Objective To observe the repair effect and mechanism of Danhuang Powder-containing serum on high glucose-induced vascular endothelial cell injury.Methods Danhuang Powder-containing serum was prepared.Human umbilical vein endothelial cells(HUVECs)were cultured to be divided into control group,recombinant human epidermal growth factor(called"growth factor"for short)group,Danhuang Powder group,high glucose group,high glucose+growth factor group,and high glucose+Danhuang Powder group.After corresponding intervention in each group for 48 hours,the cell ultrastructure and autophagy were observed under transmission electron microscope,apoptosis was detected by flow cytometry,and the protein expression levels of vascular endothelial growth factor(VEGF),epidermal growth factor(EGF)and basic fibroblast growth factor(bFGF)in the cells were detected by Western Blot.Results(1)The intra-mitochondrial ridges in the control group were clearly visible,autophagosomes and autolysosomes were fewer;mitochondria in the high glucose group were swollen and irregular,and appeared vacuolated;and the more typical autophagy-like structures were seen in the high glucose+Danhuang Powder group.(2)Compared with the high glucose group and high glucose+growth factor group,the apoptosis rate of cells in the high glucose+Danhuang Powder group was significantly decreased(P<0.05).(3)Compared with the high glucose group and the high glucose+growth factor group,the protein expression levels of VEGF,EGF and bFGF in the cells of the high glucose+Danhuang Powder group were significantly increased(P<0.05).Conclusion Danhuang Powder-containing serum can reduce the high glucose-induced damage in HUVEC cells,and its mechanism may be related to the activation of mitochondrial autophagy,and the inhibition of apoptosis,as well as the up-regulation of the expression of VEGF,EGF and bFGF.

Objective To observe the clinical and imaging features of invasive Klebsiella pneumoniae liver abscess syndrome(IKPLAS).Methods Data of 68 patients with Klebsiella pneumoniae liver abscess(KPLA)were retrospectively analyzed.The patients were divided into IKPLAS group(n=25)or non-IKPLAS group(n=43)according to extrahepatic invasive infection or not.Clinical data as well as CT and/or MRI findings were compared between groups.Results The patients'age was lower,while glycated hemoglobin and D-dimer levels were higher in IKPLAS group than those in non-IKPLAS group(all P＜0.05).Hepatic venous thrombophlebitis was detected in 18 cases in IKPLAS group and 6 cases in non-IKPLAS group,while arterial phase abnormal high perfusion around abscess was noticed in 10 cases in IKPLAS group and 28 cases in non-IKPLAS group,both being significantly different between groups(both P＜0.05).The extrahepatic infection in IKPLAS group mainly observed in lungs(19/25,76.00%).Conclusion The ages were lower,while glycated hemoglobin and D-dimer levels were both higher in IKPLAS than in the other KPLA patients.Often appeared hepatic venous thrombophlebitis and extrahepatic infection mainly affecting lungs were imaging characteristics of IKPLAS.

