Objective To explore the correlation between the systemic immune-inflammation index(SII)and the clinical and pathological characteristics of patients with IgA nephropathy(IgAN).Methods A total of 350 patients who underwent renal biopsy and were initially diagnosed with primary IgAN were selected.The clinical and pathological data of the patients were collected,and SII was calculated.According to the median SII level of 554.78 in peripheral blood,the IgAN patients were divided into the low SII group(SII≤554.78,175 cases)and the high SII group(SII>554.78,175 cases).Based on the presence or absence of endocapillary hyperplastic(E)lesion,350 patients were also divided into the E0 group(279 cases,79.7%)and the E1 group(71 cases,20.3%).Multivariate Logistic regression analysis was conducted to determine the influencing factors of E1 in IgAN patients.A predictive model was established,and the predictive value of the model was evaluated using the receiver operating characteristic(ROC)curve.Results There were higher systolic blood pressure(SBP),platelet count(PLT),neutrophil count(NEU),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),total cholesterol(TC),serum creatinine(Scr),serum C3 and 24-hour urine protein levels in the high SII group than those of the low SII group,while the lymphocyte count(LYM)was lower(P＜0.05).In terms of pathological manifestations,the proportion of E1 was higher in the high SII group than that of the low SII group(P＜0.05).There were lower PLT,NEU,NLR,PLR,Scr and 24-hour urine protein in patients of the E0 group than those of the E1 group,while higher Hb,LYM and ALB levels in the E0 group than those of the E1 group(P＜0.05).Multivariate Logistic regression analysis showed that elevated SII,Scr and 24-hour urine protein levels were independent risk factors for E1 lesion in IgAN patients(P＜0.05).The area under the curve(AUC)of the predictive model for E1 lesion in IgAN patients was 0.781(95%CI:0.722-0.840).Conclusion SII can reflect the clinical and pathological severity in IgAN patients,providing new insights for clinical evaluation of the disease progression in IgAN patients.

Objective:To develop a Knowledge-Attitude-Practice (KAP) Scale for Dietary Management During Hemodialysis and to test its reliability and validity.Methods:Based on the KAP theoretical framework, an initial version of the scale was developed through a literature review and expert consultations. A convenience sampling method was used to recruit hemodialysis patients from four hospitals in Suzhou in March 2024. Questionnaire item analysis and reliability and validity tests were conducted.Results:A total of 460 questionnaires were distributed and 438 valid responses were collected, with an effective response rate of 95.22%. The final scale included three dimensions (knowledge, attitude, and practice) with 34 items. Content validity at the scale level was 0.910, and the item level ranged from 0.800 to 1.000. Exploratory factor analysis extracted three common factors, with a cumulative variance contribution rate of 74.520%. Confirmatory factor analysis showed a good model fit. The total Cronbach's α coefficient of the scale was 0.971, and the Cronbach's αcoefficients for the three dimensions were 0.963, 0.933, and 0.934, respectively. The test-retest reliability coefficient was 0.839.Conclusions:The Knowledge-Attitude-Practice Scale for Dietary Management During Hemodialysis demonstrates good reliability and validity, making it a valuable tool for assessing the KAP level of dietary management in hemodialysis patients.

Objective To explore the correlation between the systemic immune-inflammation index(SII)and the clinical and pathological characteristics of patients with IgA nephropathy(IgAN).Methods A total of 350 patients who underwent renal biopsy and were initially diagnosed with primary IgAN were selected.The clinical and pathological data of the patients were collected,and SII was calculated.According to the median SII level of 554.78 in peripheral blood,the IgAN patients were divided into the low SII group(SII≤554.78,175 cases)and the high SII group(SII>554.78,175 cases).Based on the presence or absence of endocapillary hyperplastic(E)lesion,350 patients were also divided into the E0 group(279 cases,79.7%)and the E1 group(71 cases,20.3%).Multivariate Logistic regression analysis was conducted to determine the influencing factors of E1 in IgAN patients.A predictive model was established,and the predictive value of the model was evaluated using the receiver operating characteristic(ROC)curve.Results There were higher systolic blood pressure(SBP),platelet count(PLT),neutrophil count(NEU),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),total cholesterol(TC),serum creatinine(Scr),serum C3 and 24-hour urine protein levels in the high SII group than those of the low SII group,while the lymphocyte count(LYM)was lower(P＜0.05).In terms of pathological manifestations,the proportion of E1 was higher in the high SII group than that of the low SII group(P＜0.05).There were lower PLT,NEU,NLR,PLR,Scr and 24-hour urine protein in patients of the E0 group than those of the E1 group,while higher Hb,LYM and ALB levels in the E0 group than those of the E1 group(P＜0.05).Multivariate Logistic regression analysis showed that elevated SII,Scr and 24-hour urine protein levels were independent risk factors for E1 lesion in IgAN patients(P＜0.05).The area under the curve(AUC)of the predictive model for E1 lesion in IgAN patients was 0.781(95%CI:0.722-0.840).Conclusion SII can reflect the clinical and pathological severity in IgAN patients,providing new insights for clinical evaluation of the disease progression in IgAN patients.

