Pancreatic duct stones are one of the benign pancreatic diseases. It is often combined with chronic pancreatitis. The disease will progress to pancreatic cancer without timely treatment, thus reducing the quality of life of patients and seriously affecting their physical and psychological health. In recent years, with the development of imaging technology, the detection rate of pancreatic duct stones has been increasing year by year. This article reviewed the etiology, diagnosis and treatment strategies for pancreatic duct stones in recent years.

Objective:To investigate the current status of social support, readiness for discharge, and loneliness in elderly patients with diabetes mellitus type 2 (T2DM) and the relationship among them.Methods:A total of 230 elderly T2DM patients treated in the Endocrinology Department of the First Affiliated Hospital of Anhui Medical University from April to October 2022 were selected as research objects by the convenient sampling method. Patients were surveyed using a general information questionnaire, Readiness for Discharge Scale, Perceived Social Support Scale and UCLA Loneliness Scale. The Spearman correlation analysis was used to investigate the correlation between social support, loneliness and discharge readiness in elderly T2DM patients. Model 4 in SPSS Process 4.0 software was used to examine the mediating effects of discharge readiness, social support and loneliness in elderly patients with T2DM. A total of 230 questionnaires were sent out and 222 were effectively received, with effective recovery of 96.5% (222/230) .Results:The total scores of Readiness for Discharge Scale, Perceived Social Support Scale and UCLA Loneliness Scale in 222 elderly T2DM patients were 104.00 (91.00, 113.00), 65.00 (57.50, 72.00) and 36.50 (26.00, 44.25), respectively. Spearman correlation analysis showed that social support was positively correlated with discharge readiness ( r=0.448, P<0.05), and loneliness was negatively correlated with social support and readiness for discharge ( r=-0.563, -0.512, P<0.05). The mediating effect analysis showed that loneliness played a partial mediating role between social support and hospital readiness, with an effect ratio of 42.8%. Conclusions:Clinical medical staff should pay attention to the psychological state of patients, alleviate the loneliness of elderly T2DM patients, improve the level of social support, so as to improve the readiness of patients for discharge and increase the self-management ability of elderly diabetes mellitus type 2 patients after discharge.

Objective To establish a quality control method for bomeol and artificial musk in Xinfufang-Zhenzhusan and Xinfufang-Zhenzhugao.Methods We used petroleum ether-toluene-ethyl acetate (9:3:2)as developer for TLC to identify isoborneol and borneol and petroleum ether-dichloromethane (2:3) as developer for TLC to identificate musk ketone.Agilent 7890 B gas chromatograph,FDI detector;Column:Thermo-TG-WaxMS GC (0.25 mm × 30 m,0.25 mm) was employed;the carrier gas was high purity nitrogen and flow rate for 1 mg/ml,the injection port temperature is 200 C and detector temperature is 250 ℃;the split ratio is 10:1 and injection volume was 1 μl,using temperature programmed.Results The isoborneol,borneol and musk ketone in the range of 0.001-10 mg/ml showed good linearity.The recovery of the method is in the range of 95 ％ to 105 ％.The TLC for isobomeol,bomeol,musk ketone can be identified easily.Conclusions The method was simple and reasonable,which can be used for the quality control of borneol and artificial musk in the Xinfufang-Zhenzhusan and Xinfufang-Zhenzhugao.

Objective:To examine the validity and reliability of the Pediatric Symptom Checklist(PSC)in suspended students in China(based on parent reports).Methods:A total of 184 parents were included in this study,PSC was used to assess students aged 10-19 who were suspended from primary and secondary school due to psy-chological problems.Results:After removing the fourth entry of the original scale("too active,non-active"),the confirmatory factor analysis showed that the three-factor model fit well(x2/df=1.57,RMSEA=0.06,CFI=0.93,TLI=0.91,SRMR=0.07).The Cronbach's alpha coefficients of the scale overall and the three dimensions of internalization,externalization and attention problem were 0.85,0.80,0.76 and 0.69,respectively.Conclusion:After removing the fourth entry,PSC has good construct validity and reliability evaluating psychological problems of suspended primary and secondary school students.

