Objective To study the relationship between acute myocardial infarction with the distribution of ABO blood type antigen in patients with diabetes.Methods 2 052 patients with diabetes were selected.All patients had blood type records.The patients were divided into A blood type group(n=625),B blood type group(n=548),AB blood type group(n=204),O blood type group(n=675).Records were analyzed for the incidence of acute myocardial infarction.Results (1)The incidence rate of acute myocardial infarction in the A blood type group was 9.44%,which in the B blood type group was 8.03%,whith in the AB blood type group was 6.86%,which in the O blood type group was 5.19%,there was significant difference among the four groups(χ2=9.02,P<0.05).(2)For patients with diabetes,the incidence rate of acute myocardial infarction in the A blood type group was 9.44%,which was significantly higher than 6.52% in the non-A blood type group,the difference was statistically significant(χ2=5.41,P<0.05).(3)For patients with diabetes,the incidence rate of acute myocardial infarction in the non-O blood type group was 8.50%,which was significantly higher than 5.19% in the O blood type group,the difference was statistically significant(χ2=7.24,P<0.05).Conclusion There is a correlation between acute myocardial infarction with ABO blood type in patients with diabetes.For patients with diabetes,the patients with A blood type develop acute myocardial infarction more often than patients with non-A blood type,patients with blood type non-O develop acute myocardial infarction more often than patients with blood type O.

This paper describes a practical process for a SGLT2 inhibitor dapagliflozin. The target product was synthesized from 1-chloro-2-( 4-ethoxybenzyl)-4-iodobenzene and 2, 3, 4, 6-tetra-O-acetyl-alpha-D-glucopyranosyl bromide by iodine-magnesium exchange, and coupling and acetyl removing reactions with the total yield of 50%. This practical process highlights fewer reaction steps, less waste and mild reaction conditions.

bjective　To analyze the drug resistance screening status and drug resistance influencing factors of high-risk groups of drug-resistant pulmonary tuberculosis in Qingdao, and to understand the inclusion of rifampicin patients in treatment, so as to provide a reference for the prevention and treatment of drug-resistant pulmonary tuberculosis. Methods　The medical records of 726 cases of drug-resistant pulmonary tuberculosis among high-risk populations registered in Qingdao from 2018 to 2022 were obtained from the National Health Insurance Information System of the China Center for Disease Control and Prevention. The drug resistance to five anti-tuberculosis drugs, namely isoniazid (INH), rifampicin (RFP), ethambutol (EMB), levofloxacin (Lfx), and amikacin (Am), in the high-risk populations of drug-resistant pulmonary tuberculosis was analyzed. Univariate and multivariate logistic regression were used toidentify factors influencing rifampicin resistance, and the detection and inclusion of treatment for rifampicin-resistant patients were evaluated. Results　Of the 726 subjects, 278 were drug-resistant, with a total drug resistance rate of 38.29%. The drug resistance for the five anti-tuberculosis drugs in descending order was: INH 25.90%(188/726), RFP 22.87%(166/726), Lfx 14.19%(103/726), EMB 11.29%(82/726), Am 2.48%(18/726). Analysis of the drug resistance spectrum showed that among those resistant to one drug, RFP was most common, accounting for 13.67% (38/278); among those resistant to two drugs, INH+RFP was predominant, accounting for 15.83% (44/278); among those resistant to three drugs, INH+RFP+Lfx was most frequent, at 7.19% (22/278); and among those resistant to four drugs, INH+RFP+EMB+Lfx was highest, at 6.12% (17/278). Multivariate logistic regression analysis of rifampicin resistance showed that compared with patients under 25 years of age, the risk of developing rifampicin resistance was lower in the groups aged 45 to under 65 and those aged 65 and above (OR=0.356, 95%CI: 0.181-0.700; OR=0.352, 95%CI: 0.170-0.729). Compared with migrant patients in other provinces, local patients from within the same county or district had a lower risk of developing rifampicin resistance (OR=0.599, 95%CI:0.383-0.962). Compared with patients who were smear-positive at the end of the second month of initial treatment, the risk of developing rifampicin resistance was higher in patients with relapse/return, failure of retreatment/chronic, and other categories of patients (OR=9.380, 95%CI:3.717-23.671;OR=25.749, 95%CI:8.037-82.490; OR=36.651, 95%CI:8.438-159.201). Conclusions　The situation of drug-resistant pulmonary tuberculosis in Qingdao cannot be ignored. Individuals under 25 years old, migrants from other provinces, and patients with relapse/return, failure of retreatment/chronic, and other categories are significant risk factors for developing rifampicin resistance in the high-risk groups of drug-resistant pulmonary tuberculosis.

