Objective To compare the clinical efficacy of shenmabiejia and decitabine combined with CAG chemotherapy regimens in elderly patients with acute myeloid leukemia, so as to provide suggestions for the treatment of elderly patients with acute myeloid leukemia.Methods120 elderly patients with acute myeloid leukemia were randomly divided into Chinese medicine group (40 cases) and Western medicine group (40 cases) and control group (40 cases).The traditional Chinese medicine group were treated with shenmabiejia combined with CAG chemotherapy regimens;the western medicine group with decitabine combined with CAG chemotherapy regimens;the control group received CAG therapy only.Clinical data, effect, ECOG score and adverse reactions were collected.ResultsCompared with control group, CR (χ2=10.131,8.020, P=0.001,0.005) and ORR (χ2=14.245,8.791, P=0.000,0.003) of Chinese medicine group and Western medicine group were higher, NR were lower than those in the control group(χ2=14.245,8.791, P=0.000,0.397).Compared with the control group, ECOG physical scores of Chinese medicine group and Western medicine group were lower (t=5.125,3.427, P=0.000,0.000).The incidence of group, pulmonary infection, fever, thrombocytopenia, nausea and vomiting, diarrhea, liver injury of traditional Chinese medicine was lower than in the control group (t=10.286,5.556,15.126,4.800,7.207,21.344, P=0.001,0.018,0.000,0.028,0.007,0.000).The incidence of pulmonary infection, fever and nausea and vomiting the probability in Western medicine group is higher than that of control group (t=11.782,8.456,4.036, P=0.000,0.004,0.045).The probability of adverse reaction of traditional Chinese medicine is lower than that of western medicine group.ConclusionShenmabiejia combined with CAG chemotherapy is superior to docetaxel combined with CAG chemotherapy for elderly patients with AML.

Objective To investigate the risk factors of mild cognitive impairment (MCI) in patients with type 2 dia-betes (T2DM), and the clinical evidence for the early diagnosis and treatment thereof. Methods A total of 217 T2DM pa-tients were divided into T2DM with MCI group (n=92) and T2DM with normal cognitive function(NMCI) group (n=125). Mon-treal cognitive assessment scale (MoCA) and activities of daily living scale (ADL) were used to assess the functional status in two groups of patients. The general clinical data and biochemical indicators were obtained and compared in two groups. Re-sults There were statistical differences in age, smoking history, education status, high sensitive C reactive protein (hs-CRP), coronary heart disease, hypertension, glycated hemoglobin A1c (HbA1c) and T2DM history between two groups. Re-sults of univariate logistic regression analysis showed that old age, longer course of T2DM, smoking history, higher hs-CRP and HbA1c, complicated with coronary heart disease and hypertension were risk factors for T2DM with MCI, while the higher education status was a protective factor. Multiple logistic regression analysis showed that old age and longer T 2DM history were risk factors, and the higher education was a beneficial factor for T2DM with MCI. Conclusion Many risk factors may play a part in T2DM with MCI. Early detection and prompting medical attention may help prevent and decrease the preva-lence of MCI in patients with T2DM.

Objective: To elucidate the expression levels of key immune biomarkers, phosphate and tension homology deleted on chromosome ten (PTEN) and programmed cell death protein1(PD-1),of different immune tolerance pathway in classic Hodgkin’s lymphoma (CHL) to further determine their clinical role and prognostic significance. Methods: The clinical features and prognostic factors of 56 CHL patients, who were admitted to the TianJin Medical University Cancer Institute from February 2003 to August 2013, were retrospectively analyzed. PTEN and PD-1 protein expression levels were analyzed by immunohistochemistry, Epstein-Barr virus encoded RNA (EBER) was performed by in situ hybridization assay. Correlations between the expression of biomarkers and clinicopathologic parameters were examined and survival analyses were performed. Results: This cohort of 56 CHL patients included 34 males and 22 females with a median age of 25 years (ranged from 7 to 71 years). In a univariate analysis, age≥45, IPS score >2, EBER positive, high expression of PTEN protein conferred inferior 5-year OS and 5-year PFS; In a multivariate model, age≥45, IPS score >2, EBER positive, high expression of PTEN protein were identified as the independent adverse prognostic factors for CHL. Conclusions This study suggested for the first time that PTEN was independent prognostic immune biomarkers in CHL, which provided the novel therapeutic strategy of immune therapy for CHL.

ObjectiveTo investigate the safety and efficacy of endoscopic retrograde cholangiopancreatography （ERCP） combined with electrohydraulic lithotripsy under the direct view of eyeMax biliary-pancreatic imaging system in the treatment of difficult choledocholithiasis. MethodsA retrospective analysis was performed for the clinical data of 12 patients with difficult choledocholithiasis who underwent ERCP and electrohydraulic lithotripsy under the direct view of eyeMax biliary-pancreatic imaging system in Department of Gastroenterology， Jilin People’s Hospital， from May to November 2022. The clinical effect of lithotripsy and lithotomy was observed， and postoperative complications and time of surgical operation were assessed. ResultsAmong the 12 patients， 11 （91.67%） were successfully treated by electrohydraulic lithotripsy under direct view， 9 （75.00%） achieved first-attempt success in lithotripsy， and 11 （91.67%） had complete removal of calculi； 1 patient was found to have stenosis of the bile ducts caused by multiple biliary tract surgeries， and grade Ⅱ intrahepatic bile duct stones above the sites of stenosis were removed under direct view， but there were still residues of grade Ⅲ intrahepatic bile duct stones， which led to the fact that complete calculus removal was not achieved. The mean time of ERCP operation was 91.3±26.2 minutes， including a time of 41.8±22.2 minutes for energy lithotripsy. There were 2 cases of postoperative biliary tract infection which were improved after anti-infective therapy， 2 cases of hyperamylasemia which were not given special treatment， and 3 cases of mild pancreatitis which were improved after symptomatic medication， and there were no complications such as bleeding and perforation. ConclusionERCP combined with electrohydraulic lithotripsy under the direct view of eyeMax biliary-pancreatic imaging system is safe， effective， and feasible in the treatment of difficult choledocholithiasis.