Blinding is an important means to control and reduce measurement bias in clinical research， and blinding assessment is the main method to measure the success of the blinding method. By summarizing the current situation of blinding assessment in randomized controlled trials （RCT） of acupuncture， it was found that the report rate of blinding assessment by acupuncture RCT was relatively low， and the studies reporting blinding assessment had several problems， such as incomplete assessment individuals， unreasonable assessment questionnaires， and unscientific analysis methods， and the setting of the assessment time point is controversial. Given the above problems， this paper discussed the key elements of blinding assessment individuals， assessment questionnaires， assessment time points， and analysis methods. It is suggested that blinding assessment should be carried out on all blinded participants and personnel in the study； the assessment questionnaire should be designed by direct inquiry， with responses designed using three or more categorical options that include an "unclear" option； the early stage of the trial should be taken as the mandatory time point for assessment， integrating the evaluation index of the James blinding index and the Bang blinding index， in order to standardize the application of blinding assessment in acupuncture RCT and improve the quality of acupuncture clinical research.

Objective:To investigate the correlation between exhaled nitric oxide and obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods:Eighty patients with OSAHS (OSAHS group) who received treatment in Pingxiang People's Hospital from September 2019 to September 2021 were included in this study. An additional 60 patients with snoring (snoring group) who concurrently received treatment in the same hospital were included in the control group. The value of exhaled nitric oxide was measured using an exhaled nitric oxide detector. The relationship between exhaled nitric oxide and apnea-hypopnea index, and the lowest oxygen saturation level during sleep (LSaO 2) was analyzed using Pearson correlation analysis. The optimal cut-off value of exhaled nitric oxide for predicting OSAHS was analyzed using the receiver operating characteristic curve. Results:Exhaled nitric oxide and apnea-hypopnea index in the OSAHS group were (18.61 ± 6.23) μg/L and (44.50 ± 16.15) times/hour, respectively, which were significantly greater than (11.17 ± 4.31) μg/L and (2.91 ± 0.79) times/hour in the snoring group ( t = 7.94, 14.08, both P < 0.05). LSaO 2 in the OSAHS group was significantly lower than that in the snoring group [(66.53 ± 10.17)% vs. (92.15 ± 1.62)%, t = -13.61, P < 0.05]. Correlation analysis showed that exhaled nitric oxide levels in patients with OSAHS were positively correlated with apnea-hyponea index ( r = 0.56, P = 0.001), and negatively correlated with the lowest oxygen saturation level ( r = -0.54, P = 0.002). The receiver operating characteristic curve analysis revealed that when the optimal cut-off value of exhaled nitric oxide was 11.5 μg/L, the area under the curve was 0.846, with sensitivity of 91.3%, and specificity of 63.3%. Conclusion:Patients with OSAHS have airway inflammatory reactions. The level of nitric oxide in exhaled air is positively correlated with the severity of OSAHS, which has a certain clinical value.

Immune checkpoint inhibitors (ICIs) show unique advantages in the treatment of lung cancer, making the treatment of lung cancer enter the era of immunotherapy, but ICIs will also have adverse reactions, and the incidence of immune-induced hematological toxicity is not very high. Immunotherapy-induced thrombocytopenia is a rare adverse event.We report one case of thrombocytopenia induced by ICIs and review the literature on thrombocytopenia associated with ICIs and discuss the clinical features, possible mechanisms, and optimal treatment. 
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Humans ; Purpura, Thrombocytopenic, Idiopathic/drug therapy* ; Lung Neoplasms/drug therapy* ; Thrombocytopenia/chemically induced* ; Antibodies, Monoclonal, Humanized/adverse effects*

