Objective To analyze the status quo and identification efficiency of metabolic-associated fatty liver disease (MAFLD) in patients with chronic hepatitis C (CHC). Methods A total of 407 patients with CHC who were admitted to the hospital between January 2022 and January 2025 were collected as study subjects. According to whether MAFLD was newly diagnosed during the study period, all enrolled patients were classified into two groups, including MAFLD group (CHC with MAFLD, n=143) and CHC group (CHC, n=264). The general data [gender, age, place of residence, body mass index (BMI), systolic blood pressure, diastolic blood pressure, course of chronic hepatitis C (CHC), history of diabetes mellitus], liver function indicators [alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyl transferase (GGT)], glucose metabolism indicators [fasting blood glucose (FBG), fasting insulin (FINS), hemoglobin A1c (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR)], lipid metabolism indicators [total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C)], serum specific protein markers {serum 25-hydroxyvitamin D [25(OH)D], adipocyte fatty acid binding protein (A-FABP), retinol binding protein 4 (RBP4), sterol regulatory element binding protein-1c (SREBP-1c)}were compared between both groups. Binary logistic regression analysis was performed for multivariate regression analysis. ROC curve was utilized to evaluate the identification value. Results The levels of ALT, AST, ALP, GGT, FBG, FINS, HbA1c, TC, TG, LDL-C, A-FABP, RBP4 and SREBP-1c in the MAFLD group were higher than those in the CHC group (P<0.05) while the levels of HDL-C and 25(OH)D were lower compared to the CHC group (P<0.05). Multivariate logistic regression analysis results suggested that TG, 25(OH)D, RBP4, HbA1c and HOMA-IR were independent related factors influencing MAFLD occurrence (P<0.05). ROC curve analysis results revealed that the identification efficiency of combined prediction (AUC=0.854, 95% CI : 0.812-0.887)was better than that of TG (AUC=0.653, 95% CI: 0.607-0.720), 25(OH)D (AUC=0.685, 95% CI: 0.607-0.715), RBP4 (AUC=0.649, 95%CI: 0.633-0.741), HbA1c (AUC=0.718, 95% CI: 0.657-0.755) or HOMA-IR (AUC=0.726, 95% CI: 0.654-0.757), and combined prediction had the best identification efficiency (P<0.05). Conclusion CHC patients with MAFLD have significant metabolic disorders and changes in specific protein markers. TG, 25(OH)D, RBP4, HbA1c and HOMA-IR are independent related factors, and combined prediction model of multiple indicators exhibits good identification efficiency.

Objective:To investigate the changes of serum complement C1q/tumor necrosis factor-associated protein 3 (CTRP3) in patients with rheumatoid arthritis (RA) and its clinical significance.Methods:A total of 60 RA patients admitted to Chongming Hospital affiliated to Shanghai University of Medicine & Health Sciences (Chongming Branch of Xinhua Hospital) from January 2023 to February 2024 were collected.They were divided into a plaque group (38 cases) and a plaque free group (22 cases) according to the results of carotid intima-media thickness (cIMT) by carotid artery ultrasonography. ESR, CRP, blood lipid, HOMA-IR, RF, CCP antibody and CTRP3 levels were detected, and the relationship between CTRP3 levels and disease activity and atherosclerosis in RA patients was analyzed. The statistical analysis was carried out with independent t-test, analysis of variance, Pearson correlation analysis and logistic regression. Results:Serum CTRP3 level in RA patients was lower than that in healthy control group [(116±44)ng/ml and (184±63)ng/ml, t=-6.54, P=0.004]. The CTRP3 level in RA group with plaque was lower than that in RA group without plaque [(98±28) ng/ml and (123±38)ng/ml, t=-5.57, P=0.008]. Serum CTRP3 levels in RA patients were correlated with LDL-C ( r=-0.68, P=0.011), HOMA-IR ( r=-0.74, P=0.001), RF ( r=-0.46, P=0.042), anti-CCP antibody( r=-0.54, P=0.037), DAS28 ( r=-0.66, P=0.024) were negatively correlated with cIMT ( r=-0.76, P=0.001), and positively correlated with DMARDs duration ( r=0.51, P=0.040) and flow-mediated di latatiton ( r=0.70, P=0.004). The CTRP3 level [( OR(95% CI)=0.683(0.355, 0.807), P=0.023] was an independent correlation factor affecting cIMT. Conclusion:CTRP3 level in RA patients is significantly lower than that in healthy control group, and is negatively correlated with insulin resistance, autoantibody level and disease activity, and has a protective effect on early atherosclerosis in RA patients.

