Table of Content

21 June 2024, Volume 45 Issue 3

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Stay true to the original aspiration, forge ahead, and strive for excellence in the realm of science—Professor Ji Xunming, academician of Chinese Academy of Engineering

Gu Chaoxiong, Li Ming

2024, 45(3):  375-378.  doi:10.3969/j.issn.1006-7795.2024.03.001

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Professor Ji Xunming is an academician of Chinese Academy of Engineering in the field of neurology. He has made systematic and original achievements in the pathogenesis of arterio-venous stroke, cerebral blood flow reconstruction, and neuroprotection， in addition, he has also advanced their clinical translation and application. It mainly includes: ① Proposing the “hypoxic tissue adaptation” theory, discovering and confirming the neuroprotective effects of hypoxic adaptation, and further elucidating its mechanisms against ischemic and hypoxic injuries. ② Establishing a new method of “remote ischemic conditioning of the limbs”, verifying its role in preventing and treating ischemic stroke, and revealing the multi-target coordinated regulation mechanism of “intervening peripherally to protect centrally”, laying the foundation for clinical translation. ③ Developing specialized equipment for remote ischemic conditioning of the upper limbs, obtaining medical device registration and production licenses, and achieving clinical translation. ④ Creating a new strategy for the clinical application of remote ischemic conditioning of the upper limbs in the prevention and treatment of ischemic stroke, and formulating international guidelines. These scientific breakthroughs are of great significance for understanding the mechanisms of injury in arterio-venous stroke, systematic treatment, and neuroprotective strategies, and his many research findings are included in international academic monographs, guidelines, and classic textbooks.

Somatic mutations in endothelial cells and cerebral vascular malformations

Zhao Shaozhi, Cao Yong

2024, 45(3):  379-384.  doi:10.3969/j.issn.1006-7795.2024.03.002

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Cerebral vascular malformations (CVMs) are non-neoplastic lesions of local brain vasculature in which the quantity and structure of cerebral vessels are altered due to genetic, cytokine, and protein changes caused by various intrinsic and extrinsic factors during embryonic development. Somatic mutations in endothelial cells, as one of the initiating factors, play a crucial role in the occurrence and development of CVMs. Understanding the endothelial cell mutations in CVMs is of great significance for preventing CVMs occurrence and development, developing targeted drugs, and guiding clinical treatment. This review focuses on the discovery, clinical relevance, and potential therapeutic implications of endothelial cell somatic mutations in CVMs.

To explore the potential biomarkers of proliferative diabetic retinopathy by plasma proteomics

Yang Fangyuan, Peng Shijie, Liu Jing, Yang Jinkui, Zhu Xiaorong

2024, 45(3):  385-391.  doi:10.3969/j.issn.1006-7795.2024.03.003

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Objective  To identify potential biomarkers of proliferative diabetic retinopathy (PDR) through the difference of protein expression between PDR patients and diabetes patients without retina diseases (NDR) by using isobaric tag for relative and absolute quantification (iTRAQ) proteomics. Methods  A total of 42 patients admitted to the Department of Endocrinology, Beijing Tongren Hospital from 2016 to 2017 were recruited, including 21 PDR patients and 21 gender- and age-matched NDR patients. After proteins extraction from patients' serum samples, iTRAQ labeling with liquid chromatograph-mass spectrometer and mass spectrometer (LC-MS/MS) analysis was performed to screen the differential proteins. Gene Ontology (GO）enrichment and Kyoto Encyclopedia of Genes and Genome(KEGG) pathway were analyzed. Comparisons were conducted using independent sample t-tests, to determine the changes in protein expression levels through fold change (FC) and P-values. Results  Totally 29 differentially expressed proteins were identified based on a FC>1.2 (up/down) and a P value ≤ 0.05. Among them, 8 proteins were upregulated and 21 proteins were downregulated in the PDR group. GO enrichment analysis showed that the functions of differentially expressed genes were classified into three categories: biological processes, cellular components, and molecular functions. The differential gene expressions were involved in biological regulation, cell composition, cellular metabolic processes, and cell binding or catalytic activity. KEGG pathway analysis showed that the most significantly upregulated angiotensin converting enzyme (ACE) is involved in the renin angiotensin system (RAS) and renin secretion pathways. The upregulated protein insulin like growth factor I (IGF-1) is involved in metabolic related signaling pathways, including HIF-1, FoxO, mTOR, PI3K-Akt, and AMPK. The significantly downregulated protein myosin-6 is involved in myocardial cell contraction and signaling pathways. Conclusion  The iTRAQ proteomics analysis suggested, many differential expressed proteins between PDR and NDR groups. ACE, IGF-1 and myosin-6 were potential serum diagnostic markers and maybe new therapeutic targets for diabetic retinopathy.

