Objective To investigate the role of sLOX?1 and leptin in metabolic syndrome ,glucose and lipid metabolism. Methods 58 patients with metabolic syndrome were included in the study ,with other 35 normal controls as control group. Fasting venous blood samples were collected. ELISA method was used to detect serum sLOX?1 and leptin levels. The related biochemical indicators were tested. Results The sLOX?1 and leptin levels in the metabolic syndrome group were significantly higher than those in the control group(P < 0.01). The levels of sLOX?1 and leptin were further compared between different genders. The differences were not statistically significant (P > 0.05). sLOX?1 and leptin levels were positively correlated. They were positively correlated with WAIST,TG,SBP,DBP,and negatively correlated with HDL?C. Leptin and age,FPG also had positive correlation,but sLOX?1 was not correlated with age and FPG. Conclusion sLOX?1 may be able to predict endothelial damage in patients with metabolic syndrome in an early stage. Combined with leptin ,the endothelial dysfunction could be reflected more accurately. They may be the important factors for early diagnosis and risk assessment of metabolic syndrome.

Objective To investigate the expression of recombinant human adiponectin(ADPN) using baculovirus expression system in Sf 9 insect cell line.Methods PCR method was used to amplify human ADPN gene,and then the gene was inserted into plasmid pFastBacl.Recombinant plasmid was transformed into E.coli DH10Bac containing a shuttle vector,Bacmid.Recombinant shuttle vector Bacmid-ADPN was obtained by site-specific transposition and transfect Sf 9 cells.To identify the expressed product by SDS-PAGE、Western blot.Results Sf 9 cells infected by the recombinant baculovirus was observed for morphological changes.The Mw of recombinant protein was about 30 ku and Western blot proved that expressed protein could combine with ADPN polyclonal antibody.ConclusionHuman ADPN gene was successfully expressed in Sf 9 cells,and thus provided the material for studying its bioactivity and mechanism of action.

Objective To find out the health status and community health care requirement of the elderly in urban Fuzhou and to provide suggestions on how to develop and consummate the community health care for elderly. Methods With the method of stratified random sampling, 3285 elderly people aged 60 years and over were surveyed by a questionnaire. Results The average quality of life of elderly people in urban Fuzhou was above the moderate level. But education level of the elderly was low. And the prevalence rate of chronic diseases was high. There were 2134 elderly people (65.0%) who had more than one chronic disease. The older the people, the higher proportion the coincidence of multiple diseases (P＜0.01). The first five chronic diseases in the elderly were hypertension, diabetes, coronary heart disease, arthropathy and stroke. The incidence rate of depression was high up to 60%. The requirement rate of community health care was 75.2%, and the older the people, the more items they needed(P＜0.05). The requirement of community health care at the first 5 rank position were regular physical examination, health education, regular home visiting, health direction and diet direction. Conclusions Elderly people have many health problems and requirements of community health care.We should provide more and more community health care, in order to improve the quality of life of elderly people.

This paper aims to define the concept of autonomous learning and explore the purpose and significance of medical students' autonomous learning by combing the literature review at home and abroad in this field.Through analyzing the research progress and research methods of autonomous learning,this paper attempts to raise problems and provide countermeasures accordingly.In the current research of autonomous learning,researchers' perception of this study is insufficient.The scope of the current research is too limited and the research fields need to be further widened.In addition,the classification of disciplines in this subject is unbalanced and the coverage also needs to be further expanded.There are many theoretical studies but few empirical studies so far,and thus empirical research should be strengthened.

30%) might be a risk factor in HAPE susceptibility.

Objective To learn the current status of family doctor service at pilot communities in Guangzhou, and discover existing problems and influencing factors by investigating the residents who have contracted such service , those have not and the family doctors . Methods This study chose typical community health centers of six communities in Guangzhou in January 2016 .In random sampling , residents who visited doctors during the survey and all the family doctors were surveyed .EpiData was used to doubly inputdata,withSPSS20.0forstatisticalanalysis.Results 66.0％ofthoseresidentswhohavenot contracted the service are willing to contract a family doctor .According to the binary logistic regression analysis after eliminating the interference factors , there are two factors affecting their willingness:gender and whether needing a family doctor for themselves and their family for health management .According to the binary logistic regression analysis after eliminating the interference factors , the influencing factors of renewing contract are overall satisfaction and necessity for signing family doctors .Conclusions The smooth development of the family doctor service is faced with many bottlenecks , while improving willingness to contract and renew contract to family doctors are the cornerstone for sustainability of the family doctor system.

