ObjectiveTo observe the clinical efficacy of Tongfu Xiezhuo enema in treating stage 3-4 chronic kidney disease （CKD） and the effect of the therapy on the neutrophil-to-lymphocyte ratio （NLR） as an inflammation marker. MethodSixty patients diagnosed with stage 3-4 CKD who visited the Nephrology Department of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from December 2022 to June 2023 were included and randomly assigned into observation and control groups in a ratio of 1∶1. The control group received conventional therapy plus Shenkang suppositories， while the observation group received conventional therapy plus Tongfu Xiezhuo enema. After 8 weeks of treatment， the clinical efficacy was assessed based on the changes in traditional Chinese medicine （TCM） symptom scores， renal function indicators， and NLR. Result① Both groups showed decreases in TCM symptom scores after treatment （P<0.01）， and the decreases were more significant in the observation group than in the control group （P<0.05）. The total response rate of TCM symptoms in the observation group was 79.31% （23/29）， which was higher than that （62.96%， 17/27） in the control group （Z=0.604，P<0.05）. ② After treatment， the observation group showed declined serum levels of creatinine （SCr）， blood urea nitrogen （BUN）， and cystatin C （Cys C） and increased glomerular filtration rate （GFR） （P<0.01）， and the control group showed lowered SCr level and increased GFR （P<0.05）. The observation group had lower SCr level and higher GFR than the control group after treatment （P<0.05）. The total response rate of renal function in the observation group was 79.31% （23/29）， which was higher than that （55.56%， 15/27） in the control group （Z=1.127，P<0.01）. ③ The NLR in the observation group decreased after treatment （P<0.05）， and it was lower than that in the control group （P<0.05）. ④ There were no significant differences in safety indicators between the two groups before and after treatment. ConclusionTongfu Xiezhuo enema ameliorated symptoms and improved renal function indicators in the patients with stage 3-4 CKD by reducing the NLR and inhibiting inflammation.

Objective To investigate the role and mechanism of silent information regulator 1(SIRT1)-NOD-like receptor protein 3(NLRP3)axis in the effect of remifentanil against ischemia-reperfusion injury(IRI)in rat livers.SD rats were randomly divided into sham operation group(sham group),IRI group,IRI+remifentanil pretreatment group(IRI+RPC group),IRI+SIRT1 inhibitor EX-527 group(IRI+EX-527 group)and IRI+RPC+EX-527 group,with 8 rats in each group.The levels of serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),lactate dehydrogenase(LDH),interleukin(IL)-1β and IL-18 of rats in each group were detected.The liver tissue pathology was observed.The apoptosis rate of hepatocytes in rats was detected.The expressions of SIRT1,NLRP3,cleaved cysteinyl aspartate specific proteinase-1(Cleaved Caspase-1)and Gasdermin D(GSDMD)proteins in rat liver tissue were detected.Results Compared with the sham group,the liver tissue pathological score and hepatocyte apoptosis rate of rats in the IRI group were increased,the serum ALT,AST,LDH,IL-1β,and IL-18 levels were increased,the relative expression of SIRT1 protein in liver tissue was decreased,and the relative expression of NLRP3,Cleaved Caspase-1,and GSDMD proteins were increased(all P<0.05).Compared with the IRI group,the liver tissue pathological score and hepatocyte apoptosis rate of rats in the IRI+RPC group were decreased,the serum ALT,AST,LDH,IL-1β,and IL-18 levels were decreased,the relative expression of SIRT1 protein in liver tissue was increased,and the relative expression of NLRP3,Cleaved Caspase-1,and GSDMD proteins were decreased;the liver tissue pathological score and hepatocyte apoptosis rate of rats in the IRI+EX-527 group were increased,the ALT,AST,LDH,IL-1β,and IL-18 levels were increased,the relative expression of SIRT1 protein in liver tissue was decreased,and the relative expression of NLRP3,Cleaved Caspase-1,and GSDMD proteins were increased(all P<0.05).Compared with the IRI+RPC group,the liver tissue pathological score and hepatocyte apoptosis rate in the IRI+RPC+EX-527 group were increased,the levels of ALT,AST,LDH,IL-1β,and IL-18 were increased,the relative expression of SIRT1 protein in liver tissue was decreased,and the relative expression of NLRP3,Cleaved Caspase-1,and GSDMD proteins were increased(all P<0.05).Conclusions SIRT1 may participate in the regulation of remifentanil against rat liver IRI by inhibiting NLRP3 mediated cell pyroptosis.

