Objective To investigate the relationship between keratinocyte growth factor (KGF), nerve growth factor(NGF)and psoriasis;and to study the interaction between keratinocytes and interstitial cells in psoriasis. Methods The expression of KGF, KGF receptor (KGFR), NGF, NGF receptor (NGFR), epidermal growth factor receptor (EGFR) and proliferating cell neuclear antigen (PCNA) was studied with immunohistochemical technique (SP) in lesional skin, non lesional skin and normal controls. Results Significant overexpression of KGF and KGFR was present in psoriatic basal cell layers and suprabasal cell layers compared to that in non lesional and normal controls (P0.05). Expression of KGF and KGFR was absent in dermis. Expression of NGF and NGFR was observed mainly in granular cell layers and upper spinous layers, and was significantly different between normal controls and non lesional, between non lesional and lesional skin (P

Objective To investigate the status and associated factors of demand satisfaction (DS) of services for older adults with visual disability (OAVD).Methods Based on the 2nd National Sample Survey on Disability in 2006,a total number of 24 017 OAVD cases were included.Associated relationships among demographic,health-related,social,economic factors and services of DS,including health demand (Type Ⅰ),basic livelihood demand (Type Ⅱ),and environmental support demand (Type Ⅲ) were analyzed.Results The proportions of DS of Type Ⅰ,Ⅱ,Ⅲservices for OAVD were 35.1％,9.3％ and 4.3％ respectively.Eight factors as:having pension insurance (OR =1.64),living in urban areas (OR =1.54),per capita household income at ≥ 5 000 or over Yuan (OR=1.46) were favorable ones on OAVD DS while at age ≥ 80 or above (OR =0.90),being male (OR=0.93) were adverse factors of Type Ⅰ.Four factors as:being male (OR=1.43),living in urban areas (OR=1.15),subjects defined as grade Ⅱ (OR=1.36) and grade Ⅰ (OR=1.70)etc.,were favorable factors on OAVD DS.Five factors as:range of age groups at 15-59(OR=0.57)or at ≥60 (OR=0.45),per capita household income at 1 000-1 999 Yuan(OR=0.77),2 000-4 999 Yuan (OR =0.58) and ≥ 5 000 Yuan (OR =0.39) were adverse factors of Type Ⅱ.Factors as:living in urban areas (OR =1.23),defined as grade Ⅱ (OR =1.38) and grade Ⅰ (OR =1.34),having pension insurance (OR=1.62) and per capita household income at ≥5 000 Yuan (OR=1.42) etc.,were favorable factors of Type Ⅲ.Conclusion The DS degree of older adults with visual disability was generally very low while factors as:per capita household income,situation on social insurance,age,degree of disability,age when disability was identified,areas of residence,gender,grade of disability,marriage status,levels of education etc.,were significantly associated with the service on DS.

Objective:To analyze the input and output status of health resources in primary medical and health institutions and their allocation efficiency in different regions of China, and to provide an empirical basis for optimizing the allocation of primary medical and health resources in China among regions.Methods:The input index data (number of beds and number of health personnel) and output index data (number of primary medical and health institutions visits, number of family health services, number of hospital admissions) of primary medical and health institutions in China in 2020 were extracted from the China Health Statistical Yearbook 2021. Based on the BCC ( Banker, Charnes, Cooper) model of data envelopment analysis ( DEA), the Bootstrap- DEA method was used to correct bias, the allocation efficiency of primary medical and health resources in 31 provinces was calculated and the regional differences were analyzed. Results:After bias correction, the technical efficiency (TE) of resource allocation in primary medical and health institutions decreased by 0.102. The average TE score of all 31 primary medical and health institutions was 0.669, indicating a serious problem of ineffective use of technology. The TE of the eastern, central and western regions was 0.694, 0.663, and 0.649 respectively. There was obvious polarization in the central regions.Further analysis of the efficiency improvement of non DEA efficient provinces showed that 2 DEA weakly efficient provinces and 16 DEA ineffective provinces had several reference provinces for efficiency configuration improvement; The provinces that have been referenced more than 10 times were Zhejiang, Chongqing, Sichuan, and Ningxia, while the provinces that were listed as the first reference by other provinces were Ningxia, Chongqing, Zhejiang, and Tibet.Conclusions:The resource allocation efficiency of primary medical and health institutions in China is relatively low, and regional differences are obvious. The balance between different inputs and outputs should be considered when allocating the resources. Non DEA effective provinces can use DEA analysis to find the most suitable reference object and make reference improvements in the short term.

Polycystic ovary syndrome (PCOS) is a common disease that lead to endocrine disorders and infertility in women of child-bearing age.A large number of studies have shown that the pathogenesis of PCOS is related to insulin resistance (IR),hyperandrogenism and high body mass index.At present,remarkable progress has been made in the study of conception methods and the reduction of multiple pregnancies in PCOS patients.However,there is relatively little research on the adverse pregnancy outcomes after conception.Therefore,this study will use evidence-based medicine to make a review of complications in maternal.For instance,pregnancy-induced hypertension syndrome (PIH),gestational diabetes mellitus (G DM),miscarriage,premature delivery and so on.This study provides an overall basis for early prevention and intervention in clinical work through discussing the pathophysiology of PCOS,the risk factors of its occurrence and development,and the management strategies of pre-pregnancy and gestation period.

