This study was aimed to investigate renal protective effects and mechanism of Gui-Zhi(GZ) decoction in hyperuricemic mice.Potassium oxonate was used to induce hyperuricemia mouse model.Mice were randomly divided into 6 groups,which were the blank control group,model group,allopurinol group (5 mg·kg-1) and GZ decoction group (900,1 799 and 3 598 mg·kg-1).Hematoxylin eosin staining was used to observe the histopathological changes of renal tissues in mice.Commercial assay kits were used to measure levels of uric acid (UA),creatinine (Cr) and blood urea nitrogen (BUN) in serum and urine,as well as the xanthine oxidase (XOD) activity in liver.Renal protein levels of urate transporter 1 (URAT1),glucose transporter 9 (GLUT9),ATP-binding cassette G member 2 (ABCG2),organic cation transporter 1 (OCT1),OCT2,organic cation/carnitine transporter 1 (OCTN1) and OCTN2 were detected by western blot.The results showed that compared with the model group,GZ decoction can obviously decrease serum levels of UA,Cr and BUN,increase urine levels of UA and Cr,resulting in the elevation of fractional excretion of UA in hyperuricemic mice.Additionally,GZ decoction obviously inhibited hepatic XOD activity in hyperuricemic mice.Furthermore,GZ decoction downregulated renal URAT1 and GLUT9 protein levels,upregulated renal ABCG2,as well as OCT1,OCT2,OCTN1 and OCTN2 protein levels in hyperuricemic mice.It was concluded that GZ decoction had hypouricemic and renal protective effects in hyperuricemic mice,which might be associated with the reduction of UA production via inhibiting hepatic XOD activity,promoting UA and other organic ion excretion via regulating renal organic ion transporter protein levels.

ObjectiveTo apply the physical function test in evaluating the lower extremity muscle strength in patients with knee osteoarthritis. Methods33 patients with knee osteoarthritis who had radiological diagnosis and clinical symptoms were tested with 5 times sit-to-stand, 10 m walking speed, timed up and go test and isokinetic muscle strength. ResultsThere were very high correlation among 5 times sit-to-stand, 10 m walking speed and timed up and go (P<0.001). The lower extremity extensor muscle strength correlated with 5 times sit-to-stand, 10 m walking speed and timed up and go respectively (P<0.05). Conclusion5 times sit-to-stand test reflects the walking ability and the lower extremity muscle strength in patients with knee osteoarthritis, which can be used as a kind of assessment for knee osteoarthritis.

Objective To investigate the expressions of FAT10 and p53 mutant in gastric cancer tissues and their relations. Methods Immunohistochemistry and RT-PCR were used to detect the expressions of FAT10 and p53 in gastric cancer tissues (n=62), para-cancerous tissues (2-5 cm apart from cancer, n=62), and normal gastric tissues (7>5 cm apart from cancer, n=62). The association of FAT10 with p53 and clinical outcomes were analyzed by Spearman and Pearson correlation. Results The immunohistochemistry examination showed that expressions of FAT10 [51.61%(32/62)] and p53 [45.16% (28/62)] were significantly higher in cancerous tissues than in para-cancerous tissues [12.90%(8/62) and 14.51% (9/62), χ2=21.26 and 20.69, P<0.01] and normal tissues [6.45% (4/62) and 9.68% (6/62), χ2=13.91 and 19.61, P<0.01]. Overexpressions of FAT10 protein and mRNA in cancerous tissues were closely related to lymph node metastasis and TNM staging (both P value<0.05). There was a positive correlation between FAT10 and p53 in protein and mRNA expressions (protein r=0. 865, P<0.05; mRNA r=0.761, P< 0.01). Those with positive expression of FAT10 had lower survival rate compared to those with negative expression (P<0.05). Conclusions The positive relation between over-expression of FAT10 and p53 implicates that both are involved in the gastric carcinogenesis, and FAT10 is a novel gastric cancer marker with prognostic significance.

