OBJECTIVE To study the improvement effect and mechanism of Tripterygium wilfordii multiglucoside （TWM） on nephrotic syndrome in rats. METHODS The nephrotic syndrome model was established by intravenous injection of adriamycin via the tail vein. The modeling rats were randomly divided into the model group （distilled water）， prednisone group （10 mg/kg）， and TWM high- and low-dose groups （10 and 5 mg/kg， respectively）. Additionally， blank group （distilled water） without model induction was established. Each group consisted of 9 rats. Rats in each group were administered the corresponding drugs or distilled water by gavage， once a day， for 6 consecutive weeks. The histopathological morphology of kidney tissues in rats was observed； the levels of 24-hour urinary protein （24 h-UTP） and serum biochemical indicators [albumin （ALB）， blood urea nitrogen （BUN）， serum creatinine （SCr）， cholesterol （CHOL）， and triglyceride （TG）] in rats were determined； the levels of oxidative stress indicators [superoxide dismutase （SOD）， malondialdehyde （MDA）] in kidney tissue of rats were determined； expressions of hypoxia-inducible factor-1α （HIF-1α）/microRNA-155-5p （miR-155-5p）/nuclear factor erythriod 2- related factor 2 （Nrf2） signaling pathway-related mRNA and protein in the renal tissues of rats were detected. RESULTS Compared with the blank group， the rats in the model group exhibited disordered renal tissue structure， with a small amount of glomerular necrosis and edema of the renal tubular epithelial cells. 24 h-UTP， serum levels of SCr， BUN， CHOL and TG， MDA content， mRNA and protein expressions of HIF-1α and Keap1 as well as the expression of miR-155-5p in renal tissues were increased significantly （ P ＜0.05）. Serum level of ALB， SOD level in renal tissue as well as mRNA and protein expressions of Nrf2 were decreased significantly （ P ＜0.05）. Compared with the model group， TWM high-dose and low-dose groups exhibited significant improvements in renal injury， with notable reversals in the levels of the above quantitative indicators （ P ＜0.05）. CONCLUSIONS TWM can alleviate oxidative stress-induced damage and thereby improve nephrotic syndrome in rats by regulating the HIF-1α/miR-155-5p/Nrf2 signaling pathway.

With the rapid development of medical big data and artificial intelligence,Clinical Prediction Models(CPMs)have become pivotal tools for disease prevention,diagnosis,and treatment.Current research predominantly focuses on the economic analysis of pharmacological or public health interventions,yet a comprehensive methodological framework for the economic evaluation of CPMs has been notably absent.The Guidelines for Economic Evaluation of Clinical Prediction Models(hereafter the Guidelines),jointly initiated by the Chinese Research Hospital Association and Peking University,Tsinghua University,and Capital Medical University,adheres to the WHO Handbook for Guideline Development and the Reporting Items for Practice Guidelines in Healthcare(RIGHT)standards.A multidisciplinary collaboration,including a steering committee,expert panel,secretariat,and external review group,was established to develop the guideline following evidence-based principles and procedures.Consensus recommendations were formulated through the Delphi method.It describes the background,objectives,target group,and the development methodology and process,ensuring the entire compilation process of the Guidelines is transparent and standardized.Through comprehensive evidence retrieval,systematic evidence appraisal,and a scientific approach to forming recommendations,the scientific rigor and validity of the Guidelines were further enhanced.

With the rapid development of medical big data and artificial intelligence,Clinical Prediction Models(CPMs)have become pivotal tools for disease prevention,diagnosis,and treatment.Current research predominantly focuses on the economic analysis of pharmacological or public health interventions,yet a comprehensive methodological framework for the economic evaluation of CPMs has been notably absent.The Guidelines for Economic Evaluation of Clinical Prediction Models(hereafter the Guidelines),jointly initiated by the Chinese Research Hospital Association and Peking University,Tsinghua University,and Capital Medical University,adheres to the WHO Handbook for Guideline Development and the Reporting Items for Practice Guidelines in Healthcare(RIGHT)standards.A multidisciplinary collaboration,including a steering committee,expert panel,secretariat,and external review group,was established to develop the guideline following evidence-based principles and procedures.Consensus recommendations were formulated through the Delphi method.It describes the background,objectives,target group,and the development methodology and process,ensuring the entire compilation process of the Guidelines is transparent and standardized.Through comprehensive evidence retrieval,systematic evidence appraisal,and a scientific approach to forming recommendations,the scientific rigor and validity of the Guidelines were further enhanced.

