ObjectiveTo observe the therapeutic effect and recurrence of treating Benign Paroxysmal Positional Vertigo(BPPV) by the treatment that combined Canalith Repositioning Maneuver(CRM) with Chinese and Western medicine.MethodsCollecting 40 cases suffered from BPPV,and randomized controlled method was used.Control group:20 cases( using Western and Chinese medicine),treatment group:20cases( using Western and Chinese medicine wrbined with CRM),judge the effect after 7days and telephone followed up 3 months,inquiring about recurrence situation.ResultsCure rate of treatment group was 90％,total effective rate was 100％ which was higher than the control group which was 50％,the total effective rate was 95％ (P ＜0.001 ) ;20 cases in treatment group followed up by telephone didn't recur.1 case in control group recurred,but got better after the treatment of CRM.ConclusionCRM which was effective,safe,simple and convenient to treat BPPV could be used as the preferred treatment for BPPV,if combined with Chinese and western medicine,it could significantly alleviate the symptoms and reduce the relapse.

Objective To explore the relationships among implicit self-esteem,explicit self-esteem and alexithymia.Methods According to the scores of Toronto Alexithymia Scale(TAS-20),82 tests were divided into the alexithymia group and the control group,which were assessed with Rosenberg Self-Esteem Scale(SES) and Implicit Association Test (IAT).Results The level of explicit self-esteem in the alexithymia group was significantly lower than that of the control group((28.57 ±4.57 vs 32.44 ±2.71)),there was significant differences between two groups(P＜ 0.01).Each factor of the alexithymia (as difficulty describing feelings,difficulty identifying feelings and externally oriented thinking) had significantly negative correlation with explicit self-esteem (r =-0.572,-0.52,-0.56,-0.378,P ＜ 0.01),and the alexithymia was positively correlated with the degree of separation in implicit and explicit self-esteem (r =0.421) (P ＜ 0.05).Conclusion The alexithymia group has defects in the process of controlling emotional; Alexithymia as a kind of psychological traits may be influence consistency of implicit and explicit self-esteem.

Objective To investigate the inhibitive effects of viral protein r (Vpr) of human immunodeficiency virus 1 ( HIV-1 ) on human colorectal cancer cell line HCT-8,and to find the possible mechanisms.Methods The HCT-8 cells were divided into the control group,adv group and adv-Vpr group.HCT-8 cells were not treated in the control group; HCT-8 cells were treated with Adv or Adv-Vpr at different multiplicity of infection (MOI) in the Adv group or Adv-Vpr group,respectively.Cell proliferation was detected by MTT assay.Cell cycle,apoptosis and mitochondrial membrane potential were detected by flow cytometry.The expression of apoptosisrelated proteins was detected by Western blot.All data were analyzed by using the q test,t test and one-way or two-way analysis of variance.Results The proliferation of HCT-8 cells was significantly inhibited by Vpr.The MTT value of HCT- 8 cells in the Adv-Vpr group was 1.03 ± 0.04,which was significantly lower than 2.46 ± 0.15 in the Adv group and 2.51 ± 0.14 in the control group at 72 hours after Adv-Vpr transfection ( MOI =200) ( F =144.6,P ＜ 0.05).The ratio of HCT-8 cells in the G2/M phase was 37.31％ ± 5.90％ in the Adv-Vpr group,which was significantly higher than 18.30％ ± 6.04％ in the Adv group and 16.66％ ± 3.51％ in the control group ( F =10.08,P ＜ 0.05 ).The ratio of HCT-8 cells with decreased mitochondrial membrane potential was 32.07％ ±5.64％ in the Adv-Vpr group,which was significantly higher than 3.32％ ±0.79％ in the Adv group and 2.76％ ±1.43 ％ in the control group at 48 hours after Adv-Vpr transfection ( MOI =200) ( F =64.45,P ＜ 0.05).The apoptosis rate of HCT-8 cells was 37.62％ ±6.48％ in the Adv-Vpr group,which was significantly higher than 3.44％ ± 1.11％ in the Adv group and 2.93％ ± 1.07％ in the control group at 72 hours after Adv-Vpr transfection ( MOI =200) ( F =122.4,P ＜ 0.05 ).The results of Western blot showed that Vpr induced cleavage and activation of Caspase-9 and Caspase-3 and phosphorylation of Chk1-S345,while the expression levels of Fas,Fas-L,ERK1,ERK2 remained the same at 48 hours after Adv-Vpr treatment ( MOI =200).Conclusions Vpr inhibits the proliferation of the HCT-8 cells in vitro through G2/M phase arrest and apoptosis.Vpr plays its role by activating DNA damaging pathway and initiating mitochondria apoptotic pathway.Vpr is a potential therapeutic agent for colorectal cancer.