A retrospective analysis was performed on the clinical data of patients with normal lung function who underwent elective thoracoscopic lung resection for the first time in our hospital from January 2018 to December 2018.According to the minimum serum albumin level obtained within 48 h before operation, the patients were divided into hypoalbuminemia group (<35 g/L) and normal albumin level group (≥35 g/L). The perioperative baseline data and intraoperative and postoperative conditions were compared between the two groups after propensity score matching.The risk factors for postoperative pulmonary complications (PPCs) in the perioperative period were analyzed by logistic regression analysis, and the patients were divided into complication group and non-complication group according to whether PPCs occurred.Among the 1 127 patients enrolled in the study, there were 306 cases in complication group, and 821 cases in non-complication group.Logistic regression analysis showed that hypoalbuminemia was an independent risk factor for PPCs in the patients undergoing thoracoscopic lung resection ( OR=1.643, 95% confidence interval 1.201-2.249, P<0.05). After matching the propensity score, there were 498 cases in normal albumin group and 178 cases in hypoalbuminemia group.The total incidence of PPCs and incidence of pneumonia were significantly higher in hypoalbuminemia group than in normal albumin level group ( P<0.05). In summary, preoperative hypoalbuminemia is a risk factor for pulmonary complications after pneumonectomy.

Objective To establish a lncRNA prognostic risk model for gastrointestinal tumors based on the TCGA database and evaluate the prognosis of patients. Methods We collected the data of patients with esophageal cancer, gastric cancer, colon cancer and rectal cancer in the TCGA database. Univariate Cox analysis, Lasso and multivariate Cox analysis were performed to construct the prognostic risk scoring model. The model was validated and tested for independence. Time-dependent ROC curve analysis was performed to evaluate the clinical application value of the model. Results We established a prognostic risk model based on 13 lncRNAs. The three-year AUC of the training set and the validation set were 0.746 and 0.704, respectively. The pan-cancer data set was divided into high- and low-risk groups for survival analysis. The 5-year survival rate of the low-risk group was significantly higher than that of the high-risk group; among all cancer types, the five-year survival rates of the low-risk group were higher than those of the high-risk group. Multivariate Cox analysis showed that the risk score could be an independent indicator of prognosis. Conclusion The 13-gene prognostic risk score model is constructed successfully. The risk score obtained by this model can be used as an independent prognostic predictor of the patients with gastrointestinal cancer.

Objective To analyze the clinical features and prognosis of anti-leucine rich glioma inactivated protein 1 (LGI1) encephalitis.Methods Twelve encephalitis patients with anti-LGI1 antibodies were collected from the First Affiliated Hospital of Zhengzhou University from June 2015 to December 2016.The clinical manifestations,electroencephalogram,laboratory examination and imaging findings were summarized and the prognosis was observed.The modified Rankin Scale (mRS) was used for evaluation before and after treatment.Results The major clinical features included memory deficit (10/12),spatial disorientation (7/12),epilepsy with generalized tonic-clonic seizures (9/12),faciobrachial dystonic seizures (7/12),hyponatremia (5/12),mental and behavioral abnormalites (1/12),light sleep (1/12),increased sleep (3/12),aphasis (4/12),dysphagia,choking (2/12),headache (1/12),dizziness (2/12),fatigue (2/12),ataxia (2/12),bradycardia (3/12),urinary disorders (2/12),intestinal obstruction (1/12),diarrhea (1/12).Admission mRS score was found to be three in eight cases,four in four cases.The abnormal electroencephalogram was found in six cases,mainly manifested as focal or diffuse slow wave,some accompanied by epileptic wave.MRI scan of brain showed abnormal signals in four cases,mainly involved medial temporal lobe,hippocampus,basal ganglia,while one patient avoided MRI scan due to implantation of pacemaker.Two patients presented with pulmonary nodules,one case with positive thyroid antibody and increased rheumatoid factor.The follow-up after treatment showed no one died;mRS score was two in two cases,one in nine cases and zero in one case;the sequelae were memory deficit,increased sleep,faciobrachial dystonic seizures.Conclusions Anti-LGI1 encephalitis is a treatable disease,cardinal clinical features of which are seizures,cognitive disorders,hyponatremia.Immunotherapy can improve the symptoms of the disease significantly,and the prognosis is better comparatively.

Developing new therapeutic agents for cancer immunotherapy is highly demanding due to the low response ratio of PD-1/PD-L1 blockade in cancer patients. Here, we discovered that the novel immune checkpoint VISTA is highly expressed on a variety of tumor-infiltrating immune cells, especially myeloid derived suppressor cells (MDSCs) and CD8⁺ T cells. Then, peptide C1 with binding affinity to VISTA was developed by phage displayed bio-panning technique, and its mutant peptide VS3 was obtained by molecular docking based mutation. Peptide VS3 could bind VISTA with high affinity and block its interaction with ligand PSGL-1 under acidic condition, and elicit anti-tumor activity in vivo. The peptide DVS3-Pal was further designed by d-amino acid substitution and fatty acid modification, which exhibited strong proteolytic stability and significant anti-tumor activity through enhancing CD8⁺ T cell function and decreasing MDSCs infiltration. This is the first study to develop peptides to block VISTA/PSGL-1 interaction, which could act as promising candidates for cancer immunotherapy.