ObjectiveTo explore the effects of nutritional intervention and individualized nursing on nutritional risk, undernutrition and quality of life (QOL) in end-stage renal disease (ESRD) patients with peritoneal dialysis. MethodsA total of 104 ESRD patients with peritoneal dialysis who met the inclusion criteria of the protocol were enrolled and randomized to receive nutritional intervention plus individualized nursing ( study group, n =52 analyzed) or self-diet plus routine nursing ( control group, n =50 analyzed) for 6 months. Nutritional risk, anthropometry, and QOL of the two groups were analyzed pre- and post-nutritional intervention. ResultsBaseline data were comparable in the two groups. Prevalences of nutritional risk and undernutrition in study group were significant lower than those in control group after the intervention ( nutritional risk: 32.6％ vs. 56.0％, P =0.028 ;undernutrition: 15.4％ vs. 34.0％, P =0.038). The decrease of grip strength in study group between pre- and post-study was significantly less than that in control group [( - 1.6 ± 0.9 ) kg vs. ( - 9.9 ± 1.4 ) kg, P =0.001], but there were no significant differences in other parameters related to anthropometry, including triceps skin-fold thickness, upper arm circumference, and arm muscle circumference ( all P ＞ 0.05 ). The QOL score significantly increased in study group after intervention but decreased in control group. The differences of renal disease and dialysis-related scores ( △KDTA: 2.5 ± 4.4 vs.- 7.9 ± 7.4, P =0.001 ) and general condition scores (△SF-36 : 3.4 ±4.1 vs.- 6.8 ± 6.3, P =0.001 ) before and after intervention were significantly different between two groups. ConclusionNutrition intervention and individualized nursing may help to improve the nutritional status and QOL in ESRD patients with peritoneal dialysis.

Objective To investigate the relationship between hematocrit(HCT) and the risk of nonalcoholic fatty liver disease.Methods A community-based health examination survey in individuals who were randomly selected from residents living in the urban area of Xuzhou was carried out in 2006.2 798 subjects without nonalcoholic fatty liver disease were included in the present study.Subjects were divided into two groups according to HCT level,group A (HCT ≤ 0.49 L/L) and group B (HCT ＞ 0.49 L/L).Serum alanine aminotransferase,aspartate aminotransferase,triglycerides,total cholesterol,high density lipoprotein-cholesterol,low density lipoproteincholesterol,fasting plasma glucose,and imaging examinations were determined.Results The prevalence of nonalcoholic fatty liver disease was higher in group B than that in group A (26.5％ vs 15.9％,P＜0.01),and the difference was statistically significant.Logistic regression showed that the incidence of nonalcoholic fatty liver disease was increased along with elevated levels of HCT.Conclusions HCT is found to be correlated with the prevalence of nonalcoholic fatty liver disease.

Methotrexate (MTX)has dual effects of anti-inflam-matory and immune suppression,and its pharmacological mecha-nism is complex,diverse and synergistic.This paper summari-zes the main anti-inflammatory mechanism of low-dose MTX,in-cluding inhibition of JAK/STAT pathway,inhibition of inflam-matory reaction and immune response,increasing the accumula-tion of adenosine and the function of intracellular metabolites (methotrexate polyglutamate).In addition,low-dose MTX can inhibit oxidation by decreasing the level of lipid peroxidation, suppress the inflammatory response to secondary spinal cord in-jury,reduce spinal cord ischemia reperfusion injury and neuro-pathic pain,thus playing a neuroprotective role by a series of pharmacological mechanism.The anti-inflammatory mechanism of low-dose MTX and its application in spinal cord injury were reviewed,to guide the further research on the anti-inflammatory effect of MTX,and provide a theoretical basis for new drugs for clinical treatment of spinal cord injury.

Objective To OxplorO thO clinical Officacy of oral fluconazolO combinOd with clotrimazolO vaginal administration in thO trOatmOnt of candida vaginitis by mOta analysis. Methods FluconazolO combinOd with clotrima-zolO was sOlOctOd as OxpOrimOnt group and clotrimazolO alonO was sOlOctOd as control group. ThO randomizOd controllOd trials( RCTs) wOrO rOtriOvOd from PubMOd, CochranO library, EmbasO, China Notional KnowlOdgO infrastructurO (CNKI), WangFang and VIP databasO and rOfOrOncOs listOd in all studiOs. RCTs mOOting inclusivO studiOs wOrO includOd, thO data wOrO OxtractOd, thO quality was OvaluatOd and cross - chOckOd by two rOviOws indOpOndOntly according to CochranO Handbook for SystOmatic ROviOws of IntOrvOntions and thOn MOta -analysis was conductOd using Stata14.0 softwarO. Results A total of 15 studiOs and 1 792 patiOnts wOrO includOd.ThO OxpOrimOnt group had a highOr ovOrall OfficiOncy(OxpOrimOnt group in 96.13% and control group in 83.8% ),thO diffOrOncO was statistically significant (RR=1.13,95% CI 1.08~1.18,P<0.001). ThO rOcurrOncO ratO aftOr trOatmOnt( OxpOrimOnt group in 6.46% and control group in 20.74% ) had statistically significant diffOrOncO bOtwOOn thO two groups ( RR=0.31, 95% CI 0.21~0.46,P<0.001).Conclusion MOta analysis showOd that oral fluconazolO combinOd with clotrima-zolO vaginal administration has a bOttOr clinical Officacy.

