Objective To analyze the significance of serum glucagon-like peptide-1(GLP-1)expression in patients with type 2 diabetes mellitus(T2DM)and its predictive value for diabetic retinopathy(DR).Methods A total of 160 T2DM patients admitted to our hospital from January 2020 to January 2022 were enrolled in this study and divided into DR group(n=68)and T2DM group(n=92)according to whether they had DR.Another 80 healthy physical examination subjects were selected as normal control(NC)group from our physical examination center during the same period.Serum GLP-1 levels were detected and compared among all the groups.Serum GLP-1 levels were compared among patients with different stages of DR.The correlation between serum GLP-1 and other indexes was evaluated by Pearson analysis.The influencing factors for DR were analyzed by Logistic regression analysis.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)was generated,and the predictive efficacy of serum GLP-1 on DR was analyzed.Results Serum GLP-1 in NC,T2DM and DR groups decreased in turn(P<0.05).Serum GLP-1 in subgroups Ⅱ,Ⅲ,Ⅳ and Ⅴ decreased in turn(P<0.05).Pearson analysis showed that serum GLP-1 was negatively correlated with systolic blood pressure(SBP),diastolic blood pressure(DBP),2 h postprandial blood glucose(2 hPG),low density lipoprotein cholesterol(LDL-C),tumor necrosis factor-α(TNF-α)(r=-0.359,-0.314,-0.361,-0.308,-0.429,P<0.05),positively correlated with fasting C-peptide(FC-P)(r=0.382,P<0.05).Logistic regression analusis showed that DM duration,SBP,DBP,2 hPG,LDL-C,TNF-α and FC-P were the influencing factors for DR.The AUC of GLP-1 was 0.091 in predicting DR,and the sensitivity and specificity were 93.76%and 90.23%when the optimal cut-off value was 1.95 pmol/L.Conclusions Serum GLP-1 expression is low in T2DM patients,and serum GLP-1 is correlated with SBP,DBP,2 hPG,LDL-C,TNF-α and FC-P to a certain extent,which has high sensitivity and specificity in predicting the occurrence of DR.Abnormal low expression of serum GLP-1,metabolic disorders of blood glucose and lipids,hypertension,inflammation and other factors are involved in the progression of the disease,all of which are influencing factors for inducing DR,and should attract clinical attention.

Objective To analyze the significance of serum glucagon-like peptide-1(GLP-1)expression in patients with type 2 diabetes mellitus(T2DM)and its predictive value for diabetic retinopathy(DR).Methods A total of 160 T2DM patients admitted to our hospital from January 2020 to January 2022 were enrolled in this study and divided into DR group(n=68)and T2DM group(n=92)according to whether they had DR.Another 80 healthy physical examination subjects were selected as normal control(NC)group from our physical examination center during the same period.Serum GLP-1 levels were detected and compared among all the groups.Serum GLP-1 levels were compared among patients with different stages of DR.The correlation between serum GLP-1 and other indexes was evaluated by Pearson analysis.The influencing factors for DR were analyzed by Logistic regression analysis.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)was generated,and the predictive efficacy of serum GLP-1 on DR was analyzed.Results Serum GLP-1 in NC,T2DM and DR groups decreased in turn(P<0.05).Serum GLP-1 in subgroups Ⅱ,Ⅲ,Ⅳ and Ⅴ decreased in turn(P<0.05).Pearson analysis showed that serum GLP-1 was negatively correlated with systolic blood pressure(SBP),diastolic blood pressure(DBP),2 h postprandial blood glucose(2 hPG),low density lipoprotein cholesterol(LDL-C),tumor necrosis factor-α(TNF-α)(r=-0.359,-0.314,-0.361,-0.308,-0.429,P<0.05),positively correlated with fasting C-peptide(FC-P)(r=0.382,P<0.05).Logistic regression analusis showed that DM duration,SBP,DBP,2 hPG,LDL-C,TNF-α and FC-P were the influencing factors for DR.The AUC of GLP-1 was 0.091 in predicting DR,and the sensitivity and specificity were 93.76%and 90.23%when the optimal cut-off value was 1.95 pmol/L.Conclusions Serum GLP-1 expression is low in T2DM patients,and serum GLP-1 is correlated with SBP,DBP,2 hPG,LDL-C,TNF-α and FC-P to a certain extent,which has high sensitivity and specificity in predicting the occurrence of DR.Abnormal low expression of serum GLP-1,metabolic disorders of blood glucose and lipids,hypertension,inflammation and other factors are involved in the progression of the disease,all of which are influencing factors for inducing DR,and should attract clinical attention.