Objective:To develop a Knowledge-Attitude-Practice (KAP) Scale for Dietary Management During Hemodialysis and to test its reliability and validity.Methods:Based on the KAP theoretical framework, an initial version of the scale was developed through a literature review and expert consultations. A convenience sampling method was used to recruit hemodialysis patients from four hospitals in Suzhou in March 2024. Questionnaire item analysis and reliability and validity tests were conducted.Results:A total of 460 questionnaires were distributed and 438 valid responses were collected, with an effective response rate of 95.22%. The final scale included three dimensions (knowledge, attitude, and practice) with 34 items. Content validity at the scale level was 0.910, and the item level ranged from 0.800 to 1.000. Exploratory factor analysis extracted three common factors, with a cumulative variance contribution rate of 74.520%. Confirmatory factor analysis showed a good model fit. The total Cronbach's α coefficient of the scale was 0.971, and the Cronbach's αcoefficients for the three dimensions were 0.963, 0.933, and 0.934, respectively. The test-retest reliability coefficient was 0.839.Conclusions:The Knowledge-Attitude-Practice Scale for Dietary Management During Hemodialysis demonstrates good reliability and validity, making it a valuable tool for assessing the KAP level of dietary management in hemodialysis patients.

Objective:To investigate the clinical efficacy, quality of life, safety, and medical expense of second-line treatment with ametinib versus first-line treatment with oxitinib in patients with advanced non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations. Methods:This is a prospective clinical research study. A total of 72 patients with NSCLC who received second-line treatment with ametinib at the Affiliated Hospital of Jining Medical University from July 2020 to April 2022 were included in the amitinib group. Sixty-six patients with advanced NSCLC harboring EGFR mutations who underwent first-line treatment with ositinib were included in the ositinib group (one patient dropped out of the study, and sixty-five patients were included in the final analysis). There was no statistically significant difference in general information between the two groups. The ositinib group received ositinib treatment, while the amitinib group received amitinib treatment. After three courses of treatment, the short-term effectiveness was evaluated in both groups. The quality of life was compared before and after three courses of treatment in each group. Adverse reactions and average per-day hospital cost were compared between the two groups.Results:The disease control rate in the amitinib and oxitinib groups were 91.67% (66/72) and 90.77% (59/65), respectively, while the overall response rate was 43.06% (31/72) and 41.54% (27/65), respectively. The disease control rate and overall response rate did not differ significantly between the two groups (both P > 0.05). After treatment, the scores for physical well-being [(21.05 ± 4.18) points vs. (19.16 ± 3.95) points, t = 4.05], social/family well-being [(19.38 ± 2.65) points vs. (17.26 ± 2.28) points, t = 3.11], emotional well-being [(18.83 ± 3.07) points vs. (17.00 ± 2.86) points, t = 3.20], functional well-being [(22.02 ± 3.83) points vs. (20.14 ± 2.98) points, t = 3.83], and additional attention [(26.11 ± 5.00) points vs. (24.33 ± 4.30) points, t = 3.05] in the amitinib group were significantly higher than those in the oxitinib group (all P < 0.05). There was no significant difference in incidence rate of grade 3-4 adverse reactions between amitinib and oxitinib groups [6.94% (5/72) vs. 10.77% (7/65), P > 0.05]. Average per-day hospital cost in the amitinib group was significantly lower than that in the oxitinib group ( t = 4.83, P < 0.05). Conclusion:Second-line treatment with ametinib for advanced NSCLC harboring EGFR mutations can significantly enhance the quality of life and offer comparable short-term efficacy and safety to first-line treatment with oxitinib. Advantageously, its medical cost is relatively lower.

Objective:To retrieve, evaluate, and integrate the best evidence for prevention of hemodialysis catheter thrombosis, so as to provide evidence-based basis for catheter thrombosis prevention in hemodialysis patients.Methods:Guidelines, clinical decisions, evidence summaries, systematic reviews, and expert consensus on the prevention of hemodialysis catheter thrombosis were systematically searched on Guidelines International Network, Scottish Intercollegiate Guidelines Network, Agency for Healthcare Research and Quality, Registered Nurses' Association of Ontario, National Institute for Health and Clinical Excellence, UpToDate, British Medical Journal (BMJ) Best Practice, Joanna Briggs Institute Evidence-Based Health Care Center Database, European Renal Association, National Kidney Foundation, UK Kidney Association, Canadian Society of Nephrology, Japanese Society for Dialysis Therapy, Medlive, Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure, VIP, and Wanfang Data and Chinese Biomedical Database. The search period was from database establishment to March 31, 2023. Investigators conducted quality evaluations separately and extracted and summarized evidence based on the theme.Results:A total of 16 articles were included, including five clinical decisions, four guidelines, two evidence summaries, and five expert consensuses. Finally, 15 best pieces of evidence were formed, including four themes of indwelling dialysis catheters, anticoagulation strategies, flushing and sealing techniques, and daily management.Conclusions:Nursing staff should choose the best evidence for preventing thrombosis in hemodialysis catheters based on clinical situations, reduce the occurrence of catheter thrombosis, extend the usage time of catheters, and improve patient outcomes.

