Effects of autophagy inhibitor 3-methyladenine on a diabetic mice model

AIM:To investigate the role of autophagy inhibitor 3-methyladenine(3-MA)on a diabetic mice model(DM)and the potential mechanism.METHODS:Male C57BL/6J mice were randomly divided into a normal control group(NC group)and an DM group.DM were induced by multiple low-dose intraperitoneal injection of streptozotocin(STZ)60 mg/kgd for 5 consecutive days.DM mice were randomly subdivided into untreated group(DM group),3-MA(10 mg/kgd by gavage)treated group(DM+3-MA group)and chloroquine(CQ;50 mg/kg by intraperitoneal injection)treated group(DM+CQ group).The fasting blood glucose(FBG)levels were recorded every week.At the end of experiment,retinal samples were collected.The expression levels of pro-apoptotic proteins cleaved caspase-3,cleaved poly ADP-ribose polymerase 1(PARP1)and Bax,anti-apoptotic protein Bcl-2,fibrosisassociated proteins Fibronectin and type 1 collagenα1 chain(COL1A1),vascular endothelial growth factor(VEGF),inflammatory factors interleukin(IL)-1βand tumor necrosis factor(TNF)-α,as well as autophagy related proteins LC3,Beclin-1 and P62 were determined by Western blotting.The oxidative stress indicators 8-hydroxydeoxyguanosine(8-OHdG)and malondialdehyde(MDA)were detected by commercial kits.RESULTS:Both 3-MA and CQ had shor t-term hypoglycemic effect on FBG and reduced the expression of VEGF and inflammatory factors IL-1βand TNF-αin DM mice.3-MA also significantly alleviated oxidative stress indicators 8-OHdG and MDA,decreased the expression of fibrosisrelated proteins Fibronectin and COL1A1,pro-apoptotic proteins cleaved caspase-3,cleaved PARP1,as well as the ratio of Bax/Bcl-2.CQ had no significant impact on the oxidative stress indicators,fibrosis,and apoptosis related proteins.The results of Western blotting for autophagy related proteins showed that the ratio of LC3 II/LC3 I and the expression of Beclin-1 in the retina of DM mice were decreased by 3-MA treatment,and the expression of P62 was further increased by CQ treatment.CONCLUSION:3-MA has anti-apoptotic and anti-fibrotic effects on the retina of DM mice,and can attenuate retinal oxidative stress,VEGF expression and the production of inflammatory factors in the retina of DM mice.The underlying mechanism of the above effects of 3-MA may be related to its inhibition of early autophagy and hypoglycemic effect.

Fertility Values among Women of Childbearing Age in Hunan Province, China: A Cross-Sectional Study

Background: China is facing with a crisis of the aging population. After the implementation of the latest fertility policy, the research on fertility related issues is urgent. Objective: The objective of this study is to explore the fertility values among women of childbearing age and the socio-demographic factors associated with it under the background of three-child policy, which is helpful to cope with the aging of the population. Methods: This study was conducted among 383 women of childbearing age who met the inclusion criteria using a general information questionnaire and the fertility values questionnaire from May to August 2021 in Hunan Province, China. Data were collected on the women’s socio-demographic characteristics and fertility values. The descriptive statistics, t-test and analysis of variance were used for data analysis. Results: The total mean score of the positive values was 43.55 ± 10.10, and that of the negative values was 50.87 ± 13.85. There were significant differences in the scores of the overall positive and negative values, as well as scores of each dimension (p The item mean score of the overall negative values (3.38 ± 0.93) was higher than that of the overall positive values (2.90 ± 0.67). Among the positive values, “emotional value” (4.26 ± 0.93) scored the highest, while “worrying about life changes” (3.88 ± 1.10) scored the highest among the negative values. There were significant differences in both the positive and negative values in terms of age, marital status, and “only-child” women or not (p Conclusion: The fertility values among women of childbearing age in Hunan Province were relatively negative, especially, excessive worries about life change since having a child, which may lead to further declines in fertility levels. Relevant support measures are urgently needed from the government to adapt to the three-child policy.

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in treatment of gastric cancer with peritoneal carcinomatosis

Although gastric cancer with peritoneal carcinomatosis is associated with poor prognosis and is generally treated with palliative systemic therapy, recent studies have shown that cytoreductive surgery（CRS） and hyperthermic intraperitoneal chemotherapy（HIPEC） may prove to be an efficacious treatment option. In addition to reviewing the natural history of gastric cancer with peritoneal carcinomatosis, this mini-review examines literature on the efficacy of CRS and HIPEC as compared to chemotherapy and surgical options. Both randomized and nonrandomized studies were summarized with the emphasis focused on overall survival. In summary, CRS and HIPEC are indeed a promising treatment option for gastric cancer with peritoneal carcinomatosis and large randomized clinical trials are warranted.

