Objective To investigate the effects of time in range(TIR)and microRNA-2245P(miR-2245P)interac-tions on the susceptibility and severity of diabetic retinopathy(DR)in the target range of glucose.Methods A prospec-tive study was conducted on 259 patients with DR(DR group)and 259 patients with type 2 diabetes mellitus(T2DM group)admitted to the Ophthalmology Department of Yantai Yeda Hospital from April 2022 to June 2024.TIR and miR-2245P were compared between the two groups,and the multivariate Logistic analysis was used to identify the factors associated with DR susceptibility.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of TIR,miR-2245 P,and their combination for DR.The interaction coefficient γ was used to analyze the effect of the interaction between TIR and miR-2245P on DR susceptibility.The Spearman correlation analysis was used to evaluate the correlation of TIR and miR-2245P with DR staging.Results The TIR and miR-2245P levels in the DR group were lower than those in the T2DM group(both P＜0.05).The multivariate logistic regression analysis showed that Logit(P)=0.083-0.470 × TIR-0.584 × miR-2245P,high levels of TIR and miR-2245P were independent protective factors of DR susceptibility(all P＜0.05).The areas under the ROC curve(AUC)of TIR,miR-2245P,and their combination for predicting DR were 0.76,0.79,and 0.91,respectively.The AUC of TIR combined with miR-2245P was greater than that of TIR and miR-2245P(both P＜0.05).The interaction analysis showed that the OR values of DR caused by low levels of TIR and miR-2245P alone were 2.05 and 1.92,respectively.The OR value of the interaction between TIR and miR-2245P was 10.69,greater than the prod-uct of OR values of TIR and miR-2245P alone.It indicates that the effect of the interaction of TIR and miR-2245P on suscep-tibility to DR is a super-multiplication model.The interaction coefficient was γ=3.31＞1,indicating a positive relationship of the interaction between the two factors with DR susceptibility.The Spearman correlation analysis showed that TIR and miR-2245P were negatively correlated with DR staging(both P＜0.001).Conclusion Both TIR and miR-2245P are asso-ciated with DR and its severity,and they have interactive effects on DR susceptibility.Combined detection can improve the predictive value of DR.This study provides a new idea and target for the prevention and treatment of DR.

Objective To investigate the effects of time in range(TIR)and microRNA-2245P(miR-2245P)interac-tions on the susceptibility and severity of diabetic retinopathy(DR)in the target range of glucose.Methods A prospec-tive study was conducted on 259 patients with DR(DR group)and 259 patients with type 2 diabetes mellitus(T2DM group)admitted to the Ophthalmology Department of Yantai Yeda Hospital from April 2022 to June 2024.TIR and miR-2245P were compared between the two groups,and the multivariate Logistic analysis was used to identify the factors associated with DR susceptibility.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of TIR,miR-2245 P,and their combination for DR.The interaction coefficient γ was used to analyze the effect of the interaction between TIR and miR-2245P on DR susceptibility.The Spearman correlation analysis was used to evaluate the correlation of TIR and miR-2245P with DR staging.Results The TIR and miR-2245P levels in the DR group were lower than those in the T2DM group(both P＜0.05).The multivariate logistic regression analysis showed that Logit(P)=0.083-0.470 × TIR-0.584 × miR-2245P,high levels of TIR and miR-2245P were independent protective factors of DR susceptibility(all P＜0.05).The areas under the ROC curve(AUC)of TIR,miR-2245P,and their combination for predicting DR were 0.76,0.79,and 0.91,respectively.The AUC of TIR combined with miR-2245P was greater than that of TIR and miR-2245P(both P＜0.05).The interaction analysis showed that the OR values of DR caused by low levels of TIR and miR-2245P alone were 2.05 and 1.92,respectively.The OR value of the interaction between TIR and miR-2245P was 10.69,greater than the prod-uct of OR values of TIR and miR-2245P alone.It indicates that the effect of the interaction of TIR and miR-2245P on suscep-tibility to DR is a super-multiplication model.The interaction coefficient was γ=3.31＞1,indicating a positive relationship of the interaction between the two factors with DR susceptibility.The Spearman correlation analysis showed that TIR and miR-2245P were negatively correlated with DR staging(both P＜0.001).Conclusion Both TIR and miR-2245P are asso-ciated with DR and its severity,and they have interactive effects on DR susceptibility.Combined detection can improve the predictive value of DR.This study provides a new idea and target for the prevention and treatment of DR.

