Objective To evaluate the effects of low blood sugar production index (LGI) combined with low blood sugar production burden (LGL) dietary intervention on blood glucose, oxidative stress and anthropometric indicators in type 2 diabetes mellitus. Methods A total of 150 cases of type 2 diabetes were randomly divided into two groups,maintain the original treatment plan of two groups,75 patients in the control group were given traditional food interchange method for dietary intervention;the experimental group of 75 patients, provide food education based on LGI+LGI food exchange method , the time period of 3 months. Fasting blood glucose (FPG)、2h postprandial blood glucose (2hPG), Glycated hemoglobin (HbAlc), Superoxide dismutase (SOD), Malondialdehyde (MDA), Vitamin C, Vitamin E, Body Mass Index (BMI), Waist circumference (WC) Upper arm muscle circumference (AMC), Triceps skin fold thickness (TSF) were observed before and after the intervention. Results There were no significant differences in blood glucose, oxidative stress and anthropometry between the two groups (P>0.05). After intervention, in the control group: FPG, 2hPG, HbAlc, SOD, MDA, Vitamin C, Vitamin E, BMI, WC, AMC, TSF were (10.27 ± 2.67) mmol/L, (11.51 ± 2.54) mmol/L, (8.78 ± 1.95)%, (322.73 ± 51.97) kU/L, (5.80 ± 1.76)μmol/L, (40.78±4.86)μmol/L, (19.33±4.79)μmol/L, (23.94±3.18) kg/m2, (89.57±10.23) cm, (24.10± 3.01) cm, (18.38 ± 3.79)mm respectively. In the experimental group: they were (8.76 ± 2.77) mmol/L, (10.63 ± 1.76) mmol/L, (7.96 ± 1.86)%, (357.29 ± 60.04) kU/L, (5.26 ± 1.33)μmol/L, (44.01 ± 7.06)μmol/L, (21.58 ± 5.25) μmol/L, (22.93 ± 2.75) kg/m2, (86.05 ± 10.79) cm, (22.75 ± 2.86) cm, (16.98 ± 4.48) mm respectively. There was significant difference between the two groups after intervention (t=2.049-3.769, all P < 0.05). In the experimental group, the improvement of blood sugar, oxidative stress and anthropometry was better than that of the control group (P < 0.05). Conclusions LGI combined with LGL diet intervention is better than the traditional method of food interchange, the blood glucose, oxidative stress and anthropometric indicators have improved, which can improve treatment efficacy in type 2 diabetes and easy for home self-management.

Objective: To explore the impact of knocking out wildtype p53 phosphatase 1 gene on heart function with the changes of cardiac tissue mRNA and protein expressions in experimental mice. Methods: Our research included in 2 groups: Wildtype (WT) mice group and Wip1 knockout (Wip1-KO) mice group. n=10 in each group. The heart function, ratio of heart weight to body weight (HW/BW) were examined and compared between 2 groups; cardiac tissue morphology was observed by HE staining; mRNA expressions of ANP, BNP, MCP-1 andα-SMA were determined by RT-PCR and protein expressions of Bcl-2, Bax and c-caspase3 were measured by Western blot analysis. Results: Compared with WT mice group, Wip1-KO mice group showed decreased Wip1 mRNA expression,P<0.05, decreased LVEF, LV fraction shortening and increased left ventricular end systolic diameter (LVESD), allP<0.05; Wip1-KO mice group had reduced BW and elevated ratio of HW/BW, bothP<0.05 even the heart weight was similar between 2 groups. There was no difference in cardiac tissue morphology between 2 groups; mRNA expressions of ANP, BNP, MCP-1 and α-SMA were similar between 2 groups,P>0.05; apoptosis related protein expressions of Bax/Bcl-2 and c-caspase3 were similar between 2 groups,P>0.05. Conclusion: Wip1 gene knockout may impair the heart function in experimental mice, while the relevant mechanism should be further investigated.