Objective To investigate the incidence of contrast-induced nephropathy (CIN) in the elderly undergoing coronary angiography and the correlated clinical risk factors.Methods 0.90% sodium chloride (1 ml · kg~-1 · h~-1 ) was administered 6 hours before and 12 hours after contrast media administration for 195 elderly patients,and the dose of sodium chloride was half when the patients were suffering from severe congestive heart failure.The levels of serum creatinine (Scr) and cystatin C were measured 3 days before and on the 2nd,5th day after the administration of contrast,respectively .Results(1) The incidence of CIN was 8.7% (17/195).The renal function of 11 cases recovered to baseline level 3 months after the use of contrast,2 cases had transformation to chronic renal failure but without undergoing maintenance hemodialysis,and 3 cases were dependent on maintenance hemodialysis,while 1 case developed multiple organ dysfunction until death.(2) There was no significant difference between pre-and post-contrast administration in the level of cystatin C (t=O.137,P= 0.891). But the concentration of Scr was reduced significantly on the 2nd day compared with the baseline (t=4.776,P = 0.000).Both the cystatin C and Scr recovered to the baseline on the 5th day.(3) There were no significant differences between the CIN and non-CIN group in gender,the dose of contrast,the baseline Scr,and the proportion of coronary heart disease.But there were significant differences in age,the baseline serum cystatin C,the proportions of diabetes mellitus,hypertension and congestive heart failure.(4) The clinical risk factors of CIN were the baseline Scr (OR = 1.039),the baseline serum cystatin C (OR=6.654),diabetes mellitus (OR=8.104) and congestive heart failure (OR=9.597) according to the analysis of logistic regression.ConclusionsWith the hydration and the use of low-osmolar nonionic contrast,it is safe to receive contrast examination for the elderly patients.The baseline serum levels of Scrand cystatin C,diabetes mellitus and congestive heart failure are the clinical risk factors of CIN.Compared with Scr,serum cystatin C is the more powerful predictor for the development of CIN.

Objective:To compare and explore the clinical efficacy and safety of endoscopic thyroidectomy by gasless unilateral axillary approach for the treatment of papillary thyroid microcar cinoma (PTMC) .Methods:One hundred and ten patients with unilateral PTMC admitted to the Department of Thyroid and Breast Surgery, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, from Jan.3 2019 to Mar. 2022 were used as clinical study subjects, and according to the patients' choice of surgical modality, they were divided into 30 cases in the endoscopic thyroidectomy by gasless unilateral axillary approach (ETGUA) group and 80 cases in the minimally invasive video-assisted thyroidectomy (MIVAT) group. We retrospectively compared and analyzed the differences in the surgery-related indexes, aesthetic satisfaction rate at 3 months postoperatively and functional status of the anterior cervical region between the 2 groups. SPSS 26.0 statistical software was used to process the data, analyze and draw conclusions. P<0.05 was considered a statistically significant difference. Results:The number of lymph nodes cleared in the study group (6.60±4.41) was less than that in the control group (9.63±6.25) ( P<0.05) ; the total operative time (169.83±28.76) min, postoperative drainage (173.60±94.33) ml, and time to remove drainage tubes after surgery (5.73±1.86 ) d was significantly higher than the total operative time (145.56±33.89) min, postoperative drainage (107.28±53.82) ml, and time to remove drainage tubes after surgery (2.88±1.07) d in the control group ( P<0.01) ;the intraoperative bleeding, number of positive lymph nodes, and postoperative hospital stay were not statistically significant between the two groups ( P>0.05) .The aesthetic satisfaction rate of the study group had a significant advantage over the control group (90% vs 70%) ( P<0.01) .Comparing the functional status of the anterior cervical region between the two groups after surgery,the occurrence of swallowing discomfort or with pulling sensation was better in the study group than in the control group 1 week after surgery ( P<0.05), and there was no statistically significant difference between the two groups in the occurrence of neck pain score, abnormal sensory function (neck pressure, foreign body sensation, numbness and pins and needles) and vocal difficulty ( P>0.05) ; 3 months after surgery, abnormal sensory function of the neck in the study group (at 3 months postoperatively, the occurrence of abnormal neck sensory function (neck pressure, foreign body sensation, numbness and pins and needles sensation) and swallowing discomfort or pulling sensation were better in the study group than those in the control group ( P<0.05). There were no signs of local recurrence or distant metastasis in both groups at follow-up to date. Conclusions:Both minimally endoscopic thyroidectomy procedures were safe, feasible, and effective in the treatment of unilateral PTMC. Among them, the ETGUA is more suitable for patients with strong cosmetic needs within the indications because of its concealed incision and its ability to protect the function of the anterior cervical region, and can be the preferred option.

