ObjectiveExploring the role of microRNA126 （miRNA126） in chronic kidney disease combined with atherosclerosis （CKD AS） by regulating the phosphatidylinositol-3-kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR） signaling pathway and the mechanism of Shenshuai Xiezhuo decoction in the intervention of CKD AS rats with 5/6 nephrectomy combined with high-fat feeding. MethodA total of 60 SD rats were randomly divided into sham operation group， model group， losartan group， and low， medium， and high dose groups of Shenshuai Xiezhuo decoction. The CKD AS rat model was established by 5/6 nephrectomy combined with high-fat feeding for 10 weeks. The low， medium， and high dose groups （6.0， 12.0， 24.0 g·kg^-1·d^-1） of Shenshuai Xiezhuo decoction and the losartan group （20 mg·kg^-1·d^-1） were gavaged， and the corresponding intervention was carried out for eight weeks. Then， the rats were killed， and samples were collected for corresponding detection. Fully automated biochemical analyzers were used to detect kidney function and blood lipids in rats： blood creatinine （SCr）， blood urea nitrogen （BUN）， total cholesterol （TC）， triglyceride （TG）， and low-density lipoprotein cholesterol （LDL-C） levels. Hematoxylin-eosin （HE） and Masson staining of aortic tissue and pathological observation under a light microscope were carried out， and autophagosomes and autophagy lysosomes were observed by transmission electron microscopy. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to determine the mRNA levels of miRNA126， PI3K， Akt， and mTOR in rats， and Western blot was used to determine the protein expression levels of phosphorylated （p）-PI3K， PI3K， p-Akt， Akt， p -mTOR， mTOR， benzyl chloride 1 （Beclin-1）， and microtubule-associated protein light chain 3Ⅱ/Ⅰ （LC3Ⅱ/LC3Ⅰ）. ResultCompared with the sham operation group， the serum SCr， BUN， TC， TG， and LDL-C in the model group were significantly increased （P<0.01）. Compared with the model group， the SCr， BUN， TC， TG， and LDL-C were decreased in the losartan group and low， medium， and high dose groups of Shenshuai Xiezhuo decoction （P<0.05）. Compared with the sham operation group， thickening plaques， infiltration of mononuclear macrophages， a small number of foam cells， disordered arrangement of smooth muscle fibers in the tunica media， and increased collagen fibers were observed in the model group， and the lesions in the losartan group and Shenshuai Xiezhuo decoction groups were alleviated compared with those in the model group. Compared with the model group， the number of autophagosomes and autophagy lysosomes increased in the medium and high dose groups of Shenshuai Xiezhuo decoction. Compared with the sham operation group， the expression of miRNA126 in the aortic tissue of the model group was significantly decreased （P<0.01）， and the mRNA expressions of PI3K， Akt， and mTOR were significantly increased （P<0.01）. Compared with the model group， the expression of miRNA126 in the aortic tissue of rats in high， medium， and low dose groups of Shenshuai Xiezhuo decoction and losartan group was significantly increased （P<0.01）， while the mRNA expressions of PI3K， Akt， and mTOR were significantly decreased （P<0.01）. Compared with the sham operation group， the protein expressions of p-PI3K， PI3K， p-Akt， Akt， p-mTOR， and mTOR in the model group were significantly increased （P<0.01）， while the protein levels of Beclin-1， LC3Ⅰ， and LC3Ⅱ were significantly decreased （P<0.01）. Compared with the model group， the protein expressions of p-PI3K， PI3K， p-Akt， Akt， p-mTOR， and mTOR in the losartan group and low， medium， and high dose groups of Shenshuai Xiezhuo decoction were decreased （P<0.05）， while the protein levels of Beclin-1 and LC3Ⅱ/LC3Ⅰ were increased （P<0.05）. ConclusionThe expression of miRNA126 is decreased in the aortic tissue of CKD AS rats， and the PI3K/Akt/mTOR pathway is activated to inhibit autophagy flux. Shenshuai Xiezhuo decoction regulates the PI3K/Akt/mTOR signaling pathway through miRNA126， restores the autophagy of aortic endothelial cells， protects the damage of CKD vessels， reduces the formation of As plaques， and slows the development of cardiovascular complications.

