Objective To analyze the levels of serum lipoprotein (a)[Lp(a)]and homocysteine (CHY)in type 2 diabetes mellitus (T2DM)patients and todetermine the relationship between them and diabetic insulin resistance.Methods A total of 108 patients with T2DM and 50 healthy volunteers (control group)were studied.T2DM group according to the presence of kidney disease complications could be divided into simple diabetes group (SDM)in 48 patients with diabetic nephropathy (DN)group of 60 cases.Collected patients general data and determined two groups of glycosylated hemoglobin (HbA1c), low density lipoprotein (LDL),urea nitrogen (BUN),serum creatinine (SCr),urinary inhibition C (CysC),Lp(a)and HCY levels;Compared differences between groups and how they related to T2DM kidney disease,and the relationship between in-sulin resistance.Results ①Compared between three groups only the weight (NC group 60.1±10.34 kg,SDM group 67.2 ±11.38 kg,DN group 68.8±1.35 kg),the difference was statistically significant (F=0.457,P=0.035).②compared be-tween the three groups,the levels of HbA1c (F=3.421,P=0.013),LDL-C (F=2.963,P=0.041),BUN (F=4.637,P=0.031),SCr (F=2.369,P=0.024),CysC (F=3.697,P=0.011),Lp(a)(F=1.236,P=0.021),HCY (F=4.317,P=0.027)were increased significantly.③FPG,FINS and HOMA-IR in SDM group were 5.99±0.94 mmol/L,61.11±28.46 pmol/L and 2.93±1.97 respectively,FPG,FINS and HOMA-IR in DN group were 9.01±2.23 mmol/L,98.56±62.14 pmol/L and 4.34±2.74 respectively.Compared between the two groups,FPG (t=0.47,P=0.017),FINS (t=0.55,P=0.039),HOMA-IR (t=0.69,P=0.024)differences were statistical significance.④The Lp(a),HCY were significantly pos-itive correlation with HOMA-IR (r=0.761,P=0.044;r=0.840,P=0.021).Conclusion Lp(a)and HCY levels in serum associated with diabetic nephropathy,and insulin resistance.And the detection of serum Lp(a)and HCY has important sig-nificance for early detection of diabetic nephropathy.

Objective Understanding of red blood cell distribution width (RDW-CV),blood homocysteine (HCY),lipoprotein a [LP(a)] a merger with high blood pressure and high blood,coronary heart disease (CHD) relevance and explore its clinical application value in CHD.Methods 563 cases of patients with high blood pressure were enrolled,which divided into 62 cases of primary hypertension,501 cases of hypertension combined with coronary heart disease,according to the results of coronary angiography.141 normal cases were chosen as control group.Compared the three groups of RDW-CV,HCY and LP (a) level,the group of coronary artery disease was divided into Ⅰ,Ⅱ,Ⅲ and Ⅳ,and compared the RDW-CV level of each group,and the correlation between RDW and cardiac function was analyzed.Results ①Heart disease groups RDW-CV,LP (a) and HCY (13.25 ± 1.22％,17.82 ± 8.36 μmol/L,172.05 ± 122.32 mg/L) were higher than blood pressure groups (12.98 ± 0.57 ％,14.35 ± 6.36 μ mol/L,124.49 ± 75.88 mg/L) and normal control group (11.41 ± 2.85 ％,11.41 ± 2.85 μmol/L,71.07±27.55 mg/L,P＜0.05).②RDW-CV and HCY were positively correlated with the mental function classification (r=0.461,0.1970;P=0.000,0.032).③The area under the ROC curve was the order of the diagnostic value:HCY ＞LP(a) ＞RDW-CV.LP(a) sensitivity was 82.5 ％ and specificity was 31.7 ％.RDW-CV sensitivity was 48.8 ％ and specificity was 22.2 ％.Conclusion High levels of RDW-CV,HCY,and LP(a) were closely related to the occurrence of coronary heart disease;RDW-CV and HCY were related to the severity of coronary heart disease and cardiac function,and could be a potential biomarker for the development of cardiac function of coronary heart disease.