Objective:To investigate the changes of serum complement C1q/tumor necrosis factor-associated protein 3 (CTRP3) in patients with rheumatoid arthritis (RA) and its clinical significance.Methods:A total of 60 RA patients admitted to Chongming Hospital affiliated to Shanghai University of Medicine & Health Sciences (Chongming Branch of Xinhua Hospital) from January 2023 to February 2024 were collected.They were divided into a plaque group (38 cases) and a plaque free group (22 cases) according to the results of carotid intima-media thickness (cIMT) by carotid artery ultrasonography. ESR, CRP, blood lipid, HOMA-IR, RF, CCP antibody and CTRP3 levels were detected, and the relationship between CTRP3 levels and disease activity and atherosclerosis in RA patients was analyzed. The statistical analysis was carried out with independent t-test, analysis of variance, Pearson correlation analysis and logistic regression. Results:Serum CTRP3 level in RA patients was lower than that in healthy control group [(116±44)ng/ml and (184±63)ng/ml, t=-6.54, P=0.004]. The CTRP3 level in RA group with plaque was lower than that in RA group without plaque [(98±28) ng/ml and (123±38)ng/ml, t=-5.57, P=0.008]. Serum CTRP3 levels in RA patients were correlated with LDL-C ( r=-0.68, P=0.011), HOMA-IR ( r=-0.74, P=0.001), RF ( r=-0.46, P=0.042), anti-CCP antibody( r=-0.54, P=0.037), DAS28 ( r=-0.66, P=0.024) were negatively correlated with cIMT ( r=-0.76, P=0.001), and positively correlated with DMARDs duration ( r=0.51, P=0.040) and flow-mediated di latatiton ( r=0.70, P=0.004). The CTRP3 level [( OR(95% CI)=0.683(0.355, 0.807), P=0.023] was an independent correlation factor affecting cIMT. Conclusion:CTRP3 level in RA patients is significantly lower than that in healthy control group, and is negatively correlated with insulin resistance, autoantibody level and disease activity, and has a protective effect on early atherosclerosis in RA patients.

Objective To explore the impact of the connect,introduce,communicate,ask,respond,exit(CICARE)communication model combined with feedback health education model on the compliance and anxiety level of elderly outpatients before colonoscopy.Methods A total of 346 patients aged ≥60 who visited the Outpatient Department,the Second Hospital of Jiaxing City for the first time and underwent colonoscopy from September to December 2023 were randomly divided into control group(n=86),communication group(n=84),feedback group(n=86),and combined group(n=90)using random number table method.The control group were provided routine education to patients undergoing colonoscopy through watching colon preparation videos,verbal education,and written propaganda educational materials;The communication group were implemented health education for colonoscopy by using the CICARE communication model;The feedback group were implemented health education for colonoscopy by using feedback method;The combined group were implemented the above education to patients by using the CICARE communication model combined with feedback method.The compliance with colon preparation,intestinal cleanliness,and patient anxiety scores before colonoscopy were evaluated and compared among the four groups.Results There were no statistically significant differences in dietary compliance and medication compliance among the four groups(P＞0.05),but there was a statistically significant difference in exercise compliance(P＜0.05).Different educational methods had statistical significance on patients'intestinal cleanliness and anxiety scores(P＜0.001),and further post hoc comparisons showed that the education method of the combined group could improve the overall intestinal cleanliness score and reduce patient anxiety score.Conclusion The health education model of the CICARE communication method combined with feedback has a significant effect on health education for elderly patients,which can improve the compliance with colon preparation and reduce patient anxiety scores.

