Objective To analyze the clinical value of diabetic retinopathy (DR) indicators combined with urinary microalbumin/creatinine ratio (ACR) in diagnosis of diabetic kidney disease (DKD) for patients with type 2 diabetes. Methods The clinical data were retrospectively analyzed of 212 patients with type 2 diabetes mellitus complicated with kidney damage and firstly hospitalized and undergone renal biopsy in the Department of Nephropathy and Urology, the University Town Hospital of Chongqing Medical University during December 2017 to December 2020. According to the results of renal biopsy and ophthalmoscopy, all the subjects were assigned into DKD+DR group (n=96), DKD+non-DR group (n=75) and non-DKD+DR group (n=41). The general data and laboratory indexes of each group were collected and compared. The morbidity of DKD in different degrees of DR groups, risk factors for DKD and the diagnostic value of DR+ACR to DKD were analyzed. Results The levels of serum creatinine (Scr) and ACR were obviously lower, but the glomerulus filtering rate (eGFR) was markedly higher in DKD+non-DR group and non-DKD+DR group than in DKD+DR group with statistically significant difference (P<0.05); Compared with that in DKD+DR group, shorter disease course, decreased levels of mean arterial pressure (MAP), blood urea nitrogen(BUN), cystatin C (Cys-C) and 24 h urinary protein, and higher level of serum albumin (ALB) were in non-DKD+DR group with statistically significant difference (P<0.05); The morbidity ratio of DKD was obviously higher in proliferative diabetic retinopathy(PDR) group than in non-proliferative diabetic retinopathy (NPDR) group with significant difference (χ²=9.578, P=0.001). Logistic regression analysis showed that ACR, DR and PDR were the independent risk factors for DKD, while high eGFR was a protective factor (OR=0.92, P=0.004). ROC curve analysis revealed that PDR+ACR may effectively diagnose DKD with AUC of 0.88, while NPDR+ACR only have a limited diagnostic value for DKD with AUC of only 0.63. Conclusion DR combined with urinary ACR may contribute a limited value in diagnosis of DKD for patients with type 2 diabetes.

Objective To explore the high-risk factors associated with relapse of chronic drug-induced liver injury(DILI) to provide a basis for accurate prediction and treatment. Methods The clinical data of 1660 patients with chronic DILI patients, who were hospitalized from January 2012 to June 2017, were retrospectively collected. The average age of the patients was(43.9±12.3) years old and 970 were females. And they were divided into relapse group (n=196) and non-relapse group (n=1464).Spearman rank correlation was used to analyze the association of inflammation degree and fibrosis stage with relapse, while the high-risk factors associated with relapse were analyzed by univariable and multivariable logistic regression. Results With the increase in the degree of inflammation and fibrosis, the proportion of patients with relapse increased [inflammation grade (G₀: 0%, G₁: 0.9%, G₂:5.8%, G₃: 50.7%, G₄: 72.7%), fibrosis stage (S₀: 2.8%, S₁: 5.0%, S₂: 17.1%, S₃: 22.4%, S₄: 42.7%), P<0.001]. Spearman rank correlation analysis showed inflammation grade (r=0.463) and fibrosis stage (r=0.275) had a positive correlation with relapse. Especially,inflammation grade ≥G₃ (OR=5.75, 95%CI 3.83-8.64, P<0.001) is a high-risk factor associated with relapse in chronic DILI patients. Biochemically, multivariable logistic regression analysis showed that age >60 years (OR=2.14, 95%CI 1.17-3.90, P=0.014),AST >2×ULN (OR=3.62, 95%CI 1.64-7.79, P=0.001), TBIL >2×ULN (OR=2.19, 95%CI 1.39-3.44, P=0.001), CHE <1×ULN(OR=3.42, 95%CI 2.34-5.01, P<00.01), PLT <100×10⁹/L (OR=2.09, 95%CI 1.24-3.54, P=0.006) were independent high-risk predictors associated with relapse. Conclusion Older age, high AST and TBIL, low CHE and PLT, inflammation grade ≥G₃ are high risk factors for relapse, which are of great clinical significance for early prediction and effective improvement of chronic DILI outcome.

