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ObjectiveTo develop and validate a predictive risk model for vision-threatening diabetic retinopathy in patients with type 2 diabetes using readily accessible clinical data， which may provide a convenient and effective prediction tool for early identification and referral of at-risk populations. MethodsA nomogram model was developed using a dataset obtained from patients with T2DM who participated in the Guangzhou Diabetic Eye Study from November 2017 to December 2020. Logistic regression was used to construct the model， and model performance was evaluated using receiver operating characteristic curve， Hosmer-Lemeshow test， calibration curve and decision curve analysis. The model underwent internal validation through the mean AUC of k-fold cross-validation method， and further external validation was conducted in the Dongguan Eye Study. ResultsA total of 2 161 individuals were included in the model development dataset， of whom 135 （6.25%） people were diagnosed with VTDR. Age （P＜0.001，OR=0.927，95%CI：0.898~0.957） and body mass index （P＜0.001，OR =0.845，95%CI：0.821~0.932） were found to be negatively correlated with VTDR， whereas diabetes duration （P＜0.001，OR=1.064，95%CI：1.035~1.094）， insulin use （P =0.045，OR =1.534，95%CI：1.010~2.332）， systolic blood pressure （P＜0.001，OR =1.019，95%CI：1.008~1.029）， glycated hemoglobin （P＜0.001，OR =1.484，95%CI：1.341~1.643）， and serum creatinine （P＜0.001，OR =1.017，95%CI：1.010~1.023） were positively correlated with VTDR. All these variables were included in the model as predictors. The model showed strong discrimination in the development dataset with an area under the receiver operating characteristic curve （AUC） of 0.797 and in the external validation dataset （AUC 0.762）. The Hosmer-Lemeshow test（P＞0.05）and the calibration curve displayed good agreement. Decision curve analysis showed that the nomogram produced net benefit in the two datasets. ConclusionsIndependent factors influencing VTDR include age， duration of diabetes mellitus， insulin use， body mass index， systolic blood pressure， glycosylated hemoglobin， and serum creatinine. The nomogram constructed using these variables demonstrates a high degree of predictive validity. The model can serve as a valuable tool for early detection and referral of VTDR in primary care clinics. Therefore， its application and promotion are highly recommended.
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Objective:To investigate the mechanism of Shugan Bushen Yulin decoction in inhibiting voltage-dependent anion-selective channel protein 2 （VDAC2） gene methylation， affecting sperm mitochondrial function， and improving sperm motility through the cyclic adenosine monophosphate/protein kinase A （cAMP/PKA） pathway. Method:Forty male SD rats were randomly divided into the blank group， model group， high- and low-dose Shugan Bushen Yulin decoction groups， and L-carnitine group， with eight rats in each group. Adenine （0.05 g·kg<sup>-1</sup>） was administered by gavage for 14 d for inducing oligospermia and asthenospermia. Rats in the Shugan Bushen Yulin decoction groups were treated with intragastric administration of 32.4， 8.1 g·kg<sup>-1 </sup>Shugan Bushen Yulin decoction， respectively， while those in the L-carnitine group received 0.27 g·kg<sup>-1</sup> L-carnitine by gavage. Following the measurement of sperm motility using an automatic sperm analyzer， the pathological changes in testicular tissue were observed by hematoxylin-eosin （HE） staining. Sperm mitochondrial membrane potential was detected by flow cytometry. The expression of VDAC2 in the testicular tissue was determined by immunofluorescence assay. Real-time polymerase chain reaction （Real-time PCR） was conducted for detecting VDAC2 mRNA expression in testicular tissue. The methylation of VDAC2 gene was examined using bisulfite sequencing. The cAMP expression in testicular tissue was detected by enzyme-linked immunosorbent assay （ELISA）， and the PKA protein expression in testicular tissue by Western blot. Result:Compared with the blank group， the model group exhibited significantly decreased sperm density and motility （<italic>P</italic><0.01）， increased mitochondrial membrane potential （<italic>P</italic><0.01）， down-regulated VDAC2 mRNA and protein expression， PKA protein expression， and cAMP content in testicular tissue （<italic>P</italic><0.01）， and elevated VDAC2 gene methylation （<italic>P</italic><0.01）. Compared with the model group， L-carnitine and Shugan Bushen Yulin decoction at the high and low doses all remarkably increased the sperm density and motility and mitochondrial membrane potential （<italic>P</italic><0.01）， up-regulated VDAC2 mRNA and protein expression， PKA protein expression， and cAMP content in the testicular tissue （<italic>P</italic><0.01）， and lowered the methylation of VDAC2 in testicular tissue （<italic>P</italic><0.01）. The comparison with the L-carnitine group showed that the sperm density and motility and mitochondrial membrane potential in the low-dose Shugan Bushen Yulin decoction group declined significantly （<italic>P</italic><0.01）. The VDAC2 mRNA and protein expression， PKA protein expression， and cAMP content in the testicular tissue were significantly down-regulated （<italic>P</italic><0.01）， while the methylation of VDAC2 was significantly enhanced （<italic>P</italic><0.01）. Conclusion:Shugan Bushen Yulint decoction may inhibit VDAC2 gene methylation， increase VDAC2 expression， regulate cAMP/PKA pathway， and change mitochondrial membrane potential to enhance the sperm motility.
