Objective To explore the clinical characteristics and risk factors of upper urinary tract stones complicated with non-alcoholic fatty liver disease(NAFLD),so as to provide reference for the prevention of this disease.Methods The clinical data of 158 NAFLD patients undergoing surgical treatment in our hospital during Jan.2022 and Jul.2023 were retrospectively analyzed.According to whether the patients were complicated with NAFLD,they were divided into the NAFLD group(n=56)and non-NAFLD group(n=102).The general data,laboratory indexes and 24-h urinary metabolic indexes were compared between the two groups,and the risk factors were analyzed with univariate and multivariate logistic regression analyses.Results Compared with the non NAFLD group,the NAFLD group had higher BMI[(28.17±4.17)vs.(24.11±3.72),P＜0.001],blood uric acid[(354.13±111.01)μmol/L vs.(294.41±93.72)μmol/L,P＜0.001],and 24-h urinary oxalate level[(37.74±15.00)mmol vs.(27.73±15.27)mmol,P＜0.001].Multivariate logistic analysis showed that BMI(OR=1.311,P＜0.001),24-h urinary oxalate(OR=1.046,P=0.004),and 24-h urinary magnesium(OR=0.599,P=0.002)were the independent factors for NAFLD with upper urinary tract stones.Conclusion NAFLD complicated with upper urinary tract stones is significantly associated with high BMI,high 24-h urinary oxalate,and low 24-h urinary magnesium.

Diabetic kidney disease （DKD） is one of the common microvascular complications of diabetes mellitus （DM） and a primary cause of chronic kidney disease （CKD） and end-stage renal disease （ESRD）. Inflammation is currently a hot topic in exploring the pathogenesis of DKD. Macrophages， T cells， interleukins， tumor necrosis factor， NOD-like receptor protein 3 （NLRP3） inflammasome， Janus kinase/signal transducer and activator of transcription （JAK/STAT） signaling pathway， and nuclear factor-kappa B （NF-κB）-related signaling pathway all play a role in regulating the inflammation of DKD and accelerating its progression. Astragali Radix， a Chinese herbal medicine， is widely used in the treatment of DKD and possesses strong anti-inflammatory effects. Studies have revealed that active ingredients of Astragali Radix， including polysaccharides， astragaloside Ⅳ， total flavonoids， calycosin， and quercetin， can regulate multiple signaling pathways to ameliorate the microinflammatory state and alleviate kidney damage， thereby slowing down the progression of DKD. This article systematically reviews the factors influencing the inflammation in DKD and analyzes recent research findings and mechanisms concerning active ingredients of Astragali Radix in the management of DKD inflammation， aiming to offer novel insights and directions for the prevention， treatment， and research of DKD.

With the widespread application of nuclear technology,the prevention and treatment of radiation damage have become significant issues in the fields of public health and medicine.This article reviews the adverse drug reactions and their monitoring for radioprotective drugs,and discusses their post-marketing re-evaluation in terms of safety,efficacy,economics,and quality standards.Research indicates that while there is a wide variety of radioprotective drugs,safety concerns are prevalent.Future efforts should focus on strengthening the monitoring and management of adverse drug reactions,optimizing drug safety,and exploring the potential of combined drug applications through multidisciplinary collaboration to enhance anti-radiation efficacy.

Objective To explore the clinical characteristics and risk factors of upper urinary tract stones complicated with non-alcoholic fatty liver disease(NAFLD),so as to provide reference for the prevention of this disease.Methods The clinical data of 158 NAFLD patients undergoing surgical treatment in our hospital during Jan.2022 and Jul.2023 were retrospectively analyzed.According to whether the patients were complicated with NAFLD,they were divided into the NAFLD group(n=56)and non-NAFLD group(n=102).The general data,laboratory indexes and 24-h urinary metabolic indexes were compared between the two groups,and the risk factors were analyzed with univariate and multivariate logistic regression analyses.Results Compared with the non NAFLD group,the NAFLD group had higher BMI[(28.17±4.17)vs.(24.11±3.72),P＜0.001],blood uric acid[(354.13±111.01)μmol/L vs.(294.41±93.72)μmol/L,P＜0.001],and 24-h urinary oxalate level[(37.74±15.00)mmol vs.(27.73±15.27)mmol,P＜0.001].Multivariate logistic analysis showed that BMI(OR=1.311,P＜0.001),24-h urinary oxalate(OR=1.046,P=0.004),and 24-h urinary magnesium(OR=0.599,P=0.002)were the independent factors for NAFLD with upper urinary tract stones.Conclusion NAFLD complicated with upper urinary tract stones is significantly associated with high BMI,high 24-h urinary oxalate,and low 24-h urinary magnesium.