Primary familial brain calcification (PFBC) is an inherited neurodegenerative disorder mainly characterized by progressive calcium deposition bilaterally in the brain, accompanied by various symptoms, such as dystonia, ataxia, parkinsonism, dementia, depression, headaches, and epilepsy. Currently, the etiology of PFBC is largely unknown, and no specific prevention or treatment is available. During the past 10 years, six causative genes (SLC20A2, PDGFRB, PDGFB, XPR1, MYORG, and JAM2) have been identified in PFBC. In this review, considering mechanistic studies of these genes at the cellular level and in animals, we summarize the pathogenesis and potential preventive and therapeutic strategies for PFBC patients. Our systematic analysis suggests a classification for PFBC genetic etiology based on several characteristics, provides a summary of the known composition of brain calcification, and identifies some potential therapeutic targets for PFBC.
Animals ; Brain Diseases/therapy* ; Xenotropic and Polytropic Retrovirus Receptor ; Brain/pathology*

Objective:To establish the biology reference interval (RI) of peripheral blood procalcitonin (PCT) for children between 3 days and 6 years old in China.Methods:Totally 3 353 reference individuals with apparent health or no specific diseases were recruited in 18 hospitals throughout the country during October 2020 to May 2021. Reference individuals were divided into four groups: 3-28 days, 29 days - 1 year, 1-3 years and 4-6 years. Vein blood or capillary blood were collected by percutaneous puncture from every reference individual. The PCT level in serum and the capillary whole blood were assayed by Roche Cobas e601 and Norman NRM411-S7 immunoanalyzer. Outliers were deleted and 95th percentiles of every group were provided as RIs. Man-Whitney U test or Kruskal-Wallis test were used performed to assess the difference among different gender, age or method groups. Results:The difference of PCT distribution between male and female is not statistically significant, but the difference between serum and capillary whole blood is statistically significant. The differences between age groups are significant too. For Roche e601, serum PCT RI of 3-28 days group is <0.23 μg/L, 29 days - 6 years are <0.11 μg/L. For NRM411, Serum PCT RI of 3-28 days group is <0.21 μg/L, 29 days - 1 year: <0.09 μg/L, 1 - 6 years: <0.10 μg/L. For whole blood PCT, RI of 3-28 days group is <0.26 μg/L, 29 days - 6 years is <0.15 μg/L.Conclusions:Serum and capillary whole blood PCT have different RIs, however, capillary whole blood PCT testing is valuable in pediatric application. Children in 3-28 days show higher PCT levels than other age group. To establish the RIs and understand the differences among different groups are essential for the interpretation and clinical application of peripheral blood PCT testing results.

Objective To develop plantar force model of patellofemoral pain (PFP), so as to provide theoretical references for the assessment of PFP rehabilitation. Methods The case-control study was conducted, and a total of 126 patients with PFP and 126 healthy controls matched by gender and age were enrolled in the study. The participants were tested for plantar force and pressure during level walking, and twelve plantar regions were divided and recorded. Whether the participants suffered PFP was analyzed as dependent variable, meanwhile the peak force and peak pressure in 12 plantar regions of participants at selected speed during level walking were analyzed as independent variables. Conditional logistic regression (CLR) equations of peak force and peak pressure with PFP were established, respectively. The receiver-operating characteristic (ROC) curve of the corresponding equations was derived, and the area under ROC curve was calculated to analyzed the validity of different equations on PFP assessment. Results The CLC equation of peak force in 12 plantar regions of the participants with FFP was constructed, and only peak force of lateral heel was in the equation. The CLC equation of peak pressure in each plantar region included medial heel, midfoot, 1st and 2nd metatarsals. Meanwhile, the area under ROC curve of the pressure equation was larger than that of the force equation. Conclusions Peak force and pressure at different plantar regions can be used to assess PFP during level walking, and peak pressure is more effective for assessment.

