Objective To investigate the ameliorative effects and potential mechanism of Lithocarpus litseifoliu on renal function and inflammation in mice with hyperuricemic nephropathy(HN).Methods The HN model was established by the combined administration of adenine and potassium oxyzate.The mice were randomly divided into normal control group,model control group,benzbromarone group,and high,medium and low dose groups of Lithocarpus litseifoliu.Different drugs were given to the mice,and their body mass was recorded once a week.The levels of uric acid(UA),creatinine(Cr),urine protein(UP),blood urea nitrogen(BUN)and urine urea nitrogen(UUN)as well as the levels of tumor necrosis factor α(TNF-α)and interleukin 6(IL-6)in serum or urine of each group were collected and measured on the 21st day.Hematoxylin-eosin(HE)staining was performed to observe kidney tissue injury in mice;real-time PCR(RT-PCR)was performed to determine ATP-binding cassette subfamily G member 2(ABCG2),urate transporter protein(URAT1),glucose transporter protein 9(GLUT9),and cytosolic factor NF-κB p50(κB p50)in kidney tissues.Results Compared with the normal control group,the body mass of mice in the model control group was significantly lower after the second weeks of modeling(P＜0.05),and the levels of UA,Cr,UP,BUN,UUN,TNF-α,IL-6 contents and GLUT9 mRNA and κB p50 mRNA expression contents of kidney tissues were significantly higher(P＜0.01,P＜0.05).Compared with the model control group,the levels of Cr,UP,BUN and UUN contents and renal tissue nuclear cytokine κB p50 mRNA expression were significantly lower in the high,medium and low dose groups of Lithocarpus litseifoliu(P＜0.01,P＜0.05).The UA levels were significantly lower in the high dose group of Lithocarpus litseifoliu(P＜0.05),and renal ABCG2 mRNA expression was significantly higher in the medium dose group(P＜0.01).The renal URAT1 mRNA expression was significantly decreased in the low dose group(P＜0.01).Conclusion Lithocarpus litseifoliu has shown ameliorative effects on HN mice,and the mechanism may be related to the modulation of renal uric acid transporters,improvement of renal function and anti-inflammation effects.

AIM:To investigate the effects of sodium hydrosulfide(NaHS)on hexokinase 2(HK2)-nucleo-tide-binding oligomerization domain-like receptor protein 3(NLRP3)-gasdermin D(GSDMD)pathway and pyroptosis in-duced by lung ischemia/reperfusion(I/R)in rats.METHODS:Male Sprague-Dawley rats were divided into 6 groups:control group,control+NaHS group,I/R group,low-dose NaHS+I/R(L+I/R)group,medium-dose NaHS+I/R(M+I/R)group,and high-dose NaHS+I/R(H+I/R)group,with 6 rats in each group.The NaHS was administered via intraperi-toneal injection at 1.5 mL,30 min before modeling.The left lung tissues were collected 30 min after ischemia and 1 h af-ter reperfusion,and the wet/dry weight ratio and total lung water content were recorded.Hematoxylin-eosin(HE)staining was used to examine lung tissue morphological changes.The levels of malondialdehyde(MDA),myeloperoxidase(MPO)and lactate in lung tissues were measured with test kits.ELISA was employed to determine the levels of interleukin-1β(IL-1β)and IL-18.The expression of glycolysis-and pyroptosis-related indicators was analyzed by Western blot,qRT-PCR and immunofluorescence staining.RESULTS:Compared with control group,the rats in NaHS group showed no signifi-cant differences in all laboratory tests(P>0.05).The rats in I/R group exhibited significant lung injury,oxidative stress,increased lactate level,and up-regulated glycolysis and pyroptosis(P<0.05 or P<0.01).Compared with I/R group,the indicators in L+I/R group showed a downward trend(P<0.01)or no difference(P>0.05),while those in M+I/R group dis-played a significant reduction(P<0.05 or P<0.01).However,the indexes in H+I/R group exhibited no significant dif-ferences in these tests(all P>0.05).CONCLUSION:A moderate dose(56 μmol·L-1·kg-1)of NaHS mitigated the oc-currence of pyroptosis by inhibiting the HK2-NLRP3-GSDMD pathway,thus contributing to the attenuation of lung I/R in-jury in rats.

