To observe the clinical efficacy and safety of rituximab injection combined with valsartan capsules in the treatment of patients with chronic glomerulonephritis.

The patients with chronic glomerulonephritis were randomly divided into control group and treatment group. The control group was given valsartan capsules 80 mg each time, qd, orally; on the basis of control group, the treatment group was combined with rituximab 1 000 mg per time, intravenous infusion, once on the 1st and 15th day. Two groups were treated for 12 months. The clinical efficacy, inflammatory indexes, renal function, disease recurrence and safety were compared between two groups.

Seventy-eight cases were enrolled in the treatment group, 9 cases were dropped out, and finally 69 cases were included in the statistical analysis; 79 cases were enrolled in the control group, 8 cases were dropped out, and finally 71 cases were included in the statistical analysis. After treatment, the total effective rates of treatment and control groups were 88.41% (61 cases/69 cases) and 61.97% (44 cases/71 cases), with significant difference (P<0.05). After treatment, the levels of interleukin-1 in the treatment and control groups were (73.88±9.91) and (86.47±10.27) pmol·L^-1, the levels of tumor necrosis factor-α were (42.17±5.66) and (47.94±5.52) pg·mL^-1, the levels of interferon-γ were (13.29±3.86) and (17.72±4.08) pg·mL^-1, the levels of creatinine were (82.17±12.23) and (87.89±10.21) μmol·L^-1, the levels of urea nitrogen were (4.66±1.26) and (5.71±1.65) mmol·L^-1, the 24-hour urinary protein quantifications were (3.55±1.12) and (4.69±1.57) g, the recurrence rates were 1.64% and 18.18%, and the differences were statistically significant (all P<0.05). The adverse drug reactions of treatment group were infection, neutropenia, nausea and vomiting, and leukopenia, while those in the control group were angioedema, nausea and vomiting, and neutropenia. The total incidences of adverse drug reactions in the treatment and control groups were 7.25% and 4.23%, without significant difference (P>0.05).

The clinical efficacy of rituximab injection combined with valsartan capsules in the treatment of patients with chronic glomerulonephritis is better than valsartan capsules alone, without increasing the incidence of adverse drug reactions.

To observe the clinical efficacy and safety of caffeine citrate injection combined with poractant alfa injection in the treatment of respiratory distress syndrome (RDS) in premature infants.

RDS premature infants were divided into control group and treatment group according to the cohort method. The control group was given 100-200 mg·kg^-1 of poractant alfa injection by endotracheal tube injection and added 100 mg·kg^-1 after 12 h, whereas the treatment group received intravenous injection of caffeine citrate injection on the basis of the control group (with the initial loading dose of 20 mg·kg^-1 for 30 min, followed by an additional maintenance dose of 5 mg·kg^-1 for 10 min every 24 h). Both groups were treated continuously for 7 days. The clinical efficacy, treatment-related indicators, blood gas indicators, serological indicators and complications were compared between groups, and the safety evaluation was performed.

There were 57 cases in treatment group and 51 cases in control group. After treatment, the total effective rates in treatment group and control group were 94.74% (54 cases/57 cases) and 78.43% (40 cases/51 cases), respectively (P<0.05). After treatment, the mechanical ventilation time in treatment group and control group was (101.29±22.24) and (113.57±27.55) h; oxygen therapy time was (199.21±43.28) and (238.72±44.01) h; the hospitalization time was (25.63±3.37) and (29.98±4.90) d; the partial pressure of arterial blood oxygen (PaO₂) values were (79.55±7.27) and (74.83±6.16) mmHg; the arterial partial pressure of carbon dioxide (PaCO₂) values were (40.65±3.94) and (45.72±4.46) mmHg; blood pH values were 7.40±0.05 and 7.34±0.05; adrenocorticotropic hormone (ACTH) levels were (30.71±6.92) and (36.80±7.04) pg·mL^-1; cortisol (Cor) levels were (272.90±34.51) and (306.47±30.11) ng·mL^-1; interleukin-6 (IL-6) levels were (35.10±8.49) and (42.55±9.72) pg·mL^-1, and compared with control group, the above indicators in treatment group were statistically different (all P<0.05). During treatment, the incidence rates of complications in treatment group and control group were 3.51% (2 cases/57 cases) and 5.88% (3 cases/51 cases), respectively (P>0.05). There were no adverse drug reactions such as hypotension, bradycardia and irritability in both groups during treatment.

