Objective To investigate the correlations of serum eukaryotic translation promoter 2α (eIF2α) and activated transcription factor 4 (ATF4) levels with the degree of renal tissue injury and renal function in patients with diabetic nephropathy (DN). Methods A total of 102 patients with DN (DN group) and 102 patients with simple diabetes (control group) were selected. According to the severe degree of renal tissue damage, the patients with DN were divided into microalbuminuria group (MG group, 35 cases) and dominant albuminuria group (PG group, 41 cases) and renal dysfunction group (RIG group, 26 cases). Serum levels of eIF2α, ATF4, urea nitrogen (BUN), creatinine (Scr), cystatin C (CysC) and estimated glomerular filtration rate (eGFR) were measured. Pearson correlation analysis was used to explore the correlations of eIF2α and ATF4 with BUN, Scr, CysC and eGFR; multivariate Logistic regression analysis was used to explore the risk factors of DN; receiver operating characteristic (ROC) curve was used to analyze the value of eIF2α and ATF4 in diagnostic of DN. Results Serum levels of eIF2α, ATF4, BUN, Scr and CysC in the DN group were higher than those in control group, eGFR was lower than that in control group (P < 0.05). Serum eIF2α and ATF4levels in the RIG group were higher than those in PG and MG groups (P < 0.05). Serum eIF2α and ATF4 levels in DN patients were positively correlated with BUN, Scr and CysC, and negatively correlated with eGFR (P < 0.05). Long duration of diabetes, higher body mass index, high level of eIF2α and high level of ATF4 were risk factors for DN (P < 0.05). The area under the curve of eIF2α and ATF4 in diagnosis DN was 0.770 and 0.799, respectively, and the area under the curve of their combined diagnosis was 0.879, which was higher than that of single diagnosis (P < 0.05). Conclusion Serum levels of eIF2α and ATF4 are increased in patients with DN, which is related to the severity of renal injury and renal dysfunction in DN. The combination of eIF2α and ATF4 is of high value in the diagnosis of DN.

Objective:To study the effect of Sanjie Xiaoliu Recipe on transplanted tumors in breast cancer mice through in vivo experiments, in order to explore the efficacy and mechanism of Sanjie Xiaoliu Recipe on breast cancer patients. Methods:45 BaL B/c female mice were selected to establish the transplanted tumor model of breast cancer. All the transplanted tumor models of breast cancer mice were randomly divided into five groups: the control group (intragastric administration of normal saline), the low, medium and high dose group of Sanjie Xiaoliu Recipe (intragastric administration of different doses of Sanjie Xiaoliu Decoction), and the paclitaxel group (intraperitoneal injection of paclitaxel). After 24 days of continuous administration, the diet and activities of mice were observed; the body weight, weight and volume changes of transplanted tumor mice were recorded, and the tumor inhibition rate was calculated. Western blot was used to detect the expression of epithelial mesenchymal transformation related proteins (E-cadherin, N-cadherin, Vimentin) in the transplanted tumor tissues of mice in each group.Results:(1) The food intake and activity status of mice treated with Sanjie Xiaoliu Recipe were less affected by the transplanted tumor of breast cancer. (2) The volume and weight of transplanted tumor in the treat groups were smaller than those in the control group (all P<0.01), and the volume of transplanted tumor in the middle dose group of Sanjie Xiaoliu Recipe was smaller than that in the low dose group ( P<0.05). The tumor inhibition rates among the treatment groups were: Sanjie Xiaoliu Recipe medium dose group 52.4%, paclitaxel group 40.3%, Sanjie Xiaoliu Recipe low dose group 39.5%, Sanjie Xiaoliu Recipe high dose group 34.1%. (3) The results of Western blot showed that the expression level of E-cadherin in the transplanted tumor tissue of the treat groups was higher than that in the control group, and the expression levels of N-cadherin and Vimentin were lower than that in the control group, with statistically significant difference (all P<0.05). Conclusions:The Sanjie Xiaoliu Recipe can improve the weakness and reduced consumption of breast cancer mice, which can inhibit the tumor mass growth in mice to a certain extent. Its mechanism may be that Sanjie Xiaoliu Recipe can inhibit the epithelial mesenchymal transformation of breast cancer and the invasion and metastasis of breast cancer.

