Uninephrectomy was performed in a ll rats of this study, and diabetic model was induced in partial rats by streptozo tocin. Then these rats were divided into uninephrectomy group, diabetes group an d benazepril-treated diabetes group. After 4 weeks, renal tubulo-interstitial morphological change was observed and type Ⅳ collagen, fibronectin and transfor ming growth factor ? 1 (TGF-? 1) proteins as well as TGF-? 1 mRNA were d etermined. The results suggested that benazepril played a protective role in ren al tubulo-interstitial injury, which was associated partially with down-regula ted overexpression of TGF-? 1.

Objective To summarize the perioperative nursing experience of microsurgical denervation of the spermatic cord to treat idiopathic chronic orthialgia.Methods We retrospectively analyzed the clinical record data of two patients with idiopathic chronic orthialgia,who received microsurgical denervation of the spermatic cord in our hospital,including pre-and postoperative symptom scores,evaluation of mental state and wound nursing.Results Both patients got complete pain relief and were discharged one week after operation.No would infection and mental fluctuation was noted.Conclusions The reasonable individual perioperative nursing is an elemental component of recovery for patients with chronic orthialgia who experienced microsurgical management.

Objective To explore the relationship between receptor for advanced glycosylation end products (RAGE) gene expression in the kidneys of diabetic rats and the role of aminoguanidine on it.Methods Among four groups of rats, 2 groups received streptozotocin (STZ) to induce diabetics (DM) and were followed by either aminoguanidine(AG) treatment for 12 weeks or no therapy. Two groups of normal rats in which one received AG and the other given water served as control (Con). Reverse transcription-polymerase chain reaction (RT-PCR) was used to measure the amount of receptor of advanced glycosylation and products (RAGE) messenger RNA (mRNA) expression. Results After 4 weeks of diabetes inducement, RAGE mRNA levels showed a continuous increase up to 12 weeks both in diabetic renal cortex and medulla compared with mRNA levels at the end of 2 weeks. The RAGE mRNA levels in renal cortex and medulla of control rats did not change significantly with age. AG as the prototype inhibitor of advanced glycosylation end products (AGEs) formation, when administered to diabetic rats for 4 weeks, had no visible effect on the alterations of renal RAGE mRNA in diabetes. By continuous administration up to 8 weeks, those alterations of RAGE mRNA both in diabetic renal cortex and medulla were all ameliorated [P<0.05, (diabetes without AG) versus (diabetes with AG)]. In addition, diabetic animals had a progressive increase in urinary protein excretion compared to control rats from week 4 onwards. Similarly, after 8 weeks diabetic rats had significantly higher glycated Hb (GHb) (DM without AG vs Con: 7.71±0.22% vs 2.95±0.52% P<0.001). AG treatment for 8 weeks decreased GHb by 24.78% and retarded the rate of rise in albuminuria in diabetic rats as compared with that in untreated diabetic rats (DM with AG vs DM without AG: 22.04±0.91 μg/24h vs 70.25±13.05 μg/24h, P<0.001).Conclusions Gene expression of RAGE in renal cortex and medulla was altered in diabetic rats and excessive gene expression of RAGE in kidney tissue may enhance the interactions between advanced glycosylation end products (AGEs) and its receptor (RAGE) which would contribute to the development of diabetic nephropathy. Cumulative AGEs play an important role in increasing RAGE gene expression in vivo. The decrease of AGEs level by AG therapy ameliorate the abnormal regulation of RAGE gene expression.

AMP-Activated Protein Kinases ; metabolism ; Adiponectin ; metabolism ; Fatty Liver, Alcoholic ; pathology ; Humans ; Signal Transduction ; Sirtuin 1 ; metabolism

