Objective Based on network pharmacology,molecular docking and animal experiment,this study explored the mechanism of Icariin combined with Prednisone in the treatment of steroid-resistant nephrotic syndrome(SRNS)in rats.Methods The targets of Icariin active components were determined by TCMSP,GeneCards and CTD databases.The targets of SRNS were screened from GeneCards,OMIM,CTD and DRUGBANK databases,Remove and integrate.Venn graph was drawn to obtain the intersection target.A protein-protein interaction network was constructed using STRING database,and core targets were screened by topological analysis using Cytoscape 3.7.2.DAVID 6.8 was employed for GO term enrichment and KEGG pathway enrichment.And AutoDockTools Vina,PyMOL for molecular docking.SRNS rat model was constructed.The body weight of rats was measured,The 24-hour urinary protein quantity was detected,and the pathological morphology of renal tissue was observed by HE staining.,and the expression of core target proteins was de tected by Western blot.Results Network pharmacologic analysis showed that 139 targets corresponding to Icariin active ingredients were obtained,and 58 common targets were obtained by intersection with 1476 SRNS related targets.In PPI network,the top three degree values were Akt,JUN and IL6.KEGG enrichment analysis showed that Icariin played a therapeutic role in SRNS mainly by PI3K/AKT singnaling pathway.Molecular docking verification showed that Akt,PI3K and autophagy-related protein LC3-II had good binding activity with Icariin.Animal experiment result showed that Icariin combined with Prednisone significantly increased the body weight of SRNS rats(P<0.05),decreased the 24 hour urine protein quantity(P<0.01),and improved the glomerular morphological changes.The results of Western-blotting showed that Icariin combined with Prednisone could significantly improve the abnormal decrease of LC3-II protein and the abnormal increase of Akt and PI3K protein expression in renal tissue of SRNS rats(P<0.01).Conclusion Icariin can play a role in the treatment of SRNS through a multi-target and multi-pathway,regulate the PI3K-Akt signaling pathway,and increase the autophagy activity of kidney tissue in SRNS rats,which may be one of its main mechanisms.

Objective:To investigate the application effect of arteriovenous fistula cannulation by buttonhole technique with blunt needles in patients subjected to hemodialysis.Methods:Seventy-six patients who underwent hemodialysis in Hemodialysis Room, The First Hospital of Jiaxing between June 2016 and June 2019 were included in this study. They were randomly divided into control and observation groups ( n = 38/group). The control group was subjected to arteriovenous fistula cannulation using a regional puncture method. The observation group was subjected to arteriovenous fistula cannulation by buttonhole technique with blunt needles. One-time success rate of puncture was recorded in each group. The maximum transverse diameters of the fistula before and after 6 months of puncture were measured. Severity of pain at the time of puncture was evaluated using Visual Analogue Scale (VAS). Complications were recorded in each group. Patient compliance was investigated using a questionnaire. Patient's quality of life was evaluated using Kidney Disease Quality of Life Short Form 1.3. Results:One-time success rate of puncture in the observation group was significantly higher than that in the control group [97.37% (37/38) vs. 84.21% (32/38), χ2 = 3.93, P = 0.04]. The maximum transverse diameter of the fistula in the observation group was significantly smaller than that in the control group [(4.36 ± 0.11) mm vs. (7.26 ± 0.48) mm, t = 36.30, P < 0.01]. At 6 months after puncture, the maximum transverse diameter of the fistula in each group increased compared with that before puncture (both P < 0.05). The VAS score in the observation group was significantly lower than that in the control group [(0.82 ± 0.24) points vs. (3.11 ± 0.32) points, t = 35.29, P < 0.01]. The incidence of complications in the observation group was significantly lower than that in the control group [5.26% (2/38) vs. 21.05% (8/38), χ2 = 4.15, P = 0.04]. The compliance score in the observation group was significantly higher than that in the control group [(36.32 ± 3.21) points vs. (27.18 ± 2.69) points, t = 13.45, P < 0.01]. The scores of role limitations caused by physical health problems, pain, role limitations caused by emotional health problems in the observation group were significantly lower than those in the control group (all P < 0.05). The scores of physical functioning, general health perceptions, emotional well-being, social functioning, energy/fatigue, and overall health rating item in the observation group were significantly higher than those in the control group (all P < 0.05). Conclusion:Arteriovenous fistula cannulation by buttonhole technique with blunt needles can increase success rate of puncture, reduce pain, decrease the incidence of complications and exhibit protective effects on arteriovenous fistula, thereby improving patient's quality of life and increasing treatment compliance.

