Objective Differential genes related to prognosis of endometrial carcinoma(EC)were screened and prognostic models were constructed.Methods Gene Expression data of EC and normal control samples were downloaded from The Cancer Genome Atlas(TCGA)database and Gene Expression Omnibus(GEO)dataset GSE63678 to screen out common differential genes.LASSO regression analysis was used to screen out the genes with prognostic significance and construct prognostic characteristics.EC patients with complete information were obtained from the TCGA database and randomly divided into the training group and the validation group in a ratio of 1:1.In the training group,survival curves were constructed based on prognostic characteristics.Functional annotation and pathway enrichment analysis were conducted using gene ontology(GO)analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis.Combined with prognostic features and clinical risk factors,a calibration curve and C-index were used to evaluate the performance of the histogram.Finally,use a verification group for validation.Results A total of 4800 and 257 differentially expressed genes were screened from TCGA and GEO databases respectively,of which 73 up-regulated genes and 52 down-regulated genes were co-expressed.6 prognostic genes(ORMDL2,BNC2,TTK,MAMLD1,KCTD7 and DCLK2)were screened out by LASSO regression analysis.The survival curve showed that the overall survival of patients in the high-risk group was significantly lower than that in the low-risk group(P<0.01).GO analysis and KEGG results exhibited that prognostic signature was associated with cell cycle.The nomogram showed powerful predictive ability in the training and validation groups.Conclusion We constructed a predictive model based on prognostic genes,which can accurately predict the prognosis of patients with EC and provide new theoretical support for clinical diagnosis and treatment.

Objective:To systemically evaluate the characteristics of cytokine levels in intraocular fluid of neovascular glaucoma (NVG).Methods:Literature on the detection of cytokine levels in NVG published before June 2022 was searched in PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang databases, and China Science and Technology Journal Database (VIP).Two investigators independently completed the literature search, inclusion, and data extraction following the inclusion and exclusion criteria.Quantitative analyses were performed using Stata 16.0 software.Study heterogeneity was assessed using the I2 test, and effects were combined using the appropriate effect model to complete the meta-analysis. Results:A total of 24 studies were screened, including 771 NVG cases and 727 age-related cataract cases (control group).The standardized mean difference ( SMD) of the combined effect value of vascular endothelial growth factor (VEGF) mass concentration in the aqueous humor between the two groups was 8.79, with a 95% confidence interval ( CI) of 6.43 to 11.14.The SMD of interleukin-6 (IL-6) between the two groups was 12.50, with a 95% CI of 9.41 to 15.58.The VEGF and IL-6 levels in aqueous humor and vitreous humor were significantly higher in NVG group than in control group (all at P<0.05).The pigment epithelium-derived factor (PEDF) level in aqueous humor was lower in NVG group than in control group ( SMD: -3.03, 95% CI: -5.50--0.55, P<0.05).The levels of IL-8 ( SMD: 3.99, 95% CI: 1.14-6.85), erythropoietin (EPO) ( SMD: 9.62, 95% CI: 0.44-18.79), placental growth factor (PIGF) ( SMD: 2.62, 95% CI: 1.38-3.86), tumor necrosis factor-α (TNF-α) ( SMD: 3.37, 95% CI: 1.87-4.87) were all significantly higher in NVG group than in control group (all at P<0.05).There was no significant difference in IL-1β level in aqueous humor between the two groups ( P>0.05). Conclusions:In NVG patients, VEGF, IL-6, IL-8, EPO, PIGF, TNF-α levels are obviously increased and PEDF level is obviously decreased.These biomarkers can be used as potential predictors or therapeutic targets for NVG.

Adult ; Humans ; Non-alcoholic Fatty Liver Disease/complications* ; Cross-Sectional Studies ; Folic Acid/therapeutic use* ; Risk Factors

