T Cells Trafficking into the Brain in Aging and Alzheimer's Disease.

The meninges, choroid plexus (CP) and blood-brain barrier (BBB) are recognized as important gateways for peripheral immune cell trafficking into the central nervous system (CNS). Accumulation of peripheral immune cells in brain parenchyma can be observed during aging and Alzheimer's disease (AD). However, the mechanisms by which peripheral immune cells enter the CNS through these three pathways and how they interact with resident cells within the CNS to cause brain injury are not fully understood. In this paper, we review recent research on T cells recruitment in the brain during aging and AD. This review focuses on the possible pathways through which T cells infiltrate the brain, the evidence that T cells are recruited to the brain, and how infiltrating T cells interact with the resident cells in the CNS during aging and AD. Unraveling these issues will contribute to a better understanding of the mechanisms of aging and AD from the perspective of immunity, and hopefully develop new therapeutic strategies for brain aging and AD.

Single-Shot Direct Transmission Terahertz Imaging Based on Intense Broadband Terahertz Radiation.

There are numerous applications of terahertz (THz) imaging in many fields. However, current THz imaging is generally based on scanning technique due to the limited intensity of the THz sources. Thus, it takes a long time to obtain a frame image of the target and cannot meet the requirement of fast THz imaging. Here, we demonstrate a single-shot direct THz imaging strategy based on a broadband intense THz source with a frequency range of 0.1~23 THz and a THz camera with a frequency response range of 1~7 THz. This THz source was generated from the laser-plasma interaction, with its central frequency at ~12 THz. The frame rate of this imaging system was 8.5 frames per second. The imaging resolution reached 146.2 µm. With this imaging system, a single-shot THz image for a target object with a size of more than 7 cm was routinely obtained, showing a potential application for fast THz imaging. Furthermore, we proposed and tested an image enhancement algorithm based on an improved dark channel prior (DCP) theory and multi-scale retinex (MSR) theory to optimize the image brightness, contrast, entropy and peak signal-to-noise ratio (PSNR).

Aberration of social behavior and gut microbiota induced by cross-fostering implicating the gut-brain axis.

The gut microbiota and neurological development of neonatal mice are susceptible to environmental factors that may lead to altered behavior into adulthood. However, the role that changed gut microbiota and neurodevelopment early in life play in this needs to be clarified. In this study, by modeling early-life environmental changes by cross-fostering BALB/c mice, we revealed the effects of the environment during the critical period of postnatal development on adult social behavior and their relationship with the gut microbiota and the nervous system. The neural projections exist between the ascending colon and oxytocin neurons in the paraventricular nuclei (PVN), peripheral oxytocin levels and PVN neuron numbers decreased after cross-fostering, and sex-specific alteration in gut microbiota and its metabolites may be involved in social impairments and immune imbalances brought by cross-fostering via the gut-brain axis. Our findings also suggest that social cognitive impairment may result from a combination of PVN oxytocinergic neurons, gut microbiota, and metabolites.

Aberrant Enhanced NLRP3 Inflammasomes and Cell Pyroptosis in the Brains of Prion-Infected Rodent Models Are Largely Associated with the Proliferative Astrocytes.

Neuroinflammation is a common pathological feature in a number of neurodegenerative diseases, which is mediated primarily by the activated glial cells. Nucleotide-binding oligomerization domain-like receptor pyrin domain-containing-3 (NLRP3) inflammasome-associated neuroinflammatory response is mostly considered. To investigate the situation of the NLRP3-related inflammation in prion disease, we assessed the levels of the main components of NLRP3 inflammasome and its downstream biomarkers in the scrapie-infected rodent brain tissues. The results showed that the transcriptional and expressional levels of NLRP3, caspase-1, and apoptosis-associated speck-like protein (ASC) in the brains of scrapie-infected rodents were significantly increased at terminal stage. The increased NLPR3 overlapped morphologically well with the proliferated GFAP-positive astrocytes, but little with microglia and neurons. Using the brain samples collected at the different time-points after infection, we found the NLRP3 signals increased in a time-dependent manner, which were coincidental with the increase of GFAP. Two main downstream cytokines, IL-1ß and IL-18, were also upregulated in the brains of prion-infected mice. Moreover, the gasdermin D (GSDMD) levels, particularly the levels of GSDMD-NT, in the prion-infected brain tissues were remarkably increased, indicating activation of cell pyroptosis. The GSDMD not only co-localized well with the astrocytes but also with neurons at terminal stage, also showing a time-dependent increase after infection. Those data indicate that NLRP3 inflammasomes were remarkably activated in the infected brains, which is largely mediated by the proliferated astrocytes. Both astrocytes and neurons probably undergo a pyroptosis process, which may help the astrocytes to release inflammatory factors and contribute to neuron death during prion infection.