Objective:To evaluate the diagnostic efficacy of FibroScan combined with various noninvasive diagnostic models for liver fibrosis in patients with chronic hepatitis B (CHB) complicated with nonalcoholic fatty liver disease (NAFLD), and to establish a new predictive model with common clinical indicators.Methods:From January 2016 to May 2024, the clinical data of 118 CHB patients complicated with NAFLD from the First Affiliated Hospital of Zhengzhou University, who underwent liver biopsy and FibroScan examination were respectively analyzed. According to the Scheuer scoring system, different diagnostic endpoints were set based on the degree of liver fibrosis (S0 to S1, ≥S2, ≥S3, and S4), fibrosis stage ≥S2 was designated as the criterion for significant liver fibrosis. Fibrosis-4 (FIB-4), γ-glutamyl transpeptidase (GGT) to platelet ratio (GPR), GGT-age-platelet-international normalized ratio (GAPI) model, S index, King index and Forns index were calculated according to the common clinical indicators. The independent t test or Mann-Whitney U test was used to compare the two groups. Spearman rank correlation was used to analyze the correlation between each noninvasive diagnostic method and the degree of liver fibrosis. Receiver operating characteristic curve (ROC) was plotted, and the DeLong test was performed to compare the area under the curve (AUC), and to evaluate the predictive value of FibroScan combined with various noninvasive diagnostic models for the diagnosis of liver fibrosis. The laboratory indicators were compared between patients with non-significant liver fibrosis and patients with significant liver fibrosis. And the indicators with statistically significant differences ( P<0.05) in the univariate analysis were further analyzed by multivariate logistic regression to establish a new predictive model for liver fibrosis. Hosmer-Lemeshow test was used to assess the model′s goodness of fit. Results:The results of Spearman rank correlation showed that FIB-4, GPR, FibroScan, GAPI model, S index, King index, and Forns index were positively correlated with the stage of liver fibrosis ( r=0.413, 0.458, 0.512, 0.473, 0.533, 0.380 and 0.478, all P<0.001). The results of ROC analysis indicated that among combination of FibroScan and other diagnostic models, the AUC values of FibroScan+ FIB-4, FibroScan+ Forns index were relatively high in ≥S2 and ≥S3, which were 0.804 and 0.907, respectively. The platelet count ((200.65±50.89)×10 9/L vs. (169.96±63.68)×10 9/L), total cholesterol ((4.69±0.77) mmol/L vs. (4.32±1.00) mmol/L), high-density lipoprotein (HDL) (1.28 (1.05, 1.46) mmol/L vs. 1.08 (0.92, 1.21) mmol/L), total protein (74.00 (70.63, 77.08) g/L vs. 68.80 (64.60, 73.55) g/L), albumin (47.06 (44.65, 48.81) g/L vs. 44.70 (41.55, 46.20) g/L), and globulin (26.80 (24.48, 29.70) g/L vs. 25.80 (23.05, 27.60) g/L) of the non-significant liver fibrosis group were higher than those of the significant liver fibrosis group, and the differences were statistically significant ( t=2.74, 2.09; Z=-3.30, -3.88, -3.95, -2.01; P=0.007, =0.040, =0.001, <0.001, <0.001, =0.044). GGT (27.50 (17.00, 41.75) U/L vs. 37.00 (22.50, 87.00) U/L), the liver stiffness measurement (LSM) in the non-significant hepatic fibrosis group was lower than the significant liver fibrosis group (6.85 (5.60, 9.26) kPa vs. 11.60 (7.08, 17.26) kPa), and the differences were statistically significant ( Z=-2.73, -4.39; P=0.006, <0.001). The result of multivariate logistic regression analysis revealed that globulin, albumin, HDL, and LSM were independent factors of liver fibrosis ( OR (95% confidence interval)=0.865 (0.759 to 0.985), 0.804 (0.691 to 0.935), 0.128 (0.023 to 0.711), and 1.251 (1.091 to 1.433), respectively; P=0.029, 0.025, 0.019, 0.001). A novel model, GLAH, was established with globulin, LSM, albumin, and HDL. The AUC for diagnosing liver fibrosis degree ≥S2, ≥S3, and S4 was 0.847, 0.938, and 0.909, respectively, which were higher than those of the above models. The positive predictive value for diagnosing liver fibrosis degree ≥S2 with GLAH>1.12 as the cutoff value was 95.8%. The negative predictive value for excluding fibrosis stage ≥S2 with GLAH<-1.41 was 92.3%. This approach could reduce the number of liver biopsies by 48.3% (57/118), with an accuracy of 94.7% (54/57). Conclusions:The clinical value of FibroScan combined with FIB-4 or Forns index is better in the diagnisis of fibrosis stage ≥S2 and ≥S3. The GLAH model has higher diagnostic value and can accurately predict the degree of liver fibrosis in CHB patients complicated with NAFLD, thus reducing the need for liver biopsy.

