Objective To investigate the application value of chronic kidney disease epidemiology collaboration (CKD-EPI) equations and amendatory equations for calculating glomerular filtration rate (GFR) in Chinese patients with diabetes,including CKD-EPI serum creatinine (Scr) equation (CKD-EPLcr),CKD-EPI serum cystatin C (ScysC) equation (CKD-EPLcysc),combination of CKD-EPLcr and CKD-EPIScrSCysC (CKD-EPISr SCysC),Asian modified CKD-EPI equation (CKD-EPIAsian),Chinese diabetes CKD-EPI equation (CKD-EPIDiabctes),refitted modification of diet in renal disease (MDRD) equation (rMDRD),Cockcroft-Gault equation (CG) and Simplified MDRD equation.Methods Serum creatinine (Scr) was detected using basic picric acid method,serum cystatin C (CysC) was measured by Latex enhanced turbidimetric,and the reference value of GFR was worked out by 99Tcm-DTPA renal dynamic imaging and standardization of body surface area.Relation of Scr,Scysc,GFR measured by every equations and rGFR were analyzed.The accuracy of 30％ of each equation,the consistency and deviation of the evaluation of renal function by each equation were compared.The diagnostic efficacy in GFR＜60 ml/(min · 1.73 m2) was compared using the receiver operating characteristic (ROC) curve.Results The rGFR had negative correlation with Scr、ScysC (both P＜0.001).The rGFR had positive correlation with GFR measured by CKD-EPIScr,CKD-EPIScysC,CKD-EPIS-SCysC,CKD-EPIAsian,CKD-EPIDiabetes rMDRD,CG and Simplified MDRD (all P＜0.001).The coincidence rate between 30％ of rGFR and GFR measured byCKD-EPIDiabetes and simplified MDRD were higher.There was no significant difference of rGFR and GFR measured by CKD-EPIscr,CKD-EPIScysC,CKD-EPIScr-SCysC,CKD-EPIAsian,CKD-EPIDiabetes,rMDRD,CG and Simplified MDRD.GFR measured by CKD-EPIDiabetes has the best consistent degree with rGFR.ROC curve showed that the area under curve of GFR measured by CKD-EPIDiabctes was largest and the Youden index was the highest.Conclusion There are different degrees of deviation in eGFR predicted by the eight kinds of equations.The accuracy and consistency of CKD-EPIDiabetes in Chinese 2-type diabetes is the best.

Objective To investigate the effects of early physiotherapy in combination with atorvastatin on the levels of serum brain-derived neurotrophic factor (BDNF) and neurological function in patients with acute ischemic stroke.Methods Fifty patients with acute ischemic stroke were randomly divided into either an atorvastatin group (monotherapy group,n =25) or a early physiotherapy + atorvastatin group (combination treatment group,n =25).All patients received the prescribed drugs according to the diagnosis and treatment guidelines for ischemic stroke.The monotherapy group added atorvastatin calcium (20 mg,1 tablet every night orally).On the basis of the monotherapy group,the combination treatment group also conducted early physical therapy.At 2 and 6 weeks before and after treatment,a double-antboody sandwich enzyme-linked immunosorbent assay was used to detect the serum BDNF levels.The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the degree of neurological deficit.Barthel index (BI) was used to evaluate the activities of daily living.The modified Rankin scale (mRS) was used to assess the degree of disability.Results There was no significant difference in demographics and baseline data between the monotherapy group and the combination treatment group.The scores of NIHSS,BI,and mRS in both groups after treatment were significantly better than those before treatment (all P ＜ 0.001).There were no difference in the scores of NIHSS,BI and mRS at 2 weeks before and after treatment,but at 6 weeks after treatment,the scores of NIHSS (2.40 ± 1.38 vs.3.36 ± 1.73; P =0.035) and mRS (1.40 ± 0.87 vs.1.96 ±0.94; P =0.047) of the combination treatment group were significantly lower than those of the monotherapy group,and the BI scores (92.60 ±7.50 vs.85.20 ± 11.68; P=0.011) were significantly higher than those of the monotherapy group.After treatment,the serum BDNF levels were increased significantly in both groups.There were significant differences among all the time points (all P＜0.001).At 2 weeks after treatment,the serum BDNF levels (3.07 ±0.93 ng/ml vs.2.45 ±0.76 ng/ml; t =2.559,P =0.014) and at 6 weeks after treatment,those (2.90 ± 0.93 ng/ml vs.2.31 ± 0.77 ng/ml; t =2.433,P =0.019) in the combination treatment group were significantly higher than those in the monotherapy group.Spearman correlation analysis showed that the serum BDNF levels were significantly negatively correlated with the scores of NIHSS (r =-0.738,P ＜ 0.001) and mRS (r =-0.654,P ＜ 0.001),but they were significantly positively correlated with the BI scores (r =0.716,P ＜ 0.001).No serious adverse reaction occurred in both groups.Conclusions Early physiotherapy in combination with atorvastatin for the treatment of acute ischemic stroke can more effectively promote the recovery of neurological function,and its mechanism may be associated with the increased serum BDNF levels.