Application of Three-Dimensional Magnetic Resonance Imaging in the Diagnosis of Perianal Abscess

Perianal abscess is a common disease in anorectal surgery. If the diagnosis is not clear and the cure is thoroughly cleared, the recurrence and spread of anal fistula will cause life-long pain. Objective: To investigate the application of 3.0T MRI 3D CUBE T2WI lipid suppression sequence in the diagnosis of perianal abscess. Methods: Thirty-six patients with perianal abscess confirmed by operation were examined with 2D T2WI and 3D CUBE T2WI lipid suppression sequences before operation. Two imaging techniques were evaluated to show the types of perianal abscess, the number of abscesses, the number of internal orifices of abscess, and the number of fistula branches with anal fistula in abscess. Results: Among 36 cases of perianal abscess, there were 5 cases of anal subcutaneous abscess, 12 cases of ischiorectal space abscess (8 cases complicated with anal fistula), 6 cases of posterior anal space abscess, 5 cases of anal sphincter abscess (3 cases complicated with anal fistula), 2 cases of high intermuscular abscess, 2 cases of rectal submucosal abscess, 3 cases of complex abscess (3 cases complicated with anal fistula), 1 case of misdiagnosis, 2D T2WI lipid suppression sequence and 3D CUBE T2WI suppression. The accuracy of lipid sequence abscess typing was 80.6% (29/36) and 88.9% (32/36), respectively, with no significant difference (P > 0.05). Thirty-six patients were surgically diagnosed as having 32 internal orifices, 68.8% (22/32) and 93.8% (30/32) of 2D T2WI and 3D CUBE T2WI lipid-suppressing sequences, respectively, with significant difference (P Conclusion: 3D CUBE T2WI lipid suppression sequence is superior to 2D T2WI lipid suppression sequence in the classification of perianal abscess, the number of internal orifices of abscess and the number of fistula branches of abscess complicated with anal fistula. It can also determine the number of internal orifices of abscess complicated with anal fistula, the number of fistula branches, the shape of primary and branch fistula and the relationship among pelvic floor muscle tissues. It can provide more accurate images for preoperative and intraoperative clinical surgery.

Strategies to improve the effect of mesenchymal stem cell therapy on inflammatory bowel disease

Inflammatory bowel disease(IBD)includes Crohn’s disease and ulcerative colitis and is an idiopathic,chronic inflammatory disease of the colonic mucosa.The occurrence of IBD,causes irreversible damage to the colon and increases the risk of carcinoma.The routine clinical treatment of IBD includes drug treatment,endoscopic treatment and surgery.The vast majority of patients are treated with drugs and biological agents,but the complete cure of IBD is difficult.Mesenchymal stem cells(MSCs)have become a new type of cell therapy for the treatment of IBD due to their immunomodulatory and nutritional functions,which have been confirmed in many clinical trials.This review discusses some potential mechanisms of MSCs in the treatment of IBD,summarizes the experimental results,and provides new insights to enhance the therapeutic effects of MSCs in future applications.

Analysis of Thorax Injuries in 112 Death Cases Caused by Traffic Accidents

Objective: To explore the characteristics and mechanisms of serious injuries of chest caused by road traffic accidents. Methods: Totally 112 autopsy cases with chest injuries in the urban of Jingzhou road traffic accidents were collected. Systematic review and analysis of the general information, postmortem examinations and assessments of chest injury had carried out from Feb. 2016 to Mar. 2018. Results: Average age of the victims was 52.2 years and the ratio of male to female deaths was 2.39:1. The proportion of motor-cyclists and pedestrians increased significantly. The overwhelming majority of accident vehicles were motorcycles and bicycles. Fractures of ribs and pulmonary contusion were the most common injuries. Craniocerebral and abdominal injuries were the most common associated injuries. Conclusion: Fractures of ribs and pulmonary contusion were the most common features of fatal road traffic injuries, often associated with vitreoretinal damage and serious multiple damages. These features reflect the characteristics of great violence in traffic accidents, which provides the evidence of identification of violent injuries.

