Objective To analyze the related factors of retinopathy in elderly patients with type 2 diabetes mellitus (T2DM) and explore the discriminant efficiency. Methods A retrospective analysis was conducted on 314 elderly patients with T2DM who were treated in Beijing Aerospace General Hospital between April 2022 and April 2025. The related factors of retinopathy in elderly patients with T2DM were explored by logistic regression analysis. ROC curve was drawn to analyze the discriminant efficiency of related factors. Results Compared with the patients in the non-concurrent group, the patients in the concurrent group had a longer course of diabetes mellitus, a higher level of glycosylated hemoglobin (HbA1c), and higher proportions of diabetic peripheral neuropathy, hypertension history, high myopia history and smoking history (P<0.05). After logistic regression analysis, the course of diabetes mellitus, HbA1c, diabetic peripheral neuropathy, history of hypertension and history of high myopia were found to be related factors of retinopathy in elderly patients with T2DM (P<0.05). Based on the above related factors, a model was established for ROC curve analysis, and it was found that the area under the curve was 0.935, with sensitivity, specificity, and 95%CI being 0.867, 0.916, and 0.890-0.979, respectively. Conclusion Course of diabetes mellitus, HbA1c, diabetic peripheral neuropathy, history of hypertension, and history of high myopia are related factors of retinopathy in elderly patients with T2DM. These related factors demonstrate good discriminant efficiency on retinopathy in elderly patients with T2DM.

BACKGROUND:Research has found that human umbilical cord blood platelet rich plasma and human umbilical cord blood derived mesenchymal stem cells have certain therapeutic effects on thin endometrium.However,there are currently no reports on the study of human umbilical cord blood mononuclear cells on thin endometrium,and there is a lack of relevant research comparing the three.OBJECTIVE:To explore the effects and mechanisms of human umbilical cord blood platelet rich plasma,monocytes,and mesenchymal stem cells in repairing thin endometrium in rats.METHODS:Sixty female SPF grade SD rats were randomly divided into sham operation group,model group,human umbilical cord blood platelet rich plasma group,human umbilical cord blood mononuclear cell group,and human umbilical cord blood derived mesenchymal stem cell group,with 12 rats in each group.The sham operation group received 0.5 mL physiological saline injection into the uterine horn,followed by 0.5 mL of PBS infusion after 5 minutes;The model group,human umbilical cord blood platelet rich plasma group,human umbilical cord blood mononuclear cell group,and human umbilical cord blood derived mesenchymal stem cell group were injected with 0.5 mL of 95％ethanol by volume.After 5 minutes,the remaining ethanol was aspirated and washed twice with physiological saline.Then,0.5 mL of PBS,human umbilical cord blood platelet rich plasma,human umbilical cord blood mononuclear cells(1×107 cells/mL),and human umbilical cord blood derived mesenchymal stem cells(1×107 cells/mL)were perfused separately.During the third normal estrus cycle after reperfusion,organs,tissues and serum were collected for testing of relevant indicators.RESULTS AND CONCLUSION:(1)The macroscopic view of uterine tissue,hematoxylin eosin staining and Masson staining results:the sham operation group had intact structure,moderate endometrial thickness,and clear vascular structure.Compared with the sham operation group,the model group showed uterine atrophy,incomplete structure,significantly reduced endometrial thickness and glandular quantity,disordered vascular structure,and increased fibrosis.Compared with the model group,after treatment with human umbilical cord blood derivatives,the size,structure,and endometrial thickness of the uterus were restored(all P＜0.01),and fibrosis was reduced,with the most significant recovery observed in the human umbilical cord blood mononuclear cell group.The increase in glandular quantity was most significant in the human umbilical cord blood platelet rich plasma group(P＜0.000 1).