Objective To explore the regularity of the distribution of traditional Chinese medical syndrome elements in early renal injury patients with type 2 diabetes mellitus ( T2DM) . Methods A total of 200 patients with T2DM early renal injury were enrolled into the study. Syndrome element differentiation was carried out for the analysis of the distribution of syndrome location and syndrome nature. Results ( 1) Kidney had the highest scores of syndrome location , and then came the spleen, and meridians and collaterals . The syndrome location scores of kidney, spleen, meridians and collaterals differed from those of liver, heart, lung, and stomach ( P<0.01) . ( 2) In excess syndrome elements, the percentage of syndrome elements of phlegm, blood stasis, dampness was in decreasing sequence. In deficiency syndrome elements, the percentage of syndrome elements of yin deficiency, qi deficiency, and yang deficiency was in decreasing sequence. ( 3) For the distribution of syndrome elements, kidney yin deficiency had the highest scores, next came spleen qi deficiency, and finally came blood stasis of meridians and collaterals. Conclusion In T2DM early renal injury patients, kidney, spleen, meridians and collaterals are the main affected location; yin deficiency, qi deficiency, and yang deficiency are the predominant deficiency syndrome elements, and phlegm, blood stasis, dampness are the predominant excess syndrome elements. Kidney yin deficiency, spleen qi deficiency , and blood stasis of meridians and collaterals are the commonly-seen syndrome patterns in T2DM patients with early renal injury.

Substance P (SP) and calcitonin gene-related peptide (CGRP) are the neuropeptides released from the sensory nerve endings.Neuropeptides play a role in bone and the relevant organs.It exerts functions in regulation of the bone metabolism,fracture healing and pain by a certain way.The biological properties and distributions of SP and CGRP are closely related to the pathogenesis and development of bone metabolism,fracture healing and pain.

OBJECTIVE:To optimize the decoction technology of Zhuanggufang decoction powder. METHODS:Central com-posite design with 2 factors and 5 levels was conducted to design the test,taking water (fold) and decoction time as independent variables,the extraction amount of icariin and extraction yield overall desirability value of as dependent variables,regression equa-tion were fitted;response surface method was used to optimize the decoction technology of Zhuanggufang decoction powder,and was verified. It was compared with the traditional decoction piece effect. RESULTS:The optimized technology was decocted twice with 16-fold water,20 min each time;relative error of predicted and theoretical value by overall desirability value was 2.97%;af-ter decoction powder and piece decocted in the same conditions,the extraction amounts of icariin were 1.2343 μg/g and 1.1324μg/g,extraction yields were 23.73% and 17.84%,respectively. CONCLUSIONS:Central composite design-response surface meth-od optimizing decoction technology is simple and reliable,the optimized decoction technology is stable and feasible,and the decoc-tion capability of Zhuanggufang decoction powder is better than the traditional pieces.

Objective:To investigate the effect and molecular mechanism of circ_0001955 on the radiosensitivity of prostate cancer DU145 cells.Methods:The si-con, si-circ_0001955, miR-con and miR-149 were transfected into DU145 cells and recorded as the si-con group, si-circ_0001955 group, miR-con group, miR-149 group. The miR-149 and pc-circ_0001955 were co-transfected into DU145 cells and recorded as the miR-149+ pc-circ_0001955 group. Untreated cells were used as the blank control (NC) group. Real-time quantitative PCR was employed to detect the expression levels of circ_0001955 and miR-149. MTT assay was performed to detect cell viability. Flow cytometry was carried out to detect cell apoptosis. Transwell chamber assay was conducted to observe cell migration and invasion. Western blot was performed to detect the expression levels of MMP-2, MMP-9, Cleaved caspase-3, Cleaved caspase-9 and γ-H 2AX proteins. Colony formation assay was employed to determine the cell radiosensitivity. Dual-luciferase reporter assay was conducted to verify the targeting relationship between circ_0001955 and miR-149. Results:The circ_0001955 was highly expressed, whereas the miR-149 was lowly expressed in prostate cancer DU145 cells. Silencing circ_0001955 or over-expressing miR-149 could decrease the cell viability, migration and invasion, down-regulate the expression levels of MMP-2 and MMP-9, up-regulate the expression levels of Cleaved caspase-3 and Cleaved caspase-9, and increase the apoptosis rate (all P<0.05). After 4 Gy dose irradiation, the expression level of γ-H 2AX was up-regulated, the cell survival fraction was decreased, and the sensitivity ratio was 1.38. circ_0001955 could targetedly regulate the expression level of miR-149. After simultaneous overexpression of circ_0001955 and miR-149, cell proliferation activity and the number of migrating and invading cells were increased, cell apoptosis rate was decreased, and cell survival fraction was increased, and the sensitivity ratio was calculated as 0.72. Conclusion:Silencing circ_0001955 can targetedly up-regulate the expression level of miR-149, which inhibits the proliferation, migration, and invasion, induces cell cycle arrest, induces cell apoptosis and increases the radiosensitivity of prostate cancer DU145 cells.

