Cardiac arrest (CA) induced by army combat trauma is a specific type of traumatic cardiac arrest. Since it is inextricably intertwined with tactical combat casualty care (TCCC), the diagnosis and therapeutic strategy is dependent on various stages, i.e., care under fire/threat, tactical field care, and tactical evacuation care. In addition, active abdominal compression-decompression cardiopulmonary resuscitation (AACD-CPR) should be considered among patients with lung, pleural and heart injury resulted from chest trauma. Moreover, portable ultrasound to identify reversible etiologies in CA should be highlighted.

Objective To investigate the role and mechanism of circRNA BRAF_2 in proliferation and apoptosis of placental trophoblast cells in preeclampsia (PE). Methods Placental tissues of pregnant women with normal pregnancy and PE were collected (n=21) in the General Hospital of Ningxia Medical University from January 2018 to February 2019. The expression level of circRNA BRAF_2 in placental tissues of the two groups was detected by qRT-PCR, and the correlation between circRNA BRAF_2 expression level and blood pressure was analyzed. Human placental trophoblast cell lines (HTR8-S/Vneo) were cultured in vitro, (1) Cells were divided into control group and hypoxia group, and the expression of circRNA BRAF_2 were detected by qRT-PCR. (2) HTR8-S/Vneo was transfected with circRNA BRAF_2 lentivirus empty vector and circRNA BRAF_2 overexpression lentivirus, and then divided into control group, circRNA BRAF_2 negative control group and circRNA BRAF_2 overexpression group. The overexpression of circRNA BRAF 2 was verified with qRT-PCR. (3) Based on the successful transfection of circRNA BRAF_2 overexpressing lentivirus, the cells were divided into control group, circRNA BRAF_2 negative control group, circRNA BRAF_2 overexpression group, hypoxia group, hypoxia +circRNA BRAF_2 negative control group, and hypoxia +circRNA BRAF_2 overexpression group. EdU and CCK-8 methods were used to detect the proliferation. Flow cytometry was used to detect the changes of apoptosis level. Western blotting was used to detect the expression levels of apoptosis-related proteins caspase-3, caspase-9,Bcl-2 and Bax. qRT-PCR was used to detect the expression levels of circRNA BRAF_2 in HTR8-S/Vneo cytoplasm and nucleus.Bioinformatics analysis was performed to screen out the miRNA that might bind circRNA BRAF_2 and detect their expression levels in tissues and cells. Results Compared with normal pregnancy group, the expression level of circRNA BRAF_2 was significantly decreased in placenta of PE group (P<0.001), and of circRNA BRAF_2 was negatively correlated with systolic pressure and diastolic pressure (r=-0.4531, P<0.01; r=-0.4381, P<0.01). qRT-PCR showed that compared with control group, the expression level of circRNA BRAF_2 in hypoxia group was significantly decreased (P<0.01), and the relative expression level of circRNA BRAF_2 in negative control group showed no significant difference when ompared with control group (P>0.05). Compared with that in circRNA BRAF_2 negative control group, the circRNA BRAF_2 expression level increased significantly in circRNA BRAF_2 overexpression group (P<0.001). The detection results of EdU and CCK-8 showed that, compared with control group, the percentage of positive EdU cells decreased significantly (P<0.001) in hypoxia group, trophoblast proliferation ability decreased (P<0.001); Compared with the hypoxia +circRNA BRAF_2 negative control group, the percentage of EdU positive trophoblast cells increased significantly in hypoxia +circRNA BRAF_2 overexpression group (P<0.001), and the proliferation ability of trophoblast cells was significantly enhanced (P<0.001). The detection results of flow cytometry showed that, compared with control group, the apoptosis rate of hypoxia group increased obviously (P<0.001); Compared with the hypoxia +circRNA BRAF_2 negative control group, the apoptosis rate of the hypoxia + circRNA BRAF_2 overexpression group decreased significantly (P<0.001). Western blotting showed that compared with control group, the relative expressions of caspase-3, caspase-9 and Bax proteins increased (P<0.01 or P<0.001), and of Bcl-2 protein decreased (P<0.01) in hypoxia group; Compared with the hypoxia + circRNA BRAF_2 negative control group, the relative expressions of caspase-3, caspase-9 and Bax proteins decreased (P<0.001 or P<0.01), and of Bcl-2 protein increased (P<0.05) in hypoxia + circRNA BRAF_2 overexpression group. The results of qRT-PCR showed that circRNA BRAF_2 was expressed mainly in cytoplasm, and bioinformatics analysis showed that binding sites existed between circRNA BRAF_2 and miR-7855-5p. and miR-7855-5p was highly expressed in PE placental tissue than that in normal pregnancy group (P<0.05); Compared with control group, miR-7855-5p was obviously highly expressed in hypoxia group (P<0.001). Conclusion circRNA BRAF_2 can promote proliferation and inhibit apoptosis of PE placental trophoblast cells, and the mechanism may be related to miR-7855-5p.

