Objective To investigate the evaluation value of serum 25-hydroxyvitamin D[25-(OH)D],heart-type fatty acid-binding protein(H-FABP),and N-terminal pro-brain natriuret-ic peptide(NT-ProBNP)in early myocardial injury in patients with acute exacerbation of chronic ob-structive pulmonary disease(AECOPD).Methods A total of 120 patients with AECOPD(AECOPD group)were enrolled in this study.Based on the presence of early myocardial injury,they were divided into injury group(n=68)and non-injury group(n=52).Additionally,40 healthy individuals undergoing physical examinations during the same period were included as control group.The differences in serum 25-(OH)D,H-FABP,and NT-ProBNP levels were compared,and the correlations between these markers and clinical data were analyzed.Binary logistic regression analysis was used to explore the relationships between these markers and the occurrence of early myocardial injury.Receiver op-erating characteristic(ROC)curve analysis was employed to assess the diagnostic value of these markers for early myocardial injury in AECOPD patients.Results The forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),the ratio of FEV1 to FVC(FEV1/FVC),and arterial partial pressure of oxygen[pa(O2)]levels in the AECOPD group were lower than those in the control group,while the arterial partial pressure of carbon dioxide[p a(CO2)]level was high-er,with statistically significant differences(P＜0.05).The serum 25-(OH)D levels in the AECOPD group and the injury group were lower than those in the control group and the non-injury group,re-spectively,while the H-FABP and NT-ProBNP levels were higher,with statistically significant differences(P＜0.05).In AECOPD patients,serum 25-(OH)D was positively correlated with FEV1,FVC,FEV1/FVC,and pa(O2),and negatively correlated with pa(CO2)(P＜0.05).In contrast,H-FABP and NT-ProBNP were negatively correlated with FEV1,FVC,FEV1/FVC,and pa(O2),and positively correlated with pa(CO2)(P＜0.05).Binary Logistic regression analysis revealed that 25-(OH)D,H-FABP,and NT-ProBNP were related influencing factors for early myo-cardial injury in AECOPD patients(P＜0.05).ROC curve analysis showed that the areas under the curve(AUCs)for evaluating myocardial injury status based on 25-(OH)D,H-FABP,and NT-ProBNP values were 0.814,0.959,and 0.837,respectively.The AUC of their combination was 0.983,with a sensitivity of 97.06％and a specificity of 80.77％.Conclusion During early myocardial injury in AECOPD patients,there is low expression of serum 25-(OH)D and high ex-pression of H-FABP and NT-ProBNP.These three markers are correlated with early myocardial inju-ry and can serve as reference indicators for clinical diagnosis.

Objective:To carry out evidence-based nursing for standardized management of stress hyperglycemia in perioperative period of gastrointestinal tumor patients, and to formulate indicators, analyze obstacles and promoting factors, formulate action strategies.Methods:Guided by the Johns Hopkins evidence-based nursing model, evidence were searched, evaluated and summarized. Clinical indicators and review methods were formulated to carry out quality review. From November 2021 to April 2022, the medical staff and patients in the gastrointestinal surgery department of the First Affiliated Hospital of Anhui Medical University who met the inclusion criteria were conducted, and the incidence of compliance rate was calculated. Based on the results of the baseline review, the obstacles and contributing factors were analyzed.Results:A total of 26 pieces of best evidence were included and 14 indicators were formulated for 48 medical staff and 45 patients to clinical review, among which the compliance rate of 7 indicators was less than 60%. The main obstacle factors were lack of procedures and instruments for management of perioperative stress hyperglycemia in gastrointestinal tumor patients, lack of knowledge of medical staff, etc. The main promoting factors were organizational support, good atmosphere of medical team cooperation, strong willingness to change, etc.Conclusions:There is a big gap between the clinical practice and the best evidence of perioperative stress hyperglycemia management in patients with gastrointestinal tumor. Action strategies should be put forward for obstacles and promoting factors to promote evidence transformation.

The incidence of blood tumors is getting higher and higher. In addition to traditional chemoradiotherapy, in recent years, with the development of nuclear medicine technology and nuclide, nuclide therapy is playing an increasingly important role in the treatment of blood tumors. At present, the main research on the treatment of blood tumors focuses on acute myeloid leukemia (AML), but progress has also been made in other blood tumors. 213Bi and 225Ac-labeled monoclonal antibodies have achieved good results in blood tumors. 225Ac has overcome the short half-life of 213Bi and the problems of transportation and preservation. However, there are still many problems to be solved in the clinical use of α particles. This article reviews the progress of α-particle therapy in blood system, in order to provide a broader idea for the treatment of blood tumors.