Objective: To analyze the clinical efficacy and safety of thalidomide combined with conventional chemotherapy in treatment of acute leukemia by using Meta analysis. Methods: Thalidomide combined with conventional chemotherapy was treated as the experiment group, chemotherapy alone was treated as the control group. Thalidomide was taken 100mg once a day, oral administration. The literatures were retrieved from PubMed, Cochrane library, Embase, China Notional Knowledge Infrastructure (CNKI),Wanfang and VIP database. The data of the randomized controlled trial (RCT) conformed to inclusion criteria were extracted, and the quality was evaluated, and then StataMP 14.0 software was used to make a Meta analysis. Results: A total of 14 studies with 752 patients were included. The experiment group had a higher complete remission rate and the overall response rate compared with the control group, and the difference was statistically significant (RR= 1.61, 95% CI 1.36-1.90, P < 0.01; RR= 1.36, 95%CI 1.24-1.50, P < 0.01). The experiment group had a better efficacy in the improvement of vascular endothelial growth factor (VEGF), VEGF receptor (VEGFR), basic fibroblast growth factor (bFGF) and bone marrow microvessel density (MVD) after the treatment compared with the control group, and the differences between the two groups were statistically significant (all P < 0.05), but there was no significant difference in the adverse events between the two groups (all P > 0.05). Conclusion Meta analysis showed that oral administration daily thalidomide 100 mg combined with conventional chemotherapy has a better clinical efficacy and antiangiogenic effect compared with chemotherapy alone, without the increase of adverse reactions.

Objective To investigate the prevalence of Helicobacter pylori(H.pylori)positivity in the urban areas of Chongqing and its relationship with age,season,and gender.Methods A total of 4,836 patients who underwent 14C-UBT testing at our hospital from April 2023 to March 2024 were selected.The detection rate of H.pylori and the infection status of H.pylori in different age groups,genders,and seasons were analyzed.Logistic regression analysis was performed on factors related to H.pylori infection identified in the univariate analysis.Results The positive detection rate of H.pylori in the 4,836 subjects was 29.3％,with a higher rate in males than in females,showing a statistically significant difference(P＜0.05).The highest positive detection rate of H.pylori was in the summer season,and the peak positivity rate for H.pylori was observed in the 30-39 age group.There was a statistically significant difference in the positive detection rate of H.pylori across seasons and among different age groups(P＜0.05).Multivariate logistic regression analysis indicated that gender,age,and season were all influential factors in the outcome of H.pylori infection(P＜0.05).Conclusion The prevalence of H.pylori infection in the urban areas of Chongqing is relatively low,and gender,age,and season are all influential factors for H.pylori infection.

Objective:To analyze the status quo and advanced trend of voice training research in the world, and provide new ideas for voice training research in China.Methods:The literature on voice training in Web of Science core collection database was searched from January 1, 2013 to July 31, 2023, and visual analysis was performed using CiteSpace 6.1.R6 software.Results:A total of 964 papers were retrieved, and the number of published papers showed an increasing trend. The country with the largest number of publications was the United States, with 387. The Journal with the most publications was Journal of Voice. The research focused on voice rehabilitation of patients with different voice disorders, voice training intervention methods, improvement of quality of life and improvement of training compliance. The application of voice training in geriatric diseases might be a future research trend. Conclusions:At present, the field of voice training is deepening in the direction of new research and application, and the public's demand for voice rehabilitation is increasing. It is suggested that multidisciplinary collaboration should be strengthened in the future to explore the clinical efficacy of voice training in more different populations and diseases.

