Glucocorticoids are among those most important hormones that maintain the energy metabolic homeostasis within body.The actions of glucocorticoids on target tissues,such as liver and adipose tissue,are not only dependent on circulating glucocorticoid levels but also on glucocorticoid receptor expression.The elevated level of circulating glucocorticoid caused by exogenous or endogenous reasons may contribute to insulin resistance and the other metabolic syndrome such as dyslipidemia,visceral obesity and hypertension.This review summarizes recent advances in the study of glucocorticoid receptor-mediated insulin resistance and its antagonists.

Objective To compare the efficiency difference of 3 serological methods in syphilis blood SCreening,and then select the most proper method to prevent the transmission of syphilis via blood.Methods The samples of 2 000 blood donors were tested by TP-ELISA,TRUSlT and TPPA.Those positive samples detected by TP-ELISA and TRUST were confirmed by TPPA again.Results Of the 2 000 samples,11 samples were-TP-ELISA positive in which 8 samples were confirmed positivewith TPPA;2 samples were TRUSlT positive and both the two samples were confirmed positive withTPPA;and 8 cases were TPPA positive.There was obvious difference in detection rate between TRUST and TP-ELISA method(P

Objective To investigate the therapeutic effects and mechanism of biliopancreatic diversion (BPD) surgery on type 2 diabetes mellitus(T2DM) in GK rats.Methods 16 GK rats were randomly divided into 2 groups:BPD surgery group included 10 rats undergoing BPD surgery,sham-BPD group included 6 rats undergoing a sham operation.Fasting plasma glucose,insulin,glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide(GIP)were detected one week before BPD surgery and the 1st week,4th week,10th week,26th week after BPD surgery.Oral glucose tolerance test(OGTT) and insulin tolerance test(ITT) were done in the 10th week after BPD surgery.Results There was no statistical difference in fasting plasma glucose,insulin,plasma GLP-1 or GIP between the 2 groups before surgery.Plasma glucose had significant reduction in BPD group compared to that in the sham group(P ＜0.05) and insulin level had no significant difference between the 2 groups.Rats in BPD group had significant improvement in glucose tolerance and insulin sensitivity compared to those in the sham group.Serum level of GLP-1 was significantly elevated in BPD group compared to that before surgery (P =0.0337 at the 1st week after surgery; P =0.0002 at the 4th week after surgery,P ＜ 0.0001 at the 10th week after surgery,P ＜0.0001 at the 26th week after surgery) and that in sham-BPD group(P =0.0354 at the 1st week after surgery,P =0.0032 at the 4th week after surgery,P =0.0001 at the 10th week after surgery,P ＜0.0001 at the 26th week).Serum level of GIP was significantly lowered in BPD group compared to that before surgery(P =0.0189 at the 1st week after surgery; P =0.0007 at the 4th week after surgery,P =0.0003 at the 10th week after surgery,P ＜0.0001 at the 26th week after surgery) and that in sham-BPD group(P =0.0089 at the 1st week after surgery,P =0.0002 at the 4th week after surgery,P =0.0006 at the 10th week after surgery,P ＜0.0001 at the 26th week after surgery).The difference had statistical significance (P ＜0.05).Conclusion BPD surgery can significantly reduce fasting plasma glucose,improve glucose tolerance and insulin sensitivity.The change of serum levels of GLP-1 and GIP may play the major role in BPD treatment of diabetes mellitus.

Objective To detect the expression of BP1 gene in thyroid cancer and its relationship with clinicopathological features of thyroid cancer.Methods BP1 gene expression in 60 cases of thyroid cancer tissues and 20 cases of normal thyroid tissues were detected by in situ hybridization and immunohistochemistry.Results The positive expression rate of BP1 mRNA was 78.3 ％ (47/60) in the 60 cases of thyroid cancer tissues while it was 20％ (4/20) in the 20 cases of normal thyroid tissues detected by in situ hybridization.The difference had statistical significance (P ＜ 0.05).Of the 3 pathological types of thyroid cancer,the positive expression rate of papillary carcinoma was 81.6％ (40/49),follicular carcinoma 85.7％ (6/7),and medullary carcinoma 25.0％ (1/4).The expression of BP1 mRNA had statistical difference between medullary carcinoma and other pathological types like papillary carcinoma and follicular carcinoma (P ＜ 0.05).The positive expression rate of BP1 protein was 93.3％ (56/60)in the 60 cases of thyroid cancer tissues while it was 10.0％ (2/20) in the 20 cases of normal thyroid tissues detected by immunohistochemistry.The difference had statistical significance(P ＜0.05).Conclusion BP1 gene expression is up-regulated in human thyroid cancer and it is related to tumor stage and pathological type but not related to patients' age,sex or lymph node metastasis.

