Objective:To explore the association of hemoglobin(HGB) levels with bone mineral density(BMD) and osteoporosis in patients with type 2 diabetes mellitus(T2DM).Methods:A cross-sectional study was conducted in 364 patients with T2DM who were hospitalized in the Department of Endocrinology and Geriatrics of the Affiliated Huaian No. 1 People′s Hospital of Nanjing Medical University from September 2019 to September 2020. Participants were stratified into tertiles(lower, middle, and upper) according to femoral BMD determined by dual-energy X-ray absorptiometry. Demographic characteristics, medical history, chronic diabetes complications, and comorbid conditions were compared among the 3 groups. The association between hemoglobin levels and BMD/osteoporosis was examined using multivariable logistic regression analyses. Interaction and stratified analyses were conducted according to age, body mass index(BMI), duration of diabetes, estimated glomerular filtration rate(eGFR), glycosylated hemoglobin(HbA 1C), total cholesterol(TC), triglycerides(TG), high-density lipoprotein-cholesterol(HDL-C), low-density lipoprotein-cholesterol(LDL-C) and uric acid(UA). Results:After adjusting for age, BMI, and duration of diabetes, there were no significant differences observed in the association between hemoglobin levels and BMD or osteoporosis among postmenopausal women with T2DM(all P>0.05). After adjusting for age, BMI, duration of diabetes, and eGFR, men aged≥50 years with hemoglobin≥130 g/L showed a positive association between hemoglobin level and femoral neck BMD compared to those with hemoglobin<130 g/L( β=0.057, 95% CI 0.014-0.100, P=0.011). However, no significant associations were observed between hemoglobin level and BMDs at the total hip or lumbar spine(L1-L4), nor the risk of osteoporosis(all P>0.05). Stratified analyses revealed no significant differences in the subgroups classified based on age, BMI, diabetes duration, eGFR, HbA 1C, TC, TG, HDL-C, LDL-C, and UA(all interaction P>0.05). Conclusion:In males aged 50 and above with T2DM, elevated hemoglobin levels may be a protective factor for femoral neck bone density.

Objective Based on 5 different chemical synaptic models,the anti-interference characteristics of neural network based on Hodgkin-Huxley neuron model are compared and studied.Methods The Hodgkin-Huxley neuron model and chemical synapses were used to construct biological neuron networks with different topologies by numerical simulation.By constructing different chemical synaptic neuron networks,the specificity of neuron anti-interference under the stimulation of sine wave signal superimposed with certain Gaussian white noise was studied,and the signal transmission mode of neuron networks under different stimulation signals was analyzed.The correlation coefficient method was used to calculate the correlation coefficient of the 0-50 ms of neuron 10 in the network under two kinds of stimulation signals,and the quantitative analysis was carried out.Results The anti-interference characteristics of the neural network were related to the chemical synaptic model,and the anti-interference waveforms of neural networks constructed based on different chemical synaptic models were different.Under the two stimulation signals,the correlation coefficients of the first 50 ms of neuron 10 in the network constructed by the 5 types of chemical synapses were 0.141 2,0.914 5,0.9965,0.567 3 and 0.881 6,respectively.The types 2 and 3 chemical synapses exhibited better anti-interference ability than the other types;the types 2 and 3 chemical synapse model were the most complex;and the types 4 and 5 chemical synapses had the fastest delayed response.Conclusion The types 2 and 3 chemical synapse models are most suitable for studying the anti-interference characteristics of neural networks.This study provides some insights into the selection of chemical synapses in the construction of neuron networks.

Objective:This study was performed to assess the effect of glycemic control on atrial fibrillation recurrence rates after heart surgery concomitant with Cox-Maze Ⅳ ablation.Methods:A retrospective analysis was performed on 317 diabetic patients with atrial fibrillation who underwent cardiac surgery combined with Cox-Maze Ⅳ ablation in our hospital from May 2016 to February 2020. The patients were followed up for(37.7±27.7) months, and the data of atrial fibrillation recurrence and clinical outcome were collected and compared. The limited cubic spline model was used to analyze the dose-relationship between HbA1c level and the recurrence of atrial fibrillation. The univariate and multivariate Cox proportional regression analysis was used to explore the risk factors of recurrent atrial fibrillation after Cox-Maze Ⅳ ablation. Results:Higher glycated hemoglobin(HbA1c) at the time of ablation was associated with higher post-ablation recurrence rates. The cumulative survival freedom from atrial fibrillation recurrence for patients with HbA1c ≥7.4% at time of operation at 12, 24, 36 and 48 months were 96.3%、75.8%、52.7% and 35.7%, respectively( P<0.001). Besides, the rates of all-cause mortality, cardiac mortality and rehospitalization were significantly lower in patients with HbA1c<7.4%(1.7% vs. 6.3%, P=0.03; 1.1% vs. 5.6%, P=0.02 and 5.7% vs. 20.4%, P=0.01). The multivariate Cox regression model showed that HbA1c was an independent risk factor for atrial fibrillation recurrence( P<0.05). Conclusion:Higher preoperative HbA1c levels were associated with increased recurrence of atrial fibrillation and adverse clinical outcomes in patients undergoing cardiac surgery combined with Cox-Maze Ⅳ ablation.

