Objective To investigate the correlation between the stroke-related risk factors and carotid stenosis lesions of ≥40 year′s old Han and minority populations in a community in Beijing as well as the clinical value of carotid ultrasound screening. Methods An investigation of risk factors for stroke and the results of carotid artery ultrasound screening in 510 cases (≥40 years old) Han population and 243 minority population in a community in Minzu University of China in Beijing in April 2014 were analyzed. Results (1)The prevalence of hypertension of the Han population was significantly higher than that of the minority population (53. 5% [n=273] vs. 44. 4% [n=108]; χ2 =5. 43,P=0. 02). (2) The detected rate of carotid intima-media thickness ( IMT ) of the Han population was higher than that of the minority population (77. 5% [n=395] vs. 69. 1% [n=168]; χ2 =6. 03,P=0. 01). There was no significantly difference in the detected rates of carotid plaques and carotid artery stenosis between the two groups (χ2 =0. 56,1. 13 respectively,all P>0. 05). (3) Hypertension and smoking were the independent risk factors for carotid-intima thickening in Han population ( hypertension:OR,1. 851;95% CI 1. 213-2. 825; smoking:OR,2. 311;95% CI 1. 065-5. 016;all P<0. 05). Hyperlipidemia was an independent risk factor for carotid artery intima-media thickening in the minority population (OR,2. 586;95% CI 0. 952-8. 694,P<0. 01). Conclusion To investigate the risk factors for stroke in minority population in China are of particular importance for the prevention of carotid atherosclerotic disease. Carotid ultrasound examination is an important diagnostic technique for early detection of carotid atherosclerotic disease.

AIM: To explore the effects of exendin-4 (EX-4) on endoplasmic reticulum stress (ERS)-mediated insulin resistance in the 3T3-L1 adipocytes.METHODS: In vitro 3T3-L1 pre-adipocytes were differentiated into adipocytes, and the cells were treated with tunicamycin (TM), tauroursodeoxycholic acid (TUDCA) or EX-4, respectively.The cell viability was measured by MTT assay.The glucose consumption was determined by glucose oxidase assay to evaluate insulin sensitivity of the 3T3-L1 adipocytes with different interventions.The protein levels of p-Akt, Akt and endoplasmic reticulum stress markers, including inositol requiring enzyme-1 (IRE1), p-IRE1, JNK, p-JNK, protein kinase R-like endoplasmic reticulum kinase (PERK), p-PERK, eukaryotic initation factor 2 alpha (eIF2a), p-eIF2a, activating transcription factor-6(ATF-6) were detected by Western blot.RESULTS: The insulin-stimulated glucose consumption and the protein level of p-Akt were inhibited by TM at 5 mg/L for 5 h (P<0.05), while they were increased when the cells were treated with TUDCA at 1 mmol/L or EX-4 at 100 nmol/L for 24 h (P<0.05).The effects above induced by TM (5 mg/L for 5 h) were also blunted by pretreating with TUDCA at 1 mmol/L or EX-4 at 100 nmol/L for 24 h (P<0.05).The protein levels of ERS markers such as p-IRE1, p-JNK, p-PERK, p-eIF2a and ATF-6 were significantly increased by treating with TM at 5 mg/L for 5 h, whereas 24 h pre-treatment with TUDCA or Ex-4 alleviated the ERS of the 3T3-L1 adipocytes induced by TM.The expression of total IRE1, JNK, PERK and eIF2a was not changed in different groups.CONCLUSION: Exendin-4 improves endoplasmic reticulum stress mediated insulin resistance in 3T3-L1 adipocytes.

