Traditional four examinations of traditional Chinese medicine （TCM） are based on the symptoms and signs of patients， which are the advantages of TCM but also have shortcomings. Chronic kidney disease has the characteristics of insidiousness， long-term， deficiency and variability during its onset， which are difficult to be intervened in time based on only symptoms， therefore it is necessary to extend the application of the four examinations in the diagnosis and treatment process of chronic kidney disease. Based on the background of the continuous development of TCM syndrome differentiation techniques， this article proposed the extension and application strategies of the traditional four examinations in chronic kidney disease， including the incorporation of microscopic syndrome differentiation to identify the causes of kidney disease and prevent symptom deterioration； the utilization of accurate examination information enhanced by artificial intelligence for controlling development of existing disease； the integration of disease differentiation and syndrome differentiation to summarize clinical rules towards using constant to measure variation； and the establishment of a kidney disease database for the storage of four examinations information to prevent recurrence after recovery. The four above extension and application strategies can be used to achieve the long-term management and treatment effects of timely and early diagnosis， dynamic observation of the condition， accurate application of intervention， and strengthened prognosis assessment in the diagnosis and treatment of chronic kidney disease， and expand the advantages of TCM in the prevention and treatment of chronic kidney disease.

Objective To evaluate the value of rs61330082 and rs4730153 polymorphisms of Visfatin locus for the diagnosis of type 2 diabetes mellitus(T2DM)in a high-risk population.Methods SNPscanTM high-throughput single nucleotide polymorphism typing technique was used to genotype Visfatin gene loci rs61330082 and rs4730153 in 346 T2DM patients(T2DM group)and 1426 normal controls(NC group).Logistic regression analysis was used to analyze T2DM risk factors.ROC curves were used to analyze the optimal cut-off values of Visfatin gene rs61330082 and rs4730153 for the diagnosis of T2DM.Results The proportion of women,age,obesity,smoking,hypertension,FPG,HbA1c and TG were higher in T2DM group than those in NC group(P<0.01)and HDL-C was lower than in NC group(P<0.01).The frequency of G allele and GG genotype was higher in T2DM group compared with NC group(P<0.05).Logistic regression analysis showed that age,female,obesity,hypertension,TG,and GG genotype at rs4730153 locus were risk factors for T2DM,HDL-C was a protective factor for T2DM.The area under the ROC curve of GG genotype at Visfatin rs4730153 mutation for diagnosis of T2DM was 0.668 and the optimal cut-off point for predicting T2DM was 20.04%,with sensitivity 60.1%and specificity 66.1%,respectively.Conclusion The GG genotype of Visfatin gene rs4730153 locus is associated with the risk of T2DM and can beused as a candidate gene for predicting phenotype of T2DM.

Objectives:To investigate the effect of inhibition of long non-coding RNA(lnc RNA)in human metastasis associated lung adenocarcinoma transcript 1(MALAT1)on glycolipitoxicity-induced human umbilical vein endothelial cell dysfunction. Methods:Human umbilical vein endothelial cells were treated with glucose and palmitic acid in vitro to establish the glycolipitoxic endothelial cell models.Following groups were examined:control group,high-glucose and high-fat group,high-glucose and high-fat + non-targeting RAN control group,high-glucose and high-lipid+MALAT1 siRNA group,and high-glucose and high-lipid+MAPK1 siRNA group.RT-qPCR was used to detect the mRNA expression of MALAT1 and MAPK1.Western blot was used to detect the expression levels of autophagy,mitochondrial fusion division,apoptosis,and pathway-related proteins.Immunofluorescence confocal localization was used to detect the fluorescence colocalization of autophagy and lysosome-related proteins.The number of autophagolysosomes in endothelial cells was observed by transmission electron microscopy.Mitochondrial probe staining was used to detect mitochondrial morphology,immunofluorescence was used to detect intracellular reactive oxygen species(ROS)production,flow cytometry was used to detect the apoptosis of cells in each group,cell proliferation and scratch assays were used to detect the proliferation and migration ability of cells in different groups at different time points.The angiogenesis was quantified by counting the number of new blood vessels in each group. Results:Compared with the control group,the expression of lncRNA MALAT1 mRNA and the expression of phosphorylated mito-activated protein kinase 1(p-MAPK1)were upregulated(both P＜0.05)and the expression of phosphorylated mammalian target protein(p-mTOR)was downregulated in the high-glucose and high-fat group and the high-sugar and high-fat control group(all P＜0.01).Compared with the high-glucose and high-fat non-targeting RNA control group,the expressions of microtubule-associated protein 1A/1B-light chain 3(LC3)and p62 were downregulated(P＜0.01,P＜0.05),LC3 and lysosome-associated membrane protein 2(LAMP2)protein co-localized positive fluorescence particles were increased(both P＜0.01),number of lysosomes were decreased,the expression of ROS was decreased(P＜0.01),the expression level of mitochondrial fusion protein optic nerve atrophin 1(OPA1)was increased(P＜0.05),the expressions of cleaved caspase-3 and BCL-2-related X protein(BAX)were decreased and BCL-2 was increased(all P＜0.05),cell proliferation,migration,and tube-forming ability were increased(all P＜0.01),and the expression of p-MAPK1 was decreased(P＜0.05)and p-mTOR expression was increased(both P＜0.05)in the high-glucose and high-lipid+si-MALAT1 group.Compared with the high-glucose and high-fat non-targeting RNA control group,the expression of p-MAPK1 in endothelial cells was decreased and the expression of p-mTOR was increased in the high-glucose and high-lipid+si-MAPK1 group(both P＜0.01). Conclusions:Inhibition of lncRNA MALAT1 expression can reduce the level of mitophagy in glycolipidotoxic environments,reduce apoptosis of endothelial cells and improve endothelial cell function,which may be related to the regulation of MAPK1/mTOR signaling pathway.

