Objective:To explore the diagnostic value of whole blood cell parameters logistic regression model for radiation injury on radiation workers by comparing the differences of whole blood cell parameters between occupational radiation injury population and occupational health examination population.Methods:In February 2023, 184 radiation workers who received occupational health examinations in our hospital and occurrenced chromosome aberration from July 2021 to July 2022 were retrospectively selected as the radiation injury group. And other 184 radiation workers encountered in the same period without chromosome aberration occurrence were selected as the control group. Collected whole blood cell parameters from two groups of research subjects, conducted comparative analysis, constructed a logistic regression model, and evaluated the diagnostic value of the logistic regression model for radiation injury on radiation workers by receiver operating characteristic curve (ROC) and area under curve (AUC) . In addition, with the same standard, 60 radiation workers with chromosome aberration and 60 radiation workers without chromosome aberration from August 2022 to January 2023 were included in the validation queue to validate the logistic regression model.Results:Neu_X, Neu_Y, Neu_Z, Lym_X, Lym_Y, Lym_Z, Mon_X, Mon_Y, Mon_Z, Micro, MCHC in the radiation injury group were significantly higher than those in the control group, and the difference was statistically significant ( P<0.05) . And MCV and Macro in the radiation injury group were lower than those in the control group, and the difference was statistically significant ( P<0.05) . Moreover, logistic regression analysis showed that Lym_X, Lym_Y, Lym_Z, MCHC, Micro were all independent risk factors for diagnosing radiation injury on radiation workers ( OR=1.08、1.02、0.99、1.06、51.32, P<0.05) . ROC curve analysis showed that the AUC, sensitivity, specificity, and accuracy of the logistic regression model based by Lym_X, Lym_Y, Lym_Z, MCHC and Micro in diagnosing radiation injury on radiation workers were 0.80, 85.9%, 65.8% and 75.9% respectively. The validation queue verified the logistic regression model and the AUC, sensitivity, specificity, and accuracy of the logistic regression model were 0.80, 81.7%, 71.7% and 76.7% respectively, the model fitted well. Conclusion:Radiation damage can cause changes in multiple whole blood cell parameters of radiation workers. The logistic regression model based by Lym_X, Lym_Y, Lym_Z, MCHC and Micro showed good diagnosis ability and can be used for the screening of radiation injury on radiation workers.

Objective:To explore the diagnostic value of whole blood cell parameters logistic regression model for radiation injury on radiation workers by comparing the differences of whole blood cell parameters between occupational radiation injury population and occupational health examination population.Methods:In February 2023, 184 radiation workers who received occupational health examinations in our hospital and occurrenced chromosome aberration from July 2021 to July 2022 were retrospectively selected as the radiation injury group. And other 184 radiation workers encountered in the same period without chromosome aberration occurrence were selected as the control group. Collected whole blood cell parameters from two groups of research subjects, conducted comparative analysis, constructed a logistic regression model, and evaluated the diagnostic value of the logistic regression model for radiation injury on radiation workers by receiver operating characteristic curve (ROC) and area under curve (AUC) . In addition, with the same standard, 60 radiation workers with chromosome aberration and 60 radiation workers without chromosome aberration from August 2022 to January 2023 were included in the validation queue to validate the logistic regression model.Results:Neu_X, Neu_Y, Neu_Z, Lym_X, Lym_Y, Lym_Z, Mon_X, Mon_Y, Mon_Z, Micro, MCHC in the radiation injury group were significantly higher than those in the control group, and the difference was statistically significant ( P<0.05) . And MCV and Macro in the radiation injury group were lower than those in the control group, and the difference was statistically significant ( P<0.05) . Moreover, logistic regression analysis showed that Lym_X, Lym_Y, Lym_Z, MCHC, Micro were all independent risk factors for diagnosing radiation injury on radiation workers ( OR=1.08、1.02、0.99、1.06、51.32, P<0.05) . ROC curve analysis showed that the AUC, sensitivity, specificity, and accuracy of the logistic regression model based by Lym_X, Lym_Y, Lym_Z, MCHC and Micro in diagnosing radiation injury on radiation workers were 0.80, 85.9%, 65.8% and 75.9% respectively. The validation queue verified the logistic regression model and the AUC, sensitivity, specificity, and accuracy of the logistic regression model were 0.80, 81.7%, 71.7% and 76.7% respectively, the model fitted well. Conclusion:Radiation damage can cause changes in multiple whole blood cell parameters of radiation workers. The logistic regression model based by Lym_X, Lym_Y, Lym_Z, MCHC and Micro showed good diagnosis ability and can be used for the screening of radiation injury on radiation workers.