High salt diet exacerbates cognitive deficits and neurovascular abnormalities in APP/PS1 mice and induces AD-like changes in wild-type mice.

High salt diet (HSD) is a risk factor of hypertension and cardiovascular disease. Although clinical data do not clearly indicate the relationship between HSD and the prevalence of Alzheimer's disease (AD), animal experiments have shown that HSD can cause hyperphosphorylation of tau protein and cognition impairment. However, whether HSD can accelerate the progression of AD by damaging the function of neurovascular unit (NVU) in the brain is unclear. Here, we fed APP/PS1 mice (an AD model) or wild-type mice with HSD and found that the chronic HSD feeding increased the activity of enzymes related to tau phosphorylation, which led to tau hyperphosphorylation in the brain. HSD also aggravated the deposition of Aß42 in hippocampus and cortex in the APP/PS1 mice but not in the wild-type mice. Simultaneously, HSD caused the microglia proliferation, low expression of Aqp-4, and high expression of CD31 in the wild-type mice, which were accompanied with the loss of pericytes (PCs) and increase in blood brain barrier (BBB) permeability. As a result, wild-type mice fed with HSD performed poorly in Morris Water Maze and object recognition test. In the APP/PS1 mice, HSD feeding for 8 months worsen the cognition and accompanied the loss of PCs, the activation of glia, the increase in BBB permeability, and the acceleration of calcification in the brain. Our data suggested that HSD feeding induced the AD-like pathology in wild-type mice and aggravated the development of AD-like pathology in APP/PS1 mice, which implicated the tau hyperphosphorylation and NVU dysfunction.

Effect of SARS-CoV-2 infection on semen quality in males:a retrospective study and meta-analysis / 临床检验杂志

Objective To investigate the impact of SARS-CoV-2 infection on male semen quality through meta-analysis and retrospec-tive study.Methods Literature retrieval was conducted in PubMed,CNKI,Wanfang Database and CBM database.Meta-analysis was performed using Stata 15.0.The male patients meeting the inclusion criteria from our hospital were enrolled as study subjects.General demographic data and semen parameters were collected.Single factor analysis of variance and graphing of semen parameters were con-ducted using GraphPad Prism 9.5.1.The test level was set at 0.05.Results A total of 9 studies involving 267 patients were included in the meta-analysis.There were no significant differences in sperm concentration and survival rate before and after SARS-CoV-2 infec-tion(P＞0.05).Semen volume and percentage of normal morphology significantly increased during 1-3 months after infection(P=0.005,P=0.010),with semen volume recovering to pre-infection level＞3 months later(P＞0.05).Sperm motility and progressive mo-tility increased＞3 months after infection(P=0.046,P=0.045),recovering to pre-infection levels(P=0.099,P=0.098).Sperm DNA fragmentation index may be temporarily elevated within 3 months after infection but gradually decreased＞3 months later.In the retrospective study of 8 cases,there were no statistical differences in semen parameters at different stages compared with pre-infection(P＞0.05),but semen parameters showed a negative trend during＜1 month after infection and recovered to pre-infection levels＞3 months later.Conclusion The results of this laboratory study are basically consistent with the meta-analysis.SARS-CoV-2 infection in males only caused short-term negative effects on sperm morphology,vitality and DNA integrity,but generally recovered to pre-infection levels＞3 months after infection.Due to the limitations of study subjects and sample size,the impact of SARS-CoV-2 infection on male semen quality needs to be further confirmed by long-term large-scale prospective studies.

Study of the mechanism of acupuncture and moxibustion in protecting the intestinal mucosal barrier in DSS-induced UC rats based on the IL-9/IL-9R pathway / 针灸推拿医学（英文版）