Objective:To analyze the bone turnover markers in systemic lupus erythematosus (SLE) patients with different disease activity and the risk factors of osteoporosis.Methods:In this retrospective study, a total of 417 SLE inpatients were enrolled from the Department of Rheumatology and Immunology, the First Affiliated Hospital of Xi′an Jiaotong University, from March 2019 to June 2020. According to SLEDAI score, the patients were divided into 3 groups: 281 patients disease with inactive disease group; 99 patients with mild active disease group; and 37 patients with moderate/severe active disease. ANOVA test was used to compare the differences in serum bone turnover markers (PTH, NOST, VITDT, β-crossl, TP1NP, Ca and P) and bone density (Spine L 1~4 and left femur) among the three groups, and Tukey's method was used for the two groups comparison. Logistic regression analysis was used to investigate the risk factors of osteoporosis. Results:Serum VITDT, β-crossl and Ca levels were significantly different among the 3 groups ( F=11.66, P<0.001; F=7.22, P<0.001; F=29.38, P<0.001). Compared with patients in the inactive group, patients with both the mild disease group (VITDT: t=3.94, P<0.001; Ca: t=5.10, P<0.001) and the moderate/severe disease group (VITDT: t=3.33, P<0.001; Ca: t=7.19, P<0.001) had lower VITDT levels [(20.3±9.7) ng/ml vs. (15.9±9.3) ng/ml vs. (14.8±7.4) ng/ml] and serum Ca levels [(2.19±0.15)mmol/L vs. (2.09±0.21)mmol/L vs. (2.00±0.16)mmol/L]. Moreover, the moderate/severe disease group patients had much lower serum Ca levels ( t=2.36, P<0.05), compared with patients with the mild disease group. Compared with the patients with inactive group, both the mild activey group ( t=3.06, P<0.01) and the moderate/severe activie group ( t=2.99, P<0.01) patients had higher serum β-crossl levels [(419±316) pg/ml vs. (543±424) pg/ml vs. (586±343) pg/ml]. Compared with patients with the inactive disease group both patienes with the mild active group and the moderate/severe disease group patients had significantly decreased spine BMD ( t=2.75, P<0.01; t=2.71, P<0.01), Z-score ( t=5.65, P<0.001; t=4.70, P<0.001), T-score ( t=3.02, P<0.01; t=3.37, P<0.001), whereas, no difference was found between the mild disease group and moderate/severe disease group. Compared with the inactive group patients, both the mild active group and moderate/severe disease group patients had lower left femur BMD levels ( t=2.83, P<0.001; t=2.65, P<0.001) and T-score ( t=2.24, P<0.05; t=1.977, P<0.05) and no difference was found between the mild disease group and the moderate/severe disease group. Logistic regression analysis showed that age [ HR (95% CI)=1.080 (1.052, 1.109), P<0.001], BMI [ HR (95% CI)=0.801 (0.704, 0.911), P<0.001], SLEDAI score [ HR (95% CI)=1.047 (1.025, 1.076), P<0.05] and cumulative glucocorticoids dose [1.046 (1.006, 1.087), P<0.05] were associated with osteoporosis of SLE patients. Conclusion:Abnormal bone metabolism and decreased bone density are associated with SLE disease activity in SLE patients, especially in those with advanced age, low BMI and receiving high cumulative dose of glucocorticoids. Osteoporosis should be proactively prevented in the SLE patients.

