Dent disease is a rare X-linked recessive renal tubular disease characterized by low molecular weight proteinuria，hypercalcemia and nephrocalcinosis. It is also a major cause of tubular proteinuria in children. According to different causative genes，Dent disease can be divided into three types：type 1 is caused by mutations in the CLCN5 gene，accounting for about 60%-70%；type 2 is caused by mutations in the OCRL gene，accounting for about 15%-20%；type 3 has a similar clinical phenotype but no known pathogenic gene mutations. CLCN5 encodes the voltage-dependent 2Cl -/1H +exchange channel CIC-5，which is involved in proximal renal tubule endocytosis. Its mutations can cause a variety of proximal tubular dysfunction symptoms，mainly including low molecular weight proteinuria. The use of gene detection technology has resulted in an increase in reports on Dent disease year after year. At present，the specific mechanism underlying Dent disease remains unknown. This article reviews the research progress of CLCN5，hoping to provide new insight for the mechanism research of CLCN5 and the specific treatment of Dent disease type 1.

Wu Jutong's academic thoughts are inherited from Ye Tianshi and traced back to Zhongjing,and have a unique under-standing and play of the evil invading Shaoyang.Wu Jutong believes that Shaoyang has two major functional characteristics:ascending and pivoting.The principle of treating evil invading Shaoyang is to follow the ascending nature of Shaoyang and restore the pivoting function of Shaoyang.For Shaoyang fire-heat syndrome,follow Shaoyang to ascend and disperse to penetrate heat,and often use light,scavenging and dispersing products;for Shaoyang phlegm-fluid syndrome,creat Xiangfu Xuanfuhua Decoction to benefit the liver and gallbladder and resolve phlegm-fluid;for malaria invading Shaoyang,turn the pivot to stop malaria,and use Xiaochaihu Decoction and Qinghao Biejia Decoction for the treatment;for yin evil invading Shaoyang and Jueyin,Xiao Chaihu Decoction and Bupleurum chinense DC.are often used to turn the pivot of Shaoyang and warm and unchoke Jueyin.The contraindications of Xiao Chaihu Decoction are al-so summarized.

Wu Jutong's academic thoughts are inherited from Ye Tianshi and traced back to Zhongjing,and have a unique under-standing and play of the evil invading Shaoyang.Wu Jutong believes that Shaoyang has two major functional characteristics:ascending and pivoting.The principle of treating evil invading Shaoyang is to follow the ascending nature of Shaoyang and restore the pivoting function of Shaoyang.For Shaoyang fire-heat syndrome,follow Shaoyang to ascend and disperse to penetrate heat,and often use light,scavenging and dispersing products;for Shaoyang phlegm-fluid syndrome,creat Xiangfu Xuanfuhua Decoction to benefit the liver and gallbladder and resolve phlegm-fluid;for malaria invading Shaoyang,turn the pivot to stop malaria,and use Xiaochaihu Decoction and Qinghao Biejia Decoction for the treatment;for yin evil invading Shaoyang and Jueyin,Xiao Chaihu Decoction and Bupleurum chinense DC.are often used to turn the pivot of Shaoyang and warm and unchoke Jueyin.The contraindications of Xiao Chaihu Decoction are al-so summarized.