Objective:To evaluate the role of spinal Leucine-rich Repeat Kinase 2 (LRRK2) in neuropathic pain in rats.Methods:Fifty SPF healthy male Sprague-Dawley rats, aged 6-7 weeks, weighing 210-245 g, were divided into 5 groups ( n=10 each) using a random number table method: control group (C group), neuropathic pain group (NP group), low dose GNE-7915 group (low-dose GNE-7915 group), medium-dose GNE-7915 group (medium-dose GNE-7915 group), and high-dose GNE-7915 group (high-dose GNE-7915 group). Neuropathic pain was induced by the spared nerve injury in anesthetized rats. At 7 days after developing the model, LRRK2 inhibitor GNE-7915 12.5, 25.0 and 50.0 mg/kg were intraperitoneally injected in low-, medium- and high-dose GNE-7915 groups, respectively. The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured before developing the model, at 7 days after developing the model, and at 4 h after injecting the inhibitor. After measurement of the pain threshold, the rats were sacrificed and the spinal cord tissues were taken for determination of the positive expression of ionized calcium-binding adapter molecule 1(Iba-1) (by immunofluorescence staining), contents of interleukin-1β (IL-1β), monocyte chemotactic protein-1 (MCP-1) and IL-18 (by enzyme-linked immunosorbent assay), positive expression of phosphorylated LRRK2 (p-LRRK2) (by immunofluorescence staining), and expression of LRRK2, IL-1β, MCP-1 and IL-18 (by immunoblotting). The ratio of p-LRRK2/LRRK2 was calculated. Results:Compared with C group, the MWT was significantly decreased, the TWL was shortened, the proportion of Iba-1 and p-LRRK2 positive cells in spinal cord tissues, contents of IL-1β, MCP-1 and IL-18, and p-LRRK2/LRRK2 ratio were increased, and the expression of IL-1β, MCP-1 and IL-18 proteins was up-regulated in NP group ( P<0.05). Compared with NP group, the MWT was significantly increased, the TWL was prolonged, the proportion of Iba-1 and p-LRRK2 positive cells in spinal cord tissues, contents of IL-1β, MCP-1 and IL-18, and p-LRRK2/LRRK2 ratio were decreased, and the expression of IL-1β, MCP-1 and IL-18 proteins was down-regulated in low-, medium- and high-dose GNE-7915 groups ( P<0.05). Conclusions:LRRK2 in the spinal cord may be involved in the pathophysiological mechanism of neuropathic pain by activating microglia and inducing inflammatory responses in rats.

Objective To investigate the relationship between sleep duration and obesity, and the risk of common chronic diseases in the occupational population in Shanghai City. Methods A total of 18 775 occupational individuals were selected as the study subjects using convenience sampling method in Shanghai City. Data on personal lifestyle behaviors and medical examination results were collected. The relationship between sleep duration and different types of obesity with dyslipidemia, hyperuricemia, hypertension, and hyperglycemia was analyzed. Results The incidence of dyslipidemia, hyperuricemia, hypertension, and hyperglycemia among the study subjects was 24.9%, 16.2%, 11.5%, and 7.3%, respectively. The incidence of these four chronic diseases were higher in individuals with central obesity and suboptimal sleep compared to the control group (all P<0.01). Multivariate logistic regression analysis showed that suboptimal sleep combined with general obesity/overweight increased the risk of dyslipidemia, hyperuricemia, hypertension, and hyperglycemia in the study subjects ［odds ratio (OR) were 2.40, 3.47, 3.30, and 2.79, respectively; all P<0.01］, after adjusting for age, gender, education level, marital status, occupation type, labor intensity, smoking, and drinking. Suboptimal sleep combined with central obesity also potentially increased the risk of these four chronic diseases (OR were 2.25, 3.09, 3.09, and 2.98, respectively; all P<0.01). Conclusion The incidence of common chronic diseases is relatively high in the occupational population in Shanghai City. Suboptimal sleep combined with different types of obesity increases the risk of common chronic diseases.

