Objective To investigate ATM deletion [del (ATM)] in chronic lymphocytic leukemia (CLL) and study its correlation with the clinical stage. Methods Spectrum Orange~(TM) labeled sequence specific DNA probe for ATM locus on 11q22.3 and fluorescence in Situ hybridization (FISH) was used to examine del (ATM) in 28 newly diagnose patients with CLL. FISH analysis were performed on bone marrow smears. Clinical staging was done according to Binet Method.Fisher exact propability was used to study the relations between del (ATM) and clinical feature. Results 4 out of the 28 cases were found with deletion of ATM. The incidence of del (ATM) in BinetA, BinetB and BinetC was 1/9 (11.1 %), 1/8 (12.5 %), 2/11 (18.2 %), respectively. Fisher exact propability showed that deletion of ATM was not associated with its clinical feature. Conclusion Application of FISH on archival bone marrow smears is a simple, liable method, and can be readly used to retrospective study of clonal blood system diseases. Deletion of ATM was common cytogenetic changes in CLL patients.And the significance of del (ATM) in the prognosis of CLL in China needs to be further investigated.

Objective To study the over-expression and clinical implications of the oncogene MDM2 in acute leukemia (AL). Methods The expression of MDM2 gene in 100 patients with newly diagnosed and relapse or refractory AL and 20 healthy as control was measured by relative quantitative reverse transcriptase polymerase chain reaction (RT-PCR),then the results was measured by χ2-test,t-test and one-way ANOVA to compare expession positive rate and intensity of MDM2. Results Among 100 patients,fifty-eight had the high expression of MDM2 gene (58 %). The expression level of MDM2 gene in patients was higher than that of health controls(P ＜0.05). The expression positive rate of MDM2 is higher in poor outcome group (67.9 %,19/28)than that in general outcome group (33.9%,19/56) (P＜0.05). Conclusion Our results suggest that the expression of MDM2 gene plays an important role in the pathogenesis and poor outcome of AL.

Objective:Scope review of exercise-related research in patients with inflammatory bowel disease (IBD), while pointing out the limitations of existing research, and providing references for future studies in this area.Methods:We searched PubMed, EMBASE, Web of science, Cochrane databases, China Biology Medicine, Chinese National Knowledge Infrastructure, Wan Fang Data, and Chinese Science Journal Database for studies related to exercise intervention in patients with IBD from January 1974 to July 2020. We extracted data from the included studies. Then we summarized and presented the results.Results:16 articles were finally included, of which 14 were randomized controlled trials and 2 were quasi-experimental studies. Results show that exercise methods can be divided into four categories: aerobic exercise, resistance exercise, flexibility exercise and mixed exercise. The intensity of exercise was mostly low to moderate. The frequency of exercise was mostly 3 times/week, lasting for 30-60 minutes per session. The results showed that exercise had positive effects on physical fitness, bone density, anxiety and depression, quality of life among patients with IBD. However, the effect of exercise on disease activity are diverse.Conclusion:exercise is beneficial to the mental and physical health among this group, but the existing studies have small sample sizes, short exercise intervention period, neglect of individualization in exercise prescription design, low exercise compliance, non-uniformity of exercise effect evaluation indicators.

Objective: To compare the effectiveness of Internet plus mode with tradition education mode on tuberculosis prevention in schools,so as to provide the reference for reducing the risk of catching tuberculosis in schools. Methods: Two junior and two senior high schools as well as two universities were selected from Baoding. The two same level schools were randomly divided into the traditional education group and the Internet plus group. All the students received 2-month TB health education intervention. Questionnaire survey was conducted before and after intervention. A total of 2 804 and 2 821 students were investigated before and after intervention respectively. Results: The awareness rate of TB prevention and treatment core knowledge among the traditional education group and the Internet plus group before intervention was 47.5% and 47.8%, respectively (χ2=0.19, P>0.05). After intervention, the percentage of students with positive attitude and behavior regarding TB was 93.0% and 85.1% in the Internet plus group and the traditional model education group, respectively, including willingness to accept TB test (88.6% vs 81.5%), active reporting to school on TB diagnosis (96.4% vs 90.5%), no spitting in public, cover up when sneeze or cough (94.3% vs 90.6%), opening windows for ventilation (98.1% vs 95.7%), and willingness to share knowledge (98.7% vs 96.4%), active prevention of TB (86.3% vs 78.2%)(P<0.05). Conclusion Internet plus mode health education intervention shows more effectiveness on tuberculosis health education, compared with traditional health education.

Self-disclosure is a simple and effective intervention to improve the health outcomes of patients. Foreign scholars have paid attention to it and applied it in the self-management of patients with chronic diseases widely. However, there are few domestic related studies in China. This article reviewed the definition, significance, assessment tools, and summarized the influencing factors and intervention studies of self-disclosure in patients with chronic diseases. It would provide references for research of self-disclosure, further improving the self-management and mental health of patients with chronic diseases.

The eating habits of children developed during infancy and toddlerhood is the foundation of their eating behaviors in later life, and have great influence on their nutritional status and health.Caregivers′ feeding practices affect children′s eating behaviors.Feeding practices are modifiable and can be used as an intervention.In recent years, responsive feeding practices have been extensively recommended.In order to expand knowledge of responsive feeding practices, and promote optimal feeding practices and children′s healthy eating behaviors, evidence about the associations between responsive feeding and infant and toddler′s eating behaviors was summarized in this paper.

OBJECTIVETo analyze the correlation between mitral regurgitation grading and left ventricular ejection fraction in elderly patients (>60 years of age) in a 2-year follow-up.

