Objective To investigate the relationship between serum solute carrier family 7 member 11(SLC7A11)and Janus kinase 2(JAK2)levels and the severity and prognosis of acute non-variceal upper gas-trointestinal bleeding(ANVUGIB).Methods A total of 108 patients with ANVUGIB who were treated in the hospital from April 2019 to April 2023 were selected and divided into severe group(31 cases),moderate group(44 cases)and mild group(33 cases)according to the severity of ANVUGIB.The patients were divided into poor prognosis group(41 cases)and good prognosis group(67 cases)according to their prognosis.An-other 50 healthy volunteers who underwent physical examination in the hospital during the same period were selected as the control group.Serum SLC7A11 and JAK2 levels were detected by enzyme-linked immunosor-bent assay.Spearman correlation analysis was used to analyze the correlation between serum SLC7A11 and JAK2 levels and Framingham risk score(FRS)and Glasweg-Blatchford bleeding score(GBS).Multivariate Logistic regression was used to analyze the influencing factors of poor prognosis in patients with ANVUGIB.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum SLC7A11 and JAK2 for poor prognosis in patients with ANVUGIB.Results The serum SLC7A11 level was significantly lower and the serum JAK2 level was significantly higher in the three groups of ANVUGIB patients than in the control group(all P＜0.05).As the severity of the disease increased,the serum SLC7A11 level gradually de-creased,and the serum JAK2 level,FRS and GBS scores gradually increased(all P＜0.05).In ANVUGIB pa-tients,serum SLC7A11 level was negatively correlated with FRS and GBS scores,and serum JAK2 level was positively correlated with FRS and GBS scores(all P＜0.05).Compared with the good prognosis group,the poor prognosis group had significantly higher proportion of patients with bleeding volume＞400 mL,red blood cell distribution width,FRS score,GBS score,and JAK2 level,and significantly lower levels of hemoglo-bin and SLC7A11(P＜0.05).Bleeding volume＞400 mL and elevated JAK2 level were risk factors for poor prognosis in ANVUGIB patients,while elevated SLC7A11 level was a protective factor(all P＜0.05).The ar-ea under the curve of combined SLC7A11 and JAK2 in predicting poor prognosis of ANVUGIB patients was better than that of each index alone(Zcombination-SLC7A11=3.086,Zcombination JAK2=2.330,P=0.020,0.030).Conclu-sion The decrease of SLC7A11 level and increase of JAK2 level in patients with ANVUGIB can effectively e-valuate the severity and prognosis of patients,and the combination of the two can predict the prognosis of pa-tients with ANVUGIB.

Objective:To explore the diagnostic value of quantitative analysis of contrast-enhanced ultrasound for deep venous thrombosis of lower extremity after total hip arthroplasty.Methods:A total of 150 patients suspected of deep venous thrombosis of lower extremity undergoing total hip arthroplasty treatment in Jiaozhou Central Hospital of Qingdao from June 2021 to June 2022 were selected. Color Doppler ultrasound diagnostic instrument was used to examine the deep vein vessels of the lower limbs of patients, and quantitative analysis of contrast-enhanced ultrasound was performed to record the color Doppler detection results of patients. Quantitative parameters of contrast-enhanced ultrasound including time to peak (TIP), derived peak intensity (DPI), slope of ascending branch of curve (C) were compared between patients with deep vein thrombosis of lower extremities and normal patients. According to the onset time of symptoms of lower extremity thrombus group, patients were divided into acute stage, subacute stage and chronic stage, and the thrombus elasticity score and thrombus strain ratio among the three subgroups were compared.Results:Angiography results showed that 82 patients were diagnosed with deep vein thrombosis of lower extremities. The Kappa = 0.904, sensitivity was 95.00%, specificity was 91.43%, accuracy was 93.33%, positive prediction rate was 92.68%, and negative prediction rate was 94.12% by using contrast-enhanced ultrasonography and angiography in the diagnosis of deep vein thrombosis of lower extremity. The Kappa = 0.616, the sensitivity was 77.55%, specificity was 88.46%, accuracy was 81.33%, positive prediction rate was 92.68%, negative prediction rate was 67.65% by using ultrasonography and angiography in the diagnosis of deep venous thrombosis of lower extremities. The TIP level in patients with deep venous thrombosis of lower limbs was higher than that in normal patients, the DPI and C levels were lower than that in normal patients: (40.21 ± 12.34) s vs. (13.50 ± 4.59) s, (- 32.27 ± 7.56) dB vs. (- 11.33 ± 3.07) dB, (1.88 ± 0.40) dB/s vs. (4.75 ± 1.34) dB/s, there were statistical differences ( P<0.05). There were 28 cases of acute stage thrombosis, 22 cases of subacute stage thrombosis, and 32 cases of chronic stage thrombosis. There were statistically significant differences in thrombus elasticity score and thrombus strain ratio among patients with lower extremity thrombosis at different periods. Thrombus elasticity score and thrombus strain ratio of patients with acute stage thrombus were the lowest. Conclusions:Quantitative analysis of contrast-enhanced ultrasound has good consistency in the diagnosis of lower extremity deep vein thrombosis after total hip arthroplasty, and has certain clinical significance for staging diagnosis of lower extremity deep vein thrombosis.