Objective To investigate the effect of early injection of umbilical cord mesenchymal stem cells (UC-MSCs)on the progression of diabetic nephropathy (DN) in type 2 diabetes mellitus (T2DM) mice and its mechanism. Methods Twenty 5-week-old male db/db mice were used to establish T2DM model and randomly divided into stem cell treatment group(MSCs group, n=10) and T2DM group (DM group, n=10); In addition, age-matched db/m mice were set as normal control group(NC group, n=10). Human UC-MSCs (1×10⁶/0.2 ml saline) were infused into the tail vein of mice in MSCs group for 6 weeks,while the same volume of saline was infused into the tail vein of mice in NC and T2DM groups once a week for 6 consecutive times. Blood glucose and body weight of mice in each group were monitored weekly. At the end of the sixth treatment, the mice in each group were killed by heart perfusion, and the blood and kidney tissues were collected for biochemical and histopathological examination. Western blotting was used to detect the expression of silent information regulator 2 homolog 1 (SIRT1) and Claudin-1,and immunohistochemistry was used to detect the expression of SIRT1, Claudin-1, type 1 collagen (Col Ⅰ) and Col Ⅳ. The morphology of glomeruli was observed by electron microscope. HK-2 cells in logarithmic growth phase were divided into control group, high glucose induced model group (HG group), high glucose induced siRNA group (HG+siRNA group), MSC groups(HG+MSC group) and SIRT-1 siRNA group (HG+MSC+siRNA group). The expression levels of apoptosis-related proteins were detected by Western blotting. Results After the sixth treatment, compared with NC group [(7.66±0.37) mmol/L], the levels of blood glucose increased significantly (P<0.01) in T2DM group and MSCS group [(32.54±0.36) mmol/L, (29.74±1.04)respectively]; Compared with T2DM group, the level of blood glucose in MSCs group decreased significantly (P<0.05).Pathological results showed that compared with NC group, glomerular sclerosis, diffuse thickening of basement membrane and renal interstitial fibrosis were significantly increased in T2DM group; compared with T2DM group, glomerular sclerosis, deposition of mesangial extracellular matrix and renal interstitial fibrosis were alleviated in MSCs group. The results of Western blotting and immunohistochemistry showed that compared with T2DM group, the expression level of SIRT1 protein in MSCs group increased significantly (P<0.01), the expression of Claudin-1 protein decreased significantly (P<0.01), and of α-smooth muscle actin (α-SMA)protein decreased significantly in MSCs group (P<0.05). In addition, the immunohistochemical results showed that the percentage of Col Ⅰ and Col Ⅳ positive area in MSCs group was significantly lower than that in T2DM group (P<0.01). Compared with NC group, T2DM group showed marked destruction of glomerular filtration barrier, diffuse thickening of basement membrane, and extensive fusion and disappearance of foot processes. Compared with T2DM group, the structure of glomerular foot process in MSCs group was regular and complete. Western blotting results showed that SIRT-1 protein content was significantly lower in HG group than that in control group (P<0.01), while apoptosis-related Cytochrome-C protein contents were significantly higher in HG group than that in control group (P<0.01). Compared with HG group, the protein content of SIRT-1 in HG+MSC group was significantly higher (P<0.01), and the content of apoptosis-related Bax and Cytochrome-C protein decreased significantly (P<0.01).Compared with HG+MSC group, the protein content of SIRT-1 in HG+MSC+siRNA group was significantly decreased (P<0.01),while the protein content of apoptosis-related Bax and Cytochrome-C increased significantly (P<0.01). Conclusion UC-MSCs treatment may play a protective role for kidney of T2DM mice and delay the development of DN by up-regulating the expression of SIRT1 and down-regulating the expression of Claudin-1.