Objective: To understand the characteristics and clinical significance of anti-soluble liver antigen antibody (anti-SLA) in patients with liver diseases. Methods: Serum samples from seventy-seven patients with anti-SLA were collected from Beijing You'An Hospital during the period between January 2010 and December 2018. Anti-SLA, anti-liver cytosol type 1 antibody (anti-LC1), anti-glycoprotein 210 antibody(anti-gp210) and anti-nuclear body protein sp100 antibody(anti-sp100) were detected by immunoblotting; indirect immunofluorescence assay used for detecting anti-nuclear antibody (ANA), anti-mitochondrial antibody (AMA), anti-smooth muscle antibody (SMA), and anti-liver kidney microsome antibody (anti-LKM). One-way analysis of variance was used to compare the ages of different anti-SLA groups. The non-parametric rank sum test was used to compare the liver function indexes and immunoglobulins in different intensity groups of anti-SLA. P<0.05 was considered statistically significant. Further comparisons were made between the two groups, the correction level α′=0.008 3, P<0.008 3 was considered statistically significant. Results: The average age of 77 anti-SLA positive patients was (52.50±1.25) years old, 70 females (90.9%) and 7 males (9.1%). 80.5% of anti-SLA-positive patients (62/77 cases) were strongly positive at the time of initial diagnosis (+++ to ++++).The Alanine aminotransferase (ALT) level in the SLA++ group was higher than that in the SLA++++ group (232.7 U/L vs 65.6 U/L,χ²=7.751,P=0.005) and the immunoglobulin M(IgM) level in the SLA+++ group was lower than that in the SLA++++ group (1 270 mg/L vs 2 270 mg/L,χ²=8.337,P=0.004).There was no significant difference in age, other liver function and immunological indicators among the different groups.Seventy cases (90.9%) were both anti-SLA and ANA positive, 13 cases (16.9%) were positive with SMA, and none positive with anti-LKM and anti-LC1. Among anti-SLA positive patients, 58 cases were diagnosed with autoimmune hepatitis (AIH), 12 were AIH/primary biliary cholangitis (PBC) overlap syndrome (OS), 2 were drug-induced liver injury, 2 were chronic hepatitis B, and 3 were hepatitis A, hepatitis E and acquired immune deficiency syndrome (AIDS) with liver injury, respectively.Cases of AIH and AIH/PBC OS accounted for 90.9% (70/77 cases) of anti-SLA-positive patients, and 5 of 7 patients diagnosed with non-AIH (and OS) had elevated IgG, showing AIH feature.92.3% (12/13 cases) of anti-SLA with high titers of AMA were diagnosed as AIH/PBC overlap syndrome. Of the 77 anti-SLA-positive patients, 28 (36.4%) had advanced or end-stage liver disease, including decompensated cirrhosis (22 cases), chronic acute liver failure (4 cases), and liver transplantation (1 case) and death from liver failure (1 case). Conclusions Anti-SLA has high diagnostic specificity for AIH;anti-SLA positive in patients with PBC should be an important biomarker for the diagnosis of AIH/PBC overlap syndrome.

Objective To study the effects of the compound medicine of icariin and puerarin on peak bone mass in rats during growth period, and to explore its possible mechanism. Methods Forty female Sprague-Dawley rats aged 1 month were randomly divided into normal control group( C), icariin group( I), puerarin group( P), icariin and puerarin compound groupc(I+P), 10 in each group. The body weights were recorded once every two weeks, and the bone mineral density was measured by dual-energy X-ray absorptiometry every month. After the bone mineral density of the whole body was significantly different between the control group and drug groups the animals were sacrificed. The right femur and vertebrae were separated to measure the bone mineral density. The biomechanical properties of the femur and vertebra were detected by AG-IS series desktop electronic universal testing machine. The bone formation index osteocalcin, PINP and bone resorption index were determined by ELISA. Changes in the contents of tartrate-resistant acid phosphatase 5b(TRACP 5b) and CTX-1; and changes in trabecular bone related parameters were recorded after magenta-picric acid staining. Results There was no significant difference in body weight between the two groups (P＞0.05). There was no significant difference in whole body bone density after 1 month of treatment (P＞0.05). After 2 months of treatment, the body bone density of the drug-administered group was higher than that of the control group. Whole body bone density, femur and vertebral bone density, femur maximum load value, maximum vertebrae load value and trabecular bone number and area, serum OC and PINP levels increased, while TRACP 5b and CTX-1 levels decreased(P＜0.01) in drug group. The difference from the control group was statistically significant (P＜0. 05). There were significant differences in biochemical parameters and bone histomorphology between the compound drug group and the two-flavor monomer group ( P＜0. 01). There was no significant difference in bone mineral density and biomechanics, but the average value was higher than that of the monomer group. Conclusion The combination of icariin and puerarin can effectively increase the peak bone mass in rats.