Objective:To explore a new method for correcting the senile blepharochalasis and depression of the upper eyelid.Methods:Fourteen female patients with blepharochalasis and depression of upper eyelid were treated with subcutaneous tissue flap filling during eyebrow lifting. The under-eyebrow incision was used to remove the loose skin and lift the eyebrow, and a subcutaneous tissue flap was made to fill up the upper eyelid depression.Results:All the incisions were healed in one stage without complications such as infection and subcutaneous hematoma. 12 patients were followed up for more than 6 months. In the 3rd month after operation, 1 patient had obvious scar under the eyebrow, 1 patient had skin traction wrinkles at the eyebrow. After 6 months, the incision scar was not obvious in all patients, the appearance of eyebrow ptosis was eliminated, the upper eyelid was smooth and flat, and no absorption and further depression of the upper filler were observed; the effect was satisfactory.Conclusions:The eyebrow lifting combined with the subcutaneous tissue flap filling to correct the senile upper eyelid chalasis and depression is significantly effective with less trauma and complications, and it is worthy to be promoted.

INTRODUCTION: Diabetes mellitus is a major public health issue in Singapore. To shape healthcare policies for the primary prevention of diabetes, it is crucial to understand Singaporeans' knowledge, attitudes and practices related to diabetes and its prevention. This study aimed to assess the knowledge, attitudes and lifestyles of individuals without diabetes. MATERIALS AND METHODS: A cross-sectional household survey was performed between 31 January to 3 February 2019 to examine knowledge, attitudes and practices related to diabetes. Inclusion criteria of the participants included: 1) Singaporeans/permanent residents, 2) between 30 to 64 years old, and 3) who did not have a diagnosis of diabetes. Logistic and linear regression models were used to analyse the association of knowledge and attitudes with physical activity and diet habits, respectively. RESULTS: Among 806 participants, 72.2% did not meet the Health Promotion Board's physical activity recommendation. Physical activity was associated with better diabetes knowledge (odds ratio [OR] 5.38, 95% confidence interval [CI] = 1.65-17.53, = 0.049), stronger beliefs in diabetes prevention (OR 3.36, 95% CI = 1.02-11.12, = 0.047) and lower levels of worry about diabetes (OR 0.41, 95% CI 0.17-1.00, = 0.049). Neither knowledge nor beliefs or worries about diabetes was associated with diet. CONCLUSION There is a need to reinforce the importance of physical activity and healthy diet in preventing diabetes. Although improving the knowledge level of diabetes may increase physical activity of the population, it is unlikely to improve dietary choices without effective behavior change interventions.

Objective Analysis of hybrid cardiac and non-cardiac operations.Methods 11 patients received hybrid operations during 2000 ～2016 in our hospital were summarized, meanwhile another 11 patients undergoing only cardiac sur-gery served as controls.The level of CK-MB, TNI and visual analogue pain scores were recorded.The hospitalization expenses and postoperative hospital time were compared between the two groups .Results There was no death during hospitalization . There were no serious complications such as wound infection, delayed wound healing, postoperative bleeding requiring re-thora-cotomy and hemostasis, malignant arrhythmia, cerebral infarction and so on.Longer operation time[(358 ±79)min vs.(224 ±56)min, P<0.01], more allogeneic red blood cells transfusion[(3.2 ±1.6)U/case vs.(1.1 ±0.8)U/case, P<0.05] and more plasma transfusion[(515 ±234)ml/case vs.(284 ±92)ml/case, P<0.01]in hybrid operation group than those in the control group.There was no significant difference about CK-MB and TNI between two groups perioperatively(P>0.05). The wound pain was mild after cardiac surgery , and the wound pain was moderate after hybrid operation , which had little effect on rehabilitation exercises such as cough.4 days longer of postoperative hospital stay and 23 thousand yuan of hospitalization cost in hybrid operation group than those in the control group.One patient diagnosed of unstable angina pectoris and sigmoid colon cancer with intestinal obstruction was failed to resection of the tumor after received pericardial stripping and coronary ar-tery bypass surgery.The patient died three weeks after surgery due to intestinal obstruction and cachexia .The remaining 10 pa-tients were underwent successful surgery, cured and left hospital.No serious cardiovascular events, tumor recurrence and me-tastasis were found as followed up for 6-20 months.Conclusion Our practices show that hybrid cardiac and non-cardiac op-erations can be done safely and effectively.

