Objective : To explore the association between serum γ-aminobutyric acid ( GABA) levels and the risk of developing type 2 diabetes( T2DM) ． Methods : 187 cases of T2DM patients attending the hospital were selected as the T2DM group，and 187 cases of non-T2DM population attending the same period of time were selected as the control group according to age ( ± 3 years) and gender 1 ∶ 1．On-site questionnaires and physical examination were conducted for the study subjects，and serum levels of GABA，Malondialdehyde ( MDA) and activities of superoxide dismutase ( SOD) and Glutathione peroxidase ( GSH-Px) were detected by using ELISA kits．The differences in the levels of GABA and oxidative stress indicators ( SOD，GSH-Px，MDA) between the two groups were compared， and the correlation between GABA and oxidative stress indicators was analyzed by Spearman's method; GABA and oxidative stress indicators were divided into three groups according to their control quartiles，respectively ［low level group ( Q1: ＜P25) ，medium level group ( Q2: P25 －P75) ，high level group ( Q3: ＞P75) ］，and conditional logistic regression was applied to analyze the relationship between GABA，oxidative stress indicators and the risk of develo- ping T2DM; the dose-response relationship between GABA，oxidative stress indicators and the risk of developing T2DM was analyzed by using restricted cubic spline ( RCS) ． Results : T2DM group ( P＜0. 05) ．Spearman's correlation analysis showed that GABA level was positively correlated with SOD and GSH-Px activities and negatively correlated with MDA level ( P＜0. 001) ．Conditional logistic regression analysis showed that medium levels of SOD and GSH-Px as well as medium and high levels of GABA were protective factors for T2DM compared with low levels in each group ( P＜0. 05) ．RCS results showed that a negative dose-response relationship between GABA，GSH-Px and the risk of developing T2DM，and SOD showed a trend of decreasing and then increasing the risk of developing T2DM ( P＜0. 05) ． Conclusion Serum GABA levels have been associated with the risk of developing T2DM．As serum GABA levels increase，the risk of developing T2DM may decrease．

Objective:To correlate rs6677604 single nucleotide polymorphism (SNP) with mesangial C3 deposition and prognosis among patients with IgA nephropathy.Methods:A retrospective nested case-control study was conducted among 380 patients with IgA nephropathy who received treatment at Taizhou Central Hospital from July 2018 to July 2021. All patients were tested for rs6677604 SNP. Among them, 36 AG genotypes and 72 GG genotypes were selected. The clinical data (IgA, C4, C3 deposit scores, percutaneous kidney biopsy, interstitial fibrosis/glomerular atrophy, mesangial C3 deposition), tissue and circulating complement levels, and CFHR gene copy numbers were compared between two genotypes. Regular follow-ups were conducted for 2 years to analyze the prognosis of patients with different rs6677604 genotypes. Results:Patients with the rs6677604-AG genotype had scores of (1.34 ± 0.50) points for IgA, (1.47 ± 0.31) points for C4 deposit, and (2.65 ± 0.36) points for C3 deposit, all of which were significantly lower than those in patients with rs6677604-GG genotype [(1.77 ± 0.73) points, (2.17 ± 0.33) points, (3.00 ± 0.48) points, t = -3.17, -10.59, -3.86, all P < 0.05]. The deposition intensity of mesangial C3 was predominantly 2+. Circulating levels of C3, C4, and complement factor H were significantly higher in patients with rs6677604-AG genotype compared with patients with rs6677604-GG genotype ( t = 7.90, 9.87, 2.27, all P < 0.05). Circulating levels of IgA and Gd-IgA1 were significantly lower in patients with rs6677604-AG genotype compared with those with rs6677604-GG genotype ( t = -2.98, -2.08, both P < 0.05). All patients with rs6677604-AG genotype had 1 copy of the CFHR3 gene, with 33 cases (91.67%) having 1 copy and 3 cases (8.33%) having 2 copies of the CFHR1 gene. Both CFHR3 and CFHR1 genes in patients with rs6677604-GG genotype were 2 copies. There was no statistically significant difference in composite endpoint between patients with rs6677604-AG and rs6677604-GG genotypes over the 2-year period (χ 2 = 0.19, P = 0.656). Conclusion:RS6677604 SNP is correlated with circulating complement factor H levels and mesangial C3 deposition in patients with IgA nephropathy, and may have a regulatory effect on complement activation in IgA nephropathy.