Objective To investigate the unmet needs for assistive technology for people with physical disabilities in Chengdu,and analyze the related factors. Methods From November,2023 to March,2024,the persons with physical disabilities in Chengdu were selected from Sichuan Individuation service platform,and investigated using World Health Organization rapid Assistive Tech-nology Assessment. Results A total of 558 questionnaires were set up,and 527 effective questionnaires retured.26.8%of them reported un-met needs for aids,with the highest need for mobility aids(66.0%).Lack of support(54.9%),high price(26.3%)and lack of knowledge about aids(20.3%)were the main reasons for not obtaining the aids they needed.Loss of spouse(OR=3.615),serious mobility impairment(OR＞2.926)and serious self-care impairment(OR＞2.781)were the risks of unmet needs for aids. Conclusion It is important to popularize policies and products of aids,pay attention to personal adaptation for people with different barriers,and strengthen the service system,to meet the needs of people with disabilities.

Objective:To compare the perioperative outcomes and safety of percutaneous nephrostomy (PCN) and retrograde ureteral stenting (RUS) in the treatment of acute obstructive upper urinary tract infection.Methods:A comprehensive search was performed on the MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials to identify relevant literatures. The retrieval period was from the establishment of the database to August 2022. Inclusion criteria: ①Randomized controlled trial (RCT) of PCN and RUS in the treatment of acute obstructive upper urinary tract infection; ②Studies provided accurate data for analysis, including the total number of subjects and the results of each index; ③The full text of the study was available, and different literatures published in the same cohort were included in the newly published data. ④The observation indexes included the time for the recovery of body temperature, creatinine, leukocyte, operation, radiation exposure, postoperative fever, postoperative pain, and the incidence of postoperative fistulotomy or stent displacement. Exclusion criteria: ①non-RCT study; ②unable to obtain the full text. Two researchers independently screened the literature and evaluated the literature quality, and all the statistical data were analyzed by RevMan5.3 software.Results:Seven trials enrolled 727 patients were included in the meta-analysis, 412 in the PCN group and 315 in the RUS group included. Meta-analysis revealed that the advantages of PCN were lower incidence of postoperative hematuria ( OR=0.54, 95% CI 0.30-0.99, P=0.040) and lower incidence of insertion failure ( OR=0.42, 95% CI 0.21-0.81, P=0.010), but the fluoroscopy time of RUS group was shorter than that of PCN group ( MD=0.31, 95% CI 0.14-0.48, P<0.01). Moreover, there was no significant difference in time to normalization of temperature, time to normalization of creatinine, time to normalization of WBC, operative time, postoperative fever, postoperative pain, postoperative nephrostomy tube or stent slippage rate between the two surgical methods( P>0.05). Conclusions:The radiation exposure time of PCN was longer than that of RUS, but the incidence of postoperative hematuria and catheterization failure was lower than that of RUS.

Objective     To compare the clinical efficacy and safety of da Vinci robot with totally no tube (TNT) versus subxiphoid video-assisted thymectomy surgery (SVATS) in the treatment of thymic tumors. Methods     From 2019 to 2021, a retrospective analysis was conducted on patients with thymic tumor resection in the Department of Thoracic Surgery, General Hospital of Northern Theater Command. All patients underwent total thymectomy and mediastinal fat removal, and they were divided into a TNT group and a SVATS group according to the operation method. The intraoperative blood loss, conversion rate, postoperative visual analogue score (VAS), postoperative hospital stay time and postoperative complications were compared between the two groups. Results     We finally included 435 patiets. There were 168 patients with 83 males and 85 females at an average age of 61.920±9.210 years in the TNT group and 267 patients with 147 males and 120 females at an average age of 61.460±8.119 years in the SVATS group. There was no death or postoperative myasthenic crisis in both groups. There was no statistical difference in postoperative hospital stay (1.540±0.500 d vs. 3.400±0.561 d, P=0.000), intraoperative blood loss (13.450±5.498 mL vs. 108.610±54.462 mL, P=0.000), postoperative 24 h VAS score (4.960±1.757 points vs. 3.600±1.708 points, P=0.000), or postoperative complication rate (3.0% vs. 11.6%, P=0.001). Conclusion     TNT is a more efficient, safe, and effective surgical approach for treating thymic tumors, which can shorten hospital stay time and reduce postoperative complications. However, SVATS can minimize postoperative pain.

Objective To analyze the gait kinematics parameters of patients with unilateral leg amputation after wearing prosthesis using the computer assisted rehabilitation environment (CAREN) gait assessment system,and the reasons for the differences.Methods Nine patients with unilateral mid-leg amputation were selected as the prosthesis group,and 11 healthy subjects were selected as the standard group.The gait kinematics parameters of the two groups were collected,processed and analyzed by using the CAREN gait evaluation system.Results The gait phase index of the prosthetic limb group was (0.88±0.04).Significant differences were observed between the prosthetic and healthy limbs in terms of step length,stance phase percentage,maximum hip extension angle and maximum knee flexion angle,maximum dorsiflexion and plantar flexion angle of the ankle joint during the stance phase,as well as the dorsiflexion angle of ankle joint during heel strike to the ground (P＜0.05).Moreover,there were significant differences between the affected limbs of the prosthetic limb group and limbs of the standard group in terms of the walking speed,gait cycle,stride length,percentage of stance phase,hip flexion angle,knee flexion and ankle dorsiflexion during heel strike,maximum hip extension and flexion angle,maximum dorsi-and plantar-flexion of ankle joint during stance phase (P＜0.05).Conclusion The relative symmetry of the gait of the unilateral leg amputee is (0.88±0.04),with their kinematics parameters of the prosthetic limb significantly weaker than those of the contralateral side and the healthy controls.

