Objective To investigate the effect of Angelica polysaccharides on the balance of Th17/T-regulatory(Treg)cells and the expression of related inflammatory factor proteins in the bone marrow of mice with aplastic anemia.Methods 50 male BALB/c mice were randomly divided into a normal group,model group,cyclosporine A(CsA)group,and angelica polysaccharide low-(APS-L)and high-dose(APS-H)groups.A mouse model of aplastic anemia was prepared by combining irradiation with allogeneic lymphocyte infusion.After modeling,the mice were orally administered with corresponding drugs for 28 days.The general condition,weight changes,and spleen index of the mice were observed.Blood samples were taken to test for changes in basic hematological parameters of peripheral blood,and hematoxylin and eosin staining was used to evaluate the pathological changes in mouse bone marrow tissue.An ELISA method was applied to detect bone marrow TGF-β1.The expression levels of proteins such as IL-10,IL-17A,and IL-6 were analyzed,and flow cytometry was used in detecting the bone marrow Th17/Treg cell ratio.Results Compared with the normal group,the model group mice showed clumsiness during activity;lethargy;pale eyelids,lips,and ears;and reduced food and water intake.Both body weight and spleen index were significantly decreased.Peripheral red blood cell,white blood cell,and platelet counts and hemoglobin concentration were significantly reduced.A disordered bone marrow tissue structure and significantly reduced proliferation of hematopoietic tissue were seen.The expression of IL-17A and IL-6 proteins was significantly upregulated,and the expression of TGF-β1 and IL-10 protein was significantly downregulated.The proportion of Th17 cells in bone marrow significantly increased,the proportion of Treg cells significantly decreased,and the ratio of Th17/Treg cells significantly increased(P＜0.01).Compared with the model group,the general condition of the APS-L and APS-H groups improved,showing an increase in food and water intake;a significant increase in body weight and spleen index;a significant increase in peripheral red blood cells,white blood cells,platelets,and hemoglobin concentration(P＜0.05);an improvement in bone marrow tissue structure;and an increase in hematopoietic tissue proliferation(P＜0.05).The expression of IL-17A and IL-6 proteins was significantly downregulated.The expression of TGF-β1 and IL-10 protein was significantly upregulated(P＜0.05 or P＜0.01).The proportion of Th17 cells in bone marrow significantly decreased,the proportion of Treg cells significantly increased,and the ratio of Th17/Treg cells significantly decreased(P＜0.01).Conclusions Angelica polysaccharides can improve bone marrow hematopoietic function in aplastic anemia mice,and its mechanism of action may include the regulation of Th17/Treg cell balance.

Objective To observe the application effect of magnetic resonance imaging technology in evaluating the brain structure and function of patients with type 2 diabetic painful neuropathy (PDN). Methods Forty patients with type 2 diabetes mellitus hospitalized in our hospital were selected as the study objects, and were divided into diabetes mellitus (DM) group (n=12), peripheral neuropathy (DPN) group (n=14) and PDN group (n=14). General clinical biochemical indexes of three groups were analyzed. The structural brain and function of brain area in three groups were compared. Results Age, duration of diabetes, systolic blood pressure, diastolic blood pressure, fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), free fatty acid (FFA), albumin (ALB), creatinine (Cr), uric acid (UA), estimated glomerular filtration rate (eGFR), cystatin C (Cys-C), total cholesterol (TC), triglyceride (TG) of the three groups were compared, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH), thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPO-Ab) and serum calcium (Ca) in the three groups showed no significant differences (P > 0.05). Compared with the DM group, the gray matter volume (GMV) in the DPN group was significantly decreased (P < 0.05). Compared with the DM group, amplitude of low frequency fluctuation (ALFF) and fractional amplitude of low frequency fluctuation (fALFF) of left medial superiorfrontal gyrus in the PDN group were significantly decreased (P < 0.05). Conclusion Abnormal GMV in the left angular gyrus in DPN patients may be associated with a higher risk of concomitant cognitive impairment. The decrease of ALFF in the right cerebellar vermis and fALFF in the left medial superior frontal gyrus in PDN patients may be related to the pathogenesis of pain.

