ObjectiveTo investigate the effect and mechanism of Yishen Tongluo prescription in protecting mice from oxidative stress injury in diabetic kidney disease （DKD） via the nuclear factor erythroid 2-related factor 2 （Nrf2）/heme oxygenase-1 （HO-1）/NAD（P）H quinone oxidoreductase 1 （NQO1） signaling pathway. MethodsSpecific pathogen-free （SPF） male C57BL/6 mice were assigned into a control group （n=10） and a modeling group （n=50）. The DKD model was established by intraperitoneal injection of streptozotocin. The mice in the modeling group were randomized into a model group， a semaglutide （40 μg·kg^-1） group， and high-， medium-， and low-dose （18.2， 9.1， 4.55 g·kg^-1， respectively） Yishen Tongluo prescription groups， with 10 mice in each group. The treatment lasted for 12 weeks. Blood glucose and 24-h urine protein levels were measured， and the kidney index （KI） was calculated. Serum levels of creatinine （SCr）， blood urea nitrogen （BUN）， alanine aminotransferase （ALT）， and aspartate aminotransferase （AST） were assessed. The pathological changes in the renal tissue were evaluated by hematoxylin-eosin， periodic acid-Schiff， periodic acid-silver methenamine， and Masson’s trichrome staining. Enzyme-linked immunosorbent assay kits were used to measure the levels of β2-microglobulin （β2-MG）， neutrophil gelatinase-associated lipocalin （NGAL）， kidney injury molecule-1 （KIM-1）， liver fatty acid-binding protein （L-FABP）， nitric oxide synthase （NOS）， glutathione （GSH）， total antioxidant capacity （T-AOC）， and 8-hydroxy-2'-deoxyguanosine （8-OHdG）. Immunohistochemical staining was performed to examine the expression of Kelch-like ECH-associated protein 1 （Keap1） and malondialdehyde （MDA）. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR） and Western blot were employed to determine the mRNA and protein levels， respectively， of factors in the Nrf2/HO-1/NQO1 signaling pathway. ResultsCompared with the control group， the DKD model group showed rises in blood glucose， 24-h urine protein， KI， SCr， BUN， and ALT levels， along with glomerular hypertrophy， renal tubular dilation， thickened basement membrane， mesangial expansion， and collagen deposition. Additionally， the model group showed elevated levels of β2-MG， NGAL， KIM-1， L-FABP， NOS， and 8-OHdG， lowered levels of GSH and T-AOC， up-regulated expression of MDA and Keap1， and down-regulated expression of Nrf2， HO-1， NQO1， and glutamate-cysteine ligase catalytic subunit （GCLC） （P<0.05）. Compared with the model group， the semaglutide group and the medium- and high-dose Yishen Tongluo prescription groups showed reductions in blood glucose， 24-h urine protein， KI， SCr， BUN， and ALT levels， along with alleviated pathological injuries in the renal tissue. In addition， the three groups showed lowered levels of β2-MG， NGAL， KIM-1， L-FABP， NOS， and 8-OHdG， elevated levels of GSH and T-AOC， down-regulated expression of MDA and Keap1， and up-regulated expression of Nrf2， HO-1， NQO1， and GCLC （P<0.05）. ConclusionYishen Tongluo prescription exerts renoprotective effects in the mouse model of DKD by modulating the Nrf2/HO-1/NQO1 signaling pathway， mitigating oxidative stress， and reducing renal tubular injuries.