Objective:To evaluate the safety and efficacy of tumor-treating fields (TTFields) and chemoradiation in patients with high-grade glioblastoma.Methods:Clinical data of 38 patients admitted to the Jiangsu Cancer Hospital from September 2021 to May 2023 who were diagnosed with high-grade glioblastoma (36 cases of World Health Organization grade Ⅳ and 2 cases of grade Ⅲ) were retrospectively analyzed. All patients received TTFields combined with concurrent chemoradiation after surgery. Response assessment in neuro-oncology (RANO) criteria was used to evaluate the glioma responses as tumor remission, stable or progression. Common terminology criteria for adverse events v5.0 and TTFields related skin adverse reaction (dAE) criteria were used to evaluate the adverse events. Treatment compliance was assessed by data on the NovoTTF-200A therapeutic device, calculated as a percentage of daily TTFields usage time. Survival analysis was estimated by the Kaplan-Meier method and compared by the log-rank test.Results:The median duration of treatment with TTFields in 38 patients was 20 h (rang: 2.4-22.6 h), and the median treatment compliance was 83% (range: 10%-94%). After 42 days of TTFields combined with concurrent chemoradiation, 12 patients who underwent complete tumor resection were assessed as stable according to RANO criteria. Among the 26 patients who underwent partial tumor resection, 23 (88%) were evaluated as disease remission according to RANO criteria. The 7-, 10-, 13-month progression-free survival rate was 81.0%、64.0%、49.5%, repectively. The common adverse events included grade 1 (45%) and grade 2 (8%) dAE, without grade 3-4 dAE. Typical presentations included contact dermatitis, blisters, lesions or ulcers, and abscesses. The median follow-up time was 10.0 months (range: 1.6-21.3 months). At follow-up as of July 2023, 26 of the 38 patients were stable and 12 had disease progression (8 died).Conclusion:The preliminary results show that TTFields combined with chemoradiation is effective, safe and reliable treatment for high-grade glioblastoma.

Objective To explore the impact of IL10-592 (rs1800872) single nucleic acid polymorphism (SNP) on the prognosis of HLA matched unrelated hematopoietic stem cell transplantation (HSCT).Methods The polymorphism of IL10-592 in 104 recipient-donor pairs and 100 healthy volunteers was analyzed with sequence based typing (SBT).Results When the genotype of IL1 0-592 in donors and recipients matched,AA/AA genotype had higher incidence of Ⅲ-Ⅳ aGVHD than AC/AC or CC/CC genotype (47.1％,3.7％,0,P=0.002).When the genotype of IL10-592 in donors and recipients mismatched,recipients with AC genotype or donors with AA genotype,there was significant different incidence of Ⅲ-Ⅳ aGVHD among donors or recipients with different genotype (P=0.046,P=0.041).The recipients with AA genotype had higher incidence of Ⅲ-Ⅳ aGVHD than AC or CC genotype (27.8％ vs 10.2％,11.1％;P=0.072),and higher incidence of intestinal aGVHD (22.2％vs 5.1％,11.1％;P=0.040),lower incidence of 2-year overall survival (OS:48.2％ vs 75.1％,85.7％;P=0.002),lower incidence of 2 year disease free survival (DFS:48.5％ vs 66.3％,76.2％;P=0.045).Patients had higher incidence of Ⅲ-Ⅳ aGVHD with donors of AA genotype than with donors of AC or CC genotype (26.5％ vs 8.9％,0;P=0.024),and higher incidence of intestinal aGVHD (20.4％ vs 4.4％,0;P=0.026).In multivariate analysis,the genotype of IL10-592AA in recipients and donors had increased risk of Ⅲ-Ⅳ aGVHD (OR=3.3,P=0.049;OR=3.9,P=0.043).There were no statistical differences on the incidence of cGVHD and relapse.Conclusion In HLA-10/10 matched unrelated HSCT,the presence of IL10-592 AA genotype in recipients and/or donors is an adverse factor for Ⅲ-ⅣaGVHD,worse OS and 2-year DFS.