Abstract OBJECTIVE To develop an ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method for determination of hynchophylline, isorhynchophylline, isocorynoxeine, corynoxeine, hirsutine and hirsuteine in Uncaria decoction, and investigate the effect of different storage conditions on the stability of active ingredients. METHODS An UHPLC-MS/MS method was established to investigate the effects of different storage temperature and time on the stability of six active components in Uncaria decoction. Separation was performed with a gradient mobile phase system of acetonitrile-0.1% formic water solution, the flow rate was 0.4 mL·min-1, the temperature of column was 30℃, the injection volume was 2 μL, the MS detection was dynamic multiple reaction monitoring mode. The effects of different storage temperature and time on the stability of six active components in Uncaria decoction was investigated. RESULTS Rhynchophylline, isorhynchophylline, corynoxeine, isocorynoxeine, hirsutine and hirsuteine were successfully separated using this method, with good linear relationship in the corresponding concentration range. The precision, repeatability, stability and recovery rate were good. The six alkaloids were basically stable within 14 d under low temperature storage, basically stable within 3 d under normal temperature storage, and not stable under high temperature storage. CONCLUSION The UHPLC-MS/MS method is stable, rapid and reproducible. It can be used to determine the contents of six effective components in Uncaria decoction. Cold storage is beneficial to the stability of Uncaria decoction.

Objective:To observe the clinical effect of scraping therapy on lumbar disc herniation (LDH) with different syndromes.Methods:Using the convenient sampling method, a total of 30 non-emergency LDH patients who were admitted to Department of Orthopedics and Traumatology of Yangzhou Hospital of Traditional Chinese Medicine from July 2017 to June 2018 were selected as the research objects. Among them, there were 11 cases of qi stagnation and blood stasis syndrome, 8 cases of damp-heat obstruction syndrome, 7 cases of cold-damp obstruction syndrome and 4 cases of liver and kidney deficiency syndrome. Du meridian, the bladder meridian of Foot Taiyang, as well as Jiaji (EX-B2) in pathological or painful sections, Ashi point, Shenshu (BL 23) , and Weizhong (BL 40) were mainly scraped. The treatment interval is 2~5 days (the marks of scrapping fade) , twice of scrapping as a treatment course and a total of 3 courses involved in the whole treatment. Japanese Orthopaedic Association (JOA) Score, Visual Analogue Scale (VAS) , serum interleukin-1 β (IL-1β) and interleukin-10 (IL-10) were compared before and after scraping.Results:Compared with those before scraping, the JOA score increased, the VAS decreased, the serum IL-1β content decreased and the serum IL-10 content increased after scraping, and the differences were sttaistically significant ( P<0.01) . Among them, the JOA scores of patients with qi stagnation and blood stasis syndrome and cold-damp obstruction syndrome were higher than those of damp-heat obstruction syndrome and liver-kidney deficiency syndrome, and the differences were statistically significant ( P<0.05) . The levels of serum IL-10 in patients with qi stagnation and blood stasis syndrome, damp-heat obstruction syndrome and cold-damp obstruction syndrome were higher than those in patients with liver-kidney deficiency syndrome, and the differences were statistically significant ( P<0.05) . Conclusions:The curative effect of scraping in the treatment of LDH is definite, and the curative effect is better for excessive syndromes.

The existing researches on scraping mostly focus on the observation of curative effect and preliminary attempts to explore the mechanism of action, but the research on scraping manifestation is slightly insufficient. At present, scraping manifestation studies mainly include skin appearance, skin blood perfusion, and skin temperature. These studies have laid the foundation and provided a reference for the standardization, normalization, and visualization research of scraping technology in the future. However, these studies are still in their infancy and need to be further studied.