Steroid-resistant nephrotic syndrome (SRNS) is the second cause of chronic kidney disease in children. The SRNS has high risk of rapid progression to end-stage renal disease. With the advancement of high-throughput sequencing technology, more than 70 monogenic mutation having the Mendelian inheritance patterns are identified to be associated with SRNS. Most of these genes are involved in podocyte function. Accurate diagnosis of monogenic mutation in SRNS patients helps with guiding clinical treatment protocols and genetic counseling, avoiding the excessive use of steroids/immunosuppressive therapy, and opening up possibilities for targeted therapies in SRNS patients. In this article, our research team summarizes and generalizes the molecular mechanisms, genetic testing, and specific treatment for the major types of monogenic mutations associated with SRNS.

This study aimed at conducting retrospective analysis of the clinical symptoms and genetic mutations in 20 children with Gitelman syndrome treated at the Affiliated Children′s Hospital of Nanjing Medical University from August 2015 to November 2022 and also explored the molecular mechanism of the pathogenic high-frequency mutation D486N in the Chinese population.

Asari Radix et Rhizoma （AR） is a traditional Chinese medicine with a history of more than 2 000 years of medication and has been included in ancient herbal works in the past dynasties. It is effective in releasing the exterior， dispersing cold， dispelling wind， relieving pain， opening orifices， warming the lung， and resolving fluids， and is still widely used in the clinical treatment of influenza， coronavirus disease-2019 （COVID-19） pneumonia， asthma， allergic rhinitis， eye pain， headache， toothache， oral ulcer， eczema， etc. Modern pharmacological studies have shown that AR has antipyretic， anti-inflammatory， analgesic， antibacterial， antiviral， relieving cough and asthma， anti-allergy， and other effects. AR contains a variety of chemical components， in which essential oil is not only associated with functions such as dispelling cold， relieving heat， relieving pain， and resisting inflammation and allergy， but is also toxic. AR also contains lignans， flavonoids， amides， phenanthrenes， alkaloids， and other non-volatile oil components， which play an important role in immunity regulation， anti-inflammation， pain relief， heart strengthening， and blood vessel expansion. The phenanthrene compounds are mainly aristolochic acid analogues， such as aristolochic acid Ⅳ_a and aristolochic lactam Ⅰ. Aristolochic acid Ⅳ_a has been proven to have a significant anti-inflammatory effect. The toxicity of AR is related to safrole， aristolochic acids and their analogues， and is also affected by many factors， such as preparation method， dosage， origin， collection time， medicinal part， and decocting time， which should be comprehensively considered in clinical application. Based on the relevant literature in China and abroad， the present study reviewed the correlation of chemical composition and pharmacological and toxicological effects of AR， and the safety of AR， aristolochic acid， safrole， and other components to provide a new perspective for an objective understanding of AR safety， as well as references for rational clinical application， production risk prevention and control， and drug scientific supervision of AR.

Objective: To investigate the effects of the link between overweight/obesity and type 2 diabetes mellitus (T2DM) on leptin and visfatin levels. Methods: Males without T2DM and male patients with T2DM hospitalized in Lishui Municipal Central Hospital from January to June, 2017 were enrolled. Subjects' age and medical history of diseases were collected. The height and body weight were measured, and the body mass index (BMI) was estimated. The leptin and visfatin levels were determined, and compared between patients with and without T2DM, and between patients with and without overweight/obesity. The effect of the link between overweight/obesity and T2DM on leptin and visfatin levels was examined using a generalized linear regression model. Results: There were 66 patients with T2DM, with a mean age of (49.70±9.45) years and a mean diabetes duration of (4.99±4.46) years, and there were 64 patients without T2DM, with a mean age of (43.89±0.20) years. The leptin [ (3.17±0.36) vs. (3.03±0.30) ng/mL; t=2.387, P=0.018] and visfatin levels [ (29.14±3.16) vs. (21.81±3.32) ng/mL; t=12.900, P<0.001] were significantly greater in T2DM patients than in patients without T2DM. The leptin level was significantly greater in patients with overweight/obesity than in those without overweight/obesity [ (3.27±0.32) vs. (2.92±0.26) ng/mL; t=6.634, P<0.001], and the visfatin level was significantly lower in patients with overweight/obesity than in those without overweight/obesity [(24.38±5.14) vs. (26.71±4.36) ng/mL; t=2.780, P=0.006]. Generalized linear regression analysis showed interacting effects of overweight/obesity and T2DM on leptin (β=0.286, P=0.003) and visfatin levels (β=2.709, P=0.008). Conclusion The interaction between overweight/obesity and T2DM affects leptin and visfatin levels.