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@#AIM: To analyze the clinical characteristics of retinopathy of prematurity(ROP)in preterm infants with very low birth weight. <p>METHODS: A retrospective analysis was made of 3 121 premature infants who were admitted to the ophthalmic clinic and neonatal department of our hospital from December 2009 to June 2018 and underwent fundus examination. There were 1 862 males and 1 259 females. Among them, there were 400 premature infants with very low birth mass whose body mass was less than 1 500g. 191 males and 209 females. To compare the detection rate of ROP, gestational age, gender ratio, diagnosis time of ROP, severity of ROP and prevalence of other eye diseases, among different birth quality groups in preterm infants with extremely low birth mass.<p>RESULTS: In this study, 3 121 premature infants were screened, and the ROP detection rate was 8.2%(255/3 121). There were 400 premature infants with very low birth mass with a body mass less than 1 500g, ROP detection rate was 23.8%(95/400), stage 1-2 lesions that do not require treatment were 93.7%(89/95), pre-threshold and threshold lesions were 3.2%(3/95), stage 4-5 lesions were 3.2%(3/95). ROP detection rates of birth weight(g)<1 000, 1 000-1 499, ≥1 500, were: 25.0%, 23.7%, 5.9%, respectively. There were statistically significant differences in gestational age, ROP diagnostic time, between different birth weight groups(<i>P</i><0.001). There were significant differences in the severity of ROP among the groups with birth weight <1 000g, 1 000-1 499g and ≥ 1 500g. But, there was no significant difference in the severity of ROP between the group with birth weight 1 000-1 499g and the group with birth weight ≥1 500g(<i>P</i>>0.05). There was no statistical difference in the incidence of other eye diseases in different birth weight groups(<i>P</i>>0.05).<p>CONCLUSION: The lower of birth weight, with the higher of incidence of ROP. The severity of ROP in preterm infants with birth weight <1 000g was significantly higher than that of preterm infants with birth weight≥1 000g. Ophthalmology should combine obstetrics and neonatology to reduce the incidence of very low birth weight premature infants, and improve the compliance of screening and follow-up of retinopathy of very low birth weight premature infants, which is an important way to reduce the blindness caused by ROP.
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@#AIM: To analyze the clinical characteristics of retinopathy of prematurity(ROP)in preterm infants with very low birth weight. <p>METHODS: A retrospective analysis was made of 3 121 premature infants who were admitted to the ophthalmic clinic and neonatal department of our hospital from December 2009 to June 2018 and underwent fundus examination. There were 1 862 males and 1 259 females. Among them, there were 400 premature infants with very low birth mass whose body mass was less than 1 500g. 191 males and 209 females. To compare the detection rate of ROP, gestational age, gender ratio, diagnosis time of ROP, severity of ROP and prevalence of other eye diseases, among different birth quality groups in preterm infants with extremely low birth mass.<p>RESULTS: In this study, 3 121 premature infants were screened, and the ROP detection rate was 8.2%(255/3 121). There were 400 premature infants with very low birth mass with a body mass less than 1 500g, ROP detection rate was 23.8%(95/400), stage 1-2 lesions that do not require treatment were 93.7%(89/95), pre-threshold and threshold lesions were 3.2%(3/95), stage 4-5 lesions were 3.2%(3/95). ROP detection rates of birth weight(g)<1 000, 1 000-1 499, ≥1 500, were: 25.0%, 23.7%, 5.9%, respectively. There were statistically significant differences in gestational age, ROP diagnostic time, between different birth weight groups(<i>P</i><0.001). There were significant differences in the severity of ROP among the groups with birth weight <1 000g, 1 000-1 499g and ≥ 1 500g. But, there was no significant difference in the severity of ROP between the group with birth weight 1 000-1 499g and the group with birth weight ≥1 500g(<i>P</i>>0.05). There was no statistical difference in the incidence of other eye diseases in different birth weight groups(<i>P</i>>0.05).<p>CONCLUSION: The lower of birth weight, with the higher of incidence of ROP. The severity of ROP in preterm infants with birth weight <1 000g was significantly higher than that of preterm infants with birth weight≥1 000g. Ophthalmology should combine obstetrics and neonatology to reduce the incidence of very low birth weight premature infants, and improve the compliance of screening and follow-up of retinopathy of very low birth weight premature infants, which is an important way to reduce the blindness caused by ROP.
