OBJECTIVE: To investigate the factors related to renal impairment in patients with diabetic kidney disease (DKD) from the perspective of integrated Chinese and Western medicine. METHODS: Totally 492 patients with DKD in 8 Chinese hospitals from October 2017 to July 2019 were included. According to Kidney Disease Improving Global Outcomes (KDIGO) staging guidelines, patients were divided into a chronic kidney disease (CKD) 1-3 group and a CKD 4-5 group. Clinical data were collected, and logistic regression was used to analyze the factors related to different CKD stages in DKD patients. RESULTS: Demographically, male was a factor related to increased CKD staging in patients with DKD (OR=3.100, P=0.002). In clinical characteristics, course of diabetes >60 months (OR=3.562, P=0.010), anemia (OR=4.176, P<0.001), hyperuricemia (OR=3.352, P<0.001), massive albuminuria (OR=4.058, P=0.002), atherosclerosis (OR=2.153, P=0.007) and blood deficiency syndrome (OR=1.945, P=0.020) were factors related to increased CKD staging in patients with DKD. CONCLUSIONS Male, course of diabetes >60 months, anemia, hyperuricemia, massive proteinuria, atherosclerosis, and blood deficiency syndrome might indicate more severe degree of renal function damage in patients with DKD. (Registration No. NCT03865914).
Humans ; Male ; Diabetes Mellitus, Type 2 ; Diabetic Nephropathies ; Hyperuricemia ; Kidney ; Proteinuria ; Renal Insufficiency, Chronic/complications*

BACKGROUND/OBJECTIVES: Previous research has shown maternal betaine supplementation alleviates fetal-derived hepatic steatosis. Therefore, this study examined the anti-inflammatory effect of maternal betaine intake in offspring mice and its mechanism.MATERIALS/METHODS: Female C57BL/6J mice and their offspring were randomly divided into 3 groups according to the treatment received during gestation and lactation: control diet (CD), fatty liver disease (FLD), and fatty liver disease + 1% betaine (FLD-BET). The FLD group was given a high-fat diet and streptozotocin (HFD + STZ), and the FLD-BET group was treated with HFD + STZ + 1% betaine. After weaning, the offspring mice were given a normal diet for 5 weeks and then dissected to measure the relevant indexes. RESULTS: Compared to the CD group, the offspring mice in the FLD group revealed obvious hepatic steatosis and increased serum levels of alanine aminotransferase, interleukin (IL)-6, and tumor necrosis factor (TNF)-α; maternal betaine supplementation reversed these changes. The hepatic mRNA expression levels of IL-6, IL-18, and Caspase-1 were significantly higher in the FLD group than in the CD group. Maternal betaine supplementation reduced the expression of IL-1β, IL-6, IL-18, and apoptosis-associated speck-like protein containing C-terminal caspase recruitment domain (ASC). Maternal betaine supplementation also reversed the increasing protein expressions of nitric oxide dioxygenase-like receptor family pyrin domain containing 3 (NLRP3), ASC, Caspase-1, IL-1β, and IL-18 in offspring mice exposed to HFD + STZ. Maternal betaine supplementation decreased the homocysteine (Hcy) and s-adenosine homocysteine (SAH) levels significantly in the livers. Furthermore, the hepatic Hcy concentrations showed significant inverse relationships with the mRNA expression of TNF-α, NLRP3, ASC, and IL-18. The hepatic SAH concentration was inversely associated with the IL-1β mRNA expression. CONCLUSIONS The lipotropic and anti-inflammatory effect of maternal betaine supplementation may be associated with the inhibition of NLRP3 inflammasome in the livers of the offspring mice.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.

OBJECTIVE: Larotaxel is a new chemical structure drug, which has not been marketed worldwide. Accordingly, the standard identification and quantification methods for larotaxel remain unclear. The spectrometric analyses were performed for verifying weight molecular formula, molecular weight and chemical structure of larotaxel. Besides, a quantification method was developed for measuring larotaxel in the liposomes. METHODS: The molecular formula, molecular weight and chemical structure of larotaxel were studied by using mass spectrometry (MS), infra-red (IR), nuclear magnetic resonance (NMR) and ultraviolet-visible (UV-vis) spectrometric techniques. The absorption wavelength of larotaxel was investigated by UV-vis spectrophotometry full-wavelength scanning. Besides, a quantification method was developed by high performance liquid chromatography (HPLC), and then validated by measuring the encapsulation efficacy of larotaxel liposomes. RESULTS: The four spectral characteristics of larotaxel were revealed and the corresponding standard spectra were defined. It was confirmed that larotaxel had the structure of tricyclic diterpenoids, with the molecular formula of C45H53NO14, the molecular weight of 831.900 1, and the maximum absorption wavelength of 230 nm. The quantitative method of larotaxel was established by using HPLC with a reversed phase C18 column (5 μm, 250 mm×4.6 mm), a mobile phase of acetonitrile-water (75:25, volume/volume), and a detection wavelength of 230 nm. The validation study exhibited that the established HPLC method was stable, and had a high recovery and precision in the quantitative measurement of larotaxel in liposomes. In addition, a new kind of larotaxel liposomes was also successfully prepared. The particle size of the liposomes was about 105 nm, with an even size distribution. And the encapsulation efficiency of larotaxel in the liposomes was above 80%. CONCLUSION The present study offers reference standard spectra of larotaxel, including MS, IR, NMR, and UV-vis, and confirms the molecular formula, molecular weight and chemical structure of larotaxel. Besides, the study develops a rapid HPLC method for quality control of larotaxel liposomes.
Chromatography, High Pressure Liquid ; Liposomes ; Magnetic Resonance Spectroscopy ; Taxoids

