There are many reversible factors in chronic renal failure,mainly including multifarious infections,insufficient effective blood volume,hypertension,heart failure,urinary obstruction,nephrotoxicity drugs and so on.Traditional Chinese medicine can exert the predominances of whole adjustment and treatment based on syndrome differentiation.After taking traditional Chinese medicine in time,many patients' renal function can recover in some extent.

OBJECTIVE: To explain the current situation of the study on Chinese herb nephropathy (CHN), clarify the concept of CHN and investigate the pathogenesis, also suggest the measures for the prevention and treatment of CHN.DATA SOURCES: Articles about kidney impairment induced by Chinese herbal medicine containing aristolochic acid (AA) published in English between January 1994 and April 2006 were searched in Pubmed database by using the keywords of "kidney impairment induced by Chinese herbal medicine containing aristolochic acid (AA), nephropathy induced by aristolochic acid (AA), Chinese herb nephropathy (CHN)". Other articles were collected by the specific name of journals and title of papers by retrieving VIP database.STUDY SELECTION: The original articles were checked primarily, those about kidney impairment induced by Chinese herbal medicine containing AA were selected, those obviously irrelevant ones were excluded, and the full-texts of the involved articles were searched manually.DATA EXTRACTION: Totally 86 articles were collected, 20 of them were involved, and the other 66 repetitive studies or reviews were excluded:DATA SYNTHESIS: At present, kidney impairment induced by Chinese herbal medicine has not attracted enough attentions in Chinese, and effective monitoring system should be established. The diagnosis and pathogenesis of nephropathy induced by AA are still unclear, and the prevention is the main treatment. Therefore, we should realize its harmfulness, and reinforce its basic and clinical researches.CONCLUSION: The main damage in kidney caused by AA focuses on the renal tubulointerstitial matrix. Renal glomerulus is rarely involved in the toxic process. Clinical manifestations also reflect the impairment of renal tubules and interstitium such as interstitial fibrosis. A more effective diagnosis monitoring and screening system should be set up in order to mesh the patients at the early stage. A more stringent method for classification of the species in fourstamen stephania root family will be established to avoid confusion and error. More valid therapeutic channels should investigate for its remedy.

OBJECTIVE: To investigate the effects of Shenshuning Recipe (SSNR) on gene expression of hepatocyte growth factor (HGF) in renal tissues in rats with glomerulosclerosis. METHODS: Glomerulosclerosis was induced in 42 rats by unilateral nephrectomy and intravenous injection of doxorubicin. Then these 42 rats were randomly divided into three groups: untreated group, SSNR-treated group and benazepril-treated group. Another eight rats were included into sham-operation group. The rats in the SSNR-treated group and the benazepril-treated group were fed SSNR or benazepril respectively for 8 weeks. The levels of 24 h urine protein (Upr), serum creatinine (Cr) and blood urea nitrogen (BUN) of rats in each group were examined. The renal morphological changes were observed under microscope, and the diameter of glomerular capillary, mesangial matrix and glomerulosclerosis index were analyzed by image analysis software. Reverse transcription-polymerase chain reaction (RT-PCR) method was used to detect the gene expression of HGF in the renal tissues. RESULTS: The levels of 24 h Upr, serum Cr and BUN in the untreated group were remarkably increased than those in the sham-operation group (P<0.01). The pathological morphological changes in the untreated group showed that the glomerulosclerosis was diffused around the renal tissue and the capillaries were shrunk. The expression level of mesangial matrix was up-regulated and the glomerulosclerosis index was 3.32+/-0.35. The expression level of HGF mRNA in the untreated group was obviously lower than that in the sham-operation group (P<0.05). The levels of 24 h Upr, serum Cr and BUN in the SSNR-treated group and the benazepril-treated group were remarkably decreased as compared with those in the untreated group, while the expression levels of HGF mRNA were both obviously higher than that in the untreated group (P<0.01). The pathological morphological changes in the SSNR-treated group and the benazepril-treated group were both alleviated. There was no significant difference in therapeutic effect between the SSNR-treated group and the benazepril-treated group. CONCLUSION: Shenshuning Recipe can up-regulate the expression of HGF mRNA, decrease the mesangial matrix, and improve the renal function, so that it may retard the development of glomerulosclerosis.

