ObjectiveThis study aims to observe the clinical effect of Danggui Liuhuang Tang （DGLHT） on patients with type 2 diabetes mellitus （T2DM） complicated by atherosclerotic cardiovascular disease （ASCVD） at high risk， focus on evaluating the influence of DGLHT on cardiovascular risk indicators such as flow-mediated dilation （FMD）， atherogenic index of plasma （AIP）， and triglyceride-glucose index （TyG）， and explore the regulatory effect of DGLHT on the myeloid differentiation factor 88/nuclear factor-kappa B （MyD88/NF-κB） signaling pathway. MethodsThe clinical study was a single-center， double-blind， and randomized controlled trial. A total of 68 patients with T2DM-ASCVD at high risk for cardiovascular events with Yin deficiency and fire excess syndrome were enrolled and randomly assigned to a treatment group and a control group. The treatment group was given atorvastatin calcium tablets and DGLHT， while the control group was given atorvastatin calcium tablets and placebos. The treatment course was 12 weeks， with a final study completion of 30 patients in the treatment group and 29 in the control group. Changes in cardiovascular risk indicators such as FMD， AIP， TyG， and small dense low-density lipoprotein cholesterol （sdLDL-C） index were compared. Human umbilical vein endothelial cells （HUVECs） were used to establish a vascular endothelial injury and inflammation model. The protective effect of DGLHT on endothelial injury was verified by reverse transcription polymerase chain reaction （Real-time PCR） and Western blot . ResultsAfter 12 weeks of treatment， the AIP in the treatment group significantly decreased compared with that before the treatment （P<0.05）. Compared with the control group， the treatment group showed significant improvements in FMD and TyG （P<0.05）. Additionally， the treatment group demonstrated significant reductions in two-hour postprandial glucose （2 hPG）， glycated albumin （GA）， triglycerides （TG）， apolipoprotein E （Apo E）， and sdLDL-C （P<0.05）. Analysis of traditional Chinese medicine （TCM） syndrome efficacy indicated that in the treatment group， Yin deficiency and fire excess syndromes， including dry throat and mouth （P<0.05）， excessive thirst （P<0.01）， tidal fever and night sweats （P<0.05）， and dry stools （P<0.05）， improved. Compared with the control group， the treatment group showed significant improvements in symptoms of dry throat and mouth （P<0.05） and excessive thirst （P<0.01）. TCM syndrome scores significantly decreased （P<0.01）， and the overall efficacy rate was 56.67%， significantly higher than the 10.34% observed in the control group （P<0.01）. At the cellular level， increasing concentrations of DGLHT led to decreased messenger ribonucleic acid （mRNA） levels of pro-inflammatory cytokines interleukin-6 （IL-6）， tumor necrosis factor-alpha （TNF-α）， and interleukin-1-beta （IL-1β） in lipopolysaccharide （LPS）-stimulated HUVECs （P<0.01）， with significant reductions in the high-concentration group （P<0.01）. DGLHT may inhibit the expressions of MyD88 and phosphorylated （p）-NF-κB p65 proteins in a concentration-dependent manner. ConclusionDGLHT shows significant effects in reducing cardiovascular risks and may exert an anti-inflammatory effect by inhibiting the MyD88/NF-κB signaling pathway. This finding provides a new perspective for the prevention and treatment of cardiovascular diseases in high-risk individuals with T2DM-ASCVD.

