ObjectiveTo investigate the effect and mechanism of Shenqi Tangluo pill （SQTLP） on oxidative stress injury of skeletal muscle of type 2 diabetes mellitus （T2DM） mice based on nuclear factor erythroid 2-related factor 2 （Nrf2）/heme oxygenase-1 （HO-1）/NAD（P）H quinone oxidoreductase 1 （NQO1） pathway. MethodA total of 60 7-week-old male db/db mice ［specific pathogen-free （SPF） grade］ were selected and fed for one week for adaption. They were divided into the model control group， SQTLP low-， medium- and high-dose （19， 38， and 76 g·kg^-1） groups and metformin group （0.26 g·kg^-1） by gavage. Each group consisted of 12 mice. Twelve male db/m mice of the same age were selected as the blank group. The intervention was implemented continuously for 8 weeks. Fasting blood glucose （FBG） was detected. Fasting serum insulin （FINS） levels were detected by enzyme-linked immunosorbent assay （ELISA）， and the homeostasis model assessment-insulin resistance （HOMA-IR） index and the homeostasis model assessment-insulin sensitivity index （HOMA-ISI） were calculated. Oral glucose tolerance test （OGTT） and insulin tolerance test （ITT） were conducted. The activities of superoxide dismutase （SOD） and glutathione peroxidase （GSH-Px） and the contents of malondialdehyde （MDA） and reduced nicotinamide adenine dinucleotide phosphate （NADPH） in skeletal muscle tissues were detected by biochemical kits. Hematoxylin-eosin （HE） staining was used to observe the pathological changes in skeletal muscle tissues. The levels of reactive oxygen species （ROS） and 4-hydroxynonenal （4-HNE） in skeletal muscle tissue were detected by immunofluorescence （IF）. The expression levels of Nrf2， HO-1， NQO1 and glutamate-cysteine ligase catalytic subunit （GCLC） proteins in skeletal muscle tissues were detected by Western blot. ResultCompared with those in the blank group， FBG， FINS and HOMA-IR in the model group were significantly increased （P<0.05）， while HOMA-ISI was decreased （P<0.05）. The results of OGTT and ITT showed that blood glucose was significantly increased at all time points （P<0.05）， and glucose tolerance and insulin tolerance were significantly impaired. SOD and GSH-Px activities in skeletal muscle tissues were significantly decreased （P<0.05）， and MDA and NADPH contents were significantly increased （P<0.05）. In skeletal muscle tissues， the arrangement of muscle fibers was loose， the nucleus was disordered， and inflammatory cells were infiltrated. The expression levels of ROS and 4-HNE in skeletal muscle tissues were significantly increased （P<0.05）. The protein expression levels of Nrf2， HO-1， NQO1 and GCLC in skeletal muscle tissues were significantly decreased （P<0.05）. Compared with those in the model group， FBG， FINS and HOMA-IR in the metformin group were significantly decreased （P<0.05）， while HOMA-ISI was increased （P<0.05）. The results of OGTT and ITT showed that blood glucose in the metformin group was significantly decreased at all time points （P<0.05）. The activities of SOD and GSH-Px in skeletal muscle tissues were significantly increased （P<0.05）， while the contents of MDA and NADPH were significantly decreased （P<0.05）. No obvious abnormality was found in the skeletal muscle tissue of the metformin group. The expressions of ROS and 4-HNE in skeletal muscle tissues were decreased （P<0.05）. The protein expression levels of Nrf2， HO-1， NQO1 and GCLC in skeletal muscle tissues were significantly increased （P<0.05）. Compared with those in the model group， FBG， FINS and HOMA-IR in the SQTLP medium- and high-dose groups were significantly decreased （P<0.05）， while HOMA-ISI was increased （P<0.05）. The results of OGTT and ITT showed that the glucose tolerance and insulin tolerance of mice were improved in each dose group of SQTLP. The GSH-Px activity in the SQTLP low-dose group was significantly increased （P<0.05）， and the NADPH content was decreased （P<0.05）. The activities of SOD and GSH-Px in the SQTLP medium- and high-dose groups were significantly increased （P<0.05）， while the contents of MDA and NADPH were significantly decreased （P<0.05）. The skeletal muscle tissue injury of mice in each dose group of SQTLP was ameliorated to different degrees. In the SQTLP medium- and high-dose groups， the expressions of ROS and 4-HNE were decreased （P<0.05）， and the protein expression levels of Nrf2， HO-1， NQO1 and GCLC were significantly increased （P<0.05）. Compared with those in the SQTLP low-dose group， FBG and HOMA-IR in the SQTLP high-dose group were significantly decreased （P<0.05）， while HOMA-ISI was increased （P<0.05）. The results of OGTT and ITT showed that the SQTLP high-dose group significantly improved the glucose tolerance and insulin tolerance of mice. The activities of SOD and GSH-Px in skeletal muscle tissues were significantly increased （P<0.05）， while the contents of MDA and NADPH were significantly decreased （P<0.05）. No obvious abnormality was found in the skeletal muscle tissue， the expressions of ROS and 4-HNE were decreased （P<0.05）， and the protein expression levels of Nrf2， HO-1， NQO1 and GCLC were significantly increased （P<0.05） in the skeletal muscle tissue of the SQTLP high-dose group. ConclusionSQTLP can significantly improve IR in T2DM mice， and the mechanism is related to SQTLP activating the Nrf2/HO-1/NQO1 signaling pathway， promoting the expression of antioxidant enzymes， and thus improving the oxidative stress injury in the skeletal muscle.

