Preparation and in vitro evaluation of polylactic acid nanoparticles containing arginine and glucose oxidase / 药学学报

Hydrogen peroxide (H2O2) and nitric oxide (NO) has a short half-life, low bioavailability, poor tumor targeting and systemic adverse reactions in the physiological environment. In this study, phacoemulsification and nano-precipitation were used to synthesize didecyl dimethyl ammonium bromide (DDAB)/polylactic acid nanoparticles (PLA), then L-arginine (L-Arg) and glucose oxidase (GOx)-loaded nanoparticles (GADP) were prepared, and the in vitro antitumor activity was investigated．The particle size, potential, embedding rate and the ability to produce H2O2/NO of the nanoparticles were investigated. Meanwhile, in vitro cell cytotoxicity against human hepatoma cells (HepG2) was evaluated．The results showed that the prepared L-Arg-DDAB/PLA (ADP) nanoparticles were spherical particles. And the particle size and zeta potential were (225.7 ± 6.33) nm and (+23.5 ± 0.12) mV, respectively. The adsorption rate of GOx was 87.23% ± 0.02%. The drug loading of L-Arg was 15.6% ± 0.22%. The pH value of glucose solution and the amount of H2O2 showed that GADP had good catalytic activity. In vitro cytotoxicity experiments showed that blank nanoparticles were nontoxic, while the drug-loaded nanoparticles presented enhanced antitumor effect on HepG2 cells. And can inhibit tumor cell migration. The low dose nano-scale NO delivery system GADP can effectively inhibit the migration of tumor cells and kill tumor cells, thus producing therapeutic benefits.

Diagnosis and treatment of the portal vein complications for children undergoing spilt liver transplantation / 器官移植

Objective To investigate the diagnosis and treatment strategy of the portal vein complications in children undergoing split liver transplantation. Methods The clinical data of 88 pediatric recipients who underwent split liver transplantation were retrospectively analyzed. Intraoperative anastomosis at the bifurcating site of the portal vein or donor iliac vein bypass anastomosis was performed depending on the internal diameter and development of the recipient's portal vein. A normalized portal venous blood stream monitoring was performed during the perioperative stage. After operation, heparin sodium was used to bridge warfarin for anticoagulation therapy. After portal vein stenosis or thrombosis was identified with enhanced CT or portography, managements including embolectomy, systemic anticoagulation, interventional thrombus removal, balloon dilatation and/or stenting were performed. Results Among the 88 recipients, a total of 10 children were diagnosed with portal vein complications, of which 4 cases were diagnosed with portal vein stenosis at 1 d, 2 months, 8 months, and 11 months after surgery, and 6 cases were diagnosed with portal vein thrombosis at intraoperative, 2 d, 3 d (n=2), 6 d, and 11 months after surgery, respectively. One patient with portal vein stenosis and one patient with portal vein thrombosis died perioperatively. The fatality related to portal vein complications was 2% (2/88). Of the remaining 8 patients, 1 underwent systemic anticoagulation, 2 underwent portal venous embolectomy, 1 underwent interventional balloon dilatation, and 4 underwent interventional balloon dilatation plus stenting. No portal venous related symptoms were detected during postoperative long term follow up, and the retested portal venous blood stream parameters were normal. Conclusions The normalized intra- and post-operative portal venous blood stream monitoring is a useful tool for the early detection of portal vein complications, the early utilization of useful managements such as intraoperative portal venous embolectomy, interventional balloon dilatation and stenting may effectively treat the portal vein complications, thus minimizing the portal vein complication related graft loss and recipient death.

Expert Consensus on Clinical Diseases Responding Specifically to Traditional Chinese Medicine：Fibromyalgia Syndrome / 中国实验方剂学杂志

Fibromyalgia syndrome （FMS） is a refractory， chronic non-articular rheumatic disease characterized by widespread pain throughout the body， for which there are no satisfactory therapeutic drugs or options. There are rich Chinese medical therapies， and some non-drug therapies， such as acupuncture， Tai Chi， and Ba-Duan-Jin， have shown satisfactory efficacy and safety and definite advantages of simultaneously adjusting mind and body. FMS is taken as a disease responding specifically to traditional Chinese medicine （TCM） by the National Administration of Traditional Chinese Medicine in 2018. In order to clarify the research progress in FMS and the clinical advantages of TCM/integrated Chinese and Western medicine， the China Academy of Chinese Medicine organized a seminar for nearly 20 experts in Chinese and Western medicine， including rheumatology， psychology， acupuncture and moxibustion， and encephalopathy， with the topic of difficulties in clinical diagnosis and treatment of FMS and advantages of TCM and Western medicine. The recommendations were reached on the difficulties in early diagnosis and solutions of FMS， mitigation of common non-specific symptoms， preferential analgesic therapy， TCM pathogenesis and treatment advantages， and direction of treatment with integrated Chinese and Western medicine. FMS is currently facing the triple dilemma of low early correct diagnosis， poor patient participation， and unsatisfactory benefit from pure Western medicine treatment. To solve the above problems， this paper suggests that rheumatologists should serve as the main diagnostic force of this disease， and they should improve patient participation in treatment decision-making， implement exercise therapy， and fully utilize the holistic and multidimensional features of TCM， which is effective in alleviating pain， improving mood， and decreasing adverse events. In addition， it is suggested that FMS treatment should rely on both TCM and Western medicine and adopt multidisciplinary joint treatment， which is expected to improve the standard of diagnosis and treatment of FMS in China.

