Objective To investigate the clinical effect of Mudan Granules combined with pentoxifylline in the treatment of type 2 diabetes mellitus (T2DM) with early renal disease and analyze its impact on the Toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB) signaling pathway. Methods A total of 164 patients with T2DM and early renal disease admitted to the Second People's Hospital of Hunan Province between May 2022 and October 2023 were enrolled and randomly divided into observation group(n=82) and control group (n=82) using a random number table in a 1-to-1 ratio. The control group received pentoxifylline treatment, while the observation group received Mudan granules combined with pentoxifylline. The clinical effects and changes in renal function indicators[serum creatinine (SCr), urea nitrogen, urinary albumin-to-creatinine ratio (UACR)], TLR4/NF-κB signaling pathway indicators (TLR4, MyD88, NF-κB mRNA), and inflammation and oxidative stress indicators [C-reactive protein (CRP), glutathione peroxidase (GSH-PX), malondialdehyde (MDA), total antioxidant capacity (TAC), and transforming growth factor β1 (TGF-β1)] before and after treatment were compared between the two groups. Results The total effective rate in the observation group was 97.56%, which was higher than 89.02% in the control group (P<0.05). At 6 and 12 weeks after treatment, the levels of SCr, urea nitrogen, and UACR in both groups decreased compared with those before treatment, and the levels of these indicators in the observation group were lower than those in the control group (P<0.05). At 6 and 12 weeks after treatment, the levels of TLR4, MyD88, and NF-κB mRNA in both groups decreased compared with those before treatment, and the levels of these indicators in the observation group were lower than those in the control group (P<0.05). At 6 and 12 weeks after treatment, the levels of GSH-PX and TAC in both groups increased, while the levels of CRP, MDA, and TGF-β1 decreased compared with those before treatment. The levels of GSH-PX and TAC in the observation group were higher than those in the control group, while the levels of CRP and MDA were lower (P<0.05). Conclusion Mudan Granules combined with pentoxifylline in the treatment of T2DM with early renal disease can improve renal function to a certain extent, regulate the TLR4/NF-κB signaling pathway, and reduce inflammation and oxidative stress responses, which is beneficial for disease control.

There are few clinical reports on the diagnosis and treatment of upper urinary tract stones secondary to urinary diversion. This study included 30 patients with upper urinary tract stones secondary to urinary diversion, and all of which were successfully managed. The individualized treatment with the ureteroscopy and/or percutaneous nephrolithotripsy with antegrade, retrograde, or a combination of antegrade and retrograde is safe and feasible.

Objective: To compare the efficacy and safety of combining diosmin with Jiuhua hemorrhoid suppository versus diosmin alone for the treatment of hemorrhoid hemorrhage. Methods: The Jiuhua hemorrhoid suppository study was conducted in 10 medical centers across China from April 1, 2019 to June 30, 2020. Patients with hemorrhoid bleeding were randomized in a ratio of 1 : 1 to either receive Jiuhua hemorrhoid suppository and diosmin tablets (the study group) or diosmin tablets alone (the control group). The suppository was used once a day after defecation or at bedtime after rinsing the anus with warm water. Diosmin tablets were administered only once a day (0.9 g). The primary endpoint of the study was the assessment of hemorrhoid bleeding relief 7 ± 2 days after treatment, classified as “very effective” “effective” and “ineffective”. The secondary endpoint included the evaluation of pain alleviation using the visual analogue scale (VAS, with scores ranging from 0 to 10) and edema (with scores ranging from 0 to 3). The safety of the two treatment regimens was evaluated 14 ± 2 days after drug administration. Results: The full analysis set (FAS) comprised 107 participants in the study group and 111 in the control group, while the per-protocol set (PPS) included 106 participants in the study group and 111 in the control group. In terms of hemorrhoid bleeding, the proportion of very effective and effective cases in the study group were significantly higher than that in the control group [106 (99.06%) vs. 91 (81.98%), P < 0.0001] in the FAS, and the PPS results [105 (99.06%) vs. 91 (81.98%), P < 0.0001] were comparable to the FAS results. The pain VAS scores at day 7 after treatment were comparable between the two groups (0.80 ± 1.17 vs. 0.80 ± 1.20, P = 0.2177). The majority of the participants in both groups had an edema score of 0 at day 7 after treatment [96 (89.72%) vs. 99 (91.67%), P = 0.370 5]. Adverse events (AEs) occurred in 9 patients (8.4%) in the study group and 3 patients (2.7%) in the control group. In addition, 5 AEs in the study group and 1 AE in the control group were possibly in association with the study drug. Conclusion Compared with the administration of diosmin oral tablets alone, the addition of Jiuhua hemorrhoid suppository to the tablets demonstrates enhanced efficacy in addressing hemorrhoid bleeding, with satisfactory patient adherence and acceptable safety.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