Objectives:To investigate the expression and clinical implication of long non-coding RNA(lncRNA)metastasis associated lung adenocarcinoma transcript 1(MALAT1)in peripheral blood of patients with acute coronary syndrome(ACS). Methods:A total of 159 patients diagnosed with ACS who were admitted to the heart center of the First Affiliated Hospital of Xinjiang Medical University from January 2015 to December 2018 were selected as the ACS group,and 148 participants without coronary heart disease confirmed by physical examination and enhanced coronary CT examination in the physical examination center of our hospital during the same period were selected as the control group.Peripheral blood mononuclear cells of patients in two groups were extracted,and the expression level of MALAT1 was detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR),and the correlation between the expression level of MALAT1 and ACS and the diagnostic and prognostic value of MALATI expression level for ACS were analyzed. Results:The expression level of MALAT1 in peripheral blood was significantly higher in the ACS group than in the control group(P<0.05).Multivariate logistic regression analysis showed that the expression level of MALAT1 in peripheral blood was independently correlated with ACS(OR=1.193,95%CI:1.037-1.372,P=0.014).ROC curve showed that the expression level of MALAT1 in peripheral blood was of certain diagnostic value for ACS(AUC=0.664,95%CI:0.600-0.720).Kaplan-Meier survival analysis showed that ACS patients with high expression level of MALAT1 in peripheral blood(≥0.816)had higher cumulative incidence of major adverse cardiovascular events than those with low expression level of MALAT1 in peripheral blood(<0.816)during(558±223)days follow-up(39.05%vs.30.61%,P<0.05). Conclusions:The expression level of MALAT1 in peripheral blood of patients with ACS is significantly increased,and the expression level of MALAT1 in peripheral blood has potential clinical value for the diagnosis and prognosis of patients with ACS.

Objective:To evaluate the effect of two-way referral service in referral and treatment of patients with coronary disease.Methods:A non-randomized controlled study was used, 80 patients with coronary disease who were referred to the First Affiliated Hospital of Xinjiang Medical University through the fast referral channel, also called green referral channel (GRC) of telemedicine service mode from January 2021 to January 2022 were selected as the GRC referral group. A propensity score was used to match 110 patients from the same period with coronary disease who were referred to this hospital through conventional medical channels and had similar basic conditions such as age, gender, region and medical insurance type as the conventional referral group. The differences in disease severity, referral time, hospitalization cost and other indicators were compared using t-test, χ2 test and nonparametric test between the two groups, and the satisfaction of the GRC referral group was investigated. Results:The proportion of patients with heart function grade Ⅲ (NYHA grading), heart failure, atrial fibrillation and interventional therapy in the GRC referral group was significantly higher than conventional referral group (all P<0.05). The total referral time and bed waiting time of patients in the GRC referral group were significantly shorter than conventional referral group [14.16 (9.62, 25.61) vs 34.39 (28.51, 49.68) h, 2.13 (0.83, 6.64) vs 24.58 (20.27, 27.68) h] ( Z=8.465, 9.172, all P<0.001). The hospitalization cost, surgical treatment cost and material cost in GRC referral group were significantly higher than conventional referral group [24 755 (11 559, 56 521) vs 14 700 (9 375, 29 534) CNY, 6 013 (2 096, 8 256) vs 2 562 (2 044, 6 154) CNY, 12 093 (1 267, 35 689) vs 1 329 (826, 16 125) CNY] ( Z=2.814, 2.917, 3.353, all P<0.05), and the diagnosis cost was significantly lower than conventional referral group [4 878 (3 628, 6 847) vs 5 719 (4 228, 7 639) CNY] ( Z=2.323, P<0.05). In the GRC referral group, the satisfaction rates with referral process, visit time and patient experience were all above 90%. Conclusion:Two-way referral service based on telemedicine has a good application effect in the referral and treatment of patients with coronary disease.