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Objective: To set up a callus induction system for Amomum villosum by tissue culture. Method: The rhizome buds of A. villosum and stem segments,root tip segments of sterile A. villosum plantles were used as explants and cultured in MS media with different concentrations of 6-BA,NAA and 2,4-D (the pH of each medi is about 5.8). A callus induction system was established to explore the effect of different explants and different medium on callus induction for A. villosum. Result:The findings showed that the rhizome buds and sterile plantlet stems and root tip segments of three different explants can be successfully induced into calli. The most suitable medium for callus induction from rhizome buds and sterile plantlet stems was MS with 6-BA (1.5 mg·L-1),2,4-D (1.0 mg·L-1) and NAA (0.5 mg·L-1) with the highest induction rates of 15% and 60% respectively. MS medium combined with 6-BA (2.0 mg·L-1),2,4-D (1.0 mg·L-1) and NAA (1.0 mg·L-1) was the most suitable proposal for inducing the callus from sterile root tip segments with the highest induction rate of 76%. Conclusion:Under certain culture conditions,rhizome buds,stem or root tip segments of sterile plantlet can be effectively induced into callus. The callus induction system of A. villosum is preliminarily established, and root tip segments of sterile plantlet are the optimal explant.
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Objective To conduct Meta analysis and trial sequential analysis (TSA) on warm acupuncture treatment on lumbar intervertebral disc protrusion (LIDP); To provide references for evidence-based medicine of this disease.Methods Articles about warm acupuncture treatment for LIDP clinical randomized controlled trials in CNKI, Wanfang database, Chonging Wepu, CBM, OubMed, Cochrane Library, and Emnase were retrieved by computer. The retrieval range was from the database establishing to March, 2017. According to Cochrane Handbook for Systematic Reviews of Interventions 5.2.0 Bias risk assessment tool, included articles were under quality evaluation. Revman5.2 software was used to carry out Meta analysis, and TSAv0.9 software was used to conduct TSA.Results Ten articles were included, involving 1035 cases. Meta analysis showed that the total effective rates of warm acupuncture treatment for LIDP [95％CI (2.43, 5.40),Z=6.31,P<0.00001], pain index [95％CI (-1.05, -0.58),Z=6.77,P<0.00001], lumbar function [95％CI (2.56, 8.61),Z=3.62,P=0.0003] were better than other therapies, with statistical significance. Funnels included in the study suggest publication bias. TSA results suggested that the total efficiency and pain index Meta analysis results of this study were reliable.Conclusion Warm acupuncture treatment for LIDP has confirmed efficacy, with certain advantages. However, the literature included is not with good quality, so more large sample, multicenter, methodological RCTs are needed for further validation.
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<p><b>OBJECTIVE</b>The aim of this study is designed to explore the anti-tumor effect of lipoteichoic acid (LTA) of Bifidobacterium on the expression of survivin in colon cancer LoVo cells and its possible regulatory mechanism.</p><p><b>METHODS</b>The changes of survivin mRNA and protein in LoVo cells treated with LTA of Bifidobacterium were detected by RT-PCR and Western blot. Meanwhile, the expressions of pAKT (the key protein kinase in P13K/AKT signal transduction pathway), p53 and PTEN were measured by Western blot.</p><p><b>RESULTS</b>There were overexpressions of survivin mRNA and protein in LoVo cells. After treated with different dose of LTA of Bifidobacterium, the expressions of survivin mRNA and protein were markedly decreased in a dose-dependent manner (P < 0.01). Besides, the activity of pAKT was decreased significantly (P < 0.01) and the expression of p53 and PTEN was increased (P < 0.01).</p><p><b>CONCLUSION</b>LTA of Bifidobacterium can down-regulate the expression of survivin in LoVo cells through inhibiting the activity of PI3K/AKT signal transduction pathway and up-regulate the expression of p53. Accordingly, the activity of caspases is increased, and apoptosis of LoVo cells occurs ultimately.</p>