Objective To investigate the effect and the underlying molecular mechanism of zinc finger protein Zpr1 on differentiation and the insulin signaling pathway of pre-adipocytes. Methods A high-fat diet-induced insulin resistance mouse model (IR group, n=7) was established by feeding 8-week-old C57BL/6J male mice using high-fat feed for 16 weeks, with conventional diet feeding mice as control group (n=7). Glucose tolerance and insulin tolerance tests were used to observe the blood glucose values of mice in each group and verify the insulin resistance phenotype of mice in the induction group. Western blotting and RT-PCR were performed to detect the protein and mRNA expression of Zpr1 in subcutaneous and visceral adipose tissue from high-fat diet induced insulin resistance mice and regular diet mice. Bioinformatic prediction combined with dual-luciferase reporter gene system were employed to detect the influence of single nucleotide polymorphism (SNP) rs964184 GG genotype and CC genotype in human ZPR1 against miR-4286 binding to the 3'UTR of ZPR1. After mouse preadipocyte 3T3-L1 transfected with miR-4286 simulant to observe the effect of miR-4286 regulating Zpr1 expression on adipocyte differentiation and insulin signaling pathway. Results The protein and mRNA expression levels of Zpr1 decreased obviously in the subcutaneous and especially in the visceral adipose tissues of high-fat diet induced insulin resistant (IR) mice compared with the mice in control group (P<0.05, P<0.01).The rs964184 SNP locus of ZPR1 made it difficult that ZPR1 3'UTR forms a multi-hairpin structure, but may promote miR-4286 to recognize and bind to ZPR1 3'UTR. The miR-4286 level increased obviously in subcutaneous and especially in visceral adipose tissues of IR model group mice (P<0.05); meanwhile, the protein expression level decreased of Zpr1 in mouse pre-adipose cells 3T3-L1 regulated by miR-4286 simulacrum (P<0.05). At the same time, after transfection of miR-4286 simulacrum, the expression levels of fat cell differentiation and insulin signaling pathway-related proteins PPAR-γ, Perilipin A, pAkt, and IRS-1 in 3T3-L1 cells were reduced markedly (P<0.05). Conclusions The GG genotype rs964184 locus can promote the post-transcriptional regulation of Zpr1 by miR-4286. The decreased expression of Zpr1 can inhibit the differentiation of 3T3-L1 preadipocytes and interfere the insulin signaling pathway.

