Objective To evaluate the neuroprotective effect of electro‐acupuncture(EA) on cerebral ischemia‐reperfusion (IR) injury and deeply investigate the relationship between this neuroprotective effect and PI3K/Akt pathway .Methods A total of 60 Male adult SD rats were randomly divided into five groups:sham control group(SC ,n=12) ,ischemia control group ,(IC group , n=12) electro‐acupuncture group(EA group ,n= 12) ,EA + DMSO group(DMSO group ,n= 12) and EA + LY294002 group (LY2940002 group ,n=12) .Rats in the IC group、EA group、DMSO group and LY2940002 group underwent 2 h of middle cerebral artery occlusion(MCAO) ,followed by 72 h of reperfusion .DMSO or LY294002 was injected into the lateral ventricle at 30 min be‐fore the ischemia .Rats of the IC group ,EA group ,DMSO group and LY2940002 group received electro‐acupuncture at 24 h after the operation and continued until animals were sacrificed at 72 h after the operation ,and the stimulation parameters were set as fol‐lows :disperse wave ,30 min of each time ,once a day .Neurological deficit scores were assessed at 24 h ,48 h and 72 h after the IR in‐jury .The infarct volume was determined at 72 h after the IR injury using TTC staining .Apoptotic cells in the cerebral cortex were quantified under confocal fluorescence microscope using TUNEL staining .The expression of PI3K ,Akt ,p‐Akt ,Bad and p‐Bad at the protein level was assessed by Western blotting .Results Significant differences were observed in terms of neurological deficit scores between and among the EA group ,DMSO group and other groups at 48 h and 72 h after the cerebral IR injury(P<0 .05) .At 72 h after the cerebral IR injury ,the infarct volume of the IC group and LY294002 group was significantly larger than those of the EA group and DMSO group(P<0 .05) .Compared with the IC group and LY294002 group ,EA treatment greatly reduced the number of apoptotic nerve cells(P<0 .01) .The expression of PI3K ,p‐Akt and p‐Bad at the protein level in the EA group and DMSO group were higher than those of the IC group and LY294002 group(P<0 .05) .Conclusion EA treatment at points of Zusanli(ST36) and Quchi(LI11) exerted the neuroprotective effect on the cerebral IR injury through the modulation of PI3K/Akt pathway .

Objective:To compare the clinicopathological differences between elderly and non-elderly patients with idiopathic membranous nephropathy(IMN).Methods:Patients diagnosed with IMN via renal biopsy at Beijing Huairou Hospital, Beijing Changping Hospital of Traditional Chinese Medicine, and Beijing Hospital of Traditional Chinese Medicine from January 2017 to August 2021 were retrospectively enrolled.They were classified into the elderly group(≥65 years)and the non-elderly group(<65 years), and the clinicopathological differences between the two groups were compared.Results:A total of 207 IMN patients were included in the study, with a male to female ratio of 1.7∶1.0.There were 56 patients in the elderly group, aged(68.2±3.1)years, and 151 patients in the non-elderly group, aged(48.2±6.2)years.Compared with the non-elderly group, the elderly group had a longer time from onset to renal biopsy and a higher proportion of patients with renal insufficiency and hypertension( P<0.05). The elderly group had a lower eGFR, lower serum albumin, higher serum cholesterol, and higher low-density lipoprotein than the non-elderly group( P<0.05). The proportions of patients with glomerulosclerosis, renal tubular atrophy, and interstitial fibrosis in the elderly group were higher than in the non-elderly group( P<0.05). The positive rates of glomerular PLA2R antigen staining in the two groups were 90.6%(29/32)and 91.0%(111/122), respectively, and there was no statistically significant difference between the two groups.IgG4 deposition represented the most common IgG subtype, with 93.8%(30/32)in the elderly group and 94.3%(115/122)in the non-elderly group.There was no statistical significance between the two groups( P>0.05). Conclusions:Compared with non-elderly IMN patients, a higher proportion of elderly IMN patients has renal insufficiency, hypertension and chronic renal pathology.The glomerular deposition of pathogenic antigens in elderly IMN patients was similar to that in non-elderly IMN patients, suggesting no difference in pathogenesis between the two groups.The clinicopathological differences between the two groups may be related to age and complications.

