Experience in Diagnosis and Treatment of Oculomotor Nerve Palsy based on Channel Pattern Differentiation / 中医杂志

It is believed that the basic pathogenesis of oculomotor nerve paralysis （ONP） is qi and blood depletion and channel obstruction. Taking channel pattern differentiation as the core， it is recommended to use acupuncture mainly based on location， syndrome and channel deficiency-excess differentiation. Location and channel tropism differentiation mainly follows the principle of “where the channels and collaterals pass， the main treatment can reach”， and commonly uses acupuncture points on Dumai （督脉）， the hand Shaoyang （少阳） Sanjiao （三焦） channel， the hand Taiyang （太阳） small intestine channel， three yang channels of the foot， the hand Shaoyin （少阴） heart channel， the foot Jueyin （厥阴） liver channel， and others， and combines scalp acupuncture with electro-acupuncture to enhance channel stimulation. Pattern and channel tropism differentiation is to differentiate the entered channel according to clinical symptoms and zang-fu patterns. The differentiation of deficiency-excess should be payed attention to， and the principle of “supplementing the deficiency， and draining the excess” should be followed. The supplementing and draining method should be used rationally by considering the differences in the supplementing and draining acupoints themselves， as well as the actual condition of the patients. Simultaneously， it is suggested to combine manipulation and stimulation amount and effect in clinical practice.

Establishment of rat model of dysphagia after stroke by thread embolism / 中国康复理论与实践

ObjectiveTo explore a feasible animal model of dysphagia after stroke. MethodsTwenty-two clean Sprague-Dawley rats were randomly divided into normal group (n = 11) and model group (n = 11). The model of dysphagia after stroke was established by the thread embolism, and the normal group received no intervention. The latency of the first swallowing attack and the number of swallowing were recorded three and seven days after modeling. The cerebral infarction was detected by TTC staining, and the neuronal apoptosis in ischemic brain was detected by TUNEL fluorescence staining. ResultsCompared with the normal group, the swallowing latency prolonged and the number of swallowing reduced three days in the model group, however, there was no significant difference (P > 0.05); seven days after modeling, the swallowing latency prolonged (P < 0.05), and the number of swallowing slightly reduced with little significant difference (P > 0.05). Compared with the normal group, the brain tissue showed obvious infarction area and a large number of apoptotic cells, while the body mass reduced in the model group (P < 0.05). ConclusionThe model rats express some features of dysphagia, which may become a transformation model of dysphagia after stroke.

Peripheral retinopathy under intraoperative optical coherence tomography / 中华眼底病杂志

Objective:To observe the histopathological changes in peripheral retinal lesions under intraoperative optical coherence tomography (iOCT).Methods:A retrospective case series study. Eighty-eight patients (194 eyes) who underwent vitreoretinal surgery in the Department of Ophthalmology at the East Ward of the First Affiliated Hospital of Zhengzhou University from October 2021 to May 2022 in 94 eyes were included in the study. Among them, 49 cases were male and 39 cases were female, with the mean age of (50.93±17.55) years. Ninety-four eyes included 32 eyes with retinal detachment, 6 eyes with proliferative diabetic retinopathy, 28 eyes with vitreous hemorrhage, 8 eyes with ocular trauma, 14 eyes with the macular lesion, 1 eye with uveitis, 1 eye with family exudative vitreoretinopathy (FEVR), 1 eye with acute retinal necrosis (ARN), and 3 eyes with lens dislocation. All affected eyes were examined with iOCT during vitreoretinal surgery. The iOCT scanning of the peripheral retina was performed with the help of episcleral pressure. The pre-equatorial and serrated edge anterior and posterior of retinas were scanned according to the characteristics of different fundus diseases. Various abnormal fundus manifestations were recorded.Results:In 94 eyes, 53 eyes (56.38%, 53/94) have different types of retinopathy in the peripheral retina. Of these, 7 eyes (7.45%) have retinal cystoid degeneration; 19 eyes (20.21%) have lattice degeneration; and 8 eyes (8.51%) have pigment degeneration; 9 eyes (9.57%) have pavement-like degeneration; 7 eyes (7.45%) have small occult holes; 1 eye (1.06%) has familial exudative vitreoretinopathy (FEVR) serrated edge "dyke-like" proliferative degeneration; 4 eyes (4.26%) have vitreous and retinopathy adhesions; and one eye (1.06%) has ARN.Conclusion:With clear refractive media, iOCT can provide clear scans of different peripheral retinal lesions.