A 28-year-old woman was found to have coagulation factor Ⅷ activity (FⅧ∶C) <1% and von Willebrand factor antigen (VWF∶Ag) <1% during routine prenatal examinations. No pathogenic variation was found in the exon region of the VWF gene using next-generation sequencing. The clinical presentation of this patient does not match the clinical characteristics of type Ⅲ hemophilia [von Willebrand disease (VWD) ]; therefore, third-generation sequencing technology was used to perform whole-genome sequencing on the patient and her family members. Multiple members of the patient’s paternal family carried a heterozygous variant of VPS33B, c.869G>C. The family members carrying this variant all had varying degrees of reduced VWF levels (39% -56% ). Moreover, the proband was detected with the heterozygous variant c.1474dupA in GP1BA. The ACMG and Clinvar databases determined that this variation was associated with platelet-type pseudo VWD. The decrease in VWF levels caused by heterozygous variations in VPS33B in families is the first international report, and no previous studies have reported cases of severe decrease in plasma VWF levels caused by double heterozygous variations in VPS33B and GP1BA.

Objective To explore the clinical features oflymphoplasmacytic diseases with MyD88 L265P mutation.Methods To analyze the distribution of MYD88 L265P mutation in patients with lymphoplasmacytic diseases by using of ARMS PCR-CE.Results There were 25(30.9％) MyD88 L265P mutated patients in 81 patients.The mutation was frequently observed in 14 patients with WM (77.8％,14/ 18),2 patients with lymphoplasmacytic lymphoma (66.7％,2/3),1 acute lymphocytic leukemia patient (50.0％,1/2),3 multiple myeloma patients (30.0％,3/10),1 patient with monoclonal gammopathy of undetermined significance (25％,1/4),3 patients with chronic lymphocytic leukemia (13.0％,3/23) and 1 lymphoma patient (4.8％,1/21).20 (80％,20/25) patients were identified with IgM subtype.Compared with wild-type group of 56 cases,mutated patients were older (median age:67 years vs 55 years,P＜ 0.001),with lower WBC count (median count:5.23 × 109/L vs 10.80× 109/L,P=0.001),lower HGB level (median count:85 g/L vs 119 g/L,P＜0.001).Conclusion MyD88 L265P mutation was mainly observed in patients with IgM subtype lymphoplasmacytic diseases,and Waldenstrom's macroglobulinemia was the most common disease.Compared with the wild-type group,patients with MyD88 L265P mutation were older and had lower WBC count,lower level of HGB.However,further studies were needed to test the prognostic value of MyD88 L265P mutation.

OBJECTIVETo explore the impact of ITD mutation characteristics on the overall survival (OS) and complete remission duration (CRD) in FLT3-ITD positive non-M3 acute myeloid leukemia (AML).

METHODSCapillary electrophoresis was used to detect the FLT3-ITD characteristics after PCR amplication. Single or multiple mutations were identified by the numbers of peak. FLT3-ITD mutation burden was calculated by the peak area of mutant divided by the wild-type and mutant peak areas. Clinical data was collected and followed up in the FLT3-ITD mutation patients.

RESULTSMultiple ITD mutations were common in patients aged 60 and above. Patients with single ITD mutation had higher percentage of blasts in bone marrow than multiple ITD mutations (0.758 vs 0.638, P=0.028). The numbers and length of FLT3-ITD mutation had no impact on prognosis. Patients with less than 10% of ITD mutation burden showed no difference with the intermediate-risk c-kit group in OS and CRD, but the two groups had longer OS and CRD than ITD mutation burden above 10% (OS: undefined, undefined, 9.9 months, P<0.05; CRD: undefined, undefined, 6.7 months, P<0.05). In patients with ITD mutation burden above 10%, cases with NPM1 or CEBPA mutation alone had markedly longer CRD than ITD mutation alone (25.0 vs 5.1 months, P=0.003), while OS were similar (11.4 vs 8.0 months, P>0.05).

CONCLUSIONNon-M3 AML patients with less than 10% FLT3-ITD mutation burden had a better prognosis than those above 10%.