Objective To evaluate the association between hypersensitive C reactive protein (hs-CRP) and the incidence of acute kidney injury in subarachnoid hemorrhage(SAH) patients.Methods It retrospectively recruited 213 cases of computerized tomography validated SAH patients from the neurology ICU from Beijing Tiantan Hospital between January 2012 and January 2015.The average age was (56.29±11.95) years old,and the patients were divided into AKI and non-AKI groups according to Kidney Disease: Improving Global Outcomes (KDIGO) diagnosis standards, Clinical features of AKI and Non-AKI patients including serum levels of hs-CRP were compared and multi-logistic regression was applied to find the risk factors concerning with the incidence of AKI.Receiver operating characteristics (ROC) curve was also plotted to evaluate the diagnostic value of hs-CRP towards the incidence of AKI.Results A total of 25 (11.74%) patients developed AKI.Average age of the SAH patients in both AKI and non-AKI groups were (63.60±12.21) years old vs.(55.31±11.60) years old(t=-3.33, P<0.05).The ratios of diabetics were were 28.00% vs.11.17% (χ2=5.47,P<0.05) and the ratio of proteinuria were 80.00% vs.34.57%, respectively (χ2=3.83, P<0.05).The median of serum creatinie were 63.72(51.45, 79.72)μmol/L vs.53.21(45.27, 65.62)μmol/L (P<0.05), and serum hs-CRP were (14.12±5.03)mg/L vs.(10.23±6.76)mg/L (P<0.05), and the ratios of antibiotics application were 84.00% vs.43.08% (P<0.05 for all).Multi-logistic regression analysis showed that serum hs-CRP was an independent risk factors for AKI after age, serum creatinine at admission were adjusted.[OR (95% CI) was 3.33(1.13, 9.85),P<0.05 for all].The area under curve of ROC was 0.69 (P<0.05), and the cut-off point of serum hs-CRP under the maximum Youden index was 13.85 mg/L.Conclusion Serum hs-CRP is an independent risk factor of theincidence of AKI in SAH patients, the significantly increase of serum hs-CRP might be an important predictor of the incidence of AKI in SAH patients.

OBJECTIVE:To study the spectrum-effect relationship of the antipyretic effect of Radix Bupleuri injection. METH-ODS:HPLC method was used to establish the fingerprint of Radix Bupleuri injection. The antipyretic effect of 10 batches of Radix Bupleuri injection on fever rats induced by dried yeast were determined respectively. The fingerprint peaks were screened,along with the temperature value of different time points(0,10,15,30,40,55,70 min). The principal components were extracted by principal component method and the indirect relationship between the fingerprint and antipyretic effect was analyzed,depending on the principal component correlation coefficient matrix. RESULTS:There were 39 common peaks in fingerprint(similarity>0.85), No. 8,12,14,19,26,31,34,35 and 39 common peaks with large peak area were included in the study. Four principal compo-nents were extracted by principal component analysis(87% of total variant). First principal component showed that the active com-ponents of the 12th peak may be related to the antipyretic effect of 6 to 13 hours. The second principal component showed that the active components of the 26th peak may be related to the antipyretic effect of 0.5 to 5 hours. The third principal component showed that the similar effect of the active components could be caused by 34th,35th and 39th peaks. The fourth principal component sug-gested that there were some similarities between the 14th and the 31st peaks. CONCLUSIONS:Radix Bupleuri injection have obvi-ous improvement for fever rats. There is certain corresponding relation between HPLC fingerprint and antipyretic effect of Radix Bu-pleuri injection .

ObjectiveTo investigate the clinical feature peripheral neuropathy and vasculopathy after acrylamide toxication. Methods2 young male patients with peripheral neuropathy who had exposed to acrylamide for job more than one year were reported.ResultsNeuroelectrophysiological examination showed marked abnormalities in both peripheral and central nerve conduction in both patients. Sural nerve biopsies revealed axonal degeneration, Wallerian degeneration and giant axon with accumulated neurofilaments. Additonally, vasculopathies including prominant thickness of arterial intesma and basal membrane of capillary as well as apoptosis of vascular pericyte, were evident. ConclusionAxonal degeneration and vascular involvement has been found in acrylamide toxication. Vascular impairment maybe plays an important role in the pathogenesis of neuropathy.

