Objective To explore the relationship between TCF7L2 genetic polymorphisms with intimal -medial thickness (IMT),carotid arterial stiffness in patients of type 2 diabetes mellitus(T2DM)with hypertension. Methods 872 patients of hypertension and T2DM were enrolled into this study,and they were divided into two groups according to IMT,carotid arterial stiffness and cPWV:the observation group(n =432,IMT >1.0mm,cPWV >12m/s),the control group(n =440,IMT≤1.0mm,cPWV≤12m/s).Meanwhile,400 healthy subjects(normal fasting gluose,blood pressure,without diabetes and hypertension family history)were selected as the healthy group.Typed gene polymorphisms of TCF7L2 by RT -PCR,the body mass index(BMI),waist -hip ratio,systolic blood pressure, diastolic blood pressure,total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL -Ch), low -density lipoprotein cholesterol(LDL -Ch),insulin sensitivity index(ISI),glycated hemoglobin A1C(HbA1c) between groups were compared.Calculated each allele and genotype frequencies and implemented Hardy -Weinberg equivalent test.The distributional differences of alleles frequencies between groups were analyzed by χ2 test and geno-type frequencies through dominant model.Results Distributional differences of rs290487 genotype frequencies had statistically significant differences in the observation group vs the control group(χ2 =33.296,P <0.05 )and the T2DMgroup vs the normal group(χ2 =100.801,P <0.05).Statistically significant differences existed in C and T alleles frequencies as well:the observation group vs the control group(χ2 =16.280,P <0.05),the T2DM group vs normal group(χ2 =27.190,P <0.05).However,the gene polymorphisms of rs11196205 and rs11196218 showed no statistically significant difference (P >0.05 ).Conclusion rs290487 involved in the development of T2DM with hypertension,C and T alleles might be the risk factors of increasing the IMT and carotid arterial stiffness levels in patients of T2DMwith hypertension.Logistic regression analysis revealed that the increase of SBP,DBP,TC,TG,LDL-Ch and decrease of HDL -Ch may be the risk factors of hypertension and diabetic patients.Meanwhile,it dedicated that the increase of those biochemical indexes might be the important elements which would lead to the gene variations of C and T alleles.

The hospital is a dynamic, discrete, flexible, open and complicated system. The paper offered an analysis of the hospital system from the Wuli-Shili-Renli perspective, simplifying the complex process of medical activities into a clear-cut diagram of the system architecture. It also gave an account of the construction of a simulation model of specialized knowledge in hospital management by means of KBS, with the integration of the Wuli-Shili-Renli ideology into the KBS, and expounded the significance of Renli in the model of hospital management.

Objective To explore expression of nuclear factor kappa B (NF-κB) and change of peripheral blood dendritic cells(DCs) surface. Methods The expression of NF-κB and DCs in kidney of 40 LN cases were measured,by ALP-anti-ALP mice immune complex law(APAAP) and density gradient separation centrifugal meth-ods. Results kidney tissue of LN patients, NF-κB in the glomeruli and tubules showed a high level of expression ; CD80+ ,CD86+, HLA-DR+ expression decreasedtacrolimus group than the control group Division before and after the shape of the DCs had no effect on tacrolimus after the DCs could inhibit the proliferation of T cells and T cells to Th2 cell transformation. Conclusinn In vitro Tacrolimus inhibits the DCs mature in LN patients, NF-κB in LN kidney LN local expression and the occurrence and development of related.