Objective:To explore the correlation between protein energy wasting(PEW)and frailty in elderly patients on maintenance hemodialysis(MHD)and influencing factors of frailty.Methods:Clinical data of patients over 60 who had received regular hemodialysis treatment at Beijing Huairou Hospital between September to December 2021 were collected.According to Fried's evaluation criteria, patients were divided into a frailty group and a non-frailty group, and differences between the two groups were compared.Spearman correlation analysis was conducted to assess the correlation between protein energy wasting and frailty.Logistic regression was used to analyze the influencing factors of frailty in elderly patients on MHD.Results:A total of 81 MHD patients enrolled in this study, with 36 in the frailty group.The frailty group was older, had a higher proportion of patients with PEW, and underwent more months of dialysis, with a higher proportion of patients with diabetic nephropathy as the primary disease, having high levels of C-reactive protein(CRP), and having low KT/V, hemoglobin, albumin, body mass index(BMI), mid-arm circumference(MAC)and mid-arm muscle circumference(MAMC), and the differences with the control group were statistically significant(all P<0.05). The Fried frailty phenotype was positively correlated with age( r=0.021, P=0.047), but negatively associated with HGB( r=-0.329, P=0.003), albumin( r=0.021, P=0.047), BMI( r=0.021, P=0.047), TSF( r=-0.274, P=0.013), MAC( r=-0.554, P<0.001)and MAMC( r=-0.293, P=0.008). A Logistic regression equation was constructed using frailty as the dependent variable.The results showed that age, months of dialysis, KT/V, serum albumin and CRP were independent factors influencing the development of frailty in elderly patients with MHD. Conclusions:PEW and frailty coexist and interact with each other in elderly patients with MHD.Clinicians should place emphasis on the assessment of frailty and protein energy wasting in elderly dialysis patients and achieve early detection and intervention to avoid adverse clinical outcomes.

OBJECTIVE： To observe the improvement effect and mechanism of 4-hydroxy-2-benzoxazolone （HBOA） on carbon tetrachloride-induced hepatic fibrosis in rats. METHODS： Male SD rats were randomly divided into normal control group， model group， colchicine group （positive control， 0.4 mg/kg） and HBOA low-dose， medium-dose and high-dose groups （50， 75， 100 mg/kg）， with 12 rats in each group. Except for normal control group was given constant volume of normal saline intragastrically， other groups were given 50％CCl4-olive oil solution （2 mL/kg， initial dose double） intragastrically， twice a week， for consecutive 12 weeks， to induce hepatic fibrosis model. Since the 9th week of modeling， administration groups were given relevant medicine intragastrically. Normal control group and model group were given constant volume of 0.6％ Carboxymethylcellulose sodium solution intragastrically， once a day， for consecutive 4 weeks. After last administration， the serum contents of ALT， AST， IL-1β and IL-10， the protein expression of NF-κB p65， TNF-α， IL-6 and ICAM-1 in liver tissue were determined. RESULTS： Compared with normal control group， the positive expression of NF-κB p65 in liver tissue was increased significantly in model group； serum contents of ALT， AST and IL-1β as well as protein expression of NF-κB p65， TNF-α， IL-6 and ICAM-1 in liver tissure were increased significantly， while serum content of IL-10 was decreased significantly （P＜0.05）. Compared with model group， the positive expression of NF-κB p65 in liver tissue were decreased to different extents in administration groups； serum contents of ALT， AST and IL-1β as well as protein expression of NF-κB p65， TNF-α， IL-6 and ICAM-1 in liver tissue were decreased significantly， while serum content of IL-10 was increased significantly （P＜0.05）. CONCLUSIONS： HBOA can improve carbon tetrachloride-induced hepatic fibrosis in rats， and the mechanism of which may be associated with relieving inflammatory reaction by blocking NF-κB signaling pathway and down-regulating the protein expression of ICAM-1.