Objective To investigate the effects of paeonol on the nuclear factor erythroid 2-related factor 2(Nrf2)signaling pathway and pyroptosis levels in ectopic lesion tissues of endometriosis(EMS)mice and mouse endometrial epithelial cells(mEECs).Methods An allograft transplantation method was used to establish an EMS mouse model.Thirty-five Balb/c mice were divided into a sham group,a model group,a 12.5 mg/kg paeonol group,a 25 mg/kg paeonol group,a 50 mg/kg paeonol group,a 0.5 mg/kg gestrinone group(positive control group),and a 50 mg/kg paeonol+Nrf2 inhibitor ML385(30 mg/kg)group,with 5 mice in each group.mEECs were divided into a cell control group,a 10 ng/ml transforming growth factor-β1(TGF-β1)or 100 ng/ml lipopolysaccharide(LPS)model group,a 50 μmol/Lpaeonol group,a 100 μmol/L paeonol group,and a 100 μmol/L paeonol+ML385 group.Enzyme-linked immunosorbent assay(ELISA)kits were used to detect the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-1β,and IL-18 in the serum of EMS mice and the culture supernatant of mEECs.Hematoxylin and eosin(H&E)staining was used to detect histopathological changes in ectopic lesion tissues of mice.Western blot experiments were conducted to detect the protein expression levels of NOD-like receptor thermal protein domain-associated protein 3(NLRP3),apoptosis-associated speck-like protein(ASC),caspase-1,gasdermin D protein N-terminal fragment(GSDMD-N),Nrf2,heme oxygenase-1(HO-1),and quinone oxidoreductase-1(NQO-1)in ectopic lesion tissues and mEECs.The MTT method was used to detect the cell survival rate of mEECs,and the EdU staining method was used to detect the proliferation ability of mEECs.Wound healing assay and Transwell chambers were used to detect the migration and invasion abilities of mEECs,respectively.The FAM-FLICA? Caspase-1 kit was used to detect Caspase-1 levels in mEECs.AutoDock Vina software was used for molecular docking of paeonol with Nrf2 to evaluate their binding ability.Results Compared with the model group,the paeonol groups and the gestrinone group showed reduced ectopic lesion volumes in EMS mice(P<0.05),decreased serum levels of TNF-α,IL-6,IL-1β,and IL-18,decreased expression of pyroptosis marker proteins NLRP3,ASC,Caspase-1,and GSDMD-N in ectopic lesion tissues,and increased expression levels of Nrf2,HO-1,and NQO-1.Compared with the TGF-β1 model group,the paeonol group showed reduced proliferation,migration,and invasion abilities of mEECs.Compared with the LPS model group,the paeonol group showed decreased levels of inflammatory factors TNF-α,IL-6,IL-1β,and IL-18 in mEECs,decreased expression levels of NLRP3,ASC,Caspase-1,and GSDMD-N,and increased expression levels of Nrf2,HO-1,and NQO-1.In the EMS mouse model,the Nrf2 inhibitor ML385 reversed the inhibitory effects of 50 mg/kg paeonol on pyroptosis and inflammatory levels in ectopic lesion tissues.In the in vitro cell model,ML385 reversed the effects of 100 μmol/L paeonol on mEECs.The binding score of paeonol with Nrf2 was-6.1 kcal/mol,and paeonol formed hydrogen bonds with the VAL-604 and LEU-365 amino acid residues of Nrf2.Conclusion Paeonol can alleviate inflammatory responses in EMS mice,reduce NLRP3 inflammasome activation and pyroptosis levels in ectopic lesion tissues,and activate the Nrf2/HO-1 signaling pathway in ectopic lesion tissues of EMS mice.

