AIM:To establish a nomogram model to predict the effect of serum ferritin on diabetic retinopathy and evaluate the model.METHODS:A total of 21 variables, including ferritin, were screened by univariate and multivariate regression analysis to determine the risk factors of diabetic retinopathy. A nomogram prediction model was established for evaluation and calibration.RESULTS:Ferritin, duration of diabetes, hemoglobin, urine microalbumin, regularity of medication and body mass index were included in the nomogram model. The consistency index of the prediction model with serum ferritin was 0.813(95%CI: 0.748-0.879). The calibration curves of internal and external verification showed good performance, and the probability of the threshold suggested by the decision curve was in the range 10% to 90%. The model had a high net profit value.CONCLUSIONS:Serum ferritin is an important risk factor for diabetic retinopathy. A new nomogram model, which includes body mass index, duration of diabetes, ferritin, hemoglobin, urine microalbumin and regularity of medication, has a high predictive accuracy and could provide early prediction for clinicians.

Objective:To investigate the clinical efficacy of distal tibiofibular screw fixation combined with ligament repair for the treatment of ankle fracture accompanied with distal tibiofibular syndesmosis injuries.Methods:A retrospective cohort analysis was made on clinical data of 72 patients with ankle fracture accompanied with distal tibiofibular syndesmosis injuries admitted to 909th Hospital of Joint Service Support Force of PLA from September 2017 to September 2020, including 38 males and 34 females, aged 19-65 years [(42.5±12.2)years]. The fracture was type B in 30 patients, type C 1 in 29 and type C2 in 13 according to Danis-Weber classification. A total of 36 patients were treated by distal tibiofibular screw fixation combined with ligament repair (fixation+repair group) and 24 patients by distal tibiofibular screw fixation (fixation group). Operation time, intraoperative blood loss and hospital stay were recorded. Visual analogue scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) ankle hindfoot score and ankle range of motion (ROM) were determined at 1, 3 months postoperatively and at the final follow-up. Complications were documented. Results:All patients were followed up for 12-22 months [(15.9±2.2)months]. There were no significant differences in operation time, intraoperative blood loss and hospital stay between the two groups (all P>0.05). VAS in fixation+repair group was (3.1±1.0)points and (2.1±0.6)points at 1, 3 months postoperatively, significantly lower than (3.9±0.8)points and (2.6±0.8)points in fixation group (all P<0.05), but the score showed no significant difference between the two groups at the final follow-up ( P>0.05). AOFAS score in fixation+repair group was (64.7±4.0)points, (73.2±3.4)points and (87.2±3.4)points at 1, 3 months postoperatively and at the final follow-up, significantly higher than (60.1±4.9)points, (70.2±1.9)points and (84.1±2.6)points in fixation group (all P<0.05). There was no significant difference in the ROM between the two groups at 1 month postoperatively ( P>0.05), but the ROM at 3 months postoperatively and at the final follow-up in fixation+repair group [(44.4±2.9)° and (52.3±2.5)°, respectively] was significantly higher than that in fixation group [(41.4±2.7)° and (50.1±2.7)°, respectively] (all P<0.05). There was 1 patient with internal fixation loosening in fixation+repair group, with the incidence of complications of 3% (1/36). While the incidence of complications was significantly lhigher in fixation group [17%(6/36)], including 2 patients with re-separation of distal tibiofibular syndesmosis, 2 with internal fixation loosening and 2 with internal fixation breakage ( P<0.05). Conclusion:Compared with distal tibiofibular screw fixation, distal tibiofibular screw fixation combined with ligament repair for the treatment of ankle fracture accompanied with distal tibiofibular syndesmosis injuries is effective to early relieve ankle pain, improve ankle function and ROM, and reduce occurrence of complications.

In recent years, with the increasing incidence of diabetes, diabetic keratopathy has gradually attracted more attention from clinicians.Diabetic keratopathy is mainly manifested as delayed corneal epithelial healing, corneal edema, decreased corneal sensitivity, and neurotrophic corneal ulcer.There are many mechanisms of diabetic keratopathy, including the abnormal accumulation of metabolites, an inflammatory reaction, oxidative stress, the lack of neurotrophic factors, corneal limbal stem cell abnormalities, etc.At present, most of the research on diabetic keratopathy at home and abroad has mainly focused on epithelial damage repair and changes in nerve function, and the pathological mechanism is mainly inflammatory response and apoptosis.Nuclear factor kappa B(NF-κB) is an important transcription regulatory factor, and is involved in regulating the expression of inflammatory factors, chemokines, cell adhesion molecules, apoptosis-related genes, growth factors, and other target genes.Studies have reported that chronic inflammation and epithelial cell apoptosis of the diabetic corneal epithelium are involved in the regulation of the NF-κB signaling pathway, which is also involved in the regulation of diabetic peripheral neuropathy, and diabetic corneal neuropathy belongs to the category of diabetic peripheral neuropathy.The NF-κB signaling pathway is closely related to the occurrence and development of diabetic keratopathy, and this article summarizes its mechanism.