Tertiary lymphoid structure (TLS) is the ectopic lymphoid tissue around the chronic inflammatory site of tumor, infection diseases, autoimmunity diseases, organ transplantation and so on. TLS is regarded as the vital niche of antitumor immune response in tumor microenvironment for abundant immune cells, and is correlated with better clinical outcomes and immunotherapy response in most solid tumors. As a typical inflammation-driven cancer, hepatocellular carcinoma (HCC) is controversial with the influence of TLS on patients prognosis. In this paper, the composition, formation mechanism, recognition and clinical value of TLS in HCC were briefly reviewed.

Objective: To observe the clinical efficacy of different dialysis frequency and methods in the treatment of chronic renal failure uremia patients, and to provide a reliable reference for clinical practice. Methods: From February 2016 to February 2017, 140 chronic renal failure uremic patients who admitted to the Department of Nephrology at Taizhou Central Hospital were selected and divided into the observation group and the control group by complete random distribution method, with 70 cases in each group.The patients in the control group received 3 times of regular hemodialysis treatment per week, while the observation group received 3 times of regular hemodialysis combined with 1 time of hemodiafiltration treatment per week.The clinical treatment effects and complications of the two groups were compared. Results: Compared with blood uric acid(BUA)[(532.09±71.05)mmol/L], serum creatinine(Scr)[(734.34±63.08)μmol/L], blood urea(BUN)[(23.84±2.58)mmol/L], serum phosphorus[(1.98±0.37)mmol/L], parathyroid hormone(PTH)[(464.37±113.92)ng/L], β₂ microglobulin(β₂-MG)[(13.48±6.38)mg/L]in the control group, BUA[(495.89±58.23)mmol/L], Scr[(684.34±77.32)μmol/L], BUN[(20.62±1.77)mmol/L], serum phosphorus[(1.74±0.44)mmol/L], PTH[(352.14±123.25)ng/L], β₂-MG[(9.58±5.45)mg/L] were significantly lower in the observation group, the differences were statistically significant (t=3.29, 4.19, 8.61, 3.49, 5.59, 3.88, all P<0.01). Compared with the incidence rate of pruritus in the control group(61.43%), the incidence rate of pruritus in the observation group(34.29%) was significantly lower (χ²=9.72, P<0.01), the incidence of other complications had no statistically significant differences(χ²=1.14, 1.58, 3.08, all P>0.05). Conclusion Hemodialysis 3 times combined with 1 time of hemodiafiltration per week has significant advantage in the treatment of chronic renal failure uremia patients, which can effectively remove urine toxin molecules and reduce the incidence of complications, and it is worthy of clinical application.

Objective To explore the value of craniocerebral ultrasonography in evaluation on neonatal brain development.Methods Totally 135 newborns were collected in neonatal intensive care unit.The sagittal length of the corpus callosum and the sagittal length of the cerebellar vermis were measured on the day of birth.The impact of gestational age and birth weight on the development of the corpus callosum and cerebellar vermis were analyzed.Results The mean sagittal length of corpus callosum at birth in premature infants and term infants was (39.18 ± 2.53) mm and (41.62 ± 3.28) mm,respectively (t =4.87,P＜0.05).The sagittal length of cerebellar vermis in premature infants and term infants was (19.03 ±2.00)mm and (20.91 ±2.29)mm,respectively (t=5.05,P＜0.05).The length of the corpus callosum was positively correlated with gestational age and birth weight (rs =0.45,0.51,both P ＜ 0.05),while the sagittal length of cerebellar vermis was positively correlated with gestational age and birth weight (rs =0.42,0.46,both P＜0.05).The length of the corpus callosum was positively correlated with the length of cerebellar vermis (rs =0.43,P ＜0.05).Conclusion Craniocerebral ultrasonography can be used to dynamically observe the neonatal intracranial structure and the development of corpus callosum and cerebellar vermis,therefore providing reliable references for clinical intervention.

