Purpose To evaluate the value of shear wave elastic imaging of liver and spleen in predicting high risk esophageal and gastric varices in cirrhosis.Materials and Methods Sixty-four patients with cirrhosis in the First Hospital of Lanzhou University from November 2019 to April 2022 were enrolled prospectively,and underwent gastroscopy,elastography and serological examination.According to gastroscopy,patients were divided into high-risk varices(HRV,30 cases)and non-HRV group(34 cases),the differences of each clinical index and shear wave elastic imaging parameter between the groups were compared.The diagnostic efficacy of liver and spleen stiffness measurement for HRV was analyzed.And the diagnostic models were established for exploring the diagnostic effectiveness of different models with respect to excluding HRV in compensated liver cirrhosis.Results There were significant differences in platelet[(74±24)×109/L vs.(124±50)×109/L],liver stiffness[(16.1±5.6)kPa vs.(13.6±5.5)kPa]and spleen stiffness[(41.7±8.9)kPa vs.(28.1±8.6)kPa]between HRV and non-HRV groups(t/Z/χ2=5.136,-1.832,-6.206,all P<0.05).The areas under the curve of liver stiffness and spleen stiffness for predicting HRV were 0.660 and 0.858,respectively.The Baveno Ⅵ combined with the spleen stiffness model had the best performance(30.0％)for excluding HRV.Conclusion The measurement of liver and spleen stiffness by shear wave elastography has great diagnostic value for predicting HRV in cirrhosis,and spleen stiffness is better than liver stiffness.

ObjectiveTo explore the effect of Youguiwan on the rats with adriamycin-induced nephrotic syndrome （NS） and its mechanism. MethodSD rats were randomly divided into a normal group， a model group， three Youguiwan low， medium， and high-dose groups， and a prednisone group. Rats in the model group were intravenously injected with adriamycin in the tail vein to induce the NS model. Rats in the Youguiwan low， medium， and high-dose groups were given 2.8， 5.6， 11.2 g·kg^-1·d^-1 of crude drugs， respectively， and rats in the prednisone group were given 6.3 mg·kg^-1·d^-1 of prednisone acetate. Each administration group was given continuous medicine for 6 weeks， and the normal group and model group were given an equal volume of normal saline. Bicinchoninic acid （BCA） assay was used to detect 24 h urine protein （24 h UP）. Automatic biochemical analyzer was used to detect serum urea nitrogen （BUN）， creatinine （SCr）， albumin （ALB）， total cholesterol （TC）， and triglyceride （TG） levels. Hematoxylin-eosin （HE） staining was used to observe renal tissue morphology， and kit was used to detect serum advanced oxidized protein products （AOPPs） and reactive oxygen species （ROS）. Western blot was used to detect the receptor of advanced glycation endproducts （RAGE） of renal tissue， nuclear factor-κB （NF-κB） phosphorylation levels， Wnt， and β-catenin protein expression. ResultAs compared with the normal group， 24 h UP， serum BUN， SCr， TC， TG， AOPPs， and ROS levels in the model group increased significantly （P<0.01）， whereas ALB decreased （P<0.01）. There were typical pathological injuries in the renal tissue， and the expressions of RAGE， phosphorylation（p）-NF-κB， Wnt1， and β-catenin protein were significantly increased （P<0.01）. As compared with the model group， the 24 h UP， serum BUN， SCr， TC， TG， AOPPs， and ROS levels of rats in the Youguiwan low， medium， and high-dose groups significantly reduced （P<0.01）， and ALB significantly increased （P<0.01）. The renal tissue damage was reduced， and the expressions of RAGE， p-NF-κB， Wnt1， and β-catenin protein were significantly decreased （P<0.01） in a dose-dependent manner. ConclusionYouguiwan improves the kidney injury of rats with adriamycin-induced NS. The mechanism may be related to the reduction of AOPPs level， inhibition of RAGE/ROS/NF-κB axis， and activation of Wnt/β-catenin signal.

Osteoporosis (OP) is a common systemic bone disease which has become a serious public health problem in China. In clinical practice, we found that some primary osteoporosis may be due to parathyroid hyperfunction (subclinical hyperparathyroidism) or hyperparathyroidism which is the result of negative calcium balance and hypocalcemia caused by insufficient calcium intake and/or vitamin D deficiency/insufficiency, which is preventable and controllable. Therefore, we call this kind of osteoporosis parathyroid hyperfunction or hyperparathyroidism associated osteoporosis. The daily calcium intake of Chinese people is generally insufficient, and vitamin D deficiency/insufficiency is also a worldwide public health problem. Parathyroid hyperfunction or hyperparathyroidism associated osteopenia and osteoporosis which are results of hypocalcemia and negative calcium balance caused by long-term insufficient calcium intake and/or vitamin D deficiency/insufficiency exist extensively in clinical practice. Its prevention and treatment can effectively prevent and treat osteopenia and osteoporosis, so as to effectively prevent and treat diseases such as short stature, rachiokyphosis, backache, fatigue, bone pain, fracture, metastatic vascular calcification and systemic calcinosis, improve people’s health and help achieve the goal of "Healthy China 2030" .