Objective To explore the relationship between optical coherence tomography (OCT) characteristics and peripheral blood leukocyte count in patients with acute myocardial infarction(AMI). Methods A total of 33 patients with AMI hospitalized in Fuwai Hospital for primary percutaneous coronary intervention were consecutively enrolled,and underwent intracoronary OCT procedures after manual aspiration of coronary thrombus. Demographic data, risk factors, procedural and OCT data, past medical history and perioperative laboratory findings were collected in all patients. Results The lymphocyte count,monocyte count and basophil count were significantly higher in the patients with fibrous cap thickness ≥ 65 μm than in those patients with fibrous cap thickness ≤ 65 μm. Patients presenting with cholesterol crystallization had lower eosinophil count than those patients with crystallization-free [(0.04±0.06)×109/L vs.(0.10±0.09) ×109/L,P =0.028]. In addition,the former had significantly higher to neutrophil lymphocyte ratio than the latter [(8.35±6.13)vs.(4.97±2.01), P =0.020]. Higher monocyte count was found in the patients with calcified plaque (P <0.05). Platelet to lymphocyte ratio was significantly increased in the patients with macrophage infiltration [(165.72±85.93)vs.(113.47±19.13),P <0.05]. The leukocyte count,neutrophil count and monocyte count showed the treat of elevation as the number of OCT characteristics increased,but only the elevation of monocyte count had statistical significant level (P = 0.014). Conclusions Peripheral blood leukocyte count seems to be associated with OCT characteristics of plaque rupture in patients with acute myocardial infarction,suggesting the potential role of inflammation in plaque rupture.

Objective Ticagrelor-related dyspnea may affect the medication adherence of patients with coronary artery disease.This study aims to assess the impact of ticagrelor adherence on 1-year cardiovascular outcomes in pateints with stable coronary artery diseases (SCAD).Methods This study includes the patients with SCAD from Fuwai hospital who discharged with ticagrelor between Jan.2015 to Jun.2015.We collected data of clinical characteristics and ticagrelor adherence from these patients by reviewing the electronic medical records and personnel interview.Follow-up was performed at 6 and 12 months by telephone interview or office visits.Results A total of 155 patients with SCAD were enrolled,of whom 122 (78.7％) were males with a mean age (57.0 ± 10.0) years.Among them,50 (32.3％) patients have a history of myocardial infraction and 106 (68.4％) patients had angiographic confirmed left main and/or multivessel disease.Forty-six patients (29.7％) with SCAD prematurely stopped ticagrelor within 12 months,while 25 (16.1％) patients switched from ticagrelor to clopidogrel.Hemorrhagic events and locally unavailable ticagrelor were the major reasons causes of the premature discontinuation of ticagrelor.Univariate analysis showed age,body mass index (BMI),hypertention and locally unavailable ticagrelor as relative factors for early ticagrelor discontinuation after discharge.Multivariate analysis revealed unavailable drug locally (OR 0.25,95％ CI 0.09-0.69) and elderly patients (OR 4.13,95％ CI 1.40-12.19) were risk factors for low persientence or premature ticagrelor discontinuation.Conclusion This study showed poor ticagrelor adherence in patients with SCAD after discharge.Locally unavailable ticagrelor and elderly patients were strong predictors of poor ticagrelor adherence.Discontinuation to ticagrelor prematurely may not have impact on adverse cardiovascular outcomes.

Objective:To analyze the clinical features and prognosis of lymphoma patients with monoclonal immunoglobulin (McIg).Methods:The data of 14 patients who were pathologically diagnosed as lymphoma and with McIg in the First Affiliated Hospital of Fujian Medical University from January 2014 to January 2019 were retrospective analyzed. At the same time, 40 lymphoma patients without McIg were sellected as controls. The patients'age, gender, international prognostic index (IPI) score, B symptoms, tumor cell source and Ki-67 index were analyzed by prognostic single factor analysis. Kaplan-Meier method was used for survival analysis, and the overall survival (OS) and progression-free survival (PFS) were compared between the two groups.Results:Among 14 lymphoma patients with McIg, 6 were males and 8 were females. The median age of onset was 63 years (42-78 years). There were 13 cases of clinical stage Ⅲ-Ⅳ, and 12 cases of extranodal disease. The most common type was IgM-κ. The results of univariate analysis showed that IPI score≥3 points and elevated D-dimer level were related to poor prognosis (both P < 0.05). At the end of follow-up, the median OS time of lymphoma patients with McIg had not reached, the 2-year OS rate was 64.3%, and the median PFS time was 16 months; the median OS time of lymphoma patients without McIg had not reached, the 2-year OS rate was 90.8%, and the median PFS time was 37 months; the difference of OS between the two groups was statistically significant ( P = 0.040). Conclusions:Most lymphoma patients with McIg have extranodal involvement, the clinical stage is more inclined to stage Ⅲ-Ⅳ, IPI score ≥3 points and elevated D-dimer level are poor prognostic factors. The secretion of McIg is an important factor for the poor prognosis of patients with lymphoma.

