Objective To explore the level of angiopoietin‐like protein 4 (ANGPTL4) in patients with early chronic kidney disease (CKD ) in diabetes and the influence of pioglitazone on the level. Methods 92healthypeoplewithnormalglucosetolerancewereselectedasthecontrols(NCgroup).89 newly diagnosed T2DM were selected (T2DM group ). 90 cases of CKD group were divided into pioglitazone (PGZ) and glimepiride (GLI) treated subgroups ,45 cases in each subgroup. After treatment , serum ANGPTL4 levels were observed in CKD group. Results There were significant differences in serum ANGPTL4 levels among NC ,T2DM and CKD groups [(34.8 ± 4.75) vs (31.1 ± 3.65) vs (27.1 ± 3.52)ng/ml ,P<0.05 or P<0.01]. ANGPTL4 level was positively correlated with SOD ,TG (r=0.635 , 0.526 ,P< 0.05 or P< 0.01) ,and negatively correlated with BMI ,FPG ,HbA1c ,hsC‐RP ,UAlb/Cr , VEGF ,FIns ,HOMA‐IR (r= -0.502 ,-0.624 ,-0.542 ,-0.520 ,-0.538 ,-0.566 ,-0.576 ,-0.509 ,P< 0.05 or P < 0.01 ). In PGZ subgroup after treatment ,ANGPTL4 levels were significantly increased and UAlb/Cr significantly decreased [(31.51 ± 3.87 ) vs (27.60 ± 3.58 )ng/ml ,P < 0.05 ;(88.50 ± 8.90 ) vs (116.20 ± 10.30 )mg/24 h ,P < 0.01 ]. In GLI subgroup after treatment ,there were no significant difference in FPG and HbA1 c as compared with PGZ subgroup but ANGPTL4 levels have no significant differences after treatment ,and UAlb/Cr decreased [(27.20 ± 3.54 ) vs (26.60 ± 3.48 )ng/ml ,P > 0.05 ;(99.70 ± 12.80 ) vs (122.40 ± 13.10 )mg/24 h ,P < 0.05]. HbA1 c ,FIns ,UAlb/Cr were the independent related factors influencing ANGPTL4 of CKD patients. Conclusion Serum ANGPTL4 has a lower level in CKD patients. PGZ is effective in treating CKD. This role is associated with the increase of serum ANGPTL4.

Objective To evaluate the influence of autophagy on pain behavioristics and astrocytic activation in rats with inflammatory pain.Methods Seventy-eight clean male Sprague-Dawley (SD) adult rats were randomly divided into four groups: control group (n = 12), model group (n = 42), autophagy inducer rapamycin (Rap) pretreatment group (n = 12) and autophagy inhibitor 3 methyladenine (3-MA) pretreatment group (n = 12). The inflammatory pain rat model was reproduced by subcutaneous injection of freund's complete adjuvant (CFA) 100μL at foot sole, whilein control group, the same volume 0.9% normal saline 100μL was injected at the same site. One hour before modeling, Rap 10 mg/kg and 3-MA 15 mg/kg were intraperitoneally injected in rats in Rap and 3-MA pretreatment groups respectively, and the same volume of 0.9% normal saline was injected intraperitoneally in rats of control and model groups. Before modeling and 6, 12, 24 hours and 3 days after modeling, the L4-L6 spinal cord tissue was harvested from 6 rats in model group, and autophagy protein membrane microtubule-associated protein 1 light chain 3 Ⅱ (LC3 Ⅱ) and autophagy related gene Beclin-1 expressions were detected by Western Blot in the tissue; the changes of pain behavioral indexes mechanical withdraw threshold (MWT) and thermal withdrawal latency (TWL,n = 6), were observed at6, 12, 24 hours and 3 days, 7 days after modeling in the 6 rats taken from each group; in another 6 rats in each group, 24 hours after modeling, L4-L6 spinal cord tissue was collected, immunofluorescence staining was used to observe the changes of astrocytes and the positive expression of glial fibrillary acidic protein (GFAP) under a confocal microscopy, and the protein expression quantity of GFAP was detected by Western Blot in the tissue.Results ① The inflammatory pain could induce the increase of rat autophagy protein LC3Ⅱ and Beclin-1 expressions in spinal cord tissue, reaching their peaks at 24 hours (A value: 0.59±0.07, 0.51±0.06, respectively), and then they were gradually decreased. ② With the prolongation of time, in the model group MWT was gradually decreased, TWL was gradually shortened, they reached their valley values at 24 hours after modeling [MWT (g): 17.8±1.9, TWL (s): 6.8±0.4], and from 12 hours they were significantly decreased compared with those in control group [12hours MWT (g): 21.5±2.4 vs. 43.4±5.1, TWL (s): 12.0±1.1 vs. 17.6±1.2, bothP < 0.05], after modeling for 3 days they were increased; Compared with model group, 12 hours after autophagy inducer Rap was given, MWT was significantly increased (g: 36.8±4.9 vs. 21.5±2.4,P < 0.05), TWL was significantly prolonged (s: 14.3±1.1 vs. 12.0±1.1,P < 0.05); from 12 hours after autophagy inhibitor 3-MA was given, MWT was further reduced (g: 18.6±1.9 vs. 21.5±2.4, P<0.05), TWL was further shortened (s: 8.4±0.6 vs. 12.0±1.1,P < 0.05). ③ Confocal microscopic findings showed, there was no significant acstrocytic change, and only litter GFAP expression was seen in control group. In model group, the inflammatory pain induced astrocyte activation, manifesting glial cell hypertrophy, hyperplasia, gelatinousnetwork deformation, and GFAP expression was obviously increased compared with that in the control group (A value: 0.54±0.09 vs. 0.16±0.02,P < 0.05). Since autophagy inducer Rap can decrease astrocyte activation and inhibit GFAP expression, there was statistical significant difference between Rap pretreatment and model groups (A value: 0.33±0.06 vs.0.54±0.09,P < 0.05); autophagy inhibitor 3-MA can further aggravate astrocytes activation and up-regulate GFAP expression in 3-MA pretreatment group (A value: 0.73±0.08 vs. 0.54±0.09,P < 0.05).Conclusion Autophagy participates in the process of astrocytic activation and pain behavioristics in rats with inflammatory pain.

