Objective To study the effect of fosinopril on the expression of NADPH oxidase subunit p22phox mRNA and the extracellular matrix (ECM) accumulation in the kidneys of rats with diabetes mellitus . Methods Diabetic rats induced by streptozotocin were randomly divided into control group(DM group) and fosinopril group (fosinopril 10 mg'kg-1·d-1) (DM+Fosin group) and treated for 12 weeks . Expression of p22phox mRNA of NADPH oxidase in kidneys was measured by RT-PCR . The expression of fibroneetin was studied by immunohistochemistry and matrix metalloproteinases 9 activity was detected by Zymography . Meanwhile, the kidney hypertrophy index, serum creatinine level and 24-hour urinary protein excretion were evaluated . Results The expression level of p22phox mRNA in the kidneys of DM+Fosin group rats was decreased by 45% than that of DM group at week 4 (P＜0 .05) . At week 8 fosinopril significantly decreased the expression of glomerular and tubulointerstitial fibronectin by 52,5% and 42 .9% respectively (P＜0 .05), while increased MMP-9 activity by 29 .6% (P＜0 .05) compared with DM group . Fosinopril significantly decreased 24-hour urinary protein excretion of diabetic rats from week 8 . Serum creatinine level, 24-hour urinary protein excretion and kidney hypertrophy index were significantly decreased by 35 .9%, 50 .2% and 17 .2% in rats of DM+Fosin group than those of DM group at week 12 (P＜0 .05) . Fosinopril did not affect blood sugar significantly . Conclusion Fosinopril has beneficial effect on diabetic nephropathy partly through inhibiting the expression of NADPH oxidase p22 phox mRNA .

Objective To investigate the diagnostic value of the soluble transferrin receptor (sTfR)in non-adult iron deficiency anemia (IDA)and its differential diagnostic value between IDA and anemia of chronic disease(ACD).Methods 26 cases in the IDA group involved 12 males and 14 females,aged 1 month to 15.5 years;33 cases in the ACD group involved 17 males and 16 females, aged 2 months to 14.0 years;30 cases in the normal control group involved 15 males and 15 females,aged 1 month to 15.5 years. Serum sTfR and ferritin (SF)were detected by the immunonehelomitery,serum iron (SI)was detected by Ferrous Oxazine colori-metric method.Results The gender and age had no statistically significant difference among 3 groups;the SI mean value in the ACD group located between the IDA group′s and the normal control group′s;the SF mean value of the IDA group was significantly lower than that of ACD group (P <0.001)and that of control group (P <0.001),while the sTfR mean value of IDA group was significantly higher than that of the ACD group (P <0.001)and that of the normal control group (P <0.001).The best cutoff of sTfR for the differential diagnosis between IDA and ACD was 3.56 mg/L,its sensitivity,specificity,negative predictive value,posi-tive predictive value and accuracy were 95.12%,93.92%,94.11%,97.53% and 95.50% respectively.Conclusion sTfR has higher sensitivity and specificity for IDA and is conducive to diagnose IDA and differentially diagnose ACD.

OBJECTIVE To develop a rapid system for bacteria identification and susceptibility test in 24 hours,and provide bacteriological evidence for the control of nosocomial infection and the timely diagnosis and treatment.METHODS The simple constant temperature box was replaced by revolving constant temperature box;2,3,5-triphenyltetrazolium chloride(TTC) and succinate were added to the culture bottle and the culture medium of drug susceptibility;the concentration of the reactive substrate in the bacterial biochemical tube and the number of the inoculated bacteria were increased at the same time.RESULTS The time of positive blood culture in the revolving constant temperature box was significantly shorter than that in the simple one(?2=74.92,P

【Objective】To investigate the role of mycophenolate mofetil (MMF) in the prevention of acute rejection in renal transplantation.【Methods】A total of 106 patients were randomized into two groups.One group received MMF (n=56),the other received azathioprine (Aza) (n=50).The time of the following study was within the first 6 months after transplantation.【Results】The rate of acute rejection of group receiving MMF was 20%,it′s lower than that of the group receiving Aza 44% (P<0.01).The recovery rate of acute rejection treated by methylprednisolone (MP),in MMF group 82% was higher than Aza group 55%.(P<0.05).Meanwhile the hepatotoxicity as well as cytomegalovirus (CMV) infection were lower in MMF group than those in Aza group.【Conclusion】MMF as a new anti-rejection drug could more effectively prevent acute rejection than Aza after renal transplantation,and has lower toxicity and side effect.

