Objective To investigate the effects of Atorvastatin Combined with valsartan on the degree of coronary artery lesion and the level of serum lipoprotein and C reactive protein in patients with coronary heart disea.Methods 95 cases of patients with coronary heart disease from September 2015 to September 2016 in our hospital were randomly divided into observation group and control group,the control group were treated with atorvastatin,observation group of patients in the control group patients on the basis of the combination of valsartan treatment,severity of coronary artery disease,serum lipid and protein levels in patients with C reaction protein levels before and after treatment were compared between two groups.Results After treatment,the patients in the observation group were fibrous plaque,calcified plaque,lipid plaque,mixed plaque were significantly decreased,and lower than that of control group,and control group before and after treatment of fibrous plaque,calcified plaque had no obvious change after treatment,the observation group were HDL,LDL,TG,TC were(2.12±1.01),3.27±0.94),(1.53±0.98),(3.35±1.78)was significantly higher than the control group,the difference was significant,2 months after treatment,3 months to observe the levels in patients with C reactive protein were(10.27±1.78)and(7.26±2.63)was significantly lower than the control group with significant difference,with statistical significance(P<0.05).Conclusion Atorvastatin Combined with valsartan can help to reduce the coronary plaque,regulate lipid metabolism,reduce the level of C reactive protein.

Objective To explore the expression profile of Wnt4 in rat kidney during renal development and its effect on renal development. Methods Rats with embryonic age of 18 days (E 18 d) , 20 days (E 20 d) as well as postnatal age of 0 day (P 0 d), 1 day (P 1 d), 3 days (P 3 d), 5 days (P 5 d) and 7 days (P 7 d) were selected. Expression levels of Wnt4 in rat kidney during renal development were quantified by immunohistochemistry and Western blot in all time points. Results Immuno?histochemistry analysis showed that during E 18 d to P 7 d, Wnt4 mainly expressed in proximal tubules, ureteric bud, comma shaped bodies and S shaped bodies of nephrogenic zone;the expression in the distal tubule was weak;the expression in renal corpuscle decreased with time;Western blot analysis showed that the expression of Wnt4 in rat kidney began to decrease from E 18 d and reached bottom at P 1 d then rise again until P 7 d when it dropped again. Conclusion During renal development, Wnt4 proteins were involved in the development of the nephrogenic zone through regulating canonical Wnt/β-catenin signaling pathway, and was involved in extension of proximal tubules by inducing the non canonical Wnt/PCP signaling pathway. Expression of Wnt4 protein in rat kidney was closely related to nephron formation and development of proximal tubules.

Objective To compare the initial stability between anterior transpedicular screw (ATPS) fixation,anterior plate (AP) fixation and combining anterior and posterior (CAP) fixation for subaxial cervical three-column injury.Methods Six specimens of cervical spine were prepared.After measurement of the range of motion (ROM) of the intact cervical spine,the specimens were made into models of three-column injury.After the models were simulatively reconstructed using an anterior cervical cage,they were stabilized by ATPS,AP and CAP.After the ROMs of the models in the 3 fixation states were measured,the data were normalized by standardizing them to the intact state ROM which was set at 100％.The normalized ROMs of the models in the 3 fixation states were compared.Results The normalized ROMs of AP fixation state in flexion,extension,lefi lateral bending,right lateral bending,left axial rotation and right axial rotation were 119.68±8.34％,119.63±6.74％,115.20±7.91％,117.47±7.81％,120.67±5.99％ and 112.35 ± 8.42％,respectively,significantly larger than those of the intact state (P ＜ 0.05).The normalized ROMs of the other 2 states in all directions were significantly smaller than those of the intact state (P ＜0.05).The normalized ROM of ATPS state in flexion was 87.48 ± 5.31％,significantly larger than that of CAP state (69.60 ± 2.06％) (P ＜ 0.05).There were no significant differences between the normalized ROMs of ATPS state and those of CAP state in extension (65.53 ± 4.36％ versus 67.17 ± 3.10％),in left lateral bending (82.13 ± 2.85％ versus 82.30 ±4.69％),in right lateral bending (81.78 ± 3.42％ versus 81.27 ± 2.79％),in left axial rotation (83.20 ± 2.30％ versus 82.95 ± 2.40％),or in right axial rotation (83.03 ± 1.30％ versus 83.60 ± 6.56％) (P ＞ 0.05).Conclusions In subaxial cervical three-column injury,the initial stability of ATPS fixation may be superior to that of AP fixation and similar to that of CAP fixation.We believe that ATPS can provide enough initial stability for subaxial cervical three-column injury.

