Diabetic kidney disease （DKD） is one of the common microvascular complications of diabetes mellitus （DM） and a primary cause of chronic kidney disease （CKD） and end-stage renal disease （ESRD）. Inflammation is currently a hot topic in exploring the pathogenesis of DKD. Macrophages， T cells， interleukins， tumor necrosis factor， NOD-like receptor protein 3 （NLRP3） inflammasome， Janus kinase/signal transducer and activator of transcription （JAK/STAT） signaling pathway， and nuclear factor-kappa B （NF-κB）-related signaling pathway all play a role in regulating the inflammation of DKD and accelerating its progression. Astragali Radix， a Chinese herbal medicine， is widely used in the treatment of DKD and possesses strong anti-inflammatory effects. Studies have revealed that active ingredients of Astragali Radix， including polysaccharides， astragaloside Ⅳ， total flavonoids， calycosin， and quercetin， can regulate multiple signaling pathways to ameliorate the microinflammatory state and alleviate kidney damage， thereby slowing down the progression of DKD. This article systematically reviews the factors influencing the inflammation in DKD and analyzes recent research findings and mechanisms concerning active ingredients of Astragali Radix in the management of DKD inflammation， aiming to offer novel insights and directions for the prevention， treatment， and research of DKD.

Internal radionuclide contamination is one of important issue in medical response to nuclear or radiological emergency, which is the key of medical rescue. The medical uses of both preventive absorption drugs and acceleration elimination drugs are crucial means to control internal contamination. Usually the earlier use of such drugs could result in the better effects. Chinese national standards formulate that both preventive absorption of radionuclides and decorporation treatment should be applied as soon as possible in the event of there bing definite or highly suspected excessive intake of radionuclides. However, there are differences and inconsistencies in use of acceleration elimination drugs and strategies of acceleration elimination drugs between many national standards to some degree, easily causing confusion. Thus, this paper proposes the applicable time for applying decorporation drugs on the basis of comparison of the applicable scope and conditions between relevant national standards in combination with the related foreign advancements. It suggests that the ideas of decorporation strategies in both domestic on-site emergency response for nuclear accidents and abroad "urgent approach" are worth to advocate. According to the strategies, it is prudent and advisable to start decorporation treatment immediately even when radionuclide incorporation is just suspected, and treatment should be discontinued once internal dosimetric result are below intervention level. Meanwhile, the issues in need of attention in the application of the above-mentioned strategies for internal contamination are discussed.

