Objective To explore the clinical efficacy of omacycline(OMC)in the treatment of diabetes mellitus complicated with community-acquired bacterial pneumonia(CABP).Methods Clinical data of T2DM patients with CABP admitted to The First Hospital of Jiaxing from August 2022 to July 2023 were divided into OMC group and non-OMC(NOMC)group according to wheter they received OMC treatment or not.The absorption of pulmonary lesions after treatment,changes in inflammatory indicators[white blood cell count(WBC),C-reactive protein(C-reactive protein,CRP),and anterior calcitonin(procalcitonin,PCT)],comprehensive index[hospitalization days,total hospitalization costs,blood glucose standard within 3 d and glucocorticoid use]and the occurrence of adverse reactions were analyzed and compared.Results A total of 100 diabetes mellitus patients with CABP were included in this study,including 36 cases in OMC group and 64 cases in NOMC group.The absorption of pulmonary inflammation in the OMC group was significantly higher than that in the NOMC group(P<0.05).Before treatment,there was no statistical difference in WBC,CRP and PCT between the two groups(P>0.05).After treatment,WBC,CRP,and PCT in both groups were significantly lower than those before treatment(P<0.05).Furthermore,WBC,CRP,PCT levels,hospital stay,total hospitalization costs and glucocorticoid use rate were significantly lower in the OMC group than in the NOMC group(P<0.05).The blood glucose compliance rate within 3 d in the OMC group was significantly higher than that in the NOMC group(P<0.05).None of the patients had serious complications during the treatment period.Conclusion OMC treatment of T2DM complicated with CABP is helpful for early disease control and rehabilitation,and reduces the treatment burden.

Objective:To summarize the genotype and clinical characteristics of chylomicron retention disease (CMRD) caused by secretion associated Ras related GTPase 1B (SAR1B) gene variations.Methods:Clinical data and genetic testing results of 2 children with CMRD treated at Children′s Hospital of Fudan University and Jiangxi Provincial Children′s Hospital from May 2022 to July 2023 were summarized. To provide an overview of the clinical and genetic characteristics of CMRD caused by SAR1B gene variations, all of the literature was searched and reviewed from China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, China VIP database, China Biology Medicine disc and PubMed database (up to January 2024) with "chylomicron retention disease" "Anderson disease" or "Anderson syndrome" as the search terms. All relevant literatures were reviewed to summarize the clinical and genetic features of CMRD caused by SAR1B gene variations.Results:One 11-year-old boy and one 4-month-old girl with CMRD. Both patients had lipid malabsorption, failure to thrive, decreased cholesterol, elevated transaminase and creatine kinase, and Vitamin E deficiency, with homozygous variations (c.224A>G) and compound heterozygous variations (c.224A>G and c.554G>T) in SAR1B gene, respectively. Case 1 was followed up for over a month, and he still occasionally experienced lower limb muscle pain. Case 2 was followed up for more than a year, and her had caught up to normal levels. Both patients had no other significant discomfort. Literature search retrieved 0 Chinese literature and 22 English literatures. In addition to the 2 cases reported in this study, a total of 51 patients were identified as CMRD caused by SAR1B gene variations. Twenty-one types of SAR1B variants 10 missense, 4 nonsense, 3 frameshift, 1 in-frame deletion, 1 splice, 1 gross deletion, and 1 gross insertion-deletion were found among the 51 CMRD cases. Among all the patients, 49 cases had lipid malabsorption (43 cases had diarrhea or fatty diarrhea, 17 cases had vomiting, and 12 cases had abdominal distension), 45 cases had lipid soluble Vitamin deficiency (43 cases had Vitamin E deficiency, 10 cases had Vitamin A deficiency, 9 case had Vitamin D deficiency, and 5 cases had Vitamin K deficiency), 35 cases had failure to thrive, 32 cases had liver involvement (32 cases had elevated transaminases, 5 cases had fatty liver, and 3 cases had hepatomegaly), 29 cases had white small intestinal mucosa under endoscopy, and 17 cases had elevated creatine kinase, 14 cases had neuropathy, 5 cases had ocular lesions, 2 cases had acanthocytosis, 1 case had decreased cardiac ejection fraction, and 1 case was symptom-free.Conclusions:Early infancy failure to thrive and lipid malabsorption are common issues for CMRD patients. The laboratory tests are characterized by hypocholesterolemia with or without fat-soluble Vitamin deficiency, elevated liver enzymes and (or) creatine kinase. Currently, missense variations are frequent among the primarily homozygous SAR1B genotypes that have been described.

