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Whether Mineralocorticoid receptor antagonists (MRA) reduce mortality and cardiovascular effects of dialysis patients remains unclear. A meta-analysis was designed to investigate whether MRA reduce mortality and cardiovascular effects of dialysis patients, with a registration in INPLASY (INPLASY2020120143). The meta-analysis revealed that MRA significantly reduced all-cause mortality (ACM) and cardiovascular mortality (CVM). Patients receiving MRA presented improved left ventricular mass index (LVMI) and left ventricular ejection fraction (LVEF), decreased systolic blood pressure (SBP) and diastolic blood pressure (DBP). There was no significant difference in the serum potassium level between the MRA group and the placebo group. MRA vs. control exerts definite survival and cardiovascular benefits in dialysis patients, including reducing all-cause mortality and cardiovascular mortality, LVMI, and arterial blood pressure, and improving LVEF. In terms of safety, MRA did not increase serum potassium levels for dialysis patients with safety.Systematic Review Registration: (https://inplasy.com/inplasy-protocol-1239-2/), identifier (INPLASY2020120143).

In this paper, a kind of magnetorheological elastomer sandwich plate is proposed. The novel nonlinear differential term is applied to describe the force-displacement curve of the magnetorheological elastomer. The constitutive model of the system is established using the Hamilton Modeling Principle. By Galerkin dispersion, the response equation of the system is obtained, and its stochastic dynamic behavior is discussed. The numerical results are simulated by MATLAB mathematics software and show that the magnetorheological elastomer sandwich plate has rich dynamic characteristics, including stochastic Hopf bifurcation, which can be avoided if the parameters vary and only small amplitude vibrations appear.

Objective: To explore the protective effects of ursolic acid (UA) on adriamycin nephropathy in mice. Methods: Totally 40 male Balb/c mice were randomly divided into normal group, model group, low dose of UA group and high dose of UA group. One-time injection of Adriamycin (ADR) at 10.0 mg/kg via tail vein was used to establish the model. Different doses of UA were administered to the mice in treatment groups from the first day after successful modeling. After 3 consecutive weeks, 24 h urine protein was measured, and BUN, Scr and TG as well as SOD, MDA and GSH were also measured. The IL-1β, TNF-α and TGF-β1 were measured by ELISA; SMAD2/3 phosphorylation and its target protein α-SMA expression were measured by Western Blot; pathological changes of renal tissues were observed. Results: Compared with the model group, UA can significantly reduce the urine protein, BUN, Scr, TG, MDA, IL-1β, TNF-α, TGF-β and SMAD2/3 phosphorylation and its target protein α-SMA expression while increasing the GSH and SOD, and the difference is significant (P < 0.05). Conclusions: Ursolic acid can protect against renal damage by inhibiting oxidative stress and reducing the release of inflammatory cytokines, which may be related to the inhibition of TGF-β1/Smads-related signaling pathway.

AIM:To observe the clinical efficacy of phacoemulsification combined with goniosynechialysis for chronic angle-closure glaucoma with cataract. METHODS:Fifty eyes in 50 patients with chronic angle-closure glaucoma and cataract, but without complications underwent phacoemulsification and intraocular lens(IOL)implantation, combined with goniosynechialysis. All patients were followed up for 3mo. The best corrected visual acuity(BCVA), intraocular pressure(IOP), anterior chamber depth and angle were recorded and compared between pre-operation and post-operation. The results were showed by means plus or subtracting deviation standard. The BCVA, IOP, anterior chamber depth and angle were analysed by t test. RESULTS:The best corrected visual acuity at 3mo after operations was significantly higher than that before operations(t=8.76, P=0.001). The IOP at 3mo after operations was 15.63±3.11mmHg and was significantly lower than that(45.12±5.30mmHg)before operations(t=6.27, P=0.000). The anterior chamber depth at 3mo after operations was 3.57±0.02mm, and was significantly deeper than that(1.43±0.25mm)before operations(t=8.16, P=0.001). Compared with preoperative anterior chamber angle, those after operations were wider(Z=-4.432,P=0.000; Z=-2.432,P=0.016; Z=-4.379,P=0.000; Z=-4.538,P=0.000).CONCLUSION:Phacoemulsification combined with goniosynechialysis is safe and effective for chronic angle-closure glaucoma with cataract, which can control IOP and improve the visual acuity.

AIM: To study the characteristics and variability of flash electroretinogram(F-ERG)in normal adults of different age stages.METHODS: Thirty cases(60 eyes)of healthy physical examinaees were divided into two groups according to age: 20～30 years old group(15 cases, 30 eyes )and 40～50 years old group(15 cases, 30 eyes), F-ERG was recorded according to standard of International Society for Clinical Electrophysiology of Vision(ISCEV), and the parameters and coefficient of variation in the two groups were compared.RESULTS: Compared with 20～30 years old age group, the implicit time was extended and the amplitude decreased in the 40～50 years old age group, especially amplitude of the dark adaptation of 3.0, light adaptation of 3.0 and oscillatory potentials showed statistical significance(PCONCLUSION: Compared with 20～30 years old age group, the implicit time of ERG is extended and the amplitude is decreased in the 40～50 years old age group. The coefficient of variation of implicit time is the minimum.

