Objective To assess the efficacy of fish oil in the treatment of IgA nephropathy using the method of Meta-analysis. Methods Randomized controlled trials of fish oil in the treatment of IgA nephropathy were searched in the database of Cochrane library,PubMed, EMBASE and CNKI. Data extracted from the literatures were analyzed with Revman software (version 5.0). Results In comparison with the controlled group, proteinuria in the fish oil group was significantly decreased [SMD=-0.27, 95%CI (-0.52 to -0.03), P=0.03], while the renal function deteriorated [SMD=0.30,95%CI(0.05 to 0.55), P=0.02]. Conclusion Fish oil can decrease the proteinuria of IgA nephropathy, but can not prevent renal function from deterioration.

Adult ; Arsenic ; pharmacology ; Chromosome Aberrations ; chemically induced ; Dose-Response Relationship, Drug ; Female ; Humans ; Lymphocytes ; drug effects ; metabolism ; Male ; Middle Aged

Adult ; Humans ; Male ; Middle Aged ; Neoplasms, Neuroepithelial ; radiotherapy ; surgery

Objective - - （BCL2L2）- （ ） To investigate the differential expression of the fusion gene BCL 2 like protein 2 poly A （PABPN1） （ ） binding protein nuclear 1 induced by sodium arsenite SA and its methylated metabolites in 16HBE cells and the Methods ） ， related mechanism. i The 16HBE cells exposed to SA at concentrations of 1.5 3.0 and 4.5 µmol/L were set as -， - - low medium and high dose arsenic exposure groups. The 16HBE cells exposed to 4.5 µmol/L monomethylarsonic acid （ ）， （ ） ， MMA dimethylarsonic acid DMA and SA were set as MMA group DMA group and SA group. The 16HBE cells without ， BCL2L2-PABPN1 toxic stimulation were set as control group. After the cells were cultured for 48 hours the expression of was - （ - ） ） （ ） detected by quantitative real time polymerase chain reaction qRT PCR . ii Two small interfering RNA siRNA silencing 基金项目：国家自然科学基金（ ）； 年云南省科技厅昆明医科大学应用基础研究联合专项面上项目 82160607 2021 （ ） 202101AY070001-054 作者简介：施雅（ —），女，在读大学本科生，主要从事劳动卫生与环境卫生学研究；尹锦瑶（ —），女，在读劳动卫生与环境卫 2001 1995 生学硕士研究生，主要从事劳动卫生与环境卫生学研究；施雅和尹锦瑶为共同第一作者 通讯作者：何越峰教授，博士研究生导师，- ： E mail heyuefeng@kmmu.edu.cn中国职业医学 年 月第 卷第 期 ， ， ， · · 2022 10 49 5 Chin Occup Med October 2022 Vol.49 No.5 523 BCL2L2-PABPN1， - fragments were designed and transfected into 16HBE cells to knockdown which were set as siRNA 1 group - - BCL2L2-PABPN1 and siRNA 2 group. Non transfected control group without knockdown of transfection was set up. After ， BCL2L2-PABPN1 - culturing for 48 hours the expression level of in the three groups of cells was detected by qRT PCR. The cell - survival rate and early apoptosis rate were detected by MTS method and JC 1 mitochondrial membrane potential detection ， （ ） ， method respectively. The apoptosis was detected by Hoechest33342/propidium iodide PI double staining and the expression - Results ） level of P53 signaling pathway related proteins was detected by Western blotting. i The relative expression of BCL2L2-PABPN1 （P ） BCL2L2- in 16HBE cells increased with the increasing SA doses <0.01 . The relative expression of PABPN1 - ， - - in high dose arsenic exposure was higher than that in control group low dose and medium dose arsenic exposure （ P ） BCL2L2-PABPN1 ， groups all <0.05 . The relative expression of in SA group was higher than those in control group MMA （ P ） BCL2L2-PABPN1 group and DMA group all <0.05 . The relative expression of showed no significant difference between ， （ P ） ） BCL2L2-PABPN1 control group MMA group and DMA group all >0.05 . ii The relative expression levels of and cell - - - （ P ） survival rate in siRNA 1 group and siRNA 2 group were lower than those in non transfected control group all <0.05 . ， （P ） However there was no significant difference in the early apoptosis rate among the three groups >0.05 . The results of - Hoechest33342/PI double staining showed that the number of nuclear shrinkage and early apoptotic cells in siRNA 1 group and - - ， - siRNA 2 group was higher than that in non transfected control group. The relative protein expression levels of P53 phospho ， - - ， - - （ P ） p53 BCL 2 associated death promoter P21 and cytochrome C in siRNA 1 group and siRNA 2 group were higher all <0.05 , - - P and the relative protein expression levels of P53 up regulated modulator of apoptosis were lower (all <0.05), when compared - Conclusion with the non transfected control group. SA may block the apoptosis of 16HBE cells by inducing the expression of BCL2L2-PABPN1 fusion gene . The mechanism may be related to the activation of P53 signaling pathway. The SA methylated BCL2L2-PABPN1 BCL2L2-PABPN1 - metabolites MMD and DMA had no effect on the expression of . may affect anti apoptosis BCL2L2 PABPN1 through affecting the synergistic effect of and genes.

