Objective To investigate the influence of different hemodialysis modes on serum levels of beta 2 microspheres , leptin and hemoglobin(Hb) in the patients with chronic renal failure (CRF) and to analyze its safety .Methods Sixty inpatients with CRF in our hospital from January 2014 to January 2015 were selected as the research subjects and divided into the common he‐modialysis group (common HD groups) ,hemodialysis filtration group(HDF group) and the common hemodialysis plus hemoperfu‐sion group(HD+ HP group) according to different treatment methods .The levels of serum leptin ,beta 2 microspheres (β2‐MG) , Hb and erythropoietin (EPO) were measured .The occurrence rates of adverse reactions were observed .The living quality was eval‐uated and conducted the comparative analysis .Results Compared with before hemodialysis ,the levels of serum leptin and β2‐MG levels after the first time of hemodialysis and 6‐month hemodialysis in the three groups were decreased ,moreover the levels in the HD+ HP group were the lowest ,the differences were statistically significant (P<0 .05) ;compared with the common HD group , the levels of Hb and EPO after the first time of hemodialysis and 6‐month hemodialysis in the HDF group and HD+ HP group were increased ,the differences were statistically significant (P<0 .05);the incidence rate of complications after hemodialysis in the HD +HP group was lower than that in the common HD group and the HDF group ,the differences were statistically significant (P<0 .05);the living quality scores of each item after hemodialysis in the HDF group and HD + HP group were superior to those in the common HD group ,moreover the living quality scores in each item in the HD + HP group were higher ,the differences were statisti‐cally significant(P<0 .05) .Conclusion Adopting the HP therapy in the patients with CRF can better reduce the levels of blood leptin andβ2‐MG without affecting the Hb level ,moreover with low occurrence rate of complications ,and the patient′s living quali‐ty is significantly improved after treatment .

【Objective】 To investigate the control rate of blood glucose and its influencing factors in type 2 diabetes mellitus patients in Yulin area. 【Methods】 We selected the adult type 2 diabetes patients who visited our hospital from May 2020 to December 2021 as the subjects. Then we collected their basic information (gender, age, household income, type of medical insurance payment, education level, and duration of disease), measured their height and weight, calculated their body mass index (BMI), detected HbA1c, and measured their subcutaneous and visceral fat. The Chi-square test and multivariate Logistic regression methods were used to analyze the influencing factors. 【Results】 The total attainment rate of HbA1c (HbA1c<7%) among 877 adults with type 2 diabetes was 13.34%. The Chi-square test showed that statistical differences in the attainment rate of HbA1c among different ages, family annual income, type of medical insurance, and duration of disease. Further unconditional multivariate Logistic regression analysis model results showed that the HbA1c attainment rate in 18-44 years old group was 0.418 times higher than that in ≥60 years old group (95% CI=0.219-0.799, P=0.008). The HbA1c compliance rate of patients with employees’ medical insurance was 1.744 times that those with residents’ medical insurance (95% CI=1.131-2.782, P=0.013). The HbA1c attainment rate of diabetic patients with an annual family income of 30 000 yuan to 100 000 yuan was 1.873 times (95% CI=1.074-3.266, P=0.027), and with an annual family income of more than 100 000 yuan was 2.649 (95% CI=1.299-5.404, P=0.007) times than that of diabetic patients with less than 30 000 yuan. 【Conclusion】 The blood glucose control rate in adults with type 2 diabetes mellitus in Yulin area is lower compared with the level of the nation and other regions. Age, annual household income, and type of medical insurance payment are independent influencing factors.

Objective To explore the correlation between BCL2 binding component 3 (BBC3) expression and postoperative survival time of lung squamous cell carcinoma (LUSC),and investigate its molecular mechanism.Methods The expression of BBC3 in 39 patients was detected by using qRT-PCR assay.Meanwhile,clinical data of all patients were collected by follow-up visit.Then,the survival analysis was performed by using Kaplan-Meier and log rank tests.Moreover,multiple factors analysis was performed using COX proportional hazard model.At last,BBC3 was over-expressed in NCI-H226 cell lines,then detected the effects of BBC3 expression on cell proliferation and apoptosis by using MTT assay and flow cytometry.Results BBC3 expression were significantly correlated with the tumor metastasis (r=0.556,P=0.023),tumor size (r=0.532,P =0.042),T staging (r =0.551,P=0.021) and TNM staging (r=0.524,P=0.047).Meanwhile,the results of Kaplan-Meier and log rank tests found that BBC3 expression was significantly correlated with survival time of patients with LUSC,and the length of survival time in patients with high BBC3 expression was longer than that in patients with low BBC3 expression (x2 =7.542,P=0.006).The COX proportional hazard model indicated that tumor metastasis,T staging,TNM staging and BBC3 expression were independent factors which significantly affected survival time.Moreover,the proportion of apoptotic cells in the recombinant plasmid BBCs group was higher than that in the empty plasmid group and control group (P＜0.05).Conclusion BBC3 expression could suppress the proliferation of tumor cells and promote apoptosis,and are significantly correlated with survival time of patients,so which may be assistant biomarkers for prognosis of LUSC.

