Objective:To investigate the correlation between the secreted frizzled related protein 5 (SFRP5), 25-hydroxy vitamin D [25(OH)D], retinol binding protein 4 (RBP4) and the degree of illness in elderly patients with type 2 diabetes mellitus (T2DM) and the evaluation value of curative effect.Methods:One hundred and thirteen elderly patients with T2DM who treatment in Taihu Hospital of Wuxi City from January 2018 to October 2019 were selected as the study group, and 113 healthy patients during the same period were selected as the control group. The serum levels of RBP4, SFRP5, and 25(OH)D were compared between the two groups, patients with different disease levels, and patients with or without vascular complications. Spearman was used to analyze the correlation between each index and the degree of illness, and Pearson was used to analyze the correlation between each index and the insulin resistance index (HOMA-IR). The receiver operating characteristic (ROC) curve and area under ROC (AUC) were used to analyze the value of SFRP5, 25(OH)D, RBP4 and the combination of the three to predict vascular disease in T2DM patients.Results:The levels of RBP4 , HOMA-IR in study group were higher than those in control group: (22.96 ± 2.26) μg/L vs.(11.28 ± 1.69) μg/L, 3.83 ± 0.70 vs.1.65 ± 0.59, the levels of SFRP5, 25(OH)D in study group were lower than those in control group: (9.28 ± 3.14) μg/L vs. (14.65 ± 3.38) μg/L, (32.65 ± 5.12) nmol/L vs. (51.29 ± 6.33) nmol/L, and the differences were statistically significant ( P<0.05). The level of RBP4 in severe group was higher than that in mild group:(26.91 ± 2.51) μg/L vs. (19.35 ± 2.23) μg/L, the levels of SFRP5, 25(OH)D in severe group were lower than those in mild group: (7.13 ± 2.98) μg/L vs. (11.25 ± 3.30) μg/L, (27.97 ± 4.56) nmol/L vs. (36.93 ± 5.50) nmol/L, and the differences were statistically significant ( P<0.05). The levels of SFRP5, 25(OH)D in patients with macrovascular disease were the lowest, followed by those with microvascular and those without vascular disease; the level of RBP4 in patients with macrovascular disease was the lowest, followed by those with microvascular and those without vascular disease, and the differences were statistically significant ( P<0.05). There was a positive correlation between RBP4 and the degree of illness and HOMA-IR ( P<0.05), and there was a negative correlation between 25(OH)D and SFRP5 and the degree of illness and HOMA-IR ( P<0.05). The AUC of SFRP5 for predicting vascular disease was 0.721, and the cut-off value was ≤11.14 μg/L , with a sensitivity of 78.21%, and a specificity of 60.00%.The AUC of 25(OH)D for predicting vascular disease was 0.786, and the cut-off value was ≤ 36.56 nmol/L, with a sensitivity of 87.18%, and a specificity of 65.71%. The AUC of RBP4 for predicting vascular disease was 0.816, and the cut-off value was greater than 21.45 μg/L , with a sensitivity of 57.69% and a specificity of 94.29%. The AUC of SFRP5 + 25(OH)D + RBP4 for predicting vascular disease was 0.847, with a sensitivity of 70.51% and a specificity of 85.71% ( P<0.05). Conclusions:In severe T2DM elderly patients with vascular complications, the levels of blood SFRP5, 25(OH)D and RBP4 are increased and significantly related to the patient′s condition and insulin resistance, and they can predict the occurrence of vascular disease.

OBJECTIVETo study the chemical constituents of Periploca calophylla.

METHODVarious chromatographic techniques were used to isolate the constituents, and their structures were identified by spectral and chemical methods.

RESULTTwo oligosaccharides were isolated from the chloroform part of P. calophylla and their structures were identified as 4-O-acetyl-beta-cymaropyranosyl (1-->4)-O-beta-D-cymaropyranosyl(1-->4)-O-beta-D-canaropyranosyl (1-->4)-O-beta-D-cymaropyranosy(1-->4)-O-oleandronic acid-delta-lactone(1), and perisaccharide B (2).

CONCLUSIONCompound 1 is a new compound. Compound 2 is reported for the first time from this plant.