Objective:To investigate the antagonistic and therapeutic effects of Ginkgo biloba on arsenic-induced lung injury in rats and its mechanism.Methods:A total of 42 healthy clean grade Wistar rats, half male and half female, weighing 120 - 130 g, were randomly divided into 7 groups with 6 rats in each group. Two intervention models of Ginkgo biloba antagonism and treatment were established, respectively. The specific treatments were as follows: (1) Experimental study on the antagonism of Ginkgo biloba (4 groups): the control A group was given deionized water; the Ginkgo biloba control (GBE) group was given Ginkgo biloba solution (50 mg·kg -1·bw); the arsenic-treated (As) group was given sodium arsenite solution (10 mg·kg -1·bw); the Ginkgo biloba antagonistic (As + GBE) group was treated with sodium arsenite solution (10 mg·kg -1·bw) and Ginkgo biloba solution (50 mg·kg -1·bw), and the above administration was by gavage for 6 days/week, for 4 months. (2) Experimental study on the treatment of Ginkgo biloba (3 groups): the control B group was given deionized water for 5.5 months; in the arsenism natural recovery (recovery) group, sodium arsenite solution (10 mg·kg -1·bw) was administered by gavage for 4.0 months and deionized water for 1.5 months; the Ginkgo biloba treatment (treatment) group was given sodium arsenite solution (10 mg·kg -1·bw) by gavage for 4.0 months and Ginkgo biloba solution (50 mg·kg -1·bw) for 1.5 months, and the above administration was for 6 days/week. Masson staining was used to evaluate collagen fiber deposition in lung tissue. Western blotting was used to detect the expression level of related proteins in lung tissue homogenates, including inflammatory cytokines matrix metalloproteinase-9 (MMP-9), interleukin (IL)-1β, IL-18; high mobility group box 1 (HMGB1) and receptor for advanced glycation end-products (RAGE) of the HMGB1/RAGE pathway; phosphatidylinositol-4, 5-bisphosphate 3-kinase (PI3K), protein kinase B (AKT), phosphorylated AKT (p-AKT) of the PI3K/AKT pathway; transforming growth factor (TGF)-β1, SMAD2, p-SMAD2, SMAD3, p-SMAD3 and SMAD4 of the TGF-β1/SMAD pathway. Results:(1) Antagonistic effect of Ginkgo biloba: compared with the control A group, there was no significant change in protein expression and collagen fiber deposition in the lung tissue of GBE group ( P > 0.05); the levels of MMP-9, IL-1β and IL-18 protein expression and collagen fiber deposition in the lung tissue of As group were significantly increased ( P < 0.05); and the levels of HMGB1, RAGE, PI3K, p-AKT, TGF-β1, p-SMAD2, p-SMAD3 and SMAD4 protein expression were significantly increased ( P < 0.05). Compared with As group, the levels of MMP-9, IL-1β and IL-18 protein expression and collagen fiber deposition were significantly decreased in As + GBE group ( P < 0.05); and levels of HMGB1, RAGE, PI3K, p-AKT, TGF-β1, p-SMAD2, and p-SMAD3 protein expression were significantly decreased ( P < 0.05). (2) Therapeutic effect of Ginkgo biloba: compared with control B group, the levels of MMP-9, IL-1β, IL-18 protein expression and collagen fiber deposition were significantly increased in recovery group ( P < 0.05); and the levels of HMGB1, RAGE, PI3K, p-AKT, TGF-β1, p-SMAD2, p-SMAD3 and SMAD4 protein expression were significantly increased ( P < 0.05). Compared with recovery group, the levels of MMP-9, IL-1β, IL-18, HMGB1, RAGE, PI3K and p-AKT protein expression were significantly decreased in treatment group ( P < 0.05); and there was no significant change in collagen fiber deposition and TGF-β1, p-SMAD2, p-SMAD3 and SMAD4 protein expression levels in lung tissue ( P > 0.05). In both experiments, there was no significant difference in the protein expression levels of AKT, SMAD2 and SMAD3 between the groups ( P > 0.05). Conclusion:Ginkgo biloba intervention has ameliorated inflammatory injury and collagen fiber deposition in lung tissue of arsenic-treated rats possibly by inhibiting the expression levels of HMGB1/RAGE pathway-related proteins.

