The effects of pioglitazone on the expressions of hypoxia-inducible factor-1 α (HIF-1 α) and vascular endothelial growth factor (VEGF) in renal tissues of diabetic rats were observed. Diabetic rat model was established by feeding high-carbonhydrate-fat diet and injecting streptozotocin. After the treatment with pioglitazone, the kidney index, 24 h urinary albumin, blood urea nitrogen, serum creatinine, fasting blood glucose, fasting insulin, homeostasis model assessment for insulin resistance (HOMA-IR), total cholesterol,triglycerides, and low-density lipoprotein-cholesterol of diabetic rats were significantly lower than those of untreated ones, high-density lipoprotein-cholesterol was increased, the expressions of HIF-1α and VEGF in renal tissue were decreased ( all P＜0. 01 ). It suggested that pioglitazone may improve renal function and the balance of glucose-lipid metabolism in diabetic rats via down-regulating HIF-1/VEGF pathway.

Objective To investigate the efficacy of sling-exercise therapy on cervicogenic headache. Methods 60 patients with cervicogenic headache were divided into 2 groups with 30 patients each. Group I received paravertebral block of C2 once a week for 4 weeks, and Group II received sling-exercise therapy 3 times a week in addition. The Visual Analogue Score (VAS), frequency of pain (per month) before and 1, 3, 6 months after treatment were recorded, and the incidence of improvement was observed. Results In group I, VAS significantly improved 1 and 3 months after treatment (P<0.001), while it lasted 6 months in group II (P<0.001). The VAS improved more in group II 3, 6 months after treatment (P<0.001). It was similar in pain frequency. The incidence of improvement was 33.3% (10/30) and 73.3% (22/30) in group I and group II, respectively (P<0.01). Conclusion Sling-exercise therapy may improve the efficacy of paravertebral block on cervicogenic headache, especially for the long-term.

Objective To investigate the protective effect of quercetin on diabetic nephropathy and to explore its possible mechanism.Methods Type 2 diabetes mellitus rat model was established by feeding high-carbonhydrate-fat diet and injecting with streptozotocin.At 72 hour after injection,blood samples were collected from the tail veins of all rats.Those rats with blood glucose level ≥ 16.7 mmol/L were considered as the diabetes model been successfully established.The model rats were randomly divided into type 2 diabetic group ( group DM,n =9 ) and quercetin group ( group QUE,n =9 ).Other rats were used as normal controls (group NC,n =8).All rats were performed by intragastric administration for 8 weeks.At the end of experiment,the rats were sacrificed and fasting plasma glucose( FPG),fasting insulin( Flns),serum creatinine (SCr),blood urea nitrogen(BUN),TG,TC,LDL-C,24 h urine protein (24 h UP),and kidney index ( KI ) were evaluated.Pathological changes of kidney were observed by periodic acid-silver metheramine( PASM ).The expressions of ubiquitin and NF-κB p65 on glomeruli w ere examined by immunohistochemical method,and its association with the incidence of proteinuria was analyzed.Results In groups DM and QUE,the level of FPG [ ( 25.45 ± 1.23 ) mmol/L and ( 19.99 ± 1.20 ) mmoL/L],FIns [ ( 25.67 ± 2.58 ) mU/L and ( 19.29 ± 1.80 ) mU/L ],SCr[ ( 44.00 ± 2.53 ) μmol/L and ( 34.43 ± 2.23 )μmol/L],BUN[ ( 11.60 ± 0.39 )mmol/L and (8.20 ± 0.37) mmoL/L],TG [ (3.32 ± 0.22 ) mmol/L and (2.43±0.25)mmol/L],TC[(2.95 ±0.21) mmol/L and (2.24 ±0.17)mmol/L],LDL-C[(2.03 ±0.22 ) mmol/L and ( 1.49 ± 0.13 ) mmol/L ],24 h UP [ ( 46.67 ± 2.50 ) mg/24 h and ( 25.57 ± 2.82 )mg/24 h]and KI[ (9.76 ±0.30) × 103 and (8.44 ±0.26) × 103 ] were significantly increased than the indexes of group NC [ (6.56 ± 0.41 ) mmol/L,( 12.63 ± 1.41 ) mU/L,( 22.88 ± 2.36 ) μmol/L,( 5.45 ±0.51 ) mmoL/L,( 1.64 ± 0.1 1 ) mmol/L,( 1.33 ± 0.17 ) mmol/L,(0.46 ± 0.05 ) mmol/L,( 12.38 ±1.19)/24 h and (6.78 ±0.12) × 103].Moreover,the above indexes in group QUE were obviously lower than group DM.There was evidence of pathological changes associated with diabetes,such as focal and segmental sclerosis and thickened basement and mesangial expansion.The expressions of ubiquitin and NF-κB p65 in renal tissues of group DM increased significantly ( P ＜ 0.01 ).The expression of ubiquitin and NF-κB p65 were positively related with the level of 24 h UP ( r =0.893,0.879,P ＜ 0.01 ).Compared with group DM,all above indexes in group QUE were markedly alleviated ( P ＜ 0.01 ).The expression of ubiquitin and NF-κB p65 was reduced but didn't reach level in group NC ( P ＜ 0.01 ).Conclusion The increased expression of NF-κB induced by ubiquitin-proteasome system may participate in the pathogenesis of proteinuria in diabetic nephropathy.Quercetin has renal protective effects partly through reducing NF-κB p65 expression.

