Objective:To investigate the characteristics of elastic program of excited shear wave of plantar soft tissue of diabetic patients and its correlation with levels of glucose metabolism.Methods:A total of 92 patients with type 2 diabetes who admitted to Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine during January 2022 and January 2023 were selected as diabetes group,and another 92 patients in the prediabetes stage were included in the prediabetes group.Both groups of patients used excited shear wave with different frequencies(400,450,500,550,and 600 Hz)under elastic technique of shear wave.The velocities of shear waves at the 1st metatarsal head,the 3rd metatarsal head and calcaneus of plantar soft tissue,and the thickness of soft tissue of these patients were assessed.The fasting plasma glucose(FPG),2-hour postprandial glucose(2hPG),and glycosylated hemoglobin(HbA1c)levels of sugar metabolism level of two groups were measured,and the correlations between velocity of shear wave,thickness of soft tissue,and level of glucose metabolism were further analyzed.The occurrence of diabetic foot ulcer in the diabetes group was investigated by using follow-up.The receiver operating characteristic(ROC)curve was adopted to assess the predictive value of the velocity of shear wave,and the thickness of soft tissue for diabetic foot ulcer.Results:The FPG,2hPG and HbA1c of glucose metabolism level in the diabetes group were(6.48±0.48)mmol/L,(9.64±1.31)mmol/L and(6.21±0.15)%,respectively,all of which were higher than those[(8.03±0.62)mmol/L,(12.26±1.25)mmol/L and(7.66±0.42)%]in the prediabetes group,and the differences were statistically significant(t=18.961,18.961,31.185,P<0.05).The thickness level of soft tissue at the first metatarsal head was(10.42±3.11)mm in the diabetes group,which was less than(11.76±3.24)mm in the prediabetes group,with a statistically significant difference(t=2.862,P<0.05).Spearman correlation analysis showed that the velocity of shear wave at 500 Hz frequency had a strongest correlation with FPG and HbA1c(r=0.320,0.256,P<0.05),respectively.In the follow-up for patients of diabetes group,14 cases occurred ulcers and 78 cases did not occur ulcers.The velocities of shear wave of the first metatarsal head of 14 patients with ulcers were higher than those of patients without ulcers at all tested frequencies(400,450,500,550,and 600 Hz).The area under curve(AUC)value of ROC curve,specificity and sensitivity of 500 Hz were respectively 0.775,88.46%,and 78.57%in predicting plantar ulcer of patients with diabetes.Conclusion:The velocity of shear wave of soft tissue at the first metatarsal head is significantly correlated with abnormal glucose metabolism in patients with type 2 diabetes.The velocity of shear wave appeared strongest correlation with FPG and HbA1c at500 Hz frequency,which has higher predictive value for diabetic foot ulcer.

Objective:To investigate the characteristics of elastic program of excited shear wave of plantar soft tissue of diabetic patients and its correlation with levels of glucose metabolism.Methods:A total of 92 patients with type 2 diabetes who admitted to Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine during January 2022 and January 2023 were selected as diabetes group,and another 92 patients in the prediabetes stage were included in the prediabetes group.Both groups of patients used excited shear wave with different frequencies(400,450,500,550,and 600 Hz)under elastic technique of shear wave.The velocities of shear waves at the 1st metatarsal head,the 3rd metatarsal head and calcaneus of plantar soft tissue,and the thickness of soft tissue of these patients were assessed.The fasting plasma glucose(FPG),2-hour postprandial glucose(2hPG),and glycosylated hemoglobin(HbA1c)levels of sugar metabolism level of two groups were measured,and the correlations between velocity of shear wave,thickness of soft tissue,and level of glucose metabolism were further analyzed.The occurrence of diabetic foot ulcer in the diabetes group was investigated by using follow-up.The receiver operating characteristic(ROC)curve was adopted to assess the predictive value of the velocity of shear wave,and the thickness of soft tissue for diabetic foot ulcer.Results:The FPG,2hPG and HbA1c of glucose metabolism level in the diabetes group were(6.48±0.48)mmol/L,(9.64±1.31)mmol/L and(6.21±0.15)%,respectively,all of which were higher than those[(8.03±0.62)mmol/L,(12.26±1.25)mmol/L and(7.66±0.42)%]in the prediabetes group,and the differences were statistically significant(t=18.961,18.961,31.185,P<0.05).The thickness level of soft tissue at the first metatarsal head was(10.42±3.11)mm in the diabetes group,which was less than(11.76±3.24)mm in the prediabetes group,with a statistically significant difference(t=2.862,P<0.05).Spearman correlation analysis showed that the velocity of shear wave at 500 Hz frequency had a strongest correlation with FPG and HbA1c(r=0.320,0.256,P<0.05),respectively.In the follow-up for patients of diabetes group,14 cases occurred ulcers and 78 cases did not occur ulcers.The velocities of shear wave of the first metatarsal head of 14 patients with ulcers were higher than those of patients without ulcers at all tested frequencies(400,450,500,550,and 600 Hz).The area under curve(AUC)value of ROC curve,specificity and sensitivity of 500 Hz were respectively 0.775,88.46%,and 78.57%in predicting plantar ulcer of patients with diabetes.Conclusion:The velocity of shear wave of soft tissue at the first metatarsal head is significantly correlated with abnormal glucose metabolism in patients with type 2 diabetes.The velocity of shear wave appeared strongest correlation with FPG and HbA1c at500 Hz frequency,which has higher predictive value for diabetic foot ulcer.