Objective To detect the expression profile of heme oxygenase-1(HO-1)during the process of wound repair in radiation-wound combined injury(R-W-CI),and evaluate its wound healing improving effects of R-W-CI by HO-1 knockdown with siRNA.Methods A total of 36 male C57BL/6J mice(8 weeks old)were randomly and equally divided into a simple skin wound group(W group)and a skin wound group combined with whole-body radiation(6 Gy)injury(R-W-CI group).During the wound healing process,the wounds were photographed and recorded,and the residual areas were quantified by Image J.Wound tissues were sampled and stained with HE staining for pathological and histological observation,and the damage to the hematopoietic system was assessed by dynamic examination of the peripheral blood.The expression and changes of HO-1 in wound tissues were detected by q-PCR and Western blotting.Then,26 male C57BL/6J mice(8 weeks old)were randomly and equally divided into siRNA knockdown HO-1 group(si-HO-1 group)and siRNA negative control group(si-NC group).After radiation combined injury was inflicted,60 μL of F127 gel loaded with si-HO-1(5 μm/L)was applied to each wound in the si-HO-1 group,and an equal amount of F127 gel loaded with negative control si-NC was applied to the wound in the si-NC group.The knockdown of HO-1 in wound tissues was detected by Western blotting,and the changes in wound area were observed.In the wound tissues harvested in 3 d after wounding,the expression of cytokines IL-1β,IL-6 and TNF-α was examined by q-PCR and the proliferation of granulation tissues was evaluated by Ki67 immunohistochemical staining.HE staining was performed on wound tissues on day 3 and day 9 post-injury to assess the improvement effect of knockdown of HO-1 on wound healing of radiation combined injuries.Results Compared with the W group,semi-quantitative analysis of the residual wound area showed that healing was significantly delayed in the R-W-CI group on days 7 and 10 post-injury(P＜0.01).HE staining on day 7 showed that in the R-W-CI group,the re-epithelialization was delayed,and the growth of granulation tissues was poor;and at the same time,peripheral blood leukocytes and their classified counts showed a significant decrease in the early period after injury(P＜0.05).Further tests indicated that the expression of HO-1 protein was slightly higher in the wound of the R-W-CI group than that of the W group in 3 and 7 d after injury,though no significant difference(P＞0.05),whereas statistical difference was seen in 10 d(P＜0.05),accompanied by the distribution of the full-length and truncated forms of HO-1 protein.Quantitative PCR obtained similar results in the mRNA expression of HO-1 in wounds in both 7 and 10 d after injury(P＜0.05).siRNA intervention could effectively knock down the HO-1 protein level of the wounds(P＜0.05),promote wound contraction(P＜0.05),reduce the width of the wound(P＜0.01),up-regulate the inflammatory cytokines IL-6 and TNF-α in 3 d,enhance the proliferation of repair cells in wound margin,and improve the growth of the granulation tissue in the R-W-CI model when compared with the conditions after si-NC intervention.Conclusion There exists a sustained high expression level of HO-1 during wound repair,and wound knockdown of HO-1 by siRNA can improve the lack of inflammation status and promote wound healing in R-W-CI mice.

Radionuclide-contaminated wounds are common in medical response to nuclear emergencies, which have different manifestations in different types of accidents. Medical treatment is the key part of the response. Based on the drill experience gained from medical response to nuclear emergencies, the authors summarize the research advances in radionuclide-contaminated wounds in recent years, mainly involving the biokinetic characteristics, medical response, surgical debridement, and prevention and treatment of internal contamination of radionuclide-contaminated wounds; the authors summarize the key points of technical operations and provide suggestions on improvements in the drills. The authors believe that medical treatment of radionuclide-contaminated wounds requires highly compatible integration of the practical skills from clinical medicine and radiological knowledge; emergency response, surgical debridement, and prevention and treatment of internal contamination all together constitute an integrated rescue and treatment strategy with internal logic correlations. However, targeted improvements are needed to achieve desired effects in the drills.

ObjectiveTo understand the health-related life quality and its influencing factors in elderly community residents in Shanghai， and to provide reference for improving their life quality. MethodsDuring April to June 2021， a cross-sectional survey was conducted in five selected community health care centers， from Baoshan District， Minhang District， Songjiang District and Pudong New District of Shanghai， respectively. The elderly residents aged 65 and over who received physical examination were face-to-face interviewed using EQ-5D-5L scale. SPSS 26.0 and Stata 16 were used for statistical analysis. Binary logistic regression， multiple linear regression and Tobit regression were used to analyze influencing factors of each dimension in EQ-5D scale， EQ-VAS score and health utility value. ResultsA total of 1302 elderly residents were included in the study， and the proportions of problems in the five dimensions of EQ-5D-5L scale were pain/discomfort （13.9%）， mobility （9.1%）， daily activity （5.8%）， self-care ability （4.8%） and anxiety/depression （3.6%）， while age was a factor influencing problems in each dimension. The average score of EQ-VAS was 84.28±10.32， and the average health utility value based on Chinese population was 0.97±0.08， which was higher than the rest of the country. Tobit regression analysis showed that female （t=-3.96， P<0.001）， age group over 75 （t=-5.28， P<0.001）， high school education or above （t=-2.53， P=0.012）， chronic disease （t=-5.12， P<0.001） had poor quality of life （P<0.05）. ConclusionThe overall quality of life of the elderly in Shanghai community is good， but the quality of life in the elderly women and in the group suffering from chronic diseases is relatively poor. It is necessary to pay more attention to the key populations to improve their health status.

