Objective To analyze the changes and clinical significance of aqueous humor stromal cell-de-rived factor-1(SDF-1),macrophage chemoattractant protein-1(MCP-1)and soluble adhesion molecule CD44(sCD44)in patients with diabetic cataract(DC).Methods A total of 80 patients with DC admitted to the hos-pital from January 2021 to January 2023 were selected as the DC group,and 40 patients with simple cataract during the same period were selected as the age-related cataract group.According to the stage of cataract,DC patients were divided into group A(incipient stage,32 cases),group B(intumescent stage,26 cases)and group C(mature stage and over mature stage,22 cases).According to the presence or absence of macular ede-ma after treatment,the patients were divided into occurrence group(20 cases)and non-occurrence group(60 cases).The levels of SDF-1,MCP-1 and sCD44 in each group were detected by enzyme-linked immunosorbent assay.The receiver operating characteristic curve and area under the curve(AUC)were used to analyze the value of SDF-1,MCP-1 and sCD44 levels in the diagnosis of DC.Results The levels of SDF-1,MCP-1 and sCD44 in the DC group were higher than those in the age-related cataract group(P<0.05),and the levels of SDF-1,MCP-1 and sCD44 in the A,B and C groups increased sequentially(P<0.05).The level of MCP-1 in the occurrence group was higher than that in the non-occurrence group(P<0.05).The AUC of MCP-1,sCD44 and SDF-1 in the diagnosis of DC was 0.869,and the diagnostic efficiency was better.Conclusion The changes of aqueous SDF-1,MCP-1 and sCD44 levels are related to the stage of cataract in DC patients.Dynam-ic monitoring of these three indexes,especially MCP-1,is helpful to judge the condition and prognosis of DC patients.

Objective To investigate the pathological and magnetic resonance imaging (MRI) characteristics of orbital diffuse large B-cell lymphoma (DLBCL). Methods A total of 48 patients with orbital DLBCL were selected via a retrospective case-control study in the orbital DLBCL group, and 51 patients with DLBCL of primary central nervous system during the same period were included in primary DLBCL group. The clinical characteristics and MRI features of the orbital DLBCL group were analyzed, and the pathological characteristics and peripheral blood platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR) were compared between the two groups. Results The main clinical manifestations of orbital DLBCL patients included local orbital mass in 48 cases (100.00%), limited ocular motility in 38 cases (79.17%), exophthalmos in 33 cases (68.75%), decreased visual acuity in 25 cases (52.08%), diplopia in 17 cases (35.42%), and epistaxis in 9 cases (18.75%). Orbital DLBCL predominantly occurred in the extraconal space (54.17%), with lesions mostly located above the orbit (52.08%). T1-weighted images mainly showed intermediate signal intensity (60.42%), T2-weighted images mainly showed intermediate (56.25%) and high signal intensity (29.17%), diffusion-weighted images mainly showed high signal intensity (58.33%), and apparent diffusion coefficient maps mainly showed low signal intensity (60.42%). There were no statistically significant differences in histopathological subtype, CD20 positive expression, CD79a positive expression, CD45RO positive expression, International Prognostic Index score, and pathological stage between the two groups (P>0.05). The PLR in the orbital DLBCL group was higher, while NLR and LMR were lower than that in the primary DLBCL group (P < 0.05). Conclusion Orbital DLBCL exhibits specific clinical manifestations and MRI characteristics. MRI can serve as the primary diagnostic tool, and its combination with pathological immunohistochemical analysis and peripheral blood PLR, NLR, and LMR test results can improve the accuracy and timeliness of diagnosis.

