Objective:To explore the causal association between insulin-like growth factor-1(IGF-1)and colorectal cancer(CRC)based on two sample Mendelian randomization(MR)analysis.Methods:A bidirectional two sample MR analysis was conducted based on publicly aggregated data from the IEU OpenGWAS project.The inverse variance weighted(IVW)method was used as the main analysis model to assess the causal relationship between IGF-1 and CRC.Additional analyses were performed using weighted median(WM),MR-Egger regression,weighted mode estimator(WME),and simple mode(SM)methods.Sensitivity analysis was performed to assess the robustness of the results.Results:A total of 386 single nucleotide polymorphisms(SNPs)were selected as instrumental variables(IVs)with IGF-1 as the exposure factor.The MR analysis results revealed a positive causal association between IGF-1 and the risk of CRC[odds ratio(OR)=1.178,95％confidence interval(CI):1.092-1.272)](P＜0.001),and the association remained significant after adjusting for height[OR(95％CI)=1.214(1.111,1.327)](P＜0.001).Cochran's Q-test showed heterogeneity among the IVs(P＜0.05),while the horizontal pleiotropy of IV was not detected by the MR-Egger regression(P＞0.05).The leave-one-out analysis showed that the MR results were robust.Reverse MR analysis indicated no reverse causal relationship between IGF-1 and CRC[OR(95％CI):1.017(0.997,1.037)](P=0.103).Conclusion:There is a causal relationship between IGF-1 level and CRC,and elevated IGF-1 level could be a risk factor for CRC.

Objective To compare clinical efficacy of different regimens in treatment of pruritus in maintenance hemodialysis(MHD)patients.Methods A total of 50 patients with MHD admitted to the Sixth People's Hospital of Jiujiang City from August 1,2022 to April 30,2024 as subjects and were divided into two groups according to random number table method.Control group(n=25)was treated with sodium thiosulfate.On this basis,gabapentin combination therapy was added in observation group(n=25).Effects of two groups were compared after 8 weeks of treatment.Results Total clinical effective rate of observation group was significantly higher than that of control group(P＜0.05).After 8 weeks of treatment,scores and total scores of all dimensions of quality of life in two groups were higher than before treatment,and observation group was higher than control group(P＜0.05).Conclusion Sodium thiosulfate combined with gabapentin in treatment of MHD patients with pruritus can not only relieve pruritus symptoms,improve sleep quality,but also have good safety.

Objective To compare clinical efficacy of different regimens in treatment of pruritus in maintenance hemodialysis(MHD)patients.Methods A total of 50 patients with MHD admitted to the Sixth People's Hospital of Jiujiang City from August 1,2022 to April 30,2024 as subjects and were divided into two groups according to random number table method.Control group(n=25)was treated with sodium thiosulfate.On this basis,gabapentin combination therapy was added in observation group(n=25).Effects of two groups were compared after 8 weeks of treatment.Results Total clinical effective rate of observation group was significantly higher than that of control group(P＜0.05).After 8 weeks of treatment,scores and total scores of all dimensions of quality of life in two groups were higher than before treatment,and observation group was higher than control group(P＜0.05).Conclusion Sodium thiosulfate combined with gabapentin in treatment of MHD patients with pruritus can not only relieve pruritus symptoms,improve sleep quality,but also have good safety.

