Objective To explore the relationship between serum CXC chemokine ligand 12(CXCL12),an-giotensin Ⅱ receptor-like 1 endogenous ligand 13(Apelin-13)and carotid atherosclerosis(CAS)in patients with type 2 diabetes mellitus(T2DM).Methods From October 2022 to September 2024,a total of 105 T2DM patients in Rugao People's Hospital(the hospital)were included as the T2DM group,and healthy volunteers who experienced physical check ups in the hospital were regarded as the control group.According to whether T2DM patients developed CAS,they were assigned into non CAS group(n=61)and CAS group(n=44).Fully automatic biochemical analyzer was applied to detect the levels of blood lipid indicators total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein choles-terol(LDL-C).Fully automatic glycated hemoglobin analyzer was used to detect glycated hemoglobin(HbA1c)level.Enzyme-linked immunosorbent assay(ELISA)was applied to detect the levels of CXCL12 and Apelin-13.Multivariate Logistic regression was applied to analyze the influencing factors of concurrent CAS in T2DM.Pearson correlation was used to analyze the correlation between CXCL12,Apelin-13 and the course of diabetes,blood glucose and lipid indicators.Receiver operating characteristic(ROC)curve was applied to ana-lyze the predictive value of CXCL12 and Apelin-13 for T2DM complicated with CAS,and the Z-test was ap-plied to compare the differences in the area under the curve(AUC).Results The level of CXCL12 in the T2DM group was higher than that in the control group(P＜0.05),and Apelin-13 level was lower than that in the control group(P＜0.05).The course of T2DM,HbA1c,TC,TG,LDL-C,and CXCL12 levels in the CAS group were higher than those in the non CAS group(P＜0.05),while HDLC and Apelin-13 levels were lower than those in the non CAS group(P＜0.05).The level of CXCL12 in the CAS group was positively correlated with the course of T2DM,HbA1c,TC,TG,and LDL-C levels(P＜0.05),and negatively correlated with HDL-C levels(P＜0.05),while the correlation of Apelin-13 was opposite(P＜0.05).CXCL12 and Apelin-13 were independent influencing factors for concurrent CAS in T2DM patients(P＜0.05).The AUC predicted by CX-CL12 and Apelin-13 in T2DM patients complicated with CAS was 0.916,which was better than 0.783 and 0.788 predicted separately(P＜0.05).Conclusion The high levels of CXCL12 and low levels of Apelin-13 in the serum of T2DM patients are independent influencing factors for concurrent CAS in T2DM.The combined detection of CXCL12 and Apelin-13 to predict CAS in T2DM patients has certain clinical significance and pro-vides a basis for disease assessment and treatment.

Objective:To evaluate the dynamic changes in fibrinolytic states after initial resuscitation in severe trauma patients, and to analyze the relationship between the changes and clinical outcomes.Methods:A prospective cohort study was conducted on severe trauma patients admitted to the trauma center in Taicang Hospital, affiliated with Soochow University, from July 2021 to December 2022. Resuscitation treatments, including tranexamic acid (TXA), were administered. Thromboelastography was performed at three intervals: upon admission, 1 hour and 8 hours after initial resuscitation. Fibrinolytic states were categorized into three phenotypes based on clot lysis at 30 minutes: fibrinolysis shutdown (SD), physiologic fibrinolysis (PY), and hyperfibrinolysis (HF). The primary outcomes included all-cause mortality at 24 hours and 28 days. Multivariate logistic regression was used to analyze the association between early fibrinolytic changes and clinical outcomes.Results:A total of 132 patients with severe trauma were included. Upon admission, fibrinolytic phenotypes were distributed as follows: SD in 61 patients (46.2%), PY in 59 patients (44.7%), and HF in 12 patients (9.1%). After resuscitation with TXA and other interventions, SD and PY remained predominant, whereas HF further decreased. Compared with the SD and PY groups, the HF group had significantly higher 24-hour mortality (25.0% vs. 3.3% vs. 3.4%, P<0.05) and 28-day mortality (58.3% vs. 32.8% vs. 11.9%, P<0.05), with massive hemorrhage being the primary cause of death. Among the non-HF groups, 28-day mortality was significantly higher in the SD group than in the PY group (32.8% vs. 11.9%, P<0.05), with traumatic brain injury as the leading cause of death. After the exclusion of 12 HF patients, multivariate logistic regression showed that after adjusting for age, Glasgow Coma Scale score ≤ 8, prothrombin time, and 24-hour crystalloid infusion volume, identified persistent SD was a risk factor for 28-day mortality in severe trauma patients, compared with sustained PY status ( OR=7.009, 95% CI: 1.141-43.079, P=0.036). Conclusions:In patients with severe trauma, SD and PY are the predominant fibrinolysis phenotypes after initial and early resuscitation. Persistent SD following resuscitation is significantly associated with an increased risk of 28-day mortality.

