Objective To analyze the early predictive value of urinary insulin-like growth factor binding protein-7(IGFBP-7) and tissue inhibitor of metalloproteinase-2(TIMP-2) in acute renal injury(AKI) in sepsis.Methods Fifty-eight patients with sepsis admitted to the Emergency Department of Shanxi Provincial People's Hospital from January 2020 to December 2021 were selected and divided into a sepsis AKI group of 22 cases and a non AKI group of 36 cases according to KDIGO's diagnostic criteria. Collect urine and blood samples from patients at 0 h, 24 h, 48 h, and 72 h after enrollment, and detect levels of urine creatinine(SCr), IGFBP-7, and TIMP-2. Analyze the correlation between SCr, urinary IGFBP-7, TIMP-2, and sepsis AKI. The diagnostic value of receiver operating characteristic curve(ROC) analysis of SCr, urinary IGFBP-7, and TIMP-2 in early acute kidney injury in sepsis.Results Compared with the non AKI group, the levels of SCr, urinary IGFBP-7, and urinary TIMP-2 in the AKI group increased at all time points, with statistically significant differences(F/P=147.848/<0.001, 330.849/<0.001, 136.777/<0.001). SCR was positively correlated with urinary IGFBP-7 and urinary TIMP-2(r/P=0.680/<0.001, 0.392/0.002), while urinary IGFBP-7 was positively correlated with urinary TIMP-2(r/P=0.618/<0.001). ROC curve analysis showed that the area under the curve(AUC) of SCr, urinary IGFBP-7, urinary TIMP-2, and urinary IGFBP-7/TIMP-2 in predicting sepsis AKI were 0.586, 0.907, 0.738, and 0.914, respectively. Urinary IGFBP-7 and urinary IGFBP-7/TIMP-2 were superior to SCr(Z/P=4.117/<0.001, 4.196/<0.001). Urinary IGFBP-7 and urinary IGFBP-7/TIMP-2 are better than urinary TIMP-2(Z/P=2.663/0.008, 3.378/0.008).Conclusion Urinary IGFBP-7, urinary TIMP-2, and urinary IGFBP-7/TIMP-2 can all be used as indicators for early prediction of acute kidney injury in sepsis, and the predictive value of urinary IGFBP-7 and urinary IGFBP-7/TIMP-2 is superior to urinary TIMP-2.

Objective To analyze the application value of dulaglutide in promoting ulcer healing in patients with Diabetic foot ulcer. Methods From March 2021 to June 2022, 92 patients with diabetic foot ulcer who were admitted to the Endocrinology Department of the East Hospital of Zhangjiakou First Hospital in Hebei Province were selected as the study subjects. According to the random number table method, they were divided into the control group and the observation group according to the ratio of 1:1, with 46 cases in each group. The control group received routine treatment, while the observation group received treatment with Dulaglutide in addition to the control group. After 8 weeks of treatment, compare the clinical efficacy and ulcer healing rate between the two groups, observe the ulcer area, ulcer local symptom score(wound depth, carrion coverage, redness and swelling range, secretions, granulation situation), and levels of inflammatory factors on the wound surface [cyclooxygenase-2(COX-2), interleukin-1 β(IL-1β),Tumor Necrosis Factor-α(TNF-α)],The level of angiogenic factors [Vascular endothelial growth factor(VEGF), basic Fibroblast growth factor(bFGF), pigment epithelium derived factor(PEDF)] and the incidence of adverse reactions. Results After 8 weeks of treatment, the total effective rate of the observation group was higher than that of the control group(93.48% vs. 78.26%,χ2/P=4.390/0.036); The ulcer area in the observation group was smaller than that in the control group, and the ulcer healing rate was higher than that in the control group(t/P=4.901/<0.001, 4.438/<0.001). The wound depth, carrion coverage, swelling range, secretion, and granulation score in the observation group were lower than those in the control group(t/P=2.992/0.004, 3.606/0.001, 4.166/<0.001, 8="" after="" weeks="" of="" and="" level="" in="" the="" wound="" observation="" group="" levels="" were="" lower="" than="" control="" p="" serum="" vegf="" bfgf="" higher="" pedf="" there="" was="" no="" statistically="" significant="" difference="" incidence="" adverse="" reactions="" between="" two="">0.05). Conclusion Dulagopeptide has a significant effect in patients with Diabetic foot ulcer, which can effectively promote ulcer healing, alleviate local symptoms of ulcer, reduce wound inflammatory response, regulate the expression of angiogenic factors, and has high safety.

