Objective To explore the influence of type 2 diabetes mellitus combined with subclinical hypothyroidism on diabetic vascular complications.Methods One hundred and two patients with type 2 diabetes mellitus were selected.The serum free triiodothyronine (FT3),free thyroxine (FT4),thyroid stimulating hormone (TSH),anti-thyroid peroxidase antibody (TPO-Ab),thyroglobulin antibody (TG-Ab) levels were measured by chemiluminescence method.The patients were divided into type 2 diabctes mellitus combined with subclinical hypothyroidism group (47 cases) and type 2 diabetes mellitus with normal thyroid function group (55 cases) according to the thyroid function.The glycated hemoglobin (HbA1c),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),triacylglycerol (TG),high-density lipoprotein cholesterol (HDL-C),urea nitrogen,creatinine and albumin levels were measured.The estimated glomerular filtration rate (eGFR) was calculated according to the formula of modification of diet in renal disease (MDRD).The presence of diabetic retinopathy was examined by fundus examination,and the presence of lower limb artery lesions was measured by vascular ultrasound.All indicators were compared between 2 groups.Results There were no statistical differences in age,disease course,HbA1c,body mass index (BMI),TC,TG,HDL-C,LDL-C,incidence of lower limb artery lesions and incidence of diabetic retinopathy between 2 groups (P＞ 0.05).TheeGRF in type 2 diabetes mellitus combined with subclinical hypothyroidism group was significantly lower than that in type 2 diabetes mellitus with normal thyroid function group:(83.74 ± 21.55) ml/(min· 1.73 m2) vs.(115.02 ± 12.29) ml/(min· 1.73 m2),and there was statistical difference (t =4.274,P ＜ 0.01).The incidence of diabetic nephropathy in type 2 diabetes mellitus combined with subclinical hypothyroidism group was significanlty higher than that in type 2 diabetes mellitus with normal thyroid function group:48.9％ (23/47) vs.23.6％(13/55),and there was statistical difference (x2 =7.103,P＜ 0.01).Logistic regression analysis showed that subclinical hypothyroidism was a risk factor for diabetic nephropathy (OR =0.524,95％ CI 0.12-0.93,P ＜ 0.05),but it was not the risk factor for diabetic retinopathy (OR =0.618,95％ CI0.19-2.16,P =0.475) and lower limb artery lesions (OR =0.485,95％ CI 0.32-2.13,P =0.689).Conclusion Subclinical hypothyroidism in patients with type 2 diabetes mellitus has no obvious effect on lower limb arterial complications and diabetic retinopathy,but may increase the risk of diabetic nephropathy.

Objective To analyze the clinicopathologic characterizations and patients prognosis of basal-like breast cancer. Methods The clinicopathologic eharacterizations,patient 5 year disease-free survival rate and overall survival rate of 25 basal-like breast cancer patients were compared with 34 CerbB2 overexpressing subtype and 37 ER positive subtype breast cancer patients admitted in our hospital in the same period. Results Patients of basal-like breast cancer accounted for 15.7% of all patients admitted.Compared with CerbB2 over-expressing subtype(29.4%)and ER positive subtype(35.1%),basal-like breast cancer patients were eider with 56.0% being≥50 years old(P＜0.05).Basal-like subtype breast cancer was larger in tumor size than ER positive subtype(P＜0.05),56% of basal-like subtype were of poor-differentiated grade pathologically compared with 18% in CerbB2 overexpression type and 16% in ER positive subtype respectively. Meanwhile, axillary lymph node metastasis was hishbar in CerbB2 overexpressing and ER positive subtype(64.7%,64.9%)than that of basal-like subtype(40.0%).Most visceral metastases were found in basal-like and CerbB2 subtype,but there were more local lymph node and bone metastases in ER positive subtype.Five year overall survoval rate of CerbB2 overexpressing subtype (48.5%)and basal-like subtype breast cancer patients(44.1%)were poorer than that of ER positive subtype(83.8%).respectively;However,there was no difference in 5 year disease-free surviVal rate between the three subtypes(42.7%,40.4%,58.3%,respectively).Conclusions Similar to CerbB2 over-expressing subtype.tlle clinicopathologic characterization and prognosis in basal-like breast cancer are poorer than that in ER positive subtype.