OBJECTIVE: The purpose of this study was to investigate the expression of PKM2 and HIF-1α in laryngeal squamous cell carcinoma and to analyze their correlation in laryngeal squamous cell carcinoma. METHOD: Total 37 laryngeal carcinoma samples and para-carcinoma tissues were taken from the patients who accepted operation treatment in the Second Hospital of HeBei Medical University from 06/2013 to 06/2014. The protein expression levels of PKM2 and HIF-1α were detected with SP immunohistochemical methods. The data were analyzed by the SPSS 13.0 statistical software. RESULT: The positive expression of PKM2 in laryngeal carcinoma tissues and adjacent tissues were 62.16% and 13.15%. The difference was statistically significant (P < 0.01). The positive expression of HIF-1α in laryngeal carcinoma tissues and adjacent tissues were 64.86% and 21.62%. The difference was statistically significant (P < 0.01). The positive expression of PKM2 and HIF-1α in well differentiated laryngeal squamous cell carcinoma were both 47.83%, while in medium and poorly differentiated laryngeal squamous cell carcinoma were 85.71% and 92.86% respectively. The difference was statistically significant (P < 0.05). The positive expression of PKM2 and HIF-1α in patients with lymph metastasis were 90.00% and 100.00% respectively, 51.85% in those without lymph metastasis, the difference was statistically significant (P < 0.05). The rate of HIF-1α positive expression in I-II stage was 53.85%, 90.91% in III-IV stage. The difference between the two groups was statistically significant (P < 0.05). The expression of PKM2 and HIF-1α had no relationship with the age and smoking (P > 0.05). The expression of PKM2 was positively related with HIF-1α in laryngeal squamous cell carcinoma (P < 0.01). CONCLUSION The expression of PKM2 and HIF-1α are related with the proliferation, invasion and metastasis of laryngeal squamous cell carcinoma. It provides a certain theoretical basis for laryngeal cancer diagnosis and screening to measure the expression of PKM2 and HIF-1α as biological indicators.
Biomarkers, Tumor ; metabolism ; Carcinoma, Squamous Cell ; metabolism ; Carrier Proteins ; metabolism ; Head and Neck Neoplasms ; metabolism ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Laryngeal Neoplasms ; metabolism ; Lymphatic Metastasis ; Membrane Proteins ; metabolism ; Squamous Cell Carcinoma of Head and Neck ; Thyroid Hormones ; metabolism

