BACKGROUND: At present, treatment of diabetes mellitus with western medicine starts from the angle of stimulating injured β cell of islet to strength insulin secreting. Treatment with traditional Chinese medicine is very important in protecting injured β cells.OBJECTIVE: To observe the protective effect of lycium barbarum polysaccharide and nourishing yin and activating blood compound recipe on pancreatic islet function in rats with streptozotocin-induced diabetes mellitus.DESIGN: A randomized and controlled animal experiments.SETTING: First Affiliated Hospital and Medical College of Henan University of Science and Technology.MATERIALS: Totally 70 male Wistar rats, aged 6 weeks, with body mass of 200 g, were used in this experiment.METHODS: This experiment was carried out at the Animal Room of Henan University of Science and Technology from October 2001 to April 2002. Totally 70 rats were divided into two groups: normal control group (n=10) and modeling group (n=60). Totally 30 successful model rats were randomly subdivided into 3 groups: streptozotocin model group, compound recipe treated group and lycium barbarum polysaccharide-treated group,with 10 rats in each group ;Intragastric administration of 60 g/kg Chinese herb compound recipe for nourishing yin and activating blood was performed on the rats in the compound recipe treated group at 9:00 every day (huangqi, shanyao, gegen respectively 30 g, gouqizi, danshen, huafen,digupi respectively 15 g, danggui, zhimu respectively 12 g, danpi, wuweizi respectively 10 g, shuizhi 5 g, shanyurou 20 g, etc, provided by drug store of First Hospital Affiliated to Henan University of Science and Technology,were decocted and condensed to be equivalent crude drug 3.0 kg/L with routine method). Intragastric administration of 0.5 g/kg lycium barbarum polysaccharide was given in the lyciun barbarum polysaccharide treated group (lycium barbarum polysaccharide was isolated and purified from ningxia barbary wolfberry fruit). Intragastric administration of comparative volume of normal saline was performed in the streptozotocin model group and normal control group, totally 3 weeks. The levels of fasting blood glucose (FBG) and insulin were measured at 3 weeks before and after experiment, and function index of β cell of islet was calculated; Pancreas was taken out to detect SOD activity, NOS activity and concentrations of NO and MDA were also detected.RESULTS: Ten rats in normal control group and 30 successful model rats in model group entered the stage of result analysis. ① In the initial stage of experiment, FBG level in each modeling group was significantly increased (t=16.51 to 10.07,P ＜ 0.01), while fasting insulin level and function index of β cell were significantly decreased (t=13.64 to 100.99 ,P ＜ 0.01 ) in comparison with normal control group. ② At 3 weeks after experiment, levels of FBG, NO , MDA , NOS activity were significantly decreased in the compound recipe treated group and lycium barbarum polysaccharide group compared with streptozotocin model group (t=8.08 to 72.68 ,P ＜ 0.01 ), while level of fasting insulin and function index of β cell, SOD activity were significantly increased in the compound recipe treated group and lycium barbarum polysaccharide group compared with streptozotocin model group (t=4.39 to 17.87,P ＜ 0.05-0.01 ). ③ Levels of FBG and MDA , NOS activity and concentration of NO were significantly decreased in the compound recipe treated group, and fasting insulin and function index of βcells were significantly increased in comparison with lycium barbarum polysaccharide group(P ＜ 0.01 ).CONCLUSION: Lycium barbarum polysaccharide and nourishing yin and activating blood compound recipe increase the level of fasting insulin and function index of βcell of rats with streptozotocin induced diabetes mellitus, decrease the level of blood glucose, improve the function of βcell of islet, which might be related to the increase of pancreatic islet SOD activity and decrease NOS activity.