ObjectiveTo explore the protective effects of Dahuang Tangluo pills on early diabetic kidkdey disease （DKD） in db/db mice. MethodEight db/m mice were selected as the control group. Forty male db/db mice were selected and blood samples were collected via tail vein to measure fasting blood glucose （FBG）. Mice with FBG ≥ 16.7 mmol·L^-1， increased urine output， and persistent albuminuria were considered successful in model establishment. After successful modeling， they were randomly divided into a model group， a dapagliflozin group （1.5 mg·kg^-1·d^-1）， and high， medium， and low dose groups of Dahuang Tangluo pills （3.6， 1.8， 0.9 g·kg^-1·d^-1， respectively）， with eight mice in each group. All medication groups were administered orally， while the control and model groups were given an equal amount of distilled water by gavage daily. After continuous administration for 10 weeks， the survival status of the mice was observed， and their body weight， FBG， and kidney function-related indicators were measured. Inflammatory indicators in renal tissues were determined by enzyme-linked immunosorbent assay （ELISA）. Hematoxylin-eosin （HE） staining， Masson staining， and electron microscopy were used to observe the pathological changes in renal tissues in each group. Immunofluorescence was employed to examine the expression of advanced glycation end products （AGEs） and receptors for advanced glycation end products （RAGE） proteins. Real-time quantitative polymerase chain reaction （Real-time PCR） and Western blot were utilized to detect the gene and protein expression levels of AGEs， RAGE， inhibitor of nuclear factor-κB （NF-κB） kinase （IKK）， and NF-κB in the renal tissues of mice in each group. ResultCompared with control group， the model group showed a significant increase in body weight， FBG， serum creatinine （SCr）， urinary microalbumin/urine creatinine ratio （ACR）， total cholesterol （TC）， and triglycerides （TG） （P<0.05）. The levels of intercellular adhesion molecule-1 （ICAM-1）， interleukin-6 （IL-6）， and tumor necrosis factor-alpha （TNF-α） in renal tissues were significantly elevated （P<0.05）. Renal histopathological staining and electron microscopy revealed loose arrangement， gaps， structural disarray， mesangial proliferation， and significant fibrosis in renal tissues. Real-time PCR results showed a significant increase in the expression of RAGE， IKK， and NF-κB genes in renal tissues （P<0.05）. Immunofluorescence results demonstrated a significant increase in the expression of AGEs and RAGE proteins in renal tissues （P<0.05）. Western blot results showed a significant increase in the expression of AGEs， RAGE， IKK， and NF-κB proteins in renal tissues （P<0.05）. After drug intervention， compared with model group， the dapagliflozin group and the high-dose Dahuang Tangluo pills group showed significant reductions in body weight， FBG， SCr， and ACR （P<0.05）， and a significant decrease in TC in mouse serum （P<0.05）， while the high-dose Dahuang Tangluo pills group showed a significant decrease in TG in mouse serum （P<0.05）. All treatment groups showed a significant reduction in ICAM-1， IL-6， and TNF-α in renal tissues （P<0.05）. Renal histopathological staining and electron microscopy showed improved kidney injury， decreased collagen fiber deposition， and reduced mesangial proliferation in all treatment groups. Real-time PCR results showed a significant decrease in the expression of RAGE， IKK， and NF-κB genes in the dapagliflozin group and the high- and medium-dose Dahuang Tangluo pills groups （P<0.05）. Immunofluorescence results demonstrated a significant decrease in the expression of AGEs and RAGE proteins in the dapagliflozin group and the high- and medium-dose Dahuang Tangluo pills groups （P<0.05）. Western blot results showed a significant decrease in the expression of AGEs， RAGE， IKK， and NF-κB proteins in the dapagliflozin group and the high- and medium-dose Dahuang Tangluo pills groups （P<0.05）. ConclusionDahuang Tangluo pills can improve the pathological structure of the kidneys and reduce renal inflammation in DKD mice， possibly through inhibiting the AGEs/RAGE/IKK/NF-κB pathway.

