Research progress of palmitoylation in non-alcoholic fatty liver disease and related liver diseases / 中国药科大学学报

@#Non-alcoholic fatty liver disease (NAFLD) has become a major public health hazard threatening human health worldwide.Yet, due to its complex pathogenesis, new drug development is difficult, with still insufficient clinical medication.Palmitoylation is a universal posttranslational modification of proteins catalyzed by palmitoyltransferase, affecting their stability, membrane localization and function.Recent studies have shown that palmitoylation is closely associated with NAFLD.This review summarizes the mechanisms of palmitoylation in NAFLD and analyzes the expression levels of the palmitoyltransferase family in liver tissues of NAFLD patients from GEO database, aiming to provide important clues to explore new mechanisms for NAFLD.

Expression and functions of transient receptor potential channels in liver diseases

Liver diseases constitute a major healthcare burden globally, including acute hepatic injury resulted from acetaminophen overdose, ischemia-reperfusion or hepatotropic viral infection and chronic hepatitis, alcoholic liver disease (ALD), non-alcoholic fatty liver disease (NAFLD) and hepatocellular carcinoma (HCC). Attainable treatment strategies for most liver diseases remain inadequate, highlighting the importance of substantial pathogenesis. The transient receptor potential (TRP) channels represent a versatile signalling mechanism regulating fundamental physiological processes in the liver. It is not surprising that liver diseases become a newly explored field to enrich our knowledge of TRP channels. Here, we discuss recent findings revealing TRP functions across the fundamental pathological course from early hepatocellular injury caused by various insults, to inflammation, subsequent fibrosis and hepatoma. We also explore expression levels of TRPs in liver tissues of ALD, NAFLD and HCC patients from Gene Expression Omnibus (GEO) or The Cancer Genome Atlas (TCGA) database and survival analysis estimated by Kaplan-Meier Plotter. At last, we address the therapeutical potential and challenges by pharmacologically targeting TRPs to treat liver diseases. The aim is to provide a better understanding of the implications of TRP channels in liver diseases, contributing to the discovery of novel therapeutic targets and efficient drugs.

The value of dual-layer spectral CT in assessment of solid lung adenocarcinoma based on 2011 and 2020 pathological grading system / 中华放射学杂志

Objective:To explore the value of spectral CT in the preoperative evaluation of solid lung adenocarcinoma with different pathological grades based on the 2011 and 2020 version of the pathological grading system.Methods:A total of 76 cases of solid lung adenocarcinoma confirmed by surgery in Renji Hospital, School of Medicine, Shanghai Jiao Tong University, from January 2019 to September 2021 were analyzed retrospectively. All cases were divided into groups according to the grading system for invasive adenocarcinoma proposed by the International Association for the Study of Lung Cancer (IASLC) in 2011 and 2020 (G low group included G1 and G2 adenocarcinoma, G high group included G3 adenocarcinoma). The tumors with stage Ⅰ and Ⅱ were non-advanced and the tumors with stage Ⅲ and Ⅳ were advanced. The clinical manifestations (gender, age, smoking history and stage), routine CT parameters (tumor size, morphological characteristics, plain CT value and enhancement degree) and spectral parameters [iodine concentration, effective atomic number, enhanced monochromatic CT attenuation values of 40-200 keV (CT 40 keV-CT 200 keV), and the slope of spectral curve (k value)] were compared between G low group and G high group using independent sample t-test or Mann-Whitney U test. And the efficacy of each parameter for indicating G high adenocarcinoma was analyzed using receiver operating characteristic curve analysis and area under the curve (AUC), and the Z test was used to compare the AUC. Results:Seventy-six cases were included (59 cases of G low group and 17 cases of G high group in 2011 version; 46 cases of G low group and 30 cases of G high group in 2020 version). Among the 76 cases, 62 cases were non-advanced stage (50 cases of G low group and 12 cases of G high group in 2011 version; 37 cases of G low group and 25 cases of G high group in 2020 version) and 14 cases were advanced stage (9 cases of G low group and 5 cases in G high group in both 2011 and 2020 version). Among the non-advanced adenocarcinomas, the CT parameters of enhancement degree, k value and CT 40 keV-CT 60 keV in arterial phase and enhancement degree, k value and CT 40 keV-CT 70 keV in venous phase of G high group in 2011 grading system were significantly lower than those of G low group ( P<0.05), while other parameters were similar between G low and G high group in 2011 grading system ( P>0.05); and the CT parameters of CT 60 keV in arterial phase and CT 50 keV-CT 70 keV in venous phase of G high group in 2020 grading system were significantly lower than those of G low group ( P<0.05). Among the advanced adenocarcinomas, all of the clinical and CT parameters were similar between G low and G high group in both 2020 and 2011 grading systems ( P>0.05). For the non-advanced adenocarcinomas, there was medium to good efficacy of the CT parameters of enhancement degree, k value and CT 40 keV-CT 60 keV in arterial phase and enhancement degree, k value and CT 40 keV-CT 70 keV in venous phase for diagnosing 2011 grading system G high adenocarcinoma (AUC=0.700-0.853), with CT 50 keV in venous phase as the best; while the diagnosis efficacy of CT parameters of CT 60 keV in arterial phase and CT 50 keV-CT 70 keV in venous phase was poor for 2020 grading system G high adenocarcinoma (AUC=0.652-0.688), with CT 60 keV in venous phase as the best. After combining smoking history and CT 60 keV in venous phase, the diagnosis efficacy for 2020 grading system G high adenocarcinoma was slightly improved (AUC=0.772), but the difference had no significance ( Z=0.93, P=0.176). Conclusion:The spectral parameters are useful for distinguishing the pathological grades of solid lung adenocarcinoma. And the detecting efficacy for G high adenocarcinoma of IASLC 2011 version is slightly better than that of 2020 version.

Exploration and Application of ESB High-availability Architecture Construction Based on Hospital Information System / 中国医疗器械杂志

OBJECTIVE@#To solve the ESB bus performance and safety problems caused by the explosive growth of the hospital's business, and to ensure the stable interaction of the hospital's business system.@*METHODS@#Taking the construction of our hospital's information system as an example, we used AlwaysOn, load balancing and other technologies to optimize the ESB bus architecture to achieve high availability and scalability of the hospital's ESB bus.@*RESULTS@#The ESB bus high-availability architecture effectively eliminates multiple points of failure. Compared with the traditional dual-machine Cluster solution, the security is significantly improved. The nodes based on load balancing can be scaled horizontally according to the growth of the hospital's business volume.@*CONCLUSIONS@#The construction of the ESB bus high-availability architecture effectively solves the performance and security issues caused by business growth, and provides practical experience for medical information colleagues. It has certain guiding significance for the development of regional medical information.

