Comparison of visual function before and after wearing amber filter in low vision patients with primary retinitis pigmentosa / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the visual function of low-vision patients with primary retinal pigmentosa(RP)before and after wearing amber filter.METHODS: Self-control before and after study. A total of 30 patients(60 eyes)with low vision who were diagnosed with primary RP in the ophthalmology clinic of Xi'an No.1 Hospital from August 2021 to March 2022 were collected. The uncorrected distance visual acuity(UCDVA), best-corrected distance visual acuity(BCDVA), uncorrected near visual acuity(UCNVA), best-corrected near visual acuity(BCNVA), visual field and Farnsworth-Munsell(FM)-100 color visions were recorded before and after wearing amber filter. The contrast sensitivity(CS)in three visual environments including bright room, darkroom and darkroom with glare was measured and recorded respectively, and the changes of those parameters were analyzed before and after wearing filter.RESULTS: UCDVA and BCDVA after wearing the filter were better than those before wearing(t=-2.32, P<0.001; t=-6.77, P<0.001), while there was no statistically significant difference in UCNVA and BCNVA before and after wearing filter. The visual field index(VFI)after wearing filter was lower than that before wearing(t=8.62, P<0.001), and the mean defect(MD)of visual field was greater than that before wearing(t=7.73, P<0.001). FM100 color chess test showed that both total error score(TES)and partial error score(PES)in multiple regions were higher than those before wearing filter(P<0.001). After wearing, the CS of each frequency band in the environment of bright room and darkroom with glare was higher than that before wearing(P<0.001), and there was no statistically significant difference in each frequency band before and after wearing amber filter under the environment of darkroom without glare.CONCLUSION: Patients with low vision of primary RP showed improved UCDVA and BCDVA, but unchanged UCNVA and BCNVA after wearing amber filter, while the visual field and color discrimination were worse than those before wearing filter. The CS of the bright room and darkroom with glare environment was improved than before wearing filter, while there were no significant changes in CS under darkroom without glare.

Research progress of visual perception training on postoperative reconstruction of binocular vision in patients with intermittent exotropia / 国际眼科杂志(Guoji Yanke Zazhi)

Intermittent exotropia(IXT)is a common ophthalmic disease with high incidence, variable deviation, and varying degrees of impaired binocular visual function. The defect of binocular visual function is related to the changes of visual cortex. IXT involves the functional changes of many brain regions, including the cortical areas related to binocular fusion. After correcting the eye position, the abnormal changes of cerebral cortex still exist in some patients with IXT, and the recovery of binocular vision is still difficult. In order to solve these problems, visual perception training is gradually applied to the postoperative reconstruction of binocular visual function in patients with IXT. Visual perception training repairs the visual cortex from the brain level, improving the ability of the visual cortex to process information by constantly stimulating the visual center, thus repairing the visual central function, so that patients can obtain good binocular visual function, stabilize the eye position and reduce recurrence. This article reviews the mechanism of binocular visual impairment and the role of visual perception training in the treatment of IXT. It is hoped to provide more evidence for visual perception training to reconstruct postoperative binocular visual function and reduce the recurrence rate in patients with IXT.

Effect of miR-30c/YWHAZ axis on drug resistance of pancreatic cancer cells / 中华内分泌外科杂志

Objective:To investigate whether microRNA-30c (miR-30c) mediates the resistance of pancreatic cancer cells to gemcitabine (Gb) by targeting tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activating protein zeta polypeptide (YWHAZ) .Methods:SW1990 cell line with the lowest expression of miR-30c in human pancreatic cancer cell lines was screened by RT-qPCR. Gb-resistant cell line SW1990/Gb was established and divided into SW1990/Gb group (untransfected) , miR-30c over expression (Ad-miR-30c) group, Ad-miR-30c negative control (Ad-eGFP) group, and SW1990 group. The level of miR-30c was measured by RT-qPCR; the half inhibitory concentration (IC50) and drug resistance index (IR) were measured by CCK-8 method; the expression of drug resistance-related protein P-gp, apoptosis-related protein Caspase-1, migration and transfer-related proteins MMP-9, YWHAZ and downstream pathway-kinase mitogen-activated protein kinase (p38MAPK) /extracellular regulatory protein kinase 1 (ERK1) protein was measured by Western blot. After co-transfection of Ad-miR-30c and YWHAZ overexpressing adenovirus (Ad-YWHAZ) , the expression of P-gp and YWHAZ pathway related proteins was measured by Western blot method.Results:The IC50 (59.16±5.14, nmol/L) , IR (11.15±0.19) , expressions of YWHAZ protein (1.59±0.15) and P-gp (2.43±0.26) in SW1990/Gb-resistant cells were high, the expression of miR-30c (0.25 ±0.02) was low ( P<0.05) , and the p38MAPK/ERK pathway was activated. After up-regulating the expression of miR-30c (1.59±0.15) in SW1990/Gb cells, the IC50 (25.14±2.15, nmol/L) and IR (5.48±0.12) , YWHAZ (1.49±0.13) , P-gp (1.46± 0.10) decreased ( P<0.05) , and the p38MAPK/ERK pathway was activated. Up-regulating the expression of YWHAZ could reverse the above-mentioned effects of Ad-miR-30c ( P<0.05) . Conclusions:The expression of miR-30c is low in pancreatic cancer Gb-resistant cell lines. Up-regulating the expression of miR-30c can target and inhibit the YWHAZ/p38MAPK/ERK pathway, inhibit the expression of drug-resistant protein P-gp, and reduce the resistance of pancreatic cancer cells to Gb.

