Objective Microcystin-leucine-arginine(MC-LR)exposure induces lipid metabolism disorders in the liver.Secreted frizzled-related protein 5(SFRP5)is a natural antagonist of winglesstype MMTV integration site family,member 5A(Wnt5a)and an anti-inflammatory adipocytokine.In this study,we aimed to investigate whether MC-LR can induce lipid metabolism disorders in hepatocytes and whether SFRP5,which has anti-inflammatory effects,can alleviate the effects of hepatic lipid metabolism by inhibiting the Wnt5a/Jun N-terminal kinase(JNK)pathway. Methods We exposed mice to MC-LR in vivo to induce liver lipid metabolism disorders.Subsequently,mouse hepatocytes that overexpressed SFRP5 or did not express SFRP5 were exposed to MC-LR,and the effects of SFRP5 overexpression on inflammation and Wnt5a/JNK activation by MC-LR were observed. Results MC-LR exposure induced liver lipid metabolism disorders in mice and significantly decreased SFRP5 mRNA and protein levels in a concentration-dependent manner.SFRP5 overexpression in AML12 cells suppressed MC-LR-induced inflammation.Overexpression of SFRP5 also inhibited Wnt5a and phosphorylation of JNK. Conclusion MC-LR can induce lipid metabolism disorders in mice,and SFRP5 can attenuate lipid metabolism disorders in the mouse liver by inhibiting Wnt5a/JNK signaling.

OBJECTIVE: To assess health related quality of life (HRQOL) in patients with kidney stones and to predict risk factors for reduced HRQOL in the patients by the Chinese version of Wisconsin stone quality of life questionnaire (C-WISQOL). METHODS: The patients with renal stones admitted to Peking University People ' s Hospital from July 2020 to June 2021 were prospectively enrolled. The inclusion criteria included the patients with renal stones aged 18-80 years and sufficient Chinese language foundation, and the exclusion criteria included the patients with internal ureteral stents, malignant tumors, sepsis, etc. Demographic data and clinical data related to kidney stones were collected, and the C-WISQOL and the short form 36 health survey (SF-36) questionnaire completed by the patients was recorded. C-WISQOL included four domains (D): emotional impact (D1), social impact (D2), stone-related impact (D3) and vitality impact (D4). Cronbach ' s α coefficient was used to verify the internal consistency of C-WISQOL, Spearman ' s rho coefficient was used to verify the criterion validity between C-WISQOL and SF-36 questionnaire, confirmatory factor analysis was used to verify the structural validity, convergent validity and discrimination validity of C-WISQOL, and univariate and multivariate analyses were used to explore the risk factors leading to the decline of HRQOL in the patients with kidney stones. RESULTS: The study included 307 patients with kidney stones, of whom 212 (69.1%) were male, with a mean age of (51.9±13.5) years, and a mean body mass index (BMI) of (25.4±3.6) kg/m². 160 (52.1%) patients were complicated with metabolic syndrome (MS), 202 (65.8%) had history of calculi, 217 (70.7%) had calculi related symptoms, 53 (17.3%) had bilateral renal calculi, 82 (26.7%) had ureteral calculi, 199 (64.8%) had hydronephrosis, 78 (25.4%) had renal insufficiency, and urinary tract infection (UTI) was found in 168 patients (54.7%) with an average diameter of (15.6±5.9) mm. The mean total score of C-WISQOL questionnaire for all the patients was (94.9±13.7) points, D1 was (27.2±4.2) points, D2 was (23.8±3.7) points, D3 was (27.0±3.6) points, and D4 was (10.1±1.9) points. The Cronbach ' s α coefficient of the total score of C-WISQOL questionnaire was 0.968 and the four dimensions ranged from 0.860 to 0.898. The Spearman' s rho co- efficient between C-WISQOL and SF-36 total score was 0.564, and the Spearman' s rho coefficient between dimensions was 0.684-0.901, indicating that C-WISQOL had good internal consistency and criterion validity. Confirmatory factor analysis showed that C-WISQOL had good structural validity, convergent validity and discrimination validity. Univariate analysis showed that the patients with MS (OR=1.607, P < 0.001), calculi related symptoms (OR=1.268, P < 0.001), bilateral kidney stones (OR=1.900, P < 0.001), combined with ureteral calculi (OR=1.018, P < 0.001), accompanied by hydronephrosis (OR=1.685, P < 0.001), and UTI (OR=1.275, P < 0.001) were risk factors for decreased HRQOL in the patients with kidney stones, and multivariate analysis showed that the patients with MS (OR=1.475, P < 0.001), calculi related symptoms (OR=1.546, P=0.043) and UTI (OR=1.646, P=0.005) were independent risk factors for HRQOL decline in the patients with renal calculi. The t-test results showed that C-WISQOL scores were significantly higher in the patients without MS, stone-related symptoms and UTI than those in the patients with associated risk factors (P < 0.001). CONCLUSION C-WISQOL the questionnaire can be used to evaluate the HRQOL of patients with kidney stones with good reliability. The combination of MS, stone-related symptoms and UTI were independent risk factors for HRQOL reduction in the patients with renal stones.
Humans ; Quality of Life ; Kidney Calculi/psychology* ; Surveys and Questionnaires ; Middle Aged ; Male ; Adult ; Female ; Risk Factors ; Aged ; Prospective Studies ; China/epidemiology* ; Adolescent ; Aged, 80 and over ; Language ; Young Adult