Shifting patterns of disparities in unintentional injury mortality rates in the United States, 1999-2016 / Tendencias cambiantes en las disparidades en las tasas de mortalidad por traumatismo no intencional en Estados Unidos entre 1999 y 2016 / Mudança nos padrões de disparidade nas taxas de mortalidade por lesões acidentais nos Estados Unidos, 1999-2016

ABSTRACT Objectives. To analyze changes in racial/ethnic disparities for unintentional injury mortality from 1999-2016. Methods. Mortality data are from the National Center for Health Statistics (NCHS) for all unintentional injuries, analyzed separately by injury cause (motor vehicle accidents [MVA], poisonings, other unintentional) for white,black, and Hispanic populations within four age groups: 15-19, 20-34, 35-54, 55-74 for males and for females. Results. Rates across race/ethnic groups varied by gender, age and cause of injury. Unintentional injury mortality showed a recent increase for both males and females, which was more marked among males and for poisoning in all race/ethnic groups of both genders. Whites showed highest rates of poisoning mortality and the steepest increase for both genders, except for black males aged 55-74. MVA mortality also showed an increase for all race/ethnic groups, with a sharper rise among blacks, while Hispanics had lower rates than either whites or blacks. Rates for other unintentional injury mortality were similar across groups except for white women over 55, for whom rates were elevated. Conclusions. Data suggest while mortality from unintentional injury related to MVA and poisoning is on the rise for both genders and in most age groups, blacks compared to whites and Hispanics may be suffering a disproportionate burden of mortality related to MVAs and to poisonings among those over 55, which may be related to substance use.

RESUMEN Objetivos. Analizar cambios en las disparidades por raza y grupo étnico en materia de mortalidad por traumatismos no intencionales de 1999 al 2016. Métodos. Los datos de mortalidad de todos los traumatismos no intencionales provienen del Centro Nacional de Estadísticas Sanitarias y se han analizado por separado por causa de traumatismo (colisiones automovilísticas, intoxicaciones y otras causas no intencionales) y por población blanca, negra e hispana, tanto en hombres como en mujeres, en cuatro grupos etarios: de 15 a 19, de 20 a 34, de 35 a 54 y de 55 a 74. Resultados. Las tasas en todos los grupos raciales y étnicos variaron según el sexo, la edad y la causa del traumatismo. La mortalidad por traumatismo no intencional mostró un aumento reciente tanto en hombres como en mujeres, que fue más marcado en el caso de los hombres, y por intoxicación en todos los grupos raciales y étnicos de ambos sexos. La población blanca mostró las tasas más elevadas de mortalidad por intoxicación y el incremento más acentuado en ambos sexos, con excepción de los hombres negros entre 55 y 74 años de edad. La mortalidad por colisión automovilística también registró un aumento en todos los grupos raciales y étnicos, con un incremento mayor en la población negra, mientras que la población hispana mostró tasas inferiores que la blanca o la negra. Las tasas de mortalidad por otros traumatismos no intencionales fueron similares en todos grupos salvo en el caso de las mujeres blancas de más de 55 años, cuyas tasas mostraron un incremento. Conclusiones. Los datos indican que, si bien la mortalidad por traumatismo no intencional relacionada con colisiones automovilísticas e intoxicación está en alza en ambos sexos y en la mayoría de los grupos etarios, la población negra en comparación con la blanca y la hispana puede estar presentando una carga desproporcionada de mortalidad relacionada con colisiones automovilísticas e intoxicación en personas mayores de 55, que podrían estar relacionado con el consumo de sustancias psicoactivas.

RESUMO Objetivos. Analisar as mudanças nas disparidades étnico-raciais da mortalidade por lesões acidentais no período 1999-2016. Métodos. Os dados de mortalidade foram obtidos do Centro Nacional de Estatísticas de Saúde (NCHS) dos Estados Unidos para todos os tipos de lesões acidentais e analisados em separado por causa de lesão (acidentes de trânsito de veículos a motor, envenenamento/intoxicação e outros tipos de acidentes) em grupos populacionais de brancos, negros e hispânicos de ambos os sexos divididos em quatro faixas etárias: 15-19, 20-34, 35-54 e 55-74 anos. Resultados. As taxas de mortalidade nos grupos étnico-raciais variaram segundo sexo, idade e causa de lesão. Houve um aumento recente na mortalidade por lesões acidentais nos sexos masculino e feminino, sendo mais acentuado no sexo masculino e por envenenamento/intoxicação em todos os grupos étnicos-raciais de ambos os sexos. A população branca apresentou as maiores taxas de mortalidade por envenenamento/intoxicação e o aumento mais acentuado na mortalidade em ambos os sexos, exceto por homens negros de 55-74 anos. Ocorreu também um aumento da mortalidade por acidentes de trânsito de veículos a motor em todos os grupos étnico-raciais, sendo mais acentuado em negros, e a mortalidade na população hispânica foi menor que em brancos ou negros. As taxas de mortalidade por outros tipos de acidentes foram semelhantes em todos os grupos, exceto em mulheres brancas acima de 55 anos que apresentaram taxas elevadas. Conclusões. Os dados analisados indicam que, apesar de a mortalidade por lesões acidentais por acidentes de trânsito de veículos a motor e envenenamento/intoxicação estar aumentando em ambos os sexos e na maioria das faixas etárias, em comparação a brancos e hispânicos, os negros possivelmente sofrem um ônus desproporcional de mortalidade por acidentes de trânsito e envenenamento/intoxicação no grupo acima de 55 anos que pode estar associada ao uso de substâncias químicas.