Objective To investigate the effect of irbesartan combined with resuvastatin on early diabetic nephropathy( DN) complicated with cardiovascular disease,and its influence on SDF -1/CXCR4 expression. Methods From January 2016 to December 2017,130 early DN patients complicated with cardiovascular disease in the Second People＇s Hospital of Linhai were selected as study objects,and according to the digital table,they were randomly divided into three groups: irbesartan group(control group 1,n＝43),resuvastatin group(control group 2,n＝43) and irbesartan combined with resuvastatin group (observation group,n＝44).The clinical efficacy,blood pres-sure,blood lipids and SDF -1/CXCR4 expression were compared among the three groups.Results After treatment,the total effective rate in the observation group was 93.18%(41/44 ),which in the control group 1 was 69.77%(30/43),which in the control group 2 was 74.42%(32/43),there was statistically significant difference among the three groups(χ2＝12.341,10.106,all P＜0.05).After treatment,the levels of SBP and DBP in the observation group had statistically significant differences compared with those in the control group 1 and control group 2( F＝23.087,20.249,all P＜0.05).After treatment,there were statistically significant differences in TC,TG,HDL-C and LDL-C between the observation group and control group 1,control group 2(F＝18.408,15.623,14.852,9.845,all P＜0.05).After treatment,the level of SDF -1 in the observation group was significantly higher than that before treatment,and which was also significantly higher than that in the control group 1 and control group 2(F＝21.085,P＜0.05).After treatment,the positive rate of CXCR4 in the observation group was significantly higher than that before treatment,and compared with that in the control group 1 and control group 2,the difference was statistically significant(F＝23.641,P＜0.05).Conclusion Irbesartan combined with resuvastatin in the treatment of early DN patients with cardiovascular disease has significant clinical efficacy,can effectively improve blood pressure and blood lipid levels,significantly improve the level of SDF -1 and CXCR4 positive rate.

Objective:To evaluate the effect of adductor canal block(ACB)and local infiltration anesthesia(LIA)around the knee joint on inflammatory responses in the patients undergoing total knee arthroplasty(TKA).Methods:Sixty American Society of Anesthesiologists physical status Ⅱor Ⅲ patients of both sexes, aged 54-76 yr, scheduled for elective TKA, were divided into 2 groups ( n=30 each) using a random number table method: ACB group (group A) and ACB combined with LIA around knee joint group (group AL). ACB was performed with 0.5% ropivacaine 15 ml after endotracheal intubation in group A and group AL, and in addition LIA was performed around the knee joint after the osteotomy was completed during surgery in group AL.The patient-controlled ACB analgesia was applied at the end of surgery in both groups.The analgesic solution contained ropivacaine 400 ml (in 0.9% normal saline 200 ml), and the analgesic pump was set up to deliver a 5 ml bolus dose with a 30-min lockout interval and background infusion at 5 ml/h.When visual analog scale score>4, and pain was still not relived at 30 min after pressing by patients, pethidine hydrochloride 100 mg was intramuscularly injected as rescue analgesic.Peripheral venous blood samples were collected immediately before surgery (T 0) and at 24, 48 and 72 h after surgery (T 1-3) for determination of serum interleukin-6 (IL-6) and IL-10 concentrations by enzyme-linked immunosorbent assay.The muscle strength on the affected side was assessed at T 1-3.The patients′ satisfaction score, requirement for rescue analgesia, and adverse effects were recorded. Results:Compare with group A, the serum IL-6 concentrations were significantly decreased and serum IL-10 concentrations were increased at each time point after surgery, postoperative patients′ satisfaction scores were increased, the requirement for rescue analgesia was decreased ( P<0.05), and no significant change was found in the quadriceps strength of the affected limb and incidence of adverse reactions after surgery in group AL ( P>0.05). Conclusion:ACB and LIA around the knee joint can mitigate postoperative inflammatory responses in the patients undergoing TKA.

