糖尿病视网膜病变微血管神经病变发病机制的研究进展

糖尿病视网膜病变(diabetic retinopathy,DR)是糖尿病(diabetic melitus,DM)常见且严重的微血管并发症之一。在国外,DR是工作人群(20～64岁)首位的致盲因素;在国内,DR的发病率和致盲率也在逐年增加,严重影响患者的生存质量。以往对DR发病机制和治疗的研究主要集中在微血管方面,近年来,随着研究的深入,越来越多的学者认为DR不再单纯是一种微血管病变,同时伴随着视网膜神经退行性改变,但国内外文献对DR的微血管病变与神经退行性改变发病机制的研究多是单一的。本文就DR微血管病变与神经退行性改变之间的关系做一综述。

Small balloon strategy associated with low pacemaker implantation rate after self-expanding transcatheter valve implantation

BACKGROUND: This study aims to investigate whether small balloon aortic valvuloplasty(BAV) reduces the need for permanent pacemaker implantation (PPMI) after transcatheter aortic valveimplantation (TAVI).METHODS: This was a retrospective analysis using data from our local TAVI database. SmallBAV was defined as a small balloon size (=18 mm) pre-dilatation. Normal BAV was defined as aballoon size >18 mm. The primary endpoint was the incidence of new PPMI.RESULTS: Of 99 consecutive TAVI patients, five patients were excluded due to pre-existingpermanent pacemaker. Patients in the small BAV group (n=57) had a signifi cantly lower PPMI ratecompared with the normal BAV group (n=37) (3.5% vs. 18.9%, P=0.026). Moderate or severe aorticvalve regurgitation post-procedure was similar between the small BAV and normal BAV groups (5.3%vs. 8.1%, P=0.480);likewise, the mean aortic gradient post-procedure did not differ significantly(11.5±5.2 mmHg vs. 12.2±7.3 mmHg, 1 mmHg=0.133 kPa, P=0.580) between the groups. Devicesuccess rates were also similar (94.7% vs. 91.8%, P=0.680). In multivariable analysis, small BAV(P=0.027), the ratio of prosthesis diameter to annulus diameter (P=0.048), and mean aortic gradientby echo in the basement (P=0.021) were independent predictors of PPMI.CONCLUSIONS: The small BAV strategy is associated with a low rate of permanentpacemaker implantation after transcatheter self-expanding valve implantation in this single-centerobservational study.

Summary and clinical application of Zhuang medicine medicated thread moxibustion

Zhuang medicine medicated thread moxibustion is a kind of external therapy with ethnic medicine characteristics that spreads in Guangxi Zhuang region.It has a wide range of clinical application and significant curative effect,and can be used to treat diseases such as internal medicine,surgery,dermatology,gynecology,pediatrics,and five sense organs.Through reviewing and combing the literature on the Zhuang medicine medicated thread moxibustion in recent years,this paper summarizes and prospects its clinical application,with a view to further explaining the basic principles and application rules of Zhuang medicine medicated thread moxibustion and digging its clinical value.

Extensively infarcted giant solitary hamartomatous polyp treated with endoscopic full-thickness resection:A case report

BACKGROUND Solitary hamartomatous polyps(SHPs)are rare lesions.Endoscopic full-thickness resection(EFTR)is a highly efficient and minimally invasive endoscopic procedure that benefits from complete lesion removal and high safety.CASE SUMMARY A 47-year-old man was admitted to our hospital after experiencing hypogastric pain and constipation for over fifteen days.Computed tomography and endoscopy revealed a giant pedunculated polyp(approximately 18 cm long)in the descending and sigmoid colon.This is the largest SHP reported to date.Having considered the condition of the patient and mass growth,the polyp was removed using EFTR.CONCLUSION On the basis of clinical and pathological evaluations,the mass was considered an SHP.