Ureteral artery fistula (UAF) is a rare complication after long-term indwelling of ureteral stent. In this study, two cases were presented. Both of them underwent pelvic tumor surgery and radiotherapy, and had a history of cutaneous terminal ureterostomy and long-term indwelling of ureteral stents. The first case, a 52-year-old female, was admitted to hospital because of intermittent bleeding from ureteral dermostomy for 1 week on April 2, 2020. CT examination revealed hematocele in the left upper urinary tract, and left nephrectomy was performed.However, bleeding still presented and the distal ureteral resection was performed at the same time, and partial ureteral was ligated. Postoperative diagnostic was ureteral artery fistula. After 8 months of follow-up, no recurrent bleeding presented. Another case, a 82-year-old male, was admitted to hospital because of bleeding at the ureteral dermostomy for an hour on June 15, 2020. Contrast enhanced CT examination revealed intersecting of the left ureter and common iliac artery, and interventional surgery was performed, by which UAF was diagnosed. Embolization of left internal iliac artery and stent implantation of common iliac artery and external iliac artery were performed intraoperatively. The bleeding stopped immediately after the operation, and there was no further bleeding during follow-up of 6 months.

Objective: To understand the current status of follow up of people living with HIV/AIDS by health service at grass root in rural area of Jiangxi province and related factors, and provide references for the promotion of the follow up by grass root health service. Methods: People living HIV/AIDS aged ≥18 years and diagnosed before 31 December 2017 in 6 townships of Xinjian, Yushan counties and Guixi city were included in the study in Jiangxi province. They had been followed up for more than one time after the first epidemiologic survey. The information about their demographic characteristics and HIV infection status were collected by using self-designed questionnaire. Univariate and multivariate logistic regression analyses were conducted to identify the factors that influencing the acceptance of follow up by grass root health service. Results: Of the 373 surveyed HIV infected subjects aged (53.06±16.15) years, 261 were males (70.0%, 261/373). Among the surveyed subjects, the illiteracy and people who received only primary school education accounted for 54.7% (204/373). The rate of follow up of the HIV infected subjects by grass root health service was 55.8% (208/373), and those through heterosexual contact were 58.5% (190/325). The multivariate regression analysis showed that the acceptance of follow up by grass root health service was higher in those who were farmers (OR=7.36, 95%CI: 2.52-21.45), had family support (OR=16.01, 95%CI: 2.25-49.73), didn’t worry about discrimination (OR=12.97, 95%CI: 4.75-35.42), trusted health care provider (OR=5.07, 95%CI: 2.19-11.76) and showed AIDS symptoms (OR=10.58, 95%CI: 2.25- 49.73). Conclusions The performance of follow up of people living with HIV/AIDS by grass root health service was well, suggesting it is a feasible management model. Being famer or not, family member supporting or not, worry about discrimination or not, trusting health care provider or not and showing AIDS symptoms or not were the main factors influencing the acceptance of follow up by grass root health service.

The HIV-infected people were investigated for their satisfactory situation towards the follow-up management of primary medical and health care institutions in Xinjian County, Yushan County and Guixi City of Jiangxi Province from January to July 2018 and related factors were also analyzed. The total score of the Infected Patients′ Follow-up Management Satisfaction Scale higher than 59 was defined as the satisfactory. 75.68% of 259 infected patients were satisfied with the follow-up management. Compared to farmers and other follow-up modes, non-farmers (OR=10.72, 95%CI: 2.07-55.63), and patients receiving follow-up service in responsible institutions (OR=6.44, 95%CI: 3.12-13.30) were more satisfied with follow-up management.