Objective:To observe the effects of acupuncture and moxibustion on interleukin(IL)-9/IL-9 receptor(IL-9R)in the colon tissue of rats with ulcerative colitis(UC)and investigate the protective mechanism of acupuncture and moxibustion on the intestinal mucosal barrier in UC rats. Methods:Male Sprague-Dawley rats were randomly divided into a normal control(NC)group and a modeling group.UC models were prepared by giving 4%dextran sulfate sodium(DSS)water for 7 d.After the successful construction of the UC rat model,the modeling group was randomly divided into a UC group,a herb-insulated moxibustion(HM)group,and an electroacupuncture(EA)group.HM and EA interventions at bilateral Tianshu(ST25)were performed once a day for 7 d.Hematoxylin-eosin(HE)staining was used to observe the histopathological changes in the colon.The serum concentrations of IL-9,IL-6,IL-1β,and hemoglobin-H(HbH)were determined by enzyme-linked immunosorbent assay.The protein expression levels of IL-9,IL-9R,claudin-2,zonula occludens-1(ZO-1),and occludin in the colon tissue were measured by Western blotting or immuno-histochemistry.Immunofluorescence was used to detect the co-expression of PU.1 and CD4 with the IL-9 protein. Results:Compared with the NC group,the colon tissue of UC rats was severely damaged and ulcerated with congestion and edema,and the colonic histopathological score increased significantly(P<0.01).The serum HbH concentration decreased significantly(P<0.01),while the serum concentrations of IL-9,IL-6,and IL-1β increased(P<0.01).The protein expression of colonic ZO-1 and occludin decreased significantly(P<0.01),while the protein expression of colonic IL-9 and IL-9R increased(P<0.05).The positive co-expression levels of IL-9/PU.1 and IL-9/CD4 increased in the colon tissue(P<0.05).Compared with the UC group,the colonic mucosal structures were gradually repaired in both HM group and EA group,and healed ulcers could be observed,the colonic histopathological score decreased significantly(P<0.05).The serum concentration of HbH increased(P<0.01),while the serum concentrations of IL-9,IL-6,and IL-1β decreased(P<0.05).The protein expression levels of ZO-1 and occludin increased(P<0.05),while the protein expression levels of IL-9 and IL-9R decreased(P<0.01).The positive co-expression levels of IL-9/PU.1 and IL-9/CD4 decreased in the colon tissue(P<0.05). Conclusion:Both HM and EA can inhibit the protein expression levels of IL-9 and IL-9R in the UC colon by regulating the transcription factor PU.1,promote the repair of intestinal mucosal barrier,and down-regulate protein contents of proinflammatory factors IL-9,IL-6,and IL-1β in the serum,which may be one of the key mechanisms of acupuncture and moxibustion in reducing the inflammation of UC colonic mucosa and protecting the intestinal mucosal barrier.

The Anti-inflammatory Effects of Qinggan Tongyin Based on the Network Pharmacology and UHPLC-MS/MS / 中药新药与临床药理

Objective To preliminary explore the in vitro anti-inflammatory effects of Qinggan Tongyin based on serum pharmacology and network pharmacology.Methods The effects of the serum containing Qinggan Tongyin on the release of NO,cell necrosis factor-α(TNF-α),and interleukin-6(IL-6)in LPS-induced RAW264.7 cells were confirmed using serum pharmacology.UHPLC-MS/MS was used to determine the index components of Qinggan Tongyin.The possible targets and pathways of active components in Qinggan Tongyin for anti-inflammatory properties were predicted by using network pharmacology.Results The results of cellular assay showed that Qinggan Tongyin could dramatically lessen the levels of NO,TNF-α,and IL-6(P＜0.05,P＜0.01,P＜0.001).The higher contents of Qinggan Tongyin were phillyrin A,arctiin,chlorogenic acid,scutellarin,gallic acid,rosmarinic acid,paeoniflorin and phillyrin.A totsl of 215 intersection targets between 17 active components in Qinggan Tongyin and inflammation were obtained,and the 31 core targets were ALB,VEGFA,IL-6,TNF-α,etc..The primary targets can exhibit anti-inflammatory actions by regulating several signaling pathways,such as AGE-RAGE,PI3K-Akt,and MAPK signaling pathway.Conclusion Qinggan Tongyin exerts its anti-inflammatory effects with the characteristic of multiple components and multiple targets.

