AIM: To analyze the effects of atorvastatin and folic acid tablets on homocysteine and carotid atherosclerosis in patients with type H hypertension. METHODS: A total of 140 patients with H-type hypertension admitted to our hospital from January 2016 to October 2018 were enrolled in the study. Random number table method was divided into observation group (70 cases) and control group (70 cases). The control group was treated with folic acid tablets on the basis of routine blood pressure reduction. The observation group was given atorvastatin calcium tablets on the basis of the control group, and the treatment was 10 weeks. Comparing the two groups of homocysteine, low-density lipoprotein, brachial-ankle pulse wave velocity, carotid intima-media thicknessbefore and after treatment, blood pressure and heart rate levels, and observed the occurrence of adverse reactions. During a follow-up of one year, the incidence of cardiovascular and cerebrovascular events was compared between the two groups. RESULTS:The plasma Hcy level and LDL level in the observation group was significantly lower than that in the control group (P<0.05). There was significant difference in BaPWV and IMT between the two groups (P<0.05). After treatment, the systolic and diastolic blood pressures of the two groups were treated. The systolic blood pressure and diastolic blood pressure were significantly lower than those in the control group (P<0.05), but there was no significant difference in heart rate between the two groups after treatment (P>0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). CONCLUSION:Atorvastatin combined with folic acid tablets can effectively reduce carotid atherosclerosis in patients with type H hypertension, and it can reduce the levels of Hcy and LDL, and it is clinically safe.

Objective To evaluate the clinical value of detecting serum underglycosylated IgA1 in diagnosis and differentiation of lgA nephropathy (IgAN). Methods Serum underglycosylated IgA1 was isolated by microspincolumn coupled with vicia villosa lectin (VVL) from 48 cases with IgAN and 43 cases with other primary glomemlonephritis. All the patients were diagnosed by renal biopsy. Sera from 20 healthy persons were used as control group. After isolation, the eluant with rich underglycosylated lgAl was detected by incubation with biotin- labeled horseradish peroxidase (HRP) and Helix aspersa (HAA, recognizing N-acetylgalactosamine specifically)in enzyme-linked immunosorbent assay (ELISA). The sensitivity and specificity of diagnosis and differentiation of IgAN with elevated serum underglycosylated IgA1 were analyzed. Results The level of serum underglycosylated IgA1 in IgAN patients [(83.7±41.0) U] was significantly higher than that in healthy control group [(52.6±22.9) U] and the patients with other primary glomerular diseases[(49.2±27.3) U] (all P<0.01). Twenty-two cases of non-IgA mesangial proliferative glomerulonephritis accounted for 51% of other primary glomerular disease, whose underglycosylated IgA1 level [(47.6±21.5 ) U] (all P<0.01 ) was significantly lower as compared to IgAN patients. Taking the renal biopsy diagnosis as golden diagnostic criteria, the ROC curve was performed. The area under the curve was 0.797 with a standard error 0.047 (P<0.01). The sensitivity as a diagnostic test was 72.9%, with specificity 72.1% and accuracy 72.5%. Conclusion Detection of serum underglycosylated lgAl level by mierospineolumn method and ELISA assay has certain clinical value in diagnosis and differentiation of IgAN.

Objective To investigate the effect of different concentrations of rapamycin on the proliferation and apoptosis of glomerular mesangial cells(GMCs)and to investigate the mechanism. Methods GMCs were treated with different concentrations of rapamycin(1 μg/L,2 μg/L,4 μg/L,8 μg/L,16 μg/L).After treatment for 24 h,48 h and 72 h,cell proliferation was assessed bv MTT colorimetric assay and the growth curve was traced.After treatment for 72 h,the cell cycle distribution and the apoptotic rate of GMCs in different concentrations of rapamycin were analyzed bv flow cytometry.The effects of different concentrations of rapamycin on the mRNA and protein expression of p27 and p53 were detected by RT-PCR and Western blot respectivelyResult The low dose of rapamycin(1 μ/L)could signiticanfly inhibit the proliferation of GMCs and showed no effect on apoptosis.The high dose of rapamycin (8-16 μg/L)could significantly increase the apoptotic rate of GMCs.Rapamycin could increase the mRNA and protein expression of p27 and p53. Conclusion Rapamycin can inhibit GMCs proliferation and promote GMCs apoptosis by increasing the expression of p27 and p53.