Construction of the Lepr and eNos genes double-knockout mouse model with diabetic kidney disease based on CRISPR/Cas9 technology

Zhao Miaomiao, Li Mingjia, Li Xiaoya, Duan Rui, Zhang Jingyi, Yang Jinkui

2024, 45(3):  392-398.  doi:10.3969/j.issn.1006-7795.2024.03.004

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Objective  To establish a leptin receptor (Lepr) and endothelial nitric oxide synthase (eNos) double-knockout (DKO) mouse model based on CRISPR/Cas9 gene editing technology, in order to construct a mouse model with advanced diabetic nephropathy. Methods The corresponding gRNA was prepared based on the eNos gene, and the CRISPR-Cas9 system was microinjected into the fertilized eggs of C57BL/Ks (BKS) background mice. The fertilized eggs were transferred into the fallopian tubes of female mice with pseudopregnancy. After birth, the F0 generation positive mice with the eNos^+/－ genotype were sorted out through polymerase chain reaction（PCR） identification and sequencing analysis, and Lepr gene heterozygous mice, Lepr－F0, under the BKS background were obtained. The eNos－F0 and Lepr－F0 generation mice were crossed to obtain eNos^+/－/Lepr^db/m double heterozygous F1 generation mice. The double heterozygous F1 generation mice were further mated to screen out Lepr and eNos double gene knockout mice. The mouse genotypes were identified using PCR method, and mice were divided into wild-type (WT) group and DKO group according to the gene identification results. The body weight, blood glucose, water and food intake of the mice in each group were monitored. The urinary albumin and urinary creatinine levels of the mice were detected with enzyme-linked immunosorbent assay（ELISA）, and the urinary albumin excretion rate was calculated. The pathological changes of the renal tissue of the mice in each group were examined with hematoxylin-eosin（HE） and periodic acid-silver metheramine（PASM） staining. Results PCR detection results showed that lepr^db/db/eNos^－/－ DKO mice were successfully constructed. Compared with the littermate control group, the body weight, blood glucose level, drinking water and food intake of DKO mice were significantly higher than those of the littermate control group. The urinary albumin and urinary albumin excretion rate of DKO mice were significantly higher than those of WT mice. The pathological results showed that the glomerular volume of DKO mice was significantly increased, and the mesangial matrix hyperplasia was obvious. Conclusions Lepr^db/db/eNos^－/－ DKO mice can be successfully constructed based on CRISPR/Cas9 gene editing technology. DKO mice can manifest the typical diabetic nephropathy and provide an animal model for in-depth study of the mechanisms of diabetic nephropathy.

Changes of cytokines in patients with Graves' ophthalmopathy before and after treatment with glucocorticoid

Shi Tingting, Xie Rongrong, Xin Zhong, Liu Wei, Su Zhiyan, Yang Jinkui

2024, 45(3):  399-405.  doi:10.3969/j.issn.1006-7795.2024.03.005

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Objective To explore the correlation between the changes of serum cytokine in active Graves' ophthalmopathy (GO) patients before and after glucocorticoid therapy and efficacy of glucocorticoid therapy.Methods Twenty-eight patients diagnosed with GO in the Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University from January 2021 to January 2024 were selected. All patients were diagnosis as active GO patients (CAS≥3). Patients received regular weekly glucocorticoid weekly pulse therapy with a total dose of 4.5 g. The concentrations of 34 cytokines in serum were examined. Meanwhile, clinical indicators such as gender, age, liver and kidney function, thyroid function before and after treatment, and antibodies of all subjects were collected. Results The levels of interleukins (IL)（IL-1α, IL-1β, IL-1Rα, IL-2Rα, IL-6, IL-8, IL-18, IL-12p40 and IL-16）and cytokines including cutaneous T cell attraction chemokines（CTACK), monocyte chemoattractant protein-1（MCP-1）, macrophage migration inhibitory factor (MIF), stromal cell-derived factor 1α (SDF-1α), basic fibroblast growth factor（basic-FGF）, granulocyte colony-stimulating Factor (G-CSF), tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) in active GO patients after glucocorticoid treatment were significantly decreased compared with before treatment (P<0.05). Conclusion The levels of interleukins（IL-1α, IL-1β, IL-1Rα, IL-2Rα, IL-6, IL-8, IL-18, IL-12p40 and IL-16）and cytokines including CTACK, MCP-1, MIF, SDF-1α, basic-FGF、G-CSF, TNF-α and IFN-γ in active GO patients decreased significantly after glucocorticoid therapy, suggesting that these cytokines may be involved in the efficacy of glucocorticoid therapy for GO.

Relationship between diet quality scores and all-cause mortality in diabetic patients of different genders

Liu Chang, Xin Zhong, Yang Jinkui

2024, 45(3):  406-412.  doi:10.3969/j.issn.1006-7795.2024.03.006

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Objective To prospectively study the influence and difference of various dietary patterns on all-cause mortality in diabetes patients of different genders.Methods A total of 20 002 participants (3 737 patients with diabetes) from National Health and Nutrition Examination Survey (NHANES) were enrolled. The relationship between dietary quality score and all-cause mortality was analyzed with COX proportional hazards regression model, and whether other factors interact with dietary pattern scores was evaluated with the method of stratified analysis.Results During the median follow-up period of 74 months, there were 512 deaths recorded, with 311 males and 201 females. The adjusted risk ratios for high dietary quality are as follows: dietary inflammation index ［male: hazard ratio(HR)= 1.22, P =0.084; female: HR= 1.00, P=0.818］, mediterranean diet score (male:HR= 0.99, P=0.873; female:HR= 0.79, P =0.027), healthy diet index 2020 (male:HR= 1.00, P =0.956; female: HR= 0.83, P =0.046). The influence of diet score on the death risk of diabetes patients is independent, and no internal interaction between diet score and other variables was found.Conclusion In the population with diabetes, mediterranean diet and healthy diet index 2020 are associated with lower mortality risk in women, while no significant association is found in men.







