Objective To explore the effects of Xiaoke Shen'an decoction combined with losartan on renal vascular endothelial function and urine podocyte transmembrane protein level in patients with diabetic nephropathy(DN).Methods One hundred and two DN patients admitted to Wujin Hospital of TCM from March 2022 to December 2023 were selected as the research subjects,and according to the treatment method,they were randomly divided into observation group and control group,with 51 patients in each group.All patients in the two groups were given losartan potassium tablets orally,and patients in the observation group were additionally given self-proposed Xiaoke Shen'an decoction for three months.Traditional Chinese medicine symptom scores of patients in the two groups were evaluated before treatment and three months after treatment according to the Guiding Principles for Clinical Trials of New Chinese Medicines.A 5 mL fasting venous blood sample was collected from patients in both groups before treatment and three months after treatment,respectively.After centrifugation,the serum was obtained,and the levels of serum creatinine(Scr)and blood urea nitrogen(BUN)were measured by using a fully automatic biochemical analyzer.The levels of serum endothelin-1(ET-1),soluble intercellular adhesion molecule-1(sICAM-1),superoxide dismutase(SOD)and malondialdehyde(MDA)were detected by using the enzyme-linked immunosorbent assay.Urine samples were collected from patients in both groups before treatment and three months after treatment,and the levels of urinary albumin and creatinine were detected by using a fully automatic biochemical analyzer;and the urinary albumin-to-creatinine ratio(UACR)was calculated.The levels of podocin and nephrin were measured by using flow cytometer.Results Before treatment,there was no statistically significant difference in restlessness,thinness&overeating,fatigue,and edema scores of patients between the two groups(P＞0.05);three months after treatment,the restlessness,thinness&overeating,fatigue,and edema scores of patients in both groups were significantly lower than those before treatment,and patients in the observation group had significantly lower restlessness,thinness&overeating,fatigue,and edema scores compared to the control group(P＜0.05).Before treatment,there was no statistically significant difference in Scr,BUN,and UACR levels between the two groups(P＞0.05);three months after treatment,the levels of Scr,BUN,and UACR in both groups were significantly lower than those before treatment,and patients in the observation group had significantly lower levels of Scr,BUN,and UACR compared to the control group(P＜0.05).Before treatment,there was no statistically significant difference in urinary podocin and nephrin levels between the two groups(P＞0.05);three months after treatment,the levels of urinary podocin and nephrin in both groups were significantly lower than those before treatment,and patients in the observation group had significantly lower levels of urinary podocin and nephrin compared to the control group(P＜0.05).Before treatment,there was no statistically significant difference in serum ET-1 and sI-CAM-1 levels between the two groups(P＞0.05);three months after treatment,the levels of serum ET-1 and sICAM-1 in both groups were significantly lower than those before treatment,and patients in the observation group had significantly lower levels of serum ET-1 and sICAM-1 compared to the control group(P＜0.05).Before treatment,serum SOD and MDA levels showed no statistically significant difference in patients between the two groups(P＞0.05);three months after treatment,the serum SOD levels of patients in both groups were significantly higher than those before treatment,while the serum MDA levels were significantly lower than those before treatment;three months after treatment,the serum SOD level of patients in the observation group was significantly higher than that in the control group,while the serum MDA level was significantly lower than that in the control group(P＜0.05).Conclusion Xiaoke Shen'an decoction combined with losartan can improve renal vascular endothe-lial function,reduce urinary podocin and nephrin levels,and alleviate the stress response in patients with DN.