Inflammatory bowel disease （IBD）， mainly including ulcerative colitis （UC） and Crohn's disease （CD）， is a common chronic inflammatory disease of the gastrointestinal tract， with its incidence increasing year by year. Due to its long treatment duration， difficulty in treatment， prolonged remission， and high costs， it has attracted global attention. Exploring safe， effective， and sustainable treatment regimens has become an urgent global issue. The pathogenesis of IBD is complex， involving intestinal mucosal injury，disturbances in the internal environment， and inflammatory responses. In recent years， research has found that ferroptosis is also one of the important pathogenic factors of IBD. Ferroptosis， as a new form of non-apoptotic cell death， is characterized by iron dependence， lipid peroxidation， and imbalance in the redox system. Studies have shown that inhibiting ferroptosis in intestinal epithelial cells can protect the intestinal mucosa. Targeted intervention in ferroptosis may be a new direction for the treatment of IBD. IBD is mainly treated with drugs， including corticosteroids， aminosalicylates， biologics， and immunomodulators， but drug resistance and adverse reactions are common. Traditional Chinese medicine （TCM） has unique advantages such as low cost， low drug resistance， and fewer side effects， and has accumulated rich experience in the treatment of IBD. Scholars have confirmed that TCM can inhibit ferroptosis， and recent studies have shown that TCM can not only inhibit iron-dependent lipid peroxidation in intestinal cells but also enhance the antioxidant and anti-inflammatory abilities of intestinal mucosa， thus playing a role in the treatment of IBD. Increasing evidence suggests that TCM may treat IBD by interfering with ferroptosis. This article explores the relevance of TCM intervention in ferroptosis and the treatment of IBD， discusses the possible mechanisms of ferroptosis in IBD， and aims to provide a basis for the diagnosis and treatment of IBD.

Objective: To investigate the incidence trend of tuberculosis in Haidong City, Qinghai Province from 2006 to 2020, and the effects of age, period, and cohort on tuberculosis incidence, so as to provide the basis for enhancing the prevention and control for tuberculosis. Methods: Data of tuberculosis cases in Haidong City from 2006 to 2020 were collected from the Chinese Disease Prevention and Control Information System. Incidence rates were calculated and standardized using data from the Sixth National Population Census in 2010. The trends in incidence of tuberculosis were analyzed by annual percent change (APC). Effects of age, period and cohort on the incidence of tuberculosis were analyzed by an age-period-cohort model. Results: The crude incidence rates of tuberculosis in Haidong City from 2006 to 2020 ranged from 37.69/105 to 100.93/105, and the standardized incidence rates ranged from 42.85/105 to 115.24/105. The standardized incidence rates from 2006 to 2015 showed a decreasing trend (APC=-7.148%, P<0.05), while there was no significant trend observed from 2015 to 2020 (all P>0.05). The age-period-cohort model analysis showed that the highest incidence risk of tuberculosis in Haidong City from 2006 to 2020 was observed in the age group of 20-<25 years (RR=2.973, 95%CI: 2.353-3.756), followed by the age group of 80-<85 years (RR=2.785, 95%CI: 2.206-3.516). The incidence risk of tuberculosis was higher in the period from 2016 to 2020 (RR=1.253, 95%CI: 1.203-1.306) compared to the period from 2011 to 2015 (RR=0.796, 95%CI: 0.770-0.823). Tuberculosis incidence risk was the highest in the birth cohort from 1936 to 1940 (RR=3.050, 95%CI: 2.356-3.949), and then gradually decreased over time thereafter. Conclusions The incidence of tuberculosis in Haidong City showed a decreasing trend from 2006 to 2015, while there was no significant trend observed from 2015 to 2020. The incidence risk of tuberculosis was higher in the age groups of 20-<25 years and 80-<85 years, and the risk decreased for those born in more recent years.