Objective To investigate the clinical efficiency of endoscopic pancreatic sphincterotomy ( EPS) combined with pancreatic duct stent for acute recurrent pancreatitis ( ARP ) caused by biliary microlithiasis. Methods A total of 71 patients were diagnosed as having ARP resulting from biliary microlithiasis from April 2005 to November 2016, and their clinical data were retrospectively analyzed. Patients were divided into two groups according to different endoscopic therapy, EPS ( n=34) and EST group (n=37), respectively. The rate of pancreatitis recurrence, post-ERCP pancreatitis (PEP) and biliary complications were compared by Chi-square test and the influencing factors of recurrence were evaluated by survival analysis. Results The follow-up time ranged from 2 to 108 months ( median 21. 5 months) in EPS group and ranged from 5 to 120 months ( median 39 months) in EST group. Twelve months after endoscopic therapy, 2 patients in EPS group and 5 in EST group suffered recurrent pancreatitis(χ2=0. 461, P=0. 497). Recurrence occurred in 13 patients in 60 months after endoscopic therapy, 4 patients in EPS group and 9 in EST group. Cox regression analysis indicated different endoscopic treatment ( RR=6. 808, 95%CI: 1. 389-33. 356, P=0. 018) and type 2 diabetes ( RR=0. 134, 95%CI:0. 029-0. 608, P=0. 009) were statistically significant factors. There were no significant difference in incidence of PEP (20. 6% in EPS group, 10. 8% in EST group,χ2=1. 294, P=0. 255) and biliary complications between two groups (11. 8% in EPS group, 24. 3% in EST group, χ2=1. 869, P=0. 172). Conclusion EPS combined with pancreatic stenting is effective for acute recurrent pancreatitis caused by microlithiasis. Type 2 diabetes may also lead to recurrence of acute pancreatitis.

Segmental bone defects and nonunion of fractures caused by trauma,infection,tumor or systemic diseases with limited osteogenesis and prolonged bone healing cycles are challenging issues in orthopedic clinical practice.Therefore,identifying regulatory factors for bone tissue regeneration and metabolism is crucial for accelerating bone repair and reconstructing defective areas.Silence information regulator 6(SIRT6),functioning as a deacetylase and nucleotide transferase,is extensively involved in the regulation of differentiation,apoptosis,metabolism,and inflammation in bone cells including osteoblasts and osteoclasts,and is considered to be an important factor in regulating bone metabolism.SIRT6 forms a complex with B lymphocyte-induced maturation protein 1(Blimp1),down-regulates the expression of the nuclear factor κB(NF-κB)pathway,and promotes the expression of the ERα-FasL axis signal to inhibit osteoclast formation and maturation differentiation,thereby hindering bone resorption and increasing bone mass.In addition,SIRT6 activates the Akt-mTOR pathway to regulate the autophagy level and osteogenesis of bone marrow mesenchymal stem cells,inhibits glycolysis and reactive oxygen production in osteoblasts,promotes osteoblast differentiation through the CREB/CCN1/COX2 pathway and the bone morphogenetic protein(BMP)signaling pathway,enhances bone formation,and accelerates bone regeneration and repair of skeletal tissue.This article provides an overview of the research progress on SIRT6 in the pathophysiology of bone regeneration,revealing its potential as a novel therapeutic target for bone tissue repair to alleviate the progression of skeletal pathological diseases.

To systematically construct a guideline to provide a methodological guide for researchers to develop patient decision aids.

