AIM:To investigate the effects of Zhenwu decoction ( ZWD) on the expression of α-smooth muscle actin (α-SMA) and NF-κB in diabetic nephropathy ( DN) rats.METHODS:Diabetic rat model was induced by intrape-ritoneal injection of streptozotocin ( STZ) , and the animals were randomly divided into STZ group ( n=22) and STZ+ZWD group (n=23).The normal rats served as control (n=16).All rats were sacrificed on 8 weeks after modeling.Biochemical assay and pathological observation ( HE staining and transmission electron microscopy ) were used to evaluate the effects of Zhenwu decoction on the renal function and pathological morphology .The body weight , renal index , blood glucose , total urinary protein in 24 h, and superoxide dismutase ( SOD ) , malondialdehyde ( MDA ) , inducible nitric oxide synthase ( iNOS) were determined as well .Western blotting was used to observe the effects of Zhenwu decoction on the expression ofα-SMA and NF-κB in diabetic nephropathy ( DN) rats.RESULTS:Compared with normal group , the renal index , blood glucose concentration, total urinary protein in 24 h, blood urea nitrogen (BUN), serum creatinine (SCr) and MDA were significantly higher and body weight was lower in DN rats (P<0.05).Pathological examination of the kidneys in DN group showed glomerular hypertrophy , glomerular basement membrane thickening , tubular epithelial cell degeneration , me-sangial matrix proliferation , protein cast formation in some renal tubules .The protein expression levels of α-SMA and NF-κB were markedly increased (P<0.05).After ZWD treatment, the level of renal index, total urinary protein in 24 h, BUN, SCr and the expression of α-SMA and NF-κB at the protein level were significantly decreased (P<0.05).The renal histological injury in ZWD group was significantly ameliorated .CONCLUSION: Zhenwu decoction might protect kidney against STZ-induced injury via decreasing the expression of α-SMA and NF-κB.

This article was aimed to study the proteomic spectra expression of traditional Chinese medicine (TCM) cold and heat constitution rats with two-dimensional gel electrophoresis (2-DE), in order to search for the cold and heat-associated proteins for the investigation of the biological basis of TCM cold and heat body constitution formation. The total protein in rat’s liver cell was extracted. The 2-DE and MALDI-TOF/TOF mass spectrometry (MS) were used in the screening and identification of differentially expressed proteins of cold and heat constitution rats. The results showed that a total of 10 different points in the protein expression were obtained with statistical significance after screening and MS, which were carbamoyl-phosphate synthase, protein disulfide isomerase associated 3, catalase, hydroperoxide isomerase, cytosol aminopeptidase, glutamate dehydrogenase 1, 3-hydroxy-3-methylglutaryl-coenzyme A synthase 2, heat shock protein 60 (Hsp60) precursor, homocysteine, 78 kDa glucose-regulated protein precursor. It was concluded that some differences were existed in the proteomic spectra expression of TCM cold and heat constitution rats. The abnormality of enzyme protein metabolism may be one of the material bases for the formation of cold and heat constitution.

Objective:To early identify and manage secondary malposition of peripherally inserted central catheter (PICC), and to reduce other PICC related complications.Methods:A total of 8 509 patients were included form January 2017 to December 2018 in intravenous therapy department in the Second Affiliated Hospital of Medical College of Zhejiang University. PICC was implanted and the original tip location was in the superior vena cava (SVC). The function and complications of the catheter were evaluated during the indwelling process. X-ray was taken for every abnormal patient to confirm the route and tip position of the catheter. Tip malposition were adjusted by external manipulation (pulling out part of the catheter, changing body position, external percussion, rapid flushing with 0.9% sodium chloride) when patients’ situation were allowed.Results:A total of 31 cases of PICC secondary malposition were early identified, 27 of them were treated with external manual reduction. Totally 19 cases succeeded, and 8 cases failed. The success rate was 70.4%. There was no other complication during the process. 3 cases were found venous thrombosis, and 1 case was unable to do external manipulation due to his poor situation.Conclusion:X-ray is a simple and easy method to identify secondary malposition of PICC. Using external manipulation to adjust the tip position back to SVC is effective, and the complications are few, which is worthy of clinical application.

