Objective:To explore prognosis and related risk factors of patients with systemic lupus erythematosus(SLE)combined with decreased complement C3 level.Methods:A total of 173 SLE patients with decreased complement C3 level who were treated in Chongzuo People's Hospital from June 2018 to March 2022 were selected as research subjects,and divided into good progno-sis group(n=151)and poor prognosis group(n=22)according to follow-up prognostic effect.Clinical data and biochemical indicators of patients were recorded.A nomogram model was established for analysis and model validation.Results:There were statistical signifi-cance in lupus activity,C3,A/G,hs-CRP between two groups(P<0.05);lupus activity,C3,A/G,hs-CRP were independent risk factors for outcomes of SLE patients with reduced complement C3.Prediction effect of nomogram model was good,and consistency of model validation was strong.Complement C3 level was correlated with SLE(χ2=7.524,P=0.002),with a linear dose-response relation-ship(χ2=1.527,P=0.118).Conclusion:SLE patients with decreased complement C3 level have poor prognosis,who has many risk factor.Prognosis of SLE can be enhanced from aspects of lupus activity,C3,A/G and hs-CRP.

Objective:To explore prognosis and related risk factors of patients with systemic lupus erythematosus(SLE)combined with decreased complement C3 level.Methods:A total of 173 SLE patients with decreased complement C3 level who were treated in Chongzuo People's Hospital from June 2018 to March 2022 were selected as research subjects,and divided into good progno-sis group(n=151)and poor prognosis group(n=22)according to follow-up prognostic effect.Clinical data and biochemical indicators of patients were recorded.A nomogram model was established for analysis and model validation.Results:There were statistical signifi-cance in lupus activity,C3,A/G,hs-CRP between two groups(P<0.05);lupus activity,C3,A/G,hs-CRP were independent risk factors for outcomes of SLE patients with reduced complement C3.Prediction effect of nomogram model was good,and consistency of model validation was strong.Complement C3 level was correlated with SLE(χ2=7.524,P=0.002),with a linear dose-response relation-ship(χ2=1.527,P=0.118).Conclusion:SLE patients with decreased complement C3 level have poor prognosis,who has many risk factor.Prognosis of SLE can be enhanced from aspects of lupus activity,C3,A/G and hs-CRP.

Objective To explore a scientific and practical nursing plan for patients with severed finger reunion in their rehabilitation.Methods Based on literature research as well as the investigation and analysis of rehabilitation training in patients with severed finger reunion, we combined the existing rehabilitation nursing plan and investigation results together, to draft a rehabilitation nursing plan for patients with severed finger reunion. The medical, nursing and rehabilitation specialist were selected and two rounds of Delphi expert consultation were taken, to revise the draft of rehabilitation nursing plan. Results The questionnaire collecting rates of two rounds of expert consultation were 95. 00% and 94. 11%; the authority degree was 0. 79 and the coordination coefficient was 0.49 and 0.43. The significant test result of the coordination coefficient was P<0.05, and the evaluation results were desirable. The rehabilitation nursing plan developed by this paper contains 3 first-grade indicators, 11 second-grade indicators and 22 third-grade indicators.Conclusions The process of making rehabilitation nursing plan is scientific and simple, and it can be used for rehabilitation nursing and effect assessment in clinical patients with severed finger reunion.

In order to simultaneously remove carbon and nitrogen from organic-rich wastewater, we used an up-flow anaerobic sludge bed/blanket (UASB) reactor that was started up with anammox with high concentration of carbon and nitrogen by gradually raising the organic loading of influent. We optimized the removal of nitrogen and carbon when the chemical oxygen demand (COD) concentration varied from 172 to 620 mg/L. During the entire experiment, the ammonium and total nitrogen removal efficiency was higher than 85%, while the average COD removal efficiency was 56.6%. The high concentration of organic matter did not restrain the activity of anammox bacteria. Based on polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) and tapping sequencing analyses, the Planctomycete, Proteobacteria, Chloroflexi, Chlorobi bacteria are detected in the UASB reactor, which indicated complex removal pathway of carbon and nitrogen coexisted in the reactor. However, a part of Planctomycete which referred to anammox bacteria could tolerate a high content of organic carbon, and it provided help for high performance of nitrogen removal in UASB reactor.
Ammonia ; chemistry ; Biological Oxygen Demand Analysis ; Bioreactors ; Carbon ; chemistry ; Nitrogen ; chemistry ; Sewage ; Waste Disposal, Fluid ; methods ; Waste Water ; chemistry