objective:To observe the effect of high-flow nasal cannula (HFNC) oxygen therapy on patients with acute respiratory failure after gastrointestinal operation under general anesthesia and its efficacy on prognosis.Methods:Totally 107 patients with acute respiratory failure after gastrointestinal operation under general anesthesia in ICU of our hospital were selected from January 2017 to June 2019. Patients were randomly divided into the HFNC group ( n=57) and non-invasive ventilation (NIV) group ( n=50). The changes of pH, PaO 2, PaCO 2, PaO 2/FiO 2, SpO 2, heart rate (HR), respiration rate (RR), and intra-abdominal pressure (IAP) before and after oxygen treatment were compared. The differences of comfort level, duration of oxygen treatment, re-intubation rate, 48-h pulmonary infection rate, incidence of anastomotic fistula, length of stay in ICU, length of hospital stay, hospitalization cost, and 28-day mortality were compared between the two groups. The t test of two independent samples was used for the comparison of normal measurement data. Non-normal data were expressed by median (quartile), fractional count data by case number (percentage), and comparison between the two groups by Chi-square test. Results:PaO 2, PaCO 2, PaO 2/FiO 2 and SpO 2 were not significantly different after 2-h oxygen therapy. PH of the HFNC group was lower than that of the NIV group (7.39 ± 0.04 vs. 7.42 ± 0.03), PaO 2, PaCO 2, PaO 2/FiO 2 and SpO 2 were higher than that of the NIV group [ (89.22 ± 8.70) vs. (84.99± 9.76) mmHg, (41.3 ± 3.43) vs. (39.34 ± 4.21) mmHg, (250.07 ± 18.34) vs. (237.89±19.38) mmHg, (96.14 ± 2.19) vs. (94.78 ± 2.76)%, P <0.05]; pH, PaO 2, PaCO 2, PaO 2 /FiO 2 and SpO 2 were significantly higher in the HFNC group than those in the NIV group [ (7.39 ± 0.04) vs. (7.36 ± 0.04) ; (97.2 ± 12.45) vs. (93.82 ± 12.54) mmHg; (40.84 ± 5.22) vs. (45.10 ± 6.40) mmHg; (277.16 ± 13.98) vs. (248.86 ± 12.81) mmHg, (98.14 ± 1.64)% vs. (95.48 ± 2.71) %] after 12 h oxygen treatment. The HR, RR and IAP of the HFNC group were lower than those of the NIV group, and the differences were statistically significant ( P <0.05). The duration of oxygen therapy in the HFNC group was shorter than that in the NIV group [(32.01 ± 7.57) vs. (40.88 ± 8.89) h], the reintubation rate was lower than that in the NIV group (1.75% vs. 12%), the pulmonary infection rate within 48 h oxygen therapy was lower than that in the NIV group (8.78% vs.30%), and the length of stay in ICU was shorter than that in the NIV group [(5.61 ± 1.73) vs. (7.60 ± 2.31) d], and the hospitalization cost was lower than that in the NIV group ( t = 4.822, P <0. 05). Conclusions:HFNC can improve the oxygenation index of patients with hypoxemia after gastrointestinal operation under general anesthesia, reduce oxygen treatment time, reduced reintubation rate, reduce pulmonary infection rate within 48 h, and improve the prognosis.

Objective To explore the clinical features and prognosis of different PML_RARα fusion gene isoforms in acute promyelocytic leukemia (APL). Methods The clinical data of 78 patients initially diagnosed with APL in Fujian Medical University Union Hospital from February 2013 to July 2016 were collected. The clinical features and prognosis of different PML_RARα fusion gene isoforms were analyzed. Results There were 32 females (41%) and 46 males (59%) in 78 patients, with a median age of 40 years old (13-68 years old). The most common PML_RARα fusion gene was L type (48.7%, 38/78), followed by S type (46.2%, 36/78) and V type (5.1%, 4/78). The patients with white blood cell count more than 10×109/L (high_risk) occurred mostly in S type (61.1%, 22/36), compared with V type and L type, and there were statistically different (χ 2 ＝ 7.683, P < 0.05). A total of 78 patients included 8 cases (10.2%) of combined CD34 positive, 17 cases (21.8%) of combined FLT3_ITD mutation, 12 cases (15.4%) of combined DNMT3A mutation and 9 cases (11.5%) of additional chromosomal abnormalities. There were no significant differences in CD34 positive, FLT3_ITD, DNMT3A, and the incidence of additional chromosomal abnormalities among the three different isoforms (P＞0.05). The most common occurrence of retinoic acid syndrome (RAS) during treatment was S type (21/36), while rare for L type and V type (χ2＝ 7.633, P< 0.05). There were no statistical differences in the complete remission (CR) rate and disease_free survival rate among the patients with different PML_RARα isoforms (P＞0.05). Conclusions The clinical characteristics of different PML_RARα fusion gene isoforms are different, including most_common L type, more_common V type and S type in high risk groups; complicated RAS is commonly found in S type during the treatment. And different isoforms have no effect on the CR and DFS rate.