Objective:To investigate the impact of different ventilation modalities during initial resuscitation on short-term outcomes in adult patients with in-hospital cardiac arrest (IHCA).Methods:This retrospective study included adult patients (age ≥18 years) admitted to the emergency resuscitation or observation units of our hospital from September 2019 to December 2021. Demographic data, comorbidities, and short-term outcomes of IHCA patients who underwent airway management during resuscitation were recorded. Participants were stratified into non-advanced airway and advanced airway groups based on ventilation modality. The primary outcome was defined as sustained return of spontaneous circulation (ROSC) ≥20 min, and secondary outcomes included survival to discharge and favorable neurological status at discharge. Logistic regression analyses were performed to assess the impact of different ventilation modalities on short-term outcomes among adult IHCA patients. and developed a prediction model of ROSC for adult IHCA patients, and its predictive performance was evaluated by the area under the curve (AUC) of the receiver operating characteristic.Results:Among 285 IHCA patients (non-advanced airway: n=75; advanced airway: n=210), 127 achieved ROSC ≥20 min, 51 survived to discharge, and 35 had favorable neurological outcomes. Logistic regression identified ventilation modality, epinephrine dose, and arrest location as independent predictors of ROSC in adult IHCA patients. Advanced airway management demonstrated significantly higher ROSC rates compared to non-advanced interventions ( OR=3.698, 95% CI:1.844-7.419, P<0.001). However, no significant associations were observed between ventilation modalities and survival to discharge ( OR=1.097, 95% CI:0.506-2.376, P=0.815) or favorable neurological outcomes at discharge ( OR=0.548, 95% CI:0.224-1.339, P=0.187). Ventilation modality, epinephrine dose, and arrest location were incorporated as predictors in a multivariable logistic regression model to develop a ROSC prediction model for adult IHCA patients. The discriminative ability of model was evaluated through receiver operating characteristic (ROC) curve analysis, yielding an AUC of 0.735 (95% CI:0.678-0.793). Subgroup analyses demonstrated that early advanced airway management significantly enhanced ROSC rates in noncardiac etiology cases, whereas no such benefit was observed in cardiac etiology cases, while this intervention correlated with decreased survival to discharge rates and deteriorated neurological outcomes among survivors. Conclusions:Advanced airway management demonstrated improved ROSC rates in adult IHCA cases, while showing no significant improvement in survival rates or favorable neurological outcomes at discharge. Ventilation modality, epinephrine dose, and arrest location are independent predictors of ROSC. A model integrating these factors exhibits moderate predictive utility for IHCA outcomes.

Objective To explore the correlation between tongue features of type 2 diabetes patients with coronary heart disease and glycosylated hemoglobin,liver function,blood lipids,C-reactive protein,so as to provide reference for related research.Methods Using the TFDA-1 tongue imaging device to collect patients'tongue images,experts will interpret the tongue images and extract objective parameters of the tongue images through the intelligent auxiliary diagnosis system of traditional Chinese medicine tongue diagnosis;Record patient laboratory indicators and use SPSS statistical software to analyze the correlation between tongue image distribution characteristics,tongue image parameter characteristics,and laboratory indicators using Spearman method.Results 702 patients with type 2 diabetes and coronary heart disease were included.In terms of glycated hemoglobin indicators,bruising parameters are positively correlated with HbA1c,while tongue tip RGB values are negatively correlated with HbA1c.In terms of liver function indicators,tongue edge redness,tongue tip and tongue texture R value are positively correlated with ALT and AST;Red tongue tip,tooth marks on the tongue,etc.are positively correlated with ALT;Fat tongue is positively correlated with AST.In terms of blood lipid indicators,parameters such as tooth mark tongue and tooth mark are positively correlated with TG;The parameters of white coating and tongue coating area are positively correlated with LDL-C;Thin coating is positively correlated with HDL-C,while thick coating is negatively correlated with HDL-C;Red tongue is negatively correlated with TCHO.In terms of C-reactive protein,red tongue,tip red,and edge red are positively correlated with CRP;The GB value of tongue root and tongue substance is negatively correlated with CRP.Conclusion Type 2 diabetes patients with coronary heart disease have tongue picture distribution,tongue shape parameters,tongue color parameters,coating color parameters and HbA1c,ALT,AST,TCHO,TG,HDL-C,LDL-C,CRP indicators in varying degrees of correlation.The combination of patients'tongue picture and laboratory indicators is helpful to clarify the diagnosis and prognosis of type 2 diabetes with coronary heart disease.