Cloning the full-length CDNA of actin gene and analysing alliinase gene expression in tillering onion

Tillering onion is a herbaceous plant belonging to the Liliaceae family. We cloned the cDNAs of the actin gene (AcACT, GenBank: MF919598) of tillering onion using rapid amplification of the cDNA ends. The full-length cDNA of AcACT was 1,357 bp long with an open reading frame of 1,131 bp encoding 376 amino acids. The amino acid sequence of AcACT shared > 96% similarity with the amino acid sequences of other ACTs and was found (by means of phylogenetic tree analysis) to be closely related to those of Ananas comosus and Papaver somniferum. AcACT expressions showed no significant differences (p > 0.01) in two cultivars L-SH and L-SY over three growth periods and under suitable conditions, low temperature, and short-day conditions. In addition, AcACT was used as an internal reference gene to analyse the expression of the alliinase gene (AcALL). AcALL expression trends in the roots, stems and leaves were consistent with those of diallyl disulphide and diallyl trisulphide. Thus, AcACT is highly conserved and can be used as a suitable internal reference gene when analysing gene expression in tillering onion.

Simulated weightlessness led to the transformation of glycolipid metabolism in the livers of mice / La antigravedad simulada provocó la transformación del metabolismo de los glicolípidos en el hígado de ratones / Antigravidade simulada levou à transformação do metabolismo de glicolipídios no fígado de camundongos

ABSTRACT Objectives: The effects of weightlessness on the liver were studied using a tail suspension (TS) male mouse model. Methods: The effects of 0-, 2- and 4-week TS (CON, TS2 and TS4 groups) on glycogen and lipid content, as well as on the molecular processes of the synthesis and degradation pathways, were examined. Results: (1) The number of glycogenosomes under ultrastructure and the glycogen content were considerably larger in the TS4 group than in the other two groups. (2) In the TS4 group, glycogen synthase activity remained constant while glycogen phosphorylase activity dropped, indicating that glycogen breakdown was reduced. (3) The livers of the TS2 group had the highest lipid and triglyceride content, indicating lipid buildup in the liver at this time. (4) In the TS2 group, the activities of the fatty acid synthesis-related factors acetyl-CoA carboxylase and fatty acid synthase increased, while hepatic lipase decreased, indicating that lipid synthesis increased, while decomposition decreased. (5) In the TS2 group, the protein expression of glucose transporters 1 and 2 increased. Conclusions: From TS2 weeks to TS4 weeks, the main energy consumption mode in the livers of mice transitioned from glucose metabolism to lipid metabolism as glucose use decreased. Level of evidence II; Comparative prospective study.

RESUMEN Objetivos: Se estudiaron los efectos de la antigravedad en el hígado utilizando un modelo de ratón macho en prueba de suspensión de la cola (TS, tail suspension). Métodos: Se examinaron los efectos de la TS a las 0, 2 y 4 semanas (grupos CON, TS2 y TS4) sobre el contenido de glucógeno y lípidos, así como sobre los procesos moleculares de las vías de síntesis y degradación. Resultados: (1) El número de glucogenosomas ultraestructurales y el contenido de glucógeno fueron expresivamente más altos en el grupo TS4 que en los otros dos grupos. (2) En el grupo TS4, la actividad de la glucógeno sintasa se mantuvo constante, mientras que la actividad de la glucógeno fosforilasa disminuyó, lo que indica que la degradación del glucógeno se redujo. (3) Los hígados del grupo TS2 presentaron el mayor contenido de lípidos y triglicéridos, lo que indica la acumulación de lípidos en el hígado en ese momento. (4) En el grupo TS2, la actividad de los factores relacionados con la síntesis de ácidos grasos acetil-CoA carboxilasa y ácido graso sintasa aumentó, mientras que la lipasa hepática disminuyó, indicando que la síntesis de lípidos aumentó mientras que la descomposición disminuyó. (5) En el grupo TS2, la expresión proteica de los transportadores de glucosa 1 y 2 aumentó. Conclusiones: Desde la semana TS2 hasta la semana TS4, el principal modo de consumo de energía en el hígado de los ratones pasó del metabolismo de la glucosa al metabolismo de los lípidos a medida que disminuía el uso de la glucosa. Nivel de Evidencia II, Estudio retrospectivo comparativo.