Objective: To observe the effects of electroacupuncture (EA) at Neiguan (PC6) on arrhythmia during acute myocardial ischemia-reperfusion and the expression of connexin 43 (Cx43) in rats. Methods: A total of 40 Sprague-Dawley male rats were used. Ten rats were randomly selected as the blank group, and the remaining 30 rats were randomly divided into a model group and an EA group, with 15 rats in each group. Before modeling, rats in the EA group received one session of EA intervention at bilateral Neiguan (PC6) for 30 min; the other groups were treated with the same grasping and anesthesia for 30 min without intervention. PowerLab physiological recorder was used to record electrocardiograph within 30 min of infarction. After the experiment, cardiac tissue and serum were collected from rats. Hematoxylin-eosin (HE) staining was used to observe the morphological changes of myocardial tissue in the ventricular infarction area of rats in each group. The expression of Cx43 protein in the myocardium of each group was detected by Western blotting (WB). Enzyme-linked immunosorbent assay (ELISA) was used to determine the activity of Na+-K+-ATPase in myocardial tissue and the serum content of endogenous digitalis-like factor (EDLF) in rats. Results: There was no statistical difference in arrhythmia score between the EA group and the model group, but the total duration and average duration of arrhythmia in the EA group were decreased (P<0.01). HE staining showed that compared with the blank group, myocardial cells in the model group were disorganized and seriously damaged. The pathological changes in the EA group were similar to those in the model group, but the damage was relatively minor. The results of WB showed that compared with the blank group, the Cx43 expression in myocardial tissue of the model group was decreased (P<0.01); compared with the model group, the Cx43 expression in the EA group was increased (P<0.01); compared with the blank group, the Na+-K+-ATPase activity in myocardial tissue of the model group was significantly decreased (P<0.01); compared with the model group, the Na+-K+-ATPase activity in the EA group was increased (P<0.01). ELISA results showed that compared with the blank group, the serum EDLF content in the model group was significantly increased (P<0.01); compared with the model group, the EDLF content in the EA group was decreased (P<0.01). Conclusion: EA at Neiguan (PC6) can delay and reduce the onset of arrhythmia during myocardial infarction in the rat model of myocardial ischemia-reperfusion. Its mechanism of action may be related to the regulation of the Cx43 expression in myocardial tissue, improvement of the activity of Na+-K+-ATPase in myocardial tissue, and increase in the content of serum EDLF.

Objective To systematically evaluate the adult intraoperatively acquired pressure injury risk prediction model.Methods Related study on IAPI risk prediction model in Chinese and English databases such as CBM,CNKI,PubMed and Web of Science were searched.The language is limited to Chinese and English,and the search time is until November 4,2022.Two researchers independently screened the literature and extracted the data,and applied the bias risk assessment tool of prediction model research to analyze the bias risk and applicability of the included literature.Results 13 articles were included,including 17 models(operation time,age,diabetes,BMI and serum albumin are the most commonly used predictors).Among the 17 models,the area under the curve of 14 models was 0.616 to 0.984,and the other study did not report the AUC results.Among the 13 studies,10 had good applicability,while the remaining 3 had unclear applicability.13 studies have a high risk of bias,mainly because the included studies are retrospective studies,the predictive factors are screened based on univariate analysis,and the predictive outcomes are not defined by guidelines or standardization.Conclusions The existing IAPI risk prediction model for adults has good applicability,but the risk of bias is high,and the construction is not perfect.It is necessary to pay attention to the effectiveness of different risk assessment methods in the later construction,so as to get a better and more accurate risk prediction model and provide some reference and basis for formulating relevant prevention strategies.