Objective To explore the clinicopathological features of IgA nephrolpathy associated with malignant hypertension (IgAN-MHT) and to analyze their correlation with renal vascular lesions. Methods Twenty-nine patients of IgAN-MHT were screened from 2000 biopsy-proven eases with primary IgA nephropathy (IgAN) in our department from April 1997 to May 2007. Data of clinicopathology and follow-up of these 29 patients were collected. Semi- quantitative analysis was performed to evaluate the pathological changes. Inner lumen, outer lumen, intimal thickness, tunica media-to-internal lumen ratio of 436 arterioles, 124 interlobular arteries and 5 arcuate arteries were measured. The primary endpeint was the composite of a doubling of serum creatinine level and ESRD. Correlations of renal vascular lesions with clinical manifestation, pathological change and prognosis were examined by Spearman and Cox methods. Results 1.5% of all the IgAN patients presented malignant hypertension. The common clinical features were renal failure (100%), hyperurieacidemia (62.7%) and hypertriglyceridemia (51.7%). The average amount of urine protein excretion was 2.8 g/d. The common pathological changes were moderate mesangial proliferation, severe global sclerosis, severe interstitial inflammation and severe interstitial- tubular fibrosis. The small arteries (arcuate arteries and interlobular arteries) and arterioles (afferent arterioles) were both involved in IgAN-MHT. The characteristic lesions of intrarenal arteries included vascular occlusion, media thickening, proliferative endarteritis (onionskin lesion, musculomucoid intimal hyperplasia), hyaline arteriosclerosis, but mainly vascular occlusion (86.2%). The arteriole lesion was negatively correlated with age and total protein level; vascular occlusion was positively correlated with uric acid level. The average foUow-up period was 21.1 months. Forteen patients reached the endpoint. The arteriole lesion was the main independent risk factor for the progression of IgAN-MHT (RR=10.21, 95%CI=1.16～89.67). Conclusions The main clinical feature of IgAN-MHT is renal failure. The main histological feature of intrarenal vascular lesions is occludes arterioles. Arteriole lesion is the main independent risk factor for the progression of IgAN-MHT.

Objective To determine the urinary polypeptide patterns of glomerulonephritis by magnetic bead separation and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) technology. Methods Urinary samples of 29 healthy volunteers and 34 patients with glomerulonephritis, including 10 cases of IgA nephropathy (IgAN), 10 cases of membranous nephropathy (MN), 9 cases of minimal change disease (MCD) and 5 cases of lupus nephritis (LN), were collected and separated by magnetic bead,and were screened for polypeptide patterns with a novel high throughput method, MALDI-TOF MS. Results Under the relative molecular weights 10 000 Da, 85 protein peaks were detected in healthy controls group and 109 protein peaks were detected in glomerulonephritis group. Six peaks of 3371.5 Da, 4026.35 Da, 4085.32 Da, 4116.96 Da, 4126.32 Da and 9527.31 Da were up-regulated,while 8 peaks of 861.28 Da, 1205.41 Da, 1642.52 Da, 1913.15 Da, 1976.52 Da, 2087.74 Da, 2193.47 Da and 3015.57 Da were down-regulated by more than 2 folds (P<0.01) in glomerulonephritis group as compared to healthy controls. Urinary polypeptide patterns in different diseases differed significantly from each other, indicating specific disease pattern of polypeptide excretion. Conclusions MALDI-TOF MS is a fast, convenient and high throughput analyzing method capable of screening some relative specific, potential biomarkers from the urine of glomerulonephritis patients thus it possesses better clinical value.

Objective To investigate the relations between adiponectin(APN) and lipoprotein associated phospholipase A2 (LP‐PLA2) with the development and progress of essential hypertension .Methods 60 patients with essential hypertension were collect‐ed and divided into 3 groups of the hypertension grade 1 ,2 ,3 groups according to the levels of blood pressure ,20 cases in each group .Contemporaneous 20 healthy controls were selected .The peripheral venous blood samples were collected from the cubital vein and the serum levels of APN and LP‐PLA2 were measured by ELISE .The related biochemical indicators were simultaneously detected .Results The serum APN levels in the hypertension grade 1 ,2 ,3 groups were significantly lower than that in the control group ,moreover which in the hypertension grade 3 group was significantly lower than that in the hypertension grade 1 group(P<0 .05);on the contrary ,serum levels of LP‐PLA2 in the hypertension grade 1 ,2 ,3 groups were significantly higher than that in the healthy control group ,moreover which in the hypertension grade 3 group was obviously higher than that in the hypertension grade 1 group(P<0 .05);serum APN was significantly negatively correlated with LP‐PLA2(r= -0 .772 ,P<0 .05) .Conclusion Serum levels of APN and LP‐PLA2 are closely related with the development and progress of essential hypertension .