Carbohydrate Sequence ; Magnetic Resonance Spectroscopy ; methods ; Molecular Sequence Data ; Molecular Structure ; Oligosaccharides ; analysis ; isolation & purification ; Periploca ; chemistry ; Spectrometry, Mass, Electrospray Ionization ; methods ; Spectroscopy, Fourier Transform Infrared ; methods

Objective:To investigate the effect of occupational stress on mental health of anesthesia nurses in Shanghai tertiary and first-class hospitals. These results provide theoretical basis for managers to adjust the allocation of human resources, reduce the professional pressure of anesthesia nurses and promote the development of anesthesia nursing.Methods:A questionnaire survey was conducted among 229 anesthetic nurses in 11 tertiary and first-class hospitals in Shanghai using Chinese Nurses Work Stressors Scale and Symptom Checklist 90 (SCL-90). Each dimension and item of the stress source scale and symptom Checklist-90 for anesthesia nurses were scored, and the effects of occupational stress on mental health were analyzed.Results:The mental health status of anesthesia nurses was positively correlated with occupational stress. The occupational stressors with the highest correlation coefficient with mental health factors was"management and interpersonal relationship"dimension( P<0.01). The five dimensions of occupational stress were the highest correlation coefficient of "obsessive compulsive symptoms" in mental health factors( P<0.01).In terms of nursing specialty and work: correlation coefficient r = 0.566; workload and time distribution: correlation coefficient was 0.477; work environment and resources: correlation coefficient was 0.477; patient care: correlation coefficient was 0.588; management and interpersonal relationship: correlation coefficient was 0.604.The results of multiple regression analysis showed that the independent variable"the management and interpersonal relationship" dimension of occupational stressors had influence on the dependent variable ten factors of mental health( P<0.01). And "independent variable nursing profession and work" had an impact on dependent variable "obsessive-compulsive symptoms" and "sleep-eating" factors( P<0.05); independent "variable workload and time allocation" had an impact on dependent variable "phobic" factors( P<0.05). Conclusions:The occupational stress of anesthetic nurses in Shanghai has an impact on mental health. "Management and interpersonal relationship" has the greatest impact on mental health in occupational stressors.

Background:This study aimed to investigate the changes in the clinical indicators and influencing factors of treatment duration among human immunodeficiency virus (HIV) patients in whom antiretroviral therapy (ART) was unsuccessful.Methods:In this retrospective study,a total of 9,418 HIV patients who failed in ART during 2004-2016 were included and divided into two treatment groups-Group 1 (treatment time ≤ 3 years,n1 =5,218) and Group 2 (treatment time ＞ 3 years,n2 =4,200).Patient follow-up data,including age,cluster of differentiation 4 (CD4) count,and viral load,glucose,creatinine,and triglyceride levels,were extracted from electronic health record databases.Covariance analysis for repeated measures was used to analyze the biochemical indicators,and multiple logistic regression modeling was used to compare relevant data extracted from the Group 1 and Group 2 HIV patient cohorts with different treatment time.Results:The median initial CD4 count was 175.0 cells/μl (interquartile range,77.0-282.0),while the initial CD4 counts for Group 1 were lower than those for Group 2 (P ＜ 0.05).A significant interaction between group and time effects was observed (P ＜ 0.05) in total cholesterol (TC).Changes in hemoglobin level among HIV patients were also significantly associated with treatment time (P =0.001).The initial CD4 count (odds ratio [OR] =0.756),female sex (OR =0.713),Zerit (d4T) (OR =1.443),TC (OR =1.285),and aspartate aminotransferase level (OR =1.002) were significantly associated with the survival time of dead patients with HIV (P ＜ 0.05).Additionally,the initial CD4 count (OR =1.456),age (OR =1.022),time interval (OR =0.903),patient's living status (OR =0.597),d4T (OR =2.256),and triglyceride (OR =0.930) and hemoglobin levels (OR =0.997) were significantly associated with the treatment time of HIV patients with drug withdrawal (P ＜ 0.05).Conclusion:The initial biochemical parameters can affect the survival and treatment time of HIV patients.With a comprehensive understanding of the physiological and biochemical indicators of patients,we can reduce the probability of drug withdrawal and prolong the survival time of HIV patients.

Objective To investigate the efficacy of lateral decubitus intramedullary nailing for treatment of subtrochanteric fractures of the femur.Methods From January 2012 to December 2015,23 patients with simple femoral subtrochanteric fracture were treated at Department of Orthopedic Trauma,Changhai Hospital.They were 15 males and 8 females,aged from 19 to 77 years (average,48.3 years).According to the Seinsheimer classification,there were 6 cases of type ⅡB,8 cases of type ⅡC,6 cases of type Ⅲ A,and 3 cases of type ⅢB.Their injuries were caused by traffic accident in 10 cases,falling from a height in 5 cases,and sprain in 8 cases.All patients were treated by closed reduction and anterograde intrarnedullary nailing at lateral decubitus.Their operative time,bleeding volume,fluoroscopic frequency,fracture healing time,functional recovery and complications were recorded and analyzed.Results Their operative time ranged from 55 to 80 min,averaging 65.7 min;their bleeding volumes ranged from 240 to 420 mL,averaging 304.3 mL;their fluoroscopic frequency ranged from 30 to 60 times,averaging 42.7 times.This cohort was followed up for 12 to 28 months (average,17.9 months).Their fracture healing time ranged from 4 to 10 months,averaging 5.5 months.Nonunion occurred in one patient but was cured by secondary operation.The HSS evaluation at the final follow-ups showed 17 excellent cases and 6 good ones,yielding an excellent to good rate of 100％.All the wounds healed by the first intention.No infection,deep vein thrombosis or implant failure was observed.Conclusion As lateral decubitus intramedullary nailing can achieve satisfactory clinical efficacy for subtrochanteric fractures of the femur,the body position of lateral decubitus may be a good alternative.

