Objective To investigate the relationship between traditional Chinese medicine(TCM)syndromes and triacylglyceride-glucose(TyG)index in diabetic retinopathy(DR).Methods A total of 185 DR patients hospitalized in Jiangsu Provincial Hospital of Traditional Chinese Medicine from January to October 2019 were classified by TCM syndromes differentiation,the differences in clinical data of patients with different TCM syndromes were compared,and the correlation between each TCM syndromes and TyG index was ana-lyzed by Logistic regression.Results The distribution of the 185 DR patients was 32 cases(17.3％)with syndrome of yin deficiency and internal heat,61 cases(33.0％)with syndrome of qi-yin deficiency,35 cases(18.9％)with syndrome of liver-kidney deficien-cy,28 cases(15.1％)with syndrome of spleen deficiency and dampness retention,and 29 cases(15.7％)with syndrome of yin-yang deficiency.Statistically significant differences were observed in TyG index,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),triglyceride(TG),and high-density lipoprotein cholesterol(HDL-C)among different syndromes(P＜0.05).Patients with syndrome of spleen deficiency and dampness retention had significantly higher TyG index and TG levels than those in the other four groups(P＜0.05).FBG levels in patients with syndrome of qi-yin deficiency and syndrome of spleen deficiency and dampness retention were higher than those in patients with syndrome of yin-yang deficiency(P＜0.05).HbA1c levels in patients with syndrome of qi-yin deficiency were significantly higher than those in the other four groups(P＜0.05).HDL-C levels in the spleen deficiency with damp-ness stagnation group were lower than those in the qi-yin deficiency group,and HDL-C levels in the yin-yang deficiency group were lower than those in the liver-kidney deficiency group(P＜0.05).The results of Logistic regression analysis showed that the TyG index was positively correlated with syndrome of spleen deficiency and dampness retention,and served as an independent risk factor for this syn-drome.Conclusion The most common TCM syndrome in DR patients is syndrome of qi-yin deficiency.The TyG index is highest in pa-tients with syndrome of spleen deficiency and dampness retention,indicating its potential as an objective auxiliary indicator for TCM syn-drome differentiation in DR.

Objective To investigate the relationship between traditional Chinese medicine(TCM)syndromes and triacylglyceride-glucose(TyG)index in diabetic retinopathy(DR).Methods A total of 185 DR patients hospitalized in Jiangsu Provincial Hospital of Traditional Chinese Medicine from January to October 2019 were classified by TCM syndromes differentiation,the differences in clinical data of patients with different TCM syndromes were compared,and the correlation between each TCM syndromes and TyG index was ana-lyzed by Logistic regression.Results The distribution of the 185 DR patients was 32 cases(17.3％)with syndrome of yin deficiency and internal heat,61 cases(33.0％)with syndrome of qi-yin deficiency,35 cases(18.9％)with syndrome of liver-kidney deficien-cy,28 cases(15.1％)with syndrome of spleen deficiency and dampness retention,and 29 cases(15.7％)with syndrome of yin-yang deficiency.Statistically significant differences were observed in TyG index,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),triglyceride(TG),and high-density lipoprotein cholesterol(HDL-C)among different syndromes(P＜0.05).Patients with syndrome of spleen deficiency and dampness retention had significantly higher TyG index and TG levels than those in the other four groups(P＜0.05).FBG levels in patients with syndrome of qi-yin deficiency and syndrome of spleen deficiency and dampness retention were higher than those in patients with syndrome of yin-yang deficiency(P＜0.05).HbA1c levels in patients with syndrome of qi-yin deficiency were significantly higher than those in the other four groups(P＜0.05).HDL-C levels in the spleen deficiency with damp-ness stagnation group were lower than those in the qi-yin deficiency group,and HDL-C levels in the yin-yang deficiency group were lower than those in the liver-kidney deficiency group(P＜0.05).The results of Logistic regression analysis showed that the TyG index was positively correlated with syndrome of spleen deficiency and dampness retention,and served as an independent risk factor for this syn-drome.Conclusion The most common TCM syndrome in DR patients is syndrome of qi-yin deficiency.The TyG index is highest in pa-tients with syndrome of spleen deficiency and dampness retention,indicating its potential as an objective auxiliary indicator for TCM syn-drome differentiation in DR.