(2)The immunohistochemistry and immunofluorescence results of uterine tissue showed that compared with the sham operation group,the expression levels of cell proliferation related indicators such as keratin 9 and vimentin,endometrial receptivity related indicators such as leukemia inhibitory factor and integrin αyβ3,platelet endothelial cell adhesion molecule,basic fibroblast growth factor,and vascular endothelial growth factor were all reduced in the model group(all P＜0.05).Compared with the model group,the above indicators were significantly increased after treatment with human umbilical cord blood derivatives.Comparison of human umbilical cord blood derivatives among groups showed that keratin 9 and vascular endothelial growth factor protein:human umbilical cord blood mononuclear cell group＞human umbilical cord blood derived mesenchymal stem cell group＞human umbilical cord blood platelet rich plasma group;Wave shaped protein and leukemia inhibitory factor protein:human umbilical cord blood derived mesenchymal stem cell group＞human umbilical cord blood mononuclear cell group＞human umbilical cord blood platelet rich plasma group;Integrin αyβ3 protein:human umbilical cord blood platelet rich plasma group＞human umbilical cord blood derived mesenchymal stem cell group＞human umbilical cord blood mononuclear cell group;Platelet endothelial cell adhesion molecule protein:human umbilical cord blood platelet rich plasma group＞human umbilical cord blood mononuclear cell group＞human umbilical cord blood derived mesenchymal stem cell group;Basic fibroblast growth factor protein:human umbilical cord blood mononuclear cell group＞human umbilical cord blood platelet rich plasma group＞human umbilical cord blood derived mesenchymal stem cell group.(3)Western blot analysis showed that compared with the sham operation group,the protein levels of interleukin-6,interleukin-1β,and tumor necrosis factor alpha in the model group were significantly increased(all P＜0.001),and their expression levels decreased after treatment(all P＜0.05).(4)ELISA assay showed that compared with the sham operation group,the model group had lower levels of anti Mullerian hormone,estradiol,and progesterone,and increased levels of follicle stimulating hormone and luteinizing hormone(except for luteinizing hormone,all P＜0.05).After treatment,there was a certain degree of recovery in the levels of sex hormones and anti Mullerian hormones.(5)Fertility experiments showed that compared with the sham operation group,the model group had an increase in conception time and a significant decrease in litter size(all P＜0.05).After treatment with human umbilical cord blood derivatives,the litter size of all three groups increased(P＜0.05),and no significant differences were found between the groups.This study preliminarily reveals that human umbilical cord blood mononuclear cells have a certain therapeutic effect on thin endometrium,and human umbilical cord blood platelet rich plasma,human umbilical cord blood mononuclear cells,and human umbilical cord blood derived mesenchymal stem cells have different advantages and differences in improving endometrial regeneration function,endometrial receptivity,angiogenesis,inflammation regulation,and improving pregnancy outcomes in thin endometrium.

BACKGROUND:Research has found that human umbilical cord blood platelet rich plasma and human umbilical cord blood derived mesenchymal stem cells have certain therapeutic effects on thin endometrium.However,there are currently no reports on the study of human umbilical cord blood mononuclear cells on thin endometrium,and there is a lack of relevant research comparing the three.OBJECTIVE:To explore the effects and mechanisms of human umbilical cord blood platelet rich plasma,monocytes,and mesenchymal stem cells in repairing thin endometrium in rats.METHODS:Sixty female SPF grade SD rats were randomly divided into sham operation group,model group,human umbilical cord blood platelet rich plasma group,human umbilical cord blood mononuclear cell group,and human umbilical cord blood derived mesenchymal stem cell group,with 12 rats in each group.The sham operation group received 0.5 mL physiological saline injection into the uterine horn,followed by 0.5 mL of PBS infusion after 5 minutes;The model group,human umbilical cord blood platelet rich plasma group,human umbilical cord blood mononuclear cell group,and human umbilical cord blood derived mesenchymal stem cell group were injected with 0.5 mL of 95％ethanol by volume.After 5 minutes,the remaining ethanol was aspirated and washed twice with physiological saline.Then,0.5 mL of PBS,human umbilical cord blood platelet rich plasma,human umbilical cord blood mononuclear cells(1×107 cells/mL),and human umbilical cord blood derived mesenchymal stem cells(1×107 cells/mL)were perfused separately.During the third normal estrus cycle after reperfusion,organs,tissues and serum were collected for testing of relevant indicators.RESULTS AND CONCLUSION:(1)The macroscopic view of uterine tissue,hematoxylin eosin staining and Masson staining results:the sham operation group had intact structure,moderate endometrial thickness,and clear vascular structure.Compared with the sham operation group,the model group showed uterine atrophy,incomplete structure,significantly reduced endometrial thickness and glandular quantity,disordered vascular structure,and increased fibrosis.Compared with the model group,after treatment with human umbilical cord blood derivatives,the size,structure,and endometrial thickness of the uterus were restored(all P＜0.01),and fibrosis was reduced,with the most significant recovery observed in the human umbilical cord blood mononuclear cell group.The increase in glandular quantity was most significant in the human umbilical cord blood platelet rich plasma group(P＜0.000 1).