Objective: To observe the clinical effect of vitrectomy with internal limiting membrane peeling and air tamponade in the treatment of idiopathic macular hole (IMH). Methods: A prospective, non-randomized controlled case cohort study. Twenty eyes of 20 patients with IMH in Ophthamology Department of The Second Hospital of Jilin University from September 2016 to January 2017 were included in this study. There were 4 males (4 eyes) and 16 females (16 eyes), with the mean age of 60.60±9.50 years and the mean disease course of 9.55±15.5 months. The stage of macular hole ranged from Ⅱ to Ⅳ. All patients underwent BCVA, intraocular pressure, spectral-domain OCT (SD-OCT) and multifocal ERG examinations. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logMAR visual acuity. The minimum diameter (MIN), bottom diameter (BD), height (H), the defective diameter of ellipsoid zone, the defective diameter of external limiting membrane (ELM) of the macular hole were measured by SD-OCT (German Heidelberg). Then the macular hole index (MHI=H/BD), hole traction index(THI=MD/BD) and hole diameter index (DHI=H/MD) were calculated. The response density in P1 wave was detected by mf-ERG. The logMAR BCVA was 1.18±0.54. There were 5 eyes with less than 400 μm MIN, 13 eyes with 400-700 μm MIN and 2 eyes with over than 700 μm MIN. All the patients were underwent vitrectomy with internal limiting membrane peeling and air tamponade. According to the SD-OCT image features after surgery, IMH closure was divided into type Ⅰ closed, type Ⅱ closed and unclosed. The follow-up was equal or greater than 3 months. The closure rate of IMH, BCVA and the changes of microstructure parameters of macular area were observed. Spearman correlation analysis was used to analyze the correlation between BCVA and the wave response density in P1 before surgery and the efficacy after IMH surgery. Results: Closure rate of IMH: 18 eyes (90.0%) were completely closed (all type Ⅰ closed). The closure rate of macular hole with the MIN less than 400 μm was 100.0% (5/5), 400-700 μm was 92.3% (12/13), and over than 700 μm was 50% (1/2). BCVA: the mean logMAR BCVA at 1 week, 1 month, 3 months after surgery were 0.83±0.54, 0.65±0.41, 0.48±0.34, and there was statistically significant difference between preoperative and postoperative BCVA (t=3.382, 4.459, 5.250; P=0.003, 0.007, 0.004). The outcomes of SD-OCT at 3 months after surgery: 18 eyes (90.0%) with intact ELM. The defective diameter of ellipsoid zone was 260.34±272.08 μm, there was statistically significant difference between before and after surgery (t=13.545, P=0.002). The outcomes of mf-ERG: the P1 wave response density of the ring 1 and ring 2 after surgery were increased compared with before surgery (t=-16.748, - 6.151; P<0.01,<0.01). The results of Spearman correlation analysis: there was a positive correlation between postoperative BCVA and preoperative MIN, the defective diameter of ellipsoid zone and ELM, and postoperative the defective diameter of ellipsoid zone (r=0.56, 0.59, 0.68, 0.52; P=0.010, 0.006, 0.001, 0.019). The postoperative BCVA was negatively correlated with the P1 wave response density of ring 1 and ring 2 of mf- ERG (r=-0.34, -0.16; P=0.006, 0.020). The IMH closure had a significant negative correlation with MIN and the defective diameter of ELM(r=-0.449, -0.449; P=0.047, 0.047). MHI and THI were positively correlated with the closure of the hole (r=0.474, 0.546; P=0.035, 0.013). Intraocular pressure increased in 2 eyes during the follow-up period, and returned to normal within 1 week after the administration of antihypertensive drugs. There were no complications during or after the operation. Conclusions Vitrectomy with internal limiting membrane peeling and air tamponade in the treatment of IMH is safe and effective. The MIN, MHI THI are significantly correlated with the curative effect after IMH surgery, which could be used as the index to predict and evaluate the curative effect. The response density of ring 1 and ring 2 in P1 wave of mf-ERG is signifi-cantly improved compared with before surgery, and which is negatively correlated with BCVA.

Traditional Chinese medicine (TCM) nursing is an important part in the nursing discipline which plays an important role in prevention, health care and nursing rehabilitation. It is imperative to strengthen the cultivation of health service ability of TCM for nurses. However, the expert consensus on the training standard of core knowledge and practical ability of TCM nursing has not been formed so far. On the basis of establishing a research group, a questionnaire was formed based on literature research, university research, brain storm and expert interviews. A total of 76 TCM nursing experts from universities and hospitals at home and abroad of TCM were investigated with the questionnaire to form an expert consensus. Finally, the training standard of core knowledge and practical ability of TCM nursing was established, including three course modules of basic courses of TCM, basic courses of TCM nursing, and specialized courses of TCM nursing, and 9 courses of basic theory of TCM, diagnosis of TCM, science of Chinese materia medica, pharmacology of TCM, fundamental of TCM nursing, TCM diet therapy, acupuncture and moxibustion and nursing, TCM nursing skill operation, TCM nursing clinical practice so as to provide a reference for the training of nursing talents of TCM at home and abroad.