Objective: To investigate the prevalence and influencing factors of comorbidity of chronic diseases among hypertensive patients with uncontrolled blood pressure in Huzhou City, so as to provide insights into community hypertension control. Methods: Hypertensive patients with uncontrolled blood pressure at ages of 35 to 74 years were sampled using a cluster random sampling method from 5 districts (counties) of Huzhou City. Participants' demographics, living behaviors, and development of chronic diseases were collected using questionnaires, and the height, body weight, waist circumference and blood pressure were measured. Blood glucose, blood lipid and other biochemical parameters were detected, and the number and combination of comorbidity of chronic diseases were descriptively analyzed. Factors affecting the comorbidity of chronic diseases were identified using a multivariable ordinal logistic regression model. Results: A total of 1 215 respondents were included, with a mean age of (60.83±7.76) years, and including 652 men (53.66%) and 563 women (46.34%). The prevalence of dyslipidemia, diabetes, hyperuricemia and cardiac encephalopathy was 45.10%, 30.95%, 23.05% and 5.10%, respectively. The prevalence of comorbidity of chronic diseases was 69.22% among respondents, and there were 497 respondents with one comorbidity (40.91%), 272 with two comorbidities (22.39%) and 72 with three and more comorbidities (5.93%). Hypertension+dyslipidemia (20.74%), hypertension+diabetes+dyslipidemia (9.96%) and hypertension+diabetes+dyslipidemia+hyperuricemia (4.36%) were predominant comorbid combinations. Multivariable ordinal logistic regression analysis showed that participants with overweight (OR=1.782, 95%CI: 1.390-2.286), obesity (OR=2.411, 95%CI: 1.802-3.222), grade 2 hypertension (OR=1.438, 95%CI: 1.077-1.919) had a higher risk of multiple comorbidities than those with normal body mass index and controlled blood pressure, and women (OR=0.563, 95%CI: 0.456-0.696) had a lower risk of multiple comorbidities than men. Conclusions The prevalence of comorbidity of chronic diseases was 69.22% among community hypertensive patients with uncontrolled blood pressure in Huzhou City, and the comorbidity of chronic diseases mainly included dyslipidemia and diabetes. Men, overweight, obesity and hypertension resulted in a high risk of comorbidity of chronic diseases.

ObjectiveTo explore the mechanism of Gancao Fuzitang （GCFZ）in inhibiting the bone destruction of collagen-induced arthritis （CIA） model in mice. MethodThirty male DBa/1J mice were randomly divided into normal group， CIA group， low-dose GCFZ group （GCFZ-L， 2.4 g·kg^-1）， high-dose GCFZ group （GCFZ-H， 4.8 g·kg^-1）， and methotrexate group （MTX， 1 mg·kg^-1）， with six mice in each group. The CIA model was induced by secondary immunization method. The arthritis index of mice in each group was observed and recorded， and the histopathological changes in ankle joint were observed by hematoxylin-eosin （HE） staining. The damage to ankle cartilage was detected by safranin O-fast green staining. Micro-CT scanning was used to detect the bone destruction of ankle joint， and the expression of nuclear factor-κB p65 （NF-κB p65）， p-NF-κB p65， inhibitory-κB kinase α/β （IKKα/β）， and p-IKKα/β was observed by immunohistochemical staining. ResultCompared with the normal group， the CIA group showed manifest joint swelling and increased arthritis index score （P<0.01）. Compared with the CIA group， the groups with drug intervention could inhibit joint swelling and reduce arthritis index score （P<0.05， P<0.01）. As revealed by HE staining and safranine O-green staining， compared with the CIA group， the groups with drug intervention could inhibit synovial invasion and reduce the destruction of articular cartilage. Micro-CT scanning analysis showed that compared with the CIA group， the GCFZ-H group and the MTX group showed reduced bone destruction scores （P<0.01）. The immunohistochemical results showed that compared with the normal group， the CIA group showed increased optical density values of NF-κB p65， p-NF-κB p65， IKKα/β， and p-IKKα/β（P<0.01）. Compared with the CIA group， the GCFZ-H group and the MTX group showed reduced optical density values of NF-κB p65， p-NF-κB p65， IKKα/β， and p-IKKα/β（P<0.05，P<0.01）. In the GCFZ-L group， only the NF-κB p65 optical density value decreased（P<0.01）. ConclusionGCFZ may inhibit bone destruction in CIA mice by regulating the NF-κB signaling pathway.

Objective: To explore the anesthetic effect of low dose remifentanil in patients undergoing sequential painless gastroscopy and painless colonoscopy in accordance with intravenous induction of propofol. Methods: From July 2017 to January 2018, 86 patients who needed painless gastroscopy and painless colonoscopy in sequence were selected as observation objects in the Second Hospital of Jiaxing and were divided into control group and observation group according to random number table method, with 43 cases in each group.The control group was anesthetized with propofol only, while the observation group was anesthetized with low dose remifentanil in accordance with propofol.The occurrence of adverse reactions and recovery were compared between the two groups. Results: The incidence rate of adverse reactions of the control group was 20.93%(9/43), which of the observation group was 13.95%(6/43), there was no statistically significant difference between the two groups (χ²=0.272, P=394). The recovery time and the observation time after awakening in the observation group were (7.19±1.98)min and (6.94±2.04)min, respectively, which were significantly shorter than those in the control group [(10.33±2.42)min and (11.69±3.21)min], the differences were statistically significant (t=6.585, 8.190, P=0.000, 0.000). Conclusion Intravenous induction with low dose remifentanil combined with propofol in patients undergoing painless gastroscopy and painless colonoscopy in sequence has less adverse reactions, good anesthesia persistence and short recovery time, which is worthy of clinical popularization.

