Objective To investigate the expression of apelin and its recoptor (APJ) in myocardium in insulin-resistant CIR rats with myocardial ischemia.Methods Totally 24 male SD rats were randomly divided into three groups:IR group,IR+ischemia group,the control group (n=8 each).Rats in IR and IR+ischemia groups were fed with the high fat diet.Rats in control group were given the basic diet.The rat model of insulin resistance was assessed by fasting blood glucose (FBG),fasting insulin (Fins) and insulin resistance index (HOMA-IR).The rat model of myocardial ischemia was conducted by subcutaneous injection of isoprenaline 1 mg/kg per day in IR+ ischemia group.The other groups were injected an equal volume of saline.The expression levels of apelin and APJ mRNA in myocardium were determined by real-time-PCR.The positive expression of apelin polypeptide was detected by immunochemistry.Results Compared with the control group,the apelin average optical density was increased in IR group and was decreased in IR+ ischemia group [(0.16±0.004) vs.(0.13±0.005),(0.10±0.002) vs.(0.13±0.0050),both P＜0.05].There was a significant difference in apelin average optical density between IR group and IR+ischemia group [(0.16± 0.004) vs.(0.10±0.002),P＜0.05].Compared with the control group,the relative expression of apelin mRNA was increased in IR group [(5.89±0.36) vs.(4.40±0.24),P＜0.05]The relative expression of apelin mRNA was decreased in IR± ischemia group as compared with IR group [(2.66 ± 0.17) vs.(5.89 ± 0.36),P ＜ 0.05].The APJ mRNA relative expression was increased in IR group as compared with control group and was decreased in IR+ ischemia group as compared with IR group [(10.46±1.06) vs.(6.54±0.63),(3.31±0.31) vs.(10.46±1.06),both P＜0.05].Conclusions The expressions of apelin and APJ are inhibited in insulin-resistant rats with myocardial ischemia,which attenuates their protective effects on myocardium.

Objective To investigate the role of insulin resistance in patients with prostate cancer who received surgical castration. Methods Sixty-seven patients with advanced prostate cancer who received with surgical castration were divided into obesity group [30 cases, BMI (26.85±1.22) kg/m2] and non-obesity group[37 cases, BMI(22.72±1.28) kg/m2]. The fasting blood glucose (FBG) and the fasting serum insulin, while evaluated the insulin resistance index(IRI) were determined before treatment, 6 months after treatment and 12 months after treatment. Results The levels of fasting serum insulin were significantly higher 6 months[(23.21±5.78 )mU/L] and 12 months [(24.34±5.37) mU/L] after treatment than that be-fore treatment[(20.01±4.82) mU/L] in obesity group, but 12 months after treatment [(22.19±6.14) mU/L ]was higher than that before treatment [(17.36±6.01) mU/L] in non-obesity group (P<0.01). The IRI were significantly higher 6 months (2.94±0.79) and 12 months (3.10±0.73) after treatment than that be-fore treatment (2.53±0.64) in obesity group, but 12 months after treatment (2.79±0.75) was higher than that before treatmeat(2.17±0.73) in non-obesity group(P<0.01). Conclusion The current data suggests that the patients with prostate cancer who received surgical castration is at risk for developing insulin resistance, thus leading to increasing risk of cardiovascular disease and type 2 diabetes mellitus.

Objective To investigate the quality of life in man after treatment of advanced prostate cancer by surgical castration. Methods A total of 69 patients with advanced prostate cancer treated by sur-gical castration completed the European organization for research and treatment of cancer quality of life questionnaire (QLQ-C30) and QLQ-prostate specific 25-item (PR25) module third at a 12-month interval.The assessment points were preoporative,6 months postoperative and 12 months postoperative. Results Although there were improvement on pain relief (P ＜ 0.01 ) and symptom of urinary (P ＜ 0.01 ) and global health (P ＜ 0.01 ), the physical functioning (P ＜ 0.05 ), role functioning (P ＜ 0.01 ), emotional functioning (P ＜ 0.01 ), cognitive functioning (P ＜ 0.05 ), social functioning (P ＜ 0.05 or ＜ 0.01 ) were found significantly reduced , and insomnia (P ＜ 0.05) and fatigue (P ＜ 0.01 ) aggravated, treatment related symptoms (P ＜0.01 )appeared predominantly, especially deprivation of sexual functioning. Conclusion The surgical cas-tration when treating advanced prostate cancer did appear to impair the physical and psychological of patients, especially the sexual functioning.

In recent years, the incidence of diabetic kidney disease(DKD) has been increasing gradually, and it has become the leading cause of end-stage renal disease. However, current therapies show limited efficacy in preventing the progression of DKD. Against the backdrop of chip and high-throughput sequencing, long non-coding RNAs are revealed to an important role in the pathogenesis of DKD. This article summarizes the research progress of long non-coding RNA in DKD, and look forward to the more extensive application of long non-coding RNA in the future.