Objective To investigate the diagnostic effect of diffusion tensor imaging (DTI) on spinal neurotype brucellosis spondylitis (BS).The characteristics of apparent diffusion coefficient (ADC) value and fractional anisotropy (FA) value of spinal neurotype BS in different disease stages were quantitatively analyzed to evaluate the different forms of spinal neurofibrillary tract injury.Methods A prospective design was used to collect data of BS patients with spinal neurological symptoms from June 2015 to July 2017 in the First Affiliated Hospital of Hebei North University as the brucellosis group (n =39),including 23 males and 16 females,aged (20.8 ± 15.3) years old.Healthy subjects were selected as the control group (n =30),including 20 males and 10 females,aged (25.2 ± 4.0) years old.The brucellosis group was divided into acute stage (＜ 3 months),subacute stage (3-6 months) and chronic stage (＞ 6 months),with 12,10 and 17 cases,respectively.Routine spinal scans and DTI scans were performed using a 3.0T superconducting magnetic resonance imaging (MRI) scanner,DTI used Fiber Trak package to measure ADC value and FA value and perform quantitative analysis [receiver operating characteristic (ROC) curve],and reconstructed the changed form of the spinal neurotype BS nerve fiber bundle.Results A total of 39 patients' data were collected in the brucellosis group.Among them,5 patients showed segmental thickening of spinal nerves on conventional MRI,high signal on T2 weighted imaging (T2WI) and short time inversion recovery (STIR),and color code changes on DTI scan FA imaging.Routine MRI of 34 patients showed spinal cord compression,spinal cord morphological changes or cauda equina nerve aggregation and displacement,while DTI scan FA imaging showed spinal cord or cauda equina nerve morphological changes,but no color code changes.The ADC values of patients in the acute and subacute stages were higher than that of the control group [(1.41 ± 0.05),(1.31 ± 0.05),(1.23 ± 0.05) × 10-3 mm2/s,P ＜ 0.05],and the FA values were lower than that of the control group (0.40 ± 0.04,0.68 ± 0.08,0.76 ± 0.05,P ＜ 0.05).There were no statistically significant differences in ADC and FA values between patients with chronic spinal neurotype BS [(1.25 ± 0.04) × 10-3 mm2/s,0.72 ± 0.04] and the control group (P ＞ 0.05).ROC curve analysis showed that the area under curve (AUC),specificity,sensitivity and accuracy of ADC were 0.912,0.942,0.930 and 0.924,respectively.The AUC,specificity,sensitivity and accuracy of FA were 0.901,0.937,0.928 and 0.943,respectively.The change forms of spinal neurotype BS were:① color code change;② loss/fracture;③ displacement and pressure;④ rarity.Conclusion DTI plays a diagnostic role in spinal neurotype BS,and can quantitatively analyze the characteristics of changes in ADC value and FA value in different periods,and can clearly display the forms of changes in spinal neurofiber,providing a reliable basis for the diagnosis of spinal neurotype BS.

Objective To explore the differential diagnosis of breast ductal carcinoma in situ (DCIS)and breast ductal carcinoma in situ with microinvasion (DCIS-Mi)by ADCMin ,ADCDR and DCE-MRI,and to analyze the correlation between DCIS-Mi and biological factors. Methods Preoperative breast MRI examinations were performed in 41 patients with DCIS-Mi and 3 7 patients with DCIS.DCIS-Mi and DCIS patients were compared in terms of ADCMin ,ADCMax ,ADCDR ,early enhancement rate (EER)and the morphological characteristics of DCE-MRI.The optimal diagnostic variables were determined by binary Logistic regression,the threshold value of the optimal diagnostic variables was ensured by ROC,and the correlation between DCIS-Mi and biological factors was analyzed by Spearman.Results ADCMin of DCIS-Mi patients was lower than that of DCIS (t＝6.294,P＝0.033),and ADCDR was higher than that of DCIS (t＝9.246,P＝0.020).70.7 3% DCIS-Mi showed non-tumor-like enhancement,inclined to segmental distribution,and internal heterogeneous or cluster ring enhancement;29.27% manifested tumor-like enhancement,internal heterogeneous or ring enhancement,and unclear margin.64.86% DCIS showed non-tumor-like enhancement,inclined to linear distribution,internal homogeneous/heterogeneous enhancement;35.14% expressed tumor-like enhancement,internal homogeneous enhancement,and clear margin.The accuracy,sensitivity and specificity of ADCMin , ADCDR ,tumor or non-tumor internal enhancement features in the diagnosis of DCIS-Mi were higher (84.0%,9 5.3%,9 2.4%;89.3%, 9 5.3%,9 2.4%;85.1%,9 2.5%,9 3.8%;87.4%,9 6.8%,84.7%, respectively).ADCMin and ADCDR threshold value were 1.1 1× 10－3 mm2/s and 0.35×10－3 mm2/s,respectively.ADCMin of patients with DCIS-Mi was positive correlation with ER(－)and PR(－), and negative correlation with HER-2(+)(P＜0.05).ADCDR ,non-tumor distribution,and non-tumor internal enhancement characteristics,the tumor edge and internal enhancement characteristics were negative correlation with ER(－)and PR(－),and positive correlation with HER-2 (+)(P＜0.05).Conclusion ADCMin ,ADCDR and DCE-MRI can be used for the differential diagnosis of DCIS-Mi and DCIS, and provided evidence for clinical treatment plan.