Objective To observe the application effect of a quantitative nursing management program in the operating room constructed based on risk assessment strategies for patients with osteochondroma. Methods Thirty patients who underwent osteochondroma surgery from July 2021 to June 2022 at Suqian Hospital Affiliated to Xuzhou Medical University were set as control group (receiving conventional nursing management), and 30 patients who underwent osteochondroma surgery from July 2022 to June 2023 were set as study group (receiving quantitative nursing management centered on risk assessment strategies). The perioperative indicators, psychological stress status, self-care ability, quality of life, and complication occurrence were compared between the two groups. Results The recovery time of gastrointestinal function, postoperative anal exhaust time, and hospital stay in the study group were (0.72±0.12), (1.71±0.32), and (21.32±3.47) days, respectively, which were shorter than (1.04±0.28), (2.02±0.42), and (28.02±4.02) days in the control group (P < 0.05). After nursing, the scores of the Self-rating Depression Scale and Self-rating Anxiety Scale in the study group were (36.87±5.64) and (32.42±6.82), respectively, which were lower than those (45.24±6.32) and (48.33±6.56) in the control group (P < 0.05). After nursing, the total scores of the Exercise of Self-Care Agency Scale (ESCA) and SF-36 Scale in the study group were (142.87±15.62) and (86.42±7.28), respectively, which were higher than (125.42±16.32) and (78.33±8.56) in the control group (P < 0.05). The total complication rate in the study group was 6.67%, which was lower than 26.67% in the control group (P < 0.05). Conclusion The quantitative nursing management program in the operating room constructed centered on risk assessment strategies can effectively improve the postoperative recovery effect of patients with osteochondroma, relieve psychological stress responses, enhance self-care ability and quality of life, and reduce the occurrence of complications.

BACKGROUND: The clinical importance of hypokalemia is likely underrecognized in Chinese dialysis patients, and whether its clinical effect was mediated by serum albumin is not fully elucidated. This study aimed to explore the association between serum potassium and mortality in dialysis patients of a Chinese nationwide multicenter cohort, taking albumin as a consideration. METHODS: This was a prospective nation-wide multicenter cohort study. Restricted cubic splines were used to test the linearity of serum potassium and relationships with all-cause (AC) and cardiovascular (CV) mortality and a subsequent two-line piecewise linear model was fitted to approach the nadir. A mediation analysis was performed to examine relations of albumin to potassium and mortalities. RESULTS: A total of 10,027 patients were included, of whom 6605 were peritoneal dialysis and 3422 were hemodialysis patients. In the overall population, the mean age was 51.7 ± 14.8 years, 55.3%(5546/10,027) were male, and the median dialysis vintage was 13.60 (4.70, 39.70) months. Baseline serum potassium was 4.30 ± 0.88 mmol/L. After a median follow-up period of 26.87 (14.77, 41.50) months, a U-shape was found between potassium and mortality, and a marked increase in risk at lower potassium but a moderate elevation in risk at higher potassium were observed. The nadir for AC mortality risk was estimated from piecewise linear models to be a potassium concentration of 4.0 mmol/L. Interestingly, the significance of the association between potassium and mortality was attenuated when albumin was introduced into the extended adjusted model. A subsequent significant mediation by albumin for potassium and AC and CV mortalities were found ( P < 0.001 for both), indicating that hypokalemia led to higher mortality mediated by low serum albumin, which was a surrogate of poor nutritional status and inflammation. CONCLUSIONS Associations between potassium and mortalities were U-shaped in the overall population. The nadir for AC mortality risk was at a potassium of 4.0 mmol/L. Serum albumin mediated the association between potassium and AC and CV mortalities.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; East Asian People ; Hypokalemia/etiology* ; Kidney Failure, Chronic/mortality* ; Potassium/blood* ; Prospective Studies ; Renal Dialysis ; Serum Albumin/analysis*

Objective To study the antifungal activity of a new series of triazole compounds with n-propyl side chain and disubstituted benzyl structure. Methods Eleven target compounds were designed and synthesized. The structures were confirmed by ¹H NMR, and some compounds were confirmed by ¹³C NMR or HRMS. Three fungal strains were selected as experimental strains, and the antifungal activity was tested in vitro according to the standardized antifungal sensitivity test method recommended by National Committee for Clinical Laboratory Standards (NCCLS). Results Compound B11 showed better activity against candida albicans SC5314 than fluconazole and was comparable to posaconazole; Compounds B10, B11 and B4 showed better activity against cryptococcus neoformanis H99 than fluconazole, while compounds B2, B3, B5, B6 and B7 showed similar activity to fluconazole against cryptococcus neoformanis H99; while all compounds showed poor activity against aspergillus fumigatus. Conclusion Some of the target compounds with n-propyl side chain and disubstituted benzyl group structure had certain antifungal activity and could be identified as potential lead antifungal drugs.