AIM: To accurately measure the implicit time and amplitude of a-, b-wave from flash electroretinogram(ERG)through filtering technology, eliminate oscillatory potentials interference. METHODS: Full-field ERGs were recorded in 30 eyes of 15 physical check-ups, measured the implicit time and amplitude of a-, b-wave, when the passband was set at 0.6～300Hz and 0.6～70Hz, and correlation was performed among those results by paired t-test.RESULTS: When the passband was set at 0.6～70Hz, a-, b-wave had a single peak, compared with the passband was set at 0.6～300Hz, the implicit time of a-, b-wave was prolonged, amplitude was decreased(PCONCLUSION: A passband of 0.6～70Hz was the best choice to obtain smooth a- and b-waves from the original ERG, It could accurately measure the implicit time and amplitude of a-, b-wave.

Detection of M-type phospholipase A2 receptor (PLA2R) can be used in serologic diagnosis of idiopathic membranous nephropathy (IMN), but there are limited data about the sensitivity and specificity of its diagnostic values. Meta-analysis of diagnostic test studies assessing the values of PLA2R in diagnosis of IMN. MEDLINE, EMBASE, and CENTRAL databases and congress abstracts were searched for studies reporting the value of PLA2R to predict IMN. The quality of the studies was evaluated using the guidelines of the updated Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The results are summarized as sensitivity, specificity, and diagnostic odds ratio (OR). Data from 10 studies involving 1,550 participants were analyzed. Across all settings, the diagnostic OR for serum anti-PLA2R level to predict IMN at different stages was 247.41, with sensitivity of 0.69 and specificity of 0.99. The estimated sensitivity and specificity of serum anti-PLA2R level for diagnosis of IMN in the active stage were 74.0 and 95.0 %, respectively, with diagnostic OR of 54.22. The estimated sensitivity and specificity of biopsy anti-PLA2R for diagnosis of IMN at different stages was 73.0 and 83.0 %, respectively, with diagnostic OR of 13.75. This meta-analysis shows that serum anti-PLA2R level is of diagnostic value for IMN in the active stage. Future large-cohort prospective studies are required to reveal the diagnostic value of circulating anti-PLA2R antibodies versus PLA2R antigens in kidney biopsy for IMN at different stages.

To explore the differentially expressed microRNA (miRNA) of human retinal microvascular endothelial cell (HRCEC) in hyperglycemic environment by miRNA gene chip, then adopt bioinformatics methods to forecast target genes of part differentially expressed miRNA.Experimental study. HRCEC were cultured. Took the 3-4 generation growth good cells and divided the cells into three groups: (1) normal control group: DMEM medium with 25 mmol/L glucose; (2) high glucose group: conditioned medium with 90 mmol/L glucose; (3) mannitol high permeability control group: conditioned medium with 65 mmol/L mannitol and 25 mmol/L glucose. Each group cells were cultured in the above conditions for five days, then used in situ cell death detection kit for apoptosis detection; the total RNA was isolated and examined; the differentially expressed miRNA were detected by miRNA gene chip, part results of miRNA array were verified by real-time quantitate polymerase chain reaction (PCR), potential miRNA targets were analyzed by bioinformatics methods.Observed apoptotic HRCEC by fluorescence microscope: the nucleus of normal control group and mannitol control group were dyed by DAPI and appeared blue fluorescence, but hadn't apoptosis fluorescent signals; the nucleus of high glucose group also appeared blue fluorescence, and had green apoptosis fluorescent signals. Quality testing of total RNA: with spectrophotometer measurement, the ratio of absorbance of total RNA in normal control group at A(260)/A(280) nm was 1.99, at A(260)/A(230) was 2.05;total RNA of high glucose group at A(260)/A(280) was 1.98, at A(260)/A(230) was 2.26. The results of formaldehyde degeneration agarose gel electrophoresis showed that the electrophoresis strips were clear and complete, indicated that the total RNA had better quality and high purity. Compared with normal control group, 49 miRNAs were found to be differentially expressed in high glucose group (fold change2 and fold change0.5), including 31 up-regulated miRNAs and 18 down-regulated miRNAs. The results of real-time quantity PCR revealed that hsa-miR-320c and hsa-miR-29a(*) were up-regulated in high glucose group, which were consistence with the miRNA gene chip. Furthermore, the target genes prediction of two above miRNAs were involved many growth factors and proteins.miRNA are differently expressed in HRCEC under hyperglycemic conditions.