Objective To investigate the effect of plasma homocysteine (Hcy) levels and cognitive dysfunction on patients with type 2 diabetes and explore the other factors that affect cognitive function.Methods 80 patients with type 2 diabetes were selected as our subjects and they were divided into cognitive impairment group (38 cases),cognitive normal group (42 cases) according to a simple mental state scale(MMSE) score.The plasma Hcy,glycosylated hemoglobin,blood lipid,uric acid,24 h urine trace albumin were measured.Results Plasma Hcy concentration in diabetic cognitive dysfunction,non cognitive impairment group and normal control group respectively were(19.56 ± 5.23),(16.21 ± 3.27),(14.67 ± 4.27) tmol/L,and there was statistically significant difference(F =3.76,P ＜0.05).The plasma Hcy levels in diabetic cognitive impairment group was higher than that non-cognitive impairment group(P ＜ 0.05) and normal control group (P ＜ 0.01),The factors impaired cognitive function in patients with other factors included age,glycosylated hemoglobin,body mass index,diabetes duration and plasma Hcy levels,and there were negative correlation with MMSE score (r =-0.336,-0.285,-0.226,-0.392,-0.312 ; all P values were less than 0.05).Conclusion Patient's age,duration of diabetes,glycosylated hemoglobin and BMI can affect cognitive function in patients.Higher Hcy levels in patients with type 2 diabetes is a risk factor for cognitive impairment.

BACKGROUND:Previous studies have shown that different doses of ionizing radiation may have some impact on maturation and immune function of dendritic cells. OBJECTIVE:To evaluate the effect of 18 F-FDG with different concentrations on maturation and immune function of dendritic cells from human peripheral blood mononuclear cells in vitro. METHODS:Human peripheral blood mononuclear cells-derived mature dendritic cells were divided into five groups:PBS, 92.5×10 4, 185×104, 370×104, 740×104 Bq/mL 18 F-FDG were separately added into each group. Dendritic cells were col ected 24 hours later. Apoptosis rate, phenotypic expression (CD1α, CD80, CD83, CD86, HLA-DR), ability of mixed lymphocyte reaction and expression of macrophage inflammatory protein 1αand monocyte chemotactic factor-1 in cellculture supernatant were detected. RESULTS AND CONCLUSION:Apoptosis rate, phenotypic expression of CD86, ability of mixed lymphocyte reaction and expression of monocyte chemotactic factor-1 were down-regulated after culture in 740×10 4 Bq/mL 18F-FDG. However, 18F-FDG at other concentrations had no influence on maturation and immune function of dendritic cells. This study demonstrates that low-concentration 18F-FDG has little influence on apoptosis, maturation, antigen presentation, and migratory capacity of dendritic cells, and it may be selected at an appropriate concentration as a label for dendritic cells in vitro.

Breast cancer is one of the most common malignant tumors in women, and its morbidity is increasing gradually in recent years. Precision treatment has been developed with individualized and standardized protocols according to the molecular classification of breast cancer. Targeted therapy is one of the most important methods. How to evaluate targeted therapy is the focus of attention. PET/CT plays an im-portant role in the diagnosis, staging, treatment plan and evaluation of therapeutic effect and prognosis, es-pecially in targeted therapy of breast cancer. This review summarizes the applications of PET/CT in targeted therapy of breast cancer.

Objective: To investigate the application of rope band therapy training on lower extremity motion function of children with spastic cerebral palsy. Methods: A total of 55 children with spastic cerebral palsy were admitted to the Second Hospital Affiliated to Guangxi Medical University from January 2017 to March 2018, 27 males and 28 females, and the average age was(51.2±1.7)months.They were divided into a regular group (28 cases) and a rope band therapy training group (27 cases) according to random number table.The regular group included 14 males and 14 females, aged 2 to 6 years old, the mean age was (51.3±1.8) months; the rope therapy training group included 13 males and 14 females, aged 2 to 6 years old, the mean age was (51.1±1.9) months.The regular group was only treated by routine rehabilitation training.On the basis of routine rehabilitation training, the rope therapy training group also underwent the rope therapy training.Before and after 12 weeks of treatment, the 2 groups of children were evaluated and compared by Ashworth improved rating scale (MAS), children balance scale (PBS) and gross motor function test scale(GMFM-88 D and E regions). Results: After 12 weeks of treatment, the MAS score of the regular group was (2.64±1.63) scores, the PBS score was (25.44±9.71) scores, the GMFM score of D regions score was (23.82±3.61) scores and E regions score was (26.34±8.81) scores. The MAS score of the rope therapy training group was (2.11±8.75) scores, the PBS (31.92±6.84) scores, the GMFM score of D region was (27.75±6.81) scores, and E region (31.92±6.84) scores.All evaluation criteria of 2 groups of children were improved than those before treatment (all P<0.05). However, the scores of the rope therapy training group were significantly better than those of the regular group, and the difference was significant (t=4.144, 5.186, 3.769, 4.254, all P<0.05). Conclusions Rope therapy training can effectively improve lower extremity motion function of children with spastic cerebral palsy, the gross motor function, spastic level and balance ability.