Objective To explore the correlation between tongue features of type 2 diabetes patients with coronary heart disease and glycosylated hemoglobin,liver function,blood lipids,C-reactive protein,so as to provide reference for related research.Methods Using the TFDA-1 tongue imaging device to collect patients'tongue images,experts will interpret the tongue images and extract objective parameters of the tongue images through the intelligent auxiliary diagnosis system of traditional Chinese medicine tongue diagnosis;Record patient laboratory indicators and use SPSS statistical software to analyze the correlation between tongue image distribution characteristics,tongue image parameter characteristics,and laboratory indicators using Spearman method.Results 702 patients with type 2 diabetes and coronary heart disease were included.In terms of glycated hemoglobin indicators,bruising parameters are positively correlated with HbA1c,while tongue tip RGB values are negatively correlated with HbA1c.In terms of liver function indicators,tongue edge redness,tongue tip and tongue texture R value are positively correlated with ALT and AST;Red tongue tip,tooth marks on the tongue,etc.are positively correlated with ALT;Fat tongue is positively correlated with AST.In terms of blood lipid indicators,parameters such as tooth mark tongue and tooth mark are positively correlated with TG;The parameters of white coating and tongue coating area are positively correlated with LDL-C;Thin coating is positively correlated with HDL-C,while thick coating is negatively correlated with HDL-C;Red tongue is negatively correlated with TCHO.In terms of C-reactive protein,red tongue,tip red,and edge red are positively correlated with CRP;The GB value of tongue root and tongue substance is negatively correlated with CRP.Conclusion Type 2 diabetes patients with coronary heart disease have tongue picture distribution,tongue shape parameters,tongue color parameters,coating color parameters and HbA1c,ALT,AST,TCHO,TG,HDL-C,LDL-C,CRP indicators in varying degrees of correlation.The combination of patients'tongue picture and laboratory indicators is helpful to clarify the diagnosis and prognosis of type 2 diabetes with coronary heart disease.

Objectiveto investigate the differential expression of intestinal flora and serum metabolites and potential biomarkers in patients with pre-diabetic sputum syndrome. MethodA total of 34 patients with pre-diabetic sputum syndrome were included as the phlegm syndrome group，and 37 healthy people were selected as the normal group. Serum and fecal samples of the two groups were collected，and liquid chromatography-mass spectrometry （LC-MS） non-targeted metabolomics and 16S rRNA high-throughput sequencing technology were used to detect serum metabolites and different intestinal flora of the two groups and explore the relationship among pre-diabetic sputum syndrome，serum metabolites，and intestinal flora. ResultIn the distribution of disease syndrome elements in the phlegm syndrome group，the first five disease syndrome elements in terms of frequency and proportion were dampness （73.53%），Qi stagnation （58.82%），Yin deficiency （50.00%），blood stasis （41.18%），and heat （35.29%）. According to the frequency and proportion of disease location syndrome elements，the first three main disease location syndrome elements were spleen （100.00%），liver （41.18%），and kidney （23.53%）. The results of 16S rRNA high-throughput sequencing showed that there were 44 different intestinal flora between the two groups. In order genus，there were significant differences in Bifidobacterium，Veillonococcus，and Roseococcus between the two groups （P<0.05）. The diversity，abundance，and evenness of intestinal flora in the phlegm syndrome group were lower than those in the normal group，with the difference not statistically significant. There was no significant difference in the community structure between two groups. The results of serum metabolomics showed that there were 13 differential metabolites in the two groups，which were mainly concentrated in amino acid metabolism，bile secretion，bile acid biosynthesis，and lipid metabolism （P<0.05）. The correlation among differential metabolites，intestinal flora，and syndrome elements was analyzed，and the results showed that ① lysine was positively correlated with spleen，Yin deficiency，and blood stasis，while taurocholic acid was positively correlated with liver，kidney，blood stasis，and dampness，and there was a positive correlation between taurocholic acid and yin deficiency and heat. The taurochenodeoxycholic acid was positively correlated with liver and dampness，and there was a negative correlation between arachidonic acid and dampness，as well as a positive correlation between glucose and spleen and blood stasis. ② Clostridium was positively correlated with spleen，kidney，Yin deficiency，and Qi stagnation. Rosepiella was negatively correlated with spleen，and Sutterella was negatively correlated with dampness. Bacteroides was negatively correlated with the spleen and kidney，and Bifidobacterium was negatively correlated with the spleen and dampness. ③ Bifidobacterium was positively correlated with glycine，threonine，lysine，and deoxycholic acid significantly，negatively correlated with cholic acid significantly，and positively correlated with taurochenodeoxycholic acid and pyruvic acid. Clostridium was positively correlated with glycine significantly and positively correlated with threonine and lysine. Lachnospira was negatively correlated with glycine，threonine，and pyruvic acid. Lysine was also negatively correlated with Faecalibacterium and Eubacterium ventriosum and positively correlated with Megamonas. There was a positive correlation between taurocholic acid and glycine bile acid and Campylobacter，between taurochenodeoxycholic acid and Veillonococcus，and between glucose and Rosepiella and Eubacterium ventriosum. There was a negative correlation between pyruvic acid and Escheria-Shigella and between taurochenodeoxycholic acid and Prevotella. Conclusionthere are differences in intestinal flora and serum metabolites between patients with pre-diabetic sputum syndrome and healthy people. The intestinal flora and metabolites have been disturbed in the stage of pre-diabetes，Bifidobacterium，Clostridium，Lachnospira，glycine，threonine，and lysine may be the breakthrough to explore the development of pre-diabetic sputum syndrome.

