Objective To retrieve,evaluate and summarize the best evidence for blood glucose monitoring and management in patients with diabetes of the exocrine pancreas(DEP),and to provide evidence-based basis for clinical practice.Methods According to the"6S"evidence model,relevant evidence on blood glucose management in patients with DEP was searched from computer decision support systems,guideline networks,professional association websites and databases from top to bottom,covering clinical decision-making,clinical practice guidelines,evidence summaries,systematic reviews,expert consensuses,and randomized controlled trials.The search scope was from the establishment of the databases to June 30,2024.Totally 2 researchers independently evaluated the quality of the included literature,and extracted data and summarized evidence that met the criteria.Results A total of 10 articles were included,including 3 guidelines,1 expert consensus,2 systematic reviews,l clinical decision,1 RCT,and 2 cohort studies.Finally,26 pieces of best evidence were formed from 5 aspects,including blood glucose management team construction and goals,blood glucose monitoring methods,glucose control medication management,lifestyle health education and treatment of hypoglycemia.Conclusion This study summarizes the best evidence for blood glucose monitoring and management in DEP patients,which can provide resource preparation for clinical translation and a basis for medical staff to carry out blood glucose management in DEP patients.

Objective:To explore the binding characteristics of N, N-diethyl-2-(2-(4-(2- 18F-fluoroethoxy)phenyl)-5, 7-dimethylpyrazolo[1, 5-a]pyrimidin-3-yl)acetamide ( 18F-DPA-714) and ( R)- N-sec-butyl- N-methyl-4-(3-( 18F-trifluoromethyl)phenyl)quinazoline-2-carboxamide ( 18F-TFQC) to the single nucleotide polymorphisms of the 18×10 3 translocator protein (TSPO), and to evaluate the imaging efficacy and feasibility of those 2 molecular probes in neuroinflammation rat models. Methods:To test the selectivity of 18F-DPA-714 and 18F-TFQC for TSPO polymorphisms, the wild-type (high-affinity binding, HAB) and mutant (low-affinity binding, LAB) sequences of the human TSPO gene were transfected into 293T cells respectively. A competitive inhibition assay was carried out with N-methyl- N-(1-methylpropyl)-1-(2-chlorophenyl)-3-isoquinoline carboxamide (PK11195) as an inhibitor to determine the binding affinities of 2 probes to TSPO polymorphisms. Rat neuroinflammation models ( n=6) were established using lipopolysaccharide. Three days after modeling, small animal PET/CT imaging was performed using 18F-DPA-714 and 18F-TFQC, respectively, to observe and compare the uptake of the tracers, and the ratio of SUV mean of the right striatum to SUV mean of the left striatum (SUVR) was calculated. After the imaging, the expression and distribution of microglia and TSPO were detected by tissue immunofluorescence. Repeated-measures analysis of variance was used to analyze the SUVR data of different groups. Results:The inhibition constants ( Ki) of 18F-TFQC on 293T-LAB and 293T-HAB cells were 23.51 and 14.60 nmol/L, respectively, with a Ki LAB/ Ki HAB ratio of 1.61, indicating low sensitivity to TSPO single nucleotide polymorphisms. The Ki of 18F-DPA-714 for binding to 293T-LAB and 293T-HAB cells were 45.23 and 6.47 nmol/L, respectively, with a Ki LAB/ Ki HAB ratio of 6.99. Small animal PET/CT imaging demonstrated that specifically uptake of both probes could be found in neuroinflammatory lesions. The overall SUVR of 18F-DPA-714 in the lesions within 60minutes was slightly higher than that of 18F-TFQC, but no significant difference was observed ( F values: inter-group 0.40, time effect 0.30, cross-effect 0.03; all P>0.05). Conclusions:Compared with 18F-DPA-714, 18F-TFQC is less sensitive to TSPO gene polymorphisms, thus being more suitable for clinical application and promotion. It holds promise for the early identification of neuroinflammation and the efficacy monitoring of anti-inflammatory drug treatments.

