Objective To investigate the relationship between insomnia,gastrointestinal symptoms,and glycosylated hemoglobin(HbA1c)levels in individuals diagnosed with type 2 diabetes mellitus(T2DM),as well as the related influencing factors.Methods A total of 910 T2DM patients treated in our multicenter from January 2022 to December 2022 were enrolled in this study.General information(gender,age,smoking and drinking history,exercise,course of disease,treatment and complications),HbA1c,Athens Insomnia Scale(AIS)scores and Gastrointestinal Symptoms Rating Scale(GSRS)scores of patients were collected.The differences of sleep and gastrointestinal symptoms between groups were analyzed,and the correlation between the differences and HbA1c was analyzed.Furthermore,the risk factors for non-standard HbA1c were analyzed.Results The AIS score and GSRS score in the HbA1c control group were less than those in the non-standard group(P＜0.01).Insomnia was reported by 37.0％of T2DM patients,and the HbA1c level in the insomnia group was significantly higher than that in the non-insomnia group(10.00％±2.38％vs.8.26％±1.73％,P＜0.01).Gastrointestinal symptoms were present in 57.5％of T2DM patients,and the HbA1c levels in the group with gastrointestinal symptoms were significantly higher than those in the group without gastrointestinal symptoms(9.26％±2.23％vs.8.43％±1.98％,P＜0.01).Furthermore,26.3％of T2DM patients experienced both insomnia and gastrointestinal symptoms.Remarkably,the HbA1c levels in the group with both insomnia and gastrointestinal symptoms were significantly higher than those in the group without either condition(10.18％±2.44％vs.8.45％±1.86％,P＜0.01).Correlation analysis demonstrated a significant association between sleep quality,gastrointestinal function,and HbA1c levels(P＜0.01).The logistic regression analysis result revealed that age,GSRS score,AIS score,and the presence of insomnia combined with gastrointestinal symptoms were independent risk factors for predicting HbA1c≥6.5％(P＜0.01).Having both insomnia and gastrointestinal symptoms concurrently was the strongest risk factor for substandard HbA1c control,and the risk of blood sugar control may increase about 5 times when both appear together.Conclusion Insomnia and gastrointestinal symptoms are common comorbidities in T2DM patients,showing a cross-interfering relationship,and they appear together with poor blood sugar control,interact causally,and amplify each other.

Cell therapy based on mesenchymal stem cells (MSCs) has been a hot research topic in recent years, including the traditional cell therapy strategy based on living cells and the new cell-free therapy strategy based on soluble proteins or bioactive molecules such as extracellular vesicles (EVs). At present, MSC-induced cells have mature functions and specific structures, and insitu transplantation combined with biomaterials or organic technology has greatly improved the settlement rate and function. On the other hand, as the large-scale culture technique and EVs separation technique evolve, it is possible to obtain a large number of pure EVs, and EVs are gradually becoming a hot spot of current research. An increasing number of studies have shown that the therapeutic effect of MSCs not only occurs by implantation and differentiation but also manifests as the paracrine effect of MSCs. In this review, we discuss the emerging outcomes of cell therapies and acellular therapies to alleviate these pathological conditions.

Objective:To study the feasibility of indwelling ureteral stent for a short time (72 hours) in patients after uncomplicated retrograde intrarenal stone surgery(RIRS).Methods:The clinical data of 58 patients who underwent uncomplicated flexible ureteroscopic lithotripsy in Xuancheng People's Hospital from October 2020 to December 2021 were retrospectively analyzed. According to indwelling time of ureteral stent after surgery, the patients were divided into two groups. There were 26 cases indwelling within 72 hours after operation, named as the observation group, and 32 cases indwelling for about 3 weeks after operation, named as the control group. There was no significant difference in gender [male/female: 14/12 vs. 21/11], age [(43.4 ± 10.2) vs. (43.9 ± 11.9) years old], affected side [left/right: 17/9 vs. 20/12], and maximum diameter of stones [(9.3 ± 1.8) mm vs. (9.7 ± 1.9) mm] between the observation group and the control group. All patients in the two groups underwent unilateral ureteroscopic lithotripsy under general anesthesia. The stone removal rate, recovery of water accumulation and incidence of postoperative complications in the first and third months after the surgery were compared.Results:There was no statistical difference between the observation group and the control group in the stone removal rate [100.0% (26/26) vs. 96.9% (31/32)] and recovery of hydronephrosis [100.0% (26/26) vs. 96.9% (31/32)] at the first month after surgery. All the stones were removed and all the hydronephrosis recovery in the two groups at the 3rd month after surgery. The rates of postoperative lumbar and abdominal pain [3.9% (1/26) vs. 28.1% (9/32)], carnal hematuria [3.9% (1/26) vs. 59.4% (19/32)], urinary tract infection [0 vs. 15.6% (5/32)], and bladder irritation [0 vs. 68.8% (22/32)] in the observation group were significantly lower than those in the control group ( P<0.05). Conclusions:Indwelling a ureteral stent for a short time (72 hours) after uncomplicated RIRS does not affect the surgical effect and does reduce the risk of complications as well as promote rapid postoperative recovery.

