Objective To investigate the effect of angiotensin Ⅱ (Ang Ⅱ) type 1 receptor blocker (ARB) on 12-lipoxygenase (12-LO) activity and P-cadherin expression in type 2 diabetic rat glomeruli.Methods Podocytes were stimulated by 107 mol/L Ang Ⅱ for 24 hours.12(S)-HETE (1mg· kg 1 · d-1) and Ang Ⅱ (400 ng· kg-1· min-1) were infused to rats by osmotic mini-pump for 1 week and 2 weeks respectively.Rats fed with high fat diet received low dose streptozotocin (STZ) to make type 2 diabetes and divided into 2 groups:low dose STZ (DN group),low dose STZ + ARB treatment (Losartan group).Rats fed with regular chow were used as control group.All the rats were sacrificed after 6 weeks.Urine,blood,kidney cortical tissue and isolated glomeruli by sieving method were collected at the end of study respectively.ELISA,RT-PCR and Western blotting for related target were performed respectively.Results Ang Ⅱ increased 12(S)-HETE levels in podocytes and glomeruli (all P ＜ 0.01).Ang Ⅱ levels in the glomeruli were significantly increased by 12(S)-HETE stimulation (P ＜0.01).Blood glucose,kidney/body weight and 24 hour urinary protein were increased in DN group compared with that in control group (all P ＜ 0.01).However,urine protein,Kidney/body weight were decreased in Losartan group compared with DN group (all P ＜ 0.05).Increment of 12(S)-HETE content and decrement of P-cadherin expression were observed in DN glomeruli compared with that in control group(all P ＜ 0.01).These abnormalities were prevented by administration of the losartan (all P ＜ 0.05).Conclusions Ang Ⅱ can down-regulate glomerular P-cadherin expression via activation of 12-LO.ARB can ameliorate the progression of DN via up-regulation of glomerular P-cadherin through inhibition of 12-LO activation in type 2 DN rats.

Objective To explore and analyze the pathogen proifle and risk factors of infected diabetic foot ulcers, and propose appropriate prevention and intervention measures for early recovery of patients.Methods The data of 120 patients with diabetic foot ulcers treated in our hospital from February 2012 to May 2014 were retrospectively analyzed. These patients were classified into infection group (38 patients) and non-infection group (82 patients) based on whether their ulcer was infected or not. The pathogens and risk factors of infection in diabetic foot ulcer were analyzed.Results In this study, 43 strains of pathogenic bacteria were isolated from 38 cases of infection, of which gram positive bacteria accounted for 51.2 %, gram negative bacteria 41.9 %, and fungi 7.0 %.Staphylococcus aureus,Pseudomonas aeruginosa and Enterobacter cloacae were the top three pathogens, accounting for 16.3 % each. Univariate analysis showed that diabetic vascular complication, retinopathy, more than 2 foci of ulcer, osteomyelitis, and diabetic nephropathy were closely associated with infection (P<0.05). Multivariate logistic regression analysis showed that HDL-C, albumin, diabetic vascular complication, number of ulcers, osteomyelitis were independent risk factors for infection in patients with diabetic foot ulcer. Conclusions HDL-C, red blood cell, hemoglobin, diabetic complications, white blood cell, triglyceride, albumin, diabetic vascular complication and smoking are the risk factors for infection in patients with diabetic foot ulcer. These factors should be prevented and controlled to reduce the incidence of infection in diabetic foot ulcer.

Objective To investigate the effects of 12-lipoxygenase (12-LO) and angiotensin Ⅱ (Ang Ⅱ) on the CIP/KIP family of cyclin-dependent kinase inhibitors (CKIs) p21,p27 and p57 related to cell hypertrophy.Methods Mesangial cells were treated with high glucose for 24 hours and 48 hours respectively.12(S)-hydroxyeicosatetraenoic acid [12(S)-HETE] and Ang Ⅱ were infused to rats by osmotic mini-pump for 1 week and 2 weeks respectively.Rats fed high fat diet were received low dose streptozotocin (STZ) to make type 2 diabetes (DN).The rats were divided into normal control group,DN group,DN+Ang Ⅱ type 1 receptor blocker (ARB) group or 12-LO inhibitor (CDC) group.DN+ARB rats were treated by losartan for 6 weeks,and DN+CDC rats were treated for 8 weeks.Urine albumin and protein expressions of p21,p27 and p57 were detected by ELISA and Western blotting respectively.Glomeruli injury and expressions of p21 and p27 were detected by PAS staining and immunohistochemistry respectively.Results High glucose increased p21 and p27 protein expression in mesangial cells significantly compared with the relative control (all P ＜ 0.05),but had no effect on p57.Ang Ⅱ increased p27 protein expression in gloneruli significantly (P ＜ 0.05),but had no effect on p21 and p57 protein expression.12(S)-HETE increased both p21 and p27 protein expression in glomeruli significantly (all P ＜ 0.05),but had no effect on p57 protein expression.Blood glucose,kidney/body weight,urinary protein,and glomerular p21 and p27 protein expressions were increased in DN group (all P ＜ 0.05) compared with those in control group,with little change of p57 protein expression (P ＜ 0.05).Moreover,glomerular hypertrophy and extra cellular matrix accumulation were observed in DN group.However,urine protein,kidney/body weight,renal injury,but not blood glucose,were decreased in DN+ARB group and DN+CDC group compared with DN group respectively (P＜ 0.05).Further DN+CDC rats had decreased both p21 and p27 protein expressions in glomeruli,but DN+ ARB rats only had decreased p27 protein expression (all P ＜ 0.05).Conclusions 12-LO may induce both p21 and p27 protein expression in DN glomeruli,but Ang Ⅱ may induce only p27 expression.