Objective To explore the effect of expression of protein kinase C receptor 1(RACK1) induced by lipopolysaccharide (LPS) on Sonic hedgehog(SHH) signaling pathway in rat puhnonary microvascular endothelial cells (RPMVEC).Methods The healthy male SPF grade SD rat with 100-120 g body weight were gotten from the laboratory animal center of Anhui province.Using immunocytochemistry method,the expression of RACK1 protein in RPMVECs was detected,cultured RPMVECs were randomly divided into different groups as LPS dose-dependent group,SAG(smoothened Agonist,a SHH signaling pathway specific agonist) dose-dependent group,LPS time-dependent group,SAG time-dependent group and LPS+SAG group.In LPS dose-dependent groups,RPMVECs were cultured with 0.1,1,10 mg/L LPS for 8 h.In LPS time-dependent groups,RPMVECs were cultured with 10 mg/L LPS for 0,2,4,8,12,24 h.In SAG dose-dependent groups,RPMVECs were cultured with 0.1,1,10 μ mol/L for 8 h.In SAG time-dependent groups,RPMVECs were cultured with 1 μ mol/L SAG for 0,2,4,8,12,24 h.In LPS+SAG group,RPMVECs were cultured with 1 μ mol/L SAG 8 h after 10 mg/L LPS treatment for 1 h.In addition,blank group,LPS group and SAG group were set for control.Western blot were used to detect the level of RACK1 and RT-PCR were used to detect the expression of GLI-1 mRNA after intervention.Results Immunocytochemistry revealed that RACK1 were present in RPMVEC.1.In LPS dose-dependent groups (0,0.1,1,10 mg/L),the level of RACK1 elevated as LPS dose increased correspondingly with inter-group difference (P＜0.05);the relative expression levels of GLI-1 mRNA were (1.109 + 0.063),(1.039 + 0.135),(0.813 ± 0.066),(0.770 + 0.105),(1 mg/L vs.10 mg/L,P＞0.05;the rest P＜0.05).In LPS time-dependent groups,the relative expression level of RACK1 at 2 h (0.370 + 0.010) was higher than that at 0 h (0.329 ± 0.008),peaked at 12 h (1.296 ± 0.048),and compared with 0 h,there was significant differences (F=1 272.204,P＜0.05).The relative expression level of GLI-1 mRNA was decreased at 2 h (0.929 ±-0.007),and compared with 0 h(1.089 ± 0.042),there was significant differences (F=306.609,P＜0.05).2.In SAG dose-dependent groups,there was no significant difference in level of RACK1 between groups(all P＞0.05).The relative expression levels ofGLI-1 mRNA were (1.109 ± 0.063),(1.169 ± 0.052),(3.468 ± 0.128),(3.434 ± 0.054),(0 μ mol/L vs.0.1 μ mol/L and 1 μ mol/L vs.10 μ mol/L,P＞0.05,the rest P＜0.05).Among SAG time-dependent groups,there was no significant difference in levels of RACK1 protein(P＞0.05).The relative expression level of GLI-1 mRNA increased at 2 h (3.027 ± 0.065),and compared with 0 h (2.651 + 0.123),there was significant differences (F=132.841,P＜0.05).3.In LPS+SAG intervention groups,the expression of RACKI was lower than that in LPS group (0.831 ±0.040 vs.1.189 ± 0.149,P＜0.05),and the expression of GLI-1 mRNA was higher than that in LPS group (2.720 + 0.130 vs.0.796-4-0.082,P＜0.05).Conclusions The LPS up-regulates the expression of RACK1 in RPMVECs,and the activated SHH signaling pathway can down-regulate the expression of RACK1 induced by LPS in RPMVECs.

Objective:To study the eftect of plateau environment on the body compositions of soldiers.Methods:A total of 120 male soldiers were selected for the study.All of the study subjects received a physical examination between June and November in 2014.Bio-electrical impedance technique was used to measure the subjects' body composition including 33 parameters such as body mass index (BMI) and body fat mass.Results:Compared to that before entering into the plateau,the levels of 31 parameters were significantly lower after entering into plateau,except the distribution of muscles in left lower limb and ECW/TBW in right upper extremity.Conclusion:The body compositions of soldiers may decrease under plateau environment.This phenomenon need to be interfered purposefully to aTange scientific diets and training intensity.