Objective To investigate the effects of sevoflurane inhalation anesthesia and propofol-remifentanil combined maintenance anesthesia on the incidence of postoperative residual curarisation (PORC) in minor surgery. Methods A total of 104 patients who underwent elective surgery under general anesthesia in the Second Affiliated Hospital of Chongqing Medical University from May 2020 to January 2021 were selected for this study. Patients were divided into Sevo group (maintenance by inspirating sevoflurance) and PR group (maintenance by intravenous injecting propofol and remifentanil). The train-of-four ratio (TOFr) during extubation and the existence of adverse respiratory events after extubation were recorded. The incidence of residual muscle relaxation during extubation and the incidence of adverse respiratory events after extubation were compared under different anesthesia maintenance conditions. Results There were no significant differences in age, gender, American Society of Anesthesiologists (ASA) classification, body mass index (BMI), operation time, time from muscle relaxant administration to extubation, and bispect ralindex (BIS) at extubation between two groups (P>0.05). There was no significant difference in the incidence rate of PORC and adverse respiratory events between Sevo group and PR group [69.4%(34/49) vs. 53.8%(28/52),P>0.05; 2.0%(1/49) vs. 9.6%(5/52), P>0.05]. TOFr in Sevo group was slightly lower than that in PR group, and the difference was statistically significant [85%(78%, 90%) vs. 89%(84%, 93%), P<0.05]. The overall incidence of PORC was high, which was correlated with age, BMI, operative time, time from muscle relaxant administration to extubation, and BIS at extubation (P<0.05). Conclusion Sevoflurane anesthesia maintenance does not increase the incidence of muscle relaxation residual during extubation.The incidence of PORC can be high during extubation under general anesthesia in minor surgery. Muscle relaxation monitoring should be performed routinely during general anesthesia to improve safety.

Objective To compare the safety and curative effect of video-assisted thoracoscopic surgery (VATS) and traditional thoracotomy in treatment of traumatic hemothorax. Methods The clinical data of 91 patients with hemothorax (received VATS) and 131 patients (received thoracotomy) in the Second Affiliated Hospital of PLA Air Force Military Medical University from January 2012 to December 2018 were retrospectively case-control analyzed. The curative effects between the two groups were compared by propensity score matching (PSM) method, and the risk factors of complications were predicted with multivariate logistic analysis. Results The total incidence of complications in the 222 patients was 22.1%. One patient died in thoracotomy group, whereas no patient died in VATS group. Before PSM, the numbers of fractured ribs, proportions of ribs fixation surgery and blunt injuries were lower (P<0.001) with lower incidence of complications (P=0.008) and shorter hospital length of stay (LOS) (P<0.001) in VATS group than those in thoracotomy group. After 1:1 PSM, 120 patients (60 patients in each group) were selected for further statistical analysis, and no significant difference was then identified between the two groups in the rate of complications and the hospital LOS (P>0.05). Significant statistical differences existed between the two groups in postoperative volume of drainage (P=0.006), drainage time (P=0.008), as well as postoperative hospital LOS (P=0.022) and ICU length of stay (P=0.010). Multivariate logistic analysis showed that the operation mode was not the independent risk factor for postoperative complications of traumatic hemothorax operation (OR=0.848, P=0.755). Conclusions VATS is safe and effective for hemodynamically stable patients with traumatic hemothorax since it can avoid the huge trauma of traditional thoracotomy,accelerate postoperative recovery of patients and shorten their postoperative hospital stay.

Stereotactic ablation or surgery known as the lesioning therapies (LT) is a method to treat nervous system diseases by destroying specific tissue structures in the brain through stereotactic minimally invasive technology, mainly consisting of magnetic resonance guided focused ultrasound surgery (MRgFUS), gamma knife stereotactic radiosurgery (GK) and radiofrequency thermal ablation (RF). For Parkinson's disease (PD) patients with poor drug response, LT can significantly improve the clinical symptoms (such as stiffness, tremor, dyskinesia, etc.), reduce drug dosage and improve the long-term quality of life,and is an important alternative to deep brain stimulation (DBS). Fully understanding the mechanism, characteristics, advantages and disadvantages and applicable population of the different methods of LT is of great guiding significance for formulating an individualized treatment plan. The research progress of MRgFUS, GK and RF in LT in the treatment of PD in recent years were reviewed, and the therapeutic effects and adverse reactions of different methods and targets have been summarized in present paper,so as to provide some reference for the selection of clinical operation scheme in the future.