Objective To understand the dominant pathogens of febrile respiratory syndrome (FRS) patients in Gansu province and to establish the Bayes discriminant function in order to identify the patients infected with the dominant pathogens.Methods FRS patients were collected in various sentinel hospitals of Gansu province from 2009 to 2015 and the dominant pathogens were determined by describing the composition of pathogenic profile.Significant clinical variables were selected by stepwise discriminant analysis to establish the Bayes discriminant function.Results In the detection of pathogens for FRS,both influenza virus and rhinovirus showed higher positive rates than those caused by other viruses (13.79％,8.63％),that accounting for 54.38％,13.73％ of total viral positive patients.Most frequently detected bacteria would include Streptococcus pneumoniae,and haemophilus influenza (44.41％,18.07％) that accounting for 66.21％ and 24.55％ among the bacterial positive patients.The original-validated rate of discriminant function,established by 11 clinical variables,was 73.1％,with the cross-validated rate as 70.6％.Conclusion Influenza virus,Rhinovirus,Streptococcus pneumoniae and Haemophilus influenzae were the dominant pathogens of FRS in Gansu province.Results from the Bayes discriminant analysis showed both higher accuracy in the classification of dominant pathogens,and applicative value for FRS.

Objective:To investigate the clinical effect of bridging fixation with locking plate for the Seinsheimer type V subtrochanteric femoral fracture. Methods:From March 2009 to September 2014,18 cases of Seinsheimer type V sub-trochanteric femoral fracture were treated by open reduction and bridging fixation with locking plate through proximal and distal approach including 16 males and 2 females with an average age of 41 years old ranging from 22 to 67 years old. Among them , 12 cases caused by traffic accident,5 cases by falling,1 case by heavy aboving. All cases were fresh and closed fractures. Time between injury and operation was from 4 to 9 days with an average of 6.2 days. Of them ,11 cases were fixed with reverse LISS and the other 7 cases were fixed with anatomical locking plates of proximal femur. Results:The mean time of operation was 110 min (ranged from 90 to 155 min). The mean blood loss during operation was 425 ml (ranged from 350 to 650 ml) and 16 cases got blood transfusion which was meanly 300 ml. The mean hospital time was 14 days (ranged from 12 to 18 days). The mean duration of followed up was 11.8 months (ranged from 8 to 22 months). The mean time of bone union was 6.6 months (ranged from 5 to 8 months). There was not any complication such as infection,implant failure,hip varus,external rotation deformity of low limb or fat embolism. The Sanders hip scores were 53.22±6.48,the result was excellent in 12 cases and good in 6 cases at the last follow up. Conclusion:Under the principle of biological osteosynthesis ,treatment of Seinsheimer type V sub-trochanteric femoral fracture with bridging locking plate fixation has such advantages as high mechanism ,less interference of blood supply,stable fixation and little complication. It is a safe and idea way for the treatment of the Seinsheimer type V sub-trochanteric femoral fracture.

To reveal the effects of harvesting stage on the functional constituents of four kinds of Hangbaiju and determine the best harvesting stage. Sixteen samples of Hualei, Taiju, Youju, Quanju were collected from Zhejiang Tongxiang. The content of total flavonoids were determined by UV spectrophotometry. Chlorogenic acid, lutelin-7-O-beta-D-glucoside and 3,5-O-discaffeoylquinc acid were analyzed by HPLC. The results showed that the effect of harvesting stage on the functional constituents of four kinds of Hangbaiju was significant. The contents of total flavonoids and chlorogenic acid reached maximum at the Hualei stage, and next was Taiju. The highest content of lutelin-7-O-beta-D-glucoside and 3,5-O-discaffeoylquinc acid was found in samples of Taiju. The yield of the four kinds of Hangbaiju increased obviously as the collection time deferred. Considering the functional constituents, yield and harvesting stage, the stage of Taiju is the best harvesting time.
Chlorogenic Acid ; analysis ; metabolism ; Chromatography, High Pressure Liquid ; Chrysanthemum ; chemistry ; growth & development ; metabolism ; Drugs, Chinese Herbal ; analysis ; metabolism ; Flavonoids ; analysis ; metabolism ; Glucosides ; analysis ; metabolism ; Time Factors