Objective To investigate and analyze the relationship between bone metabolism indicators,bone mineral density(BMD)T value,osteoporosis and fracture risk in patients with type 2 diabetes mellitus(T2DM).Methods A retrospective analysis was conducted on the clinical data of 175 patients with T2DM ad-mitted to the hospital from January to August 2024.According to the T value,they were divided into the oste-oporosis group(n=65),the osteopenia group(n=50),and the normal bone mass group(n=60).The general clinical data and bone metabolism indicators were compared among the three groups,including 25-hydroxyvi-tamin D3[25-(OH)D3],osteocalcin(OC),calcitonin(CT),type Ⅰ procollagen amino-terminal peptide(PⅠNP)and β-collagen degradation products(β-CTX),parathyroid hormone(PTH),T value,and the differences between the fracture risk assessment tools[FRAX,including 10-year major osteoporotic fracture(MOF)risk and 10-year hip fracture(HF)risk],analyzed the influencing factors of osteoporosis in T2DM patients,as well as the relationship between bone metabolism indicators,T values and fracture risk.Results The results of un-ivariate and multivariate logistic regression analyses showed that PⅠNP and β-CTX were risk factors for oste-oporosis in patients with T2DM,while estradiol(E2),testosterone(T),25-(OH)D3,OC,and T values were all protective factors(P<0.05).The 10-year risks of MOF and HF in the osteoporosis group were higher than those in the osteopenia group and the normal bone mass group,while the 10-year risks of MOF and HF in the osteopenia group were higher than those in the normal bone mass group,the differences were statistical-ly significant(P<0.05).According to Pearson correlation analysis,25-(OH)D3 and T values were negatively correlated with the risks of 10-year MOF and HF,while OC,PⅠNP,and β-CTx were positively correlated with the risks of 10-year MOF and HF(P<0.05),CT and PTH were not correlated with the risks of 10-year MOF and HF(P>0.05).Conclusion Bone metabolism indicators and BMD are important influencing factors for the occurrence of osteoporosis in patients with T2DM,and they are closely related to the occurrence of os-teoporotic fractures.Clinically,the monitoring of bone metabolism and BMD in patients with T2DM should be strengthened.

Objective:To investigate the clinical effect of "standardized 4 steps" in rheumatic mitral valve repair.Methods:We retrospectively analyze the clinical data of 136 rheumatic mitral valve disease patients undergoing mitral valve repair with "standardized 4 steps" from June 2016 to July 2019 and investigate its clinical outcome. The clinical outcome was compared with those of patients undergoing rheumatic mitral valve replacement.Results:The perioperative mortality was 2.94% in patients with mitral valve repair. Compared with preoperative period, left atrial diameter was significantly reduced and the early diastolic blood flow velocity across mitral valve(E peak) was significantly decreased at 1-week postoperative and follow-up period. The elimination rate of atrial fibrillation was 80.7% during follow-up period. The early clinical outcome and related complications had no difference between mitral repair group and mitral valve replacement group. The main echocardiographic indexes in two groups also had no statistical significance.Conclusion:The early clinical outcome of rheumatic mitral valve repair with "standardized 4 steps" is satisfactory. Rheumatic mitral valve repair with "standardized 4 steps" is feasible, safe and effective.

Objective To investigate the effect of histone deacetylase inhibitor LBH589 on proliferation,apoptosis and drug resistance of chemoresistant acute myeloid leukemia cells HL60/ADM.Methods HL60/ADM cells were treated with LBH589.Proliferation,apoptosis and adriamycin IC50 were evaluated by MTT assay and AnnexinV-FITC/PI stain.The change in MRP1 expression and intercellular adriamycin accumulatiom were analyzed by flow cytometry.Results Effective proliferative inhibition and apoptotic induction in HL60/ADM cells were observed after treatment with 10-80 nmol/L LBH589 with maximal effect detected after treatment with 70 nmol/L LBH589 for 60 hours.However,inhibition ratio remain unchanged with the further increase of drug dose and incubation time (P ＞ 0.05).Downregulation of MRP1 [(93.90±4.20) ％ vs (76.19±6.53) ％],upregulation of adriamycin accumulation [(8.53±0.68) ％ vs (25.67±1.34) ％] and decrease in adriamycin IC50 [(6.833±0.319) μg/ml vs (1.382±0.104) μg/ml] were induced by the treatment with 20 nmol/L LBH589 (P ＜ 0.01),whose reversal fold was 4.9.The expression of acetylated histone 3 after treatment with LBH589 was higher than that before treatment (P ＜ 0.01).However,relative p-Akt levels after treatment for 24 h and 48 h were 1.07±0.09 and 0.59±0.01,respectively,which were lower than that before treatment (2.03±0.12) (P ＜ 0.01).Meanwhile,expression levels of p53 were 0.57±0.04 and 1.31±0.09,respectively,which were higher than that before treatment (0.21 ±0.02) (P ＜ 0.01).Conclusion Treatment with LBH589 has the capability of inhibiting proliferation and inducing apoptosis,as well as increasing intercellular adriamycin accumulation and sensitivity through downregulation of MRP1 expression and inhibition of PI3K-Akt signaling pathway in HL60/ADM cells.