Objective To explore the therapeutic effects and mechanism of bone marrow mesenchymal stem cells (MSC) transplantation in mice autoimmune hepatitis (AIH).Methods AIH model was established in 44 C57BL/6 mice,which were induced by homologous series liver-specific antigen S-100 and Freund's complete adjuvant.After modeling,six mice were collected for AIH model confirming.The other 38 mice were divided into three groups.Fourteen mice of MSC transplantation group (group A) were treated by MSC tail vein injection,12 mice of dexamethasone (DXM) group (group B) were treated by DXM intraperitoneal injection,and 12 mice of PBS control group (group C) received phosphate buffer saline (PBS) intraperitoneal injection.Eighteen mice of healthy control group (group D) weren't modeled and received no treatment.At the 5th and 9th week,the mice weights and serum alanine aminotransferase (ALT) level were tested,mice liver tissues of each group were estimated by pathological examination and Knodell scoring,and spleen T lymphocytes of mice were isolated for proliferation-inhibition examination.The data were analyzed by rank sum test,ANOVA and t test.Results After treatment,mice weights of both group A and B showed upward trend (F=15.678,P＜0.01; F=3.730,P=0.037).Before and after treatment,there was no significant difference in group C (P＞0.05).At the 5th and 9th week,the ALT level of group A and B gradually decreased,there was statistical significance between the time points (F=20.267,P＜0.01; F=4.277,P=0.034).Before and after treatment,there was no significant difference in ALT level of group C (P＞0.05).At the 5th and 9th week,the degree of mice serum ALT reduction of group A was larger than that of group B,and the difference was statistically significant (t=3.566 and 3.218,both P＜0.05).At the 5th and 9th week,the Kondell scores of group A and B gradually decreased,there was statistical significance between the time points (F=8.070,P=0.003; F=6.547,P=0.009).Before and after treatment,there was no significant difference in Kondell scores of group C (P＞0.05).At the 9th week,there was statistical significance in Kondell scores among group A,group B and group C (F =4.477,P =0.029).The in vitro spleen lymphocytes proliferation-inhibition experiment demonstrated that the supernatant of MSC could significantly inhibit the proliferation of T lymphocytes stimulated by S-100 antigen and concanavalin A,the absorbance values were0.267±0.167 vs.0.217±0.128 and0.165±0.187 vs.0.082±0.051 respectively,the differences were statistically significant (t =7.187 and 4.602,both P＜ 0.01).Conclusion MSC transplantation may play a therapeutic role in mice AIH through inhibiting T lymphocyte proliferation.

Objective To investigate the psychological resilience and its influencing factors among patients after hepatectomy. Methods A total of 126 cases of hepatocellular carcinoma patients undergoing surgery eradication were selected. 1 d before the patients discharged,the general information was collected, the patients were investigated by using psychological elasticity scale, medical coping questionnaire, social support rating scale, quality of life measurement scale of liver cancer patients. The correlations between variables were analyzed by using Pearson correlation analysis. The influencing factors of psychological resilience were analyzed by using multiple linear regression equation. Results The overall psychological resilience score for patients after hepatectomy was (54.73 ± 10.61) points. The psychological resilience among patients after hepatectomy was related with age, educational level and postoperative hospital stay(t=2.959,3.452,2.507,P<0.05).Pearson correlation analysis showed that the psychological resilience among patients after hepatectomy was positively correlated with the confront coping, social support score, objective support, subjective support, supportive utilization, total quality of life, physical function, psychological function and social function (r =0.208-0.429, P<0.05), while was negatively correlated with avoiding coping, resignation coping, symptoms/side effects (r =-0.187,-0.442,-0.325, P<0.05). Multivariate stepwise linear regression analysis showed that resignation coping, subjective support, objective support, physical function and postoperative time entered the regression model and explained 59.4% of all the variation. Conclusions Patients after hepatectomy had poor psychological resilience, postoperative time, resignation coping, subjective support, supportive utilization and physical function were important influencing factors.