Objective:To survey the awareness status of risk factors for gastric cancer and related factors among residents in Shijiazhuang city.Methods:From October to November 2020, residents aged>18 years were selected through convenience sampling from Xinhua District and Yuhua District in Shijiazhuang for a face-to-face questionnaire survey. The demographic characteristics and awareness levels of risk factors for gastric cancer among 1 490 subjects were analyzed. The multivariate linear regression model was applied to analyze the related factors.Results:There were 522 male participants (35.0%) and 968 female participants (65.0%). The mean knowledge score of risk factors of gastric carcinoma in the respondents was 5.0 (1.0, 11.0). There were 57.0% (849/1 490) of the participants who had a low knowledge level about risk factors of gastric cancer. The more highly recognized risk factors were irregular diet (47.4%, 706/1 490), consumption of pickled foods (45.2%, 674/1 490), consumption of smoked foods (45.0%, 671/1 490); the less-recognized risk factors included physical inactivity (14.8%, 221/1 490), male sex (17.3%, 258/1 490) and older age (19.5%, 291/1 490). Only 26.8% (400/1490) of the participants regarded H. pylori infection as a risk factor of gastric cancer. Univariate analysis showed that educational level ( Z=39.34), marital status ( Z=53.31), monthly income ( Z=11.82), family member or friend ever having stomach problem ( H=-2.98), and family history of gastric cancer ( H=-2.34) were significantly associated with the knowledge score of risk factors for gastric cancer ( P<0.05). Multivariate analysis showed that compared to participants with educational levels of primary school or below, those with educational level of junior high school ( β=0.27, P<0.001), high school ( β=0.23, P<0.001), or college ( β=0.16, P<0.001) had a higher levels of knowledge of risk factors for gastric cancer; compared to unmarried participants, awareness of risk factors was significantly better in those who were married ( β=0.16, P<0.001), divorced ( β=0.05, P=0.039), or widowed ( β=0.06, P=0.027); compared to participants with monthly income<3 000 yuan, the subjects with monthly income from 5 000 to 10 000 yuan ( β=0.07, P=0.020) had a higher knowledge score; compared to participants with no family history of gastric cancer, subjects with family history had higher knowledge level of risk factors for gastric cancer ( β=0.06, P=0.029). Conclusion:The knowledge levels of risk factors for gastric cancer are generally low among residents in Shijiazhuang city. Educational initiatives are required to improve the awareness of risk factors for gastric cancer, and interventions need to be implemented concurrently to change unhealthy behaviors among residents in Shijiazhuang city.

Trousseau′s syndrome(TS) is a complication of cancer-associated thrombosis caused by hypercoagulability. A 58-years female patient admitted to the Affiliated Hospital of Qingdao University on October 2020 and diagnosed with Trousseau′s syndrome was reported. This was a patient with pancreatic malignant tumor. On the second day of admission, the mouth angle was distorted and the speech was vague. Craniocerebral MR showed multiple DWI high signals in the brain parenchyma, and brain MR enhancement showed no abnormal enhancement in the brain parenchyma. The patient was considered to be Trousseau′s syndrome. Using "Trousseau′s syndrome" and "cerebral infarction" as key words, the relevant literature was searched in CNKI, Wanfang and PubMed databases from January 2011 to June 2021, total of 76 cases of Trousseau′s syndrome complicated with cerebral infarction were reported in the literature. Among 77 cases (including one in this study) 36 were males and 41 were females, with a median age of 63 years old. The most common tumor type was lung adenocarcinoma (24 cases, 31.2 %). The mean D-dimer level was (17.3±12.8) mg/L, Craniocerebral CT or MRI showed that 57 cases (74.0 %) had bilateral multiple lesions; and 56 cases received anticoagulant therapy. A total of 68 patients were followed up, with a median survival time of 90 days, and one year overall survival rate was 32.6 %. The study indicates that for cerebral infarction with significantly elevated D-dimer level and multiple vascular involvement, malignant tumors should be considered.

