Objective To investigate the effects of icariin on high glucose-induced autophagy and apoptosis of podocytes,and the regulating effects on mammalian target of rapamycin(mTOR)/serine-threonine kinase(Akt)/cyclic adenosine monophosphate response element binding protein(CREB)pathway.Methods The mouse podocytes MPC5 were taken and divided into five groups:normal control group(5.5 mmol·L-1 glucose),high glucose group(30 mmol·L-1 glucose),icariin group(30 mmol·L-1glucose+5 μmol·L-1icariin),GDC-0349 group(30 mmol·L-1glucose+50 μmol·L-1 GDC-0349),icariin+GDC-0349 group(30 mmol·L-1 glucose+5 μmol·L-1 icariin+50 μmol·L-1 GDC-0349).Cultured for 48 hours,the tetramethylazozolium salt method was used to detect the viability of MPC5 cells;acridine orange staining was used to observe the autophagy of MPC5 cells;apoptosis of MPC5 cells was detected by flow cytometry;Western blotting was used to detect the expression of autophagy[microtubule associated protein one light chain 3(LC3)II,LC3Ⅰ,autophagy-related protein(Beclin-1)],apoptosis[Bcl-2 related X protein(Bax),B cell lymphoma-2(Bcl-2)]and mTOR/Akt/CREB pathway-related proteins of MPC5 cells.Results Compared with the normal control group,the cell viability,expression levels of Bcl-2,phosphorylated mTOR(p-mTOR)/mTOR,phosphorylated Akt(p-Akt)/Akt,phosphorylated CREB(p-CREB)/CREB protein of MPC5 cells in the high glucose group were significantly decreased(P＜0.05),the autophagy ability was enhanced,the autophagosome showed orange fluorescence,and the apoptosis rate,LC3Ⅱ/LC3Ⅰ,Beclin-1,Bax protein expression levels were significantly increased(P＜0.05).Compared with the high glucose group,the cell viability,LC3Ⅱ/LC3Ⅰ,Beclin-1,Bcl-2,p-mTOR/mTOR,p-Akt/Akt,p-CREB/CREB protein expression levels of MPC5 cells in icariin group were significantly increased,the autophagy ability was further enhanced,the number of autophagosomes was increased,the autophagosomes showed brick red fluorescence(P＜0.05),the apoptosis rate and Bax protein expression level were significantly decreased(P＜0.05),and the cell viability,LC3Ⅱ/LC3Ⅰ,Beclin-1,Bcl-2,p-mTOR/mTOR,p-Akt/Akt and p-CREB/CREB proteins expression levels of MPC5 cells in GDC-0349 group were significantly decreased,the autophagy ability was weakened,the number of autophagosomes was reduced,the autophagosomes showed orange fluorescence(P＜0.05),and the apoptosis rate and Bax protein expression level were significantly increased(P＜0.05);icariin+GDC-0349 could reverse the effect of icariin on high glucose induced MPC5 cells(P＜0.05).Conclusion Icariin promotes elevated glucose-induced podocyte autophagy and inhibits apoptosis by activating the mTOR/Akt/CREB pathway.

Wound infections, secondary to acute and chronic wounds caused by mechanical, thermal, chemical factors, etc, not only delay wound healing but also may lead to mortality. The prolonged or inappropriate use of antibiotics lead to the growth of drug-resistant bacteria, resulting in refractory wound infections and poor treatment outcomes, which highlights the urgent need for effective therapies. Bacteriophages show great promise in treating drug-resistant wound infections due to their effectiveness in killing drug-resistant bacteria, their good resistance against bacterial biofilm (BBF) and their absence of cytotoxicity to eukaryotic cells. However, the mechanisms underlying bacteriophages′ resistance against BBF remain incompletely understood and their antibacterial efficacy for wound infections may also vary. For this purpose, the authors reviewed the biological characteristics and mechanisms of bacteriophages and their application in antibacterial therapies for wound infections, aiming to provide a reference for further research and application of bacteriophages in the treatment of wound infections.