Objective:To investigate the current situation and influencing factors of clinical nurses'clinical decision-making ability,and provide a reference and evidence for improving and enhancing the correct clinical decision-making ability of clinical nurses.Methods:A total of 300 clinical nurses in Shaanxi Province were selected as the research subjects by using the convenience sampling method.The General Information Questionnaire,Clinical Decision-Making Scale,and Comprehensive Decision-Making Style Scale were used to conduct the investigation and study.The influencing factors of clinical nurses'clinical decision-making ability were analyzed by using single-factor analysis and multivariate linear regression.Results:The total score of clinical nurses'clinical decision-making ability was(163.85±13.78)points,reaching the high-level standard of clinical decision-making ability(146.68-200.00)points.The results of Spearman rank correlation analysis showed that there was a significant positive correlation between the total score and the score of each dimension of clinical decision-making ability and the score of rational decision-making style(P<0.05).The score of the dimension of searching for information or new information was only negatively correlated with the score of intuitive-impulsive decision-making style(P<0.05).Avoidant decision-making style was negatively correlated with the scores of seeking information or new information,clarifying goals and values,the total score of clinical decision-making ability,and the dimensions of finding alternative solutions(P<0.05).The results of multiple linear regression showed that rational decision-making style can positively affect clinical nurses'clinical decision-making ability,while avoidance decision-making style can negatively affect it.Conclusion:The clinical nurses'clinical decision-making ability has been maintained at a relatively constant high level,and it is greatly influenced by rational and avoidant decision-making styles.Medical managers need to organize targeted training activities and other measures to promote the construction of clinical nurses'rational decision-making style and minimize the influence of avoidant decision-making style,thus improving the clinical nurses'clinical decision-making ability.

Objective:To investigate the clinical efficacy of ginkgo biloba extract dense tablets combined with pitavastatin in the treatment of elderly stable coronary heart disease (SCAD), as well as its impact on patients′ thrombotic status, neutrophil-to-lymphocyte ratio (NLR), and serum high-sensitivity C-reactive protein (hs-CRP) levels.Methods:A prospective study was conducted on 82 elderly SCAD patients admitted to the 928th Hospital of PLA Joint Logistics Support Force from October 2019 to December 2020. The patients were divided into an observation group and a control group using a random number table method, with 41 patients in each group. The control group received oral pitavastatin calcium tablets, while the observation group received oral ginkgo biloba extract dense tablets on the basis of the control group. After 8 weeks of continuous treatment, the clinical efficacy of the two groups was observed. The frequency of angina attacks, thrombotic status indicators [D-dimer (D-D), fibrinogen (FIB)], peripheral blood NLR, serum hs-CRP levels were compared before and after treatment between the two groups. The incidence of adverse reactions was compared between the two groups.Results:The total effective rate of the observation group was 78.05%(32/41), which was significantly higher than 56.10%(23/41) of the control group, and the difference was statistically significant ( P<0.05). After treatment, the frequency of angina attacks [weekly attack times, duration of single attack, severity (weekly nitroglycerin usage)] in both groups significantly improved compared with before treatment (all P<0.05), and the observation group improved more significantly (all P<0.05). After treatment, plasma D-D and FIB levels in both groups significantly decreased compared with before treatment (all P<0.05), and the observation group decreased more significantly (all P<0.05). Peripheral blood NLR and serum hs-CRP levels in both groups significantly decreased compared with before treatment (all P<0.05), and the observation group was significantly lower than the control group (all P<0.05). There was no significant difference in the incidence of adverse reactions between the observation group and the control group [9.76%(4/41) vs 7.32%(3/41)] ( P>0.05). Conclusions:The overall efficacy of ginkgo biloba extract dense tablets combined with pitavastatin in the treatment of elderly SCAD is exact, which can effectively improve patients′ angina attacks, thrombotic status and inflammatory state with good safety.