Purpose To evaluate the changes of carotid artery elasticity in children with type 1 diabetes mellitus (T1DM) via RF-data based quantitative analysis on vessel stiffness technique (R-VQS),and to detect its correlation with the duration of diabetes mellitus and blood sugar control. Materials and Methods A total of 75 children with T1DM from the Pediatrics Department of Henan Chest Hospital,the Pediatrics Department of Henan People's Hospital,and the Endocrinology,Genetics,and Metabolism Department of Henan Children's Hospital were prospectively collected from September 2019 to November 2021. According to the T1DM duration,all patients were divided into long course group (duration ≥5 years,n=30 cases) and short course group (duration<5 years,n=45 cases). And 30 age and sex matched controls were also collected. The systolic diameter (Diam),vascular displacement (Dist),pulse wave velocity (PWV),stiffness coefficient (HC) and intima-media thickness (IMT) of common carotid artery were measured by R-VQS. Fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),triglyceride (TG),serum total cholesterol (TC),high-density lipoprotein (HDL),low-density lipoprotein cholesterol (LDL) were collected to compared the differences of parameters among the three groups. Results The FBG,HbA1c and IMT of the long and short course groups were all significantly higher than those of control group (all P<0.05). There were statistically significant differences in PWV and HC among the three groups (F=22.854,P<0.001;F=16.811,P<0.001;H=33.214,P<0.001). The course of disease was moderately correlated with PWV and HC (r=0.621,0.517,respectively,P<0.001). HbA1c was moderately correlated with PWV (r=0.562,P<0.001). Conclusion Early onset of T1DM in children may lead to decreased carotid artery elasticity,and prolonged hyperglycemia can aggravate the degree of arterial elasticity damage. R-VQS is a simple,effective,and non-invasive method for assessing arterial elasticity,providing a basis for clinical diagnosis and treatment.

Purpose To evaluate the changes of carotid artery elasticity in children with type 1 diabetes mellitus (T1DM) via RF-data based quantitative analysis on vessel stiffness technique (R-VQS),and to detect its correlation with the duration of diabetes mellitus and blood sugar control. Materials and Methods A total of 75 children with T1DM from the Pediatrics Department of Henan Chest Hospital,the Pediatrics Department of Henan People's Hospital,and the Endocrinology,Genetics,and Metabolism Department of Henan Children's Hospital were prospectively collected from September 2019 to November 2021. According to the T1DM duration,all patients were divided into long course group (duration ≥5 years,n=30 cases) and short course group (duration<5 years,n=45 cases). And 30 age and sex matched controls were also collected. The systolic diameter (Diam),vascular displacement (Dist),pulse wave velocity (PWV),stiffness coefficient (HC) and intima-media thickness (IMT) of common carotid artery were measured by R-VQS. Fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),triglyceride (TG),serum total cholesterol (TC),high-density lipoprotein (HDL),low-density lipoprotein cholesterol (LDL) were collected to compared the differences of parameters among the three groups. Results The FBG,HbA1c and IMT of the long and short course groups were all significantly higher than those of control group (all P<0.05). There were statistically significant differences in PWV and HC among the three groups (F=22.854,P<0.001;F=16.811,P<0.001;H=33.214,P<0.001). The course of disease was moderately correlated with PWV and HC (r=0.621,0.517,respectively,P<0.001). HbA1c was moderately correlated with PWV (r=0.562,P<0.001). Conclusion Early onset of T1DM in children may lead to decreased carotid artery elasticity,and prolonged hyperglycemia can aggravate the degree of arterial elasticity damage. R-VQS is a simple,effective,and non-invasive method for assessing arterial elasticity,providing a basis for clinical diagnosis and treatment.