Left Radial Approach versus Right Radial Approach of Coronary Angiography in the Diagnosis of Coronary Heart Disease

Background: Transradial coronary angiography has established itself as safe alternative to transfemoral approach. Today, the artery of approach lies completely on the operator’s choice. The Right Radial Approach (RRA) has been a favorite for most of the interventional cardiologists due to the convenience in operating from the right side. The Left Radial Approach (LRA) has always been a neglected route. LRA does have many advantages over the right, the vascular anatomy being one of them. The aim of our study was to compare the right radial approach of diagnostic coronary angiography with left radial approach. Method: A total of 70 cases of Coronary Angiography (CAG) with normal Allen test and satisfying the inclusion criteria were prospectively observed and studied after randomly assigning them into two equal groups, LRA (Left Radial Approach) n = 35 and RRA (Right Radial Approach) n = 35. Multipurpose TIG (Tiger) catheter was used in both the approaches to catheterize the right as well as left coronary artery. Results: The access time, catheter manipulation time, procedure time, amount of contrast used, hospital stay, intensity of pain experienced, cost of the procedure and quality of coronary angiogram observed were statistically insignificant while the fluoroscopy time was slightly statistically significant which was independent to catheter manipulation time. Conclusions: The neglected Left Radial Approach to coronary angiography is as efficacious, safe and cost effective with reduction in arterial spasm complications when compared to the Right Radial Approach performed by multipurpose Tiger catheter.

Progress on the Study of the Anti-Tumor Effect of Emodin

Cancer is a disease caused by the loss of normal cell regulation and excessive proliferation. At present, there are a lot of anticancer drugs, but most of them are not ideal, with sereve side effects. Besides, during the treatment, the patients feel very bad, and they are always in great pain. Emodin is a natural anthraquinone derivative found in a variety of herbal preparations. Many studies have shown that emodin has a significant therapeutic effect on lung cancer, liver cancer, breast cancer, and so on. After reviewing a large amount of literatures, this paper summarizes the research progresses of emodin anticancer in the past five years, in order to provide theoretical basis for further development and utilization of emodin and its metabolites.

Therapeutic Potential of FGF21 in Alzheimer’s Disease

Alzheimer’s disease (AD) is the most common form of dementia which mostly affects persons younger than 65 years old. Mounting findings showed that amyloid-β(Aβ) peptides, oxidative stress, neuroinflammation and insulin resistance may play central role in the pathogenesis of AD. There are very many methods to slow it through affecting these aforementioned factors. However, more efficient prevention of the progression of AD is still ambiguous. Fibroblast growth factor 21 (FGF21) is an endocrine hormone that is expressed by several organs. It increases insulin sensitivity and regulates lipid metabolism and energy homeostasis. Emerging evidence demonstrates that FGF21 has potential effects in the brain involving metabolic regulation, neuroprotection and cognition. Hence, we hypothesize that FGF21 may be a protective factor in AD by attenuating Aβ generation, inflammation, oxidative stress, and insulin resistance. Our hypothesis will shed new light on the understanding of pathogenesis of AD and help to find a new way to prevent the genesis and progress of AD.

The Development and Functional Regulation of the Fetal Adrenal Cortex

As an important endocrine organ of the human, the adrenal cortex is responsible for the synthesis of various steroids. It is important to maintain pregnancy, promote fetal growth and nervous system development. Moreover, it is also important for the growth and development of the fetus after birth. Abnormal functional development of the adrenal cortex will induce the abnormal synthesis of steroid hormones and trigger the occurrence of related diseases. In this review, we discuss the morphological and functional development of fetal adrenal cortex and its regulatory factors in humans and rodents.

Effect of Modified Breakfast-Education for Type 2 Diabetes Mellitus: A Single-Center Randomized Clinical Trial

Objective: The effect of postprandial blood glucose (BG) by eating modified noodles and health education in type 2 diabetic mellitus (T2DM) patients was observed. Methods: To select T2DM patients who need therapies in hospital from June to September 2017 and divide the patients into study (n?= 41, Dried Noodles) and control (n?= 39, Noodles with Soup) groups. After 3 months, the clinical/biochemical parameters and compliance of two groups were observed. Results: The study group has lower clinical/biochemical parameters and higher compliance than control group for 3 months of intervention. The difference between the two groups is statistically significant (P Conclusion: The improvement of breakfast and health education mode effectively controls T2DM, promotes the development of good living habits of patients, and improves self-management ability and compliance of patients.

