Objective To investigate the expression level of WT1 gene in the bone marrow of patients with AML-M2 and its impact on the therapeutic effect and prognosis.Methods qRT-PCR was used to detect WT1 gene and AML1-ETO gene expression in bone marrow of 126 patients with AML-M2 and 30 control samples.The mutations of NPM1,FLT3-ITD/TKD,C-Kit8/17,DNMT3A and CEBPa were detected by Sanger gene sequencing method.Results The expression level of WT1 gene was significantly higher in patients with AML-M2 than the control group(0.0024 vs 0.080,P＜0.001).The level of WT1 gene expression was positively correlated with age(r=0.314,P=0.011)and the proportion of bone marrow original cells(r=0.534,P=0.010),the differences were statistically significant.The expression level of WT1 gene in normal karyotype group and abnormal karyotype group was significantly different(P=0.040).A comparison of AML1-ETO positive group and AML1-ETO negative group showed that the WT1 gene expression levels of the two groups were significantly different(P=0.032).The WT1 gene in the bone marrow of patients,who were AML1-ETO positive,with AML-M2 was positively correlated with the AML1-ETO gene expression level(r=0.524,P=0.037),and the AML1-ETO gene and WT1 gene expression levels were effectively tracked in 20 patients who werel AML1-ETO positive,with all positively correlationship(P＜0.05).There was no significant difference in the complete remission(CR)rate between WT1 gene high expression group and WT1 gene low expression group(66.7％vs 60.4％,P＞0.05).Both univariate analysis and multivariate COX analysis indicated that WT1 high expression group had higher overall survival(OS)rate(P＜0.05).Conclusion The expression level of WT1 gene in bone marrow may be used as a molecular index to monitor minimal residual disease(MRD),which has important clinical significance for prognosis as-sessment of AML-M2 patients.

Objective To establish a predictive nomogram model for diabetic peripheral neuropathy(DPN)in elderly diabetic patients.Methods A total of 200 elderly patients with T2DM admitted to our hospital were enrolled in this study from January 2021 to October 2023.All the patients were divided into a simple T2DM group(n=160)and a T2DM combined with DPN(DPN,n=40)group.The general data and biochemical indexes were compared between the two groups.Spearman correlation analysis was used to explore the correlation between clinical indicators and the occurrence of DPN in the elderly.Logistic regression was used to analyze the influencing factors for DPN in the elderly,and a nomogram was constructed.The receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of the model.Results The DM duration,DR and HbA1c were higher(P<0.05),while HDL-C was lower in the DPN group than in the T2DM group(P<0.05).Spearman correlation analysis showed that elderly DPN were positively correlated with DR,DM duration and HbA1c(r=0.456,0.565,0.580,P<0.05),and negatively correlated with HDL-C(r=-0.542,P<0.05).Logistic regression analysis showed that DR(OR 1.035,95%CI 1.032～1.040),DM duration(OR 1.070,95%CI 1.045～1.080),HbA1c(OR 1.235,95%CI 1.156～1.280)and HDL-C(OR 0.895,95%CI 0.877～0.950)were both influencing factors for elderly DPN.A nomogram prediction model for elderly DPN was constructed based on DR,DM duration,HbA1c and HDL-C.ROC curve analysis showed that the area under curve of this prediction model was 0.955,with a sensitivity of 92.50%,a specificity of 95.00%,and a cutoff value of 0.251.Conclusions The established predictive diagram model involves four variables,including DR,DM duration,HbA1c and HDL-C,which can assist the clinic to make an early assessment of DPN risk.

Objective To establish a predictive nomogram model for diabetic peripheral neuropathy(DPN)in elderly diabetic patients.Methods A total of 200 elderly patients with T2DM admitted to our hospital were enrolled in this study from January 2021 to October 2023.All the patients were divided into a simple T2DM group(n=160)and a T2DM combined with DPN(DPN,n=40)group.The general data and biochemical indexes were compared between the two groups.Spearman correlation analysis was used to explore the correlation between clinical indicators and the occurrence of DPN in the elderly.Logistic regression was used to analyze the influencing factors for DPN in the elderly,and a nomogram was constructed.The receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of the model.Results The DM duration,DR and HbA1c were higher(P<0.05),while HDL-C was lower in the DPN group than in the T2DM group(P<0.05).Spearman correlation analysis showed that elderly DPN were positively correlated with DR,DM duration and HbA1c(r=0.456,0.565,0.580,P<0.05),and negatively correlated with HDL-C(r=-0.542,P<0.05).Logistic regression analysis showed that DR(OR 1.035,95%CI 1.032～1.040),DM duration(OR 1.070,95%CI 1.045～1.080),HbA1c(OR 1.235,95%CI 1.156～1.280)and HDL-C(OR 0.895,95%CI 0.877～0.950)were both influencing factors for elderly DPN.A nomogram prediction model for elderly DPN was constructed based on DR,DM duration,HbA1c and HDL-C.ROC curve analysis showed that the area under curve of this prediction model was 0.955,with a sensitivity of 92.50%,a specificity of 95.00%,and a cutoff value of 0.251.Conclusions The established predictive diagram model involves four variables,including DR,DM duration,HbA1c and HDL-C,which can assist the clinic to make an early assessment of DPN risk.