Objective: To explore the relationship of sleep quality and emotional regulation difficulties in middle school students, and to analyze its mediating role of daytime dysfunction, social rejection and selfcontrol ability, so as to provide a scientific reference for improving middle school students mental health. Methods: From October to November, 2023, the Pittsburgh Sleep Quality Index, Adolescent Social Rejection Questionnaire, Brief Selfcontrol Scale and Difficulties in Emotion Regulation Scaleshort Form (DERS-16) were used to assess 806 students recruited from four middle schools in Bengbu City by a convenient cluster random sampling method. And model-6 of PROCESS and 5 000 Bootstraps were used to make a chainmediating model analysis. Results: Daytime dysfunction was positively correlated with sleep quality(r=0.57), social rejection(r=0.19), selfcontrol(r=0.29, P＜0.01). Selfcontrol was positively correlated with emotional regulation difficulties(r=0.54, P<0.01).Poor sleep quality showed a significant positive association with on daytime dysfunction, and daytime dysfunction further affected social rejection, selfcontrol ability and emotional regulation difficulties (β=0.86, 0.60, 1.27, 1.56, P<0.05). Meanwhile, daytime dysfunction, social rejection and selfcontrol played a serial mediating role in the relationship between sleep quality and emotional regulation difficulties (Estimate=0.11,95%CI=0.04-0.20,P<0.05). Conclusion The study reveals the complex relationship between sleep quality and emotional regulation difficulties in middle school students and provides a new theoretical basis for adolescent sleep improvement and mental health interventions.

Objective:To investigate the value of brainstem auditory evoked potential (BAEPs) combined with cochlear electrogram (ECochG) monitoring in the protection of auditory function during microvascular decompression (MVD) for patients with facial spasm (HFS).Methods:Clinical data of 908 patients with HFS who received MVD treatment in our hospital from January 2018 to December 2020 were retrospectively analyzed. The patients were divided into BAEPs group ( n=309), ECochG group ( n=301) and BAEPs+ECochG group ( n=298) according to the different methods of auditory nerve function monitoring. Waveform extraction rate, mean extraction time, amplitude, latency, intraoperative warning effect of 3 monitoring methods, as well as hearing status immediately after surgery and during follow-up were compared in patents from the 3 groups. Results:(1) The overall waveform extraction rate in ECochG group and BAEPs+ECochG group was significantly higher than that in BAEPs group, and the average waveform extraction time in ECochG group and BAEPs+ECochG group was significantly shorter than that in BAEPs group ( P<0.05). The amplitude of compound action potential (CAP) wave in ECochG group was significantly higher than that of V wave in BAEPs group, and the latency of CAP wave was also significantly earlier than that of V wave ( P< 0.05). (2) A total of 48 patients of the 288 patients in the BAEPs group showed warning signs; a total of 73 of the 292 patients in the ECochG group showed warning signs; and a total of 65 of the 292 patients in the BAEPs+ECochG group showed warning signs. (3) There was significant difference in hearing grading (American Association of Otolaryngology Head and Neck Surgery [AAO-HNS] grading) among the 3 groups immediately after surgery ( H=18.041, P=0.000), and the average rank suggested that the hearing of patients in the BAEPs+ECochG group was superior to the other two groups. All patients were followed up for an average of 15 months (ranged 3-24 months); there was still a significant difference in AAO-HNS grading among the 3 groups ( H=29.625, P=0.000), and the hearing of patients in the BAEPs+ECochG group was still superior to the other two groups. Conclusion:The combined application of ECochG and BAEPs monitoring can reflect the changes of intraoperative hearing impairment comprehensively, accurately and timely, which is of great significance for the protection of auditory function in HFS patients during MVD.