Objective To investigate the effect of hnRNPAB overexpression on epithelial-mesenchymal transformation(EMT) and its molecular mechanism using human colorectal cancer line SW480 and HT29. Methods SW480 and HT29 cells were infected with lentivirus overexpressing hnRNPAB and negative control virus to generate the corresponding cell lines in experimental group (SW480-hnRNPAB, HT29-hnRNPAB) and control group (SW480-NC, HT29-NC). To quantify the levels of hnRNPAB and EMT-related indicators (E-cadherin, N-cadherin and vimentin), RT-qPCR and Western blotting were used. Cell migration was measured using the scratch assay. Cell invasion was evaluated using the Transwell assay. Western blotting was used to detect the expression levels of Wnt/β-catenin signaling key indicators WNT3A, WNT5A and β-catenin. Results Compared with control group, the expression levels of hnRNPAB mRNA and protein in experimental group significantly increased, and the differences were statistically significant (P<0.01). The scratch healing rates in experimental group were significantly higher than that in control group (SW480: 19.6%±0.90% vs. 2.23%±0.80%, P<0.01; HT29: 40.30%±0.70% vs. 6.40%±0.06%, P<0.01). The number of Transwell cells was significantly higher than that in control group [SW480: (315.0±6.7) cells vs. (62.0±4.3) cells, P<0.01; HT29:(289.0±7.2) cells vs. (54.0±5.2) cells, P<0.01]. Compared with control group, the epithelial cell marker E-cadherin mRNA and protein expression levels in experimental group significantly decreased. As expected, the mesenchymal cell markers N-cadherin and vimentin mRNA and protein levels significantly increased, and the differences were statistically significant (P<0.01). Compared with control group, the expressions of WNT3A, WNT5A and β-catenin protein in experimental group significantly increased (P<0.01). Conclusions The overexpression of hnRNPAB could induce EMT of human colorectal cancer SW480 and HT29, demonstrated by enhanced cell migration and invasion ability. The mechanism may be related to the activation of the Wnt/β-catenin signaling pathway.

Objective To investigate the effect and mechanism of transplanting Leydig-like cells from BMSCs to repair the testicular function of diethylhexyl phthalate (DEHP) infected mice. Methods Six C57 mice were randomly divided into two groups (3 each): control group (corn oil) and DEHP group [900 mg/(kg.d) DEHP mixed with corn oil]. Venous blood was taken from the eyeball 28 days after treatment to determine the serum testosterone level. One testis was stored in paraformaldehyde for HE and TUNEL staining, the other side of testis, after homogenization, was used to determine the changes of apoptotic proteins of caspase-3, caspase-8, caspase-9, Bcl-2 and Bax with Western blotting, the contents of MDA and GSH and the activities of SOD and GSH-Px were determined. Twenty-seven C57 mice were poisoned with DEHP for 28 days, and then randomly divided into Leydig-like cell transplant group, BMSCs transplant group and control group (9 each). BMSCs and Leydig-like cells from BMSCs were transplanted into the testis of mice in corresponding groups. Venous blood was taken from 3 mice of each group at 7th, 14th and 21st day after transplantation for determining the serum testosterone, and bilateral testis were obtained simultaneously to determine the contents of MDA and GSH and the activities of SOD and GSH-Px. The testis of mice was got 7th day after transplantation for HE and TUNEL staining, and the changes of apoptotic proteins of caspase-3, caspase-8, caspase-9, Bcl-2 and Bax were detected simultaneously. Results Compared with control group, the serum testosterone level decreased significantly, testicular spermatogenic cell disorder, tissue cells showed apoptosis, the serum levels of apoptotic protein caspase-3, caspase-8, caspase-9 and Bax increased obviously, while of Bcl-2 decreased markedly in testis of DEHP group, the content of MDA increased, and of GSH decreased, the activities of GSH-Px and SOD were inhibited with statistically significant difference (P<0.05 or P<0.01). Compared with control group, the serum testosterone level in Leydig-like cell transplantation group increased significantly at 7th, 14th and 21st day after testicular cell transplantation. The serum level of testosterone in BMSC transplantation group was higher than in control group at 14th and 21st day after transplantation. The content of MDA in testicular tissue decreased and of GSH increased,and the activities of GSH-Px and SOD recovered at 7th, 14th and 21st day after testicular cell transplantation (P<0.05 or P<0.01).The 7th day after transplantation, the apoptosis of testicular tissue was alleviated obviously in Leydig-like cell transplantation group and BMSC transplantation group than that in control group, the morphology of spermatogenic cells recovered, and the expression levels of apoptotic protein caspase-3, caspase-8, caspase-9 and Bax decreased significantly, while of Bcl-2 protein increased obviously(P<0.05 or P<0.01). Conclusion Transplantation of Leydig-like cells derived from BMSCs may repair the DEHP induced testicular damage by alleviating testicular oxidative stress and inhibiting testicular apoptosis, increase the teatosterone secretion, so as to promote the recovery of damaged testicular function.