(2)The immunohistochemistry and immunofluorescence results of uterine tissue showed that compared with the sham operation group,the expression levels of cell proliferation related indicators such as keratin 9 and vimentin,endometrial receptivity related indicators such as leukemia inhibitory factor and integrin αyβ3,platelet endothelial cell adhesion molecule,basic fibroblast growth factor,and vascular endothelial growth factor were all reduced in the model group(all P＜0.05).Compared with the model group,the above indicators were significantly increased after treatment with human umbilical cord blood derivatives.Comparison of human umbilical cord blood derivatives among groups showed that keratin 9 and vascular endothelial growth factor protein:human umbilical cord blood mononuclear cell group＞human umbilical cord blood derived mesenchymal stem cell group＞human umbilical cord blood platelet rich plasma group;Wave shaped protein and leukemia inhibitory factor protein:human umbilical cord blood derived mesenchymal stem cell group＞human umbilical cord blood mononuclear cell group＞human umbilical cord blood platelet rich plasma group;Integrin αyβ3 protein:human umbilical cord blood platelet rich plasma group＞human umbilical cord blood derived mesenchymal stem cell group＞human umbilical cord blood mononuclear cell group;Platelet endothelial cell adhesion molecule protein:human umbilical cord blood platelet rich plasma group＞human umbilical cord blood mononuclear cell group＞human umbilical cord blood derived mesenchymal stem cell group;Basic fibroblast growth factor protein:human umbilical cord blood mononuclear cell group＞human umbilical cord blood platelet rich plasma group＞human umbilical cord blood derived mesenchymal stem cell group.(3)Western blot analysis showed that compared with the sham operation group,the protein levels of interleukin-6,interleukin-1β,and tumor necrosis factor alpha in the model group were significantly increased(all P＜0.001),and their expression levels decreased after treatment(all P＜0.05).(4)ELISA assay showed that compared with the sham operation group,the model group had lower levels of anti Mullerian hormone,estradiol,and progesterone,and increased levels of follicle stimulating hormone and luteinizing hormone(except for luteinizing hormone,all P＜0.05).After treatment,there was a certain degree of recovery in the levels of sex hormones and anti Mullerian hormones.(5)Fertility experiments showed that compared with the sham operation group,the model group had an increase in conception time and a significant decrease in litter size(all P＜0.05).After treatment with human umbilical cord blood derivatives,the litter size of all three groups increased(P＜0.05),and no significant differences were found between the groups.This study preliminarily reveals that human umbilical cord blood mononuclear cells have a certain therapeutic effect on thin endometrium,and human umbilical cord blood platelet rich plasma,human umbilical cord blood mononuclear cells,and human umbilical cord blood derived mesenchymal stem cells have different advantages and differences in improving endometrial regeneration function,endometrial receptivity,angiogenesis,inflammation regulation,and improving pregnancy outcomes in thin endometrium.

Colorectal adenoma is a definite precancerous lesion,and the"inflammation-cancer transformation"is a key pathological link in the process of colorectal adenoma-cancer evolution.Under the guidance of the theory of"preventive treatment of diseases"in TCM,prevention before disease onset and preventing the development of the occurred disease has become the consensus and the important subject of clinical research to block the"inflammation-cancer transformation"and prevent the precancerous lesions of colorectal cancer.This article discussed the effectiveness of TCM in preventing and treating the"inflammation-cancer transformation"from different aspects.Its advantages are reflected in improving the symptoms of TCM and improving the quality of life,etc.Its mechanism may be related to inhibiting the activation of cancer-promoting signals,regulating inflammation,maintaining intestinal microbial homeostasis,and protecting the intestinal barrier.By explaining the pathogenesis of adenoma-cancer transformation in TCM,this article discussed the efficacy and advantages of TCM to block"inflammation-cancer transformation",analyzed its intervention targets and pathways,providing references for the intervention of TCM in the management of precancerous lesions of colorectal cancer and the synergistic prevention and treatment of traditional Chinese and Western medicine.