Objective To investigate the prevalence of sleep disorders and the relevant determinants in a cohort of systemic lupus erythematosus (SLE) patients.Methods One hundred patients with SLE were included in the study.Sleep quality was assessed using the Pittsburgh sleep quality index (PSQI).Depression,anxiety,quality of life,and fatigue were evaluated by patient health questionnaire (PHQ)-9,generalized anxiety disorder (GAD)-7,short form 36 health survey (SF-36),and visual analogue scale (VAS) respectively.The demographic and clinical data were also recorded.SLE disease activity and damage severity were assessed by systemic lupus erythematosus disease activity index (SLEDAI) and systemic lupus erythematosus damage index (SDI) respectively.Mann-Whitnry U test,t test,Logistic regression were used for statistically analysis.Results The prevalence of sleep disorders in SLE patients was 42％.Compared with patients without sleep disorders,the ratio of males and married patients,age,the score of SDI,PHQ-9,GAD-7,and fatigue were higher in SLE patients with sleep disorders,while the score of SF-36 was lower (r＜0.05).Age,SLEDAI,SDI,PHQ-9,GAD-7,and fatigue correlated positively with sleep disorders (The values of r were 0.215,0.230,0.311,0.529,0.455,0.541,P＜0.05).C3 and the score of SF-36 correlated negatively with sleep disorders (The values of r were-0.204,-0.342,-0.490,-0.464,-0.497,-0.590,-0.428,-0.478,-0.398,-0.412,-0.659respectively,P＜0.05).In multi-ple logistic regression analyses,gender (OR=22.22),anxiety (OR =2.895),body pain (OR =0.964),and energy (OR =0.947) were the independent determinants of sleep disorders (R2=0.494,P＜0.01).Conclusion Poor sleep quality is common in SLE patients.Gender,age,disease activity and severity,anxiety,depressed mood,and quality of life contribute significantly to sleep disorders in SLE.

Objective:To analyze the value of 68Ga-fibroblast activation protein inhibitor (FAPI)-04 PET/CT in the detection of myocardial injury in patients treated with anti-tumor therapy. Methods:A retrospective study was conducted on 164 patients who underwent 68Ga-FAPI-04 PET/CT to evaluate the efficacy of anti-tumor therapy in Renji Hospital, School of Medicine, Shanghai Jiao Tong University between August 2021 and March 2024. The patients were divided into 68Ga-FAPI-04-positive group ( n=63, 36 males, 27 females, age (66.7±9.6) years) and 68Ga-FAPI-04-negative group ( n=101, 42 males, 59 females, age (55.2±14.1) years) based on the uptake of left ventricular myocardium (LVM). Moreover, FAPI-04 uptake was analyzed based on different types and locations, and the corresponding SUV max differences were analyzed by Kruskal-Wallis rank sum test. The differences of SUV max between 68Ga-FAPI-04-positive group and 68Ga-FAPI-04-negative group were analyzed by Mann-Whitney U test. The clinical factors such as gender, age, body mass index (BMI), previous history of coronary heart disease, left ventricular ejection fraction (LVEF), smoking history, hypertension, diabetes, cancer types and immune checkpoint inhibitors (ICIs) treatment were collected, and their predictive values for LVM 68Ga-FAPI-04 uptake were investigated by the binary logistic regression analysis. Results:Fifty patients of the 68Ga-FAPI-04-positive group (79.4%, 50/63) showed focal uptake of LVM, 7 patients (11.1%, 7/63) showed multifocal myocardial uptake, and 6 patients (9.5%, 6/63) showed diffuse myocardial uptake. A total of 127 uptake lesions were found, and most of them were located in the septum (37.8%, 48/127). The SUV max of LVM in 68Ga-FAPI-04-positive group and 68Ga-FAPI-04-negative group were 4.00(3.10, 5.40) and 1.31(1.20, 1.40) respectively ( z=-10.82, P<0.001). Differences of the SUV max among focal uptake group, multifocal myocardial uptake group, and diffuse myocardial uptake group were not significantly different (4.00(3.00, 5.10) vs 7.60(3.60, 9.30) vs 3.95(3.05, 5.05); H=3.81, P=0.149). There is no statistically significant difference either in FAPI uptake among different sites of LVM ( H=1.51, P=0.825). Age, previous history of coronary heart disease, BMI, LVEF and ICIs treatment were independent predictive factors for positive 68Ga-FAPI-04 uptake in the LVM (odds ratio ( OR) values: 0.87-10.43, all P<0.05). Conclusion:68Ga-FAPI-04 PET/CT is a potential new imaging method for the visualization of myocardial injury in patients with anti-tumor therapy.