Objective To investigate the changes of serum stromal cell‐derived factor‐1α (SDF‐1α) in patients with diabetic peripheral neuropathy (DPN) and the influence of mouse never growth factor (MNGF) on the levels of serum SDF‐1α. Methods 180 patients with type 2 diabetes (T2DM ) were divided into T2DM with DPN (DPN group ,n=92) and T2DM without DPN (T2DM group ,n=88). 90 healthy people were select as normal control (NC group). DPN group was divided into 47 cases of MNGF treatment (A) subgroup and 45 cases of basic treatment (B) subgroup. The levels of serum SDF‐1αwere measured using ELISA method. The relationships between the levels of serum SDF‐1αand SOD ,TGF‐β1 , hsC‐RP ,and GAP‐43 were analyzed. After treatment ,the levels of serum SDF‐1α in A and B subgroups were compared. Results Compared with NC group [(0.91 ± 0.37)μg/L] ,the levels of serum SDF‐1αin T2DM and DPN group were higher [(2.58 ± 0.58) μg/L and(1.71 ± 0.43)μg/L ,respectively ,P<0.05 or P<0.01]. The levels of SDF‐1αwere positively correlated with FPG ,HbA1 c ,TGF‐β1 and hsC‐RP ,and negatively correlated with SOD in T2DM group. The levels of SDF‐1αwere positively correlated with TG and TGF‐β1 ,and negatively correlated with course of disease ,FPG ,HbA1 c ,SOD ,hsC‐RP ,GAP‐43 , MMCV ,PMCV ,MSCV and PSCV in DPN group. SDF‐1α levels were significantly increased after treatment with MNGF in subgroup A [(1.75 ± 0.39) vs (2.09 ± 0.45)μg/L ,P<0.05]. There were no significant difference of SDF‐1αlevels after treatment in subgroup B [(1.67 ± 0.48) vs (1.71 ± 0.51)μg/L , P>0.05] .Multiple stepwise regression analysis showed that HbA1c ,hsC‐RP and PSCV were the independent factors related with the levels of SDF‐1αin DPN patients. Conclusion The levels of serum SDF‐1αin DPN patients are lower than in T2DM patients without DPN. MNGF may increase the level of serum SDF‐1α.