Humans ; Female ; Prevalence ; Breast Neoplasms ; Cancer Survivors ; Non-alcoholic Fatty Liver Disease ; Liver

Objective:To explore the value of liver stiffness and spleen stiffness measured by two-dimensional shear wave elastography (2D-SWE) in predicting high-risk varices (HRV) with compensated cirrhosis patients.Methods:Seventy patients with compensated cirrhosis who attended the First Hospital of Lanzhou University from November 2019 to April 2022 were recruited. All patients underwent examinations of liver stiffness measurement (LSM) and spleen stiffness measurement (SSM) by 2D-SWE. Binary logistic regression was used to analyze the risk factors affecting the occurrence of HRV. The diagnostic performances of LSM, liver stiffness (by 2D-SWE)-spleen length-to-platelet (LSPS) score, and SSM in predicting HRV were compared.Results:SSM was not technically feasible in 6/70 (8.6%) patients due to small volume of spleen.Among 64 patients with compensated cirrhosis, 30/64 (46.9%) were HRV. Binary multivariate Logistic regression analysis showed that SSM and platelet counts were independent influencing factors for predicting HRV, with OR values of 1.126 ( P=0.006) and 0.971 ( P=0.039), respectively. The area under the receiver operating characteristic curve (AUC) of LSM, LSPS score, and SSM were 0.660, 0.828 and 0.858, respectively. The AUCs of SSM and LSPS score were significantly higher than that of LSM ( P<0.05), but there was no statistical difference between SSM and LSPS score ( P=0.608). Conclusions:LSM and SSM measured by 2D-SWE have high success rate. SSM and LSPS score have high value in predicting HRV in patients with compensated cirrhosis, and the diagnostic performances of the above two methods are significantly higher than that of LSM.

Real world data (RWD) refers to the data generated in routine clinical practices, daily life, and real work environment and has been widely used in clinical or public health research. Still, issues related to the quality of RWD, such as incompleteness, inconsistency, and inaccuracy, would affect the validity of real-world research. To overcome the challenges due to the lack of standardization of real world source data, case report form based on clinical data interchange standards consortium (CDISC-CRF) on certain diseases was developed to promote the ecology construction of RWD based on the data standards set by the CDISC which has been widely used. Firstly, we described how to apply data standards to make up the gap between RWD and real world evidence. Then, the process was designed to build RWD ecology based on CDISC-CRF, in which the development technology of CDISC-CRF form is mainly introduced. Finally, the application prospect and significance of building real-world data based on disease-specific CDISC-CRF are described. It is believed that the present paper can provide a new idea for promoting the ecology construction of RWD in China.

Cholestasis refers to a pathological state of disorders in the formation, secretion, and excretion of bile flow, and liver fibrosis is a process of tissue repair induced by liver injury. Cholestatic liver disease is a chronic liver disease caused by cholestasis, progressive bile duct injury, and persistent intrahepatic inflammation, and it may cause cholangiocyte and hepatocyte injury, which will gradually progress to liver fibrosis. With reference to the current research advances, this article reviews the pathogenesis of cholestasis-induced liver fibrosis and the strategies for blockade.

Pregnancy has increased susceptibility to H1N1 influenza virus infection. Maternal influenza infection is associated with increased risk of morbidity and mortality. A case of influenza A (H1N1) during late pregnancy (pregnancy 1, birth 0, pregnancy 30⁺² weeks) was admitted to the Second Affiliated Hospital of Kunming Medical University on December 16th, 2018. The patient was set on mechanical ventilation with a FiO₂ of 1.0, a positive end-expiratory pressure (PEEP) of 15 cmH₂O (1 cmH₂O = 0.098 kPa), and a tidal volume of 4-6 mL/kg (ideal body weight). However the pulse oxygen saturation (SpO₂) could only be maintained at about 0.85. The disease was controlled by the treatments of anti-infection, mechanical ventilation, immune therapy, nutritional support, preventive anticoagulant treatment by heparin sodium, adequate negative fluid balance, and other organ support therapy. This article introduced the treatment process of the patient in detail, and provided experience for clinical treatment.

Pregnancy has increased susceptibility to H1N1 influenza virus infection. Maternal influenza infection is associated with increased risk of morbidity and mortality. A case of influenza A (H1N1) during late pregnancy (pregnancy 1, birth 0, pregnancy 30⁺² weeks) was admitted to the Second Affiliated Hospital of Kunming Medical University on December 16th, 2018. The patient was set on mechanical ventilation with a FiO₂ of 1.0, a positive end-expiratory pressure (PEEP) of 15 cmH₂O (1 cmH₂O = 0.098 kPa), and a tidal volume of 4-6 mL/kg (ideal body weight). However the pulse oxygen saturation (SpO₂) could only be maintained at about 0.85. The disease was controlled by the treatments of anti-infection, mechanical ventilation, immune therapy, nutritional support, preventive anticoagulant treatment by heparin sodium, adequate negative fluid balance, and other organ support therapy. This article introduced the treatment process of the patient in detail, and provided experience for clinical treatment.
Female ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; Positive-Pressure Respiration ; Pregnancy ; Pregnancy Complications ; Respiratory Distress Syndrome ; Tidal Volume

In order to figure out phylogenetic relationship and genetic diversity of different geographical populations,genetic analyses of Aedes albopictus were performed based on mitochondrial gene COI.Based on samples collected from most distribution regions in China,mitochondrial gene Cytochrome C Oxidase Subunit I was obtained through PCR and DNA sequence.Together with some COI sequences downloaded from GenBank,60 COI sequences with the final length of 598 bp were used for subsequent analyses.Results showed that there was no obvious divergence according to phylogenetic analyse,all sequences were clustered together in Maximum Likelihood tree.Sixteen haplotypes were detected,and four of them shared haplotypes.Haplotype diversity (Hd) was 0.737,nucleotide diversity (π) was 0.20 ％.Population genetic differentiation analyses demon strated that Hainan population showed obvious divergences.In the network of haplotypes,H1 and H6 was found to be the primary haplotypes,and they formed two radical centers.All these results indicate that A.albopictus populations of China are expanding presently,and Hainan population become differential with other geographical populations,which probably attribute to geographical isolations.