BackgroundAt least 77.0% of breast cancer patients will experience cancer-related fatigue. Hope level and resilience play as two important factors that have influence on cancer-related fatigue. Currently， most studies involve one single factor， either the level of hope or resilience， and explore its relationship with the cancer-related fatigue. Only limited studies explore the action mechanism behind with all three factors put together. ObjectiveTo investigate the mediating role of resilience between hope and cancer-related fatigue in patients with breast cancer， and to provide references for finding intervention targets for cancer-related fatigue in breast cancer patients. MethodsFrom March to October 2022， this study was conducted on the sample size of 324 hospitalized patients from three Grade-A tertiary hospitals in Shaanxi Province. These patients were over 18 years old and pathologically diagnosed as breast cancer. Hope level， resilience and cancer-related fatigue were assessed， respectively， using Adult Dispositional Hope Scale （ADHS）， Connor-Davidson Resilience Scale （CD-RISC-10） and Cancer Fatigue Scale （CFS）. Pearson Correlation Analysis was used to analyze the relationship between ADHS score， CD-RISC-10 score and CFS score. AMOS 22.0 was used to analyze the mediating effect of resilience between hope level and cancer-related fatigue in breast cancer patients. ResultsThe detection rate of cancer-related fatigue in patients with breast cancer was 88.58%. Scores of ADHS and CD-RISC-10 were negatively correlated with CFS score （r=-0.750， -0.809， P<0.01）. ADHS score was positively correlated with CD-RISC-10 score （r=0.901， P<0.01）. Resilience had a mediating effect between the hope level and cancer-related fatigue. The mediating effect value was -0.676（95% CI： -1.005~-0.347）， accounting for 81.90% of the total effect. ConclusionThe hope level of breast cancer patients can affect cancer-related fatigue directly as well as indirectly through resilience. Resilience plays a partial mediating role between hope level and cancer-related fatigue .

Objective:To observe the effects of 0.01% atropine eye drops on ocular biometrics in myopic adolescents.Methods:A prospective cohort study was conducted.Two hundred and nineteen myopic adolescents who visited the First Affiliated Hospital of Zhengzhou University from June 2016 to June 2017 and completed the 1-year follow-up on time were enrolled.The 219 adolescents were divided into a 0.01% atropine+ single-vision spectacles (SV) group (119 cases) wearing single-vision spectacles with one drop of atropine eye drop applied to both eyes once nightly, and a simple SV group (100 cases) wearing SV only.Axial length (AL), corneal power and anterior chamber depth were measured with the IOLMaster.Lens power was calculated using the Bennett-Rabbetts formula.Intraocular pressure was measured by non-contact tonometry.Spherical equivalent (SE) was examined by cycloplegic autorefraction.Total astigmatism and corneal astigmatism were calculated by vector decomposition.The right eye data were analyzed to compare the ocular biometrics changes between the two groups, and multiple linear regression analysis was used to evaluate the influencing factors.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of First Affiliated Hospital of Zhengzhou University (No.2016-35). Written informed consent was obtained from guardians before any medical examination.Results:The SE change and AL elongation 12 months after treatment in 0.01% atropine+ SV group were (-0.47±0.45) D and (0.37±0.22) mm, respectively, which were significantly lower than (-0.70±0.60)D and (0.46±0.35)mm in simple SV group ( t=5.523, 9.651; both at P<0.001). There were significant differences in SE and AL between before and after treatment in both groups (SE: Fgroup=1.556, P=0.015; Ftime=12.538, P=0.002; AL: Fgroup=3.425, P=0.021; Ftime=18.235, P=0.008). The SE and AL at 4, 8 and 12 months after treatment were all increased in comparison with before treatment in both groups, showing statistically significant differences (all at P<0.001). The SE and AL at 8 and 12 months after treatment in 0.01% atropine+ SV group were smaller than in simple SV group, and the differences were statistically significant (all at P<0.001). At 8 and 12 months after treatment, total astigmatism and the anterior chamber depth were increased and the lens power was decreased in comparison with before treatment in both groups, and the differences were statistically significant (all at P<0.05). There was no significant difference in corneal astigmatism, corneal power and intraocular pressure at different time points before and after treatment between the two groups (all at P>0.05). In the multiple linear regression analysis, an equation of Δmyopic SE=-0.012-2.685×ΔAL-1.002×Δcorneal astigmatism-0.656×Δlens power+ 0.477×Δtotal astigmatism+ 0.363×Δanterior chamber depth-0.060×age+ 0.011×sex was used, showing the change of SE was mainly caused by the change of AL ( β=-2.685), then corneal power, lens power, total astigmatism and anterior chamber depth. Conclusions:In adolescents, 0.01% atropine eye drops can effectively retard myopia progression and axial elongation, showing no effect on astigmatism, corneal power, lens power, anterior chamber depth and intraocular pressure.The controlling effect of 0.01% atropine eye drops in the development of myopia is mainly achieved by reducing axial elongation.