OBJECTIVE: To investigate the role of Keap1-Nrf2-ARE pathway in laryngeal carcinoma occurrence and development. METHOD: Thirty-five laryngeal carcinoma samples and para-carcinoma tissues were taken from the patients who accepted operation treatment in our hospital from Feb 2012 to Sep 2013. The expression levels of Nrf2 and Keap1 were detected in 35 cases of laryngeal carcinoma with SP immunohistochemical methods. The data were analyzed by the SPSS 13.0 statistical software. RESULT: The expression of Nrf2 in the 35 cases of laryngeal carcinoma was 77.14%, which in the para-carcinoma tissues was 8.57%, the difference between these two groups was statistically significant (P < 0.01). The expression of Keap1 in the 35 cases of laryngeal carcinoma was 71.43%, which in the para-carcinoma tissues was 31.43%, the difference between these two groups was statistically significant (P < 0.01). The expression of Nrf2 in I -II stage was 65.00% and in III-IV stage was 93.33%, the difference was significant (P < 0.05). The expression of Keap1 in I-II stage was 55.00% and in III-IV stage was 93.33%, the difference was significant (P < 0.05). Of the 35 cases, the positive expression rate of Nrf2 and Keap1 in laryngeal carcinoma with lymphnode metastasis were both 100.00%, compared with those without lymph nodes metastasis 68.00% and 60.00%, the difference was significant (P < 0.05). The expression of Nrf2 and Keap1 had no relationship with tumor differentiation, smoking and patient age (P > 0.05). CONCLUSION Keap1-Nrf2-ARE pathway may play an important role in progression of laryngeal squamous cell carcinoma.
Biomarkers, Tumor ; metabolism ; Carcinoma, Squamous Cell ; metabolism ; Head and Neck Neoplasms ; metabolism ; Humans ; Intracellular Signaling Peptides and Proteins ; metabolism ; Kelch-Like ECH-Associated Protein 1 ; Laryngeal Neoplasms ; metabolism ; Lymphatic Metastasis ; NF-E2-Related Factor 2 ; metabolism ; Neoplasm Staging ; Squamous Cell Carcinoma of Head and Neck

Objective: To discuss the value of femoral head coverage (FHC) in the follow-up of infants with developmental dysplasia of the hip(DDH). Methods: Two hundred and seventeen DDH infants(434 hips) diagnosed by clinical examination and ultrasonography were chosed as treatment group, and then received the brace treatment and followed up with ultrasonography. Four hundred and sixteen infants(832 hips) with normal hips diagnosed by clinical examination and ultrasonography were chosed as control group. The ultrasonographic examination included Graf method and FHC measurement. The infants in the treatment group were followed up with ultrasonography examination up to the age of 6 months. Results: The FHC in the control group was (59.69±4.36)%. In the treatment group, 302 hips were diagnosed to be DDH.Among them, 36 hips were Graf type Ⅱa, 132 hips were Graf type Ⅱb, 69 hips were Graf type Ⅱc, 8 hips were Graf type D, 41 hips were Graf type Ⅲ, and 16 hips were Graf type Ⅳ. The FHC of these hips were (51.33±5.18)%, (53.07±3.94)%, (44.52±5.32)%, (38.70±5.85)%, (27.23±6.82)% and 0, respectively. After treatment, 222 hips became Graf type Ⅰ, 49 hips were improved, and their FHC increased. Twenty-eight hips were not significantly improved after treatment, but the FHC of most hips (including 14 hips of type Ⅱb, 3 hips of Ⅱc and 4 hips of type Ⅲ) increased. Three hips of Graf type Ⅲ aggravated to Graf type Ⅳ, and the FHC decreased to 0. Conclusions The FHC has important value in the follow-up of infants with DDH.

Objective:To measure the pubo-femoral distance of hips of the infants diagnosed with Graf type Ⅰ by high frequency ultrasound.Methods:A total of 1 084 infants(2 168 hips) diagnosed with Graf type Ⅰ by ultrasonography were collected in Beijing Jishuitan Hospital from June 2019 to May 2020. The ultrasonographic examinations included Graf method and pubo-femoral distance measurement. The 95% medical reference value was adopted to confirm range of normal values of the pubo-femoral distance. And the differences of the pubo-femoral distance between different gender, age and bilateral hip were compared.Results:The pubo-femoral distance of hips diagnosed with Graf type Ⅰ was (0.27±0.06)cm, the pubo-femoral distance of males was(0.27±0.06)cm, the pubo-femoral distance of females was (0.27±0.07)cm. The 95% medical reference value was 0.15-0.38 cm. The 95% medical reference value of males was 0.15-0.39 cm, and the 95% medical reference value of females was 0.13-0.41 cm. There were no significant differences between the sexes or between the age(all P>0.05). The difference between the bilateral hip joints from the same infant was statistically significant[(0.274±0.064)cm vs (0.265±0.064)cm, P<0.05]. Conclusions:The 95% medical reference value of hip diagnosed with Graf type Ⅰ is 0.15-0.38 cm.