Study on the prognostic value of circulating tumor cells in colorectal cancer patients / 中华普通外科杂志

Objective:To explore the prognostic value of circulating tumor cell (CTC) for colorectal cancer.Method:We analyze the correlation between CTC and clinicopathological data, survival curve and overall survival.Results:The positive rates of preoperative and postoperative CTC in 181 colorectal cancer patients were 66.3% and 65.7% respectively ( χ2=0.012, P=0.912). The postoperative CTC positive rates for recurrence and non-recurrence of stage Ⅱ colorectal cancer were 29.2% and 8.0%, respectively ( χ2=4.303, P=0.038). The progress free survuval of CTC-positive and CTC-negative in postoperative stage Ⅱ colorectal cancer patients were 28.7 months and 34.0 months, respectively ( χ2=4.096, P=0.043). Conclusion:Postoperative CTC detection has predictive prognostic value for patients with stage Ⅱ colorectal cancer.

Chidamide inhibits the NOTCH1-MYC signaling axis in T-cell acute lymphoblastic leukemia / 医学前沿

T-cell acute lymphoblastic leukemia (T-ALL) is one of the most dangerous hematological malignancies, with high tumor heterogeneity and poor prognosis. More than 60% of T-ALL patients carry NOTCH1 gene mutations, leading to abnormal expression of downstream target genes and aberrant activation of various signaling pathways. We found that chidamide, an HDAC inhibitor, exerts an antitumor effect on T-ALL cell lines and primary cells including an anti-NOTCH1 activity. In particular, chidamide inhibits the NOTCH1-MYC signaling axis by down-regulating the level of the intracellular form of NOTCH1 (NICD1) as well as MYC, partly through their ubiquitination and degradation by the proteasome pathway. We also report here the preliminary results of our clinical trial supporting that a treatment by chidamide reduces minimal residual disease (MRD) in patients and is well tolerated. Our results highlight the effectiveness and safety of chidamide in the treatment of T-ALL patients, including those with NOTCH1 mutations and open the way to a new therapeutic strategy for these patients.

Spinal Angiolipomas : Clinical Characteristics, Surgical Strategies and Prognosis

Objective@#: Angiolipomas are usually found in the subcutaneous tissue of the trunk and limbs. Spinal angiolipomas (SALs) are uncommon and have rarely been reported. We report a series of nine SALs patients who received surgical treatment in our department. To summarize the clinical characteristics of SALs, propose our surgical strategies, and evaluate the effects of the operation. @*Methods@#: This was a retrospective review of nine SALs patients who received surgical treatment from August 2015 to March 2020. Total or subtotal resection was determined by the axial localization (dorsal or ventral) and the extent of intervertebral foramen involvement. The outcomes were assessed based on the modified Japanese Orthopaedic Association (mJOA) scoring system utilized before surgery and at various follow-up points. @*Results@#: Among the nine patients, the mean mJOA score before surgery was 6.6±2.3, compared with 10.1±1.1 at the last follow-up time point (33.4±11.8 months). All patients achieved good outcomes, even in cases of subtotal resection. @*Conclusion@#: Early surgical resection of SALs is recommended, and the specific procedures should be determined by the axial localization (dorsal or ventral) and the extent of intervertebral foramen involvement. Most of the patients had a good prognosis, even in cases of subtotal resection.