Objective: To probe into the correlation between chronic liver disease and intestinal barrier function. Methods: 1 491 cases of hospitalized patients were enrolled, of which 741 cases were of chronic liver diseases, including 397 cases of fatty liver diseases, 230 cases of chronic hepatitis, 114 cases of liver cirrhosis, and 750 cases of non-hepatic diseases. All admitted patients’ intestinal barrier function like diamine oxidase (DAO), D-lactate, lipopolysaccharide, and biochemical indicators of liver functions were tested. According to different data, statistical analysis was done using t-test, ANOVA, Dunnett’s test, χ ² test of fourfold table, Pearson’s correlation, and binary logistic regression. Results: The intestinal barrier dysfunction was more likely to occur in the chronic liver disease group than that of non-hepatic disease group [54.15% (379/741) vs. 18.53% (139/750), χ ² = 193.58, P < 0.001]. The correlation analysis between biochemical indicators of liver function and intestinal barrier function in chronic liver disease group showed that alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), and total bilirubin levels were more susceptible to intestinal barrier dysfunction than those with normal indexes (P < 0.05 ). GGT had stimulated DAO (P < 0.05, OR > 1), D-lactate (P < 0.05, OR > 1), lipopolysaccharide (P < 0.05, OR > 1), ALT and AST. Conclusion Chronic liver disease increases with damage to intestinal barrier function.

Objective:To assess the efficacy of different modes of high-flow nasal cannula (HFNC) oxygen therapy modes in preventing hypoxaemia during general anesthesia in obese patients without endotracheal intubation.Methods:Eighty-four American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients of either sex, aged 18-64 yr, with body mass index ≥ 30 kg/m 2, undergoing non-intubated general anesthesia surgery, were divided into 3 groups ( n=28 each) by a random number table method: nasal cannula oxygen therapy group (NC group), HFNC oxygen therapy full-course non-pure oxygen group (HFNC1 group) and HFNC oxygen therapy half-course non-pure oxygen group (NHFC2 group). NC group received oxygen through bilateral nasal cannula, and the oxygen flow rate was 5 L/min, and the oxygen flow rate remained unchanged after anesthesia induction. In NHFC1 group, the flow rate was 30 L/min and the FiO 2 was 41%, and the flow rate was adjusted to 60 L/min after anesthesia induction, and the FiO 2 remained unchanged. NHFC2 group received HFNC oxygen inhalation with a flow rate of 30 L/min and FiO 2 100%, and the flow rate was adjusted to 60 L/min and FiO 2 41% after anesthesia induction. Sufentanil 0.1 μg/kg was intravenously injected after 3 min of oxygen pre-inhalation and target effect-site concentration of propofol was 4 μg/ml in open-loop TCI mode, the closed-loop mode was used to continue intravenous infusion of propofol when the BIS value reached 60 with the same target effect-site concentration, and the intraoperative BIS value was maintained at 45-60. The occurrence and total duration of hypoxemia (SpO 2 <92%) and the lowest value of SpO 2 during anesthesia were recorded. Arterial blood gas analysis was performed before anesthesia induction, at 3 min of oxygen pre-inhalation and at 10 min after anesthesia, and PaO 2 and PaCO 2 were recorded. Respiratory interventions and adverse events were recorded. Results:One patient was excluded due to change of anesthesion method in NC group.Compared with NC group, the incidence of hypoxemia was significantly decreased, the total duration of hypoxemia was shortened, the lowest value of SpO 2 was increased, and the usage rate of respiratory intervention methods was decreased, and PaO 2 was increased and PaCO 2 was decreased at 3 min of oxygen pre-inhalation and 10 min after anesthesia in HFNC2 group ( P<0.05), and PaCO 2 was significantly decreased at 3 min of oxygen pre-inhalation, PaO 2 was increased and PaCO 2 was decreased at 10 min after anesthesia ( P<0.05), and no significant change was found in the other parameters in HFNC1 group ( P>0.05). Compared with HFNC1 group, the incidence of hypoxemia was significantly decreased, the total duration of hypoxemia was shortened, the lowest value of SpO 2 was increased, the usage rate of respiratory intervention methods was decreased, and PaO 2 was increased at 3 min of oxygen pre-inhalation in HFNC2 group ( P<0.05). There was no significant difference in adverse events between the three groups ( P>0.05). Conclusions:HFNC in the mode of FiO 2 100% during oxygen pre-inhalation and FiO 2 41% during anesthesia maintenance can reduce the occurrence of hypoxemia during general anesthesia in obese patients without intubation.

