Diabetic peripheral neuropathy (DPN) is one of the chronic complications of diabetic neuropathy, and also the main cause of chronic wounds and disability. Exosomes and exosomal-microRNAs (miRNAs) are closely related to DPN and participate in the signal transduction and protein expression of the peripheral nervous system by mediating intercellular communication. However, the specific role and mechanism of EVs and exosomal-miRNAs in the occurrence and development of DPN in high-glucose environments are not fully understood. This article reviews the promotion of EVs and exosomal-miRNAs in the occurrence and development of DPN in inhibiting axon growth, promoting inflammatory response, and inducing vascular injury in a high glucose environment.

Objective To analyze the predictive value of DNA methylation degree of serum Wnt4 gene pro-moter region in preterm patients.Methods A total of 480 pregnant women were randomly selected from the obstetrics ward of the hospital from January to December 2019.Among them,450 were followed up until de-livery,and 40 spontaneous preterm pregnant women were selected as the preterm group.410 full-term preg-nant women were selected as the health group.The DNA methylation degree of serum Wnt4 gene promoter region was compared between health group and preterm group,and the pregnant women with different gesta-tional week in preterm group.The clinical data of health group and preterm group were compared.Logistic re-gression analysis was used to analyze the influencing factors of premature delivery.Receiver operating charac-teristic(ROC)curve was plotted to analyze the predictive value of DNA methylation degree of serum Wnt4 gene promoter region for premature delivery.Results Compared with health group,the DNA methylation de-gree of serum Wnt4 gene promoter region in preterm group was significantly increased(P<0.05).Compared with pregnant women with 34-<37 gestational weeks in the preterm group,the DNA methylation degree of serum Wnt4 gene promoter region in pregnant women with 28-<34 gestational weeks was significantly in-creased(P<0.05).Compared with the health group,the proportions of pregnancies≥2 times,passive smok-ing during pregnancy,positive vaginal fetal fibronectin(fFN),and average monthly household income<1 000 yuan in the preterm group were significantly increased(P<0.05),and cervical length was significantly short-ened(P<0.05).Logistic regression analysis showed that pregnancies≥2 times,passive smoking during pregnancy,short cervical length,positive vaginal fFN,average monthly household income<1 000 yuan and high degree of DNA methylation in serum Wnt4 gene promoter region were all risk factors for premature de-livery(P<0.05).ROC curve results showed that the area under the curve of DNA methylation degree of ser-um Wnt4 gene promoter region for predicting premature delivery was 0.868(95%CI:0.834-0.898),the cut-off value was 51.43%,and sensitivity,specificity and accuracy were 82.50%,84.63%and 84.44%,respective-ly.Conclusion The high degree of DNA methylation in serum Wnt4 gene promoter region has certain clinical value in predicting the premature delivery.

Objective: To investigate the role of fibroblast growth factor receptor(FGFR) 1 in endothelial to-mesenchymal transition(EndMT) and epithelial-to-mesenchymal transition(EMT), and to find out a new strategy to study the vascular endothelial function of diabetic renal fibrosis. Methods: Culture media from FRS2 knockdown HMVECs was transferred to HK-2 cells. Western blot and immunofluorescence staining were used to measure EMT markers and key moleculars of transforming growth factor(TGFβ). Results: It was found that the medium from FRS2 siRNA-transfected HMVECs reduced E-cadherin protein levels, increased EMT markers levels, and activated TGFβ signal pathway in HK-2 cells. Conclusion Endothelial FGFR1 deficiency-induced EndMT leads to EMT in neighboring cells in a manner dependent on TGFβ1 signaling. Endothelial cell FGFR1 is an important molecule for maintaining endothelial homeostasis and epithelial homeostasis, and seems to be a key target for anti-diabetic renal fibrosis.

Objective To investigate the diagnostic value of B7-H3 and carcinoembryonic antigen (CEA) on diagnosis of malignant pleural effusion (MPE).Methods We collected and analysed the expression of B7-H3 and CEA in 40 MPE cases and 22 cases of benign pleural effusion (BPE) using enzyme-linked immunosorbent assay (ELISA).Receiver operator characteristic curves (ROC) were drawn according to the expression of B7-H3 and CEA, calculated diagnosis sensitivity, specificity and the area under curve (AUC).Results The diagnosis sensitivity of B7-H3 was 62.5％, specificity 81.0％, with the AUC of 0.777;similarly, The diagnosis sensitivity of CEA was 72.5％, specificity 81.0％, with the AUC of 0.850.Higher AUC of 0.910 was gained in combination ROC, with sensitivity and specificity of 72.5％, 81.0％, respectively.Conclusion B7-H3 and CEA could be available diagnosing markers for MPE.Combined applications of B7-H3 and CEA have higher AUC.They may be widely applied in future clinical practice.

Objective To evaluate he significance of the Neutrophil-Lymphocyte Ratio(NLR)and the red blood cell(erythrocyte)distribution width(RDW)in distinguishing between simple and complex febrile seizures and evaluate the diagnostic values of NLR and RDW in febrile seizures. Methods Totally,100 patients aged between 6 months and 5 years diagnosed with febrile seizure were admitted to the emergency department of the hospital.Complete blood count obtained from the peripheral blood samples collected from the patients at admis-sion were evaluated. Results The average values of NLR for simple and complex seizure groups were 2.16 ± 1.26 and 3.62 ± 1.51 respectively.The average values of RDW for simple and complex seizure groups were 15.04 ± 1.73 and 16.89 ± 1.44,respectively.Using receiver operating characteristic curve(ROC),the sensitivity and specificity were 65.5% and 66.2%,respectively,with the area under the curve[AUC]of 0.670 when the cut-off value was 2.52 for NLR,and they were 62.1% and 59.3%,respectively,with AUC of 0.619 when the cut-off value was 16.47 for RDW. Conclusion NLR and RDW may provide clinicians with an insight into differentiation between simple and complex febrile seizures,however,we need much better diagnostic value to classify the febrile seizures

Intestinal flora can participate in and influence the physiological function and disease process of the organism as part of the host .The symbiotic relationship between intestinal flora and the host is the result of species′evolution over millions of years .Immunity system , which is complex and includes multiple influencing factors , is the necessary defense system that runs through human life .Among them, the intestinal flora plays an important role in maintaining the steady state of human immunity system .In this paper, the relationship between intestinal flora and immune system disease is briefly described , in order to deepen the understanding for medical workers and researchers , and provide references for the prevention , treatment and prognosis of the disease .

Objective To explore the diagnostic value of C‐reactive protein(CRP) for diagnosing chronic obstructive pulmonary disease(COPD) to dig a new marker for COPD diagnosis .Methods A total of 199 cases of COPD ,159 cases of pulmonary malig‐nant tumor and 115 individuals undergoing the physical examination were collected .The whole blood CRP level was detected in 3 groups and the detection results were compared among 3 groups .The receiver operating characteristic(ROC) curve was drawn . Then the sensitivity ,specificity and Youden′s index(YI) were calculated to find the cut‐off value of diagnosis .Results Compared with the individuals undergoing healthy physical examination ,the CRP level in the COPD patients and the patients with pulmonary malignant tumor was significantly increased ,the difference was statistically significant(P<0 .05);the area under ROC curve(AUC) was 0 .768 ,the maximal YI was 0 .418 ,the sensitivity and specificity were 64 .7% and 77 .1% respectively ,the corresponding cut‐off value was 49 .75 mg/L .Conclusion CRP has a certain diagnostic value and can serve as a new index of COPD diagnosis .