Objective:To investigate the serum levels of soluble growth stimulation expression gene 2 protein (sST2) and inflammatory factors in patients with acute left ventricular ejection fraction reduction heart failure (HFrEF) treated with sacubitril/valsartan.Methods:Ninety six patients with acute HFrEF admitted in The Affiliated Hospital of Qingdao University from March 2020 to March 2021 were enrolled. The patients were treated with sacubitril/valsartan,the dose was gradually increased from 50 mg b.i.d to the target dose of 200 mg b.i.d according to hemodynamics. After 12 weeks, the target dose was achieved in 72 cases (compliance group), and did not achieved in 24 cases (non-compliance group). The serum levels of sST2, IL-1β, IL-6, TNF-αand IL-10 were measured and compared between the two groups. The changes in left atrial anteroposterial diameter (LA), left ventricular end-diastolic diameter (LVDd) and left ventricular ejection fraction (LVEF) values were assessed with echocardiography. The adverse reactions, readmission rate and all-cause death within 3 months after discharge were compared between the two groups.Results:A total of 96 patients with acute HFrEF completed the follow-up, including 72 patients (75.0%) in the compliance group and 24 (25.0%) in the non-compliance group; aged 50-75 (66.1±6.7) years old, and 68 (70.8%) males. After treatment, the serum levels of sST2, IL-1β, IL-6 and TNF-α were decreased, and the IL-10 level was increased in both groups ( P<0.05); while the improvement of serum indicators in the compliance group was more marked ( P<0.05). Echocardiography showed that the LA, LVDd, and LVEF were significantly increased after treatment ( P<0.05) in compliance group, while there was no significant changes before and after treatment in the non-compliance group. SST2, inflammatory factors and echocardiographic measurements of patients in the standard group had statistical significance before and after treatment ( P<0.05), and the difference showed a downward trend. No deterioration of renal function and angioedema were observed in both groups, and there was no significant difference in hyperkalemia (two in compliance group and one in non-compliance group), symptom hypotension (each in two groups) between the two groups (χ 2=0.12, 0.68; P>0.05). In the non-compliance group, 10 patients (41.7%) were readmitted due to heart failure, and 6 patients (25.0%) died; while there were no readmitted cases or fatal cases in compliance group (χ 2=33.49, 19.20; P<0.05). Conclusion:Early application of sacubitril and valsartan sodium in patients with acute HFrEF after hemodynamic stabilization can significantly improve left ventricular remodeling, for those with earlier escalation to the target dose, it is more beneficial. The changes of serum sST2 and inflammatory factor level after treatment may predict the efficacy of sacubitril/valsartan therapy.

Objective: To assess the effect of health coaching on interventional effect in high-risk population of stroke. Methods: A baseline survey was conducted among 897 residents aged 40 years and above selected by cluster sampling method in a community of Shijiazhuang city from January 2016 to June 2016, and 178 subjects were identified as high risk population of stroke. The high-risk subjects were randomly divided into two groups: the control group (n=89) was given routine health education, while the intervention group (n=89) received health coaching based on motivational interview for 13 months. The behavioral risk factors and self-efficacy scores were compared between two groups before and after intervention. Results: There were no significant differences in behavioral risk factors between the two groups: for hypertension 72 vs. 74 cases (χ²=0.152, P=0.67), for hyperglycocemia 44 vs.48 cases (χ²=0.360, P=0.55), for dyslipidemia 62 vs. 60 cases (χ²=0.104, P=0.75), for smoking 35 vs.32 cases (χ²=0.215, P=0.64), for obesity 50 vs.52 cases (χ²=0.092, P=0.76), for lack of exercises 72 vs.70 cases (χ²=0.139, P=0.71), for atrial fibrillation 14 vs. 16 cases (χ²=0.160, P=0.19). And there was no significant difference in self-efficacy scores between the two groups [(5.3±1.2) vs. (5.6±2.0), t=0.997,P=0.32]. After intervention, there were significant differences between the two groups in behavioral risk factors: for hypertension 25 vs. 34 cases (χ²=19.984, P<0.05) , for hyperglycaemia 16 vs.32 cases (χ²=8.448, P<0.05) , for dyslipidemia 30 vs. 48 cases (χ²=13.216, P<0.05) , for smoking 20 vs.28 cases (χ²=7.583, P<0.05) , for obesity 18 vs.38 cases (χ²=14.158, P<0.05) , for lack of exercises 28 vs. 36 cases (χ²=10.235, P<0.01) , for atrial fibrillation 5 vs. 13 cases (χ²=6.451, P<0.05) . And the self-efficacy scores of intervention group were higher than those of control group[ (8.4±2.1) vs. (6.8±2.2), t=4.852, P<0.01]. Conclusion Health coaching based on motivational interview is beneficial to reduce risk factors and improve self-efficacy in high risk population of stroke, which is worthy of popularization.

Objective To evaluate the effect of "5As" (ask,advice,assess,assist,arrange) model based on the "two-in-one team" management (integrated hospital and community health service center management team) on the self-management behavior in stroke high-risk population.Method A stroke risk screening was conducted among 1 196 residents aged ≥40 years selected by cluster sampling in a community of Shijiazhuang city from March 2016 to March 2017,and 218 high-risk individuals were identified.The high risk individuals were randomly divided into intervention group and control group.The control group received routine health instruction,the intervention group was managed by "two-in-one team" with 5As model.Stroke prevention knowledge questionnaire and self-evaluation scale were applied for evaluation before and after intervention.Results Before intervention,scores of the stroke prevention knowledge and self-management behavior in the intervention group and the control group were (21.6 ±4.7) and (130.8 ± 6.4) points,(20.4±5.0) and (131.4 ±6.3) points,respectively (t =1.79,P =0.08;t =0.67,P =0.50).After intervention,the scores of prevention knowledge and self-management behavior in the intervention group were higher than those in the control group [(30.5 ± 5.1) vs.(21.7 ± 6.0) points,t =16.83,P=0.00;(158.3±19.0) vs.(135.6±20.0)points,t=7.85,P=0.00].Conclusion The 5As intervention model based on the two-in-one team management can improve stroke prevention knowledge and self-management behavior among stroke high-risk individuals in the community.