Objective To investigate the relationship between atrial fibrillation and left heart structure change in patients with hemodialysis combined with hemoperfusion.Methods A total of 60 patients with end-stage renal disease who underwent hemodialysis combined with hemoperfusion treatment in Ganzhou Hospital of Traditional Chinese Medicine from December 2020 to December 2021 were selected.Thirty patients with atrial fibrillation were included in observation group,and thirty patients without atrial fibrillation were included in control group.The left heart structure indexes of two groups were compared,and the relationship between atrial fibrillation and left heart structure change in patients with hemodialysis combined with hemoperfusion was analyzed.Results Left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left atrium diameter(LAD),interventricular septal thickness(IVST),and left ventricular posterior wall thickness(LVPWT)in observation group were higher than those in control group,and left ventricular ejection fraction(LVEF)was lower than that in control group(P<0.05).Logistic regression analysis showed that the decrease of LVEF and the increase of LVEDD,LVESD,LAD,IVST and LVPWT were associated with atrial fibrillation in patients with hemodialysis combined with hemoperfusion(P<0.05).The results of receiver operating characteristic curve showed that area under the curve of LVEDD,LVESD,LAD,LVEF,IVST and LVPWT in diagnosing atrial fibrillation in patients with hemodialysis combined with hemoperfusion were 0.724,0.708,0.760,0.761,0.762 and 0.758,respectively,which had certain diagnostic value.Conclusion Atrial fibrillation in patients with hemodialysis combined with hemoperfusion is related to the change of left heart structure,and the left heart structure indexes are helpful to assist the diagnosis of atrial fibrillation.

Objective:To study the current status of research in the field of iodine nutrition for pregnant women and to detect the hot spots and future trends in the field of iodine nutrition for pregnant women.Methods:Using "pregnant women" and "iodine" as search terms, we searched the literature related to iodine nutrition in pregnant women from January 2000 to December 2021 in China Knowledge Network (CNKI) database, Wanfang database and Chinese Medical Journal Full Text Database. CiteSpace 6.2.2.0 software was used to sort out the publication status, core authors and research hotspots of the papers.Results:A total of 879 valid papers were included, with an overall number of publications increasing trend from 2000 - 2021 and a decline after 2017. Among the 879 papers, 29 first authors were core authors (M≈3), and 109 papers were published, accounting for 12.40% of the total literature; several research groups with relatively stable collaborative relationships had been formed, with the larger collaborative team of Chen Zupei and Zhang Wanqi at Tianjin Medical University. Keyword co-occurrence analysis showed that pregnant women, urinary iodine, and iodine nutrition were high-frequency keywords; keywords with mediated centrality > 0.07 were pregnant women (0.48), pregnancy (0.40), urinary iodine (0.37), iodine deficiency disorders (0.25), iodine nutrition (0.20), thyroid (0.12), thyroxine (0.10), infants and children (0.09). The analysis of the emergent words showed that the evolution of iodine nutrition research themes in pregnant women was broadly based on studies of iodine nutrition monitoring results in key populations such as newborns and infants from 2000 - 2011, studies such as the range of thyroxine reference values during pregnancy from 2012 - 2016, and changes in iodine nutrition status of pregnant women and children after adjustment of iodized salt concentration from 2017 - 2021. The clustering results showed that a total of 355 keywords were aggregated to yield 10 clusters, and the average profile value of clusters (Silhouette) > 0.8, which was a reasonable clustering result; the study topics can be divided into three major categories, iodine nutrition and goiter monitoring results in key populations, thyroid hormones and pregnancy outcomes during pregnancy, and studies on thyroid-related diseases.Conclusions:Iodine plays an important role in the health of pregnant women and their offspring, and changes in the iodine nutrition status of pregnant women should be closely monitored. In response to the new trends of change that are currently present, multidisciplinary cooperation should be developed to respond to social concerns and jointly promote the maintenance of iodine nutrition in pregnant women at appropriate levels.

Abstract Plant exocrine-like nanovesicles(PELNs) is a new nano-therapeutic agent and delivery platform, which not only has the potential for disease treatment, but also can be used as a drug carrier to target disease sites and play a dual role in treatment and delivery. More importantly, PELNs has the characteristics of green nature and low immunogenicity. This review systematically introduced several secretory mechanisms of PELNs:Outer capsule positive organelle, polyvesicular body, vacuole and autophagosome; three components such as lipid, protein and nucleic acid; centrifugation, ultrafiltration, size exclusion chromatography, flow field-flow fractionation, immunomagnetic beads, polymer precipitation and other separation methods and their biological functions such as anti-inflammation, anti-tumor, protection of regeneration, antivirus, liver protection, etc.; sorted out the potential mechanism of PELNs as a therapeutic agent and molecular delivery platform, and put forward the problems existing in the research process of PELNs, such as quantification, mechanism research and few clinical trials. And its development potential in the future is discussed.