Objective To investigate the effect and mechanism of fenvalerate (Fen) on testosterone synthesis in Leydig cells of rats testis. Methods Leydig cells of SD rat testis were isolated and purified by differential adhesion method, then treated with 0, 25, 50 and 100 μmol/L Fen for 1, 12 and 24 h, and the level of testosterone was detected by ELISA. Set blank control group(treatment with 0.1% DMSO), Fen exposure group (treatment with 100 μmol/L Fen), Fen+NAC group (treatment with 100 μmol/L Fen and 5 mmol/L NAC), Fen+CsA group (treatment with 100 μmol/L Fen and 2 mmol/L CsA), and cultured for 24 h after administration. The changes of cellular reactive oxygen species (ROS) and mitochondrial membrane potential were detected by flow cytometry, the levels of testosterone, glutathione (GSH) and cAMP were detected by ELISA, and the content of ATP was detected by chemi-luminescence, Western blotting was used to detect the expressions of superoxide dismutase (SOD), steroidogenic acute regulatory protein (StAR), 3β-hydroxysteroid dehydrogenase (3β-HSD) and cytochrome P450 cholesterol side-chain cleavage(CYP11A1). Results 100 μmol/L Fen treatment for 24 h was selected in the experiments. Compared with blank control group, the testosterone synthesis level, the contents of GSH, SOD, ATP and cAMP, mitochondrial membrane potential, and the relative expression levels of StAR, 3β-HSD and CYP11A1 decreased significantly in Leydig cells of Fen exposure group (P<0.01), the ROS content increased significantly (P<0.01). Compared with Fen exposure group, the testosterone synthesis level, the contents of GSH, SOD, ATP and cAMP, mitochondrial membrane potential, and the relative expression levels of StAR, 3β-HSD and CYP11A1 increased significantly in Leydig cells of Fen+NAC group and Fen+CsA group (P<0.05 or P<0.01), the ROS content decreased significantly (P<0.01). Conclusion Fen may cause mitochondrial damage in Leydig cells by inducing oxidative stress, resulting in the inhibition of ATP and cAMP synthesis, thereby inhibiting the expression of testosterone synthesis related proteins and enzymes dependent on cAMP/PKA signaling pathway, and ultimately leading to testosterone synthesis disorder in Leydig cells.

Objective To compare the differences between exosomes derived from three-dimensional (3D) cultured human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) and conventional (2D) cultured hUC-MSCs in promoting osteoblast differentiation, and to explore the application possibility of exosomes derived from 3D-cultured hUC-MSCs in treatment related to promoting bone formation. Methods hUC-MSCs were divided into 2D group and 3D group, and cultured respectively.The morphological characteristics of the both groups were observed under optical microscope, and the viability of 3D-cultured hUC-MSCs was detected by calcein AM/PI double staining of living and dead cells. Transcriptome sequencing was performed to screen the differentially expressed genes between 2D group and 3D group, and GO enrichment analysis was conducted. Exosomes of 2D group and 3D group were extracted and divided into 2D-Exo group and 3D-Exo group. Characterization of exosomes was conducted by transmission electron microscope, nanoparticle tracking analysis and Western blotting. The exosomes excreted by 2D group and 3D group were applied to C57BL/6J mouse calvarial osteoblasts, respectively, and osteogenic differentiation was induced in vitro. The effects of exosomes cultured in 2D and 3D on osteogenic differentiation were identified by alizarin red staining, alkaline phosphatase staining and RT-qPCR. Results Comparing to 2D group, cells in 3D group were equal in size and grew into spherical shape. 3D-cultured hUC-MSCs showed higher rate of viability verified by calcein AM/PI double staining of living and dead cells.Transcriptome sequencing results showed that the up-regulated genes in 3D group were enriched in bone mineralization, cartilage development, composition of extracellular matrix, osteoblast differentiation, angiogenesis, cell proliferation and gene expression.The down-regulated genes were enriched in negative regulation of cell proliferation, cell migration, and apoptotic process, etc.Transmission electron microscope observation showed that the exosome diameter in both 2D-Exo group and 3D-Exo group were around 100 nm and exhibited typical cup shape features, and expressed exosome related marker proteins CD9, CD63 and CD81.Staining results of osteoblasts in calvaria of newborn rats showed that the number of calcium nodules stained with alizarin red and the intensity of alkaline phosphatase staining increased significantly in 3D-Exo group than in 2D-Exo group. Results of RT-qPCR showed that the relative expression levels of osteogenic differentiation related genes Bglap, Runx2, Alp, Col1a1 and Spp1 mRNA increased significantly in 3D-Exo group than in 2D-Exo group with statistically significant differences (P<0.05). Conclusion Exosomes from 3D-cultured hUC-MSCs can up-regulate the expressions of osteogenic genes Bglap, Runx2, Alp, Col1a1 and Spp1,and have stronger capabilities to promote osteogenic differentiation compared with 2D-cultured exosomes.