Objective:To explore the risk factors for hemophagocytic syndrome (HPS) in childhood Epstein-Barr virus (EBV)-associated infectious mononucleosis (IM).Methods:From January 2013 to December 2017, the medical charts of all children who were diagnosed with EBV-associated IM and HPS in Children′s Hospital of Soochow University were analyzed retrospectively. Statistical analyses were performed using SPSS version 22.0.Results:A total of 316 IM and 59 HPS were enrolled. The age was (4.26 ± 2.95) years old with a male-to-female ratio of 1.2∶1. In addition to the diagnostic criteria of HPS, there were significantly lower rates of fever >10 d, hepatomegaly, jaundice, alanine aminotransferase >500 U/L, aspartate aminotransferase >500 U/L, LDH >1 000 U/L, C-reactive protein >50 mg/L and hypoalbuminemia in children with EBV-associated IM compared to those with HPS, and the differences were statistically significant ( P<0.05). Multivariate Logistic regression analysis showed that fever >10 d, eyelid edema, lymphadenopathy and purulent tonsils were independent predictors of HPS in children with EBV-associated IM ( P<0.05). Hepatomegaly and fever >10 d were risk factors ( OR = 16.079 and 12.138, 95% CI 2.788 to 92.744 and 2.878 to 51.180). Eyelid edema, lymphadenopathy and purulent tonsils were protective factors ( OR = 0.087, 0.006 and 0.031; 95% CI 0.010 to 0.723, 0.001 to 0.058 and 0.007 to 0.146). Conclusions:Hepatomegaly and fever >10 d are the risk factors for hemophagocytic syndrome in childhood EBV-associated infectious mononucleosis.

Objective To explore the effects of systematic nursing intervention on psychology and quality of life in primary liver cancer patients undergoing surgery. Methods From January 2014 to December 2016, a total of 160 primary liver cancer patients undergoing surgery were selected as subjects by purposive sampling. All of the patients were divided into observation group and control group by the random number table, 80 cases in each group. Patients of control group were treated with the perioperative conventional nursing. On the basis, patients of observation group accepted systematic nursing intervention. We assessed patients in two groups with the SDS, SAS, Quality of Life of Cancer Patient Core Scale before and after intervention. Results After intervention, the score of SDS and SAS of patients in the observation group was lower than that of the control group with significant differences (P<0.01). Besides, the score of general health, physical functioning, role functioning, emotional functioning, cognitive functioning of patients in the observation group were significantly higher than those of the control group (P<0.05). Conclusions Systematic nursing intervention can improve negative emotions and quality of life of patients ,which is worthy of generalization and application.

Objective:To analyze the clinical and laboratory characteristics of acute myeloid leukemia (AML) patients with NPM1 mutation, and to explore the prognostic factors.Methods:A total of 77 AML patients with NPM1 gene mutation admitted to Hebei Yanda Ludaopei Hospital from May 1st 2012 to December 31st 2021 were enrolled in the study, including 34 male and 43 female patients. The median age was 40 (3, 68) years old. Patients were selected and divided into 4 groups according to the morphological FAB classification. There were 29 cases (37.7%) of M1 type, 13 cases (16.9%) of M2 type, 23 cases (29.9%) of M4 type, and 12 cases (15.5%) of M5 type. The clinical characteristics, bone marrow/peripheral blood cell morphology, immunophenotype, cytogenetics, molecular biology and overall survival of different groups were retrospectively analyzed, and the risk factors affecting the prognosis of AML were also explored. Cox multivariate regression was used to analyze the clinical influencing factors of survival and prognosis.Results:The white blood cell counts were highest in M4 and M5 patients and lowest in M2 patients, while no significant difference in the red blood cell, hemoglobin, and platelet counts( P>0.05). Morphologically, there were significant differences in the percentage of blasts and blasts with cup-like nuclei on bone marrow (BM) and peripheral blood (PB). The proportion of blasts in BM and PB was the highest in M1 and the lowest in M2 ( P<0.001). The positive rate of blasts with cup-like nuclei was the highest in M1 and the lowest in M5 of BM ( P<0.001), while the highest in M2 and the lowest in M5 of PB ( P=0.006). The scores of myeloperoxidase and chloroacetate esterase were all the highest in M1 and the lowest in M5 ( P<0.001, 0.001, respectively). In terms of molecular biology, the occurence rate of blasts combined with DNMT3A mutation was the highest in M4 and the lowest in M2 ( P=0.044), while those combined with FLT3-ITD mutation was the highest in M4 and the lowest in M5 ( P=0.002). In immunophenotype, there were significant differences in the expression positivities of seven antigens including HLA-DR, CD56, CD11c, CD15, CD14, CD96 and cMPO ( P<0.05). Multivariate COX regression analysis showed that no recurrence after treatment ( P<0.001), complete remission after treatment ( P=0.015) and transplantation ( P<0.001) were correlated with overall survival (OS). No recurrence after treatment ( P=0.033), transplantation ( P=0.027), no mutation of FLT3-ITD ( P=0.040), and hemoglobin concentration ( P=0.023) were associated with relapse-free survival (RFS). Survival analysis by Kaplan-Meier curve showed that there was no significant difference in survival time between the M1, M2, M4 and M5 groups in OS and RFS. Conclusion:There were significant differences in the white blood count, the percentage of blasts and blasts with cup-like nuclear morphology, cytochemical staining (MPO integration, CE integration and percentage of NAS-DCE), gene mutation (DNMT3A and FLT3-ITD) and immunophenotypes (HLA-DR, CD56, CD11c, CD15, CD14, CD96 and cMPO) between the four groups. The multivariate analysis revealed that no recurrence after treatment and transplantation were independent prognostic factors in NPM1 mut AML patients. On the other hand, FLT3-ITD mutation and hemoglobin concentration were associated with RFS and complete remission after treatment was associated with OS in the entire NPM1 mut cohort.

