Objective:To observe the role of Huaiqihuang Granules (HQ) in the long-term management of bronchial asthma in young children, and the effective effect on concomitant rhinitis.Methods:A prospective real-world multicenter study was conducted in children aged 2-5 years with asthma diagnosed in the outpatient department (from April 2016 to March 2019)who received either inhaled corticosteroid (ICS)/leukotriene receptor antagonist (LTRA)(control group); inhaled ICS/LTRA plus HQ(combination group), or HQ alone(HQ group). All patients were followed up at week 4, 8, 12 after treatment. The number of days with asthma symptoms, the frequency of severe asthma attacks, the level of asthma control, and the days with rhinitis symptoms in the last 4 weeks were recorded. Differences before and after treatment, and those among groups after treatment were compared using Kruskal- Wallis H test or Wilcoxon rank-sum test. Results:A total of 2 234 eligible patients were recruited, and 2 147 cases completed followed-up visits, including 477, 1 374 and 296 cases in the control group, combination group, and HQ group, respectively. After the treatment, all 3 groups showed significant declines in the days with asthma symptoms, frequency of severe asthma attack and the days with rhinitis symptoms (all P<0.01), and the rate of well-controlled asthma increased significantly ( P<0.01). It lasted until the end of follow-up. Among groups, patients in the combination group showed significantly less days of asthma symptoms than those of the other 2 group at week 8 and 12[0(0, 0.9) d vs.0(0, 0.3) d, P<0.05; 0(0, 0.1) d vs. 0(0, 1.0) d, P<0.01]. Patients in the combination group and HQ group showed a significantly lower rate of severe asthma attacks than that of the control group at week 12 [0(0, 1), 0(0, 1), 0(0, 2), all P<0.05]. The well-controlled rate of asthma in the combination group was significantly higher than that of the control group and HQ group at week 8 and 12 (89.6% vs. 85.9% vs.82.1%, H=15.28; 90.9% vs. 84.1% vs. 81.8%, χ2=29.32, all P<0.01). Conclusions:HQ can significantly alleviate symptoms of asthma and rhinitis, severe attack of asthma, and increase the control rate of asthma when used as an additional treatment or used alone.

Objective:To analyze the clinical value of noninvasive pressure strain loop (PSL) in assessing left ventricular myocardial work in patients with essential hypertension.Methods:In this cross-sectional study, 66 patients with essential hypertension who were admitted to the Affiliated Hospital of Yangzhou University from August to December 2020 were continuously enrolled. According to left ventricular mass index (LVMI) >95 g/m 2 in women and >115 g/m 2 in men,≤95 g/m 2 in women and ≤115 g/m 2 in men, the 66 patients were divided into left ventricular hypertrophy (LVH) group (14 cases) and non-left ventricular hypertrophy (NLVH) group (52 cases). Furthermore, the NLVH group was divided into a mild group (30 cases) and a moderate/severe group (22 cases) according to the systolic blood pressure of 140~159 mmHg (1 mmHg=0.133 kPa) and ≥160 mmHg. Another 25 healthy adults who underwent physical examination during the same period were included as healthy control group. The height, weight and blood pressure were measured in all the subjects, and routine echocardiography and speckle tracking imaging analysis were performed. PSL results were obtained by combining the results of speckle tracking imaging analysis with systolic blood pressure. The differences of general clinical data, basic parameters of two-dimensional ultrasound and myocardial work parameters of PSL (global work index, global effective work, global wasted work, and global work efficiency) were compared among the groups, and the clinical value of PSL in assessing left ventricular myocardial work in patients with essential hypertension was analyzed. Results:There was no significant difference in left ventricular ejection fraction among all groups (all P>0.05). The global work index of moderate/severe NLVH group was significantly higher than that of mild NLVH group, LVH group and healthy control group [(2 630±231) vs (2 254±179), (1 847±261), (1 724±209) mmHg%]. The global effective work of moderate/severe NLVH group was significantly higher than that of LVH group and healthy control group [(2 965±261) vs (2 330±258) and (2 121±163) mmHg%] (all P<0.05). The global wasted work of LVH group was significantly higher than that of moderate/severe NLVH group, mild NLVH group and healthy control group [(248±107) vs (141±57), (116±57), (83±58) mmHg%] (all P<0.05). The global work efficiency was significantly lower than that of moderate/severe NLVH group, mild NLVH group and healthy control group (89.1%±3.9% vs 94.3%±1.9%, 95.0%±1.8%, 95.8%±2.3%) (all P<0.05). With the increase of blood pressure, the PSL decreased in the LVH group and increased in the other three groups. The bull′s eye diagram of myocardial work in the healthy control group was uniform green (normal effective work area), red began to appear in the mild NLVH group (high intensity myocardial work area), red area increased in the moderate/severe NLVH group, and blue appeared in the LVH group (ineffective work area). Conclusions:PSL has good clinical value in assessing left ventricular myocardial work in patients with primary hypertension. The parameters derived from PSL data can sensitively identify impaired systolic function in individuals with normal left ventricular ejection fraction.