Objective To investigate the effect of resveratrol (Res) on microglia function after intracerebral hemorrhage (ICH) and its possible mechanism. Methods (1) Animal experiment: 27 SD rats (12-week-old) were randomly divided into 3 groups (9 each): control group, ICH group and Res group; each group was randomly divided into three subgroups (3 each) at 6 h,24 h and 72 h after operation. Rats in ICH group were modeled by autologous blood modeling method, while in control group were only injected with needles without autologous blood injection. Rats in Res group were intraperitoneally injected with 50 mg/(kg.d)resveratrol on the basis of ICH group, and 2% dimethyl sulfoxide (DMSO) solvent of the same volume were injected in control group and ICH group. 6 h, 24 h and 72 h after successful modeling, the corresponding rats were subjected to modified neurological severity score (mNSS). Then the rats in each subgroup were sacrificed and their brain tissues were taken from the same area and embedded in wax blocks. The expression of TRL4, CD36, HO-1 and Nrf2 protein in rat brain tissue was observed by tissue section, HE staining,Nissl staining, TUNEL staining and immunofluorescence method. (2) Cell experiment: BV2 mouse microglia cells were divided into control group, Fe²⁺ group (FeSO₄ 10 μmol/L) and Fe²⁺+low dose resveratrol (25 μmol/L) group and Fe²⁺+high dose resveratrol(50 μmol/L) group. The expression levels of TLR4, CD36, Nrf2, p-Nrf2, and HO-1 proteins were detected by Western blotting after incubation for 24 h and 72 h, respectively, and the localization of Nrf2 protein was observed by cell immunofluorescence. Results (1) mNSS score indicated that rats in ICH group had obvious neurological dysfunction while normal in control group. mNSS score of rats was significantly higher in ICH group than in control group (P<0.01). As time went by 24 h or 72 h, mNSS score of rats reduced significantly in Res group than in ICH group (P<0.05, P<0.01). HE staining of rat brain tissue indicated that increased infiltration of red blood cells and inflammatory cells were in ICH group, and the infiltration of red blood cells and inflammatory cells in the brain tissue of rats in Res group was improved compared with those in ICH group. Nissl staining of rat brain tissue showed that, compared with the control group, the dissolution of nissl corpuscles in brain tissue of ICH group increased, and in Res group decreased. TUNEL staining of rat brain tissue showed that the neurocyte apoptosis index in brain tissue of rats in ICH group increased significantly compared with that in control group (P<0.05), and it was significantly lower in Res group compared with ICH group (P<0.05). The immunofluorescence of proteins indicated that the expressions of TLR4, CD36, Nrf2 and HO-1 protein in rats'brain tissue in ICH group increased significantly compared with rats in control group (P<0.05). Compared with rats in ICH group,the expression of TLR4 protein in brain tissue of the rats in Res group decreased at the same time point (P<0.05), while the protein expressions of CD36, Nrf2 and HO-1 increased significantly (P<0.05). (2) Compared with the control group, the relative expression of TLR4, CD36 and HO-1 protein in BV2 cells of Fe²⁺ group increased (P<0.05), the expressions of Nrf2 and p-Nrf2 increased at 72 h (P<0.05), the expression of Nrf2 protein in the nucleus increased (P<0.01); Compared with the Fe²⁺ group, the expression of TLR4 in the low dose group of Fe²⁺+Res and the high dose group of Fe²⁺+Res decreased (P<0.001), and the expression of CD36,HO-1, Nrf2, p-Nrf2 and nuclear Nrf2 protein increased (P<0.05). Conclusions Intraperitoneal injection of resveratrol can improve the neurological function of rats after ICH. The microglia activated by Fe²⁺ within 72 hours after intracerebral hemorrhage mainly showed pro-inflammatory function. Resveratrol may regulate Nrf2/HO-1 signal pathway and promote the transformation of microglia function to anti-inflammatory after ICH.