Objective To investigate the clinical significance of YMDD mutation during Lamivudine therapy on chronic hepatitis B.Methods Fluorometric analysis PCR, ELISA were used to estimate the YMDD mutation, HBVDNA quantative level and HBeAg for HBV of 72 cases with chronic hepatitis B before therapy (0 month), and after Lamivudine therapy for 9,12,18 months.Results The YMDD mutation was not observed in these cases before Lamivudine therapy. The mutation was found in 8 cases (11.1%), 17 cases (23.6%) and 28 cases (38.9%) at 9, 12, 18 month for therapy. The YMDD mutation rate rose with the therapy time lasting (P＜0.05). Moreover, the YmDD mutation rate in the patients with HBVDNA quantity higher than 108 copies/ml was significantly higher than that in the patients with HBVDNA quantity lower than 108 copies/ml (P＜0.005). The YMDD variation rate in patients with HBeAg positive and in patients with HBeAg negative showed no significant difference (P＞0.05). The HBeAg negative conversion rate was significantly higher in non-mutation group than that in mutation group (P＜0.05).Conclusion The serum virus quantity may be regard as an early estimate indication of the development of YMDD mutation during Lamivudine therapy.

BACKGROUND:Treatment programs for low back pain are of great varieties, but there is stil no a definite treatment. Pressure biofeedback instrument is a tool to measure abdominal muscle activity, and its reliability in the treatment of low back pain is less reported. OBJECTIVE:To explore the reliability and feasibility of the pressure biofeedback instrument for assessment of low back pain. METHODS:Thirty patients with chronic low back pain were enrol ed and subject to four kinds of postures:posture A was prone position;posture B was supine position with flexion of the knee joints, posture C was supine position with unilateral flexion of the hip and knee joint, posture D was prone position with unilateral shoulder flexion. Intra-abdominal pressure values under the different postures were measured twice within a week in the same subject. Intraclass correlation coefficient (ICC) was used to assess the reliability. RESULTS AND CONCLUSION:Posture A had good test-retest reliability, and the value of ICC was 0.853 (95%confidence interval:0.691-0.930);posture B showed moderate test-retest reliability, and the ICC value was 0.751 (95%confidence interval:0.477-0.882);posture C also had moderate test-retest reliability, and the ICC value was 0.789 (95%confidence interval:0.557-0.900), posture D had good test-retest reliability, and the value of ICC was 0.892 (95%confidence interval:0.641-0.919). Therefore, the pressure biofeedback for evaluation of low back pain has good reliability, which can be used for the evaluation of low back pain.

Objective To observe the suppression of HBsAg and HBeAg expression by DNAzyme and LNAzyme located at HBV pre-area of HBV.Methods Eecoding sequence of(10-23 DNAzyme) thiolmodificated 10-23DNAzyme and LNAzyme that were directed against Pre C/C region of HBV were designed and synthesized.Experimental groups and control groups were set up.The experimental groups included 10-23 DNAzyme group,(S-10-23) DNAzyme group and LNAzyme group.The control groups include blank control group,simple lipofectamine group,simple 10-23DNAzyme group and random 10-23 DNAzyme group.In the dosege of 0.16,0.64,1.28,1.60,(1.92 ?mol?L~(-1)) and the time of 12,24,36,48,60,72,84 and 96 h,the suppression of HBsAg and HBeAg expression by 10-23 DNAzyme and LNAzyme in 2.2.15 cells were studied.Results The suppression of HBsAg and HBeAg expression by 10-23 DNAzyme and LNAzyme in 2.2.15 cells were significant.The inhibitory effects caused by LNAzyme was more significant than that by thiolmodified 10-23 DNAzyme whose inhibitory effects were more significant than that of 10-23 DNAzyme.The inhibitory rates of LNAzyme and 10-23 DNAzyme thiolmodification reached(91.6?8.4)%,(78.4?2.0)% on HBsAg,respectivelly and(90.1?5.2)%,(76.4?4.8)% on HBeAg.The inhibitory effects of LNAzyme and thiolmodification of 10-23 DNAzyme were found 12 h after they were added to 2.2.15 cells,and optimized at 48 h,effective inhibitory time for LNAzyme was 84 h,for thiolmodification 10-23 DNAzyme was 72 h.Addition of LNAzyme and 10-23 DNAzyme to 2.2.15 cells didn′t exert cytotoxicity.Conclusion 10-23 DNAzyme and LNAzyme have demonstrated significant inhibitory effects on the HBsAg and HBeAg expressions in 2.2.15 cells.Morever,the inhibitory effects of LNAzyme is more significant than that of DNAzyme.LNAzyme is a specific anti-HBV therapeutic agent.