Objective:To establish a nomogram model for predicting the risk of sepsis in diabetic foot patients, and to provide reference for clinical prevention and treatment.Methods:The clinical data of 430 patients with diabetic foot who were hospitalized in Chu Hsien-I Memorial Hospital of Tianjin Medical University from January 2022 to March 2023 were reviewed and collected, including age, gender, past medical history, smoking and drinking history, family history, diabetes course, Texas grade of diabetic foot and laboratory indicators within 24 hours after admission. Patients were divided into sepsis group and non-sepsis group according to the presence or absence of sepsis during hospitalization. The differences in clinical data between the two groups were compared. Multivariate Logistic regression analysis was used to screen the influencing factors of sepsis in patients with diabetic foot during hospitalization, and a nomogram predictive model was established. The performance of the prediction model was evaluated by receiver operator characteristic curve (ROC curve), calibration curve and decision curve analysis (DCA). Internal validation was performed by using Bootstrap method.Results:A total of 430 patients were enrolled, among which 90 patients developed sepsis during hospitalization and 340 patients did not. There were statistically significant differences in diabetes course, Texas grade of diabetic foot, white blood cell count (WBC), neutrophil count (NEU), lymphocyte count (LYM), neutrophil to lymphocyte ratio (NLR), hemoglobin (Hb), albumin (Alb), glycosylated hemoglobin (HbA1c), C-reactive protein (CRP), and blood urea nitrogen (BUN) between the two groups. Multivariate Logistic regression analysis showed that diabetes course [odds ratio ( OR) = 2.774, 95% confidence interval (95% CI) was 1.053-7.308, P = 0.039], Texas grade of diabetic foot ( OR = 2.312, 95% CI was 1.014-5.273, P = 0.046), WBC ( OR = 1.160, 95% CI was 1.042-1.291, P = 0.007), HbA1c ( OR = 1.510, 95% CI was 1.278-1.784, P < 0.001), CRP ( OR = 1.007, 95% CI was 1.000-1.014, P = 0.036) were independent risk factors for sepsis in patients with diabetic foot during hospitalization, while Alb was a protective factor ( OR = 0.885, 95% CI was 0.805-0.972, P = 0.011). A nomogram predictive model was constructed based on the above 6 indicators. The ROC curve showed that the area under ROC curve (AUC) of the nomogram predictive model for identifying the sepsis patients was 0.919 (95% CI was 0.889-0.948). The AUC of the nomogram predictive model after internal verification was 0.918 (95% CI was 0.887-0.946). Hosmer-Lemeshow test showed χ2 = 2.978, P = 0.936, indicating that the calibration degree of the predictive model was good. Calibration curve showed that the predicted probability of sepsis was in good agreement with the actual probability. DCA curve showed that the nomogram predictive model had good clinical usefulness. Conclusion:The nomogram predictive model based on the risk factors of diabetes course, Texas grade of diabetic foot, WBC, HbA1c, CRP and Alb has good predictive value for the occurrence of sepsis in patients with diabetic foot during hospitalization, which is helpful for clinical screening of the possibility of diabetic foot patients progressing to sepsis, and timely personalized intervention for different patients.