Myopia,as one of the most prevalent eye diseases in the world,has become an important public health problem.In addition to damaging eye health,myopia also negatively affects students'academic performance,interpersonal interactions,and quality of life,leading to mental health problems such as anxiety and depression.In recent years,schol-ars at home and abroad have been paying more and more attention to the mental health status of myopic people,but how to objectively and accurately assess the mental health of myopic people is still an urgent problem to be solved.In this paper,we summarize the current situation and characteristics of the application of mental health scales for myopic people in do-mestic and international studies,analyze the applicability of the scales,and provide references for the scientific selection of myopic mental health scales.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To elucidate the therapeutic mechanism of Qingxin Jieyu Granule(QXJYG)against atherosclerosis(AS)based on network pharmacology.Methods The major targets and pathways of QXJYG against AS were analyzed using network pharmacology.Rat models of AS established by high-fat feeding combined with intraperitoneal vitamin D3 injection were treated daily with normal saline,atorvastatin(13.15 mg/kg),or QXJYG at 0.99,1.98,and 3.96 g/kg for 8 weeks(n=6).Ultrasound and HE staining were used to assess the function and pathologies of the abdominal aorta.Blood lipids and serum levels of Ang II,ET-1,TXA2,PGI2,and ox-LDL of the rats were detected using an automatic biochemical analyzer or ELISA.The expressions of LOX-1,PPARγ,RXRα,p-P65,VCAM-1 and ICAM-1 in the abdominal aorta were detected with immunohistochemistry.Results The rat models of AS showed obvious abdominal aorta wall thickening,increased pulse wave velocity and pulse index,decreased inner diameter of the abdominal aorta,elevated levels of TC,LDL-C,Ang II,ET-1 and TXA2,and lowered levels of HDL-C and PGI2.QXJYG and atorvastatin treatment of the rat models significantly alleviated histopathological changes of the abdominal aorta,decreased serum levels of TC,LDL-C,Ang II,ET-1 and TXA2,and increased the levels of HDL-C and PGI2.Network pharmacology study suggested the therapeutic effect of QXJYG against AS was mediated by regulating lipid metabolism,PPAR and NF-κB pathways.Consistently,treatments with QXJYG were found to significantly decrease ox-LDL level and LOX-1,P-P65,VCAM-1 and ICAM-1 protein expressions while increasing PPARγ and RXRα expressions in the aorta of AS rats.Conclusion QXJYG alleviates lipid metabolism disorder and improves histopathological changes of the abdominal aorta of AS rats possibly by lowering ox-LDL level,reducing LOX-1 expression,activating PPARγ and RXRα,and inhibiting P65 phosphorylation to reduce VCAM-1 and ICAM-1 expression in the aorta.

Objective To elucidate the therapeutic mechanism of Qingxin Jieyu Granule(QXJYG)against atherosclerosis(AS)based on network pharmacology.Methods The major targets and pathways of QXJYG against AS were analyzed using network pharmacology.Rat models of AS established by high-fat feeding combined with intraperitoneal vitamin D3 injection were treated daily with normal saline,atorvastatin(13.15 mg/kg),or QXJYG at 0.99,1.98,and 3.96 g/kg for 8 weeks(n=6).Ultrasound and HE staining were used to assess the function and pathologies of the abdominal aorta.Blood lipids and serum levels of Ang II,ET-1,TXA2,PGI2,and ox-LDL of the rats were detected using an automatic biochemical analyzer or ELISA.The expressions of LOX-1,PPARγ,RXRα,p-P65,VCAM-1 and ICAM-1 in the abdominal aorta were detected with immunohistochemistry.Results The rat models of AS showed obvious abdominal aorta wall thickening,increased pulse wave velocity and pulse index,decreased inner diameter of the abdominal aorta,elevated levels of TC,LDL-C,Ang II,ET-1 and TXA2,and lowered levels of HDL-C and PGI2.QXJYG and atorvastatin treatment of the rat models significantly alleviated histopathological changes of the abdominal aorta,decreased serum levels of TC,LDL-C,Ang II,ET-1 and TXA2,and increased the levels of HDL-C and PGI2.Network pharmacology study suggested the therapeutic effect of QXJYG against AS was mediated by regulating lipid metabolism,PPAR and NF-κB pathways.Consistently,treatments with QXJYG were found to significantly decrease ox-LDL level and LOX-1,P-P65,VCAM-1 and ICAM-1 protein expressions while increasing PPARγ and RXRα expressions in the aorta of AS rats.Conclusion QXJYG alleviates lipid metabolism disorder and improves histopathological changes of the abdominal aorta of AS rats possibly by lowering ox-LDL level,reducing LOX-1 expression,activating PPARγ and RXRα,and inhibiting P65 phosphorylation to reduce VCAM-1 and ICAM-1 expression in the aorta.