ObjectiveTo explore the impact of different types of virtual reality environments balance exercise on human balance and posture control. MethodsFrom March to April, 2022, 30 male students from Dalian University of Technology were recruited to accept VR balance training of dynamic background (dynamic VR training) and static background (static VR training), respectively, with an interval of one week. They were measured the average moving speed of the center of pressure of human body under eight conditions before and after training, namely open-eye floor standing, close-eye floor standing, static VR background floor standing, dynamic VR background floor standing, open-eye sponge pad standing, close-eye sponge pad standing, static VR background sponge pad standing, and dynamic VR background sponge pad standing. Meanwhile, the weight of human body sensation was calculated. ResultsBefore training, the average movement speed of center of pressure was higher under the static VR than under open-eye (|t| > 2.811, P < 0.01), and lower than under close-eye (t > 3.279, P < 0.01) on both planes; while it was higher under dynamic VR than under close-eye (|t| > 4.830, P < 0.001). After dynamic VR training, the average movement speed of center of pressure increased under open-eye stable floor standing (t = 2.305, P < 0.05), decreased under close-eye on both planes (t > 3.405, P < 0.01), and decreased under static and dynamic VR on both planes (|t| > 3.285, P < 0.01). After static VR training, the average movement speed of center of pressure increased under open-eye floor standing (t = 2.224, P < 0.05), decreased under close-eye sponge pad standing (t = 2.223, P < 0.05), and decreased under dynamic VR on both planes (|t| > 2.380, P < 0.05). The weight of vision decreased after training (t > 4.132, P < 0.001), and the visual weight under normal proprioception was less after dynamic VR training than after static VR training (t = 3.611, P < 0.01). ConclusionUnder static VR background, the balance stability is poorer than under open-eye, but stronger than under close-eye. Under dynamic VR background, the balance stability is poorer under close-eye. VR balance training may decrease the stability without interference, but improve the stability under interference, which may result from reducing the dependence on visual sensation and strengthening the use of vestibular sensation, especially after VR training with dynamic background.

From 1951 to 1980, stroke was the main cause of disability and death among middle-aged and elderly residents in Japan. Its mortality once stood in the first place among all the developed countries, with the mortality of hemorrhagic stroke significantly higher than that of the western countries. In 1965, the mortality of stroke in Japan reached a peak of 175.8 per 100 000. Since then, it began to decline rapidly with a range of 5%-7%, and dropped to 139.5 per 100 000 in 1980, and from the top cause of death to the third place. By 2010, the mortality had dropped to 97.7 per 100 000. The significant decline in stroke morbidity and mortality in Japan is mainly attributed to controlling important risk factors and the public health service system's improvement. Setting up related policies and regulations to ensure comprehensive interventions and using the existing monitoring systems and surveys to assess interventions' effectiveness also contributes. Given the similarities of epidemiological characteristics and risk factors on stroke in Japan and China, strategies and measures adopted in Japan will have certain positive significance for China.

Objective:To evaluate the role of Z-DNA-binding protein 1 (ZBP1)/receptor-interacting protein kinase 1 (RIPK1) signaling pathway in lipopolysaccharide (LPS)-adenosine triphosphate (ATP)-induced pyroptosis in macrophages of mice.Methods:The RAW264.7 macrophages from mice were routinely cultured and divided into 6 groups ( n=9 each) using a random number table method: control group (group C), LPS-ATP group, LPS-ATP+ transfection negative control scRNA group (group LPS-ATP+ scRNA), LPS-ATP+ ZBP1 small interference RNA group (group LPS-ATP+ siRNA), LPS-ATP+ dimethyl sulfoxide group (group LPS-ATP+ DSMO), and LPS-ATP+ RIPK1 inhibitor nec-1 group (group LPS-ATP+ nec-1). The siRNA technique was used to inhibit the expression of ZBP1 in group LPS-ATP+ siRNA. The RIPK1 inhibitor nec-1 was given to inhibit the expression of RIPK1 protein in group LPS-ATP+ nec-1. Group C was routinely cultured. Cells were incubated with 10 μg/ml LPS for 24 h, then 5 mmol/L ATP was added, and the cells were incubated for 30 min to develop the cell pyroptosis model in the remaining 5 groups. The cell survival was detected by the CCK-8 assay. The concentrations of interleukin-1beta (IL-1β), IL-6, IL-18 and tumor necrosis factor-alpha (TNF-α) in cell supernatant were determined by enzyme-linked immunosorbent assay. The pyroptosis was determined by propidium iodide fluorescence staining. Western blot was used to detect the expression of ZBP1, RIPK1, caspase-1 and GSDMD. Results:Compared with group C, the cell survival rate was significantly decreased, the cell pyroptosis rate and concentrations of IL-1β, IL-6, IL-18 and TNF-α in the supernatant were increased, and the expression of ZBP1, RIPK1, caspase-1 and GSDMD was up-regulated in group LPS-ATP ( P<0.05). Compared with group LPS-ATP, no significant change was found in the parameters mentioned above in group LPS-ATP+ scRNA and group LPS-ATP+ DSMO ( P>0.05). Compared with group LPS-ATP+ scRNA, the cell survival rate was significantly increased, the cell pyroptosis rate and concentrations of IL-1β, IL-6, IL-18 and TNF-α in the supernatant were decreased, and the expression of ZBP1, RIPK1, caspase-1 and GSDMD was down-regulated in group LPS-ATP+ siRNA ( P<0.05). Compared with group LPS-ATP+ DMSO, the cell survival rate was significantly increased, the cell pyroptosis rate and concentrations of IL-1β, IL-6, IL-18 and TNF-α in the supernatant were decreased, the expression of ZBP1, caspase-1 and GSDMD was down-regulated ( P<0.05), and no significant change was found in the expression of ZBP1 in group LPS-ATP+ nec-1 ( P>0.05). Conclusions:Activation of ZBP1/RIPK1 signaling pathway is involved in LPS-ATP-induced pyroptosis in macrophages of mice.

