Diabetic kidney disease(DKD)is one of the commonest microvascular complications of type 2 diabetes mellitus(T2DM).Inflammatory cytokines play an important role during the pathogenesis and development of DKD.This article reviews the research progresses on the role of inflammatory cytokines in DKD.

Mitochondrial diabetes mellitus(MDM)is a type of diabetes caused by mitochondrial gene mutations resulting in progressive secretory function defects of pancreatic islet β cells.MDM is a rare single-gene genetic disease,accounting for about 1%of all diabetes mellitus.We reported a case of MDM patient and their family.

Restless legs syndrome （RLS） is a common sensory-motor disorder of the nervous system， and its mechanism remains unknown， which may be related to neuropsychiatric diseases， nutritional and metabolic diseases， kidney diseases， and pregnancy. We report a special case of RLS which was diagnosed prior to hyperthyroidism and experienced worsening of the RLS symptoms. We aim to discuss the mechanism of hyperthyroidism aggravating RLS， helping clinicians have a better understanding of the influencing factors for RLS.
Hyperthyroidism ; Comorbidity

BACKGROUND: Many nutritional supplements and pharmacological agents have been reported to show preventive effects on colorectal adenoma and colorectal cancer (CRC). We performed a network meta-analysis to summarize such evidence and assess the efficacy and safety of these agents. METHODS: We searched PubMed, Embase, and the Cochrane Library for studies published in English until October 31, 2021 that fit our inclusion criteria. We performed a systematic review and network meta-analysis to assess the comparative efficacy and safety of candidate agents (low-dose aspirin [Asp], high-dose Asp, cyclooxygenase-2 inhibitors [coxibs], calcium, vitamin D, folic acid, ursodeoxycholic acid [UDCA], estrogen, and progesterone, alone or in combination) for preventing colorectal adenoma and CRC. Cochrane risk-of-bias assessment tool was employed to evaluate the quality of each included study. RESULTS: Thirty-two randomized controlled trials (278,694 participants) comparing 13 different interventions were included. Coxibs significantly reduced the risk of colorectal adenoma (risk ratio [RR]: 0.59, 95% confidence interval [CI]: 0.44-0.79, six trials involving 5486 participants), advanced adenoma (RR: 0.63, 95% CI: 0.43-0.92, four trials involving 4723 participants), and metachronous adenoma (RR: 0.58, 95% CI: 0.43-0.79, five trials involving 5258 participants) compared with placebo. Coxibs also significantly increased the risk of severe adverse events (RR: 1.29, 95% CI: 1.13-1.47, six trials involving 7109 participants). Other interventions, including Asp, folic acid, UDCA, vitamin D, and calcium, did not reduce the risk of colorectal adenoma in the general and high-risk populations compared with placebo. CONCLUSIONS: Considering the balance between benefits and harms, regular use of coxibs for prevention of colorectal adenoma was not supported by the current evidence. Benefit of low-dose Asp for chemoprevention of colorectal adenoma still requires further evidence. REGISTRATION PROSPERO, No. CRD42022296376.
Humans ; Cyclooxygenase 2 Inhibitors ; Calcium ; Network Meta-Analysis ; Vitamins ; Colorectal Neoplasms/drug therapy* ; Chemoprevention ; Aspirin ; Adenoma/prevention & control* ; Vitamin D

