Aim To study the effect of liraglutide on myocardial metabolites and related metabolic pathways in diabetic cardiomyopathy(DCM)rats.Methods Among 60 SPF male SD rats aged 3 weeks,10 rats were randomly selected as normal control group(n=10),and the remaining 50 rats were established by peritoneal injection of streptozoto-cin combined with high-sugar and high-fat diet for DCM rat model.A total of 36 rats were successfully modeled for DCM and randomly divided into DCM model group(DCM group,n=12),low-dose liraglutide treatment group(LL group,n=12)and high-dose liraglutide treatment group(HL group,n=12).Rats in LL group(100 μg/kg)and HL group(200μg/kg)were given intraperitoneal injection of liraglutide once a day.And after 12 weeks of intervention,the rats were killed under anesthesia after echocardiography to detect cardiac function,and the heart tissues were taken for metabolomics detection.The differential metabolites and related pathways that may be related to liraglutide improving myocardial metab-olism in DCM rats were screened and enriched.Results Compared with normal control group,left ventricular ejection fraction(LVEF)and left ventricular fractional shortening(LVFS)in DCM group were significantly decreased,and the ra-tio of early to late diastolic mitralflow velocities(E/A)was significantly increased(P＜0.05).Compared with DCM group,LVEF and LVFS in LL group and HL group were significantly increased,and E/A ratio was significantly decreased(P＜0.05),suggesting that the impairment of left ventricular systolic and diastolic function in LL group and HL group was significantly alleviated.395 metabolites were detected by metabolomics,among which 239,116 and 187 different metab-olites and 13,6 and 20 metabolic pathways were enriched in DCM group and normal control group,LL group and DCM group,HL group and DCM group.In the above three groups,29 key differential metabolites were identified related to 3 metabolic pathways including choline metabolic pathway,caffeine metabolic pathway and valine,leucine and isoleucine bi-osynthesis pathway,among which choline metabolic pathway had the most significant differences.Conclusion These results indicated that liraglutide can ameliorate cardiac dysfunction in DCM rats through improving myocardial metabolism in which choline metabolism pathway may play a key role.

Humans ; Diabetic Neuropathies/diagnostic imaging* ; Diabetes Mellitus, Type 2 ; Ultrasonography ; Diabetic Foot/diagnostic imaging*

Objective:To investigate the protective effect and potential mechanisms of microRNA-26a-5p (miR-26a-5p) on podocyte injury in diabetic kidney disease (DKD).Methods:(1) In vivo experiment: Four-week-old db/db mice were divided into db/db group, db/db+agomir-NC group and db/db+miR-26a-5p agomir group according to random number table method, with 10 mice in each group, and 10 db/m mice of the same week-old were set as normal control group. At the age of 10 weeks, pathological changes were observed through light and electron microscopy. Kidney weight/body weight (KW/BW), urinary albumin to creatinine ratio (ACR), fasting blood glucose (FBG) and other biochemical indicators were also detected. The position and expression of miR-26a-5p in kidney tissue were determined through fluorescence in situ hybridization and quantitative real-time PCR, while the expressions of transient receptor potential cation channel-6 (TRPC6) and Nephrin in kidney tissue were determined by Western blotting and immunohistochemistry. (2) In vitro experiment: The immortalized mouse podocytes (MPC5) were divided into 5 groups: normal glucose group, high mannitol group, high glucose group, high glucose+miR-26a-5p mimic group, and high glucose+mimic-NC group. The expressions of miR-26a-5p, TRPC6 and Nephrin were detected. Luciferase reporter assay was conducted to research the relationship of miR-26a-5p and TRPC6. Results:(1) In vivo experiment: Compared with db/m group, db/db mice exhibited lower KW/BW and disrupted conditions of ACR, FBG, total cholesterol, triglycerides and low density lipoprotein cholesterol (all P<0.01). Increased glomeruli volume, more extracellular matrix deposition, thicker basement membrane and more foot process fusion were observed by light and electron microscope. Increased expression of TRPC6 protein as well as decreased expression of Nephrin protein and miR-26a-5p were detected in kidney tissues of db/db mice ( P<0.05). Compared with db/db+agomir-NC group, db/db mice transfected by miR-26a-5p agomir exhibited less albuminuria, with less protein expression of TRPC6 and more Nephrin in kidney tissue (all P<0.05). (2) In vitro experiment: Compared with normal glucose group, high glucose-treated podocytes exhibited increased expression of TRPC6 ( P<0.05), as well as decreased expression of Nephrin ( P<0.05) and miR-26a-5p ( P<0.01). Compared with high glucose+mimic-NC group, lower expression of TRPC6 and higher expression of Nephrin were detected in podocytes transfected by miR-26a-5p mimic (both P<0.05). Luciferase reporter assay confirmed that miR-26a-5p could regulate the expression of TRPC6 precisely. Conclusions:The expression of miR-26a-5p in podocytes is down-regulated in the context of high glucose and miR-26a-5p protects podocytes from injury via inhibiting the expression of TRPC6 in DKD.