Objective:To analyze the incidence of malignant tumors and its risk factors in patients on maintenance hemodialysis.Methods:Clinical data of 627 hemodialysis patients in Huadu District People′s Hospital of Guangzhou who met the inclusion criteria and exclusion criteria from January 2015 to December 2020 were retrospectively collected. Clinical characteristic of patients with malignant tumors was summarized. Multivariate logistics regression analysis was performed to explore the related factors of malignant tumors.Results:Among the 627 patients, 19(3.03%) developed malignant tumors. There were 14 males and 5 females with a mean age of (65.7±13.7)years. Their mean dialysis duration was (45.16±38.18)months. Gastrointestinal tumor was the most common tumor type (9/19). Univariate analysis showed that the age of the patients combined with malignant tumors was significantly higher, and the serum prealbumin was significantly lower than those patients without malignant tumors (all P<0.05). Logistic regression analysis showed that age was the independent risk factor of developing cancers after adjusting dialysis age, hemoglobin, albumin and parathyroid hormone ( P<0.05). Conclusions:The incidence of malignant tumor is significantly higher in maintenance hemodialysis patients than that in the general population. Age is the risk independent risk factor. Therefore, we should strengthen the monitoring of elderly hemodialysis patients, discover the disease in time, and take measures to improve the prognosis.

Objective:To explore the effect of case management of chronic obstructive pulmonary disease (COPD) in the nurse-led clinics.Methods:A total of 50 patients with COPD who met the selection criteria in the outpatient department of the respiratory department of Shantou Central Hospital were enrolled from March 2019 to March 2020. Case management was carried out by specialist nurses in the outpatient department. Body Mass Index (BMI), the forced expiratory volume in one second/predicted value ratio (FEV 1%pred), modified British medical research council (mMRC), 6-min walking distance (6MWD), COPD assessment test (CAT), and St.George Respiratory Questionnaire (SGRQ), basic activities of daily living (BADL) were compared before and after 6 months′ case management. The difference of medication compliance after case management was also analyzed. Results:There were statistically significant differences in the mMRC[(1.9±1.2) vs (1.4±1.1) points], 6MWD[(238.1±84.9) vs (284.1±113.8) m] and CAT scores [(19.7±6.6) vs (17.1±5.9) points], which suggested the improvement of dyspnea, self-conscious symptoms and exercise performance in these patients (all P<0.05). The BADL scores [(87.8±5.4) vs (90.00±7.5) points] and the total score of SGRQ [(48.0±7.3) vs (45.0±6.9) points] were significantly different (both P<0.01). These indicators were improved after the implementation of case management. Patients were followed up for 1 month, 3 months and 6 months, and the improvement of medication compliance score was statistically significant [(7.1±0.8) vs (7.4±0.8) vs (7.7±0.5) points] ( P<0.01). Conclusion:The implementation of respiratory nursing clinic can effectively manage COPD patients, improve medication compliance of patients, so as to improve the degree of dyspnea, self-conscious symptoms, self-care ability and exercise endurance of patients.

Accurate detection of low frequency mutations from plasma cell-free DNA in blood using targeted next generation sequencing technology has shown promising benefits in clinical settings. Duplex sequencing technology is the most commonly used approach in liquid biopsies. Unique molecular identifiers are attached to each double-stranded DNA template, followed by production of low-error consensus sequences to detect low frequency variants. However, high sequencing costs have hindered application of this approach in clinical practice. Here, we have developed an improved duplex sequencing approach called SinoDuplex, which utilizes a pool of adapters containing pre-defined barcode sequences to generate far fewer barcode combinations than with random sequences, and implemented a novel computational analysis algorithm to generate duplex consensus sequences more precisely. SinoDuplex increased the output of duplex sequencing technology, making it more cost-effective. We evaluated our approach using reference standard samples and cell-free DNA samples from lung cancer patients. Our results showed that SinoDuplex has high sensitivity and specificity in detecting very low allele frequency mutations. The source code for SinoDuplex is freely available at https://github.com/SinOncology/sinoduplex.

