To study the benefits of autogenous bone marrow transplantation on the blood circulation of lower-extremity with diabetic arterial sclerosis and obstruction. A total of 28 patients of diabetic arterial sclerosis and obstruction treated with autogenous bone marrow transplantation, were recruited in this study from June 2003 to June 2006. Ankle-brachium index and Doppler alterations were observed before operation and 30 days after operation. Results showed that, the ankle-brachium index and circulation state of Doppler had significantly increased at 30 days after operation compared to before operation (P

According to the training of all levels and all kinds of personnel during our hospital's digital construction and implementation process,this article discussed the training char-acteristic of computer skill and the teaching principle for doctors and nurses

OBJECTIVE:To systematically review the efficacy and safety of salmeterol and fluticasone propionate aerosol in the treatment of AECOPD and provide evidence-based reference for the clinical treatment. METHODS:CJFD,Wanfang database, VIP,CBM,Cochrane Library,PubMed and EMBase were retrieved to collect the randomized controlled trial(RCT)of efficacy and safety of salmeterol and fluticasone propionate aerosol in the treatment of AECOPD. After information collection and quality evalua-tion,Meta-analysis was performed by using Rev Man 5.1 software. RESULTS:There were totally 17 RCTs,including 2 872 pa-tients. Results of Meta-analysis showed FEV1[SMD=0.47,95%CI(0.41,0.53),P<0.001],FEV1/FVC [SMD=1.08,95%CI(0.76, 1.39),P<0.001],FEV1 percentage of predicted value[SMD=0.83,95%CI(0.60,1.06),P<0.001] and incidence of adverse reac-tions [RR=1.38,95%CI(1.02,1.87),P=0.03] in test group were significantly higher than control group,with significant differenc-es. CONCLUSIONS:Salmeterol and fluticasone propionate aerosol has good efficacy in the treatment of AECOPD,can better im-prove patients’lung function and the safety needs to be improved. Due to the limit of research methodology,it remains to be fur-ther verified by large-sample and high-quality RCT.

Objective Infrared spectroscopy was used to study on both raw material and different degree water processing varieties extract of Radix Aconiti kusnezoffii,to observe the changes of main toxic components in processing,and thus to improve the quality of Radix Aconiti kusnezoffii processed products.Methods Fu Liye transform infrared spectroscopy was adopted to study the infrared spectrum characteristic of raw materials and different degree water processing varieties of.Radix Aconiti kusnezoffii.Results ①Aconitine and hypaconitine infrared spectrum showed that 1717 cm-1,1727 cm-1 and 1711 cm-1 is the C=O stretching vibration peak.It is a diester alkaloids characteristic peaks; ② although absorption peak of all vesicular samples had a certain change,it still existed diester alkaloids absorption peak,indicating the incomplete hydrolysis; ③ boiled aconite processing methods demonstrated diester alkaloids absorption peak shift in the water sample.Conclusion Diester alkaloids in Radix Aconiti kusnezoffii shows a positive relation with its time soaked in water.

