Objective To investigate the correlation between serum 25-hydroxyvitamin D[25(OH)D]level and diabetic kidney disease(DKD)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 174 T2DM patients admitted to Jiashan County Second People's Hospital from May 2019 to May 2021 were selected and divided into normal albuminuria(NUAlb)group(<30 mg/g,n=71),microalbuminuria(MUAlb)group(30～300 mg/g,n=85)and large albuminuria(LUAlb)group(≥300 mg/g,n=18)according to the urine albumin-creatinine ratio(UACR)level.The levels of 25(OH)D in each group and its relationship with UACR were analyzed.Results The age,DM duration,use of ACEI or ARBs,SBP,DBP,FPG,SUA,proportion of 25(OH)D<30 nmol/L and UACR in NUAlb,MUAlb,LUAlb graup increased in turn(P<0.05).Spearman correlation analysis showed that UACR in T2DM patients was positively correlated with gender,age,DM duration,BMI,SBP,DBP,FPG,HbA1c,TG,and SUA(P<0.05),and negatively correlated with HDL-C and 25(OH)D(P<0.05).Logistic regression analysis showed that gender,SBP,HbA1c,SUA,and 25(OH)D were influencing factors for albuminuria in T2DM patients.Conclusions T2DM patients have 25(OH)D shortage,especially in DKD patients.25(OH)D deficiency is closely related to proteinuria in T2DM patients.

Objective To investigate whether endoscopic ultrasonography (EUS) can be an alternative method for diagnostic endoscopic retrograde cholangiopancreatography (ERCP) by comparing the ability of EUS versus CT and transabdominal ultrasonography (TUS) in the diagnosis of muddy stones of the common bile duct. Methods A prospective study was conducted for 53 patients suspected of muddy stones of the common bile duct who attended Nanxishan Hospital of Guangxi Zhuang Autonomous Region from July 2019 to December 2021, and all patients underwent EUS, TUS, and CT before ERCP. With ERCP and endoscopic sphincterotomy (EST) for removing muddy stones of the common bile duct as the gold standard for the diagnosis of muddy stones of the common bile duct, EUS, TUS, and CT were compared in terms of their ability to display the muddy stones of the common bile duct. The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. Results In the 53 patients, EUS, TUS, and CT had a positive rate of 88.68%, 50.94%, and 62.26%, respectively, in detecting muddy stones of the common bile duct. As for the positive results confirmed by EST under ERCP, EUS had a sensitivity of 93.75%, a specificity of 60.00%, and an accuracy of 90.57% in detecting muddy stones of the common bile duct, while TUS had a sensitivity of 56.25%, a specificity of 100.00%, and an accuracy of 60.38% and CT had a sensitivity of 66.67%, a specificity of 80.00%, and an accuracy of 67.92%. There was a significant difference between EUS and CT in the accuracy in detecting muddy stones of the common bile duct ( χ 2 =8.26, P =0.004), and there was also a significant difference in diagnostic accuracy between EUS and TUS ( χ 2 =13.05, P < 0.001). Conclusion EUS is more accurate than TUS and CT in the diagnosis of muddy stones of the common bile duct, and instead of ERCP, EUS is thus recommended for suspected muddy stones of the common bile duct when TUS and CT fail to identify the lesions in clinical practice, so as to make a confirmed diagnosis and reduce related costs and complications.

Objective:To explore the clinical characteristics of poisoned patients with poisons purchase online.Methods:A retrospective case-control study was conducted on poisoned patients purchased poisons online from 1st January 2021 to 31th May 2022 in the Emergency Department of the First Affiliated Hospital of Nanjing Medical University. The clinical data including sex, age, way of medical treatment, cause of poisoning, exposure routes, category of toxic drugs, gastric lavage, toxic detection and prognosis of patients were collected and compared with those patients obtained poisons at stores as the control group.Results:Totally 318 poisoned patients were included in this study, of which 44 (13.8%) were obtained poisons online. Compared with the patients obtained poisons at stores, the patients obtained poisons online were younger ( P<0.001), and had higher proportion of suicide intention ( P=0.006), more oral route exposure ( P=0.029), and more proportions of receiving gastric lavage before transfer to the hospital ( P=0.001). Pesticides and fertilizers with organic heterocycles were the main types of poisons in the online group, and there was no statistical difference in the distribution of poisons compared with the control group. Mixed drug poisoning was the leading cause in both online group (27.8%) and control group (38.8%) in drug overdose poisoned types, followed by dextromethorphan (16.7%) and estazolam (15.5%) in the online group. Conclusions:Young people are the main group getting poisons through the Internet. Health education should be strengthened for this group, and online shopping platforms should pay attention to the poisoning risk of potential overdose drugs or poisons transactions.