Objective:To investigate the effects of liraglutide on the expressions of autophagy markers LC3B, LC3B mRNA and lipid deposition in myocardial tissue of rats with early diabetes mellitus.Methods:A total of 36 healthy male Wistar rats aged 4-5 weeks and weighing (l80-200) g were selected and divided into normal group (group NC, 10 rats) and model group (26 rats) according to random number table. Rats in the NC group were fed with routine diet and rats in the model group were given high glucose and high fat diet for 12 weeks. Rats in the model group were injected with streptozotocin into the abdominal cavity in a single dose of 25 mg/kg after molding. Rats in the model group were further divided into three groups: T2DM group (group DM/NS, 9 rats, given equal volume of saline) , liraglutide intervention group (group DM/LIR, 8 rats, injected with 100 μg/kg liraglutide twice daily) and Liraglutide and Chloroquine intervention group (group DM/LIR+CQ, 8 rats, injected with 100 μg/kg liraglutide twice daily, and injected with Chloroquine 50 mg/kg once every two days) . Rats in group NC were given equal volume of saline. At the end of 12 weeks, all the rats were tested blood glucose and anaesthetized to collect myocardial tissues to observe myocardial lipid deposition and fiber arrangement under light microscope after HE staining. The expressions of LC3B were detected by immunohistochemical method, and the expressions of LC3B mRNA were detected by real-time fluorescence quantitative polymerase chain reaction method. Differences among groups were compared by one-way analysis of variance, pairwise comparison was conducted by using LSD-t test, correlation was analyzed by Pearson correlation.Results:(1) Compared with group NC, the myocardial fibers arranged in disorder, and the ratio of myocardial foam cells/total cardiomyocytes were increased, the level of LC3B mRNA and LC3B were decreased in group DM/NS and DM/LIR+CQ (in group DM/NS: 2.18±0.90 vs 11.79±0.74, 2.03±0.10 vs 1.85±0.06, 194.18±10.19 vs 175.99±6.09, t=25.24, 4.69, 3.22, respectively; in group DM/LIR+CQ: 2.18±0.90 vs 11.24±1.29, 2.03±0.10 vs 1.89±0.08, 194.18±10.19 vs 176.73±7.82, t=17.56, 4.65, 3.99, respectively, all P<0.05) . There is no difference in above indicators (2.18±0.90 vs 1.29±0.60, 2.03±0.10 vs 2.01±0.20, 194.18±10.19 vs 201.27±11.35, t=2.20, 0.28, 1.40, respectively, all P>0.05) . (2) Compared with group DM/NS, the ratio of myocardial foam cells/total cardiomyocytes, the level of LC3B mRNA and LC3B were no difference in group DM/LIR+CQ ( t=1.09, 1.18,0.22, respectively, all P>0.05) . The ratio of myocardial foam cells/total cardiomyocytes was decreased, the level of LC3B mRNA and LC3B were increased in group DM/LIR (11.79±0.74 vs 1.29±0.60, 1.85±0.06 vs 2.01±0.20, 175.99±6.09 vs 201.27±11.35, t=31.86, 2.39, 5.82, respectively, all P<0.05) . (3) The significant negative correlation were observed between the ratio of myocardial foam cells/total cardiomyocytes and LC3B mRNA, LC3B levels (r=-0.977, -0.986, respectively, all P<0.05) . Conclusion:Liraglutide can protect the myocardial structure in early diabetic rats by increasing myocardial autophagy, reducing the number of myocardial foam cells, and improving the myocardial lipid deposition.

To investigate the effects of ()infection on autonomic nervous function and calcitonin gene-related peptide in patients with functional dyspepsia(FD). Thirty-one patients with FD matching Rome Ⅳ criteria were included and divided into -positive group and -negative group.All patients were evaluated by Symptom Index of Dyspepsia(SID),Nepean Dyspepsia Index(NDI),and Hospital Anxiety and Depression Scale(HADS).Their heart rate variability(HRV)and calcitonin gene-related peptide(CGRP)level were also measured. There were no significant differences in SID(=-0.858, =0.858),NDI(=-1.464, =0.143),and Hospital Depression Scale score(=0.699, =0.485).However,the Hospital Anxiety Scale score was significantly higher in -positive group than the -negative group(=-2.470, =0.014).The level of CGRP in -positive group[(0.999±0.274)ng/ml]was significantly higher than that in the -negative group[(0.812±0.172)ng/ml;=2.238, =0.033].HRV data showed no significant difference between these two groups at very low frequency(=-1.210, =0.236),low frequency(LF)(=0.419, =0.678),high frequency(HF)(=0.612, =0.546),LF/HF(=-0.882, =0.399),and total power(=-0.963, =0.344). In FD patients,patients with -positive FD patients have higher depression and CGRP levels than those without infection,although their dyspepsia symptoms and HRV show no notable changes.
Anxiety ; Calcitonin ; Calcitonin Gene-Related Peptide ; Dyspepsia ; Helicobacter Infections ; Helicobacter pylori ; Humans