Objective:To explore the efficacy of votioxetine on the cognitive function in patients with major depressive disorder (MDD) by meta-analysis.Methods:PubMed, EMBASE, Cochrane Library, PsycINFO, web of science, CNKI and Wanfang databases were retrieved. The retrieval years were from the establishment of the database to July 9, 2021. Randomized controlled studies (RCTs) of votioxetine in the treatment of cognitive impairment in MDD patients were included for meta-analysis. The essential demographic characteristics, intervention programs, outcome indicators were extracted from the included literatures. Changes from baseline of cognition and function rating scales was chosen as primary outcome. The GRADE quality of evidence system was used to evaluate the quality of evidence. Meta-analysis was performed using Revman version 5.3.Results:Six RCTs were included in the current meta-analysis. Compared to patients in the placebo group, votioxetine statistically improved individual′s performance on the Rey Auditory Verbal Learning Test Acquisition (RAVLT Acquisition; SMD=0.19, 95% CI=0.06-0.33 , P=0.004 , I 2= 0%), Rey Auditory Verbal Learning Test Delayed Recall (RAVLT Delayed Recall; SMD=0.25, 95% CI=0.11-0.38, P=0.000 3, I 2= 0%), Trail Making Test A (TMT-A; SMD=-0.19, 95% CI=-0.32--0.06 , P=0.004 , I 2= 0%), Trail Making Test-B (TMT-B; SMD=-0.30, 95% CI=-0.43--0.17 , P<0.01, I 2= 0%) and Perceived Deficits Questionnaire-Depression (PDQ-D; SMD=-0.39, 95% CI=-0.52--0.27 , P<0.01, I 2= 0%) at the end of the 2nd and 8th weeks of treatment. Conclusion:Votioxetine has significant early efficacy in improving objective and subjective cognitive impairment in patients with MDD.

Objective:To explore the efficacy of votioxetine on the cognitive function in patients with major depressive disorder (MDD) by meta-analysis.Methods:PubMed, EMBASE, Cochrane Library, PsycINFO, web of science, CNKI and Wanfang databases were retrieved. The retrieval years were from the establishment of the database to July 9, 2021. Randomized controlled studies (RCTs) of votioxetine in the treatment of cognitive impairment in MDD patients were included for meta-analysis. The essential demographic characteristics, intervention programs, outcome indicators were extracted from the included literatures. Changes from baseline of cognition and function rating scales was chosen as primary outcome. The GRADE quality of evidence system was used to evaluate the quality of evidence. Meta-analysis was performed using Revman version 5.3.Results:Six RCTs were included in the current meta-analysis. Compared to patients in the placebo group, votioxetine statistically improved individual′s performance on the Rey Auditory Verbal Learning Test Acquisition (RAVLT Acquisition; SMD=0.19, 95% CI=0.06-0.33 , P=0.004 , I 2= 0%), Rey Auditory Verbal Learning Test Delayed Recall (RAVLT Delayed Recall; SMD=0.25, 95% CI=0.11-0.38, P=0.000 3, I 2= 0%), Trail Making Test A (TMT-A; SMD=-0.19, 95% CI=-0.32--0.06 , P=0.004 , I 2= 0%), Trail Making Test-B (TMT-B; SMD=-0.30, 95% CI=-0.43--0.17 , P<0.01, I 2= 0%) and Perceived Deficits Questionnaire-Depression (PDQ-D; SMD=-0.39, 95% CI=-0.52--0.27 , P<0.01, I 2= 0%) at the end of the 2nd and 8th weeks of treatment. Conclusion:Votioxetine has significant early efficacy in improving objective and subjective cognitive impairment in patients with MDD.

Objective:To investigate the incidence of acute kidney injury (AKI) following cardiac surgery and related risk factors in 4 878 patients.Methods:The information from patients who underwent cardiac surgery through March 2015 to October 2015 was collected retrospectively from the electronic database of Beijing Anzhen Hospital. A total of 4 878 patients were divided into AKI group and non-AKI group according to whether AKI occurred within 7 days after cardiac surgery. The incidence of AKI was calculated, and the AKI incidence in different types of cardiac surgeries were compared. Clinical data such as baseline clinical information, operation information, comorbidity, hospital stay time, life ability score in discharge from the hospital, and so on, were compared between AKI group and the non-AKI group using univariate analysis. Risk factors for AKI following cardiac surgery were analyzed using the binary multivariate logistic regression.Results:A total of 933 patients suffered from AKI (19.1%) following cardiac surgery. The time of stay in the hospital was longer in AKI group than that in the non-AKI group [(14.4±8.9) vs (13.7±7.7) d, P<0.05)]. The incidence of AKI in different types of cardiac surgeries varied significantly ( P<0.001). The logistic regression analysis showed that male, diabetes, hypertension, the elevated basic serum creatinine, cardiac dysfunction (NYHA grade≥Ⅲ), cardiopulmonary bypass, a combination of operations≥3, the rethoracotomy exploration and hemostasia, and using an invasive ventilator for over 96 hours were the independent risk factors for the AKI following cardiac surgery (all P<0.05), and the odds ratio (95% confidence interval) were 1.81(1.46-2.24), 1.29(1.03-1.62), 5.85(4.73-7.22), 1.81(1.36-2.40), 4.49(3.60-5.60), 1.84(1.49-2.27), 23.24(18.25-29.59), 2.34(1.45-3.77) and 1.94(1.09-3.43) respectively. Conclusions:The incidence of AKI after cardiac surgery in Beijing Anzhen Hospital is 19.1%. AKI following cardiac surgery prolongs the time of stay in the hospital. Independent risk factors for AKI following cardiac surgery are multiple, and one of the most critical factors is a combination of operations≥3.