Bacitracin is a broad-spectrum cyclic peptide antibiotic, and mainly produced by Bacillus. Energy metabolism plays as a critical role in high-level production of target metabolites. In this study, Bacillus licheniformis DW2, an industrial strain for bacitracin production, was served as the original strain. First, our results confirmed that elimination of cytochrome bd oxidase branch via deleting gene cydB benefited bacitracin synthesis. Bacitracin titer and ATP content were increased by 10.97% and 22.96%, compared with those of original strain, respectively. Then, strengthening cytochrome aa3 oxidase branch via overexpressing gene qoxA was conducive to bacitracin production. Bacitracin titer and ATP content were increased by 18.97% and 34.00%, respectively. In addition, strengthening ADP synthesis supply is also proven as an effective strategy to promote intracellular ATP accumulation, overexpression of adenosine kinase DcK and adenylate kinase AdK could all improve bacitracin titers, among which, dck overexpression strain showed the better performance, and bacitracin titer was increased by 16.78%. Based on the above individual methods, a method of combining the deletion of gene cydB and overexpression of genes qoxA, dck were used to enhance ATP content of cells to 39.54 nmol/L, increased by 49.32% compared to original strain, and bacitracin titer produced by the final strain DW2-CQD (DW2ΔcydB::qoxA::dck) was 954.25 U/mL, increased by 21.66%. The bacitracin titer produced per cell was 2.11 U/CFU, increased by 11.05%. Collectively, this study demonstrates that improving ATP content was an efficient strategy to improve bacitracin production, and a promising strain B. licheniformis DW2-CQD was attained for industrial production of bacitracin.
Bacillus licheniformis ; metabolism ; Bacitracin ; biosynthesis ; Energy Metabolism ; genetics ; Industrial Microbiology ; methods

Objective: To evaluate the efficacy of the local injection of Salvia miltiorrhiza combined with triamcinolone acetonide and triamcinolone acetonide alone in the treatment of oral submucous fibrosis (OSF). Methods: A meta-analysis was performed by searching the related literature. Three randomized controlled trials meeting the inclusion criteria were identified. Changes in the Visual Analogue Scale (VAS) score and the degree of mouth opening were included in 172 cases (86 cases in the experimental group and 86 in the control group), and changes in the oral mucosal lesion area were included in 152 cases (76 cases in the experimental group and 76 in the control group). Changes in the VAS score, the degree of mouth opening and the oral mucosal lesion area were compared in the context of the local injection of Salvia miltiorrhiza combined with triamcinolone acetonide and triamcinolone acetonide alone. Results : There were no significant differences between the treatment with Salvia miltiorrhiza combined with triamcinolone acetonide and triamcinolone acetonide alone in reducing the VAS score (P > 0.05). Salvia miltiorrhiza combined with triamcinolone acetonide resulted in a greater increase in the degree of mouth opening than did triamcinolone acetonide (P = 0.05). The reduction in the oral mucosal lesion area induced by Salvia miltiorrhiza combined with triamcinolone acetonide was significantly greater than that induced by triamcinolone acetonide alone (P < 0.05). Conclusion The local injection of Salvia miltiorrhiza combined with triamcinolone acetonide is more effective than triamcinolone acetonide alone in the treatment of OSF.

