One hundred patients with early diabetic nephropathy were randomly divided into control group and study group with 50 cases in each group.All patients received conventional antidiabetic therapy with valsartan tablets 80mg, q.d;patients in study group were given additional TCM Jiawen Dihuang decoction.TCM syndrome scores, relevant biochemical testing and renal function changes were evaluated before and after treatment in two groups.After 8 weeks of treatment, the results showed than the TCM scores in both groups were significantly reduced (study group: 18.9±1.6 vs.7.2±5.1, control group 18.8±1.5 vs.10.3±6.2.both P<0.05);the improvement rate of TCM syndrome in study group was significantly higher than that of control group (90% vs.68%, x2=5.3,P<0.05);and the improvement of relevant biochemical index and renal function in study group was more marked than that in control group.The study indicates that the integrated TCM and Western medicine can enhance the efficacy in treatment of early diabetic hephropathy.

Objective To analyze the effect of psychological intervention and intraoperative operation cooperation on cesarean de-livery outcome of pregnant women with heart disease .Methods 60 cases of pregnant women complicating heart disease in this hos-pital from July 2010 to July 2012 were taken as the research subjects and divided into the control group by the conventional inter-vention and the observation group(30 cases) by the psychological intervention and intraoperative cooperation according to the differ-ent intervention measures .The differences of delivery outcomes and the negative mood scores were compared between the two groups .Results The delivery outcome after receiving psychological intervention and intraoperative cooperation in the observation group was significantly better than that in the control group(P<0 .05);the negative mood scores after the systematic nursing in the observation group were significantly lower than those in the control group patients (P<0 .05) .Conclusion Using the whole course psychological intervention and intraoperative cooperation can effectively improve the maternal and fetal negative outcomes ,reduce anxiety ,depression and other negative moods .

Objective To explore the relationship between serum microRNA-124(miR-124),CD146,angio-poietin-like protein 2(Angptl2)and the stability of carotid atherosclerosis(CAS)plaque in patients with a-cute cerebral infarction(ACI),and to provide reference for early prevention and treatment of patients with ACI.Methods A total of 191 patients with ACI admitted in Handan Central Hospital from January 2020 to February 2023 were selected as ACI group,and another 61 healthy volunteers who were underwent physical examination during the same period were selected as control group.The patients with ACI were divided into unstable plaque group(56 cases),stable plaque group(71 cases),and non plaque group(64 cases)based on carotid color doppler ultrasound results.The serum miR-124 expression levels of all subjects were detected by real time fluorescence quantitative polymerase chain reaction(RT-qPCR),and the serum CD146 and Angptl2 levels were detected by enzyme-linked immunosorbent assay(ELISA).The influencing factors of the instabili-ty of CAS plaque in patients with ACI was analyzed by univariate and multivariate Logistic regression.The predictive value of serum miR-124,CD146 combined with Angptl2 for the instability of CAS plaque in patients with ACI was analyzed by the receiver operating characteristic(ROC)curve.Results The serum CD146 and Angptl2 levels in ACI group were higher than those in control group(P＜0.05),and the miR-124 expression level was lower than that in control group(P＜0.05).Univariate analysis showed that the stability of CAS plaques in ACI patients was correlated with age,hypertension,hyperlipidemia,fibrinogen(FIB),serum C-reac-tive protein(CRP),serum cystatin C(CyC),CD146,Angptl2 and miR-124(P＜0.05).Multivariate Logistic regression analysis showed that the decrease of serum miR-124,the increase of CD146,the increase of Angptl2 and the combination of hyperlipidemia were risk factors for CAS plaque stability in ACI patients(P＜0.05).The area under ROC curve(AUC)of serum miR-124,CD146,Angptl2 and the combination of the three indi-cators to predict CAS plaque instability in ACI patients were 0.741,0.719,0.781 and 0.834,respectively.Conclusion The serum miR-124 expression level,CD146 and Angptl2 levels are the influencing factors of CAS plaque instability in ACI patients,which may be involved in the formation and development of CAS plaque in ACI patients.The combined detection of the three factors has a good predictive effect on CAS plaque instability in ACI patients.

OBJECTIVE To conduct a rapid qualitative study on the chemical constituents of the methanol extract in Thamnolia subuliformis (Ehrh.) W.Culb. by UHPLC-Q-Exactive Focus-MS/MS. METHODS The chromatographic separation was performed on a Waters Acquity UPLC BEH C18(2.1 mm×50 mm, 1.7 μm) column with acetonitrile(A)-0.1% formic acid aqueous solution(B) as mobile phase for gradient elution, the flow rate was 0.3 mL·min–1 and the column temperature was 30 ℃. Mass spectrometry was performed using an electrospray ionization and data was collected in negative ion modes, and the detection range was m/z 80−1 200. The chemical constituents in Thamnolia subuliformis (Ehrh.) W.Culb. were identified rapidly and comprehensively based on the accurate relative molecular and combined with literature data and reference substances. RESULTS A total of 39 chemical constituents were speculatively identified, including 9 mono-substituted phenyl rings, 11 depsides, 5 depsidones, 2 dibenzofuran, 10 lipids, and 2 others. CONCLUSION The chemical constituents in the Thamnolia subuliformis (Ehrh.) W.Culb. can be identified accurately and rapidly by this method. Among them, 3 compounds(β-resorcylic acid, usnic acid, atranorin) are unambiguously identified by comparing with reference standards, 19 compounds are found from Thamnolia subuliformis (Ehrh.) W.Culb. for the first time. This paper can provide the important basis for study on pharmacodynamic material and substitute development of Thamnolia subuliformis (Ehrh.) W.Culb..