Transforming growth factor-β1(TGF-β1)has become an important biological marker and therapeutic target of clinical progression of chronic kidney diseases. Sma- and Mad-related protein (Smad)is a downstream signal transduction protein of the TGF-β family. TGF-β1 activates Smad2 and Smad3 before increasing the transcription of connective tissue growth factors in the nucleus. Smad3 promotes mesangial cell proliferation,extracellular matrix accumulation,epithelial-mesenchymal transition, leading to renal fibrosis. However,Smad2 and Smad7 play a negative regulatory role by inhibiting renal fibrosis. TGF-β1 specific inhibitor (SB431542,etc.) has antifibrosis effect,most of which is in the preclinical stage. The drugs on the market that are effective for DN,such as benzodiazepines,atorvastatin, losartan,and pirfenidone,can inhibit the expression of TGF-β1,while tripterygium wilfordii,cordyceps sinensis,and berberine can delay the process of diabetic nephropathy by reducing TGF-β1 levels.

The present residents training for ultrasound departments depends mostly on poorlyscheduled rotation and clinical clerkship,with repeated and obsolete subjects in their training.The authors identified these setbacks and such characteristics as complication of ultrasound medicine,complex and variable ultrasonic scan technique,and the high threshold for beginners.In view of this,the authors adopted the tutorial system training mode for cultivating the residents in their medical care,teaching,research and foreign language competencies.A questionnaire survey of 44 residents so trained evaluated outcomes of the mode,with constructive suggestions raised on expansion of the training base,improvement of teachers’competency and reduction of trainees' workload.

Objective To investigate the effect of transcatheter arterial chemoembolization (TACE)combined with radiofrequency ablation (RFA) in the treatment of liver cancer,and its influence on the serum markers.Methods 108 patients with primary liver cancer were selected as the subjects of this study.According to the random number table method,the patients were divided into two groups.The control group (54 cases) received TACE treatment,and the observation group (54 cases) received TACE combined with RFA treatment.The treatment effects,the changes of tumor recurrence related indicators and the levels of tumor related indicators were compared and analyzed.Results The effective rate of the observation group was 79.7 ％ (43/54),which was significantly higher than 50.0％ (27/54) of the control group (x2 =10.391,P =0.001).After treatment,the E-calcium protein (EC),vascular endothelial growth factor (VEGF),matrix metalloproteinase (MMP),tumor recurrence index alpha fetoprotein (AFP),CA199,glutamate transferase (GGT) levels in the observation group were (1 738.8 ± 114.8) μg/L,(207.9 ± 37.2) ng/L,(34.9 ± 4.6) ng/L,(72.2 ± 19.5) μg/L,(34.2 ± 5.1) U/L,(88.9 ± 9.4) U/L,respectively,which were significantly lower than those in the control group [(2 382.4 ± 159.4) μg/L,(367.3 ± 49.3) ng/L,(72.1 ± 7.4) ng/L,(135.2 ± 21.8) μg/L,(66.9 ± 8.2) U/L,(124.6 ± 12.5) U/L],the differences were statistically significant(t =24.076,18.967,31.373,15.828,24.884,16.774,all P ＜0.05).Conclusion TACE combined with RFA is effective in the treatment of liver cancer,which can effectively kill tumor cells and reduce the contents of serum tumor markers,and it is worthy of popularizing in clinic.

Diabetic nephropathy （DN） has become one of the main causes of end-stage renal disease，and its pathogenesis is still unclear. Currently，it is believed to be closely related to kidney injury mediated by various factors such as autophagy disorder under the condition of high glucose，oxidative stress and inflammation. Mammalian target of rapamycin （mTOR） signaling pathway is crucial for protein synthesis and autophagy regulation，which plays an important role in the occurrence and development of DN. In recent years，the research on the prevention and treatment of DN with traditional Chinese medicine （TCM） has made important progress. Plenty of evidence has shown that the active ingredients of TCM can enhance autophagy，improve oxidative stress and inflammation，inhibit cell apoptosis and abnormal proliferation by regulating mTOR signaling pathway，so as to relieve pathological changes in the kidney such as podocyte injury，glomerular basement membrane thickening，mesangial tissue abnormalities and renal tubule dysfunction，thereby reducing proteinuria and improving renal function. All of the above are of great significance for delaying the progression of DN. This article systematically summarizes the research progress of saponins，flavonoids，polyphenols，alkaloids， terpenoids and other active ingredients of TCM intervening in DN through mTOR signaling pathway，in order to provide some reference for further basic research and the development of new drugs.