Objective:To evaluate the efficacy and safety of first-line anti-tuberculosis (TB) drugs combined with linezolid in treatment of children with tuberculous meningitis (TBM).Methods:A retrospective cohort study design was performed . Eight-nine Children diagnosed as TBM during January 1 st 2016 and December 31 st 2023 in Department of Infectious Disease, Children′s Hospital of Chongqing Medical University were enrolled in the study. According to different treatment regimens, children were divided into a group of first-line anti-tuberculous drugs (isoniazid, rifampicin, pyrazinamide, ethambutol (HRZE)) and a group of HRZE and linezolid combination (HRZEL). The efficacy and safety of the 2 regimens were compared and the relationship between linezolid drug concentration and adverse reactions were analyzed. Comparisons between groups were performed using χ2 test and Mann-Whitney U test. Results:The 89 children with TBM included 53 males and 36 females with an onset age of 4.6 (1.4, 9.6) years. There were 27 cases in the HZREL group and 62 cases in the HRZE group. Before treatment, positive rate of interferon-gamma release assays (IGRA) in HRZEL group was lower than that in HRZE group (64% (16/25) vs.92% (55/60), χ2=9.82, P<0.05), but protein level of cerebrospinal fluid (CSF) was higher than that in HRZE group (1.2 (1.0, 2.0) vs.0.8 (0.4,1.4) g/L, Z=0.32, P<0.05). By the end of the intensive phase, there were no significant differences of rates of CSF improvement and etiology negativity between HRZEL group and HRZE group (both P>0.05).The 44 TBM children with high CSF protein (>1 g/L) included 25 males and 19 females with an onset age of 6.7 (3.0, 11.8) years. There were 21 cases in the HZREL group and 23 cases in the HRZE group accordingly. Before treatment, there were no significant differences of positive rate of IGRA test and CSF protein level between the 2 groups (62% (13/21) vs. 87% (20/23), 1.7 (1.1, 2.2) vs. 1.5 (1.2, 1.9) g/L, χ2=3.67, Z=0.23, both P>0.05). There were no significant differences in CSF indicators, etiology negativity or imaging remission between the two groups by the end of intensive phase (all P>0.05). Higher frequencies of granulocytopenia, gastrointestinal symptoms as well as withdrawal or change of drugs were found in HRZEL group when compared to those in HRZE group (44% (12/27) vs. 19% (12/62), 7% (2/27) vs. 0, 33% (9/27) vs. 3% (2/62), χ2=6.01, 4.70, 15.74, all P<0.05). Conclusions:The efficacy of HRZEL regimen is similar to conventional HRZE regimen in children with TBM, but with higher adverse effect. Prudentially evaluating the pros and cons of linezolid in the usage of drug-susceptible TB and carefully monitoring of linezolid associated adverse effects is suggested.

With the continuous development of medical science and the widespread use of antibiotics,the problem of bacterial resistance is increasing,especially the increasing carbapenem-resistant Enterobacteriaceae(CRE)infection,and the high mortality rate,which brings great challenges to clinical treatment.In this paper,the mechanism of drug resistance,existing antibac-terial drugs,and exploratory treatment options for CRE are reviewed,and the research progress in treating CRE infection is dis-cussed to provide more reliable evidence and a theoretical basis for clinical practice.

