It was reported that autocrine and paracrine of cytokines play a central role in the pathogenesis of glomeru-lonephritis(GN)and glomerulosclerosis(GS).previous studies demanstrated that IL—1 like factor is not onlyproduced by MSc,but also stimulates MSc proliferation.In order to examine the autocrine and paracrine of IL—1 in MSc in molecular biologic level,we explored the effects of rIL—1 on MSc IL—1 and TGFB mRNA geneexpression.Total RNA was extracted from subcultured MSc in presence of absence of rIL-1 in 3,6,12,hoursand dot blots.The MSc proiferation was a dose dependent of rIL—1,and IL—1 promoted MSc IL—1 andTGFB mRNA gene expression.Our results support the possible role of IL—1 autocrine and paracine in MSc.

Aim To study the pharmacokinetics of po-lyethylene glycol conjugation on EILDVP peptide in mice by injection through tail vein.Methods KM mice,saturated thyroid gland with compound of NaI, were injected for 1 25 I labeled EILDVP-Tyr-NH2 ,EILD-VP-Cys (mPEG2000-MAL)-Tyr-NH2 and EILDVP-Cys (mPEG20000-MAL)-Tyr-NH2 peptides (1 25 I:5 mL · kg -1 volume 3.441 GBq·L -1 concentration)by tail intravenous,respectively.Blood samples at different time intervals were obtained,blood plasma was separa-ted,and the radioactivity of precipitation after trichloro-acetic acid (TCA)treatment was tested.According to standard curve equation, the plasma concentration curve and pharmocokinetic parameters were depicted by means of 3P97 pharmocokinetics software.Results Concentration range of 3.75 ~480 μg·L -1 of three 1 25 I labled peptides in plasma from mice had good line-ar relationship.Recovery of method was 88.92% ~
1 06.66%,and RSD <1 0%.The half-life time (T1 /2 ) of EILDVP-Tyr-NH2 peptide modified by mPEG2000 and mPEG20000 ,labled by 1 25 I was 0.43h and 1 .94h,re-spectively,which was 1 .54 times and 6.93 times that of prototype peptide (T1 /2 =0.28h),and the clear-ances (Cl)were 1 .23 times and 24.71 times,respec-tively.The apparent distribution volume (V)values of the three species were small,which might mainly dis-tributed in the plasma.Conclusions Suitable for mo-lecular mass mPEG modified the EILDVP peptides could extend to maintain time in vivo,which could play a positive role in improving efficacy.In the experimen-tal range,EILDVP peptide modified by larger molecu-lar mass of mPEG20000 has better effect.

Hospice care requires all-round care provided by medical staff for end-stage patients. Due to the particularity of its objects, nursing staff need to have a broader vision and practice ability, so as to play a professional role in the care of end-stage patients and their families. By combing the core elements of nursing staff’s hospice care practice ability, this paper analyzed the influencing factors of nursing staff’s hospice care practice ability, systematically summed up the intervention measures to improve nursing staff’s hospice care practice ability, and put forward the cultivation prospect and development expectation of nursing staff’s hospice care practice ability in China, so as to lay the foundation for the management and training of hospice care nursing staff.

Objective:To explore the application value of the family-centered nursing model and home care platform in PICC nursing of elderly tumor patients, in order to provide reference for PICC nursing of elderly tumor patients.Methods:A total of 122 elderly tumor patients admitted to Boao Hengda International Hospital, Hainan Province from October 2017 to October 2019 were selected and divided into control group (61 cases) and observation group (61 cases) according to the random number table method. The control group received routine care. The observation group combined family-centered care with home care platform for nursing intervention. Before and 3 months after intervention, the self-management ability, quality of life and mental resilience of the two groups were evaluated by Cancer Patients PICC Self-Management scale(CPPMS), 36-item Short Form Health Survey(SF-36) and Connor-Davidson Resilience Scale(CD-RISC). The incidence of complications during the observation period and service volume was recorded.Results:There was no significant difference in the score of CPPMS,SF-36, CD-RISC before intervention between the two groups( P>0.05). The CPPSM scores of the observation group and the control group after intervention were (144.21±8.93) points and (125.85±10.52) points, the difference was statistically significant ( t value was 10.392, P<0.05). The scores of social function, life vitality, physical pain, physical function, physical role limitation, emotional role limitation, mental health and overall health were (70.34±5.96),(68.27±5.01),(63.46±4.57),(58.53±5.78),(59.74±6.49),(60.32±5.69),(59.83±6.72),(66.58±6.76) points in the observation group, and (65.32±6.04), (65.33±6.57), (58.35±4.92), (54.51±4.82), (55.64±6.12), (54.59±6.42), (55.67±5.06), (62.14±4.77) points in the control group, the differences were statistically significant ( t values were 2.779-5.943, P<0.05). The CD-RISC scores of the observation group and the control group after intervention were (82.41±8.79) points and (73.39±7.64) points, the difference was statistically significant ( t value was 6.049, P<0.05). There was no significant difference in the complication rate between the two groups ( P>0.05). The number of calls, consultations, and door-to-door services were (6.77±1.27), (6.34±1.92), (2.58±0.52) times/person in the observation group, and (4.52± 1.48), (4.06±1.41), (2.03±0.19) times/person in the control group, the difference was statistically significant( t values were 9.011, 7.475, 7.759, P<0.05). Conclusions:Compared with conventional care, the family-centered care model and home care platform have higher application value in elderly patients with PICC oncology, which can effectively improve the PICC management ability and quality of life of patients, and further improve the psychological flexibility. It is worthy of promotion and application.