Objective:To explore the binding characteristics of N, N-diethyl-2-(2-(4-(2- 18F-fluoroethoxy)phenyl)-5, 7-dimethylpyrazolo[1, 5-a]pyrimidin-3-yl)acetamide ( 18F-DPA-714) and ( R)- N-sec-butyl- N-methyl-4-(3-( 18F-trifluoromethyl)phenyl)quinazoline-2-carboxamide ( 18F-TFQC) to the single nucleotide polymorphisms of the 18×10 3 translocator protein (TSPO), and to evaluate the imaging efficacy and feasibility of those 2 molecular probes in neuroinflammation rat models. Methods:To test the selectivity of 18F-DPA-714 and 18F-TFQC for TSPO polymorphisms, the wild-type (high-affinity binding, HAB) and mutant (low-affinity binding, LAB) sequences of the human TSPO gene were transfected into 293T cells respectively. A competitive inhibition assay was carried out with N-methyl- N-(1-methylpropyl)-1-(2-chlorophenyl)-3-isoquinoline carboxamide (PK11195) as an inhibitor to determine the binding affinities of 2 probes to TSPO polymorphisms. Rat neuroinflammation models ( n=6) were established using lipopolysaccharide. Three days after modeling, small animal PET/CT imaging was performed using 18F-DPA-714 and 18F-TFQC, respectively, to observe and compare the uptake of the tracers, and the ratio of SUV mean of the right striatum to SUV mean of the left striatum (SUVR) was calculated. After the imaging, the expression and distribution of microglia and TSPO were detected by tissue immunofluorescence. Repeated-measures analysis of variance was used to analyze the SUVR data of different groups. Results:The inhibition constants ( Ki) of 18F-TFQC on 293T-LAB and 293T-HAB cells were 23.51 and 14.60 nmol/L, respectively, with a Ki LAB/ Ki HAB ratio of 1.61, indicating low sensitivity to TSPO single nucleotide polymorphisms. The Ki of 18F-DPA-714 for binding to 293T-LAB and 293T-HAB cells were 45.23 and 6.47 nmol/L, respectively, with a Ki LAB/ Ki HAB ratio of 6.99. Small animal PET/CT imaging demonstrated that specifically uptake of both probes could be found in neuroinflammatory lesions. The overall SUVR of 18F-DPA-714 in the lesions within 60minutes was slightly higher than that of 18F-TFQC, but no significant difference was observed ( F values: inter-group 0.40, time effect 0.30, cross-effect 0.03; all P>0.05). Conclusions:Compared with 18F-DPA-714, 18F-TFQC is less sensitive to TSPO gene polymorphisms, thus being more suitable for clinical application and promotion. It holds promise for the early identification of neuroinflammation and the efficacy monitoring of anti-inflammatory drug treatments.

Objective To retrieve,evaluate and summarize the best evidence for blood glucose monitoring and management in patients with diabetes of the exocrine pancreas(DEP),and to provide evidence-based basis for clinical practice.Methods According to the"6S"evidence model,relevant evidence on blood glucose management in patients with DEP was searched from computer decision support systems,guideline networks,professional association websites and databases from top to bottom,covering clinical decision-making,clinical practice guidelines,evidence summaries,systematic reviews,expert consensuses,and randomized controlled trials.The search scope was from the establishment of the databases to June 30,2024.Totally 2 researchers independently evaluated the quality of the included literature,and extracted data and summarized evidence that met the criteria.Results A total of 10 articles were included,including 3 guidelines,1 expert consensus,2 systematic reviews,l clinical decision,1 RCT,and 2 cohort studies.Finally,26 pieces of best evidence were formed from 5 aspects,including blood glucose management team construction and goals,blood glucose monitoring methods,glucose control medication management,lifestyle health education and treatment of hypoglycemia.Conclusion This study summarizes the best evidence for blood glucose monitoring and management in DEP patients,which can provide resource preparation for clinical translation and a basis for medical staff to carry out blood glucose management in DEP patients.

The translocator protein (TSPO) positron emission tomography (PET) can noninvasively detect neuroinflammation associated with epileptogenesis and epilepsy. This study explored the role of the TSPO-targeting radioligand [¹⁸F]F-TFQC, an m-trifluoromethyl ER176 analog, in the PET neuroimaging of epileptic rats. Initially, [¹⁸F]F-TFQC was synthesized with a radiochemical yield of 8%-10% (EOS), a radiochemical purity of over 99%, and a specific activity of 38.21 ± 1.73 MBq/nmol (EOS). After determining that [¹⁸F]F-TFQC exhibited good biochemical properties, [¹⁸F]F-TFQC PET neuroimaging was performed in epileptic rats at multiple time points in various stages of disease progression. PET imaging showed specific [¹⁸F]F-TFQC uptake in the right hippocampus (KA-injected site, i.e., epileptogenic zone), which was most pronounced at 1 week (T/NT 1.63 ± 0.21) and 1 month (T/NT 1.66 ± 0.20). The PET results were further validated using autoradiography and pathological analysis. Thus, [¹⁸F]F-TFQC can reflect the TSPO levels and localize the epileptogenic zone, thereby offering the potential for monitoring neuroinflammation and guiding anti-inflammatory treatment in patients with epilepsy.