Objective:To comparatively observe the effects of 20(R)-ginsenoside Rg3 and PEG-PLGA-Rg3 nanoparticles on the Lewis lung cancer mice and to explore the mechanisms of Rg3 and PEG-PLGA-Rg3 nanoparticle anti-cancer in vivo.Methods:Lewis lung cancer mouse model was established and 60 mice were randomly divided into 5 groups with twelve in each group:PEG-PLGA-Rg3 nanoparticles group (Rg3-N),PEG-PLGA group (PEG),Rg3 group (Rg3 ),normal control group (C),saline control group(NS),and received intragastric administration for 1 4 days.The weights of the mice were measured every 2 days and the weight curves were obtained.At the same time,the color pattern,activity and men-tal status were observed.The mice were sacrificed when the administration was over,and the effects of 20 (R)-ginsenoside Rg3 and PEG-PLGA-Rg3 nanoparticles on tumor weight,and the tumor:weight ratios were analysed.In addition,the tumor microvessel density (MVD)was measured by immunohistochemi-cal staining with anti-CD31 antibody to compare the effects of Rg3 and PEG-PLGA-Rg3 nanoparticles on the tumor angiogenesis in vivo.Furthermore,the levels of such angiogenesis and proliferation factors as MMP-9,HIF-1 α,VEGF,Ki-67 were examined by RT-PCR,Western blot and immunohistochemistry to explore the internal molecular mechanisms of anti-tumor effects in vivo.Results:The trends of variation of the mice weights in NS group and PEG group were rising early but declining later.In contrast,the trends of the other three groups were rising early and became stable later.In comparison with NS group, the mice of Rg3 group and Rg3-N group had better general status:brighter color,more active and better spirit.Compared with NS group,the tumor weight in PEG group,Rg3 group and Rg3-N group showed no significant difference but the tumor:weight ratio and MVD in Rg3 group and Rg3-N group declined signi-ficantly (P <0.01 ).Besides,there was no significant difference between Rg3 group and Rg3-N group. At the same time,the level of VEGF mRNA,the protein expression of MMP-9,HIF-1 α,VEGF in Rg3 group and Rg3-N group decreased compared with NS group.Furthermore,the level of each index above-mentioned in Rg3-N group was lower than that in Rg3 group.The expression of Ki-67 in PEG group,Rg3 group and Rg3-N group showed no significant difference compared with NS group.Conclusion:Rg3 and PEG-PLGA-Rg3 nanoparticle may suppress the expression of VEGF,MMP-9 and HIF-1 αin Lewis lung cancer mice,thereby indirectly contributing to their antitumor effects and alleviating the mice’s general status.In addition,PEG-PLGA nanoparticles embedding can promote Rg3 antitumor effect in vivo.

Objective To explore the influences of the network medical health management on the coping styles , hope level and quality of life in patients with primary kidney cancer surgery .Methods The patients of control group received normal health management and the participants included 77 kidney cancer patients who were laboratory diagnosed during March 2011 and September 2012 .The patients of intervention group received the network medical health management based on the normal health management and the participants included 79 kidney cancer patients who were laboratory diagnosed during March 2013 and September 2014 .The coping styles , hope level and quality of life before and after the intervention were compared between the two groups .Results Before the intervention , the coping styles and the hope level had no statistical differences between the two groups (P>0.05).After the intervention for the coping styles , the intervention group had higher scores of the positive coping style (25.44 ±2.61) and lower scores of the negative coping style (9.76 ±1.89) and presented statistical differences compared with that of the control group ( t=-10.468, 7.572;P <0.01).For the hope level, there was no statistical significance between two groups before intervention (P >0.05); however, after intervention, the intervention group had higher scores of positive attitudes (14.5 ±2.6), positive behaviors (15.1 ±2.4) and close contact with people (15.6 ±2.1), and presented statistical differences with that of the control group (t=4.965, 5.569, 4.965; P<0.05).For the quality of life, there were no statistical differences for the dimensions of PF , RF and DY (P>0.05) but the intervention group performed better on other 12 dimensions′scores ( P <0.05 ); the quality of life in the intervention group was better than that of control group .Conclusions The network medical health management should be further applied to the clinical practice , because it can significantly improve the coping styles , hope level and quality of life among the patient with primary kidney cancer surgery .