A 22-year-old male patient visited the Department of Dermatology of the First Affiliated I Iospital of Zbengzhou University on October 31,2016 due to dark red papules,nodules,pustules and cysts on the face,neck,back and in the axillary and inguinal regions for 6 years,and multiple dark purple plaques and ulcers on bilateral lower limbs for 1 year.Six years ago,the patient was diagnosed with acne in other hospital,and no treatment was given.One year ago,multiple purple plaques occurred on the bilateral lower limbs,which then ruptured and progressed into ulcers with diameters of 1-12 cm.On May 9,2002,the patient visited the Department of Pediatric Medicine of the First Affiliated Hospital of Zhengzhou University due to the left knee joint swelling and pain for half a year.Laboratory examination showed negative rheumatoid factor,and smear examination of the left knee joint effusions revealed that there were neutrophils and a small amount of lymphocytes and monocytes in the joint effusions,and no abnormal cells were observed.Then,the patient was diagnosed with pyogenic arthritis of the left knee.Physical examination at admission showed poor general condition,walking difficulty,slightly increased blood pressure of 142/92 mmHg (1 mmHg =0.133 kPa),multiple purple plaques on the bilateral lower limbs with central ulcer formation.Histopathological examination of ulcer margin on the lower limbs showed ulceration,intercellular edema and infiltrating neutrophils in the epidermis,and edema,focal erythrocyte extravasation,diffuse infiltration of neutrophils,lymphocytes and histiocytes in the superficial and middle dermis.Clinical manifestations and pathological features confirmed a diagnosis of pyoderma gangrenosum.There were extensive inflammatory papules,pustules,abscesses and cysts on the face,neck,waist and back,and a small amount of dark red nodules on the axillary and inguinal regions,which were consistent with cystic acne and hidradenitis suppurativa.As PSTPIP1 gene sequencing showed,no mutations were found in exon fragments,while compound heterozygous mutations c.36 + 68 G ＞ A,c.137 + 47 G ＞ C and c.562 + 114 C ＞ G her were found in intron fragments.Among 100 healthy controls,45 carried the same mutations.So,these mutation sites were considered to be polymorphic sites,and the pathogenicity of these mutations was still unclear.Finally,the patient was diagnosed with PAPASH syndrome.The patient was treated with methylprednisolone,cefminox,isotretinoin and thalidomide,and the lesions were markedly improved after 2 weeks.Now the patient was still followed up.

OBJECTIVETo study long-term effect on renal function exposed to environmental cadmium.

METHODSStratified random sampling and cluster sampling method of epidemiological investigations were carried out in northern Guangdong province between April, 2011 and August, 2012. A total of 167 residents who lived in high cadmium exposure area for more than 15 years, aged above 40 were selected in exposed group. Moreover, A total of 145 residents who had similar living and economic conditions and lived in local for more than 15 years, aged above 40 were selected in control group. We used health questionnaires and medical examinations in order to acquire their health status. Home-harvested rice and vegetables were collected using quartering method for detection of cadmium level. Urine specimens of residents were collected for detection of cadmium level and creatinine as well as renal dysfunction biomarkers, namely, N-acetyl-beta-D-glucosamidase (NAG), β2-microglobulin (β2-MG), and retinol binding protein(RBP), respectively. The analysis of spearman rank correlation and multiple regression were used to investigate the relationships between age, urinary cadmium levels and renal injury biomarkers.

RESULTSThe cadmium levels in rice and vegetables of exposed group were 0.75 and 0.10 mg/kg, both were significantly higher than 0.07 and 0.01 mg/kg in the control group (Z values were -6.32 and -7.84, all P values < 0.001). The urinary cadmium level of exposed group was 8.29 µg/g · cr, which was higher than that of the control group 2.03 µg/g · cr with significant difference (Z value was -11.39, P < 0.001). After stratified the total population by age, the urinary cadmium level in 40-49 years, 50-59 years and ≥ 60 years subgroups were 7.22, 8.71, and 13.10 µg/g · cr, which both were significantly higher than 1.80, 2.04, and 2.05 µg/g · cr in the control group (Z values were -5.22, -7.41, and -7.14, all P values < 0.001). After stratified the total population by gender, the urinary cadmium level of male and female were 5.12 and 12.36 µg/g · cr, which both were significantly higher than 1.79 and 2.16 µg/g · cr in the control group (Z values were -7.68 and -9.03, all P values < 0.001). Comparing the differences of renal dysfunction biomarkers (NAG, β2-MG, RBP) between two groups. The level of urinary β2-MG and RBP of exposed group were 0.21 and 0.04 µg/g · cr, which were higher than 0.05 and 0.00 µg/g · cr of the control group with significant difference (Z value was -7.08 and -9.65, all P values < 0.001). Pearson correlation analysis showed that NAG, β2-MG and RBP were positively correlated with urinary cadmium and age, the correlation coefficients were 0.57, 0.49, 0.21 and 0.22, 0.26, 0.23 respectively (all P values < 0.001). After adjusting the effect of age, it was appeared that urinary cadmium levels contributed most to the alteration of NAG, β2-MG and RBP, the standardized regression coefficients were 0.57, 0.49 and 0.20 (all P values < 0.001), and suggested that the cadmium body burden was one of the most important factors for renal dysfunction.

