A total of 1 007 inpatients with type 2 diabetes mellitus (T2DM) were divided into 2 groups,according to whether there was accompanied with nonalcoholic fatty liver(NAFLD) ; and the data of the two groups were analysed.Serum uric acid levels were positively correlated with body mass index and blood urea nitrogen and creatinine,while negatively correlated with HbA1c.T2DM patients complicated with NAFLD were younger,had shorter duration of T2DM,and showed impaired uric acid clearance with raised serum uric acid.The prevalence of NAFLD was higher with increasing serum uric acid levels.

Objective To investigate the changes and clinical significance of serum total and high molecular weight adiponectin (HMW APN) levels in type 2 diabetic patients with non-alcoholic fatty liver disease (NAFLD).Methods Serum levels of total adiponectin and HMW APN were measured by ELISA,in 58 type 2 diabetic patients with nonalcoholic fatty liver disease (T2DM with NAFLD group),59 type 2 diabetic patients without nonalcoholic fatty liver disease (T2DM group),and 55 control subjects with normal glucose tolerance and without nonalcoholic fatty liver disease (NC group).Results (1) Alanine transaminase and total cholesterol levels were significantly higher in T2DM with NAFLD group than those in NC group(P＜0.01),while body mass index (BMI),aspartate aminotransferase,triglyceride (TG),and fasting insulin were also significantly increased (P＜0.05 or P＜ 0.01),and high density lipoprotein-cholesterol (HDL-C) were significantly decreased compared with those in NC and T2DM groups (P＜0.01).(2) Total adiponectin,HMW APN,and the ratio of HMW APN to total adiponectin in T2DM group were lower than those in NC group.Total adiponectin and HMW APN levels in T2DM with NAFLD group were significantly lower than those in T2DM group(P＜0.01).(3) Regression analysis showed that homeostasis model assessment insulin resistance index (HOMA-IR),TG,and HDL-C levels were independent predicting factors for total adiponectin and HMW APN levels.TG and BMI were independent risk factors for T2DM complicated with NAFLD,while total adiponectin and HMW APN levels were the protective ones (OR =0.701,0.489,respectively).Conclusions Hypoadiponectinemia may partially play an important role in the development and progression of NAFLD in T2DM.

[ ABSTRACT] AIM:To investigate the mechanism underlying breast cancer metastasis and to provide theoretical da-ta for studying the pathogenesis of breast cancer onset and development.METHODS: Human breast cancer MCF-7 cells were treated with different concentrations of furin inhibitorα1-PDX for 48 h.Wound healing assay and Transwell assay were applied to detect the migration and invasion abilities of the MCF-7 cells.The expression of cell migration-associated proteins, including membrane-type 1 matrix metalloproteinase ( MT1-MMP) , vascular endothelial growth factor ( VEGF)-C and VEGF-D, was determined by Western blotting.The protein levels of MMP2 and MMP9 in the supernatant were measured by ELISA. RESULTS:Compared with control group, 200 nmol/L of furin inhibitor exerted significant inhibitory effects on the cell mi-gration (P<0.05).The expression of cell migration-associated proteins MT1-MMP, VEGF-C and VEGF-D was significantly inhibited after treated withα1-PDX ( P<0.05 ) .Significant inhibitory effects of α1-PDX on the expression of MMP9 and MMP2 (P<0.05) in the supernatant were observed.CONCLUSION:Furin inhibitor suppresses the metastasis of MCF-7 cells via down-regulating the expression of MMPs and VEGFs.

AIM: The contents of pachymic acid in Poria in different parts and in different localities were measured and compared. METHODS: 9 samples were measured with HPLC. RESULTS: The content of pachymic acid in Fushen is the highest in different parts and the content of pachymic acid in Guangxi province is the highest in five localities. CONCLUSION: The content of pachymic acid was obviously variable in different parts and this result made the basis of the application of with the different parts of Poria. The content of pachymic acid wasn't obviously variable in different localities.