Obesity type 2 diabetes mellitus （T2DM） strengthens insulin resistance （IR） and metabolic abnormalities and significantly increases the risk of heart disease， cancer， and other diseases， and it is characterized by IR and malnutrition. As a metabolic regulation center， adenosine phosphate activated protein kinase （AMPK） mainly responds to the changes in intracellular serine/threonine kinase adenosine monophosphate （AMP） levels. After its activation， AMPK converts the cell metabolism mode from synthesis to decomposition to improve energy metabolism and acts on pathological conditions such as inflammation， ischemia， obesity， and aging. In recent years， a large number of studies have found that AMPK is an important target for the treatment of obesity T2DM. Traditional Chinese medicine（TCM） monomers/extracts and TCM formulas mainly affect the mammalian target of rapamycin （mTOR）， recombinant sirtuin 1 （SIRT1）， nuclear factor erythroid 2-related factor 2 （Nrf2）， nuclear factor kappa-B （NF-κB）， and other key signaling factors by regulating the AMPK signaling pathway， so as to achieve a variety of effects such as regulating metabolism and autophagy， reducing oxidative stress and inflammatory response， and treating obesity T2DM. It also has advantages such as multiple targets， comprehensiveness， and low toxicity. The regulation of the AMPK pathway by TCM in the prevention and treatment of obesity T2DM has become an important research direction at the present and in the future， but there is no systematic summary and induction in this field. Therefore， this article attempts to summarize the composition and regulatory mechanisms of the AMPK signaling pathway in affecting obesity. It provides a review of the current research status of TCM in regulating the AMPK signaling pathway for the prevention and treatment of obesity T2DM， so as to provide a reference for the diagnosis and treatment of obesity T2DM in TCM and the development of new drugs.

Objective To explore the relationship between the expression levels of microRNA-155(miR-155)and suppressor of cytokine signaling 1(SOCS1)in the colonic mucosal tissue of patients with ulcerative co-litis(UC)and the severity of the disease.Methods A total of 130 UC patients admitted to the Second Affiliated Hospital of Hebei North University from September 2021 to June 2023 were selected.According to the modified Mayo score system,the patients were assigned into an active stage group(n=85)and a remission stage group(n=45).According to the modified Truelove and Witts classification criteria,the UC patients at the active stage were as-signed into a mild group(n=35),a moderate group(n=30),and a severe group(n=20).A total of 90 healthy individuals who underwent colonoscopy for physical examination or those who had normal colonoscopy re-sults after single polypectomy and excluded other diseases were selected as the control group.The colonic mucosal tissues of UC patients with obvious lesions and the colonic mucosal tissue 20 cm away from the anus of the control group were collected.The levels of miR-155 and SOCS1 mRNA in tissues were determined by fluorescence quanti-tative PCR,and the expression of SOCS1 protein in tissues was determined by immunohistochemistry.The corre-lations of the levels of miR-155 and SOCS1 mRNA in the colonic mucosal tissue with the modified Mayo score of UC patients were analyzed.The values of the levels of miR-155 and SOCS1 mRNA in predicting the occurrence of severe illness in the UC patients at the active stage were evaluated.Results Compared with the control group and the remission stage group,the active stage group showed up-regulated expression level of miR-155,down-regula-ted level of SOCS1 mRNA,and decreased positive rate of SOCS1 protein in the colonic mucosal tissue(all P＜0.001).The expression level of miR-155 and modified Mayo score in colonic mucosal tissues of UC patients at the active stage increased,while the mRNA level of SOCS1 was down-regulated as the disease evolved from being mild to severe(all P＜0.001).The modified Mayo score was positively correlated with the miR-155 level and neg-ative correlated with the mRNA level of SOCS1 in colonic mucosal tissues of UC patients(all P＜0.001).The high miR-155 level(OR=2.762,95％CI=1.284-5.944,P=0.009),low mRNA level of SOCS1(OR=2.617,95％CI=1.302-5.258,P=0.007),and modified Mayo score≥ 12 points(OR=3.232,95％CI=1.450-7.204,P=0.004)were all risk factors for severe disease in the UC patients at the active stage.The ar-ea under curve of miR-155 combined with SOCS1 mRNA in predicting severe illness in the UC patients at the ac-tive stage was 0.920.Conclusions The expression levels of miR-155 and SOCS1 mRNA were correlated with the disease severity in the UC patients at the active stage.The combination of the two indicators demonstrates good performance in predicting the occurrence of severe illness in UC patients at the active stage.