Caffeine citrate injection combined with poractant alfa injection in the treatment of RDS in premature infants can improve the efficacy, shorten the mechanical ventilation time, oxygen therapy time and hospitalization time, improve the blood gas and serum oxidative stress and inflammatory indicators, and the safety is good.

To observe the clinical efficacy and safety of different doses of esketamine injection combined with sevoflurane inhalation in the treatment of children undergoing laparoscopic surgery.

The elective laparoscopic surgery children with general anesthesia were randomly divided into control group and treatment -L, -H groups. Three groups received anesthesia induction with 2%-3% sevoflurane + 2-3 μg·kg^-1 fentanyl + 0.15 mg·kg^-1 remimazolam. Five minutes before the start of the surgery, the treatment -L group was administered 0.25 mg·kg^-1 esketamine + 2%-3% sevoflurane for anesthesia maintenance, the treatment -H group received 0.50 mg·kg^-1 esketamine + 2%-3% sevoflurane for anesthesia maintenance, the control group was given an equal volume of 0.9% NaCl + 2%-3% sevofluran for anesthesia maintenance, sevoflurane inhalation was stopped 10 minutes before the end of the surgery. The pediatric anesthesia emergence delirium (PAED) score at the time of entering the post-anesthesia care unit (PACU), face, legs, activity, cry, consolability (FLACC) score at 6 h after surgery, wakefulness time and safety were compared among three groups.

Treatment -L group was enrolled 94 cases, 5 cases dropped out, and 89 cases were finally included in the statistical analysis; treatment -H group was enrolled 94 cases, 1 case dropped out, and 93 cases were finally included in the statistical analysis; control group was enrolled 88 cases, 2 cases dropped out, and 86 cases were finally included in the statistical analysis. The PAED scores at the time of entering the PACU in treatment -L, -H groups and control group were (9.15±1.30), (7.03±1.24) and (12.45±1.43) points; the FLACC scores at 6 h after surgery were (1.54±0.58), (1.22±0.51) and (2.26±0.64) points; the wakefulness time was (10.84±2.25), (15.92±2.62) and (10.56±2.19) min, respectively; the differences of above indexes were statistically significant between the treatment -L and control groups and the treatment -H group (all P<0.05). The adverse drug reactions of treatment -L and treatment-H groups were drowsiness and tachycardia, while those in the control group were experienced laryngospasm, respiratory depression and tachycardia. The incidences of total adverse drug reactions in treatment -L, treatment -H and control groups were 7.87%, 8.60% and 8.14%, respectively, without significant differences (all P>0.05).

Esketamine injection combined with sevoflurane inhalation can help to maintain children’s hemodynamic stability undergoing laparoscopic surgery, the dose of 0.25 mg·kg^-1·h^-1 of esketamine can improve analgesia efficacy without prolonging the recovery time and increasing the incidence of adverse drug reactions.

To analysis the relationship between urinary albumin creatinine ratio (UACR) and heart rate variability (HRV) in patients with type 2 diabetes mellitus (T2DM).