Objective: To compare the protective effect of various preparations from Tiaogan Lipi prescription on mouse ethanol hepatic injury.Methods:The hepatic injury model of mice was replicated with ethanol.Comparing with Fufang Biejia Ruan’gan prescription,three preparations from Tiaogan Lipi prescription were administrated for protecting the hepatic injury.The contents of AST,ALT,CHOL and TG in serum and the MDA and SOD in liver tissue were tested.The pathological changes of the liver had been evaluated.Results:Three preparations from Tiaogan Lipi reduces the level of ASTALTCHOL TG,lowers the content of MDA(P

Objective To investigate the genotypes of interleukin (IL) 28B polymorphism and the effect of IL28B genotypes on the responses to therapy in patients with chronic hepatitis C (CHC).Methods A total of 74 patients with CHC were prospectively treated with pegylated interferon α (PEG-IFN α) in combination with ribavirin (RBV) for 48 or 72 weeks.After finishing the therapy,the patients were followed up for 24 weeks and the therapeutic effect was evaluated with rapid virological response (RVR) and sustained virological response (SVR).The IL28B rs8099917,rs12979860 and rs12980275 were identified by sequencing the PCR products amplified from the genome DNA of each participate.The IL28 B genotypes in CHC patients were analyzed and the effect of singlenucleotide polymorphism (SNP) on responses to therapy was assessed.Result rs8099917 TT,TG,GG were 63(85.1％),11(14.9％),0(0％),respectively.rs12979860 CC,CT,TT were 60 (81.1％),14 (18.9％),0 (0％),respectively.rs12980275 AA,AG,GG were 57 (77.0％),17 (23.0％),0 (0％),respectively.In patients infected with HCV genotype-1,only rs12979860 was associated with SVR rate,and the proportion of rs12979860 CC in SVR group was significantly higher than that in non-SVR group (88.4％ vs 58.3％,P ＜ 0.05).In patients infected with HCV non genotype-1,none of the three SNPs was associated with RVR or SVR (P ＞ 0.05).Conclusions The majority of the patients with CHC carry IL28B genotype rs8099917 TT,rs12979860 CC and rs12980275 AA in Guangdong.The genotypes of IL28 B(rs12979860) is closely related to the effect of PEG-IFN α/RBV therapy,and it might be an important predictive factor for SVR before treatment in patients with CHC.

Objective:To systematically evaluate the qualitative research on the psychological experience and coping of patients undergoing colonoscopy, so as to provide a basis for understanding the psychological status of patients undergoing colonoscopy and carrying out better psychological nursing.Methods:Chinese and English databases such as PubMed, Embase, Web of Science, CNKI, Wanfang Database and China Biology Medicine disc were searched by computer to collect qualitative studies related to the psychological experience of colonoscopy. The quality of the included studies was evaluated using Australian JBI Evidence-based Health Care Center Qualitative Research Quality Evaluation Standard (2016) , and the research results were integrated through a pooled integration method.Results:A total of 9 studies were included, 33 main results were extracted and summarized into 7 new categories, which were summarized into 3 integrated results, including psychological characteristics of patients undergoing colonoscopy, psychological needs of patients undergoing colonoscopy and coping styles of psychological changes of patients undergoing colonoscopy.Conclusions:Medical staff should pay attention to the psychological characteristics and psychological needs of patients undergoing colonoscopy during the examination, provide a variety of psychological support, improve satisfaction of patients undergoing colonoscopy and reduce the discomfort and negative emotions of patients.

Thrombocytopenia is one of the common complications of cirrhotic patients, which can induce an increasing bleeding risk and closely correlate with bleeding following invasive procedures. Consequently, how to respond to thrombocytopenia is crucial for improving the prognosis of patients with cirrhosis. This article reviews the main mechanisms of cirrhosis concurrent with thrombocytopenia, as well as the corresponding clinical management strategies.