Clinical outcomes following microsurgery and endovascular embolization in the management of spinal dural arteriovenous fistula: A meta-analysis study / 北京大学学报(医学版)

OBJECTIVE@#To compare the clinical effect of microsurgery and endovascular embolization in the treatment of spinal dural arteriovenous fistula (SDAVF) by meta-analysis.@*METHODS@#A systematic review was performed to retrieve all relevant literature about surgical treatment or endovascular embolization of SDAVF up to December 2019 through PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials Results, CNKI, Wanfang Data, and SinoMed. The Chinese and English key words included: "SDAVF", "spinal dural arteriovenous fistula", "spinal AVM", "spinal vascular malformation and treatment". The included studies were evaluated using the Newcastle-Ottawa scale. The early failure rate, long-term recurrence, neurological recovery, and complications were evaluated and the clinical effects of the two methods in the treatment of SDAVF were compared by using RevMan 5.3 software. And a further subgroup analysis of the therapeutic effect of endovascular embolization with different embolic agents was conducted.@*RESULTS@#A total of 46 studies involving 1 958 cases of SDAVF were included, in which 935 cases were treated by microsurgery and 1 023 cases were treated by endovascular embolization. The funnel plot demonstrated that there was no publication bias. The results of meta-analysis showed that the incidence of early surgical failure was lower than that of endovascular embolization (OR=0.20, 95%CI: 0.13-0.30, P < 0.05), and the long-term recurrence was also lower than that of endovascular embolization (OR=0.36, 95%CI: 0.22-0.58, P < 0.05). The improvement of neurological function in the surgical patients is significantly higher than that in the patients treated with endovascular embolization (OR=2.86, 95%CI: 1.36-5.99, P < 0.05). There was no significant difference in the occurrence of complications in these two groups (OR=1.52, 95%CI: 0.88-2.64, P=0.14). In the cases of endovascular embolization, the risk of treatment failure or recurrence was higher with Onyx glue than with n-butyl 2-cyanoacrylate (NBCA), and the difference was statistically significant (OR=4.70, 95%CI: 1.55-14.28, P < 0.05).@*CONCLUSION@#Although the treatment of dural arteriovenous fistulas by intravascular embolization has been widely used, the clinical effect of microsurgery is still better than that of endovascular embolization. Large scale and high-quality randomized controlled trials are required to validate the efficacy and safety of endovascular treatment in SDAVF patients.

Non-erythrocyte blood products transfusion in very preterm and extremely preterm infants in Chinese neonatal intensive care units / 中华儿科杂志

Objective: To describe the use of non-erythrocyte blood products transfusion in very preterm and extremely preterm infants in the neonatal intensive care units (NICU) of the Chinese Neonatal Network (CHNN) in 2019, to explore the disparity between different centers, and to further investigate the rationality and standardability of non-erythrocyte blood products transfusion. Methods: This was a cross-sectional study based on the CHNN cohort of very preterm and extremely preterm infants. All 6 598 infants with gestational age (GA)<32 weeks and admitted to the 57 NICU of CHNN within 24 h of life in 2019 were enrolled. Non-erythrocyte blood products included platelet, plasma, albumin, immunoglobulin, cryoprecipitate and prothrombin complex. Infants who received at least one type of non-erythrocyte blood products were defined in transfusion group. The comparison between infants with and without transfusion was done by t-test, rank-sum test or χ2 test as appropriate. Linear regression model was used to generate adjusted transfusion rate of each center, and to investigate the correlation between adjusted rate and center-level characteristics. Results: A total of 6 598 infants were enrolled in the study, with gestational age of 30.0 (28.7, 31.0) weeks and birth weight of (1 353±312) g, and 43.6 % (2 877) of them were female. Among them, 42.7% (2 816) infants were enrolled in transfusion group, with the times of transfusion as 3 (1, 6) times. Compared to the infants without any transfusion of non-erythrocyte blood products, those infants received transfusion had lower gestational age (Z=17.62, P<0.01), lower birth weight (t=18.64, P<0.01), higher proportion of small-for-gestation age (χ2=31.06, P<0.01), multiple birth (χ²=12.82, P<0.01) and intensive resuscitation in delivery room (χ²=287.52, P<0.01), as well as lower proportion of females (χ²=10.68, P<0.01) and even lower proportion of infants born in this hospital (χ²=78.23, P<0.01). Among the entire study population, albumin (25.4%, 1 674 cases), immunoglobulin (21.5%, 1 417 cases) and plasma (18.9%, 1 245 cases) were the most commonly used non-erythrocyte blood products. Overall, 60.4% (544/901) infants with gestational age <28 weeks received transfusion 4 (2, 8) times. A total of 39.9% (2 272/5 697) infants between 28-31weeks received non-erythrocyte blood products 3 (1, 6) times. The non-erythrocyte blood products transfusion rates of critically-ill and non-critically-ill infants were 62.2% (1 693/2 723) and 29.0% (1 123/3 875) respectively, and the transfusion times were 4 (2,7) and 2 (1,4) times. The transfusion rates varied significantly among different NICU, and the disparities remained obvious after adjustment (adjusted χ²=153.48, P<0.01). Conclusion: Near half of very preterm and extremely preterm infants admitted to Chinese NICU in 2019 receive non-erythrocyte blood products during hospitalization with significant disparities among different hospitals.