Objective:To investigate the risk factors for hemorrhagic transformation (HT) after intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS), and the predictive value of Neutrophil to lymphocyte ratio (NLR).Methods:Consecutive patients with AIS received IVT in Zhengzhou People’s Hospital from January 2021 to December 2022 were retrospectively enrolled. HT was defined as no intracranial hemorrhage was found on the first imaging examination after admission, and new intracranial hemorrhage was found on the imaging examination 24 h after IVT or when symptoms worsened. sHT was defined as HT and the National Institutes of Health Stroke Scale (NIHSS) score increased by ≥4 compared to admission or required surgical treatment such as intubation and decompressive craniectomy. The baseline clinical and laboratory data of the patients were collected, and NLR, lymphocyte to monocyte ratio (LMR), and platelet to neutrophil ratio (PNR) were calculated. Multivariate logistic regression analysis was used to identify the independent predictors of HT and sHT, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of NLR for HT and sHT after IVT. Results:A total of 196 patients were included (age 65.37±13.10 years, 124 males [63.3%]). The median baseline NIHSS score was 4 (interquartile range: 2-10). Twenty patients (10.2%) developed HT, and 12 (6.1%) developed sHT. Univariate analysis showed that there were statistically significant differences in age, baseline NIHSS score, creatinine, NLR, and stroke etiology type between the HT group and the non-HT group (all P<0.05); there were statistically significant differences in age, NLR, PNR, creatinine, baseline NIHSS score, and stroke etiological type between the sHT group and the non-sHT group (all P<0.05). Multivariate logistic regression analysis showed that NLR was an independent predictor of HT (odds ratio [ OR] 1.375, 95% confidence interval [ CI] 1.132-1.670; P=0.001) and sHT ( OR 1.647, 95% CI 1.177-2.304; P=0.004) after IVT. The ROC curve analysis showed that the area under the curve for predicting HT by NLR was 0.683 (95% CI 0.533-0.833; P=0.007), the optimal cutoff value was 5.78, the sensitivity and specificity were 55.0% and 84.1%, respectively. The area under the curve for predicting sHT by NLR was 0.784 (95% CI 0.720-0.839; P=0.001), the optimal cutoff value was 5.94, the sensitivity and specificity were 66.67% and 84.24%, respectively. Conclusions:A higher baseline NLR is associated with an increased risk of HT and sHT after IVT in patients with AIS, and can serve as a biomarker for predicting HT and sHT after IVT.

Objective To observe the differential expression of high mobility group box - 1 protein (HMGB1) in renal tissues of heat stroke mice models, and to explore its role in the pathogenesis of heat stroke associated acute kidney injury(HS-associated AKI). Methods According to random number table, 20 healthy male C57BL/6J mice were randomly divided into 2 groups, including normal control (n=10) and heat stroke group (n=10). The mice in heat stroke group were given with a 2-hour-exposure in biological simulation chamber (temperature 41℃, humidity 70％). Heat stroke was defined as anal temperature lasting more than 40 degrees Celsius. A 18F - deoxyglucose nuclide labeled vivo imaging was conducted with micro - positron emission tomography(PET)/computer tomography (CT). Serum creatinine was examined with blood example. In order to evaluate the pathological changes, HE stain was conducted with kidney tissue, and mitochondrial morphological changes in kidney tissue were observed by transmission electron microscopy. The expressions of HMGB1 and apoptosis inducing factor mitochondria associated 2 (Aifm2) were examined by immunohistochemical method, and the levels of HMGB1 and RAGE were examined by Western blotting. The cell apoptosis of renal tissue was detected by terminal deoxynucleotidyl transferase -mediated dUTP - biotin nick end labeling assay (TUNEL). The metabolomics of kidney tissue in mice were detected by liquid chromatography - mass spectrometry (LC - MS), and the pathway enrichment analysis was carried out by KEEG database. Results (1) The body temperature of the mice in heat shock group was significantly higher than that in normal control group 45 min after model establishment (P＜0.05). The level of serum creatinine in heat shock group was significantly higher than that in normal control group (P＜0.05), and the levels of 18F - deoxyglucose increased in skeletal muscle and visceral tissue of the mice in heat - shock group. (2) HE staining showed hemorrhage in collecting duct and tubular endothelial cell swelling, and mitochondrial swelling and deformation were observed by transmission electron microscopy in kidney tissue of the heat shock group. (3) Immunohistochemical method showed that the levels of Aifm2 and HMGB1 in heat shock group were higher (P＜0.05). (4) Western blotting showed that the levels of HMGB1 and RAGE in heat shock group were higher than those in normal control group (P＜0.05). (5) TUNEL showed that the number of cells with positive stain in kidney tissue of the heat shock group was higher than that in normal control group (P＜0.05). (6) Between normal control group and heat shock group, 136 differential metabolites were detected in kidney tissues. After analysis by KEGG database, pathway abnormalities such as unsaturated fatty acid metabolism disorder may be associated with HS - associated AKI, and many differential metabolites such as adrenic acid may be important regulatory points in the pathogenesis. Conclusion Acute kidney injury is a common complication of heat shock. It may be related to the dysfunction of renal mitochondria and activation of apoptotic pathway caused by systemic hypercatabolism, which may be related to the disorder of unsaturated fatty acid metabolism and activation of HMGB1. Some differential metabolites may be of high value in HS- associated AKI studies.