Objective To monitor the antifungal resistance of clinical isolates of Candida spp.in the East China region.Methods MALDI-TOF MS or molecular methods were used to re-identify the strains collected from January 2018 to December 2022.Antifungal susceptibility testing was performed using the broth microdilution method.The susceptibility test results were interpreted according to the breakpoints of 2022 Clinical and Laboratory Standards Institute(CLSI)documents M27 M44s-Ed3 and M57s-Ed4.Results A total of 3 026 strains of Candida were collected,65.33％of which were isolated from sterile body sites,mainly from blood(38.86％)and pleural effusion/ascites(10.21％).The predominant species of Candida were Candida albicans(44.51％),followed by Candida parapsilosis complex(19.46％),Candida tropicalis(13.98％),Candida glabrata(10.34％),and other Candida species(0.79％).Candida albicans showed overall high susceptibility rates to the 10 antifungal drugs tested(the lowest rate being 93.62％).Only 2.97％of the strains showed dose-dependent susceptibility(SDD)to fluconazole.Candida parapsilosis complex had a SDD rate of 2.61％and a resistance rate of 9.42％to fluconazole,and susceptibility rates above 90％to other drugs.Candida glabrata had a SDD rate of 92.01％and a resistance rate of 7.99％to fluconazole,resistance rates of 32.27％and 48.24％to posaconazole and voriconazole non-wild-type strains(NWT),respectively,and susceptibility rates above 90％to other drugs.Candida tropicalis had resistance rates of 29.55％and 26.24％to fluconazole and voriconazole,respectively,resistance rates of 76.60％and 21.99％to posaconazole and echinocandins non-wild-type strains(NWT),and a resistance rate of 2.36％to echinocandins.Conclusions The prevalence and species distribution of Candida spp.in the East China region are consistent with previous domestic and international reports.Candida glabrata exhibits certain degree of resistance to fluconazole,while Candida tropicalis demonstrates higher resistance to triazole drugs.Additionally,echinocandins resistance has emerged in Candida albicans,Candida glabrata,Candida tropicalis,and Candida parapsilosis.

Objective: To investigate the clinically and genetic characteristics of children with Leigh syndrome. Method: Patients with clinically diagnosed Leigh syndrome(LS)in the department of Neurology, Beijing Children′s Hospital from January 2013 to February 2016 underwent the mitochondrial DNA (mtDNA) and nuclear DNA (nDNA) detecting with next generation sequencing (NGS) technology. The clinical data of gene confirmed cases were retrospectively collected and analyzed. The differences in the onset age, clinical manifestations, lactic acid level and MRI results between the mtDNA variation and nDNA variation were compared and analyzed.t test, Chi-square test and Fisher′s exact test were used for statistical analysis. Result: Thirty-five cases were diagnosed by gene detection, including 20 males and 15 females. The median onset age was 1 year (ranging from the neonatal period to 4.4 years old). The age of onset within 2 years accounted for 74%(26 cases). The onset age of initial symptoms, including developmental delay, developmental regression, and seizures, were 6 (4, 12) months, 12 (8, 14) months, and 6 (1, 23) months respectively. The onset age of ptosis, extrapyramidal symptoms and ataxia were 26 (18, 44) months, 28 (23, 40) months and 28 (19, 35) months, respectively. There were significant differences in the onset age between the three groups (H=21.919, P=0.01). Within the 35 cases, 29 were manifested with developmental delay (83%), 26 with dystonia (74%), 18 with growth retardation, 15 with myasthenia, 13 with developmental regression, 11 with dysphagia, 10 with feeding difficulties, 4 with skeletal dysplasia, and 2 with digestive tract symptoms; nystagmus and respiratory abnormalities were observed in 9 cases respectively; extrapyramidal symptoms, peripheral nerve injury, ptosis, seizures were observed in 8 cases respectively; and ataxia, ophthalmoplegia and hypertrichiasis were found in 5 cases respectively.The blood lactic acid was measured in 32 LS patients, within which 23 cases (72%) had increased results; 8 out of 11 cases who underwent were cerebrospinal fluid lactic acid test had increased results. The results of neuroimaging revealed that all the patients were involved in the brainstem and (or) basal ganglia, of whom 27 (77%) had brainstem involvement, 24 (69%) had basal ganglia involvement. Thirteen out of 14 patients who had medulla oblongata involvement had nDNA variation; while 7 out of 8 patients with cerebellar involvement had nDNA variation. Genetic etiology was confirmed in all patients, among whom there were 17 cases (49%) with mtDNA mutation, including 8993T>C/G (n=5), 14487T>C (n=4), 13513G>A (n=2), 9176T>C, 10158T>C, 3697G>A, 10191T>C, 14459A>G and 11777C>A (n=1) respectively. Remaining 18 cases(51%) had nDNA mutation, including SURF1 gene(n=10), PDHA1 gene(n=3) and one case each of NDUFV1, NDUFAF6, NDUFAF5, NDUFS1 and COQ7 genes. In this study, 27 types of mutations were founded, 15 of which had not been previously reported. Respiratory chain gene mutations have been found in 31 cases(89%); 3 cases had PDHc gene mutations, and 1 case had other mutation. Conclusion LS usually occurs in infants. The most common primary symptoms are age-dependent abnormal movements, ocular symptoms, and seizures. Respiratory chain defects is the most common causes of LS.SURF1 is the most common variation, followed by 8993T>C/G, 14487 T>C and 13513G>A mutation.