Objective:To evaluate the impact of self-crosslinked hyaluronic acid (SCH) gel on endometrium recovery after artificial abortion.Methods:A multicenter, prospective randomized controlled trial was conducted across 18 hospitals from December 2021 to February 2023, involving 382 women who underwent artificial abortion. Participants were randomly allocated to receive either treatment with SCH gel (SCH group) or no treatment (control group) in a 1∶1 ratio. The primary outcome was endometrium thickness in 14 to 18 days after the first postoperative menstruation. Secondary outcomes included changes in menstrual volume during the first postoperative menstruation, menstruation resumption within 6 postoperative weeks, time to menstruation resumption, duration of the first postoperative menstruation, and incidence of dysmenorrhea.Results:Baseline characteristics of participants were comparable between the two groups (all P>0.05), with 95.3% (182/191) in SCH group and 92.7% (177/191) in the control group completed the study. The postoperative endometrial thickness in SCH group was significantly greater than that in the control group [(9.78±3.15) vs (8.95±2.32) mm; P=0.005]. SCH group also had significantly fewer participants with reduced menstrual volume [23 cases (12.6%, 23/182) vs 31 cases (17.5%, 31/177); P=0.038]. Although SCH group experienced less dysmenorrhea during the first postoperative menstrual period, this difference was not statistically significant [28.5% (51/179) vs 37.1% (65/175); P=0.083]. Outcomes were similar between SCH group and the control group regarding the proportion of participants who resumed menstruation within 6 weeks postoperatively, time to menstruation resumption, and duration of the first postoperative menstruation ( P=0.792, 0.485, and 0.254, respectively). No serious adverse events were observed during the study period, and no adverse events were attributed to SCH gel treatment. Conclusion:The application of SCH gel after artificial abortion is safe and might aid in the recovery of the endometrium.

Objective:To estimate the hospitalization rate of Haemophilus ( H.) influenzae associated community-acquired pneumonia in children under 5 years in Suzhou. Methods:From 2010 to 2014, medical records and bacteriology results of children under 5 years hospitalized with community-acquired pneumonia in Children's Hospital of Soochow University were collected, retrospectively. Detection rate of H. influenzae was describe. The hospitalization rate of H. influenzae associated community-acquired pneumonia was estimated using the number of local children in urban area of Suzhou, which was obtained from the immunization platform of Suzhou Center for Disease Prevention and Control. Results:A total of 28 043 hospitalized pneumonia cases were included from 2010 to 2014, in which 19 526 (69.63%) had bacteriological examination. The overall detection rate of H. influenzae was 11.06% (2 160/19 526), and children aged 12-23 months had the highest positive rate (14.29%, 550/3 850), and the rate was higher during winter-spring than during summer-autumn ( χ 2=455.11, P<0.01). The average hospitalization rate of H. influenzae associated pneumonia in children under 5 years was 760.36/100 000 (95% CI: 733.70/100 000-787.01/100 000), which was higher in winter and spring (898.79/100 000 and 1 249.52/100 000) than in summer and autumn (514.35/100 000 and 359.04/100 000), and the hospitalization rate was higher in boys (942.12/100 000) than in girls (563.76/100 000), the differences were all significant ( P<0.01). The highest hospitalization rate was observed in children aged 1-5 months (2 478.31/100 000) and the hospitalization rate decreased with age ( χ 2=2 129.80, P<0.01). Conclusion:There was a considerable burden of H. influenzae associated community-acquired pneumonia in children under 5 years in Suzhou, especially in children under 6 months.

Objective: To investigate the effect of biology and mTOR pathway activity of down-regulated TSC2 gene expression on U937 leukemia cells. Methods: Gene expression was down-regulated by lentivirus induced RNA interference on TSC2 high expressed U937 cell line; the proliferation, apoptosis and differentiation were detected by CCK-8 assay, colony formation assay and flow cytometry; the gene expression level and protein kinase activity were detected by qRT-PCR and Western blot. Results: Down-regulated expression of TSC2 gene promoted U937 cell proliferation and colony formation ability (P<0.05) . The proportion in G₀/G₁ phase of TSC2 down-regulated U937 cell was much lower than that of the control cells [ (52.53±3.75) % vs (75.10±4.33) %, t=6.829, P=0.002], the S phase [ (22.43±1.00) % vs (15.47±1.20) %, t=-5.581, P=0.019] and G₂/M phase [ (25.03±4.34) % vs (14.33±0.91) %, t=-5.413, P=0.013] was remarkably higher than that of the control cells (P<0.05) . There were no statistically significant differences in cell apoptosis and differentiation (P>0.05) . Down-regulation of TSC2 led to the increased activity of mTOR, 4EBP1 and S6K1, but did not influence the activity of AKT. The expressions of proliferation related cyclinD1, c-myc and PTEN were also up-regulated after TSC2 silenced, but the expressions of P27KIP and BCL-XL were not changed. Conclusion Downregulation of TSC2 could promote the proliferation of U937 cells through up-regulation of mTOR activity.

