Objective To explore the development trajectory and root cause of kinesiophobia in patients with diabetic peripheral neuropathy.Methods By the convenience sampling method,240 diabetic peripheral neuropathy patients who were hospitalized in the Department of Endocrinology of a tertiary A hospital in Jiangsu Province from May 2022 to November 2022 were selected.The baseline data of the patients are collected using a general questionnaire,the Tampa Scale for Kinesiophobia,the Chinese version of the Multidimensional Fatigue Inventory-20,the Pittsburgh Sleep Quality Index,the Social Support Rate Scale,and the Numerical Rating Scale for Pain.At the time of discharge,and at 3,6,and 12 months post-discharge,the level of kinesiophobia in the patients is assessed.The growth mixture model was used to classify the trajectory of kinesiophobia and analyze its root causes.Results Ultimately,227 patients in this study completed the survey.The trajectories of kinesiophobia in patients with diabetic peripheral neuropathy were divided into 3 latent classes:persistent high kinesiophobia group(22.5％),moderate kinesiophobia decline group(44.9％)and persistent low kinesiophobia group(32.6％).The results of multivariate Logistic regression analysis showed that age,frequency of hypoglycemia,complications,sleep quality,fall history within a year,pain and fatigue score were influencing factors of the latent classes of kinesiophobia trajectories in patients with DPN(P＜0.05).Conclusion Within 12 months after discharge,the kinesiophobia of patients with diabetic peripheral neuropathy shows population heterogeneity.Medical staff should give targeted interventions according to the developmental trajectories of kinesiophobia and root cause analysis.

Objective To explore the development trajectory and root cause of kinesiophobia in patients with diabetic peripheral neuropathy.Methods By the convenience sampling method,240 diabetic peripheral neuropathy patients who were hospitalized in the Department of Endocrinology of a tertiary A hospital in Jiangsu Province from May 2022 to November 2022 were selected.The baseline data of the patients are collected using a general questionnaire,the Tampa Scale for Kinesiophobia,the Chinese version of the Multidimensional Fatigue Inventory-20,the Pittsburgh Sleep Quality Index,the Social Support Rate Scale,and the Numerical Rating Scale for Pain.At the time of discharge,and at 3,6,and 12 months post-discharge,the level of kinesiophobia in the patients is assessed.The growth mixture model was used to classify the trajectory of kinesiophobia and analyze its root causes.Results Ultimately,227 patients in this study completed the survey.The trajectories of kinesiophobia in patients with diabetic peripheral neuropathy were divided into 3 latent classes:persistent high kinesiophobia group(22.5％),moderate kinesiophobia decline group(44.9％)and persistent low kinesiophobia group(32.6％).The results of multivariate Logistic regression analysis showed that age,frequency of hypoglycemia,complications,sleep quality,fall history within a year,pain and fatigue score were influencing factors of the latent classes of kinesiophobia trajectories in patients with DPN(P＜0.05).Conclusion Within 12 months after discharge,the kinesiophobia of patients with diabetic peripheral neuropathy shows population heterogeneity.Medical staff should give targeted interventions according to the developmental trajectories of kinesiophobia and root cause analysis.