Objective To explore the mediation effect of emotional intelligence in social support and subjective happiness,and to provide practical guidance for scientific management of nursing talents in hemodialysis center.Methods Using a cross-sectional study,by a proportional stratified sampling method,from October 2022 to January 2023,800 hemodialysis nurses in Guangzhou area were selected as the respondents,using the general data adjustment table,general well-being schedule(GWB),social support rating scale(SSRS),and wong law emotional intelligence scale(WLEIS-C).The pearson correlation was used to analyze the correlation between emotional intelligence,social support and subjective happiness of hemodialysis nurses in Guangzhou;the process macro program was used to explore the mediation effect of emotional intelligence in social support and subjective happiness in Guangzhou.Results 707 valid questionnaires were collected,and the effective recovery rate was 88.38%.The total score of subjective well-being of hemodialysis nurses in Guangzhou was(75.67±8.17),the total score of emotional intelligence(82.29±16.20),and the total score of social support(38.76±8.40).The total score of social support was positively associated with the total score of subjective well-being(r=0.517,P<0.01)and the total score of emotional intelligence(r=0.633,P<0.01),the total score of emotional intelligence was positively related to the total score of subjective well-being(r=0.634,P<0.01).Social support had a direct effect on subjective well-being(β=0.165,95%CI:0.103-0.261),and indirectly affected it through the partial mediation effect of emotional intelligence(β=0.095,95%CI:0.069-0.142),and the indirect mediation effect accounted for 36.54%of the total effect.Conclusion Guangzhou area hemodialysis nurses subjective well-being is in upper level,and emotional intelligence in hemodialysis nurses social support and subjective happiness plays intermediary effect,managers should focus on hemodialysis nurses emotional intelligence,take various measures to improve their emotional intelligence level,enhance social support,so as to improve hemodialysis nurses subjective well-being.

Objective:To evaluate the safety and efficacy of belimumab(BLM) in patients with SLE.Methods:Clinical data were collected for SLE patients who were diagnosed and treated with BLM in the Department of Rheumatology and Immunology (inpatient and outpatient department) of Guilin Medical College Affiliated Hospital from 1 December, 2019 to 12 May, 2023. BLM + standard of care (SOC) for the BLM group and SOC only for the SOC group. The primary clinical endpoint was adverse events (AE) occurring in groups, and the secondary clinical endpoint was disease activity index including SLEDAI-2000, clinical indicators, glucocortoid dosage reduction, and disease flare in the two groups. Propensity score matching method, independent sample t-test, non-parametric rank-sum test, variance analysis were used for statistical analysis. Results:Among the 79 BLM patients included, 48 had hematological impairment (61%), 53 had renal impairment (67%), 11 had skin and mucosal impairment (14%), 20 had joint impairment (25%), and 2 had neurological impairment(3%). There were no serious adverse events during the treatment in both groups. In the BLM group, with 14 cases experienced respiratory system infection, 1 with urinary system infection, 3 with skin infection, 4 with herpes virus infection, and 16 with liver function impairment. In the SOC group, there were 26 cases experienced respiratory system infection, 1 with urinary system infection, 6 with digestive system symptoms, 6 with skin infection, 4 with herpes virus infection, 10 with liver function impairment, 2 with thrombosis, and 1 with sepsis. Patients tolerated BLM generally well, with fewer adverse events occurring [in patients with the long course treatment, the number of AE cases in the BLM group vs SOC group 11 [(33%) vs 22 (68%), ( χ2=3.74, P=0.053)]. From all study groups and high-dose glucocorticoid (≥20 mg) groups, it was observed that the BLM group had a more significant reduction in glucocortoid dose [baseline glocucorticoid reduction in the BLM group decreased from 20 (12, 40)mg/d to 6 (4, 10)mg/d ( Z=0.12, P=0.01). In the renal injury group, after treatment, serum creatinine level decreased in the BLM group glomerular filtration rate increased from 72.37 (41.97, 95.74) to 97.03 (71.18, 114.34) ( Z=-4.62, P<0.001). There was less flares in the BLM group [7 cases (28%) vs 18 cases (72%), χ2=5.58, P=0.018] when compared with the soc group. Conclusion:BLM is safe and effective for the treatment of SLE, which can reduce disease activity, improve clinical parameters, reduce glocucorticoid dosage, and have a low flare rate.