Objective To investigate the expression level of WT1 gene in the bone marrow of patients with AML-M2 and its impact on the therapeutic effect and prognosis.Methods qRT-PCR was used to detect WT1 gene and AML1-ETO gene expression in bone marrow of 126 patients with AML-M2 and 30 control samples.The mutations of NPM1,FLT3-ITD/TKD,C-Kit8/17,DNMT3A and CEBPa were detected by Sanger gene sequencing method.Results The expression level of WT1 gene was significantly higher in patients with AML-M2 than the control group(0.0024 vs 0.080,P＜0.001).The level of WT1 gene expression was positively correlated with age(r=0.314,P=0.011)and the proportion of bone marrow original cells(r=0.534,P=0.010),the differences were statistically significant.The expression level of WT1 gene in normal karyotype group and abnormal karyotype group was significantly different(P=0.040).A comparison of AML1-ETO positive group and AML1-ETO negative group showed that the WT1 gene expression levels of the two groups were significantly different(P=0.032).The WT1 gene in the bone marrow of patients,who were AML1-ETO positive,with AML-M2 was positively correlated with the AML1-ETO gene expression level(r=0.524,P=0.037),and the AML1-ETO gene and WT1 gene expression levels were effectively tracked in 20 patients who werel AML1-ETO positive,with all positively correlationship(P＜0.05).There was no significant difference in the complete remission(CR)rate between WT1 gene high expression group and WT1 gene low expression group(66.7％vs 60.4％,P＞0.05).Both univariate analysis and multivariate COX analysis indicated that WT1 high expression group had higher overall survival(OS)rate(P＜0.05).Conclusion The expression level of WT1 gene in bone marrow may be used as a molecular index to monitor minimal residual disease(MRD),which has important clinical significance for prognosis as-sessment of AML-M2 patients.

Objective:To evaluate the value of target blood pressure management based on cerebral oximetry index (COx) during cardiopulmonary bypass (CPB) in preventing postoperative delirium (POD) in patients with acute type A aortic dissection (ATAAD).Methods:One hundred and fifty-seven patients with ATAAD, aged 18-64 yr, regardless of gender, were divided into 2 groups by a random number table method: traditional experience group (group C, n=81) and COx management group (group M, n=76). The mean arterial pressure in group C was maintained in the traditional range of 60-80 mmHg during CPB. In group M, the mean arterial pressure range was obtained based on the COx and maintained within this range during CPB. The primary outcome assessed was the development of delirium within 7 days after surgery. Secondary outcomes included other postoperative complications, tracheal extubation time, and duration of cardiac intensive care unit stay. Results:Compared with group C, the incidence and severity scores of POD were significantly decreased, the duration of POD was shortened, the duration of POD was shortened, the extubation time and duration of cardiac intensive care unit stay were shortened, and the incidence of postoperative cerebral infarction and acute kidney injury was decreased in group M ( P<0.05). Conclusions:Target blood pressure management based on COx during CPB is helpful in reducing the occurrence of POD and improving the prognosis of patients undergoing surgery for ATAAD.