Objective:To assess the impact of the construction of smoke-free government on the smoking and cessation behaviors of staff members.Methods:This was a retrospective cohort study. The study used stratified random cluster sampling method to select 144 government institutions from 31 Provinces (Autonomous Regions and Municipalities) and the Xinjiang Production and Construction Corps. The survey was carried out between October and November, 2023 by filling out questionnaires online among the insiders of the institutions and all the smoking staff members. The main indicators included the number of smokers before and after the construction of smoke-free governments and the measures for the construction of smoke-free governments. 144 questionnaires from insiders were recovered, all of which were included in the analysis; 1 776 questionnaires from smokers were recovered, including 1 716 valid questionnaires. The SAS 9.4 was used to perform χ 2 test and log-binomial regression analysis. Results:The percentage of smoking staff members decreased from 8.81% before the construction to 6.70% after the construction, and the difference was statistically significant ( χ 2=63.23, P<0.001). Comprehensive smoking ban in indoor public places ( OR=2.301, 95% CI: 1.433-3.694), punishment mechanism for smoking staff members ( OR=1.219, 95% CI: 1.124-1.322), smoking cessation competitions ( OR=1.865, 95% CI: 1.234-2.818) and reimbursement for or provision of smoking cessation medications ( OR=2.210, 95% CI: 1.002-4.874) were facilitators to motivate the smoking staff members to quit (all P<0.01). Numbers of smoking leaders ( OR=0.858, 95% CI: 0.807-0.913) and smoking years of smoking staff members ( OR=0.932, 95% CI: 0.918-0.946) negatively influenced the smoking staff members to quit (both P<0.001). Conclusions:The construction of smoke-free governments can effectively promote the smoking cessation behaviors of smoking staff members. In addition, comprehensive smoke-free policies, punishment mechanism for smoking staff members and activities such as smoking cessation competitions, and reimbursement for or provision of smoking cessation medications are important.

[Abstrca t] Objective BRCA 1 ( breast cancer susceptibility gene 1) and RAP80 ( receptor-associated protein 80) play key roles in predicting chemosensitivity of platinum and taxanes .A randomized trial was carried out to compare non-selected cisplatin-based chemotherapy with therapy customized according to BRCA1 and RAP80 expression.Methods Advanced stage NSCLC patients whose tumor specimen was sufficient for molecular analysis were randomized (1∶3) to the control or experimental arm.Patients in the control arm received docetaxel/cisplatin; in the experimental arm , patients with low RAP 80 expression received gemcitabine/cisplatin ( Arm 1 ) , those with intermediate/high RAP 80 expression and low/intermediate BRCA 1expression received docetaxel/cisplatin ( Arm 2 ) , and those with intermediate/high RAP80 expression and high BRCA1 expression received docetaxel alone (Arm 3).The primary end point was progression-free survival (PFS).Results 226 patients were screened and 124 were randomized in this trial.ORR in the four subgroups was 22.6%, 48.4%, 30.3%and 19.2%, respectively (P=0.08);PFS was 4.74, 5.59, 3.78 and 2.73 months, respectively (P=0.55); and OS was 10.82, 14.44, 10.86 and 10.86 months, respectively (P=0.84).The common adverse effects included neutropenia , nausea, anemia and fatigue.Conclusions No statistically significant difference of ORR , PFS or OS is observed in the experimental arms compared with the control arm .Patients with low RAP 80 mRNA levels have a trend of better survival and higher response rate to gemcitabine /cisplatin chemotherapy .