Objective: To optimize the ultrahigh pressure extraction ( UPE) process for forsythoside from Forsythia suspensa by Box-Behnken experimental design. Methods:On the basis of single factor screening, a three-factor and three-level Box-Behnken ex-perimental design was employed with liquid/material ratio( X1 ) , extraction pressure ( X2 ) and extraction time ( X3 ) as the independent variables. The response variable was the extraction yield of forsythoside. Results:The optimal UPE conditions for forsythoside were as follows:the ratio of solvent to material (ml·g-1) was 70, the extraction pressure was 151 MPa, and the extraction time was 114 s. With the optimal extraction process, the extraction yield of forsythoside was 13. 15 mg·g-1 . Conclusion:As a novel extraction tech-nology for Chinese herbal medicines, UPE procedure has higher extraction yield, lower extraction temperature, shorter extraction time and less power consumption, which provides a brand-new method for the extraction of forsythoside from Forsythia suspensa.

Rational drug use and patient medication safety have always been key to pharmaceutical management.The authors introduced the practice of informationization management of rational drug use in the medical alliance of Luohu Hospital Group.The main measures refer to building an informationization platform for drug purchasing and supply management, dispensing management, medication intervention and medication guidance.This practice can realize closed-loop drug management, achieving full-range supervision and traceability for drugs and higher patient drug use safety.

Objective To understand the compliance of highly active anti-retroviral therapy (HAART) and influencing factors in people living with HIV/AIDS (PLWHA) in Nanjing. Methods PLWHA receiving HAART in No. 2 Hospital of Nanjing during May-June 2014 were recruited in this study. Self-administrated questionnaire was used to collect the data about HAART compliance and socio-demographic characteristics of PLWHA surveyed. Descriptive and multivariate statistical analysis were conducted to examine the effects of the factors on self-reported HAART adherence. Results A total of 276 PLWHA were surveyed,According to the evaluation criterion of Center for Adherence Support Evaluation (CASE),252 cases showed good compliance (91.3%). logistic regression analysis revealed that smoking,progress of the disease and side effects,reminding of taking drug and age were correlated with self-reported HAART adherence. Conclusion It is suggested to strengthen the education about antiviral therapy compliance in PLWHA with mild infection and those who are smokers and young,suffer from side effects,have no reminding methods for taking drug.

Objective:To investigate the efficacy and safety of bronchoscopic lavage in children with severe adenoviral pneumonia.Methods:Patients with severe adenovirus pneumonia who were admitted to ICU department of Hunan Children′s Hospital for bronchoscopy were collected from February to June 2019 and divided into lavage group( n=36) and non-lavage group( n=15) in line with whether lavage was performed.Their results, namely, bronchoscopic diagnosis, blood gas analysis before and 2 hours, 24 hours and 48 hours after bronchoscopy, improvement time of clinical symptoms(fever and pulmonary moist rales), the positive rate of pathogen detection and mortality rate, main vital signs such as heart rate, respiratory rate, mean arterial pressure and bronchoscopy-related complications were recorded before and 1 hour, 2 hours and 24 hours after bronchoscopy. Results:A total of 51 children were collected, all of whom suffered from endobronchitis.More secretions were observed in the airways of 36 patients in the lavage group, and only a little or no secretions were observed in 15 patients in the non-lavage group.P/F value and PCO 2 at 2 hours, 24 hours and 48 hours after treatment in the lavage group were improved comparing to those before treatment and were superior to those in the non-lavage group( P<0.05). P/F values at 24 hours and 48 hours after treatment in the non-lavage group increased and PCO 2 decreased at 48 hours after treatment( P<0.05). The thermal duration, time to resolution of moist rales in the lungs in the lavage group were shorter than those in the non-lavage group( P<0.05). The mortality rate in the lavage group was lower than that in the non-lavage group[2.8%(1/36) vs.26.7%(4/15), P<0.05]. The positive rate of pathogen detection in lavage group was higher than that in non-lavage group[55.6%(20/36) vs. 20.0%(3/15), P<0.05]. There was no significant difference in heart rate, respiratory rate, and mean arterial pressure at each time point before and after bronchoscopic treatment( P>0.05). Associated complications were 11 cases of intraoperative transient hypoxemia, four cases of bronchial mucosal bleeding, and one case each of postoperative hypoxemia, intraoperative hypertension and hypotension.There was no significant difference in the incidence of complications between the two groups( P>0.05). Conclusion:Bronchoscopic lavage, in treating children with severe adenovirus pneumonia, may improve clinical symptoms, respiratory function, and rate of pathogen detection, reduce mortality, and is effective and safe.