Objective:To explore the effects of continuing nursing mode based on theory of use and satisfaction in patients with peripherally inserted central catheter (PICC) .Methods:From August 2017 to June 2018, this study selected 400 patients with PICC as subjects in the First Affiliated Hospital of Wenzhou Medical University.All of patients were divided into control group and intervention group with the method of random number table, 200 cases in each group. Control group carried out the routine nursing. Intervention group analyzed the needs of patients for content and form of continuing nursing, and built the PICC continuing nursing intervention plan based on the theory of use and satisfaction. This study compared the incidence of catheter-related and unplanned extubation, self-management ability, nursing satisfaction of patients between two groups after intervention.Results:After intervention, the incidences of catheter-related complications and unplanned extubation of intervention group were 1.5% and 0 respectively lower than those (16.0% and 5.0%) of control group with statistical differences ( P<0.05) . In intervention group, the scores of the daily catheter observation, maintenance compliance, catheter management confidence, exception handling of catheter, information acquisition, motion with catheter, daily life with catheter and total score of self-management ability, and nursing satisfaction of patients were higher than those in control group with statistical differences ( P<0.05) . Conclusions:Continuing nursing mode based on theory of use and satisfaction can reduce the incidence of catheter-related and unplanned extubation in patients with PICC, improve patients' catheter self-management ability as well as nursing satisfaction which is worthy of being widely used in clinical application.

Objective:To conduct periodic revalidation of the 15 items and 43 terms autoverification rules of blood analysis after 1 year of application, analyze the application suitability and make the rules improved.Methods:Track the results of 528 010 blood analysis samples of our hospital from August 1, 2019 to January 31, 2020, and analyze the pass rate and interception rate of autoverification; 600 specimens in total were selected randomly for microscope examination, including 300 specimens which touched autoverification rules (1 012 items of autoverification rules) and were intercepted by autoverification and 300 specimens which untouched autoverification rules and were released by autoverification. The abnormal characteristics and unacceptable Delta check of the specimens also need to be concerned at the same time.The false negative rate and false positive rate, true negative rate, true positive rate and pass correct rate of autoverification were verified and compared with the rate of the second phase verification when the autoverification rule was established. The false negative rate, false positive rate, true negative rate and true positive rate of the Delta check rule which 54 716 specimens touched were calculated and compared with the second phase verification rate when the autoverification rule was established.The results of microscopic examination were used as the gold standard for the calculation of the rates, and P<0.05 was considered as a significant difference. The false positive and true positive of 1 012 autoverification rules were analyzed item by item.The false positive and true positive of 108 specimens which touched blast cell autoverification rule were analyzed terms by terms. The mean TAT and median TAT of 528 010 specimens and 193 750 outpatient specimens were calculated respectively, and the report percentages of 528 010 samples that TAT<30, 30-60　and>60 min were calculated respectively. Analyze and evaluate the application suitability of autoverification rules to juge whether they meet the needs of doctors and laboratory. The design process and the rules and application process of autoverification were optimized and improved.Results:The autoverification pass rate was 63.06% (332 971/528 010), the interception rate was 36.94% (195 039/528 010). The false negative rate was 1.00% (1/600), the false positive rate was 12.67% (76/600), the true negative rate was 49% (294/600), the true positive rate was 37.33% (224/600), and the correct rate was 98% (294/300). The pass rate, true negative rate, true positive rate and correct rate of the periodic reverification group were higher than the second phase verification group, the false negative rate and false positive rate were lower than that the second phase verification group. The false negative rate and true positive rate of the Delta check of periodic verification group were lower than that the second phase verification group, the false positive rate and true negative rate were higher than the second phase verification group, there were significant differences in the comparition results. The mean TAT of 528 010 specimens was25 min, and the median TAT was 22 min. The mean TAT of 193 750 outpatient specimens was 23 min, and the median TAT was 20 min. The report percentages of 528 010 samples that TAT<30 min, 30 min-60 min and>60 min were 83.30% (439 819/528 010), 8.00% (42 250/528 010) and 8.70% (45 941/528 010), respectively.Conclusion:The results of periodic revalidation of autoverification after 1 years application show that the 15 items and 43 terms autoverification rules of blood analysis could meet requirements about the accuracy and efficiency of the laboratory, and have a good suitability for application.