Objective : To provide a reference for the diagnosis and treatment of mucoepidermoid carcinoma arising in Warthin’s tumor of the lip by investigating the diagnosis, treatment and prognosis of the disease. Methods : A case of mucoepidermoid carcinoma arising in Warthin’s tumor of lip was reported, including the clinical manifestation, treatment, pathological characteristics and prognosis. The related literature was also reviewed and analyzed. Results: A painless mass on the left lip lasting more than one month was found. Resection of the left lip was performed. Pathological examination showed that the tumor was a hybridoma composed of mucoepidermoid carcinoma and Warthin’s tumor. There was no recurrence or distant metastasis after 34 months. To date, this type of disease has been rarely reported. After thorough resection, the prognosis and survival rate are promising in most cases, with no recurrence or metastasis. Conclusion Mucoepidermoid carcinoma in Warthin’s tumor of the lip is rare. Clinical manifestations, imaging features and histological examination are useful when diagnosing the disease. Thorough resection will reduce the risk of disease recurrence.

Objective To examine the impact of case management on hospitalizations of the chronically and severely mentally ill patients in Zhongshan. Methods Patients with severe and chronic mental illness,aged ≥ 15 years and living in pilot area were divided into two groups naturally since the program of case management launched, 65 cases in the group of case management and 112 patients in the group of standard management. Hospitalizations of the two groups before and after case management were compared. Results Data were analysised with MIXED procedure. Length of stay in days per admission (LOS) of both groups decreased with time in years (F=11.02, P=0.001), and the decline in LOS of case management group was greater than that of standard management group (F=9.02, P=0.003). The average admissions of case management group was more than that of standard management group (F=4.98,P=0.03). There was no significant differences in average hospitalization incidents before and after case management in both groups(case management group 5.13%vs. 5.38%, standard management group 7.14%vs. 8.92%, P>0.05). Conclusions Case management was effective in reducing hospitalizations for a group of Chinese with chronic and severe mental illness, and may contribute to the balance on mental health resources between community and hospital.

Objective To investigate the influence of transcriptional factor Sp1 on expression of bile acids transporters MRP3 and MRP4 so as to perfect the regulatory mechanism of MRP3 and MRP4 expression.Methods Transformed Sp1-overexpression and Sp1 siRNA plas-mids to HepG2 cell and obtained the stably cells line.Then the expression levels of bile acids transporters MRP3 and MRP4 were measured by RT-qPCR,and the change of protein levels were detected by Western blot.Results The stably cells line Sp1-OE-HepG2 and Sp1siRNA-HepG2 were successfully transformed.The mRNA expression and protein levels of MRP3 and MRP4 were significantly increased in Sp1-OE-HepG2 cells,among which the mRNA expression of MRP3 mRNA increased 2.8 times,the protein levels of MRP3 increased 3.0 times,and the mRNA expression and protein levels of MRP4 increased 3.2 times and 2.5 times respectively.Conversely,the mRNA expression and protein levels of MRP3 and MRP4 were decreased in Sp1 siRNA-HepG2 cells,among which the mRNA expression of MRP3 mRNA de-creased 52%,the mRNA expression of MRP4 mRNA decreased 58%,the protein levels of MRP3 decreased 57%,and the protein levels of MRP4 decreased 60%.Conclusion Transcriptional factor Sp1 could regulate the expression of bile acids transporters MRP3 and MRP4 in HepG2 cells.

Objective To assess the effective of helicobacter pylori in gallbladder malignant disease ,cholelithiasis ,cholecysti‐tis .Methods The literature about helicobacter pylori and gallbladder disease were collected in EMbase ,Pubmed ,VIP and CBM from inception to May ,2015 .Two reviewers independently screened the literature according to the inclusion and exclusion criteria , extracted the data ,and assessed the quality ,and then the meta‐analysis were performed by using Stata11 software .Results A total of 24 case control study were included .The results of meta‐analysis showed that ,helicobacter pylori had a higher incidence rate in gallbladder maliganant disease and cholelithiasis(OR=5 .31 ,95% CI:2 .34 -12 .05 ,P= 0 .000)and (OR=1 .84 ,95% CI:1 .13-2 .98 ,P=0 .014) compared with control group .Also it have influence on cholecystitis (OR= 9 .92 ,95% CI:4 .04 -24 .39 ,P=0 .000) .Conclusion Helicobacter pylori is a risk factor of inducing cholelithiasis and gallbladder malignancy disease ,cholecystitis .