Objective To investigate the early diagnosis value of neutrophil-side-fluorescence intensity (NE-SFI) on heat stroke (HS)-related disseminated intravascular coagulation (DIC). Methods According to the International Society of Thrombosis and Haemostasis (ISTH) scoring criteria, thirty-four HS patients admitted to the General Hospital of Southern Theater Command from January 1, 2017 to December 31, 2018 were selected and divided into HS without DIC group (DIC score <5 points, n=23)and HS with DIC group (DIC score ≥5 points, n=11). The patient's general information, NE-SFI, and neutrophil extracellular traps (NETs)-related markers such as, dsDNA (double-stranded DNA), myeloperoxidase (MPO) and citrullinated histone (CitH3)were compared between the two groups. Receiver operating characteristic (ROC) curve was used to analyze the early diagnostic value of NE-SFI in HS with DIC. Results There was no significant difference in age, maximum body temperature, white blood cell count and neutrophil count between the two groups (P>0.05). The proportion of patients in the HS with DIC group whose core temperature dropped below 38.5 ℃ within 3 hours and the GCS (Glasgow Coma Scale) score were lower than those in the HS without DIC group, while the alanine aminotransferase (ALT), creatinine, ISTH (International Society of Thrombosis and Haemostasis) score, and the proportion of concurrent multiple organ dysfunction syndrome (MODS) in the HS with DIC group were higher than those in the HS without DIC group (P<0.05). On the 1st to 3rd day of onset, the NE-SFI values of the HS with DIC group were higher than those of the HS without DIC group (P<0.001). Compared with the serum dsDNA, MPO, and CitH3 in HS without DIC group [respectively (30.14±7.01) ng/ml, (56.39±34.64) pg/ml, (320.26±89.60) ng/μl], the serum dsDNA, MPO and CitH3 levels in HS with DIC group [respectively (372.93±135.77) ng/ml, (108.32±38.58) pg/ml, (600.18±183.74) ng/μl]are significantly increased (P<0.001). Spearman correlation analysis showed that the value of NE-SFI on day 1-3 were positively correlated with the levels of dsDNA, MPO and CitH3 on day 1 (P<0.05 or P<0.01). ROC curve analysis showed that NE-SFI on day 2 had a high value for the early diagnosis of HS complicated with DIC, and its AUC was 0.921 (95%CI 0.820-1.000, P<0.001). Conclusion NE-SFI can be used as an effective indicator for the early diagnosis in HS complicated with DIC.

Objective To explore the effect of endoscopic radical thyroidectomy combined with parathyroid autotransplantation on the recovery of postoperative parathyroid function. Methods The clinical data of 323 patients undergoing endoscopic radical resection of thyroid carcinoma in the General Surgery Department of Gansu Provincial People's Hospital from January 2019 to April 2021 were retrospectively analyzed and divided into transplant group (n=171) and non-transplant group(n=152) according to whether combined with selective parathyroid. The incidence of circulating parathyroid hormone (PTH),Ca²⁺ concentration and hypoparathyroidism were recorded before surgery and 1 day, 1 week, 1 month, 3 months, 6 months and 12 months after surgery in both groups, and the PTH concentration in the elbow fossa veins of both arms were collected in the transplant patients. Risk factors for hypoparathyroidism after thyroid surgery were analyzed using logistic regression. Results The incidence of transient hypoparathyroidism was higher, while of permanent hypoparathyroidism was lower in transplant group than in non-transplant group (33.33% vs. 23.03%; 0.58% vs. 5.26%), the differences were significant (P=0.007). The PTH concentrations were significantly higher in transplant group than in non-transplant group from 1 week to 12 months after surgery with statistically significant difference (P<0.001). The PTH concentration in vein of transplant side cubital fossa was significantly higher from 1 week to 12 months after surgery in transplant group than in non-transplant group, and the differences were statistically significant(P<0.001). Twelve months after surgery, PTH secretion function in transplant group and non-transplant group had recovered to 85.42% and 67.60% of preoperative baseline, respectively. Univariate logistic regression analysis showed that transplantation and Hashimoto's thyroiditis were the risk factors for temporary hypoparathyroidism after thyroid surgery (OR=1.671, 95%CI 1.020-2.738,P=0.041; OR=1.925, 95%CI 1.138-3.259, P=0.015), and transplantation was a protective factor for permanent hypoparathyroidism(OR=0.106, 95%CI 0.013-0.857, P=0.035). Multi-factor logistic regression analysis showed that transplantation and Hashimoto's thyroiditis were the risk factors for temporary hypoparathyroidism (OR=1.736, 95%CI 1.044-2.887, P=0.034; OR=1.903, 95%CI 1.111-3.258, P=0.019), and transplantation was a protective factor for permanent hypoparathyroidism (OR=0.101, 95%CI 0.012-0.839, P=0.034). Conclusion In endoscopic radical resection of thyroid carcinoma, parathyroid autotransplantation is an effective strategy to prevent permanent hypoparathyroidism, but can also lead to short-term postoperative hypoparathyroidism. As far as possible, selective transplantation of the inferior pole parathyroid glands with intraoperative damage or poor blood supply, based on in situ preservation of the superior pole parathyroid glands, is more conducive to recovery of postoperative parathyroid function.