Objective:To investigate the correlation between the level of thyrotropin receptor antibody(TRAb) and bone turnover markers(BTMs) in the patients with newly-diagnosed Graves′ disease(GD).Methods:The clinical data of GD patients who were newly-diagnosed in the First Affiliated Hospital of Zhengzhou University from October 2016 to June 2021 were collected, including free triiodothyronine(FT 3), free thyroxine(FT 4), thyroid stimulating hormone, thyroid related antibodies, N-terminal procollagen of type I collagen(PINP), N-terminal osteocalcin(N-MID), β-cross-linked C-telopeptide of type I(β-CTX), blood lipid and renal function, etc. Results:There were 618 GD patients with an average age of(43.7±13.2) years(male∶female=1∶1.99). The PINP and β-CTX level in male GD patients were significantly higher than those in female(all P<0.05). Spearman correlation analysis showed that PINP, N-MID and β-CTX were positively correlated with FT 3, FT 4, TRAb, serum calcium and serum phosphorus; and negatively correlated with body mass index and low density lipoprotein cholesterol(all P<0.05). Linear regression analysis showed that TRAb was positively correlated with lg-PINP, lg-N-MID and sqrt-β-CTX in the univariate model of total GD patients( β were 0.006, 0.005, and 0.006, respectively; all P<0.001); positive correlation remained after adjusting for thyroid function(all β=0.004, all P<0.001); and for multiple confounding factors(model 3 and 4, all P<0.05). Results of univariate and adjusted thyroid function models with GD in different genders were consistent with the total patients(all P<0.05). Conclusion:TRAb is a risk factor for accelerated bone turnover in GD patients which is independent of thyroid function.

OBJECTIVE To identify the influence factors associated with 28-day fatality among COVID-19 hospitalizations and to analyze the interaction between the disease severity at admission and the use of hospital preparations.METHODS A retrospective review of records from COVID-19 hospitalizations aged 18 to 90 who were admitted to the Jiangsu Province Hospital of Chinese Medi-cine from December 15,2022 to January 15,2023 were conducted.Patients who died or were lost to follow-up within 48 h of admis-sion were excluded.Patients were divided into survival and death groups based on their 28-day fatality status.Descriptive statistics were used to characterize the two groups and multivariate logistic regression models were employed to identify factors influencing 28-day fatality risk.The interaction between the severity of illness at admission and the use of hospital preparations was explored through cross-over analysis and hierarchical regression analysis.RESULTS Significant differences were observed between the survival and death groups in terms of severity of illness at admission,hospital preparations usage,steroid therapy,age,platelet count,lactate dehydro-genase levels,and urea(P<0.05.Crossover analysis and hierarchical logistic regression analysis revealed a significant antagonistic interaction between the severity of illness at admission and the use of hospital formulations both before adjustment(RERI=-20.678,95%CI:-33.703～-7.652;APAI=-2.301,95%CI:-4.027～-0.575 and after adjusting for gender,age,clinical characteristics and further adjusting for laboratory parameters(RERI=-5.972,95%CI:-10.564～-1.380;APAI=-2.205,95%CI:-4.131～-0.279,and it was an antagonistic interaction both before(SI=0.279,95%CI:0.157～0.493 and after adjustment(SI=0.222,95%CI:0.095～0.523.CONCLUSION The use of hospital preparations significantly reduces the 28-day fatality risk among COV-ID-19 hospitalizations and a clear antagonistic interaction was observed between the disease severity at admission and the use of hospi-tal preparations.

