Objective To investigate the changes of inflammation levels in patients with impaired glucose tolerance(IGT) and the clinical significance.Methods A total of 30 IGT patients(IGT group) and 30 type 2 diabetes (T2DM) patients (T2DM group) were enrolled in current study.Meanwhile,30 health people were selected as control group (NGT group).The concentration of fasting plasma glucose (FPG),insulin resistance index (HOMA-IR),glycosylated hemoglobin (HbA1c),high-sensitivity C-reactive protein (hsCRP),cystatin C(Cys C) and fibrinogen(FIB) were measured.Results The levels of FPG,2 h glucose(2 h PG),HOMA-IR and HbA1c in three groups were significant (F =8.805,14.403,7.389,10.246 ; P ＜ 0.05).The levels of CRP,Cys C and FIB in three group were also significant (F =6.766,4.733,11.683 ;P ＜ 0.05).The levels of CRP,Cys C,FIB in IGT were (1.12 ±0.22) mg/L,(0.23 ±0.10) mg/L,(0.93 ±0.18) mg/L,higher than that in NGT group((0.70 ±0.16) mg/L,(6.02 ±0.49) g/L and (4.36 ±0.30) g/L).Meanwhile,the levels of CRP,Cys C and FIB in T2DM were significantly higher than of NGT(P ＜ 0.05).Single factor correlation analysis showed that there was positive associationship between hs-CRP,Cys C and FIB with 2 h PG,HbA1 c and HOMA-IR(P ＜ 0.05).Conclusion Endothelial dysfunction is seen in prediabetes stage,which plays an important role in the occurrence and development of vascular disease in impaired glucose regulation and diabetic patients.

Objective To explore the significance of combined detection of urinary podocalyxin (PCX), nephrin and mono-cyte chemoattractant protein-1(MCP-1) for diabetic nephropathy in newly diagnosed type 2 diabetic patients.Methods A total of 132 newly diagnosed type 2 diabetes mellitus (T2DM) patients and 36 healthy subjects were recruited .The concentrations of urinary PCX (UPCX), nephrin (UNephrin) and MCP-1(UMCP-1) were measured with enzyme-linked immunosorbent assay (ELISA), and urina-ry UAE ( UAlb) concentration was measured with turbidimetric immunoassay method .All the results were shown by dividing the urine creatinine ( UCR) concentration in the same sample .The comparisons among UAlb/UCR, UPCX/UCR, UNephrin/UCR, and UMCP-1/UCR among groups were investigated .The correlation among UAlb/UCR, UPCX/UCR, UNephrin/UCR and UMCP-1/UCR was in-vestigated in T2DM patients.The comparison among positive rate of UMCP-1/UCR, UNephrin/UCR, UPCX/UCR and UAlb/UCR was investigated in T2DM patients.Results The levels of UPCX/UCR and UMCP-1/UCR were significantly higher in diabetes melli-tus(DM) group (37.37 ±22.83 and 47.19 ±29.98, respectively) than in healthy subjects (9.59 ±2.28 and 9.98 ±3.63, respec-tively) ( P <0.05 ) .The levels of UAlb/UCR、UPCX/UCR and UMCP-1/UCR were significantly higher in diabetic nephropathy (DN) group (90.39 ±59.35, 72.11 ±58.88, and 104.82 ±82.77, respectively) than in DM group (17.50 ±9.49, 37.37 ± 22.83 , and 47.19 ±29.98 , respectively ) and in healthy subjects ( 8.93 ±3.81 , 9.59 ±2.28 , and 9.98 ±3.63 , respectively ) ( P<0.05).The level of UNephrin/UCR was significantly higher in DN group (83.60 ±61.61) than in DM group (38.74 ±35.27) ( P <0.05).The levels of UPCX/UCR, UMCP-1/UCR, and UNephrin/UCR were positively correlated with UAlb/UCR ( r =0.619, 0.568, and 0.535, respectively) ( P <0.05) in T2DM patients.The level of UPCX/UCR was positively correlated with the levels of UMCP-1/UCR and UNephrin/UCR ( r =0.799 and 0.718 , respectively ) ( P <0.05 ) .The level of UNephrin/UCR was positively correlated with the level of UMCP-1/UCR ( r =0.635 P <0.05) in T2DM patients.The positive rate of UMCP-1/UCR, UNephrin/UCR, and UPCX/UCR was significantly higher than that of UAlb/UCR(χ2 =9.818, 6.673, and 5.395, respectively, P <0.05)in T2DM patients.Conclusions The combined detection of urinary PCX , Nephrin and MCP-1 is very important for the early renal dam-age in newly diagnosed type 2 diabetic patients .

Objective To discuss the establishment,implementation and clinical effect of appraisal system of self-injection of insulin.Methods 100 type 2 diabetes patients were chosen as the objects.The appraisal system of self-injection of insulin for diabetes patients was established to quantify the level of related knowledge and self-injection level.Selective health education was given to patients and plan-imple-mentation-appraisal-processing(PDCA)method was adopted in the quality control management of health education.Results After the implementation of the appraisal system,the patients'grades of the related knowledge and skill on self-injection of insulin were enhanced.Fasting blood glucose and 2 h postprandial Mood glucose was stably controlled,which was statistically different from that before the implementation of the appraisal system.Conclusions The implementation of the appraisal system can sharpen the patients'self-control ability of disease and avoid the blindness,low efficiency and duplication of health education workers.