Objective With various doses of lipopolysaccharide (LPS) intra-amniotic injection in pregnant rats to establish histologic chorioamnionitis (HCA) model,and to determine the effects of HCA on fetal lung maturation and development in preterm fetal rats.Methods Thirty pregnant Sprague-Dawley rats were randomly assigned to four groups.On 19 days of gestation,rats in three model groups (n=8) were given intra-amniotic injection of LPS 2,8,10 μg,respectively,and those in the only one control group (n=6)was given normal saline (NS) 40 μl.Fetal rats were taken out 48 hours after LPS injection.Placenta,fetal membrane,fetal lung and umbilical cord were collected for pathological examination.mRNAs of surfactant protein (SP)-A,B and C and keratinocyte growth factor (KGF) in lung were determined by quantitative real-time polymerase chain preaction.KGF protein expression in lung was measured by immunohistochemistry.Morphologic observation of lung was performed on postnatal day 3.R× C table Chi-square test,KruskalWallis test and analysis of variance were used as statistical methods.Results (1) Fetal rat mortality in control,LPS2,LPS8 and LPS10 group was 0.0％ (0/55),22.5％ (18/80),51.4％ (36/70) and 87.5％(35/40),respectively,which increased with increasing dose of LPS (x2=46.183,P＜0.005).(2) HCA,fetal lung inflammation and umbilical vasculitis were induced in LPS groups,and the severity was dosedependent (fetal lung inflammation:Hc=39.84,HCA:Hc=41.13,umbilical vasculitis:Hc=41.52,all P＜0.01).(3) The expression of SP-A,SP-B,SP-C and KGF mRNAs in the four groups (control,LPS2,8,10) had statistical differences (SP-A mRNA:0.99±0.28,2.48±0.34,1.09±0.31 and 0.09±0.09,F=78.051; SP-B mRNA:0.99±0.34,2.23±0.53,1.49±0.51 and 0.14±0.06,F=28.327; SP-C mRNA:1.20±0.39,2.00±0.20,1.04±0.37 and 0.12±0.16,F=39.546; KGF mRNA:0.97±0.19,2.18±0.61,0.93±0.09 and 0.21±0.11,F=37.544; all P＜0.01).All mRNA expressions in LPS2 group were higher than those in the control group and those in LPS10 group was lower (all P＜0.05).(4) The expression of KGF protein in LPS2 group was significantly higher than that in other groups (0.60±0.20 vs 0.28±0.12,0.37±0.22,0.24±0.12,F=17.280,all P＜0.01).(5) Alveolarization was significantly inhibited in LPS8 group on postnatal day 3,and less maturity of pulmonary tissue was observed.Conclusions Various doses of LPS intra-amniotic injection in rats could induce HCA,fetal lung inflammation and umbilical vasculitis with different degrees.Histological inflammation would be worse with increasing LPS dosage.Moderate inflammation could promote lung maturation without inducing bronchopulmonary dysplasia,and KGF may play a role in this process.

Objective To measure the macular thickness of natural population in Changping district of Beijing by optical coherence tomography (OCT), and to analyze whether there is an increased thickness in diabetic patients.Methods In a cross-sectional population-based study, OCT was performed on 521 subjects (233 with normal glucose homeostasis, 174 with pre-diabetes and 114 with type 2 diabetes (T2D) according to 2011 Health Examination Survey of Changping.The subjects also received physical examination and laboratory measurements including fasting plasma glucose (FPG), oral glucose tolerance test (OGTT)-2 h plasma glucose and hemoglobin A1c (HbA1c).Results The results showed that central subfield thickness (CST) of the retina of men ((246±22) μm) was significantly greater than that of women ((235±26) μm) (P＜0.001).Meanwhile, no significant difference was found in the CST in subjects of different age, HbAlc and body mass index (BMI) (P＞0.05).Difference in thickness of different glucose groups was not seen in central subfield, inner subfields and outer subfields(P＞0.05).Conclusions Retina CST of men was significantly greater than that of women.No significant difference was found in the CST in subjects of different age, HbA1c and BMI.

BACKGROUND:Previous studies have found that electroacupuncture can delay articular cartilage degeneration mediated by JAK-STAT signaling pathway through upregulating the expression level of transforming growth factor β1 as well as mRNA expression levels of STAT3, Smad3 and LepR. In the meanwhile, electroacupuncture can inhibit the mRNA expression of p38 and Fas mRNA mediated by MAPK signaling pathways, further inhibiting the apoptosis of chondrocytes. OBJECTIVE: To explore the effect of electroacupuncture on the degeneration of articular cartilage in rats with knee osteoarthritis based on Ras-Raf-MEK1/2-ERK1/2 signaling pathway. METHODS:120 male healthy Sprague-Dawley rats aged 2 months olds were selected and randomly divided into normal, model, 15-minite electroacupuncture and 30-minute electroacupuncture groups (n=30 per group). The rats in the latter three groups received the intra-articular injection of 4% papain bilaterally, and the remaining rats received no intervention. At 2 weeks after modeling, the latter two groups were respectively given 15- and 30-minute electroacupuncture, five times weekly for consecutive 12 weeks. The morphology of the cartilage was observed by hematoxylin-eosin staining, the expression level of interleukin-1β in the synovium was detected by ELISA assay, and the protein expression levels of Ras, Raf, MEK1/2, ERK1/2, C-MYC, C-FOS, and C-JUN were detected by western blot analysis. RESULTS AND CONCLUSION: Hematoxylin-eosin staining showed that: in the model group, the cartilage surface was rough, the cartilage layer became thinner, and the cartilage structure was damaged with incomplete tidal line; in the 15- and 30-minute electroacupuncture groups, the cartilage structure was complete with clear layers and complete tidal line. ELISA showed that the expression level of interleukin-1β in the model group was significantly higher than that in the normal group (P< 0.01), and the level in the 15- and 30-minute electroacupuncture groups was significantly lower than that in the model group (P < 0.05). Western blot assay found that compared with the normal group, the protein expression levels of Ras, Raf, MEK1/2, ERK1/2, C-MYC, C-FOS, and C-JUN were increased in the model group. However, all above protein levels except ERK1/2 in the 15- and 30-minute electroacupuncture groups were significantly lower than those in the model group (P < 0.01,P < 0.05). To conclude, electroacupuncture inhibits the degeneration of articular cartilage in osteoarthritisvia Ras-Raf-MEK1/2-ERK1/2 signaling pathway and downregulating the expression level of interleukin-1β.

