Diabetic nephropathy (DN) is one of the most important microvascular complications of diabetes, which is one of the most important causes of death in diabetic patients. Because of its high efficiency and few adverse reactions, TCM has been widely studied and used in the treatment of DN, with unique advantages. The recent research showed that a variety of TCM polysaccharides have the effects of reduce blood sugar and protect kidney. This article reviewed the research on TCM polysaccharides on the prevention and treatment of DN, which can provide references for further study and application.

Objective To investigate the relationship between the related indexes with rheumatic heart disease (RHD) and its clinical significance .Methods The medical records information in 236 patients with rheumatic fever caused cardiac were collected and divided into the RHD group ,simple rheumatic fever group and normal healthy control group .The levels of related indiexe such as Mb and cTnI were detected in the three groups .Results The Mb ,cTnI and CK‐MB and NT‐proBNP had statistical differences between the RHD group and simple rheumatic fever groups (P<0 .05);the levels of ESR ,RF ,CRP ,cTnI ,Mb ,CK‐MB ,CK and NT‐proBNP had statistically significant differences between the RHD group and healthy control group (P<0 .05);With the NT‐proB‐NP level of 136 .17 pg/mL as the critical value ,the sensitivity ,specificity ,positive predictive value and negative predictive value of NT‐proBNP for diagnosing RHD were 95 .48% ,90 .15% ,86 .7% and 97 .86% respectively .Conclusion The levels of blood cTnI , Mb and CK‐MB in the patients with RHD are significantly higher than those in the normal controls ,so detecting the serum NT‐proBNP concentration is a sensitive indicator for early diagnosis of RHD .

Objective To analyse the differences of indirect immuno‐fluorescence (IIF) ,enzyme‐linked immunosorbent assay (ELISA) and immunoblotting technique(IBT) for the determination of anti‐dsDNA antibody ,and evaluate the value of joint detec‐tion of the three methods for diagnosing systemic lupus erythematosus(SLE) .Methods From January 2012 to March 2015 ,50 ca‐ses of patients with SLE ,100 cases of patients with other autoimmune disease(AID)and 100 healthy individuals were selected .Ser‐um levels of anti‐dsDNA antibody were detected by using IIF ,ELISA and IBT respectively .Then ,compared the sensitivity and spe‐cificity of the three methods ,and analysed the sensitivity and specificity of joint detection .Results The IIF method had the highest specificity(99 .5% ) ,while ELISA had the highest sensitivity(74 .0% ) .There were statistically significant differences in the positive detection rates of serum anti‐dsDNA antibody in patients with SLE between IIF and ELISA ,IIF and IRT ,ELISA and IBT(χ2 values were 11 .435 ,13 .994 and 4 .539 ;P<0 .05) ,and the Kappa values were 0 .411 ,0 .522 and 0 .278 respectively .The specificity of three methods joint in series was increased to 99 .5% ,and the sensitivity of parallel combined detection of the three methods was in‐creased to 82 .0% .Conclusion Among the three methods for detecting anti‐dsDNA antibody ,ELISA has the highest sensitivity , and IIF has the highest specificity .Moreover ,joint detection could increase the sensitivity and specificity .

Objective To establish reference ranges of venous blood cell parameters in Lanzhou area ,through investigating 1 880 cases of healthy people .Methods Retrospective analysis method was adopted ,and changes of 26 venous blood cell parameters were observed by using Sysmex XE‐5000 automatic hematology analyzer .Results Some parameters ,including platelet(PLT) and hemo‐globin(Hb) ,were close to normal distribution ,while most of parameters were skewed distribution .In the 6 parameters of white blood cells ,except for percentage of lymphocyte and neutrophi ,the 95% CI of the rest of parameters had statistically significant differences between male and female(P<0 .05) .In the 8 parameters of red blood cell ,except for mean corpuscular haemoglobin con‐centration (MCHC) and standard deviation of red blood cell volume distribution width (RDWSD) ,the 95% CI of the rest of parame‐ters had statistically significant differences between male and female (P<0 .05) .The 95% CI of PLT related parameters and per‐centage of juvenile cells had no statistically significant differences between male and female (P>0 .05) .In some parameters ,there were significant differences between 95% CI observed in this study and reference ranges currently used .Conclusion There are sig‐nificant differences between 95% CI of these parameters and original reference ranges ,so the original reference ranges are lack of ac‐curacy and applicability ,which indicates that it is necessary to scientificlly and rationally establish reference ranges of blood cell in region .