Objective To investigate the value of strong ion gap (SIG) for predicting acute heart failure (AHF) after acute myocardial infarction. Methods A total of 189 patients with acute myocardial infarction were enrolled from July 2015 to December 2016 in the First Affiliated Hospital of Soochow University. Based on AHF occurrence, the patients were divided into the AHF group (n=76) and the non-AHF group (n=113). General clinical data and laboratory tests were compared between the two groups. The univariate analysis and multivariate logistic regression analysis were performed to estimate the contribution of clinical risk factors to triggering AHF after acute myocardial infarction. Spearman correlation analysis was performed to estimate the correlation between SIG and Killip classification. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of ALB, anion gap (AG) and SIG in AHF after acute myocardial infarction. Results Age, proportion of history of diabetes, the serum level of C-reactive protein (CRP), AG and SIG of the AHF group were higher than those of the non-AHF group (P<0.05). Meanwhile, the serum level of albumin (ALB) of the AHF group were lower than those of the non-AHF group (P<0.05). Univariate analysis showed AHF after acute myocardial infarction was closely associated with age, history of diabetes, serum ALB, AG and SIG (P<0.05). Multivariate logistic regression analysis showed that history of diabetes (OR=2.034, 95％CI:1.075-4.113, P<0.05) and SIG (OR=2.445, 95％CI: 1.538-4.297, P<0.05) were significantly correlated with AHF after acute myocardial infarction. The ROC analysis revealed SIG (AUC=0.837,95％CI:0.781-0.893) had a large area under curve compared to ALB (AUC=0.671,95％CI: 0.593-0.750) and AG (AUC=0.728,95％CI: 0.654-0.802). The optimal diagnostic intercept value was 5.24 mmol/L, and the sensitivity and specificity were 76.32％ and 78.36％, respectively. Conclusions SIG could be used as an independent predictor for AHF secondary to acute myocardial infarction, and was significantly correlated with severity of AHF.

As an important part of the construction of national emergency management system, emergency material support is the material basis and important guarantee for the smooth implementation of emergency work. In the face of the outbreak and spread of COVID-19, China′s public health emergency management system and emergency management system have achieved certain results in epidemic prevention and control, but also exposed some shortcomings. The authors summarized the management experience and existing problems of China′s emergency medical materials in storage, production, transportation and deployment during the COVID-19 epidemic, and discussed the management path and method of emergency medical materials in peacetime and wartime, which should be jointly built by the government, society, enterprises and the public. The following suggestions are put forward: multi agent participation in expanding the scope and scale of emergency medical supplies reserve, refining and adjusting the inventory and structure of emergency medical supplies reserve; establishing a supply chain list of emergency medical supplies to ensure the " wartime" production capacity; establishing a comprehensive management information platform for medical materials with " peacetime and wartime integration" ; and improving the awareness and ability of community and family′s " peacetime" medical material reserve.

Objective To investigate the epidemic features of pediatric allergic rhinitis (AR) in Chongqing City .Methods The children aged 2 to 12 years old from 11 kindergartens and primary schools in Chongqing City were randomly extracted as the study subjects .The AR questionnaire was designed and conducted the epidemiologic survey and statistical analysis .Results The self-reported AR prevalence rate among children in Chongqing City was 28 .5% (334/1170) .The clinical diagnosis rate was 18 .1%(212/1170) and definite diagnosis rate was 17 .3% (202/1170);intermittent AR accounted for 36 .6% (74/202) and persistent AR accounted for 63 .4% (128/202) .Among the nasal symptoms in AR children patients ,nasal itch occupied the highest proportion (70 .7% ) ,followed by nasal discharge(59 .3% ) ,nasal obstruction(56 .3% ) and continuous sneezing (45 .5% );complicating ocular symptoms accounted for 34 .1% ,those with cough symptom accounted for 56 .9% .Eczema was the most common concomitant dis-ease for children with AR(37 .7% ) ,followed by allergic conjunctivitis (27 .5% ) ,nasosinusitis(26 .9% ) ,epistaxis(25 .1% ) ,asthma (19 .2% ) and secretory otitis media (6 .6% ) .Conclusion The self-reported morbidity rate of children AR in Chongqing City is higher and persistent AR is more common than intermittent AR .