OBJECTIVE To explore the regulatory mechanism of compatibility of ginseng and gecko dispensing granule on kidney yang deficiency model rats. METHODS Male SD rats were randomly divided into normal group （no modeling ，no administration），model group （modeling，no administration ），Jinkui shenqi pill group （modeling，dose of 2.33 g/kg），ginseng group（modeling，dose of 0.53 g/kg），gecko group （modeling，dose of 0.21 g/kg）and compatibility group （modeling，ginseng 0.53 g/kg and gecko 0.21 g/kg）. The body mass and anal temperature of rats were measured at different time points ；the serum levels of cAMP ，cGMP，CRH，ACTH，CORT，T，T3，T4，E2，IgG and IgM were measured ；the pathomorphological changes of adrenal gland ，thyroid gland and testis were observed ；mRNA expression of CRH ，thyroid stimulating hormone releasing hormone （TRH）and gonadotropin releasing hormone （GnRH）in hypothalamus were detected. RESULTS Compared with model group ，the anal temperature ，the levels of cAMP ，CRH，ACTH，CORT，T3，T and cAMP/cGMP ，T/E2 in serum and mRNA expressions of TRH and GnRH in hypothalamus were significantly increased in the compatibility group （P＜0.05 or P＜0.01）；the levels of cGMP，E2 and IgG in serum and mRNA expression of CRH in hypothalamus decreased significantly （P＜0.05 or P＜0.01）； the pathological injuries of adrenal gland ，thyroid gland and testis were all improved. Compared with ginseng or gecko dispensing granules alone ，the anal temperature and T/E 2 of rats in the compatibility group increased significantly ，and mRNA expression of CRH in hypothalamus decreasedsignificantly （P＜0.05 or P＜0.01）. CONCLUSIONS Thecompatibility of ginseng and gecko dispensing granule has a synergistic regulatory effect on kidney yang deficiency model rats ， the mechanism of which may be associated with hypothalamus-pituitary-adrenal axis ， hypothalamus-pituitary-thyroid axis ， hypothalamus-pituitary-gonad axis and neuroendocrine immune network formed by immune function. Compatible drugs are better than single drugs.