Mullerian Agenesis in One of the Non-Identical Twins: A Case Report and Literature Review

Mullerin agenesis also referred as mullerian aplasia, Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKH) or vaginal agenesis is the congenital anomaly of vertical fusion defect of mullerian system resulting in variable abnormalities of female reproductive tract with normal functioning ovaries. It is second most common cause of primary amenorrhea after gonadal agenesis. The occurrence of mullerian agenesis in twins is very rare. We present the case of one of the non-identical twins, 22 years female, with primary amenorrhea. Her elder twin sister had a normal female reproductive system. In our case, diagnosis was supported by presence of definitive primary amenorrhea with well-developed secondary sexual characteristics. Normal physiological hormonal levels ruled out the ovarian or pituitary pathology. Imaging studies like ultrasonography and magnetic resonance imaging (MRI) provided additional confirmation.

IgG4-Related Pancreatitis: A Case Report and Review of Literature

Background: Immunoglobulin G4-related pancreatitis (IgG4-RAIP) is a relatively rare chronic inflammatory disease of the pancreas. The cause of this disease is still unclear. Due to the lack of specific clinical symptoms and imaging findings, it is often misdiagnosed as pancreatic cancer. Clinicians are paying more and more attention to it. Case report: We are reporting an IgG4-RAIP case, in which the patient had been misdiagnosed as pancreatic cancer and prepared for surgical treatment but finally was diagnosed as IgG4-RAIP after pancreatic biopsy and serum immune test. And the patient was recovered after the treatment of glucocorticoids. Discussion: In order to make more patients get correct diagnosis and reasonable treatment, when we encounter undiagnosed cases of pancreatitis or pancreatic cancer in clinical work, it is very important to conduct pancreatic biopsy and serum immune blood test before operation for these patients. Conclusion: Pancreatic biopsy and serum immune blood test can effectively reduce the occurrence of misdiagnosis of IgG4-RAIP.

Clinical Characteristics and Prevention Strategies of Falls in Hospitalized Patients with Chronic Kidney Disease

Objectives: To analyze the clinical features of falls in hospitalized patients with chronic kidney disease (CKD), and to provide basis for preventing the occurrence of falls in hospitalized patients with CKD. Method: A retrospective study was conducted to analyze the 27 adverse events of falls in hospitalized patients from the department of nephrology in Peking University Shenzhen Hospital during May 2009 and May 2019. Results: Among the 27 patients with falls, people over 65 years old accounted for 55.56%;74.07% of the patients had caregivers;the peak period of falls was from June to August, accounting for 40.74%, mainly occurring from 7:00 to 8:00, 12:00 to 13:30 and 19:00 to 21:00;the locations of falls were mostly near the bed and in the bathroom, accounting for 33.33% and 22.22%, respectively;suffering from anemia, hypoproteinemia, abnormal serum potassium, calcium-phosphorus metabolism disorders accompanied by abnormal parathyroid hormone and hypertension accounted for 88.89%, 85.19%, 29.63%, 96.30% and 81.48% respectively. The inpatients on dialysis therapy accounted for 66.67%. Conclusion: The occurrence of falls in hospitalized patients with CKD was not only related to age, caregivers, time, months, locations or other conventional factors, but also the complications and dialysis therapies. To effectively reduce the occurrence of falls, it’s necessary to enhance the sense of safety and responsibility of caregivers. Besides, nurses should strengthen the inspection of wards for inpatients engaging in some intensive activities, and nurses should also pay more attention to the inpatients with anemia, hypoproteinemia, calcium-phosphorus metabolism disorders and those on dialysis therapies.

A Qualitative Study on Experiences of Patients with Esophageal Speech Training after Total Laryngectomy

Background: Patients who had total laryngectomy not only have a pressure from the possible diagnosis of laryngeal cancer, but also suffer from unspeakable misery. To relieve the suffering, some patients choose esophageal speech training. However, most of the current researches focus solely on the results of the training with the negligence of the patients’ mental health and their life experience during the training. A qualitative research is highly sensitive to patients’ subjective feelings, and thus able to capture their subtle emotional changes. Objective: To explore deeply patients’ real experiences of esophageal speech training after total laryngectomy and reveal the public their training experience of the unique and special group. Methods: In May 2018, researchers conducted a two-month field observation on and in-depth interviews with 15 patients who were on esophageal speech training after total laryngectomy in the esophageal speech training room of the Eye and ENT Hospital of Fudan University. The research applied phenomenological research method and Colaizzi Data Analysis. Results: The data analysis indicated four main themes: changes of mindset;showing positive attitudes and behaviors in training;shift in social relations;and arduous training process. Conclusion: The study has the finding that patients on esophageal speech training had negative emotions in the early stage of the training and dissatisfaction with its teaching. The repercussion of the surgery brought them changes of social relations, social bias and prejudice ensued. It is, therefore, urgent and crucial to give the speech trainees psychological counseling in the early stage to improve their qualities of life, to mobilize social support to incentivize their training, to optimize esophageal speech training teaching, and to regulate the management of the esophageal speech training environment.