Objective:To establish a rapid and ultrasensitive detection of human adenovirus (HAdV) antigen via Au@Ag NPs-based SERS lateral flow immunoassay(LFIA).Methods:Firstly, the Au@Ag NPs modified with dual-layer 5, 5’-dithiobis-(2-nitrobenzoic acid) (DTNB) was synthesized, and conjugated with specific anti-HAdV antibodies to prepare SERS tags. Next, the SERS tags, HAdV and specific detecting antibodies of anti-HAdV on the test lines (T lines) of strips formed the complex structure of sandwich based on the reaction of antigen and antibody, and the rapid detection of HAdV can be achieved by collecting and analyzing the SERS signals on the T lines. Next, the sensitivity, reproductivity and specificity of the method were evaluated, respectively.Results:The proposed SERS-LFIA via dual-layer DTNB-modified Au@Ag NPs can achieve the qualitative and quantitative detection of HAdV within 15 min. The visual result was 10 ng/ml, and limit of detection (LOD) was 0.1 ng/ml with the quantitative range from 0.1 ng/mL to 1 000 ng/ml. Furthermore, this SERS-LFIA displayed great reproducibility and specificity, and there was no cross-reaction with other five emerging infectious virues including dengue virus, yellow fever virus, west nile virus, zika virus and ebola virus.Conclusions:In this study, the proposed SERS-LFIA based on Au/DTNB@Ag/DTNB NPs can accomplish rapid and ultrasensitive detection of HAdV, revealing the great potential in the field of point of care testing.

Objective:To explore the effect of stepwise nursing in postoperative rehabilitation of patients with spinal cord injury.Methods:From January 2020 to June 2021, convenience sampling was used to select 91 patients with spinal cord injury admitted to the Henan Third Provincial People's Hospital as the research object. The patients were divided into the observation group ( n=46) and the control group ( n=45) by random number table method. The control group received routine nursing, while the observation group received stepwise nursing on the basis of the control group. The postoperative functional independence and quality of life were compared between the two groups. Results:After six months of intervention, the scores of the Spinal Cord Independence Measure Ⅲ and the scores of each dimension of the Generic Quality of Life Inventory 74 in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Stepwise nursing can promote postoperative functional recovery and improve the quality of life of patients with spinal cord injury.

Humans ; Pulmonary Disease, Chronic Obstructive ; Smoke/adverse effects* ; Tobacco ; Tobacco Smoke Pollution

Objective:To explore the relationship between family conflict and adolescent future suicidal behavior.Methods:A total of 7 072 adolescents who participated in the baseline survey and the first follow-up survey of Shandong Adolescent Behavior and Health Cohort were included in the analysis. They were sampled from 8 middle schools in 3 counties of Shandong province, China. A self-reported questionnaire was used to measure suicidal behavior, family conflict, depression, and demographic characteristics. Logistic regression model was used to analyze the relationship between family conflict and suicidal behavior.Results:In the baseline survey, the age of 7 072 subjects was (14.58±1.45) years, and boys and girls accounted for 50.0% respectively. 750 people (10.6%) had any suicidal behavior, of which 707 (10.0%), 258 (3.6%) and 190 (2.7%) had suicidal ideation, suicide planning and suicide attempt, respectively. The family conflict scores of the suicidal group were higher than those of the non-suicidal group. After adjusting for covariates, logistic regressions showed that family conflict was associated with increased risk of suicidal behavior ( OR=1.05, 95% CI: 1.01-1.10), suicidal ideation ( OR=1.05, 95% CI: 1.00-1.09), suicide planning ( OR=1.08, 95% CI: 1.01-1.16) and suicide attempt ( OR=1.10, 95% CI: 1.02-1.19). Further stratified by gender, results showed no significant association between family conflict and suicidal behavior in girls; the association of family conflict with suicidal behavior was more significant in boys, especially for suicidal ideation and suicide planning, and the OR value of the latter was higher than the former. The results were stable after sensitivity analysis in males. Conclusions:Family conflict might increase the risk of adolescent suicidal behavior, especially in males. Harmonious family environment and good family atmosphere are of great significance to adolescent suicide prevention and control.