Objective:To investigate the value of quantitative CT (QCT) body component parameters before and after transcatheter arterial chemoembolization (TACE) as prognostic indicator for patients with hepatic cell carcinoma (HCC).Methods:Retrospective analysis was performed on 40 patients with advanced HCC who received TACE treatment in Anhui Provincial Hospital Affiliated to Anhui Medical University from November 2013 to May 2017, all of them received QCT scanning before and after treatment. The information were recorded, including gender, age, alpha-fetoprotein (AFP), TNM stage, liver function Child-Pugh grade, portal venous thromboembolism, cirrhosis, maximum tumor diameter, tumor type, and frequency of interventional therapy. QCT parameters were measured before and after treatment, including L1, L2 bone mineral density (BMD), L3-level paravertebral muscle area (MA), subcutaneous fat area (SFA) and visceral fat area (VFA), and the change rate of QCT parameters (ΔBMD, ΔMA, ΔSFA, ΔVFA) before and after TACE were calculated after the QCT scan interval was standardized. The cut-off values of ΔBMD, ΔMA, ΔSFA and ΔVFA to diagnose the prognosis of HCC patients after TACE were obtained by drawing the ROC curves. The Kaplan-Meier method was used to calculate the survival rate, the Log-rank method was used for univariate analysis, and the Cox regression analysis model was used for multivariate analysis to screen out independent factors affecting the prognosis of HCC patients after TACE.Results:ROC curve analysis showed that the cut-off values of ΔBMD, ΔMA, ΔSFA and ΔVFA to diagnose the prognosis of HCC patients after TACE were -8.64%, -6.84%, -9.84% and 5.70%, respectively. Univariate analysis showed that AFP, TNM stage, liver function Child-Pugh grade, portal venous thrombosis, tumor type and ΔMA, ΔSFA, ΔVFA had statistically significant effects on prognosis ( P<0.1). Multivariate analysis showed that ΔMA, ΔVFA and portal venous thromboembolism were independent influencing factors for the prognosis of HCC patients after TACE treatment ( P<0.05). Conclusions:ΔMA, ΔVFA and portal venous thromboembolism have reference value for prognosis assessment of TACE treatment for HCC patients, and QCT body composition analysis is helpful to evaluate the prognosis of HCC patients.

Objective:To study the real-world outcome of China FDA-approved Sofosbuvir (SOF)/Velpatasvir (VEL) in Northwest China.Methods:In this multicenter, prospective, real-world cohort study, we recruited patients from 10 sites from Northwest China, who were chronically infected with HCV GTs 1-6 from 06/2018 to 09/2019. Patients received SOF (400mg)/VEL (100mg) for 12 weeks, and with ribavirin 900-1200 mg for GT3 cirrhosis and for any genotype decompensated cirrhosis. The primary endpoint was sustained virological response at 12-weeks post-treatment (SVR12) and safety. The secondary endpoint was the change of liver function after the achievement of SVR12.Results:Totally, 143 patients were enrolled in the study, four patients were lost to follow-up and one died during the follow-up, 138 patients were included in per-protocol analysis. Of the 138 patients, the mean age 53 years, 53.6% male, 94.2% Han nationality, 53.6% liver cirrhosis, 10.1% HBsAg +, 6.5% renal dysfunction, 5.1% treatment-experienced, and 16.7% patients received ribavirin treatment. The genotype distribution was as follows: 35.5% GT1, 42.8% GT2, 15.9% GT3, and 5.8% un-typed. The SVR12 rate was 96.5% (138/143, 95% CI: 93.5%-99.6%) for intention-to-treat analysis, and in per-protocol analysis, all 138 patients obtained SVR12 (100%). Compared with baseline, the serum total bilirubin, ALT and AFP levels decreased (all P < 0.05), as well as increased ALB and platelet count (all P < 0.001) at post-treatment 12-weeks. Overall adverse events (AEs) rate is 29.0%, and the most common AEs were anemia (14.5%) and fatigue (8.0%). Severe side effects (edema and fatigue) occurred in 2 patients, one of whom needed a short-term interruption of treatment due to fatigue. Conclusion:In this real-world cohort study, 12-week SOF/VEL regimen with or without ribavirin achieved high SVR12 rates (96.5%-100% overall) with excellent safety profile among patients with HCV GT1/2/3 infection including patients with GT3 and cirrhosis, and led to improvement of liver function.

Betel quid dependence(BQD)is a chronic recurrent brain disease characterized by loss of self-control and compulsive repeated use of drugs,which conforms to the characterics of addictive behavior classified by the World Health Organization. Long term chewing Betel nut can increase the risk of a variety of cancers such as oral cancer. The BQD research lacks the ideal animal model whereas the mechanism of BQD is still not clear,and there is no effective treatment and prevention. Notably,neuroimaging technology has provided a non-invasive,quantitative assessment method for the neural mechanism of BQD. The author sum-marized the neural mechanism and imaging studies progress of BQD,and these findings provided preliminary objective evidence for the brain changes of BQD,which was helpful for the deep understanding of the neuro-pathic mechanism of BQD,and provided theoretical basis for the early intervention and treatment.