Objective To investigate the species, antimicrobial resistance, and fluoroquinolone resistance gene profiles of Nocardia in the General Hospital of Ningxia Medical University. Methods Nocardia isolates were collected in the General Hospital of Ningxia Medical University during the period from January 2013 to June 2017. Broth dilution method was used to determine the susceptibility of the Nocardia strains to 15 antibiotics. Fluoroquinolone resistance genes gyrA, parC, qnrA, qnrB and qnrS were detected by polymerase chain reaction. Results A total of 16 isolates of Nocardia were collected, including Nocardia cyriacigeorgica (62.6％, 10/16), Nocardia farcinica (18.7％, 3/16), and Nocardia otitidiscaviarum (18.7％, 3/16). Most Nocardia isolates (81.2％, 13/16) were resistant to ciprofloxacin. About 12.5％, 12.5％, 25.0％ and 18.7％ of the strains were resistant to ceftriaxone, tobramycin, gentamicin and cefepime. Overall, gyrA, parC, qnrA and qnrB were identified in 18.8％, 37.5％, 25.0％ and 18.7％ of the Nocardia strains. The qnrS gene was not found in any strain. Conclusions The most frequently Nocardia species in the hospital was Nocardia cyriacigeorgica. Fluoroquinolone resistance is serious in the Nocardia isolates.Fluoroquinolone resistance of Nocardia is likely associated with gyrA, parC, qnrA, and qnrB genes. We should pay close attention to the emergence and antimicrobial susceptibility of Nocardia infection.

Objective:To investigate the stability of fat emulsions after the preparation of parenteral nutrient solution under different storage conditions.Methods:Standardized parenteral nutrient solution was used to prepare a total of 24 bags of nutrient solution with the same formula, except for that Group A (12 bags) contains 20% of medium and long chain fat emulsion (C6-24) while Group B contains 20% of C8-24. The preparations were stored under 2-8℃, 23-25℃, and 35-37℃ and were examined at 24h, 48h and 72h after preparation. The appearance, average size of fat particles, pH value of nutrient solution, and lipid peroxidation were investigated.Results:After storage at 4℃, 25℃ and 36℃ for 24h, 48h and 72h respectively, both groups of preparations showed no obvious change in appearance. There was no significant difference in pH ( P>0.05) nor lipid peroxidation ( P>0.05). Conclusion:Both kinds of fat emulsion are stable in terms of pH value, fat particle size and lipid peroxidation, and can be used for patients receiving intravenous nutrition support.