Standard for monitoring and evaluation of two-dimensional- and three-dimensional-transesophageal echocardiography during transcatheter tricuspid valve replacement / 中华超声影像学杂志

Transcatheter tricuspid valve intervention is the new frontier of interventional cardiology. The LuX-Valve is a radial force-independent orthotopic tricuspid valve replacement device developed in China. The LuX-Valve Plus transcatheter tricuspid valve replacement (TTVR) system is changed from the trans-atrial to the transjugular approach, which further reduces trauma and pulmonary complications compared with the first generation LuX-Valve. The first-in-human study has been completed at Zhongshan Hospital, Fudan University and an exploratory multicentre clinical study is underway. Echocardiography plays an important role in pre-TTVR screening, intraoperative guidance and postoperative evaluation and follow-up, especially two-dimensional transoesophageal echocardiography (2D-TEE) and three-dimensional transoesophageal echocardiography (3D-TEE). However, there is a lack of appropriate intraoperative guidance and assessment protocols. In this study, we briefly described the protocols and imaging considerations for intraoperative 2D-TEE and 3D-TEE to ensure the successful implantation of TTVR.

Advances in the genetics of pediatric chronic intestinal pseudo-obstruction / 国际儿科学杂志

Chronic intestinal pseudo-obstruction is a serious intestinal dysmotility disorder with symptoms of bowel obstruction without mechanical obstruction.Compared with chronic intestinal pseudo-obstruction in adults, pediatric chronic intestinal pseudo-obstruction has unique clinical characteristics.Generally, 80% of pediatric chronic intestinal pseudo-obstruction cases are primary and idiopathic and there is no specific treatment, and management is mainly symptomatic.With the advancements in genetic testing, new findings have been identified, allowing for a better understanding of the underlying mechanisms of intestinal dysmotility and potential etiologies.This article reviews the genetic research progress of pediatric chronic intestinal pseudo-obstruction in recent years, introduces the pathological mechanism and clinical characteristics, and summarizes the pearls of diagnosis and treatment.

Associations between various lipid components and premature myocardial infarction: a cross-sectional study / 中华心血管病杂志

Objective: Hyperlipidemia is closely related to premature acute myocardial infarction (AMI). The present study was performed to explore the correlation between various blood lipid components and the risk of premature AMI. Methods: This is a cross-sectional retrospective study. Consecutive patients with acute ST-segment elevation myocardial infarction (STEMI), who completed coronary angiography from October 1, 2020 to September 30, 2022 in our hospital, were enrolled and divided into premature AMI group (male<55 years old, female<65 years old) and late-onset AMI group. Total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), non-HDL-C, lipoprotein (a) (Lp (a)), apolipoprotein B (ApoB), apolipoprotein A-1 (ApoA-1), non-HDL-C/HDL-C and ApoB/ApoA-1 were analyzed. The correlation between the above blood lipid indexes and premature AMI was analyzed and compared by logistic regression, restricted cubic spline and receiver operating characteristic curve (ROC). Results: A total of 1 626 patients with STEMI were enrolled in this study, including 409 patients with premature AMI and 1 217 patients with late-onset AMI. Logistic regression analysis showed that the risk of premature AMI increased significantly with the increase of TG, non-HDL-C/HDL-C, non-HDL-C, ApoB/ApoA-1, TC and ApoB quintiles; while LDL-C, ApoA-1 and Lp (a) had no significant correlation with premature AMI. The restricted cubic spline graph showed that except Lp (a), LDL-C, ApoA-1 and ApoB/ApoA-1, other blood lipid indicators were significantly correlated with premature AMI. The ROC curve showed that TG and non-HDL-C/HDL-C had better predictive value for premature AMI. Inconsistency analysis found that the incidence and risk of premature AMI were the highest in patients with high TG and high non-HDL-C/HDL-C. Conclusion: TG, non-HDL-C/HDL-C and other blood lipid indexes are significantly increased in patients with premature AMI, among which TG is the parameter, most closely related to premature AMI, and future studies are needed to explore the impact of controlling TG on incidence of premature AMI.