Objective:To compare the changes of biliary microbiota after enteral extended biliary stents (EEBS) implantation with that of conventional plastic stents in animal experiment, and to preliminarily investigate its possible mechanism in preventing stents occlusion.Methods:A total of 12 healthy Bama minipigs were randomly assigned to the conventional plastic stent group ( n=6) and the EEBS group ( n=6) using simple random method. The bile samples of all pigs were collected before stents implantation and 4 weeks after stents placement. The biliary microbiota composition and diversity before and after different stents implantation were analyzed by 16S rRNA gene sequencing and compared. Results:No complications including acute cholangitis, perforation, bleeding, or death occurred in 12 pigs. Eight days after stents implantation, stents were out of bile duct in all pigs under endoscopy, while the bile samples were collected again for analysis. The main composition of biliary microbiota at the phylum level were Proteobacteria, Firmicutes and Bacteroidota. Alpha-diversities revealed the Shannon ( P=0.004) and Simpson index ( P=0.008) significantly decreased in the conventional stent group after stents placement, and Bata diversity analysis also showed a significant difference in microbial composition (Anosim: R=0.514 8, P=0.011). There was no significant difference in Observed species index ( P=0.095), Chao1 index ( P=0.136), Shannon index ( P=0.353), Simpson index ( P=0.227) or Bata diversity (Anosim: R=0.059 3, P=0.187) in the EEBS group before and after stents placement. LEfSe algorithm indicated Bacteroides_ fragilis and Proteobacteria- Gammaproteobacteria- Enterobacterales- Enterobacteriaceae- scherichia_ Shigella- Escherichia_ coli significantly increased in the conventional stent group, and Desulfobacterota- Desulfovibrionia- Desulfovibrionales- Desulfovibrionaceae- Bilophila significantly increased in the EEBS group after stents placement. Conclusion:The biliary microbiota change slightly after EEBS implantation in the short-term, and EEBS may prevent duodenobiliary reflux by prolonging the reflux path.

As a first-line classical drug, glucocorticoids are used in most combination treatment regimens of keloid. However, there are issues such as poor treatment efficacy and recurrence of keloid after keloid was treated with glucocorticoids, which seriously affect the therapeutic effect. In recent years, many studies have explored the factors influencing the efficacy of glucocorticoids in treating keloid and the action mechanism of glucocorticoids from different perspectives. Based on this, this paper reviews the mechanism and the factors influencing the efficacy of glucocorticoids in treating keloid, and explores ways to improve the treatment efficacy of glucocorticoids, aiming to provide thoughts for improving glucocorticoid-related diagnostic and therapeutic strategies.

Objective The purpose of this study is to investigate patients'willingness to pay for pharmacy services and its influencing factors by reviewing and analyzing the literature related to pharmacy services.Methods Relevant studies were identified by searching the CNKI database,Wanfang database,Sinomed,PubMed,and Web of Science from January 2010 to December 2023.Literature in both English and Chinese that elicited patient willingness to pay for pharmacy services was included.An analysis was carried out according to the year of publication,country,methodology,patient willingness to pay,and its influencing factors.Results 24 studies were retrieved,and the average willingness to pay ranged from ＄1 to ＄20.Patient willingness to pay for pharmacy services is influenced by various factors.Higher willingness to pay for pharmacy services is associated with higher income and education levels and lower out-of-pocket spending.Conclusions It is generally found that patients'willingness to pay is generally influenced by their income level,educational background,and medical insurance.We suggest that pharmacy services should be promoted and integrated into medical insurance coverage,and pharmacists'competency should be enhanced to accelerate the high-quality development of pharmacy services.

Objective To investigate the constitutive characteristics and the change trend of gynecologic malignant tumors in hospitalized patients in Guangxi Zhuang Autonomous Region over the recent 20 years.Methods Clinical data of 8009 in-patients who suffered from gynecologic malignant tumors in 23 hospitals from 1985 to 2004 in Guangxi Zhuang Autonomous Region were analyzed,with respect to the tumor types and change trend.Results(1)The leading 4 types of malignant tumors were cervical cancers, ovarian cancers,endometrial cancers,and malignant trophoblastic tumors according to the constitutive ratios of the tumors.The constitutive ratio of cervical cancer patients rose year by year,from 17.48% during the 1985-1989 period to 49.25% during the 2000-2004 period(P0.05).(2)The occurring age of cervical cancers became younger obviously,from≥60 years old dropped to