Road traffic injuries and substance use among emergency department patients in the Dominican Republic and Peru / Traumatismos causados por el tránsito y consumo de sustancias psicoactivas en pacientes del departamento de urgencias en Perú y República Dominicana / Lesões por acidentes de trânsito e uso de substâncias químicas em pacientes que deram entrada no setor de emergência na República Dominicana e Peru

ABSTRACT Objective. To report demographic and substance use characteristics and risk of road traffic injury (RTI) from alcohol use, cannabis use, and combined use in a sample of emergency department patients from two countries in Latin America and the Caribbean. Methods. A cross-sectional study in which patients 18 years and older admitted within six hours of suffering an RTI to one emergency department in Santa Domingo, Dominican Republic (n = 501) and in Lima, Peru (n = 431) were interviewed. Case-crossover analysis, based on self-reported use prior to the RTI, was used to analyze risk from alcohol, cannabis, and co-use. Results. Overall, 15.3% reported alcohol use prior to the event and 2.5% cannabis use. Drivers using alcohol only were over twice as likely to have an RTI (OR = 2.46, p < 0.001), and nearly eight times more likely if using both alcohol and cannabis (OR = 6.89, p < 0.01), but risk was not elevated for cannabis alone. Significant differences were not found for passengers or pedestrians. Conclusions. Risk of RTI for drivers in these two samples is significantly elevated from alcohol use, and more so for co-use with cannabis. Differences between the two countries underscore the need for similar data from the region to determine risk of RTI from substance use, including risk for passengers and pedestrians. Data suggest that alcohol contributes significantly to the burden of RTI, which calls for more stringent enforcement of alcohol control policy related to drink driving in the region.

RESUMEN Objetivo. Presentar las características demográficas y de consumo de sustancias psicoactivas y el riesgo de traumatismos causados por el tránsito debidos al consumo de alcohol, cannabis y su consumo combinado en una muestra de pacientes del departamento de urgencias de dos países de América Latina y el Caribe. Métodos. Se realizó un estudio transversal en que se entrevistaron pacientes de 18 años o más ingresados en las siguientes seis horas de haber recibido traumatismos causados por el tránsito en un departamento de urgencias en Lima (Perú) (n = 431) y en Santo Domingo (República Dominicana) (n = 501). Se empleó el análisis de cruce de casos, basado en el consumo autoinformado con anterioridad a los traumatismos causados por el tránsito, para evaluar el riesgo por consumo de alcohol, cannabis y consumo combinado. Resultados. En términos generales, 15,3% notificó consumo de alcohol con anterioridad al evento y 2,5%, consumo de cannabis. Los conductores que consumieron alcohol únicamente tuvieron más del doble de probabilidades de sufrir traumatismos causados por el tránsito (OR = 2,46, p < 0,001) y casi ocho veces más probabilidades si consumieron tanto alcohol como cannabis (OR = 6,89, p < 0,01), si bien el riesgo no fue tan elevado para el consumo único de cannabis. No se encontraron diferencias significativas en pasajeros o peatones. Conclusiones. El riesgo de sufrir traumatismos causados por el tránsito para los conductores en estas dos muestras es significativamente más elevado por el consumo de alcohol y más aún por el consumo combinado con cannabis. Las diferencias entre ambos países ponen de manifiesto la necesidad de obtener datos similares sobre la región para determinar el riesgo de sufrir traumatismos causados por el tránsito debidos al consumo de sustancias psicoactivas, así como el riesgo para pasajeros y peatones. Los datos indican que el alcohol agrava significativamente la carga de los traumatismos causados por el tránsito, lo que exige un cumplimiento más estricto de las políticas de control del alcohol relacionadas con la conducción bajo los efectos del alcohol en la región.

RESUMO Objetivo. Descrever as características demográficas e uso de substâncias químicas e o risco de lesões por acidentes de trânsito associados ao consumo de álcool, uso de cannabis (maconha) e uso combinado de álcool e cannabis em uma amostra de pacientes que deram entrada no setor de emergência em dois países da América Latina e no Caribe. Métodos. Estudo transversal em que foram entrevistados pacientes maiores de 18 anos que deram entrada no setor de emergência no espaço de seis horas após sofrerem lesões por acidentes de trânsito em Santo Domingo, na República Dominicana (n = 501), e em Lima, Peru (n = 431). Foi realizada uma análise cruzada de casos com dados obtidos do autorrelato do uso de substâncias químicas anterior ao acidente de trânsito para avaliar o risco associado ao consumo de álcool, uso de cannabis e uso combinado. Resultados. Dos pacientes entrevistados, 15,3% relataram consumo de álcool e 2,5% referiram uso de cannabis antes do acidente. Os condutores que fizeram uso de álcool tiveram uma chance duas vezes maior de ter lesões por acidente de trânsito (OR = 2,46, p < 0,001) e uma chance de cerca de oito vezes maior com o uso combinado de álcool e cannabis (OR = 6,89, p < 0,01). Porém, o risco não foi elevado com o uso somente de cannabis. Não foram observadas diferenças significativas no risco para passageiros ou pedestres. Conclusões. Verificou-se que o risco de lesões por acidentes de trânsito para os condutores nas duas amostras estudadas foi significativamente elevado com o consumo de álcool e foi ainda maior com o uso combinado de álcool e cannabis. As diferenças entre os dois países reforçam a necessidade de dados semelhantes da Região para determinar o risco de lesões por acidentes de trânsito com o uso de substâncias químicas, inclusive para determinar o risco para passageiros e pedestres. Os dados indicam que o álcool contribui significativamente à carga de lesões por acidentes de trânsito requerendo o cumprimento mais rigoroso da política de controle do consumo de álcool associado à condução de veículos na Região.

The reference value of ultrasonography image features, elastography and serum TSH levels in preoperative diagnosis of differentiated thyroid carcinoma / 中华地方病学杂志

Objective:To investigate the reference value of ultrasonography (US) image features, elastography and serum thyroid stimulating hormone (TSH) levels in preoperative diagnosis of differentiated thyroid carcinoma (DTC).Methods:Retrospective analysis was conducted to collect clinical data of patients undergoing thyroid surgery in the Fourth Affiliated Hospital of Harbin Medical University from September 2018 to January 2020. All patients underwent conventional ultrasound, elastography examination and serum TSH level measurement before surgery; patients were divided into benign group and DTC group according to the results of pathological results of the operation, and the US image features and elasticity score were analyzed by chi-square test and multivariate logistic regression to evaluate the causes of DTC; a multivariate logistic regression model was established and the receiver operating characteristic curve (ROC) was drawn with the regression model, by analyzing the area under the ROC curve (AUC), sensitivity, specificity and accuracy, the reference value of US image features, elastography and serum TSH levels in the preoperative diagnosis of DTC were judged.Results:Clinical data of 81 patients were collected, including 17 men and 64 women, aged (48.72 ± 10.58) years. In benign group, there were 37 cases, including 10 men and 27 women, with age of (53.24 ± 9.59) years; there were 44 patients in DTC group, including 7 men and 37 women, with age of (44.91 ± 9.95) years old, the age difference between benign group and DTC group was significant ( t = 3.822, P < 0.05), while the gender difference was not statistically significant (χ 2 = 1.498, P > 0.05). There were significant differences in the number, size, echo level, microcalcification, aspect ratio and elasticity score between benign group and DTC group (χ 2 = 49.000, 4.457, 32.111, 5.444, 4.457, 49.926, P < 0.05); multivariate logistic analysis showed that hypoecho, microcalcification, aspect ratio > 1 and elasticity score were risk factors for DTC ( OR = 8.042, 4.787, 4.160, 2.380, P < 0.05), the ROC curve of the multivariate logistic regression model showed that the AUC was 0.841 (95% CI = 0.743 - 0.939), sensitivity was 90.91%, specificity was 72.97%, and accuracy was 82.72%; the AUC of serum TSH level prediction of DTC showed that the AUC was 0.721 ( P < 0.05), sensitivity was 72.70%, specificity was 64.90%, accuracy was 54.30%, and TSH best cut-off value was 2.215 μU/ml. Conclusion:In the preoperative diagnosis of DTC, US image features, elastography and serum TSH levels are of important clinical reference value for diagnosis of DTC, and the establishment of multivariate logistic regression model is conducive in improving the clinicians prediction of the occurrence of DTC.