Objective To evaluate the awareness of primipara on self-care knowledge and explore its related factors. Methods 200 cases of pregnant women were surveyed through a self-designed questionnaire about their self-care knowledge, and analyze the influencing factors.Results The situation of awareness in 200 cases on self-care knowledge was in the middle level and related factors involving pregnant women education background, occupation, family income per capita, production inspection situation, etc. Most of the pregnant women were not enough to grasp the intrapartum and postpartum self-care knowledge. Conclusions The awareness of self-care knowledge in pregnant women is generally not enough, and was widespread demand. We should pay attention to the diversification and individuation of self-care education, cultivate pregnant women′s will to learn self-care knowledge actively. Multi-lateral cooperation, strengthen education, pay attention to prenatal examination, and do a good job of follow-up. Introduce the nursing mode “caring presence” to the obstetric nursing, focus on maternal active participation, in order to improve the ability of maternal self-care, and ensure the safety of mothers and children.

Hepatosteatosis is characterized by abnormal accumulation of triglycerides(TG),leading to prolonged and chronic inflammatory infiltration.To date,there is still a lack of effective and economical therapies for hepatosteatosis.Oridonin(ORI)is a major bioactive component extracted from the traditional Chinese medicinal herb Rabdosia rubescens.In this paper,we showed that ORI exerted significant protective ef-fects against hepatic steatosis,inflammation and fibrosis,which was dependent on LXRα signaling.It is reported that LXRα regulated lipid homeostasis between triglyceride(TG)and phosphatidylethanol-amine(PE)by promoting ATCL and EPT1 expression.Therefore,we implemented the lipidomic strategy and luciferase reporter assay to verify that ORI contributed to the homeostasis of lipids via the regulation of the ATGL gene associated with TG hydrolysis and the EPT1 gene related to PE synthesis in a LXRα-dependent manner,and the results showed the TG reduction and PE elevation.In detail,hepatic TG overload and lipotoxicity were reversed after ORI treatment by modulating the ATCL and EPT1 genes,respectively.Taken together,the data provide mechanistic insights to explain the bioactivity of ORI in attenuating TG accumulation and cytotoxicity and introduce exciting opportunities for developing novel natural activators of the LXRα-ATGL/EPT1 axis for pharmacologically treating hepatosteatosis and metabolic disorders.

Atrial fibrillation is the most common type of chronic cardiac arrhythmia. Catheter ablation and left atrial appendage occlusion are effective treatment methods for atrial fibrillation， but these procedures require anesthesia support. However， anesthetic drugs often cause side effects such as nausea， vomiting， involuntary movements， and respiratory depression. This paper presents a case of a successful one-stop procedure for cryoballoon ablation and left atrial appendage occlusion of atrial fibrillation performed entirely under acupuncture anesthesia. Thirty minutes before the procedure， acupuncture needles were inserted perpendicularly at bilateral Neiguan （PC 6）， Lieque （LU 7）， Ximen （PC 4） and （LU 6）. After obtaining the deqi （得气） sensation， an electroacupuncture device was connected， and electroacupuncture anesthesia was used for pain control throughout the procedure. The patient exhibited good tolerance and cooperation， with electroacupuncture anesthesia completely replacing intravenous anesthetics， ensuring the smooth completion of the surgery. Postoperative follow-up showed favorable outcomes.

【Objective】 To explore the safety and efficacy of a modified one-piece posterior laparoscopic total nephroureterectomy with cystic sleeve resection in the treatment of upper urinary tract uroepithelial carcinoma (UTUC). 【Methods】 A total of 24 patients treated during Jan. and Jun. 2022 were involved, including 16 males and 8 females, aged 62 to 90 (average 73) years. The UTUC was in the left side in 15 cases, and in the right side in 9 cases. There were 10 cases of renal pelvis tumor, 6 cases of upper ureteral tumor and 8 cases of lower ureteral tumor. 【Results】 All operations were successful without conversion to open surgery. The operation time ranged from 60 to 100 minutes, average (71.25±9.80) minutes. The intraoperative bleeding volume was 20 to 200 mL, average (30.03±8.13) mL. No significant intraoperative or postoperative complications occurred. The postoperative hospital stay was 4 to 7 days, average (5.83±1.44) days. Bladder perfusion chemotherapy was performed after surgery. 【Conclusion】 The modified one-piece posterior laparoscopic total nephroureterectomy plus cystic sleeve resection for UTUC is an effective and feasible procedure with satisfactory tumor control, which is worth further promotion in clinical practice.