Exposed bone cement technique and pectoralis major advancement muscle flap in treatment of chronic sternal osteomyelitis after coronary artery bypass surgery / 中华显微外科杂志

Objective:To analyse the effect of the exposed bone cement technique combined with pectoralis major muscle flap in the treatment of chronic sternal osteomyelitis after coronary artery bypass surgery(CABS), and to summarise the clinical experience of staged surgery and comprehensive treatment.Methods:A retrospective analysis were carried out on 5 patients who had chronic sternal osteomyelitis and treated with exposed bone cement after the CABS from October 2017 to October 2020. Five patients(4 males and 1 female) met the inclusion criteria with a mean age of 65(range from 54 to 72) years old. Duration of all the chronic sternal osteomyelitis was 3 weeks to 3 months at admission. During the perioperative period, the general condition of the patients was controlled and systemic nutritional support was given. At the first stage, all patients underwent complete debridement. Then all the wounds were treated with exposed bone cement and covered by vacuum sealing drainage(VSD) to control the infection. At the second stage, bone cement was removed, and the dead cavity was packed with pectoralis major advancement muscle flap. Close attention was paid to the tension of wound, the patency of drainage catheter and the drainage after surgery. The wound healing, scar hyperplasia and complications were observed during the follow-up.Results:The suture tension was moderate, the drainage catheter was unobstructed, and a little liquid was drawn without turbid. All patients were clinically cured and entered follow-up for 6 to 15 months. During the follow-up, there was neigher recurrence of osteomyelitis nor sinus tract formation. No significant complication occurred at the last follow-up. The quality of life of the patients was significantly improved and all the patients were satisfactory to the treatment.Conclusion:Exposed bone cement technique combined with pectoralis major muscle flap is an effective method in the treatment of chronic sternal osteomyelitis after CABS. It has a good short-term treatment efficacy and is worthy for further clinical trials.

Correlation between serum VEGF level and white matter hyperintensity and cognitive dysfunction in patients with cerebral small vessel disease / 中华行为医学与脑科学杂志

Objective:To investigate the relationship between serum vascular endothelial growth factor (VEGF) levels and white matter high signal and non-dementia vascular cognitive dysfunction in patients with cerebral small vascular disease (CSVD).Methods:Total 106 patients with CSVD who were admitted to the Department of Neurology of the First Affiliated Hospital of Xinxiang Medical College from April 2019 to December 2020 were enrolled.They were divided into vascular cognitive impairment no dementia group (VCIND group, n=47) and no vascular cognitive impairment group (N-VCI group, n=59)according to mini-mental assessment scale (MMSE), Montreal cognitive assessment (MoCA) scale and activity of daily living scale (ADL). Serum VEGF levels were detected by enzyme-linked immunosorbent assay (ELISA). The baseline data, serum VEGF levels, MoCA score and Fazekas score were compared between the two groups.The correlation between serum VEGF level and white matter high signal and cognitive function was analyzed.SPSS 19.0 software was used for data processing.The statistical methods were t-test, Chi square test, nonparametric test, Logistic regression analysis, Pearson correlation analysis and Spearman correlation analysis. Results:There were significant differences in serum VEGF level((464.18±114.58)pg/mL, (414.17±45.80)pg/mL, F=22.880), MoCA score((13.07±6.48), (20.17±4.06), F=17.920) and Fazekas score (4(3, 5), 3(1, 3), Z=-4.189)between the two groups (all P<0.05). The level of VEGF( β=0.008, OR=1.008, 95% CI=1.001-1.015, P<0.05) was the influencing factor of cognitive function in patients with CSVD .The level of VEGF was negatively correlated with the total score of MoCA, attention and calculation power, and orientation ability ( r=-0.345, -0.373, -0.445, all P<0.05) and it was positively correlated with the total Fazekas score and the Fazekas score of paraventricular and deep white matter ( r=0.392, 0.495, 0.302, all P<0.05). There was a linear trend between the high signal grade of paraventricular and deep white matter and VCIND (both P<0.05). Conclusion:Serum VEGF level is correlated with cognitive function and white matter hyperintensity in patients with CSVD.The increase of VEGF level may be a factor reflecting cognitive dysfunction.In addition, with the increase of white matter hyperintensity level, the risk of VCIND in CSVD is increased.