Objective:To investigate the occupational damage to workers exposed to chromate in a steel plant.Methods:In January 2021, a retrospective analysis was used to select 850 workers exposed to chromate (observation group) and 598 workers not exposed to chromate (control group) in a steel plant in Shandong Province from 2016 to 2017 as the investigation. We collected their occupational-related information, blood routine, fasting blood sugar, nasal lesions, skin lesions, chest X-rays and other inspection results, compared the differences in the abnormal detection rate of the two groups of respondents, and analyzed the occupational hazards of chromium workers.Results:Incidence of nasal damage, skin lesion, up-regulation of ALT (Alanine aminotransferase), abnormal chest radiograph, abnormal serum biochemical index, and abnormal serum glucose level were observed higher in the exposed group than those in the control group (χ 2=125.69, 12.25, 5.82, 10.37, 10.46, 20.66, P=0.000, 0.000, 0.016, 0.001, 0.001, 0.000). Among the symptoms, the incidence of erythra, nasal septum deviation, nasal mucosal congestion, nasal mucosal erosion and rhinitis were more frequent than those in the control group (χ 2=101.54, 4.07, 13.20, 32.05, P=0.000, 0.044, 0.000, 0.000). There was no significant increase in the incidence of work type, age, length of work and the area of nasal mucosa erosion in the observation group compared with the control table, and the difference was not statistically significant (χ 2=5.31、0.42、0.28, P=0.505, 0.662, 0.871) . Conclusion:Occupational hazards of long-term exposure to chromate cannot be ignored. Attention should be paid to strengthening occupational protection and health education of workers exposed to chromium, and increasing their attention.

Objective:To investigate the occupational damage to workers exposed to chromate in a steel plant.Methods:In January 2021, a retrospective analysis was used to select 850 workers exposed to chromate (observation group) and 598 workers not exposed to chromate (control group) in a steel plant in Shandong Province from 2016 to 2017 as the investigation. We collected their occupational-related information, blood routine, fasting blood sugar, nasal lesions, skin lesions, chest X-rays and other inspection results, compared the differences in the abnormal detection rate of the two groups of respondents, and analyzed the occupational hazards of chromium workers.Results:Incidence of nasal damage, skin lesion, up-regulation of ALT (Alanine aminotransferase), abnormal chest radiograph, abnormal serum biochemical index, and abnormal serum glucose level were observed higher in the exposed group than those in the control group (χ 2=125.69, 12.25, 5.82, 10.37, 10.46, 20.66, P=0.000, 0.000, 0.016, 0.001, 0.001, 0.000). Among the symptoms, the incidence of erythra, nasal septum deviation, nasal mucosal congestion, nasal mucosal erosion and rhinitis were more frequent than those in the control group (χ 2=101.54, 4.07, 13.20, 32.05, P=0.000, 0.044, 0.000, 0.000). There was no significant increase in the incidence of work type, age, length of work and the area of nasal mucosa erosion in the observation group compared with the control table, and the difference was not statistically significant (χ 2=5.31、0.42、0.28, P=0.505, 0.662, 0.871) . Conclusion:Occupational hazards of long-term exposure to chromate cannot be ignored. Attention should be paid to strengthening occupational protection and health education of workers exposed to chromium, and increasing their attention.

