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.

The gradually acidified tumor microenvironment plays a key role in the formation and advance of hepatocellular carcinoma. Under the regulation of acidic microenvironment, the differentiation and function of immune cells change to immunosuppression, which further leads to the occurrence of immune escape of hepatocellular carcinoma. In this paper, the formation of acidic microenvironment of hepatocellular carcinoma, the changes of various immune cells in acidic microenvironment and their effects on the occurrence and development of hepatocellular carcinoma, as well as their further mechanisms are reviewed in order to provide new ideas for the study of immunotherapy of hepatocellular carcinoma.

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.

Objective:To explore the value of blood lipids, serum interleukin-6 (IL-6) and thyroid-stimulating hormone (TSH) detection in patients with differentiated thyroid cancer.Methods:From Mar. 2016 to Oct. 2021, 120 cases of DTC were admitted to the DTC group, 138 patients with benign thyroid nodules were included in the benign group, and 100 healthy people undergoing the physical examination in our hospital during the same period. were enrolled in the control group. Triglyceride (TG) , total cholesterol (TC) , high density liptein cholesterol (HDL-C) , low density lipoprotein (LDL-C) , IL-6, and TSH were compared between groups, and statistically significant indexes were included for multivariate analysis of the occurrence of DTC. The sensitivity, specificity and optimal cut-off value were analyzed, and their relationship with the clinicopathological characteristics of DTC patients was analyzed.Results:Serum TSH and IL-6 levels from high to low were malignant group, benign group and control group, and HDL-C levels from high to low were control group, benign group and malignant group ( P<0.05) . There was no significant difference in the levels of TC, TG or LDL-C ( P>0.05) . Multivariate Llogistics regression analysis indicated that TSH and IL-6 may be risk factors for the occurrence of differentiated thyroid cancer (all OR>1, P<0.05) . HDL-C may be a protective factor for the occurrence of differentiated thyroid cancer ( OR<1, P<0.05) . The ROC curve was drawn to determine the optimal cut-off value of TSH for the diagnosis of differentiated thyroid cancer, AUC: 0.985, sensitivity was 93.25%, specificity was 96.34%, 95% CI: 0.949-1.000 ( P<0.001) ; the best cut-off value of IL-6 for the diagnosis of differentiated thyroid cancer was 48.96 ng/L, AUC: 0.980, sensitivity was 96.98%, the specificity was 91.53%, 95%CI: 0.956-1.000 ( P<0.05) ; the best cut-off value of HDL-C for the diagnosis of differentiated thyroid cancer was 1.441 mmol/L, AUC: 0.0.691, the sensitivity was 85.10%, the specificity was 48.06%, 95%CI: 0.563-0.812 ( P<0.05) . The serum levels of TSH and IL-6 in patients with lymph node metastasis were significantly higher than those in patients without lymph node metastasis, and the level of HDL-C was significantly lower than those in patients without lymph node metastasis ( P<0.05) . TNM staging The serum levels of TSH and IL-6 in patients with stage III and IV were significantly higher than those in patients with stage I and II, and HDL-C was significantly lower than that in patients with stage I and II ( P<0.05) . Conclusions:Serum IL-6, TSH and HDL-C are closely related to the occurrence of differentiated thyroid cancer. The detection of serum IL-6, TSH and HDL-C is helpful for the differentiation of benign and malignant thyroid nodules. The presence or absence of lymph node metastasis in patients with differentiated thyroid cancer is related to TNM staging, and the detection value is high.

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 understand the current status of BMI of the elderly and related factors in longevity areas in China, and provide scientific evidence for the control of BMI level in elderly population. Methods: Data used in this study were obtained from Healthy Aging and Biomarkers Cohort Study, a sub-cohort of the Chinese Longitudinal Healthy Longevity Survey. A total of 2 825 elderly in 8 longevity areas in China were surveyed and measured in 2017. The BMI levels of 2 217 elderly aged 65 years and older were calculated and in follow up. The ordered classification logistic regression model was used to analyze the influencd factors for the BMI in the elderly. Results: The BMI of the elderly in 8 longevity areas in China was (22.36±3.87) kg/m², and it was (22.76±3.58) kg/m² for males and (21.75±3.98) kg/m² for females. The BMI levels were normal in 1 165 elderly persons. The prevalence of underweight, overweight and obesity were 15.8%, 24.0% and 7.7%, respectively. Multivariate analysis showed that the main factors affecting the BMI of people under 100- years old were age (65-: OR=2.78, 95%CI: 1.87-4.15; 80-: OR=1.47, 95%CI: 1.00-2.17), smoking status (OR=0.46, 95%CI: 0.32-0.66), annual household income (<30 000 Yuan: OR=1.26, 95%CI: 1.07-1.47; 30 000-70 000 Yuan: OR=1.52, 95%CI: 1.12-1.86), and frequency of tea intake(OR=1.36, 95%CI: 1.01-1.71), while the factor in people aged ≥100 years was gender (OR=3.68, 95%CI: 1.32-10.36). Conclusions The prevalence of underweight, overweight and obesity were high in the elderly from longevity areas in China. It is necessary to pay attention to the trend of overweight and obesity due to smoking, higher annual household income and regular tea drinking in the elderly men.

