Objective To explore the predictive value of serum SMAD4 and NLRP3 for visual prognosis in CRVO patients. Methods This study included 232 CRVO patients(CRVO group) and 100 healthy subjects(control group) from Lanzhou University Second Hospital Eye Clinic from November 2021 to November 2023. All CRVO patients were treated with anti-VEGF intravitreal injections and followed up for 12 months. Based on their best corrected visual acuity(BCVA) changes, they were divided into good-prognosis(165 cases) and poor-prognosis(67 cases) subgroups. Serum SMAD4 and NLRP3 levels were measured by ELISA. Multivariate Logistic regression analysis was used to identify risk factors for poor visual prognosis. ROC curves assessed the predictive value of SMAD4 and NLRP3 for poor visual prognosis. Results Serum SMAD4 and NLRP3 levels were higher in the CRVO group than in the control group(t/P=23.536/0.000, 16.918/<0.001) and higher in the poor-prognosis subgroup than in the good-prognosis subgroup(t/P=9.614/<0.001, 8.864/<0.001). Multivariate analysis showed high initial BCVA, persistent macular edema, ischemic type, high SMAD4, and high NLRP3 were independent risk factors for poor prognosis [OR(95%CI)=1.685(1.143-2.484), 1.772(1.193-2.633), 2.061(1.241-3.424), 2.325(1.359-3.978), 2.149(1.291-3.577)]. The AUCs for predicting poor prognosis were 0.853 for SMAD4, 0.849 for NLRP3, and 0.932 for the combination, which was better than either alone(Z/P=2.191/0.028, 2.470/0.014).Conclusion Serum SMAD4 and NLRP3 levels were elevated in CRVO patients. Their combination showed high predictive efficiency for visual prognosis.

Objective To observe the anatomical variations of Celiacomesenteric trunk(CMT) through dual-source CT enhanced scanning, summarize its anatomical features and complications, and provide guidance for clinical practice and surgery. Methods The imaging data of 107 patients with CMT diagnosed by CT enhanced scanning were retrospectively analyzed. Maximum intensity projection(MIP),multiplane reconstruction(MPR) and volume rendering(VR) images were reconstructed. The length and diameter of the common trunk of CMT were measured. The origin of the left gastric artery and complications were observed. The differences in anatomy and complications among different types of CMT were compared. Results Among the 107 cases of CMT, 69 cases(64.49%) were long type and 38 cases(35.51%) were short type; 37 cases(34.58%) were type Ⅰ, 19 cases(17.76%) were type Ⅱ, 40 cases(37.38%) were type Ⅲ, and 11 cases(10.28%) were type Ⅳ. The diameter of the common trunk of long type CMT was(8.92 ± 1.66) mm, and that of short type CMT was(10.88 ± 1.65) mm. The difference was statistically significant( t/P=5.860/<0.001). The differences in subtype distribution, combined with other branch variations, combined vascular lesions, and combined malrotation of the midgut between long type and short type CMT were all statistically significant( χ2/P=38.458/<0.001,4.955/0.026,5.608/0.018,7.089/0.008). Conclusion The anatomical features and imaging manifestations of different types of CMT are different. Dual-source CT enhanced scanning combined with post-processing techniques can provide three-dimensional stereoscopic visualization images, which can help clinical practice and necessary surgical treatment.

Objective To explore the role of CREB/SHP2/AKT signaling pathway in the differentiation of human bone marrow mesenchymal stem cells into skeletal muscle cells and the effect of this signaling pathway on postnatal pelvic floor rehabilitation. Methods The experiments were conducted from November 2022 to April 2023 in the Laboratory of the Third Hospital of Shijiazhuang. Using various analytical techniques on the human bone marrow stem cell osteogenic differentiation dataset, different gene expression patterns and regulatory relationships were revealed, shedding light on the underlying mechanisms of the disease. Experiments were performed using the human bone marrow MSC cell line CP-H166, and the cells were divided into a control group(NC group), a 5-azacytidine group, a 5-azacytidine+electrostimulation group, a 5-azacytidine+electrostimulation+CREB inhibitor group, and a 5-azacytidine+electrostimulation+CREB agonist group. The expression and distribution of relevant proteins and calcium ion concentration in cells of each group were detected by Western blot, Fura-2 calcium ion fluorescence staining and immunofluorescence staining. Results Western blot assay showed that 5-azacytidine and electrical stimulation treatments increased the expression levels of CREB, SHP2, AKT, MyoD, MyoG, and TPM1 proteins compared with the control group(P<0.05). The addition of CREB inhibitor decreased the expression of SHP2 and AKT(P<0.05), which in turn decreased the expression of MyoD, MyoG, and TPM1; whereas the addition of CREB agonist increased the level of the above-mentioned proteins(P<0.05). The results of calcium fluorescence staining of Fura-2 showed that 5-azacytidine and electrical stimulation increased the calcium ion concentration(P<0.05). Immunofluorescence staining showed that 5-azacytidine and electrical stimulation treatments increased the expression and distribution of p-CREB and MyoD(P<0.05), and the addition of CREB agonists further increased the expression of these proteins(P<0.05), whereas the addition of CREB inhibitors decreased their expression(P<0.05). Conclusion The CREB/SHP2/AKT signaling pathway has an important role in the differentiation of BMSCs into skeletal muscle cells. Modulation of this signaling pathway can significantly affect the cell differentiation process and promote postnatal pelvic floor rehabilitation.

This paper reports the clinical data of a case of Fabry disease complicated with systemic lupus erythematosus and reviews.

Hypertensive brainstem hemorrhage(HBSH), characterized by acute onset, rapid hemorrhage, high mortality and disability, is one of the most dangerous types of hemorrhagic stroke, accounting for about 6% to 10% of hypertensive cerebral hemorrhage. Hypertensive brainstem hemorrhage prognosis prediction is a research hotspot in recent years, clinical manifestations, imaging features, laboratory and scoring system can effectively provide the basis for the prognosis of brain stem hemorrhage judgment, help clinicians to optimize treatment decisions and improve patients prognosis.