Objective:To construct a risk prediction model for the inter-hospital transfer of critically ill children using machine learning methods, identify key medical features affecting transfer outcomes, and improve the success rate of transfers.Methods:A prospective study was conducted on critically ill children admitted to the pediatric transfer center of Hunan Children's Hospital from January 2020 to January 2021. Medical data on critical care features and relevant data from the Pediatric Risk of Mortality (PRISMⅢ) scoring system were collected and processed. Three machine learning models, including logistic regression, decision tree, and Relief algorithm, were used to construct the risk prediction model. A back propagation neural network was employed to build a referral outcome prediction model to verify and analyze the selected medical features from the risk prediction model, exploring the key medical features influencing inter-hospital transfer risk.Results:Among the 549 transferred children included in the study, 222 were neonates (40.44%) and 327 were non-neonates (59.56%). There were 50 children in-hospital deaths, resulting in a mortality rate of 9.11%. After processing 151 critical care medical feature data points, each model selected the top 15 important features influencing transfer outcomes, with a total of 34 selected features. The decision tree model had an overlap of 72.7% with PRISMⅢ indicators, higher than logistic regression (36.4%) and Relief algorithm (27.3%). The training prediction accuracy of the decision tree model was 0.94, higher than the accuracy of 0.90 when including all features, indicating its clinical utility. Among the top 15 important features selected by the decision tree model, the impact on transfer outcomes was ranked as follows based on quantitative feature violin plots: base excess, total bilirubin, ionized calcium, total time, arterial oxygen pressure, blood parameters (including white blood cells, platelets, prothrombin time/activated partial thromboplastin time), carbon dioxide pressure, blood glucose, systolic blood pressure, heart rate, organ failure, lactate, capillary refill time, temperature, and cyanosis. Eight of these important features overlapped with PRISMⅢ indicators, including systolic blood pressure, heart rate, temperature, pupillary reflex, consciousness, acidosis, arterial oxygen pressure, carbon dioxide pressure, blood parameters, and blood glucose. The decision tree was used to select the top 15 medical features with high impact on the neonatal and non-neonatal datasets, respectively. A total of 19 features were selected, among which there were 8 differences and 11 overlap terms between the important features of the neonatal and non-neonatal.Conclusions:Machine learning models could serve as reliable tools for predicting the risk of inter-hospital transfer of critically ill children. The decision tree model exhibits superior performance and helps identify key medical features affecting inter-hospital transfer risk, thereby improving the success rate of inter-hospital transfers for critically ill children.

OBJECTIVETo understand the compliance of highly active anti-retroviral therapy (HAART) and influencing factors in people living with HIV/AIDS (PLWHA) in Nanjing.

METHODSPLWHA receiving HAART in No. 2 Hospital of Nanjing during May-June 2014 were recruited in this study. Self-administrated questionnaire was used to collect the data about HAART compliance and socio-demographic characteristics of PLWHA surveyed. Descriptive and multivariate statistical analysis were conducted to examine the effects of the factors on self-reported HAART adherence.

RESULTSA total of 276 PLWHA were surveyed, According to the evaluation criterion of Center for Adherence Support Evaluation (CASE), 252 cases showed good compliance (91.3%). logistic regression analysis revealed that smoking, progress of the disease and side effects, reminding of taking drug and age were correlated with self-reported HAART adherence.

CONCLUSIONIt is suggested to strengthen the education about antiviral therapy compliance in PLWHA with mild infection and those who are smokers and young, suffer from side effects, have no reminding methods for taking drug.

Acquired Immunodeficiency Syndrome ; drug therapy ; Age Factors ; Antiretroviral Therapy, Highly Active ; Antiviral Agents ; adverse effects ; therapeutic use ; China ; Disease Progression ; HIV Infections ; drug therapy ; Humans ; Medication Adherence ; statistics & numerical data ; Reminder Systems ; Smoking ; Surveys and Questionnaires