In recent years, the use of fluorescent contrast agents staining to guide surgery has flourished in various fields of surgery under the concept of precision surgery, which is helpful to guide surgery and provide surgeons with actual visible fluorescence imaging.Clinically, fluorescent contrast agent can be used to display tumor’s outline with high recognition degree, guide operation in real time, locate lymph node metastasis, detect small metastases, and identify important anatomical structures during the operation to avoid possible side-injury. Great progress has been made in the study of fluorescent contrast agents that can mediate surgery, including the study and surgical application development of classical fluorescent contrast agents such as indocyanine green and methylene blue, etc, as well as the discovery and clinical application of new targeted fluorescent contrast agents such as folate receptor targeting contrast agents, monoclonal antibody based fluorescent targeting contrast agents and intelligent contrast agents, etc. This paper will review the research and surgical application of fluorescent contrast agents in two aspects: classical fluorescent contrast agents and new targeted fluorescent contrast agents.

Objective To explore the correlation between the level of glucagon like peptide-1 (GLP-1) and the extent of coronary lesions in coronary heart disease (CHD).Methods One hundred and ninety-two CHD patients included in the study were divided into simple CHD group (n =60),CHD accompanied with impaired glucose tolerance(IGT) group (n =67),and CHD accompanied with type 2 diabetes mellitus (T2DM) group (n =65).48subjects were used as controls.The levels of GLP-1 in all the patients were analyzed by ELISA.Oral glucose tolerance test (OGTF) was performed.Blood glucose,insulin,and C-peptide levels were measured.The area under curves of insulin(AUCINS),C-peptide (AUCC-P),glucose (AUCGlu),and GLP-1 (AUCGLP-1) were calculated.All the patients underwent coronary angiography and the extent of coronary lesions was analyzed by total amount of coronary narrow degree integral.The association of GLP-1 level with coronary narrow degree was analyzed by correlation analysis and multivariate linear stepwise regression analysis.Results The levels of blood glucose and AUCGlu during OGTT in CHD accompanied with T2DM group were significantly higher than those in CHD with IGT group (P＜0.01),while the levels of insulin and C-peptide,AUCINS,and AUCC-P were decreased (P＜0.05).The levels of blood glucose,insulin,C-peptide,AUCGlu,AUCINs,and AUCC-P in CHD accompanied with IGT group were significantly higher than those in control group and simple CHD group (P＜0.01).Compared with simple CHD group and CHD accompanied with IGT group,GLP-1 level in CHD accompanied with T2DM group was markedly decreased(P＜0.01) while coronary artery narrow degree was raised(P＜ 0.05).Compared with simple CHD group,CHD accompanied with IGT group showed lower GLP-1 level and higher coronary artery narrow degree(P＜0.01).Correlation analysis revealed that GLP-1 level was negatively correlated with the coronary artery narrow degree in CHD patients (P ＜ 0.01).Multivariate linear regression analysis showed that systolic blood pressure,high density lipoprotein-cholesterol,fasting C-peptide and GLP-1 had a predictive effect on the coronary narrow degree integral in CHD patients.Conclusion The level of GLP-1 is closely correlated with the coronary artery narrow degree in CHD patients,especially in patients accompanied by hyperglycemia.

Objective To analyze the influence of liraglutide intervention combined percutanous coronary intervention(PCI) therapy on acute myocardial infarction( AMI) with type 2 diabetes( T2DM) patients'myocardial injury, ventricular remodeling( VR), and cardiac function. Methods Eighty patients with AMI and T2DM were included in the study, and they were randomly divided into observation group and control group according to the random number table, each with 40 patients. The patients in the control group received metformin and conventional insulin combined PCI treatment, and the patients in the observation group received metformin and liraglutide combined PCI treatment. The changes in the values of ventricular remodeling indexes, cardiac function and serum related indexes were compared after 3 months treatment between the two groups. Results ( 1) The body weight and fasting blood glucose levels of the observation group were significantly lower than those of the control group( P＜0.05), and fasting insulin levels were significantly higher than those of the control group(P＜0.01). (2)The levels of N-terminal-pro-B- type natriuretic peptide ( NT-proBNP ), creatine kinase isoenzymes-MB ( CK-MB), and troponin I ( TnI) in the observation group 3 months after treatment were significantly lower than those in the control group(P＜0.05). (3)The levels of serum hypersensitive C-reactive protein(hs-CRP), tumor necrosis factor-α(TNF-α), and interleukin-6(IL-6) in the observation group were significantly lower than those in the control group 3 months after treatment( P＜0. 05). ( 4) The values of left ventricular end systolic diameter ( LVESD ), left ventricular end diastolic diameter (LVEDD), interventricular septum thickness ( IVST), left ventricular posterior wall thickness ( LVPWT), left ventricular mass index ( LVMI), left ventricular end systolic volume ( LVESV), and left ventricular end diastolic volume(LVEDV) in the observation group were lower than those in the control group; the values of left ventricular fraction shortening(LVFS), left ventricular ejection fraction(LVEF), and mitral valve early diastolic blood flow rate (VE)/atrial systolic flow velocity ( VA), all were higher than those of the control group ( P＜0. 05). Conclusion Lraglutide intervention combined with PCI therapy on AMI with T2DM patients may reduce myocardial injury, induce ventricular remodeling, enhance cardiac function, and improve prognosis.