【Objective】 To investigate the effects and mechanism of STAT3 inhibitor Stattic combined with arsenic trioxide (ATO) on the survival and apoptosis of acute myeloid leukemia (AML) THP1 cells. 【Methods】 CCK8 assay was used to detect the effects of Stattic combined with ATO on cell viability, flow cytometry was used to detect cellular apoptosis and ROS levels, and Caspase 3/7 Glo assay was used to determine Caspase 3/7 activity. qPCR was used to detect mRNA expression levels of GCLM, GCLC and HO-1 genes, and Western blotting was used to detect protein expression levels of P-STAT3, STAT3 and Nrf2. 【Results】 Stattic significantly inhibited the level of phosphorylated STAT3, aggravated the inhibitory effect of ATO on THP1 cell viability, and enhanced the apoptosis and reactive oxygen species (ROS) induced by ATO. Stattic significantly inhibited the expression of ATO-upregulated Nrf2 and the expression of Nrf2 downstream genes including HO-1, GCLM and GCLC. 【Conclusion】 Stattic can enhance the effects of ATO-mediated viability inhibition and apoptosis. The mechanism may be related to the increased ROS via inhibition of Nrf2 and Nrf2 downstream gene expression.

Cholelithiasis is a major health burden and is classified into two types of gallstones and bile duct stones. Biliary sludge is a special type of cholelithiasis and is often known as microlithiasis, microcrystal disease, and bile sand. It has complex clinical manifestations, with no symptoms or various clinical symptoms, and may also lead to serious complications. At present, major diagnostic methods for this disease include ultrasound, computed tomography, magnetic resonance, endoscopic retrograde cholangiopancreatography, intraductal ultrasound, and endoscopic ultrasound, and major treatment methods include traditional Chinese and Western medicine therapy, medical treatment, surgery, and minimally invasive treatment. This article reviews the advances in clinical diagnosis and treatment.

Objective To investigate the effects of basic fibroblast growth factor (bFGF) on pericytes in the blood brain barrier at acute stage after traumatic brain injury (TBI) in mice.Methods A total of 90 mice with a C57BL/6 background were randomly divided into sham group,TBI group,and TBI + bFGF group,with 30 rats per group.The models of moderate TBl were established using the controlled cortical impactor.After 24 hours,the changes of nerve function were evaluated by Garcia neurological score.Each mouse received an intraperitoneal injection of Evans blue dye for measuring the permeability of blood brain barrier.Western blot was used to test the related indices of pericytes after the cerebral cortex was quickly dissected:platelet-derived growth factor receptor beta (PDGFR-β),aminopeptidase N (CD13),desmin,neurogliocyte 2 (NG2),and glyceraldehyde-3-phosphate dehydrogenase (GAPDH).Paraffin sections were prepared for HE staining and morphological changes were observed.Immunofluorescence assay was used to test the related indices of pericytes:PDGFR-β,CD13,and cell surface glycoprotein MUC18 (CD146).Results Garcia neurological score revealed that the score in TBI group was significantly decreased compared with that in sham group (P ＜ 0.01),but the score of TBI + bFGF group was significantly increased compared with that of TBI group (P ＜ 0.05).Permeability of blood brain barrier in TBI group was significantly increased compared with that in sham group (P ＜0.01),but in TBI + bFGF group this parameter significantly reduced compared with that in TBI group (P ＜ 0.01).Western blot analysis revealed that the expressions of PDGFR-β,CD13,desmin,NG2 proteins in TBI group were significantly decreased compared with those in sham group (P ＜0.05),while the expressions of PDGFR-β,CD13,desmin,NG2 proteins in TBI + bFGF group were significantly increased compared with those in TBI group (P ＜ 0.05).HE staining revealed injury of brain parenchyma in TBI group was the severest compared with both sham group and TBI + bFGF group.Immunofluorescence staining results revealed that the proteins expressions of PDGFR-β,CD13,and CD146 in TBI group were significantly decreased compared with those in sham group (all P ＜0.01),and those in TBI + bFGF group were significantly increased compared with those in TBI group (all P ＜ 0.05).Conclusions bFGF can prevent pericyte death via protecting its proteins to conserve blood-brain barrier,bFGF can also significantly ameliorate the injury of brain parenchyma.