Objective To analyze the effect of guizhi gancao decoction on dardiac function and serum VCAM-1 and sE-selectin levels in patients with coronary heart diseaser. Methods Fifty-eight patients with coronary heart disease were enrolled in this study from September 2014 to June 2015. According to the different treatment methods, 40 patients were treated with conventional western medicine. The observation group of 40 cases were treated with conventional western medicine and Guizhi licorice soup. The effects of cardiac function, 6-minute walking test, cardiac parameters and serum sE-Selectin and ICAM-1 levels were observed. Results Observation group of patients with cardiac ultrasound parameters LVEF (43.27 ± 5.21)%, LVEDd (59.34 ± 5.43) mm, FS (26.32 ± 1.63)%, E / A (1.23 ± 0.22) and 6 min walking distance were better than those of the control group (t=2.3628,P =0.0206;t=2.4643,P=0.0159;t=2.7831,P =0.0068;t=2.5023,P =0.0144;t=3.7571,P =0.0006). The markedly effective rate was 47.50%, which was higher than that of the control group (25.00%), and there was significant difference (χ2 = 4.3813, P= 0.0363). In the observation group, 4 patients were ineffective and the inefficiency rate was 10.00%, which was significantly lower than that of the control group (χ2 = 4.0205,P= 0.0450). The levels of TC (5.21 ± 0.82) mmol / L, TG (1.22 ± 0.32) mmol / L and LDL-C (2.44 ± 0.52) mmol / L were significantly lower in the observation group than those in the control group (t= 3.2729, P = 0.0016; t= 3.5119, P = 0.0007; t= 3.5136, P= 0.0007). While the HDL-C (1.21 ± 0.17) mmol / L index was higher than that of the control group (t = 5.4575, P = 0.0000). There was no significant difference in serum index between the two groups before treatment . After treatment, the serum sE-Selectin (75.58 ± 9.97) ng / mL and VCAM-1 (662.43 ± 65.78) ng / mL were lower than those in the control group (t = 3.4082, P = 0.0010;t = 3.3088, P = 0.0014). Conclusion Treatment of CHF patients with CRT / CRT-D pacemaker implantation in the heart after surgery can effectively improve its clinical condition, and the effect is outstanding, side effects, and CRT-D better effect.

Objective To explore the effect of regional synergistic treatment system on the treatment time and short-term prognosis of patients with ST-segment elevation myocardial infarction (STEMI).Methods A retrospective analysis of the clinical data of STEMI patients who admitted to emergency center of Suzhou Kowloon Hospital Affiliated to Shanghai Jiaotong University School of Medicine and underwent primary percutaneous coronary intervention (PPCI) from January 2013 to January 2017 were conducted. All patients were divided into two groups, group A was the patients who underwent the PPCI before the establishment of the acute chest pain area co-treatment system (from January 2013 to December 2014), and group B was the patients who received the treatment after the establishment of the area co-treatment system (from January 2015 to January 2017). The length of time from onset of symptoms to the balloon dilatation (S2B), the length of time from the first medical contact to the balloon dilatation (FMC2B), the length of time from entering the gate of hospital to the balloon dilatation (D2B), and the incidence of 90-day end point events (including heart failure, all-cause death, and other related adverse events) were collected. The relations of the establishment of the acute chest pain area co-treatment system and the incidence of 90-day end point events were analyzed by multivariable Logistic regression analysis.Results Among the 221 enrolled patients with STEMI, 83 patients were in group A and 138 patients were in group B respectively. Compared with group A, S2B time [minutes: 180 (140, 210) vs. 201 (154, 225)], FMC2B time [minutes: 89 (78, 100) vs. 94 (83, 107)] and D2B time [minutes: 66 (62, 70) vs. 85 (72, 99)] were significantly shortened in group B (allP < 0.05), the incidence of 90-day end point events were significantly decreased (heart failure:20.3％ vs. 32.5％, all-cause death: 1.4％ vs. 7.2％, other related adverse events: 23.2％ vs. 36.1％, allP < 0.05). It was shown by multivariable Logistic regression analysis that the establishment of the acute chest pain area co-treatment system could lower the incidence of 90-day end point events [heart failure: odds ratio (OR) = 1.904, 95％ confidence interval (95％CI) = 0.968-1.004, P = 0.048; all-cause death:OR = 11.724, 95％CI = 0.955-1.048,P = 0.013; other related adverse events:OR = 1.925, 95％CI = 1.049-3.530,P = 0.034].Conclusion The construction of regional synergistic treatment system can shorten the emergency treatment time of STEMI patients and reduce the incidence of 90-day end point events including heart failure and death.