Objective: To study the association of single nucleotide polymorphism (SNP)276 in adiponectin gene with essential hypertension in population with impaired glucose regulation in Han people of Shanxi region. Methods: The study population consisted of 216 Chinese Hans residents with impaired glucose regulation (IGR) in Shanxi province. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was applied to test the adiponectin SNP276G/T polymorphism. Results: The distributions of genotypes and alleles of SNP276 both displayed significant difference between the IGR complicating norm tension group and the hypertension group (P=0.025, P=0.007). Compared with the TT genotype, the SNP276 non-TT (GT+ GG) genotype was associated with increased risk of complicating with hypertension (OR=3.346, 95% CI: 1.115-8.986, P=0.037), while after age- , sex- and BMI-adjusted, there was no significant difference between the 2 groups (P=0.349). Conclusions SNP276 in adipose most abundant gene transcript 1 (APM1) was associated with the susceptibility to be complicating essential hypertension in population with impaired glucose regulation in Han people of Shanxi region.

Virus infection induces the production of type I interferons (IFNs). IFNs bind to their heterodimeric receptors to initiate downstream cascade of signaling, leading to the up-regulation of interferon-stimulated genes (ISGs). ISGs play very important roles in innate immunity through a variety of mechanisms. Although hundreds of ISGs have been identified, it is commonly recognized that more ISGs await to be discovered. The aim of this study was to identify new ISGs and to probe their roles in regulating virus-induced type I IFN production. We used consensus interferon (Con-IFN), an artificial alpha IFN that was shown to be more potent than naturally existing type I IFN, to treat three human immune cell lines, CEM, U937 and Daudi cells. Microarray analysis was employed to identify those genes whose expressions were up-regulated. Six hundred and seventeen genes were up-regulated more than 3-fold. Out of these 617 genes, 138 were not previously reported as ISGs and thus were further pursued. Validation of these 138 genes using quantitative reverse transcription PCR (qRT-PCR) confirmed 91 genes. We screened 89 genes for those involved in Sendai virus (SeV)-induced IFN-β promoter activation, and PIM1 was identified as one whose expression inhibited SeV-mediated IFN-β activation. We provide evidence indicating that PIM1 specifically inhibits RIG-I- and MDA5-mediated IFN-β signaling. Our results expand the ISG library and identify PIM1 as an ISG that participates in the regulation of virus-induced type I interferon production.
Cells, Cultured ; Gene Library ; Humans ; Interferon Type I ; metabolism ; Interferon-beta ; genetics ; metabolism ; Proto-Oncogene Proteins c-pim-1 ; genetics ; Up-Regulation