Objective To evaluate the role of nutritional parameters in prognosis,especially in the early and late mortality of hospital-acquired acute kidney injury (AKI) patients.Methods This study was a prospective cohort study conducted in a hospital comprising 1500 beds in Shanghai, China. One hundred ninety-four patients with hospital-acquired AKI, as determined using the RIFLE staging criteria,were enrolled as subjects after obtaining informed consent.Patients with AKI caused by postrenal obstruction,glomerulonephritis,interstitial nephritis or vasculitis were excluded.Nutritional evaluation,including subjective global assessment (SGA),anthropometric and laboratory examination,was conducted. Other laboratory measurements and clinical data were recorded.The primary outcome was early mortality (≤ 7 days) and late mortality (8-28 days) after enrolling into the study. Results AKI patients at enrollment were characterized by a high prevalence of malnutrition as determined by SGA, anthropometric and laboratory examination.Univariate analysis showed that the SGA,the serum levels of prealbumin,cholesterol and total lymphatic cells, and the Maastricht index were significantly different among early mortality,late mortality and survival groups.The serum prealbumin and cholesterol levels in the early death group were significantly lower than those in the survival and late death groups (P＜0.05).Multivariate analysis revealed that SGA,albumin,prealbumin and cholesterol remained independently and significantly associated with early mortality after adjusting for age,sex,dialysis,ventilation,hemoglobin,platelets,bilirubin,and Glasgow coma score.The areas under the receiver operating characteristic curve to predict early mortality for albumin,prealbumin and cholesterol were 0.591,0.736 and 0.603,respectively,with that of prealbumin significantly higher than others (P＜0.05). Conclusion Low levels of serum prealbumin,albumin and cholesterol at enrollment are independtly associated with increased early mortality in hospital-acquired AKI patients.

Objective:To analyze the ultrasonographic features of lymphadenitis caused by cat-scratch disease (CSD) of the elbow, and to improve the diagnosis and differentiation of CSD by sonologist.Methods:According to the inclusion and exclusion criteria, we retrospectively collected the patients who visited Changsha Third Hospital from March 2015 to October 2021 due to elbow mass, and divided them into CSD group and non CSD group according to the pathological source. We compared and analyzed the ultrasonic manifestations inside and around the mass in the two groups, and summarized the ultrasonic image characteristics of CSD.Results:In 90 cases of elbow mass, there were 14 cases in CSD group and 76 cases in non CSD group. There were 8 cases of cat scratch history and 2 cases of bite history in CSD group. The incubation period ranged from 4 days to 3 months. There were 4 cases of denied cat scratch and bite history or close contact history. Eight patients were treated with antibiotics, and 6 patients did not receive any treatment. 14 patients with CSD were followed up after 1-3 months. There was statistically significant difference between CSD group and non CSD group in tumor location (χ 2=14.507, P<0.05), the masses in CSD group were all located in the medial elbow; The specificity of internal ultrasound in CSD lymphadenitis was not high, but the ultrasonic changes outside the mass had certain characteristics, such as lymphadenitis and localized superficial phlebitis. There was also a statistical difference between CSD group and non CSD group in the ultrasonic changes outside the mass (χ 2=34.070, P<0.05). Conclusions:CSD lymphadenitis usually occurs in the medial epitrochlear region of the elbow. Ultrasound can be highly suggestive when there is a relevant epidemiological history and typical intra and extra-nodal sonographic changes, thus reducing the unnecessary invasive manipulation of the elbow mass.

Objective:To explore the health economic evaluation methods of disease screening,providing insights for scholars conducting related research.Methods:By integrating relevant content from modem epidemiology,health statistics,and health economics,it investigates the differences in conducting health economic evaluations of disease screening using authenticity indicators(sensitivity,specificity)and predictive value indicators(positive predictive value,negative predictive value),and combines empirical studies with cases from the literature.Results:Authenticity indicators(sensitivity,specificity)are intrinsic measures of diagnostic tests,unaffected by the disease prevalence in the sample population,making them more suitable for conducting health economic evaluations of disease screening.Moreover,authenticity indicators are easy to obtain,and the model calculations are straightforward and convenient.Case study results demonstrate that compared to risk score screening,the Incremental Cost-Effectiveness Ratio(ICER)of fasting plasma glucose(FPG)testing for type 2 diabetes is 626,indicating that for every additional diabetic patient identified through risk score screening,an extra 626 yuan is spent.Conclusion:It is recommended to use authenticity indicators for conducting health economic evaluations of disease screening,standardize the path methods for model selection,and continuously improve the evidence quality of health economic evaluations of disease screening in China.