Objective:To analyze the distribution and drug resistance of wound pathogenic microorganisms in outpatients of wound healing center so as to provide a basis for the standardized construction of wound healing centers.Methods:A retrospective case series study was used to analyzed the data of 365 outpatients treated at Ruijin Hospital, Shanghai Jiaotong University School of Medicine from December 2017 to October 2019. There were 220 males and 145 females, aged (58.8±18.9)years (range, 18-98 years). The patients included 92 first-visit patients and 273 re-visit patients. The culture results (positive rate of pathogenic microorganisms, bacterial species, bacterial distribution) and drug sensitivity results of the wound secretions were compared and analyzed.Results:(1) Among 365 samples of wound secretions, 198 patients were positive for pathogenic microorganisms with a positive rate of 54.3%. A total of 107 strains (51.0%) of Gram-positive bacteria were detected, mainly Staphylococcus aureus (70 strains, 33.3%); 95 strains (45.2%) of Gram-negative bacteria were detected, mainly Escherichia coli (20 strains, 9.5%), followed by Pseudomonas aeruginosa (17 strains, 8.1%); 8 strains (3.8%) of fungi were detected. (2) A total of 26 (28.3%) first-visit patients were positive for pathogenic microorganisms, and 172 (63.0%) re-visit patients were positive for pathogenic microorganisms. The rate of positive microorganism detection had significant differences between first-visit and re-visit patients ( P<0.05). (3) A total of 29 strains were detected in first-visit patients, including 16 strains (55.2%) of Gram-positive bacteria, 11 strains (37.9%) of Gram-negative bacteria and 2 strains (6.9%) of fungi. A total of 181 strains were detected in re-visit patients, including 91 strains (50.3%) of Gram-positive bacteria, 84 strains (46.4%) of Gram-negative bacteria and 6 strains (3.3%) of fungi. The microbial distribution was significantly different between first-visit and re-visit patients ( P<0.05). (4) Compared with first-visit patients, the resistance of Staphylococcus aureus isolated from the re-visit patients to spenicillin, oxacillin, ciprofloxacin, tetracycline, clindamycin, moxifloxacin, erythromycin, and levofloxacin were increased variably. No vancomycin-resistant Staphylococcus aureus was detected, indicating that the staphylococcus aureus presented in the wound was highly sensitive to vancomycin. Conclusions:Staphylococcus aureus is the most common microorganism in wound secretions in outpatients of wound healing center. The rate of positive pathogenic microorganisms in wound secretions of re-visit patients is significantly higher than that of first-visit patients, and the distribution of pathogenic microorganisms of first-visited and revisited patients differs significantly. The Staphylococcus aureus detected in re-visit patients has a higher resistance to common antibiotics compared with first-visit patients. It is suggested that timely detection of pathogenic microorganisms in outpatients and effective control and supervision of outpatient infections are important contents that cannot be ignored in the construction of wound healing center.

Objective:To explore independent predictors for poor outcome at 3 months in elderly patients with acute cerebral infarction(ACI)treated with intravenous thrombolysis(IVT), and to develop a nomogram-based predictive model.Methods:This was a retrospective cohort study.Clinical, laboratory and imaging data of 346 elderly patients with ACI treated with IVT from January 2016 to April 2021 in our hospital were collected.Poor outcome was defined as a modified Rankin Scale(mRS)score >2 at 3 months after the stroke.Logistic regression analysis was used to screen for independent factors predicting poor outcome in elderly ACI patients treated with IVT, and a corresponding nomogram model was developed using the R software.The ROC curve, calibration plots and decision curve analysis were used to evaluate discrimination, calibration and clinical application value of the nomogram model.Results:Among 346 candidates, 109 developed a poor outcome, representing a rate of 31.5%.Logistic regression analysis showed that symptomatic hemorrhagic transformation( OR=15.647, 95% CI: 8.913-27.454), stroke severity(moderate stroke, OR=3.322, 95% CI: 1.414-7.811; moderate-severe stroke, OR=8.169, 95% CI: 4.102-16.258; severe stroke, OR=9.653, 95% CI: 5.440-17.121), stroke-associated pneumonia( OR=2.239, 95% CI: 1.134-4.420), and heart failure( OR=2.758, 95% CI: 1.424-5.336)were independent predictors for poor outcome at 3 months in elderly ACI patients treated with intravenous thrombolysis(all P<0.05). With the area under curve(AUC-ROC)value at 0.85(95% CI: 0.80-0.89), the nomogram model, which was composed of the above four predictors, demonstrated good discrimination.On the calibration plot, the mean absolute error was 0.020, indicating that the model had good calibration.Decision curve analysis revealed that the model had good clinical application value. Conclusions:The nomogram model composed of symptomatic hemorrhagic transformation, stroke severity, stroke-associated pneumonia and heart failure may predict poor outcome at 3 months in elderly ACI patients treated with IVT, with high prediction accuracy and high clinical application value.

Statistics show that 76.74% (4 688) of 6 109 patients with chronic wounds are those over 50 years of age; the proportion of patients with underlying diseases in all age groups above 50 years ranges from 78.25% to 100.00%; among the underlying diseases of chronic wound patients, the top four diseases are diabetes mellitus , cardiovascular and cerebrovascular diseases, hypertension, and respiratory diseases. The above underlying diseases and ages of patients are the susceptibility factors of corona virus disease 2019 released by National Health Commission of China. It is an unavoidable fact that patients with chronic wounds have to go to the hospital for treatment prescribed by the physician. At the same time, we found that there were not a few patients who go far afield because of various reasons when go to the hospital for treatment. During the period of epidemic prevention and control, this kind of "go far afield" style of seeking medical treatment may increase the exposure risk during transportation. Accordingly, we convened 36 wound care clinics in different regions in Shanghai to implement the "Five Measures" to encourage patients with chronic wounds to seek medical treatment proximately. The principle of this operation is that when seeking medical treatment, trying our best to reduce as much as possible the transportation distance for patients with chronic wounds to minimize the exposure risk during the epidemic period and eventually support the epidemic prevention and control campaign.