Objective To explore the effect of mucle force on contact force, peak pressure and contact area of foot joint in in vitro biomechanical experiment of foot and ankle, so as to provide references for choosing appropriate loading modes. Methods In neutral position of the ankle joint, fresh calf and foot specimens were simulated with or without mucle force loading. The contact force, peak pressure and contact area of the 1st metatarsophalangeal joint, the 2nd metatarsophalangeal joint, the 1st tarsometatarsal joint, the 2nd tarsometatarsal joint, the medial cuneonavicular joint, the intermediate cuneonavicular joint, the talonavicular joint, the calcicocuboid joint, the subtalar joint ( posterior articular surface) and the tibiotalar joint of normal foot under loading were measured, the results are compared and analyzed. Results Under muscle force loading, the contact force of the 1st metatarsophalangeal joint, the 2nd metatarsophalangeal joint, the 1st tarsometatarsal joint,the 2nd tarsometatarsal joint, the medial cuneonavicular joint, the intermediate cuneonavicular joint, the talonavicular joint and the tibiotalar joint were significantly greater than those without muscle force loading (P<0. 05), and the change percentages were 719. 28% , 311. 37% , 128. 67% , 50. 82% , 54. 89% , 57. 63% ,79. 98% and 50. 34% , respectively. The peak pressures of the 1st metatarsophalangeal joint , the 1st tarsometatarsal joint and the talonavicular joint under muscle force loading were significantly higher than those without muscle force loading ( P < 0. 05), and the change percentages were 176. 14% , 62. 91% and 40. 07% ,respectively. The contact area of the 1st metatarsophalangeal joint, the 1st tarsometatarsal joint, the intermediate cuneonavicular joint and the subtalar joint ( posterior articular surface) under muscle force loading increased significantly (P<0. 05), and the change percentages were 132. 20% , 55. 41% , 30. 97% and 26. 87% , respectively. Conclusions In biomechanical experiment of foot and ankle specimens, muscle force loading has a significant effect on contact force, peak pressure and contact area of each foot joint, especially the forefoot.Therefore, it is necessary to consider the effect of muscle force loading on stress of foot and ankle in the study ofrelated in vitro specimens

Objective·To explore the relationship between sleep quality and carotid atherosclerosis in the population with low or moderate risk of cardiovascular and cerebrovascular diseases.Methods·Based on the population-based cohort study of chronic diseases in Xinjiang,the researchers selected residents aged 35-75 from two fixed communities in Urumqi and Korla,in Northern and Southern Xinjiang,respectively,using a two-stage random cluster sampling method from July 2019 to September 2021.In the population without a history of coronary heart disease and cerebrovascular events,the prediction model for atherosclerotic cardiovascular disease(ASCVD)risk in China(China-PAR)was used to evaluate the risk of cardiovascular and cerebrovascular diseases.Low and moderate risk population of cardiovascular and cerebrovascular diseases were included.Participants completed physical examinations,questionnaires[including the Risk Factors Assessment Scale of Cardiovascular and Cerebrovascular Diseases in Xinjiang,Pittsburgh Sleep Quality Index(PSQI),International Physical Activity Questionnaire(IPAQ),and Food Frequency Questionnaire],cardiovascular and metabolic biochemical examinations,and carotid color doppler.Carotid intima-media thickness(CIMT)and plaque formation were used to determine the carotid atherosclerosis of the study subjects.Multivariate Logistic regression model and restricted cubic spline(RCS)were used to analyze the relationship between sleep quality and carotid intima-media thickening/plaque formation in the population with low and moderate risk of cardiovascular and cerebrovascular diseases.Results·A total of 1 528 subjects were included in the study,the mean age was(49.4±8.2)years,and 685(44.8％)were male.In the included population,there were 581(38.0％)subjects with carotid intima-media thickening and 305(20.0％)subjects with carotid plaque formation.Among them,intima-media thickening and plaque formation both occurred in 154(10.1％)people.Therefore,the prevalence of carotid atherosclerosis was 47.9％(732 subjects).Compared with the group without carotid artery thickening,the group with carotid intima-media thickening/plaque formation had higher levels of general cardiovascular and cerebrovascular risk factors,including age,male ratio,blood lipid levels and obesity,and higher PSQ1 sleep score[(7.06±2.13)vs(7.43±2.51),P=0.001].The proportion of patients with poor sleep quality was higher(6.5％vs 12.1％,P=0.001).Multivariate Logistic regression analysis showed that poor sleep quality was an independent risk factor for carotid atherosclerosis[adjusted OR(aOR)=1.22,95％CI 1.004-1.492,P=0.040].RCS analysis suggested that PSQI and the risk of carotid atherosclerosis showed a positive linear correlation,that is,the worse quality of sleep,the higher risk of carotid atherosclerosis.Conclusion·Although the traditional metabolic risk factors are at a low risk level,the prevalence of carotid atherosclerosis is high and poor sleep quality is an independent risk factor for carotid atherosclerosis in the low and moderate risk population of cardiovascular and cerebrovascular diseases.