To study the enrichment regulation of anammox bacteria during the whole start-up process of anammox reaction, two reactors with addition of carries of Spherical Plastic (SP) and Bamboo Charcoal (BC) and one without carrier (CK) were used to start anammox reaction. Then FISH and q-PCR analyses for the growth of all anammox bacteria were conducted during the operational process. The results indicate that the number of anammox bacteria in all reactors increased with time during the whole start-up process, which was consistent with the removal rate of ammonium and nitrite. On day 123 of stable phase, the percent of anammox cells in the sludge of CK, SP and BC accounted for 23.3%, 32.6% and 43.7%, respectively. The number of anammox bacteria 16S rRNA gene copies was (25.64 +/- 2.76) x 10(7), (47.12 +/- 2.76) x 10(7) and (577.99 +/- 27.25) x 10(7) copies g(-1) VSS in the sludge of CK, SP and BC, respectively. Carrier addition could dramatically increase enrichment of anammox bacteria. BC addition significantly increased the anammox bacteria number in the UASB reactor which resulted in the acceleration of the anammox start-up process. In addition, the max specific growth rate and the minimum doubling time were 0.064 d(-1) and 10.8 d in BC reactor. The max specific growth rate of anammox bacteria in BC reactor was 1.78 times and 1.88 times greater than that in CK and SP reactor, respectively. Therefore, the FISH and q-PCR analyses were suitable for determining the enrichment regulation of anammox bacteria during the start-up time, while a bit of differences in results existed between the two analytical methods due to the difference in analysis targets.
Ammonia ; metabolism ; Bacteria ; growth & development ; metabolism ; Bioreactors ; Industrial Microbiology ; Nitrites ; metabolism ; Oxidation-Reduction ; Sewage ; microbiology

Objective To investigate Smoothened (Smo) expression in endothelial cells of synovial tissues in active rheumatoid arthritis (RA),and the expression of Sonic Hedgehog (Shh) signaling pathwayassociated factors after TNF-α treatment in EA.hy926 cells,and the effects of specific inhibitor of Smo (cyclopamine) on the apoptosis of EA.hy926 cells.Methods The Smo expression in endothelial cells in synovial tissue from 4 RA patients and 4 patients with traumatic or meniscal injury (with no arthritis,act as control group) were detected by immunohistochemistry assay.EA.hy926 cells were treated with different concentrations of TNF-α or TNF-α together with different concentrations of cyclopamine,and Shh,Ptch1,Smo,Gli1 mRNA expression levels were detected by real time-PCR.EA.hy926 cells were co-cultured with three different concentrations of cyclopamine for 24 hours before the addition of TNF-α and ActinomycinD (ActD).The cell survival rate was detected using CCK-8,and the population of apoptotic cells was detected using a flow cytometry.T-test and one-way ANOVA were used for statistical analysis.Results The positive expression rate of Smo in endothelial cells of synovial tissue in RA group was (81±23)％,which was higher than that in the control group (20±17)％ (P＜0.05).After being treated with TNF-α,the expressions of Shh and Smo mRNA in EA.hy926 cells increased,while the expression of Gli1 mRNA decreased (P＜0.05),and the expression of Ptch1 mRNA did not change significantly (P＞0.05).The expressions of Shh,Smo and Gli1 mRNA were down-regulated (P＜0.05).EA.hy926 cells treated with different concentrations of cyclopamine (2,4 and 8 μmol/L) showed a significant decrease in cell viability,in cell survival rates (57±6)％,(44±8)％ and (32±5)％ compared with that of TNF-α/ActD group (64±6)％ (P＜0.05),and cell apoptosis rates [(12.4±3.3)％,(14.5±2.7)％ (15.7±2.4)％] compared with that of TNF-α/ActD group (7.1±1.3)％ (P＜0.05).Conclusion Shh pathway is activated in endothelial cells of synovial tissue in active RA.The apoptosis in endothelial cells is promoted after cyclopamine treatment.Shh pathway may play an important role in the antiapoptotic regulatory mechanism of endothelial cells.