Objective To investigate the prevalence of feeding intolerance (FI),and to explore the FI within 7 days of ICU admission in association with clinical outcome in critically ill patients.Methods The adult patients from 14 general ICUs in Zhejiang Province with an expected admission to ICU for at least 24h were recruited from March 2014 to August 2014,and all clinical,laboratory,and survival data were prospectively collected.The AGI (acute gastrointestinal injury) grade was daily assessed based on gastrointestinal (GI) symptoms,feeding details and organ dysfunction within the first week of ICU stay.The intra-abdominal pressures (IAP) was measured using AbViser device.Results Of 550 patients enrolled,418 were assessed in GI symptoms and feeding details within 7 days of ICU stay.The mean age and SOFA score were (65.1 ± 18.3) years and (8.96 ±4.10),respectively.Of them,355 patients (84.9％) were under mechanical ventilation support,and 37 (8.85％) received renal replacement therapy.The mean length of time for enteral feeding was (30.8 ±26.2) h,and the prevalence of FI on the 3rd and 7th day of ICU stay accounted for 39.2％ and 25.4％,respectively.Compared to those with FI within 7 days of ICU stay,the patients without FI had higher rate of successively weaning from mechanical ventilation (21.3％ vs.5.7％,P =0.003) and higher rate of withdrawal of vasoactive medication (45.5％ vs.20.0％,P =0.037),as well as lower mortality rate of 28-day (24.4％ vs.38.7％,P =0.004) and 60-day (29.6％ vs.44.3％,P =0.005).In multivariate Cox regression model with adjustment for age,sex,participant center,serum creatinine and lactate,AGI grade on the first day of ICU stay,and comorbidities,the FI within 7 days of ICU stay (x2 ≥ 7.24,P ＜ 0.01) remained to be independent predictors for 60-day mortality.After further adjusted for SOFA score,the FI within 7 days of ICU stay (HR =1.71,95％ CI:1.18-2.49;P =0.006) and AGI grade on the first day of ICU stay (HR =1.33,95 ％ CI:1.07-1.65;P =0.009) could provide independent prognostic values of 60-day mortality.Conclusions There is high rate of FI occurred within 7 days of ICU stay,and is significantly associated with worse outcome.In addition,this study also provides evidence to further support that measurement of gastrointestinal dysfunction could increase value of SOFA score in outcome prediction for the risk of 60-day mortality.

Tetraspanins are a class of cell surface glycoproteins that are expressed very broadly, which can form a complex tetraspanins net by combining with many kinds of cell surface molecules such as integrins, signal proteins, growth factors and so on.In recent years, more and more studies suggest that tetraspanins are closely related to the invasion and metastasis of malignancies and show a certain clinical value, which can be used as new diagnosis and prognosis indicators of malignancy.