RESUMO Objetivos: Os efeitos da antigravidade no fígado foram estudados usando um modelo de camundongo macho com a suspensão pela cauda (TS, tail suspension). Métodos: Foram examinados os efeitos da TS em 0, 2 e 4 semanas (grupos CON, TS2 e TS4) sobre o conteúdo de glicogênio e lipídios, bem como nos processos moleculares das vias de síntese e degradação. Resultados: (1) O número de glicogenossomos ultraestruturais e o teor de glicogênio foram expressivamente maiores no grupo TS4 do que nos outros dois grupos. (2) No grupo TS4, a atividade de glicogênio sintase permaneceu constante, enquanto a atividade de glicogênio fosforilase caiu, indicando que a degradação do glicogênio foi reduzida. (3) Os fígados do grupo TS2 tiveram o maior teor lipídico e de triglicérides, indicando acúmulo de lipídios no fígado no momento. (4) No grupo TS2, a atividade dos fatores relacionados com a síntese de ácidos graxos acetil-CoA carboxilase e ácido graxo sintase aumentaram, enquanto a lipase hepática diminuiu, indicando que a síntese de lipídios aumentou, enquanto a decomposição diminuiu. (5) No grupo TS2, a expressão proteica dos transportadores de glicose 1 e 2 aumentou. Conclusões: De TS2 semanas para TS4 semanas, o principal modo de consumo de energia no fígado de camundongos passou do metabolismo da glicose para o metabolismo lipídico, à medida que o uso de glicose diminuiu. Nível de evidência II, Estudo retrospectivo comparativo.

Bone marrow-derived mesenchymal stem cell-conditioned medium ameliorates diabetic foot ulcers in rats

Abstract Objectives: This study aimed to explore the effects of bone marrow-derived Mesenchymal Stem Cell-Conditioned Medium (MSC-CM) treating diabetic foot ulcers in rats. Methods: Models of T2DM rats were induced by a high-fat diet and intraperitoneal injection of STZ in SD rats. Models of Diabetic Foot Ulcers (DFUs) were made by operation on hind limbs in diabetic rats. Rats were divided into four groups (n = 6 for each group), i.e., Normal Control group (NC), Diabetes Control group (DM-C), MSC-CM group and Mesenchymal Stem Cells group (MSCs). MSC-CM group was treated with an injection of conditioned medium derived from preconditioned rats' bone marrow MSCs around ulcers. MSCs group were treated with an injection of rats' bone marrow MSCs. The other two groups were treated with an injection of PBS. After the treatment, wound closure, re-epithelialization (thickness of the stratum granulosums of the skin, by H&E staining), cell proliferation (Ki67, by IHC), angiogenesis (CD31, by IFC), autophagy (LC3B, by IFC and WB; autoly-sosome, by EM) and pyroptosis (IL-1β, NLRP3, Caspase-1, GSDMD and GSDMD-N, by WB) in ulcers were evaluated. Results: After the treatment wound area rate, IL-1β by ELISA, and IL-1β, Caspase-1, GSDMD and GSDMD-N by WB of MSC-CM group were less than those of DM group. The thickness of the stratum granulosums of the skin, proliferation index of Ki67, mean optic density of CD31 and LC3B by IFC, and LC3B by WB of MSC-CM group were more than those of DM group. The present analysis demonstrated that the injection of MSC-CM into rats with DFUs enhanced the wound-healing process by accelerating wound closure, promoting cell proliferation and angiogenesis, enhancing cell autophagy, and reducing cell pyroptosis in ulcers. Conclusions: Studies conducted indicate that MSC-CM administration could be a novel cell-free therapeutic approach to treat DFUs accelerating the wound healing process and avoiding the risk of living cells therapy.

Effect of functional training on adolescent health / Efeito do treinamento funcional na saúde do adolescente / Efecto del entrenamiento funcional en la salud del adolescente

ABSTRACT Introduction The high rate of obesity caused by the modern sedentary lifestyle associated with bad eating habits and the high intellectual demand at school generates a physical and psychological deficit in contemporary youth. The damage caused in this growth phase is irrecoverable, and the habits acquired during this period are crucial to individual health. The urgency of this problem has generated research on methods to reverse this situation, among them functional training. Objective To study the effect of functional training on adolescent health. Methods 30 boys and 30 girls were recruited as study subjects. The experiment lasted one semester, including two weekly physical education classes focused on functional training. Data on body indexes, fitness, and physical test results were collected before and after the intervention. The results of the experiment were integrated and compared. Results The selection of functional training can optimize adolescents' biochemical indexes, making adolescents' orthostatic posture more balanced, and significantly improve muscle strength, body flexibility, explosive strength of upper and lower extremities, motor coordination, body flexibility, muscular endurance, cardiopulmonary function, etc. Conclusion Functional training can effectively improve the physical health of adolescents. Participants have increased their interest in sports, and this intervention can potentially promote the development of adolescents' physical and mental health if replicated nationwide. Studies are needed to popularize functional training in adolescents. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução O elevado índice de obesidade ocasionada pelo sedentarismo moderno associado a maus hábitos alimentares e a alta demanda intelectual escolar geram um déficit físico e psicológico na juventude contemporânea. Os danos ocasionados nessa fase de crescimento são irrecuperáveis e os hábitos adquiridos nesse período são determinantes para a saúde individual. A urgência desse problema tem gerado pesquisas sobre métodos para reverter essa situação, dentre eles desponta o treinamento funcional. Objetivo Estudar o efeito do treinamento funcional na saúde do adolescente. Métodos 30 meninos e 30 meninas foram recrutados como sujeitos de estudo. O experimento durou um semestre, incluindo duas aulas semanais de educação física, com foco no treinamento funcional. Os dados dos índices corporais, aptidão física e resultados dos testes físicos foram coletados antes e depois da intervenção. Os resultados do experimento foram integrados e comparados. Resultados A seleção do treinamento funcional pode otimizar os índices bioquímicos dos adolescentes, tornar a postura ortostática dos adolescentes mais equilibrada, melhorar significativamente a força muscular, a flexibilidade corporal, a força explosiva das extremidades superior e inferior coordenação motora, flexibilidade corporal, resistência muscular, função cardiopulmonar, etc. Conclusão O treinamento funcional pode melhorar efetivamente a saúde física dos adolescentes. Os participantes aumentaram seu interesse pelo esporte e essa intervenção tem o potencial de promover o desenvolvimento da saúde física e mental dos adolescentes caso replicada a nível nacional. Estudos são necessários para a popularização do treinamento funcional em adolescentes. Nível de evidência II; Estudos terapêuticos - investigação dos desfechos do tratamento.