Objective:To study the expression of miR-496 in gastric cancer cells, and explore its role and mechanism in the proliferation and apoptosis of gastric cancer cells. Methods:Real-time fluorescence quantitative PCR (qPCR) was used to detect the expression of miR-496 in normal gastric epithelial cell lines and gastric cancer cell lines AGS and MKN45. miR-496 was knocked down in AGS cells with the lowest expression level, and a negative control group and a blank control group were set up. Cell proliferation and apoptosis were detected by CCK8 assay and flow cytometry. LYN, the target gene of miR-496, was screened using bioinformatics software, and the effect of transfection of miR-496 on LYN expression was detected by qPCR. Subsequently, rescure experiment was conducted to further study the mechanism of miR-496 on gastric cancer cells through regulation of LYN. Data were analyzed by GraphPad Prism 9 software. Measurement data were presented as mean ± standard deviation, and the comparison between the two groups was performed by t test. Results:The expression of miR-496 in AGS and MKN45 was significantly lower than that in normal gastric epithelial cells ( P<0.05). After overexpression of miR-496, the proliferation of AGS cells could be inhibited and the apoptosis ratio of AGS cells could be significantly increased ( P<0.05). QPCR results showed that miR-496 overexpression group could inhibit the expression of LYN ( P<0.05). Bioinformatics analysis showed that miR-496 binds to LYN kinase ( LYN) 3 ′UTR region, and overexpression of miR-496 can inhibit the expression of LYN in AGS cells, while CCK8 rescue experiment showed that overexpression of LYN could remove the inhibitory effect of miR-496 on cell proliferation. Flow cytometry showed that LYN expression could cancel the promoting effect of miR-496 on apoptosis ( P<0.05). Conclusion:miR-496 is low expressed in gastric cancer cells, and it inhibits the proliferation and promotes apoptosis of gastric cancer cells by targeting the expression of LYN in gastric cancer cells.

The hazard of vehicle emissions mainly come from the four wheel positioning, drum test and vehicle emissions test sections in automobile assembly workshop, which can lead to abnormal hemoglobin and hepatic insufficiency in workers. We researched on preventing toxic gases technologies for the vehicle emissions generated by these three sections, designed the ventilation facilities, and then detected and evaluated the operation effect, thereby improving the working environment, ensuring the occupational health of workers, and providing scientific basis for the control of vehicle emissions hazards.

The hazard of vehicle emissions mainly come from the four wheel positioning, drum test and vehicle emissions test sections in automobile assembly workshop, which can lead to abnormal hemoglobin and hepatic insufficiency in workers. We researched on preventing toxic gases technologies for the vehicle emissions generated by these three sections, designed the ventilation facilities, and then detected and evaluated the operation effect, thereby improving the working environment, ensuring the occupational health of workers, and providing scientific basis for the control of vehicle emissions hazards.