Objective To investigate the effects of paeonol on the nuclear factor erythroid 2-related factor 2(Nrf2)signaling pathway and pyroptosis levels in ectopic lesion tissues of endometriosis(EMS)mice and mouse endometrial epithelial cells(mEECs).Methods An allograft transplantation method was used to establish an EMS mouse model.Thirty-five Balb/c mice were divided into a sham group,a model group,a 12.5 mg/kg paeonol group,a 25 mg/kg paeonol group,a 50 mg/kg paeonol group,a 0.5 mg/kg gestrinone group(positive control group),and a 50 mg/kg paeonol+Nrf2 inhibitor ML385(30 mg/kg)group,with 5 mice in each group.mEECs were divided into a cell control group,a 10 ng/ml transforming growth factor-β1(TGF-β1)or 100 ng/ml lipopolysaccharide(LPS)model group,a 50 μmol/Lpaeonol group,a 100 μmol/L paeonol group,and a 100 μmol/L paeonol+ML385 group.Enzyme-linked immunosorbent assay(ELISA)kits were used to detect the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-1β,and IL-18 in the serum of EMS mice and the culture supernatant of mEECs.Hematoxylin and eosin(H&E)staining was used to detect histopathological changes in ectopic lesion tissues of mice.Western blot experiments were conducted to detect the protein expression levels of NOD-like receptor thermal protein domain-associated protein 3(NLRP3),apoptosis-associated speck-like protein(ASC),caspase-1,gasdermin D protein N-terminal fragment(GSDMD-N),Nrf2,heme oxygenase-1(HO-1),and quinone oxidoreductase-1(NQO-1)in ectopic lesion tissues and mEECs.The MTT method was used to detect the cell survival rate of mEECs,and the EdU staining method was used to detect the proliferation ability of mEECs.Wound healing assay and Transwell chambers were used to detect the migration and invasion abilities of mEECs,respectively.The FAM-FLICA? Caspase-1 kit was used to detect Caspase-1 levels in mEECs.AutoDock Vina software was used for molecular docking of paeonol with Nrf2 to evaluate their binding ability.Results Compared with the model group,the paeonol groups and the gestrinone group showed reduced ectopic lesion volumes in EMS mice(P<0.05),decreased serum levels of TNF-α,IL-6,IL-1β,and IL-18,decreased expression of pyroptosis marker proteins NLRP3,ASC,Caspase-1,and GSDMD-N in ectopic lesion tissues,and increased expression levels of Nrf2,HO-1,and NQO-1.Compared with the TGF-β1 model group,the paeonol group showed reduced proliferation,migration,and invasion abilities of mEECs.Compared with the LPS model group,the paeonol group showed decreased levels of inflammatory factors TNF-α,IL-6,IL-1β,and IL-18 in mEECs,decreased expression levels of NLRP3,ASC,Caspase-1,and GSDMD-N,and increased expression levels of Nrf2,HO-1,and NQO-1.In the EMS mouse model,the Nrf2 inhibitor ML385 reversed the inhibitory effects of 50 mg/kg paeonol on pyroptosis and inflammatory levels in ectopic lesion tissues.In the in vitro cell model,ML385 reversed the effects of 100 μmol/L paeonol on mEECs.The binding score of paeonol with Nrf2 was-6.1 kcal/mol,and paeonol formed hydrogen bonds with the VAL-604 and LEU-365 amino acid residues of Nrf2.Conclusion Paeonol can alleviate inflammatory responses in EMS mice,reduce NLRP3 inflammasome activation and pyroptosis levels in ectopic lesion tissues,and activate the Nrf2/HO-1 signaling pathway in ectopic lesion tissues of EMS mice.

Objective? To expLore the effects of Home FaLL Hazards Assessment (HFHA) on the incidence rate of home faLLs and recovery of hip function in patients receiving totaL hip arthropLasty (THA). Methods? TotaLLy 423 patients who received uniLateraL THA for the first time in the Department of Orthopedics, Nanjing Drum Tower HospitaL admitted from JuLy 2015 to JuLy 2017 were seLected by convenient sampLing and divided into the controL group (n=203) and the treatment group (n=220). Patients in the controL group received conventionaL postoperative nursing care and discharge guidance, whiLe the home faLL hazards of patients in the treatment group were evaLuated by HFHA in addition to conventionaL postoperative nursing care and discharge guidance. Nursing care was provided to them based on the assessment resuLts. The joint function score at discharge and 3 months after discharge, the incidence rate of faLLs over the past one year and the severity of injury caused by faLLs were compared between the two groups. ResuLts? There was no statisticaL difference in Harris index and BartheL index scores between the two groups at discharge (P＞ 0.05). Harris index and BartheL index scores 3 months after discharge were statisticaL differences in both groups (P＜0.05). 55 faLLs occurred over the past one year in the controL group, 7 of them with moderate or above injuries, whiLe 35 faLLs occurred over the past one year in the treatment group, 1 of them with moderate or above injuries. There were statisticaL differences in the incidence rate of faLLs and injury degrees between the two groups (P＜0.05). ConcLusions? HFHA, when used to assess the home faLL hazards, enabLes THA patients to know and note the high-risk hazards contributing to faLLs in their environment of rehabiLitation and effectiveLy reduces the patients home faLLs by improving the home environment.

Taking the Wechat public service platform of Administration of Traditional Chinese Medicine of Yunnan- Yunnan Zhongyi as an example,the paper uses the Importance-performance Analysis (IPA) and corresponding analysis method,from the users' satisfaction perspective,evaluates 28 satisfaction indicators,discusses the relationship between the importance recognition of health Wechat of Traditional Chinese Medicine (TCM) and user characteristic,so as to propose the development of individual TCM health information recommendation and strengthen the effective interaction of platform users.