Objective To investigate the situation of admission nursing evaluation on elderly patients of geriatrics departments in several Shanghai comprehensive hospitals, and the results will be the base for designing elderly patient′s comprehensive admission nursing evaluation form. Methods 41 nurse managers of geriatrics department in Shanghai comprehensive hospitals were selected as research object. Self-designed questionnaire included general data, elderly patient admission nursing evaluation content and the importance of each item. Results The effective recovery rate was 97.56%(40/41). 98%(39/40) hospitals considered that elderly patients need to have a comprehensive assessment according to the elderly characteristics, only 18%(7/40) hospitals used the special nursing evaluation form for elderly patients. The score of importance of five dimensions were as follows: geriatric syndromes or problems scored (4.64 ± 0.38), physical function assessment scored (4.60 ± 0.46), physiological function assessment scored (4.53 ± 0.45), mental and psychological assessment scored (4.10 ± 0.57) and social assessment scored (4.07±0.52). The score of importance of 29 items were as follows:fall assessment scored (4.90±0.30), pressure ulcer assessment scored (4.85 ± 0.36), activities of daily living scored (4.75 ± 0.44), urinary incontinence assessment scored (4.70 ± 0.52), pain assessment scored (4.70 ± 0.46). Conclusions It is of great significance to carry on the comprehensive admission nursing evaluation for the elderly patients, which needs to be valued and strengthened.

Objective To investigate the effect of parathyroid hormone (PTH) on the epithelial to mesenchymal transition (EMT) in human renal proximal tubular epithelial cells (HK-2 cells),and determine the role of β-catenin signaling pathway.Method The expression of α-smooth muscle actin (α-SMA),E-cadherin and β-catenin in HK-2 cells was measured by real-time PCR,Western blotting and immunofluorescence technique.The signaling pathway by which PTH activated EMT in HK -2 cells was identified by using synthetic β-catenin siRNA.Results Parathyroid hormone (10-10mol/ L) increased α-SMA expression and decreased E-cadherin expression in HK-2 cells (P＜ 0.01,respectively).Untreated cells showed the expression of E-cadherin,whereas α-SMA staining was noticeably increased in cells treated with PTH.β-catenin activity was significantly increased after exposed to PTH.Theα-SMA expression was decreased strongly and E-cadherin expression was increased after β-catenin siRNA transfection (all P ＜ 0.05).Conclusion PTH significantly induces epithelial to mesenchymal transition in HK-2 cells throughβ-catenin signaling pathway.

ObjectiveTo observe the efficacy of L-carnitine in prevention and treatment of toxicity of LFP chemotherapy with gastrointestinal cancer. Methods60 cases of gastrointestinal cancer were divided into 2 groups according to the admission date. The treatment groups received LFP chemotherapy and L-carnitine, while the control group received LFP chemotherapy alone.Both groups received 3 cycles chemotherapy. The gastrointestinal toxicity, neurotoxicity, hematologic toxicity and physical state were compared.ResultsThere were 12 cases of peripheral neurotoxicity in treatment group,the incidence rate was 40.0 ％;but in control group there were 21 patients, and the incidence rate was 70.0 ％. There was a significant difference between the two groups(x2=5.4545,P =0.0195). Anemia in the treatment group was 56.7 ％ (17/30); in the control group the rate was 86.7 ％ (26/30).There was a significant difference between the two groups (x2 =6.698,P =0.0351).After chemotherapy,in the treatment group,there were 4 cases with increasing Karnofsky score ≥ 10,19 patients whose Karnofsky score did not change,and 7 cases with reduced Karnofsky score ≥ 10; in the control group,there was 1 case with increasing Karnofsky score ≥ 10,13 cases with Karnofsky score no changing,and 16 cases with reduced Karnofsky score ≥ 10.The changes in physical state of two groups had a significant difference(x2 =5.711,P =0.0169).The gastrointestinal toxicity,thrombocytopenia,and neutropenia of two groups had no significant difference.ConclusionL-carnitine can reduce peripheral neurotoxicity and hematologic toxicity,improve the patient's physical state in patients received LFP chemotherapy.