OBJECTIVETo observe therapeutic effects of locking titanium plate for the treatment of comminuted proximal humeral fracture in elderly.

METHODSFrom June 2011 to May 2013, 72 elderly patients with comminuted proximal humeral- fractures were divided into locking titanium plate group and anatomical plate group, 36 cases in each group. In locking titanium plate group, there were 16 males and 20 females aged from 60 to 79 years old with an average of (69.55±5.62) years old; 10 cases were type Neer II, 18 were type Neer III and 8 cases were type Neer IV in accordance with Neer classification; treated with locking titanium plate. In anatomical plate group, there were 15 males and 21 females aged from 60 to 81 years old with an average of (69.76±5.70) years old; 9 cases were type Neer II, 20 were type Neer III and 7 cases were type Neer IV; and treated with anatomical plate. Clinical effects, preoperative and postoperative Neer scoring, operative time, bone healing time and incidence of complications between two groups were compared.

RESULTSAll patients were followed up from 1 to 3 years with an average of 15 months. The excellent and good rate of locking titanium plate group (91.7%) was significantly higher than anatomical plate group (75.0%). Postoperative Neer score of two groups were improved obviously, but locking titanium plate group (92.51±7.85) was higher than anatomical plate group (83.64±8.56); there was no significant differences between two groups in operative time (P>0.05); bone healing time in locking titanium plate was (18.6±3.4) weeks, and shorter than anatomical plate group (24.3±3.9) weeks; incidence of complications in locking titanium plate was (5.6%) shorter than anatomical plate group (22.2%), and had obviously differences between two groups.

CONCLUSIONLocking titanium plate for the treatment of comminuted proximal humeral fracture in elderly plays an important role in good rate, bone healing time and Neer score. It has advantages of early rehabilitation exercise, less shoulder pain, rapid recovery of shoulder joint, less complications, safe and effective, and be worthy of clinical application, especially for senile osteoporosis patients.

Aged ; Aged, 80 and over ; Bone Plates ; Case-Control Studies ; Female ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Shoulder Fractures ; surgery ; Titanium

Objective To investigate the clinical features and effective treatment of patients with severe type A H1N1 flu in Wenzhou. Methods The clinical data of 42 hospitalized patients with severe type A H1N1 flu were analyzed and the clinical features were summarized. Results A total of 42 patients with severe type A H1N1 flu all began with fever and cough. The symptoms of expectoration, pharyngalgia, chilly accounted for 92. 9%, 90. 5% and 42. 9%, respectively. The peripheral leucocyte counts were normal or reduced. C-reactive protein and erythrocyte sedimentation rate levels both increased in 30 patients (71.4%). About 95.2% (40/42) patients had changes of pulmonary imaging. All of the patients were treated with oseltamivir and effective antibiotic drugs as well as symptomatic management. No patients was treated with glucocorticoid. The patients with underlying diseases were given proper treatment. Three cases were treated with antifungal therapy and 3 pregnant patients were timely terminated of pregnancy. Conclusions Severe type A H1N1 flu progresses rapidly and the lower respiratory tract is involved soon after onset. Therefore, the patient should be diagnosed early and treated promptly after presenting fever, which will lead to good prognosis.

Objective To investigate the feasibility and safety of elective synchronous laparoscopic splenectomy plus portaazygous disconnection and hepatectomy for cirrhotic portal hypertension patients with hypersplenism, esophageal and gastric variceal bleeding and hepatocellular carcinoma.Methods Two hepatocellular carcinoma patients with a history of upper gastrointestinal hemorrhage and secondary hypersplenism underwent one stage, non-emergency laparoscopic splenectomy plus portaazygous disconnection and hepatectomy between April 2015 and May 2015 in our department.Autologous red cell salvage was used during the operation.Liver resection was performed after splenectomy, portaazygous disconnection and the use of cell saver.Results The two operations were performed successfully.The operative time was 190 min and 205 min respectively, Volume of intraoperative bleeding was 180 ml and 260 ml.There was no intraoperative homologous blood transfusion.The two patients recovered smoothly, without major complications and postoperative hospital stay was 8 d and 9 d.Conclusions The procedure of synchronous laparoscopic splenectomy and azygoportal disconnection with hepatectomy for cirrhotic patients with hepatocellular carcinoma, hypersplenism and esophageal and gastric variceal bleeding is safe and feasible.