Research progress on the exposure pathway and toxic effect of microplastics / 中国职业医学

Global plastics production has been increasing year by year. Due to the large quantity of plastics and the difficulty of their degradation, plastics are continuously accumulated in the environment. Therefore, plastic waste has become one of the most serious threats to the global environment. Microplastics can be absorbed into organisms through the mouth, respiratory tract and skin, causing organ(intestine, liver) toxicity, reproductive and developmental toxicity, and neurotoxicity. Moreover, microplastics can also take up other pollutants distributed in the surrounding environment, such as heavy metals and organic pollutants, jointly exerting combined toxic effects. The extracts of microplastics, including microplastics unstable polymers and additives, also have toxic effects. The molecular mechanisms involved in the toxic effects induced by microplastics include oxidative stress, inflammation, disturbance of intestinal flora, disturbance of gene expression, and others.

Value of dual-layer spectral detector CT in differentiating the diagnosis of lung cancer and inflammatory nodules / 中华放射学杂志

Objective:To explore the value of dual-layer spectral detector CT in differentiating the diagnosis of lung cancer and inflammatory nodules.Methods:A total of 92 patients undergoing enhanced chest scan from March 2019 to September 2020 at Renji Hospital, School of Medicine, Shanghai Jiaotong University, were retrospectively enrolled in the study. The conventional CT parameters, spectral CT parameters were measured and the nodules′ morphological characteristics were analyzed. Later the factors with statistical significance were identified as independent variables in a logistic regression model to establish models for predicting malignant nodules. ROC curve was used to assess the diagnostic performance for the conventional CT model, spectral CT parameters and combined model, respectively. Differences in the area under the ROC curve (AUC) were analyzed by the DeLong test.Results:Lobulated sign (42 and 8, respectively, χ2=10.779, P=0.001), short burr sign (41 and 7, respectively, χ2=11.911, P=0.001), pleural indentation sign (45 and 9 respectively, χ2=11.705, P=0.001), vascular convergence sign (35 and 8, respectively, χ2=5.337, P=0.021) and the venous phase iodine concentrations (IC) value [(2.1±0.5) mg/ml, (2.3±0.5) mg/ml, t=-2.464, P=0.016], normalized iodine concentrations (NIC) value (0.40±0.06, 0.45±0.08, t=-6.943, P<0.001), and Z-effective (Z eff) values (8.38±0.21, 8.49±0.19, t=-2.122, P=0.037) were significantly different between the lung cancer group and the inflammatory group, while other CT signs and CT indicators were not significantly different between the lung cancer group and the inflammatory group ( P>0.05). The conventional CT model was established with lobulated sign, short burr sign, pleural indentation sign, vascular convergence sign, and the AUC for differential diagnosis of lung cancer and inflammatory nodules was 0.827. The spectral CT parameter model was established with venous phase IC, venous phase NIC, and venous phase Z eff value, and the AUC for differential diagnosis of lung cancer and inflammatory nodules was 0.899. The conventional CT model combined spectral CT parameter model was established with the significant factors in the univariate analysis, and the AUC for differential diagnosis of lung cancer and inflammatory nodules was 0.925. The AUC of the combined model showed no significant difference from that of the spectral CT parameter model ( Z=1.794, P=0.073). However, AUC of the combined model was significantly higher than that of evaluation based on conventional CT alone ( Z=2.156, P=0.031). Conclusion:Spectral CT parameters combined with conventional CT signs can improve the differential diagnosis efficiency between lung cancer and inflammatory nodules.

Prevalence of syphilis, gonorrhoea and chlamydia in women in Fiji, the Federated States of Micronesia, Papua New Guinea and Samoa, 1995–2017: Spectrum-STI model estimates

Objectives@#To estimate prevalence levels of and time trends for active syphilis, gonorrhoea and chlamydia in women aged 15–49 years in four countries in the Pacific (Fiji, the Federated States of Micronesia [FSM], Papua New Guinea [PNG] and Samoa) to inform surveillance and control strategies for sexually transmitted infections (STIs).@*Methods@#The Spectrum-STI model was fitted to data from prevalence surveys and screenings of adult female populations collected during 1995−2017 and adjusted for diagnostic test performance and to account for undersampled high-risk populations. For chlamydia and gonorrhoea, data were further adjusted for age and differences between urban and rural areas.@*Results@#Prevalence levels were estimated as a percentage (95% confidence interval). In 2017, active syphilis prevalence was estimated in Fiji at 3.89% (2.82 to 5.06), in FSM at 1.48% (0.93 to 2.16), in PNG at 3.91% (1.67 to 7.24) and in Samoa at 0.16% (0.07 to 0.37). For gonorrhoea, the prevalence in Fiji was 1.63% (0.50 to 3.87); in FSM it was 1.59% (0.49 to 3.58); in PNG it was 11.0% (7.25 to 16.1); and in Samoa it was 1.61% (1.17 to 2.19). The prevalence of chlamydia in Fiji was 24.1% (16.5 to 32.7); in FSM it was 23.9% (18.5 to 30.6); in PNG it was 14.8% (7.39 to 24.7); and in Samoa it was 30.6% (26.8 to 35.0). For each specific disease within each country, the 95% confidence intervals overlapped for 2000 and 2017, although in PNG the 2017 estimates for all three STIs were below the 2000 estimates. These patterns were robust in the sen sitivity analyses.@*Discussion@#This study demonstrated a persistently high prevalence of three major bacterial STIs across four countries in WHO’s Western Pacific Region during nearly two decades. Further strengthening of strategies to control and prevent STIs is warranted.

