Objective The purpose of this study was to observe the effects of bumetanide on elderly type 2 diabetic patients with middle and advanced stages nephropathy. Methods Forty cases with diabetic nephropathy (DN) were divided into two groups:control group (20 cases) and treatment group (20 cases) . The control group accepted furosemide (20 mg, once a day) and the bumetanide was orally administrated at the dose of 1.0 mg, twice a day to the treatment group for 3 months. The assessment of transferrin (TRF) and urine microalbumin (UALB) was performed at the time points at the end of 1, 4, 8, 12 weeks after treatment. Results (1) The levels of BUN, SCr and UA after treatment were lower than before treatment, but there were no significant differences. (2) In the treatment group, the levels of TRF and UALB have decreased after treatment for 1 week, with no statistically significant. But at the end of 4, 8 and 12 weeks,the differences were statistically significant ( <0.05) . Especially, during the three months follow-up,the levels of TRF and UALB at 12 weeks have decreased obviously. Conclusion The therapeutic effect of bumetanide on DN might be better than that of furosemide.

The microscopic identification technique plays an important role in quality standard of Chinese herbal medicines. It has been adopted as a routine identification method in the major pharmacopoeias due to its accurate, simple, speedy, inexpensive, feasible as well as environmentally friendly properties. In this article, the theoretical principles of microscopic identification, the stability and specificity of microscopic characters, are firstly discussed. The applications of microscopic identification in ChP, USP, Ph. Eur. and JP are listed and typically compared. A protocol for microscopic identification is thus proposed based on our previous investigations. Finally, some challenges facing modernizaiton of Chinese herbal medicines are also outlined.

Objective The changes of CECs,EPCs and CPCs in the old type 2 diabetes mellitus retinopathy(DR)patients and the clinical purpose were discussed.Methods 30 cases of T2DM(including 10 DM cases without complications and 20 DM cases with retinopathy)and 10 cases of health controls were enrolled in this study.Results(1)The changes of CECs in DR Patients were significantly higher while the levels of EPCs and CPCs were significantly lower than those in the patients of the control group.(2)There were some corrlation beteen the level of CECs,EPCs and CPCs and the degree of diabetic retinopathy.(3)The serum EPCs levels in type 2 diabetics were negativey associated with body mass index,waist-hip ratio,abdominal circumference,FPG,triglyceride,UAER,creatinine.Conclusion The levels of EPCs and CPCs in T2DM-DR patients may be the important detected targets for early discovery and monitoring of DR.

Objective To check the changes of endothelial progenitor cell (EPC) number of patients with anaplastic large cell lymphoma (ALCL) in the peripheral blood,investigate their clinical significance.Methods The number of EPC in blood was determined by FCM method in 30 patients with ALCL and 10 healthy cases as the control group.Results The number of EPC in the peripheral blood of patients with ALCL before treatment was significantly higher (15.530±28.659/μl) than that in control group (0.515 ±0.294/μl,P ＜ 0.001).The number of EPC of ALCL patients in the high-risk groups (21.521±36.057/μl) and the middle-risk groups (16.830±24.273/μ1) differently increaasd than that of the low-risk group (6.508±7.356/μl,P ＜ 0.01),but between the high-risk groups and the middle-risk groups there was no significant value (P ＞ 0.05).There were significant difference between the number of EPC of ALK+-ALCL (8.367±9.609/μl) and ALK-ALCL (22.541± 20.845/μl) patients (P ＜ 0.01).The survive curve before 60 weeks had significant difference between groups of ＞20/μl and ＜20/μl of EPC.Conclusion EPC may be correlated with progression of the disease in a certain degree.Dynamic observation with the level of EPC may be used to evaluate the treatment outcomes and act as a prognostic marker for ALCL.