Objective:To investigate the coverage of qualified iodized salt in catering service units where residents ate out in Shanxi Province, so as to provide a basis for taking targeted preventive measures timely and adjusting of intervention strategies scientifically, and to consolidate the achievements of eliminating iodine deficiency disorders (IDD) continuously.Methods:One prefecture level city from each of the five directions of east, west, south, north and middle in Shanxi Province in 2021 was selected. One mountainous county and one plain county were selected in each city. Each of the counties was divided into five sampled regions along five different geographic directions: east, west, south, north and middle. From each region, one town/street was selected randomly and then two canteens of enterprises and institutions (canteens), five medium-sized restaurants and five small restaurants were selected from each town/street. We investigated the basic information of catering service units, collected salt samples and then detected the iodine content of these salt samples. In addition, salt iodine testing data of county residents corresponding to catering service units in the 2021 iodine deficiency disorders monitoring were collected from the Shanxi Institute of Endemic Disease Prevention and Treatment, and compared with the survey results of catering service units.Results:A total of 660 salt samples were detected, the median value of salt iodine was 27.65 mg/kg, the coverage rate of iodized salt was 99.39%(656/660), and the coverage rate of qualified iodized salt was 90.76% (599/660). The median value of salt iodine was 26.70, 28.00 and 27.60 mg/kg in canteens, medium-sized restaurants and small restaurants, respectively, and the coverage rate of qualified iodized salt was 95.54% (107/112), 90.42% (236/261), and 89.20% (256/287), respectively. There was no significant difference in the coverage rate of qualified iodized salt among different types of catering service units (χ 2 = 3.92, P = 0.141). The median value of salt iodine was 28.00 and 27.20 mg/kg in mountainous counties and plain counties, respectively, and the coverage rate of qualified iodized salt was 88.67% (266/300) and 92.50% (333/360), respectively. There was no significant difference in the coverage rate of qualified iodized salt among the counties of different geographical types (χ 2 = 2.87, P = 0.090). The median value of salt iodine in catering service units and households was 27.65 and 23.50 mg/kg, respectively, and the coverage rate of qualified iodized salt was 90.76% and 95.91%, respectively. There was a statistically significant difference in the coverage rate of qualified iodized salt between catering service units and households (χ 2 = 31.19, P < 0.001). Conclusions:The coverage rate of qualified iodized salt in catering service units in Shanxi Province generally meets the national elimination standard (> 90%), but there are still some counties that do not meet the standard. The coverage rate of qualified iodized salt in small and medium-sized restaurants is also not optimistic. It is recommended to strengthen monitoring and supervision of edible salt in catering service units in the future.

Objective:To investigate the current situation of water-borne high iodine hazards in Shanxi Province and the implementation of prevention and control measures, providing a scientific basis for prevention and control of the high iodine hazards in the future.Methods:In 2020, a survey was conducted on iodine content of drinking water and water improvement situation in all high iodine administrative villages in 12 water-borne high iodine counties of 4 cities in Shanxi Province. In each monitoring county, five administrative villages were selected as monitoring villages using a systematic sampling method, sorted by the iodine content of the water in the administrative villages. Forty non-boarding students aged 8 - 10 from one primary school and 20 pregnant women were selected from each monitoring village. Household edible salt samples and one random urine sample were collected for salt iodine and urinary iodine content test. B-ultrasound method was used for thyroid examination in children.Results:A total of 297 high iodine administrative villages were surveyed on the drinking water situation of residents, including 268 villages with improved water and 29 villages without improved water, with a water improvement rate of 90.24%. The range of water iodine was 0.33 - 803.75 μg/L, and there were 159 villages with water iodine content > 100 μg/L. A total of 1 926 samples of household edible salt were tested, and the rate of non iodized salt was 62.20% (1 198/1 926); 1 704 urine samples from children and 222 urine samples from pregnant women were tested, with median urinary iodine contents of 426.2 and 318.9 μg/L, respectively. The 1 690 cases of thyroid gland in children were examined, with a goiter rate of 3.91% (66/1 690) and a nodule detection rate of 13.67% (231/1 690).Conclusions:Children's iodine nutrition in water-borne high iodine areas of Shanxi Province is at an iodine excess level, while pregnant women's iodine nutrition is at an iodine excess level. Efforts should be made to increase the popularization of non iodized salt and improve water quality to reduce iodine in areas with high iodine levels, in order to control the harm of high iodine in water sources as soon as possible.

