 respectively.The AUC values of VFA in various populations were significantly higher than those of age,TG,and UA,and the combined prediction by multivariate analysis has higher predictive value than that by univariate analysis.Conclusion The AUC value of VFA for predicting the risk of MAFLD is the highest in patients with CHB,and the possibility of the complication of MAFLD increased with the increase of the cut-off point level of VFA.The optimal cut-off values of VFA varies in non-obese group and overweight/obese group of CHB patients and in CHB patients with different TCM constitution.

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

The incidence of knee osteoarthritis(KOA)is in-creasing year by year,seriously affecting patients'health.Mes-enchymal stem cells are multipotent cells with multiple differen-tiation functions.The extracellular vesicles released by these cells can carry various"cargo"to corresponding cells and tis-sues,exerting biological functions.They have shown great clini-cal potential in the treatment of KOA.This study reviews the therapeutic effects and mechanisms of extracellular vesicles se-creted by mesenchymal stem cells from different tissues such as bone marrow,adipose tissue,and synovium in KOA.It is found that miRNA is an important biological component in exerting therapeutic effects.The study also discusses the research pro-gress of engineered extracellular vesicles in KOA,pointing out the current challenges in clinical application,such as standard-ized acquisition of extracellular vesicles and difficulties in targe-ted action,aiming to provide a certain reference for the basic re-search and clinical application of extracellular vesicle therapy for KOA.

Urethral stricture is characterized by the chronic formation of fibrous tissue, leading to the narrowing of the urethral lumen. Despite the availability of various endoscopic treatments, the recurrence of urethral strictures remains a common challenge. Postsurgery pharmacotherapy targeting tissue fibrosis is a promising option for reducing recurrence rates. Although drugs cannot replace surgery, they can be used as adjuvant therapies to improve outcomes. In this regard, many drugs have been proposed based on the mechanisms underlying the pathophysiology of urethral stricture. Ongoing studies have obtained substantial progress in treating urethral strictures, highlighting the potential for improved drug effectiveness through appropriate clinical delivery methods. Therefore, this review summarizes the latest researches on the mechanisms related to the pathophysiology of urethral stricture and the drugs to provide a theoretical basis and new insights for the effective use and future advancements in drug therapy for urethral stricture.

Humans ; Amino Acid Metabolism, Inborn Errors/genetics* ; Mutation, Missense ; Proline Oxidase/genetics*

Objective:To investigate the clinical efficacy of arthroscopic limited incision of the articular capsule to repair the glenoid labrum in the treatment of borderline developmental dysplasia of the hip (BDDH) complicated with labral tear.Methods:A retrospective study was conducted to analyze the data of 18 patients with BDDH complicated with labral tear who had been admitted to Department of Orthopaedics, The Second Hospital Affiliated to Suzhou University from January 2016 to December 2019 (observation group). There were 12 males and 6 females with an age of (41.8 ± 8.5) years. Simultaneously, another 18 patients were selected as the control group whose hip development was normal but age and gender were matched with those in the observation group. There were 9 males and 9 females with an age of (43.5 ± 10.3) years. Both groups were treated by arthroscopic limited incision of the articular capsule to repair the glenoid labrum. The 2 groups were compared in terms of modified Harris hip score (MHHS), Hip Outcome Score Activities of Daily Living Subscale (HOS-ADL), and visual analogue scale (VAS).Results:There was no significant difference in the demographic data like age, gender ratio, body mass index, severity of labral tear or time from injury to operation between the 2 groups, indicating comparability between groups ( P>0.05). The observation and control groups were followed up for (38 ± 7) and (43 ± 6) months, respectively. For the observation and control groups, respectively, MHHS was (97.1 ± 3.3) points and (95.4 ± 4.2) points, HOS-ADL (92.6 ± 2.8) points and (91.4 ± 4.1) points, and VAS (0.6 ± 0.5) points and (1.0 ± 0.8) points, all showing no significant difference between groups ( P>0.05). Conclusion:In the treatment of BDDH patients complicated with labral tear, simple arthroscopic limited incision of the articular capsule to repair the glenoid labrum can lead to the same good medium-term efficacy as it can in those with normal hip development.