Objective To investigate the diagnostic value of 3.0T MR high field high-b-value diffusion weighted imaging (DWI) in prostate cancer (PCa) and to analyze its correlation with Gleason classification.Methods A total of 78 cases proved by operation and pathology were collected,including 41 cases of benign prostatic hyperplasia(BPH) and 37 cases of PCa.PCa patients were classified according to postoperative pathological scores,and their correlation with ADC values was analyzed subsequently.Parameter scanning was performed in all patients by using Philps 3.0T MR with b value at 0 s/mm2,1 000 s/mm2 and 1 500 s/mm2.The signal intensity and ADC value of PCa and BPH were compared under two kinds of high-b-values,and the correlation between ADC value and Gleason classification was analyzed.Results It was found that the specificity and accuracy of T2WI combined with b value of 1 500 s/mm2 were higher than these of T2WI combined with b value of 1 000 s/mm2 for the diagnosis of PCa.The ranking result of ADC value corresponding to Gleason score of PCa after operation was:2-4 points ＞ 5-6 points ＞7 points ＞ 8-10 points.Besides,the ADC value of the corresponding lesion with b value of 1 500 s/mm2 was lower than that with b value of 1 000 s/mm2,and the difference was statistically significant (P＜0.05).Conclusion High field high-b-value DWI combined with T2WI is of high value in differential diagnosis of PCa and BPH,and the specificity and accuracy of PCa and BPH improve obviously with the increase of the b value.Additionally,the ADC value is negatively correlated with the Gleason score.

Objective To investigate the status of social support and self-efficacy management of postoperative patients with gastrointestinal tumor and explore the correlation between them. Methods From March 2016 to February 2017, 114 patients from the First Affiliated Hospital of Anhui Medical University with gastrointestinal tumor who underwent surgery were selected as the research object by convenient sampling method. They were investigated by the Strategies Used by People to Promote Health and Social Support Revalued Scale. Results The total score of self-management efficacy of patients was (91.73±28.48), the total score of social support was (41.73±7.79); the total score of social support was positively correlated with the total score of self-management efficacy (r=0.418, P<0.01). Conclusions Social support and self-management efficacy are closely related among postoperative patients with gastrointestinal tumor. Medical stuff should help postoperative patients with gastrointestinal tumor to build perfect social support system, so as to improve their self confidence and ability to manage disease.

Objective To investigate the effect and mechanism of electroacupuncture at acupoints on radiation-induced hippocampal neuronal apoptosis in C57 mice. Methods Forty one-month-old C 57/6J mice were equally and randomly divided into control group, model group(8 Gy), acupoint-electroacupuncture group, and non-acupoint-electroacupuncture group. In the acupoint-electroacupuncture group,mice received electroacupuncture intervention at Baihui, Fengfu, and Shenshu points. The novel object recognition test was used to evaluate the cognitive, learning, and memory abilities in mice. Immunohistochemistry was used to determine the levels of caspase-3 and apoptosis-inducing factor(AIF). TUNEL assay was used to detect DNA breaks. The data were analyzed by one-way analysis of variance and the Tukey's multiple comparison. Results Compared with the control group, the model group had a significantly reduced recognition index(P= 0.040);compared with the model group, the acupoint-electroacupuncture group had a significantly increased recognition index(P=0.043),shown by significantly longer time spent exploring novel objects(P=0.035).According to the results of immunohistochemistry,the model group had significantly higher apoptosis rate and levels of caspase-3 and AIF in hippocampal neurons than the control group(P= 0.002, 0.003, 0.023), while the acupoint-electroacupuncture group had significantly lower apoptosis rate and levels of caspase-3 and AIF in hippocampal neurons than the model group(P=0.027, 0.005, 0.004). Conclusions Radiation can induce hippocampal neuronal apoptosis and damage cognitive function in mice. Electroacupuncture intervention can, to some degree, reduce above damages.

Objective To investigate the treatment of diabetes mellitus complicated acute necrotizing sinusitis .Methods By way of reviewing the clinical procedures of 2 patients with diabetes mellitus complicated acute necrotizing sinusitis .Results In perioper-ative period ,by means of glycemic control ,anti-infection ,and emergency surgery to remove the necrotic tissue in nasal sinuses and open the sinuses ,one of the patients discharged from hospital after 8 days .He has been followed up for more than 4 years without recurrence ,and is still in follow-up .Due to complicating renal failure and ascites ,the another patient gave up treatment and dis-charged on the third postoperative day ,and died on the same day .Conclusion Glycemic control ,homeostasis ,surgical removal of necrotic tissue and anti-infection treatment in perioperative period as soon as possible ,is the key to a successful treatment .