Objective To know the effect of using clustering intervention on insulin injection in the patients with type 2 diabetes.Methods 123 patients with type 2 diabetes were selected in the research.Clustering intervention was carried out in these patients with a series of effective measures to develop and integrate the application.Compared the controlling condition of blood sugar and the condition of insulin injection in patients by self control.Results The fasting blood glucose and the postprandial blood glucose after the intervention was (5.91±0.41) mmol/L and (8.27±0.53)mmol/L respectively,which was significant lower than that of before the intervention [(8.94±1.32) mmol/L and (11.15±1.34)mmol/L respectively,P＜0.01].Conclusion Clustering intervention can regulate insulin injections,improve patients' ability of self-management and the treatment compliance,effectively control blood sugar and delay or reduce complications after the implementation of cluster intervention.

Objective To observe the effect of Ginkgo Biloba Extract Injection on urinary albumin excretion rate in patients with diabetic nephropathy (DN). Methods A total of 90 patients with DN were divided into two groups: group A was micro-urinary-albumin group; group B was multiple-urinary-albumin group. Both groups were treated with routine therapy plus Ginkgo biloba extract injection (at a dose of 15ml) q.d. for 4 consecutive weeks. The urinary albumin excretion rate was compared between the two groups before and after treatment. Results As compared with the group B, urinary albumin excretion rate was significantly lowered in the group A (P＜0.01). Conclusion Ginkgo Biloba Extract Injection had effects in lowering microalbumin in urine and therapeutic effect for patients with early DN.

Aim To investigate the expression of Notch pathway and Nephrin in angiotensin Ⅱ ( AngⅡ)-stimulated mice podocyte. Methods Mice podo-cyte was stimulated by AngⅡ, and then was treated with valsartan. The levels of Notch1, Notch intracellu-lar domain 1 ( NICD1 ) , Hes1 and Nephrin were deter-mined by immunofluorescence, Western blot and Real-time PCR. Results AngⅡincreased Notch1, NICD1 and Hes1 expression, and decreased Nephrin expres-sion in a time-dependent manner ( P<0. 01 ) . Valsar-tan inhibited AngⅡ-induced activation of Notch path-way and enhanced Nephrin level ( P <0. 01 ) . Con-clusion AngⅡdecreases Nephrin expression in podo-cyte by activating Notch pathway.

Purpose To investigate the adverse reactions and management in the process of transvaginal real-time three-dimensional hysterosalpingo-contrast sonography (3D-HyCoSy).Materials and Methods A total of 976 patients with infertility accepting 3D-HyCoSy in Jiangsu Provincial Hospital of Traditional Chinese Medicine,Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,from December 2014 to August 2016 were retrospectively analyzed.The pain degree was evaluated using visual analog scale (VAS).Adverse reactions,including contrast countercurrent,vomiting,syncope and allergies,were recorded.The relationship between adverse reactions and ultrasound imaging signs was explored.Results There were 66 cases (6.76％) of VAS grade 0,346 cases of mild pain (35.45％),374 cases of moderate pain (38.32％) and 190 cases (19.47％) of severe pain.With the increase in the degree of tubal obstruction,the degree of pain gradually increased.Pain was the most common adverse reaction among patients,followed by vomiting (15 cases,1.54％),syncope (1 case,0.10％),and allergies (1 case,0.10％).The incidence of contrast countercurrent was 12.30％ (120 cases).The adverse reaction incidence of patients with abnormal ultrasound imaging signs was significantly higher than that of patients with normal signs (x2=29.02,P＜0.01).Conclusion With the extensive use of 3D-HyCoSy examination,its clinical application value has attracted a lot of attention,meanwhile,the understanding of its safety and related adverse reactions should also be improved.The state of patients should be closely observed before,during and after 3D-HyCoSy.Medical personnel should watch out for syncope and allergic reactions,and prepare for emergency management.