ObjectiveTo explore the clinical effectiveness and safety of stick-point sinew-soothing and bone-setting manipulation for scapulohumeral periarthritis. MethodsUsing prospective randomised controlled trial method， 60 cases of patients with scapulohumeral periarthritis were collected and randomly divided into 30 cases each in control group and trial group. Both groups of patients were orally treated with celecoxib， on the basis of which the control group was treated with traditional bonesetting manipulation once every other day for 14 days， while the trial group was treated with stick-point sinew-soothing and bone-setting manipulation once every 3~5 days for 14 days. Both groups were treated for 2 courses. The main observation indexes were pain visual analogue scale （VAS） score and shoulder pain and dysfunction index （SPADI）， which were evaluated once before treatment and after 2 and 4 weeks of treatment. The secondary effectiveness indicators included the university of California at Los Angeles shoulder rating scale （UCLA）， traditional Chinese medicine syndrome score （including symptom scores as joint pain， pain in a fixed place， activity limitation， local stiffness）， and serum interleukin （IL-6） and tumour necrosis factor α （TNF-α） levels before and after the treatment， in order to evaluate the clinical effectiveness， and to record the adverse reactions that occurred in the process of diagnosis and treatment. ResultsCompared with the groups before treatment， the pain VAS score， SPADI and scores of joint pain， pain with a fixed place， activity limitation and local stiffness were lower， UCLA score was higher， and serum IL-6 and TNF-α levels were lower at 4 weeks of treatment in the two groups （P＜0.05）. When comparing the two groups between the groups at 2 and 4 weeks of treatment， the pain VAS score， SPADI and TCM scores of each symptom in the study group were lower than those in the control group， the UCLA score was higher than those in the control group （P＜0.01）， and the serum IL-6 and TNF-α levels were lower than those in the control group at 4 weeks of treatment （P＜0.01）. The clinical effectiveness rate of the study group was 66.67%， which was significantly higher than that of the control group， which was 40.00% （P = 0.038）. No adverse reactions were seen in both groups during the study. ConclusionCompared with the traditional massage manipulation， the treatment of scapulohumeral periarthritis with stick-point sinew-soothing and bone-setting manipulation has more advantages in relieving pain symptoms， reducing inflammatory reaction， and promoting the recovery of shoulder joint function.

Objective: To explore the relationship between adolescents physical fitness and depressive symptoms, and to provide reference for the early prevention and intervention of depressive symptoms and improvement of physical fitness in Chinese adolescents. Methods: From September to December 2021, a total of 8 102 adolescents were selected by random cluster sampling method in Shanghai, Urumqi, Changsha and Kunming. The Center for Epidemiologic Studies Depression Scale(CES-D) was used to investigate the depressive symptoms, and completed grip strength, standing long jump, 50 m running, modified sitting forward flexion, 20 s repeated traverse, 30 s sit ups, 20 m round trip running (20 m SRT) test. χ 2 test, Goodman Kruskal Gamma and Logistic regression analysis were used to analyze the relationship between physical fitness index(PFI) and depressive symptoms. Results: The overall detection rate of depressive symptoms in adolescents with high level PFI was 23.4%, and the detection rate of low level adolescents was 26.3%, with a statistically significant difference ( χ 2=6.73, P =0.01). There was a significant positive correlation between PFI and depressive symptoms in the high school group ( G=0.09, P <0.05) and the boy group ( G=0.12, P < 0.05 ), and there was no significant association between PFI and depressive symptoms in the junior high school group and the girl group ( P >0.05). After adjusting for gender and age in the Logistic regression model, compared with those with high PFI, the risk of depressive symptoms in those with low PFI was 1.18 times (95% CI =1.05-1.33). Conclusion There is a correlation between physical fitness and depressive symptoms in adolescents. Adolescents with low PFI are at higher risk of developing depressive symptoms than those with high PFI.