Objective To study the effect of sex on reperfusion time delay in ST-segment elevation myocardial infarction (STEMI) patients after diagnosis.Methods A total of 1647 STEMI patients admitted to our hospital were included in this study.Their clinical data and treatment time points were recorded.The reperfusion time delay after diagnosis refers the time from ECG-based diagnosis to PCI.The reperfusion time delay after diagnosis was divided into 0-3 h,＞3-6 h,＞6-12 h,＞12-24 h and ＞24 h.The effect of sex and other risk factors on reperfusion time delay after diagnosis was assessed according to the established logistic regression model.Results The age of female STEMI patients was older than that of male STEMI patients (65±10 years vs 60±11 years,P＜0.05).The rate of past CABG and PCI was significantly higher and the reperfusion time delay was significantly longer in female STEMI patients than in male STEMI patients (4.3 ％ vs 1.5％,20.7％ vs 17.4％,P＜0.05;404±34 min vs 280±14 min,P＜0.01).Multivariate logistic regression analysis showed that female and visiting form were related with the reperfusion time delay for ＞3-6 h and ＞12-24 h (95％CI:1.052-264.306,P=0.046;95％CI:1.089-2.751,P=0.013).Conclusion Female is related with reperfusion time delay,visiting form and call for emergency treatment in STEMI patients.

Objective To study the effect of xuebijing on the expression of Caspase-3 in lung tissues and inflammatory factors in serum in acute respiratory distress syndrome rat model with paraquat poisoning. Methods Selecting 50 healthy rats and dividing into 5 groups randomly, Control group, Paraquat group, Low-dose xuebijing group(LD), Middle-dose xuebijing group(MD), High-dose xuebijing group(HD). Using 25 mg/kg paraquat solution to establish the animal model. 14 μmol/kg, 28 μmol/kg, 56μmol/kg xuebijing solution were injected into the abdominal cavity in LD, MD and HD group respectively, and the same dose of normal saline was injected into Control and Paraquat group. The expression levels of TNF-α and IL-6 in plasma were detected by ELISA after 24 hours, Immunohistochemistry was used to detect the expression levels of caspase-3 in the right lung tissue, and TUNEL method was used to detect apoptosis in the right lung tissue. Results The expression levels of TNF-α and IL-6 in plasma were significantly increased after paraquat poisoning, and expression of Caspase-3 protein was also significantly increased in lung tissue(P<0.01). After different dose of xuebijing treatment, the levels of TNF-α and IL-6 in plasma and the protein expression of Caspase-3 in lung tissue were much lower than those in Paraquat group, but still higher than those in Control group(P<0.05), the apoptosis levels in MD and HD groupwere much lower than those in Paraquat group(P<0.05). Conclusions Xuebijing can significantly reduce the level of inflammatory factors in plasma, suppress the Caspase-3 protein expression and apoptosis in lung tissue in acute respiratory distress syndrome rat model with paraquat poisoning.

Objective To explore the value of contrast enhanced ultrasound (CEUS) in the diagnosis of peripheral pulmonary lesions,and to evaluate the diagnostic efficiency of CEUS combined with tumor markers peripheral lung cancer.Methods According to the pathological results,105 patients with 105 peripheral pulmonary lesions were divided into benign (50 cases) and malignant group (55 cases).Before CEUS examination,lesions' location,size,shape and internal echogenicities were recorded by twodimensional (2D) ultrasound.After contrast agent injection,arrive time (AT) in the lesion,difference of AT between the lesion and lung (tAT),and lesions' enhanced morphology were observed.The time intensity curve (TIC) was used to obtain the rise time (RT),mean transit time (MTT),time from peak to one half of peak(TPH),time to peak (TTP),peak intensity (PI) and wash-in slope (WIS).The parameters of TIC between the two groups were compared.Serum carcino-embryonic antigen (CEA),neuron specific enolase (NSE) and cyrokeratin fragment antigen 21-1 (CYFRA21-1) level were detected and analyzed between the two groups.Results Lesions' shape and intralesional bronchial syndrome had significant difference in the diagnosis of peripheral pulmonary benign and malignant lesions (P ＜0.01).In benign group,27 lesions (54.00％,27/50) were enhanced in late pulmonary arterial phase and 32 lesions(64.00％,32/50) showed homogeneous enhancement.At the meantime,in malignant group,most of lesions (76.36％,42/55) were enhanced in bronchial arterial phase and 36.00％ (18/50) of lesions indicated inhomogeneous enhancement.The difference of enhanced phase and morphology between benign and malignant lesions were significant (all P ＜0.05).While the statistical differences of such quantitative parameters AT,tAT,RT,TTP,PI and WIS,except to MTT and TPH were found between benign and malignant lesions (all P ＜0.05) in experiment group.In the diagnosis of peripheral lung cancer,the accuracy and specificity of tAT combined with joint detection of 3 kinds of tumor markers were 76.37％ and 75.00％,respectively,and higher than any single detection,but the sensitivity was a little lower (76.47％).Conclusions CEUS quantitative analysis has certain value in the diagnosis of benign and malignant peripheral lung lesions,and combined with tumor markers can improve the diagnostic efficiency of peripheral lung cancer.

