Objective To explore the diagnostic and prognostic value of insulin growth factor 1 receptor(IGF1R)as a biomarker for the progression of heart failure with preserved ejection fraction(HFpEF)in patients with type 2diabetes mellitus(T2DM).Methods A total of 383 patients with type 2diabetes who received treatment in the hospital from June 2019 to March 2023 were selected as the study objects,and they were divided into non-HFPEF group(n=190)and HFpEF group(n=193)according to diagnostic criteria of HF-pEF.The clinical data of the patients were collected,and the IGF1R level was determined by enzyme-linked immunosorbent assay(ELISA).Paired sample t-test,nonparametric test or x2 test were used to compare clinical data and echocardiographic results.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of IGF1R in HFpEF.Nonparametric test was used to com-pared baseline and post-follow-up echocardiography;Kaplan-Meier curves were used to assess the effects of IGF1R levels on readmis-sion.Results Analysis by whether to merge HFpEF groups showed that,in HFpEF group,the patients were older,the proportion of atri-al fibrillation patients was higher,the duration of diabetes was longer(P＜0.05),the levels of blood glucose,creatinine,N-terminal pro-brain natriuretic peptide(NT-proBNP)and IGF1R were significantly increased(P＜0.05),and echocardiography also showed that the systolic and diastolic function of the heart was significantly decreased(P＜0.05).Similar results were obtained by IGF1R hori-zontal grouping.The ROC curve showed that the area under the curve(AUC)of IGF1R for predicting HFpEF in T2DM patients was 0.79.Subgroup analysis of non-HFPEF and HFpEF groups based on IGF1R levels showed that patients with high IGF1R in both the non-HFPEF and HFpEF groups had worse systolic and diastolic function(P＜0.05).Follow-up revealed that the systolic and diastolic function in the high IGF1R group decreased significantly from baseline(P＜0.05).Kaplan-Meier curve analysis showed a significantly increased risk of re-hospitalization due to cardiovascular events in the high IGF1R group(P=0.007).Conclusion IGF1R can be used as a biomarker to monitor structural and functional damage of heart,diagnosing the risk of HFpEF,and predicting the long-term de-terioration of cardiac structure and function in T2DM patients.

Objective To explore the diagnostic and prognostic value of insulin growth factor 1 receptor(IGF1R)as a biomarker for the progression of heart failure with preserved ejection fraction(HFpEF)in patients with type 2diabetes mellitus(T2DM).Methods A total of 383 patients with type 2diabetes who received treatment in the hospital from June 2019 to March 2023 were selected as the study objects,and they were divided into non-HFPEF group(n=190)and HFpEF group(n=193)according to diagnostic criteria of HF-pEF.The clinical data of the patients were collected,and the IGF1R level was determined by enzyme-linked immunosorbent assay(ELISA).Paired sample t-test,nonparametric test or x2 test were used to compare clinical data and echocardiographic results.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of IGF1R in HFpEF.Nonparametric test was used to com-pared baseline and post-follow-up echocardiography;Kaplan-Meier curves were used to assess the effects of IGF1R levels on readmis-sion.Results Analysis by whether to merge HFpEF groups showed that,in HFpEF group,the patients were older,the proportion of atri-al fibrillation patients was higher,the duration of diabetes was longer(P＜0.05),the levels of blood glucose,creatinine,N-terminal pro-brain natriuretic peptide(NT-proBNP)and IGF1R were significantly increased(P＜0.05),and echocardiography also showed that the systolic and diastolic function of the heart was significantly decreased(P＜0.05).Similar results were obtained by IGF1R hori-zontal grouping.The ROC curve showed that the area under the curve(AUC)of IGF1R for predicting HFpEF in T2DM patients was 0.79.Subgroup analysis of non-HFPEF and HFpEF groups based on IGF1R levels showed that patients with high IGF1R in both the non-HFPEF and HFpEF groups had worse systolic and diastolic function(P＜0.05).Follow-up revealed that the systolic and diastolic function in the high IGF1R group decreased significantly from baseline(P＜0.05).Kaplan-Meier curve analysis showed a significantly increased risk of re-hospitalization due to cardiovascular events in the high IGF1R group(P=0.007).Conclusion IGF1R can be used as a biomarker to monitor structural and functional damage of heart,diagnosing the risk of HFpEF,and predicting the long-term de-terioration of cardiac structure and function in T2DM patients.