Objective:To explore the accuracy of array comparative genomic hybridization(aCGH) in the unexpected detection of Duchenne muscular dystrophy ( DMD) gene duplication/deletion in prenatal diagnosis. Methods:A retrospective analysis was performed on 31 cases with DMD gene duplication/deletion detected by aCGH among 5 025 prenatal diagnosis samples without family history of DMD in Henan Provincial People's Hospital from July 2018 to December 2019. The multiplex ligation-dependent probe amplification (MLPA) method was used to verify the above results. The American College of Medical Genetics and Genomics (ACMG) guideline was referred for pathogenicity analysis of the detected duplicates/deletions. Descriptive analysis was adopted in analysis. Results:The total unexpected DMD gene duplication/deletion rate was 0.62% (31/5 025), among which 25 cases were with microduplication/microdeletion ≤ 200 kb and six were >200 kb; there were 24 cases of deletion, seven cases of duplication; exon or intron duplication/deletion were accounted for 19 and 12 cases, respectively. According to the five classification standards of ACMG guideline, there were 17 cases with pathogenic variants and 14 cases with uncertain pathogenicity/likely benign variants. Of the 19 with exon mutations, 17 cases were DMD intragenic variants, and two cases involved variants in and outside DMD gene, which were verified by MLPA whose results were all positive. Conclusions:The duplication/deletion of exon region of DMD gene detected by aCGH technique is accurate and reliable, which plays an important role in the diagnosis of DMD. For these cases involved both internal and external regions of DMD gene, aCGH can identify the upstream and downstream breaking points of DMD gene, thus providing the basis for ACMG grading.

Objective:To explore a new training mode for nursing professionals suitable for the 1+X certificate system, and realize the training goal of "one specialty and multi-ability" compound technical nursing talents.Methods:To take the "1+ X" certificate standard as the basis for the construction of nursing specialty, to reconstruct the talent training program of integration of graduation certificate and certificate. To take the content of "1+X" certificate as the basis for the construction of professional courses, construct the core curriculum system of integration of curriculum and certificate. To build a "new double-qualified" teaching staff and constructing of new double-qualified teachers and accelerate the development of quality resources.Results:The talent training mode of integration of graduation certificate and certificate under the 1+X certificate system was constructed. The curriculum structure has been optimized. The teachers′ability of teaching, training and examination was improved.Conclusions:The new mode of training nursing professionals under the 1+X certificate system meets 1 degree education and X vocational training of nursing students and achieve a "1" and "X" seamless convergence. It provides innovative ideas for the promotion and implementation of 1+X certificate system pilot work in the field of nursing education nationwide.

OBJECTIVE: To carry out genetic diagnosis for a pedigree affected with cutis laxa. METHODS: Genomic DNA was extracted from peripheral blood samples from members of the pedigree and 50 unrelated healthy controls. Potential mutation was screened by next-generation sequencing and verified by Sanger sequencing. RESULTS: A heterozygous c.1985delG mutation was identified in the ELN gene among all patients from this pedigree. The same mutation was not found among unaffected family members and 50 healthy controls. CONCLUSION The genetic etiology for the pedigree has been elucidated, which has enabled genetic counseling and guidance for reproduction.
Cutis Laxa ; genetics ; Elastin ; genetics ; Heterozygote ; High-Throughput Nucleotide Sequencing ; Humans ; Mutation ; Pedigree

OBJECTIVE： To explore the effects of different primary processing methods on quality change of Polygonatum sibiricum， and to optimize primary processing method of P. sibiricum with different grades and shapes. METHODS： After processed with different drying methods， boiling method and steaming method， sulfuric acid-phenol method was used to determine the contents of indicator component P. sibiricum polysaccharide in samples. The contents of ethanol-soluble extract， water-soluble extract and total ash were investigated. The optimal primary processing methods were screened. RESULTS： After processed with different methods， the contents of polysaccharide （≥7％）， ethanol-soluble extract （≥45％） and total ash （≤4％） of samples at all levels conformed to the requirements of the 2015 edition of Chinese Pharmacopoeia （part Ⅰ）； from aspect of drying method， microwave drying method was better than oven drying method；for P. sibiricum with different morphologies （individual and lamellar）， the quality of lamellar samples of P. sibiricum was better than that of individual P. sibiricum. As primary processing method， steaming was better than boiling. The contents of P. sibiricum polysaccharide were in relatively high level， when the steaming and boiling time of gradeless and uniformly-priced goods of P. sibiricum were 20 and 15 minutes respectively. CONCLUSIONS： By discussing the different primary processing methods， high-efficient primary processing method for the individual and lamellar samples of P. sibiricum as well as gradeless and uniformly-priced goods of P. sibiricum are preliminarily obtained， which can provide a scientific basis for the effective utilization of P. sibiricum resources.

Objective To compare the differences and characteristics of the dose distribution of the two optimization methods in the three dimensional brachytherapy,and provide the basis for clinieal treatment.Methods Excel 2007 was used to generate random number.And a total of 21 patients of cervical cancer were selected from those who have completed the treatment.Inverse simulated annealing optimization (IPSA) plans were designed for graphical optimization (GO) plans.The dose volume histogram (DVH) parameters of the targets (V100％,V150％) and the organs (D1 cm3,D2cm3) of the two methods were analyzed.Results The targets dose of both plans could meet the prescription requirements.There was no statistically significant difference in the dose parameters of all targets (P ＞ 0.05).The closes of D1 cm3 and D2cm3 in the bladder of IPSA plan were significantly lower than that of the GO plan (t =3.596,3.490,P ＜ 0.05).There was no statistically significant difference in the dose parameters of rectum (P ＞ 0.05).Conclusions For cervix brachytherapy,the GO and IPSA have no effect on targets dose,but IPSA optimization can reduce the maximum dose of bladder.