Objective To study the effect of early administration of a mixture of Anisodamine and A-luminium hydroxide gel via nasal gastric tube in preventing in stress - induced digestive tract bleeding in patients with severe brain damage. Method One thousand one hundred and thirteen patients with severe brain damage were divided into three groups: control group 410 cases without any measures to prevent digestive tract bleeding within 72 hours after injury, treatment group A 540 cases when given cimetidine, ranitidine and Losec by intravenous injection or nasal feeding. Group B 240 cases who received nasal feeding of aniso-damine and Aluminium Hydroxide gel mixture. The incidence of bleeding in each group was recorded . Results The incidence of the upper digestive tract bleeding in group B is 1.25% , compared with that of control group( x2 = 90. 13, P

Objective To investigate the effects of HO/CO pathway on inflammation cytokines in a rat model of incisional pain. Methods Thirty-six rats were executed to collect ipsilateral spinal cord tissues for HO-1 detection by Western blot assay, and cytokines tumor necrosis factor (TNF)-a, interleukin (IL)-1b, IL-6 and high mobility group box (HMGB)1 were detected by ELISA before and at 1, 4, 8, 12 and 24 h after establishing incisional pain model. Additionally, 36 rats without establishment of incisional pain model were used as control group. A total of 144 model rats of incisional pain were divided into incisional pain (IP) group, IP+hemin group (100 mg/kg hemin was injected by i.p. before operation), IP+Znpp-IX group (45μmoL/kg Znpp-IX was injected by i.p. before operation) and IP+CORM-2 group (10 mg/kg CORM-2 was injected by i.p. before operation). Values of paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were detected, and expressions of TNF-a, IL-1 b, IL-6 and HMGB1 were measured by ELISA before and at 1, 4, 8, 12 and 24 h after operation. Results Compared with pre-operation of incisional pain in rats, expression levels of HO-1 protein and cytokines TNF-a, IL-1 b, IL-6 and HMGB1 were increased at 1, 4, 8, 12 and 24 h after operation (P<0.05). Compared with control group, values of PWMT and PWTL were obviously decreased, and expression levels of IL-1β, TNF-α, IL-6 and HMGB1 were increased at 1, 4, 8, 12 and 24 h after operation in IP groups (P<0.05). Compared with IP groups, values of PWMT and PWTL were significantly increased and cytokines TNF-a, IL-1 b, IL-6 and HMGB1 were decreased at 1, 4, 8, 12 and 24 h after operation in IP+hemin group and IP+CORM-2 group (P<0.05). Values of PWMT and
PWTL were decreased and cytokines TNF-α, IL-1β, IL-6 and HMGB1 were increased in IP+Znpp-IX group (P<0.05). Conclusion Incisional pain can increase the expression of HO-1, and HO-1/CO pathway exists the regulatory effect on inflammatory cytokines in the rat model of incisional pain.

Objective To explore the influence of injury severity on transplantation of embryonic neural stem cells (NSCs) after traumatic brain injury (TBI).Methods The NSCs were isolated from the hippocampus of fetal rats aged at from 12-14 days.The cells were cultured and proliferated in the serum-free medium and identified in vitro.The animals received transplants in the bilateral hippocampal areas at day 3 following mild or moderate TBI separately.Conventional histology,TUNEL and immunohistology were examined to detect BrdU,NSE,GFAP,GalC,NGF and BDNF at day 14 post-implantation.Results BrdU-labeled positive cells in the bilateral hippocampus in the mild TBI group were more than those in the moderate TBI group at day 14 post-implantation.Significant differentiation of the astrocytes recognized as GFAP positive cells in the bilateral hippocampus was found at day 14 post-implantation.The expression of NGF and BDNF proteins was increased following TBI,the most evident in the mild TBI group.Conclusion The influence of injury severity on transplantation may be associated with the change of the microenvironment after TBI.

This study was aimed to observe the effect of Tao-He Cheng-Qi Decoction (THCQD) on tissue injury of different organs among rats with sepsis. A total of 100 Kunming male SD rats of clean grade were randomly divided into five groups, which were the normal control group, model 6 h control group, model 12 h control group, THCQD 6 h group and THCQD 12 h group. The normal control group received no treatment. The classic CLP method was ap-plied in the establishment of sepsis rat model in other groups. Intragastric administration of saline 1 ml/100 g (weight) was given to each rat in the model group every day. Intragastric administration of THCQD 1 ml/100 g (weight) was given to each rat in the THCQD group every day. The model was established after 7 days. Tissue speci-mens of lung, heart, kidney, liver, and small intestine were collected at 6 h and 12 h after modeling, respectively. Pathomorphological changes of each group were observed by light microscopy and electron microscope. The results showed that compared with the model group at the same time point, pathomorphological changes of tissues of the lung, heart, kidney in THCQD group were not significant. However, pathomorphology of tissues of the liver and small intestine changed significantly in the THCQD 12h group. And there were statistical differences (P < 0.05) between two groups in the score of pathomorphology. It was concluded that THCQD had protective effect on tissues of the liv-er and small intestine among rats with sepsis. However, the mechanism is not clear and requires further research.