Patients with T2DM were divided into control group (patients with T2DM only) and treatment group (patients with T2DM and proteinuria) using the cohort method. The treatment group was further divided into a microalbuminuria subgroup (UACR 30 - 300 mg·g^-1) and a macroalbuminuria subgroup (UACR≥300 mg·g^-1). Collected general clinical data, biochemical indicators and 24-hour holter electrocardiogram reports from patients, recorded HRV-related indicators [including pairs of normal N-N Intervals differ by more than 50 ms (PNN50), standard deviation of normal-to-normal R-R intervals (SDNN), etc] of each group of patients, and calculated body mass index (BMI) and estimated glomerular filtration rate (eGFR). Compared the differences in clinical data and HRV parameters among groups, analyzed the impact of UACR on HRV and their interrelationships, and used the receiver operating characteristic curve (ROC) to predict the optimal cutoff point for the occurrence of proteinuria in T2DM patients.

The treatment group enrolled 190 cases, and the control group enrolled 184 cases; the microalbuminuria subgroup enrolled 120 cases, and the macroalbuminuria subgroup enrolled 70 cases. The levels of UACR in the treatment and control groups were 113.99 and 12.76 mg·mmol^-1 Cr, the levels of UAER were 74.81 and 10.92 μg·min^-1, the levels of UA were (353.83±96.41) and (326.17±81.64) μmol·L^-1, the levels of PNN50 were 2.25 and 3.95, the levels of SDNN were 102.83±38.10 and 114.14±31.23, the levels of HRV triangular index were 20.80 and 25.55, respectively; the differences of above results were statistically significant between two groups (all P<0.05). In the macroalbuminuria and microalbuminuria subgroups, the levels of UACR were 1 088.17 and 64.64 mg·mmol^-1 Cr, the levels of UAER were 878.65 and 44.26 μg·min^-1, the levels of UA were (375.88±97.58) and (340.97±93.74) μmol·L^-1, the levels of PNN50 were 1.50 and 2.70, the levels of SDNN were 88.00 and 108.00, the levels of HRV triangular index were 19.49±7.77 and 24.48±8.84, respectively; the differences of above results were statistically significant between two subgroups (all P<0.05). Logistic regression analysis showed that the duration of diabetes mellitus, fasting blood glucose (FPG) and HRV triangle index were the influencing factors for the occurrence of proteinuria in patients with type 2 diabetes mellitus. ROC showed that HRV triangle index had the largest area under ROC curve, with 66.10% sensitivity and 63.00% specificity.

UACR in T2DM patients is closely related to the duration of DM, FPG and HRV triangle index, with the increase of UACR in T2DM patients, the risk of cardiovascular autonomic neuropathy increases.

To observe the clinical efficacy and safety of citric acid solution anticoagulant hemodialysis combined with tacrolimus tablets in the treatment of patients with nephrotic syndrome complicated with acute kidney injury.

The patients with nephrotic syndrome complicated with acute kidney injury were randomly divided into control group and treatment group. The control group was given low molecular weight heparin anticoagulation (initial dose 2 000-3 000 U, additional dose 500-1 000 U·h^-1) hemodialysis + oral tacrolimus capsule, oral tacrolimus capsules at an initial dose of 0.05 mg·kg^-1·d^-1, twice a day. The treatment group was given 180 mL·h^-1 4% sodium citrate anticoagulant hemodialysis + oral tacrolimus capsules, with an initial dose of 0.05 mg·kg^-1·d^-1 twice a day. Two groups were treated for 4 weeks. The clinical efficacy, renal function, coagulation function and safety were compared between the two groups.