The correlation between vascular endothelial function and thyroid hormone sensitivity in newly diagnosed type 2 diabetes patients

Gao Xia, Hu Yanjin, Yao Zhi, Wang Guang

2024, 45(3):  413-419.  doi:10.3969/j.issn.1006-7795.2024.03.007

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Objective To explore the association between vascular endothelial function and the sensitivity to thyroid hormones in patients newly diagnosed type 2 diabetes mellitus (T2DM).  Methods  A cohort of 100 patients newly diagnosed with T2DM attending the endocrinology outpatient clinic of Beijing Chaoyang Hospital, Capital Medical University from June 2019 to November 2020 was enrolled. Key parameters measured encompassed fasting blood glucose (FBG), glycosylated hemoglobin A1c (HbA1c)，free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), and lipid profiles among other metabolic indices. Indices of central thyroid hormone sensitivity, such as the thyroid feedback quantile index (TFQI), TSH index (TSHI), and the thyrotroph thyroxine resistance index (TT4RI), were computed based on FT4 and TSH levels, with higher values indicating diminished central thyroid hormone sensitivity. Conversely, the FT3/FT4 ratio was assessed as a marker of peripheral thyroid hormone sensitivity, with lower ratios suggesting reduced sensitivity. The homeostasis model assessment of insulin resistance (HOMA-IR) was caculated.   The reactive hyperemia index (RHI) was measured across all participants to evaluate vascular endothelial function. Then, all subjects were divided into two groups based on RHI results：  T2DM-ED group （RHI<1.67, 43 cases）  those with combined vascular endothelial dysfunctionand  and T2DM-NED group (RHI≥1.67，57 cases) those without vascular endothelial dysfunction.  Results  The RHI level of the T2DM-ED group was 1.41±0.21，while the RHI level of the T2DM-NED group is 1.91±0.26. In comparison to the T2DM-NED group，individuals within the T2DM-ED group manifested markedly higher levels of low density lipoprotein-cholesterol (LDL-C), FBG and HbA1c (P<0.05). Furthermore, TSH, TFQI, TSHI and LnTT4RI were notably higher in the T2DM-ED group (P<0.05). Pearson correlation analysis revealed a negative correlation between RHI and LDL-C, FBG, LnHOMA-IR, HbA1c, TSH，TFQI, TSHI, and LnTT4RI, and a positive correlation with the FT3/FT4 ratio. Multivariate linear regression analysis identified HbA1c, LDL-C, TFQI, LnTT4RI, TSHI and TSH as factors associated with the reduction of RHI in patients newly diagnosed with T2DM.  Conclusion  The findings suggest that vascular endothelial dysfunction in newly diagnosed T2DM patients may be intricately linked to decreased sensitivity to thyroid hormones, underscoring the potential interplay between metabolic dysregulation and thyroid hormone pathways in the pathogenesis of T2DM-related vascular complications.

Effects of vitamin D₂ on albuminuria in patients with diabetic kidney disease

Zheng Xiaomin, Liu Mengyang, Xiao Xinhua, Cui Limei, Liu Cuiping

2024, 45(3):  420-428.  doi:10.3969/j.issn.1006-7795.2024.03.008

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Objective To explore the effects of vitamin D₂ soft capsules and calcitriol soft capsules on albuminuria in type 2 diabetes mellitus(T2DM) patients with diabetic kidney disease(DKD). Methods Totally 95 T2DM patients with DKD and estimated glomerular filtration rate (eGFR)≥60 mL·(min·1.73 m2)^-1 who hospitalized in the department of endocrinology  of a tertiary hospital in Beijing from October 2020 to March 2022 were analyzed retrospectively. According to the treatment protocols, the patients were divided into control group without vitamin D preparation (CON group, n=33), natural vitamin D group with vitamin D2 soft capsule (NVD group, n=31), and active vitamin D group with calcitriol soft capsule (AVD group, n=31). The clinical data and parameters of vitamin D and DKD, including serum 25-hydroxyvitamin D (25OHD), serum parathyroid hormone (PTH), blood calcium, urine calcium and urinary albumin-to-creatinine ratio (UACR) at baseline and after 12 weeks treatment were collected through the electronic medical records database system. Results In the baseline phase, there were 8 cases (24.24% ), 9 cases (29.03% ), and 7 cases (22.58% ) with macroalbuminuria in CON group, NVD group, and AVD group, respectively, with no significant difference（P=0.831）。After 12 weeks of treatment, the level of ln(UACR) decreased significantly（both P<0.001）, with no significant difference between the two treatment groups（P=0.371）. The total effective rates of NVD group and AVD group were 80.65%  and 74.19%  respectively, which were significantly higher than those of CON group（33.33% ）（P<0.001 and P=0.002）. There was no significant difference between NVD group and AVD group（P=0.245）. There were 1 case of blood calcium increased, 1 case of hypercalciuria, 1 case of hyperuricemia, 1 case of kidney stone, and 1 case of muscle spasm in CON group, 1 case of hypercalciuria and 1 case of hyperuricemia in NVD group, 1 case of blood calcium increased, 1 case of hypercalcaemia, 1 case of blood parathyroid hormone decreased, 2 cases of hypercalciuria, and 2 cases of hyperuricemia in AVD group. No drug withdrawal occurred in both treatment groups. Conclusion The administration of both Vitamin D₂ soft capsule and calcitriol soft capsule can effectively reduce albuminuria levels in T2DM patients with DKD with good renal function and significantly. Natural vitamin D may be safer compared with active vitamin D.