Objective:A high performance liquid chromatography (HPLC) method was developed to determine the enzymatic activity of CD38 in blood, which was the major enzyme responsible for consuming nicotinamide adenine dinucleotide (NAD). Additionally, the study aimed to detect the differences in CD38 enzymatic activity among individuals of varying ages and health statuses.Methods:A 50 μl whole blood matrix and enzyme reaction substrate of 150 μl β-NAD at a concentration of 500 μmol/L were selected for the analysis. To eliminate the impact of endogenous β-NAD, the whole blood sample was pre-incubated at 37 ℃ for 20 minutes before adding the substrate. The reaction was terminated by perchloric acid (PCA) after incubation at 37 ℃ for 40 min. The change in product nicotinamide (NAM) before and after the enzymatic reaction was measured by HPLC to calculate the CD38 activity. The linearity, limit of detection, limit of quantification, precision, and stability of the method were evaluated. The CD38 enzymatic activities in 60 healthy volunteers and 30 colorectal cancer patients in blood were determined by the developed method.Results:Pre-incubation at 37 ℃ for 20 minutes eliminated the effect of endogenous β-NAD. The correlation coefficient of NAM was 0.999 in the concentration range of 0.1-3.2 μmol/L, with limit of detection of 0.5 nmol/L and limit of quantification of 2.1 nmol/L. The average within-run imprecision ( CV) and total CV were 3.22%-4.03% and 2.91%-4.70%, respectively. The recovery rate ranged from 94.82% to 96.81%. The CD38 activity of whole blood was stable by storage at 4 ℃ for 48 hours, storage at room temperature for 8 hours, thawing of frozen whole blood at room temperature for 2 hours, or repeated freeze-thawing three times. NAM, NAD standards, and pre-treatment samples were stable after 48 hours at 4 ℃ and 8 hours at room temperature. CD38 activity gradually decreased with increasing concentration of the added CD38 inhibitor 4-aminoquinoline derivative (78c). Measurement of 60 healthy physical examination population samples showed significantly higher CD38 enzyme activity in the elderly group than that in the young group ( t=-2.776, P=0.007) and measurement of 30 colorectal cancer patients showed significantly higher CD38 enzyme activity than that in healthy people ( t=-2.572, P=0.012). Conclusion:The established HPLC method for determining CD38 enzymatic activity is characterized by its simplicity, efficiency, accuracy, and reproducibility. This technique serves as a valuable tool for investigating aging and aging-related diseases.

Acupuncture at Baliao points for urinary incontinence has the advantages of obvious therapeutic effect, simple operation and few complications, which is mainly used for the treatment of urinary incontinence after stroke, urinary incontinence after spinal cord injury, stress urinary incontinence and urinary incontinence of bladder overactivity, etc. Urinary incontinence after stroke and spinal cord injury is a complication of disease, most of which are combined with acupuncture at Baliao points on the basis of primary disease treatment. The bladder meridian of foot-Taiyang has the characteristics of "entering the collateral brain" and "carrying spine to the waist". Baliao points can conduct induction along the bladder meridian to the sick site along the bladder meridian, and can play a certain therapeutic role in the treatment of the primary disease. Stress urinary incontinence and urinary incontinence of bladder overactivity can be regarded as independent diseases. Since Baliao points are located in the lumbosacral region which is close to the bladder, acupuncture can play a role in the near treatment of acupoints, improve the operation of bladder qi and blood, and the curative effect has a cumulative effect.

Objective:To explore the value of neutrophil gelatinase-associated lipocalin(NGAL)and neutrophil-to-lymphocyte and platelet ratio(NLPR)for early prediction of kidney injury with Diquat(DQ)poisoning in elderly patients.Methods:In this retrospective study, a total of 106 elderly patients with DQ poisoning treated in the Emergency Intensive Care Unit(EICU)of Harrison International Peace Hospital Affiliated to Hebei Medical University between October 2019 and October 2021 were divided into an acute kidney injury group(AKI group, n=62)and a non-acute kidney injury group(NAKI group, n=44). Meanwhile, 40 non-elderly patients with DQ poisoning served as the control group.Samples of 5 ml venous blood were collected from patients admitted to the EICU to measure NGAL and NLPR levels and Logistic regression analysis was conducted to analyze independent risk factors for AKI in elderly DQ poisoning patients.The area under the curve(AUC)was calculated via the receiver operating characteristic(ROC)curve, and the value of NGAL and NLPR for early prediction of AKI in elderly patients with DQ poisoning and patient prognosis was assessed.Results:Blood NGAL and NLPR levels in the AKI group were significantly higher than in the NAKI group[(387.1±46.6)μg/L vs.(103.5±18.6)μg/L, (13.5±3.4) vs.(5.3±1.1), t=38.243, 15.608, P<0.001 for both]. Logistic regression analysis results showed that elevated levels of NGAL( OR=1.009, 95% CI: 1.003-1.015, P<0.001)and NLPR( OR=1.263, 95% CI: 1.039-1.536, P<0.001)were risk factors for AKI in elderly patients with DQ poisoning.The areas under the ROC curves of NGAL, NLPR and NGAL+ NLPR for AKI prediction were 0.834, 0.803 and 0.873 respectively.The predictive power of NGAL and NLPR for the death of elderly patients with DQ poisoning was higher than that of creatinine clearance(Ccr). The sensitivity of the combination of the two to predict the risk of death was 0.850, the specificity was 0.828, and the AUC was 0.887. Conclusions:NGAL and NLPR are independent risk factors for the occurrence of AKI in elderly patients with DQ poisoning.Combined detection of NGAL and NLPR improves AKI prediction and prognosis assessment in elderly patients with DQ poisoning.