Objective It conducted a rapid health technology assessment to evaluate the comparative safety,efficacy and economy of tumor treating fields(TTFields)combined with temozolomide treatment versus temozolomide(TMZ)alone for patients with glioblastoma(GBM).Methods It provided an extensive electronic search of databases,including PubMed,Embase,Cochrane Library,CNKI,and WanFang Data,to collect clinical evidence and health economic evaluations related to the,safety,efficacy,and economy of TTFields for Glioblastoma patients.The search covered literature from inception to July,2023,and assessed the risk of bias in the included studies.Descriptive analyses and data summaries were performed.Results A total of 19 references were included,comprising 5 randomized controlled trials,3 retrospective studies,8 systematic reviews or meta-analyses,and 3 cost-effectiveness analysis(CEA)studies.The quality of the literature evidence was heterogeneous.Recent meta-analyses mostly support the conclusion that TTFields combined with TMZ treatment provides a survival benefit compared to standard TMZ alone.However,the cost-effectiveness analysis literature from 2 countries showed different results,likely due to differences in socioeconomic levels,health systems,and heterogeneity in sources,model selection,and parameter selection.The majority of evidence supports the benefits of TTFields combined with TMZ for the treatment of GBM patients,but the results of CEAs tend to favor the view that this therapy is not cost-effective.Conclusion Current evidence indicates that TTFields combined with TMZ treatment have better safety and efficacy.However,there is still no consensus on whether it is cost-effective.

Objective:To explore the health economic evaluation methods of disease screening,providing insights for scholars conducting related research.Methods:By integrating relevant content from modem epidemiology,health statistics,and health economics,it investigates the differences in conducting health economic evaluations of disease screening using authenticity indicators(sensitivity,specificity)and predictive value indicators(positive predictive value,negative predictive value),and combines empirical studies with cases from the literature.Results:Authenticity indicators(sensitivity,specificity)are intrinsic measures of diagnostic tests,unaffected by the disease prevalence in the sample population,making them more suitable for conducting health economic evaluations of disease screening.Moreover,authenticity indicators are easy to obtain,and the model calculations are straightforward and convenient.Case study results demonstrate that compared to risk score screening,the Incremental Cost-Effectiveness Ratio(ICER)of fasting plasma glucose(FPG)testing for type 2 diabetes is 626,indicating that for every additional diabetic patient identified through risk score screening,an extra 626 yuan is spent.Conclusion:It is recommended to use authenticity indicators for conducting health economic evaluations of disease screening,standardize the path methods for model selection,and continuously improve the evidence quality of health economic evaluations of disease screening in China.

Objective It conducted a rapid health technology assessment to evaluate the comparative safety,efficacy and economy of tumor treating fields(TTFields)combined with temozolomide treatment versus temozolomide(TMZ)alone for patients with glioblastoma(GBM).Methods It provided an extensive electronic search of databases,including PubMed,Embase,Cochrane Library,CNKI,and WanFang Data,to collect clinical evidence and health economic evaluations related to the,safety,efficacy,and economy of TTFields for Glioblastoma patients.The search covered literature from inception to July,2023,and assessed the risk of bias in the included studies.Descriptive analyses and data summaries were performed.Results A total of 19 references were included,comprising 5 randomized controlled trials,3 retrospective studies,8 systematic reviews or meta-analyses,and 3 cost-effectiveness analysis(CEA)studies.The quality of the literature evidence was heterogeneous.Recent meta-analyses mostly support the conclusion that TTFields combined with TMZ treatment provides a survival benefit compared to standard TMZ alone.However,the cost-effectiveness analysis literature from 2 countries showed different results,likely due to differences in socioeconomic levels,health systems,and heterogeneity in sources,model selection,and parameter selection.The majority of evidence supports the benefits of TTFields combined with TMZ for the treatment of GBM patients,but the results of CEAs tend to favor the view that this therapy is not cost-effective.Conclusion Current evidence indicates that TTFields combined with TMZ treatment have better safety and efficacy.However,there is still no consensus on whether it is cost-effective.