This case report describes the treatment of an adult female patient with a history of periodontal disease, Class I malocclusion with extrusion, dental spaces, and pathologic tooth migration. The patient was treated with clear aligners, which effectively controlled the strength and direction of orthodontic forces after 3 months of systematic periodontal treatment. The Peer Assessment Rating (PAR) index was calculated from study models before and after treatment. The pretreatment PAR score was 24, and the posttreatment PAR score was 4. The PAR score for this patient changed by 83%. Satisfactory appearance and good function were achieved for this patient.

Objective To explore the distributions and clinical characteristics of pathogenic bacteria in SAP patients with secondary infection.Methods We collected clinical data from SAP patients with secondary infection,to analyze the source of samples,pathogenic bacteria and its resistance to commonly used antimicrobial agents.Results (1) Samples Source:A total of 156 positive specimens were obtained,with the largest number from sputum samples (46.79％);The blood samples (70.59％) were collected most within 1 week,sputum samples (64.38％) from 1 week to 2 weeks,and pancreatic necrotic tissues or peripancreatic fluid samples (51.79％) after 3 weeks,with statistically significant differnces.(2) Pathogenic bacteria:156 strains were isolated including 86 strains (55.13％) of gram-negative bacteria (55.13％),of which acinetobacter baumannii and escherichia coli were the most commonly seen,followed by gram-positive bacteria of 41 strains (26.28％),and then fungus of 27 strains (18.59％).(3) Drug resistance:There was a high tolerance rate of commonly used antimicrobial agents,and the drug resistance rate of cinetobacter baumannii to carbapenems antibiotics was 88.00％.Conclusions SAP combined with secondary infection is mainly caused by gram-negative bacteria,and there is a high proportion of multidrug-resistant bacteria.Selecting suitable antimicrobial agents according to bacterial culture is beneficial for the early control of infections.

Astract: Objective To explore the efifcacy and safety of endoscopic tissue adhesive injection in treatment of gastric variceal bleeding from liver cirrhosis.Methods Object of study are 92 cirrhotic patients (72 male/20 female) in hospital, who had been diagnosed with gastric varices bleeding from June 2014 to May 2016. Child-Pugh score at presentation for cirrhotic patients was A-28; B-36; C-28. According to endoscopic classiifcation of gastric varices, GEV1 were detected in 80 patients, GEV2 in 12. All patients were treated with endoscopic hypertonic glucose tissue adhesive ‘sandwich’ injection.Result Successful injection rate was 100.0% in 92 patients, among which 40 patients had accepted emergency endoscopic treatment and the immediate hemostasis rate was 100.0%. 65 patients were Having gastroscope review after the injection six months, 22 patients were significantly effective, accounting for 33.8%; 38 patients were effective, accounting for 58.4%; 5 patients were invalid, accounting for 7.7%. All the patients were followed up in 1 to 24 months. The late-rebleeding rate was 2.2%. None of them were having early-rebleeding or dead; Complications the incidence of rebleeding rate which caused by removing the needles which trapped in the varices was 2.2%. The incidence of chest pain rate was 4.3%, the bloating rate was 6.5% and the ulceration rate was 15.2%. There was no complications like fever, infection, stomachache, embolism and so on.Conclusion With low rebleeding rate and light side-effect, endoscopic tissue adhesive injection in the treatment of gastric variceal bleeding caused by cirrhosis portal hypertension has really good effect.

Objective To explore the learning and memory impairment and pathology in hippocampus in rats after spinal cord contu-sion. Methods 36 adult female Sprague-Dawley rats were randomly divided into sham group (n=18) and spinal cord injury group (n=18). Spinal cord injury model at T10 was established with modified Allen's technique (10 g × 25 mm). The hindlimbs behavior of rats was rated with Basso-Beattie-Bresnahan (BBB) scores once a week for 5 weeks. They were tested with motor evoked potentials (MEP) and Morris wa-ter maze 5 weeks after injury. The pathology of hippocampus was detected with HE staining 1 week, 3 weeks and 5 weeks after injury, 4 rats in a group, repectively. Results The BBB scores were significantly lower in the spinal cord injury group than in the sham group at each time point (P<0.05). The latencies of both N1 and P1 wave of MEP were significantly longer in the spinal cord injury group than in the sham group (P<0.001), while the amplitudes were significantly less (P<0.001). For the Morris water maze, the latency of arrival platform were sig-nificantly longer in the spinal cord injury group than in the sham group (P<0.001), and the time in target was significantly less (P<0.001), with more systematic positioning or annular positioning, while the sham group with more space-based positioning. Morphologically abnor-mal cells in hippocampus gradually increased since the first week after injury, with the decrease of cells survival, while it was normal in the sham group. Conclusion Spinal cord contusion can cause learning and memory impairment in rats, which may be related to injury in hippo-campus.