Purpose To investigate the role of SOCS3 on diabetic renal injury. Methods Male CD-1 mice were randomly divided into four groups:control group, diabetic group, empty plasmid vector transfection group and SOCS3 plasmid transfection group. The diabet-ic mice were induced by intraperitoneal injection of STZ at a dose of 150 mg/kg body weight. The mice of transfection group were re-ceived an injection of SOCS3 plasmid or empty vector at every 7 days thereafter. Specimens were collected at 12 week after STZ injec-tion. The morphological changes of tubular epithelial cells were observed by transmission electron microscope. RT-PCR and immuno-histochemistry were used to determine the mRNA and protein expression of CK18 and α-SMA. Western blotting analysis was used to determine the protein expression of SOCS3, p-STAT3, CK18 and α-SMA. Results SOCS3 overexpression in kidney down-regulated the levels of p-STAT3 andα-SMA but up-regulated the expression of CK18. Conclusion Overexpression of SOCS3 can ameliorate the tubular epithelial-mesenchymal transdifferentiation of diabetic mice via inhibiting the phosphorylation of STAT3.

Objective To evaluated intra-articular injection of TNF-α inhibitors into the sacroiliac joint as an effective and viable alternative. Methods Sixteen patients with documented ankylosing spondylitis (AS), without steroids or disease modifying anti-rheumatic drugs (DMARDs) were performed CT-guided intra-articular injections of etanercept (TNF-α antagonist) at week 0, 4 and 8 (25 mg per dose). Similarly, 20 patients with AS in the control group received systemic etanercept therapy at a dose of 50 mg per week for 8 weeks. All patients were followed up clinically and evaluated periodically. Pathological features of sacroiliitis were observed with light microscopy and immunohistochemistry. Expression of cytokines in joint biopsy samples was estimated by RT-PCR. Image changes of sacroiliitis were observed by SPECT/CT and MRI. Ttest, t'tesr and χ2 Fisher's test were selected. Results All the 16 patients who received intra-articular etanercept, the mean value of radiological nuclide decrease of the SIJ ROI (region of interest) in the SPECT improved significantly after 8 weeks treatment [(1.38±0.16 vs 1.45±0.14) P<0.05] . Bone marrow edema and fat deposition in MRI were relieved significantly after 8 weeks (P<0.05). In 8 patients the expression of TNF-α and TGF-β mRNA in joint tissue decreased significantly after 8 weeks [(0.89±0.06, 0.84±0.05) vs (l.08± 0.19, 1.13±0.33) (P<0.05)]. The occurrence of gynonitis, enthesitis, chondritis, subehondral bony plate destruction, bone marrow inflammation and inflammatory cell index also decreased significantly (P<0.05). Participants given intra-articular injection showed significant clinical improvement after 8 weeks and 12 weeks treatment(P<0.01 ) in BASDAI score [(32±13) mm]. Conclusion This study has shown that intra-articular injection of etanercept in SIJ can improve joint function and quality of life. It has a satisfactory safety profile and is cost effective. This mode of treatment is most beneficial in local arthropathy of recent onset and in those patients who do not tolerate systemic etanercept therapy.

OBJECTIVETo investigate the role of apoptosis in radiation-induced mouse thymus lymphocyte damage and repair and provide the basis for understanding the molecular mechanism of radiation-induced lymphocyte damage and repair as well as the prevention and treatment of acute radiation sickness.

METHODSWe studied the dynamic changes of apoptosis of mouse thymus lymphocytes and the expression of bax and bcl-2 gene products after 2, 4, 6 and 8 Gy of whole body gamma-irradiation using in situ terminal labeling, DNA electrophoresis and immunohistochemical techniques.

RESULTSAt the early stage after irradiation, the percentage of apoptotic lymphocytes increased rapidly in accordance with the increasing of radiation doses, while the counts of the thymus and peripheral lymphocytes decreased sharply, showing an opposite change to lymphocyte apoptosis. After 6 Gy gamma-irradiation, typical morphological characteristics of thymus apoptotic lymphocytes in early, middle and late stages were found by transmission electron microscopy. The thymus lymphocytes displayed characteristic DNA ladders 4 hr and 8 hr after 2-6 Gy gamma-irradiation,using DNA gel electrophoresis techniques. Abnormal expression of bcl-2 and bax gene products were shown in irradiated lymphocytes.