Objective:To investigate the clinical efficacy of daratumumab-containing regimen in the treatment of multiple myeloma (MM) and the associated factors affecting patients' progression-free survival (PFS).Methods:A retrospective case series study was conducted. Clinical data of 21 MM patients who were treated with daratumumab-containing regimen in the Heping Hospital Affiliated to Changzhi Medical College from January 2021 to September 2023 were collected. The patients were treated with daratumumab (16 mg/kg intravenous drip) combined with other drugs for 28 d as 1 cycle until disease progression. Among the 21 cases, 6 cases were newly diagnosed multiple myeloma (NDMM), 7 cases were relapsed/refractory multiple myeloma (RRMM), and 8 cases were second-line treatment with daratumumab after the poor outcome of VRD (bortezomib + lenalidomide +dexamethasone) regimen at the time of initial treatment (daratumumab second-line treatment group). The efficacy of the patients after 2 cycles of daratumumab treatment was summarized; the PFS of the whole group and the NDMM and RRMM patients was analyzed by using Kaplan-Meier method, and log-rank test was used for comparison between the groups; the different status of disease, gender and age were included in the univariate and multivariate Cox proportional hazards models to screen the factors affecting the PFS of MM patients.Results:The median age [ M ( Q1, Q3)] of 21 patients was 62 years old (55 years old, 68 years old); 17 were male and 4 were female. After 2 cycles of daratumumab treatment, the overall remission rate (ORR) of the whole group was 85.7% (18/21), 2 cases (9.5%) achieved strict complete remission (sCR), 3 cases (14.3%) achieved complete remission (CR), 9 cases (42.9%) achieved very good partial remission (VGPR), 4 cases (19.0%) achieved partial remission (PR), 2 cases (9.5%) had stable disease and 1 case (4.8%) had disease progression. After 2 cycles of daratumumab treatment, all 6 NDMM patients were in remission, with 2 cases of sCR, 1 case of CR, and 3 cases of VGPR; 4 of 7 RRMM patients were in remission, with 1 case of CR and 3 cases of PR; 8 patients with daratumumab second-line treatment were in remission, with 1 case of CR, 6 cases of VGPR, and 1 case of PR; the difference in ORR among the 3 groups was statistically significant ( P = 0.010), the difference in ORR between patients with NDMM and daratumumab second-line treatment was not statistically significant ( P = 0.245), the ORR of NDMM patients was higher than that of RRMM patients, and the difference was statistically significant ( P = 0.029). The median follow-up time was 15.4 months (95% CI: 13.7-17.1 months). The median PFS time for the whole group was 10.6 months (95% CI: 7.3-15.5 months); the median PFS time was not reached in NDMM patients, the median PFS time was 14.6 months (95% CI: 2.1-27.2 months) in RRMM patients, the median PFS time was 9.6 months (95% CI: 9.5-9.7 months) in patients with daratumumab second-line treatment, and the difference in PFS among the 3 groups was not statistically significant ( P = 0.085). Multivariate Cox regression analysis showed that high age was an independent risk factor for PFS in MM patients ( HR = 1.12, 95% CI: 1.03-1.21, P = 0.009). Conclusions:Daratumumab has good results in treating MM and can be used as a first-line treatment option for NDMM patients, which may improve the remission rate of MM patients with previous ineffective treatment of VRD regimen, and may also improve the prognosis of RRMM patients. High age may be a risk factor for disease progression in MM patients treated with daratumumab.