Treatment group was enrolled 85 cases, 2 cases dropped out, and 83 cases were finally included in the statistical analysis. Control group was enrolled 84 cases, 3 cases dropped out, and 81 cases were finally included in the statistical analysis. After treatment, the total effective rates of treatment group and control group were 96.38% (80 cases/83 cases) and 92.59% (75 cases /81 cases), without statistical significance (P>0.05). After treatment, the albumin levels of treatment group and control group were (40.19±7.01) and (35.72±6.12) g·L^-1, the serum creatinine levels were (82.39±12.66) and (73.65±11.27) μmoL·L^-1, the 24 h urinary proteins were (1.41±0.26) and (1.75±0.31) g, the prothrombin time was (15.32±1.61) and (18.71±1.74) s, the activated partial thrombin time was (46.29±3.08) and (50.23±3.12) s, the thrombin time was (18.01±1.73) and (21.04±1.85) s, the urine output was (1 358.79±397.22) and (1 283.02±378.97) mL·d^-1, and the differences of above indexes were statistically significant between two groups (all P<0.05). The adverse drug reactions of treatment group were metabolic alkalosis, metabolic acidosis, hypocalcemia and citric acid accumulation, while those in the control group were bleeding, metabolic alkalosis and metabolic acidosis. The incidences of total adverse drug reactions in treatment and control groups were 16.87% and 14.81%, without statistical significance (P>0.05).

Compared with lower molecular weight heparin calcium anticoagulant hemodialysis combined with tacrolimus tablets, sodium citrate anticoagulant hemodialysis combined with tacrolimus tablets can more effectively improve renal function and coagulation function in patients with nephrotic syndrome and acute kidney injury, and will not increase the incidence of adverse drug reactions.

To observe the clinical efficacy and safety of salmon calcitonin nasal spray combined with calcium carbonate D₃ tablets in the treatment of disuse osteoporosis patients after ankle fracture surgery.

The disuse osteoporosis patients with postoperative ankle fractures were randomly divided into control group and treatment group using a random number table method. The control group was treated with calcium carbonate D₃ tablets 600 mg per time, twice daily, while the treatment group received salmon calcitonin nasal spray 200 U per time, once daily, in addition to the treatment in the control group. Both groups were treated for 6 months. The clinical efficacy, bone metabolic markers (osteocalcin, alkaline phosphatase), changes in bone mineral density (BMD) and postoperative pain level (VAS) were compared between the two groups, the safety evaluation was also conducted.

A total of 3 cases dropped out during the trial. Ultimately, the treatment group and the control group included 63 and 62 patients, respectively. After treatment, the overall effective rates for the treatment group and the control group were 93.65% (59 cases/63 cases) and 75.81% (47 cases/62 cases), respectively, with statistically significant difference (P<0.01). After 3 months of treatment, the BMD of the control and treatment groups were (0.87±0.09) and (0.93±0.08) g·cm^-2, respectively; serum osteocalcin levels were (20.10±3.20) and (22.80±3.50) ng·mL^-1, respectively; alkaline phosphatase levels were (74.50±12.30) and (80.10±13.20) U·L^-1, respectively; after 6 months of treatment, the BMD values for the control and treatment groups were (0.90±0.08) and (1.01±0.07) g·cm^-2, respectively; serum osteocalcin levels were (21.00±3.40) and (24.60±3.40) ng·mL^-1, respectively; alkaline phosphatase levels were (76.00±12.50) and (84.90±13.80) U·L^-1, respectively; statistically significant differences were observed for the above indicators between the experimental and control groups (P<0.05, P<0.001). After 3 months of treatment, the visual analog scale (VAS) scores of the control and treatment groups were (5.30±1.30) and (4.50±1.20) points, respectively; after 6 months of treatment, the VAS scores were (4.20±1.10) and (2.90±1.00) points, respectively; the differences between the treatment and control groups were statistically significant (all P<0.001). The main adverse drug reactions in the treatment group were nasal discomfort and nausea, while the control group were gastrointestinal discomfort. The total incidence of adverse drug reactions in the treatment and control groups were 7.94% (5 cases/63 cases) and 4.84% (3 cases/62 cases), respectively, without statistically significant difference between the two groups (P>0.05).

Salmon calcitonin nasal spray combined with calcium carbonate D₃ tablets can significantly increases BMD in disuse osteoporosis patients after ankle fracture surgery, reduce the risk of disuse osteoporosis, with good safety.

