Objective:To explore the effect of Tripterygium glycosides tablets combined with rituximab on the Wnt/β-catenin signaling pathway and nailfold microcirculation in adult patients with nephrotic syndrome (NS).Methods:Eighty adult patients with NS treated in the Affiliated Hospital of Jining Medical College from January 2022 to January 2023 were selected and they were randomly divided into two groups by treatment method, with 40 patients in each group. Both groups were treated with prednisone acetate, while the control group was treated with rituximab. The study group was treated with Tripterygium glycosides tablets based on the control group, and the treatment lasted for 6 months. After treatment for 6 months, the therapeutic effects, Wnt/β-catenin signaling pathway-related mRNA and proteins, nail fold microcirculation index and adverse effects were compared between the two groups.Results:After treatment for 6 months, the total effective rate in the study group was higher than that in the control group : 87.50%(35/40) vs. 67.50%(27/40), there was statistical difference ( χ2 = 4.59, P<0.05). After treatment for 3, 6 months, the levels of Wnt4, β-catenin mRNA and protein were lower than those before treatment, and in the study group were lower than those in the control group :after treatment for 3 months: 4.86 ± 0.55 vs. 6.11 ± 0.70, 5.02 ± 0.68 vs. 5.96 ± 0.74, 3.68 ± 0.61 vs. 4.13 ± 0.66, 3.42 ± 0.55 vs. 4.27 ± 0.59; after treatment for 6 months: 3.12 ± 0.44 vs. 4.59 ± 0.53, 3.05 ± 0.41 vs. 4.11 ± 0.46, 2.00 ± 0.53 vs. 2.86 ± 0.61, 1.24 ± 0.30 vs. 2.67 ± 0.32, there were statistical differences ( P<0.05). After treatment for 3, 6 months, the scores for the flow state and morphology of nailfold microcirculation in the study group were lower than those in the control group: after treatment for 3 months: (1.44 ± 0.26) scores vs. (1.58 ± 0.31) scores, (1.18 ± 0.24) scores vs. (1.49 ± 0.30) scores; after treatment for 6 months: (0.80 ± 0.10) scores vs. (1.38 ± 0.12) scores, (0.97 ± 0.11) scores vs. (1.25 ± 0.12) scores, there were statistical differences ( P<0.05). The incidence of adverse reactions between the two groups had no statistical difference ( P>0.05). Conclusions:The combination of Tripterygium glycosides tablets and rituximab has a definite effect on the treatment of adult NS, which is beneficial for improving nailfold microcirculation. The possible mechanism may be related to the downregulation of the Wnt/β-catenin signaling pathway.

Objective:To explore the effect of Tripterygium glycosides tablets combined with rituximab on the Wnt/β-catenin signaling pathway and nailfold microcirculation in adult patients with nephrotic syndrome (NS).Methods:Eighty adult patients with NS treated in the Affiliated Hospital of Jining Medical College from January 2022 to January 2023 were selected and they were randomly divided into two groups by treatment method, with 40 patients in each group. Both groups were treated with prednisone acetate, while the control group was treated with rituximab. The study group was treated with Tripterygium glycosides tablets based on the control group, and the treatment lasted for 6 months. After treatment for 6 months, the therapeutic effects, Wnt/β-catenin signaling pathway-related mRNA and proteins, nail fold microcirculation index and adverse effects were compared between the two groups.Results:After treatment for 6 months, the total effective rate in the study group was higher than that in the control group : 87.50%(35/40) vs. 67.50%(27/40), there was statistical difference ( χ2 = 4.59, P<0.05). After treatment for 3, 6 months, the levels of Wnt4, β-catenin mRNA and protein were lower than those before treatment, and in the study group were lower than those in the control group :after treatment for 3 months: 4.86 ± 0.55 vs. 6.11 ± 0.70, 5.02 ± 0.68 vs. 5.96 ± 0.74, 3.68 ± 0.61 vs. 4.13 ± 0.66, 3.42 ± 0.55 vs. 4.27 ± 0.59; after treatment for 6 months: 3.12 ± 0.44 vs. 4.59 ± 0.53, 3.05 ± 0.41 vs. 4.11 ± 0.46, 2.00 ± 0.53 vs. 2.86 ± 0.61, 1.24 ± 0.30 vs. 2.67 ± 0.32, there were statistical differences ( P<0.05). After treatment for 3, 6 months, the scores for the flow state and morphology of nailfold microcirculation in the study group were lower than those in the control group: after treatment for 3 months: (1.44 ± 0.26) scores vs. (1.58 ± 0.31) scores, (1.18 ± 0.24) scores vs. (1.49 ± 0.30) scores; after treatment for 6 months: (0.80 ± 0.10) scores vs. (1.38 ± 0.12) scores, (0.97 ± 0.11) scores vs. (1.25 ± 0.12) scores, there were statistical differences ( P<0.05). The incidence of adverse reactions between the two groups had no statistical difference ( P>0.05). Conclusions:The combination of Tripterygium glycosides tablets and rituximab has a definite effect on the treatment of adult NS, which is beneficial for improving nailfold microcirculation. The possible mechanism may be related to the downregulation of the Wnt/β-catenin signaling pathway.