With the widespread application of nuclear technology,the prevention and treatment of radiation damage have become significant issues in the fields of public health and medicine.This article reviews the adverse drug reactions and their monitoring for radioprotective drugs,and discusses their post-marketing re-evaluation in terms of safety,efficacy,economics,and quality standards.Research indicates that while there is a wide variety of radioprotective drugs,safety concerns are prevalent.Future efforts should focus on strengthening the monitoring and management of adverse drug reactions,optimizing drug safety,and exploring the potential of combined drug applications through multidisciplinary collaboration to enhance anti-radiation efficacy.

Internal radionuclide contamination is one of important issue in medical response to nuclear or radiological emergency, which is the key of medical rescue. The medical uses of both preventive absorption drugs and acceleration elimination drugs are crucial means to control internal contamination. Usually the earlier use of such drugs could result in the better effects. Chinese national standards formulate that both preventive absorption of radionuclides and decorporation treatment should be applied as soon as possible in the event of there bing definite or highly suspected excessive intake of radionuclides. However, there are differences and inconsistencies in use of acceleration elimination drugs and strategies of acceleration elimination drugs between many national standards to some degree, easily causing confusion. Thus, this paper proposes the applicable time for applying decorporation drugs on the basis of comparison of the applicable scope and conditions between relevant national standards in combination with the related foreign advancements. It suggests that the ideas of decorporation strategies in both domestic on-site emergency response for nuclear accidents and abroad "urgent approach" are worth to advocate. According to the strategies, it is prudent and advisable to start decorporation treatment immediately even when radionuclide incorporation is just suspected, and treatment should be discontinued once internal dosimetric result are below intervention level. Meanwhile, the issues in need of attention in the application of the above-mentioned strategies for internal contamination are discussed.

Objective To detect the expression profile of heme oxygenase-1(HO-1)during the process of wound repair in radiation-wound combined injury(R-W-CI),and evaluate its wound healing improving effects of R-W-CI by HO-1 knockdown with siRNA.Methods A total of 36 male C57BL/6J mice(8 weeks old)were randomly and equally divided into a simple skin wound group(W group)and a skin wound group combined with whole-body radiation(6 Gy)injury(R-W-CI group).During the wound healing process,the wounds were photographed and recorded,and the residual areas were quantified by Image J.Wound tissues were sampled and stained with HE staining for pathological and histological observation,and the damage to the hematopoietic system was assessed by dynamic examination of the peripheral blood.The expression and changes of HO-1 in wound tissues were detected by q-PCR and Western blotting.Then,26 male C57BL/6J mice(8 weeks old)were randomly and equally divided into siRNA knockdown HO-1 group(si-HO-1 group)and siRNA negative control group(si-NC group).After radiation combined injury was inflicted,60 μL of F127 gel loaded with si-HO-1(5 μm/L)was applied to each wound in the si-HO-1 group,and an equal amount of F127 gel loaded with negative control si-NC was applied to the wound in the si-NC group.The knockdown of HO-1 in wound tissues was detected by Western blotting,and the changes in wound area were observed.In the wound tissues harvested in 3 d after wounding,the expression of cytokines IL-1β,IL-6 and TNF-α was examined by q-PCR and the proliferation of granulation tissues was evaluated by Ki67 immunohistochemical staining.HE staining was performed on wound tissues on day 3 and day 9 post-injury to assess the improvement effect of knockdown of HO-1 on wound healing of radiation combined injuries.Results Compared with the W group,semi-quantitative analysis of the residual wound area showed that healing was significantly delayed in the R-W-CI group on days 7 and 10 post-injury(P＜0.01).HE staining on day 7 showed that in the R-W-CI group,the re-epithelialization was delayed,and the growth of granulation tissues was poor;and at the same time,peripheral blood leukocytes and their classified counts showed a significant decrease in the early period after injury(P＜0.05).Further tests indicated that the expression of HO-1 protein was slightly higher in the wound of the R-W-CI group than that of the W group in 3 and 7 d after injury,though no significant difference(P＞0.05),whereas statistical difference was seen in 10 d(P＜0.05),accompanied by the distribution of the full-length and truncated forms of HO-1 protein.Quantitative PCR obtained similar results in the mRNA expression of HO-1 in wounds in both 7 and 10 d after injury(P＜0.05).siRNA intervention could effectively knock down the HO-1 protein level of the wounds(P＜0.05),promote wound contraction(P＜0.05),reduce the width of the wound(P＜0.01),up-regulate the inflammatory cytokines IL-6 and TNF-α in 3 d,enhance the proliferation of repair cells in wound margin,and improve the growth of the granulation tissue in the R-W-CI model when compared with the conditions after si-NC intervention.Conclusion There exists a sustained high expression level of HO-1 during wound repair,and wound knockdown of HO-1 by siRNA can improve the lack of inflammation status and promote wound healing in R-W-CI mice.