Objective To investigate the effect of shikonin on atrial fibrillation of rats with myocardial fibrosis mediated by extracellular signal-regulated protein kinase1/2(ERK1/2)/nuclear transcription factor-kappaB (NF-κB). Methods Thirty SD rats were randomly divided into normal control group, model group, shikonin group (10 each). Rats in shikonin group were intragastrically given shikonin 4 mg/kg, in normal control and model groups were given the same amount of normal saline, 1 time/d for consecutive 7 days; Rats in model and shikonin groups were tail intravenous injected with 1 ml/kg ACh-CaCl₂ mixed liquor to establish atrial fibrillation model, 1 time/d for consecutive 7 days, and in normal control group were injected with the same amount of normal saline, taken materials after 7 days. Electrocardiogram was used to record the induced time and duration of atrial fibrillation, and the cardiac function was detected by echocardiography. The pathological condition of myocardial tissue was observed by HE staining. Masson staining was performed to detect the percentage of collagen area in myocardial tissue. The protein expressions of Collagen Ⅰ (ColⅠ), ERK1/2, p-ERK1/2, NF-κB p65 and p-NF-κB p65 were detected by Western blotting. Results The cardiomyocytes were arranged in compact and orderly manner in normal control group, while in model group were disordered, hypertrophic and widened. Shikonin improved the morphology and structure of cardiomyocytes. Compared with normal control group, left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) decreased, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), percentage of collagen area, the expressions of ColⅠ, p-ERK1/2, p-NF-κB p65 protein increased (P<0.05) in model group and shikonin group; Compared with model group, the induced time of atrial fibrillation was longer, duration time was shorter in shikonin group, LVEF and LVFS increased, LVESD and LVEED, percentage of collagen area, and the expressions of ColⅠ, p-ERK1/2, p-NF-κB p65 protein were decreased in shikonin group (P<0.05). Conclusion Shikonin may mitigate the myocardial fibrosis, inhibit the occurrence of atrial fibrillation, and improve myocardial function by inhibiting ERK1/2-NF-κB signaling pathway.