OBJECTIVE To investigate the improvement effects of limonin on intestinal injury and intestinal flora disturbance in rats with ulcerative colitis （UC） and its mechanism. METHODS UC rat models were established， and 70 rats with successful modeling were randomly divided into model group， limonin low-， medium-， and high-dose groups （12.5， 25， 50 mg/kg）， and sulfasalazine group （positive control group，500 mg/kg）， with 14 rats in each group. Another 14 rats were selected as the control group. After modeling， each group was given the corresponding drug or equal amount of normal saline， once a day， for 2 weeks. Twenty-four hours after the last administration， the general condition of rats was observed and the body weight was measured， and colon tissue was collected for colonic mucosal damage index （CMDI） scoring； the levels of interleukin-1β （IL-1β）， IL-6 and tumor necrosis factor-α （TNF-α） in colon tissue were detected； the pathological changes of colon tissue were observed； the protein expressions of Claudin-1， Occludin， ZO-1， high mobility group protein B1 （HMGB1） and receptor for advanced glycation end products （RAGE） in colon tissue were detected； fecal 16S rRNA sequencing was used to detect the relative abundance of zhangxiaxia5287@163.com intestinal microbiota in rats. RESULTS Compared with the control group， the rats in the model group were in poor mental state， with darker fur， irritable mood， disordered arrangement of colon glands， inflammatory cell infiltration， cell necrosis and edema； CMDI score， the levels of IL-1β， IL-6 and TNF-α， protein expressions of HMGB1 and RAGE in colon tissue， the relative abundance of Proteobacteria and Bacteroidetes were significantly increased （P＜0.05）； body weight， the protein expressions of Claudin-1， Occludin and ZO-1 in colon tissue， the relative abundance of Firmicutes in the intestine were significantly decreased （P＜0.05）. Compared with the model group， general situation and pathological damage of colonic tissue in limonin groups were improved， the levels of the above indicators were significantly reversed （P＜0.05）， and in a dose-dependent manner （P＜0.05）； there was no significant difference in various indexes between sulfasalazine group and limonin high-dose group （P＞0.05）. CONCLUSIONS Limonin can improve intestinal injury and intestinal flora disturbance in UC model rats， the mechanism of which may be associated with the down-regulation of HMGB1/RAGE signaling pathway.

Objective To explore the mediation effect of emotional intelligence in social support and subjective happiness,and to provide practical guidance for scientific management of nursing talents in hemodialysis center.Methods Using a cross-sectional study,by a proportional stratified sampling method,from October 2022 to January 2023,800 hemodialysis nurses in Guangzhou area were selected as the respondents,using the general data adjustment table,general well-being schedule(GWB),social support rating scale(SSRS),and wong law emotional intelligence scale(WLEIS-C).The pearson correlation was used to analyze the correlation between emotional intelligence,social support and subjective happiness of hemodialysis nurses in Guangzhou;the process macro program was used to explore the mediation effect of emotional intelligence in social support and subjective happiness in Guangzhou.Results 707 valid questionnaires were collected,and the effective recovery rate was 88.38%.The total score of subjective well-being of hemodialysis nurses in Guangzhou was(75.67±8.17),the total score of emotional intelligence(82.29±16.20),and the total score of social support(38.76±8.40).The total score of social support was positively associated with the total score of subjective well-being(r=0.517,P<0.01)and the total score of emotional intelligence(r=0.633,P<0.01),the total score of emotional intelligence was positively related to the total score of subjective well-being(r=0.634,P<0.01).Social support had a direct effect on subjective well-being(β=0.165,95%CI:0.103-0.261),and indirectly affected it through the partial mediation effect of emotional intelligence(β=0.095,95%CI:0.069-0.142),and the indirect mediation effect accounted for 36.54%of the total effect.Conclusion Guangzhou area hemodialysis nurses subjective well-being is in upper level,and emotional intelligence in hemodialysis nurses social support and subjective happiness plays intermediary effect,managers should focus on hemodialysis nurses emotional intelligence,take various measures to improve their emotional intelligence level,enhance social support,so as to improve hemodialysis nurses subjective well-being.