ObjectiveTo explore the influence of domestic violence on drinking and aggressive behaviors of adolescent， and to analyze the mediating role of psychological needs and moral disengagement. MethodsA cluster stratified random sampling method was adopted to select 1 280 students from 2 junior high schools and 2 high schools in Dazhou City， and all the enrolled students were assessed using Childhood Trauma Questionnaire-Short Form （CTQ-SF）， Basic Psychological Needs Scale （BPNS）， Moral Disengagement Scale （MDS） and Adolescent Health related Risky Behavior Inventory （AHRBI）. Then the relationship of domestic violence with drinking and aggressive behaviors， along with the mediating roles of psychological needs and moral disengagement were discussed through the chain mediating effect analysis. ResultsCTQ-SF score was negatively correlated with BPNS score （r=-0.160， P=0.012）， and positively correlated with MDS and AHRBI scores （r=0.330， 0.250， P<0.01）. BPNS score was negatively correlated with MDS and AHRBI scores （r=-0.220， -0.270， P<0.01）. MDS score was positively correlated with AHRBI score （r=0.420， P<0.01）. The direct mediation value of domestic violence to drinking and aggressive behaviors was 0.041 （P>0.05）， the mediation effect values of domestic violence to psychological needs， domestic violence to moral disengagement， psychological needs to moral disengagement， psychological needs to drinking and aggressive behaviors， and moral disengagement to drinking and aggression behaviors were -0.468， 0.536， -0.241， -0.412 and 0.094， respectively （P<0.05）. The total mediation effect value of domestic violence to psychological needs to moral disengagement to drinking and aggressive behaviors was 0.295 （P<0.05）. ConclusionPsychological needs and moral disengagement mediate the influence of domestic violence on adolescent drinking and aggressive behaviors.

Diabetic cardiomyopathy （DCM） is one of the complications of diabetes. It refers to a specific type of idiopathic cardiomyopathy that occurs in individuals with diabetes， distinct from other cardiovascular diseases such as coronary heart disease， valvular heart disease， or congenital heart disease. It has also been identified as one of the leading causes of death in diabetic patients for many years. Research has shown that the pathogenesis of DCM is closely associated with insulin resistance， activation of various inflammatory responses， increased oxidative stress， impaired coronary microcirculation， and accumulation of advanced glycation end products （AGEs）. Among various inflammatory responses， the activation of the NOD-like receptor protein 3 （NLRP3） inflammasome can induce the secretion of a large amount of pro-inflammatory cytokines through the cascade reaction of inflammation， subsequently mediating cellular pyroptosis and promoting myocardial damage. Currently， extensive experimental studies on traditional Chinese medicine （TCM） have been conducted in China and abroad based on the significant role of the NLRP3 inflammasome in the prevention and treatment of DCM. These studies have demonstrated that Chinese medicinal extracts， such as Astragalus polysaccharide and ginsenoside Rb₁， single drugs like Coriolus and Cordyceps， and Chinese medicinal formulas like Didangtang and modified Taohe Chengqitang， as well as acupuncture and TCM exercise therapy， can regulate the relevant pathways of the NLRP3 inflammasome to inhibit its assembly or activation， reduce inflammatory responses， inhibit myocardial remodeling in DCM， and improve cardiac function. This article reviewed the relationship between the NLRP3 inflammasome and DCM， as well as the research progress on TCM in exerting anti-inflammatory effects in this field， aiming to provide new insights for the development of therapeutic approaches for DCM.