To investigate the protective effects of Angelicae and Astragalus ultra-filtration (AAU) on H₉C₂ myocardial cell injury induced by X-ray radiation based on NOD-like receptor thermal protein domain-associated protein 3 (NLRP3) inflammasome.

The H₉C₂ myocardial cells were divided into blank group, model group and experimental -L, -M, -H groups. The H₉C₂ myocardial cells injury model of model group and experimental -L, -M, -H groups were constructed with X-ray 6 Gy irradiation. After successful modeling, the blank and model groups were treated with 0.9% NaCl; the experimental -L, -M, -H groups were treated with 2%, 5%, 10% AAU drug-containing serum 0.5 mL, respectively. After 24 h of treatment, EdU staining was used to observe cell survival rate, Western blot was used to detect the expression levels of NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC) and Caspase-1 protein.

The cell viability rates of the experimental -M, -H groups, model group and blank group were (89.91±1.16)%, (91.66±1.93)%, (78.61±1.30)% and (98.10±0.20)%; the relative expression levels of NLRP3 protein were 0.79±0.05, 0.74±0.04, 0.94±0.02 and 0.53±0.12; the relative expression levels of ASC protein were 0.40±0.04, 0.41±0.07, 0.48±0.01 and 0.22±0.02; the relative expression levels of Caspase-1 protein were 0.25±0.03, 0.23±0.01, 0.58±0.04 and 0.18±0.01; the relative expression levels of IL-18 protein were 0.67±0.03, 0.62±0.02, 0.91±0.07 and 0.61±0.03; the relative expression levels of IL-1β protein were 0.41±0.06, 0.38±0.02, 0.78±0.02 and 0.34±0.09, respectively. Compared with the experimental -M, -H groups, the differences of above indicators in the model group were statistically significant (all P<0.05).

AAU may protect H₉C₂ myocardial cells from injury induced by X-ray radiation by regulating NLRP3 inflammasome.

To explore the regulation by cardamonin through targeting family 110 member A (FAM110A) regulate Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) signaling pathway on human breast cancer cells MCF-7 and effects of aerobic glycolysis and epithelial-mesenchymal transformation.

The breast cancer cells MCF-7 were divided into control group (cultured normally), experimental group (cells treated with 20 μmol·L^-1 cardamonin), oe-NC group (transfected with negative control plasmid oe-NC on the basis of experimental group), oe-FAM110A group (transfected with overexpressed plasmid oe-FAM110A on the basis of experimental group). Quantitative real-time polymerase chain reaction was used to detect the relative expression levels of FAM110A messenger RNA (mRNA) in each group of cells. The relative expression levels of FAM110A protein and the expression of E-cadherin and N-cadherin, which are related to epithelial mesenchymal transformation, were detected by immunofluorescence assay. Detection indexes of aerobic glycolysis in each group were detected by kit. The JAK2/STAT3 signaling pathway related protein phosphorylation level in each group was detected by Western blot.

The relative expression levels of FAM110A mRNA in control group and experimental group were 1.00±0.12 and 0.54±0.10, respectively, and the relative expression levels of FAM110A protein were 1.00±0.15 and 0.13±0.03, respectively; the mRNA and protein relative expression levels of FAM110A in experimental group were significantly different from those in control group (all P<0.05). The relative expression levels of E-cadherin protein in control group, experimental group, oe-NC group and oe-FAM110A group were 1.00±0.14, 2.98±0.51, 3.00±0.54 and 1.47±0.26, respectively; the relative expression levels of N-cadherin protein were 1.00±0.11, 0.41±0.08, 0.47±0.10 and 0.94±0.17; the relative lactic acid production were 1.00±0.19, 0.61±0.11, 0.59±0.09 and 0.98±0.16, respectively; the relative glucose absorption values were 1.00±0.16, 0.41±0.08, 0.42±0.08 and 0.88±0.15, respectively; the relative adenosine triphosphate production were 1.00±0.20, 0.29±0.05, 0.33±0.06 and 0.96±0.18, respectively; the phospho-JAK2/JAK2 levels were 1.00±0.17, 0.54±0.11, 0.58±0.10 and 0.91±0.15, respectively; the phospho-STAT3/STAT3 levels were 1.00±0.14, 0.37±0.06, 0.38±0.06 and 0.92±0.12, respectively; the above indexes in the experimental group were significantly different from those in the control group, and those in the oe-FAM110A group were significantly different from those in the oe-NC group (all P<0.05).