Objective: To discuss and summarize the nursing care of a patient with difficult extubation due to asymptomatic thrombosis of PICC. Methods: By observing the local and global conditions, psychological tests, chest X-ray localization and vascular ultrasound, using critical thinking, the causes of difficult extubation were analyzed; after active anticoagulation and thrombolytic therapy, intermittent extubation of PICC; after extubation, continuous nursing was done. Results: After the above nursing measures were implemented, PICC was removed intermittently within 24 hours, and after 3 months vascular ultrasound was showing that the thrombus in the blood vessel had been completely organized. Conclusion When we encounter difficulties in PICC removal, it is not necessary to extubate the PICC forcibly. It is necessary to analyze the causes and implement correct nursing measures to improve the success rate of extubation.

Objective:To determine the effects of menopausal stage, age and other associated risk factors on symptoms of anxiety and depression among women in a community in Beijing.Methods:This study was a community-based prospective cohort. Participants who had transitioned through natural menopause, completed two or more depressive and anxiety symptoms evaluations, aged 35 to 64 years, and did not use hormone therapy were selected from the Peking Union Medical College Hospital aging longitudinal cohort of women in midlife to this analysis. The primary outcome variables were depressive and anxiety symptoms, assessed by hospital anxiety and depression scale (HADS). The generalized estimation equation was used in the statistical analysis.Results:Followed up from 2006 to 2014, 430 women and 2 533 HADS assessments were retained in the cohort. Depressive symptoms were more common than anxiety symptoms during all menopausal stages. The incidences of depressive and anxiety symptoms were 14.5% (19/191) and 3.1% (4/191) in the premenopausal -3 stage, respectively. The incidence increased in both menopausal transition and postmenopausal stage, with the highest incidence in the +1c stage [20.6% (155/751) and 8.8% (66/751), respectively]. However, these differences were not statistically significant (all P>0.05). Depressive symptoms were highest in the ≥60-<65 age group [20.8% (74/355)], and anxiety symptoms were highest in the ≥50-<55 age group [8.2% (62/754)]; but there were no statistical significances between different age groups and depressive and anxiety symptoms (all P>0.05). Multivariable analysis showed that high body mass index, low education status, and poor health status were independently associated with depressive symptoms (all P<0.05), and that poor health status, trouble falling asleep, and early awakening were independently associated with anxiety symptoms (all P<0.01). Conclusions:Depressive and anxiety symptoms are more common during menopausal transition and postmenopausal stage compared with reproductive stage. Depressive symptoms are more common than anxiety symptoms. To screen and assess depressive and anxiety symptoms in perimenopausal women is essential, especially for women with high risk factors.

Objective: To detect the effect of the ball compressor method to prevent jugular vein malposition in peripherally inserted central catheter insertion (PICC). Methods: Convenient sampling method was used to recruit 1 358 patients with PICC insertions during October 2017 to September 2018 in Second affiliated hospital Zhejiang University, school of medicine. 681 were included in experimental group, and 677 patients were included in control group. The control group used traditional turning head to the PICC insertion side or fingers compression to block the entrance of jugular vein to prevent jugular vein malposition in control group. While in experimental group, rugby- shape ball compression were used to block jugular vein to reduce jugular vein malposition. The rate of jugular vein malposition in the first try of catheterization was calculated in both groups. Results: The rate of jugular vein malposition in the first try of catheterization was 19.1%(130/681) in experimental group and 23.5% (159/677) in control group respectively. There is statistically significant difference between two groups (χ²=3.917, P=0.047 8). Conclusion Rugby- shape ball compression could reduce jugular vein malposition in the first try of catheterization effectively.

Glaucoma is one of the most common optic neuropathies, featuring progressive retinal ganglion cell damage and visual field loss (Tham et al., 2014; Xu et al., 2020). Currently, the only effective treatment for this condition is the reduction of intraocular pressure (IOP) (Palmberg, 2001; Heijl et al., 2002). Canaloplasty is a proven bleb-independent surgery with good efficacy and safety profiles in primary open-angle glaucoma (POAG) (Gołaszewska et al., 2021). However, early transient postoperative IOP elevation has been reported in up to 30% of cases (Riva et al., 2019), similar to that commonly observed in other internal drainage glaucoma surgeries such as implantation using iStent (0%-21.0%), CyPass (10.8%), and Hydrus (4.8%-6.5%) (Lavia et al., 2017). This complication may be a predictor of poor reserve in the outflow system and is potentially associated with surgical failure. Nonetheless, the exact pathophysiology of glaucoma remains unknown, and studies clarifying the risk factors for postoperative IOP elevation have been scarce.
Humans ; Intraocular Pressure ; Glaucoma, Open-Angle/surgery* ; Incidence ; Treatment Outcome ; Risk Factors