RESUMEN Introducción La alta tasa de obesidad causada por el sedentarismo moderno asociado a malos hábitos alimenticios y la alta exigencia intelectual escolar generan un déficit físico y psicológico en la juventud contemporánea. Los daños causados en esta fase de crecimiento son irrecuperables y los hábitos adquiridos durante este periodo son cruciales para la salud del individuo. La urgencia de este problema ha generado la investigación de métodos para revertir esta situación, entre ellos surge el entrenamiento funcional. Objetivo Estudiar el efecto del entrenamiento funcional en la salud de los adolescentes. Métodos Se reclutaron 30 chicos y 30 chicas como sujetos de estudio. El experimento duró un semestre, incluyendo dos clases semanales de educación física, centradas en el entrenamiento funcional. Se recogieron datos sobre los índices corporales, la forma física y los resultados de las pruebas físicas antes y después de la intervención. Los resultados del experimento se integraron y compararon. Resultados La selección del entrenamiento funcional puede optimizar los índices bioquímicos de los adolescentes, hacer que la postura ortostática de los adolescentes sea más equilibrada, mejorar significativamente la fuerza muscular, la flexibilidad corporal, la fuerza explosiva de las extremidades superiores e inferiores la coordinación motora, la flexibilidad corporal, la resistencia muscular, la función cardiopulmonar, etc. Conclusión El entrenamiento funcional puede mejorar eficazmente la salud física de los adolescentes. Los participantes han aumentado su interés por el deporte y esta intervención tiene el potencial de promover el desarrollo de la salud física y mental de los adolescentes si se reproduce a nivel nacional. Se necesitan estudios para la popularización del entrenamiento funcional en adolescentes. Nivel de evidencia II; Estudios terapêuticos - investigación de los resultados del tratamiento.

Clinical and gene mutation characteristics of patients with hereditary ellipsocytosis: nine cases report and literature review / 中华血液学杂志

Objective: To report gene mutations in nine patients with hereditary elliptocytosis (HE) and analyze the characteristics of pathogenic gene mutations in HE. Methods: The clinical and gene mutations of nine patients clinically diagnosed with HE at Institute of Hematology & Blood Diseases Hospital from June 2018 to February 2022 were reported and verified by next-generation sequencing to analyze the relationship between gene mutations and clinical phenotypes. Results: Erythrocyte membrane protein gene mutations were detected among nine patients with HE, including six with SPTA1 mutation, one with SPTB mutation, one with EPB41 mutation, and one with chromosome 20 copy deletion. A total of 11 gene mutation sites were involved, including 6 known mutations and 5 novel mutations. The five novel mutations included SPTA1: c.1247A>C (p. K416T) in exon 9, c.1891delG (p. A631fs*17) in exon 15, E6-E12 Del; SPTB: c.154C>T (p. R52W) ; and EPB41: c.1636A>G (p. I546V) . Three of the six patients with the SPTA1 mutation were SPTA1 exon 9 mutation. Conclusion: SPTA1 is the most common mutant gene in patients with HE.

Interpretation of the World Society of the Emergency Surgery/the Global Alliance for Infection in Surgery/the Surgical Infection Society-Europe/the World Surgical Infection Society/the American Association for the Surgery of Trauma global clinical pathways for patients with intra- abdominal infections / 中华危重病急救医学

Intra-abdominal infections (IAI) is common surgical emergencies and have been reported as major contributors to non-trauma deaths in hospitals worldwide. The principles of IAI management included early diagnosis, adequate source control, appropriate antimicrobial therapy, and prompt physiologic stabilization using critical care resources, combined with an optimal surgical approach. In order to facilitate clinical management, establish a global standard and provide guidance for clinicians, the World Society of Emergency Surgery (WSES), the Global Alliance for Infection in Surgery (GAIS), the Surgical Infection Society-Europe (SIS-E), the World Surgical Infection Society (WSIS), and the American Association for the Surgery of Trauma (AAST) worked together to complete an international multi-society document, which provided the evidence-based clinical pathways. Herein, we made a comprehensive interpretation for the clinical pathways combined with the latest domestic and international research developments, aiming to provide evidence for domestic doctors on the diagnosis and treatment of IAI, and ultimately benefit patients.