Xylanase is a high-profile glycoside hydrolase with applications in brewing, feed, pharmacy and bioenergy industries, but most of xylanases are in active below 30 ℃. In order to obtain low temperature active xylanase, a xylanase gene, XYN11A, was cloned from Penicillium sp. L1 and expressed in Pichia pastoris GS115. After purification and enzyme assay, optimal pH and temperature were determined to be 3.5 to 4.0 and 55 ℃. This enzyme was stable at acid and neutral condition (pH 1.0 to 7.0) or under the treatment of 40 ℃ for 1 hour. This xylanase displayed strong resistance to all tested ions and chemicals. Noteworthily, XYN11A maintained a higher activity of 6 700 U/mg than a lot of GH11 xylanase, and demonstrated higher activity (24% to 58%) at lower temperature from 20 to 40 ℃. After beechwood xylan hydrolysis for 16 h, the hydrolysates consisted mainly of xylobiose, xylotriose and xylotetraose and barely of xylose, thus XYN11A could be used for the production of prebiotic xylooligosaccharide. Possessing the features of acidophilic, highly active at lower temperature and oligosaccharide production, XYN11A demonstrated great potential in food and feed industrials.

This study aimed to investigate the protective effects of Baibu Tang on bleomycin-induced pulmonary fibrosis in mice. After intratracheally giving bleomycin(3. 5 mg/kg), mice were orally administered Baibu Tang once a day for 14 consecutive days, takingnintedanib as a positive control. The anti-fibrotic effects were assessed by the hydroxyproline level and the histopathological changes in H&E or Masson stained lung tissues. The results revealed that the lung coefficient, hydroxyproline content, inflammation and collagen deposition were increased significantly in the lung tissue of the model mice. Both ethanol and water extracts of Baibu Tang significantly improved all the pathological indexes in mice, but the effect of the ethanol extract was better than that of the water extract. Baibu Tang with Baibu(root of Stemona tuberosa)containing different components(neotuberostemonine, tuberostemonine and stemoninine, respectively)could significantly reduce hydroxyproline level and collagen deposition in the lung tissue of bleomycin-induced mice, and there was no significant difference in their activity. This result showed that the changes in the chemical composition of Stemona tuberosa(Baibu, monarch drug for Baibu Tang)have little effect on the anti-fibrosis activity of Baibu Tang, and its mechanism and material basis need further investigation.

Objective To explore the effects of individualized comprehensive intervention on complications during indwelling implantable venous access port (IVAP), so as to provide reasonable suggestion and theory evidence for reducing the incidence of IVAP complications. Methods We selected 400 breast cancer patients with IVAP. All of the patients were completely randomized divided into control group and experimental group. Patients of control group (n=200) received routine intervention including education before implanting IVAP and discharge instruction. On this basis of routine intervention, patients of experimental group (n=200) were treated with the individualized comprehensive intervention and enhancing continuous intervention out hospital aiming at common complications of IVAP. We compared patients' incidences of complications during IVAP between two groups. Results Patients' incidences of complications during IVAP in control group and experimental group were 27.0% and 7.5% respectively with a significant difference (P＜ 0.01). There were 12 patients with unplanned port drawing due to complications in control group and 3 in the experimental group with a significant difference (P＜ 0.05). Conclusions Individualized comprehensive intervention can effectively reduce the incidences of complications during IVAP, improve the utilization time and ratio of IVAP. Enhancing continuous intervention out hospital is also the important measure to decrease the incidence of severe complications.