Objective:To investigate the effect of continuous hemoperfusion (HP) on the levels of soluble CD14 isoform (sCD14-st) and neutrophil gelatinase-associated lipocalin (NGAL) on patients with diquat (DQ) poisoning and its significance.Methods:A total of 86 patients with acute DQ poisoning admitted to the department of emergency medicine, Harrison International Peace Hospital Affiliated to Hebei Medical University from May 2018 to August 2021 were enrolled and divided into the intermittent HP group (40 cases) and the continuous HP group (46 cases) according to the random number table method. All patients received basic treatment and continuous veno-venous hemofiltration (CVVH) within 24 hours after admission. On this basis, the intermittent HP group received HP treatment within 2 hours, lasting 2 hours each time for every 8 hours, 3 times in all; the continuous HP group received continued HP treatment until there was no DQ component in urine samples. Serum NGAL levels were detected in all patients before treatment and at 3 hours, 12 hours, 24 hours, 2 days, 3 days, 5 days, and 7 days after treatment. At the same time, serum sCD14-st, blood lactate (Lac), arterial partial pressure of oxygen (PaO 2), serum creatinine (SCr), MB isoenzyme of creatine kinase (CK-MB) and interleukin-18 (IL-18) levels were detected before treatment and at 24 hours, 3 days, and 7 days after treatment. Kaplan-Meier survival curve was drawn to analyze the 28-day survival of patients. Results:Before treatment, there was no significant difference in serum NGAL, sCD14-st, Lac, PaO 2, SCr, CK-MB and IL-18 levels between the two groups. With the prolongation of treatment, the serum levels of NGAL, sCD14-st, Lac, SCr, CK-MB and IL-18 in the intermittent HP group increased at first and then decreased. Serum levels of NGAL, sCD14-st, CK-MB and IL-18 reached their peaks at 24 hours after treatment, and the Lac and SCr levels reached their peaks at 3 days after treatment. In addition, the levels of the above indexes at each time point in the continuous HP group were all significantly lower than those in the intermittent HP group [after 24 hours of treatment: NGAL (μg/L) was 345.90±30.75 vs. 404.24±38.79, sCD14-st (ng/L) was 1 941.88±298.02 vs. 2 656.35±347.93, CK-MB (U/L) was 30.67±9.11 vs. 43.28±8.06, IL-18 (ng/L) was 139.49±16.29 vs. 177.98±27.85; 3 days of treatment: Lac (mmol/L) was 2.98±0.26 vs. 3.72±0.49, SCr (μmol/L) was 125.01±24.24 vs. 156.74±28.88; all P < 0.05]. However, there was no significant difference in PaO 2 levels between the two groups at each time point after treatment. The Kaplan-Meier survival curve showed that the 28-day mortality of patients in the continuous HP group was significantly lower than that in the intermittent HP group [26.09% (12/46) vs. 52.50% (21/40); Log-Rank test: χ2 = 7.288, P = 0.007]. Conclusion:Continuous HP could effectively reduce serum sCD14-st, NGAL levels and 28-day mortality in patients with DQ poisoning, with good curative effect.

Objective:To explore the value of soluble growth stimulation expression gene 2 protein (soluble suppression of tumorigenicity 2; sST2) and N terminal B type brain natriuretic peptide (N-terminal probrainnatriuretic peptide, NT-proBNP) in evaluating the short-term prognosis of acute organophosphorus pesticide poisoning.Methods:select 228 patients with acute organophosphorus pesticide poisoning in our hospital from October 2017 to March 2020. According to the grade of poisoning degree, it was divided into 82 cases in mild and moderate group and 146 cases in severe group. hs-cTnI、CK-MB、sST2、NT-proBNP、APACHE Ⅱ score and cholinesterase activity were detected 4 h、12 h、24 h after admission. ROC curve was used to evaluate sST2 and NT-proBNP to predict the prognosis of AOPP.Results:4 hours after admission, there was no significant difference in the scores of hs-cTnI, APACHE Ⅱ, cholinesterase and CK-MB between the Severe Group and the mild and moderate Group ( P<0.05) . At 12 and 24 hours after admission, the scores of hs-cTnI, CK-MB and APACHE Ⅱ in severe group were higher than those in mild and moderate group, and the changes of Cholinesterase were more significant than those in 12 hours after Admission ( P<0.05) . 4 hours after admission, SST2 and NT-proBNP levels were significantly higher in severe group than those in mild and moderate Group ( P<0.05) . The level of SST2 and NT-proBNP in the severe group was significantly higher than that in the mild and moderate group 12 and 24 hours after Admission ( P<0.01) , and the level of SST2 and NT-proBNP was significantly higher than that in the mild group 12 hours after Admission ( P<0.05) . Correlation analysis showed that 24 hours after admission, sST2, NT-proBNP were positively correlated with APACHE-Ⅱ scores ( R=0.634, 0.723, P<0.01) . The area under sST2 combined with NT-proBNP was 0.891, higher than that under sST2 and NT-proBNP at 12 h after admission. The 24 h APACHE Ⅱ score after admission area under the curve was 0.838. Conclusion:sST2 and NT-proBNP combined detection can early predict the occurrence of recent complications in AOPP patients.