Objective To explore the potential categories of fatigue trajectory in patients with diabetic peripheral neuropathy and analyze the influencing factors.Methods Convenience sampling method was used to select 426 patients with diabetic peripheral neuropathy who were hospitalized in a tertiary hospital in Jiangsu Province from April 2022 to April 2023.General information and disease related data of the patients were collected,and the Chinese version of Multi-dimensional Fatigue Scale,Pittsburgh Sleep Quality Index Scale,Social support Rating Scale,pain number rating scale and Tampa scale of kinetophobia were used to investigate at discharge(T1).The Chinese version of multi-dimensional fatigue scale was used to investigate 3 months after discharge(T2),6 months after discharge(T3),and 12 months after discharge(T4).A mixed growth model was used to identify the potential categories of fatigue trajectory and logistic regression were employed to analyze the influencing factors of fatigue.Results 414 patients finished the study.Three categories of fatigue trajectory in the patients with diabetic peripheral neuropathy were identified:significantly increasing group(19.6%),slowly increasing group(47.8%),and decreasing group(32.6%).Logistic regression analysis showed that age,sleep,social support,number of comorbidities,body mass index(BMI),pain and fear of exercise were the factors influencing the potential categories of fatigue trajectory in the DPN patients.Conclusions There are three potential categories of fatigue trajectories in DPN patients.Age,sleep disorders,social support,comorbidities,BMI,pain score,and exercise fear were influencing factors of fatigue in patients with DPN.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To explore the potential categories of self-management behavior in prediabetes patients and analyze the influencing factors of different potential categories.Methods A convenient sampling method was used to select pre-diabetic patients treated in physical examination centers and endocrinology outpatient clinics in 2 tertiary A hospitals in Jiangsu Province from September 2022 to June 2023.General data questionnaire,Prediabetic Disease Knowledge Questionnaire,Prediabetes Self-management Scale,Diabetes Self-efficacy Scale and Social Support Rating Scale were used for investigation.Results A total of 445 subjects were included in this study,with an average age of(44.92±4.98)years.4 potential categories of self-management behavior were identified,namely low self-management(16.4％),static self-management(19.1％),dynamic self-management(25.6％)and high self-management(38.9％).Occupational status,marital status,family per capita monthly income,family history of diabetes,disease knowledge,self-efficacy and social support were the influencing factors of self-management behavior in prediabetes patients(P＜0.05).Conclusion There are significant category characteristics of self-management behavior in patients with prediabetes.Medical staff can identify the category characteristics and influencing factors early,and provide bases for medical staff to formulate targeted clinical intervention measures to help patients improve their self-management level.

OBJECTIVE: To investigate the effect of interference of P2X4 receptor expression in tumor-associated macrophages (TAMs) on invasion and migration of glioma cells. METHODS: C57BL/6 mouse models bearing gliomas in the caudate nucleus were examined for glioma pathology with HE staining and expressions of Iba-1 and P2X4 receptor with immunofluorescence assay. RAW264.7 cells were induced into TAMs using conditioned medium from GL261 cells, and the changes in mRNA expressions of macrophage polarization-related markers and the mRNA and protein expressions of P2X4 receptor were detected with RT-qPCR and Western blotting. The effect of siRNA-mediated P2X4 interference on IL-1β and IL-18 mRNA and protein expressions in the TAMs was detected with RT-qPCR and Western blotting. GL261 cells were cultured in the conditioned medium from the transfected TAMs, and the invasion and migration abilities of the cells were assessed with Transwell invasion and migration experiment. RESULTS: The glioma tissues from the tumor-bearing mice showed a significantly greater number of Iba-1-positive cells, where an obviously increased P2X4 receptor expression was detected (P=0.001), than the brain tissues of the control mice (P < 0.001). The M2 macrophage markers (Arg-1 and IL-10) and M1 macrophage markers (iNOS and TNF-α) were both significantly up-regulated in the TAMs derived from RAW264.7 cells (all P < 0.01), but the up-regulation of the M2 macrophage markers was more prominent; the expression levels of P2X4 receptor protein and mRNA were both increased in the TAMs (P < 0.05). Interference of P2X4 receptor expression significantly lowered the mRNA(P < 0.01)and protein (P < 0.01, P < 0.05)expression levels of IL-1β and IL-18 in the TAMs and obviously inhibited the ability of the TAMs to promote invasion and migration of the glioma cells (P < 0.05). CONCLUSION Interference of P2X4 receptor in the TAMs suppresses the migration and invasion of glioma cells possibly by lowering the expressions of IL-1β and IL-18.
Animals ; Culture Media, Conditioned ; Glioma ; Interleukin-18 ; Mice ; Mice, Inbred C57BL ; RNA, Messenger ; Receptors, Purinergic P2X4/metabolism* ; Tumor-Associated Macrophages