Objective To explore the effect of visualization health education of diet on diet compliance in with esophageal stenting. Methods A total of 56 esophageal neoplasms patients with esophageal stenting at Nanxishan Hospital of Guangxi Zhuang Autonomous Region were selected from January 2012 to June 2016. They were randomly divided into observation group and control group, 28 patients in each group. Patients in the control group received routine health education on diet knowledge, while patients in the observation group were provided with diet health education knowledge cards. Intervention time included the day been admitted to hospital, the day of surgery, one day after surgery and before leaving hospital. This study compared the diet compliance and the incidence of complications of patients between two groups. Results The diet compliance of patients in the observation group was better than that of the control group with a significant difference (P<0.01). The incidence of pectoralgia, fecal occult blood, stent displacement or abscission and gastroesophageal reflux of patients in the observation group was 57.1%, 53.6%, 3.6%, 14.3% lower than those (92.9%, 82.1%, 28.6%, 57.1%) of the control group with significant differences (P< 0.01). Conclusions Nurisng of visualization health education can effectively improve the diet compliance of patients with esophageal stenting and reduce the incidence of complications after esophageal stenting.

Objective To explore the effects of telephone visit on continuous nursing care in patients after esophageal stent implantation. Methods A total of 56 patients with esophageal cancer who had esophageal stent implantation in Nanxishan Hospital from January 2012 to June 2016 were collected in this study. The participants were divided into the control group (n=28) and the intervention group (n=28). Based on the health education using dietary health educational card, the intervention group received additional telephone return visit at 1 week and 1, 3, 6 months after discharged from hospital. The quality of life and satisfaction level were compared between two groups before and six months after discharge. Results After the intervention, the intervention group had significantly better assessment scores on appetite, pain, fatigue, vitality, sleep, awareness of cancer, attitude towards treatment, daily life, treatment side effects, and social support compared with the control group (P<0.05). There were no statistically significant differences in family support between two groups (P> 0.05). The satisfaction level was significantly higher in the intervention group compared with the control group (P< 0.01). Conclusions The telephone return visit nursing intervention can effectively promote the satisfaction level and quality of life in patients after esophageal stent implantation. However, the communication between medical staff and patients' family needs to be improved.

Objective To explore the role of nucleotide-binding oligomerization domain receptor protein 3 (NLRP3) inflammasome in the pathogenesis of dementia. Methods 16 patients with with Alzheimer's disease (AD), 22 patients with vascular dementia (VD) and 20 healthy persons with similar age were detected the level of NLRP3 mRNA with RT-PCR in peripheral blood mononuclear cells January, 2014 to October, 2015. The serum level of interleukin (IL)-1βand IL-18 were detected with ELISA. The total number of white blood cells (WBC) and serum total calcium were collected. Single factor correlation analysis was performed between NLRP3mRNA and IL-1β, or IL-18, or WBC, or calcium concentration. Results The levels of NLRP3 mRNA ranged from high to low were as in AD group>VD group>the healthy group (q>11.48, P<0.05). The serum level of IL-1βwas higher in AD group than in the the healthy group (q=16.74, P<0.05), but not significantly different between VD group and the healthy group, nor between VD group and AD group (P<0.05). There was no signifi-cant difference about IL-18 among AD group, VD group and the healthy group (P<0.05). NLRP3 mRNA was positively correlated with the serum levels of IL-1β(r=0.64) and calcium (r=0.58) in AD group. There was no correlation between NLRP3 mRNA and IL-18 or WBC (P<0.05). Conclusion The expression of NLRP3 inflammasome may be related with the pathogenesis of AD, but little impact on the pathogene-sis of VD.

Objective To study calcium chelator BAPTA-AM antagonize the cellular oxidative stress induced by hydrogen peroxide ( H2 O2 ) and to explore the effect of calcium ion on the cell degeneration mediated by NLRP3.Methods The SHSY5Y cell model of oxidative stress was made by hydrogen perox-ide,then the cell model was treated with calcium ion carrier A23187 or BAPTA-AM,a higher efficiency cal-cium chelating agent.The cells were divided into 4 groups:H2O2 treatment group,H2O2+A23187 group, H2 O2+A23187 +BAPTA-AM group and control group.NLRP3 protein was detected by Western blot,and Caspase-1 and IL-1βwere detected by ELISA.Results NLRP3 expression was significantly increased in cells treated by hydrogen peroxide(P<0.05) .The NLRP3 protein continued to increase, and the expression of Caspase-1((57.1±19.2)pmol/L) and IL-1β((484.2±49.5)pg/ml) protein was also increased signifi-cantly in cells treated by A23187,and the difference had statistically significant for caspase-1 or IL-1βin H2O2+A23187 group compared with those in control group(Caspase-1:(26.8±12.9)pmol/L,IL-1β:(326.9 ±52.1) pg/ml) (P<0.05, P<0.01) .NLRP3,Caspase-1 and IL-1βwere all significantly reduced after adding a high-er efficiency calcium chelating agent BAPTA-AM.Conclusion Calcium overload is likely to enhance the oxidative stress induced by hydrogen peroxide and engender neurodegeneration mediated by NLRP3 inflammasome.