objective To investigate the tissue localization of CD4+T cells producing IL-17,namely Th17 cells.in patients with systemic lupus erythematosus (SLE),as well as its relationship with the activity of lupus.Methods By using H&E staining.double-label immunofluorescence.immunohistochemistry and confocal microscopy.the localization of Th17 cells was carried out in peripheral blood mononuclear cells (PBMCs).affected tissue of skin and lung obtained from 4 patients with active SLE and 2 normal human controls.Flow cytometry.reverse transcription PCR.ELISA were used to detect the proportion of Th17 cells in PBMCs,the mRNA expression of interleukin-17(IL-17)A and IL-17 F,and serum level of interleukin 17,respectively,in 50 consecutive adult patients with SLE and 15 normal human controls.Results Th17 cells were detected in PBMCs of patients with active SLE.and the fuorescence intensity of IL-17 was significantly higher in patients with active SLE than in normal human controls(127.6±20.5 vs 40.6±11.1,P＜0.001).Infiltrates of Th17 cells were noted in both skin and lung tissues of patients with active SLE.but not in those of normal human controls.The proportion of Th17 cells in PBMCs was increased in patients with active SLE.and the proportion positively correlated with SLE disease activity index(SLEDAI) (r=0.725,P＜0.01).Further more.a significant increase was observed in the mRNA expression of IL-17 A and IL-17 F and serum level of IL-17 in patients with active SLE compared with normal human controls.The amount of Th17 cells was positively correlated with the development of vasculitis.and it experienced a decrease with the remission of SLE.Conclusions A proliferation of Th17 cells is noted in patients with active SLE.which seems to closely correlated with the activity of SLE and may take part in the development of vasculitis in SLE.

Objective To explore the intervention effect of emotional nursing of TCM on pain and anxiety in patients with gastrointestinal cancer. Methods All 80 cases of malignant tumor of digestive tract pain patients were randomly divided into two groupsstudy group and control group, 40 cases in each group, and the study group received TCM mental nursing, the control group did not receive the intervention. Compared the study group and control group at ad-mission,one week after nursing,two weeks after nursing and discharge in VAS pain score and SAS score. Results Study group and the control group at admission VAS pain score were(8.7±1.2)scores,(8.6±0.9)scores,the difference was not score statistical significant(P>0.05),study group and control group at admission VAS pain score were(5.2±0.8)scores,(7.5±1.5) scores, the differences were statistically significant(P<0.05). Research group and the control group anxiety self-assessment scale, the difference was statistically significant (P<0.05). Conclusion This study consider TCM mental nursing can significantly reduce the degree of pain in patients with malignant tumor of digestive tract.

Objective:To study the photoneutron radiation field caused by photonuclear reaction during the operation of high energy medical linac.Methods:Monte Carlo was used to simulate the photoneutron pollution of Clinic 2300CD medical electron accelerator in 15 MV X-ray mode. The photoneutron spectrum at different positions of the head and the variation in neutron ambient dose equivalent in different irradiation fields were investigated, and the dose distribution of photoneutron on the isocenter plane and the dose attenuation in the water model were analyzed.Results:When the collimator was closed, the average photoneutron energy at the lower surface of target, primary collimator, flattening filter and multi-leaf collimator was 1.08, 1.20, 0.35 and 0.30 MeV, respectively. The neutron ambient dose equivalent at the isocenter first increased and then decreased with the irradiation field expanding, reaching the maximum in about 30 cm × 30 cm irradiation field. With the increase in the depth of the measuring point in water phantom, the neutron fluent first increased and then decreased, while the neutron dose gradually decreased. In different irradiation fields, the photoneutron dose rate was almost close to the background when the depth of the water was 20 cm.Conclusions:By exploring the photoneutron spectrum and dose distribution characteristics of the high energy medical linac head, as well as the dose deposition mechanism of photoneutron in water phantom, this study provides data support for further research on the additional dose and secondary cancer effects on patients caused by photoneutron pollution from the high energy medical linac.

Objective:To identify the process nodes and types of dust existing during subway construction, evaluate the occupational health risk assessment, analyze the key control points, and provide technical basis for occupational health management.Methods:From August 2017 to December 2018, the field occupational health survey method was used to investigate the whole construction period of subway, and the occupational health risk assessment method was used to assess the degree of dust hazard, and the consistency of the assessment results of ICMM, UQ and MLSP methods were compared.Results:The dust in the operation site exists in multiple nodes of the construction cycle, and the operators were exposed to a variety of dust at the same time. Concrete workers and other jobs were key control posts. The risk level assessed by ICMM method was relatively higher than that by UQ method and MLSP method, the latter two results were relatively close.Conclusion:The three occupational health risk assessment methods are all suitable for the site risk assessment without occupational monitoring data, and UQ method has better applicability to the construction industry.