Objective To observe the value of MRI radiomics combined with ResNet101 deep learning for differentiating lumbar spine brucella spondylitis(BS)and spinal metastases(SM).Methods Seventy-one cases of lumbar spine BS and the same amount of lumbar spine SM patients were retrospectively enrolled in training set,while 33 cases of lumbar spine BS and the same amount of lumbar spine SM patients were enrolled in test set.Clinical features were screened with univariate and multivariate logistic analysis,and a clinical model(Mclinic)was constructed.ROI of lesions were drawn on lumbar sagittal T 2WI,then radiomics features were extracted to construct a radiomics model(Mradiomics).ResNet101 deep learning was integrated with radiomics,then deep learning radiomics features were extracted to construct deep learning radiomics model(MDL+R).Finally a combined model(Mcombined)was constructed through combining clinical features and deep learning radiomics features.The efficacy of the above models for differentiating BS and SM were analyzed.Results Significant differences of patients' age and proportion of fever and accessory involvement were found between BS and SM patients in training and test sets(all P＜0.05),and univariate and multivariate logistic analysis showed the latter two were clinical features(both P＜0.001).The area under the curve(AUC)of Mclinic for differentiating lumbar spine BS and SM was 0.794 and 0.773 in training set and test set,of Mradiomics was 0.895 and 0.791,of MDL+R was 0.926 and 0.882,while of Mcombined was 0.967 and 0.906,respectively.AUC of Mcombined was the highest in training set(all P＜0.05),while in test set,AUC of Mcombined was significantly higher than that of Mclinic and Mradiomics(both P＜0.05).Conclusion MRI radiomics combined with ResNet101 deep learning was helpful for differentiating lumbar spine BS and SM.Combining with clinical data could improve its diagnostic efficacy.

Objective:To explore the therapeutic effectiveness of using biomimetic electrical stimulation in conjunction with hormone replacement therapy involving estrogen and progesterone sequentially on premature ovarian failure and its influence on uterine artery hemodynamics.Methods:90 patients with premature ovarian failure in the First People's Hospital of Xianyang were selected from December 2022 to December 2023. According to the principle of matching the baseline characteristics between groups, the above patients were divided into observation group (pink ball, 45 cases) and control group (black ball, 45 cases) by random touching pink-black ball. The control group received estrogen-progesterone sequential therapy. In contrast, the observation group added biomimetic electrical stimulation combined therapy on the basis of the control group. The therapeutic effect, sex hormones (follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol), uterine artery hemodynamics indicators (uterine artery peak systolic velocity (PSV), pulsatility index (PI), resistance index) and occurrence of adverse reactions were compared between groups of patients. Measurement data with normal distribution were expressed as xˉ± s, and independent sample t test was used for between-group comparison of mean data and paired t-test was used for comparison before and after treatment. The percentage of enumeration data was calculated, and between-group rate was compared by chi-square test. P<0.05 was considered statistically significant. Results:Total effective rate with 96.56%(43/45) in observation group was higher than 82.22%(37/45) in control group ( χ2=4.05, P=0.044). After the end of treatment, FSH, LH, PI and resistance index in both groups were decreased, but the above indicators in observation group ((35.12±6.23) U/L, (33.56±4.12) U/L, 1.97±0.59, 0.41±0.13) were lower than those in control group ((49.23±6.87) U/L, (46.25±4.32) U/L, 2.33±1.04, 0.58±0.22), while the estradiol and PSV in both groups were increased, and the two indicators in observation group ((38.23±5.32) ng/L, (19.68±3.25) cm/s) were higher than those in control group were higher than those in control group ((32.12±5.12) ng/L, (16.44±2.03) cm/s) ( t value were 10.21, 2.52, 2.02, 4.62, 5.55, 5.67, respectively; Pvalue were <0.001, 0.014, 0.046, <0.001, <0.001, <0.001, respectively). The adverse reactions in the observation and control groups were nausea and vomiting (3 cases and 4 cases ), headache (2 cases and 4 cases), breast pain (1 case and 3 cases), and abdominal pain (2 cases and 4 cases), respectively,There were no statistical differences in incidence rates of adverse reactions between groups ( χ2 value were 0.16, 0.71, 1.05, and 0.71, respectively; P value were 0.694, 0.398, 0.306, and 0.398, respectively). Conclusion:The combination of biomimetic electrical stimulation technology and sequential therapy of estrogen and progesterone has shown outstanding efficacy in treating premature ovarian failure, promoting the synthesis of sex hormones in patients, improving uterine blood supply, and having high safety.

Objective:To assess the current status of geriatrics department development in public general hospitals at or above the second grade in Shandong province.Methods:A cross-sectional survey was conducted from October 27 to November 3, 2023 using a web-based electronic questionnaire to investigate the current status of geriatrics department development in all public general hospitals at or above the second grade across 16 prefecture-level cities in Shandong province.The survey included participation from medical department staff and managers of geriatric medicine departments.Results:Shandong province has 355 public general hospitals at or above the second grade, of which 337 completed the questionnaire.Among these 337 hospitals, 92.28%(311/337)have established geriatric departments, 83.09%(280/337)have set up geriatric clinics, 69.14%(233/337)have independent geriatric wards, and 71.51%(241/337)have implemented comprehensive geriatric assessments(CGA).Regarding the configuration of geriatric departments, 60.24%(203/337)of hospitals met the requirement of having at least 20 ward beds, 34.42%(116/337)met the doctor-to-bed ratio requirement of at least 0.3, and 22.26%(75/337)met the nurse-to-bed ratio requirement of at least 0.6.Only 13 hospitals met all the requirements for geriatric wards, beds, doctors, and nurses, accounting for 3.86%(13/337)of the participating hospitals.Conclusions:The establishment of geriatrics departments in second-grade or higher public general hospitals in Shandong province has surpassed the national target in China ahead of schedule.Most hospitals have established geriatric clinics and wards and have implemented CGA.However, significant challenges remain, including a shortage of ward beds and a lack of medical staff.