Objective:To explore the application effect of the milestone evaluation system based on ACGME core competencies in the standardized training of residents in the department of rheumatology and immunology.Methods:A modified Milestone Evaluation Scale was developed for the department of rheumatology and immunology. Self evaluation and mentor evaluation were conducted on 150 residents who received standardized training in grades 1-3 before May 2023. The results were collected and statistically analyzed. One-way analysis of variance and t-test were performed using SPSS 27.0. Results:The self-evaluation and mentor evaluation scores of all residents increased with the training years. Self-evaluation scores were significantly higher than mentor evaluation scores ( P<0.05) for the medical knowledge ( t=2.95, P=0.006), diagnosis and treatment ability ( t=2.57, P=0.015), and learning ability ( t=2.67, P=0.015) of grade 2 residents and the learning ability ( t=2.87, P=0.007) of grade 3 residents. There were no significant differences in the baseline score and ability improvement of residents from different institutions ( P>0.05). Conclusions:The milestone evaluation system is an effective tool for training, assessing, and providing feedback to residents in rheumatology and immunology, and provides essential feedback to resident training bases regarding the training effectiveness. The method is worth promoting.

Parkinson's disease (PD) is one of the hotspots in the research field of neurodegenerative diseases, and its pathogenesis is still controversial. Trace metal elements play an important role in normal growth and development of the human body. Metal ions can cross the blood-brain barrier and enter the brain, leading to α-synapnuclein aggregation, mitochondrial dysfunction, and degeneration of dopaminergic neurons, and then inducing the occurrence of PD. This article mainly reviewed the potential mechanisms of metal elements in PD, discussed the role of metabolic imbalance of common trace metals (copper, iron, manganese, and zinc) in PD, and put forward new insights into the treatment of PD.

Objective: To investigate the effect of antiviral therapy on the progression of liver cirrhosis and related predictive factors through a retrospective analysis of patients with compensated hepatitis C cirrhosis. Methods: The patients with compensated hepatitis C cirrhosis who were treated in our hospital from 2004 to 2015 were divided into sustained virologic response (SVR) group, non-SVR (NSVR) group, and untreated group. The baseline features of patients with or without liver cirrhosis were compared to identify the predictive factors for the progression of liver cirrhosis. The changes in platelet count, spleen sizes, Model for End-Stage Liver Disease (MELD) score, Sequential Organ Failure Assessment (SOFA) score, and Child-Turotte-Pugh (CTP) score were analyzed, and the incidence rate of liver cancer was compared between groups. A one-way analysis of variance, the Kruskal-wallis H test, the two-independent-sample t test, the chi-square test, and a multivariate logistic regression analysis were used for data analysis based on data type. Results: A total of 89 patients with compensated liver cirrhosis were enrolled, among whom 42 received the antiviral treatment with interferon and ribavirin (30 were treated with pegylated interferon-α and 12 were treated with ordinary interferon) and 47 did not receive any antiviral therapy. Among the patients who received the antiviral treatment with interferon and ribavirin, 20 achieved SVR and 22 did not achieve SVR. Compared with baseline values, platelet count in the SVR group and the NSVR group was increased by (44.93 ± 32.66)×10⁹/L and (9.73 ± 28.83)×10⁹/L, respectively, and platelet count in the untreated group was reduced by (19.76 ± 54.5)×10⁹/L; the three groups had a significant change in platelet count (F = 14.731, P < 0.001). Spleen size was reduced by 0.91 ± 1.09 cm in the SVR group and increased by 0.20±0.84 cm and 1.11 ± 1.69 cm in the NSVR group and the untreated group, respectively; the three groups had a significant change in spleen size (F = 14.943, P < 0.001). The three groups had no significant changes in MELD, SOFA, and CTP scores (P > 0.05). One patient (5.00%) in the SVR group, 5 (22.73%) in the NSVR group, and 6 (12.77%) in the untreated group progressed to liver cancer (χ ² = 13.787, P = 0.001). The univariate analysis showed that SVR, HCV RNA, total bilirubin, and albumin were predictive factors for disease progression, and the multiple logistic regression analysis demonstrated that SVR and total bilirubin were predictive factors for disease progression. Conclusion Interferon combined with ribavirin has a marked clinical effect in the treatment of compensated hepatitis C cirrhosis with good short- and long-term efficacy.