Objective To investigate the mutations of epigenetic regulation factor ASXL1 gene in myelodysplastic syndrome(MDS).Methods Mutation analysis of ASXL1 gene in 53 de novo MDS patients and 20 healthy persons was performed by using polymerase chain reaction(PCR)followed by sequence analysis at DNA level.The clinical and laboratory characteristics were compared in MDS patients with ASXL1 gene mutation and ASXL1 wild type.ASXL1 mutation in mRNA level was detected by using reverse transcription PCR(RT-PCR)followed by sequence analysis.Results ASXL1 gene mutations were observed in 9 cases(16.9%)of 53 MDS patients.6 mutation types were detected,including 4 frameshift mutations types(2 cases with p.Glu635ArgfsX15,3 cases with p.Gly646TrpfsX12,1 case with p.Ala640GlyfsX14 and 1 case with p.Gly790TrpfsX10)and 2 nonsense mutation types(1 case with p.Gln1063X and 1 case with p.Gln695X).All the mutations were heterozygous,and p.Gly790TrpfsX10 and p.Gln695X were new mutation types.In addition,a single nucletide polymorphism(SNP)p.Gly652Ser was also detected in 4 cases with MDS.5 cases of p.G652S SNP and 1 case of p.Leu1173Leu SNP were detected in 20 healthy people.Frameshift mutation(p.Gly646TrpfsX12)could be detected at mRNA level by using RT-PCR.Differences were not observed in red blood cell counts,white blood cell counts,platelet counts,hemoglobin levels,reticulocyte,neutrophil granulocyte,the peripheral blood lymphocytes percentage,T-cell subsets in the peripheral blood,the proportion of primitive cell in the marrow and MDS types between the patients with ASXL1 gene mutation and ASXL1 wild type patients(P >0.05).Conclusion There is a high frequency of ASXL1 gene mutation in MDS patients,which can be detected at mRNA level.

Objective To explore the value of the plasma miR-193a-5p level on diagnosis and monitoring the response to treatment in acute myeloid leukemia (AML). Methods Peripheral blood samples were obtained from AML patients enrolled in hematology department of the Second Hospital of Shanxi Medical University from July 2015 to December 2015, including 30 de novo AML patients, 9 patients in complete remission (CR) and 6 patients in relapse. Peripheral blood samples from 15 healthy people were randomly choosed as the health control group. Plasma miR-193a-5p expression levels were detected by using quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR). Results The plasma miR-193a-5p relative expression level of AML patients group [0.465 6 (0.103 1-5.000 2)] was obviously lower than that of health control group [0.766 1 (0.052 1-3.134 4)] (U= 122, P= 0.018 7). The plasma miR-193a-5p relative expression levels of de novo group and relapse AML group were significantly lower than those of CR group and health control group (P<0.05), and there was no significant difference between the CR group and health control group (U= 56, P= 0.511 9). No significant correlation was found between the plasma miR-193a-5p level and age, gender, blast percentage of the bone marrow, peripheral blood leukocyte count, platelet count, CD34+cells'percentage and so on. Conclusion The decreased plasma miR-193a-5p expression level can be served as a new and noninvasive biomarker for the evaluation of diagnosis and treatment in AML.

OBJECTIVETo identify the MPL L391-V392ins12 spliceosome and analyze its frequencies in patients with myeloproliferative neoplasms (MPN).

METHODSMPL aberrant spliceosome was identified through reverse transcription polymerase chain reaction (RT-PCR)combined with cloning sequencing. The mutation of this spliceosome in 248 MPN patients and 200 normal people was determined by allele-specific polymerase chain reaction (AS-PCR).

RESULTSA novel aberrant spliceosome of MPL gene (MPL L391-V392ins12)was identified, i.e. 36 bp intron was retained between exon7 and exon8, and there were 12 amino acids (EGLKLLPADIPV)inserted. MPL L391-V392ins12 mutation was detected in 19 (7.66%)of the 248 patients with MPN, including 1 (1.92%) of 52 patients with PV, 14 (9.66%) of 145 with ET, and 4 (7.84%) of 51 with PMF. And the mutation was not detected in the group of 200 normal people.

CONCLUSIONMPL L391-V392ins12 spliceosome is an aberrant spliceosome present in the MPN. It can be detected in PV, ET and PMF, and more frequently in ET and PMF. This mutation may play an important role in the process of MPN.

Humans ; Mutation ; Myeloproliferative Disorders ; genetics ; Neoplasms ; genetics ; Polymerase Chain Reaction ; Receptors, Thrombopoietin ; genetics ; Spliceosomes

Objective To investigate the relationship between proinflammatory cytokines and cognitive function in patients with mild cognitive impairment (MCI).Methods From May 2007 to May 2009,70 patients (aged ≥ 60 years) with MCI were collected.Among them,50 cases were amnestic MCI,and 19 cases developed into AD.The cognitive function was assessed,and all patients were followed up.The venous blood samples were obtained and proinflammatory cytokines (IL-1α,IL 1β,IL-6,TNF-α) were detected by using enzyme linked immunosorbent assay.Results There were differences in the levels of proinflammatory cytokines between patients with aMCI and patients with Alzheimer's disease (AD) [IL-1β,(40.5 ± 7.7) μg/L vs.(38.6 ± 7.3) μg/L ; IL 6,(70.4 ±24.3) μg/'L vs.(53.6±20.5) μg/L;TNF-α,(58.6±13.5) μg/'L vs.(50.3±-17.1) μg/'L;t=3.537,2.229,2.226,P=0.002,0.039,0.039,respectively].Conclusions MCI is a preclinical state of AD.The cognitive function damage of MCI patients are different from that of AD patients,and the immune status of MCI patients is also changed.