Objective:To compare the cumulative live birth rates per oocyte retrieval cycle in patients with normal ovarian response between the gonadotropin-releasing hormone agonist (GnRH-a) long protocol and the progestin-primed ovarian stimulation (PPOS) protocol.Methods:A retrospective cohort study was conducted in Centre of Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine between January 2017 and December 2019. Women who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment with normal ovarian reserve and <40 years of age were included. Other inclusion criteria included regular menstrual cycles, serum follicle-stimulating hormone level <10 U/L, and the antral follicle count >5. The primary outcome was the cumulative live birth rate (CLBR) within 18 months from the start of ovarian stimulation. Results:A total of 995 patients were included in the study, with 509 patients in the PPOS group and 486 patients in the GnRH-a long group. Both groups had almost comparable demographic and cycle stimulation characteristics except for duration of infertility which was shorter in the PPOS group [3 (2,4) years] than in the GnRH-a long group [3 (2,5) years, P=0.015]. In the GnRH-a long group, 372 patients (77%) underwent fresh embryo transfer, resulting in 218 clinical pregnancies and 197 live births. The clinical pregnancy rate, the ongoing pregnancy rate, and the live birth rate per embryo transfer cycle were 58.6% (218/372), 54.0% (201/372) and 53.0% (197/372), respectively. No fresh embryo transfer was performed in the PPOS group. During the study period, there were 662 frozen-thawed embryo transfer (FET) cycles in the PPOS group and 257 FET cycles in the GnRH-a long group. The PPOS group had a live birth rate of 31.1% (206/662) per FET cycle, which was notably lower than the GnRH-a long group [42.8% (110/257), OR=0.727; 95% CI: 0.607-0.871; P<0.001]. The implantation rate of all FET cycles in the PPOS group was also lower than that in the GnRH-a long group [29.2% (293/1 004) vs. 34.5% (157/455), OR=0.846, 95% CI: 0.721-0.992; P=0.041]. CLBRs after one complete IVF/ICSI cycle including fresh and subsequent FET cycles within 18 months follow up were significantly lower in the PPOS group [40.5% (206/509)] than in the long agonist group [63.2% (307/486), OR=0.641, 95% CI: 0.565-0.726]. Compared with the PPOS group, the GnRH-a long group had a significantly shorter duration from the start of ovarian stimulation to pregnancy and live birth ( P<0.001). In Kaplan-Meier analysis, the CLBR was significantly higher in the GnRH-a long group than in the PPOS group (long rank test, P<0.001). Adjusted Cox-regression analysis revealed stimulation protocol adopted was strongly associated with the CLBR ( OR=1.917, 95% CI: 1.152-3.190, P=0.012). Conclusion:Progestin primed ovarian stimulation was associated with a lower cumulative live birth rates and a long time to pregnancy/live birth than the long agonist protocol in women with a normal ovarian reserve.

Objective:To compare the cumulative live birth rates per oocyte retrieval cycle in patients with normal ovarian response between the gonadotropin-releasing hormone agonist (GnRH-a) long protocol and the progestin-primed ovarian stimulation (PPOS) protocol.Methods:A retrospective cohort study was conducted in Centre of Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine between January 2017 and December 2019. Women who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment with normal ovarian reserve and <40 years of age were included. Other inclusion criteria included regular menstrual cycles, serum follicle-stimulating hormone level <10 U/L, and the antral follicle count >5. The primary outcome was the cumulative live birth rate (CLBR) within 18 months from the start of ovarian stimulation. Results:A total of 995 patients were included in the study, with 509 patients in the PPOS group and 486 patients in the GnRH-a long group. Both groups had almost comparable demographic and cycle stimulation characteristics except for duration of infertility which was shorter in the PPOS group [3 (2,4) years] than in the GnRH-a long group [3 (2,5) years, P=0.015]. In the GnRH-a long group, 372 patients (77%) underwent fresh embryo transfer, resulting in 218 clinical pregnancies and 197 live births. The clinical pregnancy rate, the ongoing pregnancy rate, and the live birth rate per embryo transfer cycle were 58.6% (218/372), 54.0% (201/372) and 