Objective:To study the effectiveness and safety of different acupuncture therapies in treating Posttraumatic stress disorder(PTSD)after Wenchuan‘5.12’earthquake.And choose a desirable acupuncture therapy.Methods:A total of 276 patients were recruited in this trial and randomly divided into four groups:scalp electric acupuncture group(group A),scalp electric acupuncture with moxibustion group(group B),scalp electric acupuncture with auricular acupuncture group(group C)and paroxetine hydrochloride group(group D).Each group was treated for 12 weeks.Patients were scored using Clinicianadministered Scale for DSM-IV(CAPS),Hamilton Depression Rating Scale for Depression(HAMD),and Hamilton Anxiety Scale(HAMA).Results:The study was finished well with a balanced grouping and fine baseline.After the analysis of integrations of CAPS,HAMD,and HAMA,we found that the score differences before and after the treatment were of statistical significance in all four groups(P

Objective To explore latent class of psychological distress among the elderly with multiple chronic conditions in the community and to analyze differences in demographic and alexithymia characteristics across class.Methods A total of 685 urban and rural elderly with chronic disease co-morbidities in 6 prefecture-level cities in Jiangsu Province were selected for the study using the General Information Questionnaire,the Depression Anxiety and Stress Scales-21,and the Toronto Alexithymia scale from November 2022 to March 2023 using a convenience sampling method.Results A total of 662 older adults with multiple chronic conditions were finally investigated with a total psychological distress score 30.00(16.00,52.00).Psychological distress manifested itself in 4 different potential categories named"stress-depressive"(19.9%),"low distress"(26.0%),"stress-anxiety"(23.4%),and"overall high distress"(30.7%).The comparison of the different psychological distress categories with respect to age group,marital status,residential status,financial stress of illness,acute events within 1 year,and self-perceived health status showed statistically significant differences(P＜0.05).The comparison of alexithymia scores for the 4 potential categories showed statistically significant differences(F=136.544,P＜0.001).Conclusion Psychological distress in older adults with multiple chronic diseases has distinct categorical features,and alexithymia varies across different categories of psychological distress.Healthcare professionals can adopt targeted interventions according to different categories of chronic disease co-morbidities in order to reduce their psychological distress,and at the same time they should focus on older adults with the alexithymia of"stress-depressive"and"overall high distress".

Objective To observe the effect of abdominal acupuncture in treating allergic rhinitis(AR).Methods Twenty-seven AR patients who attended Fangshan Hospital,Beijing University of Chinese Medicine from August to October 2022 were selected.They were divided into treatment group(15 cases)and control group(12 cases)according to randomized numerical table method.The treatment group received abdominal acupuncture.The control group at the same point was used one-time sterile cannula acupuncture to simulate acupuncture,but no needle was inserted into the acupoint.Two groups were treated,3 times a week for 4 weeks.The visual analogue scale(VAS),rhinoconjunctivitis quality of life questionnaire(RQLQ),Pittsburgh sleep quality index(PSQI)scores,and the histamine(HIS),leukotriene D4(LTD4),immunoglobulin E(IgE)levels were compared between two groups before and after treatment.Results At each time point after treatment,the VAS,RQLQ,PSQI scores and HIS,LTD4,IgE levels of patients in treatment group were significantly lower than those before treatment(P<0.05).There were no statistically significant differences in VAS,RQLQ,and PSQI scores,the HIS,LTD4,and IgE levels after 2-week treatment in both groups(P>0.05).After 4-week treatment and follow-up 4-week,the VAS,RQLQ,and PSQI scores,the HIS,and LTD4 levels in treatment group were significantly lower than those in control group(P<0.05).Conclusion Abdominal acupuncture has good therapeutic effect on AR and significantly improves life quality of the patients,which can reduce the levels of HIS,LTD4 and IgE.The therapy is worthy of clinical application.

Objective:To retrospectively analyze the treatment status of tyrosine kinase inhibitors (TKI) in newly diagnosed patients with chronic myeloid leukemia (CML) in China.Methods:Data of chronic phase (CP) and accelerated phase (AP) CML patients diagnosed from January 2006 to December 2022 from 77 centers, ≥18 years old, and receiving initial imatinib, nilotinib, dasatinib or flumatinib-therapy within 6 months after diagnosis in China with complete data were retrospectively interrogated. The choice of initial TKI, current TKI medications, treatment switch and reasons, treatment responses and outcomes as well as the variables associated with them were analyzed.Results:6 893 patients in CP ( n=6 453, 93.6%) or AP ( n=440, 6.4%) receiving initial imatinib ( n=4 906, 71.2%), nilotinib ( n=1 157, 16.8%), dasatinib ( n=298, 4.3%) or flumatinib ( n=532, 7.2%) -therapy. With the median follow-up of 43 ( IQR 22-75) months, 1 581 (22.9%) patients switched TKI due to resistance ( n=1 055, 15.3%), intolerance ( n=248, 3.6%), pursuit of better efficacy ( n=168, 2.4%), economic or other reasons ( n=110, 1.6%). The frequency of switching TKI in AP patients was significantly-higher than that in CP patients (44.1% vs 21.5%, P<0.001), and more AP patients switched TKI due to resistance than CP patients (75.3% vs 66.1%, P=0.011). Multi-variable analyses showed that male, lower HGB concentration and ELTS intermediate/high-risk cohort were associated with lower cytogenetic and molecular responses rate and poor outcomes in CP patients; higher WBC count and initial the second-generation TKI treatment, the higher response rates; Ph + ACA at diagnosis, poor PFS. However, Sokal intermediate/high-risk cohort was only significantly-associated with lower CCyR and MMR rates and the poor PFS. Lower HGB concentration and larger spleen size were significantly-associated with the lower cytogenetic and molecular response rates in AP patients; initial the second-generation TKI treatment, the higher treatment response rates; lower PLT count, higher blasts and Ph + ACA, poorer TFS; Ph + ACA, poorer OS. Conclusion:At present, the vast majority of newly-diagnosed CML-CP or AP patients could benefit from TKI treatment in the long term with the good treatment responses and survival outcomes.