Objective:To conduct a scoping review of the current research status, influencing factors, and assessment tools regarding social isolation in lung cancer survivors and provide research ideas for clinical medical and nursing staff to develop interventional measures.Methods:Based on the framework of a scoping review, systematic searches were conducted in databases including CNKI, Wanfang, VIP, CBM, Embase, PubMed, Web of Science, CINAHL, and Cochrane Library for studies on social isolation in lung cancer survivors, up to March 18, 2023.Results:Eighteen articles were included, with research distributed across three continents (Asia, North America, Europe) and in seven countries, including China, the USA, and Spain. Frequently used research tools included the University of California Los Angeles Loneliness Scale and the Cancer Loneliness Scale. Rates and severity of social isolation varied across different studies. Factors influencing social isolation in lung cancer survivors included demographic factors, disease-related factors, symptom factors, and psychosocial factors.Conclusions:Social isolation in lung cancer survivors can affect their quality of life to a certain extent. Although there are various tools for assessing social isolation in lung cancer survivors, there is a general lack of specific assessment tools. This suggests that medical and nursing personnel should consider developing and applying more specific research tools when developing related assessment tools in the future and develop personalized intervention measures based on influencing factors to help patients alleviate social isolation.

To explore how to create and optimize a promotion index system of medical quality evaluation, this article focuses on the hospital visiting process from patients, using analyzing collected those index system from couples of Grade Ⅲ hospitals in Beijing, and combining the results of literal study, field study and specialist consult, according to the different situation of general hospitals and specially hospitals, with the spirit of "maintaining the patients benefits, safeguarding the patients safety,and enhancing the medical quality", introduces the framework of the promotion index system, the rules to select the indicator, and so on, and discusses several problerns related to creating the index system.

Objective:To review the scope of research on the application of blood flow restriction training in the rehabilitation of patients undergoing anterior cruciate ligament (ACL) reconstruction.Methods:According to the research method of scoping review, computer searches were conducted on China National Knowledge Infrastructure, Wanfang Database, China Biology Medicine disc, VIP, Cochrane Library, PubMed, Embase, with the search period was from eatablishment of databases to December 31, 2022. The included literatures were screened, summarized and analyzed.Results:A total of 16 literatures were included, all of which were randomized controlled trials. The basic content of blood flow restriction training intervention included 8 aspects, such as intervention time, training intensity, training amount, training mode, frequency, interval time, training cycle and blood flow restriction pressure. The effect evaluation mainly involved two kinds of indexes, namely safety indicators and efficacy indicators.Conclusions:Blood flow restriction training can effectively enhance muscle strength and improve knee joint function in patients undergoing ACL reconstruction. Future studies should focus on exploring the best intervention strategy, formulating standardized and unified evaluation criteria and providing the best blood flow restriction training program for patients undergoing ACL reconstruction.

OBJECTIVETo investigate the changes in red blood cell count in patients with different liver diseases and the correlation between red blood cell count and degree of liver damage.

METHODSThe clinical data of 1427 patients with primary liver cancer, 172 patients with liver cirrhosis, and 185 patients with hepatitis were collected, and the Child-Pugh class was determined for all patients. The differences in red blood cell count between patients with different liver diseases were retrospectively analyzed, and the correlation between red blood cell count and liver function status was investigated. The Mann-Whitney U test, Kruskal-Wallis H test, rank sum test, Spearman rank sum correlation test, and chi-square test were performed for different types of data.

RESULTSRed blood cell count showed significant differences between patients with chronic hepatitis, liver cancer, and liver cirrhosis and was highest in patients with chronic hepatitis and lowest in patients with liver cirrhosis (P < 0.05). In the patients with liver cirrhosis, red blood cell count tended to decrease in patients with a higher Child-Pugh class (P < 0.05).

CONCLUSIONFor patients with liver cirrhosis, red blood cell count can reflect the degree of liver damage, which may contribute to an improved liver function prediction model for these patients.

Erythrocyte Count ; Hepatitis ; blood ; Humans ; Liver ; physiopathology ; Liver Cirrhosis ; blood ; Liver Neoplasms ; blood ; Retrospective Studies