53.0% (197/372), respectively. No fresh embryo transfer was performed in the PPOS group. During the study period, there were 662 frozen-thawed embryo transfer (FET) cycles in the PPOS group and 257 FET cycles in the GnRH-a long group. The PPOS group had a live birth rate of 31.1% (206/662) per FET cycle, which was notably lower than the GnRH-a long group [42.8% (110/257), OR=0.727; 95% CI: 0.607-0.871; P<0.001]. The implantation rate of all FET cycles in the PPOS group was also lower than that in the GnRH-a long group [29.2% (293/1 004) vs. 34.5% (157/455), OR=0.846, 95% CI: 0.721-0.992; P=0.041]. CLBRs after one complete IVF/ICSI cycle including fresh and subsequent FET cycles within 18 months follow up were significantly lower in the PPOS group [40.5% (206/509)] than in the long agonist group [63.2% (307/486), OR=0.641, 95% CI: 0.565-0.726]. Compared with the PPOS group, the GnRH-a long group had a significantly shorter duration from the start of ovarian stimulation to pregnancy and live birth ( P<0.001). In Kaplan-Meier analysis, the CLBR was significantly higher in the GnRH-a long group than in the PPOS group (long rank test, P<0.001). Adjusted Cox-regression analysis revealed stimulation protocol adopted was strongly associated with the CLBR ( OR=1.917, 95% CI: 1.152-3.190, P=0.012). Conclusion:Progestin primed ovarian stimulation was associated with a lower cumulative live birth rates and a long time to pregnancy/live birth than the long agonist protocol in women with a normal ovarian reserve.

Objective:To evaluate the diagnostic efficacy of FibroScan combined with various noninvasive diagnostic models for liver fibrosis in patients with chronic hepatitis B (CHB) complicated with nonalcoholic fatty liver disease (NAFLD), and to establish a new predictive model with common clinical indicators.Methods:From January 2016 to May 2024, the clinical data of 118 CHB patients complicated with NAFLD from the First Affiliated Hospital of Zhengzhou University, who underwent liver biopsy and FibroScan examination were respectively analyzed. According to the Scheuer scoring system, different diagnostic endpoints were set based on the degree of liver fibrosis (S0 to S1, ≥S2, ≥S3, and S4), fibrosis stage ≥S2 was designated as the criterion for significant liver fibrosis. Fibrosis-4 (FIB-4), γ-glutamyl transpeptidase (GGT) to platelet ratio (GPR), GGT-age-platelet-international normalized ratio (GAPI) model, S index, King index and Forns index were calculated according to the common clinical indicators. The independent t test or Mann-Whitney U test was used to compare the two groups. Spearman rank correlation was used to analyze the correlation between each noninvasive diagnostic method and the degree of liver fibrosis. Receiver operating characteristic curve (ROC) was plotted, and the DeLong test was performed to compare the area under the curve (AUC), and to evaluate the predictive value of FibroScan combined with various noninvasive diagnostic models for the diagnosis of liver fibrosis. The laboratory indicators were compared between patients with non-significant liver fibrosis and patients with significant liver fibrosis. And the indicators with statistically significant differences ( P<0.05) in the univariate analysis were further analyzed by multivariate logistic regression to establish a new predictive model for liver fibrosis. Hosmer-Lemeshow test was used to assess the model′s goodness of fit. Results:The results of Spearman rank correlation showed that FIB-4, GPR, FibroScan, GAPI model, S index, King index, and Forns index were positively correlated with the stage of liver fibrosis ( r=0.413, 0.458, 0.512, 0.473, 0.533, 0.380 and 0.478, all P<0.001). The results of ROC analysis indicated that among combination of FibroScan and other diagnostic models, the AUC values of FibroScan+ FIB-4, FibroScan+ Forns index were relatively high in ≥S2 and ≥S3, which were 0.804 and 0.907, respectively. The platelet count ((200.65±50.89)×10 9/L vs. (169.96±63.68)×10 9/L), total cholesterol ((4.69±0.77) mmol/L vs. (4.32±1.00) mmol/L), high-density lipoprotein (HDL) (1.28 (1.05, 1.46) mmol/L vs. 1.08 (0.92, 1.21) mmol/L), total protein (74.00 (70.63, 77.08) g/L vs. 68.80 (64.60, 73.55) g/L), albumin (47.06 (44.65, 48.81) g/L vs. 44.70 (41.55, 46.20) g/L), and globulin (26.80 (24.48, 29.70) g/L vs. 25.80 (23.05, 27.60) g/L) of the non-significant liver fibrosis group were higher