Objective:To investigate genetic variation profiles of δ-globin (HBD gene) and hematological phenotypes in Guangdong population.Methods:Retrospective case analysis was performed in this study. Blood samples of 11 616 couples who participated in free thalassemia screening in Guangzhou from July 2020 to December 2022 were collected which underwent blood routine tests and hemoglobin (Hb) capillary electrophoresis. According to the results, 154 samples were enrolled in this study: (1)group of 35 cases with HbA 2 <2.0% but no HbF band; (2)group of 64 cases with HbA 2 < 2.0% and HbF band; (3)group of 25 cases with HbA 2 <2.0% and suspected HbA 2 variants; (4) group of 25 cases with HbA 2 ≥2.0% and <3.5% and HbF band, as well as abnormal blood routine report [mean corpuscular volume (MCV) <82 fl and/or mean corpuscular hemoglobin (MCH) <27 pg]; (5)group of 5 cases with HbA 2 ≥2.0% and <3.0% accompanied with β thalassemia gene carriers Sanger sequencing was used to detect single nucleotide variants of δ-globin. Results:(1) A total of 22 genetic variations were detected, including 6 de novo variations, and the top 3 genetic variations were respectively c.-127T>C (57.02%, 65/114), c.-80T>C (9.65%, 11/114), c.349C>T (7.89%, 9/114). (2) In group of patients with HbA 2 <2.0% but no HbF band, 22 cases (62.85%, 22/35) had HBD gene variation, including 7 cases with MCV and MCH lower than reference values, 4 cases with α thalassemia; 13 cases had no HBD gene variation, including 12 cases with lower MCV and MCH. Among 19 cases with abnormal blood routine test results, levels of HbA 2 in patients (7 cases) with HBD gene variation were lower compared with those without HBD gene variation (12 cases) ( P<0.01%). (3)In group of patients with HbA 2<2.0% with HbF band, 59 cases (92.18%, 59/64) had HBD gene variations whose mutations all occurred in promoter region, and the HbF were all lower than 5.0%; 5 cases with HbF >5.0% had no HBD gene variation. (4) In group of patients with HbA 2 <2.0% and suspected HbA 2 variants, the detection rate was 100% (25/25) and δ-globin variants <1.0%. (5) In group of patients with HbA 2 ≥2.0% and <3.5% and HbF band accompanied with abnormal blood routine results, no HBD gene variation was found. (6) In group of 5 patients with HbA 2 ≥2.0% and <3.0% with β thalassemia gene carriers, HBD gene variation were found in all cases, and the level of HbA 2 was (2.62±0.17)% and HbF was (3.62±2.22)%. Conclusions:There are various genotypes of HBD gene variation, among which HBD: c.-127T>C is the most common in Guangdong population in China. Mutations in the promoter region may cause decrease in HbA 2 and increase in HbF which is mostly less than 5% but exceeds 5.0% when combined with β thalassemia. Our study enriched the gene mutation profiles of HBD gene in Guangdong population.

Objective:To explore the features the gait of elderly persons with type 2 diabetes and peri-pheral neuropathy.Methods:Twenty patients no less than 60 years old with type 2 diabetes and peripheral neuropathy (DPN) formed a DPN group, while 20 counterparts with type 2 diabetes but without peripheral neuropathy composed the DM group, and another 20 healthy counterparts served as a control group. The three groups were tested using the Swedish Qualisys motion capture system and their walking speed, step length, step width, stride frequency and stride length, bipedal foot support phase time, single foot support phase time, peak plantar pressure, and regional-holding time were collected and compared.Results:The average walking speed, stride length and stepping frequency of the DPN group were all significantly lower than the other 2 groups′ averages. Their bipedal support phase was significantly longer, but their single foot support phase time was significantly shorter. And in the DPN group the average first and second peak plantar pressures and the second peak pressure time were significantly greater than the other groups′ averages.Conclusions:Elderly patients with type 2 diabetes and peripheral neuropathy have significant gait abnormalities, decreased walking stability, as well as increased plantar pressure and plantar compression time.