CONCLUSIONResidents, who had cadmium contaminated rice and vegetables for a long time, would take the risk of increasing body burden of cadmium and urinary early biomarkers of renal tubular injury that referred to occurrence of renal dysfunction.

Adult ; Aged ; Cadmium ; Creatinine ; Environmental Exposure ; Epidemiologic Studies ; Female ; Food Contamination ; Humans ; Kidney Diseases ; Male ; Middle Aged ; Multivariate Analysis ; Oryza ; Risk ; Time ; Vegetables

OBJECTIVE To systematically evaluate the hemostatic effect and safety of snake venom hemocoagulase drugs in abdominal surgery， so as to provide evidence-based evidence for clinic. METHODS Retrieved from Embase， Cochrane Library， PubMed， China Biomedical Literature Database， CNKI and Wanfang database， randomized controlled trials （RCTs） about 3 kinds of snake venom hemocoagulase drugs （Hemocoagulase injection， Hemocoagulase Bothrops atrox for injection， Haemocoagulase Agkistrodon for injection） in abdominal surgery were collected from the establishment of the database to Aug. 2023. Screening， quality evaluation， and data extraction were conducted on literature according to the inclusion and exclusion criteria， and Cochrane 5.1 was used for literature quality evaluation. The risk bias diagram and network diagram were drawn by Stata 15.1 software， and the Bayesian network meta-analysis was carried out by using R 3.6.2 software and Markov chain-Monte Carlo method. RESULTS A total of 11 studies were included， involving 1 401 patients， 852 in the study group， and 549 in the control group. In terms of hemostatic effect， Hemocoagulase injection was significantly superior to Haemocoagulase Agkistrodon for injection [MD＝－2.45， 95%CI （－4.39，－0.24）， P＜0.05]， and the probability of reducing intraoperative bleeding was ranked as follows： Hemocoagulase injection＞hemocoagulase B. atrox for injection＞Haemocoagulase Agkistrodon for injection； in terms of safety， there was no statistically significant difference between the three snake venom hemocoagulase drugs and placebo （P＞0.05）. CONCLUSIONS The hemostatic effect of Hemocoagulase injection in abdominal surgery is significantly better than that of Haemocoagulase Agkistrodon for injection； all three snake venom hemocoagulase drugs have good safety.

OBJECTIVE According to the rapid Health Technology Assessment （HTA） for postmenopausal osteoporosis （PMOP），To evaluate the efficacy ，safety and economy of calcitonin in the treatment of PMOP ，and provide evidence -based medical evidence for clinical drug decision . METHODS Retrieved from the Cochrane Library ，PubMed，Embase，CNKI，Wanfang database，CBM and HTA official website ，systematic review/meta -analysis，pharmacoeconomics research and HTA reports about calcitonin in the treatment of PMOP were retrieved from the inception to Sept . 30th，2022. Two researchers independently carried out screening ，data extraction and quality evaluation ，and analyzed the data results descriptively . RESULTS A total of 18 studies were included ，including 12 SR/meta-analysis and 6 economic studies ，and no HTA report was retrieved . In terms of effectiveness ， the results of the included studies were basically consistent ：calcitonin had a certain advantage in reducing the incidence of vertebral fracture compared with calcium and lasoxifene alone ，but did not show clinical advantage compared with other positive drugs . In terms of reducing the incidence of non -vertebral fractures ， calcitonin had some advantages ，compared with calcium al one and raloxifene ，but did not show clinical advantage compared with other positive drugs . In terms of improving bone mineral density（BMD），only 2 studies showed that calcitonin had a certain advantage over calcium but no advantage was observed compared with other positive drugs . In terms of improving non - vertebral BMD ，only 1 study showed that calcitonin combined with calcium had certain advantages compared with calcium alone in improving femoral BMD ，but there was no advantage compared with other positive drugs . In terms of lowering bone pain scores ， both included studies demonstrated short -term benefit of nasal calcitonin in reducing acute pain was found in patients with vertebral fractures，but not in patients with chronic pain . In terms of safety ，the three included studies showed that calcitonin caused mild adverse reactions compared with other positive drugs ，but there was a risk of malignant tumors after long -term use . In terms of economy，only 1 study showed the use of nasal calcitonin in the treatment of PMOP had more economic advantages than no treatment or etidronate . CONCLUSIONS Calcitonin has a certain effect on reducing acute pain in patients with PMOP vertebral fracture，and its safety needs further investigation . No obvious economic advantage has been found .