Objective:To compare the efficacy and safety of standard treatment with or without adjuvant chemotherapy in patients with highly malignant non-metastatic prostate cancer.Methods:In this prospective non-randomized controlled study, consecutive non-metastatic prostate cancer patients with pathologically proven Gleason score of 9-10 or Gleason score of 5 admitted to Peking University First Hospital were enrolled. Four to six cycles of chemotherapy using docetaxel ± carboplatin regimen were added or not after standard radical therapy. The primary end point was 5-year event-free survival (EFS), and the secondary end points were distant metastasis-free survival (MFS), overall survival (OS), and treatment-related adverse events. The survival curve was drawn by Kaplan-Meier method. The differences between two groups were analyzed by log-rank test.Results:A total of 176 patients were consecutively enrolled from November 2019 to January 2022 of which 138 patients received only standard radical therapy (control group), and 38 patients received adjuvant chemotherapy after standard radical therapy (chemotherapy group). The median follow-up time was 13.4 (2.0-34.0) months. All patients survived. The 30-month EFS rates in the chemotherapy and control groups were 100% and 85.6%, respectively ( P=0.064). There were no events in the chemotherapy group, while there were 12 cases of events in the control group, including 6 cases of biochemical recurrence and 6 cases of imaging progression. The 30-month MFS rates in two groups were 100% and 91.9%, respectively ( P=0.205). After the 1 vs. 2 propensity score matching, the EFS and MFS rates in two groups were 100% vs. 85.7% ( P=0.056), and 100% vs. 92.2% ( P=0.209), respectively. The incidence rates of grade 2 and above urinary toxicity in the chemotherapy and control groups were 2.6% and 7.2% ( P=0.354), respectively. The incidence rates of grade 2 and above rectal toxicity were 5.3% and 5.1% ( P=0.711), respectively. Grade 3 and above chemotherapy-related toxicity in the chemotherapy group were leukopenia (31.6%), thrombocytopenia (2.6%) and alopecia (13.2%). Conclusion:The addition of adjuvant chemotherapy after standard radical therapy tends to improve the overall EFS of patients with highly malignant prostate cancer, and the adverse effects are tolerable, which should be confirmed by long-term follow-up results.

Objective To investigate the association between diabetic retinopathy ( DR) and atherosclerosis cardiovascular disease ( ASCVD) .Methods Clinical data of 654 patients with type 2 diabetic mellitus (T2DM) were collected from a cross sectional , population based survey on chronic diseases and risk factors which was conducted in Beijing Changping district from July 2010 to March 2011.Among 654 T2DM patients, there were 73 patients with ASCVD (ASCVD group) and 581 patients without ASCVD ( non-ASCVD group ) .The association between DR and ASCVD was analyzed .Results Patients with ASCVD had significantly older age [58.5(53.9,65.9) years], more female sex[52(71.2%)], higher proportion of ASCVD history [45(61.6%)], higher levels of PG 2 h[16.26(11.08,19.20) mmol/L], HbA1c[7.20(6.55,8.85)%], systolic pressure [151(133,165) mmHg(1 mmHg＝0.133 kPa)] and lower eGFR[87.2(75.0,103.0) ml· min-1· 1.73 m-2] than non-ASCVD patients[52.4(46.5,58.3) years, Z＝-5.86, P＝0.00; 307(52.8%),χ2＝-8.86, P＝0.00; 256(44.1%),χ2＝8.07, P＝0.01; 13.10(8.99,17.93) mmol/L, Z＝-2.35, P＝0.02; 6.70(6.00, 7.90)%, Z＝-3.33, P＝0.00; 143(131,158) mmHg, χ2＝-2.28, P＝0.02; 94.6(84.8,106.3) ml· min-1· 1.73 m-2, Z＝-3.47, P＝0.00].The trend to develop DR in ASCVD group was significantly higher than that in non-ASCVD group [19.2%(14/74) vs.8.3%(48/581), χ2＝9.01, P ＝0.00] .DR was an independent statistical indicator of the presence of ASCVD [ OR ( 95%CI ): 2.64 ( 1.37 -5.06 ), P ＝0.00 ] . Furthermore, when DR was divided into NPDR and PDR according to its severity , only PDR was significantly associated with incident ASCVD [OR(95%CI): 12.05 (2.63-55.12), P＝0.00].After adjusting for traditional ASCVD risk factors , such an association still existed , with the risk of having ASCVD increasing by 718%[ OR (95% CI): 8.18 ( 1.56 -42.81 ), P ＝0.01] .DR associates strongly with ASCVD in the Chinese population with T 2DM.Conclussion With the severity of DR increasing , the risk of ASCVD also grows.After adjustment for traditional risk factors , PDR is still associated with the risk of prevalent ASCVD.