Cardamonin can inhibit aerobic glycolysis and epithelial-mesenchymal transition in breast cancer cells MCF-7, and the mechanism may be through down-regulating FAM110A and inhibiting JAK2/STAT3 signaling pathway.

To investigate the mechanism of Jianpi Yishentongqiao granule (JPYSTQG) in the intervention of spleen-kidney Yang deficiency type allergic rhinitis (AR) rats based on metabolomics.

The AR rat model of spleen-kidney-yang deficiency type was constructed by ovalbumin intraperitoneal injection sensitization + hydrocortisone intraperitoneal injection + rhubarb irrigation combined with modeling, and was randomly divided into model group and experimental group, with 10 rats in each group. Another 10 normal rats were selected as blank group. The experimental group was given 472.5 mg·mL^-1 JPYSTQG solution, the blank group and model group were given equal volume 0.9% NaCl. The rats in the three groups were administrated by gavage three times a day for 14 days. Serum levels of interleukin-4 (IL-4), immunoglobulin E (IgE) and interferon-γ (IFN-γ) were detected by enzyme-linked immunosorbent assay. Differential metabolites were screened by metabolomics and enriched by Kyoto Encyclopedia of Genes and Genomes.

The serum IgE levels in experimental, model and blank groups were (21.23±0.40), (23.80±0.67) and (20.03±1.42) ng·mL^-1; IL-4 levels were (111.00±5.86), (119.79±7.07) and (99.24±1.03) pg·mL^-1; IFN-γ levels were (1 980.63±15.63), (1 602.50±50.00) and (2 136.88±315.63) mg·mL^-1, respectively. Compared with the model group, the differences of experimental and blank groups were statistically significant (all P<0.01). Thirty-seven potential biomarkers of JPYSTQG intervention in spleen-kidney-yang deficiency rats were screened, mainly through arginine biosynthesis and tumor-related pathways.

JPYSTQG can regulate the expression of cytosine and other substances through arginine metabolism pathway, reduce IL-4, IgE and other inflammatory indicators, and thus have therapeutic effect on the allergic rhinitis rats with spleen-kidney-yang deficiency.

To study the effects and safety of silica nanoparticles (SiNPs) on platelets and coagulation system, and initially to explore the mechanism related to the procoagulation of SiNPs.

Blood from the abdominal aorta of rats was taken for in vitro experiments to evaluate the blood safety of 10, 50, 100, 200 μg·mL^-1 of SiNPs. Hematological toxicity was studied using hemolysis assay and lactate dehydrogenase assay. Platelet aggregation was detected by light transmission aggregometry. Platelet activation was detected by platelet surface activation receptor P-selectin. The effects of SiNPs on coagulation were also determined by activated partial tromboplastin time (APTT), thrombin time (TT), prothrombin time (PT) and fibrinogen (Fib).

In platelet-related studies, the max platelet aggregation was (49.38±13.66)% with SiNPs concentration of 200 μg·mL^-1 and platelet activation occurred with 50 μg·mL^-1 SiNPs exposing P-selectin. In coagulation sudies, the PT in 0.9% NaCl and 100 μg·mL^-1 of SiNPs were (9.04±0.20) and (8.36±0.32) s, the blood coagulation indexes were (100.00±0.00)% and (90.06±7.81)%, and the differences were statistically significant (all P<0.05).

High concentrations of SiNPs can cause platelet aggregation and activation, shorten PT and promote blood coagulation.