METHODSA total of 455 patients with the diagnosis of at least mild mitral regurgitation by echocardiography were divided into ischemic mitral regurgitation (IMR) group and non-ischemic regurgitation (NIMR) group. The patients were followed up with echocardiography every 6 months and the data were analyzed at the end of 24 months.

RESULTSMitral regurgitation grade was inversely correlated with left ventricular ejection fraction (LVEF). Patients with moderate and severe IMR had a lower LVEF than those with NIMR (P<0.05). After adjustment for age, sex, body mass index, high blood pressure, diabetes, atrial fibrillation and cardiomyopathy, the mean LVEF at 2 years was lowered by 2.7% (1.4%-4.1%), 2.7% (1.3%-4.0%), and 5.2% (3.5%-6.9%) in mild, moderate and severe IMR patients, respectively (P<0.04), and by 3.2% (1.6%-4.8%), and 3.0% (1.4%-4.5%), and 1.7%(-0.5%-3.9%) in mild, moderate and severe NIMR patients (P=0.30).

CONCLUSIONThe mean LVEF in IMR patients is significantly lowered compared to that in NIMR patients. The grade of mitral regurgitation is inversely correlated with the regurgitation area in IMR patients. Stratified management might help improve LVEF in severe IMR patients.

Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Mitral Valve Insufficiency ; Stroke Volume ; Ventricular Dysfunction, Left ; physiopathology

Objective:To investigate the ego-depletion level of adolescents with type 1 diabetes mellitus (T1DM) and to explore its association with glycemic control and quality of life.Methods:This was a cross-sectional survey study. A total of 195 adolescents with T1DM were recruited from the First Affiliated Hospital of Nanjing Medical University from March to September 2022 by convenient sampling method. The Self-Regulatory Fatigue Scale (SRF-S) and Short Form of the Chinese version Diabetes Quality of Life for Youth Scale (C-DQOLY-SF) and the general information questionnaire were collected and the glycated hemoglobin (HbA 1c) value was detected. Results:The total score of self-regulatory fatigue for 195 adolescents with T1DM was (42.23 ± 9.94) points, with a scoring rate of 52.79%, which was at a medium level. Pearson correlation analysis showed that the total score of self-regulatory fatigue was positively correlated with HbA1c ( r = 0.25, P<0.01), and negatively correlated with quality of life ( r = -0.61, P<0.01). The hierarchical linear regression results showed that after controlling for demographic sociolagy and disease variables, ego-depletion had a positive predictive effect on HbA1c ( t = 3.69, P<0.01), while ego-depletion had a negative predictive effect on Quality of life ( t = -8.48, P<0.01). Conclusions:Ego-depletion of adolescents with T1DM may affect their blood glucose control and quality of life, which should be noticed by medical workers.

Objective To explore the potential categories and influencing factors of the fear of progression in patients with inflammatory bowel diseases(IBD).Methods IBD patients who received inpatient treatment in a tertiary hospital in Nanjing from July 2022 to July 2023 were selected as the study subjects by convenience sampling method.The General Demographic Information Questionnaire,the Chinese version of the Fear of Progression Questionnaire-Short Form(FoP-Q-SF),the Chinese version of Inflammatory Bowel Disease Self-efficacy Scale(IBD-SES),and Social Support Rating Scale(SSRS)were administered to the participants.We applied one-way ANOVA and Logistic regression analysis to identify the factors associated with the potential categories of the fear of progression.Results A total of 303 retumed questionnaires(out of the 310)were valid,resulting an effective response rate of 97.74％.According to the results of latent profile analysis,we classified the respondents into 3 categories by the fear of progression,namely"low risk fear of disease adaptation group"(n=127,41.91％),"medium risk fear of illness distress group"(n=139,45.88％),"high risk fear of dysfunction group"(n=37,12.21％).3 groups showed statistically significant differences in permanent address,self-rated financial pressure,current disease status and self-efficacy(P＜0.05).Conclusion Patients with IBD had obvious differences in characteristics on the fear of progression.Nursing personnel should formulate personalized intervention strategies based on the classification characteristics of the fear of progression of IBD patients.Moreover,nurses should focus on improving patients'self-efficacy and promoting patients to treat medical care,stress and emotion management correctly.

Objective:This study aimed to investigate the effect of lipohypertrophy induced by insulin injection on blood glucose fluctuation in patients with type 1 diabetes mellitus.Methods:A total of 80 patients with type 1 diabetes mellitus were recruited between June 2021 and December 2021 from the First Affiliated Hospital of Nanjing Medical University. And these patients all received insulin injection more than six months. Lipohypertrophy was assessed by ultrasound scanning, and blood glucose fluctuation was evaluated using the flash glucose monitoring system(FGM). Univariate analysis and multivariate linear regression were used to analyze the relationship of lipohypertrophy and and core indicators of blood glucose fluctuation.Results:Compared with patients without lipohypertrophy, patients with lipohypertrophy had higher mean amplitude of glycemic excursions(MAGE), coefficient of variation(CV), mean of daily differences(MODD), standard deviation(SD) of blood glucose, time above range(TAR), and high blood glucose index(HBGI; all P<0.05), while time in range(TIR) of glucose markedly become lower( P<0.01). Moreover, multivariate linear regression analysis showed that lipohypertrophy detected by ultrasound was an independent influencing factor of TIR( β=-9.423, P=0.032), MAGE( β=1.114, P=0.039), CV( β=4.304, P=0.041), MODD( β=0.717, P=0.046) after adjusting for age at diagnosis, duration of insulin injection, fasting C-peptide, and daily dose of insulin per unit weight. Conclusion:Lipohypertrophy increases glycemic variability and imposes negative impact on glycemic control rate in patients type 1 diabetes mellitus.