The cholinergic system has been implicated in the pathophysiology of depression. The nonselective muscarinic acetylcholine receptor antagonist scopolamine manifested rapid and robust antidepressant effects. This review seeks to find available clinical and basic evidence related to the rapid antidepressant effect of scopolamine, meanwhile, summarizes possible mechanisms, side effects and biomarkers for efficacy outcomes underlying the antidepressant effect of scopolamine.

The cholinergic system has been implicated in the pathophysiology of depression. The nonselective muscarinic acetylcholine receptor antagonist scopolamine manifested rapid and robust antidepressant effects. This review seeks to find available clinical and basic evidence related to the rapid antidepressant effect of scopolamine, meanwhile, summarizes possible mechanisms, side effects and biomarkers for efficacy outcomes underlying the antidepressant effect of scopolamine.

Objective To investigate the influence of earlier renal fibrosis on ischemia and reperfusion induced acute kidney injury. Methods Male C57BL/6 mice at eight to twelve weeks old age were divided into 4 groups randomly: (1)Sham (n=3); (2)Unilateral ureter obstruction (UUO, n=6):UUO for 3 days (UUO3d, n=3) and UUO for 5 days (UUO5d, n=3);(3)Ischemia and reperfusion (IR, n=7): bilateral kidney ischemia for 40 minutes followed by 24 hours of reperfusion; (4)UUO for 3 days plus IR (UUO3d+IR, n=6): bilateral kidney ischemia after UUO 2 days for 40 minutes followed by 24 hours of reperfusion, and the real time for UUO was 3 days. Pathologic analysis for acute or chronic injury was performed on paraffin embedded kidney sections with hematoxylin and eosin (HE) or Masson staining. Apoptosis was detected by immunohistochemistry(IHC) and Western blotting with anti-caspase-3 antibody, and proliferation was observed by IHC with anti-ki67 antibody. Results On kidney sections with HE or Masson staining, it showed that the chronic kidney lesions and fibrosis got more severe as time of UUO prolonged from 3 days to 5 days; the area of matrix deposition increased in UUO5d and UUO3d mice significantly compared to Sham mice (P<0.05) and was smaller in UUO3d mice compared with UUO5d mice obviously (P<0.05). Acute kidney injury could be observed in UUO3d+IR mice, such as massive inflammatory cells infiltration, tubules dilation, brush border disappearance, tubular epithelial cells vacuolar degeneration, necrosis, casting formation, coexisting with chronic lesions: thinner cortex, broadened interstitial space, and increased blue stained matrix. Acute kidney injury score in UUO3d+IR mice was higher than that in IR mice significantly (P<0.05), and serum creatinine level increased significantly in UUO3d+IR mice compared to Sham mice (P<0.05). Caspase-3 expression increased and ki67 positive tubular cells decreased in UUO3d+IR mice than those in IR mice obviously (P<0.05). Conclusion Earlier renal fibrosis aggravates acute kidney injury induced by ischemia reperfusion in mice through increasing apoptosis and decreasing proliferation of tubular epithelial cells.