Objective To investigate the effects of application of problem-based learning (PBL) education in primary renal cell carcinoma surgical patients.Methods A total of 1 00 renal cell carcinoma patients who received surgical treatments from July 201 3 to January 201 5 in Cancer Hospital Affiliated to Zhengzhou University were randomly divided into control group (50 cases)and observation group (50 cases). The patients in control group received routine health education and the patients in observation group received PBL health education.The psychological status,satisfaction with nursing and occurrence of postoperative complications were compared in two groups when admitted and discharged from hospital.Results The difference of psychological status in two groups was not significant when admitted hospital (P >0.05),while it is better in observation group when discharged from hospital (P <0.05).In addition,the degree of satisfaction was higher in observation group (P <0.05).Furthermore,the occurrence of complications was lower in observation group (P <0.05).Conclusions Health education based on PBL can arouse patients′enthusiasm in actively learning disease-related knowledge, improve their psychological status, decrease the occurrence of postoperative complications and increase patients′satisfaction.

Objective:To study the effect of Xuebijing on inflammatory response and prognosis in patients with septic shock.Methods:A prospective randomized controlled study was conducted. Eighty septic shock patients admitted to department of critical care medicine of the First Affiliated Hospital of Zhengzhou University from January to December in 2019 were enrolled. The enrolled patients were divided into Xuebijing group and control group by randomized number table method, with 40 cases in each group. Both groups were strictly followed the guidelines for the diagnosis and treatment of septic shock to take comprehensive treatment measures against sepsis. On this basis, Xuebijing group received intravenous 100 mL Xuebijing injection twice a day for 7 days. Baseline data of enrolled patients were recorded. The levels of interleukin-6 (IL-6), procalcitonin (PCT), C-reactive protein (CRP) and heparin binding protein (HBP) were measured before treatment and 3, 7 and 10 days after treatment. Mechanical ventilation time, the length of intensive care unit (ICU) stay, total hospitalization time and 28-day mortality were recorded. The differences of every indicator between the two groups were compared. Independent risk factors affecting patient prognosis were analyzed by binary Logistic regression.Results:① There was no significant difference in baseline data such as gender, age, infection site, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and sequential organ failure score (SOFA) between the two groups. ② The levels of serum inflammatory factors in both groups showed a decreasing trend after treatment. Compared with the control group, IL-6 and HBP in the Xuebijing group significantly decreased on day 7 [IL-6 (ng/L): 66.20 (16.34, 163.71) vs. 79.81 (23.95, 178.64), HBP (ng/L): 95.59 (45.23, 157.37) vs. 132.98 (73.90, 162.05), both P < 0.05]; on day 10, PCT, CRP, IL-6 and HBP significantly decreased [PCT (μg/L): 1.14 (0.20, 3.39) vs. 1.31 (0.68, 4.21), CRP (mg/L): 66.32 (19.46, 115.81) vs. 89.16 (20.52, 143.76), IL-6 (ng/L): 31.90 (13.23, 138.74) vs. 166.30 (42.75, 288.10), HBP (ng/L): 62.45 (29.17, 96.51) vs. 112.33 (58.70, 143.96), all P < 0.05]. ③ Compared with the control group, mechanical ventilation time and the length of ICU stay were significantly shortened and the total hospitalization expenses were significantly reduced in Xuebijing group [mechanical ventilation time (hours): 57.0 (0, 163.5) vs. 168.0 (24.0, 282.0), the length of ICU stay (days): 8.80±4.15 vs. 17.13±7.05, the total hospitalization expenses (ten thousand yuan): 14.55±7.31 vs. 20.01±9.86, all P < 0.05]. There was no significant difference in 28-day mortality and the total hospitalization time [28-day mortality: 37.5% vs. 35.0%, the total hospitalization time (days): 13.05±8.44 vs. 18.30±9.59, both P > 0.05]. ④ Patients were divided into death and survival groups according to the prognosis, and univariate analysis showed that white blood cell (WBC), neutrophil percentage (NEU%), CRP, lactic acid (Lac), APACHEⅡ score, IL-6, HBP were the factors influencing the prognosis of patients. The above indicators were further analyzed by Logistic regression, which showed that CRP, IL-6, and APACHE Ⅱ score were independent risk factors for prognosis [odds ratio ( OR) was 1.007, 1.828, 1.229, all P < 0.05]. Conclusions:Combined with Xuebijing to treat septic shock can reduce the body's inflammatory response to a certain extent, thereby reducing the time of mechanical ventilation, shortening the stay of ICU and reducing the total cost of hospitalization. But it cannot reduce the 28-day mortality of patients with septic shock.