Clinical analysis of in-hospital mortality in patients with idiopathic inflammatory myopathies / 中华风湿病学杂志

Objective:To explore the clinical features and risk factors of in-hospital mortality in idiopathic inflammatory myopathies (IIM) patients.Results:We retrospectively analyzed clinical records of polymyositis (PM), classic dermatomyositis (CDM) and clinically amyopathic dermatomyositis (CADM) patients admitted to the First Affiliated Hospital of Zhejiang University from February 2011 to February 2019. The deceased group was defined as the patients who died in hospital or within 2 weeks after hospital discharge, while the survival group was defined as the survival patients. The clinical features were described. Risk factors for deceased patients were identified by logistic regression analysis.Results:The in-hospital mortality rate of IIM patients ( n=424) was 9.4%. The hospitalization time was longer in deceased group ( n=40) [0.9(0.5, 1.0) m vs 0.6(0.4, 1.0) m, Z=-2.159, P<0.05]. Ferritin [1170.8(757.6, 3 759.9) μg/L vs 374.9(182.1, 993.4) μg/L, Z=-4.665], red blood cell distribution width (RDW) [15.2(14.5, 16.3)% vs 14.4(13.5, 15.2)%, Z=-3.066], CRP con-centrations [11.3(4.4, 36.9) mg/L vs 5.1(1.8, 17.2) mg/L, Z=-2.667] and neutrophil-to-lymphocyte ratio (NLR) [10.1(5.5, 18.9) vs 4.2(2.6, 6.5), Z=-5.108] were higher in deceased group ( P<0.05). Proportion of patients with high levels of CEA (45.0% vs 12.5%, χ2=15.745), glutamyl transpeptidase (γ-GT) (55.0% vs 23.8%, χ2=11.578), fucosidase (AFU) (35.0% vs 10.0%, χ2=10.902) and with complications [including pro-gressive in-terstitial lung disease (ILD) (60.0% vs 16.3%, χ2=23.934), pulmonary infection (72.5% vs 20.0%, χ2=31.360), hemophagocytic lymphohistiocytosis (35.0% vs 1.3%, χ2=27.771) and low T3 syndrome (50.0% vs 17.5%, χ2=16.644) were higher in deceased group ( P<0.05). Steroid pulse therapy and intravenous immuno-globulin therapy were more common in deceased group. Higher on-admission disease activity [ OR=1.593, 95% CI(1.255, 2.022), P<0.001], progressive ILD [ OR=5.600, 95% CI(1.510, 20.772), P=0.010] and pulmonary infection [ OR=6.771, 95% CI(2.031, 22.574), P=0.002] were independent risk factors for death in IIM patients. In su-bsection analysis, pulmonary infection and respiratory failure were short-term adverse prognostic factors for IIM patients with progressive ILD, while heliotrope rash, progressive ILD and increased steroid dose therapy were short-term adverse prognostic factors for IIM patients with pulmonary infection. Conclusion:High disease activity at admission, progressive ILD and pulmonary infection are the independent risk factors for death in IIM patients. Therefore, it is necessary to closely monitor above indicators during hospitalization.

Analysis of clinical features and prognosis in patients with primary Sjögren's syndrome and autoimmune liver disease / 北京大学学报(医学版)

OBJECTIVE@#To analyze the clinical features and prognosis in patients with primary Sjögren's syndrome (pSS) and autoimmune liver diseases (ALD).@*METHODS@#A retrospective analysis of clinical manifestation and prognosis was performed in patients with ALD or without ALD during the three years (February 2014 to December 2017).@*RESULTS@#Totally, 203 patients with pSS were included in this study, 68 patients had ALD (31 patients with autoimmune hepatitis, 37 patients with primary biliary cholangitis), while 135 patients did not have ALD. There were no differences between the two groups regarding age, gender, clinical manifestations, such as dry mouth, dry eyes, pain, fatigue, lymphadenopathy, glandular swelling, cutaneous involvement, lung involvement, and renal involvement, and the incidence rate of other autoimmune diseases, such as autoimmune thyroid disease, rheumatoid arthritis, and vasculitis. There were also no differences in the titer of antinuclear antibody (ANA), the positive rates of anti-Sjögren's syndrome A antibody (SSA), SSA52, and anti-Sjögren's syndrome B antibody (SSB), and at the levels of erythrocyte sedimentation rate and C-reactive protein between the two groups. Most importantly, the pSS patients with ALD had a shorter disease course, a higher positive rate of anti-mitochondrial M2 antibody (AMA-M2) and anti-centromere antibody, a higher level of IgG and IgM, a lower level of complement 3, and a decreased number of blood cells. They also had a higher level of liver related serum index, such as alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, alkaline phosphatase and total bilirubin, direct bilirubin, indirect bilirubin, a higher incidence rate of liver cirrhosis, an increased death incident (the mortality was 13.24% in the pSS patients with ALD, while 2.96% in the controls, P=0.013), and a worse prognosis. Binary Logistic regression analysis revealed that liver cirrhosis, the EULAR Sjögren's syndrome disease activity index (ESSDAI) scores and the level of total bilirubin were the prognostic factors of mortality in the pSS patients with ALD. The survival curve was estimated by the Kaplan-Meier method. It demonstrated that the pSS patients with ALD had a lower survival rate when compared with the controls.@*CONCLUSION@#The patients with both pSS and ALD will suffer from a more severe disease and a higher death incident. We should pay more attention to these patients and provide a better symptomatic treatment for them during clinical practice.

Effect of Xiao Chaihutang on NF-κB Signaling Pathway in Synovial Tissue of CFA Rats / 中国实验方剂学杂志