Diagnostic value of renal tubular and glomerular markers in different stages of renal injury in patients with type 2 diabetes

Zhang Lin, Xie Rongrong, Yang Fangyuan, Li Mei, Luo Sha, Wan Xiaohua, Tian Wei, Yang Jinkui

2024, 45(3):  429-437.  doi:10.3969/j.issn.1006-7795.2024.03.009

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Objective  To investigate the diagnostic value of renal tubular and glomerular markers in type 2 diabetes patients at different stages of renal injury. Methods  Totally 272 patients with type 2 diabetes mellitus (T2DM) admitted to the  Department of Endocrinology, Beijing Tongren Hospital，Capital Medical University,  from April 1, 2018 to October 31, 2019 were enrolled, to improve the clinical biochemical indicators and four items of urine protein: urinary microalbumin/creatinine (ACR), α1-microglobulin/creatinine (UA1CR), urinary immunoglobulin G to creatinine ratio (UIGG), transferrin/creatinine (UTRF); Perform fundus photography, nuclear medicine 99mTc-EC to measure renal effective plasma flow (ERPF), and 99mTc-DTPA to measure glomerular filtration rate (GFR). According to ACR, there were 164 cases in the normal proteinuria group, 78 cases in the microalbuminuria group, and 30 cases in the macroproteinuria group. The normal proteinuria group was divided into control group  ［132 cases without diabetes retinopathy (DR)］ and  diabetic kidney disease (DKD） early stage group (32 cases with DR)  according to fundus examination. Compare the levels of urinary protein, ERPF, and GFR among four groups, and evaluate the diagnostic value of the above indicators in different stages of renal injury through ROC curves. Results  There were statistical differences (P<0.05) in the levels of urinary protein, ERPF, and GFR among different groups. In the normal urine protein group, the markers representing renal tubular function in the DR group were significantly higher in UA1CR compared to the control group (P<0.01); The markers representing glomerular function, ACR, UTRF, and GFR, showed no significant statistical difference between the two groups (P>0.05), while UIGG increased compared to the control group (P<0.01). In the group of microalbuminuria and the group of macroproteinuria, the four urinary protein levels increased with the degree of renal injury, while ERPF and GFR decreased with the degree of renal injury. ROC curve analysis showed that the area under curve (AUC) of UA1CR and ERPF, the markers reflecting renal tubular function, in type 2 diabetes patients with DR who had normal urinary protein excretion, were 68.2% (P<0.01) and 60.5% (P<0.05), respectively, while the AUC of classic ACR and GFR reflecting glomerular function were less than 60% (P>0.05) without statistical significance. The AUC of urinary protein and GFR in both trace and high proteinuria groups was greater than 60% (P<0.05), while the AUC of ERPF in high proteinuria group was 67.2% (P<0.05). Conclusion  In the very early stage of T2DM, when ACR is normal and only DR is present, renal tubular markers UA1CR and ERPF undergo changes before glomerular markers ACR and GFR. In the early stage of renal injury, the diagnostic efficacy of renal tubular markers is superior to that of glomeruli; In the later stage of renal injury, the diagnostic efficacy of glomerular markers is due to the renal tubules. The changes in renal tubular function in DKD may occur earlier than in the glomerulus.

Progresses in the drug treatment of diabetic retinopathy

Zhu Lin, Xu Yongsong, Feng Xiaotong, Zhao Dong, Ke Jing

2024, 45(3):  438-445.  doi:10.3969/j.issn.1006-7795.2024.03.010

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Diabetic retinopathy (DR) is one of the common microvascular complications of diabetes and it is the main cause of blindness in adults. In recent years,  the treatment of DR has been enriched, and the clinical and basic research related to drug therapy has made great progress.  This article summarized the current agents used to treat DR, including  calcium dobesilate (CAD), pancreatic kininogenase (PK), fenofibrate, anti-vascular endothelial growth factor (anti-VEGF) drugs, glucagon-like peptide-1 receptor agonist (GLP-1RA), sodium-dependent glucose transporter 2 inhibitors (SGLT-2i), finerenone, antioxidants, natural products and melatonin.