Retrospective cohort study on prognosis impact of preoperative obstruction in colorectal cancer / 国际外科学杂志

Objective:To investigate the effect of obstruction on the prognosis and possible mechanisms in colorectal cancer patients.Methods:Among 1574 cases of colorectal cancer who were treated in Beijing Friendship Hospital, Capital Medical University from January 2003 to December. 2014, 194 cases had preoperative intestinal obstruction. Firstly, described the clinical characteristics of 194 patients with obstruction, then COX multivariate regression analysis was performed on the 1574 colorectal cancer cohort to confirm whether the preoperative obstruction was independent predictor for the overall survival. Finally, propensity score matching method was used to match obstruction and non-obstruction cases, then compared overall survival difference.Results:In 194 cases of obstructive colorectal cancer, 60.3% and 37.1% of the tumors were located in the left and right respectively. The 55.7% of the patients had tumors larger than 5 cm in diameter, the median survival time was 39.7 months (95% CI: 28.3-60.4). Multivariate COX analysis, after adjusted for related confounding factors, found that preoperative obstruction is still an independent risk factor for poor prognosis ( HR=1.41, 95% CI: 1.01-1.97). After propensity score matching, 140 and 560 patients were included in the obstructive group and the non-obstructive group. The two groups were more balanced in most baseline characteristics. The median survival time of the two groups was 42.4 and 116.3 months ( P<0.001), the overall survival of obstructive patients was significantly worse than that of non-obstructive patients. Conclusions:Preoperative obstruction is an independent risk factor for poor prognosis of colorectal cancer. This may be due to the difficulty of surgery and low radical cure rate for obstructive colorectal cancer.

Effects of Th17 and Treg cells with their balance on thyroid-associated ophthalmopathy / 国际眼科杂志(Guoji Yanke Zazhi)

Thyroid-associated ophthalmopathy(TAO)is an organ-specific autoimmune disease, which will cause a series of symptoms to significantly reduce the health level and life quality of patients. The pathogenesis of TAO has not been fully clarified. At present, there is a lack of unified and mature treatment scheme of it. Indeed, T-helper 17 lymphocyte(Th17)cells, regulatory T(Treg)cells and their imbalance are closely related to the immunological pathogenesis of TAO. It is currently believed that the cytokines secreted by Th17 cells can not only promote the inflammatory response of TAO and the fibrosis of orbital connective tissue, but also inhibit the adipogenic differentiation of TAO orbital connective tissue. In addition, Treg cells mainly exert immunosuppressive effect on TAO and delay the disease progression. At the same time, there is a dynamic balance relationship between Th17 and Treg cells, the imbalance of Th17/Treg cells can trigger the occurrence and development of TAO. This paper mainly expounds the influence mechanism of Th17, Treg cells and their balance on TAO, and analyzes the reasons for the differences between different research results, so as to provide some reference for the study of the pathogenesis and clinical treatment of TAO.

Preclinical characterization and comparison between CD3/CD19 bispecific and novel CD3/CD19/CD20 trispecific antibodies against B-cell acute lymphoblastic leukemia: targeted immunotherapy for acute lymphoblastic leukemia / 医学前沿

The CD19-targeting bispecific T-cell engager blinatumomab has shown remarkable efficacy in patients with relapsed/refractory B-cell precursor acute lymphoblastic leukemia. However, several studies showed that blinatumomab has a short plasma half-life due to its low molecular weight, and thus its clinical use is limited. Furthermore, multiple trials have shown that approximately 30% of blinatumomab-relapsed cases are characterized by CD19 negative leukemic cells. Here, we design and characterize two novel antibodies, A-319 and A-2019. Blinatumomab and A-319 are CD3/CD19 bispecific antibodies with different molecular sizes and structures, and A-2019 is a novel CD3/CD19/CD20 trispecific antibody with an additional anti-CD20 function. Our in vitro, ex vivo, and in vivo experiments demonstrated that A-319 and A-2019 are potent antitumor agents and capable of recruiting CD3 positive T cells, enhancing T-cell function, mediating B-cell depletion, and eventually inhibiting tumor growth in Raji xenograft models. The two molecules are complementary in terms of efficacy and specificity profile. The activity of A-319 demonstrated superior to that of A-2019, whereas A-2019 has an additional capability to target CD20 in cells missing CD19, suggesting its potential function against CD19 weak or negative CD20 positive leukemic cells.