Objective To initially map the gene responsible for autosomal dominant familial IgA nephropathy of a Chinese family by exclusive the five loci that had been reported with linkage analysis.Methods The genetic pattern of the familial IgA nephropathy was identified and the genomic DNA was extracted from the blood samples collected from the family members.Short tandem repeat (STR) inside the loci that had been reported was selected,such as 2q36,3p23-24,4q26-31,6q22-23,17q12-22,and the data with two-point linkage analysis were performed.Results Autosomal dominant inheritance pattern was demonstrated in phenotypes of the family and there was no linkage relationship in the above five loci of chromosomes because the maximum two-point LOD score was 0.39 at D17S1868.Conclusion Following exclusion of the loci which had been reported,there are other new pathopoiesis loci of FIgAN and it reveals that FIgAN has the genetic heterogeneity according to initial result at the same time.

Objective To explore the effect of serum uric acid on the clinical manifestations,pathological characteristics and prognosis of IgA nephropathy.Methods Four hundred and fifty-six cases of primary IgA nephropathy confirmed by renal biopsy from Jan 2007 to Oct 2010 in the Ji'nan Military General Hospital were reviewed retrospectively.The clinical manifestations and pathological characteristics of all the patients were analyzed,x2-test and t-test were used for statistical analysis.Results There were 127 cases with hyperuricemia in 456 IgAN patients (27.9％).The mean age,percentage of male patients,number of patients with hypertension,the serum cholesterol and triglyceride level,body mass index (BMI),serum creatinine and 24 hour urine protein level in hyperuricemia group were significantly higher than those with normal serum uric acid (P＜0.01).The renal pathological changes,glomerular score (8.1 ±0.8 v 5.3t0.9 ),tubulointerstitial score (4.2±0.4 vs 2.7±0.4) and vasculopathy score ( 1.43±0.60 vs 0.76±0.29) in the hyperuricemia group were more severe than those with normal serum uric acid (P＜0.01).Conclusion High level of serum uric acid can affect IgA nephropathy significantly.It is effe-ctive to delay the kindey damage and progression of IgA nephropathy by decreasing the level of uric acid and control the clinical parameters listed above.

Objective To investigate the role of genistein (Gen) in the expression of connective tissue growth factor (CTGF) induced by parathyroid hormone (PTH) in human renal tubular epithelia cells. Methods Real-time PCR, Western blotting and reporter gene assay were employed to detect the role of Gen in PTH-induced CTGF expression in HK-2 cells. The activity of NF-κB was measured by EMSA to investigate the mechanism by which PTH induced CTGF expression in HK-2 cells. Inhibitors of NF-κB signaling pathway were used to ascertain which signal pathway was involved. Results HK-2 cells had basic amount of CTGF mRNA and protein, which, however, increased significantly after treatment with PTH, and the luciferase activity increased to a higher level as compared with control group after treatment with 10-10 mol/L PTH for 12 h (1.89±0.08 vs 0.99±0.03, P＜0.01). Gen decreased the expressions of CTGF mRNA and protein induced by PTH in dose-dependent manner. The NF-κB of nucleus was inactivation without PTH, while the activity of NF-κB significantly increased after exposed to PTH, with the maximal response of PTH at a concentration of 10-10 mol/L and the best stimulating time at 30 minute. The NF-κB inhibitor PDTC reduced the increase of CTGF transcript levels in response to PTH stimulation. Gen blunted PTH-mediated NF-κB activation. Conclusion Gen inhibits CTGF expression induced by PTH through bloking NF-κB signaling pathway in human renal tubular epithelial cells.