Diabetic nephropathy （DN） is one of the most common and severe microvascular complications of diabetes， with a complex pathogenesis involving immune inflammatory responses， oxidative stress， apoptosis， glomerulosclerosis， renal interstitial fibrosis， and other pathological processes. In recent years， numerous animal or cell model experiments have revealed that the transforming growth factor-β （TGF-β）/mothers against decapentaplegic homolog （Smad）， phosphoinositide 3-kinase （PI3K）/ protein kinase B （Akt）/mammalian target of rapamycin （mTOR）， mitogen-activated protein kinase （MAPK）， AMP-activated protein kinase （AMPK）， nuclear factor-κB （NF-κB）， Janus kinase （JAK）/signal transducer and activator of transcription （STAT）， neurogenic locus notch homolog protein （Notch）， nuclear factor E₂-related factor 2 （Nrf2）， secretory glycoprotein （Wnt）/β-catenin， and other classical signaling pathways play important roles in the occurrence and development of DN. Traditional Chinese medicines， as natural drugs， possess characteristics such as multiple components， multiple targets， and few adverse reactions， demonstrating unique advantages in regulating the aforementioned signaling pathways and improving renal pathological changes. This review summarized recent research progress on the intervention of DN through the regulation of the aforementioned signaling pathways by single compounds and formulas of traditional Chinese medicine， focusing on their mechanisms of action in regulating immune inflammatory responses， inhibiting renal fibrosis， oxidative stress， improving metabolic disorders， and other aspects. The aim is to provide theoretical references for a deeper understanding of the modern pharmacological basis and clinical application of traditional Chinese medicine in the treatment of DN.

ObjectiveTo compare the clinical effects of laparoscopic cholecystectomy (LC) and open cholecystectomy (OC) in the treatment of gangrenous cholecystitis and their influence on inflammatory mediators. MethodsA total of 82 patients with gangrenous cholecystitis who underwent surgery in 22 Hospital of PLA from January 2012 to June 2015 were enrolled and divided into LC group (42 patients) and OC group (40 patients). The condition of surgery and perioperative levels of inflammatory mediators were compared between the two groups. The t-test was used for comparison between the two groups, and the chi-square test was used for categorical data. ResultsAll the patients underwent the surgery successfully without deaths during the perioperative period, and three patients were converted to laparotomy. The rate of partial cholecystectomy, time of operation, intraoperative blood loss, and hospital costs showed no significant differences between the two groups (all P＞0.05). The LC group had a shorter length of postoperative hospital stay, a lower rate of drainage tube placement, and fewer postoperative complications compared with the OC group, but only the length of postoperative hospital stay showed a significant difference between the two groups (t=7472,P＜0.001). The LC group experienced significant reductions in the serum white blood cell count (WBC), C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor α (TNFα) on days 3 and 5 after surgery (all P＜0.05). The OC group experienced significant increases in serum WBC, CRP, IL-6, and TNFα on day 1 after surgery, and significant reductions in these indices on days 3 and 5 after surgery (all P＜0.05). The LC group had significantly lower serum WBC, CRP, IL-6, and TNFα on days 1, 3, and 5 after surgery compared with the OC group (all P＜0.05). ConclusionLC is safe and effective in the treatment of gangrenous cholecystitis. Compared with OC, LC has the advantages of less trauma and faster recovery after surgery and can reduce the release of inflammatory mediators.

PurposeTo explore the segmentation accuracy of different filtering and segmentation methods in brain tumor MRI, and to identify the best algorithm for brain glioma.Materials and Methods Using the nonlocal average ifltering, median ifltering, the anisotropic ifltering and improved mean shift algorithm segmentation, the watershed segmentation algorithm, fuzzy c-means segmentation algorithm to realize image segmentation in MATLAB program, 39 glioma images from different patients were analyzed. Pathology manual segmentation was used as gold standard to evaluate different segmentation precision.Results The signal-to-noise ratio was 7.9243, 6.2160 and 6.5426 for different iflter methods, respectively. The segmentation methods accuracy was 92.31%, 88.03% and 84.93%, respectively.Conclusion The nonlocal average ifltering effect is more accurate than median ifltering and the anisotropic ifltering. The improved mean shift algorithm segmentation is more accurate than watershed segmentation algorithm and fuzzy c-means segmentation algorithm with precision of 92.31%.

OBJECTIVETo evaluate the sensitivity and specificity of nested PCR combined with pyrosequencing in the detection of HBV drug-resistance gene.

METHODSRtM204I (ATT) mutant and rtM204 (ATG) nonmutant plasmids mixed at different ratios were detected for mutations using nested-PCR combined with pyrosequencing, and the results were compared with those by conventional PCR pyrosequencing to analyze the linearity and consistency of the two methods. Clinical specimens with different viral loads were examined for drug-resistant mutations using nested PCR pyrosequencing and nested PCR combined with dideoxy sequencing (Sanger) for comparison of the detection sensitivity and specificity.

RESULTSThe fitting curves demonstrated good linearity of both conventional PCR pyrosequencing and nested PCR pyrosequencing (R(2)>0.99, P<0.05). Nested PCR showed a better consistency with the predicted value than conventional PCR, and was superior to conventional PCR for detection of samples containing 90% mutant plasmid. In the detection of clinical specimens, Sanger sequencing had a significantly lower sensitivity than nested PCR pyrosequencing (92% vs 100%, P<0.01). The detection sensitivity of Sanger sequencing varied with the viral loads, especially in samples with low viral copies (HBV DNA ≤3log10 copies/ml), where the sensitivity was 78%, significantly lower than that of pyrosequencing (100%, P<0.01). Neither of the two methods yielded positive results for the negative control samples, suggesting their good specificity.

CONCLUSIONCompared with nested PCR and Sanger sequencing method, nested PCR pyrosequencing has a higher sensitivity especially in clinical specimens with low viral copies, which can be important for early detection of HBV mutant strains and hence more effective clinical management.

Adolescent ; Adult ; Aged ; DNA, Viral ; genetics ; Drug Resistance, Viral ; genetics ; Female ; Hepatitis B virus ; drug effects ; genetics ; isolation & purification ; Humans ; Male ; Middle Aged ; Phosphoric Acids ; Plasmids ; Polymerase Chain Reaction ; Reagent Kits, Diagnostic ; Sensitivity and Specificity ; Young Adult