The study on neural mechanism of cognitive decline in kidney deficiency syndrome based on ALFF/fALFF

Dong Linrui, Feng Sitong, Ning Yanzhe, Wu Ziyao, Jia Hongxiao

2024, 45(3):  446-452.  doi:10.3969/j.issn.1006-7795.2024.03.011

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Objective  To explore the neural mechanisms of cognitive decline of sub-health people with kidney deficiency syndrome. Methods  A total of 35 sub-health subjects with kidney deficiency syndrome and 35 matched healthy subjects were recruited in this study. They were assessed with Repeatable Battery for the Assessment of Neuropsychological Status(RBANS), clinical assessment and resting-state functional magnetic resonance imaging scan. Based on a cortical surface-based analysis, the values of amplitude of low frequency fluctuations(ALFF) and fractional ALFF(fALFF) was calculated. Furthermore, the relationships between abnormal functional activity in brain areas, cognitive function and clinical symptoms were analyzed. Results  Compared with healthy subjects, sub-health subjects with kidney deficiency syndrome showed significantly lower scores of immediate memory index, attention index, and total scale index.The brain regions with abnormal changed ALFF/fALFF values mainly included the left primary visual cortex, the left dorsal occipital cortex, and the right supplementary motor area. Moreover, the ALFF values of the left dorsal occipital and the right frontal eye fields as well the fALFF values of the left primary visual cortex were positively correlated with kidney deficiency scores.The ALFF values of the right frontal eye fields and the fALFF values of the right supplementary motor area were negatively correlated with total scores of RBANS. Conclusion  Impaired memory and attentional functions of were observed in sub-health subjects with kidney deficiency syndrome. The changed neural activity in multiple brain regions, including the left occipital lobe and the right frontal lobe, might be the underlying neural mechanism for declined cognitive function.

Study of cognitive function and social function in the subhealthy people with spleen qi deficiency syndrome

Wu Ziyao, Feng Sitong, Dong Linrui, Zheng Sisi, Ning Yanzhe, Jia Hongxiao

2024, 45(3):  453-457.  doi:10.3969/j.issn.1006-7795.2024.03.012

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Objective  To investigate on the change of cognitive function and social function in subhealthy people with spleen qi deficiency syndrome (SQDS). Methods  Totally 24 subhealthy people with SQDS and 27 healthy people matched for age, gender, and education time were evaluated with Repeatable Battery for the Assessment of Neuropsychological Status(RBANS), Global Assessment of Functioning Scale(GAF) and Symptom of SQDS Scale. Results  Compared with healthy controls, subhealthy people with SQDS showed significantly decreased scores in visuospatial index, attention index, delayed memory index, total scale and GAF(P<0.05), while scores differences in immediate memory index and language index were not statistically significant(P>0.05). Moreover, delayed memory index score(r=－0.532，P=0.009) and total scale score(r=－0.474，P=0.022)  were negatively correlated with syndrome of SQDS scale score, but delayed memory index score(r=0.564，P= 0.004) and total scale score(r = 0.785，P<0.001) were positively correlated with GAF score. Conclusions  The impairment of visuospatial ability, attention, memory and social function was observed in subhealthy people with SQDS, and poor memory was significantly associated with symptom of SQDS  and social function. It provided experimental evidence for the treatment of dysfunctional cognition diseases from the viewpoint of traditional Chinese medicine theory of spleen and enriched the connotation of spleen stores yi.

A study on the differences of cognitive functions between individuals dominated by Wood Element and Metal Element among the Five Elements people

Dai Zhiqing, Lin Jin, Duan Yuhang, Teng Fei, Lyu Hongpeng, Jia Hongxiao

2024, 45(3):  458-465.  doi:10.3969/j.issn.1006-7795.2024.03.013

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Objective  To provide a basis for enriching the theory of the Five Elements and the psychological connotation of traditional Chinese medicine (TCM) by means of investigating the differences in the cognitive functions and processing processes between individuals dominated by the Wood Element and those dominated by the Metal Element according to the Five Elements theory in the TCM.Methods  According to the previous devised Quantitative Standard for Facial Phenotype Classification of TCM Five Elements People, typical individuals with a dominant Wood or Metal Element were recruited. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) cognitive function assessment tool, as well as the Top-down and Bottom-up cue target task paradigm were employed to evaluate their cognitive functions and attentional processing differences. Independent sample t-tests and rank sum tests were applied to analyze the differences in cognitive functions between the two groups of participants. Results  This research included 32 participants with a dominant Wood Element and 40 participants with a dominant Metal Element. In RBANS cognitive function assessment tool, compared to the Wood Element group, the Metal Element group exhibited significantly higher scores in the visuospatial dimension and its subtask line orientation (P＜0.05). In the bottom-up cue target task paradigm, the Wood Element group displayed a statistically higher short reaction time difference. In contrast, the Metal Element group demonstrated a significant higher long reaction time difference (P<0.05). Conclusion  In the theory of TCM Five Elements, the Wood Element group relied more on bottom-up cognitive processing, while the Metal Element group performed better in processing visuo-spatial information and conserving cognitive processing resources.