The purpose of this study was to evaluate the efficacy of immunosuppressive agents, 99Tc-MDP and both of them in treating patients with Graves' ophthalmopathy(GO). The efficacy was evaluated by randomized controlled trial involving a total of 66 patients. In 22 patients treated with immunosuppressive agents, the general efficacy rate was 19/22, the incidence rate of serious side-effect was 8/22. In 20 patients treated with 99Tc-MDP, the general efficacy rate was 17/20, the incidence rate of serious side-effect was 2/20. In 24 patients treated with immunosuppressive agents and 99Tc-MDP, the general efficacy rate was 22/24, the incidence rate of serious side-effect was 2/24. The results suggested that in the treatment of Graves' ophthalmopathy, when satisfactory efficacy was obtained, the serious side-effect and 'rebound' of symptom could be avoided by using immunosuppressive agents in combination with 99Tc-MDP.
Graves Ophthalmopathy ; drug therapy ; Humans ; Immunosuppressive Agents ; therapeutic use ; Technetium Tc 99m Medronate ; therapeutic use

Objective:To explore the risk factors of early delayed recovery after right ventricular-extrapulmonary arterial(RV-PA)conduit reconstruction.Methods:From 2017 to 2021, the children with RV-PA conduit reconstruction, who were treated in our hospital were retrospectively analyzed.The demographic data and peri-operative clinical data of the patients were collected for statistical analysis.Results:Fifty-five patients were included in the study.The patients were sequenced by the length of ICU stay.The time at the 75th percentile was defined as the critical value for grouping.According to the ICU stay time of the children, they were divided into normal recovery group(ICU stay ≤7 days, n=40)and delayed recovery group(ICU stay>7 days, n=15).The mechanical ventilator time in the whole group was 24(0, 1 408)h, and the ICU stay time was 4(1, 67)d.Six cases required extracorporeal membrane oxygenation (ECMO) support, and two cases died.In the multivariate Logistic regression analysis of two groups, long cardiopulmonary bypass(CPB) time( OR=1.034, 95% CI 1.009-1.061, P=0.009)and poor right ventricular function( OR=9.536, 95% CI 1.010-90.037, P=0.049)were independent risk factors for early delayed recovery. Conclusion:The risk of RV-PA conduit reconstruction is high.The proportion of ECMO support is increased.The mortality rate is higher.Right heart dysfunction and prolonged CPB time are risk factors for delayed postoperative recovery.

OBJECTIVE To evaluate the quality of Angelica dahurica decoction pieces processed by different drying methods. METHODS Adobe Photoshop 2020 software was used to determine the red green degree （a）， yellow blue degree （b） and brightness （L） values of A. dahurica decoction pieces processed by 3 drying methods as steamed-cut and fresh-cut-dried， and semi- fresh-cut-dried. The contents of nine coumarins such as umbelliferone in A. dahurica decoction pieces processed by 3 drying methods were determined by HPLC. SPSS 26.00 software and SIMCA14.0 software were used to conduct principal component analysis and partial least squares-discriminant analysis on the content of coumarin in 32 batches of A. dahurica decoction pieces. Gray correlation analysis was conducted on the color of the powder and the coumarins contents in A. dahurica decoction pieces. RESULTS The a， b and L were 0-2.4， 6.0-20.3 and 35.6-51.1 in 32 batches of A. dahurica decoction pieces. The contents of umbelliferone， byakangelicin， psoralen， xanthotoxin， bergapten， oxypeucedanin， imperatorin， phellopterin and isoimperatorin were 0.026-0.324， 0.051-0.549， 0-0.113， 0-0.398， 0.256-1.115， 1.434-6.014， 1.866-4.039， 0.742-1.455 and 0.789-2.642 mg/g， respectively. And the total content ranged 6.442-13.382 mg/g， respectively. The results of principal component analysis showed that the comprehensive scores of BZ-27-BZ-30 and BZ-32 batches of semi-fresh-cut-dried decoction pieces were in the top order， and the internal quality of the other two kinds of decoction pieces was quite different. The results of partial least squares discriminant analysis showed that semi-fresh-cut-dried decoction pieces were clustered into one category， poor separation was observed in steamed-cut and fresh-cut-dried decoction pieces. Results of gray correlation analysis showed that the correlationcoefficients of L and b with bergapten， oxypeucedanin，imperatorin， phellopterin， isoimperatorin and b with psoralen were all greater than 0.8， a had a low correlation with all components. CONCLUSIONS The appearance traits of A. dahurica decoction pieces have strong correlation with the contents of coumarins. The quality of the decoction pieces can be roughly judged by the color， i.e. the whiter the color of the decoction pieces， the better the quality. The quality of sample obtained by semi- fresh-cut-dried is better than steamed-cut and fresh-cut-dried decoction pieces.