The development trend, countries, institutions, co-authors, and subjects in MEDLINE-covered papers were analyzed by Excel, Ucinet and SciMAT respectively in order to understand the current situation in studies on precision medicine, which showed that precision medicine is in a rapid development stage, the impact power of pa-pers on precision medicine published in United States of America is high, the source journals published in United States of America are the core journals in precision medicine, the academic level of papers on precision medicine published in United States of America is high. Co-authors analysis showed that the co-authors network is of the small world effect. Subject evolution analysis revealed that the subjects involved in studies on precision medicine are increasingly rich with genomics, drug treatment and oncology accounted a large proportion. Analysis of the evo-lution in genomics, drug treatment and oncology displayed that the subjects involved in studies on precision medi-cine have experienced macro-stage, micro-stage, and combined macro- and micro-stage.

Objective To investigate the clinical prediction value of chemokine CCL21 level for acute coronary syndrome.Methods Totally 212 patients receiving coronary arteriography were divided into acute myocardial infarction group(AMI,n=72),unstable angina pectoris group(UAP,n=76),and stable angina pectoris group(SAP,n=64).The serum level of chemokine CCL21 was detected by double-antibody sandwich enzyme-linked immunosorbent assay (ELISA)and the pathological changes of coronary artery were measured by Gensini scoring system.All patients were followed up for six months and the cardiovascular adverse events were recorded.Results The serum level of CCL21 was(169.72±14.64)ng/L in AMI group,(154.42±16.50)ng/L in UAP group,and(143.87±9.80) ng/L in SAP group,with statistically significant differences (F =99.818,P =0.000).Serum levels of CCL21 in ACS group and SAP group were positively correlated with Gensini score(r=0.474,P =0.000;r=0.350,P=0.049).Binary Logistic regression analysis revealed that chemokine CCL21 was an independent risk factor for predicting acute coronary syndrome (OR =1.049,P =0.022).The CCL21-judged area under the ROC curve in acute coronary syndrome group was 0.887 ± 0.028 (P =0.000),with diagnostic point of serum level of chemokine CCL21 at 159.15 ng/L,sensitivity of 0.635,specificity of 0.981.Serum level of CCL21 was higher in the patients with cardiovascular adverse events than in the patients without cardiovascular adverse events[(168.57±7.24)ng/L vs.(156.92± 6.53) ng/L],with statistically significant difference (t =16.100,P =0.000).Conclusions Serum level of chemokine CCL21 reflects the severity degree of coronary artery disease.The chemokine CCL21,as an independent and effective marker,can predict acute coronary syndrome.

Objective To observe the effects of Suhuang Zhike capsules(SZC) on the guinea pig model of cough variant asthma(CVA), and to explore its therapeutic mechanism. Methods Fifty guinea pigs were randomly divided into normal control group, model group, prednisone acetate tablets group, and high-and low-dose SZC groups. With reference to the related literatures, we set up the guinea pig model of CVA. The observation indexes included cough frequency, lung histopathology, the percentage of eosinophils in bronchoalveolar lavage fluid (BALF), and the serum levels of interleukin 4(IL-4), interferon gamma(IFN-γ), tumor necrosis factor alpha (TNF-α), and immunoglobumin E(IgE). Results Compared with the normal control group, the cough frequency of the model group was significantly increased(P<0.05); compared with the model group, the cough frequency of high-dose SZC group was reduced obviously(P < 0.05). Compared with the normal control group , the percentage of eosinophils in BALF of the model group was significantly increased(P < 0.05); the percentage of eosinophils of the three medication groups was lower than that of the model group (P<0.05). The pathological changes of lung tissue in the medication groups were relieved compared to the model group. Compared with the normal control group, the serum IL-4, TN F-α and IgE levels of the model group were increased significantly (P < 0 . 05); compared with the model group , the serum IL-4 and TN F-α levels of prednisone acetate tablets group were significantly decreased, and the serum TNF-α and IgE levels of high-dose SZC group were decreased significantly (P < 0.05). Conclusion SZC could reduce the serum, TNF-α and IgE levels , and relieve the cough symptom, airway inflammation and the lung tissue pathology in CVA guinea pig, so as to achieve the therapeutic effect on CVA.