Analysis of surgical types for patients with Kashin-Beck disease in Shaanxi Province from 2018 to 2020 / 中华地方病学杂志

Objective:To analyze the surgical types of patients with Kashin-Beck disease (KBD) in Shaanxi Province, and to provide reference for optimizing KBD surgery.Methods:Retrospective analysis was used to investigate KBD patients who underwent surgical treatment, and the patient's information was from the Shaanxi Provincial Endemic Disease Prevention and Control Information System. Patients with incomplete surgical treatment information were excluded, and χ 2 test was used to analyze the impact of factors such as gender, education level, living area, disease severity, and social environment on the selection of different surgical types (free body enucleation or joint replacement) for KBD patients. Using propensity score method to perform a 1 ∶ 1 match on patients with different surgical types, and analyzing the influencing factors of KBD patients receiving different types of surgical treatment through multivariate logistic regression. Results:From 2018 to 2020, a total of 1 084 KBD patients in Shaanxi Province underwent surgical treatment, including 555 males (51.20%) and 529 females (48.80%), with a median age of 64 years old. There were 917 patients (84.59%) in the Guanzhong region (Tongchuan, Xi'an, Weinan, Xianyang, Baoji), 120 patients (11.07%) in the northern Shaanxi region (Yulin, Yan'an), and 47 patients (4.34%) in the southern Shaanxi region (Ankang, Hanzhong, Shangluo). The number of patients with KBD grade Ⅰ,Ⅱ, and Ⅲ was 401 (36.99%), 525 (48.43%), and 158 (14.58%), respectively. Five hundred and forty-eight patients (50.55%) underwent free body enucleation surgery, and 536 patients (49.45%) underwent joint replacement surgery. Univariate analysis showed that different genders, educational levels, living areas, disease severity, economic status, whether to relocate, type of drinking water, type of staple food, and source of staple food were the influencing factors for KBD patients to choose the type of surgery (χ 2 = 81.82, 22.38, 93.68, 22.38, 5.17, 15.68, 13.82, 39.37, 49.63, P < 0.05). Among 374 pairs of patients who underwent free body enucleation and joint replacement through propensity score matching, multivariate logistic regression analysis found that high school and above education level [odds ratio( OR) = 0.42, P = 0.008], Guanzhong region ( OR = 0.12, P < 0.001), relocation ( OR = 0.60, P = 0.004), and drinking well water ( OR = 2.15, P = 0.001) were the influencing factors for KBD patients to choose different surgical types for treatment. Conclusion:When performing surgical treatment for KBD patients in Shaanxi Province, clinicians can consider the severity of the disease, as well as factors such as the education level, living area, relocation status, and type of drinking water of KBD patients, to provide more suitable surgical types for KBD patients.

The significance and strategy of cultivating medical students' independent learning ability / 中华医学教育探索杂志

It's the duty of contemporary teachers to cultivate students' independent learning, independent thinking, and self-management ability. This paper reviews the significance of independent learning for cultivating medical students with forward-looking learning ability and cutting-edge medical knowledge. It focuses on the strategies and ideas of cultivating medical students' independent learning ability from the aspects of strategy and evaluation, and tries to provide inspiration and reference for the application of independent learning teaching method in the cultivation of medical students.

Evaluation of neonatal resuscitation simulation exercise for perinatal medical personnel / 中国新生儿科杂志

Objective:To evaluate the efficacy of neonatal resuscitation simulation exercise for perinatal medical personnel.Methods:From August 2020 to July 2021, perinatal medical personnel receiving simulated training of neonatal resuscitation in our hospital were prospectively enrolled. The professional backgrounds of the trainees were collected and their performances on both knowledge skills and behavioral skills were scored. The knowledge skills included pre-resuscitation preparation, initial resuscitation, positive pressure ventilation, tracheal intubation, chest compression and umbilical vein catheterization. The behavioral skills included situational awareness, problem solving, resource utilization, communication and leadership. SPSS 26.0 was used for data analysis.Results:Among the 200 participants, 127(63.5%) were neonatal/pediatric doctors and nurses, 65(32.5%) were obstetricians and midwives, 8(4.0%) were anesthesiologists and the ratio of doctors to nurses was 1.74∶1. The score of knowledge skills was (19.52±2.92) at the beginning of the simulation exercise and (27.02±2.72) at the end. The scores on preparation before resuscitation, initial resuscitation and positive pressure ventilation were significantly improved ( P<0.05). The score of behavioral skills was (16.60±2.34) at the beginning and (20.58±1.77) at the end. The scores of resource utilization, communication and leadership were significantly improved ( P<0.05). Conclusions:The simulation exercise provides multidisciplinary teamwork training for perinatal medical personnel, may significantly improve neonatal resuscitation skills and is worth promoting.