From October 2021 to February 2023, we retrospectively analyzed the clinical and laboratory data of six patients (three male and three female, median age: 54 years, age range: 29-73 years) with mast cell leukemia (MCL) diagnosed in the First Affiliated Hospital of Soochow University (The Mastocytosis Collaborative Network of China). All patients had acute MCL, with at least one C-finding present. The main clinical presentations were hypoalbuminemia ( n=4), fatigue ( n=3), fever ( n=2), abdominal discomfort ( n=2), osteolytic lesions ( n=2), dizziness ( n=1), skin flushing ( n=1), and weight loss ( n=1). Splenomegaly and lymphadenopathy were noted in six and three patients, respectively. Six patients were strongly positive for CD117, five were positive for CD30 and CD25, and four were positive for CD2. Four patients had a normal karyotype and two patients had an abnormal karyotype. Gene mutations were detected in 4/6 cases. The median serum tryptase level was 24.9 (range: 20.1-171.9) μg/L. Two patients were treated with venetoclax and azacitidine for induction (one patient achieved partial remission by combination with afatinib, while there was no remission after combination with dasatinib in the other patient). Two patients did not achieve complete remission despite treatment with cladribine and imatinib, respectively. One patient treated with interferon combined with glucocorticoids was lost to follow-up, and one patient abandoned treatment. The follow-up time ranged from 1.1 to 21.7 months. Three patients died and two survived. Overall, MCL is a rare subtype of systemic mastocytosis with heterogeneous clinical course, and these patients have poor outcome. A better understanding of the clinical characteristics, treatment, and prognosis of MCL is urgently needed.

【Objective】 To genetically analyze the D^el sample from a blood donor in Jiangyin and make clear the molecular basis of the serological phenotype. 【Methods】 The EDTA anticoagulant blood were collected: buffy coat were used for nucleic acid extract and cDNA analysis; red blood cells for serological test. Tube method and microcolumn gel were used for serological test. Genotyping kit were used for exon analysis. Gene mutation was analyzed using the sequence analyzer. 【Results】 Serological analysis demonstrated the sample′s RhD phenotype was D^el. The phenotype of RhCE was CCEe. Real-time fluorescence quota PCR result demonstrated the existence of all exones. Weak D15 and RHD^* DEL1 [RHD(1227G>A)], which had a high frequency of occurrence in China, were excluded according to real-time fluorescence quota PCR result. Sequence analyzing result verified RHD(28C>T) SNP mutation in cDNA. The genotype of this sample was RHD^*01 W. 61[RHD(28C>T)]. 【Conclusion】 A weak D61 was found among blood donors in our city, Jiangyin.