Objective: To discuss the affect of glycosylated hemoglobin (HbA1c) level for the onset of nonalcoholic fatty liver disease (NAFLD) in cohort population. Methods: An epidemiological survey of the relationship between HbA1c and NAFLD conducted in 2012 was based at cohort baseline, and three follow-up sessions conducted in 2013, 2014 and 2015. In total 2 811 subjects were included in the study after exclusion of NAFLD patients at baseline and those who lost their lives due to relocation, and death. The Cox proportional hazard model was used to analyze the relationship between glycosylated hemoglobin and other risk factors of NAFLD. Continuous variables were compared using the t-test or the Mann-Whitney test. χ ²-test was used for the measurement of categorical data. Results: A total of 2 811 subjects with mean age of 59 (58.2±9.8) years old, including 1 664 males and 1 147 females. Age, waist circumference, body mass index, systolic blood pressure, γ-glutamyltransferase and fasting blood glucose level of HbA1c abnormal group were higher than normal group. The incidence of NAFLD in the abnormal HbA1c level group (25.4%) was higher than normal group (14.9 %), and diastolic blood pressure, high-density lipoprotein cholesterol was lower than normal group and the differences were statistically significant. During the three follow-up intervals, there were 440 new cases of NAFLD, consisting 285 males and 155 females with cumulative incidence of 15.7% (440/2 811). Multivariate Cox regression analysis showed that patients with elevated HbA1c had a higher risk of developing NAFLD (HR 1.796; 95% CI 1.335~2.418; P < 0.01), and the increased HbA1c level after adjustment for gender, age, and metabolic syndrome-related factors remained an independent risk factors for NAFLD (HR 1.580; 95.0% CI 1.161-2.152; P < 0.01). Conclusion An elevated HbA1c levels have a positive predictive value for the onset of NAFLD.

Objective To explore one mechanism of therapeutic action of electroacupuncture on Alzheimer’s disease (AD), that is, improving the way to eliminate cerebral microvascular Ab by investigating the effect of electroacupuncture on hippocampal microvascular Ab deposition and learning and memory abilities in APP/PSI double transgenic mice. Method Twenty-four 7-month-old male APP/PSI double transgenic mice were randomized into model and electroacupuncture groups, 12 mice each. Same sex transgene-negative littermate mice (12 mice) constituted a blank control group. The electroacupuncture group received electric acupuncture at points Baihui (GV20) and Yongquan (KI1), 15 min once every other day, for a total of six weeks. After treatment, mouse learning and memory abilities were tested using the Morris water maze. The expressions of Ab 1-40 and Ab 1-42 in the hippocampal microvascular wall and senile plaque were determined by immunohistochemical method. Hippocampal microvascular Ab-positive expression was semi-quantitatively analyzed using the Imagine Pro Plus software. Result The Morris water maze test showed that escape latency lengthened (P<0.05), and the number of crossing platform and swimming time in the platform quadrant decreased (P<0.05) in the model group compared with the blank control group. Escape latency shortened (P<0.05), and the number of crossing platform and swimming time in the platform quadrant increased (P<0.05) in the electroacupuncture group compared with the model group. The immunohistochemical results showed that hippocampal microvascular Ab 1-42 and Ab 1-40 integral optical densities were higher in the model group than in the blank control group (P<0.05) and senile plaques appeared in the hippocampus. Hippocampal microvascular Ab 1-42 and Ab 1-40 integral optical densities were lower in the in the electroacupuncture group than in the model group (P<0.05). Conclusion Electroacupuncture reduces mouse learning and memory impairments and hippocampal microvascular Ab deposition. Its mechanism may be that electroacupuncture improves the way of eliminating cerebral microvascular Ab to decrease cerebral Ab deposition.