Pathogenesis of Metabolic Remodeling of Energy Substrate Based on Theory of Deficient Qi Stagnation and Progress of Chinese Medicine Intervention / 中国实验方剂学杂志

In the case of cardiac dysfunction， energy metabolism changes and the metabolism of myocardial substrates is reconstructed， as manifested by variation in the selection and utilization of energy substrates such as fatty acids and glucose. Persistent metabolic disorders of substrates will decrease energy supply， thus resulting in the occurrence and development of heart failure. Metabolic remodeling of substrate is resulted from the decline of visceral function and the accumulation of pathological products. Deficient Qi stagnation is the core pathogenesis. Deficient Qi （heart Qi deficiency， insufficient energy） is the root cause， which exists in the whole disease course. Stagnation （phlegm， blood stasis， fluid， lipid toxic products， lactic acid， etc.） is the symptom， which evidences the aggravation of the disease. Deficient Qi and stagnation are intertwined and causal， which form a spiral vicious circle. The typical syndrome is excess resulted from deficiency and deficiency-excess in complexity. The treatment principle is reinforcing healthy Qi and tonifying deficiency， dredging and removing pathogen. At the early stage， the method of reinforcing healthy Qi and tonifying deficiency （benefiting Qi） should be used， and the method of dredging and removing pathogen （activating blood） can be applied according to the conditions of patients. At the middle and late stages， both reinforcing healthy Qi and tonifying deficiency （benefiting Qi and warming Yang） and dredging and removing pathogen （activating blood， resolving stasis， and excreting water） should be emphasized. Chinese medicine can be applied according to the pathogenesis， thereby promoting the utilization of fatty acids， glucose， and other substrates and reducing the accumulation of toxic products derived from metabolic remodeling of substrate. Thus， both the root cause and symptoms can be alleviated， further improving cardiac energy metabolism and heart function.

Effect of anterior capsule polishing on the visual quality after cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the effect of anterior capsule polishing on visual quality after phacoemulsification.METHODS: Prospective randomized control study. A total of 65 patients(73 eyes)with age-related cataract who underwent phacoemulsification combined with intraocular lens(IOL)implantation in the Emergency General Hospital between November 2021 and June 2022 were included. These patients were randomly assigned to two groups, with one group(anterior polishing group)underwent anterior and posterior capsule polishing(30 cases, 35 eyes), while the other(control group)receive routine posterior capsule polishing(35 cases, 38 eyes). Best corrected visual acuity was observed at 1wk, 1, 3 and 6mo after operation. Area of anterior capsule orifice was measured at 3 and 6mo after operation. Meanwhile, posterior capsular opacification(P score), IOL tilt and decentration were recorded by Pentacam Scheimpflug system. In addition, wavefront aberration, Strehl ratio(SR)of point spread function(PSF)and modulation transfer function(MTF)were evaluated by OPD-Scan Ⅲ.RESULTS: At 1wk, 1, 3 and 6mo after operation, best corrected visual acuity in anterior polishing group is significantly better than that of control group(P&#x003C;0.05). There were no significant differences in area of anterior capsule opening, P score, IOL decentration, SR of PSF and MTF between two groups at 3 and 6mo after operation(P&#x003E;0.05). At 3mo follow-up, no significant differences in IOL tilt and wavefront aberration were measured between two groups either(P&#x003E;0.05). However, IOL tilt [(1.65±0.60)° vs.(2.34±0.43)°, P&#x003C;0.001] and wavefront aberration(0.03±0.01μm vs. 0.06±0.03μm, P&#x003C;0.001)in anterior polishing group were significant lower compared to control group at 6mo after operation.CONCLUSION: 360° polishing of anterior and posterior capsule during phacoemulsification can improve best corrected visual quality, with reduced IOL tilt, lower wavefront aberration and better visual quality.

Comparison of spectral-domain optical coherence tomography parameters between the eyes of anisometropic amblyopia children and normal eyes / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the thickness of retina in macular area and retinal nerve fiber layer(RNFL)around optic disc between the eyes of monocular anisometropic amblyopia children and normal eyes.METHODS: A total of 62 children(124 eyes)with monocular anisometropic amblyopia who were treated in Chengdu Women's and Children's Central Hospital from January 2021 to October 2022 were selected as the experimental group, and 60 children(60 eyes; right eye)with normal vision who were treated in the same period were selected as the control group. Spectral-domain optical coherence tomography(SD-OCT)was used to detect the retinal thickness in macular region and the RNFL thickness around optic disc in the two groups, and comparative analysis was performed.RESULTS: The retinal thickness and perioptic RNFL thickness of amblyopic children in experimental group were thicker than those in control group, and most of them had significant differences(P&#x003C;0.05). The retinal thickness and perioptic RNFL thickness of contralateral non-amblyopic children in experimental group were thinner than those in control group, but there were no significant differences in most of them(P&#x003E;0.05).CONCLUSIONS: There are differences in the retinal thickness of the macula and perioptic RNFL in the amblyopic eye and the contralateral non-amblyopic eye of monocular anisometropic amblyopic children compared with normal eyes, and the contralateral non-amblyopic eye is not completely equal to the normal eye.