ObjectiveTo determine the mechanism of Yitangkang in correcting excessive apoptosis of skeletal muscle cells to improve insulin resistance （IR） by inhibiting the advanced glycation end product （AGE）/receptor for the advanced glycation end product （RAGE） signaling pathway. Method① In vitro experiments. Yitangkang-medicated serum was prepared. C2C12 cells were divided into a blank group， a model group， high-， medium-， and low-dose Yitangkang-medicated serum groups （40， 20， and 10 g·kg^-1）， and a RAGE inhibitor group. The IR model was induced by palmitic acid in C2C12 cells except for those in the blank group. After the corresponding intervention methods were conducted，the cell viability and glucose consumption level of each group were determined. In addition，the apoptosis rate was determined using flow cytometry. The mRNA and protein expression levels of the important apoptotic proteins ［B-cell lymphoma 2 （Bcl-2）， Bcl-2-associated X protein （Bax）， p53， cysteinyl aspartate-specific protease-3 （Caspase-3）， and cysteinyl aspartate-specific protease-9 （Caspase-9）］ were determined using Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot. ② In vivo experiments. Ninety-six eligible Wistar rats were divided into a blank group， a model group， high-，medium-，and low-dose Yitangkang groups （40， 20， and 10 g·kg^-1）， and a western medicine group （pioglitazone hydrochloride，1.35 mg·kg^-1）. The IR model was induced using high-glucose and high-fat feed for diabetes combined with intraperitoneal injection of low-dose streptozotocin （STZ） in animals and verified by the hyperinsulinemic-euglycemic clamp （HEC） test. After the model was determined successfully， the rats in each group were given intragastric administration of drugs as required. Terminal deoxynucleotidyl transferase dUTP nick end labeling （TUNEL） assay was performed to determine the number of positive apoptotic cells in the skeletal muscle tissues of rats in each group，while Real-time polymerase chain reaction（Real-time PCR） and Western blot were performed to determine the mRNA and protein expression levels of the important apoptotic proteins Bcl-2， Bax， p53， Caspase-3， and Caspase-9. Result① In vitro experiments. compared with the blank group， the model groups showed increased apoptosis rate of C2C12 cells and decreased cell viability and glucose consumption （P<0.01）. Compared with the model group， the Yitangkang-medicated serum groups and the RAGE inhibitor group showed decreased apoptosis rate of C2C12 cells and increased cell viability and glucose consumption （P<0.01）. Compared with the blank group， the model group showed decreased expression levels of Bcl-2 mRNA and protein in C2C12 cells and increased mRNA and protein expression levels of Bax， p53， Caspase-3， and Caspase-9 （P<0.01）. Compared with the model group， the Yitangkang-medicated serum groups and the RAGE inhibitor group showed increased expression levels of Bcl-2 mRNA and protein in C2C12 cells （P<0.01） and decreased mRNA and protein expression levels of Bax， p53， Caspase-3， and Caspase-9 （P<0.05， P<0.01）. ② In vivo experiments. The number of positive apoptotic cells in the skeletal muscle tissues of rats in the model group significantly increased as compared with that in the blank group （P<0.01）. The number of positive apoptotic cells in the skeletal muscle tissues of rats in the Yitangkang groups and the western medicine group decreased as compared with that in the model group （P<0.01）. Compared with the blank group， the model group showed decreased expression levels of Bcl-2 mRNA and protein in skeletal muscle tissues of rats and increased mRNA and protein expression levels of Bax， p53， Caspase-3， and Caspase-9 （P<0.01）. Compared with the model group， the Yitangkang groups and the western medicine group showed increased expression levels of Bcl-2 mRNA and protein in skeletal muscle tissues of rats （P<0.01） and decreased mRNA and protein expression levels of Bax， p53， Caspase-3， and Caspase-9 （P<0.05， P<0.01）. The medium-dose Yitangkang showed a similar effect as RAGE inhibitor， and the effect was equivalent to that of pioglitazone hydrochloride. ConclusionYitangkang can inhibit skeletal muscle cell apoptosis by inhibiting the AGE/RAGE signaling pathway.