Objective To explore the transformation of three-dimensional curve,and to observe effect of three-dimensional remodeling surgery in order to find an ideal method to achieve upper eyelid rejuvenation.Methods Retrospective analysis was conducted after surgical correction for three-dimensional reconstruction in 48 patients with upper eyelid that were female,aged 58 to 76 years;all of them had simultaneous surgery of both eyes.Using double eyelid crease incision to remove loose and redundant skin,we transplanted the herniated fat of the medial orbital septum to the deep surface of the orbicularis oculi muscle in the distinct bony structure of the extra-supraorbital margin,folded and lifted orbital septum fascia;at the same time lifted eyebrow through eyebrow incision,transplanted and filled dermis and muscle fascia flap to remodel the transverse S-shaped stereo curve of the coronal plane of the upper eyelid.Results A lot of 41 cases were followed up more than 6 months from 48 patients,except that one patient had a second surgery due to double eyelid asymmetry after one year,eyelid rejuvenation in 40 patients were improveed.Effect of 33 cases was satisfactory.Satisfaction rate was 80.49％.Less satisfaction were 6 cases,accounting for 14.63％.No satisfaction was 1 case,ac counting for 2.44 ％.Conclusions The surgery can reshape the concavity inside,the full crown outside of upper eyelid by the skin removing,fat shifting,leather fat muscle flap filling,and restore the upper eyelid to three-dimensional full round young shape.It is an ideal surgical method for eye anti-aging treatment.

Objective To explore the effect and mechanism of preventing ankle instability through exer-cise, so as to provide evidence-based references for practice. Methods The randomized and controlled trials ( RCT) on preventing ankle instability through exercise published before December 2014 were searched for in the NCBI, CNKI, VIP and Wanfang databases by computer, supplemented by manual searching. Each study′s quality was evaluated according to the standards of the Cochrane handbook by 3 researchers. The outcome indexes were ex-tracted and analyzed using RevMan 5.2 software. Results After the initial selection, 665 papers (357 in English and 308 in Chinese) were retained. From these 92 were chosen after reading the titles and abstracts. Ultimately, 14 RCT studies ( 12 in English and 2 in Chinese) met the inclusion criteria. They showed that exercise improved ankle function and symptoms of ankle instability significantly [SMD=0.98, 95%CI (0.65,1.31), P≤0.01], improved muscle strength [SMD=1.50, 95%CI (0.99,2.01), P≤0.01], improved balance and postural stability [SMD=-0.54, 95%CI (-0.84,-0.25) ,P≤0.01] , but did not improve proprioception or neuromuscular functioning sig-nificantly. Conclusions Exercise can effectively improve muscle strength, balance and postural stability, but not proprioception or neuromuscular functioning. The details of these findings may be related to the exercise intervention chosen.

Objective To investigate effects of acute normovolemic hemodilution(ANH) used in on-pump coronary artery bypass graft(CABG) surgery.Methods 60 patients had received CABG surgery under cardiopulmonary bypass,of which 30 patients using ANH techniques and 30 patients using no ANH techniques.A series of index were observed and compared between the two groups after operation.Results All patients had been revascularized completely with stable surgical procedure,no serious complications,no operative mortality.Oxygen supplying was balanced with demanding,without tissue hypoxia.Indicators of myocardial protective effect,coagulation,kidney function,degree of systemic inflammatory reaction and postoperative drainage volume were not significantly different between the two groups(P ＞ 0.05).Allogeneic blood transfusion volume of the study group was significantly lower than that of the control group [(1.1 ± 0.8) U vs.(2.3 ± 1.1) U,P ＜ 0.05].Condusion The ANH technique used in CABG operation on appropriate patient is feasible and safe,with satisfactory clinical result.