Objective To investigate the effects of ganoderma lucidum polysaccharide peptide(GLPP)on renal function and oxidative damage in diabetic nephropathy mice and its mechanism.Methods C57 mice were randomly divided into normal group,model group,positive control group(10.0 mg·kg-1 losartan),experimental-L group(50 mg·kg-1 GLPP),experimental-M group(100 mg·kg-1 GLPP),experimental-H group(200 mg·kg-1 GLPP)and GLPP+Losartan group(200 mg·kg-1 GLPP+10.0 mg·kg-1 losartan).Each group had 10 mice.After 8 weeks of continuous gastric administration,blood glucose was detected;renal function and lipid metabolism related indexes were detected by biochemical analyzer;serum inflammatory factor expression was detected by enzyme linked immunosorbent assay(ELISA);protein expression was detected by Western blot;oxidative damage related indexes were detected by kit method;apoptosis was detected by Tunel method.Results The fasting blood glucose of mice in normal group,model group,positive control group,experimental-H group and GLPP+Losartan group were(4.69±0.16),(20.31±2.04),(10.22±0.98),(10.26±0.96)and(7.76±0.43)mmol·L-1;serum creatinine(Scr)level were(25.48±2.33),(68.34±4.78),(32.93±3.25),(36.37±2.36)and(28.30±1.19)μmol·L-1,respectively;malonaldehyde(MDA)content were(2.05±0.22),(6.71±0.57),(2.69±0.27),(3.21±0.32)and(2.19±0.11)nmol·L-1,respectively;Tunel positive cell rates were(3.39±0.27)％,(26.75±1.24)％,(6.81±0.71)％,(8.05±0.80)％,(5.33±0.33)％,respectively;nuclear factor kappa B(NF-κB p65)protein expression levels were 0.31±0.05,1.07±0.08,0.40±0.03,0.47±0.04 and 0.35±0.03,respectively.The model group compared with the normal group for the above indicators,the experimental-H group compared with the model group for the above indicators,and the GLPP+Losartan group was compared with the experimental-H group for the above indicators,all differences were statistically significant in statistics(all P＜0.05).Conclusion Ganoderma lucidum polysaccharide peptide may regulate Toll-like receptor 4/NF-κB pathway to inhibit apoptosis and inflammatory response,and improve oxidative damage in diabetic nephropathy mice.

Objective To analyze the safety of idarubicin or daunorubicin combined with cytarabine in the treatment of patients with acute myeloid leukemia.Methods The Chinese Biomedical Database,Chinese Journal Full-text Database,Chinese Science and Technology Journal Full-text Database,Wanfang Database,Embase,PubMed,Cochrane Library were searched.The randomized controlled trials(RCTs)of idarubicin combined with cytarabine(treatment group)and daunorubicin combined with cytarabine(control group)were collected.The search time was from 2014-01-01 to 2024-02-23.RevMan 5.4 software was used to perform meta-analysis,sensitivity analysis and publication bias analysis on adverse drug reactions of the included studies.Results A total of 11 RCTs involving 1 818 patients were included in the Meta-analysis.The treatment and control groups were enrolled 912 and 906 cases,respectively.The results of meta-analysis showed that the total incidence of adverse drug reactions in the treatment group and the control group was 22.9％(56 cases/245 cases)and 42.9％(105 cases/245 cases),respectively,and the difference was statistically significant[relative risk(RR)=0.53,95％confidence interval(CI)=0.41-0.69,P＜0.001)].In the specific adverse drug reactions,there were no statistically significant differences in the incidence of hematological toxicity,digestive system toxicity,cardiac toxicity,liver and kidney toxicity,infection,bleeding between the two groups(all P＞0.05).Sensitivity analysis showed that the results were stable and reliable.The results of publication bias analysis showed that this study was less likely to have publication bias.Conclusion The incidence of adverse drug reactions of idarubicin combined with cytarabine in the treatment of patients with acute myeloid leukemia is significantly lower than that of daunorubicin combined with cytarabine,so the former has better safety.