Bleeding caused by ionizing radiation involves many factors, the mechanism is complicated and the management is difficult. Bleeding is recognized as one of the main causes of death after ionizing radiation. In this paper, we summarize the pathophysiological mechanisms of ionizing radiation bleeding syndrome (IRBS) from the aspects of platelet abnormality, coagulation disorder and vascular damage. Besides, we expound the clinical characteristics of IRBS in terms of the degree, time and site of the bleeding. Combined with experimental results, we put forward ideas and possible approaches for the treatment of IRBS, and the key factor is to promote the recovery of megakaryocytes and rapid platelet production after radiation exposure.

Objective To investigate the effects of G-CSF-mobilized autologous stem cells in the prevention of radiation pulmonary injury.Methods Mice were divided into control group,irradiation group and treatment group.Mouse model of pulmonary fibrosis was established by exposing chest to a single dose of 14 Gy.Animals in the treatment group received recombinant human G-CSF (250 μg/kg daily for 5 d) before the irradiation in order to mobilize autologous stem cells in vivo.The general condition and mortality were documented after radiation injury.The pathological study with histological scoring,Masson staining and Sirius red staining with polarized light analysis were used to identify lung injury and the potential benefit of stem cell mobilization.Results Local chest irradiation of a single dose of 14 Gy was a suitable dose to create radiation-induced pulmonary fibrosis in mice.The death rate was 37.5％,which mainly happened around 11 weeks after injury.In contrast,all of the animals in G-CSF treated group survived.The ratio of lung to body mass was significantly increased in both irradiation group and treatment group (F =23.20,P＜0.05) around 3 months after the injury,with a higher ratio in irradiation group than that in treatment group (P＜0.05).Histological scoring for alveolar inflammation at 3 months after injury revealed statistically significant difference in irradiation group and treatment group compared with control group (F=11.93,P＜ 0.05).At this time point,the pathological observation showed lung tissue degeneration and necrosis with alveolitis and interstitial inflammation,as well as fibroblasts proliferation and focal collagen deposition in alveolar septa.At 4 month after the injury,the inflammation ininterstitial tissue was receded,but fibrosis and collagen deposition were significantly increased.In addition,at 3 and 4 months afterinjury,the pulmonary fibrosis was aggravated in irradiation group (F=28.73,16.85,P＜0.05),and significantly alleviated in the treatment group (P＜0.05).The similar results were confirmed in collagen content analysis (IOD) by Sirius red staining and image analysis (F =17.70,17.79,P＜ 0.05).Conclusions Autologous mobilization of stem cells could prevent the death of radiation-injured animals possibly by alleviating early lung injury and interstitial inflammation as well as the late pulmonary fibrosis,suggesting a therapeutic potential of autologous stem cell mobilization in radiation pulmonary fibrosis.