Content determination of 5-HMF in glucosamine hydrochloride tablets and formation kinetics study / 中国药房

OBJECTIVE To establish the method for the content determination of 5-hydroxymethylfurfural （5-HMF） in glucosamine hydrochloride tablets， and to analyze its regularity and influential factors. METHODS Quantitative analysis of 5-HMF was performed using high-performance liquid chromatography. The analysis was conducted on Shim-pack GIST C18-AQ column with mobile phase consisted of 0.1% phosphoric acid solution-methanol （90∶10， V/V） at the flow rate of 1.0 mL/min. The column temperature was 30 ℃， and detection wavelength was 284 nm. The injection volume was 20 μL. Reaction kinetics test of different temperatures was adopted to analyze the relationship of 5-HMF content with reaction temperature and reaction time， and utilized to build its formation kinetic model. RESULTS The linger range of 5-HMF was 0.057-5.698 μg/mL （r＝0.999 9）. The limits of detection and quantitation were 5.70 and 17.09 ng/mL； RSDs of precision， repeatability and stability （24 h） tests were all lower than 1.0% （n＝6）. The average recoveries ranged from 99.38% to 99.73%（RSD＝0.53%， n＝9）. The contents of the 5-HMF in 8 batches of samples ranged 4.10-35.13 μg/g. Results of data fitting in reaction kinetics test showed that the higher reaction temperature and the longer reaction time， the higher 5-HMF content in the sample. At 50， 60， 70 and 80 ℃ ， the relationship between the content of 5-HMF and the reaction time was linear， in accordance with a zero-order kinetic model. The reaction rate constants were 6.789， 7.715， 8.815 and 11.430， respectively. CONCLUSIONS The established method has strong specificity， high sensitivity， and good accuracy； the reaction temperature and reaction time are important influential factors for the formation of 5-HMF in glucosamine hydrochloride tables. The change rule of its content conforms to the zero-order kinetic model.

Association between low ambient temperature during pregnancy and adverse birth outcomes: A systematic review and meta-analysis / 中华医学杂志(英文版)

BACKGROUND@#Extreme temperature events, including extreme cold, are becoming more frequent worldwide, which might be harmful to pregnant women and cause adverse birth outcomes. We aimed to investigate the association between exposure to low ambient temperature in pregnant women and adverse birth outcomes, such as preterm birth, low birth weight, and stillbirth, and to summarize the evidence herein.@*METHODS@#Relevant studies were searched in PubMed, Cochrane, and Embase electronic databases until November 2021. Studies involving low ambient temperature, preterm birth, birth weight, and stillbirth were included. The guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses were followed to conduct this study risk of bias and methods for data synthesis.@*RESULTS@#A total of 34 studies were included. First, pregnant women exposed to low ambient temperature had an increased risk of preterm birth (risk ratio [RR] 1.08; 95% confidence interval [CI] 1.04-1.13). Subgroup analyses revealed that exposure during late pregnancy was more likely to induce preterm birth. In addition, only pregnant women exposed to <1st percentile of the mean temperature suffered increased risk of preterm birth. Moreover, pregnant women living in medium or hot areas were more prone to have preterm births than those in cold areas when exposed to low ambient temperatures. Asians and Blacks were more susceptible to low ambient temperatures than Caucasians. Second, pregnant women exposed to low ambient temperature had an increased risk of low birth weight (RR 1.07; 95% CI 1.03-1.12). Third, pregnant women had an increased risk of stillbirth while exposed to low ambient temperature during the entire pregnancy (RR 4.63; 95% CI 3.99-5.38).@*CONCLUSIONS@#Exposure to low ambient temperature during pregnancy increases the risk of adverse birth outcomes. Pregnant women should avoid exposure to extremely low ambient temperature (<1st percentile of the mean temperature), especially in their late pregnancy. This study could provide clues for preventing adverse outcomes from meteorological factors.@*REGISTRATION@#No. CRD42021259776 at PROSPERO ( https://www.crd.york.ac.uk/PROSPERO/ ).

