Background and purpose:miRNA plays important roles in tumorigenesis. It has been reported that many kinds of serum miRNA serve as markers for tumor diagnosis and screening. This study aimed to detect the expression of serum miRNA-31 (miR-31) in colorectal cancer patients and to explore the effect of miR-31 on cell proliferation, apoptosis and cell cycle distribution. Methods: The expressions of miR-31 in 40 cases of colorectal cancer serum and 35 cases of the healthy control were examined by real-time lfuorescent quantitative polymerase chain reaction (RTFQ-PCR). The correlation between miR-31 expression and clinicopathological features of colorectal cancer (including age, gender, depth of inifltration, lymph node metastasis, clinical stage) were further analyzed. The miR-31 mimics, inhibitor and miR-control (negative control) were transfected into HCT116 cells. The effect of miR-31 on cell proliferation was evaluated by CCK-8 method. Flow cytometry was used to examine the change of cell apoptosis and cell cycle. Results:Relative expression of serum miR-31 was signiifcantly increased in cancer patients compared with healthy controls (P<0.01). Expression of serum miR-31 was higher in poorly differentiated carcinoma than that in well or moderately differentiated carcinoma (P<0.05). No correlation was found between serum miR-31 expression and other clinicopathological variables. CCK-8 assay showed that after transfection with miR-31 mimics, the cell proliferation was increased, compared with miR-31 inhibitor and negative control group. Meantime, the apoptotic cell number was signiifcantly decreased, particularly in late apoptosis. The cell number of G1 stage was remarkably increased in miR-31 inhibitor group, compared with miR-31mimics and negative control group. Conclusion:The expression of serum miR-31 is higher in colorectal cancer. miR-31 can promote cell proliferation and inhibit the apoptosis of HCT116 cells. It might be a potential biomarker for colorectal cancer.

Objective To analyze the clinical and biological features of mixed acute leukemia(MAL).Methods Bone marrow specimens of 38 MAL patients were evaluated to prove the diagnosis and the classification by morphoiogic,immunologic examinations.These patients were treated with protocols suitable for both acute myeloid leukemia(AML)and acute lymphoblastic leukemia(ALL).Results All MAL patients had a leukemia syndrome.Morphologically,the subtypes of M1,M2 and M5 were predominant in AML,as L2 Was in ALL.Immunologically,coexpression of myeloid and B lineage associated antigens was predominant,about 68.4%;cytogenetically,Ph chromosome was observed in 33.3%(5/15)of MAL patients,and immunophenotype was B-M;1 Ph chromosome(+)MAL patient,fusion gene bcr-abl 190(+)and immunophenotype was B-M.In 38 cases,32 patients received chemotherapy.The complete remission rate was 28.1%(9/32).CR of.normal karyotype was significantly higher than that of abnormal ones.Conclusion Patients with MAL have unique biological features and the complete remission rate was low and the prognosis was poor.

Objective To investigate the proportion of CD_4~+ CD_(25)~+ Tregs in the peripheral blood of the patients suffering from acute myeloid leukemia (AML) with or without chemotherapy and clinical significance.Methods The flow cytometry was used to evaluate the proportion of CD_4~+ CD_(25)~+ CD_(127)~(low) T cells in the peripheral blood of the patients with primary AML group (group A), AML who achieved complete remission over 3 years (group C) or less than 3 years(group B) and the healthy donors. Results The percentages of CD_4~+ CD_(25)~+ Tregs of group A and B was significantly higher than that of control group (P <0.05); but not significantly defferent among the group C and control group (P >0.05). The percentages of CD_4~+ CD_(25)~+ Tregs of group A was significantly higher than that of group B and C. Conclusion These results suggested that CD_4~+ CD_(25)~+ Tregs played an important role in acute myeloid leukemia.

Objective To investigate the expression features and clinical significance of CD4+ CD25+ regulatory T cells in elderly patients with newly diagnosed acute myelocytic leukemia.Methods Totally 65 patients newly diagnosed as acute myeloid leukemia (AML group) and 72 healthy volunteers (control group) were divided into the elderly group (aged over 60 years) and the young group aged (44.6±2.9) years.The expression of CD4+ CD25+ regulatory T cells was detected by CD4,CD25 and CD127 three-color fluorescein-labeled and multiparameter flow cytometry.The expression features and clinical significance of CD4+ CD25+ regulatory T cells in each group were analyzed.Results After being gated on CD4+ lymphocytes,the expression level of CD4+ CD25+regulatory T cells was significantly increased in AML group as compared to control group [(7.06±2.60) ％ vs.(5.61 ± 1.06) ％,t =4.19,P=0.000].The expression level of CD4 + CD25 + regulatory T cells was higher in elderly AML patients than in elderly controls [(7.55 ± 2.78)％ vs.(5.98 ±1.08) ％,t=3.42,P=0.001].The expression of CD4+ CD25+ regulatory T cells was higher in young AML patients than in young controls [(6.09±1.91)％ vs.(5.14±0.82)％,t=2.21,P=0.036].The expression level of CD4+ CD25+ regulatory T cells was higher in elderly AML patients than in young AML patients [(7.55±2.78)％ vs.(6.09±1.91)％,t=2.19,P=0.032].Conclusions The dual roles of immunosenescence and tumor may cause the excessive accumulation of CD4+ CD25+regulatory T cells in elderly patients with newly diagnosed acute myeloid leukemia.