The establishment of effective animal models is crucial for disease research.Dietary induction is a common method to establish animal models of non-alcoholic fatty liver disease(NAFLD).The common animal models of diet-induced NAFLD mainly include high fat and sugar,high fat and cholesterol,and choline-deficient diet-induced models.Because of the various nutrients ingested in different modeling method,pathological characteristics of the liver,such as fatty deformation,inflammation,and fibrosis,are different.Additionally,animal models vary in terms of disease progression,disease severity,and applicable studies.This study analyzed and compared the common animal models of NAFLD induced by various diets in terms of modeling method,modeling time,pathological characteristics,applicable research,and related advantages and disadvantages to provide a reference for NAFLD researchers to select animal models.

Objective: To evaluate the outcomes of splenectomy in the treatment of relapsed/refractory autoimmune hemolytic anemia (AIHA). Methods: Retrospective analysis was performed in 30 cases with relapsed/refractory AIHA who were treated with splenectomy in our hospital. The pre- and post-operative blood routine indexes and responses were followed up. Results: Among the 30 relapsed/refractory AIHA patients, 20 were pure AIHA (including 13 patients with warm antibody AIHA, 2 with warm-cold double antibody AIHA and 5 with Coombs negative AIHA) and 10 were Evans syndrome. The short-term response was evaluated 10-14 days after operation, and the overall response rate (ORR) of short-term response was 90% [12 cases in complete response (CR), 6 cases in partial response (PR)] in 20 therapeutic evaluable cases. Among 13 patients with long-term follow-up data, except 3 patients with Evans syndrome died (2 cases were refractory to splenectomy, 1 case relapsed after surgery), the ORR of 10 patients with relapsed/refractory pure AIHA at 6 months and 12 months were 90% (9/10) and 70% (7/10), respectively, with a median follow-up of 14 (4-156) months. At the end of follow-up, 3 cases had maintained CR for more than 3 years. Conclusion The short-term response of splenectomy as a second-line treatment for relapsed/refractory AIHA is satisfactory, and long-term outcome of splenectomy is up to 70% at 1 year. Approximately one-third of patients could maintain sustained remission.

Objective To explore the clinical efficacy of Qingpeng unguentum(QU)combined with auricular acupuncture(AA)and multi-dimensional collaborative intervention(MDCI)in the treatment of postherpetic neuralgia(PHN).Methods Patients with PHN who attended the department of dermatology at Zhejiang Provincial Dermatology Hospital from January 2022 to January 2023 were retrospectively selected.According to the intervention regimens,patients were divided into three groups:the QU group(QU external application),the AA group(QU external application combined with AA),and the MDCI group(QU external application combined with AA and MDCI).Changes in negative mood[self-rating anxiety scale(SAS)and self-rating depression scale(SDS)],pain degree(visual analogue scale,VAS score),sleep quality(Pittsburgh sleep quality index,PSQI score),quality of life(mos36-item short form health survey,SF-36 score)and inflammatory markers(IL-6,TNF-α and CRP)were compared before and after intervention using paired sample t-tests.Differences among the groups in these parameters and in nursing satisfaction were analyzed using ANOVA,rank-sum test,or chi-square test.Results A total of 110 PHN patients were included in this study,with 30 in the QU group,41 in the AA group,and 39 in the MDCI group.There were no significant differences among the three groups in negative mood,pain degree,sleep quality,quality of life,and inflammatory markers(P>0.05).After 1 month of intervention,the scores for SAS,SDS,VAS,PSQI,as well as serum levels of IL-6,TNF-α,and CRP,significantly decreased compared to pre-intervention levels(P<0.05).The level of these indicators were lower in the AA group than in the QU group(P<0.05),and the level in the MDCI group were lower than those in the AA group(P<0.05).SF-36 scores were elevated in the 3 groups compared with the pre-intervention period,and were greater in the MDCI group than in the AA group,and in the AA group than in the QU group(P<0.05).Additionally,the total response rate and total satisfaction rate were significantly higher in the AA group than in the QU group(P<0.05),and higher in the MDCI group than in the AA group(P<0.05).Conclusion QU combined with AA and MDCI significantly improves negative mood,pain degree,sleep quality,and quality of life in PHN patients,reduces levels of inflammatory markers,and enhances overall treatment efficacy.It is recommended for promotion in clinical practice.