Objective To analysis the T lymphocyte subsets distribution of patients with myelodysplastic syndrome (MDS)-RA and-RCMD,assess the immune status of MDS patients,and analysis the effects of cyclosporine on T lymphocyte subsets.Methods Using flow cytometry (FCM) on MDS-RA and -RCMD patients and 13 normal controls peripheral blood samples for T lymphocyte subsets,detection of patients with RA and RCMD lymphocyte subsets before and after 6 months of treatment in the application of cyclosporine-based immunosuppressive regimen.Results The MDS group Th cells (CD; CD;),Th/Ts ratio were lower than those in normal control group (t =13.39,3.64,all P ＜ 0.05).Ts cells (CD3+ CD8+) express higher than that in normal control group [(29.07±3.88) ％ vs (21.80±3.63) ％] (t =6.47,P ＜ 0.05).Before and after treatment of Th cells,Th / Ts ratio,Ts cells of T lymphocyte subset were significant difference [(35.72±5.02) ％,(29.07±3.88) ％,(1.89±0.51) ％ vs (38.19±4.98) ％,(26.03±3.03) ％,(1.96±0.35)％] (t =0.39,2.65,3.57,all P ＜ 0.05).Cyclosporine treatment after 6 months of effective and ineffective group of T cell subsets,Th cells (CD3+ CD4+),Th/Ts ratio of T lymphocyte subsets,there was significant difference in Ts cells [(42.79±7.74) ％ vs (36.46±.1.28) ％,(22.14±.3.91) ％ vs (27.51±2.84) ％,(2.40±0.40) ％ vs (2.08±0.11) ％](t =67.65,3.77,3.57,all P ＜ 0.05).Conclusion MDS patients with T-lymphocyte subsets immune disorders lead to immune dysfunction,cyclosporine may improve the imbalance of T lymphocyte subsets of MDS patients.

Objective: The study aimed to investigate the relationship between academic stress and extracurricular physical exercise among college students, with the goal of providing evidence and reference for effectively alleviating academic stress. Methods: A stratified cluster random sampling method was employed, along with the Chinese College Student Psychological Health Screening Scale and a self designed questionnaire. In January 2023, an online survey was conducted among 1 108 college students from eight colleges and universities in Jiangsu Province. Statistical analyses included independent samples t test, one way analysis of variance (ANOVA) and the optimal scale regression model. Results: It revealed that 50.8% of students worried about falling behind their peers in their studies, 51.7% expressed concerns about exams, 21.7% exerted significant effort but still struggled to keep up with the pace of learning, and 24.9% felt difficulties in their studies. The overall index of academic stress was higher among undergraduate institutions, first year students, female students, and urban residents ( t/F =3.66, 10.96, -5.46, 3.52, P <0.01). The average time of weekly extracurricular physical exercise for students was (2.35±2.18)h, and there were significant differences by gender, only child status, and grade groups( t/F =2.35, 4.66, 7.09, P <0.05). The optimal scale regression model analysis ( R 2=0.17, F=32.03, P <0.01) revealed that the regression coefficient and partial correlation coefficient between academic stress and extracurricular physical exercise time were both -0.33( P <0.01). The importance of extracurricular physical exercise in the model was 0.66, with a tolerance value of 0.97. The regression coefficients and partial correlation coefficients for academic stress and extracurricular physical exercise time were -0.35, -0.35 for undergraduate students, and -0.31, -0.32 for junior college students ( P < 0.01 ). Conclusion A significant number of college students experience varying degrees of academic stress, and their engagement in extracurricular physical exercise is insufficient. There is a negative association between academic stress and extracurricular physical activity time among college students. Universities should encourage students to increase extracurricular physical activity time to reduce academic stress and promote college students mental health.

Objective To investigate the correlation between NRAMP1 gene polymorphisms and susceptibility to tuberculosis ( TB) in Tibetan people in Qinghai. Methods A case-control study was con-ducted in this study, involving 99 Tibetan patients with TB and 89 healthy Tibetans. The single nucleotide polymorphisms of NRAMP1 gene at rs17235409 and rs3731865 sites were detected by using TaqMan probe method. Gene cloning and sequencing typing were performed to analyze the single nucleotide polymorphisms of NRAMP1 gene at the rs17235416 site. SPASS20. 0 software was used to statistically analyze the correla-tion between NRAMP1 gene polymorphisms and susceptibility to TB in Tibetan people. Results No signifi-cant difference in the genotype frequencies of rs3731865 and rs17235409 was found between the two groups (χ2=0. 852, P=0. 356;χ2=0. 279, P=0. 597). The genotype frequencies of TGTG/TGTG and TGTG/del+del/del at the rs17235416 site were 70. 7% ( 70/99 ) and 29. 3% ( 29/99 ) in patients with TB and 86. 5% (77/89) and 13. 5% (12/89) in healthy subjects. There were significant differences in the geno-type frequencies of TGTG/TGTG and TGTG/del+del/del between the two groups (χ2=6. 870, P=0. 009). The genotypes of TGTG/del and del/del at rs17235416 were risk factors for TB ( OR=0. 376; 95%CI:0. 178-1. 794 as compared with the TGTG/TGTG genotype in Tibetan people in Qinghai. Conclusion This study suggested that the NRAMP1 gene polymorphisms at rs3731865 and rs1723409 sites had no correlation with the susceptibility to TB in Tibetans in Qinghai. However, the NRAMP1 gene polymorphisms at rs17235416 site were correlated with the susceptibility to TB. The TGTG/del alleles at the rs17235416 site might be the risk factors for tuberculosis in Tibetans in Qinghai.