Objective:To investigate the correlation between c-myc gene rearrangement and clinical characteristics, 18F-deoxyglucose (FDG) PET-CT imaging features and prognosis of patients with diffuse large B-cell lymphoma (DLBCL). Methods:A retrospective cohort study was conducted. A total of 152 patients with DLBCL confirmed by pathology and underwent 18F-FDG PET-CT examination one week before treatment at Shanxi Province Cancer Hospital from September 2010 to December 2022 were selected, and their clinical data and PET-CT imaging data were collected. Fluorescence in situ hybridization (FISH) method was used to detect c-myc gene rearrangement in tumor tissues. The clinical characteristics and PET-CT imaging features between patients with and without c-myc gene rearrangement were compared. Kaplan-Meier method was used to plot the progression-free survival (PFS) and overall survival (OS) curves of patients, and log-rank test was used for inter group comparison. Univariate and multivariate Cox proportional hazards models were used to analyze the factors affecting the prognosis of DLBCL patients. Results:Among the 152 patients, there were 85 males (55.9%) and 67 females (44.1%); the age was (58±15) years old (range: 25-81 years old); 22 cases (14.5%) had c-myc gene rearrangement (including 7 cases of double hit), while the remaining 130 cases (85.5%) did not have c-myc gene rearrangement. There were statistically significant differences in the compositions of patients with different treatment plans, National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) scores, elevated lactate dehydrogenase (LDH) levels, positive bcl-6 protein, 18F-FDG PET-CT parameters, metabolic tumor volume (MTV) ≥ 256.04 cm 3, total lesion glycolysis (TLG) ≥ 2 292.34 g between patients with and without c-myc gene rearrangement (all P < 0.05); there were no statistically significant differences in the compositions of patients with different genders, age, tumor involvement range, Ann Arbor staging, immunophenotyping, bone marrow invasion, hepatitis B virus infection, CD10 protein, MUM1 protein, bcl-2 protein, and other 18F-FDG PET-CT imaging parameters (all P > 0.05). The MTV [(727±268) cm 3vs. (314±33) cm 3] and TLG [(8 965±1 868) g vs. (5 341±627) g] of patients with c-myc gene rearrangement were higher than those of patients without c-myc gene rearrangement, and the differences were statistically significant ( t values were 3.07 and 2.19, respectively, and P values were 0.003 and 0.035, respectively); there was no statistically significant difference in the maximum standardized uptake value, average standardized uptake value, tumor maximum standardized uptake value-to-blood maximum standardized uptake value ratio (TBR), and tumor maximum standardized uptake value-to-liver maximum standardized uptake value ratio between patients with and without c-myc gene rearrangement (all P > 0.05). The median follow-up period was 79.5 months (range: 6-153 months). The PFS and OS of patients with c-myc gene rearrangement were worse than those of patients without c-myc gene rearrangement, and the differences were statistically significant (both P < 0.001). Univariate Cox regression analysis showed that Ann Arbor staging, NCCN-IPI score, LDH level, c-myc gene rearrangement, MTV, TLG, and TBR were all associated with poor PFS and OS in DLBCL patients (all P < 0.05); multivariate Cox regression analysis showed that the presence of c-myc gene rearrangement was an independent risk factor for PFS (with vs. without, HR = 3.362, 95% CI: 1.825-6.193, P < 0.001) and OS (with vs. without, HR = 4.441, 95% CI: 2.226-8.857, P < 0.001) in DLBCL patients, and NCCN-IPI score (≥ 4 points vs. 0-3 points, HR = 2.439, 95% CI: 1.086-5.495, P = 0.031) and MTV (≥ 256.04 cm 3vs. <256.04 cm 3, HR = 2.439, 95% CI: 1.021-5.814, P = 0.045) were independent risk factors for PFS. Conclusions:DLBCL patients with c-myc gene rearrangement have high tumor burden, late clinical stage and poor prognosis. The rearrangement of c-myc gene may be a predictive factor for disease progression and death in DLBCL patients.