Application of capsulorhexis-chop forceps assisted prechop technique in hard cataract phacoemulsification / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the advantages of capsulorhexis-chop forceps assisted prechop(CCFP)technique in hard cataract phacoemulsification.METHODS: Prospective study. A total of 100 cases(100 eyes)with age-related grade IV hard cataract were included and randomly divided into 2 groups according to random number table, with 50 patients(50 eyes)in CCFP technique group(group A)and 50 cases(50 eyes)in stop-and-chop technique group(group B). The corneal endothelial cell count before and after operation, intraoperative US time, postoperative corneal endothelial cell loss rate, corneal edema grade at 1 and 7d and best corrected visual acuity(BCVA)were compared and statistically analyzed.RESULTS: The mean US time of group A was lower than that of group B [26.66(16, 40)s vs. 36.12(23, 46)s; Z=-5.56, P&#x003C;0.01]. The mean corneal endothelial cell count in group A was higher than that in group B at 3mo after operation(2308.12±368.18cell/mm2 vs. 2104.06±379.87cell/mm2; t=2.728, P=0.008), and the loss rate of corneal endothelial cells in group A was lower than that in group B at 3mo after operation [10%(8%, 12%)vs. 17%(14%, 20%); Z=13.231, P&#x003C;0.01]. The number of eyes with corneal edema of grade 0, 1, 2, 3 and 4 on 1d after surgery was 0, 23, 21, 6 and 0 in group A, respectively, while it was 0, 9, 26, 15 and 0 respectively in group B. Corneal edema in group A was less than that in group B(Z=10.514, P=0.005). The BCVA of group A was better than that of group B at 1d after operation, and there was significant difference in the number of eyes with different BCVA grades between the two groups(Z=7.176, P=0.029). There was no significant difference in the number of eyes with different grades of BCVA between the two groups at 3mo after surgery(Z=2.377, P=0.372).CONCLUSION: Compared with the stop-and-chop technique, CCFP technique uses less ultrasonic energy, has less damage to corneal endothelial cells and is suitable for hard cataract surgery.

Retrospective analysis of strabismus surgery in adolescents and children in Yunnan province / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the strabismus surgery situation of adolescents and children in Yunnan province.METHODS: A retrospective analysis was conducted on medical records data of 3 068 adolescents and children who received strabismus surgery at Affiliated Hospital of Yunnan University from January 2017 to December 2021. The analysis included gender, constituent ratio of age, distribution of strabismus types and combination with other ocular diseases, etc.RESULTS: Among the included patients, 52.12% were males, and 47.88% were females. Preschool patients(1 to 6 years old)accounted for 32.89%, primary pupils(7 to 12 years old)accounted for 45.89% and high school students(13 to 18 years old)accounted for 21.22%. Exotropia accounted for 63.17% of the total strabismus, of which intermittent exotropia was the most common type. Esotropia accounted for 19.69%, and concomitant esotropia was the most common type. The special type of strabismus accounted for 17.14%, and A-V syndrome and dissociative vertical deviation(DVD)were the most common types. Strabismus combined with ametropia accounted for 61.02% and amblyopia accounted for 10.89%. A few patients also combined with other eye diseases.CONCLUSION: In Yunnan province, intermittent exotropia was the most common type of strabismus among adolescents and children. Some patients combined with other ocular diseases.

Directed differentiation of human induced pluripotent stem cells into midbrain / 南方医科大学学报

OBJECTIVE@#To establish an efficient protocol for directed differentiation of human induced pluripotent stem cells (hiPSCs) into functional midbrain dopaminergic progenitor cells (DAPs) in vitro.@*METHODS@#hiPSCs were induced to differentiate into DAPs in two developmental stages. In the first stage (the first 13 days), hiPSCs were induced into intermediate cells morphologically similar to primitive neuroepithelial cells (NECs) in neural induction medium containing a combination of small molecule compounds. In the second stage, the intermediate cells were further induced in neural differentiation medium until day 28 to obtain DAPs. After CM-DiI staining, the induced DAPs were stereotactically transplanted into the right medial forebrain bundle (MFB) of rat models of Parkinson's disease (PD). Eight weeks after transplantation, the motor behaviors of PD rats was evaluated. Immunofluorescence assay of brain sections of the rats was performed at 2 weeks after transplantation to observe the survival, migration and differentiation of the transplanted cells in the host brain microenvironment.@*RESULTS@#hiPSCs passaged stably on Matrigel showed a normal diploid karyotype, expressed the pluripotency markers OCT4, SOX2, and Nanog, and were positive for alkaline phosphatase. The primitive neuroepithelial cells obtained on day 13 formed dense cell colonies in the form of neural rosettes and expressed the neuroepithelial markers (SOX2, Nestin, and PAX6, 91.3%-92.8%). The DAPs on day 28 highly expressed the specific markers (TH, FOXA2, LMX1A and NURR1, 93.3-96.7%). In rat models of PD, the hiPSCs-DAPs survived and differentiated into TH+, FOXA2+ and Tuj1+ neurons at 2 weeks after transplantation. Eight weeks after transplantation, the motor function of PD rats was significantly improved as shown by water maze test (P < 0.0001) and apomorphine-induced rotation test (P < 0.0001) compared with rats receiving vehicle injection.@*CONCLUSION@#HiPSCs can be effectively induced to differentiate into DAPs capable of differentiating into functional neurons both in vivo and in vitro. In rat models of PD, the transplanted hiPSCs-DAPs can survive for more than 8 weeks in the MFB and differentiate into multiple functional neurocytes to ameliorate neurological deficits of the rats, suggesting the potential value of hiPSCs-DAPs transplantation for treatment of neurological diseases.