Objective To compare the efficacy and safety of Saccharomyces boulardii and other probiotics in the treatment of pediatric diarrhea.Methods Retrieved from PubMed,Embase,CBM,Wanfang data,CNKI and VIP,randomized controlled trial(RCTs)about Saccharomyces boulardii(treatment group)vs other probiotics(control group)were collected.After screening the literature,extracting data and evaluating the quality,Meta-analysis was performed by using RevMan 5.3 and Stata 17.0 software.Results A total of 30 RCTs were included,involving 3 082 children.Results of Meta-analysis showed there was no statistical significance in the duration of diarrhea[mean difference(MD)=-0.65,95％confidence interval(CI)=-1.44-0.14,P＞0.05]or the total incidence of adverse reactions[odds ratio(OR)=0.85,95％CI=0.44-1.62,P＞0.05].The total effective rate(OR=1.60,95％CI=1.08-2.36,P＜0.05)and the number of stools(MD=-0.66,95％CI=-1.00--0.32,P＜0.01)in the treatment group were significantly better than control group.There was statistically significant difference in the duration of diarrhea between the two groups treated with diarrhea with fever(MD=1.81,95％CI=1.12-2.49,P＜0.01)and rotavirus gastroenteritis(MD=-0.92,95％CI=-1.20--0.64,P＜0.01).In the treatment of diarrhea with fever,the duration of diarrhea in the control group was significantly shorter than that in the treatment group.The duration of diarrhea in the treatment group was significantly shorter than that control group.At the same time,the duration of diarrhea in children with diarrhea treated with treatment group was significantly shorter than that of control group Bifidobacterium tetragenous viable(MD=-0.84,95％CI=-1.09--0.58,P＜0.01)and control group combined Bacillus subtilis and Enterococcus faecium enteric-coated(MD=-1.35,95％CI=-2.30-0.39,P＜0.01).Conclusion The safety of Saccharomyces boulardii are similar to other probiotics.The efficacy and the number of stools with Saccharomyces boulardii are significantly better than other probiotics in the treatment of diarrhea.The duration of diarrhea in Saccharomyces boulardii group was significantly shorter than other probiotics,while in the treatment of antibiotic-associated diarrhea,the duration of diarrhea of Saccharomyces boulardii was the same as that of other probiotics.However,the duration of diarrhea in children with diarrhea treated with Saccharomyces boulardii was significantly longer than other probiotics.

Objective To analyze the effects of dapagliflozin combined with insulin pump intensive therapy on elderly patients with type 2 diabetes mellitus(T2DM).Methods Elderly patients with T2DM were divided into control group and treatment group according to the random number table method.The control group was given insulin pump intensive therapy(pumping insulin aspart ejection at initial dose of 0.3-0.5 U·kg-1;dose of insulin aspart was adjusted according to the blood glucose monitoring,the insulin was stopped and the oral hypoglycemic drug was given when fasting plasma glucose was controlled at 4.4-7.0 mmol·L-1 and postprandial blood glucose was 4.4-10.0 mmol·L-1),and the treatment group was treated with 10 mg of dapagliflozin tablets once a day on this basis.Both groups of patients were continuously treated for 12 weeks.Blood glucose fluctuation indicators[mean amplitude of glycemic excursions(MAGE),largest amplitude of glycemic excursions(LAGE)],peripheral blood nuclear factor erythroid 2-related factor 2(Nrf2),Kelch-like ECH associated protein 1(Keap1)and occurrence of major adverse cardiac events(MACE)and adverse drug reactions were compared between the two groups.Results Thus 98 cases were included in control group and treatment group,respectively.After treatment,the total effective rates in control group and treatment group were 83.67％(82 cases/98 cases)and 92.86％(91 cases/98 cases);MAGE values were(3.63±0.54)and(3.38±0.49)mmol·L-1;LAGE values were(8.41±1.45)and(7.53±1.26)mmol·L-1;Nrf2 levels were(8.06±1.29)and(6.82±1.03)ng·mL-1;Keap1 levels were(7.22±1.07)and(6.09±0.86)ng·mL-1(all P＜0.05).There were no statistically significant differences in the incidence rates of MACE and adverse drug reactions between the two groups(P＞0.05).Conclusion Dapagliflozin combined with insulin pump intensive therapy for elderly patients with T2DM can effectively control the blood glucose level,reduce the blood glucose fluctuation,relieve the body's oxidative stress response,and reduce the levels of Nrf2 and Keap1,and it may lower the cardiovascular risk.

Objective To investigate the nutritional status of children with Crohn's Disease (CD) at diagnosis and its association with clinical characteristics. Methods A retrospective analysis was performed for the clinical data and nutritional status of 118 children with CD who were admitted to Beijing Children's Hospital,Capital Medical University,from January 2016 to January 2024. A multivariate logistic regression analysis was used to investigate the risk factors for malnutrition. Results A total of 118 children with CD were included,among whom there were 68 boys (57.6％) and 50 girls (42.4％),with a mean age of (11±4) years. Clinical symptoms mainly included recurrent abdominal pain (73.7％,87/118),diarrhea (37.3％,44/118),and hematochezia (32.2％,38/118),and 63.6％ (75/118) of the children had weight loss at diagnosis. The incidence rate of malnutrition was 63.6％ (75/118),and the children with moderate or severe malnutrition accounted for 67％ (50/75). There were 50 children (42.4％) with emaciation,8 (6.8％) with growth retardation,and 9 (7.6％) with overweight or obesity. Measurement of nutritional indices showed a reduction in serum albumin in 83 children (70.3％),anemia in 74 children (62.7％),and a reduction in 25 hydroxyvitamin D in 15 children (60％,15/25). The children with malnutrition had significantly higher disease activity,proportion of children with intestinal stenosis,and erythrocyte sedimentation rate and a significant reduction in serum albumin (P<0.05). The multivariate logistic regression analysis showed that intestinal stenosis was an independent risk factor for malnutrition in children with CD (OR=4.416,P<0.05). Conclusions There is a high incidence rate of malnutrition in children with CD at diagnosis,which is associated with disease activity and disease behavior. The nutritional status of children with CD should be closely monitored.