Objectives:To analyze the prevalence and risk factors of chronic nephropathy among hospitalized gout patients.Methods:537 hospitalized gout patients in Tianjin Medical University Chu Hsien-I Memorial Hospital were enrolled. According to the levels of glomerular filtration rate (eGFR>90 ml/min, 60-90 ml/min and <60 ml/min), patients were divided into normal group, mild chronic nephropathy group and moderate-severe chronic nephropathy group. The height, weight, waist, hip and blood pressure of the patients were measured. Blood samples from elbow vein were collected to measure biochemical indexes. The 24-hour urine was collected to measure creatinine and uric acid. Multivariate regression analysis was used to analyze the related factors that may affect eGFR.Results:The prevalence of chronic nephropathy among gout patients was 46.76%(251/537), which the prevalence of mild chronic nephropathy was 34.82%(187/537), and moderate severe chronic nephropathy was 11.92%(64/537). With the decline of eGFR, the older the patients, the longer the course of gout and hypertension, the more the number of joints involved, the higher the blood uric acid, urinary microalbumin, urinary protein, white blood cell count, uric acid excretion fraction (FeUA), and the lower the red blood cell count, hemoglobin and serum albumin. Pearson correlation analysis of eGFR showed that age, duration of gout and hypertension, number of involved joints, hemoglobin, serum albumin, serum uric acid, urinary microalbumin, and FeUA were correlated with eGFR ( r=-0.43, -0.238, -0.25, -0.128, 0.155, 0.138, -0.169, -0.29, -0.372, respectively, P<0.01). Multivariate regression analysis showed that age, the course of gout, serum uric acid, microalbuminuria and FeUA were independent risk factors for eGFR decline ( P<0.01). Conclusions:Eldly, long course of gout, poor control of serum uric acid and increased excretion of uric acid and microalbumin are risk factors of gout.

OBJECTIVETo delineate the phenotypic characteristics of 22q11.2 deletion syndrome and the role of CRKL gene in the pathogenesis of cardiac abnormalities.

METHODSG-banded karyotyping, single nucleotide polymorphism (SNP) array and fluorescence in situ hybridization (FISH) were performed on a fetus with tetralogy of Fallot detected by ultrasound. Correlation between the genotype and phenotype was explored after precise mapping of the breakpoints on chromosome 22q11.2. SNP array was also performed on peripheral blood samples from both parents to clarify its origin.

RESULTSThe fetus showed a normal karyotype of 46,XY. SNP array performed on fetal blood sample revealed a 749 kb deletion (chr22: 20 716 876-21 465 659) at 22q11.21, which encompassed the CRKL gene but not TBX1, HIRA, COMT and MAPK1. Precise mapping of the breakpoints suggested that the deleted region has overlapped with that of central 22q11.2 deletion syndrome. SNP array analysis of the parental blood samples suggested that the 22q11.21 deletion has a de novo origin. The presence of 22q11.21 deletion in the fetus was also confirmed by FISH analysis.

CONCLUSIONCentral 22q11.21 deletion probably accounts for the cardiac abnormalities in the fetus, for which the CRKL gene should be considered as an important candidate.

Adaptor Proteins, Signal Transducing ; genetics ; Adult ; Chromosome Deletion ; Chromosomes, Human, Pair 22 ; genetics ; DiGeorge Syndrome ; diagnosis ; embryology ; genetics ; Female ; Fetal Diseases ; diagnosis ; genetics ; Genotype ; Humans ; In Situ Hybridization, Fluorescence ; Male ; Nuclear Proteins ; genetics ; Phenotype ; Pregnancy ; Prenatal Diagnosis

OBJECTIVE:To observe the expression of IGF-1R and VEGFR2 in colorectal cancer tissue,and to explore its clinical significance. METHODS:Totally 98 colorectal cancer patients underwent surgery were selected from our hospital during Jan. 2011-Dec. 2012. The tumor tissue and paracancerous tissue were collected. The expression of IGF-1R and VEGFR2 protein were detect-ed by immunohistochemical SP method. The mRNA expression of both were detected by RT-PCR. The correlation of the expression of IGF-1R and VEGFR2 protein with clinical pathological characteristics of colorectal cancer patients were investigated,and its effects on 4-year disease-free survival rate of postoperative assisted chemotherapy patients were also investigated. RESULTS:The positive rates of IGF-1R and VEGFR2 protein expression in colorectal cancer tissue were 66.3％and 60.2％respectively,but their expression was not found in paracancerous tissue,with statistical significance(P<0.05). Relative expression of IGF-1R mRNA and VEGFR2 mRNA in tumor tissue were significantly higher than paracancerous tissue,with statistical significance(P<0.05). There was positive correla-tion between their mRNA expression in tumor tissue(r=0.729,P<0.05). The expression of IGR-1R protein was independent from pa-tient's gender and age,tumor location and formation of vascular tumor thrombus(P>0.05);but it was associated with the histological grading,depth of invasion and lymph node metastasis(P<0.05). The expression of VEGFR2 protein had nothing to do with patient's gender and age(P>0.05),but it was associated with tumor location,histological grading,depth of invasion,lymph node metastasis, and formation of vascular tumor thrombus(P<0.05). Among 98 colorectal cancer patients,14 patients didn't underwent chemothera-py after surgery;and 4-year disease-free survival rate of other 84 patients was 76.2％(64/84). Four-year disease-free survival rates of TGF-1R protein negative expression and VEGFR2 protein negative expression patients(82.8％,78.8％)were significantly higher than those of positive expression patients(72.7％,74.5％),with statistical significance(P<0.05). The multiple factor Logistic regression analysis was used to correct gender,age,histological grading,tumor location,depth of invasion,lymph node metastasis,and forma-tion of vascular tumor thrombus;the expression of IGR-1R and VEGFR2 protein were still associated with 4-year disease-free survival rate [adjusted OR were 2.31,2.15;95％CI were(0.57,4.15),(0.45,4.03);P<0.05]. CONCLUSIONS:The expression of IGF-1R, VEGFR2 protein and mRNAs increase significantly in colorectal cancer tissue;the protein expression is associated with histological grading,depth of invasion,lymph node metastasis and the prognosis of postoperative assisted chemotherapy patients. Their examina-tion can provide reference for target therapy for colorectal cancer patients.