Analysis of detection of acute respiratory infection in children under 12 years old in Pudong New Area， Shanghai from 2019 to 2023 / 上海预防医学

ObjectiveTo investigate the impact of acute respiratory infections in children under 12 years old in Pudong New Area， Shanghai from 2019 to 2023. MethodsAcute respiratory infection samples of children under 12 years old from three sentinel hospitals in Pudong New Area， Shanghai from 2019 to 2023 were collected， and 42 respiratory infection pathogens， including influenza virus， adenovirus， parainfluenza virus， respiratory syncytial virus， human enterovirus/rhinovirus， human pulmonary virus， human bokavirus， coronavirus （229E， HKU1， NL63 and OC43）， and novel coronavirus， were detected with microfluidic chips. The situation of acute respiratory infections among outpatient and inpatient children in this area was analyzed for the before the implementation of non pharmacological intervention measures （2019.12‒2020.1）， during the period of non pharmacological intervention measures （2020.2‒2022.12）， and after non pharmacological intervention measures （2023.1‒2023.6）. ResultsFrom 2019 to 2023， a total of 1 770 samples were collected， and 445 pathogens were detected， with a detection rate of 25.14% （445/1 770）. The main pathogens detected during the study period were influenza virus： 8.70% （154/1 770）， respiratory syncytial virus： 4.41% （78/1 770）， human enterovirus/rhinovirus： 2.66% （47/1 770）， human adenovirus： 2.49% （44/1 770）， and parainfluenza virus： 2.20% （39/1 770）. Before the implementation of non pharmacological intervention measures， outpatients were primarily infected with influenza， parainfluenza virus， and respiratory syncytial virus， with detection rates of 8.09%， 4.49%， and 4.04%， respectively； inpatients were mainly infected with influenza， respiratory syncytial virus， and parainfluenza virus， with detection rates of 4.49%， 3.82%， and 3.15%， respectively. During the period of non pharmacological intervention measures， influenza， rhinovirus and respiratory syncytial virus were the main viruses detected in the samples of outpatient children， with detection rates of 4.04%， 3.60%， and 2.47%， respectively； inpatient samples mainly detected respiratory syncytial virus， rhinovirus， and influenza virus， with detection rates of 3.60%， 2.02%， and 1.80%， respectively. After non pharmacological intervention measures， influenza， rhinovirus and respiratory syncytial virus were the main pathogens detected in the outpatients， with detection rates of 9.89%， 2.92% and 2.02%， respectively； influenza， respiratory syncytial virus， and rhinovirus were the main pathogens detected in inpatient children， with detection rates of 6.29%， 1.57%， and 1.35%， respectively. ConclusionThe prevalence of pathogens related to acute respiratory infections in children is influenced by non pharmacological preventive measures.

Efficacy and safety of botulinum toxin type A combined with pulsed radiofrequency in the treatment of postherpetic neuralgia / 实用医学杂志

Objective Exploring the efficacy and safety of botulinum toxin type A(BTX-A)combined with pulsed radiofrequency(PRF)in the treatment of postherpetic neuralgia(PHN).Methods A total of 80 patients with PHN were collected.They were randomly divided into experimental group(Group B)and control group(Group C),Group B was treated with BTX-A intradermal injection combined with PRF,and Group C was treated with lidocaine intradermal injection combined with PRF.Numeric pain score(NRS),Simplified McGill Pain Questionnaire(SF-MPQ)and Sleep Quality Score(QS)were used to assess the patients'pain level and sleep quality preoperatively,1,3,and 7 days postoperatively,and 1,2,and 3 months postoperatively.The patients'postoperative adverse reac-tions were collected.Interleukin-1β(IL-1β)and calcitonin gene-related peptide(CGRP)levels in patients'serum were measured preoperatively and 3 days postoperatively.Results The NRS scores,SF-MPQ scores,and QS scores of group B and group C were significantly lower at all postoperative time points compared to preoperative ones(P<0.05).The NRS and SF-MPQ score were significantly lower in group B at 1,2,and 3 months postoperatively compared with group C(P<0.05);and group B had significantly lower QS scores at 2 and 3 months postoperatively(P<0.05).The effective rate of pain relief at 3 months postoperatively in group B(90%)was statistically signifi-cant(P<0.05)compared with group C(56.7%).No serious adverse reactions occurred in either group.The levels of IL-1β and CGRP in serum of patients in both groups were significantly decreased at 3 days after surgery compared with the preoperative period,and the degree of decrease of IL-1β and CGRP in group B was more significant than that in group C(P<0.05).Conclusion BTX-A combined with PRF treatment for PHN can effectively reduce its pain level,improve the quality of sleep,and is safe.