Adult ; Aged ; Baths ; Child ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Psoriasis ; pathology ; therapy ; Tacrolimus ; therapeutic use

Objective: To explore the factors influencing the sexual function of the male patients with obstructive sleep apnea (OSA). METHODS: Using Arizona Sexual Experience Scale (ASEX) and Epworth Sleepiness Scale (ESS), we conducted a questionnaire investigation among 81 male patients with OSA aged 40.5 ± 8.6 years and 35 healthy volunteers aged 38.8 ± 10 years. According to the sex drive (SD) score in ASEX, we divided the OSA patients into an SD reduction group (SD score = 4, n = 32) and a non-SD reduction group (SD score <4, n = 49), compared the clinical data and polysomnographic (PSG) indexes, and analyzed the factors influencing SD by evaluating the association of the PSG indexes with the SD score. RESULTS: The OSA patients scored significantly higher than the healthy controls in ESS (8 ± 5 vs 5 ± 4, P <0.05) and ASEX (15 ± 4 vs 10 ± 2, P <0.05), and so did the patients of the SD reduction group than those of the non-SD reduction group in ESS (9 ± 5 vs 6 ± 5, P <0.05) and saturation impair time below 90% (SIT90) (41.01 ± 26.95 vs 21.87 ± 19.03, P <0.05). Multivariate regression analysis revealed that the SD score was significantly correlated with age (β = 0.25, P <0.001) and SIT90 (β = 0.4, P <0.001) in the OSA patients. CONCLUSIONS OSA affects various aspects of the sexual function, particularly SD, of the patient. The duration of hypoxia and age of the patient are independent risk factors for SD reduction, which can be considered as a main clinical symptom of OSA.
Adult ; Age Factors ; Case-Control Studies ; Humans ; Hypoxia ; complications ; Libido ; physiology ; Male ; Risk Factors ; Sleep Apnea, Obstructive ; complications ; Surveys and Questionnaires ; Time Factors

The effects of the feed attractants on Whitmania pigra were studied. The average weight of Wh. pigra were 5.0 g. Arginine was selected as feed attractants, xanthan gum was selected as feed substrate. The times of Wh. pigra going into the inducing room were recorded. The water temperature was 22-25 degrees C during the whole experiment. Arginine that had better inducing effect was chosen to carry on in the gradient experiment. The results showed that the best inducing effect was found when the added amount of arginine was 0.3%, which was close to the arginine content of the natural body fluid of Wh. Pigra and Bellamya purificata, 2.97 mg x g(-1).
Animal Feed ; analysis ; Animals ; Arginine ; analysis ; metabolism ; Body Weight ; Feeding Behavior ; Leeches ; growth & development ; physiology

OBJECTIVETo investigate the surgical treatment of thoracic ossification of the ligamentum flavum (TOLF) and analysis of the therapeutic effects.

METHODSSix patients with thoracic ossification of the ligamentum flavum were retrospectively studied from October 2006 to October 2009. All of the patients in this group were treated by en bloc hemi-articular process laminectomy. There were 4 males and 2 females, ranging in age from 45 to 66 years, averaged 55.2 years. The evaluate factors including the preoperative and postoperative JOA scores,and the function of the urinary bladder were analyzed.

RESULTSAll the 6 patients were followed after operation. The mean followed-up duration was 10.5 months, ranging from 2 to 18 months. According to JOA evaluation criteria, 4 patients got an excellent result, 1 good and 1 bad. The one patient with bad result had spinal cord compressed for too long time, and the T2-weight MRI showed nonreversible degeneration of spinal cord and combined with schizophrenia. The clinical symptoms improved with varying degrees.

CONCLUSIONThe en bloc hemi-articular process laminectomy is an effective method for ossification of the thoracic ligamentum flavum. A thorough decompression and real-time protection of the spinal cord is the key to the success of surgery.

Aged ; Decompression, Surgical ; Female ; Humans ; Ligamentum Flavum ; pathology ; Male ; Middle Aged ; Ossification, Heterotopic ; surgery ; Postoperative Complications ; etiology ; Retrospective Studies ; Spinal Cord Injuries ; etiology ; Thoracic Vertebrae ; pathology