Objectives To assess the plasma levels of acyl ghrelin (AG) and dys-acyl ghrelin (DG) in chronic kidney disease (CKD) and hemodialysis (HD) patients and analyze their relationships with different stages of CKD and hemodialysis. Methods Forty-six CKD stage 1-5 patients and 15 hemodialysis patients were enrolled into the study. Body weight, height, hemoglobin, biochemical parameters, inflammatory parameters, preprandial, postprandial and 3 hours after hemodialysis plasma AG and DG levels were measured. Appetite and food intake were assessed. Body mass index (BMI), and estimated glomerular filtration rate (eGFR) were calculated. Results There were no significant differences in BMI, SGA, appetite, food intake and malnutrition among CKD patients of different stages. eGFR was declining with the progression of CKD stages and patients received a three-week hemodi-alysis. Compared with that in CKD stage 1-2 patients, the level of preprandial and postprandial DG was remarkably increased in stage 3-5 patients (P<0.01). The level of DG was significantly decreased after a standard breakfast in CKD patients (P<0.01). CKD stage was positively correlated with preprandial (r=0.31, P<0.05)a nd postprandi-al DG (r=0.34, P < 0.05), TNF-α (r=0.33, P < 0.05), IL-6 (r=0.40, P < 0.05), leptin (r=0.34, P < 0.05), and age (r=0.41, P<0.05). CKD stage was also highly and positively correlated with the proportion of preprandial and postprandial DG (r=0.61, P<0.01;r=0.55, P<0.01). Multivariate partial-correlation analysis showed that CKD was independently associated with the proportion of preprandial and postprandial DG (r=0.55, P < 0.01; r=0.43, P < 0.01).There was no decrease in AG postprandially, nor any changes in AG resultant from dialysis (P > 0.05);levels of DG decreased slightly postprandially and were markedly decreased by hemodialysis (P<0.01), even lower than those seen postprandially in CKD stage 1-2;Both preprandial and postprandial DG were negatively correlated with serum albumin levels (r=-0.64, P < 0.05; r=-0.59, P < 0.05), while there was no correlation between AG and serum albumin levels. Conclusions There is a strong and independent correlation of DG with CKD stage. Postprandial suppression of ghrelin is impaired with reduced renal function. Hemodialysis removes DG but not AG.

Chronic wounds are with characteristics of long last time and cannot heal in time, which is a problem in clinic. Wound pH value plays an important role in the process of healing of chronic wounds. In this paper, we review the relative researches on wound pH value and wound microenvironment, summarize the potential relationship between wound pH value and healing of chronic wounds, as well as the method to change pH value of chronic wounds, thereby to provide theoretical basis for the treatment of chronic wounds in clinic.

Objective: To explore the expression levels of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) protein and the change of MMP-9/TIMP-1 ratio in wound exudates of patients with stages Ⅲ and Ⅳ pressure ulcers during wound healing. Methods: From July 2017 to July 2018, 30 patients with stage Ⅲ pressure ulcers [30 wounds, 16 males and 14 females, aged (65±10) years] and 34 patients with stage Ⅳ pressure ulcers [50 wounds, 17 males and 17 females, aged (65±9) years] admitted to Hebei General Hospital who met the inclusion criteria were enrolled in this prospective cohort study. According to the principle of wound treatment and the characteristics and needs of wound in different periods, individualized intervention measures were formulated for patients and appropriate dressings were selected. At the time of admission and on 7, 14, 21, 28 days of treatment, the healing of pressure ulcer wounds was evaluated by Pressure Ulcer Healing Scale. Afterwards, the wound exudate was collected at each time point to detect the expression levels of MMP-9 and TIMP-1 protein by enzyme-linked immunosorbent assay, and the MMP-9/TIMP-1 ratio was calculated. Data were processed with analysis of variance for repeated measurements of single group and linear trend test. Results: (1) There were significantly statistical differences in wound healing scores of patients with stages Ⅲ and Ⅳ pressure ulcers among the time of admission and on 7, 14, 21, 28 days of treatment within each stage (F=145.382, 153.234, P<0.01), and they all showed a gradually decreasing trend (F=170.466, 284.585, P<0.01). (2) At the time of admission and on 7, 14, 21, 28 days of treatment, the expression levels of MMP-9 protein in wound exudates of patients with stages Ⅲ and Ⅳ pressure ulcers were (171±104), (138±88), (110±70), (85±55), (62±41) ng/L and (193±107), (173±104), (139±83), (114±70), (89±56) ng/L, respectively. There were significantly statistical differences within each stage (F=58.007, 111.680, P<0.01), and they all showed a gradually decreasing trend (F=62.901, 134.628, P<0.01). At the time of admission and on 7, 14, 21, 28 days of treatment, the expression levels of TIMP-1 protein in wound exudates of patients with stages Ⅲ and Ⅳ pressure ulcers were (6.2±3.9), (5.6±3.4), (5.1±3.1), (4.4±2.5), (3.8±2.3) ng/L and (4.8±2.5), (4.7±2.6), (4.4±2.6), (4.6±2.7), (4.1±2.4) ng/L, respectively. There were significantly statistical differences within each stage (F=25.479, 7.778, P<0.01), and there was a gradually decreasing trend in stage Ⅲ (F=62.901, P<0.01) and a decreasing trend in stage Ⅳ (F=134.628, P<0.01). At the time of admission, the expression levels of MMP-9 and TIMP-1 in wound exudates of patients with stage Ⅲ pressure ulcers were similar to those of patients with stage Ⅳ pressure ulcers (t=-1.03, 1.47, P>0.05). (3) At the time of admission and on 7, 14, 21, 28 days of treatment, the MMP-9/TIMP-1 ratios in the wound exudates of patients with pressure ulcers of stages Ⅲ and Ⅳ were 30±13, 25±9, 22±9, 20±8, 17±6 and 43±19, 37±13, 32±10, 26±9, 22±9, respectively. There were significantly statistical differences within each stage (F=37.173, 97.191, P<0.01), and they all showed a gradually decreasing trend (F=54.183, 130.088, P<0.01). At the time of admission, the MMP-9/TIMP-1 ratio in wound exudates of patients with stage Ⅳ pressure ulcers was significantly higher than that of patients with stage Ⅲ pressure ulcers (t=-3.42, P<0.01). Conclusions During the wound healing process of patients with stages Ⅲ and Ⅳ pressure ulcers, the expression levels of MMP-9 and TIMP-1 protein and the MMP-9/TIMP-1 ratio in wound exudates show a decreasing trend. The stage of wound healing can be predicted according to the expression level of MMP-9 protein and the MMP-9/TIMP-1 ratio.