Objective To study the cellular changes of colonic smooth muscle cells in rats with spleen-deficiency functional diarrhea treated with Pixu Sihao Fang (PXSHF, No.4 Formula for Spleen Deficiency) dosed serum.Methods Colonic smooth muscle cells from functional diarrhea spleen-deficiency rats were extracted for primary culture and then divided into the following six groups: normal control group, model group, PXSHF low-dose, medium-dose, and high-dose groups, and montmorillonite powder (Mnt) group.All the dosed serum groups were treated with 5% drug serum for 48 h.CCK-8 test for detecting the cell proliferation activity and QRT-PCR test for checking the expression of brain-gut petide mRNA were performed.Results OD value of the model group was significantly lower than that of the control group (P<0.01) in CCK-8 test while the OD value of the drug serum groups were significantly higher than that of the model group (P<0.01).QRT-PCR test showed that the CCK/VIP/SS mRNA expression of the model group was significant lower than that of the control group (P<0.05).Compared with the model group, the CCK/VIP/SS mRNA expression in each drug serum group presented with an increase tendency.CCK mRNA expression of the group treated with low-dose PXSHF dosed serum was higher than of the model group (P<0.05).VIP mRNA expression of the groups treated with PXSHF dosed serum were significantly higher than that of the model group (P<0.01).Conclusion PXSHF dosed serum can effectively promote the proliferation activity of the colonic smooth muscle cells.Changes in the expression of CCK, VIP and SS mRNA might be indicative of the role of brain-gut peptide in the development of functional diarrhea with spleen deficiency pattern.

Day surgery, as a new perioperative management model that is safe, efficient, and consumes a small amount of medical resources, has been widely recognized in recent years. With the requirements of China's new healthcare system reform and the promotion of national policies, there is a significant increase in hospitals carrying out day surgery, and they are about to enter a new stage of rapid development. Adequate preoperative evaluation of patients undergoing day surgery is an important link in improving perioperative care during day surgery. This article reviews the importance, location and personnel, methods, timing and content of day surgery preoperative evaluation, and current situation of day evaluation in China, in order to provide reference for clinical workers related to day surgery.

Objective To investigate the efficacy of leflunomide combined with prednisone in the induction therapy of proliferative lupus nephritis (LN).Methods A prospective,multicenter,randomized controlled clinical trial was conducted in patients with biopsy-proved proliferative lupus nephritis recruited from 15 renal centers from 2013 to 2015.Patients were randomized to two groups.Oral leflunomide or intravenous cyclophosphamide was given to patients in each group.Both groups received a tapering course of oral prednisone therapy.All patients were followed up for 24 weeks.The blood biochemistry,urine index,clinical curative effect and adverse reaction were recorded and analyzed statistically.Results A total of 100 patients were enrolled in this clinical trial,including 48 patients in leflunomide group and 52 patients in cyclophosphamide group.After 24 weeks,the overall response rate was 79％ (95％ CI 67％-90％) in the leflunomide group and 69％ (95％ CI 56％-82％) in the cyclophosphamide group.23％ (95％CI 11％-35％) of patients in leflunomide group showed complete remission compared with 27％ (95％CI 24％-30％) in cyclophosphamide group (P=0.35).The levels of 24-hr urine protein excretion,SLEDAI and anti-dsDNA antibody titers were decreased in patients treated with leflunomide group after 24-weeks treatment.And the levels of serum albumin and complement 3 after treatment were significantly higher compared with these before treatment.There was also no significant difference in changes of 24-hr urine protein excretion,SLEDAI score,anti-dsDNA antibody titers,serum albumin and complement C3 levels after treatment between two groups.Incidence of adverse events did not differ between the leflunomide and cyclophosphamide group.Conclusions Leflunomide combined with prednisone showed same efficacy compared with cyclophosphamide as induction therapy for lupus nephritis.Leflunomide might be an useful medicine in the induction therapy of lupus nephritis.

Objective:To retrieve, evaluate, and integrate the best evidence for preoperative evaluation and management of adult day surgery patients.Methods:The guidelines, evidence summary, systematic review, expert consensus and randomized controlled trial on preoperative evaluation and management of adult day surgery patients were systematically searched on Guidelines International Network, Chinese Clinical Guidelines Library, Clinical Practice Guideline of Canadian Medical Association, Scottish Intercollegiate Guidelines Network, Yimaitong, New Zealand Guidelines Group, China Ambulatory Surgery Alliance, National Institute for Health and Clinical Excellence, Chinese Medical Journal Network, Agency for Healthcare Research and Quality, UpToDate, Cochrane Library, Australian Joanna Briggs Institute Evidence-Based Healthcare Center Database, British Medical Journal (BMJ) Best Practice, PubMed, Web of Science, CINAHL, Elsevier, Embase, Medline, WanFang Data, China National Knowledge Infrastructure, China Biomedical Literature Database and other databases. After conducting methodological quality evaluation, evidence was extracted and integrated based on the theme. The search period was from the establishment of the database to May 15, 2023. Two researchers trained in evidence-based knowledge conducted a rigorous literature quality evaluation, evidence extraction, and integration of all included literature.Results:A total of 12 articles were included, including two guidelines, six evidence summaries, three expert consensus and one randomized controlled trial. A total of 24 pieces of evidence were collected from five aspects, including evaluation timing and evaluation method, evaluation personnel, evaluation location, evaluation content, education and training, and quality improvement.Conclusions:The best evidence for preoperative evaluation and management of adult day surgery patients provides evidence basis for clinical medical and nursing staff to conduct preoperative evaluation and management comprehensively and effectively.