Under the combination of postgraduate education and standardized medical residents training, via exploring current situation, we put forward the limitations of routine rotation training, disconnection of theory and practice, inefficient of scientific ability. We arouse a new model by improving teaching model, enriching teaching content, optimizing teaching method, making better arrangement of rotations and cultivating scientific ability to provide references for enhancing the ability of clinical thinking, practice, scientific research and communication.

Objective To evaluate the role of programmed cell death ligand-1 (PD-L1) in a mouse model of bone cancer pain.Methods Ninety-six male C3H/HeN mice (20-25 g,4-6 weeks old),which inoculated with osteolytic NCTC 2472 cells,were used to build the model of bone cancer pain.Part one:sixtyfour male C3H/HeJ mice were randomly divided into sham group (group Sham,n =32) and tumor group (group Tumor,n=32).Part two:Twenty-four male C3H/HeJ mice which were inoculated with osteolytic NCTC 2472 cells were randomly divided into group T (tumor,n=8),group PD-L1 (intrathecal injection with PLX3397,1 μg/5μl,n=8) and group NS (intrathecal injection with normal saline,n=8).Also,there were eight male C3H/HeJ mice in group S which were intra-femur inoculated with α-MEM.The pain behaviors of Sham group and Tumor group were observed and the expression of PD-L1 was detected before inoculation and on 4,7,10,14 and 21 days after inoculation,including paw withdrawal mechanical threshold (PWMT) and the number of spontaneous flinches (NSF).On 14 d after inoculation,the mice of group PD-L1 and group NS were intrathecal injected with drugs respectively.Pain behaviors were observed before injection and 2,4,6,24h after injection.Results Compared with group Sham,PWMT was significantly decreased and NSF was increased on 7～ 21 d after inoculation in group Tumor (P＜0.05).Compared with baseline and group S (baseline (0.38±0.06),group Sham (0.35±0.08),(0.38±0.08),(0.36±0.07)),the expression of PDL1 was up-regulated on 10-21 d after inoculation in group Tumor ((0.77±0.06),(1.21±0.04),(1.18±0.06)) (P＜0.05).Compared with group NS,PWMT was significantly increased (group NS (0.25t0.12),(0.25±0.12),(0.31±0.12),group PD-L1 (1.43±0.49),(1.35±0.44),(0.95±0.26)),and NSF was decreased on 2-6 h after injection in group PD-L1 (group NS(11.74± 1.31),(13.78±0.0.91),(13.63±1.06),group P D-L1 (4.90± 0.82),(4.15± 0.71),(7.65±0.56)) (P＜0.05).Conclusion Expression of PD-L1 in spinal cord was up-regulated in the mouse model of bone cancer pain.Intrathecal injection of recombinant PD-L1 has an analgesic effect on mice with bone cancer.

Objective: To compare metabolic syndrome(MS)with Framingham risk score as predictors of cardiovascular disease(CVD)among Kazakhs population. Methods: The participants were the residents who had been followed up for more than 5 years in representative areas of Kazakhs in Xinjiang. We assigned MS a continuous risk score for predicting the development of CVD based on the weights of MS components. MS and Framingham risk score were compared in terms of their ability in predicting years in representative areas of Kazakhs in Xinjiang. We assigned MS a continuous risk score for predicting the development of CVD based on the weights of MS components. MS and Framingham risk score were compared in terms of their ability in predicting development of CVD using Cox regression and receiver operating characteristic curve. Results: The incidence of CVD was 13.87%. The incidence of CVD was higher in the MS group than it in the non-MS group(21.59% vs 11.10%, P<0.001). The area under the receiver operating characteristic(ROC)curve of MS risk score was significantly larger than that of MS classification(0.727 vs 0.585, P<0.001); the area under the curve of MS risk score was close to that of Framingham risk score(0.732 vs 0.727, P=0.673). The association between CVD and each quintile of MS risk score was more significant than that between Framingham risk score and CVD under the same exposed condition(4.61, 9.33, 14.15, 22.29 vs 3.69, 6.36, 8.47, 16.99). Conclusion MS risk score that included age may be a better predictor of CVD among Kazakhs population.