Objective:To explore the application effect of aerobic exercise combined with progressive muscle relaxation training in patients undergoing peritoneal dialysis.Methods:Using the convenient sampling method, a total of 90 patients undergoing peritoneal dialysis who were regularly followed up in Peritoneal Dialysis Center of Yancheng Third People's Hospital in Jiangsu Province were selected from July to December of 2020. According to the random number table method, they were divided into the intervention group and the control group, with 45 cases in each group. Patients in the control group were given routine nursing, while patients in the intervention group were given aerobic exercise combined with progressive muscle relaxation training for 12 weeks on the basis of routine nursing. Gastrointestinal Symptom Rating Scale (GSRS), Gastroesophageal Reflux Disease Questionnaire (GerdQ) and urea clearance index (Kt/V) were used to evaluate the intervention effects of the two groups.Results:After 12 weeks of intervention, the incidence of dyspepsia, constipation, reflux, diarrhea, abdominal pain, eating disorder and GerdQ score greater than 8 in the intervention group were lower than those in the control group, and the differences were statistically significant (χ 2=6.429, 5.421, 6.403, 6.559, 3.986, 7.647, 5.789; P<0.05). The total score of GSRS and the scores of each dimension of the intervention group were lower than those of the control group, and the differences were statistically significant ( Z=-5.829, -2.637, -2.434, -2.812, -2.447, -2.027, -2.9958; P<0.05). The Kt/V compliance ratio of the intervention group was higher than that of the control group, and the difference was statistically significant (χ 2=5.683, P<0.05) . Conclusions:Compared with conventional nursing methods, aerobic exercise combined with progressive muscle relaxation training can reduce the incidence of gastrointestinal symptoms in peritoneal dialysis patients, effectively alleviate gastrointestinal symptoms and improve adequacy of dialysis.

Objective:To understand the etiological characteristics of an acute gastroenteritis outbreak.Methods:Real-time polymerase chain reaction (PCR) and bacteria cultures were performed for the samples, including stool samples from patients and cooks, environmental swabs, raw food material (chicken meat), collected during the outbreak. Pulsed-field gel electrophoresis, antibiotics susceptibility test and whole-genome sequencing were performed for the Campylobacter jejuni isolates. Results:Four stool samples from patients were positive for Campylobacter jejuni by real-time PCR, in which 1 Campylobacter jejuni strain was isolated from a case who had no antibiotic treatment. Twelve Campylobacter jejuni and 7 Campylobacter coli isolates were obtained from 4 raw chicken meat samples. The Campylobacter jejuni strain isolated from the case was resistant to nalidixic acid, ciprofloxacin, chloramphenicol, florfenicol and tetracycline. The MLST analysis with the whole-genome sequences confirmed that the Campylobacter jejuni isolate from the case belonged to ST10075. Antimicrobial resistance genes cmeABCR, tetO/M and blaOXA-61 were found in the genome of the isolate from the patient by the whole-genome sequencing. No mutation in 23S rRNA was found and the C257T mutation in gyrA was identified in this isolate. Conclusion:Laboratory analysis indicated that Campylobacter jejuni infection might be the major cause of this gastroenteritis outbreak.

OBJECTIVETo systematically evaluate the efficacy and safety of acupuncture on diarrhea-predominant irritable bowel syndrome (IBS) in the past five years.

METHODSOnline databases, including CNKI, VIP, WANFANG, PubMed, CBM, ScienceDirect OnSite, Cochrane Library, etc. were searched for randomized controlled trials (RCTs) of acupuncture for diarrhea-predominant IBS. Retrieval time was from January of 2011 to January of 2016. According to modified Jadad standard, the bias risk and quality assessment of each RCT included were evaluated by two researchers. RevMan 5.3 software was adopted for the meta-analysis.

RESULTSTotally 17 RCTs were included with 1 333 patients. The result of meta-analysis indicated the total effective rate of clinical symptoms improvement in the acupuncture group or acupuncture combined with western medicine group was superior to that in the western medicine group (=3.92, 95%:2.83~5.43,<0.01), and the funnel plot was basically symmetry. The result of meta-analysis showed 3-month recurrence rate:=0.22, 95%:0.12~0.41 (<0.01), indicating the recurrence rate in the acupuncture group was lower than that in the western medicine group in three month.

CONCLUSIONSAcupuncture for diarrhea-predominant irritable bowel syndrome is superior to conventional treatment of western medication, which can improve the clinical symptoms and reduce the recurrence rate of patients.

OBJECTIVEThe clinical research literature regarding acupuncture treatment for vascular dementia was reviewed and analyzed to provide the references for clinical selection and compatibility of acupoints.

METHODSWith computer and manual retrieval method, the clinical literature regarding acupuncture treatment for vascular dementia in recent 10 years was collected. The acupoint type, meridian and use frequency were analyzed.

RESULTSTotally 38 articles of acupuncture treatment for vascular dementia were screened; the most selected meridians were the governor vessel, gallbladder meridian, stomach meridian and spleen meridian; the main acupoints with frequency of more than 5 times were Baihui (GV 20), Sishencong (EX-HN 1), Shenting (GV 24), Fengchi (SP 40) and Shuigou (GV 26); the matching acupoints with frequency of more than 5 times were Fenglong (ST 40), Zusanli (ST 36), Taichong (LR 3), Taixi (KI 3), Sanyinjiao (SP 6), Xuehai (SP 10), Zhongwan (CV 12), Neiguan (PC 6), Fengchi (GB 20).