Objective Through factor analysis of the quantified syndrome information of 558 cases of kidney yang deficiency syndrome,the constructing feature of kidney yang deficiency syndrome was revealed,which provides clinical data support for the objectification,standardization and normalization of kidney Yang deficiency syndrome.Methods Firstly,the frequency analysis of symptoms,tongue and pulse signs of 558 patients with kidney Yang deficiency syndrome was carried out,and then the main syndrome information of the patients with kidney Yang deficiency syndrome was quantified.Finally,the common factors and their representative variables of kidney Yang deficiency syndrome were screened out through factor analysis,and the constructing feature of kidney Yang deficiency syndrome was analyzed combined with TCM syndrome knowledge.Results Eight common factors with eigenvalues greater than 1 were extracted by principal component analysis,and the cumulative contribution rate was 60.483%.After the factor rotation,the representative variables with the absolute value of load coefficient greater than 0.45 in each common factor were selected.The representative variables of F1 are afraid of cold and fond of warmth(0.947)and intolerance to cold(0.932).The representative variables of F2 are waist pain(0.754),waist and knee weakness(0.720)and cold in waist and knees(0.466).The representative variables of F3 are depression(0.749),insomnia(0.711)and diarrhoea(0.470).The representative variables of F4 are thin fur(0.819)and white fur(0.768).The representative variable of F5 are tinnitus and deafness(0.687),frequent nocturnal urination(0.591)and decreased libido(0.587).The representative variables of F6 are pulse sinking(0.766)and pulse weakness(0.736).The representative variables of F7 is thready pulse(0.942).The representative variable of F8 is pale tongue(0.961).External syndrome of disease location involved in these common factors are waist,bone,brain,ear,anterior Yin,posterior Yin and reproductive function.The disease nature involved in these common factors is deficiency and cold.Conclusion The basic constituent units of kidney Yang deficiency syndrome include disease location syndrome elements and disease nature syndrome elements.The disease location is kidney,and the abnormal changes of kidney location are mainly external symptoms of waist,bone,brain,ear,anterior Yin,posterior Yin and reproductive function.Its disease nature is deficiency and cold.Yang deficiency leads to external cold.Yang Qi deficiency can not warm the body surface resulting in the appearance of external cold syndrome.

The occurrence of benign prostate hyperplasia(BPH)was related to disrupted sex steroid hormones,and metformin(Met)had a clinical response to sex steroid hormone-related gynaecological disease.How-ever,whether Met exerts an antiproliferative effect on BPH via sex steroid hormones remains unclear.Here,our clinical study showed that along with prostatic epithelial cell(PEC)proliferation,sex steroid hormones were dysregulated in the serum and prostate of BPH patients.As the major contributor to dysregulated sex steroid hormones,elevated dihydrotestosterone(DHT)had a significant positive rela-tionship with the clinical characteristics of BPH patients.Activation of adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK)by Met restored dysregulated sex steroid hormone homeostasis and exerted antiproliferative effects against DHT-induced proliferation by inhibiting the formation of androgen receptor(AR)-mediated Yes-associated protein(YAP1)-TEA domain transcription factor(TEAD4)heterodimers.Met's anti-proliferative effects were blocked by AMPK inhibitor or YAP1 over-expression in DHT-cultured BPH-1 cells.Our findings indicated that Met would be a promising clinical therapeutic approach for BPH by inhibiting dysregulated steroid hormone-induced PEC proliferation.

Objective:To detect and analyze the contents of eight metal elements in water samples of plague foci in Yunnan Province.Methods:During the period from December 2015 to November 2016, the plague foci of Yulong, Jianchuan and Lianghe were selected as sampling sites, water samples were collected in areas with rodent activities in the 4 seasons of spring, summer, autumn and winter. The contents of eight metal elements calcium (Ca), iron (Fe), zinc (Zn), chromium (Cr), plumbum (Pb), manganese (Mn), cadmium (Cd) and cuprum (Cu) in water samples were measured by flame atomic absorption spectrometry (FAAS), and the data [median (interquartile distance)] were statistically analyzed.Results:Twenty-six, 58 and 54 water samples were collected from Yulong, Jianchuan and Lianghe plague foci, respectively. The contents of metal elements of Pb and Cd in water samples of the three plague foci [Yulong: 0.19 (0.78) and 0.08 (0.07) mg/L; Jianchuan: 0.23 (0.56) and 0.03 (0.06) mg/L; Lianghe: 0.13 (0.61) and 0.09 (0.08) mg/L] were higher than that of "Environmental Quality Standards for Surface Water" (Pb: 0.10 mg/L, Cd: 0.01 mg/L). There were significant differences in the contents of Ca and Cd elements among the three regions ( P < 0.05), but there was no significant difference in the contents of the other 6 metal elements among the three regions ( P > 0.05). The content of Ca element was the highest in Yulong plague foci, and the lowest in Lianghe plague foci ( P < 0.017). In the Yulong plague foci, there was no statistically significant difference in the content of Fe element in different seasons ( P > 0.05), and the differences in the contents of the other 7 metal elements were statistically significant ( P < 0.05). There was no significant difference in the content of Cr element in Jianchuan plague foci in different seasons ( P > 0.05), and the differences in the content of the other 7 metal elements were statistically significant ( P < 0.05). There was no significant difference in the content of Ca element in Lianghe plague foci in different seasons ( P > 0.05), and the differences in the content of the other 7 metal elements were statistically significant ( P < 0.05). Conclusion:The metal element contents of Pb and Cd are relatively abundant in water samples from 3 plague foci of Yunnan Province, and the seasonal variation trend of metal element content in water samples of Yulong and Jianchuan plague foci is similar.