Objective:To investigate the effects of selinexor,a inhibitor of nuclear export protein 1(XPO1)on the proliferation inhibition and apoptosis of Kasumi-1 cells in acute myeloid leukemia(AML).Methods:MTS method was used to detect the inhibitory effect of different concentrations of selinexor on the proliferation of Kasumi-1 cells at different time points.The apoptosis rate and cell cycle changes after treatment with different concentration of selinexor were detected by flow cytometry.Results:Selinexor inhibited the growth of Kasumi-1 cells at different time points in a concentration-dependent manner(r24 h=0.7592,r48 h=0.9456,and r72 h=0.9425).Selinexor inhibited Kasumi-1 cells growth in a time-dependent manner(r=0.9057 in 2.5 μmol/L group,r=0.9897 in 5 μmol/L group and r=0.9994 in 10 μmol/L group).Selinexor could induce apoptosis of Kasumi-1 cells in a dose-dependent manner(r=0.9732),and the apoptosis of Kasumi-1 cells was more obvious with the increase of drug concentration.The proportion of G0/G1 phase was significantly increased and the proportion of S phase was significantly decreased after the treatment of Kasumi-1 cells by selinexor.With the increase of drug concentration,the proportion of Kasumi-1 cells cycle arrest in G0/G1 phase was increased and the cell synthesis was decreased.Conclusion:Selinexor can promote the death of tumor cells by inhibiting Kasumi-1 cells proliferation,inducing apoptosis and blocking cell cycle.

Objective:To investigate the expression and mechanism of microRNA-98-5p(miR-98-5p)and DNA methyltransferase 3A(DNMT3A)in patients with ulcerative colitis(UC)and animal model of ulcerative colitis.Methods:One-hundred UC patients in our hospital from January 2021 to December 2022 were collected as the observation group,another 100 healthy subjects were collected as the control group,serum miR-98-5p,DNMT3A mRNA and protein ex-pression were detected,the relationship between miR-98-5p,DNMT3A mRNA and clinical pathological characteristics of UC was analyzed;the UC rat model was established and randomly grouped into a blank group(CT group),a model group(UC group),a miR-98-5p control group(antagomiR-NC group),and a miR-98-5p inhibitor group(antagomiR-98-5p group),ELISA was applied to measure the levels of serum interleukin-1(IL-1),IL-6,and tumor necrosis factor(TNF),HE staining was applied to observe the histopathology changes of the colon,RT-qPCR and Western blot were applied to detect miR-98-5p,DNMT3A mRNA and protein expression levels in colon tissue.Results:Compared with the control group,the serum miR-98-5p expression of UC patients was increased,DNMT3A mRNA and DNMT3A were decreased,the expression of miR-98-5p and DNMT3A mRNA were associated with disease grading,mucopurulent bloody stools,mucosal acute and chronic inflammation,and atypical hyperplasia(P＜0.05);compared with the CT group,the colon mucosal layer of rats in the UC group showed defects,and obvious infil-tration of inflammatory cells,serum IL-1,IL-6,TNF and colon miR-98-5p expression were in-creased,the DNMT3A mRNA and protein expression were decreased(P＜0.05);compared with the antagomiR-NC group,the mucosal layer defect and inflammatory cell infiltration in the an-tagomiR-98-5p group were reduced,and the structure was clearer,serum IL-1,IL-6,TNF,and colon miR-98-5p expression were decreased,DNMT3A mRNA and protein expression were in-creased(P＜0.05);miR-98-5p had a targeted binding site with DNMT3A.Conclusion:Serum miR-98-5p expression of UC patients and the colon tissue of model rats was increased,while DNMT3A expression was decreased.Down-regulating miR-98-5p expression can promote the expression of DNMT3A and improve UC symptoms.