Thoughts on Digital Inheritance of Experiences of Famous and Veteran Physicians of Traditional Chinese Medicine / 中医杂志

@#The experience of famous and veteran physicians in traditional Chinese medicine （TCM） is a supplement to the cognition of industry groups and a high-quality learning resource. Digital inheritance of the experience of famous and veteran TCM physicians refers to the use of digital technology to record， organize， protect， spread， share and innovate the knowledge， skills and experiences of famous and veteran TCM physicians， which helps to overcome the inefficiency of traditional experience inheritance and realize the inheritance and development of TCM culture. Digital inheritance has certain advantages in accessibility， loss resistance， accuracy， innovation ability and effectiveness， which can assist the digital preservation， analysis and excavation of the experience of famous and veteran TCM physicians， and is an important supplement to the traditional way of learning from teachers. Digital inheritance is usually divided into the following steps： building a database of TCM knowledge， building a database of experienced medical records of famous and veteran TCM physicians， discovering laws by data mining， and assisting clinical decision-making with machine learning. The digital inheritance of famous and veteran TCM physicians is not only the use of experience information， but also the process of innovation and productization based on experience， which may become a new service model of TCM diagnosis and treatment.

Thoughts on Digital Inheritance of Experiences of Famous and Veteran Physicians of Traditional Chinese Medicine / 中医杂志

The experience of famous and veteran physicians in traditional Chinese medicine （TCM） is a supplement to the cognition of industry groups and a high-quality learning resource. Digital inheritance of the experience of famous and veteran TCM physicians refers to the use of digital technology to record， organize， protect， spread， share and innovate the knowledge， skills and experiences of famous and veteran TCM physicians， which helps to overcome the inefficiency of traditional experience inheritance and realize the inheritance and development of TCM culture. Digital inheritance has certain advantages in accessibility， loss resistance， accuracy， innovation ability and effectiveness， which can assist the digital preservation， analysis and excavation of the experience of famous and veteran TCM physicians， and is an important supplement to the traditional way of learning from teachers. Digital inheritance is usually divided into the following steps： building a database of TCM knowledge， building a database of experienced medical records of famous and veteran TCM physicians， discovering laws by data mining， and assisting clinical decision-making with machine learning. The digital inheritance of famous and veteran TCM physicians is not only the use of experience information， but also the process of innovation and productization based on experience， which may become a new service model of TCM diagnosis and treatment.

An investigation and analysis on multidimensional health status of the rural elderly in Shandong / 中华老年医学杂志

Objective:To evaluate and analyze the health status of the elderly from physical health, mental health and social health, so as to understand the health status and health service needs of rural elderly.Methods:A total of 263 elderly people aged 60 years and over(mean aged 70.9±7.9 years, 113 males and 150 females, 125 aged 60-69 years, 98 aged 70-79 years and 40 aged 80 years and over)in Nanwangkong Village, Shaozhuang Town, Qingzhou City, Weifang City, Shandong Province were selected by cluster sampling method.The physical, mental, social and overall health status of the elderly were comprehensively evaluated and analyzed by self-designed questionnaire.Results:The overall health rate was 30%(79 cases), and the physical health, mental health and social health rates were 73.8%(194 cases), 84.0%(221 cases)and 34.6%(91 cases), respectively, in rural elderly in this area.The physical health was better in males than in females in 80~ years old groups( χ2=5.736, P<0.05). The overall health was better in males than in females in the total age group and the 60~69 years old groups( χ2=7.468 and 11.116, both P<0.01). The proportions of unhealthy, basic healthy and healthy people in the overall and the dimensions of physical health, mental health and social health had significant differences in the 60~69, 70~79 and 80~ years old groups( χ2=40.590, 29.342, 18.503 and 27.615, all P<0.01), and the Chi-square test for trend showed that there was a statistically significant downward trend of overall health grade distribution with age( χ2=21.994, 12.831, 16.570 and 22.595, both P<0.01). Conclusions:In this study, 30.0% of the rural elderly were considered healthy, 48.3% were basically healthy, and 21.7% were unhealthy.The health status of the elderly gradually deteriorates with age.The government should strengthen the multidimensional health assessment of the rural elderly and provide the comprehensive health guidance services and targeted interventions for the elderly in terms of disease control, psychological counseling and social participation.