CONCLUSIONSApoptosis plays an important role in the process of radiation-induced mouse thymus lymphocyte damage and repair. Bcl-2 and Bax proteins may regulate the process of lymphocyte apoptosis.

Animals ; Apoptosis ; radiation effects ; Dose-Response Relationship, Radiation ; Gamma Rays ; Lymphocytes ; physiology ; radiation effects ; Male ; Mice ; Proto-Oncogene Proteins ; analysis ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; Thymus Gland ; pathology ; radiation effects ; Time Factors ; bcl-2-Associated X Protein

Objective:To investigate the expressions and significances of autophagy-related genes Beclin-1, LC3 and p62 in esophageal squamous cell carcinoma (ESCC).Methods:The clinical data of 112 patients with primary ESCC who underwent surgery at the 81st Group Army Hospital of Chinese PLA from January 2015 to December 2016 were retrospectively analyzed. Immunohistochemistry was used to examine the expressions of Beclin-1, p62 and LC3 proteins in 112 ESCC tissues and 31 adjacent normal esophageal mucosa tissues. Furthermore, the expressions of the above three autophagy-related markers in ESCC and the relationship between their expressions and the clinicopathological characteristics of patients were analyzed.Results:The positive expression rates of Beclin-1, LC3 and p62 in ESCC tissues were 32.14% (36/112), 37.50% (42/112) and 63.39% (71/112), The positive expression rates of Beclin-1, LC3 and p62 in adjacent normal esophageal mucosa tissues were 61.29% (19/31), 64.52% (20/31) and 32.26% (10/31), and the differences were statistically significant ( χ2 values ??were 8.715, 7.216 and 9.584, all P < 0.01). The positive expression rates of Beclin-1 and LC3 in ESCC were lower than those in adjacent normal esophageal mucosa tissues, and the positive expression rate of p62 in ESCC was higher than that in adjacentnormal esophageal mucosa tissues. In ESCC patients, the expression of Beclin-1 was related to histological grade, infiltration depth, TNM staging and lymph node metastasis (all P < 0.05); the expression of LC3 was related to infiltration depth and TNM staging (both P < 0.01); the expression of p62 was related to lymph node metastasis ( P < 0.01). In ESCC, the expression of LC3 was positively correlated with the expression of Beclin-1 ( r = 0.731, P = 0.001), and negatively correlated with the expression of p62 ( r = -0.215, P = 0.023). Conclusions:Autophagy plays a certain role in the occurrence and development of ESCC. Combined detection of autophagy-related genes Beclin-1, p62 and LC3 can assist clinical diagnosis and guide follow-up comprehensive treatment.

【Objective】 To investigate the changes in cellular immunity (peripheral blood lymphocyte subsets) and humoral immunity (serum immunoglobulin and ferritin) status among children with thalassemia who received repeated transfusions in Yunnan. 【Methods】 Forty-six children with thalassemia who underwent repeated blood transfusions from January 2020 to October 2022 were selected as the observation group. Forty children with thalassemia who did not receive blood transfusion were included in control group 1, and 46 healthy children underwent physical examination were included in control group 2. The differences in lymphocyte subsets, serum immunoglobulin levels and ferritin concentrations were compared among the three groups. 【Results】 For lymphocyte subsets: CD3⁺, CD4⁺ and CD4⁺/CD8⁺ in the observation group was lower than the control group 1 and 2: 57.60±8.36 vs 64.57±7.56 vs 66.58±5.65, 33.16±5.67 vs 38.62±8.36 vs 38.62±6.41 and 1.49±0.09 vs 2.32±0.15 vs 2.13±0.16, respectively; CD16⁺ CD56⁺ in the observation group was lower than the control group 2: 11.21±5.06 vs 16.70±7.92; CD8⁺ in the observation group was higher than control group 1 and control group 2: 26.63± 1.75 vs 20.60±1.43 vs 18.92±0.84; CD19⁺ in the observation group was higher than the control group 2: 24.06±6.42 vs 19.67 ±8.42, P<0.05, but no significant difference was noticed between the two control groups(P>0.05). For serum immunoglobulin and ferritin: IgG and ferritin in the observation group were higher than control group 1 and control group 2: 10.59±3.88 vs 7.02±3.88 vs 5.58±1.98 and 2 037.37±1 377.59 vs 72.63±56.71 vs 59.48±33.88. IgA in the observation group was higher than the control group 2: 1.06±0.92 vs 0.39±0.32(P<0.05), but no significant difference was noticed between the two control groups (P>0.05). The difference of IgM and IgE between the three groups was not significant (P > 0. 05). 【Conclusion】 The proportion of lymphocyte subsets in thalassemia children with repeated blood transfusion was imbalanced,and the level of immunoglobulin in humoral immunity was abnormal.