Objective: To examine the eating behaviors and associated factors among preschool children from multiple child families, so as to provide a basis for promoting healthy eating habits in this population. Methods: From April to June 2022, a stratified random cluster sampling method was employed to selected 2 647 guardians of preschool children in 11 kindergartens in Tongling City. Parenting style questionnaire, Identification and Management of Feeding Difficulty Questionnaire (IMFeD), Caregiver s Feeding Style Questionnaire (CFSQ) and a self designed questionnaire were administered. Multiple linear regression was performed to analyze the factors influencing eating behaviors among preschool children. Results: In the study, the detection of eating behavior problems among preschool children was 71.4%, and the detection of reduced appetite was the highest (55.6%). The detection rates of anorexia, picky eating, poor eating and improper eating behavior in only child families were higher (60.6%, 41.0%, 32.0%, 19.5%), compared with those in multiple child families (51.7%, 36.4%, 27.2%, 16.6%) ( χ 2=20.05, 5.95, 7.16, 3.92, P < 0.05 ). Among multiple child families, the detection rates of fear of eating and underlying disease were the lowest in 5-<10-year-old group (2.3%, 0.6%) ( χ 2=11.54, 8.51, P <0.05). In multiple child families, the detection rates of picky eating and poor eating habits for the first-born child were higher (42.0%, 32.5%), compared with second born and third born child (34.6%, 25.6%)( χ 2= 6.15, 6.38, P <0.05). The results of multiple linear regression analysis showed that multiplechild families ( β =-1.40), democratic parenting style ( β =-0.07), higher feeding response scores ( β =-0.33) were negatively associated with eating behavior problems among preschool children ( P <0.05). Eating behavior problems among preschool children were positively correlated with less educated mothers [high and junior high school education ( β =0.87), primary school education and below ( β =3.69)], longer average daily screen time ( β =0.10), higher feeding requirements scores ( β =0.64), doting parenting styles ( β =0.21), permissive parenting styles ( β =0.27) and inconsistent parenting styles ( β =0.14)( P <0.05). Conclusion The detection rate of the eating behaviors problems among preschool children is high in schools. Greater attention should be paid to only child and first born child of multiple child families, and appropriate feeding and parenting styles, so as to promote healthy eating habits among this population.

Chimeric antigen receptor T (CAR-T) cell therapy is a novel cellular immunotherapy that is widely used to treat hematological malignancies, including acute leukemia, lymphoma, and multiple myeloma. Despite its remarkable clinical effects, this therapy has side effects that cannot be underestimated. Cytokine release syndrome (CRS) is one of the most clinically important and potentially life-threatening toxicities. This syndrome is a systemic immune storm that involves the mass cytokines releasing by activated immune cells. This phenomenon causes multisystem damages and sometimes even death. In this study, we reported the management of a patient with recurrent and refractory multiple myeloma and three patients with acute lymphocytic leukemia who suffered CRS during CAR-T treatment. The early application of tocilizumab, an anti-IL-6 receptor antibody, according to toxicity grading and clinical manifestation is recommended especially for patients who suffer continuous hyperpyrexia, hypotensive shock, acute respiratory failure, and whose CRS toxicities deteriorated rapidly. Moreover, low doses of dexamethasone (5-10 mg/day) were used for refractory CRS not responding to tocilizumab. The effective management of the toxicities associated with CRS will bring additional survival opportunities and improve the quality of life for patients with cancer.

Objective To compare the dosimetric differences among three-dimensional conformal radiotherapy(3D-CRT),intensity-modulated radiotherapy(IMRT)and RapidArc for prophylactic carnial irradiation(PCI)in small cell lung cancer(SCLC)patients.Methods Ten patients with SCLC were enrolled into this study.3D-CRT,9-field IMRT(IMRT)and double arc RapidArc plans were designed and optimized for each patient.The goal was to deliver 25 Gy to ≥ 95％ of the planning target volume(PTV)while the same normal-tissue dose constraints were achieved.The dose distribution and conformal index (CI),homogeneity index(HI)of target volume,the maximum dose(D2 ％),the minimum dose(D98 ％),target coverage of PTV(V95 and V100),and Dmean and Dmax of organs at risk(OAR)were analyzed by using the dose volume histogram(DVH).The monitor units and delivery time were also evaluated.Results All plans met the clinical requirements.PTV dosimetric parameters(CI,HI,D2％,D98％,V95 and V100)of RapidArc and IMRT were superior to those of 3D-CRT with significant difference(P＜0.05).The maximum doses to the optic nerves,brainstem and the mean dose to the parotid glands of the IMRT and RapidArc plans were all significantly lower than those of the 3D-CRT plan(P＜0.05),while 3D-CRT plan provided the lowest maximum doses and mean dose of the lens and eyes(P＜0.05).Compared with IMRT plan,no obvious advantage in PTV dosimetric parameters could be observed in RapidArc plans.In terms of organ sparing,no statistical difference was observed between IMRT and RapidArc plans.The number of monitor units for 3D-CRT,IMRT and RapidArc were 287.8,1388.8 and 346.6,respectively.Conclusions Compared with 3D-CRT,IMRT and RapidArc show better dosimetric quality.The 3D-CRT plan has a significantly lower dose on the lens and eyes,less MU and shorter delivery time than IMRT and RapidArc plans.

Objective:To investigate the relationship between the expression mP53 and microvessel density urothelial carcinoma of the bladder and its clinical pathological significance. Methods: Immunohistochemistry(Envision method) was used to detect the expression of mP53 and FⅧ-RAg in 50 tissue specimens of primary BUC and 10 tissue specimens of normal mucosa of bladder .The results were analyzed with the clinic and pathological characters of BUC. Results: The expression of mP53 and MVD had significant differences between the tissues of normal mucosa of the bladder and the tissues of the BUC; but not related to the tumor size. mP53 and MVD value had correlation to different stages (according to UICC-TNM ), different grades (according to WHO), and recurrence(P