Objective To evaluate the application effect of pneumatic arm assisted single surgeon uniportal thoracoscopic surgery.Methods A total of 40 patients were admitted to our treatment group in Shanghai Pulmonary hospital in October who accepted pneumatic arm assisted single surgeon uniportal thoracoscopic surgery.All the clinic statistics of patients were collected including operative time,the volume of blood intra-operation,postoperative complications and hospitalization time.23 of 40 patients who accepted lobectomy/segmentectomy with pneumatic arm assisted single surgeon uniportal thoracoscopic surgery were assigned to the observation group,while another 30 concurrent patients who accepted lobectomy/segrnentectomy with conventional uniportal thoracoscopic surgery were assigned to the control group.Both groups were compared.Results The average postoperative hospitalization time of observation group was(4.6 ± 1.3) days.The average time for postoperative drainage tube retention was(46.7 ± 18.6) hours.The average operation time of patients in observation and control groups was(121.74 ± 25.16) min and (119.7 ± 14.26) min separately.The volume of blood intra-operation in observation group was(91.74 ± 32.88)ml and(89.00 ± 41.22) ml in control group.There is no significant difference between two groups(P ＞ 0.05).Conclusion The field of view and adjustment of camera in uniportal thoracoscopic surgery by single surgeon with pneumatic arm assistance are more accurate and steady,in which human resource can be saved.It is safe and reliable and does not prolong operative time or increase bleeding during operation,and can be applied to different kinds of diseases in thoracic surgery.It is worth promotion and application in eligible hospitals and medical institutions.

Objective To investigate the correlation between serum insulin-like growth factor-1(IGF-1)level and the 131Ⅰahsorbante of thyroid nodule in patients with struma nadosa,to search for simpler and safer methods for differentiating thyroid nodule.Methods Detecting the 131Ⅰ absorbance of thyroid nodule by radioisotope scanning.then the patients were divided into warm and cold nodule groups,and the normal control group was also set up;the levels of IGF-1,FT3,FT4,sTSH were detected in serum of patients with struma nadosa by radio immunoassay,then the correlation between these data and the 131Ⅰabsorbance of thyroid nodule was analyzed.Results In the patients with warnl nodule,the level of serum IGF-1,FT3,FT4 and the 131Ⅰ absorbance of thyroid nodule[(315.86±22.74)μg/L,(9.95±5.62),(67.27±27.31)ng/L,0.64±0.17]were increased obviously when compared with the control group [(256.13±39.85)μg/L,(2.80±1.30),(13.51±5.50)ng/L,0.35±0.15],but the sTSH[(0.35±0.03)mU/L]went down significantly than the control group[(2.71±1.17)mU/L],the difference being statistically significant(P＜0.01).In the patients with cold nodule,the level of serum IGF-1,FT3,FT4,sTSH[(263.17±30.23)μg/L,(2.89±0.98),(14.23±2.84)ng/L,(2.81±0.42)mU/L] had no significant difference compared with the control group(P＞0.05).The level of serum IGF-1 was positively correlated with the 131Ⅰ absorbance of thyroid nodule(r＝0.835,P＜0.01),but negtively correlated with sTSH(r＝-0.326,P＜0.05)in the patients with warm nodule.Conclusion The level of sernm IGF-1 is closely correlated with the 131Ⅰ absorbance of thyroid nodule in patients with struma nadosa.

Objective To study the influence of different starting time of hyperbaric oxygenation (HBO)therapy on acute cerebral infarction patients.Methods A total of 120 patients with first-time acute cerebral infarction were randomly and evenly divided into 4 groups:groups A,B,C and D.All the patients were treated with routine clinical regime.In addition,the patients in groups A,B andC started with HBO within 24 hours,between 24 and 72 hours and after 72 hours post-onset of the disease,respectively,while those in group D without HBO.All the patients were evaluated in terms of their neurological function and their perform- ante in activities of daily living,using the National Institutes of Health stroke survey(NIHSS)and Barthel In- dex(BI).Results At 14,28 and 90 davs after treatment,the patients in group A scored significantly better with NIHSS and BI than those in groups B,C and D(P0.05).No serious adverse reaction was found in the four groups.Conclusion The earlier the HBO therapy was started, the better the treatment.There will be no significant effects of HBO if it was started after 72 hours pust-onset of the disease.HBO therapy appears safe.