Objective:To investigate the status of exposure to xylene and Formaldehyde of medical and technical personnel in Pathology Department of a hospital, and to provide references for prevention of occupational hazards.Methods:From July to October in 2019, 52 medical workers and working places in Pathology Department of a third-class hospital in Jiangxi Province were selected as survey objects, the distribution of occupational hazards, protective measures and personal protective equipment were investigated, and the control wind speed of Formaldehyde, xylene and ventilation facilities were detected and analyzed statistically.Results:It showed that the detection rate of xylene and formaldehyde was 82.1% (23/28) , and the detection rate of xylene CSTEL in the two sampling posts was 14.3% (2/14) , the local suction device on each side and the control wind speed of the fume hood do not meet the national standards. Conclusion:It is necessary to strengthen the prevention and control of the occupational hazards in the Department of Pathology to prevent the occurrence of occupational diseases.

Objective:To identify the process nodes and types of dust existing during subway construction, evaluate the occupational health risk assessment, analyze the key control points, and provide technical basis for occupational health management.Methods:From August 2017 to December 2018, the field occupational health survey method was used to investigate the whole construction period of subway, and the occupational health risk assessment method was used to assess the degree of dust hazard, and the consistency of the assessment results of ICMM, UQ and MLSP methods were compared.Results:The dust in the operation site exists in multiple nodes of the construction cycle, and the operators were exposed to a variety of dust at the same time. Concrete workers and other jobs were key control posts. The risk level assessed by ICMM method was relatively higher than that by UQ method and MLSP method, the latter two results were relatively close.Conclusion:The three occupational health risk assessment methods are all suitable for the site risk assessment without occupational monitoring data, and UQ method has better applicability to the construction industry.

Objective:To investigate the status of exposure to xylene and Formaldehyde of medical and technical personnel in Pathology Department of a hospital, and to provide references for prevention of occupational hazards.Methods:From July to October in 2019, 52 medical workers and working places in Pathology Department of a third-class hospital in Jiangxi Province were selected as survey objects, the distribution of occupational hazards, protective measures and personal protective equipment were investigated, and the control wind speed of Formaldehyde, xylene and ventilation facilities were detected and analyzed statistically.Results:It showed that the detection rate of xylene and formaldehyde was 82.1% (23/28) , and the detection rate of xylene CSTEL in the two sampling posts was 14.3% (2/14) , the local suction device on each side and the control wind speed of the fume hood do not meet the national standards. Conclusion:It is necessary to strengthen the prevention and control of the occupational hazards in the Department of Pathology to prevent the occurrence of occupational diseases.

Sleep deprivation (SD) has a profound impact on the central nervous system, resulting in an array of mood disorders, including depression and anxiety. Despite this, the dynamic alterations in neuronal activity during sleep deprivation have not been extensively investigated. While some researchers propose that sleep deprivation diminishes neuronal activity, thereby leading to depression. Others argue that short-term sleep deprivation enhances neuronal activity and dendritic spine density, potentially yielding antidepressant effects. In this study, a two-photon microscope was utilized to examine the calcium transients of anterior cingulate cortex (ACC) neurons in awake SD mice in vivo at 24-hour intervals. It was observed that SD reduced the frequency and amplitude of Ca2+ transients while increasing the proportions of inactive neurons. Following the cessation of sleep deprivation, neuronal calcium transients demonstrated a gradual recovery. Moreover, whole-cell patch-clamp recordings revealed a significant decrease in the frequency of spontaneous excitatory post-synaptic current (sEPSC) after SD. The investigation also assessed several oxidative stress parameters, finding that sleep deprivation substantially elevated the level of malondialdehyde (MDA), while simultaneously decreasing the expression of Nuclear Factor erythroid 2-Related Factor 2 (Nrf2) and activities of Superoxide dismutase (SOD) in the ACC. Importantly, the administration of gallic acid (GA) notably mitigated the decline of calcium transients in ACC neurons. GA was also shown to alleviate oxidative stress in the brain and improve cognitive impairment caused by sleep deprivation. These findings indicate that the calcium transients of ACC neurons experience a continuous decline during sleep deprivation, a process that is reversible. GA may serve as a potential candidate agent for the prevention and treatment of cognitive impairment induced by sleep deprivation.