Objective:To analyze the expression levels of urinary interleukin-6 (IL-6), signal transducer and activator of transcription 3 (STAT3) and heparin-binding protein (HBP) in urinary tract infection and its correlation with infection prognosis.Methods:The clinical data of 100 patients with urinary tract infection (urinary tract infection group) from January 2021 to December 2022 in the Affiliated Hospital of Jining Medical College were retrospectively analyzed. Among them, simple urinary tract infection was in 62 cases, and complex urinary tract infection was in 38 cases; after treatment, 25 cases were not cured, and 75 cases were cured. Another 50 healthy examinees were selected as the health control group. The level of urine IL-6 was detected by luminescence assay method, the level of urine STAT3 was detected by enzyme-linked immunosorbent assay method, and the level of urine HBP was detected by fluorescence immunochromatography method. The blood routine was detected by fully automated blood cell analyzer, and the blood cell count was recorded. The levels of serum C-reactive protein (CRP) and procalcitonin (PCT) were detected by radioimmunoassay. The correlation between urine IL-6, STAT3, HBP and blood routine inflammatory response markers was analyzed by Pearson method. The receiver operating characteristic (ROC) curve was used to evaluate the predictive effectiveness of urine IL-6, STAT3, HBP and blood routine inflammatory response markers in infection prognosis.Results:The urine IL-6, STAT3, HBP, and blood CRP, PCT, white blood cell count in urinary tract infection group were significantly higher than those in healthy control group: (33.19 ± 11.02) μg/L vs. (16.84 ± 3.57) μg/L, (66.77 ± 19.58) μg/L vs. (38.69 ± 11.04) μg/L, (151.98 ± 42.00) μg/L vs. (28.55 ± 9.16) μg/L, (12.57 ± 4.19) mg/L vs. (5.23 ± 1.80) mg/L, (0.58 ± 0.19) μg/L vs. (0.22 ± 0.07) μg/L and (9.86 ± 3.20) × 10 9/L vs. (6.44 ± 2.13) ×10 9/L, and there were statistical differences ( P<0.01). The urine IL-6, STAT3, HBP, and blood CRP, PCT, white blood cell count in patients with complex urinary tract infection were significantly higher than those in patients with simple urinary tract infection: (40.25 ± 10.34) μg/L vs. (28.87 ± 8.55) μg/L, (79.50 ± 17.92) μg/L vs. (58.96 ± 13.43) μg/L, (186.51 ± 35.92) μg/L vs. (130.82 ± 39.74) μg/L, (14.09 ± 4.18) mg/L vs. (11.64 ± 3.55) mg/L, (0.64 ± 0.20) μg/L vs. (0.55 ± 0.13) μg/L and (11.27 ± 3.08) × 10 9/L vs. (8.99 ± 2.36) × 10 9/L, and there were statistical differences ( P<0.01). The urine IL-6, STAT3, HBP, and blood CRP, PCT, white blood cell count in patients with untreated urinary tract infection were significantly higher than those in patients with cured urinary tract infection: (42.97 ± 11.51) μg/L vs. (29.93 ± 8.66) μg/L, (86.81 ± 20.35) μg/L vs. (60.09 ± 17.43) μg/L, (264.27 ± 28.76) μg/L vs. (114.55 ± 21.38) μg/L, (19.11 ± 3.28) mg/L vs. (10.39 ± 2.40) mg/L, (0.85 ± 0.14) μg/L vs. (0.49 ± 0.11) μg/L and (12.26 ± 2.77) × 10 9/L vs. (9.06 ± 2.34) ×10 9/L, and there were statistical differences ( P<0.01). Pearson correlation analysis result showed that urine IL-6, STAT3, HBP were positively correlated with blood CRP, PCT, white blood cell count ( P<0.01). The ROC curve analysis result showed that the area under curve (AUC) of urine IL-6, STAT3 and HBP in predicting the infection prognosis in patients with urinary tract infection was greater than that of blood CRP, PCT and white blood cell count; moreover, the AUC and sensitivity of the combined of urine IL-6, STAT3 and HBP in predicting the infection prognosis in patients with urinary tract infection were significantly higher than the combined of blood CRP, PCT and white blood cell count (0.937 vs. 0.898 and 96.00% vs. 76.00%), but with lower specificity (81.33% vs. 98.67%). Conclusions:Urinary tract infections can cause elevated urine IL-6, STAT3 and HBP, and the degree of elevation is related to the types of simple or complicated infection and the infection prognosis. The combined detection of the urine IL-6, STAT3 and HBP is expected to be a method to predict the infection prognosis, and it provides reference information for clinical diagnosis and treatment.

Objective To monitor the constituents and resistant tendency of bacterial pathogens isolated from diarrheal patients in our hospital form 1994 to 2005 to offer the basis for guiding epidemiologic study,vaccination research and clinical treatment. Methods Enteric pathogenic bacteria were cultured and identified to species,group and serotype with biochemical and serologic methods and the susceptibility of bacteria to antimicrobial agents were tested. Results Enteric pathogenic bacteria were isolated predominantly in male patients and mainly in children and youngsters. It reached a peak from July to September every year. Shigella spp.(75.11%) was the most frequendy isolated pathogens and followed by Vibrio spp.(12.7%),Salmonella spp.(6.28%),Aeromonas spp.(4.43%) and Escherichia coli(1.25%).During the period from 1994 to 2005,diarrheal pathogens had a trend of decrease especially Shigella spp.and Salmonella spp.. Of the 6329 isolates of Shigella spp., 75.62% was S. flexneri and S.soanei,S.dysenteriae and S. boydii constituted 23.98%,0.22% and 0.01% respectively.The sensitivity of different species,group or serotype to different antimicrobial agents was not the same.S.flexneri and Aeromonas spp. were highly resistant to most of antibiotics. However, S.sonnei and Vibrio spp.had good susceptibility to antibiotics tested except trimethoprim/sulfamethoxazole and ampicillin. Conclusion There are many species and serotypes of enteric pathogenic bacteria causing infective diarrhea and the distribution changes gradually in Beijing. The resistance rate of enteric pathogenic bacteria to antibiotics is not the same in different species and serotypes.so strict surveillance iS always needed.