Effect of blood flow restriction training on the fitness benefit of upper limb muscles / 中国组织工程研究

BACKGROUND:Blood flow restriction training has broad application prospects in improving limb muscle strength.It has ideal effects on the upper limbs is ideal,and the specific application scheme has high research value. OBJECTIVE:To explain the influence of blood flow restriction training on the fitness benefits of upper limb muscles and summarize the specific programs of blood flow restriction training for upper limb,attempting to give suggestions on application programs based on existing studies. METHODS:Literature on the application of upper limb blood flow restriction training were searched in CNKI,WanFang,VIP,CBM,PubMed,Embase,EBSCO,Cochrane Library and Web of Science databases.The search terms were"blood flow restriction,blood flow restriction training,pressure training,upper limb,upper arm,forearm,arm,forearm"in Chinese and"blood flow restriction training,blood flow restriction exercise,blood flow restriction therapy,BFR therapy,occlusion training,KAATSU training,BFRT,upper extremity,upper limb,arm,forearm"in English.The relevant articles on the application of blood flow restriction training in the upper limbs included in the database from database inception to December 2022 were selected and screened according to inclusion criteria and exclusion criteria. RESULTS AND CONCLUSION:Firstly,blood flow restriction training is mainly applied to healthy people,special athletes and people with upper limb injury.Secondly,the influence of blood flow restriction training on upper limb muscle fitness is mainly reflected in the increase of upper limb circumference,muscle strength,muscle endurance,muscle thickness,muscle cross-sectional area and explosive power of upper limb,followed by the cross migration phenomenon of the upper limbs.Thirdly,blood flow restriction training for the upper limbs mainly uses inflatable blood flow restriction devices:the cuff width was 3-5 cm,the pressure position was 1/3 of the upper arm,the limiting pressure was 40%-60%arterial occlusion pressure or 80-160 mmHg,the training load is 20%-30%1RM,the training volume is four sessions(30-15-15-15 times),the interval time was 30-60 seconds,and the training frequency was 2 or 3 times per week.

Knowledge graph and future prospects of medical security research:literature analysis based on CNKI(since 1998) / 现代医院

Objective To present a knowledge graph of over 20 years of research on medical security and predict future trends.Methods Based on 4818 Chinese core journal papers indexed by CNKI since 1998,CiteSpace 5.0 was used to present a knowledge graph of medical security research from three aspects:time zone distribution,force composition,and research con-tent.Results Medical security research has gone through three stages:the initial stage,the peak stage,and the adjustment and stability stage.At present,the development of research forces is uneven,and the cooperation network shows a trend of partial concentration and overall dispersion.The research topics focus on seven aspects such as the construction of medical security sys-tem,internal design of the system,external support system,and new rural cooperative medical care.Conclusion In the future,efforts should be made to build a research system for medical security governance and highlight the innovation and development of legal construction of medical security in five aspects.

Regulatory effect of TRPC3 on the biological behavior of retina in OIR mice and human retinal endothelial cells / 中华实验眼科杂志

Objective:To investigate the regulatory effect of transient receptor potential cation channel subfamily C member 3 (TRPC3) on the retina in oxygen-induced retinopathy (OIR) mice and biological behavior of human retinal vascular endothelial cells (HREC).Methods:A total of 32 healthy SPF grade 7-day-old C57BL/6 mice were selected and randomly divided into a control group and an OIR group by the random number table method, with 16 mice in each group.The control group received no special treatment, and the OIR model was established in the OIR group.On postnatal day 17 (PN17), the success of the model establishment was verified by immunofluorescence staining of the retinal patch.The in vitro cultured HREC were divided into a normal control group, a transfection reagent group, and a si-TRPC3 group.The normal control group received no special treatment, while the transfection reagent group and the si-TRPC3 group were transfected with transfection reagent or transfection reagent + si-TRPC3.The relative expression of TRPC3 mRNA was detected by real-time quantitative fluorescence PCR.The relative expressions of TRPC3, transcription factor NF-E2 related factor (Nrf2), and superoxide dismutase (SOD) proteins were determined by Western blot.HREC were further divided into a normal control group, a vascular endothelial growth factor (VEGF) group, a si-TRPC3 group, and a Pyr3 (TRPC3 channel inhibitor) group, which were cultured in complete medium, medium containing 20 ng/ml VEGF recombinant protein, medium containing 20 ng/ml VEGF recombinant protein (si-TRPC3 transfection for 72 hours), and medium containing 20 ng/ml VEGF recombinant protein+ 1 μmol/L Pyr3 for 48 hours, respectively.The proliferation ability of HREC was detected using cell counting kit 8 (CCK-8). The horizontal and vertical migration ability of cells were detected by cell scratch assay and transwell assay, respectively.This study followed the 3R principles of animal welfare and was approved by the Ethics Committee of Hebei Eye Hospital (No.2023LW04). Results:Pathological neovascular clusters with strong fluorescent staining appeared in the retina of OIR mice on PN17.The relative expressions of TRPC3 mRNA and protein in the retina of OIR mice were 2.057±0.244 and 1.517±0.290, respectively, significantly higher than 0.983±0.033 and 0.874±0.052 of control group ( t=6.165, 3.094; both at P<0.05). The relative expression levels of TRPC3 mRNA and protein were significantly lower, and the relative expression levels of Nrf2 and SOD proteins were higher in the si-TRPC3 group than in the normal control and transfection reagent groups, and the differences were statistically significant (all at P<0.05). The CCK-8 experiment results showed that the cell absorbance value was higher in the VEGF group than in the normal control group, and lower in the si-TRPC3 and Pyr3 groups than in the VEGF group, with statistically significant differences (all at P<0.05). The results of the cell scratch experiment showed that the lateral migration rate of VEGF group cells was higher than that of normal control group, while the lateral migration rate of si-TRPC3 group and Pyr3 group cells was lower than that of VEGF group, and the differences were statistically significant (all at P<0.05). The transwell experiment results showed that the number of stained cells in the VEGF group was higher than that in the normal control group, and the number of stained cells in the si-TRPC3 group and Pyr3 group was lower than that in the VEGF group, with statistically significant differences (all at P<0.05). Conclusions:Hypoxia induces increased TRPC3 expression in OIR mouse retina, and downregulation of TRPC3 inhibits HREC proliferation and migration.The mechanism is related to the activation of the Nrf2-related oxidative stress pathway.