BackgroundResults of genetic testing for antipsychotic drugs can guide the rational use of drugs in clinical practice and help improve the clinical symptoms of patients with schizophrenia. However， there is currently limited evidence in China regarding the impact of genetic testing results on medication adherence， social function and drug side effects of antipsychotic drug treatment. ObjectiveTo explore the improvement of clinical symptoms， medication adherence and social function in patients with schizophrenia under the guidance of antipsychotic drug gene testing results and examine the safety of drug treatment， so as to provide references for ifor precise treatment of schizophrenia patients. MethodsPatients with acute schizophrenia who received hospitalization at Dazhou Minkang Hospital from July 2019 to August 2021 as well as met the diagnostic criteria of the International Classification of Diseases， tenth edition （ICD-10） were selected as research subjects （n=144）. Based on random number table， subjects were divided into study group and control group， with 72 cases in each group. Control group received drug treatment based on the doctor's clinical experience， while study group received drug treatment based on the results of gene testing for antipsychotic drug. Both treatments lasted for 12 weeks. At baseline as well as 2， 4， 8 and 12 weeks after treatment， Positive and Negative Syndrome Scale （PANSS）， 8-item Morisky Medication Adherence Scale （MMAS-8）， Social Functional Rating Scale （SFRS） and Treatment Emergent Symptom Scale （TESS） were adopted for assessment. ResultTime effect and group effect of the reducing rate of PANSS， MMAS-8 and SFRS scores in the groups were statistically significant （F_time=95.251， 6.650， 14.101， F_group=38.055， 58.175， 128.221， P<0.01）. The interaction effect of the reduction rates of MMAS-8 scores in two groups was statistically significant （F_interaction=5.837， P<0.01）. The group effect and interaction effect of the severity scores of drug side effects and patient pain scores in two groups were statistically significant （F_group=7.553， 81.533， F_interaction=8.693， 9.322， P<0.01）. ConclusionIn terms of improving clinical symptom relief， medication adherence， social function and drug side effects， medication for patients with schizophrenia guided by genetic testing of antipsychotic drugs may be more effective than that relying on medication based on clinical experience. ［Funded by 2019 Dazhou City Municipal Medical Research Project （number， 2019033）］

Objective To establish simple screening models for nonalcoholic fatty liver disease (NAFLD) in the adult Blang population. Methods Based on the survey data of metabolic diseases in the Blang people aged 18 years or above in 2017, 2993 respondents were stratified by sex and age (at an interval of 5 years) and then randomly divided into modeling group with 1497 respondents and validation group with 1496 respondents. Related information was collected, including demographic data, smoking, drinking, family history of diseases and personal medical history, body height, body weight, waist circumference, and blood pressure, and related markers were measured, including fasting plasma glucose, 2-hour postprandial plasma glucose or blood glucose at 2 hours after glucose loading, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase. The chi-square test was used for comparison of categorical data between two groups. Logistic regression analysis was used to establish the screening model. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, and negative predictive value were used to evaluate the screening performance of established models versus existing models in the study population, and the DeLong method was used for comparison of AUC. Results Three screening models for NAFLD were established based on physical and biochemical measurements, i.e., simple noninvasive model 1 (age, body mass index, and waist circumference), noninvasive model 2 with the addition of blood pressure, and model 3 with the combination of hematological parameters (diabetes and ALT/AST). In the modeling group, the three models had an AUC of 0.881 (95% confidence interval [ CI ]: 0.864-0.897), 0.892 (95% CI : 0.875-0.907), and 0.894 (95% CI : 0.877-0.909), respectively, and there was a significant difference between model 1 and models 2/3 ( P =0.004 0 and P < 0.001); in the validation group, the three models had an AUC of 0.891 (95% CI : 0.874-0.906), 0.892 (95% CI : 0.875-0.907), and 0.893 (95% CI : 0.876-0.908), respectively, and there was no significant difference between the three groups ( P > 0.05). Based on the overall consideration of screening performance, invasiveness, and cost, the simple noninvasive model 1 was considered the optimal screening model for NAFLD in this population. Model 1 had the highest Youden index at the cut-off value of 5 points, and when the score of ≥5 points was selected as the criteria for NAFLD, the model had a sensitivity of 86.5%, a specificity of 79.7%, a positive predictive value of 50.3%, and a negative predictive value of 96.1% in the modeling group and a sensitivity of 85.6%, a specificity of 80.6%, a positive predictive value of 51.7%, and a negative predictive value of 95.8% in the validation group. Conclusion The NAFLD screening models established for the adult Blang population based on age and obesity indicators have relatively higher sensitivity, specificity, and negative predictive value, and this tool is of important practical significance for the intervention of NAFLD and its closely related metabolic diseases in this population.