Objective:To explore the high-frequency ultrasonographic and clinical features of superficial intravascular tumors.Methods:Thirteen superficial intravascular tumor patients who underwent ultrasound examination form Beijing Jishuitan Hospital during 2016-2020 were retrospectively analyzed. The location, anatomic blood vessels, shape, size, boundary, internal echo, blood flow and clinical characteristics of the tumors were analyzed.Results:Among the 13 cases, most of the tumors were oval like or long strip, and a few were round like. All 11 cases of primary intravascular tumors showed hypoechoic mass; 2 cases of intravascular metastasis or recurrence showed solid hypoechoic with hyperechoic mass. Arterial blood flow spectrum was detected in 12 cases. Two patients with glomus tumor showed typical tenderness at the fixed point. Two patients had a history of bone tumors in the upper or lower extremities.Conclusions:High frequency ultrasound can clearly recognize the location of the superficial intravascular tumors, describe the morphological characteristics and sonographic features of the tumor, then help to make a more accurate qualitative diagnosis.

Objective:To discuss the value of pubo-femoral distance(PFD) in the diagnosis of infants with developmental dysplasia of the hip(DDH).Methods:Nine hundred and thirty-one infants with DDH and normal infants diagnosed by clinical examination and ultrasonography were involved from February 2022 to June 2023 in Beijing Jishuitan Hospital. The ultrasonographic examination included Graf method and pubo-femoral distance measurement. Statistical analysis was made on the measurements of PFD of different types of hips.Results:Among all the hips, 1 359 hips were Graf type Ⅰ, 274 hips were Graf type Ⅱa, 166 hips were Graf type Ⅱb, 31 hips were Graf type Ⅱc, 7 hips were Graf type D, 13 hips were Graf type Ⅲ, and 12 hips were Graf type Ⅳ. The PFD of these hips were (0.34±0.07)cm, (0.35±0.08)cm, (0.35±0.08)cm, (0.51±0.11)cm, (0.67±0.09)cm, (0.95±0.26)cm, (1.27±0.30)cm, respectively. There was no significant difference in PFD between hips of Graf Ⅰ, Graf Ⅱa and Graf Ⅱb ( P>0.05), but there was significant difference in PFD between hips of the other Graf types ( P<0.05). The area under curve(AUC) of the PFD for the diagnosis of stability of the hips in infants was 0.959 with the cut-off value of 0.435 cm, the sensitivity and specificity were 88.9% and 90.4%, respectively. Conclusions:The PFD has great value in the evaluation of the stability of hip joint, and the cut-off value is 0.435 cm.