Robot-assisted laparoscopic treatment of horseshoe kidney combined with renal tumor: a case report and literature review / 中国医师进修杂志

Objective:To explore the technical focus of robotic-assisted laparoscopic surgery for the treatment of horseshoe kidney combined with renal tumor.Methods:The clinical data of a patient with horseshoe kidney combined with renal tumor treated by robot-assisted laparoscopic partial nephrectomy in the Second Hospital of Dalian Medical University in September 2021 were retrospectively analyzed. PubMed, CNKI, Wanfang and VIP databases were searched for all the literature on the use of robot-assisted laparoscopic nephrectomy or partial nephrectomy for the treatment of horseshoe kidney combined with renal tumor from the time of establishment to December 2022.Results:A total of 11 patients from 10 articles were retrieved and 12 patients were enrolled. Among the 12 patients, 4 cases used the retroperitoneal approach and 8 cases used the transperitoneal approach. Two cases were operated by traditional laparoscope, and the arteries were searched for and controlled before the robotic arm was placed to perform the partial nephrectomy and suture; and 10 cases were operated with the robotic-assisted laparoscopic approach throughout the whole procedure. Five cases of nephrectomy were performed on one side, and 7 cases were performed in the partial nephrectomy. Postoperative pathological diagnosis was clear cell carcinoma in 8 cases, chromophobe cell carcinoma in 1 case, eosinophilic cell carcinoma in 1 case, renal cell carcinoma in 1 case, and renal abscess in 1 case. The patient in the Second Hospital of Dalian Medical University was 38 years old female who was admitted to the hospital with a fever. After CT arteriography and three-dimensional reconstruction, robotic-assisted laparoscopic partial nephrectomy of right kidney and isthmus dissecting was performed. During the operation, tumor trophoblast vessels were ligated and dissected one by one by using single-use tissue closure clips, and the isthmus was dissected using endoscopic cutting anastomosis on the left side of the tumor, with the tumor edges sharply resected and completely dissected. The operation time was 240 min, without thermal ischemia time, and the bleeding volume was about 300 ml. The patient recovered well after the operation, and the postoperative pathological diagnosis was renal abscess.Conclusions:Robot-assisted laparoscopic treatment of horseshoe kidney combined with renal tumor is safe and effective, and has more advantages than traditional laparoscopic surgery. Preoperative CT arteriography or three-dimensional reconstruction examination should be applied to fully evaluate the variant vessels. The surgical access and plan should be decided according to the size and location of the tumor. The variant vessels should be properly handled during operation. The use of endoscopic cutting anastomosis to deal with the isthmus can be more conducive to the surgical operation.