Objective Through bibliometrics and visual analysis of the related studies on traditional Chinese medicine (TCM) treatment of immune thrombocytopenia (ITP), this study aims to sort out the overall research progress, hotspots, and trends in this field, and provide reference for further research in ITP. Methods The articles on ITP treated by TCM were retrieved from China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), Web of Science Core Collection (WOSCC), and PubMed. The retrieval time was from the establishment of the databases to July 31, 2022. VOSviewer, CiteSpace, Carrot2, and NoteExpress were used for data analysis of the articles in terms of their quantities, types, and journals, and for visualization of research hotspots, authors, institutions, and keywords. Results 1 493 Chinese articles and 40 English articles were included. The articles in Chinese mainly focus on clinical trial research and clinical experience summary, while the English articles mainly focus on clinical trial research and animal research. The Chinese articles were published in 317 Chinese journals, while English articles were published in 29 English journals. Research hotspots include the clinical syndrome differentiation of ITP, the therapeutic effect of TCM compounds on ITP, and the mechanism of ITP treatment. Keyword analysis shows that there are many research achievements in integrated traditional Chinese and western medicine treatment, clinical research, famous doctors’ experience, TCM treatment, cellular immunity, and humoral immunity. The authors with the most articles in Chinese and English are Professor CHEN Xinyi and Professor MA Rou, respectively, and the research institutions with the most articles are Dongzhimen Hospital of Beijing University of Chinese Medicine and Xiyuan Hospital of China Academy of Chinese Medical Sciences. Chinese herbs often used to treat ITP clinically include Xianhecao (Agrimoniae Herba), Nvzhenzi (Ligustri Lucidi Fructus), Mohanlian (Ecliptae Herba), Zhongjiefeng (Sarcandrae Herba), etc., and the prescription usually used to treat ITP include Guipi Decoction (归脾汤), Xijiao Dihuang Decoction (犀角地黄汤), Bazhen Decoction (八珍汤), Erzhi Pill (二至丸), and Xiaochaihu Decoction (小柴胡汤). The main development trends toward retrospective study, TCM treatment mechanism, and data mining. Conclusion The research on TCM treatment of ITP has progressed steadily, but in-depth studies and close cooperation between research institutions are necessary for the modernization of TCM in treating ITP.

Background::Weight gain during chemotherapy in patients with breast cancer contributes to their poor prognosis. However, a growing number of studies have found that metabolic disorders seem to play a more important role in breast cancer prognosis than weight gain. This study aimed to explore the prognostic effects of body mass index (BMI), weight gain, and metabolic disorders on the overall survival (OS) and prognosis of patients with breast cancer who underwent chemotherapy.Methods::Data from the inpatient medical records of patients with breast cancer who underwent chemotherapy at the Beijing Cancer Hospital Breast Cancer Center from January to December 2010 were retrospectively collected, and the patients were followed up until August 2020.Results::A total of 438 patients with stages I to III breast cancer met the inclusion and exclusion criteria. Forty-nine (11.19%) patients died, while 82 (18.72%) patients had tumor recurrence and metastasis at the last follow-up (August 2020). From the time of diagnosis until after chemotherapy, no significant differences were observed in the body weight ( t = 4.694, P < 0.001), BMI categories ( χ2 = 19.215, P = 0.001), and incidence of metabolic disorders ( χ2 = 24.841, P < 0.001); the BMI categories and weight change had no effect on the OS. Both univariate ( χ2 = 6.771, P = 0.009) and multivariate survival analyses (hazard ratio = 2.775, 95% confidence interval [CI]: 1.326-5.807, P = 0.007) showed that low high-density lipoprotein cholesterol (HDL-C) levels at diagnosis had a negative impact on the OS. The multivariate logistic regression analysis showed that the HDL-C level at diagnosis (odds ratio [OR] = 2.200, 95% CI: 0.996-4.859, P = 0.051) and metabolic disorders after chemotherapy (OR= 1.514, 95% CI: 1.047-2.189, P = 0.028) are risk factors for poor prognosis in patients with breast cancer. Conclusions::Chemotherapy led to weight gain and aggravated the metabolic disorders in patients with breast cancer. Low HDL-C levels at diagnosis and metabolic disorders after chemotherapy may have negative effects on the OS and prognosis of patients with breast cancer.