Objective:To observe the expression of tumor necrosis factor receptor-associated death domain (TARDD), nuclear transcription factor-κB inhibiting protein α(IκBα)IκB kinase-α (IKKα) and nuclear transcription factor (NF)-κB p65 protein in the NF-κB signaling pathway of synovial tissues of complete Freund's adjuvant (CFA) rats after treatment with Xiao Chaihutang (XCHT). Method:In animal experiments, SPF health adult female Wistar rats were used to prepare the CFA animal model of rats with rheumatoid arthritis with Freund's complete adjuvant and cattle Ⅱ collagen type. According to the random number table, the rats were randomly divided into the normal group, the model group, the low-dose XCHT group, the medium-dose XCHT group, the high-dose XCHT group, and the Tripterygium glucosides group. The drugs were given at 7 d after the model was built. Both normal group and model group were given water for injection,and low-dose XCHT group(5.94 g·kg-1),medium-dose XCHT group(11.88 g·kg-1),high-dose XCHT group(23.76 g·kg-1),Tripterygium glucosides group(0.006 3 g·kg-1) were given corresponding drugs by gavage for three times a day, 2 mL/time. The histopathology of rat ankle joint was observed, and the protein expressions of TARDD,IKKα,IκBα,NF-κB p65 in the NF-κB signaling pathway in synovial tissue of CFA rats were detected by Western blot. Result:With the increase of the dosage of XCHT, the histopathological score of the right posterior ankle joint of the experimental rats was increased. And in the protein expressions of TARDD,IKKα,IκBα,NF-κB p65 in NF-κB signaling pathway in Synovial Tissue of CFA rats, compared with the model group, the statistical results of the low-dose XCHT group showed decreased protein expressions (PPPα, IκB α, NF-κB p65 in the NF-κB signaling pathway were significantly increased (PPα, IκBα, NF-κB p65 key protein expressions in the NF-κB signaling pathway and protein expressions in low-dose XCHT group were obviously lower (PPConclusion:This study shows that as the dose of Xiao Chaihutang increases, it could effectively improve synovitis, and suppress the expressions of key proteins in the inflammatory signaling pathway of NF-κB, thereby preventing inflammation and suppressing bone erosion.

Risk of violence-related injury from alcohol consumption and its burden to society in Latin America and the Caribbean / Riesgo de traumatismos relacionados con la violencia producto del consumo de alcohol y su carga social en América Latina y el Caribe / Risco de lesões resultantes da violência associada ao uso de álcool e o ônus à sociedade na América Latina e no Caribe

ABSTRACT Objective To determine the relative risk (RR) and societal burden of injury related to alcohol-attributable intentional interpersonal violence (alcohol-attributable fraction or AAF), and the dose-response relationship, in Latin America and the Caribbean (LAC), where both the RR and AAF for violence-related injuries are believed to be particularly high. Methods A probability sample of 1 024 emergency department patients from 10 LAC countries who reported an intentional interpersonal violence-related injury (IVRI) was analyzed using case-crossover fractional polynomial analysis of the number of drinks consumed prior to the event. Results A dose-response relationship with a sixfold increase in risk (RR = 5.6) for up to two drinks prior to injury was observed. Risk was higher for 1) females versus males at more than 10 drinks and 2) males and females 30+ years old versus those younger than 30 at all volume levels. Overall, 32.7% of the 1 024 intentional IVRIs were attributable to alcohol. The AAF was three times larger for males (38%) than for females (12.3%). Conclusions A dose-response relationship between the volume of alcohol consumed prior to the event and the risk of intentional IVRI was found. Risk was not uniform across gender or age. Females were at greater risk of injury compared to males at higher volumes of drinking but had a lower AAF due to their lower prevalence of drinking at higher levels.

RESUMEN Objetivo Determinar el riesgo relativo (RR) de la carga social de los traumatismos relacionados con actos de violencia interpersonal intencional atribuibles al alcohol (fracción atribuible al alcohol o AAF) y la relación dosis-efecto en América Latina y el Caribe, donde se cree que tanto el RR como la AAF por traumatismos relacionados con la violencia son particularmente altos. Métodos Se estudió una muestra probabilística de 1 024 pacientes que ingresaron al servicio de urgencias de 10 países de América Latina y el Caribe y que declararon un traumatismo relacionado con un acto de violencia interpersonal (IVRI) intencional, usando para ello un análisis polinomial fraccionario con cruce de casos del número de bebidas consumidas antes del incidente. Resultados Se observó una relación dosis-efecto con un aumento de seis veces el riesgo (RR = 5,6) con hasta dos bebidas antes del traumatismo. El riesgo fue mayor para: 1) las mujeres respecto de los hombres con más de 10 bebidas y 2) los hombres y mujeres mayores de 30 años de edad frente a los menores de 30 años en todos los niveles de volumen. En términos generales, 32,7% de los 1 024 IVRI intencionales fueron atribuibles al alcohol. La AAF fue tres veces mayor para los hombres (38%) que para las mujeres (12,3%). Conclusiones Se observó una relación dosis-efecto entre el volumen de alcohol consumido antes del incidente y el riesgo de IVRI intencional. El riesgo no fue uniforme entre los dos sexos ni en todas las edades. Las mujeres tuvieron un riesgo mayor de traumatismo en comparación con los hombres a volúmenes mayores de consumo, pero tuvieron una AAF más baja debido a una prevalencia más baja del consumo de alcohol en mayores cantidades.

RESUMO Objetivo Determinar o risco relativo (RR) e o ônus à sociedade de lesões intencionais resultantes da violência interpessoal atribuível ao uso de álcool (fração de risco atribuível ao consumo de álcool, FAA) e a relação de dose-resposta na América Latina e no Caribe (ALC). Acredita-se que o RR e a FAA de lesões resultantes da violência sejam particularmente altos na região. Métodos Foi estudada uma amostra probabilística englobando 1.024 pacientes atendidos no setor de emergência de 10 países da ALC por lesão intencional resultante de violência interpessoal (LIVI). Foi realizado um estudo de caso-cruzado com análise polinomial fracionada do número de doses de bebida alcoólica consumidas antes do evento. Resultados Verificou-se uma relação de dose-resposta com aumento do risco de seis vezes (RR = 5,6) associado a duas doses ou menos de bebida alcoólica consumidas antes da ocorrência das lesões. O risco foi maior: 1) no sexo feminino em comparação ao masculino com o consumo acima de 10 doses de bebida alcoólica e 2) em indivíduos do sexo masculino e feminino com acima de 30 anos em comparação aos indivíduos com idade abaixo de 30 anos em todos os níveis de consumo. De modo geral, 32,7% das 1.024 LIVI foram atribuíveis ao consumo de álcool. A FAA foi três vezes maior no sexo masculino (38%) que no feminino (12,3%). Conclusões Observou-se uma relação de dose-resposta entre o nível de consumo de álcool antes do evento e o risco de LIVI. O risco variou por sexo ou idade. Em comparação aos homens, as mulheres apresentaram maior risco de lesão nos níveis mais elevados de consumo de álcool, porém com FAA menor devido à baixa prevalência do consumo de álcool nestes níveis.