OBJECTIVE:To study the preventive effect of Qingnao tablet on cerebral ischemia-reperfusion injury in rats. METHODS:Rats were randomly divided into sham operation group,model group,Naoluotong capsule group (positive control, 0.05 g/kg),Qingnao tablet high-dose,medium-dose,low-dose groups(1.52,0.76,0.38 g/kg),10 in each group. Rats in all ad-ministration groups were intragastrically given relevant medicines,rats in sham operation group and model group were intragastrical-ly given equal volume of sodium carboxymethylcellulose solution,once a day,for 5 d. After 1 h of last administration,all rats were induced for cerebral ischemia-reperfusion injury model by suture-occluded method except for sham operation group. After 22 h of ischemia-reperfusion,neurological function deficit scoring was conducted;the pathological changes of the hippocampus were ob-served;superoxide dismutase (SOD),adenosine triphosphate (ATP),lactate dehydrogenase (LDH),tumor necrosis factor α(TNF-α)levels in brain tissue were measured. RESULTS:Compared with sham operation group,rats in model group appeared dif-ferent degrees of neurological deficits(score declined),sparse neurons,irregularly arranged in hippocampus as well as other patho-logical changes;ATP,SOD levels in brain tissue were decreased(P<0.01),LDH,TNF-α levels were increased(P<0.01). Com-pared with model group,neurological function deficit scores in Qingnao tablet doses groups were increased(P<0.05),neurologi-cal deficits were improved. Except for sham operation group,brain tissue indexes in other administration groups were significantly improved(P<0.05 or P<0.01). CONCLUSIONS:Qingnao tablet can increase ATP and SOD levels in brain tissue homogenate of model rats with cerebral ischemia-reperfusion,decrease LDH and TNF-α levels,and obviously improve rats'cerebral ischemia-re-perfusion injury.

Objective To investigate the relationship between acute biliary pancreatitis and pancreaticobiliary maljunction and the role of magnetic resonance cholangiopancreatography(MRCP) in evaluation of pancreatico biliary maljunction.Methods To compare the liver function indicators of different groups of acute biliary pancreatitis patients(153 cases) associated with pancreatico biliary maljunction and without pancreatico biliary maljunction before and after the conservative treatment.Results The 32 acute biliary pancreatitis patients with pancreatico biliary maljunction detected by MRCP were compared with the 121 cases without pancreatico biliary maljunction.The ALT,AST,GGT after conservative treatment in both group of pancreatico biliary maljunction and Npancreatico biliary maljunction were significantly decreased (P ＜ 0.05).ALT,AST and GGT of pancreatico biliary maljunction group were higher than that of Npancreatico biliary maljunction group with statistical significance (P ＜ 0.05).Conclusions MRCP as a noninvasive cholangiopancreatography study of pancreatico biliary maljunction is a safe and reliable examination method,pancreatico biliary maljunction is one of the important causes of acute biliary pancreatitis.

Secretory anti-gp96 scFv fragment was expressed in Pichia pastoris to obtain a small molecule antibody that specifically recognizes heat shock protein gp96. The gp96-scFv fragment gene was synthesized and cloned to Pichia pastoris expression plasmid pPICZa-A. Pichia pastoris X33 was electroporated with the linearized recombinant expression vector, and expression of gp96-scFv fragment was induced by methanol. The His-tagged recombinant protein was then purified by affinity chromatography and analyzed with SDS-PAGE and Western blotting assays. The biological activities of recombinant gp96-scFv fragment were determined by Western blotting, Immunofluorescence, ELISA and FACS assays. The gp96-scFv fragment was expressed successfully in Pichia pastoris. About 50 mg of recombinant protein could be purified from 1 liter of the Pichia pastoris culture supernatant. Its molecular weight was about 15 kDa. The gp96-scFv fragment could specifically bind to gp96 protein by Western blotting, immunofluorescence, ELISA and FACS analyses. Pichia pastoris-expressed gp96-scFv fragment specifically recognizes gp96 protein, which could be used for Western blotting, Immunofluorescence, ELISA and FACS analyses.
Blotting, Western ; Chromatography, Affinity ; Electrophoresis, Polyacrylamide Gel ; Enzyme-Linked Immunosorbent Assay ; Membrane Glycoproteins ; immunology ; Pichia ; metabolism ; Plasmids ; Recombinant Proteins ; biosynthesis ; Single-Chain Antibodies ; biosynthesis