Objective To investigate the relationship between CD4+CD25+ regulatory T(T-Reg)ceils and the higher prevalence of tumor in elderly people. Methods The frequencies of T-Reg in peripheral blood from 64 health adults.52 healthy elderly people and 64 elderly cancer patients were determined by multi-color detection and multi-parameter flow cytometry.and the relationships among the 3 groups were analyzed and the correlation among CD4+CD25high,CD4+CD25+FoxP3+and CD4+CD25+CD127low were studied. Results Be gated on CD4+ lymphocytes,the reference ranges of CD4+CD25high T cells in the groups of health adults.healthy elderly people and elderly cancer patients were(1.390±0.412)%,(1.729±0.247)%and(2.150±O.769)%respectively,while CD4+CD25+FoxP3+ T cells were(1.1 80±0.343)%,(2.477±0.400)%and (4.980±2.177)%respectively,and CD4+CD25+CD127low T cells were(5.213±0.942)%,(6.186±1.196)%and(7.194±1.538)%respectively.There was the same change rule in CD4+CD25high,CD4+CD25+FoxP3+and CD4+CD25+CD127low T cells of the 3 groups.elderly cancer patients was at the highest.then was healthy elderly people,and the last was health adults.The 3 markers were positively correlated among 3 groups(all P＜0.05).There were gender difference in 3 groups of CD4+CD25high,CD4+CD25+FoxP3+ and CD4+CD25+CD127low T cells. Conclusions The percentages of CD4+CD25high are increased with age and its excessive accumulation is possibly correlated with immunosenescence and the tumor development.

Objective To explore the current status of clinical inertia in the treatment of patients with type 2 diabetes mellitus (T2DM) in the suburbs of Shanghai and analyze its risk factors. Methods A total of 1, 804 T2DM patients who visited the Endocrinology and Metabolism Clinic of Shanghai Sixth People's Hospital from November 2022 to November 2023 were selected as research objects. Patients were divided into clinical inertia group and non-clinical inertia group based on whether clinical inertia occurred during their treatment, and demographic and clinical data were collected. Logistic regression analysis was used to identify risk factors for clinical inertia in the treatment of T2DM patients. Results The incidence of clinical inertia in T2DM patients was 52.00% (938/1, 804). The results of multivariate Logistic regression analysis showed that longer diabetes duration, high level of glycated hemoglobin (HbA1c), high score of the Problem Areas in Diabetes Scale(PAID) score, taking over two oral medications, shorter life expectancy, and coexisting retinopathy were risk factors for clinical inertia in the treatment of T2DM patients (P < 0.05). Conclusion The incidence of clinical inertia is high in T2DM patients during treatment in the suburbs of Shanghai. T2DM patients with poor glycemic control, longer disease duration, high level of psychological distress, taking over two oral medications, shorter life expectancy, and coexisting retinopathy are more prone to occur clinical inertia.

Objective To systematically evaluate the effectiveness of different nursing interventions for female overactive bladder, and to provide evidence- based evidence for nursing intervention for overactive bladder in women. Methods PubMed, Cochrane Library, Embase, ScienceDirect and CNKI,Wanfang database and CBM comprehensively by computer and included in the literature of nursing intervention for female overactive bladder patients. Results Four randomized controlled trials were included, a total of 426 participants were in, the intervention group was 214 participants, control group was 212 participants, the results of the study showed that pelvic floor muscle training,health education,psychological nursing intervention can improve patients with overactive bladder symptoms and enhance the quality of life. Conclusion Nursing intervention for women with overactive bladder is an effective way to control symptoms such as frequent micturition and urgency,improve bladder overactivity symptoms and enhance quality of life.