Objective:To understand the changing trend and influencing factors of lens power (LP) in children aged 3-12 in Jing'an District, Shanghai.Methods:A cross-sectional study was conducted.One hundred and thirty-one eyes of 131 patients with refractive errors were included in the Optometry Clinic of Shanghai Eye Hospital from October 2019 to January 2020.The 1% atropine sulfate was employed to dilate pupils for children aged 6 years or younger, and 0.5% topiramate for children older than 6 years.The axial length, mean keratometry (Km), anterior chamber depth (ACD), lens thickness (LT) and central corneal thickness (CCT) were measured using an IOL Master.The spherical equivalent (SE) and best corrected visual acuity (BCVA) were measured after cycloplegia using autorefractor and phoropter, and the LP was calculated using the Bennett formula.The patients were divided into different age groups, including 3-4 years group (16 eyes), 5-6 years group (20 eyes), 7-8 years group (25 eyes), 9-10 years group (33 eyes) and 11-12 years group (37 eyes). There were 57 eyes in the male group and 74 eyes in the female group.The patients were also divided into different refractive groups, including mild myopia group (38 eyes), moderate myopia group (12 eyes), high myopia group (25 eyes), emmetropia group (11 eyes), mild hyperopia group (9 eyes), moderate hyperopia group (13 eyes), and high hyperopia group (23 eyes). The differences in ocular biological parameter measurements between different age groups, different gender groups and different refractive groups were compared and the correlations between age, eye parameters and LP were analyzed using Pearson correlation analysis.The contribution of multiple influencing factors to LP was analyzed by multiple linear regression models.The study protocol followed the Declaration of Helsinki and was approved by an Ethics Committee of Shanghai General Hospital, Shanghai Jiao Tong University Hospital (No.2020KY018). Written informed consent was obtained from each guardian of the subject.Results:The average LP of children in the 3-4 years group, 5-6 years group, 7-8 years group, 9-10 years group and 11-12 years group were (27.35±1.88), (24.71±1.92), (22.92±1.87), (21.49±1.54) and (21.25±1.55) D, respectively.With the increase of age, the LP value was decreased gradually.There were significant differences between 3-4 years group and 5-6 years group, 5-6 years group and 7-8 years group, 7-8 years group and 9-10 years group (all at P<0.05). The average LP value of girls was obviously higher than that of boys ( t=-3.38, P<0.01). The LP value of the high myopia group was significantly lower than that of the emmetropia group, and the LP values of the moderate myopia and the low myopia group were significantly lower than that of the hyperopia group, and the LP values of the low hyperopia group and the moderate hyperopia group were significantly higher than that of the emmetropia group (all at P<0.05). The LP value was negatively correlated with age, AL, ACD and CCT ( r=-0.76, -0.79, -0.38, -0.18; all at P<0.05), and was positively correlated with SE and LT ( r=0.62, P<0.05; r=0.68, P<0.01). There was no obvious correlation between Km and LP ( r=0.07, P=0.45). The independent influencing factors of LP were analyzed through multiple linear regression equations, showing that LP=-0.430×AL+ 0.329×LT-0.267×age-0.108×gender-0.084×CCT (male=1, female=0). The standardized coefficients of each factor arranged in descending order were AL, LT, age, gender and CCT (all at P<0.05). Conclusions:The LP of children aged 3-12 in Jing'an District of Shanghai decreases with age and increases with SE.LP values of girls are higher than those of boys.

Objective To investigate the relationship between disrupted corticospinal tract (CST) and motor recovery after stroke by using diffusion tensor tracking (DTT). Methods From March, 2012 to June, 2013, 15 chronic stroke patients with left subcortical lesions and 15 age- and sex- matched healthy subjects were performed diffusion tensor imaging (DTI) examination. The CST was tracked by DTT technique, and the damaged values of the CST caused by the stroke lesions were quantified using a CST template generated from healthy controls. Furthermore, the correlations of the damaged values of the CST with Fugl-Meyer Assessment (FMA) were performed. Results The range of the damaged values of CST in stroke patients was 0.00% to 29.6%. There were very strong negative correlation between the damaged values of the CST and FMA scores (the wrist, r = -0.660; hand, r = -0.813; wrist plus hand, r = -0.795, respectively, P < 0.01). It also showed strong negative correlation between the damaged values of the CST and FMA scores (upper limb, r = -0.614; upper limb plus lower limb, r = -0.563, respectively, P < 0.05). Whereas, there was no correlation between the damaged values of the CST and FMA scores of lower limb (r = -0.270, P = 0.331). In addition, the lesion volumes of stroke and FMA scores were not significantly correlated (P > 0.05). Conclusion The severity of motor deficit after stroke was closely related to the overlap of lesions with CST. The damaged values of the CST based on DTT may be used as a potential biomarker to assess motor impairments of upper limbs, especially hand and wrist in stroke patients.

A brief introduction to the development milestones of postgraduate medical education in the world, highlighting the present details of such systems in the United States, United Kingdom, France, Germany and some Asian countries.It is held that common patterns can be identified despite the gaps found in such systems of these countries.In view of the training management system cornmonalities of thecountries,the authors proposed the development directions of residency training in China to enhance thehands-on capability and competence of clinical doctors in a standardized manner.