Objective To evaluate the clinical value of endoscopically nasojejunal feeding tube placement (ENFTP) for nutritional support in patients with severe acute pancreatitis (SAP). Methods Those SAP patients who treated with ENFTP (n= 47) or with total parenteral nutrition (TPN) (n=50) were retrospectively analyzed for laboratory parameters before and 1,2 and 4 weeks after nutrition support. Outcomes in the two groups were compared with respect to complications,mortality, duration of feeding, feeding costs,mechanical ventilation time and length of ICU or hospital stay. Results Four weeks after nutrition sypport, the hemoglobin and albumin were increased in ENFTP group as compared to TPN groups (P < 0. 05), while the blood sugar was decreased significant in ENFTP group than in TPN group (P<0.05). The incidence of peripancreatic or biliary infection and catheter-related infection were lower in ENFTP group than in TPN group. Duration of feeding and hospital stay were shorter, and nutrition cost was lower in ENFTP group (P<0.05). In addition, the APACHE Ⅱ score was significantly improved in ENFTP group(P<0.05). Conclusion ENFTP seems to be safe and less expensive in treatment of patients with acute pancreatitis.

Objective To analyze the change trends of death situation caused by cerebral apoplexy and myocardial infarction in Chongqing from 2006 to 2010 .Methods All death cases of cerebral apoplexy and myocardial infarction from the five years of 2006 to 2010 were extracted from the direct network report system covering the whole crowd death causes in Chongqing and performed the statistical analysis .Results The constituent ratio of cerebral apoplexy death was increased from 13 .94% to 16 .71% in these five years ,while which of myocardial infarction death in all death causes was stabilized around 4% .The sex ratio of male to female for cerebral apoplexy was descended from 1 .76∶1 .00 to 1 .43∶1 .00 in these five years ,while which for myocardial infarction was dropped from 1 .44∶1 .00 to 1 .30∶1 .00 ;which of cerebral apoplexy and myocardial infarction below 75 years old tended to de-cline ,while which above 75 years old tended to rise .Conclusion The cerebral apoplexy harm to Chongqing people′s life is increas-ing ,while the harm caused by myocardial infarction changes little ;the constituent ratio of female death caused by cerebral apoplexy and myocardial infarction is rising ;the cerebral apoplexy and myocardial infarction damage to old people above 75 years old is grea-ter ,and this damage still continues to grow .

Objective To investigate the prevalence of smoking, smoking cessation, passive smoking and awareness of the dangers of tobacco in population in Chongqing and provide evidence for developing prevention and control measures.Methods A total of 5 400 residents aged ≥ 18 years were selected from 9 districts/counties in Chongqing through stratified multi-stage cluster sampling and face-to-face interviews were conducted among them.Indicators as current smoking rates, smoking cessation rates and passive smoking rates were calculated by the weight of age proportions from 2010 population census.The analytical method was based on complex sampling design.Results The current smoking rate of the residents aged ≥ 18 years was 27.4％ (male: 53.5％ and female: 1.1％), which was highest in age group 40-50 years (58.4％) for males.The current smoking rate among rural residents was higher than that in urban residents.The prevalence of daily cigarette smoking was 27.5％, which was significantly higher in southeastern Chongqing.The rate of passive smoking was 52.4％.Among daily smokers, the mean number of cigarettes smoked was 17.5 per day (men: 17.6 per day;women: 13.5 per day).The daily smoked cigarette number in males was higher in age group 40-50 years (20.1 per day) and those with junior middle school education level (18.9 per day).The proportion of the current smokers who smoked more than 20 cigarettes per day (the rate of heavy smoker) was higher in males than in females and in rural residents than in urban residents.The proportion of heavy smokers was 59.3％, which was highest in age group 40-50 years (66.8％),followed by those with junior middle school educational level (65.2％).The average age of smokers when they stared to smoke was 20.8 years old, which was low in males and rural residents.About 80.2％ of the smokers stared to smoke under 25 years old, and 70.3％ of the smokers stared to smoke between 15 and 25 years old.The overall rate of smoking cessation was 20.1％ and the successful smoking cessation rate was 13.7％.The two rates increased with age, the successful smoking cessation rate was lowest in age group 18-40 years (4.8％).The awareness of the tobacco risk related knowledge seemed poor among the residents, only 19.6％ of the residents were aware that smoking could cause serious diseases (stoke, heart disease and lung cancer).21.9％ of the residents were aware that passive smoking could cause serious diseases (heart disease, lung disease and lung cancer).Conclusion Current prevalence of smoking in males in Chongqing remains at a high level,indicating that the publicity programs on the tobacco risk related knowledge needs to be strengthened and the tobacco control needs more efforts.The tobacco control in Chongqing is still facing serious challenge.