Objective To establish a scientific training program that takes into account both anaerobic and aerobic training for pilots,and to explore the appropriate ratio of aerobic and anaerobic training.Methods According to the physical examination standards for pilots,a total of 16 healthy subjects aged 18-24 were selected from two batches.The two batches of subjects were trained with different aerobic and anaerobic ratios.Training period was 3 months.The changes in cardiopulmonary function of the subjects before and after training were evaluated using the cardiopulmonary function exercise testing system(CPET),and the changes in anaerobic capacity were evaluated using changes in strength as an indicator.Results After training,the weight load of the subjects in the two training programs,including barbell squats,leg flexion and hard pull,and barbell under 10RM and 3RM,was significantly increased(P<0.001),and there was no statistically significant difference in anaerobic strength growth between the two groups.The results of CPET showed that the maximum load,maximum heart rate,and respiratory quotient in the two groups were significantly increased after than before the training(P<0.01).The maximum load(Experiment group 1:29.12±19.69,Experiment group 2:72.00±46.24)and respiratory quotient(Experiment grouop 1:0.11±0.09,Experiment group 2:0.28±0.16)of the subjects in experiment group 2 before and after training were greater than those in experiment group 1.The difference was statistically significant(P<0.05).Conclusion The anaerobic and aerobic capacities of the subjects in the experiment group 2 are effectively improved,indicating that ratio of aerobic and anaerobic of the training scheme is better.

As a ligand-dependent transcription factor,retinoid-associated orphan receptor γt(RORyt)that controls T helper(Th)17 cell differentiation and interleukin(IL)-17 expression plays a critical role in the pro-gression of several inflammatory and autoimmune conditions.An emerging novel approach to the therapy of these diseases thus involves controlling the transcriptional capacity of RORyt to decrease Th17 cell development and IL-17 production.Several RORyt inhibitors including both antagonists and inverse agonists have been discovered to regulate the transcriptional activity of RORyt by binding to orthosteric-or allosteric-binding sites in the ligand-binding domain.Some of small-molecule inhibitors have entered clinical evaluations.Therefore,in current review,the role of RORyt in Th17 regulation and Th17-related inflammatory and autoimmune diseases was highlighted.Notably,the recently developed RORyt inhibitors were summarized,with an emphasis on their optimization from lead compounds,ef-ficacy,toxicity,mechanisms of action,and clinical trials.The limitations of current development in this area were also discussed to facilitate future research.

To investigate the social support level and its influencial factors in patients with systemic lupus erythematosus (SLE), and to develop the management strategies for chronic disease.
 Methods: Patients with SLE were investigated by Social Support Rating Scale (SSRS), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7), 36-Item Short-Form Health Survey (SF-36) and Visual Analogue Scale (VAS) of fatigue. The demographic and clinical data of SLE patients were recorded. SLE disease activity and damage severity were assessed by SLE Disease Activity Index (SLEDAI) and SLE Damage Index (SDI), respectively. Influencial factors for social support were analyzed.
 Results: A total of 246 patients were included. Social support scores for these patients were 40.76±7.93 and the scores showed no significant difference with the national norm (P>0.05). Patients who were younger than 18, single, unemployed or damaged by disease showed lower level of social support (P<0.05). Compared with the high social support group, patients in the low social support group experienced more severe depression or anxiety, and scored lower on mental component summary scale (vitality, social functioning, emotional role and mental health perception) and physical role of SF-36 (P<0.05).
 Conclusion: Social support levels for patients with SLE are closely related to the quality of life, and influenced by age, marital status, professional condition, and disease damage. Health education for patients and their families should be strengthened in chronic disease management to enhance social support and finally, improve their quality of life.
Chronic Disease ; Health Status ; Humans ; Lupus Erythematosus, Systemic ; Quality of Life ; Severity of Illness Index ; Social Support ; Surveys and Questionnaires