than those of the significant liver fibrosis group, and the differences were statistically significant ( t=2.74, 2.09; Z=-3.30, -3.88, -3.95, -2.01; P=0.007, =0.040, =0.001, <0.001, <0.001, =0.044). GGT (27.50 (17.00, 41.75) U/L vs. 37.00 (22.50, 87.00) U/L), the liver stiffness measurement (LSM) in the non-significant hepatic fibrosis group was lower than the significant liver fibrosis group (6.85 (5.60, 9.26) kPa vs. 11.60 (7.08, 17.26) kPa), and the differences were statistically significant ( Z=-2.73, -4.39; P=0.006, <0.001). The result of multivariate logistic regression analysis revealed that globulin, albumin, HDL, and LSM were independent factors of liver fibrosis ( OR (95% confidence interval)=0.865 (0.759 to 0.985), 0.804 (0.691 to 0.935), 0.128 (0.023 to 0.711), and 1.251 (1.091 to 1.433), respectively; P=0.029, 0.025, 0.019, 0.001). A novel model, GLAH, was established with globulin, LSM, albumin, and HDL. The AUC for diagnosing liver fibrosis degree ≥S2, ≥S3, and S4 was 0.847, 0.938, and 0.909, respectively, which were higher than those of the above models. The positive predictive value for diagnosing liver fibrosis degree ≥S2 with GLAH>1.12 as the cutoff value was 95.8%. The negative predictive value for excluding fibrosis stage ≥S2 with GLAH<-1.41 was 92.3%. This approach could reduce the number of liver biopsies by 48.3% (57/118), with an accuracy of 94.7% (54/57). Conclusions:The clinical value of FibroScan combined with FIB-4 or Forns index is better in the diagnisis of fibrosis stage ≥S2 and ≥S3. The GLAH model has higher diagnostic value and can accurately predict the degree of liver fibrosis in CHB patients complicated with NAFLD, thus reducing the need for liver biopsy.

Hepatocellular carcinoma (HCC) has the features of high incidence rate, low survival rate, poor treatment outcome, and complex pathogenesis. In recent years, many studies have shown that long non-coding RNA (lncRNA) MALAT1 is upregulated in HCC and can promote the proliferation, invasion, and metastasis of HCC cells, and it can also guide the diagnosis, prognostic evaluation, and treatment of HCC in clinical practice. This article reviews the current status of research on lncRNA MALAT1 in HCC and discusses its expression pattern, mechanism of action, and clinical significance in predicting and monitoring the progression of HCC, so as to gain a deep understanding of the role of lncRNA MALAT1 in the progression of HCC. It is pointed out that lncRNA MALAT1 is expected to become a potential biomarker for the diagnosis and prognostic evaluation of HCC and may be used as a therapeutic target in clinical practice.

Objective: Through research on the geriatric nursing related literature in Chinese journals and medical care and elderly care combination related keywords from 1979 to 2017, this study provides the development trend of geriatric nursing research. Methods: Searching articles in Wanfang, CNKI, VIP database, selecting the keywords and published time of the paper. Employing descriptive statistics to describe literatures information such as publication time, quantity of keywords, word frequency of keywords, heat degree of keywords, character of keywords and so on. Results: Totally 134 791 articles were got and 58 031 articles were included in the analysis. The amount of literature growth was slow before 2005, The cumulative amount of literature in 1979-2005 was only 12.75% of the total amount of literature. After 2005, the amount of literature increased rapidly year by year. The number of literature published in 2017 has exceeded 12%. The amount of the geriatric nursing related literature was proportional to the number of people aged 65 and over in China. In the research of geriatric nursing, the content related to medical care and elderly care combination was quite dispersed, and it did not involve research at the level of Medical Association. The medical care and elderly care combination and Medical Association were new areas in the research of geriatric nursing. Conclusion The amount of the geriatric nursing related literature from 1979 to 2017 was proportional to the number of people aged 65 and over in China. There are few researches on how to carry out geriatric nursing under the policy of medical care and elderly care combination and Medical Association, which should be the focus of future research and exploration to actively respond to the challenge of aging population.