Objective: Pulmonary infectious diseases (PID) include viral pneumonia (VP) and pulmonary tuberculosis (PT). Mongolian medicine (MM) is an effective treatment option in China, however, the core group medicines (CGMs) in the treatment of PID and their underlying therapeutic mechanisms remain unclear. In this study, through the method of data mining, the CGMs of MM for the treatment of PID were excavated, and the possible mechanism of action of the CGMs in the treatment of PID was explored by using network pharmacology. Methods: First, 89 MM formulae for the treatment of pulmonary infectious diseases collected from Gan Lu Si Bu, Meng Yi Jin Kui, People's Republic of China Ministry of Health Drug Standards (Mongolian Medicine Volume), Standard of Mongolian Medicine Preparations in Inner Mongolia (2007 Edition), and Standard of Mongolian Medicine Preparations in Inner Mongolia (2014 Edition). The CGMs of MM for PID were excavated through association rule analysis and cluster analysis. Then, the active ingredients and potential targets of the CGMs were obtained from TCMSP, TCMIP, BATMAN-TCM databases. PID targets information was collected from OMIM, GeneCards, and DrugBank databases. The possible targets of CGMs treatment for PID were obtained by intersection. The PPI network was constructed through the STRING database, and the topology analysis of the network was performed. Through the enrichment analysis of the intersection targets by R language, the main action pathways and related target proteins of CGMs in the treatment of PID were screened out. The results were verified by molecular docking. Results: A total of 89 formulae were included, involving 164 MM herbs. The efficacy of the drugs was mainly cough-suppressing and panting-calming herbs, and heat-clearing herbs. The nature and flavor were mainly bitter and cold. The CGMs of MM to treatment of PID was excavated as the classic famous formula Sanzi Decoction (Toosendan Fructus-Chebulae Fructus-Gardeniae Fructus). A total of 28 candidate components and 237 predicted targets of CGMs were collected, and 61 common targets with PID were obtained, including key compounds such as quercetin, kaempferol, β-sitosterol and stigmastero and key targets such as VEGFA, IL6, TP53, AKT1. KEGG enrichment analysis yielded AGE-RAGE signaling pathways, IL-17 signaling pathways, and TNF signaling pathways. Molecular docking results showed that the key targets were well matched with the potential active ingredients of CGMs. Conclusion: This study found that MM commonly used cough-suppressing and panting-calming herbs in combination with heat-clearing herbs to treat PID, and the CGMs for the treatment of PID is “Toosendan Fructus-Chebulae Fructus-Gardeniae Fructus”. CGMs mainly play a role in the treatment of PID by acting on VEGFA, IL6, TP53, AKT1 and other targets, regulating AGE-RAGE signaling pathways, IL-17 signaling pathways, and TNF signaling pathways.

【Objective】 To explore the effects of blood routine parameters on the peripheral blood hematopoietic stem cell collection of healthy donors, and predict collection timing based on these parameters. 【Methods】 The blood routine parameters pre-donation and the total number of mononuclear cells post-donation of 249 donors who applied blood cell separator to collect peripheral blood hematopoietic stem cells in our hospital from January 2018 to August 2020 were collected. Taking total nucleated cells of circulating blood per litre as the main evaluation index, and its collection with blood routine parameters pre-collection was analyzed. The relevant influencing factors were analyzed using multiple linear regression analysis. The blood routine parameters of healthy donors who donated peripheral blood hematopoietic stem cells in our hospital from September 2020 to October 2020 were substituted into the equation to obtain the predicted values, which were then compared with the actual values obtained from actual product using t test for verification. 【Results】 The analysis showed that the parameters of Hb, RBC, Hct, leukocyte count, neutrophil, lymphocyte, monocyte and Plt were statistically correlated with the total number of mononuclear cells of circulating blood per liter volume (P<0.05). There was a linear relationship between lymphocyte, monocyte, Plt and leukocyte count and the total number of mononuclear cells of circulating blood per liter. The total number of mononuclear cells of circulating blood per liter was set to (Y), and the variables such as lymphocyte (X1), monocyte (X2), Plt (X3), leukocyte count (X), and neutrophil were used as dependent variables for multiple linear regression, and the equation was: Y=9.814+ 3.131X1+ 1.666X2+ 0.020X3+ 0.124X4. There was no statistical difference between the predicted value and the calculated value (P>0.05). 【Conclusion】 The blood routine parameters of lymphocyte, monocyte, platelet count and leukocyte count of donors before collection can effectively predict the collection efficiency, therefore help predict the collection time.