Objective:To explore the application value of apparent diffusion coefficient (ADC) of magnetic resonance diffusion weighted imaging (DWI) parameters in glioma classification and glioma microstructure evaluation.Methods:From June 2017 to November 2019, 38 patients with glioma confirmed by surgery and pathology in Haikou Hospital Affiliated to Xiangya Medical College of Central South University were retrospectively analyzed. According to the pathological results, they were divided into low-grade (WHO Ⅰ-Ⅱ, 15 cases) glioma group and high-grade (WHO Ⅲ-Ⅳ, 23 cases) glioma group. They received magnetic resonance imaging (MRI) plain scan and DWI scan respectively, and the ADC value and microstructure of different grades of glioma were compared. The correlation between ADC value of glioma and the percentage of vascular endothelial growth factor (VEGF)-positive cells, cell density and integrated optical density (IOD) value of aquaporin 1 (AQP1) expression was analyzed.Results:(1) MRI examination showed that the signals of low-grade glioma were more uniform, with no or slight peritumoral edema and space occupying effect, and the enhancement was more non enhanced or slightly enhanced. The signals of high-grade glioma were more heterogeneous due to necrosis and bleeding, and the peritumoral edema and space occupying effect were more obvious, showing uneven obvious enhancement or irregular ring enhancement; (2) The percentage of VEGF positive cells, cell density and the IOD value of AQP1 expression in high-grade glioma were significantly higher than that in low-grade glioma, and the ADC value was lower than that in low-grade glioma (all P<0.05); (3) The ADC value of glioma patients was negatively correlated with the percentage of VEGF-positive cells, cell density, and the IOD value of AQP1 expression ( r=-0.55, -0.65, -0.63, all P<0.05). Conclusions:The ADC value of glioma can indirectly reflect the expression of VEGF, cell density and AQP1 positive expression level, which is helpful for preoperative glioma classification and evaluation of glioma microstructure and biological characteristics.

Objective:To evaluate the clinical application of urine sediment score (USS) in early diagnosis, etiological differentiation, staging and prognosis of acute kidney injury (AKI), and to investigate the diagnostic efficacy of independent USS and its combination with blood urea nitrogen(Bun) serum creatinine(sCr) and uric acid(UA) in AKI.Methods:From August 23 to September 28, 2023, 9 020 morning urine samples of hospitalized patients in the First Hospital of Jilin University were detected by Sysmex UF5000.A total of 3 226 ssamples with small and round cell (SRC) > 1/μl and/or CAST>1/μl were screened for microscopic examination, and 404 cases with positive renal tubular epithelial cells and/or cast were enrolled in this study. There were 218 males and 186 females, aged 59.5 (49.0, 71.0) years. The 404 cases were divided into the USS AKI group (345 cases) and the USS non-AKI group (59 cases) according to the USS results based on the microscopic findings. According to Kidney Disease: Improving Global Outcomes (KDIGO) criteria, they were divided into KDIGO criteria AKI group (63 cases) and KDIGO criteria non-AKI group (341 cases), and the AKI group was divided into renal AKI group (33 cases) and non-renal AKI group (30 cases). According to the clinical diagnosis recorded in the medical records, they were divided into clinically diagnosed AKI group (29 cases) and clinically diagnosed non-AKI group (375 cases).The χ 2 test or Fisher exact test was used to compare USS in different AKI causes and stages. Logistic regression was used to calculate the odds ratio of renal AKI and stage 3 AKI. The area under the receiver operating characteristic curve was used to evaluate the sensitivity and specificity of USS, sCr, UA and Bun alone and in combination in the diagnosis of AKI, and the best cut-off value, sensitivity and specificity in the diagnosis of AKI were calculated. P < 0.05 was considered statistically significant. Results:The USS was used to identify the etiology of KDIGO standard AKI group,and there were significant differences in USS between renal AKI group and non-renal AKI group (χ 2=11.070, P<0.001). Compared to USS=1, the odds ratio of renal AKI was 8.125 when USS≥2 (95% CI 2.208—29.901). There was a statistically significant difference in the comparison of USS between groups in each stage of the AKI staging study based on USS (χ 2=15.724, P<0.05). Compared to USS=1, the odds ratio of stage 3 AKI was 9.714 when USS≥2 (95% CI 1.145-82.390). The AUC of independent USS in the diagnosis of AKI was 0.687 (95% CI 0.618-0.757, P<0.001), the specificity was 65.7% and the sensitivity was 61.9%. The AUC of USS combined with Bun, sCr, UA in the diagnosis of AKI was 0.794 (95% CI 0.608-0.980, P<0.05), the specificity was 82.4%, and the sensitivity was 88.9%. Conclusions:There wasan increased likelihood of renal AKI or stage 3 AKI while USS≥2,and whose combination with Bun, sCr and UA will improve the diagnostic efficiency of AKI.