Objective To analyze the relationship between cardiac autonomic neuropathy (CAN) and bone mineral density (BMD) reduction and fracture risk in patients with type 2 diabetes mellitus (T2DM). Methods A total of 396 patients with T2DM admitted to Nanchong Mental Health Center of Sichuan Province were selected, and all of them underwent detection of BMD of hip, lumbar vertebra and femoral neck. Fracture risk was evaluated using the probability of major osteoporotic fracture (PMOF) and ten-year probability of hip fracture (PHF). According to the degree of fracture risk, the patients were divided into low-risk group and high-risk group. Clinical data and CAN condition of the two groups were compared. Factors influencing fracture risk in patients with T2DM were analyzed. According to CAN condition, the patients were divided into early group, diagnosed group, and severe group. The correlation between CAN score and BMD was analyzed. Results The proportion of CAN in the high-risk group was significantly higher than that in the low-risk group (P<0.05). The BMD of hip, lumbar vertebra and femoral neck was significantly lower than that in the low-risk group (P<0.05). Logistic regression analysis showed that BMD of hip (OR=0.143, 95%CI: 0.102-0.201), BMD of lumbar vertebra (OR=0.047, 95%CI: 0.022-0.100), BMD of femoral neck (OR=0.208, 95%CI: 0.168-0.257), and CAN (OR=39.409, 95%CI: 14.704-105.623) were risk factors for fracture (P<0.05). The BMD of hip, BMD of lumbar vertebra and BMD of femoral neck in the severe group, the diagnosed group, and the early group increased in order (P<0.05). CAN score was negatively correlated with the BMD of hip, BMD of lumbar vertebra and BMD of femoral neck in patients with T2DM (P<0.05). Conclusion The condition of CAN in patients with T2DM is closely related to BMD reduction, and CAN is a risk factor for fracture.

Objective To investigate the effect of Gexia Zhuyu decoction combined with diosmin on coagulation mechanism in patients with great saphenous varicose vein surgery.Methods A total of 60 patients who received great saphenous varicose vein surgery in Shaoxing Hospital of Traditional Chinese Medicine from January 2019 to April 2022 were selected and divided into control group and observation group according to random number table method,with 30 patients in each group.Control group was treated with diosmin,and observation group was treated with diosmin + Gexia Zhuyu decoction.Coagulation indexes,vascular endothelial function and inflammatory factor levels were compared between two groups.Results After treatment,Krüppel-like factor 2,activated partial thromboplastin time,thrombin time,prothrombin time,nitric oxide,and interleukin(IL)-10 in observation group were significantly higher than those in control group,while plasminogen activator inhibitor type 1,von Willebrand factor,endothelin 1,hypersensitive C-reactive protein,IL-2 and IL-6 were significantly lower than those in control group(P<0.05).Conclusion Gexia Zhuyu decoction combined with diosmin can improve the hypercoagulable state and vascular endothelial function in patients with great saphenous varicose vein surgery,and reduce the level of inflammatory factors in the body,which is worth popularizing.

Objective:To investigate the value of systemic inflammatory response syndrome (SIRS), pediatric sequential organ failure assessment (pSOFA) and pediatric critical illness score (PCIS) in predicting mortality of pediatric sepsis in pediatric intensive care units (PICU) from Southwest China.Methods:This was a prospective multicenter observational study. A total of 447 children with sepsis admitted to 12 PICU in Southwest China from April 2022 to March 2023 were enrolled. Based on the prognosis, the patients were divided into survival group and non-survival group. The physiological parameters of SIRS, pSOFA and PCIS were recorded and scored within 24 h after PICU admission. The general clinical data and some laboratory results were recorded. The area under the curve (AUC) of the receiver operating characteristic curve was used to compare the predictive value of SIRS, pSOFA and PCIS in mortality of pediatric sepsis.Results:Amongst 447 children with sepsis, 260 patients were male and 187 patients were female, aged 2.5 (0.8, 7.0) years, 405 patients were in the survival group and 42 patients were in the non-survival group. 418 patients (93.5%) met the criteria of SIRS, and 440 patients (98.4%) met the criteria of pSOFA≥2. There was no significant difference in the number of items meeting the SIRS criteria between the survival group and the non-survival group (3(2, 4) vs. 3(3, 4) points, Z=1.30, P=0.192). The pSOFA score of the non-survival group was significantly higher than that of the survival group (9(6, 12) vs. 4(3, 7) points, Z=6.56, P<0.001), and the PCIS score was significantly lower than that of the survival group (72(68, 81) vs. 82(76, 88) points, Z=5.90, P<0.001). The predictive value of pSOFA (AUC=0.82) and PCIS (AUC=0.78) for sepsis mortality was significantly higher than that of SIRS (AUC=0.56) ( Z=6.59, 4.23, both P<0.001). There was no significant difference between pSOFA and PCIS ( Z=1.35, P=0.176). Platelet count, procalcitonin, lactic acid, albumin, creatinine, total bilirubin, activated partial thromboplastin time, prothrombin time and international normalized ratio were all able to predict mortality of sepsis to a certain degree (AUC=0.64, 0.68, 0.80, 0.64, 0.68, 0.60, 0.77, 0.75, 0.76, all P<0.05). Conclusion:Compared with SIRS, both pSOFA and PCIS had better predictive value in the mortality of pediatric sepsis in PICU.