CBL Significance in Pathophysiology Teaching

Objective: To explore the importance of CBL in pathophysiology teaching. Methods: 218 undergraduate clinical medicine students in 2015 grade were divided into CBL group and control group, and each group had 109 students. The CBL group was taught by CBL, while the control group was taught by routine teaching mode. The teaching effects was evaluated by questionnaire survey and stage test. Results: The CBL group was superior to the control group in learning interest, logical thinking, knowledge system construction, comprehensive use of knowledge to solve problems. Conclusion: CBL teaching enhanced students’ understanding of knowledge significantly, and also enhanced their clinical thinking and problem analysis ability.

Cesarean scar pregnancy

Cesarean scar ectopic pregnancy is a consequence of a scar from previous cesarean section.It is rare and is associated with catastrophic complications of early pregnancy.It can occur in women with only one prior cesarean delivery.With increasing rate of cesarean section worldwide,more and more cases are diagnosed and reported.The incidence is likely to rise substantially in the near future.A delay in diagnosis and the treatment can lead to uterine rupture,major haemorrhage,hysterectomy and serious maternal morbidity.Early diagnosis can offer treatment options of avoiding uterine rupture and haemorrhage,thus preserving the uterus and future fertility.Aim of this article is to find the demography,pathophysiology,clinical presentation,most appropriate methods of early diagnosis and management.

Training indicators and quantitative criteria for emergency nurse specialists

Objective： By constructing a training system of quality evaluation standards for emergency nurse specialist（ENS）, we can ensure smooth operations and quality training for ENS.Methods： First, the frame structure of indicators was designed on the basis of system theory and the balanced scorecard method. Meanwhile, corresponding quantitative standard indicators were compiled through literature analysis and a review of training characteristics. Next, screening indicators were collected through consultation with experts and statistical calculations. The indicators weight coefficient was calculated using the analytic hierarchy process（AHP）. Finally, indicators were validated in two groups of nurses in two different training courses.Results：（1） We created a three-level indicator system： level-Ⅰ dimensions have 4 indicators, while level-Ⅱ dimensions and level-Ⅲ dimensions have 13 and 34 indicators, respectively;（2） The coefficient of expert＇s judgment is 0.840, familiarity is 0.914 and authority is 0.877, and the three rounds of coordination coefficient are 0.456, 0.553 and 0.715, respectively;（3） There are at least 56 indicators in alternative quantitative standards; and（4） The alpha reliability value of the indicator system in the two training course had no significant difference（P 〉 0.05）. The same result was observed when examining two groups of nurses in one training course（P 〉 0.05）.Conclusions： This study established a training system of quality evaluation standards for emergency nurse specialists that is objective, reliable, easy to operate and representative according to scientific selection and verification. This system can therefore provide a basis for quality evaluation and targeted improvement for ENS training in addition to promoting health.

A Study on Lung Cancer in Jianghan Plain

This study was to investigate the epidemiology of lung cancer in Jianghan Plain, providing scientific basis for prevention and treatment of lung cancer. Pathology and clinical data of 1290 patients diagnosed lung cancer from the largest hospital in Jianghan Plain were collected and analyzed. Results found that the lung cancer incidence increased gradually from the age of 40 and at the peak during 61 to 70 years old;the male to female ratio was 2.45:1;Smoking patients were 841 cases, accounting for 65.2% of all cases. Smoke index > 400 was 771 cases accounting for 91.7 percent of smokers and smoking index < 400 was 70 cases accounting for 8.3% of smoking patients. 93.6% of the patients were to start smoking at a young age. The rate of patient pathological cytology diagnosed by fiberoptic bronchoscopy was 31.8%, which showed that it was an important diagnostic method for lung cancer. The main reason for smoking is to break up the monotony and although many patients know nicotine, carbon monoxide is the main smoking harmful substances and smoking may cause lung cancer;not many people can take the initiative to quit smoking. It also showed that squamous cell carcinoma was the main type in smoking patients, while adeno-carcinoma in non-smoking patients. The comprehensive epidemiological analysis suggested that smoking is an important factor in causing lung cancer, smoking cessation education and regular medical examinations to strengthen the prevention of lung cancer have a positive meaning to their family members.