Objective To evaluate the dietary quality of De'ang nationality residents over 18 years old in Yunnan Provinceusing the new adjusted Diet Balance Index (DBI_16), and to provide scientific basis for improving the nutritional status of De'ang residents and formulating health promotion strategies. Methods A food-frequency questionnaire was used to investigate the diet of De'ang residents, and the new adjusted dietary balance index (DBI_16) was used to evaluate the dietary quality. Results The dietary quality of De'ang nationality residents over 18 years old in Yunnan Province was in a moderately imbalanced state (DQD=42), and the main problem was insufficient dietary intake (LBS = 26). The dietary imbalance among men, 65-79 years old and low-income people was serious. The intake of milk, vegetables, fruits and aquatic products was the most insufficient and people who met the recommended intake levels of these foods were 2%, 34.7%, 31.8%, and 36%, respectively. Meanwhile, there existed the problem of excessive intakes among people studied in the present investigation. Pople who consumed more than recommended amount of Cereal food, livestock and poultry meat, and edible oil accounted for 76.9%, 60.4% and 63.5%, respectively. Conclusion The dietary structure of De'ang residents over 18 years old in Yunnan Province is unreasonable. The problems of both insufficient and excessive dietary intakes exist. Education on balance diet should be conducted to improve nutrition and health status of De'ang nationality residents.

The current document is based on a consensus reached by a panel of experts from the Chinese Society of Allergy and the Chinese Society of Otorhinolaryngology-Head and Neck Surgery, Rhinology Group. Chronic rhinosinusitis (CRS) affects approximately 8% of Chinese adults. The inflammatory and remodeling mechanisms of CRS in the Chinese population differ from those observed in the populations of European descent. Recently, precision medicine has been used to treat inflammation by targeting key biomarkers that are involved in the process. However, there are no CRS guidelines or a consensus available from China that can be shared with the international academia. The guidelines presented in this paper cover the epidemiology, economic burden, genetics and epigenetics, mechanisms, phenotypes and endotypes, diagnosis and differential diagnosis, management, and the current status of CRS in China. These guidelines—with a focus on China—will improve the abilities of clinical and medical staff during the treatment of CRS. Additionally, they will help international agencies in improving the verification of CRS endotypes, mapping of eosinophilic shifts, the identification of suitable biomarkers for endotyping, and predicting responses to therapies. In conclusion, these guidelines will help select therapies, such as pharmacotherapy, surgical approaches and innovative biotherapeutics, which are tailored to each of the individual CRS endotypes.
Adult ; Asian Continental Ancestry Group ; Biomarkers ; China ; Consensus ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Eosinophils ; Epidemiology ; Epigenomics ; Genetics ; Humans ; Hypersensitivity ; Inflammation ; International Agencies ; Medical Staff ; Neck ; Phenotype ; Precision Medicine

During the epidemic of coronavirus disease 2019 (COVID-19), the infection of the elderly population will bring great challenges to clinical diagnosis and treatment, outcome and management.Combined with the characteristics of anesthesia and the pathophysiological characteristics of COVID-19 on lung function impairment in elderly patients, Chinese Society of Anesthesiology formulated the " Recommendations for anesthesia management and infection control in elderly patients with COVID-19″. This recommendation expounds preoperative visit and infection control, anesthesia management protocol, anesthesia monitoring, anesthesia induction/endotracheal intubation, anesthesia maintenance and infection control, intraoperative lung protection strategy, anti-stress and anti-inflammatory management, hemodynamic optimization, infection control during emergence from anesthesia, and postoperative analgesia in elderly patients with COVID-19, and provides the reference for the safe and effective implementation of anesthesia management in elderly patients during the prevention and control of COVID-19 epidemic.