Humans ; COVID-19 ; SARS-CoV-2

Objective:To explore the value of nursing checklist in posterior surgery for thoracolumbar fracture with general anesthesia under prone position.Methods:A retrospective case series study was conducted to analyze the clinical data of 106 patients with thoracolumbar fracture admitted to Sir Run Run Shaw Hospital，Zhejiang University School of Medicine from June 2018 to May 2020. There were 80 males and 26 females，with age range of 25-57 years［（48.6 ± 11.9）years］. Segments of injury were located at T 11 in 18 patients，at T 12 in 26，at L 1 in 21，at L 2 in 25 and at L 3 in 16. All patients were treated with thoracolumbar posterior screw fixation under general anesthesia. Of all，51 patients received conventional postural nursing from June 2018 to May 2019（control group），and 55 patients received prone position nursing scheme for general anesthesia on the basis of conventional postural nursing from June 2019 to May 2020（verification group）. The incidence of postoperative complications including stress injury，brachial plexus injury，ulnar nerve injury and ocular discomfort as well as length of hospital stay and patients’ satisfaction were compared between the two groups. Visual analogue scale（VAS）and Oswestry disability index（ODI）were also used to measures outcome at postoperative 3 months. Results:All patients were followed up for 8-12 months［（10.5±0.9）months］. Verification group and control group showed significant differences in the incidence of stress injury（4%∶29%），brachial plexus injury（4%∶16%）and ocular discomfort consisiting of tears（2%∶12%），foreign body sensation（0%∶4%）and dryness（4%∶16%）（ P < 0.05），not in ulnar nerve injury and blurred vision. Length of hospitalization in verification group was（7.0±1.3）days，significantly shorter than that in control group［（9.9±1.9）days］（ P < 0.05）. Satisfaction of patients in verification group and control group was 85%（47/55）and 69%（35/51），respectively（ P < 0.05）. At 3 months postoperatively，VAS in verification group［（1.9 ± 0.8）points］was significantly lower than that in control group［（3.5±1.1）points］（ P < 0.05），and ODI was similar between the two groups（ P > 0.05）. Conclusions For patients with thoracolumbar fracture treated by posterior surgery with general anaesthesia under prone position，nursing checklist helps reduce occurrence of the related complication，shorten length of hospital stay，improve patient satisfaction，reduce postoperative pain and promote rehabilitation.

Objective:To study the incidence of glucose-6-phosphate dehydrogenase (G6PD) deficiency and the gene carrying status of newborns in Guangxi Zhuang Autonomous Region (Guangxi for short), so as to provide theoretical basis for clinical genetic counseling and accurate diagnosis.Methods:A total of 63 606 newborns who underwent G6PD screening in Guangxi Neonatal Disease Screening Center from January 2017 to December 2018 were selected as study subjects; heel blood was collected to prepare dry blood spots. Fluorescence quantitative analysis was used in the preliminary screening, and the newborns with positive preliminary screening were recalled by telephone; further diagnosis was carried out via the G6PD/6-phosphogluconate dehydrogenase (6PGD) ratio method and genetic testing, the diagnosis rate of the two methods of newborns with positive preliminary screening were compared and analyzed, and genetic mutation testing was conducted.Results:Among 63 606 newborns who underwent G6PD preliminary screening, 4 267 newborns with G6PD positive were detected, and the positive rate of preliminary screening was 6.7%. Among them, the positive rates of preliminary screening of males and females were 10.3% (3 508/33 988) and 2.6% (759/29 618), respectively. The positive rate of preliminary screening of males was significantly higher than that of females ( P < 0.01). A comparative analysis of 777 newborns (519 males and 258 females) that underwent G6PD/6PGD ratio method and genetic testing at the same time as the recall showed that the diagnosis rate of the two methods for male newborns was the same, both of which were 95.6% (496/519). Among female newborns, 168 and 236 confirmed cases were detected by G6PD/6PGD ratio method and genetic testing, respectively, and the diagnosis rates were 65.1% (168/258) and 91.5% (236/258), respectively. The results of genetic mutation testing showed that the five common genotypes in Guangxi were c.1388 G>A, c.1376 G>T, c.95 A>G, c.871 G>A, and c.1024 C>T, respectively. Conclusions:The positive rate of G6PD preliminary screening of newborns in Guangxi is relatively high. It is recommended that G6PD/6PGD ratio method and genetic testing should be performed at the same time for diagnosis of female newborns with positive preliminary screening to avoid missed diagnosis and misdiagnosis.