Child with adenylosuccinate lyase deficiency caused by a novel complex heterozygous mutation in the ADSL gene:A case report

BACKGROUND Adenylosuccinate lyase(ADSL)deficiency is a rare autosomal-recessive defect of purine metabolism caused by mutation of the ADSL gene.It can cause severe neurological impairment and diverse clinical manifestations,including epilepsy.CASE SUMMARY Here,we describe a 3-year-old Chinese boy who had both psychomotor retardation and refractory epilepsy.Magnetic resonance imaging showed myelin hypoplasia.Electroencephalography findings supported a diagnosis of epilepsy.Whole-exon sequencing revealed the presence of a novel complex heterozygous mutation in the ADSL gene:The splicing mutation c.154-3C>G and the missense mutation c.71C>T(p.Pro24Leu).Considering the patient’s clinical presentation and genetic test results,the complex heterozygous mutation was predicted to prevent both ADSL alleles from producing normal ADSL,which may have led to ADSL deficiency.Finally,the child was diagnosed with ADSL deficiency.CONCLUSION We identified a novel complex heterozygous mutation in the ADSL gene associated with ADSL deficiency,thus expanding the known spectrum of pathogenic mutations that cause ADSL deficiency.Additionally,we describe epilepsy that occurs in patients with ADSL deficiency.

Value of dual-energy CT virtual noncalcium in the diagnosis of sacroiliac joint bone marrow edema

Objective:To explore the clinical value of dual energy CT(DECT)virtual noncalcium(VNCa)in the diagnosis of sacroiliac joint bone marrow edema(BME).Methods:A collection of 45 patients(21 males,24 females,and an average age of 34 years)who underwent MRI and DECT(Siemens Somatom definition force)examinations for the sacroiliac joints in our hospital from January 2019 to August 2020.After the DECT scan,the bone marrow pseudo-color map was obtained after VNCa processing.The bone marrow pseudo-color map was evaluated by two physicians.Take MRI test results as the gold standard,the application value of DECT VNCa technology in the diagnosis of sacroiliac joint BME was analyzed.Results:The positive predictive value(PPV),negative predictive value(NPV),sensitivity(Sen),specificity(Spe)and accuracy(Acc)of the qualitative diagnosis of iliac bone and sacral BME with DECT VNCa technology was:80.6%,85.2%,78.4%,86.8%,83.3%and 100%,64.9%,32.5%,100%,70.0%,respectively.The area of edema displayed by quantitative measurement of DECT VNCa image is smaller than the area measured by MRI image.The VNCa CT value(-71.66±72.97Hu)of the iliac edema area was higher than that of the non-edema area(-90.27±65.85Hu),and the VNCa CT value of the sacral edema area(-62.90±46.87Hu)was higher than that of the non-edema area(-101.08±134.02Hu),the best cut-off values(Cut-off values)for the quantitative diagnosis of iliac bone and sacral BME by VNCa are-66.40Hu and-50.60Hu,respectively.The curve of the receiver operating characteristic(ROC)of the iliac bone and sacrum area under the cure(AUC)is 0.720 and 0.706 respectively.There is a moderate negative correlation between the VNCa CT values of the ilium and sacrum in the edema area and the conventional CT values.Conclusion:The DECT VNCa technique has certain effectiveness in the diagnosis of sacroiliac joint BME,and its effectiveness in the diagnosis of ilium BME is better than sacrum.