Biological function and clinical significance of long non-coding RNA LINC00342 in head and neck squamous carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the relationship between the long-non-coding RNA LINC00342 expression and the clinicopathological parameters of head and neck squamous cell carcinoma (HNSCC) and the biological function of LINC00342 in HNSCC cells. Methods: The expression level of LINC00342 in the HNSCC was analyzed using transcriptome sequencing data from TCGA (The Cancer Genome Atlas) database, and the expressions of LINC00342 in laryngeal squamous cell carcinoma tissues (LSCC) of 27 patients in the First Hospital of Shanxi Medical University were detected by transcriptome sequencing. The expression levels of LINC00342 in human embryonic lung diploid cells 2BS, HNSCC cell lines FD-LSC-1, CAL-27 and Detroit562 were determined by real-time quantitative polymerase chain reaction (qPCR). RNAi (RNA interference) was used for LINC00342 knockdown in HNSCC cell lines, and the changes of malignant phenotype in the tumor cells after LINC00342 knockdown were examined by cell counting kit-8 (CCK-8), colony formation, flow cytometry, transwell invasion and migration assays. Bioinformatics analysis was performed to construct a LINC00342-centered competing endogenous RNA (ceRNA) regulatory network, and GO (Gene Ontology) enrichment analysis was performed. Statistical analysis and graphing were performed using SPSS 25.0 software and GraphPad Prism 6 software. Results: Mean LINC00342 levels in HNSCC tissues and TCGA database were higher than that in normal control tissues, but with no significantly statistical difference (P=0.522). LINC00342 expression levels were positively correlated with cervical lymph node metastasis and pathological grade in patients with HNSCC, with higher expression in male patients than in female patients (P<0.05). Transcriptome sequencing analysis showed that mean expression level of LINC00342 in LSCC tissues of 27 patients was significantly higher than that in the paired adjacent normal mucosa tissues (t=1.56, P=0.036). LINC00342 expression was significantly upregulated in HNSCC cell lines FD-LSC-1, CAL-27 and Detroit562 (t-values of -12.17, -23.26 and -388.57, respectively; all P<0.001). Knockdown of LINC00342 by transfecting si-LINC00342-1 and si-LINC00342-2 inhibited HNSCC cell proliferation (t-values of 8.95 and 4.84, 2.70 and 5.55, 2.02 and 3.70, respectively), colony formation (t-values of 6.66 and 6.17, 7.38 and 11.65, 4.90 and 5.79, respectively), migration (t-values of 8.21 and 7.19, 5.76 and 6.46, 6.28 and 9.92, respectively) and invasion abilities (t-values of 9.29 and 10.25, 11.30 and 11.36, 8.02 and 8.66, respectively), but promoting apoptosis in cell lines FD-LSC-1 and CAL-27 (t-values of -2.21 and -5.83, -3.05 and -5.25 respectively) (all P-values<0.05). The LINC00342-centered ceRNA network consists of 10 downregulated microRNA and 647 upregulated mRNA nodes. GO analysis results indicated that LINC00342-regulated mRNAs were enriched in 22 biological processes, 32 molecular functions, and 12 cellular components. Conclusion: High level of LINC00342 is associated with the malignant progression of HNSCC. LINC00342 promotes the proliferation, migration, invasion, and antagonizes apoptosis of HNSCC cells, which serves as a potential molecular marker in HNSCC.

Current status of lymph node dissection in pyloric-preserving gastrectomy for early gastric cancer / 中华胃肠外科杂志

With the gradual increase in the diagnosis rate of early gastric cancer, clinicians must consider prevention of gastric anatomical structure and physiological function while ensuring the radical treatment of the tumor. Pylorus-preserving gastrectomy is a function- preserving operation that preserves the pylorus, inferior pyloric vessel, and the vagus nerve in patients with early middle gastric cancer. One of the major controversies at present is the thoroughness of limited lymph node dissection for pyloric-preserving gastrectomy. Various studies have reported that the lymph node metastasis rate of early middle gastric cancer was low, especially in the suprapyloric region, inferior pylorus and the upper pancreatic region. Partial lymph node dissection is required for vascular and neurological protection, which is also safe and feasible in studies reported by major centers. Many clinical studies have been carried out in Japan and Korea, and postoperative follow-up has gradually increased evidence, providing the basis for the safety of lymph node dissection. In large case studies comparing pylorus- preserving gastrectomy with traditional distal gastrectomy, the incidence of postoperative morbidity, such as dumping syndrome, bile reflux esophagitis, weight loss, and malnutrition is low. Sentinel lymph node navigation technology is gradually applied to the diagnosis and treatment of early gastric cancer, and its clinical application value still needs further research.