Absorbable Hemostatic Material with High Water Absorption Based on Polysaccharide / 中国医疗器械杂志

An absorbable hemostatic material based on polysaccharide was prepared. The concentration of blood cells and coagulation factors was increased by reducing the water content in the blood, so as to reduce the coagulation time and achieve the purpose of rapid hemostasis. The specific surface area of starch was increased by using hydrochloric acid to hydrolyze potato starch, which made it easier to combine with α-amylase and increased the degradation rate. Starch was crosslinked into microspheres by crosslinking agent, which made the particle size uniform and greatly improved the water absorption. The surface modification of crosslinked starch microspheres with carboxymethyl group can further improve the water absorption of hemostatic materials. The results showed that the water absorption rate of our hemostatic material was more than 800%, and the average hemostatic time in the animal model was 138.7s. Compared with the imported products on the market, our hemostatic material have better hemostatic performance.

Association of miR-146a rs2910164 G/C polymorphism with its abnormal expression and risk of gastric cancer / 中华医学遗传学杂志

OBJECTIVE@#To assess the influence of rs2910164 G/C single nucleotide polymorphism (SNP) of the miR-146a gene on its expression and susceptibility to gastric cancer.@*METHODS@#Fifty three gastric cancer patients and six gastric cancer cell lines were selected for determining the miR-146a expression by Taqman quantitative PCR. A model was constructed to assess the influence of miR-146a overexpression on the growth of AGS gastric cancer cells. A case-control study involving 417 gastric cancer patients and 420 cancer-free individuals was then conducted, and the allelic and genotypic frequencies of the rs2910164 G/C SNP were compared. The genotypes of all subjects were determined by using a Taqman allelic discrimination assay. A Taqman assay was also used to quantify mature and pri-miR-146a transcripts among 65 gastric cancer patients with known genotypes.@*RESULTS@#The expression of miR-146a was down-regulated among the 53 gastric cancer patients and six gastric cancer cell lines. Over-expression of miR-146a has suppressed the growth of gastric cancer by inhibiting the G1/S-phase transition of AGS cells. The case-control study showed that subjects with GC/CC genotypes had significantly lower risk for gastric cancer compared with those with GG genotype. In addition, miR-146a G/C SNP has significantly increased the level of mature miR-146a in those with GC/CC genotype compared with GG genotype.@*CONCLUSION@#Down-regulation of miR-146a may play an important role in the pathogenesis of gastric cancer. The rs2910164 polymorphism of the miR-146a gene may reduce the risk of gastric cancer by influencing the processing of mature miR-146a.

Clinical status and related factors of subclinical hypothyroidism in patients with abnormal glucose metabolism / 公共卫生与预防医学

Objective To analyze the clinical situation and related factors of subclinical hypothyroidism in patients with abnormal glucose metabolism, and to provide theoretical basis for the prevention and treatment of subclinical hypothyroidism in patients with abnormal glucose metabolism. Methods A total of 428 patients with abnormal glucose metabolism who were treated in the Department of Endocrinology of Tianmen First People's Hospital from March 2018 to March 2020 were selected, and serum FT3, FT4 and TSH levels were determined by automatic immune analysis system. Automatic analyzer was used to measure the levels of FBG, HbA1c, TC, TG, LDL-C and UA. A self-made questionnaire was used to investigate the basic information of all subjects, including gender, age, abnormal course of glucose metabolism, BMI and blood pressure. The survey method was combined with telephone inquiry and field investigation. Logistic regression was used to analyze the independent risk factors for subhypothyroidism in patients with abnormal glucose metabolism. Results Among 428 patients with abnormal glucose metabolism, 89 patients were accompanied by subclinical hypothyroidism, including 39 males and 43 females, with an average age of (45.12±8.13) years. The prevalence of subhypothyroidism in females was higher than that in males, and the difference was statistically significant (χ2=4.353 , P0.05). The serum TSH level in experimental group was significantly higher than that in control group (P<0.05). Univariate analysis showed statistically significant differences in age, gender, abnormal course of glucose metabolism, BMI, BMI, FBG, HbA1c, UA, TC, LDL-C and SBP between the two groups (P<0.05). Logistic regression analysis showed that old age, high levels of FBG, TC, SBP and UA were independent risk factors for subclinical hypothyroidism in patients with abnormal glucose metabolism (P<0.05). Conclusion The incidence rate of patients with abnormal glucose metabolism complicated with subclinical hypothyroidism is high. The biochemical indexes such as blood glucose, blood lipid, blood pressure and uric acid should be monitored regularly. The early regulation of glucose metabolism disorder is an effective way to prevent and treat subclinical hypothyroidism.