Objective To observe and compare the changes of weight,blood pressure,glycemia, blood lipid,serum uric acid,insulin sensitivity and insulin function of laparoscopic sleeve gastrectomy (LSG)for the treatment of type 2 diabetes mellitus(T2DM)with obesity,and analysed mechanism of meta-bolic surgery.Methods Changes of weight,blood pressure,glycemia,blood lipid ,serum uric acid,in-sulin sensitivity and insulin function of 8 type 2 diabetes mellitus(T2DM)with obesity patients undergoing LSG were retrospectively analyzed.Weight,BMI,EWL%,average systolic and diastolic pressure were measured 1,2,3,6 months and fasting plasma glucose (FPG),glycosylated hemoglobin (HbAl),insulin sensitivity parameter:insulin resistance index(HOMA-IR),insulin sensitivity index(ISI),insulin area un-der the curve (AUCI),insulin function parameter:glucose disposition index(DI)were measured 1,6 months after operation and compared with preoperative levels.Meanwhile medication change was observed af-ter operation and compared with preoperation.Results ⑴Weight ,BMI at 1,2,3,and 6 months after surgery showed a decreasing trend and EWL% showed a decreasing trend over time .⑵ FBG、HbA1c showed a decreasing trend after operation.Blood lipid,uric acid of 3 patients with dyslipidemia and hyperu-ricemia decreased to normal 1 month after operation.⑶ HOMA-IR,AUCI except for 1 patient showed a de-creasing trend and ISI was contrary after operation.DI ,trends were different.⑷7 patients stopped all an-tidiabetic drugs 6 months after operation,1 patient injected insulin with good glycemic control.Blood pres-sure of 5 patients with hypertension was normal without antihypertensive drugs 6 months after operation. Conclusions LSG procedure can significantly increase insulin sensitivity of T2DM with obesity,thereby improve glycemia,cholesterol,uric acid and further promot weight loss.

OBJECTIVETo compare and explore metabolic risk factors related to type 2 diabetes mellitus (T2DM) and the development of nonalcoholic fatty liver disease (NAFLD).

METHODSA total of 389 in-patients with T2DM (DM group, 204 cases) and T2DM with NAFLD (DM+NAFLD group, 185 cases) were enrolled in the study between October 2012 and July 2013. Clinical data collected for analysis included levels of blood lipids, liver function markers, uric acid (UA) and insulin, as well as results from the oral glucose tolerance test (OGTT) and C peptide releasing test. Improvements in insulin level, C peptide secretion index [HOMR-IR(CP)] and whole body insulin sensitivity index (ISIcomp) were used to estimate insulin sensitivity. Improvements in insulin level, C peptide secretion index [HOMR-islet(CP)], early insulin secretion index (delta I₃₀/delta G₃₀), correction of the islet beta cell function index (MBC1) and glucose disposition index (DI) were used to evaluate the function of pancreatic islet 1 beta cells. The t-test and repeated measures ANOVA were used for statistical analyses. Risk factors of T2DM with NAFLD were assessed by using logistic regression analysis.

RESULTSCompared with the DM group, the DM+NAFLD group had higher body mass index (BMI) and levels of triglycerides, alanine aminotransferase (ALT), aspartate aminotransferase, gamma glutamine transferase and UA (all P < 0.05), but lower age and level of high density lipoprotein cholesterol (both P < 0.05). Moreover, the DM+NAFLD group had higher postprandial blood glucose levels at 30 min (10.88 ± 2.87 mmol/L vs. 12.18 ± 2.79 mmol/L, t =-3.32), 60 min (14.65 ± 3.69 mmol/L vs. 15.99 ± 3.12 mmol/L, t =-3.46), 120 min (16.56 ± 5.11 mmol/L vs. 17.65 ± 4.29 mmol/L, t =-2.81) and 180 min (13.92 ± 5.10 mmol/L vs. 14.71 ± 4.91 mmol/L, t=-2.02) (all P < 0.05). The DM+NAFLD group had higher postprandial insulin levels at 60 min (28.62 ± 23.51 muIU/ml vs. 36.91 ± 33.47 aIU/ml, t =-3.46) and 120 min (36.36 ± 25.60 muIU/mL vs. 44.38 ± 34.95 muIU/mL, t =-3.35) (both P < 0.05). The DM+NAFLD group had higher postprandial C peptide levels at 30 min (2.74 ± 1.70 ng/mL vs. 4.30 ± 6.51 ng/ml, t =-4.97), 60 min (4.17+/-2.49 ng/ml vs. 5.19 ± 2.96 ng/ml, t =-3.29) and 120 min (6.08 ± 2.79 ng/ml vs. 6.76 ± 3.10 ng/ml, t =-2.19) (all P < 0.05). The DM+NAFLD group had higher HOMA-IR(CP) (1.505 ± 0.004 vs. 1.507 ± 0.005, t =-2.208, P less than 0.05), but lower ISIcomp (90.09+/-69.31 vs. 59.93 ± 24.52, t =5.608), MBCI (4.68 ± 4.31 vs. 3.83 ± 2.41, t =2.365) and DI (35.40 ± 71.83 vs. 15.37 ± 13.93, t =3.730) (all P < 0.05). Logistic analysis showed that BMI, ALT, postprandial level of C-peptide at 30 min, and UA were the major risk factors of T2DM with NAFLD (OR =1.208, 2.080, 1.041, and 1.005, respectively; all P < 0.05).