Objective:To compare the use of continuous constant negative pressure drainage and intermittent suction mode drainage in abdominal wall angioplasty to minimize the impact of complications.Methods:From May 2017 to August 2019, the Department of Medical Cosmetology and Plastic Surgery, Wuhan Third Hospital treated 76 female patients after expanded flap repair, aged 27-35 years, with an average age of 30.5±14.2 years, and 58 female patients after abdominal wall plasty, aged 38-55 years, with an average age of 47.8±7.8 years. They were divided into intermittent negative pressure drainage group and continuous negative pressure drainage group. The negative pressure values in different intervals were set according to the type of operation. The drainage volume, drainage time, incidence of hematoma, subcutaneous effusion, flap necrosis rate, primary wound healing rate and drainage related bleeding were recorded and compared between the two groups.Results:After expanded flap repair in 38 cases, flap necrosis occurred in 1 case and hematoma in 3 cases; After abdominal wall plasty in 29 cases, flap necrosis occurred in 0 cases and hematoma in 1 case. The primary healing of incision was higher ( P<0.05), the drainage volume was larger, but the drainage time was shorter ( P<0.05), and no bleeding related to drainage was observed. The effect of monitoring drainage was positively correlated with the effect of operation. Conclusions:Continuous and constant negative pressure drainage is related to the prognosis of patients undergoing expansion flap repair and abdominal wall plasty. It is helpful to improve the effect of plastic surgery and the quality of nursing work. It is an effective method for nursing management after plastic surgery.

Background: Livin, survivin and Pak-1 are all related to the occurrence and development of gastric cancer. Livin and survivin play their roles by inhibiting the activity of caspase-7. Aims: To investigate the expressions and significance of livin, survivin, Pak-1 and caspase-7 in different gastric mucosal lesions. Methods: A total of 45 cases of gastric cancer and paracancerous tissue, 45 chronic atrophic gastritis with intestinal metaplasia, 45 chronic non-atrophic gastritis from Jan. 2015 to Dec. 2019 at the Second Affiliated Hospital of Baotou Medical College were collected. Immunohistochemistry was used to detect the expressions of livin, survivin, Pak-1 and caspase-7, and their correlations with clinicopathological features of gastric cancer patients were analyzed. Results: Compared with chronic non-atrophic gastritis group and paracancerous group, the positivity expression rates of livin, survivin and Pak-1 in intestinal metaplasia group were significantly increased (P<0.05), while caspase-7 was significantly decreased (P<0.05). Compared with intestinal metaplasia group, the positivity expression rates of livin, survivin and Pak-1 in gastric cancer group were significantly increased (P<0.05), while caspase-7 was significantly decreased (P<0.05). Expressions of livin, survivin, Pak-1 and caspase-7 were correlated with the differentiation degree, TNM stage, depth of infiltration and lymph node metastasis in patients with gastric cancer (P<0.05). Conclusions: Livin, survivin, Pak-1 and caspase-7 play important roles in the occurrence and development of gastric cancer.

Objective: To study on the effect of clinical nursing in preventing adverse drug reaction of injection preparation of traditional Chinese medicine, explore nursing strategy of adverse drug reaction,promote the rational use of traditional Chinese medicine injection preparations in clinical practice by analyzing the adverse drug reactions of traditional Chinese medicine injection in our hospital. Methods: A retrospective analysis of 362 cases of adverse drug reactions reported by the National ADR Surveillance Center from January 2017 to November 2018 was carried out in our hospital. In accordance with the guidelines of the Ministry of Health Manual on reporting and monitoring adverse drug reactions. By using Microsoft office Excel 2007, the ADR reports were summarized and analyzed according to age, sex, type and frequency, time of adverse reactions, and involvement system of adverse reactions. Results: In 362 cases of ADR, the ratio of male to female patients was about 1.1∶1.There were 65 cases of children under 12 years old, accounting for 18%, and 117 cases of people over 61 years old, accounting for 32.3%,the proportion of other age groups was lower than those of the elderly and children. Most of the drugs with ADR appeared in blood circulation (208 cases), followed by heat-clearing and detoxifying drugs (102 cases) and anti-tumor drugs (52 cases). The common ADR involvement system of traditional Chinese medicine injection is nervous system reaction, skin allergic reaction, cardiovascular system reaction, local injury of injection, gastrointestinal tract system. Conclusions Attention should be paid to the role of nurses in monitoring adverse reactions of traditional Chinese medicine injections, strengthening the propaganda and education of nurses' ADR monitoring work, strengthening nurses' cognition of ADR, enhancing nurses' service and consciousness to patients with static injection of traditional Chinese medicine, and standardizing the process of drug use, thus reducing possible injury to patients due to adverse reactions caused by the use of traditional Chinese medicine injection.