Characteristic and prognosis of patients with non-EBV infection-associated hemophagocytic lymphohistiocytosis / 中华血液学杂志

Objective: To explore the clinical characteristics and outcomes of patients with non-Epstein-Barr virus (EBV) infection-associated hemophagocytic lymphohistiocytosis (IAHLH) . Methods: Clinical data of 48 patients diagnosed with non-EBV IAHLH in Beijing Friendship Hospital from January 2015 to March 2021 were collected, and the clinical characteristics, treatment, curative effect and prognosis of the patients were analyzed retrospectively. Results: This study included 48 patients, 28 males and 20 females, with a median (range) age of 34.5 (2-74) years. Pathogens that cause IAHLH were as follows: virus (16 cases, 33.3%) , bacteria (17 cases, 35.4%) , parasitic agents (13 cases, 27.1%) , and fungi (2 cases, 4.2%) . The median time from onset to diagnosis of hemophagocytic syndrome (HLH) was 40 (10-160) days. The median (range) time duration from prodrome to the definite diagnosis of IAHLH was 67 (23-270) days. The clinical characteristics were fever (48 cases, 100%) , splenomegaly (34 cases, 70.8%) , cytopenia (38 cases, 79.1%) , elevated ferritin (45 cases, 93.8%) , elevated fasting triglyceride levels (7 cases, 14.6%) , hypofibrinogenemia (17 cases, 35.4%) , decrease natural killer cell activity (26 in 44 cases, 59.1%) , and elevated sCD25 (35 cases, 74.5%) . Twenty-five patients (52.1%) had adenopathy. Once a certain pathogen was identified as the causative factor of hemophagocytic lymphohistiocytosis (HLH) , cytotoxic agents and glucocorticoids were withdrawn, and specific pathogen-directed treatment was initiated. After treatment, 36 cases (75.0%) achieved complete response, and 14 of 15 patients (93.3%) with parasitic and fungal HLH got a response; however, the response rate of patient with bacterial and viral HLH was only 66.7% (22 of 33 patients) . The estimated 5-year overall survival rate was 72.3% (95%CI 50.3%-69.8%) . The adverse prognostic factors were total bilirubin over the upper limit of normal (OR=20.0, 95%CI 1.1-378.3, P=0.046) and pathogenic infection not fully controlled (OR=19.9, 95%CI 2.9-134.5, P=0.002) . Conclusion: Non-EBV IAHLH has a good prognosis. When diagnosed, cytotoxic agents and glucocorticoids should be tapered off, and pathogen-targeted therapy should be critically administered to clear the triggering infection.

Cloning, induction pattern and prokaryotic expression of a small heat shock protein SmHSP21.8 gene from Salvia miltiorrhiza / 药学学报

In order to reveal the molecular mechanism of the small heat shock proteins (sHSPs) involved in stress resistance and active ingredients accumulation in Salvia miltiorrhiza, a small heat shock protein gene was cloned from Salvia miltiorrhiza by reverse transcription PCR according to the transcriptome data of orange root Salvia miltiorrhiza. The gene is named SmHSP21.8 based on the molecular weight of the protein, and it contains an open reading frame of 585 bp, which encodes 194 amino acids. The results of phylogenetic analysis and amino acid sequence alignment showed that SmHSP21.8 protein belongs to the endoplasmic reticulum (ER) subfamily, and contains a conserved endoplasmic reticulum-specific DPFR-I/V-LE-H/Q-x-P motif at N-terminus. The prokaryotic expression vector pMAL-c2X-SmHSP21.8 was constructed and transformed into E. coli BL21 competent cells. The recombinant protein was successfully expressed after inducted. Temporal and spatial expression analysis showed that SmHSP21.8 gene was the highest expressed in flowers and had significant tissue specificity. The relative expression of the gene was significantly increased in seedlings after induction by 38 ℃, PEG6000, abscisic acid(ABA), and indole-3-acetic acid (IAA), indicating that SmHSP21.8 gene may be involved in abiotic stress such as high temperature and drought, as well as the response to exogenous hormones ABA and IAA. These results lay the foundation for further research on the molecular mechanism of small heat shock proteins involved in adversity stress.