Objective : To explore the association of time in range(TIR) and glucose management indicator ( GMI) with the risk of type 2 diabetic nephropathy (DN) ． Methods : The clinical data of 215 patients with type 2 diabetes mellitus (T2DM) were collected and analyzed．According to the results of estimated glomerular filtration rate (eGFR) and urinary albumin to creatinine ratio( UACR) ，they were divided into 117 patients with T2DM and 98 patients with DN．The clinical data，biochemical indicators and continuous glucose monitoring ( CGM) indicators of the two groups were compared．Logistic regression was used to analyze the influencing factors of DN risk．The predictive value of TIR and GMI on the risk of DN was evaluated by receiver operating characteristic (ROC) curve. Results: There were significant differences in age，duration of diabetes，systolic blood pressure，glycosylated hemoglobin ( HbA1c) ，fasting plasma glucose (FPG) ，2 hour postprandial plasma glucose (2hPG) ，creatinine( Cr) ，UACR, eGFR between the two groups(P＜0. 05) ．There were statistically significant differences between the two groups in the CGM indexes of GMI，mean absolute difference of mean of daily differences ( MODD) ，glucose above target range time(TAR) and TIR(P＜0. 05) ．The results of logistic regression analysis showed that TIR was a protective factor of DN．In the ROC curve analysis of TIR prediction DN，the area under the ROC curve was 0. 718 (95% CI = 0. 648 ～0. 789，P＜0. 001) ，and the Yoden index was 0. 38．At this time，the sensitivity was 66. 7% ，and the specificity was 71. 3%．In the ROC curve analysis of GMI prediction DN，the area under the ROC curve was 0. 701 (95% CI = 0. 629 ～0. 774，P＜0. 001) ，and the Yoden index was 0. 368．At this time，the sensitivity was 63. 3% ， and the specificity was 73. 5%． Conclusion Specifically，lower TIR and higher GMI increase the risk of DN.

【Objective】 To investigate the prognosis of blood donors with occult hepatitis B virus infection (OBI) by long-term follow-up and repeated testing of HBsAg and HBV DNA. 【Methods】 From January 1, 2010 to December 31, 2020, voluntary blood donors were screened by both serological and viral nucleic acid(NAT) testing, then samples were further confirmed as HBV DNA positive by manual nested-PCR amplification.A total of 306 cases were detected as HBsAg negative /HBV DNA positive, then followed-up for a long time and re-examined of HBsAg and HBV DNA to confirm whether they had infected with OBI.The prognosis of patients with OBI who experienced long-term immunization was determined by repeated testing. 【Results】 A total of 306 HBsAg negative/ HBV DNA positive blood donors had been followed up, and 40(13.07%, 40/306) were recalled frequently for re-examination.Among them, 90%(36/40), 57.5%(23/40), 40% (16/40)were anti-HBc + , anti-HBs + and anti-HBe + , respectively, and 50%(20/40), 40%(16/40), 7.5%(3/40) and 2.5% (1/40)were anti-HBs+ / anti-HBc + , anti-HBc + / anti-HBs -, anti-HBc -/ anti-HBs + and anti-HBc -/ anti-HBs -, respectively.Those 40 blood donors were followed-up for 1-13 times, with the duration of 8-108 months (0.6~9 years).1 donor (2.5%) was followed-up less than 1 year, 11 (27.5%)>1 year and ≤3 years, 23 (57.5%) 23(57.5%)>3 years and ≤5 years, and 5 (12.5%) for more than 5 years.After long-term following up and repeated testing, 50%(20/40)of OBI blood donors turned negative for HBV DNA (HBsAg negative / HBV DNA negative), 42.5% (17/40)were confirmed as OBI infection (HBsAg negative / HBV DNA positive), and 7.5%(3/40) were hard to determine (after repeated testing, the results were either positive or negative). 【Conclusion】 After long-term following up and repeated screening, we found that none of the OBI patients turned into acute or chronic HBV infection, and most of them maintained OBI.However, OBI blood donors carry very low load of HBV DNA for a long time, which could lead to false negative results of NAT and bring a great challenge to the safety of blood transfusion.

【Objective】 To track and evaluate the clinical diagnostic efficacy of an enzyme linked immunosorbent assay (ELISA) kit for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). 【Methods】 Total antibody (TAb) specific to SARS-CoV-2 in blood donors were determined using ELISA reagent. TAb positive donors were followed up 1 month after blood donation. SARS-CoV-2 specific IgG, IgM and pseudotype lentivirus based neutralization test (ppNAT) were conducted for TAb positive blood donors and follow-up samples. ppNAT and IgG antibodies simultaneously positive in ppNAT positive samples and its follow-up samples was used as the standard for antibodies validation. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and Youden index of SARS-CoV-2 TAb ELISA were analyzed. 【Results】 Among 16 016 blood donors from January 31 to April 28, 2020, 61 donors were diagnosed as TAb positive, 6 cases were positive for ppNAT, in which 2 were positive for both ppNAT and IgG; 4 of 46 TAb positive follow-up samples were positive for ppNAT, in which 2 were positive for IgG simultaneously. The sensitivity, specificity, PPV, NPV, accuracy, Youden index, false positive rate and false negative rate of SARS-CoV-2 TAb reagent were 100.00%, 99.60%, 3.28%, 100.00%, 99.60%, 99.60%, 0.40% and 0.00%, respectively. 【Conclusion】 SARS-CoV-2 TAb ELISA has high sensitivity and good clinical diagnostic efficacy, but the false positive rate is relatively high in low-risk blood donors. Therefore, ppNAT, IgG and follow-up results should be fully considered in clinical in order to analyze the positive results and determine the infection status more accurately.