Objective:To examine the difference of long-term recurrence rate and survivals between the young patients and the old patients undergoing breast conserving therapy (BCT).Methods:Women with primary invasive breast cancer receiving BCT between December 1999 and December 2014 were selected retrospectively from the database of Breast Cancer Center, Peking University Cancer Hospital & Institute. The median age of all patients was 47 years (range: 21 to 91 years). The cases were categorized according to age at diagnosis into two subgroups: the ≤40 years group and the>40 years group. A total of 2 778 patients were included: 677 patients in the ≤40 years group and 2 101 patients in the >40 years group. Clinicopathological characteristics between two groups were compared. The recurrence rate and survival were calculated using the Kaplan-Meier method. The differences of outcomes were compared in different aged groups using the Log-rank test. Factors affecting local recurrence, distant disease-free survival (DDFS), disease-free survival (DFS), and breast cancer-specific survival (BCSS) were assessed by multivariable Cox proportional hazard models.Results:Proportions of T1 (301/677 vs. 1 160/2 101, χ2=37.660, P<0.01), involved lymph node (314/677 vs. 713/2 101, χ2=34.966, P<0.01) hormone receptor-negative (490/677 vs. 1 581/2 101, χ2=6.981, P=0.030) and neoadjuvant chemotherapy (413/677 vs. 1 010/2 101, χ 2=34.272, P<0.01)in the ≤40 years group were higher than that in the>40 years group. Median follow-up duration was 102 months. No significant difference in 10-year local recurrence was found between the two groups (2.5% vs. 1.6%, P=0.147). Ten-year DDFS rate in the ≤40 years group and in the>40 years group was 90.6% and 95.3%, respectively ( P<0.01). Ten-year DFS rate in the ≤40 years group and in the>40 years group was 86.5% and 91.1%, respectively ( P=0.001). Ten-year BCSS rate in the ≤40 years group and in the >40 years group was 91.0% and 93.7%, respectively ( P=0.105). Age was not the prognosis factor of local recurrence. Lymph node status (positive vs. negative: HR=2.73, 95%CI: 1.94 to 3.84, P<0.01), age (≤40 years vs.>40 years: HR=1.73, 95%CI: 1.24 to 2.42, P=0.001) and T stage (>2 cm vs. ≤2 cm: HR=1.61, 95%CI: 1.14 to 2.28, P=0.001) were the prognosis factors of DDFS, and also for DFS. Hormone receptor status (positive vs. negative: HR=0.54, 95%CI: 0.39 to 0.74, P<0.01), lymph node status (positive vs. negative: HR=2.94, 95%CI: 2.12 to 4.07, P<0.01) and T stage (>2 cm vs. ≤2 cm: HR=1.45, 95%CI: 1.05 to 2.01, P=0.025) were the prognosis factors of BCSS. Conclusions:The risk of local recurrence was similar between ≤40 years patient and >40 years patients receiving breast conserving therapy. Worse survivals in the ≤40 years group were found comparing to those in the >40 years group.

Objective:To examine the difference of long-term recurrence rate and survivals between the young patients and the old patients undergoing breast conserving therapy (BCT).Methods:Women with primary invasive breast cancer receiving BCT between December 1999 and December 2014 were selected retrospectively from the database of Breast Cancer Center, Peking University Cancer Hospital & Institute. The median age of all patients was 47 years (range: 21 to 91 years). The cases were categorized according to age at diagnosis into two subgroups: the ≤40 years group and the>40 years group. A total of 2 778 patients were included: 677 patients in the ≤40 years group and 2 101 patients in the >40 years group. Clinicopathological characteristics between two groups were compared. The recurrence rate and survival were calculated using the Kaplan-Meier method. The differences of outcomes were compared in different aged groups using the Log-rank test. Factors affecting local recurrence, distant disease-free survival (DDFS), disease-free survival (DFS), and breast cancer-specific survival (BCSS) were assessed by multivariable Cox proportional hazard models.Results:Proportions of T1 (301/677 vs. 1 160/2 101, χ2=37.660, P<0.01), involved lymph node (314/677 vs. 713/2 101, χ2=34.966, P<0.01) hormone receptor-negative (490/677 vs. 1 581/2 101, χ2=6.981, P=0.030) and neoadjuvant chemotherapy (413/677 vs. 1 010/2 101, χ 2=34.272, P<0.01)in the ≤40 years group were higher than that in the>40 years group. Median follow-up duration was 102 months. No significant difference in 10-year local recurrence was found between the two groups (2.5% vs. 1.6%, P=0.147). Ten-year DDFS rate in the ≤40 years group and in the>40 years group was 90.6% and 95.3%, respectively ( P<0.01). Ten-year DFS rate in the ≤40 years group and in the>40 years group was 86.5% and 91.1%, respectively ( P=0.001). Ten-year BCSS rate in the ≤40 years group and in the >40 years group was 91.0% and 93.7%, respectively ( P=0.105). Age was not the prognosis factor of local recurrence. Lymph node status (positive vs. negative: HR=2.73, 95%CI: 1.94 to 3.84, P<0.01), age (≤40 years vs.>40 years: HR=1.73, 95%CI: 1.24 to 2.42, P=0.001) and T stage (>2 cm vs. ≤2 cm: HR=1.61, 95%CI: 1.14 to 2.28, P=0.001) were the prognosis factors of DDFS, and also for DFS. Hormone receptor status (positive vs. negative: HR=0.54, 95%CI: 0.39 to 0.74, P<0.01), lymph node status (positive vs. negative: HR=2.94, 95%CI: 2.12 to 4.07, P<0.01) and T stage (>2 cm vs. ≤2 cm: HR=1.45, 95%CI: 1.05 to 2.01, P=0.025) were the prognosis factors of BCSS. Conclusions:The risk of local recurrence was similar between ≤40 years patient and >40 years patients receiving breast conserving therapy. Worse survivals in the ≤40 years group were found comparing to those in the >40 years group.