Evaluating the effect of flipped classroom combined with TBL by DOPS in clinical practice teaching for interns in ophthalmology / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the effect of flipped classroom combined with team-based learning(TBL)in ophthalmology practice teaching by applying directly observed procedural skills(DOPS). METHODS: A total of 54 students of clinical medicine “5+3” integration and clinical medicine for five years, interned at the department of ophthalmology from June 15th to November 14th, 2021 were divided into traditional teaching group(group A)and flipped classroom combined with TBL group(group B). The teaching effects of slit lamp microscopy and direct ophthalmoscopy in group A and group B were compared by DOPS score, and Mann-Whitney U test was used for statistical analysis.RESULTS: Total DOPS score for slit-lamp microscopy in group A was 59(58.00, 60.00)points,which was significantly lower than that of group B 63(61.00,65.00)points(P&#x003C;0.001). The DOPS score for direct ophthalmoscopy in group A was 63(61.00, 63.75)points, which was significantly lower than that of group B, 66(63.75,66.25)points(P&#x003C;0.001). In the two operations and especially in the aspects of “understanding of complications,relevant anatomical structure and proficiency in operation”“preparatory work” and “technical ability of operation”, the scores of group B was significantly higher than those of group A(P&#x003C;0.05).CONCLUSION: Flipped classroom combined with TBL has significant advantages in clinical practice teaching for interns in ophthalmology, which is worthy of promotion and application compared with traditional teaching.

Comparison of myopia progression in anisometropic children on the effect of orthokeratology with different degrees of unilateral myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the progress of binocular myopia with orthokeratology lens in different degrees of unilateral myopia in anisometropic children for 1a.METHODS:Retrospective case-control study. The data of 60 unilateral myopic anisometropia children, 8-12-year-old patients who fitted with orthokeratology lens in Xi'an No.1 Hospital from June 2018 to June 2019 were collected. The binocular spherical equivalent(SE)difference ≥2.5D was found in 30 cases in the high anisometropia group, and 1.0D≤ binocular SE difference &#x003C;2.5D was found in 30 cases of the low anisometropia group. The patients in the two groups were observed and compared after wearing lens for 6mo and 1a of the changes of binocular axial length(AL)and SE without-lens eyes.RESULTS: At the follow-up at 6mo and 1a, the growth of AL in the high anisometropia group with orthokeratology lens was less than that in the low anisometropia group(P&#x003C;0.001). The amount of growth of AL without-lens eyes and the growth of SE were greater than that in the low anisometropia group(all P&#x003C;0.001), and the shortening range of the binocular AL in the high anisometropia group was greater than that in the low-degree anisometropia group(P&#x003C;0.05). The correlation analysis showed that the anisometropia and the shortening of axial difference were correlated(F=0.293, 0.458, all P&#x003C;0.001).CONCLUSION: In anisometropia children with unilateral myopia, after wearing the orthokeratology lens, the progression in high anisometropia group was slower than low anisometropia after wearing the orthokeratology lens, but the progression of AL without-lens eyes and SE was faster than low anisometropia. Wearing orthokeratology lens can effectively reduce anisometropia, and the greater degree of the anisometropia the more binocular axial difference was narrowed, the more binocular axial difference was narrowed.