Objective To investigate the detection and clinical significance of thrombus molecular markers in diffuse large B-cell lymphoma (DLBCL). Methods We collected the blood specimens of 60 patients with DLBCL, involving 23 cases in the initial treatment group, 24 cases in the remission group and 13 cases in the non-remission group, 23 cases in the thrombus group and 37 cases in the non-thrombus group. We selected 46 healthy people in the same period as the control group. The levels of thrombomodulin (TM), plasmin-α2 plasmin inhibitor complex (PIC), tissue plasminogen activator-plasminogen activator inhibitor-1 complex (t-PAIC) and thrombin-antithrombin Ⅲ complex (TAT) in plasma were detected by chemical immunoassay, and the levels of lactate dehydrogenase (LDH) in serum was detected by automatic biochemical analyzer. We analyzed the differences of thrombus molecular markers among groups and prognostic factors. Results The levels of TM and PIC in plasma of lymphoma patients were higher than those in health control group (P < 0.05). The levels of TM and PIC in the initial treatment and non-remission groups were significantly higher than those in the remission group (P < 0.05). The levels of TM, PIC and TAT in thrombus group were higher than those in non-thrombus group (P < 0.05). TM and PIC levels in plasma were closely related to the prognosis of DLBCL patients. PIC was an independent prognostic factor (P < 0.001). TM and PIC levels were correlated with LDH prognostic indicators in lymphoma patients. Conclusion TM and PIC levels in plasma are significantly increased in DLBCL patients. They are expected to be the indicators for effectiveness and prognosis of DLBCL patients.

Atrial fibrillation (AF) is a common arrhythmia type. It affects more than 80％ of the elderly. The main hazards are stroke and other systemic thromboembolism. Compared with the strokes caused by other causes, the disability, mortality and recurrence rate of AF-related stroke are higher. Therefore, the prevention of stroke in patients with AF is critical. Anticoagulation is the core therapeutic strategy for stroke prevention in patients with AF. This article reviews various oral anticoagulants for stroke prevention in patients with AF.

Objective To ascertain the specific activities of nigericin on inhibiting human epithelial ovarian cancer(EOC)cells,and to investigate the possible molecular mechanism of nigericin on cell migration and invasion.Methods Cell viability under different treatments of nigericin(0.312 5,0.625,1.25,2.5,5,10,20,40,80 μmol/L)on EOC A2780 and SKOV3 cell lines was examined by CCK-8 assay,with DMSO as a control.The human epithelial ovarian cancer cell lines A2780 and SKOV3 were treated with 5,10 or 20 μmol/L nigericin or with DMSO as a control.Transwell chambers was used to observe the impact of nigericin on migration and invasion of EOC cells.Western blot was used to detect the expressions of epithelial cell marker(E-cadherin),mesenchymal cell marker(Vimentin)and the epithelial-mesenchymal transition(EMT)-related transcription factors Slug,Snail,and Twist,as well as the expressions of proteins related to Wnt/β-catenin signaling pathway such as Gsk-3β,p-Gsk-3β and β-catenin under different concentration treatment of nigericin.Results CCK-8 assay showed that nigericin exhibited strong cytotoxicity on A2780 [ IC 50(16.19 ± 0.26)μmol/L,95％CI 1.077-1.341)] and SKOV3 [ IC50(11.87 ±0.21)μmol/L,95％CI 1.003-1.146] cell lines.Transwell chamber assay revealed that nigericin at different concentration(5,10,20 μmol/L)induced a remarkable reduction in the number of cells migrating through the membrane relative to the vehicle-treated controls in A2780 and SKOV3 cells [(121±9),(92±7),(59±5)/HP and(120.4±2.6),(91.8±5.5),(80.0±4.0)/HP,all P <0.05]; the invasive ability of A2780 and SKOV3 cells also inhibited [(61.2±3.7),(43.2±4.3),(23.6±2.1)/HP and(85.2±7.0),(65.2±4.6),(45.6±4.4)/HP,all P< 0.05].Western blot revealed that the increased expression of E-cadherin and decreased expression of Vimentin,Slug,Snail,Twist,p-Gsk-3β,β-catenin in EOC cells with the nigericin treatment at different concentration(5,10 and 20 μmol/L)showed concentration dependence(P < 0.05).Conclusion Nigericin may induce EMT by activating Wnt-β-catenin signaling pathway to promote the migration and invasion of EOC cells.