Development of the International Alcohol Policy and Injury Index / Formulación de un índice internacional de políticas en materia de alcohol y traumatismos / Elaboração da Política Internacional de Álcool e do índice de lesões

ABSTRACT Objective To develop a new index to measure the effectiveness of alcohol control policies on selected indicators of alcohol-related injuries. Methods We used the World Health Organization Global Information System on Alcohol and Health (GISAH) for cross-sectional data from 156 countries for this analysis. Five policy domains were selected: physical availability, drinking context, pricing, advertising, and vehicular. Injury mortality and alcohol-attributable fractions (AAFs) for vehicular deaths were also used for the same countries. We created a new composite indicator, the International Alcohol Policy Injury Index (IAPII), in order to assess the association between policy and deaths due to alcohol-related injury. Results After we controlled for per-capita alcohol consumption, we found that injury deaths and AAF deaths were inversely associated with four of the five policy domains. The domains were weighted according to effectiveness and used to construct the IAPII, which produced acceptable sensitivity and specificity. Regression results, controlling for consumption, demonstrated that the IAPII was significantly associated with AAF vehicular injury death for males, AAF vehicular injury death for females, and overall injury death at p < 0.01. Conclusions Our findings support the IAPII as a reliable indicator of the relationship between alcohol policies and injury deaths: the stronger the policy, the less the likelihood of both overall and vehicular injury death. Future work should test the effectiveness of the IAPII in reducing alcohol-related injury morbidity, which accounts for a larger share of the global burden of disease than alcohol-related injury mortality does.

RESUMEN Objetivo Elaborar un nuevo índice para medir la eficacia de las políticas de control del consumo de alcohol sobre la base de indicadores seleccionados de traumatismos relacionados con el alcohol. Métodos En este análisis, utilizamos el Sistema Mundial de Información sobre el Alcohol y la Salud de la Organización Mundial de la Salud (GISAH) a fin de obtener datos transversales de 156 países. Se seleccionaron cinco ámbitos normativos: disponibilidad de bebidas alcohólicas, contexto del consumo de alcohol, precios, publicidad y conducción de vehículos. También se usaron datos de mortalidad por traumatismos y de "fracciones atribuibles al alcohol" de las defunciones causadas por el tránsito de los mismos países. Creamos un nuevo indicador compuesto, el índice internacional de políticas en materia de alcohol y traumatismos (IIPAL), a fin de evaluar la asociación entre la política y las muertes por traumatismos relacionados con el consumo de alcohol. Resultados Después de controlar la variable de consumo de alcohol per cápita, observamos que las muertes por traumatismos y las "fracciones atribuibles al alcohol" de las muertes se asociaban inversamente con cuatro de los cinco ámbitos normativos. Los ámbitos se ponderaron según la eficacia y se usaron para construir el nuevo índice, con una sensibilidad y especificidad aceptables. Los resultados de la regresión, con control del consumo de alcohol, mostraron que el índice se asociaba significativamente con la "fracción atribuible al alcohol" de muertes de hombres por traumatismos provocados por el tránsito, la "fracción atribuible al alcohol" de muertes de mujeres por traumatismos provocados por el tránsito y las muertes de personas de ambos sexos por traumatismos (p < 0,01). Conclusiones Nuestros resultados indican que el IIPAL es un indicador fiable de la relación entre las políticas en materia de alcohol y las muertes por traumatismos: cuanto más restrictiva la política, menor probabilidad de muertes por traumatismos en general y de muertes por traumatismos debidas al tránsito. Los futuros trabajos deberían verificar la eficacia de este índice para reducir la morbilidad por traumatismos relacionados con el alcohol, que constituyen una proporción mayor de la carga de enfermedad mundial que la mortalidad por traumatismos relacionados con el alcohol.

RESUMO Objetivo Desenvolver um novo índice para medir a efetividade das políticas de controle do uso de álcool em indicadores selecionados de lesões relacionadas ao uso de álcool. Métodos O Sistema Global de Informação sobre Álcool e Saúde (GISAH) da Organização Mundial da Saúde (OMS) foi usado para obter dados transversais de 156 países para esta análise. Foram selecionados cinco domínios de políticas: disponibilidade física, contexto relacionado ao uso de álcool, determinação de preços, publicidade e acidentes de trânsito. A mortalidade por lesões e a fração atribuível ao álcool (FAA) para mortes por acidentes de trânsito também foram usadas para os mesmos países. Foi criado um novo indicador composto, o índice de lesões da Política Internacional de Álcool (IAPII), para avaliar a associação entre política e mortes decorrentes de lesões relacionadas ao uso de álcool. Resultados Após o controle do consumo de álcool per capita, foi verificado que as mortes por lesões e a mortalidade atribuível ao consumo de álcool apresentavam associação inversa com quatro dos cinco domínios de políticas. Os domínios foram ponderados segundo efetividade e usados para construir o IAPII, que demonstrou ter sensibilidade e especificidade aceitáveis. Os resultados da análise de regressão, após controlado o consumo de álcool, revelaram uma associação significativa do IAPII com mortalidade por acidentes de trânsito atribuível ao álcool no sexo masculino, mortalidade por acidentes de trânsito atribuível ao álcool no sexo feminino e morte decorrentes de lesões em geral (p < 0,01). Conclusões Os achados desta análise respaldam o IAPII como um indicador confiável da relação entre as políticas de álcool e mortes decorrentes de lesões: quanto mais sólida a política, menor a probabilidade de mortes por acidentes de trânsito ou em geral. Outros estudos devem avaliar a efetividade do IAPII em reduzir a morbidade por lesões relacionadas ao uso de álcool, que representa uma parcela maior da carga global da doença que a mortalidade por lesões relacionadas ao álcool.

Experience of wound treatment on extremely severe mass burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident / 中华烧伤杂志

Objective@#To explore experience of wound treatment of extremely severe mass burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident.@*Methods@#On August 2nd, 2014, 98 extremely severe burn mass patients involved in August 2nd Kunshan factory aluminum dust explosion accident were admitted to 20 hospitals in China. The patients with complete medical record were enrolled in the study and divided into microskin graft group with 56 patients and Meek skin graft group with 42 patients. Split-thickness skin in area of residual skin were resected to repair wounds of patients in microskin graft group and Meek skin graft group by microskin grafting and Meek miniature skin grafting, respectively. The residual wound size on 28 days post injury and wound infection after skin grafting of patients in the two groups, and position of donor site of all patients were retrospectively analyzed. Data were processed with t test and chi-square test.@*Results@#The size of residual wound of patients in Meek skin graft group on 28 days post injury was (59±13)% total body surface area (TBSA), which was obviously smaller than that in microskin graft group [(70±14)%TBSA, t=4.379, P<0.05]. Twenty-nine patients in microskin graft group and 11 patients in Meek skin graft group suffered from obvious wound infection after skin grafting. Wounds of patients in two groups were repaired with residual skin around wound in head, trunk, groin, armpit, and uncommon donor sites of scrotum (4 patients), vola (10 patients), and toe or finger web (8 patients).@*Conclusions@#Meek skin graft is the first choice for wound repair of extremely severe burn mass patients, with faster wound healing, less wound infection. Uncommon donor sites of scrotum, vola, and toe or finger web can also be used for wound repair in case of lack of skin.