ObjectiveTo study the correlations of the characteristics of kidney Yang deficiency syndrome in patients with chronic kidney disease （CKD） with clinical indicators and to explore the risk factors of kidney Yang deficiency in CKD. MethodThe differentiation of traditional Chinese medicine （TCM） syndrome classified the 225 CKD patients who met the inclusion criteria into two groups： one group of kidney Yang deficiency syndrome （99 patients） and one group of non-kidney Yang deficiency syndrome （126 patients）. The symptoms， tongue manifestation， pulse manifestation， and accompanied symptoms of the kidney Yang deficiency syndrome group were recorded. The syndrome characteristics were summarized by factor analysis and clustering analysis. The levels of hemoglobin, red blood cell count, urinary protein, urinary glucose, creatinine, urea nitrogen and glomerular filtration rate were compared between the kidney Yang deficiency syndrome group, the non-kidney Yang deficiency syndrome group and the normal control group by ANOVA and non-parametric test. The binary logistic regression model was employed to analyze the correlations of lifestyle， body mass index （BMI） with syndrome. ResultThe high-frequency symptoms of CKD patients with kidney Yang deficiency syndrome were waist pain， fear of cold， favor of warm， lethargy， fear of cold at waist and knees， etc. The patients mainly presented deep pulse， thready pulse， or weak pulse， and the tongue with white coating， greasy coating， or thin coating. A total of 13 common factors were obtained， which can be classified into 5 categories. The patients with kidney Yang deficiency syndrome mainly had symptoms in limbs （especially lower limbs）， chest， bladder， fleshy exterior， and stomach， with the main manifestations of deficiency-cold， Qi deficiency， fluid retention， and blood stasis. The clustering analysis classified the patients into 11 categories， which reflected that kidney Yang deficiency syndrome mainly presented the symptoms of Qi deficiency， blood stasis， and fluid retention， with fleshy exterior， limbs， spleen， stomach， ears， mind， and bladder involved. The results of clustering analysis and factor analysis were consistent， both of which indicated that the patients were weak with deficiency-cold， accompanied by fluid retention and blood stasis. Frequency analysis also showed that common symptoms mainly included Qi deficiency， fluid retention， cold-dampness， and blood stasis. Compared with the non-kidney Yang deficiency group， the kidney Yang deficiency group showed a large proportion of patients in stage 3-5 CKD， elevated urea nitrogen （P<0.05）， decreased glomerular filtration rate， hemoglobin， and red blood cell count （P<0.05）， and increased qualitative grade of urine protein. In addition， the results of regression analysis showed that female， little or no exercise， and diet preference were the risk factors for kidney Yang deficiency syndrome in CKD （P<0.05）. ConclusionThe disease location and manifestations have correspondence in the CKD patients with kidney Yang deficiency syndrome. The TCM symptoms are correlated with clinical indicators. Hemoglobin， red blood cell count， glomerular filtration rate， urea nitrogen， and urine protein can reflect the connotation of kidney Yang deficiency syndrome in CKD to a certain extent. Additionally， related risk factors in life can affect the occurrence of kidney Yang deficiency syndrome in CKD.