OBJECTIVEThe aim of this study was to clarify whether the fusion of bone marrow mesenchymal stem cells (MSCs) with tumor cells can promote tumor angiogensis.

METHODSHuman glioma stem/progenitor cells (GSPCs) (SU3 cells) were transfected with red fluorescent protein (RFP) gene. Bone marrow mesenchymal stem cells (MSCs) were harvested from nude mice with whole-body green fluorescent protein (GFP) gene expression. Then the two kinds of cells were co-cultured in vitro. At the same time SU3-RFP was transplanted into the brain of GFP-expressing nude mice to establish xenograft tumors. The co-cultured cells, GFP/RFP double positive (yellow) cells and blood vessels obtained from the xenograft tumors were observed under fluorescent microscope and laser scanning confocal microscope.

RESULTSAfter five passages in vitro, MSCs maintained the proliferative activity and highly expressed CD105. CD105 was also expressed in the femurs of GFP-expressing nude mice, tumor cells, blood vessels of SU3 xenograft tumors, and clinical malignant gliomas. When MSCs were co-cultured with SU3-RFP, the ratio of yellow cells co-expressing RFP and GFP was significantly increased after extended time and continuous passages. According to the flow cytometry, yellow cells co-expressing RFP and GFP were 83.7% of the cultured cells. In tissue slices of the xenograft tumors, bundles of yellow vessel-like structure and cross-sectioned yellow vascular wall structures including vascular wall stroma cells were observed with RFP and GFP expression, and were identified as de novo formed vessels derived from fusion of MSCs with SU3-RFP cells.

CONCLUSIONCell fusion occurs between tumor cells and host MSCs and it promotes tumor angiogenesis.

Animals ; Bone Marrow Cells ; physiology ; Cell Communication ; Cell Fusion ; Cells, Cultured ; Glioma ; Green Fluorescent Proteins ; Humans ; Luminescent Proteins ; Mesenchymal Stromal Cells ; Mice ; Mice, Nude ; Microscopy, Fluorescence ; Neoplasms ; Neovascularization, Pathologic ; Stem Cells ; Transfection ; Transplantation, Heterologous

Objective To introduce triage standard for non-traumatic chest pain and SOAPIE triage method into triage work for acute chest pain patients, and to investigate its effect. Methods Based on triage standard for non-traumatic chest pain and SOAPIE triage method, a new triage record was established. And triage time, triage accuracy and patient satisfaction were compared with conventional methods. Results The triage time of the research group was (1. 94 ± 0. 30) minutes, which was significantly lower than (2. 27 ± 0. 35) minutes of the control group (t =6. 99,P <0. 05). The triage accuracy of the research group was 96. 0%, which was significantly higher than 82. 0% of the control group (χ2 =10. 01,P<0. 05). The score of patients′satisfaction was (98. 94 ± 1. 06), which was significantly higher than (89. 30 ± 5. 95) of the control group (t=15. 96,P <0. 01). Conclusions The new triage method can shorten the triage time, improve the triage accuracy and patients′satisfaction, which is worthy of promotion.

Objective To explore the application effects of LBL and PBL teaching mode on emergency triage of acute chest pain. Methods In 2013, the scenario simulation method combining with LBL and PBL teaching mode were applied in training 22 triage nurses on emergency triage of acute chest pain, and triage accuracy and theoretical level of acute chest pain were compared between two groups of nurses (6-10 years and >10 years) . Results After training, > 10 years group showed an increasing in triage accuracy rate from 89. 80% to 98. 31%, as well as the 6-10 years group, which the triage accuracy rate increased from 74. 51% to 92. 68% (χ2 =3. 91,5. 22;P<0. 05). The grade of theoretical level test in >10 years group increased from (84. 00 ± 3. 74) to (90. 00 ± 1. 79);and 6-10 years group increased from (76. 50 ± 4. 72) to (86. 50 ± 4. 13) (t=3. 54,6. 38;P<0. 05). Conclusions The combining LBL and PBL teaching mode and scenario simulation method can improve the results of theoretical level test and the triage accuracy, which is worthy of promotion.