Objective To analyze the serum levels of bone morphogenetic protein 4(BMP4)and nerve ax-on guidance factor 4(Netrin-4)in patients with diabetic retinopathy(DR),and to study their relationship with disease stage and prognosis.Methods A total of 186 patients with type 2 diabetes admitted to the hospi-tal from October 2019 to November 2022 were selected as the research objects.According to the presence or absence of retinopathy,they were divided into DR Group(108 cases)and non-DR group(78 cases),and 100 healthy people in the hospital were selected as the control group.According to the stage of DR,the DR pa-tients were divided into stage Ⅰ(19 cases),stage Ⅱ(14 cases),stage Ⅲ(22 cases),stage Ⅳ(23 cases),stage V(18 cases)and stage Ⅵ(12 cases).According to the visual impairment after treatment,the DR patients were divided into a good prognosis group(72 cases)and a poor prognosis group(36 cases).Serum BMP4,Ne-trin-4,fasting plasma glucose(FPG),glycated hemoglobin Alc(HbA1c),systolic blood pressure(SBP),dias-tolic blood pressure(DBP),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)were detected by enzyme-linked immunosorbent as-say.The serum levels of BMP4 and Netrin-4 in DR patients with different disease stages were analyzed.Multi-variate Logistic regression was used to analyze the influencing factors of DR,and the serum levels of BMP4 and Netrin-4 in DR patients with different prognosis were analyzed.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of poor prognosis in DR patients.Results The FPG,HbA1c,SBP,DBP,TG,TC,BMP4,Netrin-4 levels in DR group were higher than those in control group and non-DR group,while HDL-C level was lower than that in control group and DR group(P＜0.05).There were significant differences in serum BMP4 and Netrin-4 levels between DR patients with different disease stages(P＜0.05).HbA1c,BMP4 and Netrin-4 levels were influencing factors for the occurrence of DR(P＜0.05).The serum levels of BMP4 and Netrin-4 in the poor prognosis group were higher than those in the good prog-nosis group(P＜0.05).The combination of serum BMP4 and Netrin-4 levels in the diagnosis of poor progno-sis of DR patients was better than that of each index alone.Conclusion The serum levels of BMP4 and Ne-trin-4 are increased in DR patients,which can assist in the evaluation of the disease stage of the patients.The combination of BMP4 and Netrin-4 has a good effect in the diagnosis of poor prognosis of patients.

Familial acne inversa (AI) is an autoinflammatory disorder that affects hair follicles and is caused by loss-of-function mutations in γ-secretase component genes. We and other researchers showed that nicastrin (NCSTN) is the most frequently mutated gene in familial AI. In this study, we generated a keratin 5-Cre-driven epidermis-specific Ncstn conditional knockout mutant in mice. We determined that this mutant recapitulated the major phenotypes of AI, including hyperkeratosis of hair follicles and inflammation. In Ncstn;K5-Cre mice, the IL-36a expression level markedly increased starting from postnatal day 0 (P0), and this increase occurred much earlier than those of TNF-α, IL-23A, IL-1β, and TLR4. RNA-Seq analysis indicated that Sprr2d, a member of the small proline-rich protein 2 family, in the skin tissues of the Ncstn;K5-Cre mice was also upregulated on P0. Quantitative reverse-transcription polymerase chain reaction showed that other Sprr2 genes had a similar expression pattern. Our findings suggested that IL-36a might be a key inflammatory cytokine in the pathophysiology of AI and involved in the malfunction of the skin barrier in the pathogenesis of AI.