【Objective】 To study the changes in serum immunoglobulin levels in children with thalassemia who undergo repeated blood transfusions and explore their correlation with delayed hemolytic transfusion reactions(DHTR). 【Methods】 Serum samples from children with thalassemia who received blood transfusion treatment from June 2022 to April 2023 (observation group) and healthy children who underwent physical examination (control group) in our hospital were collected. The levels of serum immunoglobulins (IgG subtype, IgM, IgA, IgE and IgD) were detected using flow cytometry CBA multi-factor quantitative detection technology, and the differences between the two groups were compared. The children were divided into 4 groups according to different transfusion numbers: ≤10 numbers, 11-30 numbers, 31-50 numbers and >50 numbers, and the differences between different blood transfusion numbers and serum immunoglobulin levels in each group were compared using one-way analysis of variance (ANOVA). Children with thalassemia with DHTR were in the hemolysis group, and children with thalassemia who did not experience DHTR were in the non-hemolysis group. The changes in serum immunoglobulins (IgG subtypes, IgM, IgA, IgE and IgD) between the two groups were compared to explore the correlation between serum immunoglobulins in thalassemia children with repeated transfusion and DHTR. 【Results】 The levels of IgG1, IgG3, IgG4 and IgA in the observation group were significantly higher than those in the control group, with the increase of(2.07±2.12), (0.67±2.03), (0.30±0.37)and(6.04±11.40)mg/mL, respectively, while the level of IgD in observation group was significantly lower than that in the control group, with a decrease of(0.03±0.01)mg/mL, P<0.05. No significant difference was noticed in IgG2, IgM and IgE between the groups(P>0.05). IgG1 and IgG4 both significantly increased with the number of blood transfusions.The IgG1 in the 4 groups increased sequentially as(0.30±0.62), (0.41±0.51)and(3.60±3.48)mg/mL, and IgG4 increased sequentially as (0.12±0.13), (0.22±0.07) and (0.21±0.38)mg/mL. IgG2, IgM and IgD showed a significant decrease, with IgG 2, IgM, and IgD in four groups decreased as(0.91±1.50), (0.14±0.10)and(0.05±0.05)mg/mL, respectively, showing significant differences with the number of blood transfusions(P<0.05). No significant difference was found in IgG3, IgA and IgE with different number of transfusions(P>0.05). IgG1, IgG3 and IgG4 in the hemolysis group were significantly higher than those in the non-hemolysis group, with an increase of (4.44±3.41), (0.73±1.26)and(0.52±0.40), respectively(P<0.05).IgD in the hemolysis group was significantly lower than that in the non-hemolysis group, with a decrease of (0.00±0.06)mg/mL, P<0.05. No significance was noticed in IgG2, IgM, IgA and IgE between the hemolysis group and the non-hemolysis group(P>0.05). 【Conclusion】 The serum immunoglobulin levels of children with thalassemia who undergo repeated blood transfusions are abnormal. There are differences in correlation between the number of blood transfusions and serum immunoglobulin levels among children with thalassemia who undergo repeated blood transfusions. The relevant serum immunoglobulins for DHTR in children with thalassemia who undergo repeated blood transfusions are IgG1, IgG3 and IgG4.