In recent years, pharmacological researches of Chinese medicine have found that single Chinese exterior-relieving medicines such as Pueraria, Semen Sojae Praeparatum and Cimicifuga had very good anti-osteoporosis effect. They can significantly improve the bone mineral density (BMD) and bone mineral content(BMC), promote bone formation, and prevent bone absorption. Based on relative documents from home and abroad, this paper analyzed the current situation and provided new ideas and methods for prevention and treatment of osteoporosis.

[Objective] To establish an effective and stable method to induce hematopoietic cells from embryonic stem(ES) cells,the phenotype and function of ES-derived hematopoietic cells induced by stromal cell conditioned medium (SCCM) of yolk sac (YS),fetal liver (FL) or bone marrow (BM) were analyzed and compared.[Methods] 10% of YS-SCCM,FL-SCCM or BM-SCCM was added to culture system for differentiation of ES cells.Flow cytometric analysis was used to identify expression of Flk1,Integrin α4,Sca-1,and CD34.Colony analysis was used to identify the quantity of high proliferative potential colony-forming cells (HPP-CFC) in differentiated ES cells.The yield of CFU-S (colony-forming unit-spleen) was also analyzed by transplanting ES cell derivatives into lethally irradiated mice.[Results] Expression of Flk1,Integrin α4,Sca-1,and CD34 could be tested on induced EB cells.The percentage of Flk-1+,Integrin α4+ and Sca-1+ cells induced by were 3.03%,2.9%,and 13.74%,respectively,which are greater than other groups.The percentage of CD34+ cells induced by BMSC-CM was 1.07% which was greater than other groups.The yields of HPP-CFC from hematopoietic cells induced by FLSC-CM or BMSC-CM were 7.4 /105 cells (P ＜ 0.01) and 5.8 /105 cells (P ＜ 0.05) which were greater than the yields of control group.The yields of CFU-S from hematopoietic cells induced by FLSC-CM or BMSC-CM were 8.5/5 × 105 cells and 6.75/5 × 105 cells which were also greater than the yields of control group (P ＜ 0.001).[Conclusion] Both YS-SCCM,FL-SCCM,and BM-SCCM could promote hematopoietic differentiation of ESE14.1 cells.Hematopoietic differentiation induced by FL-SCCM or BM-SCCM is more effective,which generates hematopoietic progenitor cells with normal function.Application of FL-SCCM generates more primitive hematopoietic progenitor cells than that of BM-SCCM.

OBJECTIVETo evaluate the efficacy and safety of nausea oral, disintegrating buccal tablet (DBT) in the prevention of gastrointestinal reaction induced by anticancer drugs (cisplatin DDP 30 - 50 mg/m(2) or adramycin ADM >/= 40 mg/m(2)), as compared with those of kytril tablets.

METHODSA multicenter, open and randomized self-crossover control trial was carried out with all the eligible patients randomized into AB or BA group. Patients in AB group were given nausea 0.1 mg as buccal tablet one hour before chemotherapy in the first cycle and kytril tablet 2 mg in the second cycle, those in BA group were given these drugs in the reverse order.

RESULTSSeventy-three patients were allotted to this study, including 44 patients in DDP-arm and 29 in ADM-arm. Sixty-two patients were evaluable for response and 70 patients for safety. Nausea DBT was as effective as kytril tablet in the control of anorexia, nausea and vomiting during the first 24 hours after chemotherapy, with response rates of 74.2%, 77.4%, 83.9% in nausea DBT and 74.2%, 71.0%, 88.7% DBT in kytril tablets. A high efficacy in the control of vommitting induced by cisplatin was observed in both nausea DBT and kytril tablets. The complete control rates and overall control rates were 83.3%, 91.7% in nausea DBT and 86.1%, 97.2% in kytril tablets, respectively. The side effects of nausea DBT were head heaviness, dry mouth and somnolence, which were mild and comparable with kytril in their frequencies.

CONCLUSIONNausea disintegrating buccal tablet is able to effectively prevent gastrointestinal reaction induced by anticancer drugs, with efficacy and side effects similar to kytril tablets. Nausea DB tablet, an intraoral disintegrator, is very convenient for patients who can not swallow tablets for various reasons.

Adolescent ; Adult ; Aged ; Antiemetics ; therapeutic use ; Antineoplastic Agents ; adverse effects ; Cisplatin ; adverse effects ; Digestive System ; drug effects ; Doxorubicin ; adverse effects ; Female ; Granisetron ; therapeutic use ; Humans ; Male ; Middle Aged ; Nausea ; chemically induced ; drug therapy ; Ondansetron ; Tablets ; Treatment Outcome ; Vomiting ; chemically induced ; drug therapy