To observe the immunogenicity of hPDGF-B immunogens that were synthesized with the fusional expression vector pET28-Trx and to test the suppressive effect of these specific antibodies induced by both of immunogens on proliferation of human HepG2 hepatoma cells. First, we chose 2 antigenic epitopes hPDGF-BΔ103-118aa and hPDGF-BΔ152-167aa from human PDGF-B and inserted these 2 coding regions into the empty vector plasmid pET28-Trx, separately. Second, mice were immunized with purified recombinant proteins to generate polyclonal antibody. Then we intraperitoneally injected mice bearing hepatoma 22 (H22) tumor cells to prepare antibody ascites. ELISA and Western blot were used to detect the titer and the utility of the antibody, respectively. Finally, HepG2 cells were exposed to PDGF-BB protein or anti-PDGF-B ascite antibody in different dilution concentrations groups and the proliferation of HepG2 cells was quantified by CCK8 assay. As the results, we identified mice that could produce high drop of neutralizing antibodies against hPDGF-B induced by both two recombinant proteins. Two anti-PDGF-B ascite antibodies could markedly inhibit the proliferation of HepG2 cells by blocking the stimulating effect of PDGF-BB protein. Our results suggest that Trx-PDGF-B recombinant protein as immunogen provides a new method for the preparation of PDGF-B vaccine, and also a new idea for the treatment of hepatocellular carcinoma in clinical practice.

AIM: To investigate the clinical features of acute exacerbation chronic obstructive pulmonary disease (AECOPD) of complicated with type 2 diabetes mellitus (T2DM), and analyze the related clinical features and risk factors. METHODS: This was a single-center cross-sectional study. From March 2020 to January 2023, 479 hospitalized patients with AECOPD in the department of respiratory and critical care medicine, Suining Central Hospital were included. There were 215 patients in AECOPD group and 60 patients in AECOPD with T2DM group. The collected variables included demographic data, complications, blood routine, infection index, random blood glucose, blood gas analysis and lung function. The adoption rate and constituent ratio of the basic description classification data were expressed as mean standard deviation for the normal distribution measurement data and median interquartile range for the skew distribution measurement data. T-test was used for normal distribution and non - parameter test was used for non-normal distribution. The categorical variables were tested by chi-square test. Rank sum test was used for rank variable data. Binary logistic regression model was used to investigate the independent factors associated with T2DM in patients with AECOPD. Finally, the results of logistic regression were verified and visualized by nomogram, validation curve, ROC curve and DCA curve. P<0.05 was a significant statistical difference. RESULTS: Univariate analysis showed that there were significant differences in body mass index (BMI), essential hypertension, coronary heart disease, atrial fibrillation (AF), pulmonary function (GOLD stage), blood neutrophil (NS), blood lymphocyte (LYM), arterial blood gas PaCO2, Alanine transaminase (ALT) and random blood glucose (RBG) between the two groups (P<0.05). The binary logistic regression model (C-index=0.847) was constructed with the above 10 variables, the results showed that BMI (OR=1.309), Af (OR= 8.188), LYM counts (OR=0.474), PaCO2 (OR=1.082) and RBG (OR=1.434) were independently associated with type 2 diabetes in patients with AECOPD (all P>0.05). The results of logistic regression were verified and visualized by Nomogram and its-associated ccurves. The MAE and AUC curves were 0.021 and 0.847 respectively, indicating that the model had good prediction consistency and accuracy. The DCA curve showed that Nomogram's risk threshold ranged from 0.01 to 0.99, suggesting that nomogram's model had better clinical predictive value. CONCLUSION: Our results showed that increased BMI, PaCO2 and random glucose, decreased blood lymphocyte, and atrial fibrillation is an independent clinical feature of AECOPD with T2DM. These results suggest that the immune function of patients with AECOPD and T2DM are more severely impaired and more likely to be accompanied by atrial fibrillation, which is a potential cause of poor prognosis in these patients. Meanwhile, this conclusion needs to be further verified in multicenter study with large sample size.