【Objective】 To investigate the practice and benefit of national standardized management of type 2 diabetes in Yulin City. 【Methods】 We recruited the adult type 2 diabetes patients who sought medical help at our hospital from May 2020 to October 2022 as subjects. We collected their basic information (sex and age); measured height, weight, waist and hip circumference, and blood pressure; calculated body mass index (BMI); and detected blood glucose, c-peptide, HbA1c, biomarkers, urinary microalbumin, sensory nerve conduction velocity of lower limbs, ABI, and subcutaneous and visceral fat at the time of MMC recruited and the end of six months. T test and Mann-Whitney U rank sum test were used for measurement data and χ² test or Fisher’s exact probability method for counting data to analyze the data. 【Results】 After 6 months, the levels of fasting blood glucose, postprandial blood glucose, HbA1c, and visceral and subcutaneous fat in all the patients decreased, but the level of fasting c-peptide increased compared with the baseline (all P<0.05). Secondly, compared with the baseline, the control rate of HbA1c (35.21% vs. 13.71% ) and the comprehensive control rate (13.97% vs. 7.26% ) were both significantly increased at six months (P<0.05). Thirdly, after 6 months, the levels of fasting blood glucose, postprandial blood glucose, HbA1c, TG, TC, and UA were decreased more, while the fasting c-peptide and postprandial c-peptide were increased more in the patients of the HbA1c standard group (HbA1c<7% ) than those of the non-standard group. 【Conclusion】 The multiple benefits of blood glucose, blood lipid, uric acid and islet function can be achieved by taking type 2 diabetes patients into MMC. Meanwhile, the rates of HbA1c control and comprehensively reaching the standard are significantly increased. Therefore, MMC can explore a new way for the management of type 2 diabetic patients in this area.

Objective To investigate the the relationship of a high risk serum screen for Down syndrome in second trimester and adverse pregnancy outcomes,and to evaluate the predictive value for adverse pregnancy outcomes.Methods The tri-marker second trimester maternal serum screening for Down syndrome (alpha-fetoprotein,free beta-hCG and unconjugated estriol)was performed on the pregnant women at Peking Union Medical Hospital from January 2009 to January 2011.The cutoff valvue was 1/270.Pregnancy outcomes were followed up.The general condition and pregnancy complications of the pregnant women with high risk (high-risk group) were compared to that of the pregnant women with low risk (low-risk group); and with 35 years old as a demarcation,the incidences of adverse pregnancy outcomes were calculated in the two groups.Results ( 1 ) A total of 1935 cases were collected.And 1784 cases were with low risk,and 151 cases were with high risk.The difference of weight and gestational age betweem the two groups was not statistically significant ( P ＞ 0.05 ) ; the difference of age between the two groups was statistically significant ( P ＜ 0.01 ).(2) Pregnancy complications were found in 791 cases.In high-risk group,the incidences of gestational diaetes mellitus (GDM,13.9％),neonatal asphyxia (4.0％ ) and small for gestational age infant ( SGA,4.6％ ) were higher than that in low-risk group ( 8.4％,1.0％,1.6％ ),the difference was statistically significant ( P ＜ 0.05 ).The incidences of gestational hypertension disease,premature labor,oligohydrammios,placenta previa,placenta abruption,fetal macrosomia in the two groups was not statistically different (P ＞0.05).(3) In 1705 cases aged less than 35 years,129 cases (7.6％) were GDM,43 cases ( 2.5％ ) were gestational hypertension disease,61 cases ( 3.9％ ) were premature labor; in 230 cases aged 35 years or more,41 cases (17.8％ ) were GDM,12 cases (5.2％) were gestational hypertension disease,15 cases (6.5％ ) were premature labor,and the difference between the two groups was statistically significant ( P ＜ 0.05 ).In ＜ 35 years old group,the incidences of GDM,neonatal asphyxia and SGA (12.3％,4.4％,5.3％ ) were higher in the high-risk group than that (7.2％,0.9％,1.6％ ) in the low-risk group,and the difference was statistically significant ( P ＜ 0,05 ).In ≥35 years old group,the incidences of GDM,neonatal asphyxia and SGA ( 18.9％,2.7％,2.7％ ) were slightly higher in the high-risk group than that (17.6％,1.6％,1.6％ ) in the low-risk group,the difference between the two groups was not statistically significant (P ＞ 0.05 ).Conclusions The present study revealed apparertt increase in the adverse pregnancy outcomes in women with a high risk of Down syndrome screening test.Advanced age is the most important risk factor for a high risk of Down syndrome screening test and adverse pregnancy outcomes.More attention should be attached to the patients whose age were ＜35 years old and with a high risk of Down syndrome screening test.