Objective To explore the effects of metallothionein(MT) combined with nano calcium carbonate on intelligence and serum immunoglobulin E(IgE) and insulin growth factor 1(IGF-1) in children with lead poisoning.Methods Collect clinical data of 107 children with lead poisoning admitted to the Children's Health Department of Hebei Children's Hospital from October 2020 to November 2022. According to different treatment plans, 53 cases were divided into the conventional group(MT treatment) and 54 cases into the study group(MT combined with nano calcium carbonate). Compare the clinical efficacy and adverse reactions between the two groups, as well as the Gesell score, laboratory indicators, and liver and kidney function indicators before and after treatment.Results After treatment, the total effective rate of the study group was higher than that in the conventional group(94.44% vs. 79.25%,χ2/P=5.434/0.020); The adaptability, large motor, fine motor, language, and personal social scores of the two groups of children increased compared to before treatment, and the Gesell scores of the study group were higher than those of the conventional group(t/P=5.708/<0.001, 9.935/<0.001, 4.931/<0.001, 3.573/0.001, 5.750/<0.001). The blood lead and IgE levels in both groups decreased compared to before treatment, while hemoglobin and IGF-1 levels increased compared to before treatment. The degree of decrease/increase in the above indicators in the study group was greater than that in the conventional group(t/P=8.908/<0.001, 29.612/<0.001, 5.165/<0.001, 10.613/<0.001). there="" was="" no="" statistically="" significant="" difference="" in="" the="" levels="" of="" and="" bun="" liver="" kidney="" function="" indicators="" between="" two="" groups="" before="" after="" p="">0.05). There was no statistically significant difference in adverse reactions between the two groups(P>0.05). Conclusion The combination of MT and nano calcium carbonate has a significant therapeutic effect on children with lead poisoning, which can improve their intelligence level, improve serum IgE and IGF-1 levels, promote lead emissions, and have certain safety.

Objective To explore the preventive effect of folic acid(FA) treatment on abdominal aortic aneurysm(AAA) induced by angiotensin II(Ang II) combined with fumarate 3-aminopropiononitrile(BAPN) in mice and its possible mechanism.Methods The experiment was conducted in the Central Laboratory of Wuhan University People's Hospital from July to October 2022. Thirty C57BL6 mice were randomly divided into a normal control group, an abdominal aortic aneurysm group(AAA group), and a FA treatment group(AAA+FA group) using a random number table method, with 10 mice in each group. AAA group: mice were subcutaneously implanted with a micro osmotic pump to continuously pump Ang II(1 μg·kg-1·min-1) for 28 days, while feeding a feed containing 0.25% BAPN for 28 days. AAA+FA group: The model was made using the same method as the AAA group, and FA(15 mg·kg-1·d-1) was administered orally for 28 days. Normal control group: The mice were fed with regular feed throughout the experiment, with free water intake. Mice who died from ruptured aneurysms were immediately harvested, and the surviving mice were euthanized and harvested on the 29th day. After sampling, the diameter of mouse abdominal aorta was measured, and the frozen sections were stained with reactive oxygen species(ROS), and the paraffin sections were stained with elastic fibers. Western blot was used to detect the expression of matrix metalloproteinase-2(MMP-2), matrix metalloproteinase-9(MMP-9), endothelial nitric oxide synthase(eNOS), and dihydrofolate reductase(DHFR). Results Eight abdominal aortic aneurysms occurred in the AAA group(one of which died on 21 days), while four in the AAA+FA group. The incidence of abdominal aortic aneurysms in AAA+FA mice was significantly lower than that in the AAA group(40.0% vs 80.0%,χ2/P=1.667/0.110), the diameter of the abdominal aorta in the AAA+FA group was significantly smaller than that in the AAA group [(1.44±0.19) mm vs.(2.08±0.50) mm, t/P=3.598/0.005].The elastic fiber structure of the abdominal aorta in the AAA+FA group is more complete than that in the AAA group, and there are no obvious broken fibers. The expression of ROS, MMP-2, and MMP-9 in the AAA+FA group was significantly lower than that in the AAA group(t/P=4.206/0.048, 5.267/0.006), while the expression of eNOS and DHFR was higher than that in the AAA group(t/P=4.511/0.011, 2.914/0.044).Conclusion FA can improve Ang II combined with BAPN induced abdominal aortic aneurysm, possibly by upregulating the expression of DHFR to restore eNOS coupling state, reduce ROS, and alleviate vascular remodeling characterized by medial elastic fiber breakdown, MMP-2, and MMP-9 elevation.

A case of keratitis ichthyosis deafness syndrome was reported and the literature was reviewed.