Objective:To explore the expression of abnormal spindle-like microcephaly-associated (ASPM) in liver cancer tissues and clarify its prognostic relationship with clinicopathological features of liver cancer after liver transplantation.Methods:Immunohistochemistry was employed for detecting the expression of ASPM in 72 liver cancer tissues and 36 adjacent tissues of liver cancer liver transplant recipients fulfilling the Hangzhou criterion. In conjunctions with clinicopathological data, the correlation between the expression level of ASPM in liver cancer tissues and the clinicopathological characteristics and the post-transplantation prognosis for liver cancer were statistically analyzed.Results:During a median follow-up period of 29 months, 20 patients relapsed and 8 died after transplantation. Immunohistochemical results indicated that the high-expression rates of ASPM were 58.3% and 25.0% in liver cancer and adjacent tissues ( P=0.001). The difference was statistically significant. The high-expression rate of ASPM was significantly higher in liver cancer tissues than that in adjacent tissues. The expression level of ASPM was not correlated with gender, age, smoking/alcoholic history, hepatitis history, preoperative level of alpha-fetoprotein (AFP), tumor size, tumor load or vascular tumor thrombus ( P>0.05). And the postoperative high-expression rates of ASPM were 51.0% and 76.2% in pathological differentiation type Ⅰ-Ⅱ and Ⅲ-Ⅳ groups ( P=0.049). The difference was statistically significant. The wrose pathological differentiation type of liver cancer, the higher expression level of ASPM in liver cancer tissue. In liver cancer tissues, the overall 1/3/5-year survival rates of ASPM high/low-expression group were 97.6%, 80.6%, 80.6% and 93.3%, 89.7% and 89.7% respectively ( P>0.05). There was no statistical significance. And 1/3/5-year long-term disease-free survival rates were 78.6%, 55.5%, 55.5% and 86.3%, 86.3% and 86.3% respectively ( P=0.036). The difference was statistically significant. The disease-free survival rate was lower in ASPM high-expression group and post-transplantation prognosis was worse. Conclusions:The expression of ASPM is significantly higher in liver cancer tissues than that in adjacent tissues. And the expression level of ASPM in liver cancer tissues is correlated with pathological differentiation types of liver cancer and has an impact on tumor-free survival of patients after liver transplantation for liver cancer.

Objective:To detect and analyze the contents of eight metal elements in water samples of plague foci in Yunnan Province.Methods:During the period from December 2015 to November 2016, the plague foci of Yulong, Jianchuan and Lianghe were selected as sampling sites, water samples were collected in areas with rodent activities in the 4 seasons of spring, summer, autumn and winter. The contents of eight metal elements calcium (Ca), iron (Fe), zinc (Zn), chromium (Cr), plumbum (Pb), manganese (Mn), cadmium (Cd) and cuprum (Cu) in water samples were measured by flame atomic absorption spectrometry (FAAS), and the data [median (interquartile distance)] were statistically analyzed.Results:Twenty-six, 58 and 54 water samples were collected from Yulong, Jianchuan and Lianghe plague foci, respectively. The contents of metal elements of Pb and Cd in water samples of the three plague foci [Yulong: 0.19 (0.78) and 0.08 (0.07) mg/L; Jianchuan: 0.23 (0.56) and 0.03 (0.06) mg/L; Lianghe: 0.13 (0.61) and 0.09 (0.08) mg/L] were higher than that of "Environmental Quality Standards for Surface Water" (Pb: 0.10 mg/L, Cd: 0.01 mg/L). There were significant differences in the contents of Ca and Cd elements among the three regions ( P < 0.05), but there was no significant difference in the contents of the other 6 metal elements among the three regions ( P > 0.05). The content of Ca element was the highest in Yulong plague foci, and the lowest in Lianghe plague foci ( P < 0.017). In the Yulong plague foci, there was no statistically significant difference in the content of Fe element in different seasons ( P > 0.05), and the differences in the contents of the other 7 metal elements were statistically significant ( P < 0.05). There was no significant difference in the content of Cr element in Jianchuan plague foci in different seasons ( P > 0.05), and the differences in the content of the other 7 metal elements were statistically significant ( P < 0.05). There was no significant difference in the content of Ca element in Lianghe plague foci in different seasons ( P > 0.05), and the differences in the content of the other 7 metal elements were statistically significant ( P < 0.05). Conclusion:The metal element contents of Pb and Cd are relatively abundant in water samples from 3 plague foci of Yunnan Province, and the seasonal variation trend of metal element content in water samples of Yulong and Jianchuan plague foci is similar.