Objective To investigate the distribution of the single nucleotide polymorphism (SNP) of-251 (rs4073) in cytokine interleukin 8 gene promoter region and +781 (rs2227306) in the first intron in Nantong area population, to explore the correlation between the genotypes of these sites and the risk of suffering hepatocellular carcinoma (HCC), and to analyze the interaction between the genotypes and different exposure factors inducing the occurrence of HCC. Methods By using case-control study and restriction fragment length polymorphism polymerase chain reaction (RFLP-PCR) technique, the genotypes of IL-8 gene-251 site and+781 site were classified. Results (1) In individuals with-251 heterozygous mutation genotype AT the risk of developing HCC increased (OR=1.99, 95%CI: 1.01-3.85), and in individuals with +781 mutation genotype CT and TT the risk of developing HCC increased (+781 CT genotype, OR=1.78, 95%CI:1.03-3.1; +781 TT genotype, OR=1.36, 95%CI: 1.01-2.62). (2) In individuals with -251 and +781 AT-CT, TT-CT, AT-CC combined genotypes the risk of developing HCC increased (AT-CT combined genotype, OR=2.10,95%CI:1.52-2.9;TT-CT combined genotype, OR=3.33, 95%CI: 1.01-10.50; AT-CC combined genotype, OR=3.67, 95%CI:2.28-5.90). (3)SNP of-251 had positive interactions with drinking, HBV infection and family history of HCC in the occurrence of HCC, while negative interactions existed between SNP of this site and exposure factors, including age, gender and smoking, in the occurrence of HCC. SNP of +781 had positive interactions with drinking and family history of HCC in the occurrence of HCC, while negative interactions existed between SNP of this site and exposure factors, including age, sex, smoking and HBV infection, in the occurrence of HCC. Conclusion Definite correlation exists between SNP of -251,+781 sites in interleukin 8 gene and the risk of the occurrence of HCC in Nantong area population;and there are interactive effects between SNP of -251, +781 sites in interleukin 8 gene and several exposure factors.

AIM:To discuss the effect of Shenmai injection on insulin resistance ( IR) in 3T3-L1 cells and its mechanisms.METHODS:3T3-L1 preadipocytes were induced by chemical reagents to differentiate into fully differentiated adipocytes.Oil red O staining was used to detect the differentiation level of the adipocytes .The insulin-resistant 3T3-L1 cell model was demonstrated using insulin , which was confirmed by glucose concentration in cell supernatant .The IR cell model was given 10 μmol/L rosiglitazone , 25 and 50 g/L Shenmai injection and normal saline for comparison .MTT assay was used to assess the cell activity of 3T3-L1 cells which was treated with drugs for 8, 16, 24 and 36 h.Glucose oxidase method was used to detect the glucose concentration in the cell supernatant at 8, 16 and 24 h.The protein levels of glucose transporter-4 (GLUT4), phosphatidylinositol 3-kinase (PI3K), AKT and p-AKT were determined by Western blot .RE-SULTS:3T3-L1 adipocytes were successfully induced as shown by the positive oil red O staining .The IR cell model was demonstrated , and glucose concentration in the cell supernatant after treatment with Shenmai injection showed that Shenmai injection reduced the IR in 3T3-L1 cell model.The protein levels of GLUT4, PI3K and p-AKT increased compared to con-trol group.CONCLUSION:Shenmai injection reduces the IR in 3T3-L1 cell model, which functions by increasing the protein levels of GLUT4, PI3K and p-AKT.

Objective To study the correlation between non-alcoholic fatty liver disease (NAFLD)and glycosylated hemoglobin (HbA1 c) in middle-aged and aged population.Methods A total of 4 127 inservice workers and retirees aged 45 years old or above from one petrochemical enterprise in Ningbo were enrolled in our study.The waistline,body mass index,blood pressure,fasting blood-glucose,blood lipid profile,glutamyltranspeptidase,HbA1c and epigastrium B ultrasound were investigated.According to the quartile of HbA1c level,participants were divided into four groups,namely,Q1 group ≤5.2％,Q2 group ＞ 5.2％-5.4％,Q3 ＞ 5.4％-5.6％ and Q4 group ＞ 5.6％.The prevalence of NAFLD and clinical characteristics of each group were analyzed.Logistic regression was used to predict independent risk factors of NAFLD.Results The morbidity of NAFLD was 27.2％ with 31.9％ in male and 21％ in female,which was significantly higher in men.In Q1,Q2,Q3 and Q4 group,the prevalence of NAFLD were 18.5％ (178/961),22.8％ (185/812),25.6％ (280/1 095),38.1％ (480/1 259) respectively.With the increase of HbA1 c level,the morbidity of NAFLD increased synchronously.The age,systolic pressure,total cholesterol,low densitylipoprotein cholesterin and fasting blood-glucose were all elevated according to the increase of HbA1 c in 1 123 NAFLD patients.Multi-factor logistic regression analysis indicated that high HbAlc level was the risk factor of NAFLD (OR =1.67,95％ CI 1.15-2.43,P =0.007).Conclusion HbA1c is an independent risk factor of NAFLD and both of these are closely related to blood lipid metabolism disorder.