ObjectiveTo explore the mechanism of Broussonetiae Fructus （BF） in preventing and treating drug-induced liver injury （DILI） induced by acetaminophen （APAP） through the endoplasmic reticulum stress pathway. MethodSixty C57BL/6N mice were randomly divided into normal group， model group， silybin group （3.4 g·kg^-1）， and high-， medium- and low-dose BF groups （3.0， 1.5， 0.75 g·kg^-1）， with 10 mice in each group. The DILI model was induced by intragastric administration of APAP at 800 mg·kg^-1， and drugs were administered simultaneously for 10 consecutive days. The serum contents or activities of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， total bilirubin （TBIL）， and direct bilirubin （DBIL） were measured. Hematoxylin-eosin（HE） staining was performed to observe the pathological changes in liver tissues. The morphological changes in liver mitochondria were observed by transmission electron microscopy. The activities or content of superoxide dismutase （SOD）， malondialdehyde （MDA）， total antioxidant capacity （T-AOC）， glutathione （GSH）， glutathione disulfide （GSSG）， glutathione peroxidase （GSH-Px）， and adenosine triphosphate （ATP） in the serum and liver tissues were detected by the colorimetric method. The expression of reactive oxygen species （ROS） in liver tissues was detected by immunofluorescence. The gene expression of glucose-regulated protein 78 （GRP78）， CCAAT/enhancer-binding protein homologous protein （CHOP）， and c-Jun N-terminal kinase （JNK） in liver tissues was detected by Real-time quantitative polymerase chain reaction （PCR）. ResultCompared with the normal group， the model group showed increased serum activities or content of ALT， AST， TBIL， and DBIL （P<0.01）， increased MDA and GSSG contents （P<0.01）， decreased contents or activities of SOD， T-AOC， GSH， GSH-Px， and ATP （P<0.01）， swollen hepatocytes with inflammatory infiltration and lamellar necrosis， swollen and broken mitochondria of hepatocytes， and increased mRNA expression of GRP78， CHOP， and JNK （P<0.01）. Compared with the model group， the groups with drug intervention showed decreased serum content or activities of ALT， AST， TBIL， and DBIL （P<0.05， P<0.01）， reduced MDA and GSSG contents（P<0.05， P<0.01）， and increased contents or activities of SOD， T-AOC， GSH， GSH-Px， and ATP （P<0.05， P<0.01）， improved swollen hepatocytes， inflammatory infiltration， and lamellar necrosis， recovered bilayer membrane structure in mitochondria of hepatocytes， and decreased mRNA expression of GRP78， CHOP， and JNK （P<0.05， P<0.01）. ConclusionBF has preventive and therapeutic effects on APAP-induced DILI mice， and the mechanism may be related to the reduction of endoplasmic reticulum stress and oxidative stress level in vivo.

ObjectiveTo explore the protective effect of Xielitang on ulcerative colitis （UC） mice induced by dextran sodium sulfate （DSS） and its possible mechanism. MethodSixty C57BL/6 mice were randomly divided into normal group， model group， sulfasalazine group and and low-， medium-， and high-dose Xielitang groups. Free drinking DSS solution to build the chronic UC model mice. Except for normal group， other groups were given 1.5% DSS for 3 cycles of drinking （days 1-7， days 22-28 and days 43-49） and distilled water for the rest of the time （days 8-21， days 29-42 and days 50-63）. After the first cycle， corresponding drugs were given for 42 days. The changes of general condition， body weight and disease activity index （DAI） score of mice were daily recorded during the experiment. At the end of the treatment， serum and colon tissue samples were collected， colon length was measured， intestinal weight index and colonic mucosal injury （CMDI） score were calculated. The pathological status of colon tissue was observed by hematoxylin-eosin （HE） staining. The levels of interleukin-6 （IL-6）， interleukin-10 （IL-10） and tumour necrosis factor-α （TNF-α） were measured by enzyme-linked immunosorbent assay （ELISA）. The gene and protein expressions of Toll like receptor 4 （TLR4）， nuclear transcription factor-κB （NF-κB） and hypoxia inducible factor-1α （HIF-1α） in colon tissue was detected by Real-time quantitative polymerase chain reaction （Real-time PCR） and Western blot. ResultCompared with the normal group， the body weight， colon length and IL-10 content in the model group were significantly decreased （P<0.01）， DAI score， intestinal weight index， CMDI score， IL-6 and TNF-α contents， and mRNA and protein expression levels of TLR4， NF-κB and HIF-1α in the model group were significantly increased （P<0.01）. Moreover， the structure of colonic mucosa was destroyed and inflammatory cells infiltrated in the model group. Compared with model group， body weight， colon length and IL-10 content in each dose group of Xielitang were significantly increased （P<0.05， P<0.01）， DAI score， intestinal weight index and CMDI score， IL-6 and TNF-α contents， mRNA and protein expression levels of TLR4， NF-κB and HIF-1α were notably decreased （P<0.05， P<0.01）. The pathological injury of colon was obviously alleviated. ConclusionXielitang can significantly improve the inflammatory response of UC mice induced by DSS， and its mechanism may be related to the regulation of TLR4/NF-κB/HIF-1α signaling pathway.