Objective To understand the characteristics of distribution on HIV-1 subtypes and the transmission clusters in Yiwu in Zhejiang province.Methods A cross-sectional study of molecular epidemiology was carried out on newly reported H1V/AIDS cases in Yiwu.RNA was extracted from 168 plasma samples,followed by RT-PCR and nest-PCR for pol gene amplification,sequencing,phylogenetic tree construction used for analyzing the subtypes and transmission clusters.Mutations on drug resistance was analyzed by CPR 6.0 online tool.Results Subjects were mainly males (86.3％,145/168),with average age as (39.1 ± 13.4) years old and most of them were migrants (66.7％,112/168).The major routes of transmission included homosexual (51.2％,86/168) and heterosexual (48.8％,82/168) contacts.The rate of success for sequence acquisition was 89.9％ (151/168).The dominant subtypes showed as CRF01_AE (74,49.0％) and CRF07_BC (64,42.4％),followed by CRF08_BC (5,3.3％),CRF55_01B (3,2.0％),each case of subtype B,CRF45_cpx,CRF59_01B,CRF85_BC and URF (B/C).CRF45_cpx and CRF85_BC were discovered the first time in Zhejiang province.Twenty-six transmission clusters involving 65 cases were found,with the total clustered rate as 43.0％ (65/151),in which the CRF01_AE clustered rate appeared as 54.1％ (40/74),higher than that of CRF07_BC (21/64,32.8％).The average size of cluster was 2.5 cases/cluster,with average size of cluster in CRF01_AE patients infected through heterosexual transmission as the largest (3.5 cases/cluster).The prevalence of transmitted drug resistance was 4.6％ (7/151).Seven cases with surveillance drug resistant mutations (SDRM) were found,including 5 cases of M46L (3.3％),and one case of F77L or Y181C.Conclusion HIV genetic diversity and a variety of transmission clusters had been noticed in this study area (Yiwu).Programs on monitoring the subtypes and transmission clusters should be continued and strengthened.

AIM:To analyze the cause of hip prosthesis dislocation,so as to prevent the dislocation following total hip arthroplasty(THA).METHODS:Between January 2002 and June 2007,a total of 348 cases(406 hips) received THA in the Department of Orthopaedics,the Second Affiliated Hospital of Fujian Medical University,and 15 patients(15 hips) occurred dislocation(3.7%),including 6 males and 9 females.Their age ranged 35-76 years,with a mean of 58 years.Primary affections consisted of femoral neck fracture in 3 cases(one with dislocation rebuilding after THA),femoral necrosis in 5 cases,hip arthodysplasia in 5 cases,and osteoarthritis in 2 cases.THA was carried out through lateral approach in 8 patients,and posterior lateral approach in 7 patients.The first dislocation occurred in 2 patients within 2 weeks,3 patients during 2-4 weeks,6 patients during 4-6 weeks,3 patients during 6-12 weeks,and 1 patient 12 weeks later.The movement of dislocation occurrence includes moving the patients in 2,turning over in 2,turning around in 4,trying to stand from sitting in 3,sock wearing in 3,and picking up in 2.It was revealed in the clinical analysis and operational incision that anterior dislocation was found in 6 cases,while posterior dislocation in 9 cases;proper placement of prosthesis in 5 cases,while incorrect placement in 10 cases.Close reduction was conducted in short time after dislocation,achieving success in 11 cases.There were 4 cases treated with open reduction after failure of close reduction,and hip joints were restricted.Seven patients were found dislocation again.And four patients prolonged external fixation and 3 patients were performed revision.RESULTS:The follow-up period ranged from 10 to 60 months.Eight cases succeeded the first reduction,with good joint stability and without relapse.Redislocation occurred in 4 cases,and was cured by prolonging fixation.No cases following revision were found dislocation.The average score was(85?5) according to Harris scoring system.There was no biocompatibility between the materials and the host.CONCLUSION:We should emphasize prevention of dislocation in the early THA and enough fixation time after reduction.

OBJECTIVE To survey the distribution of class Ⅰ integron in extended-spectrum beta-lactamases(ESBLs)-producing Escherichia coli and Klebsiella pneumoniae and its contribution in horizontal transfer of ESBLs genes.METHODS The presence of class Ⅰ integron among 230 ESBLs-producers and 197 non-ESBLs-producers of E.coli and K.pneumoniae were detected by PCR.The correlation and co-transfer between integron and genes coding for SHV,CTX and TEM were studied. RESULTS One hundred and thirty-seven(59.6%) isolates were positive for intⅠ gene among ESBLs-producers,contrasted to 48(24.4%) in non-ESBLs-producers(P