Biological occupational hazards have occurred frequently for a long time, which have seriously affected the health of relevant occupational groups. The infection of medical staff caused by improper occupational protection in public health emergencies also sounds alarms to practitioners with biological hazards. In order to further carry out the research work of biological occupational hazards, this paper combs and summarizes the research status of biological occuational hazards in agriculture, forestry, animal husbandry, fishery and other industries, and puts forward suggestions for in-depth research from three aspects of research scope, research methods and research contents, to provide some reference for the development of biological occupational hazards research in the future.

Biological occupational hazards have occurred frequently for a long time, which have seriously affected the health of relevant occupational groups. The infection of medical staff caused by improper occupational protection in public health emergencies also sounds alarms to practitioners with biological hazards. In order to further carry out the research work of biological occupational hazards, this paper combs and summarizes the research status of biological occuational hazards in agriculture, forestry, animal husbandry, fishery and other industries, and puts forward suggestions for in-depth research from three aspects of research scope, research methods and research contents, to provide some reference for the development of biological occupational hazards research in the future.

Humulus lupulus is a kind of special resource plant used both as medicine and food in Xinjiang. In addition to being widely used in beer brewing, Humulus lupulus has long been recognized for its medicinal value, especially for the treatment of postmenopausal osteoporosis. Modern pharmacological research shows that its active components have great potential in the development of anti-osteoporosis drugs. However, in recent years, the wild Humulus lupulus resources in China have been seriously degraded, and the contents of active components are quite different. Ensuring high-quality Humulus lupulus germplasm resources is a prerequisite for the development and utilization of Humulus lupulus. This paper reviews the major chemical components of Humulus lupulus and their effects and application in the prevention and treatment of osteoporosis, and discusses the existing problems, aiming to provide a reference for the development and utilization of Humulus lupulus against osteoporosis.

Objective To establish fingerprint of Hupulus lupulus by HPLC.Methods Diamonsil C18column (250mm×4.6mm, 5μm) was used.The mobile phase consisted of acetonitrile and 0.1％phosphoric acid, in gradient elution mode, detection wavelength was 358nm, column pressure at 10.2MPa, column temperature was 30℃, injection volume of 10μl and flow rate was 1.0ml/min.Results A common mode of HPLC fingerprint of Hupulus lupulus was established.19common peaks were calibrated, xanthohumol, cohumulone, humulone, adhumulone, colupulone, lupulone and adlupulone for identification.Among the 26batches of Hupulus lupulus, 5batches of herbs had similarities of less than or equal 0.9, which were all wild varieties.Conclusion The method was fast, effective, accurate and reliably to distinguish the cultivation and wildness Hupulus lupulus, which provided reference for quality control of Hupulus lupulus.

Objective To evaluate the value of semi-quantitative indices of 68Ga-prostate specific membrane antigen (PSMA)-11 PET/CT in differentiating malignant and benign prostate lesions.Methods From November 2017 to June 2018,30 patients (age:52-86 years) who underwent 68Ga-PSMA-11 PET/CT imaging in the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed,and the serum total prostate specific antigen (tPSA) and free prostate specific antigen (fPSA) were examined within 1 week before PET/CT imaging.Semi-quantitative indices of 68Ga-PSMA-11 PET/CT on prostate lesions were measured by automatic segmentation algorithm method,including PSMA-related lesion volume (VPSMA),maximum standardized uptake value (SUVmax),mean standardized uptake value (SUVmean),peak standardized uptake value (SUVpeak) and total lesion uptake value of PSMA (TLUPSMA).The indices were compared between malignant and benign prostate lesions,and the optimal cut-off values for differentiating malignant and benign prostate lesions were obtained by receiver operating characteristic (ROC) curve analysis.Results According to the pathological results,19 patients had malignant lesions and 11 were with benign diseases.The differences of tPSA,SUVmax,SUVmean SUVpeak and TLUPSMA between malignant and benign prostate lesions were statistically significant (u values:17.00-48.00,all P＜0.05),but there were no significant differences of fPSA,fPSA/tPSA and VPSMA between 2 groups (u values:64.00-99.00,all P＞0.05).The optimal cut-off value of tPSA was 18.30 μg/L for differentiating malignant and benign prostate lesions,with sensitivity of 13/17 (PSA of 2 patients were missing),specificity of 9/11 and area under curve (AUC) of 0.743.The optimal cut-off values of SUVmax,SUVmean and SUVpeak were 5.50,3.09 and 3.56,respectively,with all corresponding sensitivity of 18/19,all specificity of 9/11,and AUC of 0.902,0.907 and 0.919,respectively.The optimal cut-off value of TLUPSMA was 54.81 cm3,with sensitivity of 14/19,specificity of 9/11 and AUC of 0.804.Conclusion The semi-quantitative indices of 68Ga-PSMA-11 PET/CT are valuable for differentiating malignant and benign prostate lesions,in which SUVpeak is superior to other indices.