Objective:To evaluate the long-term efficacy of double-tunnel peroral endoscopic myotomy (POEM) and traditional POEM in the treatment of achalasia cardia.Methods:A randomized controlled trial was performed on the data of 30 patients with achalasia cardia, who underwent POEM in the First Affiliated Hospital of Nanjing Medical University from June 2018 to June 2019. The 30 consecutive patients were randomly assigned to double-tunnel POEM group (15 cases, a second tunnel was established opposite to the traditional one) and traditional POEM group (15 cases). Intraoperative information was recorded, and patients were followed up regularly to compare the efficacy and complications between the two groups.Results:Double-tunnel POEM and traditional POEM were all completed with technical success. There were no significant differences in the intraoperative complications (5/15 VS 4/15, P=1.000), hospitalization time or cost between the two groups. The follow-up time was 17.20±4.83 months and 15.33±4.67 months in the traditional POEM group and the double-tunnel POEM group, respectively. The Eckardt scores after surgery between the two groups had no significant difference [1.53 (2.00) VS 1.60 (3.00), Z=-0.363, P=0.744]. The symptom relief cases were both 14 in the two groups. The postoperative 4-second integrated relaxation pressure (4 s IRP) of the double-tunnel group (11.27±3.14 mmHg) was significantly lower than that of the traditional group (15.05±4.21 mmHg, t=2.794, P=0.009). There was no significant difference in postoperative gastroesophageal reflux disease questionnaire scores between the two groups (4.40±1.64 VS 4.20±1.42, t=0.357, P=0.724). Conclusion:Double-tunnel POEM has almost the same efficacy as the traditional POEM except for a lower post-POEM 4 sIRP.

Background/Aims: Some inflammatory bowel disease (IBD) patients in remission suffer from irritable bowel syndrome (IBS)-like symptoms (IBD-IBS). The pathogenesis has not yet been elucidated. The study aim is to evaluate relationships among quality of life (QOL), psychological status, and visceral sensitivity, and explore the formation mechanism of IBD-IBS. Methods: Forty-seven patients with Crohn’s disease in remission, 24 ulcerative colitis in remission, 26 IBS, and 20 healthy controls were included in the study. The abdominal pain, QOL, anxiety, and depression were evaluated through questionnaires. Visceral sensitivity was measured by rectal balloon distension. The serum levels of 5-hydroxytryptamine (5-HT) and nerve growth factor (NGF) were measured by enzyme-linked immunosorbent assay. The expressions of tryptase, 5-HT, NGF, and related receptors in colonic tissues were detected by immunohistochemistry and western blot. Results: Prevalence of IBS-like symptoms in Crohn’s disease and ulcerative colitis patients in clinical remission was 29.8% and 50.0%, respectively. The QOL was lower, the anxiety/depression scores were higher in IBD-IBS patients than those without IBS-like symptoms. Additionally, patients with IBD-IBS existed visceral hypersensitivity. Besides, abdominal pain was associated with poor QOL, visceral hypersensitivity, anxiety, and depression in IBD-IBS patients. The number of mast cells (MCs) and expressions of 5-HT, NGF, and related receptors were higher in IBD-IBS patients than those with no such symptoms. The serum levels of 5-HT and NGF positively correlated with abdominal pain and visceral hypersensitivity. Conclusion IBD-IBS patients may have low QOL and psychological abnormalities, as wells as visceral hypersensitivity which may be related to increased 5-HT and NGF levels released from activated mast cells.