Objective To investigate influence of nicotinic acid adenine dinucleotide phosphate (NAADP) on autophagy in hypoxic cardiomyocytes of rats and its mechanism.Methods Five neonatal Sprague-Dawley rats were collected and sacrificed to harvest the hearts,and primary cardiomyocytes were separated for the following experiments.(1) Primary cardiomyocytes were collected and divided into normoxia group,hypoxia 9 h group,and hypoxia 9 h + NAADP group according to random number table,with 5 wells in each group.Cells in normoxia group were cultured routinely in the constant temperature incubator at 37 ℃ for 9 hours.Cells in hypoxia 9 h group and hypoxia 9 h + NAADP group were cultured in hypoxic incubator with volume fraction 94％ nitrogen,5％ carbon dioxide,and 1％ oxygen for 9 hours.Before hypoxia,cells in hypoxia 9 h + NAADP group were dealt with final amount-of-substance concentration 10 μmol/L NAADP.Cell counting kit 8 was used to measure cell viability.(2) Primary cardiomyocytes were collected and divided into normoxia group,hypoxia 9 h group,hypoxia 9 h + NAADP group,hypoxia 9 h + tran-Ned-19 group,and hypoxia 9 h + trans-Ned-19 + NAADP group according to the random number table,with 2 wells in each group.Cells in normoxia group were cultured routinely in the constant temperature incubator at 37 ℃ for 9 hours.And cells in the other 4 groups were cultured in hypoxic incubator as that in experiment (1) Before hypoxia,cells in hypoxia 9 h + NAADP group were dealt with amount-of-substance concentration 10 μmol/L NAADP,cells in hypoxia 9 h + tran-Ned-19 group were dealt with amount-of-substance concentration 1 μmol/L trans-Ned-19,and cells in hypoxia 9 h + trans-Ned-19 + NAADP group were dealt with amount-of-substance concentration 10 μmol/L NAADP and 1 μmol/L trans-Ned-19.Protein expressions of microtubule associated protein 1 light chain 3-Ⅱ and P62 were detected by Western blotting.(3) Primary cardiomyocytes were collected and grouped as those in experiment (1).The lysosomal acidity was determined by immunofluorescence method.Data were processed with one-way analysis of variance and least-significant difference test.Results (1) The cell viability in normoxia group was 1.114 ± 0.024,which was significantly higher than 0.685 ± 0.079 of cells in hypoxia 9 h group (P ＜ 0.01).The cell viability of hypoxia 9 h + NAADP group was 0.886 ± 0.061,which was obviously higher than that of cells in hypoxia 9 h group (P ＜0.05).(2) Expressions of microtubule-associated protein 1 light chain 3-Ⅱ and P62 of cells in hypoxia 9 h group were significantly higher than those of cells in normoxia group (P ＜ 0.0l).Compared with those in hypoxia 9 h group,expression of P62 in hypoxia 9 h + NAADP group was significantly decreased (P ＜ 0.01),while expression of microtubule-associated protein 1 light chain 3-Ⅱ did not change significantly (P ＞ 0.05).There were no significantly statistical difference in expressions of microtubule-associated protein 1 light chain 3-Ⅱ and P62 between hypoxia 9 h group and hypoxia 9 h + trans-Ned-19 group (P ＞ 0.05).Compared with those of cells in hypoxia 9 h + NAADP group,expression of P62 of cells in hypoxia 9 h + trans-Ned-19 + NAADP group was obviously increased (P ＜ 0.01),while expression of microtubule-associated protein 1 light chain 3-Ⅱ did not change significantly (P ＞ 0.05).(3) The intensity of green fluorescence of cells in normoxia group was strong and co-localized well with red fluorescence,and internal environment of lysosome was with stronger acidity.The intensity of green fluorescence in cells of hypoxia 9 h group was significantly lower than that of cells in normoxia group,and acidity of internal environment of lysosome was weakened.The intensity of green fluorescence and acidity of internal environment of lysosome in hypoxia 9 h + NAADP were significantly stronger than those of cells in hypoxia 9 h group,but significantly lower than those of cells in normoxia group.Conclusions NAADP can improve myocardial cell viability through acidifying internal environment of lysosome of cardiomyocyte after hypoxia,promoting degradation of autophagosomes,reducing autophagic lysosomal accumulation,and repairing damaged autophagie flow.