Research progresses on the correlation between personality traits and cognitive function

Teng Fei, Song Mingkang, Lyu Hongpeng, Jia Hongxiao

2024, 45(3):  466-471.  doi:10.3969/j.issn.1006-7795.2024.03.014

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Personality refers to a complex combination of behavior, cognition and emotion related to biological and environmental factors. Personality traits are important criteria for distinguishing different personalities, which are characterized by personality stability and personality change across the life span. Cognitive function refers to all of the different mental abilities, including learning, thinking, reasoning, memory, problem solving, decision making, and attention. The study of the correlation and neural mechanism between personality traits and cognitive function has made many progresses to prompt the understanding the relationship between personality traits and cognitive function, predicting personal development and growth, and preventing, diagnosing and treating potential diseases.

Rspo3/Lgr5 promotes the expression of N-cadherin and participates in mouse liver injury

Gao Yue, Yue Wenhui, Ding Jingru, Li Liying, Yang Le

2024, 45(3):  472-480.  doi:10.3969/j.issn.1006-7795.2024.03.015

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Objective  The aim of this study is to investigate R-spondin3 (Rspo3) up-regulates the expression of Ncad (N-cadherin, gene named Cdh2) and participates in mouse liver injury. Methods  The expression of Rspo3, leucine-rich repeat-containing G protein-coupled receptor 5 (Lgr5) and Cdh2 were measured by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The expression of Ncad was measured by Western blotting and Immunofluorescence. Serum-starved primary cultured mouse bone marrow mesenchymal stromal cell (BMSC) were transfected with Lgr5 siRNA to verify whether Rspo3 up-regulates Ncad expression by acting on Lgr5. Results   The Rspo3 and Lgr5 mRNA expression was up-regulated in the liver tissue of mouse injured liver model. The mRNA expression of Cdh2 was up-regulated and positively correlated with the expression of Rspo3 and Lgr5, which is one of the receptors of Rspo3. Immunofluorescence shows that Ncad is mainly localized in the pericytes of the mouse injured liver. The Rspo3-induced up-regulation of Ncad was inhibited after Lgr5 siRNA transfection. Conclusion  In the mouse injured liver tissue, Rspo3 up-regulates the expression of Ncad in pericytes by acting on Lgr5, and affects mouse liver injury.

Anti-fatigue effect and acute toxicity test of D-borneol refreshing atomization solution on mice

Tian Xinhui, Chen Hongbo, Cheng Fang, Han Yuhang, Yang Xinrui, Su Dandan, Li Siqi, Huang Xiaoling, Liu Chunyan, Pang Yuxin

2024, 45(3):  481-487.  doi:10.3969/j.issn.1006-7795.2024.03.016

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Objective  To investigate the anti-fatigue effects and acute toxicity of different doses of D-borneol refreshing atomization solution on mice, and to provide reference for the further development and application of D-borneol refreshing atomization solution in clinic. Methods  Sixty specifc pathogen free （SPF） male KM mice were divided into one blank group and four dose groups, with 12 mice in each group, for acute toxicity experiments and weight-bearing swimming experiments. In the acute toxicity test, the toxic reaction of mice was observed. After dissection, histopathological examination was performed. For weight-bearing swimming experiment, serum, liver and hind leg muscle tissues of mice were collected. Blood glucose (Glu), lactic acid (LA), blood urea nitrogen (BUN), and lactate dehydrogenase (LDH) activity levels were measured in serum. Liver glycogen (LG) content was assessed in liver tissue; muscle glycogen (MG) and other anti-fatigue biochemical indicators were evaluated in muscle tissue. Malondialdehyde (MDA) content and the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were determined in muscle tissue. Results  During the administration of D-borneol refreshing atomization solution, no abnormalities were observed in the mental state, fur color, or body weight of mice across all groups during the acute toxicity test. Pathological examinations did not reveal any abnormalities either. The weight-bearing swimming test results demonstrated that medium and high doses of D-borneol refreshing atomization solution could effectively prolong the time of weight-bearing exhaustive swimming in mice (P<0.001), significantly increase the content of MG (P<0.01), and reduce the activities of serum LD and LDH (P<0.05). The serum BUN level was decreased (P<0.01), the blood glucose level was increased (P<0.01), and the serum MDA (malondialdehyde) level was decreased (P<0.05). The levels of SOD (superoxide dismutase) (P<0.01) and GSH-Px (glutathione peroxidase) (P<0.001) were increased. Conclusion  D-borneol refreshing atomization solution has no obvious toxic and side effects, and has good refreshing and anti-fatigue effects. The mechanism may be related to improving antioxidant capacity and reducing muscle damage.

The causal relationship between intestinal flora and diabetes, inflammatory factors and C-reactive protein: Mendelian randomized analysis

Hu Yafen, Hua Lin

2024, 45(3):  488-493.  doi:10.3969/j.issn.1006-7795.2024.03.017

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Objective  To explore the relationship between intestinal flora and diabetes mellitus, inflammatory factors and C-reactive protein (CRP).Methods  In this study, the intestinal flora was taken as exposure factors while diabetes, inflammatory factors and CRP were taken as outcome factors, and single  nucleotide polymorphisms（SNPs） were used as instrument variables. Mendelian randomization method was used.  Results  Coprococcus1, Dialister, Lachnospiraceae and Parabacteroides were less abundant in the diabetes population whereas Bilophila and Romboutsia were more abundant in the diabetes population. Dialister is positively correlated with interleukin-17（IL-17） (β=0.797, P=0.036). CRP is negatively correlated with Coprococcus1 (β＝－0.036, P=0.027), Parabacteroides (β＝－0.216, P=0.015), and Dialister (β＝－0.028, P=0.030). CRP showed the mediation effect in the relationship between two bacteria (Coprococcus1 and Parabacteroides) and diabetes.Conclusion  Our study suggests the potential interactions between intestinal flora, CRP and diabetes.