CONCLUSIONPatients with a propensity for developing nonalcoholic fatty liver disease may experience earlier open of type 2 diabetes. T2DM patients with NAFLD have more severe glucose metabolism disorders.

Adult ; Aged ; Aged, 80 and over ; Blood Glucose ; metabolism ; Diabetes Mellitus, Type 2 ; complications ; metabolism ; Female ; Humans ; Insulin ; blood ; Lipids ; blood ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; complications ; metabolism ; Risk Factors

Objective To investigate the level change of glucose excursion , 8-iso prostaglandin F 2α( 8-iso-PGF2α) in type 2 diabetes mellitus(T2DM), and its effects on nonalcoholic fatty liver disease (NAFLD).Methods A total of 62 inpatients with type 2 diabetes mellitus including T2DM group(DM, 30 cases) and T2DM with NAFLD group(DM+NAFLD, 32 cases) were recruited from October 2012 to November 2013 , normal glucose tolerance group had normal glucose tolerance ( NGT;30 cases ) with normal physical examination results.The age, gender, duration, blood pressure, body mass index (BMI), and blood lipid among three groups were no statistical difference .The clinical data of each patient were collected by professional people .Blood lipids and glycated hemoglobin (HbA1c) were detected.Oral glucose tolerance test (OGTT) were taken in all groups.The Postprandial glucose excursion (PPGE), blood glucose standard deviation (SDBG), mean blood glucose and (MBG) and HbA1c were used to evaluate the glucose excursion.Serum 8-iso-PGF2αwas detected by enzyme-linked immunosorbent (ELISA) to evaluate oxidative stress.Inter-group com-parison was conducted with analysis of variance ( ANOVA) .Correlation analysis was used to evaluate the factors of influence .Results⑴The levels of PPGE[(7.34 ±2.23) mmol/L vs (8.52 ±2.43) mmol/L],SDBG[(2.43 ±0.90) mmol/L vs (2.80 ±0.78) mmol/L], MBG[(11.06 ±1.76) mmol/L vs (13.65 ±2.83) mmol/L], and HbA1c [(7.59 ±1.02)% vs (8.05 ±1.52)%] in T2DM group and T2DM with NAFLD group were significantly higher than that in NGT group (both P <0.05); and that in NAFLD group have significantly rise than that in DM group ( P <0.05), but there was no significant difference in HbA 1c between groups.⑵ The level of serum 8-iso-PGF2αwas gradually increased from NGT group [(33.45 ±8.60) pg/ml], DM group [(47.33 ±15.30) pg/ml], to DM +NAFLD group [(56.07 ±13.10) pg/ml], with statistically significant difference ( P <0.05);⑶The Person corre-lation analysis showed that the content of serum 8-iso-PGF2αwas positively correlated with PPGE, SDBG, and MBG ( r =0.796, 0.778 , 0.712 , P <0.01 ) .Conclusions Serum 8-iso-PGF2αis a better parameter to reflect the status of body oxidative stress .The level of oxidative stress is increased with the increase of glucose excursion in T 2DM, which is the important mechanism of its complica-tions of NAFLD.