Targeting glutamine utilization to block metabolic adaptation of tumor cells under the stress of carboxyamidotriazole-induced nutrients unavailability

Tumor cells have unique metabolic programming that is biologically distinct from that of corresponding normal cells. Resetting tumor metabolic programming is a promising strategy to ameliorate drug resistance and improve the tumor microenvironment. Here, we show that carboxyamidotriazole (CAI), an anticancer drug, can function as a metabolic modulator that decreases glucose and lipid metabolism and increases the dependency of colon cancer cells on glutamine metabolism. CAI suppressed glucose and lipid metabolism utilization, causing inhibition of mitochondrial respiratory chain complex I, thus producing reactive oxygen species (ROS). In parallel, activation of the aryl hydrocarbon receptor (AhR) increased glutamine uptake via the transporter SLC1A5, which could activate the ROS-scavenging enzyme glutathione peroxidase. As a result, combined use of inhibitors of GLS/GDH1, CAI could effectively restrict colorectal cancer (CRC) energy metabolism. These data illuminate a new antitumor mechanism of CAI, suggesting a new strategy for CRC metabolic reprogramming treatment.

Mastication efficiency among stroke survivors with dysphagia / 中华物理医学与康复杂志

Objective:To compare the effect of age and gender on mastication efficiency between healthy volunteers and dysphagic stroke survivors and to document any correlation of mastication efficiency with mandible movements.Methods:Thirty-two stroke survivors with dysphagia and 84 healthy volunteers were asked to chew two-color gum. Their chewing efficiency was indicated by the degree of color mixing after chewing (SDHue). The SDHue value was evaluated using ViewGum software. The healthy volunteers were further divided into an age 20-40 years group, a 41-60 years group and an over-60 group. The SDHue values were compared among the 3 groups. The SDHue values were correlated with clinical mandibule movement scores.Results:Among the healthy volunteers, those older than 60 years had significantly higher SDHue values on average than those between 20 and 40 years. However, no significant gender difference was observed. The dysphagic stroke survivors had, on average, significantly higher SDHue results than the healthy volunteers, and those results were positively correlated with their mandible movement scores.Conclusions:Mastication efficiency tends to be age-related but not gender-related. Among those with post-stroke dysphagia mandible movement is positively correlated with mastication efficiency.

Investigation and analysis on multidimensional health status of elderly residents in the Meiyuan community, Beijing / 中华老年医学杂志

Objective:To evaluate and analyze elderly health on the physical, psychological and social dimensions, so as to understand the health status and care needs of community-dwelling elderly residents.Methods:A cross-sectional study was carried out in the Meiyuan community, Malianwa Street, Haidian District of Beijing during July 22 to August 26, 2021.A total of 404 people aged 60 and above(70.6±8.6 years old)including 169 men and 235 women were enrolled through cluster sampling.All information about community-dwelling elderly residents was collected with face-to-face interviews and a standardized structured questionnaire for the evaluation and analysis of their physical, mental, social and overall health.Results:The rate of overall healthy residents was 21.3%(86), and the rates of physically, mentally and socially healthy residents were 66.8%(270), 86.6%(350) and 24.3%(98), respectively, in this community.There was a sex difference in social health in the whole group( χ2=9.008, P=0.011)and a higher proportion of men than women were considered generally healthy( χ2=8.963, P=0.003). People in the three age groups(224 in the 60-69 group, 109 in the 70-79 group and 71 in the ≥80 group)showed statistically significant differences in overall, physical, mental and social health( χ2=18.473, 61.186, 43.026 and 18.310, P<0.001), which declined with increasing age( χ2=13.172, 23.515, 26.806 and 10.068, P<0.001 or 0.01). Conclusions:s The overall healthy rate is not high among community-dwelling elderly residents in Beijing.The health status of the elderly gradually deteriorates with age.Health assessment for the elderly should be emphasized and targeted health education and prevention should be provided to promote disease prevention and mental health.