Group A Streptococcus (GAS) is a very important pathogen, especially for children.On a global scale, GAS is an important cause of morbidity and mortality.But the burden of disease caused by GAS is still unknown in China and also has not obtained enough attention.For this purpose, the expert consensus is comprehensively described in diagnosis, treatment and prevention of GAS diseases in children, covering related aspects of pneumology, infectiology, immunology, microbiology, cardiology, nephrology, critical care medicine and preventive medicine.Accordingly, the consensus document was intended to improve management strategies of GAS disease in Chinese children.

Endogenously eliminating the hematoma is a favorable strategy in addressing intracerebral hemorrhage (ICH). This study sought to determine the role of retinoid X receptor-α (RXR-α) in the context of hematoma absorption after ICH. Our results showed that pharmacologically activating RXR-α with bexarotene significantly accelerated hematoma clearance and alleviated neurological dysfunction after ICH. RXR-α was expressed in microglia/macrophages, neurons, and astrocytes. Mechanistically, bexarotene promoted the nuclear translocation of RXR-α and PPAR-γ, as well as reducing neuroinflammation by modulating microglia/macrophage reprograming from the M1 into the M2 phenotype. Furthermore, all the beneficial effects of RXR-α in ICH were reversed by the PPAR-γ inhibitor GW9662. In conclusion, the pharmacological activation of RXR-α confers robust neuroprotection against ICH by accelerating hematoma clearance and repolarizing microglia/macrophages towards the M2 phenotype through PPAR-γ-related mechanisms. Our data support the notion that RXR-α might be a promising therapeutic target for ICH.
Anilides/pharmacology* ; Cerebral Hemorrhage/drug therapy* ; Hematoma/drug therapy* ; Humans ; Macrophages ; Microglia ; Neuroprotection ; PPAR gamma ; Retinoid X Receptor alpha

Objective:To investigate the changes and clinical significance of gastrin 17 (G-17) in patients with diabetic nephropathy (DN).Methods:One hundred and twenty-four DN patients admitted to Hefei Second People′s Hospital from July 2018 to December 2020 were selected as the DN group, and divided into Ⅰ-Ⅱstage subgroup (68 cases) and Ⅲ-Ⅴ stage subgroup (56 cases) according to the stage of DN.Inaddition, 100 cases of type 2 diabetes mellitus(T2DM) patients without DN were selected as the T2DM group, and 100 healthy subjects who examined during the same period were selected as the control group. The levels of G-17, serum creatinine (SCr), evaluated glomerular filtration rate (eGFR) and other index in each group were detected. The normal level of G-17 was 1-7 pmol/L. G-17>7 pmol/L and ≤ 15 pmol/L was as marginal rising, and G-17>15 pmol/L was as rising.Results:The marginal rising rate of G-17 in the DN group was higher than that in the T2DM group: 43.5%(54/124) vs. 23.0%(23/100); the rising rate of G-17 in the DN group was higher than that in the T2DM group and the control group: 21.0%(26/124) vs. 7.0%(7/100), 4.0%(4/100), and the differences were statistically significant ( P<0.05). The marginal rising rate and rising rate of G-17 in Ⅲ-Ⅴstage subgroup were both higher than those in the Ⅰ-Ⅱ stage subgroup and the T2DM group: 58.9%(33/56) vs. 30.9%(21/68), 23.0%(23/100); 32.1%(18/56) vs. 11.8%(8/68), 7.0%(7/100), and the differences were statistically significant ( P<0.05). The marginal rising rate and rising rate of G-17 in DN patients with a disease course of ≥3 years was higher than that in patients with a disease course of <3 years and the T2DM group: 53.0%(44/83) vs. 24.4%(10/41), 23.0%(23/100); 27.7%(23/83) vs. 7.3%(3/41), 7.0%(7/100), and the differences were statistically significant ( P<0.05). Correlation analysis showed that G-17 was positively correlated with SCr ( r = 0.367, P<0.001) and negatively correlated with eGFR ( r = -0.619, P<0.001) in DN patients. Conclusions:The level of G-17 in ND patients is significantly increased, which is closely related to DN staging and can provide an auxiliary indicator for screening renal function in patients with T2DM.