Objective:To investigate the expression levels and diagnostic value of platelet parameters, fibrinogen and D-dimer in different Traditional Chinese Medicine (TCM) syndromes of deep venous thrombosis (DVT).Methods:From June 2015 to June 2019, a total of 500 DVT patients were enrolled and collected by two attending TCM doctors and classified according to syndromes differentiation. The differences of platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), platelet crit (PCT), platelet larger cell ratio (P-LCR), fibrinogen (FIB) and D-dimer were detected and compared.Results:According to TCM syndromes differentiation, 500 patients were divided into three groups, including 286 cases (57.2%) of downward flowing of damp-heat group, 132 cases (26.4%) of blood stasis and heavy damp group, and 82 cases (16.4%) of spleen-kidney-yang deficiency group. The levels of MPV, PDW, P-LCR, FIB and D-dimer among the groups were statistically significant difference ( P<0.05 or P<0.01). The MPV level was significantly higher and D-dimer level was significantly lower in blood stasis and heavy damp group than in the downward flowing of damp-heat group ( P<0.05). The levels of MPV, PDW and P-LCR in spleen-kidney-yang deficiency group were significantly higher than those in downward flowing of damp-heat group and blood stasis and heavy damp group ( P<0.05 or P<0.01). The levels of FIB and D-dimer were significantly lower than those in the downward flowing of damp-heat group and blood stasis and heavy damp group ( P<0.05 or P<0.01). The FIB (AUC=0.593) and D-Dimer (AUC=0.673) were statistically significant in the differential diagnosis of DVT between blood stasis and heavy damp group and spleen-kidney-yang deficiency group ( P<0.01). The MPV (AUC=0.601 5), PDW (AUC=0.615 4), P-LCR (AUC=0.606 1), FIB (AUC=0.616 4) and D-Dimer (AUC=0.721 8) were statistically significant in the differential diagnosis of DVT between downward flowing of damp-heat group and spleen-kidney-yang deficiency group ( P<0.01). Conclusion:The MPV, PDW, P-LCR, FIB and D-dimer have a certain correlation with DVT TCM syndrome types, and also have a certain reference value for its differential diagnosis, which can be used as an effective supplement to the objective indicators of Micro syndrome differentiation of traditional Chinese medicine.

Objective: To investigate the clinical significance of antegrade lower limb venography in varicose veins of lower limbs. Methods: The data of 230 cases of varicose veins of lower limb in Department of Vascular Surgery, Xiangyang Central Hospital from June 2018 to August 2019 were examined by antegrade lower limb venography. All patients were divided into simple varicose veins group (group A, 67 cases) and secondary varicose veins group (group B, 63 cases) according to the patency of deep veins. The data of sex, limb side, swelling and ulcer were analyzed respectively. Results: There was no significant difference in the results of sex between the two groups (57.5% vs 63.5%, P>0.05). The incidence of left side in group A was lower than that in group B (59.3% vs 76.2%, P<0.05). And the incidence of swelling of lower extremities and ulcer in boot area in group A was lower than that in group B (31.1% vs 49.2%, P<0.05; 18.6% vs 31.7%, P<0.05 respectively). Conclusions Combined with swelling of lower extremities, ulcer in boot area or the varicose veins in left side had a higher incidence of secondary varicose veins. Anterograde venography of lower extremities can accurately distinguish the classification of varicose veins of lower extremities and improve the diagnostic coincidence rate, which has significant clinical significance.

OBJECTIVE: To explore the effects of psoralen (PSO) plus long-wave ultraviolet-A (PUVA) on apoptosis and expression of Fas ligand (FasL) in HL-60 leukemia cells. METHODS: The HL-60 cells were taken as the study objects and their apoptosis rates, ultrastructure changes and the expression of FasL were detected in order to observe the effects of PSO and ultraviolet-A (UVA) of wave length 360 nm. The factorial design and analysis of variance were used to analyze the interaction among the factors. RESULTS: PSO, UVA and PUVA all induced the apoptosis and the effects of PUVA were stronger than those of the other two. After HL-60 cells had been treated with PUVA, they all showed obvious ultrastructure changes due to apoptosis observed under the electron microscope. PSO, UVA and PUVA all decreased the expressions of FasL gene and protein. The effects of PUVA were stronger than those of the other two. CONCLUSIONS: PUVA can induce the apoptosis of HL-60 cells and the effects are stronger than those of PSO or UVA alone. The expression of FasL gene in HL-60 cells is down-regulated during the apoptosis induced by PUVA.

To study the effects of psoralen (PSO) with long wave ultraviolet light (PUVA) on apoptosis and mitochondrial membrane potential in K562 cells.