Objective To explore the relativity of asymptomatic hyperuricemia(HUA) to lipoprotein associated phospholipase A2 (Lp-PLA2) in the middle-aged and elderly people. Methods From June 2019 to June 2020, 174 cases of epiphysically healthy middle-aged and elderly people were randomly screened from the Fuwai Hospital of the Chinese Academy of Medical Sciences for physical examination, and were divided into asymptomatic HUA group (n=58) and control group (n=116)according to the diagnostic criteria of HUA.The baseline clinical data of age, sex, body mass index (BMI) and laboratory data of blood routine, uric acid, creatinine, blood urea nitrogen, blood lipid, and Lp-PLA2 were retrospectively analyzed. Regression analysis was used to explore the risk factors of asymptomatic hyperuricemia. Results Among all the subjects, the incidence of HUA was significantly higher in women than in men (41.4% vs. 25.3%, P<0.05). The level of BMI, TG, LDL-C, Lp-PLA2 and the proportion of hypertension in asymptomatic HUA group was significantly higher than that in control group (P<0.05). Compared with the control group by sex, the incidence of HUA is higher in asymptomatic HUA group (P<0.05). The results of multivariate logistic regression analysis indicated that high level of Lp-PLA2 could be independent risk factors of high uric acid level. After divided into three quantile by the concentration of Lp-PLA2, compared with the lowest concentration, the OR value of the highest group increasing the risk of asymptomatic hyperuricemia was 4.61(95%CI 1.807-11.76, P<0.05). Conclusion Lipoprotein associated phospholipase A2 could be an independent risk factor of asymptomatic HUA in middle-aged and elderly adults.

Objective To observe the effect of gestational weight gain (GWG) on glucose metabolism and pregnancy outcomes in patients with gestational diabetes mellitus (GDM). Methods The clinical data of 1667 single pregnant women with GDM diagnosed in the Department of Obstetrics and Gynecology of the Sixth Medical Center of Chinese PLA General Hospital from January 2019 to December 2021 were collected and retrospectively analyzed. According to the degree of GWG, all the GDM pregnant women were divided into three groups: little weight gain group (n=882), moderate weight gain group (n=566)and excessive weight gain group (n=219). The levels of glycosylated hemoglobin (HbA_1c), fasting plasma glucose (FPG), fasting insulin (FIN), Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), homeostasis model assessment β cell function(HOMA-β) and neonatal birth weight were compared among the three groups. Logistic regression was used to analyze the correlation between GWG and adverse pregnancy outcomes. Results The levels of HbA_1c, FPG, FIN, HOMA-IR and HOMA-β in excessive weight gain group were significantly higher than those in little weight gain group and moderate weight gain group (P<0.05),and the levels of FIN, HOMA-IR and HOMA-β in little weight gain group were significantly lower than those in moderate weight gain group (P<0.05). The neonatal birth weight in excessive weight gain group was significantly higher than that in little weight gain group and moderate weight gain group (P<0.05), and the neonatal birth weight in little weight gain group was significantly lower than that in moderate weight gain group (P<0.05). Logistic regression analysis showed that both excessive weight gain and little weight gain were independent factors of hypertensive disorders of pregnancy (HDP), macrosomia and large for gestational age (LGA)(P<0.05). Conclusion Irrational weight gain during pregnancy may increase the incidence of glucose metabolism disorders and adverse pregnancy outcomes in pregnant women with GDM.