Objective:To investigate the relationship of blood lipid levels with bone mass and fracture risk in elderly patients with type 2 diabetes mellitus (T2DM).Methods:A total of 744 elderly patients with T2DM who were treated in Tangshan Second Hospital from November 2018 to May 2020 were divided into normal bone mass group, low bone mass group and osteoporosis group according to bone mass levels. The total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and triglyceride (TG) levels in the three groups were compared, and the relationship between lipid indexes and bone mass was analyzed. The risk of fracture was calculated in the low bone mass group, and the relationship between lipid index and fracture risk was analyzed by linear regression. The blood lipid index between subjects with fracture and without fracture in osteoporosis group was compared, and the relationship between blood lipid index and fracture was analyzed by logistic regression.Results:There were significant differences in gender and age among the three groups (χ 2=38.80, F=4.94, P<0.05). The normal bone mass group had the smallest proportion of women and the youngest average age, while the osteoporosis group had the largest proportion of women and the average age. maximum. The LDL-C level in normal bone mass group was higher than those in the low bone mass group and the osteoporosis group, and LDL-C level in the low bone mass group was higher than that in the osteoporosis group ( F=3.38, P<0.05). In the low bone mass group, the risk of systemic fracture was 3.50% (2.40%, 4.10%) and hip fracture was 0.99% (0.80%, 1.20%). Linear regression showed that LDL-C and TG were positively correlated with the risk of systemic fractures in the low bone mass group (LDL-C: B=0.98, P=0.006;TG: B=0.23, P=0.024);TG was positively correlated with the risk of hip fracture in the low bone mass group ( B=0.16, P=0.002). In the osteoporosis group, the levels of HDL-C and LDL-C were lower in the patients with fractures than those without fractures ( t=3.24, P=0.001; t=2.98, P=0.003). Logistic regression analysis showed that higher HDL-C and LDL-C levels were protection factors for fracture risk in the osteoporosis group ( β=-2.73, P=0.009, OR=0.06, 95 %CI=0.04-0.10; β=-0.15, P=0.033, OR=0.83, 95 %CI=0.74-0.99). Conclusion:The relationship of serum lipid index with bone mass and fracture risk in hospitalized elderly T2DM patients is complicated, it is suggested to set individual blood lipid control targets according to the bone mass of patients.

Objective To investigate the clinical significance of abnormally expressed PD-1 on CD 4+CD 2 8+/-T cells in peripheral blood of patients with systemic lupus erythematosus ( SLE ) . Methods Peripheral blood samples were collected form 50 patients with primary SLE and 40 healthy subjects and used to isolated mononuclear cells. Expression of CD4+CD28-, CD4+CD28+, CD4+CD28+PD-1+and CD4+CD28-PD-1+T cells in peripheral blood samples of the two groups were detected by flow cytometry. Clinical data of SLE patients were collected. Based on SLE disease activity index (SLEDAI), SLE patients were classified into two groups: stable group (SLEDAI<10) and active group (SLEDAI≥10). Based on the condition of renal damage, they were also divided into two groups: lupus nephritis group and non-lupus ne-phritis group. Differences in T cell expression were compared among these groups. Statistical analysis was performed to analyze the relationships of different T cell subsets with laboratory and clinical parameters rela-ting to SLE and SLEDAI. Results The percentages of peripheral CD4+CD28-, CD4+CD28+PD-1+and CD4+CD28-PD-1+T cells of active group were higher than those of stable and healthy control groups ( P<0. 05). Moreover, patients with lupus nephritis had higher percentages of these T cell subsets than those without (P<0. 01). SLE patients who were positive for anti-dsDNA or anti-SmRNP antibody, or had de-creased complement C3, thrombocytopenia or decreased lymphocytes had higher percentages peripheral CD4+CD28-T cells than those in the corresponding negative group. SLE patients who were positive for anti-dsDNA or anti-SmRNP antibody, or had decreased complement C3, complement C4 or lymphocytes showed en-hanced expression of peripheral CD4+CD28+PD-1+T cells as compared with those in the corresponding nega-tive group. SLE patients positive for anti-dsDNA antibody, or with decreased complement C3 or lymphocytes or suffering from alopecia had higher percentages of peripheral CD4+CD28-PD-1+T cell than those in the cor-responding negative group. Differences between different groups were statistically significant (P<0. 05). Conclusion Abnormal expression of CD4+CD28-T cells and PD-1 on CD4+CD28-and CD4+CD28+T cells in peripheral blood of patients with SLE has certain correlation with laboratory parameters and clinical indicators.

Objective: To improve the understanding of high calcium risk in patients with diffuse large B-cell lymphoma (DLBCL) during the chemotherapy. Methods: The diagnosis and treatment of high calcium risk in one patient with DLBCL during the chemotherapy in the Second Affiliated Hospital of Anhui Medical University was retrospectively analyzed, and the relevant literatures were reviewed. Results: A 52-year-old man who was diagnosed with DLBCL (non-specific, non-germinal center source; stage Ⅳ group A; International prognosis index score 4 points, high-risk group) in June 2017. Two times R-CHOP chemotherapy was performed before diagnosis. This patient was admitted to the hospital for the third chemotherapy, and the disease assessment showed that the enlarged lymph nodes were not significantly smaller than before, and the tumor burden was still high. Therefore, the chemotherapy regimen was adjusted to R-GDP regimen. However, on the 8th day after the end of rituximab treatment, the patient had head pain, which might be related to the patient's poor sleep and primary invasion of the primary disease (blood calcium: 2.94 mmol/L). And then the ibuprofen and diuresis treatments were given, but the symptoms were still gradually worsening, and vomiting appeared on the 9th day, systemic fatigue with drowsiness and irritability appeared on the 12th day. Review blood calcium: 5.02 mmol/L. Adequate fluid hydration, diuretic, renal replacement treatments were given, and the level of blood calcium gradually returned to normal. Finally, the patient's symptoms were improved significantly, and he successfully completed R-GDP chemotherapy. Conclusion If a DLBCL patient has symptoms such as headache, lethargy, irritability or even coma during the chemotherapy, it is necessary to alert the possibility of hypercalcemia and to timely improve the relevant examination and make symptomatic treatment.