Objective:To explore the value of soluble growth stimulation expression gene 2 protein (soluble suppression of tumorigenicity 2; sST2) and N terminal B type brain natriuretic peptide (N-terminal probrainnatriuretic peptide, NT-proBNP) in evaluating the short-term prognosis of acute organophosphorus pesticide poisoning.Methods:select 228 patients with acute organophosphorus pesticide poisoning in our hospital from October 2017 to March 2020. According to the grade of poisoning degree, it was divided into 82 cases in mild and moderate group and 146 cases in severe group. hs-cTnI、CK-MB、sST2、NT-proBNP、APACHE Ⅱ score and cholinesterase activity were detected 4 h、12 h、24 h after admission. ROC curve was used to evaluate sST2 and NT-proBNP to predict the prognosis of AOPP.Results:4 hours after admission, there was no significant difference in the scores of hs-cTnI, APACHE Ⅱ, cholinesterase and CK-MB between the Severe Group and the mild and moderate Group ( P<0.05) . At 12 and 24 hours after admission, the scores of hs-cTnI, CK-MB and APACHE Ⅱ in severe group were higher than those in mild and moderate group, and the changes of Cholinesterase were more significant than those in 12 hours after Admission ( P<0.05) . 4 hours after admission, SST2 and NT-proBNP levels were significantly higher in severe group than those in mild and moderate Group ( P<0.05) . The level of SST2 and NT-proBNP in the severe group was significantly higher than that in the mild and moderate group 12 and 24 hours after Admission ( P<0.01) , and the level of SST2 and NT-proBNP was significantly higher than that in the mild group 12 hours after Admission ( P<0.05) . Correlation analysis showed that 24 hours after admission, sST2, NT-proBNP were positively correlated with APACHE-Ⅱ scores ( R=0.634, 0.723, P<0.01) . The area under sST2 combined with NT-proBNP was 0.891, higher than that under sST2 and NT-proBNP at 12 h after admission. The 24 h APACHE Ⅱ score after admission area under the curve was 0.838. Conclusion:sST2 and NT-proBNP combined detection can early predict the occurrence of recent complications in AOPP patients.

A 65-year-old female patient with chronic renal failure undergoing continuous hemodialysis received an IV infusion of cefmenoxime 1 g twice daily for acute pancreatitis. The values of prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (APTT) were within the normal range before treatment. After 11 days of treatment, the patient developed multiple ecchymoses on the skin and bleeding from the venipuncture site which was not easily stopped. The reexamination of coagulation function showed PT 127 s, INR 10.72, and APTT 86 s. Coagulation dysfunction was considered and an IV infusion of leukocyte-reduced fresh-frozen plasma 150 ml was given. Examination of coagulation function next day showed PT 101 s, INR 8.49, and APTT 65 s. Mixing study for evaluation of abnormal coagulation testing showed that PT and APTT could be corrected, suggesting coagulation factor deficiency. Blood coagulation disorders caused by cefmenoxime was considered. Then the drug was discontinued and switched to amoxicillin sodium and clavulanate potassium, and a subcutaneous injection of vitamin K 1 10 mg was given once daily. Three days after the drug withdrawal, her coagulation function returned to within the normal range (PT 15 s, INR 1.19, APTT 36 s).

A 65-year-old female patient with chronic renal failure undergoing continuous hemodialysis received an IV infusion of cefmenoxime 1 g twice daily for acute pancreatitis. The values of prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (APTT) were within the normal range before treatment. After 11 days of treatment, the patient developed multiple ecchymoses on the skin and bleeding from the venipuncture site which was not easily stopped. The reexamination of coagulation function showed PT 127 s, INR 10.72, and APTT 86 s. Coagulation dysfunction was considered and an IV infusion of leukocyte-reduced fresh-frozen plasma 150 ml was given. Examination of coagulation function next day showed PT 101 s, INR 8.49, and APTT 65 s. Mixing study for evaluation of abnormal coagulation testing showed that PT and APTT could be corrected, suggesting coagulation factor deficiency. Blood coagulation disorders caused by cefmenoxime was considered. Then the drug was discontinued and switched to amoxicillin sodium and clavulanate potassium, and a subcutaneous injection of vitamin K 1 10 mg was given once daily. Three days after the drug withdrawal, her coagulation function returned to within the normal range (PT 15 s, INR 1.19, APTT 36 s).