Correlation between tear inflammatory factors and postoperative complications in glaucoma patients after trabeculectomy / 局解手术学杂志

Objective To investigate the application value of tear inflammatory factors in early evaluation of the occurrence of complications after trabeculectomy in glaucoma patients.Methods A total of 150 eyes of 150 patients with angle-closure glaucoma who underwent trabeculectomy in Department of Ophthalmology of Zhangjiagang Hospital of Traditional Chinese Medicine were included.The clinical data of all patients were collected,and the levels of inflammatory factors(including G-CSF,GM-CSF,IFN-γ,MCP-1,TNF-α,IL-12,IL-13,IL-15,IL-1β,IL-4,IL-7,IL-10,IL-17,IL-5)in tears were detected before surgery.According to the occurrence of postoperative complications,the patients were divided into the complication group and the control group,and the clinical data of the two groups were compared.Logistic regression was used to analyze the related factors of the occurrence of complications after trabeculectomy in glaucoma patients.The predictive model of tear inflammatory factors was established by Logistic regression,and the receiver operating characteristic(ROC)curve was drawn to analyze the value of this model in early evaluation of the occurrence of complications after trabeculectomy in glaucoma patients.Results Complications occurred in 35(23.33%)of 150 glaucoma patients after trabeculectomy,including 24 cases of shallow anterior chamber,5 cases of ciliary body or choroid detachment,3 cases of iridocyclitis,2 cases of hyphema,and 1 case of retinal detachment.IFN-γ,GM-CSF and IL-5 levels of the patients in the complication group were lower than those in the control group(P<0.05).There was no significant difference in the levels of other inflammatory factors of patients between the two groups(P>0.05).Multivariate Logistic regression analysis showed that increased levels of IFN-γ(OR=0.999),GM-CSF(OR=0.988)and IL-5(OR=0.996)were independent protective factors for complications after trabeculectomy in glaucoma patients(P<0.05).ROC curve analysis showed that the sensitivity and specificity of the model were 94.29%and 83.84%in early evaluation of the occurrence of complications after trabeculectomy in glaucoma patients,and the AUC was 0.906,which was higher than that predicted by IFN-γ(AUC=0.642),GM-CSF(AUC=0.721)and IL-5(AUC=0.666)alone.Conclusion Preoperative analysis of tear inflammatory factors in glaucoma patients can early evaluate the occurrence of postoperative complications,especially the combined detection of IFN-γ,GM-CSF and IL-5 levels is of great significance for predicting the occurrence of complications.

A study on the job preferences and heterogeneity of medical students from different birthplaces:A discrete choice experiment based on six hospitals in Beijing / 中国卫生政策研究

Objective:To analysis the job preference and heterogeneity of medical students by distinguishing their birthplaces,and to provide reference for optimizing the management of primary health care resources.Methods:Using a cluster sampling method,an online survey of discrete choice experiment was conducted with 925 medical students from six teaching hospitals in Beijing,741 valid questionnaires were obtained,the effective recovery rate was 80.1%.The mixed logit model was used to perform regression analysis on six job attributes and estimate the willingness to pay.Results:There were significant differences in the choice of work location among medical students from different birthplaces.The subgroup results showed that compared to medical students from city,undergraduates from rural and county district preferred a work with sufficient career development opportunities.The results of undergraduate subgroup showed that undergraduates from rural district preferred a work with good environment than those from other birthplaces.Conclusion:There is heterogeneity in job preferences of medical students from different birthplaces.Policy makers should pay attention to the medical students'birthplace,also take the educational level into account to optimize the diversified job attributes,formulating targeted intervention to attract primary health care talents.

Determination of related substances in the pharmaceutical excipient triacetin by gas chromatography / 中国药师

Objective To determine the related substances in the pharmaceutical excipient triacetin by gas chromatography(GC).Methods Rtx-1701 and DB-1701 chromatographic column(30 m×0.25 mm,0.25 μm)was used,with nitrogen as the carrier gas,the flow rate was 1.5 mL/min,the inlet temperature was 200℃,the hydrogen flame ionization detector was used,the temperature of the measuring instrument was 250℃,and the program heating was used.Results Under this chromatographic condition,each substance could be effectively separated,and showed good linearity at 2-40 μg/mL(r>0.99).The recovery rates of acetic acid,glycerol,1-monoglyceryl acetate,1,2-diglyceryl acetate and 1,3-diglyceryl acetate were 100.7%(RSD=3.12%),95.1%(RSD=3.66%),99.43%(RSD=4.62%),103.66%(RSD=5.88%)and 103.15%(RSD=4.17%)(n=6),respectively.Conclusion This method has high accuracy and good reproducibility,which can be used for the determination of related substances in the triacetin,and provides a reference for the quality standard of triacetin.