Betel quid dependence(BQD)is a chronic recurrent brain disease characterized by loss of self-control and compulsive repeated use of drugs, which conforms to the characterics of addictive behavior classified by the World Health Organization.Long term chewing Betel nut can increase the risk of a variety of cancers such as oral cancer.The BQD research lacks the ideal animal model whereas the mechanism of BQD is still not clear, and there is no effective treatment and prevention. Notably, neuroimaging technology has provided a non-invasive, quantitative assessment method for the neural mechanism of BQD. The author summarized the neural mechanism and imaging studies progress of BQD, and these findings provided preliminary objective evidence for the brain changes of BQD, which was helpful for the deep understanding of the neuropathic mechanism of BQD, and provided theoretical basis for the early intervention and treatment.

Objective: To study the correlation between angiotensin II type1 receptor autoantibodies (AT1-AAs) and the onset risk in patients with essential hypertension (EH) combiningacute coronary syndrome (ACS). Methods: Our research included in 4 groups: EH+ACS group,n=28, ACS group, n=29, EH group,n=26 and Control group,n=23 normal subjects. Serum levels of AT1-AAs were examined by ELISA; high sensitivity C-reactive protein (hs-CRP), blood levels of lipids and glucose were also measured and compared among different groups. The correlations between AT1-AAs and blood lipids, glucose, hs-CRP were studied by multiple linear regression analysis. Results: Compared with Control group, ACS group had similar level of AT1-AAs (0.26±0.09) vs (0.21±0.06),P=0.105; while EH+ACS group and HE group had increased AT1-AAs level as (0.40±0.005) and (0.33±0.10),P=0.001 andP=0.02 respectively; AT1-AAs level was higher in EH+ACS group than HE group,P=0.044. In addition, serum AT1-AAs level was positively related to hs-CRP in EH+ACS group, ACS group and EH group (r=0.589,r=0.503 andr=0.273, allP<0.01). Conclusion: Serum AT1-AAs level was positively related to the onset risk in patients with EH combining ACS; AT1-AAs was also related to hs-CRP at certain degree.

Objective To investigatethe quality of life of patients with oral cancer in different period in a hospital, and to explore the impact of patients' psychological status on their quality of life. Methods 50 cases of oral cancer patients in our hospital were investigated in this study by Convenience sampling method. The scale of the hospital anxiety and Depression Scale (HADS, the Japanese version), the quality of life of cancer patients were measured by the scale (FACT-G); the functional evaluation of tumor therapy- head and neck questionnaire (FACT-H&N). Results The comparison of HADS score between patients before and after surgery showed that the improvement of mental status was not obvious in the postoperative patients.The scores of HADS between patients before surgery and after hospital showed that the improvement of mental status was obvious (t=-2.809, P=0.01; t=-3.828, P=0.003). There were significant differences in HADS anxiety and depression-related factors between different periods (F=7.644,P=0.001;F=6.442,P=0.002);Before surgery,patients with low anxiety and depression had higher scores in both emotional and physical functional dimensions, and the difference between the two groups was statistically significant (t=7.882,5.847,6.870,7.262, P<0.05 or 0.01). The scores of the two groups were higher in the whole life quality dimension after surgery,and the difference between the two groups was statistically significant(t=3.640-7.931,P<0.01 or 0.01).There were significant differences in body function and psychological function scores between different periods(F=8.569, P=0.000; F=10.250, P=0.003). Conclusions Oral cancer patients have a higher level of anxiety and depression before and after surgery, and psychological status of patients with a certain impact on quality of life, it should be targeted for individual characteristics of patients with targeted care measures to improve the psychological status of patients,thereby improving the quality of life of patients.