Objective:To explore the status quo of nurses' nursing informatics competency and its relationship with perceived professional benefits and intention to stay, so as to provide a basis for improving nurses' nursing informatics competency and reducing nurses' turnover.Methods:Using the convenient sampling method, nurses from 7 hospitals in Shandong Province were selected as the research objects from June 2020 to June 2021. The survey was conducted using General Information Questionnaire, Self-assessment of Nursing Informatics Competencies Scale (SANICS) , Questionnaire of Nurses' Perceived Professional Benefits and Questionnaire of Nurses' Intention to Renain. A total of 900 questionnaires were distributed in this study and 880 valid questionnaires were recovered, with an effective rate of 97.8%.Results:For 880 nurses, the scores of SANICS, Questionnaire of Nurses' Perceived Professional Benefits Scale and Questionnaire of Nurses' Intention to Renain were respectively (85.54±12.43) , (132.21±19.56) and (22.68±3.84) . The structural variance model showed that the nursing informatics competency of nurses could directly affect the intention to stay (effect value 0.456) , and the nursing informatics competency could also have an indirect effect on the intention to stay through perceived professional benefits of nurses (effect value 0.067) , with a total effect value 0.523.Conclusions:The nursing informatics competency of nurses is at the medium level. By improving the nursing informatics competency, the self-development of nurses can be promoted and their perceived professional benefits can be improved, so as to increase the intention to stay and reduce the turnover of nurses.

Objective To study the effects of quality control circles ( QCC ) on the incidence of aspiration after stroke. Methods Control group included the patients in Yantaishan hospital from April 2012 to September 2012. QCC group included the patients in Yantaishan hospital from April 2013 to September 2013. The incidences of aspiration after stroke then were evaluated. Results The incidence of aspiration after stroke in control group was 41. 3%. Whereas the incidence of aspiration after stroke in QCC group was 21. 5%. The findings showed that incidence of aspiration after stroke in QCC group was lower than that in control group (χ2 =21. 96,P<0. 01). Conclusions QCC could significantly reduce the incidence of aspiration after stroke. Therefore, QCC can be used as an effective tool to improve medical quality in the patients of stroke.

Objective:To explore the effectiveness of clinical pathway (CP) and team-based learning (TBL) teaching method in standardized residency training of gynecology.Methods:The research included 40 residents as objects who took standardized training in gynecological rotation in Luohe Central Hospital from July 2017 to July 2019, and they were randomized into experimental group and control group. The combination of CP and TBL teaching method was used in the experimental group ( n=20), while the traditional teaching method was applied in the control group ( n=20). All residents were tested for the professional theory and clinical skill after training. After the training, a survey about the teaching satisfaction and the effectiveness of teaching methods was conducted for both groups. Statistical analysis was performed by SPSS 23.0 software. Results:The average scores of professional theory and clinical practice skills in the experimental group were (85.55±5.96) points and (89.90±6.40) points respectively, which were better than the average scores of the control group [(76.36±6.68) points and (75.50±4.81) points, respectively], and there were significant differences between two groups ( P<0.05). The results of the questionnaire survey showed that the experimental group residents had a higher degree of satisfaction and a higher evaluation of the teaching method than the control group. Conclusion:CP and TBL teaching is beneficial to improve the quality of standardized residency training of gynecology, and it is suggested to make wide popularization and application in the training.