This article collects related literatures which is about the Chinese medicine adjuvant treatment of bladder urothelial carcinoma, and sums up the etiology, pathogenesis and TCM auxiliary treatment methods of this disease. Through the analysis, it is believed that the pathogeny of the disease is mainly concentrated in the aspects of damp, heat, blood stasis and poison. The literature on the adjuvant treatment of bladder urothelial carcinoma mainly focuses on the treatment of syndrome differentiation, postoperative recovery, postoperative perfusion, adjuvant chemotherapy and palliative therapy. The progress of its research is summarized as follows.

Objective:To investigate the risk factors and their warning effectiveness for meniscus tear secondary to delayed anterior cruciate ligament (ACL) reconstruction.Methods:A retrospective cohort study was conducted to analyze the clinical data of 114 patients (114 knees) with ACL injury, who were admitted to Affiliated Hospital of Nanjing University of Chinese Medicine from December 2018 to December 2023, including 78 males and 36 females, aged 11-50 years [29(21, 35)years]. The patients were divided into tear group ( n=46) and non-tear group ( n=68) according to whether combined with meniscus tear or not during the surgery. Gender, age, duration of disease, smoking history, Body Mass Index (BMI), cause of injury, mechanism of injury, side of the injury, Beighton score, difference of KT-2000 examination, Tegner activity scale of the knee joint, anterior tibial translation sign, medial posterior tibial slope angle, lateral posterior tibial slope angle, and pivot shift grading of the patients in the two groups were recorded. Correlations between the above-mentioned indicators and occurrence of meniscus tear secondary to delayed ACL reconstruction were assessed. In the meantime, the independent risk factors were determined by univariate and multivariate binary logistic regression analysis. Receiver operating characteristic (ROC) curve and area under curve (AUC) were used to evaluate the warning effectiveness of each risk factor for meniscal tear secondary to delayed ACL reconstruction. Results:Univariate analysis showed correlation of duration of disease, BMI, Tegner activity scale of the knee joint, medial posterior tibial slope angle, lateral posterior tibial slope angle and high-grade pivot shift with occurrence of meniscus tear secondary to delayed ACL reconstruction ( P<0.01). The results of multivariate binary logistic regression analysis showed that the duration of disease ≥14.5 weeks ( OR=1.20, 95% CI 1.05, 1.38, P<0.01), BMI≥26.9 kg/m 2 ( OR=1.36, 95% CI 1.03, 1.81, P<0.05), Tegner activity scale of the knee joint ≥4 points ( OR=2.29, 95% CI 1.18, 4.46, P<0.05), medial posterior tibial slope angle ≥11.2° ( OR=2.27, 95% CI 1.06, 4.89, P<0.05) and high-grade pivot shift ( OR=0.03, 95% CI 0.01, 0.03, P<0.05) were significantly correlated with occurrence of meniscus tear secondary to delayed ACL reconstruction. Results of ROC curve analysis showed that the medial posterior tibial slope angle (AUC=0.86, 95% CI 0.80, 0.93) and duration of disease (AUC=0.85, 95% CI 0.77, 0.92) had good warning value, BMI (AUC=0.78, 95% CI 0.69, 0.87) and Tegner activity scale of the knee joint (AUC=0.73, 95% CI 0.64, 0.83) had ordinary warning value, and the warning value of high-grade pivot shift (AUC=0.60, 95% CI 0.49, 0.71) was the lowest. The combination of the risk factors revealed superior warning effectiveness for meniscus tear second to delayed ACL reconstruction (AUC=0.97, 95% CI 0.96, 1.00). Conclusions:The duration of disease ≥14.5 weeks, BMI ≥26.9 kg/m 2, Tegner score ≥4 points, medial posterior tibial slope angle ≥11.2°and high-grade pivot shift are independent risk factors for meniscus tear secondary to delayed ACL reconstruction. The medial posterior tibial slope angle and duration of disease have good warning value, BMI and Tegner scores have ordinary warning value and high-grade pivot shift has the lowest warning value. The combination of the above risk factors has better warning effectiveness for meniscus tear secondary to delayed ACL reconstruction.