Objective:To confirm the novel allele HLA-A*01∶130 and analyzed the nucleotide sequence of the abnormal reaction pattern.Methods: The HLA typing of sample DNA was performed by PCR-SBT.The ambiguous novel HLA allele was confirmed with single stranded SBT method,then DNA sequencing was performed to identify the difference between the novel allele and HLA-A?01:66 allele.Finally, it was modeled by Swiss-Model to three-dimensional structure of HLA Molecule.Results: The novel allele was not the same with all known HLA-A allele sequence.After analysis,there was one nucleotide differed from the A?01:66 at position 368 where A→G( codon 99 TAT→TGT) resulting in a coding change,99 Tyr was changed to Cys.The amino acid substitution at residue 99 the HLA polypeptide was located in a beta-sheet of antigenic peptide-binding region.Conclusion: The allele is a novel allele that has now been officially named as HLA-A*01∶130 by the World Health Organization( WHO) HLA Nomenclature Committee.

Objective The continuous nursing model was introduced into nursing of type 2 diabetes mellitus in order to improve the self-management ability and behavior.Methods One hundred and fifty eight patients with type 2 diabetes mellitus in endocrine department of our hospital from January to December 2013 were selected and divided into the control group and experimental group randomly.There were 79 patients in the control group,5 patients were lost to follow-up and 79 patients in the experimental group,4 patients were lost to follow-up.Traditional nursing were only done in the control group,while continuous nursing model was adopted in the experimental group.The self management ability and behavior were compared between two groups of patients.Results By took the continuous nursing model in our hospital,diet control,sports management,blood glucose monitoring,medication management compliance in the experimental group were better than those of the control group patients,x2 values were 9.86,9.37,10.12 and 17.52.The ratio of patients with better self-management behavior in diet control,sports management,medication management and blood glucose control had significant difference compared with those of the control group,x2 values were 9.497,10.285,10.016 and 13.513.Conclusions The self-management ability and behavior of type 2 diabetes mellitus patients were improved by continuous nursing model.

OBJECTIVETo explore the differences in volume and localization of the internal gross target volume and planning target volume delineated by clips and/or seroma based on four-dimensional computed tomography (4D-CT) during free-breathing in breast cancer patients after breast conserving surgery.

METHODSFifteen breast cancer patients after breast-conserving surgery (BCS) were recruited for external-beam partial breast irradiation (EB-PBI). On the ten sets CT images, the gross tumor volumes (GTV) formed by the clips, the seroma, and both the clips and seroma were delineated and defined as GTVc, GTVs and GTVc+s, respectively. Ten GTVc, GTVs and GTVc+s on the ten sets CT images produced the IGTVc, IGTVs, IGTVc+s. The PTVc, PTVs, PTVc+s were created by adding 15 mm to the IGTVc, IGTVs, IGTVc+s, respectively. The IGTV and PTV volume and distance between the centers of IGTVc, IGTVs, IGTVc+s and PTVc, PTVs, PTVc+s were all recorded. Conformity index (CI) and degree of inclusion (DI) were calculated for IGTV/IGTV and PTV/PTV, respectively.