In September 2020, three pulmonary tuberculosis cases were identified during school physical examinations at a senior high school in a district (School B) of Hangzhou City. Immediate epidemiological surveys were performed by local district and Hangzhou Center for Disease Control and Prevention, and a pulmonary tuberculosis outbreak involving 9 cases in 6 schools were identified. All cases were once Grade 9 students in Class of 2019 at a junior high school (School A), and the source of infection might be a laboratory-confirmed cases (index case) in this class reported in April, 2019. Following exposure to index case, other cases developed disease onset or were screened after entering senior high schools. In November, 2020, tuberculin skin test and chest X-ray scan were performed to screen pulmonary tuberculosis among 43 students and teachers in a class of Grade 9 in Class of 2019 at School A, and 17 students strongly positive for tuberculin skin test were given prophylactic therapy. No pulmonary tuberculosis case were identified until June 2021. It is suggested that early epidemiological surveys facilitates the identification of the epidemiological correlation between cases. Active search for individuals with common exposure history and prophylactic therapy are required if a possible outbreak is found, which is helpful to avoid the spread of the outbreak.

Objective: To identify and analyze the variants of the KCNJ1 gene in five Chinese patients with Bartter syndrome type 2 (BS2), and to describe their clinical features as well as treatment results. Methods: Data and blood samples of five BS2 patients and their relatives confirmed by Qingdao Municipal Hospital from June 2012 to January 2019 were collected. Whole-exome-sequencing (WES) based on the second generation high throughput sequencing was performed to detect variants. The 2015 American College of Medical Genetics and Genomics Standards and Guidelines were applied to analyze the pathogenicity of the variants. The clinical features and laboratory results were retrospectively studied. The response to treatment and follow-up data were reviewed. Results: Ten variants including six novel ones of KCNJ1 gene were identified through WES and verified by Sanger dideoxy sequencing. Missense variants accounted for the highest proportion. The common symptoms and signs of five BS2 patients from high to low incidence were polydipsia and polyuria (5/5), one of them (1/5) presented with diabetes insipidus; maternal polyhydramnios and premature delivery (4/5); growth retardation (3/5). Initially, two patients presented with hypochloremic metabolic alkalosis and hypokalemia, whereas the acid-base disturbance was absent in the others. One patient experienced hyperkalemia. In terms of calcium-phosphorus metabolism, one patient had evident parathyroid hormone (PTH) resistance (hypocalcemia, hyperphosphatemia and markedly elevated serum intact PTH levels), three presented with PTH overacting (hypercalcemia, hypophosphatemia and mild elevated serum intact PTH levels), and one showed normal blood calcium and phosphorus concentrations with high-normal serum intact PTH levels. All patients had nephrocalcinosis or hypercalciuria, and one of them complicated with nephrolithiasis. Indomethacin helped to correct the growth retardation, halt polydipsia polyuria, decrease the elevated urinary calcium excretion, and normalize electrolyte disturbance as well as PTH parameters in some patients. Conclusions This investigation identifies ten variants of KCNJ1 gene, including six ones that have not been previously reported, which will enrich the human gene mutation database (HGMD). These patients in our study have atypical BS phenotype, so that careful differentiation from other parathyroid diseases will be required for clinicians.

Objective To analyze the epidemic characteristics of the imported malaria cases in Guangxi Zhuang Autono?mous Region in 2014,so as to assess the transmission risk and explore the prevention and control strategy. Methods The data of the malaria epidemic situation in the network direct report system of Guangxi in 2014 and the annual report of malaria epidem?ic situation in 14 cities were collected. The epidemiological information of the imported malaria cases was analyzed. Results A total of 184 malaria patients were reported in Guangxi in 2014,with a descent rate of 85.29%when compared to that in 2013 (1 251 cases),and the incidence rate was 0.35/100 000. All the cases were imported from abroad,and four species of Plasmodi?um were found in their blood samples. The number of falciparum malaria cases was the most(49.46%),followed by the ovale malaria cases(32.07%). All the cases were distributed in 32 counties(districts)of 11 cities ,and 65.76%of them were distrib?uted in Shanglin County. Most of the cases were male(98.37%),and those aged in 20-49 years accounted for 87.50%. The im?ported cases came from 14 countries of Africa(86.41%)and 2 countries of Southeast Asia(13.59%),in which,48.37%of the cases were imported from Garner. The main occupation of the cases in abroad was gold mining work(86.96%). The cases were reported all the year around,with no obvious seasonality. The interval time of back home to attack of the patients with tertian ma?laria and ovale malaria was longer. Conclusion Africa and Southeast Asia is the main source of imported malaria cases in Guangxi,and the migrant workers returning home may have the risk of malaria recurrence,which should be paid enough atten?tion to.