OBJECTIVE: To explore the relevant clinical test indicators that affect the prognosis of patients with acute fatty liver of pregnancy (AFLP), and to provide a basis for early diagnosis and correct selection of treatment methods. METHODS: A retrospective analysis was conducted. Clinical data of AFLP patients in the intensive care unit (ICU) of the First Affiliated Hospital of Zhengzhou University from January 2010 to May 2021 were collected. According to the 28-day prognosis, the patients were divided into death group and survival group. The clinical data, laboratory examination indicators, and prognosis of the two groups were compared, and further binary Logistic regression analysis was used to analyze the risk factors affecting the prognosis of patients. At the same time, the values of related indicators at each time point (24, 48, 72 hours) after the start of treatment were recorded. The receiver operator characteristic curve (ROC curve) of prothrombin time (PT) and international normalized ratio (INR) for evaluating the prognosis of patients at each time point was drawn, and the area under the ROC curve (AUC) was calculated to evaluate the predictive value of relevant indicators at each time point for the prognosis of AFLP patients. RESULTS: A total of 64 AFLP patients were selected. The patients developed the AFLP during pregnancy (34.5±6.8) weeks, with 14 deaths (mortality of 21.9%) and 50 survivors (survival rate of 78.1%). There was no statistically significant difference in general clinical data between the two groups of patients, including age, time from onset to visit, time from visit to cessation of pregnancy, acute physiology and chronic health evaluations II (APACHE II), hospitalization time in ICU, and total hospitalization cost. However, the proportion of male fetuses and stillbirths in the death group was higher than that in the survival group. The laboratory examination indicators including the white blood cell count (WBC), alanine transaminase (ALT), serum creatinine (SCr), PT extension, INR elevation, and hyperammonia in the death group were significantly higher than those in the survival group (all P < 0.05). Through Logistic regression analysis of the above indicators showed that PT > 14 s and INR > 1.5 were risk factors affecting the prognosis of AFLP patients [PT > 14 s: odds ratio (OR) = 1.215, 95% confidence interval (95%CI) was 1.076-1.371, INR > 1.5: OR = 0.719, 95%CI was 0.624-0.829, both P < 0.01]. ROC curve analysis showed that both PT and INR at ICU admission and 24, 48, and 72 hours of treatment can evaluate the prognosis of AFLP patients [AUC and 95%CI of PT were 0.772 (0.599-0.945), 0.763 (0.608-0.918), 0.879 (0.795-0.963), and 0.957 (0.904-1.000), respectively; AUC and 95%CI of INR were 0.808 (0.650-0.966), 0.730 (0.564-0.896), 0.854 (0.761-0.947), and 0.952 (0.896-1.000), respectively; all P < 0.05], the AUC of PT and INR after 72 hours of treatment was the highest, with higher sensitivity (93.5%, 91.8%) and specificity (90.9%, 90.9%). CONCLUSIONS AFLP often occurs in the middle and late stages of pregnancy, and the initial symptoms are mainly gastrointestinal symptoms. Once discovered, pregnancy should be terminated immediately. PT and INR are good indicators for evaluating AFLP patient efficacy and prognosis, and PT and INR are the best prognostic indicators after 72 hours of treatment.
Humans ; Male ; Prognosis ; ROC Curve ; Retrospective Studies ; Intensive Care Units ; Sepsis/diagnosis*

OBJECTIVE To improve the quality evaluation method of Platycodonis Radix, to study the differences in the quality of three-years-old Platycodonis Radix under different harvesting periods, and to determine the optimal harvesting period of Platycodonis Radix. METHODS The leachate, ash, moisture, refractive index and the content of six saponins were used as the quality evaluation indexes. The differences between the herbs of Platycodonis Radix at different harvesting periods were characterized with the help of mathematical and statistical methods. And link the entropy weight method, gray correlation analysis and TOPSIS method were combined to obtain the statistical analysis of the relevant indexes and the quality ranking information of the herbs in different harvesting periods. RESULTS There were significant differences between the quality evaluation indexes of three-years-old Platycodonis Radix at different harvesting periods. The added multi-indicator testing had improved the quality evaluation system of Platycodonis Radix and enhanced the "Drug properties-Effectiveness" linkage of the herbs. And the results of the comprehensive quality evaluation model showed that the herbs harvested around October 21 (Frost’s Descent) were ranked best in terms of comprehensive index. CONCLUSION In order to ensure the quality of Platycodonis Radix, the best harvesting period for three-years-old Platycodonis Radix is determined around the "Frost’s Descent" season, taking into account the characteristics of the herbs' appearance and the material basis of herbs.