Objective To investigate the therapeutic effect of self-made Bitong Ointment combined with umbilical dressing of traditional Chinese medicine in the treatment of children with pediatric allergic rhinitis differentiated as type of latent heat in the lung meridian. Methods Eighty children with allergic rhinitis differentiated as type of latent heat in the lung meridian were randomly divided into observation group and control group, with 40 cases in each group. The control group was treated with loratadine, while the observation group was additionally treated with self-made Bitong Ointment and umbilical dressing of traditional Chinese medicine. After 4 weeks of treatment, the clinical effect, TCM syndrome score, airway stress response, inflammatory factors, and therapeutic safety were evaluated. Results The total effective rate in the observation group was 95.00% (38/40), which was higher than 77.50% (31/40) in the control group. After treatment, the scores of main TCM syndromes such as frequent sneezing, clear and thin nasal discharge, decreased sense of smell, shortness of breath, and reluctance to speak in the observation group were lower than those in the control group. After treatment, the levels of indicators of airway stress response such as exhaled nitric oxide (FeNO), lipid peroxide (LHP) and inducible nitric oxide synthase (iNOS) in the observation group were lower than those in the control group. After treatment, the levels of inflammatory factors such as monocyte chemoattractant protein-4 (MCP-4), cysteinyl leukotriene receptor 1 (CysLTR1), and interleukin-9 (IL-9) in the observation group were significantly lower than those in the control group (P < 0.05). The incidence rate of adverse reactions during treatment was 15.00% (6/40) in the observation groupand 10.00% (4/40) in the control group, with no significant difference between the two groups (P>0.05). Conclusion The combination of self-made Bitong Ointment combined with umbilical dressing of traditional Chinese medicine is effective in the treatment of children with pediatric allergic rhinitis differentiated as type of latent heat in the lung meridian, which can improve the TCM syndromes, inhibit the airway stress response, reduce the expression levels of inflammatory factors, and has good therapeutic safety.

Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.

Dermatomyositis(DM)is an autoimmune disease often complicated with malignant tumors.More than 50%of DM patients have myositis specific autoantibodies in their bodies.DM specific autoantibodies[including anti-migration inhibitory factor(Mi)-2 antibody,anti-nuclear matrix protein(NXP)-2 antibody,anti-transcription intermediary factor(TIF)1-γ antibody,and anti-small ubiquitin like modifier activating enzyme(SAE)antibody]play important roles in the pathogenesis of malignancy associated DM.Revealing the role of DM specific autoantibodies in the development of malignant tumors in DM patients can provide important evidence for accurately assessing the risk of developing malignant tumors in DM patients,and also provide new ideas for clinical diagnosis of DM and precise treatment.

【Objective】 To analyze the relevant studies on blood donor cohort and explore the current research status, research hotspots and development trends of blood donor cohort studies abroad. 【Methods】 Based on the Web of Science Core Collection, the literature related to blood donor cohort was searched. After screening and data processing, bibliometric analysis was carried out from the volume of literature trends, disciplines, authors, institutional distribution and other aspects of the included literature. At the same time, CiteSpace 5.6R5 software was used to carry out visual analysis of countries/regions, literature co-citation, keyword co-occurrence, keyword clustering and keyword emergence. Results A total of 672 papers (654 research papers, 18 review papers) were included. The total number of papers published in the field of blood donor cohort study showed a steady upward trend since 1991, the fastest growth was between 2019 and 2020. The top three cited authors were Kaaks R (1 301 citations), Rinaldi S (1 186 citations) and Riboli E (1 130 citations); the top three institutions were RLUK library in the UK, the University of California and the University of Copenhagen; the top three countries/regions in the volume of literature were the United States (176 papers), Germany (64 papers) and France (54 papers), and they all co-operated closely with other countries. The top five keywords were "blood donor" , "prevalence" , "infection" , "risk" and "antibody" . A total of 19 clusters were obtained by keyword cluster analysis, it was reflected in the immune mechanism and prevalence of blood-borne diseases, the relationship between blood donation behavior and non-communicable disease and its influencing factors, and the classification of the characteristics of blood donors. "Non-hepatitis B" was the keyword with the greatest burst intensity. The keywords that have burst out in recent years and continue to this day include "donation" , "seroprev-alence" , "donor" and "management" . Conclusion At present, the cohort study of blood donors has been paid more and more attention in the world, and its research trends mainly focus on the study of transfusion-transmitted disease risk. However, more researches begin to pay attention to the health problems and influencing factors of blood donors or recipients, which provides the research ideas and directions for establishing cohort study among blood donors in China.

The clinical practice teaching reform of pediatrics based on TBL combined with medical simulation teaching model was carried out. TBL teaching plan writing under the model of medical simulation teaching was researched. The principles, requirements, contents and procedures of compiling teaching plans were formed. Emphasis should be placed on medical simulation teaching, team cooperation, humanistic quality education and humanistic skills training. The purposes of the reform were to achieve standardized operation skills, improve clinical ability, ensure medical safety, and improve the quality of medical purposes, but still the reform need further improvement in the teaching practice.