Background/Aims: Some inflammatory bowel disease (IBD) patients in remission suffer from irritable bowel syndrome (IBS)-like symptoms (IBD-IBS). The pathogenesis has not yet been elucidated. The study aim is to evaluate relationships among quality of life (QOL), psychological status, and visceral sensitivity, and explore the formation mechanism of IBD-IBS. Methods: Forty-seven patients with Crohn’s disease in remission, 24 ulcerative colitis in remission, 26 IBS, and 20 healthy controls were included in the study. The abdominal pain, QOL, anxiety, and depression were evaluated through questionnaires. Visceral sensitivity was measured by rectal balloon distension. The serum levels of 5-hydroxytryptamine (5-HT) and nerve growth factor (NGF) were measured by enzyme-linked immunosorbent assay. The expressions of tryptase, 5-HT, NGF, and related receptors in colonic tissues were detected by immunohistochemistry and western blot. Results: Prevalence of IBS-like symptoms in Crohn’s disease and ulcerative colitis patients in clinical remission was 29.8% and 50.0%, respectively. The QOL was lower, the anxiety/depression scores were higher in IBD-IBS patients than those without IBS-like symptoms. Additionally, patients with IBD-IBS existed visceral hypersensitivity. Besides, abdominal pain was associated with poor QOL, visceral hypersensitivity, anxiety, and depression in IBD-IBS patients. The number of mast cells (MCs) and expressions of 5-HT, NGF, and related receptors were higher in IBD-IBS patients than those with no such symptoms. The serum levels of 5-HT and NGF positively correlated with abdominal pain and visceral hypersensitivity. Conclusion IBD-IBS patients may have low QOL and psychological abnormalities, as wells as visceral hypersensitivity which may be related to increased 5-HT and NGF levels released from activated mast cells.

Objective:To investigate the factors influencing the success of external cephalic version.Methods:Pregnant women who underwent an external cephalic version due to breech or transverse presentation by the same operator in the Third Affiliated Hospital of Zhengzhou University from July 2015 to July 2021 were selected as the study objects. Univariate analysis and logistic regression analysis were used to explore the clinical factors influencing the success of the external cephalic version. The receiver operating characteristic (ROC) curve was used to analyze the best cut-off value of gestational week and amniotic fluid index at the time of operation and to evaluate the predictive value of the influencing factors on the success of the external cephalic version.Results:(1) A total of 118 cases finally entered this study. Among the 118 cases,77 cases (65.3%) succeeded in the external cephalic version, among which the success rate was 49.1% (27/55) for primipara and 79.4% (50/63) for multipara. The vaginal delivery rate was 56.8% (67/118). (2) Complications occurred in 19 (16.1%) of the 118 cases. The main complications were abnormal fetal heart rate (13 cases, 11.0%), umbilical cord presentation, and fetal position reversion (two cases and 1.7% in each), and the serious complications were intrauterine fetal death and placental abruption (one case and 0.8% in each).The complication rate of patients with successful external cephalic version was 7.8% (6/77), which was lower than that of those who failed the external cephalic version [31.7%(13/41)] ( χ 2=11.33, P=0.001). (3) Multivariate analysis showed that gestational week at surgery before 38, amniotic fluid index >11.10 cm, and multipara were the factors affecting the success of the external cephalic version [ OR(95% CI)=0.561(0.351-0.897), 1.173(1.018-1.351) and 4.201(1.547-11.404), all P<0.05]. (4) The area under the ROC curve of the combination of the gestational week at surgery, amniotic fluid index, and parity was 0.744 (95% CI: 0.640-0.848, P<0.001), and the Youden index was 0.518, with a sensitivity of 70.0% and a specificity of 81.8%. Conclusion:Gestational weeks, amniotic fluid index, and multipara are related to the success of the external cephalic version, and the combination of the three has certain predictive power for the success of the surgery.