Anti-tumor Effect of Oxymatrine on Non-small Cell Lung Cancer Cell Lines and Its Mechanism / 中国实验方剂学杂志

Objective:To investigate the effects of oxymatrine（OM） on proliferation，migration， and invasion of non-small cell lung cancer（NSCLC） A549 and H1299 cells and to explore the possible mechanism. Method:A549 and H1299 cells were treated by OM of different concentrations（0， 1.0，2.0，4.0，8.0，16.0， 32.0， and 64.0 mmol·L^-1） and the cell viability was detected by cell counting kit-8 （CCK-8） assay. Transwell invasion and wound healing assays were applied to determine the effect of OM of different concentrations （8.0，16.0， and 32.0 mmol·L^-1） on the invasion and migration of A549 and H1299 cells. Western blot was adopted to detect the changes in the expression of proteins related to the Notch signaling pathway after the treatment by OM of different concentrations （8.0，16.0， and 32.0 mmol·L^-1）. Result:Compared with the control，OM could inhibit the proliferation （<italic>P</italic><0.05，<italic>P</italic><0.01） and hinder the cell invasion and migration of A549 and H1299 cells （<italic>P</italic><0.01） in a dose-dependent manner. The results of Western blot showed that OM（32.0 mmol·L^-1） could effectively counteract the expression levels of Notch1 intracellular domain（NICD），transcriptional complex proteins ［TNF-alpha converting enzyme（TACE） and recombining binding protein suppressor of hairless（RBPSUH）］， and Hes family hairy and enhancer of split 1（Hes1） in A549 and H1299 cells. Conclusion:OM was capable of inhibiting the proliferation，migration， and invasion of A549 and H1299 cells and also hindering the expression of proteins related to Notch signaling pathway.

Anti-tumor Effect of Piceatannol on Triple Negative Breast Cancer Cell Line MDA-MB-468 and Its Mechanism / 中国实验方剂学杂志

Objective:To investigate the effect of piceatannol （PIC） on the proliferation， apoptosis and cell cycle of MDA-MB-468 triple negative breast cancer cells and its mechanism. Method:The methylthiazolyldiphenyl-tetrazoliu bromide （MTT） colcorimetry method was used to investigate the effect of different concentrations of PIC （0， 2.5， 5.0， 10.0， 20.0， 40.0， 80.0， 160.0 μmol·L^-1） on the cell viabilities of triple negative breast cancer MDA-MB-468 cells and calculate the half maximal inhibitory concentration （IC₅₀） value， the effect of different concentrations of PIC （5.0， 10.0， 20.0 μmol·L^-1） on the cell cycle of MDA-MB-468 were investigated by flow cytometry with propidium iodide （PI） staining. The apoptotic effect of PIC （5.0， 10.0， 20.0 μmol·L^-1） on MDA-MB-468 cells in triple negative breast cancer was investigated by flow cytometry with cell apoptosis detection Annexin V-FITC and PI double staining. Western blot was used to investigate the effect of different concentrations of PIC （5.0， 10.0， 20.0 μmol·L^-1） on the proliferation and apoptosis of MDA-MB-468 cells and detect the expressions ofsecreted glycoprotein Wnt/<italic>β</italic>-catenin pathway related proteins. Result:MTT results showed that compared with the blank group， PIC could inhibit the proliferation of MDA-MB-468 cells in a concentration-dependent manner （<italic>P</italic><0.05， <italic>P</italic><0.01）， with IC₅₀ at（39.4±4.6）μmol·L^-1. Compared with the blank group， PIC could increase the percentage of MDA-MB-468 cells in G₀/G₁ phase about cell cycle in a concentration-dependent manner （<italic>P</italic><0.01）. Compared with the blank group， 5.0， 10.0， 20.0 μmol·L^-1 PIC could induce apoptosis of MDA-MB-468 cells for 48 h（<italic>P</italic><0.01）， and the apoptosis rate of MDA-MB-468 cells reached 49.87% when treated with 20.0 μmol·L^-1 for 48 h. Compared with the blank group， PIC could significantly reduce the expressions of <italic>β</italic>-catenin， proto-oncogene （C-myc） and adhesion factor （CD44） proteins in MDA-MB-468 cells， significantly inhibit the phosphorylation of<italic> </italic>protein kinase B （Akt） and p38 mitogen activated protein kinase （p38 MAPK） proteins and the protein expression of B lymphocyte tumor-2 （Bcl-2）， and enhance cysteine aspartic acid protease-3 （Caspase-3）， Bcl-2 related X protein （Bax） and phosphorylated <italic>β</italic>-catenin protein expression（<italic>P</italic><0.01）. Conclusion:PIC may inhibit the proliferation of MDA-MB-468 cells by inhibiting the Wnt/<italic>β</italic>-catenin signaling pathway， block the cell cycle in G0/G1 phase， and induce its apoptosis.