Objective:To analyze the clinical and laboratory characteristics of acute myeloid leukemia (AML) patients with NPM1 mutation, and to explore the prognostic factors.Methods:A total of 77 AML patients with NPM1 gene mutation admitted to Hebei Yanda Ludaopei Hospital from May 1st 2012 to December 31st 2021 were enrolled in the study, including 34 male and 43 female patients. The median age was 40 (3, 68) years old. Patients were selected and divided into 4 groups according to the morphological FAB classification. There were 29 cases (37.7%) of M1 type, 13 cases (16.9%) of M2 type, 23 cases (29.9%) of M4 type, and 12 cases (15.5%) of M5 type. The clinical characteristics, bone marrow/peripheral blood cell morphology, immunophenotype, cytogenetics, molecular biology and overall survival of different groups were retrospectively analyzed, and the risk factors affecting the prognosis of AML were also explored. Cox multivariate regression was used to analyze the clinical influencing factors of survival and prognosis.Results:The white blood cell counts were highest in M4 and M5 patients and lowest in M2 patients, while no significant difference in the red blood cell, hemoglobin, and platelet counts( P>0.05). Morphologically, there were significant differences in the percentage of blasts and blasts with cup-like nuclei on bone marrow (BM) and peripheral blood (PB). The proportion of blasts in BM and PB was the highest in M1 and the lowest in M2 ( P<0.001). The positive rate of blasts with cup-like nuclei was the highest in M1 and the lowest in M5 of BM ( P<0.001), while the highest in M2 and the lowest in M5 of PB ( P=0.006). The scores of myeloperoxidase and chloroacetate esterase were all the highest in M1 and the lowest in M5 ( P<0.001, 0.001, respectively). In terms of molecular biology, the occurence rate of blasts combined with DNMT3A mutation was the highest in M4 and the lowest in M2 ( P=0.044), while those combined with FLT3-ITD mutation was the highest in M4 and the lowest in M5 ( P=0.002). In immunophenotype, there were significant differences in the expression positivities of seven antigens including HLA-DR, CD56, CD11c, CD15, CD14, CD96 and cMPO ( P<0.05). Multivariate COX regression analysis showed that no recurrence after treatment ( P<0.001), complete remission after treatment ( P=0.015) and transplantation ( P<0.001) were correlated with overall survival (OS). No recurrence after treatment ( P=0.033), transplantation ( P=0.027), no mutation of FLT3-ITD ( P=0.040), and hemoglobin concentration ( P=0.023) were associated with relapse-free survival (RFS). Survival analysis by Kaplan-Meier curve showed that there was no significant difference in survival time between the M1, M2, M4 and M5 groups in OS and RFS. Conclusion:There were significant differences in the white blood count, the percentage of blasts and blasts with cup-like nuclear morphology, cytochemical staining (MPO integration, CE integration and percentage of NAS-DCE), gene mutation (DNMT3A and FLT3-ITD) and immunophenotypes (HLA-DR, CD56, CD11c, CD15, CD14, CD96 and cMPO) between the four groups. The multivariate analysis revealed that no recurrence after treatment and transplantation were independent prognostic factors in NPM1 mut AML patients. On the other hand, FLT3-ITD mutation and hemoglobin concentration were associated with RFS and complete remission after treatment was associated with OS in the entire NPM1 mut cohort.

Objective:To explore the effect of tibial nerve vibration on triceps surae spasticity in stroke survivors and its electrophysiological mechanism.Methods:Thirty stroke survivors with upper limb spasticity were randomly divided into a treatment group and a control group, each of 30. Both groups were given routine rehabilitation training while the treatment group was additionally provided with local vibration of the tibial nerve with an amplitude of 0.3mm at 60Hz. Before and after the treatment, the modified Ashworth scale (MAS) and Clonus grading were used to assess muscle tone and spasticity. Electrophysiological functions were evaluated using the tibial nerve motor and sensory conduction test and F wave and H reflex sensing.Results:Before the treatment there were no significant differences between the two groups in their average MAS scores, Clonus grading, maximum H amplitude (Hmax), the ratio of maximum H to maximum M amplitude (H/M) or the intensity of stimulus required to elicit Hmax. After the treatment, however, all of those measurements had improved significantly in both groups with the average improvements in the treatment group significantly greater than those in the control group.Conclusions:Local vibration of the tibial nerve combined with traditional rehabilitation is more effective than traditional rehabilitation alone in relieving triceps surae spasticity and reducing muscle tone after a stroke. The vibration seems to inhibit excitation of the reflex pathway.