Objective To explore the changes of the diurnal rhythm of cortisol secretion and insulin resistance of the type 2 diabetes mellitus(T2DM) patients with depression.Methods The 216 cases outpatient and inpatientof Department of Endocrinology of the Second People's Hospital Changshou, Clinical Psychology of City Mental Health Center of Changshou ,were divided into depression without T2DM group(D group,44 cases), T2DM without depression group(DM group, 124 cases) and the T2DM with depression group(DM-D group,48 cases).And 40 healthy people were from the medical center and as the normal control(NC) group.The levels of fasting blood glucose (FPG), glycosylated hemoglobin (HbA1c), Fins, fasting C peptide (FC-P), rhythm in cortisol(Cor) secretion at 3 time points (8:00, 16:00,24:00) and plasma adrenocorticotropin(ACTH) were detected for studies.Results Compared with the D group, DM group and NC group, there were increases of FPG,HbA1c,insulin resistance index (HOMA-IR) in the DM-D group ((11.51 ±2.05) vs.(5.18 ±0.22), (9.47±3.46), (5.11±0.25) mmol/L;(10.28±2.12)％ vs.(5.36±0.34)％, (8.89±2.21)％, (5.53 ±0.32) ％;3.78± 1.08 vs.1.58 ± 0.21,2.70 ± 1.54, 1.14 ± 0.24).Plasma cortisol levels and ACTH levels at time points of 8:00,16:00 in the DM-D group were higher than the group D, DM group and NC group, while insulin sensitivity index(ISI) in the DM-D group was lower than the D group,DM group and NC group (-4.41 ±0.27 vs.-3.57±0.13,-3.92±0.60,-3.22±0.22) ,and the differences were significant (P＜0.05).The loss of normal diurnal rhythm of cortisol secretion were significantly more often inDM-D group than in D group and in DM group(77.1％ vs.50.0％ ,47.6％ ,P＜0.05).The multiple stepwise regression analysis showed that 8:00 Cor and ISI were the related factors for the Hamilton Depression Scale (HAMD) score(95％CI:2.355-3.867, -7.903-2.780,P＜0.001).Logistic regression analysis showed that the level of 8:00 Cor was significant risk factor of the T2DM patients with depression(OR=3.024,95％CI: 1.613-5.668,P=0.002).Conclusion The T2DM patients with depression have higher plasma cortisol level, more abnormal rhythm of cortisol secretion and higher level of insulin resistance.The high level of plasma corfisol maybe significantly related to depression in T2DM patients.

Lipoma preferred partner (LPP) has been identified as a protein which is highly selective for smooth muscle progenitor cells (SMPCs) and regulates differentiation and migration of SMPCs, but mechanisms of LPP expression are not elucidated clearly. The aim of the present study was to discuss the mechanisms by which LPP expression is regulated in the differentiation and migration of SMPCs induced by TGF-β1. It was found that TGF-β1 could significantly increase the expression of LPP, smooth muscle α-actin, smooth muscle myosin heavy chain (SM-MHC), and smoothelin in SMPCs. Moreover, inactivation of Rho kinase (ROK) with ROK inhibitors significantly inhibited LPP mRNA expression in TGF-β1-treated SMPCs and mouse aortic smooth muscle cells (MAoSMCs). At the same time, LPP silencing with short interfering RNA significantly decreased SMPCs migration. In conclusion, LPP appears to be a ROK-dependant SMPCs differentiation marker that plays a role in regulating SMPCs migration.
Animals ; Bone Marrow ; metabolism ; physiology ; Cell Differentiation ; genetics ; Cell Movement ; genetics ; Cells, Cultured ; Cytoskeletal Proteins ; genetics ; metabolism ; LIM Domain Proteins ; genetics ; metabolism ; Mice ; Mice, Inbred C57BL ; Muscle, Smooth ; metabolism ; physiology ; Stem Cells ; metabolism ; physiology ; Transforming Growth Factor beta1 ; genetics ; metabolism ; rho-Associated Kinases ; genetics ; metabolism

Lipoma preferred partner (LPP) has been identified as a protein which is highly selective for smooth muscle progenitor cells (SMPCs) and regulates differentiation and migration of SMPCs, but mechanisms of LPP expression are not elucidated clearly. The aim of the present study was to discuss the mechanisms by which LPP expression is regulated in the differentiation and migration of SMPCs induced by TGF-β1. It was found that TGF-β1 could significantly increase the expression of LPP, smooth muscle α-actin, smooth muscle myosin heavy chain (SM-MHC), and smoothelin in SMPCs. Moreover, inactivation of Rho kinase (ROK) with ROK inhibitors significantly inhibited LPP mRNA expression in TGF-β1-treated SMPCs and mouse aortic smooth muscle cells (MAoSMCs). At the same time, LPP silencing with short interfering RNA significantly decreased SMPCs migration. In conclusion, LPP appears to be a ROK-dependant SMPCs differentiation marker that plays a role in regulating SMPCs migration.