Objective To investigate the application value of CEUS combined with biopsy in qualitative diagnosis of pe ripheral pulmonary lesions.Methods A total of 158 patients with peripheral pulmonary lesions underwent percutaneous puncture biopsy.Among them,97 cases underwent CEUS before biopsy (experiment group),and 61 cases underwent conventional ultrasound (control group).Puncture times,positive rate of samples pathological diagnosis and occurrence rate of complications were compared between the two groups.The time intensity curve (TIC) was used to obtain the rise time (RT),time to peak (TTP),wash-in slope (WIS) and peak intensity (PI).The parameters of TIC between the two groups were compared.The enhanced morphology of lesions was also observed and recorded.Results The positive rate of samples pathological diagnosis was 94.85 ％ (92/97) in experiment group and 83.61％ (51/61) in control group.The difference of the positive rate was significant between the two groups (P=0.02).In experiment and control group,the average puncture times were 2.11±0.48 and 2.20±0.44;While the occurrence rate of complications were 2.06％ (2/97) and 4.91％ (3/61).No significant difference was found of the average puncture times and the occurrence rate of complications between the two groups (both P＞0.05).While the statistical differences of RT,PI and WIS were found between benign and malignant lesions (all P＜0.05) in experiment group.And no statistical difference of TTP was found (P =0.08).Totally 77.50％ (31/40) of the benign lesions showed inhomogeneous enhancement,while the proportion was 88.46％ (46/52) in malignant lesions.There was no statistical difference of enhanced morphology between benign and malignant lesions (P=0.16).Conclusion CEUS is helpful in distinguishing benign and malignant peripheral pulmonary lesions.And it has great value in guiding percutaneous biopsy in peripheral pulmonary lesions.

Objective To explore the diagnostic value of CEUS for thyroid TI-RADS 3,4 nodules.Methods The CEUS performence of 95 patients with thyroid TI-RADS 3,4 nodules (all were confirmed by surgery pathology) diagosed by conventional ultrasound were reviewed retrospectively,and the value of CEUS in the revision and differential diagnosis of thyroid TI-RADS 3,4 nodules were analyzed.Results Compared with pathological pattern,conventional ultrasound TI-RADS classifications in assessing the property of thyroid nodule had no statistical differences (χ2 =3.56,P =0.06).For thyroid TI-RADS 3,4 nodules,compared with conventional ultrasound TI-RADS classifications,the diagnosis accuracy of CEUS score and revised CEUS TI-RADS classifications showed significant differeces respectively (P=0.03,＜0.01) for thyroid papillary carcinoma greater than 1 cm.But no statistical difference were found respectively (P=0.25,1.00) for thyroid papillary carcinoma smaller than 1 cm.According to the ROC curve analysis,the area under the curve of traditional ultrasound TI-RADS classifications,CEUS score and revised CEUS TI-RADS classifications were 0.64,0.75,0.81 respectively,cut-off value was TI-RADS 4a,1 score,TI-RADS 4a respectively,the sensitivity and specificity of evaluating benign and malignant nodules was 45.3％ and 80.0％,69.3％ and 65.0％,82.7％ and 60.0％,respectively.The area under the ROC curve were statistical difference between CEUS score,revised CEUS TI-RADS classifications and conventional ultrasound TI-RADS classifications (both P＜0.05),while CEUS score and revised CEUS TI-RADS classifications without statistical difference.Conclusion CEUS had the revised and improved identification value for thyroid TI-RADS 3,4 nodules.