Objective:To explore the role of hippocampal γ oscillation abnormality in sepsis-associated encephalopathy (SAE).Methods:Seventy male Sprague-Dawley rats (2-3 months) were randomly (random number) divided into three groups according to the random digital table method: sham, CLP, and CLP + dopamine 4 (D4) receptor agonists RO-10-5824 group. The SAE animal model was established by cecal ligation and puncture (CLP). On day 10-14 after surgery, the open field, novel object recognition, and fear conditioning tests were performed. After that, the hippocampus was collected to measure expressions of parvalbumin (PV) and D4 receptor. In another set of experiment, CA1 local field potential (LFP) were recorded, and the relationship between LFP and time with novel object was analyzed. Independent sample t-test was used for pairwise comparisons, and multiple comparisons were performed by one-way ANOVA, followed by the Tukey multiple comparisons test. Correlation was analyzed using Pearson correlation. Statistical significance was assumed when P<0.05. Results:Compared with the sham group, hippocampal PV (77.54±4.61)%, D4 expression (56.36±3.88)% and γ oscillation power (41.1±8.62)%, object exposure time (36±3) s, new object recognition rate (49±4)%, and scene stiffness time (56±7) s were decreased significantly ( P<0.05). However, RO-10-5824 treatment could increase hippocaml γ oscillation power (92.3±6.7)%, and reverse the decreased new object exposure time (44±3) s and new object recognition rate (63±4)%. Correlation analysis showed that hippocampal γ oscillation power was positively associated with new object exposure time ( r=0.609 2, P=0.015 9). There was no difference in total distance traveled or time spent in the center among groups ( P>0.05). Conclusion:Hippocampal γ oscillation abnormality might play a key role in cognitive impairment associated with SAE.

Objective:To explore the effect of dynamic orientation therapy on psychological stress and treatment compliance of patients with diabetic nephropathy undergoing hemodialysis.Methods:Using the convenient sampling method, a total of 120 patients with diabetic nephropathy undergoing hemodialysis who were treated in the First Hospital of Jiaxing from October 2016 to September 2019 were selected as the research objects. Using the random number table method, they were divided into the control group and the intervention group, with 60 cases in each group. The control group received conventional treatment and nursing, while patients in the intervention group received dynamic orientation therapy on this basis. The anxiety and depression scores and treatment compliance of patients in the two groups were compared before and after intervention.Results:After intervention, SAS score and SDS score in the intervention group were lower than those in the control group [ (52.57±4.53) vs. (57.39±4.21) , (45.89±3.90) vs. (49.87±4.29) ], and the differences were statistically significant ( P<0.05) . The scores of diet and medication compliance in the intervention group were higher than those in the control group [ (59.65±5.82) vs. (53.11±6.76) , (6.44±1.28) vs. (5.89±1.24) ], and the differences were statistically significant ( P<0.05) . The exercise compliance of the intervention group after intervention was better than that of the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Application of dynamic orientation therapy in patients with diabetic nephropathy undergoing hemodialysis can reduce anxiety and depression of patients and improve treatment compliance of them.