Ischemic heart disease (IHD) is one of the diseases with the highest mortality in the world, which endangers human health for a long term. Reperfusion, the preferred treatment strategy, can lead to myocardial deterioration and accelerate injury, known as myocardial ischemia-reperfusion injury (MIRI), which seriously affects the clinical efficacy and prognosis of patients. At present, the prevention and treatment of MIRI is still an unsolved clinical problem. Numerous studies have shown that adaptor protein p66Shc plays an important regulatory role in the occurrence and development of various diseases, including MIRI.The mechanism of adaptor protein p66Shc involved in oxidative stress, inflammatory response and vascular endothelial function in MIRI, and the relevant treatment strategies targeting p66Shc were reviewed in present paper in order to provide a reference for further research on prevention and treatment of MIRI.

Mucosal-associated invariant T (MAIT) cells are evolutionarily conservative and non-conventional innate T cell subsets, having the characteristics of both innate and adaptive immune cells. They have antibacterial and tissue repair functions,and are the important part of the immune system. MAIT cells are highly abundant in human liver and play a complex role in various liver diseases. Current studies have shown that the markedly reduced number of MAITs and the dysfunction of immunomodulatory effect in various liver diseases were closely related to the occurrence and progression of liver diseases. This paper mainly reviews the characteristics of MAIT cells and their latest progress in chronic viral hepatitis, autoimmune liver disease, non-alcoholic fatty liver disease, alcoholic liver disease and hepatocellular carcinoma, and further discuss the potential mechanisms underlying the loss of MAIT cells, so as to provide some references for follow-up research.

Chronic hepatitis C virus (HCV) is a worldwide epidemic and the main cause of liver cirrhosis and hepatocellular carcinoma (HCC). The anti-HCV treatment has gone through two eras of pegylated interferon-α plus ribavirin (PR therapy) and direct-acting antiviral agent (DAA). Generally, achieving a sustained virological response (SVR) can reduce the incidence of HCC through antiviral treatment. In recent years, increasing researchers pay more attention to the issue whether DAA treatment might increase the risk of HCC occurrence or recurrence. This article aims to review the related studies on the risk of HCC after PR therapy and DAA treatment, summarize the risk factors, and explore the mechanism of HCC and its impact on the efficacy of DAA, in order to help clinicians to determine the timing of initiation of antiviral therapy and provide clinical evidence for individualized management.

Perioperative hypothermia is not rare in surgical patients, and is closely related to a variety of complications,which is not conducive to postoperative recovery of patients. At present, many studies focus on the risk factors, adverse outcomes and prevention strategies of perioperative hypothermia, and few studies analyze the changes of perioperative hypothermia from a multidimensional perspective. By summarizing and analyzing the previous research results, this paper reviews the physiology of body temperature, perioperative hypothermia, perioperative monitoring and maintenance of body temperature, and the new opinions and derived parameters of perioperative hypothermia, which is expected to bring some new perspectives for researchers and clinicians to develop better strategies for the prevention and treatment of perioperative hypothermia.

Bullet vascular embolism is a serious complication of firearm injury, which is caused by military weapons in wartime and civil guns in peacetime. However, small caliber bullets and small mass fragments are mostly used in military weapons now, which makes it more likely that bullets/fragments will be left in the body, leading to a higher incidence of bullet vascular embolism. Therefore, the incidence of bullet vascular embolism in wartime in the future would be higher than it in the past. Bullet vascular embolism after firearm injury is more harmful to human body, and more emergency treatment is needed. This article reviews the mechanism, vulnerable vessels, embolization types, diagnostic methods and treatment points of bullet vascular embolism, so as to provide reference for clinical diagnosis and treatment of bullet vascular embolism.