Effectiveness and safety of acupuncture on cancer pain: a meta-analysis

Objective:The aim of the study was to evaluate the efficacy of acupuncture combined with opiates in the treatment of cancer pain through the meta-analysis system.Methods:China national knowledge infrastructure and VIP Database for Chinese technical periodicals,China Biology Medicine,PubMed,Embase databases were searched from January 2016 to February 8,2020 for the randomized controlled trials on the effects of acupuncture combined with opiates on cancer pain.Meta-analysis of ordered data was performed using Stata-MP64 and Review Manager 5.3 software.Results:A total of 242 Chinese studies and 25 English studies were retrieved.According to the inclusion and exclusion criteria,19 literatures finally were included.The fixed effect model was used to combine the total effect values,and the combined odds ratio(OR)(95%confidence interval(CI))was 2.981(2.384,3.729),suggesting that acupuncture combined with opiates was better than opiates alone in treating cancer pain(Z=9.57,P<0.05);the combination treatment could improve Karnofsky Performance Status score(Z=2.48,P=0.01),decrease Numerical Rating Scale score(Z=2.89,P=0.004);it also could reduce eruption pain frequency(Z=4.32,P<0.0001),improve the effects time(Z=2.51,P=0.01),and extend analgesia duration(Z=4.33,P<0.0001);the combination group also had lower Oxycodone dose than the control group(Z=3.193,P=0.001).At the same time,the incidence of adverse reactions was lower than that of the opiate treatment group alone,with a OR(95%CI)of 0.27(0.19,0.37)and statistical significance,Z=8.06,P<0.05.Conclusion:Acupuncture combined with opioids for cancer pain is superior to opioids alone with a lower incidence of adverse reactions.

Development of inclusions in 3104 alloy melt during heating and holding treatments

Developments in the contents of different typical inclusions in 3104 alloy melt were described during heating and holding processing. The settling process of inclusion particles was investigated by measuring the contents of inclusions in the surface, center, and bottom layers of the molten metal. In the results, main inclusions observed and determined by Prefil and PoD FA methods are MgO, Al2O3, spinel（MgAl2O4）, and TiB2 particles or thin films. It is found that some small particles of Al2O3 and MgO are transformed into spinel particles, and the formation rate increases as the temperature and the holding period of melt increase. The content of inclusions increases from 3.37 mm^2×kg^-1 to 7.54 mm^2×kg^-1 and then decreases to 3.08 mm^2×kg^-1 after holding for 90 min. This is attributed to a settling phenomenon and a significant increase in settling velocity after holding for 60 min. The content of inclusion particles decreases by means of settlement and flotation in liquid aluminum with an increase in holding time. The theoretical analysis and experiment results are in essential agreement with those from industrial production.

热重分析技术及其在高分子表征中的应用

热重分析技术(TGA)是在程序控制温度和设定气氛下表征材料受热过程中的质量随温度或时间变化的高精度研究工具,具有重复性好、灵敏度高和热过程控制精准等优点.近年来,TGA技术在高分子材料领域得到了广泛应用,促进了高分子材料热稳定性、组成分析以及热分解机理等材料细观热响应特性的深入研究.本文分别从热重分析基本原理、仪器校准、实验方案设计、实验操作、热重曲线综合解析以及各环节中易出现的不当操作、异常数据与解决方案等方面进行阐述,并给出了在高分子科学研究领域中的典型应用案例、未来发展趋势及机遇与挑战.在实际应用中,基于TGA与傅里叶红外光谱(FTIR)、示差扫描量热法(DSC)、气相色谱-质谱联用(GC/MS)等技术的联用分析,将有利于进一步揭示高分子材料在不同气氛和热激励等条件下的详细热响应信息,为性能优异的新型高分子材料研发与设计、热解机理及燃烧蔓延动力学等领域提供支撑和指导.

Appearance of Inflammation in Peripheral Blood during Menstrual Cycles in Women of Childbearing Age

Background:Chronic inflammation has been reported as a triggering and driving factor in the pathogenesis of various diseases and is believed to be closely associated with tumor pathogenesis.In this study,we aimed to explore the changes of the inflammatory stress-related indexes during the menstrual period.Methods:Cytokines and tumor-associated carbohydrate antigens from 76 childbearing-age women during the follicular phase,luteal phase,and menstrual period were measured.Results:The expression of inflammatory indexes,such as platelets(PLT),lymphocytes(Lym),the percentage of Lym(Lym%),neutrophils(Neu),the percantage of Neu(Neu%),neutrophil-to-lymphocyte ratio(NLR),interleukin-6(IL-6),and cancer antigen 125(CA125),reached the highest level during the menstrual period.Conclusions:Female genital organs are under inflammatory stress during menstruation,which hints that the changes of the inflammatory state of the body play an important role in the pathogenesis of diseases.