Effect of breast ultrasound background echotextures on diagnostic efficiency of pregnancy-associated breast cancer / 中华超声影像学杂志

Objective:To investigate the diagnostic efficacy of ultrasound in pregnancy associated breast cancer (PABC) under different breast ultrasound background echotextures.Methods:The ultrasonic images of 269 female patients with breast diseases who underwent breast surgery in Fudan University Shanghai Cancer Center from January 2016 to September 2023 and were pregnant or within one year postpartum at the time of onset were retrospectively reviewed. Breast ultrasound background echotextures were classified according to two criteria: the first classification was homogeneous-fat, homogeneous-fibroglandular, and heterogeneous; the other classification was hypoechoic dominated and hyperechoic dominated. The comparison of the diagnostic value of ultrasound in PABC under different backgrounds was conducted by the receiver operating characteristic(ROC) curves.Results:Among 269 patients, 67 patients(24.91%)were during pregnancy and 202 patients(75.09%) were within one year postpartum. Pathologically, 47 patients (17.47%) were confirmed as benign, 222 patients (82.53%) were malignant. According to the first classification, 138 patients were homogeneous-fibroglandular and 131 patients were heterogeneous, with the diagnostic sensitivity of ultrasound in PABC were 88.70% and 59.81% respectively, and the specificity were 91.30% and 83.33% respectively, the areas under the ROC curves were 0.940 and 0.826 respectively ( P=0.022). According to the second classification, 119 were hypoechoic dominated and 150 patients were hyperechoic dominated, the sensitivity were 60.21% and 85.27% respectively, the specificity 84.62% and 90.48% respectively, the areas under the ROC curves were 0.826 and 0.925 ( P=0.042). Conclusions:The heterogeneous background echotextures of the breast may cause decrease of the diagnostic efficiency of ultrasound in PABC, and hypoechoic dominated background was more unfavorable for the diagnosis of PABC compared to the hyperechoic dominated background.

Exploring the mechanism of cortex phellodendri chinsis for the treatment of rheumatoid arthritis by regulating ferroptosis based on network pharmacology and molecular docking / 中华风湿病学杂志

Objective:The potential mechanism of cortex phellodendri chinsis in the improvement of rheumatoid arthritis (RA) through ferroptosis was analyzed based on network pharmacology.Methods:The main active components and their corresponding target proteins were screened by TCMSP database and Herb database, and the UniProt database was used to convert the corresponding target protein names into gene IDs. The targets of RA disease were obtained from GenCards, OMIM, DrugBank and DisGeNET databases. The FerrDb database was used to collect genes for Driver, Suppressors and Markers of ferroptosis. Then, Venny platform was used to obtain the intersection genes of Cortex phellodendri chinsis, RA and ferroptosis, and Cytoscape 3.9.1 software was used to plot the "active component-target-RA-ferroptosis" network diagram. Protein-protein interaction (PPI), gene ontology (GO) function, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed using String and DAVID databases. PyMOL, AutoDock Vina software and RCSB PDB database were used for molecular docking between active ingredients and key genes.Results:A total of 11 active components (Quercetin, Beta-sitosterol, Melianone, Candletoxin A, Phellochin, Palmidin A, Worenine, Hispidone, Kihadalactone A, Niloticin, Stigmasterol) and 34 intersection genes (PTGS2、AR、JUN、PRKCA、TGFB1、EGFR、CDKN1A、MAPK1、RB1、IL6、TP53、HIF1A、HSPA5、HMOX1、CAV1、IFNG、ALOX5、PTEN、NFE2L2、PARP1、PPARA、GSTM1、MTOR、PIK3CA、MDM2、MAPK8、GSK3B、SIRT1、DHODH、EZH2、AKR1C2、AKR1C1、STAT3、MAPK3) were screened. Ten possible targets of Cortex phellodendri chinsis regulating ferroptosis and anti-RA were predicted, including TP53、JUN、STAT3、HIF1A、PTEN、SIRT1、EGFR、MTOR、MAPK3、AR. Ferroptosis pathway is regulated by mediating positive regulation of gene expression, response to drugs, HIF-1, FoxO, ErbB and other signaling pathways, thus combating the occurrence and progression of RA. The docking results showed that there were molecular binding sites between the key genes and their corresponding active components.Conclusion:Cortex phellodendri chinsis may treat RA through ferroptosis effect with multiple components, multiple targets, multiple pathways and mechanisms.