Objective Non-muscle myosin heavy chain 9 (MYH9) plays an important regulatory role in the development of tumor.This study aimed to explore the expression of MYH9 in osteosarcoma tissues and its effects on epithelial-mesenchymal transition and invasion of osteosarcoma cells.Methods We collected 52 cases of osteosarcoma tissues and para-carcinoma tissues at 5 cm form the edge of the tumor.RT-PCR and immunohistochemistry were used to analyze the expression level of MYH9 mRNA and protein in the osteosarcoma tissues and para-carcinoma tissues.MYH9 shRNA plasmid was transfected into U2-OS cells to silenced the expression of MYH9, after transfected, the cells were divided into three groups: the normal U2-OS cells were the control group, the U2-OS cells transfected with empty plasmid were the empty group and U2-OS cells transfected with MYH9 shRNA were interference group.RT-PCR was used to detect the changes of MYH9 mRNA levels in the U2-OS cells, the protein level of MYH9, EMT related protein E-cadherin and Vimentin were detected by Western blot, and the ability of cell invasion was evaluated by Transwell assay.Results The results of RT-PCR showed that the relative expression MYH9 mRNA in para-carcinoma tissues(1.526±0.148) was significantly lower than that in cancer tissues (3.547±0.195) (P<0.05).The results of immunohistochemistry showed that MYH9 protein was mainly expressed in cytoplasm, and the expression in cancer tissues was significantly higher than that in para-carcinoma tissues, the positive expression rate were 59.6%(31/52) and 26.9%(14/52) respectively, the difference was statistically significant(P<0.05).The results of Western blot showed that the relative expression of MYH9 mRNA in interference group was significantly lower than that in control group and empty group (P<0.05) after silenced MYH9 gene, and compared with the control group, the E-cadherin in U2-OS cells was significantly up-regulated but the Vimentin was down-regulated.After 48h, all of the groups had cells through the microfiltration membrane, the numbers of cells through the microfiltration membrane in interference group(41.2±15.1) was significantly lower than that in control group(117.3±12.4) and empty group(193.5±14.7) (P<0.05).Conclusion The expression of MYH9 protein in osteosarcoma tissues was significantly higher than that in para-carcinoma t tissues, silenced MYH9 gene can reduce the invasive ability of osteosarcoma by reducing the epithelial interstitial transition.

BACKGROUND:Studies have shown that craniocerebral injury can promote the repair of sciatic nerve injury in rats, but its precise mechanism remains unclear.
OBJECTIVE:To further explore the action mechanism of craniocerebral injury on the repair of sciatic nerve injury using morphology and histology.
METHODS:Sixty specific-pathogen-free healthy male Sprague-Dawley rats were randomly divided into two groups. Rats with craniocerebral injury and sciatic nerve injury were considered as the experimental group. Rats with simple sciatic nerve injury were considered as the control group. Classical Feeney method was used in models of craniocerebral injury and SunderlandV sciatic nerve injury. At 8 and 12 weeks after modeling, sciatic nerve index was detected. Masson staining and NF200 immunofluorescence staining were used to observethe nerve regeneration atthe anstomotic site. Transmission electron microscope was used to observe the number of regenerative axons.
RESULTS AND CONCLUSION:At 8 and 12 weeks after modeling, compared with the control group, gait and sciatic nerve index recovered better in the experimental group. In the experimental group, Masson staining showed fewer nerve membrane colagen fibers, and the axon arranged neatly.NF200 immunohistochemistry showed that in the experimental group, the density of regenerated nerves was high, and nerveswere regularly distributed. Transmission electron microscopy showed that in the experimental group, regenerative axons were regularly arranged, colagen scar was less, and myelin layer arranged regularly. Results suggested that the craniocerebral injury in rats may promote the repair of peripheral nerve injury by reducing scar colagen in nerve endings.

BACKGROUND:Recovery of motor and sensory function from peripheral nerve injury is relatively slow and incomplete. It is a difficult problem for orthopedic surgeons that mainly leads to the decline in the quality of life in patients.
OBJECTIVE: To conclude the methods and corresponding outcomes in peripheral nerve regeneration by analyzing the new treatment means for peripheral nerve injury.
METHODS:PubMed, Wanfang, CNKI databases were retrieved for relevant articles using key words of “nerve injury, regeneration”, and then retrieval data were sorted and analyzed.
RESULTS AND CONCLUSION:In recent years, in-depth studies on peripheral nerve repair have been made in the folowing aspects: surgical mode, drug, cytokine, gene transfer and biomaterials as wel as traditional Chinese medicine. If the detect size is four times longer than the diameter of nerves, the nerve regeneration chamber can achieve good outcomes. The methods of restoring nerve continuity folowing nerve injury are developed from surgical anastomosis to photochemohistological method, thermal laser welding, plastic repair and other emerging technologies. Studies have found that plasminogen activator, nerve growth factor, neurotrophic factor, recombinant erythropoietin, human tissue kalikrein, B vitamins and their derivatives, herbal preparations, immunosuppressive agents al can promote nerve regeneration.