[ ABSTRACT] AIM: To explore whether autophagy is involved in the excessive death of renal tubular epithelial cells in subtotal nephrectomy ( SNx) rats and the relationship between autophagy and necroptosis in the kidney of SNx rats. METHODS:Male Sprague-Dawley rats were randomly assigned to control group ( n=6 ) and SNx group ( n=42 ) .The rats in SNx group were subjected to SNx.Sham surgery was performed in the rats in control group.The rats in SNx group were divided into subgroups at 0, 4, 8 and 12 weeks ( n=6) and the other rats in SNx group were divided into SNx+vehi-cle group, SNx+necrostatin-1 (Nec-1) group and SNx+3-methyladenine (3-MA) group.The expression of RIP1, RIP3, LC3 and beclin-1 at mRNA and protein levels was measured at 0, 4, 8 and 12 weeks by qPCR and immunohistochemistry. The effects of Nec-1 or 3-MA on the protein expression of LC3-I, LC3-II and beclin-1, and production of reactive oxygen species ( ROS) in the rat kidney were determined by Western blot and DCFH-DA staining.The death of renal tubular epi-thelial cells in the SNx rats was observed by TUNEL staining and electron microscopy.Finally, the effects of Nec-1 and 3-MA on blood urea nitrogen ( BUN) , serum creatinine ( SCr) and the pathological changes of the renal tissues were ana-lyzed.RESULTS:The highest mRNA and protein levels of RIP1, RIP3, LC3 and beclin-1 appeared at the 8th week after SNx (P<0.01).Compared with the rats in SNx+vehicle group, the protein over-expression of LC3-II/I and beclin-1, re-nal tubular epithelial cells with typical morphological features of necroptotic cell death and TUNEL-positive renal tubular
cells were decreased in the SNx rats treated with Nec-1 and 3-MA (P<0.01), but 3-MA did not reduce the increased con-centration of ROS.In addition, treatment with Nec-1 and 3-MA obviously reduced BUN, SCr (P<0.05), glomeruloscle-rosis index and tubulointerstitial injury score (P<0.01).CONCLUSION:Autophagy participates in the excessive death of renal tubular epithelial cells in SNx rats.Inhibition of autograph prevents necroptotic cell death of renal tubular cells, and alleviates chronic renal injury in SNx rats.

Objective To observe the therapeutic effect of Guizhi Decoction plus Yupingfeng Powder for chronic urticaria and its effect on serum total IgE level.Methods One hundred and twenty patients were randomly divided into treatment group,control group 1 and control group 2,40 cases in each group.The treatment group was treated with Guizhi Decoction,Yupingfeng Powder and Loratadine Tablets orally,the control group 1 was given intramuscular injection of Bacillus Calmette-Guerin polysaccharide nucleic acid and oral use of Loratadine Tablets,and the control group 2 was only given oral use of Loratadine Tablets.The course of treatment covered 5 weeks.The levels of serum total IgE in the three groups were determined before and after treatment,and the therapeutic effect was evaluated after treatment.Results (1) The total effective rate was 85.0％ in the treatment group,80.0％ in the control group 1,and 55.0％ in the control group 2.The effect of control group 1 and the treatment group was superior to that of the control group 2 (P＜ 0.05),but the difference was insignificant between the treatment group and control group 1 (P＞ 0.05).(2)Before treatment,the serum total IgE level of the three groups was higher than that of the normal control group (P ＜ 0.05).After treatment,the serum total IgE level of the three groups was obviously decreased (P ＜ 0.05 compared with that before treatment);the inter-group comparison results showed that the effect of the treatment group and control group 1 on decreasing the serum total IgE level was superior to that of the control group 2(P ＜ 0.05),while the effect of the treatment group was similar to that of the control group 1 (P ＞0.05).(3) During the treatment,blood routine examination indexes and hepato-renal function of the three groups showed no abnormal changes,neither adverse reaction was shown.Conclusion Guizhi Decoction plus Yupingfeng Powder exerts certain therapeutic effect for the treatment of chronic urticaria,and can decrease the serum total IgE level,thus to stabilize the curative effect and reduce the recurrence.