Objective:To investigate the status and influencing factors of quality of nursing work life in a class Ⅲ hospital in Jinan.Methods:From 1st december 2018 to 31th March 2019, 658 nurses were selected from a class Ⅲ hospital in Jinan of Shandong province by convenience sampling method. 700 questionnaires were gived out and recoveried, with 658 effective questionaires and the effective recovery rate was 94.0%. The data of nursing work life quality, type of workplace violence, frequency of workplace violence and general social demographic were collected.Results:The mean total score of the quality of nursing work life was (174.61±27.61) . The lowest subscale is work life-home life (61.9%) . There were no statistical difference in the total scores of nurses with different ages and working years ( P> 0.05) , while the frequency of night shift, and working hours per day had significant impact on the quality of nursing work life ( P< 0.05) . The total score of nurses who were not suffered from workplace violence was much higher than the nurses who were suffered from language violence or physical assault ( P<0.05) , the higher the frequency of the violence, the score of the quality of nursing work life was lower ( P<0.05) . Conclusion:The quality of nursing work life of nureses who suffer from workplace violence is in a bad situation, nursing managers should give different intervention measures according to the personal characteristics of nurses to improve the quality of nursing work life.

Objective:To investigate the status and influencing factors of quality of nursing work life in a class Ⅲ hospital in Jinan.Methods:From 1st december 2018 to 31th March 2019, 658 nurses were selected from a class Ⅲ hospital in Jinan of Shandong province by convenience sampling method. 700 questionnaires were gived out and recoveried, with 658 effective questionaires and the effective recovery rate was 94.0%. The data of nursing work life quality, type of workplace violence, frequency of workplace violence and general social demographic were collected.Results:The mean total score of the quality of nursing work life was (174.61±27.61) . The lowest subscale is work life-home life (61.9%) . There were no statistical difference in the total scores of nurses with different ages and working years ( P> 0.05) , while the frequency of night shift, and working hours per day had significant impact on the quality of nursing work life ( P< 0.05) . The total score of nurses who were not suffered from workplace violence was much higher than the nurses who were suffered from language violence or physical assault ( P<0.05) , the higher the frequency of the violence, the score of the quality of nursing work life was lower ( P<0.05) . Conclusion:The quality of nursing work life of nureses who suffer from workplace violence is in a bad situation, nursing managers should give different intervention measures according to the personal characteristics of nurses to improve the quality of nursing work life.

Objective: To evaluate the expression of immunological and inflammatory biomarkers as well as to analyze their predictive value for recurrence of chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: Seventy-seven CRSwNP patients were enrolled in this survey from January 2011 to December 2012 in Beijing Tongren Hospital. There were 13 males and 64 females, with the range of age from 14 to 74 years old. The average follow-up period was more than 2 years. The demographic and clinical features of patients were compared between recurrence and non-recurrence groups, and 43 kinds of cytokines, chemokines and inflammatory mediators, tissue and serum total IgE, and morphological and cytology indexes were compared between the two groups. The receiver operating characteristic (ROC) curves were used to evaluate the predictive value of significant indicators for the postoperative recurrence of CRSwNP and to calculate the best diagnostic cut-off values. Results: The recurrence rate of CRSwNP was 44.2% (34/77). Compared with non-recurrence CRSwNP, there were higher risk of aspirin intolerance and asthma in the recurrence group, as well as higher CT and endoscopic polyp scores and lower olfactory sense (7/34 vs 0/43, 10/34 vs 4/43, 18.5[3.0, 24.0] vs 13.8[2.0, 24.0], 2.1[0.5, 3.0] vs 1.5[0.5, 3.0], 5.0[4.5, 5.0] vs 3.0[1.0, 5.0], χ² value was 9.738, 5.161, Z value was -3.267, -2.705, -3.213, respectively, all P<0.05). At the same time, the level of interleukin-5 (IL-5), eosinophilic cationic protein / myeloperoxidase (ECP/MPO), tissue inhibitor of metalloproteinase 1 (TIMP1), chemokine (C-C motif) ligand 2 (CCL2), CCL3, CCL4 and tissue and serum total IgE were higher in the recurrence group than those of the non-recurrence. Moreover, the oedema of the lamina propria were more severe. The total IgE, IL-5, ECP/MPO and CCL4 in the tissue had a acceptable discrimination value for the prediction of CRSwNP recurrence. The best diagnostic cut-off values and corresponding sensitivity and specificity were 124.85 pg/ml (82.4%, 60.5%), 6.22 pg/ml (76.5%, 58.1%), 0.61 (55.9%, 83.7%) and 2 456.96 pg/ml (61.8%, 79.1%), respectively. Conclusions The profile of the immunological and inflammatory biomarkers was different between the non-recurrence CRSwNP and recurrence CRSwNP groups. And a variety of biomarkers can be considered as indicators of recurrence of CRSwNP with acceptable predictive value.