Objective To investigate the current status and its influencing factors of ART coverage and VL inhibition rate of HIV/AIDS in Yining City, Xinjiang, and to provide reference for AIDS prevention and treatment. Methods The ART data for 2017-2019 years in Yining, Xinjiang was retrieved from the National AIDS Antiretroviral Treatment Information System, to analyze the changing trend of ART coverage rate and VL inhibition rate of HIV/AIDS. Logistics regression model was used to analyze the influencing factors of untreated HIV/AIDS and uninhibited VL. Results The coverage rate of antiviral treatment in Yining city from 2017 to 2019 was 73.39%, 78.06% and 87.03%, respectively. The inhibition rates of VL were 83.91%, 85.05% and 86.09%, respectively, showing an increasing trend year by year. Female, other transmission routes, positive sexual partner detection, and testing and special investigation reduced the risks of untreated HIV/AIDS, while other domicile locations, non-marital and non-commercial heterosexual contact, and unawareness of their own VL increased the risks of untreated HIV/AIDS. Female, 26-35 years old, 36-45 years old, 46~55 years old, >55 years old, primary school, junior high school, high school or technical secondary school, junior college or above, and male-male sex behavior reduced the risks of unsuppressed VL of HIV/AIDS, while other domicile locations, non-marital and non-commercial heterosexual contact, and unawareness of their own VL increased the risks of unsuppressed VL in HIV/AIDS. Conclusion The ART coverage rate and VL inhibition rate in Yining, Xinjiang rise year by year, approaching the expected target. Targeted education and supervision should be conducted to promote the realization of ^“90-90-90^” in 2020 and ^“95-95-95^” target in 2030.

Lenvatinib mesylate (LF), a multi-target tyrosinase inhibitor mainly used in the treatment of a variety of cancers, has low oral bioavailability mainly due to its gelation during the dissolution process. In the current study, in order to enhance dissolution and eliminate gelation of LF, a supramolecular coamorphous system of LF-baicalein (BAI) (molar ratio, 1∶1) was prepared by rotary evaporation and characterized by PLM, PXRD, DSC and FTIR. Results indicated the formation of coamorphous system with a single Tg of 118 °C. Different from original LF crystal, no gelation phenomenon was observed during the dissolution of coamorphous LF-BAI. In addition, the dissolution rate of LF was increased by 2.2-fold after coamorphization. Meanwhile, the dissolution rate of the co-former BAI was also enhanced by more than 25.4-fold. Stability test showed that the prepared coamorphous system had a good physical stability for at least 90 days under 25 °C/ 60%RH and 40 °C /75%RH conditions.

Objective:To identify the hub differentially expressed genes(DEGs)of glomerular pathological changes and potential pathways in molecular process of type 2 diabetic nephropathy(DN)based on bioinformatics technology.Methods:The differentially expressed genes of Gene Expression Omnibus(GEO)dataset GSE96804 in DN and normal kidney tissues were analyzed by R 3.6.2 software. DEGs were further assessed by Gene Ontology(GO)function enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)signal pathway analysis. Subsequently, the hub genes and their associated pathways were analyzed using String 11.0 and Cytoscape 3.7.2 software.Results:A total of 168 DEGs were obtained in the dataset. Among them, seven hub genes were identified, including ALB, FN1, EGF, PTGS2, PLG, KDR, and LOX. Three hub genes, ALB, EGF, PLG, exerted a direct action on glomerulus. GO enrichment analysis of DEGs was mainly manifested in extracellular matrix organization, extracellular structure organization, platelet degranulation and other biological processes, extracellular matrix, secretory granule lumen, platelet alpha granule and other cell components, chaperone binding, copper ion binding, antioxidant activity, and other molecular functions. DEGs mainly regulated metabolic process, which was related to fatty acid degradation signal pathway, exogenous substance metabolism related to CYP enzyme and drug metabolism signal pathway.Conclusion:A bioinformatics analysis of DN from the perspective of glomerulopathy is helpful to understand the potential molecular mechanism of DN and provide reference for further validation.