Objective:To study the early effect of arthroscopy in the treatment of obsolete traumatic subscapularis tears.Methods:A retrospective case series study was used to analyze the clinical data of 28 patients with obsolete traumatic subscapularis tears admitted to Second People 's Hospital of Changzhou City from July 2017 to July 2020，including 16 males and 12 females，aged 47-72 years［（60.5±6.3）years］. According to Lafosse classification，the injury size was upper one third tear in 9 patients，upper half tear in 18 and complete tear in 1. According to Patte classification of the degree of retraction，4 patients were with no retraction，7 with retraction to the level of the lesser tuberosity，14 with retraction to the level of the humeral head，and 3 with retraction to the level of the glenoid. According to Goutallier classification，the level of fatty infiltration was at grade 0-1 in 17 patients，at grade 2 in 10 and at grade 3-4 in 1. All patients were repaired by arthroscopic surgery. The wound healing was observed at 2 weeks postoperatively. The visual analogue score（VAS），University of California at Los Angeles（UCLA）shoulder rating score，shoulder active forward elevation（AFE），active external rotation（AER），active internal rotation（AIR）were assessed before operation and at 3 months and 6 months postoperatively. Six months after operation，reexamination of the front and side view of the shoulder and MRI of the shoulder were performed to assess the recovery of the subscapular tendon. Results:All patients were followed up for 6-12 months［（8.7±1.3）months］. All wounds healed 2 weeks after operation，with no infection occurred. The VAS was（3.5±0.7）points and（2.6±0.5）points at 3 months and 6 months postoperatively，lower than（6.3±1.2）points before operation（ P<0.01）. The UCLA score was（20.4±2.5）points and（25.6±6.2）points at 3 months and 6 months postoperatively，higher than（9.5±1.7）points before operation（ P<0.01）. The preoperative range of motion of the affected shoulder in AFE，AER and AIR was（80.2±12.6）°，（52.5±7.6）°，（3.7±1.2）°，respectively. Three months after operation，the range of motion was（113.2±7.5）°，（60.1±6.3）°，（6.8±1.6）°，respectively. Six months after operation，the range of motion was（122.3±15.2）°，（65.6±10.5）°，（7.8±2.3）°，respectively. The range of motion of the affected shoulder at 3 months and 6 months postoperativley was better than that before operation（ P<0.01）. Six months after operation，MRI showed good recovery in 27 patients，while a small re-tear in 1 patient（Goutallier classification grade 3）. Conclusion:For patients with obsolete traumatic subscapularis tears，arthroscopic repair can significantly relieve the pain，and recover range of motion and function of the joint.

Objective: To explore determinants of childhood trauma among college students with left-behind experience, and to provide a reference for effective intervention among students with left-behind experience. Methods: A total of 2 468 students selected from 5 universities and 2 higher vocational colleges in tianjin by stratified cluster sampling method were investigated by self-compiled questionnaire and childhood trauma questionnaire. Results: The scores in emotional abuse, sexual abuse, emotional neglect, physical neglect and childhood trauma of students with left-behind experience were significantly higher than those without left-behind experience(t=3.01，3.13，3.24，2.27，3.60，P<0.05)；parental separation times and the frequency of parental return had significant interaction effect on the total score of childhood trauma of students with left-behind experience (F=2.37, P<0.05)；the gender had a significant major effect on the total score of childhood trauma of students with left-behind experience under the interaction with the place of origin, age at first separation,the cumulative time of leftbehind experiences and the frequency of parents contacting (F=4.49，5.23，5.93，5.11，P<0.05)；the age of subjects when parents going out under the interaction with the place of origin, the gender, if only-child,parental separation times and the frequency of parental return；as well as the frequency of parents contacting under the interaction with the place of origin，the household registration, the gender, if only-child and the cumulative time of left-behind experiences also had significantly main effect(F=3.88，4.25，3.32，2.86，3.45；3.82，4.02，2.64，3.29，P<0.05). Conclusion It is necessary to attach great importance to demographic and context information regarding left-behind experiences,which lead to more specific and effective prevention and intervention strategy for individual with left-behind experiences.