Objective To study how to shorten the time of preoperative fasting and forbidding drink in clinical practice and the clinical application of its reconstructed process.Methods A total of 226 elective surgery patients,from the Department of Surgical Oncology of the First Affiliated Hospital of Wenzhou Medical University from November 1st,2015 to November 20th,2015 and from December 10th,2015 to December 30th, 2015,were selected by convenient sampling method as the research object. They were divided into the control group (n=117) and the experimental group (n=109) by using the before-and-after study method. In the control group,traditional preoperative fasting and forbidding drink process was adopted. In the experimental group,the new reconstructed preoperative fasting and forbidding drink process was adopted. The actual time of preoperative fasting and forbidding drink and the incidence of preoperative related adverse events were compared between two groups.Results The actual time of preoperative fasting was (7.60±0.98) h in the experimental group,which was significantly shorter than that in the control group (14.48±5.08)h(t=13.849,P<0.01). The actual time of preoperative forbidding drink was (3.39±0.97) h in the experimental group,which was significantly shorter than that in the control group (11.47±4.99)h(t=19.545,P<0.01). In the experimental group,the total incidence of adverse responses such as thirst and hunger before operation was 14.7%(16/109),which was significantly lower compared to the control group 35.9%(42/117)(χ2=13.317,P<0.01). There was no intraoperative aspiration in both groups.Conclusions The standard implementation of the new preoperative fasting and forbidding drink process can effectively shorten the preoperative fasting and forbidding drink time and improve the preoperative discomfort of elective surgery patients.

We treated 20 patients suffering from uncertainty statements syndrome (USS) with stellate ganglion block (SGB) therapy. The medical infrared thermography was examined before and after the SGB therapy. Analysis on the changes of surface temperature as well as the outcome of the patients was carried out. Among the mentioned 20 patients, 15 (75%) got obvious effect, 4 (20%) fairly good effect and 1 (5%) a little improvement after the SGB therapy. The corresponding surface temperatures of these patients were 1.32 +/- 0.27 degrees C, 0.97 +/- 0.31 degrees C, and 0.76 +/- 0.33 degrees C, respectively. The more the surface temperature changed, the better the efficacy of the therapy was. The medical infrared thermography may objectively represent the therapeutic effect of SGB on the USS.
Autonomic Nerve Block ; Fatigue ; therapy ; Humans ; Pain ; Stellate Ganglion ; Syndrome ; Thermography ; methods

Objective To explore the relationship among genetic polymorphism of angiotension Ⅱ type 1 re-ceptor(AT1 R) A1166-C, angiotensin converting enzyme (ACE) insertion/deletion (I/D), aldosterone synthase (CYP11B2)-344T/C and hypertensive disorder complicating pregnancy.Methods Polymerase chain reaction-re-striction fragment length polymorphism (PCR-RFLP) assay was used to detect the genotypes of AT1 R A1166-C ,ACE (I/O) ,CYP11B2 -344T/C in 86 cases of hypertensive disorder complicating pregnancy and 175 cases of normal control.Results There was 18 combined types in hypertensive disorder complicating pregnancy cases and normal control cases.Compared to AT1R-AA + ACE-Ⅱ + CYP11B2-TT, Odds ratios (OR) of AT1R-AA + ACE-DO +CYP11B2-TC,AT1 R-AC + ACE-ID+CYP11B2-TC and AT1R-AC+ACE-DD+CYP11B2-TC are 7.289,5.315 and 5.694 respectively.There was no statistical significance among the others.Conclusion In all 18 kinds of combined types, AT1 R-AA + ACE-DO + CYP11B2-TC,AT1R-AC+ACE-ID+CYP11B2-TC and AT1 R-AC + ACE-DD +CYP11B2-TC might increase the susceptibility of hypertensive disorder complicating pregnancy.It is possible that multigenes are interacted in the etiology of hypertensive disorder complicating pregnancy.

AIM: To investigate the possibility of 3T3 fibroblast growth on blood fibrin clot in culture medium with recombinant human basic fibroblast growth factor (rhbFGF). METHOD: Growth of the cells on blood fibrin clot was studied by phase-contrast, scanning and transmission electron microscopy and by Giemsa stain and MTT assay. RESULTS: The optimal concentration of rhbFGF for proliferation and survival of the cells was 100 ng/mL. The cells also grew on blood fibrin clot scaffold in the low-serum medium containing 100 ng/mL rhbFGF, and a greater number of the cells survived after 48 hours incubation compared to that after 24 hours. The elongated filopodia appeared to bridge the gaps among the fibroblasts after 24 hours incubation. Further incubation to 72 hours, a greater number of platycytes were found to be joined together by lamellopodia. CONCLUSION: 3T3 fibroblasts could grow and survive on blood fibrin clot in the low-serum medium containing rhbFGF, and a combination of blood fibrin clot and rhbFGF may have over proportional effects on wound healing.