Mesangial cell proliferation is an early pathological indicator of diabetic nephropathy (DN). Growing evidence highlights the pivotal role of paired-related homeobox 1 (Prrx1), a key regulator of cellular proliferation and tissue differentiation, in various disease pathogenesis. Notably, Prrx1 is highly expressed in mesangial cells under DN conditions. Both in vitro and in vivo studies have demonstrated that Prrx1 overexpression promotes mesangial cell proliferation and contributes to renal fibrosis in db/m mice. Conversely, Prrx1 knockdown markedly suppresses hyperglycemia-induced mesangial cell proliferation and mitigates renal fibrosis in db/db mice. Mechanistically, Prrx1 directly interacts with the Yes-associated protein 1 (YAP) promoter, leading to the upregulation of YAP expression. This upregulation promotes mesangial cell proliferation and exacerbates renal fibrosis. These findings emphasize the crucial role of Prrx1 upregulation in high glucose-induced mesangial cell proliferation, ultimately leading to renal fibrosis in DN. Therefore, targeting Prrx1 to downregulate its expression presents a promising therapeutic strategy for treating renal fibrosis associated with DN.

Objective: To investigate loneliness and associated factors among adolescents with mixed anxiety and depressive disorder(MADD), and to provide reference for drawing up effective and targeted interventions. Methods: Using convenience sampling method, 265 adolescents with MADD in Daqing Third Hospital were selected from September 2020 to June 2021. General information questionnaire, Pittsburgh sleep quality index(PSQI), Resilience Scale for Chinese Adolescents(RSCA), Child and Adolescent Peer Relationship Scale and UCLA Loneliness Scale were used to investigate the status and influencing factors of loneliness among adolescents with MADD. Results: The average score of UCLA among 265 adolescents with MADD was (56.49±10.83). The results of univariate analysis showed that age, gender, burden of medical expenses, drinking behavior and parents migrant work had statistically significant differences in the UCLA scores. The results of Pearson correlation analysis showed that loneliness in MADD adolescents was negatively correlated with psychological resilience( F/t=57.65, -60.62, 21.92, 8.52, 16.22, P <0.01), and positively correlated with sleep quality and interpersonal distress( F/t=-0.69, 0.76, 0.50, P <0.01). The results of multiple stepwise regression analysis showed that phase of study, sex, burden of medical expenses, interpersonal distress, sleep quality and resilience were the influencing factors of loneliness among adolescents with MADD( B=0.11, 0.13, 0.09, 0.46, 0.10,-0.24, P <0.01). Conclusion Adolescents with MADD have moderate loneliness, which needs to be improved. Nursing staff should pay attention to the negative emotional experience such as loneliness among adolescents with MADD, and reduce their loneliness by improving sleep quality and resilience, reducing interpersonal distress.

Abstract Allostatic load (AL) is related to stress. Adverse childhood experiences(ACEs), as a common stress in childhood, can make a serious and lasting impact on it. Allostatic load can reflect the wear and tear of an individual s physiological system. This article mainly reviews the functional changes of several systems of AL who have experienced ACEs, including neuroendocrine, metabolism, immune, and cardiovascular systems, as well as the different effects of the occurrence time and subtypes of ACES on AL, providing some theoretical basis for the development of early intervention plans in the future and reducing the occurrence and development of deleterious outcomes.

Objective:To explore the current situation of psychological distress in parents of children with mental disorders, analyze its influencing factors, so as to provide a reference for carrying out psychological interventions for parents of children.Methods:This study was a cross-sectional study. From October 2020 to June 2021, 240 parents of children with mental disorders in the Children and Adolescent Psychology Clinic and Ward of the Third Hospital of Daqing City were selected as the research subject by convenience sampling. The survey was conducted using the General Information Questionnaire, the Kessler Psychological Distress Scale (K10) , the General Self-Efficacy Scale (GSES) , the Social Support Rating Scale (SSRS) , the Simplified Copying Style Questionnaire (SCSQ) , and the Zarit Caregiver Burden Interview (ZBI) . A total of 240 questionnaires were distributed and 232 questionnaires were recovered, of which 217 were valid questionnaires, with a valid recovery rate of 90.42% (217/240) .Results:The K10 scores of the 217 parents of children with mental disorders were (21.47±5.05) , which was at a moderate level. The results of the univariate analysis showed that there were statistical differences in K10 scores of parents of children with different family locations, family monthly income, education level and course of disease ( P<0.05) . Pearson correlation analysis showed that the scores of parents' psychological distress were negatively correlated with the scores of social support ( P<0.01) , and positively correlated with the scores of care burden ( P<0.01) . The results of multiple linear regression analysis showed that family location, family monthly income, education level, course of distress, social support and care burden were the influencing factors of psychological distress in parents of children with mental disorders ( P<0.05) . Conclusions:The parents of children with mental disorders have a moderate level of psychological distress, which needs to be improved. Nurses should pay attention to the mental health of the parents of the children, and alleviate the psychological distress of the parents from the aspects of reducing the care burden and improving social support.

Objective:To investigate the content and mode of pharmaceutical care for the patients with severe burn and promote the rational use of drugs. Methods:Taking the treatment for one patient with severe burn as example,pharmacists provided pharmaceu-tical care in respects of anti-infection therapy,organ preservation,nutritional support, drug interactions, drug precautions, drug incom-patibility, adverse drug reactions and the effect evaluation . Results:The program of rational drug use was provided for clinics through the implementation of pharmaceutical care. The vital signs of the patient were stable, and then the patient left on pass and continued to be treated with rehabilitation therapy. Conclusion:It is necessary for clinical pharmacists to perform pharmaceutical care for the pa-tients with severe burn,reduce the abuse of drugs and improve the medication safety and effectiveness. Meanwhile, the collaborative service of doctors,pharmacists,nurses and inspectors to patients reflects the value of clinical pharmacists.