Objective:To investigate the number of necroptotic renal tubular epithelial cells in renal tissues of patients with chronic kidney disease (CKD) and the correlation with clinicopathologic parameters, and explore its role in the progression of the excessive loss of renal tubular cells and chronic kidney injury.Methods:Renal tissue samples from 60 patients (18-65 years old) with CKD proven by kidney biopsy in the First Affiliated Hospital of Hainan Medical University from June 2017 to June 2019 were collected. According to internationally accepted K/DOQI guidelines, the patients were divided into 1-4 stages of CKD, with 15 cases in each stage. The number of necroptotic renal tubular epithelial cells in patients with different stages of CKD was detected using receptor-interacting protein 3 (RIP3) and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) fluorescent staining, and the expression of RIP3 and MLKL, marker protein of necroptosis, was detected by immunohistochemistry. Pearson correlation analysis was used to analyze the correlation between the percentage of necroptotic renal tubular epithelial cells and clinicopathologic parameters. In addition, the expression of angiotensinogen Ⅱ receptor (AT2R) in renal tissue and its correlation with the percentage of necroptotic renal tubular epithelial cells were analyzed.Results:With the development of CKD, the structural destruction of renal tubules in patients with CKD was gradually aggravated, and the renal tubules in the corresponding areas were atrophied, accompanied by worsening interstitial fibrosis. The adjacent renal tubules were focally dilated and numerous protein tubules were seen in the tubules. Importantly, renal tubular injury score in second and third stage of CKD was significantly higher than that in control group (both P<0.01). TUNEL+RIP3 immunofluorescence staining results showed that the percentage of TUNEL/RIP3 double positive renal tubular epithelial cells (necroptotic renal tubular epithelial cells) in renal tubules of the second and third stage of CKD was higher (all P<0.01). Immunohistochemical results showed that RIP3, MLKL and AT2R proteins were mainly expressed in cytoplasm of renal tubular epithelial cells, and the expression of RIP3, MLKL and AT2R in renal tubular epithelial cells was higher in the second and third stage of CKD patients (all P<0.05). Pearson correlation analysis showed that the percentage of necroptotic renal tubular epithelial cells was positively correlated with blood urea nitrogen ( r=0.514, P=0.003), serum creatinine ( r=0.507, P=0.019), serum cystatin C ( r=0.571, P=0.026), serum uric acid ( r=0.592, P=0.008), renal tubules injury score ( r=0.901, P<0.001), renal interstitial fibrosis index ( r=0.700, P=0.001) and the expression of AT2R protein in renal tissue ( r=0.715, P=0.001). Conclusions:As CKD progresses, necroptosis of renal tubular epithelial cells in CKD patients occurs. The necroptotic cell death may be an important factor leading to renal tubular epithelial cell excessive death and the progression of chronic kidney injury. Furthermore, necroptosis of renal tubular epithelial cells may be related to the high expression of AT2R in kidney tissue.

A novel Cu-IUDs material, PU/PEG/Cu nanocomposite, was prepared by melt blending method with thermoplastic polyurethane (PU) as the matrix, with polyethylene glycol (PEG) as a hydrophilic modifier, and with nanometer particles of copper as active matter instead of copper wire or copper tube. The structure, morphology, mechanical properties, thermal stability and water absorption were investigated by using FT-IR, XRD, SEM and so on. The results indicated that the nanometer particles of copper were uniformly dispersed in the matrix in PU/PEG/ Cu nanocomposites. It can be seen that the water absorption ability of this nanocomposite was obviously improved while mechanical properties and thermal stability were at high levels. These results provided a good basis for the studies on the cupric ions release of the nanocomposites in future.
Biocompatible Materials ; chemistry ; Intrauterine Devices, Copper ; Nanocomposites ; chemistry ; Polyethylene Glycols ; chemistry ; Polyurethanes ; chemistry

Objective To evaluate the prevalence of chronic kidney disease (CKD) in Chinese adult health check-up population,and to compare with the prevalence of CKD in the study of the general population as well as the large CKD cross-sectional study in China.Methods Epidemiological studies about CKD in Chinese adults health check-up population from January 2007 to December 2017 were searched in PubMed,SinoMed,CNKI,VIP and Wanfang Data.Meta-analysis of the prevalence of CKD was performed with software of Stata 12.0.Subgroup analyses of CKD staging,urban and rural,as well as geographical areas of the general population were executed.Results Twenty-two studies from adult health check-up population were included (238 349 persons).Egger's regression showed no publication bias (P ＞ 0.05).The unstandardized prevalence rate of CKD was 12.49％ (male 12.8％,female 12.5％).The respective unstandardized prevalences of proteinuria,hematuria and eGFR decline were 5.90％,5.83％ and 2.75％.The unstandardized prevalences of CKD in urban and rural population were 13.21％ and 11.90％.The stages of CKD were mainly concentrated in the early stages.There was no significant difference in the non-standard detection rate of total eGFR decline among the adult medical examination population,the general population and the population studied cross-sectionally (P ＞ 0.05).Furthermore,no significant difference in the non-standard detection rate of total hematuria and male hematuria was found between the adult health check-up population and the general population.In addition,the total proteinuric non-standard detection rate of the adult general population was similar with that of population studied cross-sectionally (P ＞ 0.05).Conclusions The prevalence of CKD in Chinese adults is higher,the overall prevalence is however underestimated.The results of epidemiological investigation in adult health check-up population are similar to those of the general population,especially in men.