AIM:To investigate the role of miR-125b in regulating the sensitivity of CD133+ colorectal cancer cells to cisplatin.METHODS:The expression of miR-125b was detected by RT-qPCR in the routine SW480 cells and CD133+ SW480 cells.Flow cytometry analysis was performed to measure the percentage of CD133+ cell population in the SW480 cell line treated with miR-125b and cisplatin.MTT assay was performed to evaluate the effect of miR-125b on the cisplatin-induced cell death in the CD133+ SW480 cells.Bioinformatics and Western blot were performed to determine whether the expression of HAX-1 was regulated by miR-125b.JC-1 staining, Annexin V staining and Western blot analysis were used to study the pathway of apoptosis in the CD133+ SW480 cells co-treated with miR-125b and cisplatin.RESULTS:The expression of miR-125b was significantly lower in the CD133+ SW480 cells than that in the routine SW480 cells and normal colonic epithelial FHC cells.Treatment with cisplatin alone increased the percentage of CD133+ SW480 cell population.However, miR-125b significantly inhibited the enrichment of CD133+ cell population induced by cisplatin.In addition, the results of MTT assay showed that the anti-tumor effect of cisplatin was significantly enhanced when the miR-125b was transfected into the CD133+ SW480 cells.The results of Western blot indicated that the HAX-1 gene was the target of miR-125b.Furthermore, the apoptosis induced by the combination of miR-125b and cisplatin was dependent on the dysfunction of mitochondrial membrane, leading to the release of cytochrome C into the cytoplasm and the subsequently activation of apoptosis in the CD133+ SW480 cells.CONCLUSION:miR-125b increased the sensitivity of CD133+ colo-rectal cancer cells to cisplatin by down-regulating the expression of HAX-1.

With rapid advancements in internal fixation and new surgical instruments, surgical treatment has gradually emerged as the first treatment choice for mandibular condylar fractures. An appropriate surgical incision is the first and determinant step during surgery to avoid postoperative complications. Hence, surgical approaches in relation to oral and maxillofacial trauma surgery for the treatment of mandibular condylar fractures have been extensively investigated. This review summarizes the research progress on surgical approaches in the management of mandibular condylar fractures.
Fracture Fixation, Internal ; Humans ; Mandibular Condyle ; surgery ; Mandibular Fractures ; surgery ; Postoperative Complications ; Research ; Surveys and Questionnaires

Objective To establish a function model to modulate the tube current according to the chest circumference at Coronary CTA scan,and to evaluate the feasibility of using the function model individually.Methods Sixty-eight consecutive patients who underwent thoracic scan with automatic current modulation were studied to establish a function model of tube current and chest circumference.The other 64 consecutive patients underwent coronary CTA scan using the new function model.The image quality was scored,and the noise,tube current and radiation dose were recorded and statistically evaluated.Results The POW function model was the best one to adjust tuber current to the chest circumference (R2 =0.691,P ＜ 0.05).The mean image quality score,noise,tube current,radiation dose (CTDIvol) and dose-length product (DLP) were (3.38±0.72) scores,(31.02 ±3.97) HU,(390.63± 89.30) mA,(34.83±10.72) mGy,(751.67 ±175.16) mGy·cm,respectively.Conclusions Tube current modulation based on the chest circumference would be feasible to reduce the radiation dose individually in coronary CT angiography.