Development of a set of indexes for the assessment of healthy older Chinese adults / 中华老年医学杂志

Objective:To develop a set of indexes for the assessment of healthy older adults in China, in order to provide a reference and basis for developing aging-related national policies, standardizing and guiding health management services for the elderly.Methods:A set of indexes for the assessment of healthy older adults in China was established based on a literature review, expert discussions, 2 rounds of Delphi surveys, expert consultations and a cross-sectional study assessing the indexes.Results:The positive coefficients for 2 rounds of expert consultations were 86.25%(69/80)and 94.52%(69/73), respectively.All surveyed experts(100%)specialized in the area of geriatric health and came from 22 provincial-level administrative regions in China.In the two rounds of consultations, the familiarity degree coefficients were 0.706-0.915 and 0.835-0.922, and the authority coefficients were 0.762-0.921 and 0.863-0.932, respectively.The mean importance scores of each index were 6.10-9.74 scores and 7.87-9.56 scores, with perfect score rates of 43%-99% and 75%-99%, respectively.The mean coefficients of variation(CV)were 0.19±0.05(0.07-0.34)and 0.16±0.03(0.10-0.21), respectively.The set of indexes for the assessment of healthy older Chinese adults covered multi-dimensions including physical health, mental health and social health, with 3 primary indexes, 11 secondary indexes and 17 tertiary indexes.Conclusions:The construction process of the set of indexes for the assessment of healthy Chinese adults was scientific and rigorous, and the panelists had a high level of agreement, strong authority and active participation.The set of indexes has comprehensive coverage and an inclusive framework, and indexes at each level are scientific and feasible.It can serve as a reference for the comprehensive assessment of health status of the elderly and for aging-related government policy formulation in the future.

Real-time monitoring and step-by-step guidance for transcatheter tricuspid annuloplasty using transesophageal echocardiography / 中华超声影像学杂志

Tricuspid regurgitation (TR) interventions are under rapid development. The K-Clip? system is the first domestic transcatheter tricuspid annuloplasty system with unique clamping procedure to achieve annular reduction.Intraoperative echocardiographic monitoring procedures for transcatheter tricuspid annuloplasty have not been reported yet in China. Thus, this review aimed to propose the standard two-dimensional and three-dimensional transesophageal echocardiographic workplanes and procedures to guide and monitor the implantation of K-Clip system based on our experience in Zhongshan Hospital, Fudan University to provide a reference point for the intraoperative echocardiographic monitoring of future transcatheter tricuspid annuloplasty devices in China.

Inhibitory effect of RMT1-10-induced tolerogenic dendritic cells in vitro on high-risk corneal allograft rejection in mice and its mechanism / 中华实验眼科杂志