Objective:Build a research index performance model with discipline growth evaluation, to evaluate the scientific research performance level of various disciplines in hospital more objectively, fairly and dynamically.Methods:Take the research projects, papers, patents and achievements as the main evaluation indicators and establish the hierarchical and classified scoring standards, to form the weight index evaluation model for the total score, per capita score and growth of the discipline research.Results:Using the growth research index to evaluate the scientific research performance of departments and individual researcher between January 2018 and December 2020. Excellent departments were selected for the top 10% of the scientific research index, those whose scientific research scores increased by more than 20% compared with the previous year were selected as the progressive departments, and the top 1% of individual scientific research scores were selected as the advanced researchers, which were commended and encouraged. For the departments ranked in the bottom 5% or whose scientific research index significantly declined compared with previous year, early warning, guidance and supervision were implemented. Since the implementation of the evaluation system, the research performance of disciplines has been significantly improved, and many achievements were made.Conclusions:This evaluation mode can stimulate the enthusiasm of the disciplines and scientific researchers for entrepreneurship and innovation to set up the standards and promote the continuous improvement of the research capacity of the whole hospital.

Objective:To investigate the clinical characteristics of elderly patients with coronavirus disease 2019(COVID-19), in order to provide scientific evidence for the diagnosis and treatment of COVID-19 in elderly patients.Methods:Clinical data of 102 patients with COVID-19 admitted to the B11 East Ward of the Zhongfaxincheng campus and the E1-3 ward of the Guanggu Campus of Tongji Hospital affiliated to Huazhong University of Science and Technology in Wuhan from 1 February 2020 to 28 February 2020 were retrospectively collected and analyzed.Patients were categorized into 2 groups: the elderly group(≥60 years old)and the young and middle-aged group(<60 years old). Differences in epidemiological features, demographics, clinical symptoms, laboratory results and imaging findings between the two groups were retrospectively analyzed.Results:Among 102 patients with COVID-19, 58 were in the elderly group(≥60 years old), with a median age of 67.0(63.8, 71.0)years old, and 44 in the young and middle-aged group(<60 years old), with a median age of 47.5(38.0, 51.8)years old.There was no significant difference in gender ratio between the two groups( χ2=0.033, P=0.855). Of 102 patients, 42.0%(21/50)had close contact with an infected person, 14.0%(7/50)were from infection clusters, and 18.0%(9/50)had suspected hospital-acquired infections.Fever and cough remained the most common symptoms, but gastrointestinal symptoms such as nausea, poor appetite, diarrhea and muscle cramps were also warning signs.Fatigue and cough were the most common presenting symptoms in elderly male patients.Bilateral patchy infiltrates(57.9%, 22/38)and ground-glass opacities(42.1%, 16/38)were the main imaging features and 42.1%(16/38)patients had multiple areas of the lungs involved.Over 50% patients had increased levels of blood glucose, D-dimer, fibrinogen, C-reactive protein, procalcitonin, multiple cytokines and neutrophil-to-lymphocyte ratio, as well as decreased levels of albumin, hemoglobin, hematocrit, lymphocytes and serum calcium.Compared with the young and middle-aged group, the elderly group had higher rates of abnormality in levels of D-dimer and serum calcium( χ2=7.067 and 4.166, P=0.008 and 0.041). Conclusions:Fever and cough are the most common symptoms in elderly patients with COVID-19.Elderly patients with COVID-19 have multiple abnormalities in clinical laboratory test results, which show a certain level of specificity compared with young and middle-aged patients.

Objective:To evaluate the effect of high intensity interval training on cancer patients.Methods:Web of Science, EBSCO, PubMed, Ovid, EMbase, Cochrane Library, CBM, CNKI and Wanfang database were searched for randomized controlled trials of the effect of high intensity interval training on cancer patients, RevMan5.3 software was used for analysis.Results:Eleven articles with a population of 614 were included in the analysis, which involved 323 cases of the intervention group and 291 cases of the control group. The analysis showed that high intensity interval training could improve the total quality of life ( SMD values were 0.40, 95% CI 0.14-0.65, P<0.01) and peak oxygen uptake ( MD values were 3.00, 95% CI 2.19-3.80, P<0.01) of cancer patients, and reduce carotid intima-media thickness ( MD values were -0.06, 95% CI-0.08--0.03, P<0.01), but did not reduce the high-sensitivity C-reactive protein ( MD values were -0.61, 95% CI-1.23-0.01, P>0.05) and body weight ( MD values were 0.16, 95% CI-3.19-3.51, P>0.05). Conclusions:High intensity interval training has a positive impact on quality of life, cardiopulmonary function and carotid intima-media thickness with cancer patients, but has no significant effects on high-sensitivity C-reactive protein and body weight.