RESULTSThe volume of IGTVc+s[(35.73 ± 19.77) cm³] was significantly larger than the IGTVc [(28.35 ± 17.54) cm³] and IGTVs [(24.19 ± 21.53) cm³] (P < 0.05), and the volume of PTVc+s [(191.59 ± 69.74) cm³] was significantly larger than that of the PTVc [(161.53 ± 61.07) cm³] and PTVs [(148.98 ± 62.22)cm³] (P < 0.05). There were significant differences between the DIs of IGTVc in IGTVc+s and IGTVc+s in IGTVc, the DIs of IGTVs in IGTVc+s and IGTVc+s in IGTVs, the DIs of PTVc in PTVc+s and PTVc+s in PTVc, and the DIs of PTVs vs. PTVc+s and PTVc+s in PTVs (P < 0.05 for all). The CI of IGTVc/IGTVc+s (0.63 ± 0.14) and the CI of IGTVs/IGTVc+s (0.54 ± 0.17) were significant larger than that of the CI of IGTVc/IGTVs (0.40 ± 0.14)(P < 0.05). There were non-significant differences among the CI of PTVc/PTVs, PTVc/PTVc+s and PTVs/PTVc+s (0.73 ± 0.12, 0.78 ± 0.13 vs. 0.75 ± 0.17). The DIs and CIs of IGTV/IGTV and PTV/PTV were negatively correlated with their centroid distance (P < 0.05).

CONCLUSIONSThere are volume difference and spatial mismatch between the target volumes delineated on the basis of surgical clips and seroma. The DI and CI between the PTVs are larger than that between the IGTV. External-beam partial breast irradiation should be implemented based on the PTV that is defined based on both seroma and surgical clips.

Breast Neoplasms ; diagnostic imaging ; radiotherapy ; Female ; Four-Dimensional Computed Tomography ; Humans ; Mastectomy, Segmental ; methods ; Radiotherapy Dosage ; Respiration ; Seroma ; diagnostic imaging ; radiotherapy ; Surgical Instruments

Objective To investigate the correlations between the displacements of surgical clips,skin markers and the gross tumor volume (GTV) delineated by surgical clip and seroma based on fourdimensional computed tomography (4DCT) during normal breathing.Methods On each of the 10 respiratory phases of 4DCT with 15 patients of breast cancer,the surgical cavity,which was defined as GTV and formed by both surgical clips and seroma,all surgical clips in the cavity,and skin markers on the skin were delineated by the same radiation oncologist.The center displacements of GTV,selected boundary surgical clips and skin markers in the left-right (LR),anterior-posterior (AP),and superior-inferior (SI) directions were recorded and analyzed by Pearson method.Results In the AP direction,there was a positive correlation between the displacements of the GTV and the inner clip (r =0.643,P =O.013).In the SI direction,the displacement of GTV was positively correlated with those of the lower clip and the skin marker at anterior body midline (r =0.857 and 0.643,P =0.002 and 0.013).In the LR and AP directions,there was a positive correlation between the displacements of the outer clip and the ipsilateral skin marker (r =0.757 and 0.697,P =0.001 and 0.025),but they were negatively correlated with each other in the SI direction (r =-0.647,P =0.043).In the AP direction,there was a positive correlation between the displacements of the inner clip and the skin marker at the anterior body midline (r =0.738,P =0.015).Conclusions The correlations between the displacement of GTV delineated by surgical clips and seroma and the displacements of surgical slips and skin markers vary under different conditions,and so does the correlation between the displacements of surgical clips and skin markers.

ly decreased,which will increase during HAART.It may indicate CD4+ cells restoration was delayed during HAART compared with peripheral blood.