Objective　Visfatin, a newly identified pro-inflammatory adipokine, has been related to atherosclerosis,therefore we explore the association between the visfatin rs61330082 and ischemic stroke risk. The -1535 polymorphism (rs61330082) located in the visfatin gene promoter is reportedly associated with inflammatory related atherosclerosis. Method　A total of 368 ischemic stroke patients and 381 healthy controls were enrolled for the study. The rs61330082 polymorphism was genotyped by the polymerase chain reaction-ligase detection reaction (PCR-LDR) sequencing method. Results　No significant differences in genotypic and allelic frequencies between ischemic stroke patients and healthy controls were observed even when the OR was adjusted for the clinical variables. We also did not find any significant association from sex subtypes. Conclusion　Visfatin rs61330082 polymorphism is not associated with ischemic stroke risk in the northern Chinese Han population.

Objective To compare the efficacy of direct anterior approach ( DAA ) and posterolateral approach (PA) in hip arthroplasty for elderly patients with femoral neck fractures. Methods A retrospective case-control study was conducted to analyze the clinical data of 67 elderly patients with femoral neck fractures admitted to Second People's Hospital of Changzhou City, Affiliated Hospital of Nanjing Medical University from July 2015 to December 2017. There were 25 males and 42 females, aged 60-90 years [(76. 1 ± 7. 6)years]. There were 31 patients with right femoral neck fracture and 36 with left femoral neck fracture, all of whom underwent operations within 72 hours after injury. There were 18 patients with type III and 49 with type IV according to Garden typing. All patients were treated with total hip arthroplasty. Direct anterior approach ( DAA) was performed in 36 patients ( DAA group) and posterior approach ( PA) was performed in 31 patients ( PA group) . The operation time, intraoperative blood loss, postoperative drainage, recessive blood loss, total blood loss, the time when the patients got out of bed, and hospitalization time were compared between the two groups. Visual analogue scale ( VAS) and Harris score were used to evaluate hip joint function one month after operation. The complications of the two groups were recorded. Results All patients were followed up for 3-6 weeks, with an average of one month. The operation time of DAA group was longer than that of PA group [(75. 0 ± 10. 5)minutes vs. (54.0±11.4)minutes] (P<0.01). The DAA group had less intraoperative blood loss [(174.3 ± 60.1)ml vs. (254.8±79.9)ml] (P<0.05), total blood loss [(745.7 ±238.8)ml vs. (977.9 ± 301. 9)ml] (P<0. 05), recessive blood loss [(315. 4 ± 196. 7)ml vs. (457. 7 ± 286. 2)ml] (P<0. 05) than the PA group. There was no significant difference in the postoperative drainage between DAA groupandPAgroup[(246.1 ±110.1)ml vs. (265.3±164.2)ml] (P >0.05). DAA group had shorter durations in terms of the time when patients got out of bed [(23. 7 ± 18. 1)hours vs. (35. 1 ± 22. 5)hours] (P<0. 01) and hospitalization time [(9. 2 ± 1. 5)days vs. (12. 3 ± 2. 0)days] than the PA group (P <0. 05). The VAS scores of the DAA group and PA group at 1 month after surgery [(3. 0 ± 1. 9)points vs. (3. 3 ± 1. 9) points] and the Harris score [(87. 9 ± 6. 5) points vs. (87. 0 ± 6. 1)points ] were not significantly different (P>0. 05). Intraoperative and postoperative complications included femoral periprosthetic fracture in three patients, lateral femoral nerve injury in two patients and severe anemia requiring blood transfusion in two patients in DAA group. In the PA group, there was one patient with deep venous thrombosis of the lower extremity at one month after operation, two patients with posterior dislocation of the hip, four patients with periprosthetic fracture and four patients with severe anemia requiring blood transfusion (P>0. 05). Conclusion For femoral neck fracture in the elderly, compared with PA hip arthroplasty, DAA hip arthroplasty has less bleeding, earlier time to get out of bed and shorter hospital stay, with satisfactory short-term results.

Iodine and fluoride are indispensable elements of human life activities,excessive or insufficient intakes can cause diseases,especially thyroid diseases,the relationship between iodine,fluoride and thyroid diseases has been paid more and more attention.The water iodine and fluoride are an important source of human intakes,so researching the influence of water iodine and fluoride on thyroid diseases is of great significance for guiding the population to maintain normal thyroid morphology and function.