Background: Anal fissure is one of the most common anal-rectum diseases, and approximately 10 percent patients with chronic anal fissure ultimately receive surgery. Relieving postoperative pain and protecting functions of the sphincter are central issues for coloproctologists. Objective: To evaluate the efficacy and safety of anoplasty in the treatment of chronic anal fissures. Design, setting, participants and interventions: In this prospective, multicenter, randomized controlled trial, 120 adult patients with chronic anal fissure were referred from Department of Coloproctology of Yueyang Hospital of Integrated Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and Shanghai Municipal Hospital of Traditional Chinese Medicine. The patients were enrolled from January 2009 to April 2010 and randomly divided into study (mucosa advancement flap anoplasty, abbreviated as anoplasty) group and control (fissurectomy) group. The two groups were assessed separately, and the main outcome measures were observed for 2 weeks, with a short-term follow-up for 6 weeks. Main outcome measures: Degree of pain, haemorrhage and anal canal pressure were observed and recorded preoperatively, and on the third day, the fourteenth day and the sixth week postoperatively. The wound healing time was also recorded. Surgical complications of the two groups were recorded and compared on the third day and the sixth week postoperatively. The curative effects associated with the surgery were analyzed on the fourteenth day and the sixth week after surgery and the therapeutic results were evaluated. Results: Three patients were dropped out due to the early discharge from hospital and losing connection (1 in study group and 2 in control group). Overall the surgery showed that the anoplasty group had better results than the fissurectomy group in the curative effect on the sixth week after operation (P<0.05). Time of wound healing in the anoplasty group was (17.22±4.41) d and was better than (21.24±7.44) d of the fissurectomy group (P<0.05). Concerning the relief of wound pain, the anoplasty group achieved better results than the fissurectomy group at the third day, the fourteenth day and the sixth week after operation (P<0.05). Anoplasty reduced bleeding and had better efficacy than the fissurectomy at the third day and the fourteenth day after operation (P<0.05), however, there was no statistical difference at the sixth week after operation (P>0.05). There were no significant differences in relieving the anal canal pressure (P>0.05) and the surgical complications (dysuria, edema of anal margin, fever, infection, anal incontinence and anal deformation) between the two groups (P>0.05). None of the patients suffered postoperative complications by the sixth week after operation. Furthermore, there was no recurrence in either of the two groups at six weeks after operation. Conclusion: The results indicate that anoplasty for chronic anal fissures has advantages such as better therapeutic effects, less postoperative pain, a shorter healing time and no incidence of anal incontinence.

Objective To investigate the diagnostic value of trans-gastric peritoneoscopy with technique of natural orifice transluminal endoscopic surgery(NOTES)for tuberculosis peritonitis.Methods Clinical data of 20 patients with tuberculosis peritonitis diagnosed by trans-gastric peritoneoscopy via NOTES were retrospectively analyzed.Results All diagnoses were confirmed by biopsy.The findings of peritoneoscopy were defined as miliary type with miliary nodes scattered in ascites and on peritoneum,adhesive type with thickening of peritoneum and adhesion between peritoneum and intestines,cheese-like type with parietal peritoneal ulcer and cheese-like substances,and mixed type with 2 or 3 of above mentioned types.Positive findings in other laboratory examinations were hemoglobin decrease in 10(50％)patients,blood sedimentation rate increase in 16(80％),C reactive protein increase in 13(65％),CA125 increase in 18(90％),and positive tuberculin test in 9(45％).Abnormal findings were detected by chest X-ray in 8(40％)patients,by abdominal ultrasonography examination in 2(10％),by abdominal CT in 7(35％),and by colonoscopy in 1(5％).No abnormal results were found in all patients in anti-tuberculosis antibody test,ascites bacteria culture and gastroscopy.Conclusion Trans-gastric peritoneoscopy via NOTES with biopsy is effective for diagnosis of tuberculosis peritonitis.

Objective To investigate the diagnostic value of transgastric peritoneal endoscopy in diagnosis of ascites with unknown origin.Methods Endoscopy was introduced into peritoneal cavity through gastric wall in 23 patients with exudative ascites which was able to be diagnosed by routine methods and biopsy was made through endoscopy to get pathological diagnosis.Results Definite diagnosis was made in 22 patient (95.7%),of which 12 (54.6%) were malignant tumors,8 (36.4%) were tuberculosis peritonitis,1 (4.5%) was spontaneous peritonitis associated with liver cirrhosis and 1 (4.5%) was eosinophilic enteritis.Conclusion Natural orifice transluminal endoscopy combined with biopsy is an effective and accurate procedure for diagnosis of ascites of unknown canses.

Objective To study the level changes of matrix metalloproteinase-9 (MMP-9)and its clinical significance in patients with progressive ischemic stroke(PIS).Methods 136 cases of acute ischemic stroke including 46 cases of PIS and 90 cases of non-PIS,were studied.56 healthy subjects were selected into control group.MMP-9 level was measured by ELISA at 2,7 and 14 day after admission.The neurologic dysfunction score was observed.Results The MMP-9 level was ( 249.43 ± 63.76)μg/L,( 271.50±72.08 )μg/L,and (183.20 ±66.69)μg/L in PIS group,while it was (158.81±49.18 )μg/L,( 188.67±57.96 )μg/L,and ( 93.86 ±22.16)μg/L in non PIS group and was (88.60±15.93 )μg/L in control group at 2,7 and 14 days of admission.The MMP-9 level of PIS group at 2,7 and 14 day and the level in non PIS group at 2 and 7 day were higher than that of control group(P＜0.01 ).The MMP-9 level of PIS group was higher than that of different phrase of PIS group (P＜0.01 ).Linear X2 showed that the increase of MMP-9 level would increase the risk of ischemic stroke progression( X2=38.96,P＜0.01 ).Conclusion The remarkable increase of MMP-9 in patients with progressive ischemic stroke may be the indepent risk factor of the progression of ischemic stroke.