It is more than 20 years since the first endovascular repair of thoracoabdominal aortic aneurysm was performed. Significantly reducing risk of morbidity and mortality compared with open aortic repair, the advent of endovascular repair has revolutionized the treatment of complex aortic disease. It is now the first-line treatment for most thoracoabdominal aortic aneurysm patients. However, spinal cord ischemia (SCI) remains one of the most threatening complications after the procedure, and significantly reduces overall survival. The pathophysiology of spinal cord ischemia remains unclear but may well be multifactorial. Risk factors for SCI include excessive aortic coverage, detriment to the collateral network through occlusion of the left subclavian or internal iliac arteries, perioperative hypotension and chronic renal failure. SCI could be predicted, prevented and ameliorated through the application of motor evoked potential, permissive perioperative hypertension, cerebrospinal fluid drainage (CSFD), preoperative or concomitant left subclavian artery (LSA) revascularization and some drugs. However, there are certain complications and contraindications for CSFD and arterial revascularization. As a result, we must balance the pros and cons of these invasive measures. So we summarize our clinical experience and propose the employment of LSA revascularization and CSFD in certain kinds of high-risk patients respectively. With the development of technology and preventive measures, we believe that SCI could be minimized in the forseeable future.

It is more than 20 years since the first endovascular repair of thoracoabdominal aortic aneurysm was performed. Significantly reducing risk of morbidity and mortality compared with open aortic repair, the advent of endovascular repair has revolutionized the treatment of complex aortic disease. It is now the first-line treatment for most thoracoabdominal aortic aneurysm patients. However, spinal cord ischemia (SCI) remains one of the most threatening complications after the procedure, and significantly reduces overall survival. The pathophysiology of spinal cord ischemia remains unclear but may well be multifactorial. Risk factors for SCI include excessive aortic coverage, detriment to the collateral network through occlusion of the left subclavian or internal iliac arteries, perioperative hypotension and chronic renal failure. SCI could be predicted, prevented and ameliorated through the application of motor evoked potential, permissive perioperative hypertension, cerebrospinal fluid drainage (CSFD), preoperative or concomitant left subclavian artery (LSA) revascularization and some drugs. However, there are certain complications and contraindications for CSFD and arterial revascularization. As a result, we must balance the pros and cons of these invasive measures. So we summarize our clinical experience and propose the employment of LSA revascularization and CSFD in certain kinds of high-risk patients respectively. With the development of technology and preventive measures, we believe that SCI could be minimized in the forseeable future.

Objective To compare and analyze the soil eight metal elements contents of rat holes of three plague foci in Yunnan Province.Methods The soils were collected from the rat holes in Yulong,Jianchuan,and Lianghe plague foci.Calcium (Ca),iron (Fe),zinc (Zn),chromium (Cr),lead (Pb),manganese (Mn),cadmium (Cd),and copper (Cu) were quantified with flame atomic absorption spectrometry (FAAS).Data input,calculation and collation were conducted through Excel 2007,and statistical software SPSS 20.0 was used to carried out statistical analysis through rank sum test.Results The medians of Ca content in the rat hole soil of Yulong County,Jianchuan County,and Lianghe County,respectively,were 85.40,308.56,and 0.00 mg/kg;the medians of Fe were 2 569.07,1 950.16,and 975.72 mg/kg;the medians of Zn were 5.64,4.02,and 2.04 mg/kg;the medians of Cr were 1.09,3.06,and 0.71 mg/kg;the medians of Pb were 3.61,29.56,and 22.80 mg/kg;the medians of Mn were 223.01,212.97,and 80.43 mg/kg;the medians of Cd were 0.00,2.02,and 2.94 mg/kg;and the medians of Cu were 1.92,1.08,and 0.51 mg/kg.The contents of eight metal elements were statistically different in the soil samples between Yulong,Jianchuan,and Lianghe plague foci (H =80.538,127.687,202.583,185.359,124.747,150.057,91.346,228.546,P ＜ 0.05).Conclusions The content of Fe in soil of the three plague foci in Yunnan Province is abundant.The contents of metal elements of Yulong County and Jianchuan County are similar.

Objective: To explore the treatment effect of pedicled myocutaneous island flap of anterolateral thigh muscle on the suprapubic defect caused by bladder exstrophy in children. Methods: The clinical data of 3 adolescents with bladder exstrophy were analyzed. All 3 cases underwent one-stage Kelly procedure and received the treatment using pedicled myocutaneous island flap of anterolateral thigh muscle to repair the suprapubic defect. The bladder expansion was performed with ileal sarcoplasmic layer graft, and the Cohen ureteral reimplantation was performed as well, for 1 case 1, 1 year after the first operation. The others 2 patients didn′t receive the second operation. Results: All operations were successful. The femoral donor regions were directly closed. Postoperative follow-up period was 1-7 years. The myocutaneous island flaps were survived and grew well. All incisions of the femoral donor region were primary healing without scar hypertrophy. Urinary continence was achieved in 2 cases, and partially achieved in 1 case. Recurrent urinary tract infection, recurrent fever or abdominal pain were not observed in all patients. Conclusions The pedicled anterolateral thigh myocutaneous island flap is an alternative way to repair suprapubic defect caused by bladder exstrophy.