OBJECTIVE: To investigate the cytotoxic effect and its mechanism of the micromolecule compound on the leukemia cells. METHODS: The cytotoxic effects of 28 Nilotinib derivatives on K562, KA, KG, HA and 32D cell lines were detected by MTT assays, and the compound Nilo 22 was screen out. Cell apoptosis and cell cycle on leukemia cells were detected by flow cytometry. The effect of compound screened out on leukemogenesis potential of MLL-AF9 leukemia mice GFP RESULTS: Nilo 22 serves as the most outstanding candidate out of 28 Nilotinib derivatives, which impairs leukemia cell lines, but spares normal hematopoietic cell line. Comparing with Nilotinib, Nilo 22 could induce the apoptosis of GFP CONCLUSION Nilo 22 shows a significant cytotoxic effect on mice and human leukemia cells, especially for drug resistance cells. Nilo 22 is a promising anti-leukemia agent to solve the common clinical problems of drug resistance and relapse of leukemia.
Animals ; Apoptosis/drug effects* ; Cell Cycle/drug effects* ; Cell Line, Tumor ; Humans ; Leukemia ; Mice ; Myeloid-Lymphoid Leukemia Protein/genetics* ; Telomerase/metabolism* ; Telomere/metabolism*

Objective: To explore the effect of perioperative chemotherapy on the prognosis of gastric cancer patients under real-world condition. Methods: A retrospective cohort study was carried out. Real world data of gastric cancer patients receiving perioperative chemotherapy and surgery + adjuvant chemotherapy in 33 domestic hospitals from January 1, 2014 to January 31, 2016 were collected. Inclusion criteria: (1) gastric adenocarcinoma was confirmed by histopathology, and clinical stage was cT2-4aN0-3M0 (AJCC 8th edition); (2) D2 radical gastric cancer surgery was performed; (3) at least one cycle of neoadjuvant chemotherapy (NAC) was completed; (4) at least 4 cycles of adjuvant chemotherapy (AC) [SOX (S-1+oxaliplatin) or CapeOX (capecitabine + oxaliplatin)] were completed. Exclusion criteria: (1) complicated with other malignant tumors; (2) radiotherapy received; (3) patients with incomplete data. The enrolled patients who received neoadjuvant chemotherapy and adjuvant chemotherapy were included in the perioperative chemotherapy group, and those who received only postoperative adjuvant chemotherapy were included in the surgery + adjuvant chemotherapy group. Propensity score matching (PSM) method was used to control selection bias. The primary outcome were overall survival (OS) and progression-free survival (PFS) after PSM. OS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the last effective follow-up or death. PFS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the first imaging diagnosis of tumor progression or death. The Kaplan-Meier method was used to estimate the survival rate, and the Cox proportional hazards model was used to evaluate the independent effect of perioperative chemo therapy on OS and PFS. Results: 2 045 cases were included, including 1 293 cases in the surgery+adjuvant chemotherapy group and 752 cases in the perioperative chemotherapy group. After PSM, 492 pairs were included in the analysis. There were no statistically significant differences in gender, age, body mass index, tumor stage before treatment, and tumor location between the two groups (all P>0.05). Compared with the surgery + adjuvant chemotherapy group, patients in the perioperative chemotherapy group had higher proportion of total gastrectomy (χ(2)=40.526, P<0.001), smaller maximum tumor diameter (t=3.969, P<0.001), less number of metastatic lymph nodes (t=1.343, P<0.001), lower ratio of vessel invasion (χ(2)=11.897, P=0.001) and nerve invasion (χ(2)=12.338, P<0.001). In the perioperative chemotherapy group and surgery + adjuvant chemotherapy group, 24 cases (4.9%) and 17 cases (3.4%) developed postoperative complications, respectively, and no significant difference was found between two groups (χ(2)=0.815, P=0.367). The median OS of the perioperative chemotherapy group was longer than that of the surgery + adjuvant chemotherapy group (65 months vs. 45 months, HR: 0.74, 95% CI: 0.62-0.89, P=0.001); the median PFS of the perioperative chemotherapy group was also longer than that of the surgery+adjuvant chemotherapy group (56 months vs. 36 months, HR=0.72, 95% CI:0.61-0.85, P<0.001). The forest plot results of subgroup analysis showed that both men and women could benefit from perioperative chemotherapy (all P<0.05); patients over 45 years of age (P<0.05) and with normal body mass (P<0.01) could benefit significantly; patients with cTNM stage II and III presented a trend of benefit or could benefit significantly (P<0.05); patients with signet ring cell carcinoma benefited little (P>0.05); tumors in the gastric body and gastric antrum benefited more significantly (P<0.05). Conclusion: Perioperative chemotherapy can improve the prognosis of gastric cancer patients.
Chemotherapy, Adjuvant ; Female ; Gastrectomy ; Humans ; Male ; Neoadjuvant Therapy ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Stomach Neoplasms/surgery*