Effect of stress hyperglycemic ratio on poor in-hospital prognosis in patients with acute myocardial infarction

Dong Zheng, Yang Qingmiao, Guo Caixia

2024, 45(3):  494-500.  doi:10.3969/j.issn.1006-7795.2024.03.018

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Objective  To explore the predictive value of stress hyperglycemia ratio (SHR) on in-hospital major adverse cardiovascular events (MACEs) in patients with acute myocardial infarction (AMI). Methods  A total of 442 AMI patients with complete clinical data from January 2021 to December 2022 in the Department of Cardiology Center, Beijing Tongren Hospital were selected for retrospectively analyzed. SHR was calculated from the first blood glucose within 24 h after admission (ABG)and glycosylated hemoglobin (HbA1c) value. Patients were divided into MACEs group (n=79) and non-MACEs group (n=363) according to in-hospital MACEs. Logistic regression was used to analyze the risk factors for in-hospital MACEs. The receiver operating characteristic (ROC) curve was used to analyze SHR' s predictive value.Results  SHR in MACEs group was higher than that in non-MACEs group (1.30±0.44 vs 1.15±0.17, P<0.001). Multiple Logistic regression analysis indicated that elevated SHR level was an independent risk factor for in-hospital MACEs in AMI patients (OR=2.69, 95%CI: 1.26－5.73, P=0.011). ROC curve analysis showed that SHR (AUC=0.63, 95%CI: 0.57－0.70, P<0.001) had a certain predictive value for in-hospital MACEs in AMI patients, with the optimal cut-off value of 1.29, which is better than HbA1c (P=0.011). Conclusion  SHR is a risk factor for in-hospital MACEs in AMI patients, and has predictive value for in-hospital MACEs, which is better than HbA1c. The optimal cut-off value is 1.29.

Predictive value of three-dimensional ultrasound evaluation of endometrium on pregnancy outcomes after hysteroscopic adhesiolysis for intrauterine adhesion

hao Yuting, Huang Xiaowu, Xu Ruonan, Huang Rui, Xia Enlan

2024, 45(3):  501-507.  doi:10.3969/j.issn.1006-7795.2024.03.019

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Objective  To investigate the predictive value of endometrium-related indicators assessed by three-dimensional transvaginal ultrasound (3D-TVUS)on pregnancy outcome after hysteroscopic adhesiolysis(HA).Methods  A total of 278 patients who underwent HA for fertility purposes at the Fuxing Hospital, Capital Medical University, from June 2020 to February 2022 were included in this study. In the mid-luteal phase, 3D-TVUS was performed to assess endometrial thickness, endometrial volume, and blood flow indices. Postoperative follow-up was conducted to evaluate uterine cavity and pregnancy outcomes. Based on the pregnancy outcome, patients were divided into a pregnancy group and a non-pregnancy group. Univariate analysis and multivariate Logistic regression analysis were performed to determine the factors influencing clinical pregnancy. The predictive value of these factors for clinical pregnancy was evaluated by using the area under the receiver operating characteristic curve. Results  Among the 278 included patients, 8 cases were lost to follow-up. Clinical pregnancy was achieved in 143 cases, while 4 cases experienced ectopic pregnancy and 123 cases did not achieve pregnancy. Multivariate analysis revealed that postoperative American Fertility Society (AFS) score, endometrial thickness, and volume were independent factors influencing clinical pregnancy (P<0.05). The Logistic regression model for predicting pregnancy after HA had an area under the curve of 0.827, a Youden index of 58.5%, sensitivity of 74.8%, and specificity of 83.7%. The optimal cutoff values for postoperative endometrial thickness and endometrial volume were 6.22 mm and 1.42 mL, respectively. Conclusion  Postoperative AFS score, endometrial thickness, and volume were found to be predictive factors for pregnancy outcomes following hysteroscopic adhesion separation. They can serve as reference indices for patients in their postoperative pregnancy planning and assistive treatment decisions.