A new method for concentration analysis of bacterial endotoxins in perfluorocarbon

This communication demonstrates the feasibility of the gel-clot method for the analysis of bacterial endotoxins in water extracts of perfluorocarbon which is a water insoluble liquid medical device. Perfluorocarbon （10 mL） was shaken with 10 mL water for 15 min at 2000 r/min and the endotoxin present was extracted to the aqueous phase without interference inhibition/enhancement of the product and the recovery of endotoxin added to perfluorocarbon was determined, A validation study confirmed that endotoxins presented in perfluorocarbon pass over into the aqueous phase at concentrations of 20, 10 and 5EU/mL with recoveries from 86.8% to 96.8%. Therefore, the gel-clot test is suitable for detecting bacterial endotoxins in perfluorocarbon which is a water insoluble medical device.

GCRV NS38 counteracts SVCV proliferation by intracellular antagonization during co-infection

Viral co-infection has been found in animals;however,the mechanisms of co-infection are unclear.The abundance and diversity of viruses in water make fish highly susceptible to co-infection.Here,we reported a coinfection in fish,which resulted in reduced host lethality and illustrated the intracellular molecular mechanism of viral co-infection.The spring viremia of carp virus(SVCV)is a highly lethal virus that infects Cyprinidae,such as zebrafish.The mortality of SVCV infection was significantly reduced when co-infected with the grass carp reovirus(GCRV).The severity of tissue damage and viral proliferation of SVCV was also reduced in co-infection with GCRV.The transcriptome bioinformatics analysis demonstrated that the effect on the host transcripts in response to SVCV infection was significantly reduced in co-infection.After excluding the extracellular interactions of these two viruses,the intracellular mechanisms were studied.We found that the GCRV NS38 remarkably decreased SVCV infection and viral proliferation.The interaction between GCRV NS38 and SVCV nucleoprotein(N)and phosphoprotein(P)proteins was identified,and NS38 downregulated both N and P proteins.Further analysis demonstrated that the N protein was degraded by NS38 indispensable of the autophagy receptor,sequestosome 1(p62).Meanwhile,K63-linked ubiquitination of the P protein was reduced by NS38,leading to ubiquitinated degradation of the P protein.These results reveal that the intracellular viral protein interactions are a crucial mechanism of co-infection and influence the host pathology and expand our understanding in intracellular viral interactions co-infection.

Fish herpesvirus KLP manipulates Beclin1 to selectively degrade MITA through a precise autophagic manner for immune evasion

Control of host autophagy acceleration or attenuation has been confirmed in multiple terrestrial animal viruses.Little is known about such mechanisms in aquatic viruses.Here,we report a selective and ingenious autophagy modulation regulated by kinase-like protein(KLP)of cyprinid herpesvirus 2(CyHV2)to restrict interferon(IFN)production by degrading IFN regulatory factor(IRF)3 activation(MITA).First,exogenous DNA and RNAmediated IFN activation were both abrogated by CyHV2 KLP.The common intersection point of MITA with these two signaling pathways was the interaction with KLP.The C terminus of MITA was indispensable for the interaction and was recruited by KLP in subcellular colocalization analysis.Subsequently,we found that KLP degraded MITA in an autophagy-lysosome-dependent manner and,interestingly,individual KLP could not launch host autophagic flow except in the presence of MITA.KLP was also colocalized with the autophagy components Beclin1 and ATG14 and enhanced Beclin1 stability,but not ATG14,through K63-linked polyubiquitination.Finally,KLP significantly decreased the normal state or MITA-enhanced cellular antiviral capacity.These data demonstrated an elaborate autophagic process manipulated by a fish virus only in the presence of the host target,illuminating a mechanism of aquatic viral immune evasion.