Objective To investigate the effect and potential mechanism of Boschniakia rossica polysaccharides (BRPS) on the invasion and migration of human liver cancer cells. Methods Different concentrations of BRPS (12.5, 25, 50, 100 and 200 μg/L)were screened on liver cancer HepG2 cells to identify the appropriate concentration. Based on culture conditions, the HepG2 cells were named control group (no treatment), hypoxia-inducible factor-1α (HIF-1α) group (transfected with LV-HIF-1α), HIF-1α-NC group (transfected with LV-HIF-1α-NC), BRPS group (add 50 μg/L BRPS), and BRPS+HIF-1α group (transfected with LV-HIF-1α,and add 50 μg/L BRPS). Hoechst33258 staining was used to evaluate cell apoptosis; flow cytometry was used to detect cell apoptosis rate; the scratch test was used to detect cells migration ability; Transwell test was used to detect cell invasion ability; Western blotting was used to detect HIF-1α and epithelial-mesenchymal transition (EMT) related factors E-cadherin and vimentin protein expressions in cells. Results The ideal BRPS concentration was identified as 50 μg/L. The results of Hoechst33258 staining showed that the blue fluorescence of hepatocarcinoma cells was weak in control group and HIF-1α-NC group, the blue fluorescence of HIF-1α group was dimer than control group; the blue fluorescence of BRPS group was brighter than control group; the blue fluorescence of BRPS+HIF-1α group was lower than that in BRPS group. In the control group, the apoptosis rate was 3.89%±1.25%; the cell healing rate was 63.35%±3.35%; the number of transwell cells was 122.60±3.29. Compared with control group, HIF-1α group showed a lower apoptosis rate (1.67%±0.86%, P<0.05), higher cell healing rate (87.48%±3.92%, P<0.05), and higher number of transwell cells(208.60±6.17, P<0.05). On the contrary, BRPS group showed a higher apoptotic rate (26.58%±1.63%, P<0.05), lower cell healing rate (14.82%±3.81%, P<0.05), and decreased number of transwell cells (68.80±4.25, P<0.05). Interestingly, in BRPS+HIF-1α group,the apoptosis rate was 12.14%±1.05%, higher than HIF-1α group but lower than BRPS group; the cell healing rate and the number of transmembrane cells were 32.59%±3.76% and (123.40±4.94) cells, respectively, both of which were lower than HIF-1α group but higher than that in BRPS group (P<0.05). Compared with control group, in HIF-1α group, the expression levels of HIF-1α and vimentin increased while E-cadherin decreased; however, in BRPS group, the expression levels of HIF-1α and vimentin decreased while E-cadherin increased (P<0.05). As expected, the expression levels of HIF-1α and vimentin in BRPS+HIF-1α group were lower than those in HIF-1α group but higher than those in BRPS group; the expression levels of E-cadherin was higher than that in HIF-1α group but lower than that in BRPS group (P<0.05). Conclusion BRPS can promote HepG2 cell apoptosis, inhibit cell migration and invasion. Its mechanism may be that it can suppress EMT by regulating HIF-1α.

Objective To analyze the correlation of plasma fibrinogen (Fib) and blood lipid composition to the progression of non-culprit coronary lesions (NCCLs) in CHD patients after percutaneous coronary intervention (PCI). Methods The clinical data were collected and retrospectively analyzed of 210 patients admitted from January 2017 to December 2017 in the Department of Cardiovascular Medicine of the First Hospital of Lanzhou University, received the first PCI treatment, and repeated the coronary angiography (CAG) before December 31, 2020 (the interval between two operations should be at least 6 months). According to whether the NCCLs progressed, 210 patients were divided into progressive group (n=99) and non-progressive group (n=111), and then, according to the degree of NCCLs progression, patients in progressive group were further divided into three subgroups: mild(n=42), moderate (n=35) and severe (n=22) progressive subgroup. The baseline clinical data were compared between the patients in progressive group and in non-progressive group, and among the patients in mild, moderate and severe progression subgroups. The correlation of the plasma Fib and blood lipid composition to the progression of NCCLs, and the risk factors affecting the progression of NCCLs were analyzed. Results There were no statistical difference between progressive group and non-progressive group in gender, smoking history, drinking history, hypertension history, hyperlipidemia history, heart failure, and admission blood pressure(P>0.05), but the mean age was higher in progressive group than that in non-progressive group, and more patients with diabetes in progressive group than those in non-progressive group, and there existed statistically significant differences (P<0.05). The plasma levels of Fib, cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and non-high density lipoprotein cholesterol (non-HDL-C) were higher in progressive group than those in non-progressive group with statistically significant differences (P<0.05).There existed no significant difference (P>0.05) between the two groups in the levels of triglyceride (TG) and HDL-C; with the increasing in the severity of NCCLs, plasma Fib, TG, LDL-C, and non-HDL-C increased gradually in the mildly, moderately, and severely advanced subgroups, while the plasma level of HDL-C decreased gradually, but no statistical difference existed among the subgroups (P>0.05); Fib, TC, LDL-C, non-HDL-C, and D-dimer were positively correlated with the NCCLs progression. And also,Fib was positively correlated with TC, LDL-C, and non-HDL-C. Gender, age, and diabetes history can be used as risk factors for the progression of NCCLs with OR values of 2.284, 1.052, and 0.293, respectively. Conclusion The plasma Fib and blood lipid composition are correlated with the progression of NCCLs, and Fib is also correlated with some lipid components, but is not a risk factor for NCCLs progression.