Objective:To investigate the application of "micro ward" teaching based on the concept of dedicated education units (DEU) in the standardized training of neurosurgery residents.Methods:The 22 neurosurgery residents enrolled in 2021 for standardized training were assigned to the control group with traditional teaching method. The 24 neurosurgery residents enrolled in 2022 were assigned to the observation group with the "micro ward" teaching method based on the DEU concept. The theoretical knowledge and operational skill scores, clinical thinking ability, and teaching satisfaction were compared between the two groups of students before and after the training. SPSS 21.0 was used to perform chi-square test, Z test and t test. Results:The observation group had higher scores in terms of surgical skills [(190.63±4.35) vs. (86.79±4.82)] and case analysis [(190.54±5.06) vs. (86.13±5.35)] than the control group ( P<0.05). The scores were higher in the observation group than in the control group in terms of broadening thinking, overall thinking, curiosity, and cognitive maturity after training ( P<0.05). The observation group had a significantly higher proportion of students who were satisfied with standardized neurosurgery training teachers, teaching methods, and teaching results than the control group ( P<0.05). Conclusion:The application of "micro ward" teaching based on the concept of DEU in the standardized training of neurosurgery residents can effectively improve the clinical practice ability and professional quality of trainees, cultivate their specialized clinical thinking, enhance their independent learning ability, and improve the training quality. Therefore, this teaching method is worth promoting.

AIM: To screen the active constituents in Taohong Siwu Decoction(THSWD) by Systems Pharmacology and to study its protective effect on myocardial injury through cell experiments. METHODS: The TCMSP database and Pharmmaper database were used to retrieve the constituents and active constituent targets of THSWD. The Genecards database was used to retrieve the myocardial injury related targets gene. Then construct and analyze the constituents-disease intersection target network and the contribution value of constituents, and screen out the main active constituents of THSWD acting on the myocardium. Furthermore, CoCl

OBJECTIVE: To investigate the serological and molecular characteristics of a pedigree carrying an allele for ABO*BW.11 blood subgroup. METHODS: The ABO blood type of 9 pedigree members were determined by serological methods. Exons 6 and 7 of the ABO gene were amplified by PCR and directly sequenced. The patient and her father were also subjected to clone sequencing analysis. RESULTS: Serological tests demonstrated that the proband and her younger brother had an ABw subtype, whilst her father and two daughters had Bw subtype. Clone sequencing found that the exon 7 of the ABO gene of the proband had a T>C substitution at position 695, which was identified as a BW.11 allele compared with the reference sequence B.01. This BW.11 allele was also identified in the proband's father, brother and two daughters. Due to allelic competition, the A/BW.11 and BW.11/O alleles demonstrated significantly different phenotypes. CONCLUSION The c.695T>C substitution of the ABO gene may lead to allelic competition in the Bw11 subtype. Combined molecular and serological methods is helpful for precise blood grouping.
ABO Blood-Group System/genetics* ; Alleles ; Female ; Genotype ; Humans ; Male ; Pedigree ; Phenotype

Objective To explore the method of increasing the mastering rate of health knowledge of patients and effective rate of health education by nurses on the premise of shortened average length of hos-pital stay.Methods 316 patients were divided into group i (96 cases),group ii (117 cases) and group iii (103 cases).Patients in group i had no pre hospital education.Patients in group ii accepted quasicollective education on hospitalization notices.Patients in group iii accepted quasi-collective education on hospitalization notices and some general peri-operative knowledge.The mastering rate of knowledge and time cost for health education were compared between three groups.Results Compared to group i,group ii and group iii got higher mastering rate in 8 items of hospitalization notices.No difference was seen in acknowledge of general peri-operative knowledge.The education of hospitalization notices and total time was shortened.The difference between group ii and group iii was not positive.Conclusions Taking quasi-collective education on hospitalization notices improves patients' mastering level of hospitalization notices and nurses' education efficiency.

Objective To investigate the role of CT in the diagnois of superior vena cava syndrome secondary to pulmonary carcinoma. Method Fifty patients with pulmonary carcinoma resulting in SVCS were confirmed by pathological examinations. Relationship between anatomical distribution and gross type of pulmonary carcinoma and modes of pulmonary carcinoma resulting in SVCS were analyzed retrospectively and statistically. Correlation among obstructive degree of SVC, opening of collateral pathway and swelling of chest wall was analyzed retrospectively and statistically. Results For modes of pulmonary carcinoma resulting in SVCS, direct invasion of pulmonary carcinoma was 7 patients, metastasis of lymph node was 16 patients and both of the two was 27 patients.Modes of pulmonary carcinoma resulting in SVCS were different for different gross types of pulmonary carcinoma in different pulmonary lobes ( x2 = 30.012,P ＜ 0.05). On CT appearances of secondary lesions, cases of simple constitution and opening of collateral pathway, simple swelling of chest wall, both of the two and neither of the two were 14 patients, 12 cases, 15 patients and 9 patients in order on CT. With SVC obstruction at different extent,constitution and opening of collateral pathway and swelling of chest wall were different ( x2= 12.881, P ＜ 0.05).Conclusions SVCS resulted from pulmonary carcinoma can be diagnosed by contrast enhanced CT.