The λ pattern is a rare electrocardiogram feature in clinical practice,which often indicates the occurrence of impending fatal ventricular tachyarrhythmias or sudden cardiac death.In this case,Holter monitoring recorded a progressive evolution of the λ pattern followed by advanced atrioventricular blocks in a patient with chest pain accompanied by syncope.λ sign occurred at the time of chest pain,and advanced atrioventricular blocks were recorded at the time of subsequent syncope.Coronary stenosis was detected in the left circumflex by coronary angiography.The patient recovered after stent implantation in the culprit vessel and related medications to prevent coronary spasm.Our case indicate that the λ pattern could occur prior advanced atrioventricular blocks-induced syncope in patient with ischemic heart disease.

Objective To investigate the protective effect of Guanxinning(GXN)tablet on dilated cardiomyopathy(DCM),and to explore its effect and mechanism in pyroptosis of cardiomyocytes via the NLRP3/ASC/Caspase-1 pathway.Methods Rats were divided into GXN low-dose,GXN high-dose,digoxin,model control,and normal control groups.The DCM model was induced by multiple intraperitoneal injections of 17.5 mg/kg doxorubicin(DOX).The drug was administered at the same time as the model was established for 10 weeks.After the last administration,echocardiography was used to assess cardiac function indexes.After sacrificing the rats,serum was collected to measure IL-1β and IL-18 levels.RT-PCR was used to detect mRNA expression of NLRP3,ASC,Caspase-1,NF-κB,TXNIP,IL-1β,and IL-18.Immunohistochemistry and immunofluorescence staining and Western Blot were used to assess NLRP3,ASC,Caspase-1,IL-1β,and IL-18,GSDMD and GSDMD-NT protein,and TUNEL staining result.Changes in the microstructure of cardiomyocytes were observed by transmission electron microscopy.Results Compared with the normal control group,IVSs,IVSd,LVPWs,FS,SV,EF,and HR of the model control group were significantly reduced,LVIDs,ESV,and serum IL-1β and IL-18 were significantly increased,NLRP3,ASC,Caspase-1,NF-κB,TXNIP,IL-1β and IL-18 mRNA expression was significantly increased,and NLRP3,ASC,Caspase-1,IL-1β,IL-18 and GSDMD-NT protein expression and the TUNEL staining area were increased significantly,and the microstructure of cardiomyocytes changed significantly.Compared with the model control group,GXN significantly increased IVSs,SV,FS,EF,and HR,significantly reduced LVIDs,ESV,and the serum levels of IL-1β and IL-18,and reduced NLRP3,ASC,Caspase-1,NF-κB,TXNIP,IL-1β,and IL-18 mRNA expression,NLRP3,ASC,Caspase-1,IL-1β,IL-18 and GSDMD-NT protein expression,and the TUNEL staining area.Additionally,the microstructure was improved significantly.Conclusions GXN alleviates cardiomyocyte pyroptosis in rats with DCM by inhibiting the NLRP3/ASC/Caspase-1 pathway.

Objective To study the effects and mechanisms of Smilax glabra flavonoids(SGF)on myocardial hypertrophy and cardiac inflammation induced by isoproterenol(ISO)in mice.Methods C57/6J mice were randomly divided into a normal group,ISO model group(1.25 mg/(kg·d)),SGF low-dose group(50 mg/(kg·d)),and SGF high-dose group(100 mg/(kg·d)).The SGF groups were given prophylactic SGF for 7 days before modeling,then subcutaneous ISO injection was given to each group,and echocardiography was performed after continuous injection for 7 days.Serum was separated from orbital blood,and the NT-proBNP and inflammatory factor(IL-1β,IL-6,and TNF-α)contents of the blood were detected.Myocardial specimens were collected,and pathological changes to myocardial tissue were observed.Myocardial ROS levels were detected by DHE staining.The mRNA levels of heart-related hypertrophy genes and changes in the expression of key proteins in the inflammatory pathway of NLRP3/Caspase-1/IL-18 in myocardial tissue were detected.Results SGF prophylactic administration decreased IVSd,IVSs,and EF in echocardiography and increased LVIDs,LVIDd,and LVESV.The IL-1 β,IL-6,TNF-α,and NT-proBNP contents of blood decreased,and the mRNA expression levels of the heart-related hypertrophy genes for ANP,BNP,and β-MHC were subdued.The increase in myocardial ROS levels was also inhibited.The protein expression of NLRP3,Caspase-1(p20),and IL-18,which are key factors in the NLRP3/caspase-l/IL-18 inflammatory pathway,was down-regulated in myocardial tissue.The hypertrophy and disordered arrangement of cardiomyocytes were improved,the increase in fibroblast numbers outside myocardial fibers was reduced,and the infiltration of inflammatory cells and fibrosis of myocardial tissue were alleviated.Conclusions SGF can improve ISO-induced myocardial hypertrophy and cardiac inflammation in mice and may act through the NLRP3/Caspase-1/IL-18 inflammatory pathway.