This study was aimed to explore the curative effect of Zhuo-Du-Qing (ZDQ) particles on diabetic cystopa-thy (DCP) based on the theory of turbid toxin. A total of 100 DCP patients were randomly divided into the control group with 47 cases and the treatment group with 53 cases. Mecobalamin tablets was given in the control group. And ZDQ particles were given to the treatment group. The treatment course was 3 months. The observation was made on the bladder residual urine (BRU), clinical manifestation integral, hemodynamic indexes, HOMA-IR and HbA1c before and after the treatment. The results showed that compared with pretreatment, the BRU, clinical manifestation integral, hemodynamic indexes, and HOMA-IR were significantly reduced (P < 0.01). Compared with the control group, the BRU, clinical manifestation integral, hemodynamic indexes, and HOMA-IR were also significantly reduced (P <0.01). The effective rate in the treatment group was 81.1%, which was significantly higher than 59.6% in the control group (P< 0.05). There were no obvious changes on the blood routine examination, urine routine examination, stool routine examination, liver function, renal function, electrocardiogram and so on before and after treatment. It was con-cluded that the treatment of DCP with ZDQ particles was safe and effective. To remove toxin and descend turbid may be another effective treatment method for DCP. The occurrence and development of DCP were closely related to the turbid toxin.

Objective:To explore the feasibility and safty of robot assisted trans-diaphragmatic intropericardial inferior vena cava occlusion and thrombectomy in treatment of Ⅳa grade tumor thrombus without cardiopulmonary bypass and thoracotomy.Methods:The clinical data of 4 patients with renal cell carcinoma and Ⅳa grade tumor thrombus by robot assisted trans-diaphragmatic intropericardial inferior vena cava occlusion and thrombectomy from January 2013 to June 2019 were retrospectively analyzed. The median age was 53.5 (53-70) years. The average body mass index was 23.25 (20.7-26.3) kg/m 2. The tumors were located on the right side in 2 cases. The average maximum diameter of the tumor was 8.1 (3.6-11.2) cm.Preoperative tumor thrombus of all patients was classified as Ⅳa. The average preoperative length of tumor thrombus in vena cava was 12.3 (11.8-18.0) cm. All the operations were performed under multidisciplinary cooperation of urology, hepatobiliary, cardiovascular, ultrasound and anesthesiologist team. Surgical procedure: Robot assisted liver mobilization was used to expose the inferior vena cava. Under the guidance of intraoperative ultrasound, the central tendon and pericardium of diaphragm were dissected until the inferior vena cava and right atrium in the superior pericardium were exposed. The first porta hepatis and inferior vena cava were blocked in turn.The vena cava thrombectomy and inferior vena cava reconstruction were performed. Results:All the operations were completed without conversion. The median operation time was 553.5 (338-642) minutes, and the median time of the first porta hepatis occlusion was 18.1 (14-32)minutes. The median blood loss was 1 900(1 000-2 600)ml. All patients were transferred to ICU after operation. The median length of stay in ICU was 7(4-8) days, and the median time of indwelling drainage tube was 8(4-12) days. The average postoperative hospital stay was 13(11-20) days. There were 1 case of grade Ⅱ and 3 cases of grade Ⅲ complications (Clavien classification). One case had paroxysmal supraventricular tachycardia, one case had lymphatic fistula, one case had pleural effusion with atelectasis, and one case had hepatic and renal insufficiency and lymphatic fistula. The complications were improved after treatment. There was no perioperative death.Conclusions:Robot assisted trans-diaphragmatic intropericardial inferior vena cava occlusion and thrombectomy is an alternative method for the treatment of Ⅳa grade inferior vena cava tumor thrombus. Using this method, Ⅳa grade tumor thrombus can be treated without cardiopulmonary bypass and thoracotomy, with controllable complications and zero perioperative mortality.

In China, more than half of heart failure patients are ischemic heart failure patients. And a large proportion of left ventricular assist device implantation patients are also ischemic heart failure patients. However, left ventricular assist device implantation in ischemic heart failure patients is facing with problems such as patient screening, coronary artery disease, small left ventricle, mitral insufficiency, and ventricular aneurysm. There are only a few retrospective studies with small sample sizes abroad trying to provide solutions to these problems. While there is a lack of systematic understanding of this issue in China. Therefore, we provide an overview of the application and progress of left ventricular assist devices in ischemic heart failure patients, aiming to help clinicians have a comprehensive understanding of this issue and provide some guidance.

Objective To compare the perioperative renal function changes in patients undergoing heart transplantation (HT) and left ventricular assist device (LVAD) implantation. Methods Patients with end-stage heart failure who underwent surgical treatment at Beijing Anzhen Hospital, Capital Medical University from January 2019 to April 2024 were included. According to the surgical method, patients were divided into a HT group and a LVAD group, and the estimated glomerular filtration rate (eGFR) of patients before surgery and postoperative 1, 7, 30, 60 days was compared between the two groups. The patients with preoperative renal dysfunction were subdivided into subgroups for comparison of eGFR changes before surgery and 30 days after surgery between the two groups. Results A total of 112 patients were enrolled. There were 78 patients in the HT group, including 61 males and 17 females, aged (44.42±18.51) years. There were 34 patients in the LVAD group, including 30 males and 4 females, aged (54.94±11.37) years. Compared with the HT group, the average age of patients in the LVAD group was greater (P<0.001), body mass index was higher (P=0.008), preoperative eGFR was lower (P=0.009), and the proportions of smokers (P=0.017), alcohol drinkers (P=0.041), and diabetes mellitus (P=0.028) patients were higher. Among patients with preoperative renal dysfunction [eGFR<90 mL/(min·1.73 m2)], compared with the HT group, the postoperative eGFR of the LVAD group was significantly higher than that of the HT group, and it was significantly increased compared with that before surgery; the postoperative eGFR of the HT group was comparable to that before surgery, and more than half of the patients had a lower eGFR than before surgery. Among patients with preoperative renal dysfunction, 11 patients in the HT group received continuous renal replacement therapy, and 8 died early; 2 patients in the LVAD group received continuous renal replacement therapy, and 1 died early. Conclusion For end-stage heart failure patients with combined renal dysfunction, compared with HT, LVAD implantation enables patients to obtain better renal function benefits.