Objective:To evaluate the accuracy of glomerular filtration rate (GFR) assessed from the renal dynamic imaging method (Gates method) with 99Tc m-diethylene triamine pentoacetic acid (DTPA) in the heart transplant population. Methods:From September 2017 to June 2018, 34 patients with advanced heart failure who were prepared for surgery (30 males, 4 females; age: (45±14) years; heart transplant group) and 41 patients with normal heart function (19 males, 22 females; age: (50±17) years; control group) in Fuwai Hospital were respectively enrolled. GFRs of all patients were measured using Gates method (gGFR) and dual plasma sample method (DPSM; dGFR) with 99Tc m-DTPA. The accuracy of Gates method for detecting GRF was verified by using DPSM as the reference. Seventeen patients in heart transplant group underwent 99Tc m-DTPA renal dynamic imaging for Gates and DPSM results repeatedly after the surgery. The single kidney (left and right) functions (dGFRL and dGFRR) of DPSM were obtained according to the results of Gates method. Pearson correlation analysis and paired t test were used to analyze the data. Results:The gGFR in heart transplant group was higher than dGFR ((66.49±15.66) vs (49.16±13.24) ml·min -1·1.73 m -2; t=6.728, P<0.01), and there was a moderate correlation between them ( r=0.467, P<0.01). No difference between gGFR and dGFR in control group was observed ((65.35±26.28) vs (62.22±21.37) ml·min -1·1.73 m -2; t=1.268, P=0.212), and there was a good correlation between them ( r=0.799, P<0.01). The difference between 2 correlation coefficients was statistically significant ( z=-2.44, P<0.05). Serum creatinine decreased, while dGFR, dGFRL and dGFRR increased after the surgery, suggesting the improved renal function. Conclusions:The renal dynamic imaging method (Gates method) with 99Tc m-DTPA has less accuracy in the heart transplant patients. Combination of DPSM and Gates method can provide the precise total GFR and assess single kidney GFR, and may serve as a tool to monitor the renal function for the heart transplant patients in clinic.

Objective To explore the correlation between exon region polymorphism of PPP1R3A gene and schizophrenia in Uygur Chinese population. Methods PPP1R3A gene exon region DNA amplification was performed using multiple PCR targeted capture next-generation sequencing method in 528 patients with schizophrenia and 576 healthy controls of Uyghur descent, Illumina HiSeq X Ten was used for sequencing, the symptoms of schizophrenia were assessed by positive and negative symptoms scale (PANSS). Results The allelic and genotypic distributions in rs1800000 of PPP1R3A gene between patients with schizophrenia and healthy controls had significant difference (P＜0.05), rs1799999 in genotype frequency between the female case and control groups showed significant difference (P＜0.05). Furthermore, the allelic distributions of rs8192686 between male cases and controls had significant difference (P＜0.05). Conclusion PPP1R3A gene rs1800000 may be associated with the development of schizophrenia in Uygur Chinese population; rs1799999 may be a risk factor for susceptibility of female Uygur Chinese schizophrenia; The C allele at rs8192686 may be associated with male Uygur Chinese schizophrenia.

Objective To investigate the effect of tripterygium glycosides on the resistance to immune rejection after allogeneic islet transplantation in mice.Methods Twenty C57BL/6 mice were treated with STZ diabetes mellitus and transplanted the islets from Balb/c mice donor,then recipient mice were randomly divided into two groups:triptolide group and model control group(n=10),and were intraperitoneal injected with tripterygium glycoside solutin and equivalent solvent of 5 mg·kg-1·d-1 for 14 days.Blood glucose and body weight were measured within 4 weeks after transplantation.Two weeks later,two groups of grafted islets were stained by HE staining and immunohistochemical staining,the expression of IL-2 protein were detected by Western blotting.Results The level of blood glucose were decreased to normal in the triptolide group and model control group after islet transplantation,but blood glucose gradually increased in the model control group after two weeks.Compared with the model control group,the inflammatory cells were less infiltrated and the immunohistochemical staining of insulin was deeper in the triptolide group.The expression of IL-2 in the triptolide group was significantly decreased(P<0.05).Conclusion Tripterygium glucoside could significantly decrease the inflammatory cell infiltration and inflammation factor expression in the allogeneic islet recipients to reduce the immune rejection and improve graft survival.