Objective To compare the effectiveness of controlling blood loss in the treatment of complex acetabular fracture between temporary occlusion of abdominal aorta by interventional balloon (TOAAIB),temporary occlusion of common iliac artery by interventional balloon (TOCAIIB) and internal iliac artery ligation (IIAL).Methods Included for this study were 113 complex acetabular fractures which had been treated at Department of Orthopaedic Trauma,Shaoguang Hospital Affiliated to Southern Medical University from January 2000 through January 2017.There were 68 males and 45 females,aged from 23 to 61 years (average,42.3 years).According to the Letournel classification,all of them belonged to complex fractures,including 10 T-type,24 double-column,16 posterior column & posterior wall,46 transverse & posterior wall and 15 anterior & posterior half-transverse ones.They were all treated by open reduction and internal fixation but differed in surgical hemostasis techniques:TOAAIB was used in 37cases,TOCAIIB in 31 and IIAL in 45.Fracture reduction was evaluated by Matta criteria.Intraoperative bleeding and postoperative wound drainage,fracture union and complications related to interventions were recorded.Hip function was evaluated by Modified d'Aubigne & Postal clinical grading system after fracture healing.Results The 3 groups (TOAAIB,TOCAIIB and IIAL) were comparable because there were no significant differences in gender,age,time from injury to surgery,Letournel classification or surgical approaches between the patients in the 3 groups (P ＞ 0.05).Anatomical reduction was achieved in 91.15％ of the patients (103/113) and satisfactory reduction in 8.85％ (10/113).Intraoperative hemorrhage was 1,631.5 ±675.5 mL in the HAL group,892.6 ±217.7 mL in the TOCAIIB group and 648.0 ± 170.2 mL in the TOAAIB group,showing significant differences between the 3 groups (P ＜ 0.05).One case of femoral artery thrombosis occurred in the TOAAIB group at the end of operation but was cured by symptomatic treatment of anticoagulation.There were no interventional complications in the other 2 groups.There were no significant differences between the 3 groups in postoperative wound drainage,fracture union time,hip function score or complications (P ＞ 0.05).Conclusions In controlling intraoperative bleeding in the surgery for complex acetabular fracture,TOAAIB may be the best,followed by TOCAIIB,and IIAL may be the worst.However,choice of a proper surgical hemostasis technique should also depend on the specific intraoperative condition of a specific patient.

Objective To observe the effect of mature rehmannia extract on platelet derived growth factor (PDGF) and b-cell lymphoma-2 (bcl-2) 2 in myocardial tissue of rats with myocardial infarction.Methods A total of 30 healthy SD rats were randomly divided into blank group,model group and rehmannia glutinosa group with 10 rats in each group.Myocardial infarction models were established in rats of model group and prepared Rehmannia glutinosa group.The rats in the prepared rehmannia glutinosa group were subcutaneously injected with the extract of the prepared Rehmannia glutinosa 4 g/kg.The rats in the blank group and the model group were subcutaneously injected with the same volume of saline.Once a day for 15 days.The cardiac function was measured by echocardiography in rats.The HE staining was used to observe the histopathological changes of myocardium.The levels of PDGF and Bcl-2 in myocardium were detected by ELISA.The levels of vascular endothelial growth factor (VEGF),basic fibroblast growth factor (BFGF) and CD34 protein were detected by immunoturbidimetry.Results Compared with the model group,the levels of LVDd,LVDs,LVEDs and LVESV in the Rehmannia glutinosa group were significantly decreased (P＜0.05) and LVEF was significantly increased (P＜0.05),while the levels of PDGF (0.53 ± 0.02 g/ml vs.0.35 ± 0.01 g/ml),Bcl-2 (1.04 ± 0.20 g/ml vs.0.84 ± 0.12 g/ml),VEGF (85.24 ± 12.45 pg/ml vs.65.26 ± 10.06 pg/ml),BFGF (86.27 ± 6.56 pg/ml vs.62.26 ± 4.37 pg/ml) and CD34 (102.36 ± 10.52 pg/ml vs.26.37 ± 3.94 pg/ml) in in the Rehmannia glutinosa group were significantly increased (P＜0.05).Conclusions The Rehmannia glutinosa extract can improve the cardiac function of rats with myocardial infarction,Promote the formation of new blood vessels and improve myocardial damage.