Objective To investigate the relationship between abnormalities of maternal serum markers in Down syndrome screening in second trimester and adverse pregnancy outcome.Methods Totally,1935 pregnant women were screened for Down syndrome with maternal serum tri marker with time-resolved fluorescence assay,including alpha fetoprotein (AFP),free β-human chorionic gonadotropin (β-hCG) and unconjugated estriol (uE3),between 15 and 20+6 gestational weeks at Peking Union Hospital from January 1,2009 to January 31,2011,and were followed up till delivery.The relationship between incidence of adverse pregnancy outcomes and women with normal or abnormal levels of serum markers in Down syndrome screening was investigated.T-test or Chi-square test were applied for statistical comparison.Results (1) Among the 1935 pregnant women,normal levels of serum markers were found in 1255(normal group) and 680 were abnormal(abnormal group),in which 577 with only one abnormal serum marker,89 with two and 14 with three abnormal serum markers.According to the serum marker level,the 577 women with one abnormal serum marker were further divided into five groups,including high AFP group (n=17),low AFP group (n=114),high β-hCG group (n=242),low β-hCG group (n=139) and low uE3 group (n=65).The birth weight of infants in lower AFP group and the gestational age at delivery in low β-hCG group were greater than those in normal group [(61.3±9.1) kg vs (59.5±8.3) kg,(272.6±11.8) d vs (274.4±10.1) d,t=2.21 and 1.99,both P＜0.01].(2) The incidence of adverse pregnancy outcome in normal group was 42.8％(537/1255),while comparing with the abnormal group(43.7％,297/680),no statistical significance was shown (RR =1.02,P =0.71).While comparing with the normal group,the incidences of placenta previa [25.5％ (32/1255) vs 2/17,RR=4.61,P＜0.05] and abnormal placental morphology were higher in high AFP group [4.1％ (51/1255) vs 5/17,RR=7.24,P＜ 0.05],the incidence of gestational diabetes mellitus (GDM) was higher in low AFP group [8.1％ (101/1255) vs 14.4％(16/114),RR=1.74,P＜0.05],the incidence of placenta and membrane retention was higher in high β-hCG group [3.5％ (44/1255) vs 6.2％(15/242),RR=1.77,P＜0.05],the incidence of pre-eclampsia was higher in low β-hCG group [1.7％ (21/1255) vs 6.5％ (9/ 139),RR=3.87,P＜0.05].(3) There were 89 women with two abnormal serum markers.Comparing with the normal group,the incidences of small for gestional age (SGA) infants,oligohydramnios,abruptio placenta were higher in women with low AFP but high β-hCG [SGA infants:6.9％(2/29) vs 1.8％(22/1255),RR=3.94; oligohydramnios:20.7％(6/29) vs 6.4％(80/ 1255),RR=3.24; both P＜0.05],the incidences of oligohydramnios was higher in women with both low AFP and low uE3[3/14 vs 6.4％(80/1255),RR=3.36,P＜0.05],the incidence of premature birth and GDM were higher in women with both low β-hCG and low uE3 [premature birth:2/6 vs 4.3％(54/1255),RR=7.75; GDM:3/6 vs 8.0％ (101/1255),RR=6.21; both P＜0.05].(4) There were 14 women with three abnormal serum markers.The relationship between adverse outcome and abnormal serum markers did not show any statistical significance.Conclusions The abnormality of serum markers of Down syndrome screening is closely related to adverse pregnancy outcomes,and women with abnormal serum markers should be carefully monitored during pregnancy.

Object To study the glycosides from Swertia erythrosticta Maxim Methods The glycosides were isolated on silica gel column and purified by Sephadex LH20, their structures were identified by spectral data and chemical properties Results Seven compounds were obtained from aqueous extract and identified as swertianolin (Ⅰ), norswertianolin (Ⅱ), norswertiaglucoside (Ⅲ), isoorientin (Ⅳ), loganic acid (Ⅴ), gentiopicroside (Ⅵ) and ? gentiobiose (Ⅶ) Conclusion Compounds Ⅲ, Ⅳ, Ⅴ, and Ⅶ were first obtained from this plant