CONCLUSIONSThe rules and characteristics of acupoint selection for vascular dementia were featured with taking the local acupoints at head as main points, combining disease differentiation and syndrome differentiation as clinical principle, valuing local acupoints and distal acupoints, applying various techniques of acupuncture and moxibustion and combing traditional acupuncture manipulation and modern electroacupuncture stimulation.

OBJECTIVE:To establish a method for determining recombinant human calmodulin B subunit(rhCNB)in rat plas-ma,and study its pharmacokinetics characteristics. METHODS:ELISA double-antibody sandwich method was adopted. 1 μg/ml rhCNB monoclonal antibody mAb was wrapped,added to the to-be-test sample,rhCNB polyclonal antibody pAb(dilution ratio of 1∶5 000)and HRP-labeled conjugate of anti-IgG(dilution ratio of 1∶10 000)were added. Using tetramethylbenzidine for develop-ing,microplate reader was conducted in wavelength of 450 nm to determine the absorbance value(OD value)and plasma concen-tration of 6 rats after 2,15,30,60,120,240,480,720 min of iv 2.5 mg/kg rhCNB,and the pharmacokinetic parameters were calculated by BAPP 3.0 software. RESULTS:The linear range of rhCNB were 0.195-12.5 ng/ml(r2=0.995 0),lower limit of quan-titation was 0.195 ng/ml,accuracy were 97.300%-103.622%(RSD<7.5%,n=6);RSDs of within-batch,inter-batch,freezing and thawing 3 times were no higher than 8.5%(n=6,18,15). rhCNB pharmacokinetics characteristics in rat fitted to two-com-partment model,AUC0-720 min was 173.038 mg·min/L and t1/2 was 94.62 min. CONCLUSIONS:The established method has high specificity and sensitivity,good accuracy and precision,which can be used for rhCNB quantitative detection and pharmacokinetics study in biological samples.

Objective:To observe the clinical function of Chinese medicine enema liquid combined with antibiotics in syndrome differentiation typing treatment of chronic pelvic inflammation. Methods:A total of 240 patients with chronic pelvic inflammation were randomly divided into the control group(120)and the observation groups(120)including damp-heat stasis accumulation type,qi stagnation and blood stasis type and cold-dampness accumulation type. The patients in the control group received 0. 2g levofloxacin hydrochloride with intravenous drip,twice a day for 14 days,while those in the observation groups were given 250ml Chinese medicine enteroelysis(damp-heat stasis accumulation type was given Baiyi enteroelysis,qi stagnation and blood stasis type was given Puyao enteroelysis,and cold-dampness accumulation type was given Baiyao enteroelysis )with irrigation treatment once a day additionally. The patients in the observation group were given enteroelysis three or five days after menstruation and continued for 14 days,and the treatment course was two menstrual cycles. The indices of hemorheology and clinical efficacy were compared after the treatment between the groups. Results:The total effective rate in the observation group (91. 7% )was higher than that in the control group(81. 7% )(P < 0. 05). The improvement of whole blood viscosity,plasma viscosity,fibrinogen,erythrocyte sedimentation rate and platelet aggregation rate in the observation group were better than those in the control group(P < 0. 05). Conclusion:Chinese medicine enteroelysis shows obvious curative effect in the treatment of chronic pelvic inflammatory diseases,and combined with antibiotics,the effect can be strengthened,which is worthy of clinical application.

Objective To explore the impacts of Hospital-to-Home( HtoH) transitional nursing on the compliance of chemotherapy and quality of lives among patients with liver cancer. Methods A total of 84 cases of liver cancer ( during the period between April 2012 and April 2014 ) were selected from multiple hospital of Zaozhuang and randomly divided into research group and control group, with each group 42 cases. The patients of control group was given the routine nursing care, while the patients of research group received 6 months continuous transitional nursing care that operated by medical staff members. The living quality of life score (QOL), self-rating depression scale (SDS) score, and level of compliance to chemotherapy were compared between two groups. Results The score of SDS in the research group was lower than score in the control group ( P<0. 05) except for the somatization disorder. The score of QOL in the research group was higher than that in the control group (P<0. 05). The level of compliance of chemotherapy in the research group was significantly better than than that in the control group (P<0. 05). Conclusions The HtoH transitional nursing can decrease patients′negative emotion, improve quality of life, and increase the compliance of chemotherapy.

Objective To study the relationship between the individualized nutritional intervention during pregnancy with childbirth way and neonatal birth weight , provide clinical data for nutrition intervention treatment . Methods The outpatient pregnant women were randomly divided into intervention group and control group according the nutritional intervention intentions from January to June in 2014.The incidence of pregnancy specific disease , childbirth way and neonatal birth weight were recorded .Results The incidence of special diseases during pregnan-cy, cesarean section and abnormal neonatal birth weight in intervention group were lower than the control group , and the differences were statistically significant (p<0.05).Conclusion Individualized nutritional intervention during pregnancy can reduce the incidence of pregnancy specific disease , macrosomia and cesarean section .