Objective:To investigate the inhibitory effect of RMT1-10-induced tolerogenic dendritic cells (Tol-DCs) in vitro on high-risk corneal allograft rejection in mice and its mechanism. Methods:One hundred SPF male BALB/c mice and fifty SPF male C57BL/6 mice were selected.Bone marrow-derived immature dendritic cells (imDCs) obtained from C57BL/6 mice were divided into imDCs group, mature dentritic cells (mDCs) group, RMT1-10 group, and IgG isotype control group.The imDCs in the four groups were cultured with no intervention, lipopolysaccharide, RMT1-10 and lipopolysaccharide, or IgG isotype antibody and lipopolysaccharide for 7 days according to grouping.The expression levels of different phenotypes of DCs including CD11c, CD80, CD86, major histocompatibility complex (MHC)-Ⅱ, T cell immunoglobulin and mucin domain containing molecule (Tim)-4 and CD103 in the four groups were detected by flow cytometry.The concentrations of interleukin-10 (IL-10) and transforming growth factor-β (TGF-β) in the DCs supernatants were determined by enzyme-linked immunosorbent assay.A mixed lymphocyte culture system was established, and the stimulation index (SI) of CD4 + T cell proliferation stimulated with DCs was detected by cell counting kit 8 method.Corneal neovascularization was induced by corneal stromal suture in BALB/c mice, and the 80 mice with neovascularization in 4 quadrants growing into the middle and peripheral cornea were used as recipients.The recipient mice were randomized into imDCs group, mDCs group, RMT1-10 group, and IgG isotype control group using the random number table method, with 20 mice in each group.An injection of corresponding DCs (1×10 6 cells/100 μl) was administered to the recipient mice via the tail vein according to grouping.At 7 days following the injection, C57BL/6 mice were used as donors and penetrating keratoplasty was performed.Within one month after the operation, signs of corneal grafts rejection, including opacity, edema and neovascularization, were observed by slit lamp biomicroscopy and scored every day.At 21 days after the operation, 5 recipients selected from each group were subcutaneously injected with naive C57BL/6 splenocytes (1×10 6 cells/100 μl) behind the ear.The delayed type hypersensitivity (DTH) was evaluated by ear swelling at 24 hours after the subcutaneous injection.The use and care of experimental animals complied with the Regulations on the Management of Experimental Animals promulgated by the State Science and Technology Commission.This study protocol was approved by an Ethics Committee of the Affiliated Hospital of Chengde Medical University (No.CYFYLL2020055). Results:Compared with mDCs group, the expressions of CD80, CD86 and MHC-Ⅱ, and the percentage of Tim-4-positive cells in CD11c-positive cells were significantly decreased in RMT1-10 group, showing statistically significant differences (all at P<0.001). The percentage of Tim-4-positive cells were significantly decreased in RMT1-10 group than imDCs group, and the percentage of CD103-positive cells in RMT1-10 group was significantly higher than imDCs group, mDCs group and IgG isotype control group (all at P<0.001). The concentrations of IL-10 and TGF-β in the cell culture supernatant of RMT1-10 group were significantly higher than those of the other three groups, with statistically significant differences (all at P<0.001). There were statistically significant differences in the SI of CD4 + T cell proliferation simulated by DCs ( Fgroup=1 833.00, P<0.001; Fratio=230.40, P<0.001; Finteraction=3.06, P=0.01). The SI of DCs/CD4 + T cells ratio at 1∶5, 1∶10, 1∶20 and 1∶40 were all significantly lower in imDCs group than mDCs group, and were all significantly lower in RMT1-10 group than imDCs group (all at P<0.05). There was a statistically significant difference in corneal graft survival curve among various groups ( χ2=77.69, P<0.001). The survival rate of RMT1-10 group was significantly higher than that of imDCs group ( χ2=9.74, P=0.002), and the survival rate of imDCs group was significantly higher than that of mDCs group ( χ2=31.02, P<0.001). The ear swelling of recipient mice of positive control group, mDCs group, IgG isotype control group, imDCs group and RMT1-10 group was (503.6±17.2), (475.7±17.6), (456.2±18.8), (225.2±39.4), (118.1±12.6), and (106.4±7.4) μm, with a statistically significant difference among them ( F=377.10, P<0.001). The mice ear swelling was more serious in positive control group than mDCs group, more serious in IgG isotype control group than imDCs group, and more serious in imDCs group than RMT1-10 group (all at P<0.05). Conclusions:RMT1-10 can inhibit the rejection of high-risk corneal transplantation in mice, the mechanism of which may be attributed to inducing imDCs to transform into Tol-DCs in vitro and up-regulating the expression of TGF-β and IL-10, which promotes antigen-specific immune tolerance after adoptive transfer, thereby indirectly prolongs the survival of corneal grafts.

Research progress of respiratory microecology and bronchopulmonary dysplasia / 中华实用儿科临床杂志

Bronchopulmonary dysplasia (BPD) is a common respiratory disease in preterm infants.Infection, inflammation and oxidative stress are the main pathogenic mechanisms of BPD.Recent studies have shown that the colonization of pulmonary microorganisms begins from the perinatal period and dynamically changed by multiple factors.Respiratory microecology dysbiosis may trigger oxidative stress, inhibit the expression of miR-876-3p, change pulmonary metabolism and weaken local barrier function, thereby leading to the occurrence and progress of BPD.At the same time, abnormal pulmonary development and lung injury also exert impact on respiratory microecology, and the impact even lasts till adulthood.Probiotics have anti-inflammatory, anti-infection and antioxidant effects.Supplementation of probiotics may promote lung development and alleviate lung injury conditions by regulating respiratory microecology.In this article, the establishment and dynamic changes of neonatal respiratory microecology were elaborated, and the role of respiratory microecology in the pathogenesis, prevention and treatment of BPD was explored.