A Photoelecteochemical Sensor Based on CdS Sensitized Fe:TiO2Nanosheets for Determination of Cu2+ / 分析化学

Iron-doped titanium dioxide nanosheets was prepared by hydrothermal method using tetrabutyl titanate (C16H36O4Ti) and iron trifluoride (FeF3) and modified on ITO electrode.ITO/Fe : TiO2/CdS photoelectrochemical sensor was fabricated by successive ionic layer absorption and reaction(SILAR) method for determination of copper ion.The band gap of electode material was narrowed by iron doped TiO2 nanosheets,which made its absorption red-shifted and its response range of light was magnified.Based on the sensitization effect of CdS,the absorption and utilization of visible light of sensor was significantly enhanced and the photoelectric signal was amplified via reducing the recombination of electrons and holes.The sensor displayed excellent analytical performance for detection of copper ion with linear range of 0.2-4.0 μmol/L and 4.0-80.0 μmol/L and with the detection limit of 85 nmol/L.The sensor was used to detect copper ion in tap water,drinking water and Yongjiang river water with recoveries ranging from 94% to 111%.

The application value of DNA hybridization probe test in the diagnosis of bacterial vaginosis and vulvovagi-nal candidiasis / 实用医学杂志

Objective To investigate the sensitivity and specificity of DNA hybridization probe test(Af-firm VPIII) in the identification related microorganisms of bacterial vaginosis(BV),vulvovaginal candidiasis (VVC). Methods Vaginal secretion were detected in 103 patients with symptom and sign of vaginitis in the out patient department. According to Nungent score,the fungal culture as the gold standard. BV blue reagent assay and wet mount microscopy as a common detection method,evaluated the sensitivity and specificity of Affirm VPIII. Results Compared with the Nungent score,the sensitivity and specificity of Affirm VPIII were 98% and 96.2%. Compared with the fungi culture,the sensitivity and specificity of Affirm VPIII were 89.4% and 98.3%. Conclusion Affirm VPIII has high sensitivity and specificity which can identify pathogenic microorganisms of BV,VVC,especially in BV diagnosis.

Effects of Modified Qianjin Weijing Decoction on TNF-α and NF-κB in Rats with Lung Injury Induced by Particulate Matter / 中国中医药信息杂志

Objective To investigate the protective effect of modified Qianjin Weijing Decoction(MQJWJD)on TNF-α and NF-κB in rats with lung injury induced by particulate matter; To discuss relevant mechanism of action. Methods A tracheal drip 15 mg/kg fine particles of saline solution was used to establish modeling, every other day, three times. Thirty-two Wistar rats were randomly divided into normal group, model group and MQJWJD high-dose and low-dose groups, with eight rats in each group. Medication groups were given relevant medicine for gavage. The level of TNF-α in bronchoalveolar lavage fluid (BALF) was measured by ELISA. The expression of NF-κB protein in lung tissues was measured by immunohistochemistry. The histopathology of the lung injury was observed by light microscope. Results Compared with normal group, the level of TNF-α and the expression of NF-κB protein in the model group were higher than those in the normal group (P<0.01). Compared with model group, the level of TNF-α and the expression of NF-κB protein in MQJWJD low-dose and high-dose groups were lower than those in the model group (P<0.05, P<0.01). Pathological observation showed that, compared with normal group, model group showed intratracheal, alveolar and interstitial bacteria within a large number of fine particles calm, alveolar and pulmonary interstitial visible large amounts of phagocytic fine particles of macrophages and accompanied by more neutrophils and lymphocyte infiltration; Lung tissue pathological changes were significantly lighter in MQJWJD high-dose and low-dose groups than the model group. MQJWJD high-dose group showed mild inflammation, alveolar and pulmonary interstitial visible phagocytic fine particles of macrophages, a small amount of neutrophils and lymphocyte infiltration. Conclusion MQJWJD can reduce the pulmonary injury in rats induced by particulate matter and has protective effects on the rat model through decreasing the levels of TNF-α and the expressions of NF-κB protein in injured lung tissues.

Nicorandil improves cognitive dysfunction in mice with streptozotocin-induced diabetes / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the protective effects of potassium channel opener nicorandil against cognitive dysfunction in mice with streptozotocin (STZ)-induced diabetes.</p><p><b>METHODS</b>C57BL/6J mouse models of type 1 diabetes mellitus (T1DM) were established by intraperitoneal injection of STZ and received daily treatment with intragastric administration of nicorandil or saline (model group) for 4 consecutive weeks, with normal C57BL/6J mice serving as control. Fasting blood glucose level was recorded every week and Morris water maze was used to evaluate the cognitive behavior of the mice in the 4th week. At the end of the experiment, the mice were sacrificed to observe the ultrastructural changes in the hippocampus and pancreas under transmission electron microscopy; the contents of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) in the hippocampus and SOD activity and MDA level in the brain tissue were determined.</p><p><b>RESULTS</b>Compared with the control group, the model group showed significantly increased fasting blood glucose (P<0.001), significantly prolonged escape latency (P<0.05) and increased swimming distance (P<0.01) with ultrastructural damage of pancreatic β cells and in the hippocampus; GIP and GLP-1 contents in the hippocampus (P<0.01) and SOD activity in the brain were significantly decreased (P<0.05) and MDA content was significantly increased in the model group (P<0.05). Compared with the model group, nicorandil treatment did not cause significant changes in fasting blood glucose, but significantly reduced the swimming distance (P<0.05); nicorandil did not improve the ultrastructural changes in pancreatic β cells but obviously improved the ultrastructures of hippocampal neurons and synapses. Nicorandil also significantly increased the contents of GIP and GLP-1 in the hippocampus (P<0.05), enhanced SOD activity (P<0.05) and decreased MDA level (P<0.01) in the brain tissue.</p><p><b>CONCLUSION</b>Nicorandil improves cognitive dysfunction in mice with STZ-induced diabetes by increasing GIP and GLP-1 contents in the hippocampus and promoting antioxidation to relieve hippocampal injury.</p>