OBJECTIVE： To investigate the effects of Lindera aggregate of stir-baking with vinegar-Aucklandia lappa on gastric emptying and gastrointestinal hormones in functional dyspepsia liver depression and qi stagnation （FDLDQS） model rats. METHODS： Totally 60 SD rats were randomly divided into blank group （n＝10） and modeling group （n＝50）； FDLDQS model was induced by chronic stress restraint or food deprivation or excessive fatigue in modeling group. After modeling， model rats were randomly divided into model group （normal saline）， L. aggregate of stir-baking with vinegar group （1.62 g/kg， calculated by crude drug）， A. lappa group （1.62 g/kg， calculated by crude drug）， L. aggregate of stir-baking with vinegar-A. lappa group （1 ∶ 1， m/m，1.62 g/kg， calculated by crude drug） and mosapride group （positive control， 1.35 mg/kg）， with 10 rats in each group. Administration groups were given relevant medicine intragastrically once a day； blank group and model group were given constant volume of normal saline intragastrically， for consecutive 14 d. 2 h after last medication， gastric emptying rate and small intestinal propulsion rate of rats in each group were measured by phenol red content method. After HE staining， the morphological changes of antrum tissue were observed under microscope. The contents of motilin （MTL）， gastrin （GAS） and cholecystokinin （CCK） in serum were determined by ELISA method. RESULTS： Compared with blank group， gastric emptying rate and small intestinal propulsion rate of rats were decreased significantly in model group （P＜0.01）； the serum contents of MTL and GAS were decreased significantly （P＜0.01）， while the content of CCK was increased significantly （P＜0.01）. No organic damage was found in all model groups. Compared with model group， L. aggregate stir-baking with vinegar group and A. lappa group， gastric emptying rate and small intestinal propulsion rate of rats were increased significantly in L. aggregate of stir-baking with vinegar-A. lappa group and mosapride group （P＜0.05 or P＜0.01）； serum contents of MTL and GAS were increased significantly （P＜0.01）， while the content of CCK was decreased significantly （P＜0.01）. CONCLUSIONS： L. aggregate of stir-baking with vinegar-A. lappa can accelerate gastric emptying and small intestinal propulsion rate of FDLDQS rats， increase serum contents of MTL and GAS but decrease the content of CCK； its effects are better than that of them alone.

Objective: To investigate the clinical and laboratory features of patients with liver disease and positive anti-liver/kidney microsomal-1 (anti-LKM-1) antibody, and to provide a reference for clinical diagnosis and differential diagnosis. Methods: The clinical data of patients with positive anti-LKM-1 antibody who were treated in our hospital from 2006 to 2016 were collected, and clinical and laboratory features were analyzed and compared. An analysis was also performed for special cases. Results: The measurement of related autoantibodies was performed for about 100 thousand case-times, and 15 patients were found to have positive anti-LKM-1 antibody. Among the 15 patients, 7 were diagnosed with type 2 autoimmune hepatitis (AIH) with an age of 11.0 ± 9.0 years and were all adolescents with acute onset; 8 were diagnosed with hepatitis C with an age of 51.5 ± 9.0 years, among whom 7 were middle-aged patients and 1 was a child aged 12 years, and all of them had an insidious onset. Compared with the patients with hepatitis C, the AIH patients had significantly higher levels of alanine aminotransferase (1 003.9 ± 904.3 U/L vs 57.0 ± 84.1 U/L, P < 0.05), aspartate aminotransferase (410.7 ± 660.3 U/L vs 34.9 ± 42.9 U/L, P < 0.05), and total bilirubin (98.0 ± 191.0 μmol/L vs 15.4 ± 6.0 μmol/L, P < 0.05). There was a reduction in immunoglobulin G after the treatment with immunosuppressant, compared with the baseline. Of all 8 patients with hepatitis C, 6 received antiviral therapy with interferon and ribavirin, and 5 out of them achieved complete response, among whom 4 had a reduction in the level of anti-LKM-1 antibody after treatment; however, a 12-year-old child developed liver failure after interferon treatment and died eventually. Conclusion Positive anti-LKM-1 antibody is commonly seen in patients with type 2 AIH or hepatitis C, but there are differences between these two groups of patients in terms of age, disease onset, liver function, and the level of anti-LKM-1 antibody. The hepatitis C patients with a confirmed diagnosis and exclusion of autoimmune hepatitis can achieve good response to interferon under close monitoring, even if anti-LKM-1 antibody is positive. As for adolescent patients with hepatitis C and positive anti-LKM-1 antibody, the possibility of AIH should be excluded.