Radionuclide-contaminated wounds are common in medical response to nuclear emergencies, which have different manifestations in different types of accidents. Medical treatment is the key part of the response. Based on the drill experience gained from medical response to nuclear emergencies, the authors summarize the research advances in radionuclide-contaminated wounds in recent years, mainly involving the biokinetic characteristics, medical response, surgical debridement, and prevention and treatment of internal contamination of radionuclide-contaminated wounds; the authors summarize the key points of technical operations and provide suggestions on improvements in the drills. The authors believe that medical treatment of radionuclide-contaminated wounds requires highly compatible integration of the practical skills from clinical medicine and radiological knowledge; emergency response, surgical debridement, and prevention and treatment of internal contamination all together constitute an integrated rescue and treatment strategy with internal logic correlations. However, targeted improvements are needed to achieve desired effects in the drills.

ObjectiveTo understand the health-related life quality and its influencing factors in elderly community residents in Shanghai， and to provide reference for improving their life quality. MethodsDuring April to June 2021， a cross-sectional survey was conducted in five selected community health care centers， from Baoshan District， Minhang District， Songjiang District and Pudong New District of Shanghai， respectively. The elderly residents aged 65 and over who received physical examination were face-to-face interviewed using EQ-5D-5L scale. SPSS 26.0 and Stata 16 were used for statistical analysis. Binary logistic regression， multiple linear regression and Tobit regression were used to analyze influencing factors of each dimension in EQ-5D scale， EQ-VAS score and health utility value. ResultsA total of 1302 elderly residents were included in the study， and the proportions of problems in the five dimensions of EQ-5D-5L scale were pain/discomfort （13.9%）， mobility （9.1%）， daily activity （5.8%）， self-care ability （4.8%） and anxiety/depression （3.6%）， while age was a factor influencing problems in each dimension. The average score of EQ-VAS was 84.28±10.32， and the average health utility value based on Chinese population was 0.97±0.08， which was higher than the rest of the country. Tobit regression analysis showed that female （t=-3.96， P<0.001）， age group over 75 （t=-5.28， P<0.001）， high school education or above （t=-2.53， P=0.012）， chronic disease （t=-5.12， P<0.001） had poor quality of life （P<0.05）. ConclusionThe overall quality of life of the elderly in Shanghai community is good， but the quality of life in the elderly women and in the group suffering from chronic diseases is relatively poor. It is necessary to pay more attention to the key populations to improve their health status.

Bleeding caused by ionizing radiation involves many factors, the mechanism is complicated and the management is difficult. Bleeding is recognized as one of the main causes of death after ionizing radiation. In this paper, we summarize the pathophysiological mechanisms of ionizing radiation bleeding syndrome (IRBS) from the aspects of platelet abnormality, coagulation disorder and vascular damage. Besides, we expound the clinical characteristics of IRBS in terms of the degree, time and site of the bleeding. Combined with experimental results, we put forward ideas and possible approaches for the treatment of IRBS, and the key factor is to promote the recovery of megakaryocytes and rapid platelet production after radiation exposure.