Relationship between orthostatic hypotension and summary cerebral small vessel disease score

Li Yue, Li Man, Zuo Long, Yang Lei, Qin Wei, Hu Wenli

2024, 45(3):  508-514.  doi:10.3969/j.issn.1006-7795.2024.03.020

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Objective  To investigate the relationship between the presence and type of orthostatic hypotension (OH) and total cerebral small vessel disease (CSVD) score. Methods  Consecutive 460 patients were recruited in this study from March, 2021 to September, 2023 and divided into No OH group, Early OH (EOH) group and delayed/prolonged OH (DPOH) group according to the presence and type of OH. A total CSVD score was evaluated using a 5-point scoring method (range 0－4). The correlation was analyzed between different OH groups and lacunes, white matter hyperintensities (WMH) scores, cerebral microbleeds (CMBs), basal ganglia-perivascular spaces (BG-PVS) as well as total CSVD score. Results  The prevalence of EOH and DPOH was 10.00% and 17.17%, respectively, in these patients. There are significant differences in the proportion of lacunes and the distribution of degree of BG-PVS as well as total CSVD score among different OH groups (P<0.01). After adjusting for age, gender, hypertension and supine diastolic blood pressure, DPOH was an independent risk factor for lacunes (OR=2.421, 95% CI:  1.372－4.271, P=0.002), severe BG-PVS (OR=1.714, 95% CI:1.074－2.740, P=0.024), and higher total CSVD score (OR=1.791, 95% CI: 1.140－2.818, P=0.012).Conclusion  Among CSVD patients, DPOH is more common than EOH and is an independent risk factor for higher total CSVD score.

Clinical analysis of eosinophilic granulomatosis with polyangiitis in elderly patientsZhang Jun1， Li Jie1， Wang Jing1， Hua Lin2, Zhang Liming1*

Zhang Jun, Li Jie, Wang Jing, Hua Lin, Zhang Liming

2024, 45(3):  515-523.  doi:10.3969/j.issn.1006-7795.2024.03.021

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Objective  To analyze the clinical features of eosinophilic granulomatosis with polyangiitis (EGPA) in elderly patients. Methods  The clinical data of patients diagnosed with EGPA at Beijing Chaoyang Hospital, Capital Medical University from February 2007 to February 2022 were retrospectively analyzed. The patients were divided into the elderly group (age ≥60 years old at diagnosis) and the non-elderly group (age<60 years old at diagnosis). Clinical features between the 2 groups were compared and the prognosis was followed up. Results  A total of 101 patients were included, with 42 cases (41.6%) in the elderly group and 59 cases (58.4%) in the non-elderly group. Compared with the non-elderly group, the elderly group had significantly higher proportion of hypertension (40.5% vs 16.9%, P=0.008), blood eosinophils>10% (90.5% vs 72.9%, P=0.029) and estimated glomerular filtration rate (eGFR)<80 mL·min^－1·(1.73 m2)^－1 (61.9% vs 16.9%, P<0.001), and also had significantly higher erythrocyte sedimentation rate (ESR) ［20(10, 56.25) vs 12(5, 32.25) mm/h, P=0.028］ and lung functional parameter of residual volume/total lung capacity (RV/TLC) ［ (48.84±11.43) vs (41.92±9.06) %, P=0.009］. Compared with the non-elderly group，the incidence of cardiac involvement (73.8% vs 32.2%, P<0.001), central nervous system involvement (23.8% vs 5.1%, P=0.006), peripheral nervous system lesions（83.3% vs 64.4%, P=0.036）, kidney involvement（69.0% vs 47.5%, P=0.031）and five-factor scores (FFS) ≥2（61.9% vs 15.3%, P<0.001）were all significantly higher in the elderly group. The median follow-up time was 41 (19, 59) months, 6 patients died and the mortality rate in the elderly group was higher than that in the non-elderly group (13.9% vs 1.92%, P=0.032). Conclusion  The elderly EGPA patients have higher proportion of hypertension, blood eosinophils >10% and decreased eGFR, the organs involved and FFS ≥2, higher ESR, RV/TLC and mortality rate. Clinicians should reinforce their understanding of characteristics of EGPA in elderly patients so as to improve the diagnostic and treatment proficiency.

Advance on role of adenosine type 1 receptor in renal diseases

Bai Yu, Tian Dongli

2024, 45(3):  543-547.  doi:10.3969/j.issn.1006-7795.2024.03.025

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Adenosine plays a biological role of signal transduction inside and outside cells by activating different types of adenosine receptors. Adenosine type 1 receptor, as high affinity receptor, is widely expressed in renal tissues, involved in inflammation, immunity, and hemodynamic regulation. At present, the pathogenesis of common kidney disease such as diabetic nephropathy, hypertensive nephropathy and acute kidney injury have not been fully defined. It has been confirmed that adenosine type 1 receptor is involved in the pathological process of various renal diseases such as diabetic nephropathy, renal ischemia-reperfusion injury and contrast nephropathy. We reviewed the advance in researches of adenosine type 1 receptor in renal disease.

Understanding eosinophilic gastritis: new research insights

Li Zhongshu

2024, 45(3):  548-555.  doi:10.3969/j.issn.1006-7795.2024.03.026

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Eosinophilic gastritis (EoG) is an uncommon digestive disorder with an unclear cause. The prevalence of EoG has been on the rise in recent years. Clinically, EoG have no specific manifestations with most patients presenting with diverse features and endoscopic findings. There are no standardized diagnostic criteria for EoG as yet. Thus, vigilance among clinicians and pathologists is crucial for early diagnosis and treatment of EoG. While the use of biologics for EoG has witnessed significant advancements in recent years, there are few studies on this topic. Conventional treatments for EoG include food elimination diet, acid suppressants and glucocorticoids. Currently, research on standard therapeutic interventions is limited, which warrants further research to understand various aspects of EoG.