Objective To evaluate the efficacy of Guizhi-Fuling decoction and Danggui-Shaoyao decoction combined with metformin in patients with polycystic ovarian syndrome. Methods A total of 120 patients with fueling the polycystic ovarian syndrome were enrolled and divided into two group by random number table method, the treatment group (60 patients) and the control group (60 patients). Patients in the control group were treated with metformin, and those in the treatment group with Guizhi-Fuling decoction and Danggui-Shaoyao decoction plus metformin for 6 menstrual cycle. The vagina or rectum two-dimensional ultrasound was detected by follicle numbers (FN) and ovarian volume (OV). The height, weight, BMI calculation were recorded and evaluated before and after treatment. Results After treatment and follow-up, the OV (2.4 ± 1.5 cm3 vs. 4.7 ± 2.6 cm3, t=5.935; 1.6 ± 0.8 cm3 vs. 2.9 ± 1.3 cm3, t=-6.597), FN (8 ± 2 vs. 10 ± 2, t=-5.477; 6 ± 1 vs. 8 ± 2, t=-6.928) and BMI (20.5 ± 2.6 kg/m2 vs. 23.8 ± 2.7 kg/m2, t=-6.866; 20.1 ± 1.3 kg/m2 vs. 22.6 ± 1.7 kg/m2, t=-9.074) of the treatment group were significantly lower than those of the control group(P<0.01). Conclusions The Guizhi-Fuling decoction and Danggui-Shaoyao decoction combined with metformin can reduce the weight, ovarian volume, follicle numbers of PCOS patients.

Objective:To investigate the improvement effects of duodenal-jejunal bypass (DJB)on the blood glucose homeostasis,insulin resistance and inflammation of the obese type 2 diabetic (T2DM)ZDF rats,and to discuss its possible mechanism.Methods:A total of 20 ZDF rats were randomly divided into DJB operation group and sham operation group (n = 10).There were 8 rats survived in each group after operation.The level of blood glucose (FBG)was detected by Roche glucose meter at 1 week before operation,2 weeks,4 weeks and 6 weeks after operation;the fasting serum insulin level of the rats was measured by ELISA kit;the insulin sensitivity index (HOMA-ISI)and insulin resistance index (HOMA-IR)were calculated.The rats were executed 6 weeks after operation.HE staining was used to observe the morphology of the inflammatory cells in BP limb of the rats;the expression levels of AMPK and pAMPK in BP lamb of the rats were observed by immunohistochemical staining;the expression levels of interleukin 1β(IL-1β),interleukin 6 (IL-6),tumor necrosis factorα(TNF-α),nuclear factorκB (NF-κB),and interleukin 10 (IL-10)mRNA of the rats were detected by QRT-PCR method.Results:From the 2nd week after operation,compared with before operation,the FBG levels of the rats in DJB operation group were decreased (t=3.798,P <0.05);compared with sham operation group,the FBG level of the rats in DJB operation group was decreased (t=3.205,P <0.05).Six weeks after operation,compared with sham operation group,the HOMA-IR of the rats in DJB operation group was significantly decreased (t=4.441,P <0.05)and the HOMA-ISI was significantly increased (t=-8.65,P < 0.05).The HE staining results showed that compared with sham operation group,the morphology of the inflammatory cells in BP limb of the rats in DJB operation group was significantly improved.The QRT-PCR results showed that the expression levels of IL-1β,IL-6,TNF-αand NF-κB of the rats in DJB operation group was significantly decreased compared with sham operation group (P < 0.05), while the expression level of IL-10 was significantly increased (P < 0.05).The immunohistochemical test results showed that the expression levels of AMPK and pAMPK in BP lamb of the rats in DJB operation group were increased compared with sham operation group.Conclusion:DJB can significantly improve the blood glucose homeostasis and insulin resistance in the T2DM rats,and its mechanism may be related to the decreased expressions of inflammatory factors and the activation of AMPK molecules in BP lamb of the T2DM rats.