We designed and synthesized eighteen lycorine derivatives with five different structural types, and evaluated their antiviral activities on a HCoV-OC43-infected H460 cell model. Structure-activity relationships suggested that the introduction of appropriate substituents on the 6N atom of lycorine was beneficial to activity. Compound 6a gave a good activity with the half effective concentration (EC₅₀) and selectivity index (SI) values of 2.36 μmol·L^-1 and 16.52, respectively. Surface plasmon resonance (SPR) result indicated that 6a might target the non-structural protein 12 (NSP12) subunit in RNA-dependent RNA polymerase (RdRp) of SARS-CoV-2 with the dissociation constant (K_D) value of 1.36 μmol·L^-1. Molecular docking indicated that 6a might act on nidovirus RdRp-associated nucleotidyltransferase (NiRAN) catalytic center of NSP12, distinct from the mechanism of nucleoside-like drugs such as remdesivir. This study provides scientific data for the development of lycorine derivatives into a new class of anti-SARS-CoV-2 small molecule inhibitors.

Objective:To explore potential predictors of refractory Mycoplasma pneumoniae pneumonia (RMPP) in early stage. Methods:The prospective multicenter study was conducted in Zhejiang, China from May 1 st, 2019 to January 31 st, 2020. A total of 1 428 patients with fever >48 hours to <120 hours were studied. Their clinical data and oral pharyngeal swab samples were collected; Mycoplasma pneumoniae DNA in pharyngeal swab specimens was detected. Patients with positive Mycoplasma pneumoniae DNA results underwent a series of tests, including chest X-ray, complete blood count, C-reactive protein, lactate dehydrogenase (LDH), and procalcitonin. According to the occurrence of RMPP, the patients were divided into two groups, RMPP group and general Mycoplasma pneumoniae pneumonia (GMPP) group. Measurement data between the 2 groups were compared using Mann-Whitney U test. Logistic regression analyses were used to examine the associations between clinical data and RMPP. Receiver operating characteristic (ROC) curves were used to analyse the power of the markers for predicting RMPP. Results:A total of 1 428 patients finished the study, with 801 boys and 627 girls, aged 4.3 (2.7, 6.3) years. Mycoplasma pneumoniae DNA was positive in 534 cases (37.4%), of whom 446 cases (83.5%) were diagnosed with Mycoplasma pneumoniae pneumonia, including 251 boys and 195 girls, aged 5.2 (3.3, 6.9) years. Macrolides-resistant variation was positive in 410 cases (91.9%). Fifty-five cases were with RMPP, 391 cases with GMPP. The peak body temperature before the first visit and LDH levels in RMPP patients were higher than that in GMPP patients (39.6 (39.1, 40.0) vs. 39.2 (38.9, 39.7) ℃, 333 (279, 392) vs. 311 (259, 359) U/L, both P<0.05). Logistic regression showed the prediction probability π=exp (-29.7+0.667×Peak body temperature (℃)+0.004×LDH (U/L))/(1+exp (-29.7+0.667×Peak body temperature (℃)+0.004 × LDH (U/L))), the cut-off value to predict RMPP was 0.12, with a consensus of probability forecast of 0.89, sensitivity of 0.89, and specificity of 0.67; and the area under ROC curve was 0.682 (95% CI 0.593-0.771, P<0.01). Conclusion:In MPP patients with fever over 48 to <120 hours, a prediction probability π of RMPP can be calculated based on the peak body temperature and LDH level before the first visit, which can facilitate early identification of RMPP.

Objective:To investigate the ego-depletion level of adolescents with type 1 diabetes mellitus (T1DM) and to explore its association with glycemic control and quality of life.Methods:This was a cross-sectional survey study. A total of 195 adolescents with T1DM were recruited from the First Affiliated Hospital of Nanjing Medical University from March to September 2022 by convenient sampling method. The Self-Regulatory Fatigue Scale (SRF-S) and Short Form of the Chinese version Diabetes Quality of Life for Youth Scale (C-DQOLY-SF) and the general information questionnaire were collected and the glycated hemoglobin (HbA 1c) value was detected. Results:The total score of self-regulatory fatigue for 195 adolescents with T1DM was (42.23 ± 9.94) points, with a scoring rate of 52.79%, which was at a medium level. Pearson correlation analysis showed that the total score of self-regulatory fatigue was positively correlated with HbA1c ( r = 0.25, P<0.01), and negatively correlated with quality of life ( r = -0.61, P<0.01). The hierarchical linear regression results showed that after controlling for demographic sociolagy and disease variables, ego-depletion had a positive predictive effect on HbA1c ( t = 3.69, P<0.01), while ego-depletion had a negative predictive effect on Quality of life ( t = -8.48, P<0.01). Conclusions:Ego-depletion of adolescents with T1DM may affect their blood glucose control and quality of life, which should be noticed by medical workers.