Objective To study the real world of bicyclol tablets in the treatment of viral hepatitis and its influence on platelets.Methods The hospital information system (HIS) was selected from 18 Triple-A hospitals in China on patients with bicyclol tablets information as exposed group (2 690 cases),patients with unused bicyclol tablet (2 690 cases) as an exposed group,an exception occurs of platelet as an index of the ending.Results The incidence of abnormal platelet difference in two groups before the treatment were not statistically significant.The incidence of abnormal platelet reduce between two groups have statistical significance,can be thought of exposure of abnormal lower rate (11.75%)lower than that of non exposed group(15.17%) (P<0.01).Conclusion Bicyclol piece have signficantly curative effect on the treatment of viral hepatitis.It shows more safety,and less impact on platelets.It is worth to be used in clinical practice.

Objective To investigate the clinical efficacy of acupuncture in treating subhealth.Methods One hundred and fifty-four patients with subhealth were allocated, using a random number table, to observation and control groups, 77 cases each. The control group received basic treatment by diet, exercise, rest and rest and psychological intervention and the observation group, acupuncture therapy in addition. Subhealth scale subscores and the 36-Item Short-Form Health Survey (SF-36) subscore were recorded and blood biochemical indicators were measured in the two groups before and after treatment. the clinical therapeutic effects were compared between the two groups.Results The total efficacy rate was 96.1% in the observation group and 83.1% in the control group; there was a statistically significant difference between the two groups (P<0.05). There were statistically significant pre-/post-treatment differences in subhealth scale subscores in the two groups (P<0.05). After treatment, sleep, digestion, urination, positive emotion, ability and social relation subscores were higher, and fatigue, discomfort and negative emotion subscores were lower in the observation group than in the control group (both P<0.05). There were statistically significant pre-/post-treatment differences in blood biochemical indicators in the two groups (P<0.05). After treatment, blood uric acid (UA), total cholesterol (TC), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) were significantly lower and high-density lipoprotein cholesterol (HDL-C) was significantly higher in the observation group than in the control group (both P<0.05). The 36-Item Short-Form Health Survey (SF-36) subscore were higher in thetwo groups after treatment than before treatment (P<0.05). After treatment, physiological function, role-physical, role-emotional, body pain and general health subscore were significantly higher in the observation group than in the control group (P<0.05).Conclusions Acupuncture helps to improve subhealth status in population, regulate blood biochemical indicators and enhance the clinical therapeutic effect to raise the quality of life in the patients.

Objective To summarize the application effects of two different methods of replacing quilt covers in the operating room.Methods Between February 2016 to August 2016, 360 cases in thousand-grade clean surgery with elective surgical procedures, were randomly divided into control group (n=180) and observation group (n=180). The observation group used improved method to replace quilt covers, and the control group used the traditional method. Air sampling at different time points, the turnaround time between operations and the nurse and patient satisfaction of the two groups were compared.Results Compared with the control group, air cleanliness at different time points changed significantly in the observation group. Moreover, the turnaround time in the observation group was significantly shorten than that in the control group, and the nurse and patient satisfaction were more improved in the observation group. All the differences were statistically significant (P<0.05).Conclusions Application of improved method to replace quilt covers can effectively improve air cleanliness, reduce the surgical infection rate, shorten the cohesion of the surgery time and improve the patients' satisfaction.

Objective To investigate the cognition and compliance of medical staff in a hospital on fasting and water deprivation scheme recommended by related practice guideline and to explore its influencing factors, so as to provide an empirical evidence for further perfecting the system of preoperative preparation and improving the experience of patients to seeking medical advice. Methods A total of 237 medical personnels met the inclusion criteria were investigated with the self-designed cognition and behavior of medical staff on fasting scheme questionnaire by cross-sectional study from August to December 2016. Logistic regression analysis was used to analyze the influencing factors of the cognition and compliance of medical staff on fasting and water deprivation scheme before surgery. Results A total of 233 valid questionnaires recovered with valid recovery rate of 98.3%. There were 20.6% of the medical staff with the same cognition on the best time of fasting and water deprivation before surgery with the guidelines. There were 59.7% of the medical staff who would try to provide preoperative diet guidance according to the scheme recommended by practice guideline. The training, educational background and positional titles were the major influencing factors of cognition of medical staff on fasting and water deprivation scheme (P< 0.05). The training was the major influencing factor of compliance of medical staff on fasting and water deprivation scheme (P< 0.05). Conclusions Medical staff are with inadequate understanding and low compliance on fasting and water deprivation scheme recommended by related practice guideline. Managers should further strengthen the relevant training and create a favourable work environment so as to improve the compliance of medical staff on implementing the guidelines.