Objective:To investigate the relationship between histone deacetylase (HDAC) gene polymorphism and type 2 diabetes mellitus (T2DM) in Bai and Han populations in Dali of Yunnan province.Methods:A total of 148 patients with T2DM of Bai and Han nationalities who received treatment in Dali Bai Autonomous Prefecture People's Hospital from May 2019 to March 2021 were included in the T2DM group. An additional 100 healthy controls of Bai and Han nationalities who concurrently received physical examination in the same hospital from May 2019 to December 2020 were included in the normal control group. The susceptibility genes of T2DM were detected using the Taqman MGB probe method. The susceptibility gene loci were amplified using polymerase chain reaction. The whole sequence of susceptibility gene was sequenced.Results:There were no significant differences in the distribution frequencies of rs2530223 genotype, rs11741808 genotype, rs2547547 genotype, and rs1741981 genotype between Bai and Han populations (all P > 0.05). There was a significant difference in blood lipid level between four loci ( t = -1.06, -0.19, 0.39, -2.12, -2.04, 0.16, 1.47, < 0.01, -0.16, -3.17, -2.93, 0.69, -2.58, -2.33, all P < 0.05). There was a significant difference in homeostasis model assessment of insulin resistance between different states (all P < 0.05). The frequency distributions of each genotype and each allele did not differ significantly between healthy control people of Bai nationality and T2DM patients of Bai nationality and between healthy control people of Han nationality and T2DM patients of Han nationality (all P > 0.05). Logistic regression analysis showed that the polymorphism was not an independent risk factor for T2DM. Conclusion:The relationships between HDAC gene polymorphism and T2DM, obesity and dyslipidemia differ between Bai and Han populations.

Objective:To investigate the level of serum adiponectin (APN), high mobility group box 1 (HMGB1) and insulin resistance in patients with acute cerebral infarction complicated by myocardial infarction, and try to investigate the correlation between them.Methods:From January 2016 to June 2019, 448 patients who diagnosed as acute cerebral infarction in Haiyang People's Hospital were selected.The patients were divided into myocardial infarction(MI) group (36 cases) and non-MI group (412 cases) based on whether they complicated with MI.And 50 healthy people were selected as healthy control group.Fasting venous blood was collected from all subjects, and the adiponectin, HMGB1, coagulation indicators, inflammatory indicators, myocardial infarction markers and insulin resistance were measured.Results:The markers of myocardial infarction (CK-MB, cTnⅠ, Mb), coagulation indicators (APTT, PT, AT-Ⅲ, ACT), inflammatory levels (HMGB1, APN, CRP, IL-6)and insulin resistance related indicators (FPG, FINS, HOMA-IR, ISI)in patients with MI were different from patients with non-MI [CK-MB: (25.33±4.61)μg/L vs.(21.85±4.73)μg/L, t=6.028, P<0.001; cTnⅠ: (7.96±0.98)μg/L vs.(4.89±1.05)μg/L, t=24.135, P<0.001; Mb: (91.07±15.21)g/L vs.(147.53±16.04)g/L, t=28.981, P<0.001; APTT: (34.02±6.12)s vs.(37.21±6.31)s, t=4.144, P=0.005; PT: (14.32±1.21)s vs.(12.94±1.37)s, t=8.390, P<0.001; AT-Ⅲ: (144.62±18.35)s vs.(167.53±20.04)s, t=9.382, P<0.001; ACT: (135.84±15.21)s vs.(145.06±16.02)s, t=4.711, P<0.001; HMGB1: (25.61±3.84)μg/mL vs.(19.27±4.21)μg/mL, t=12.456, P<0.001; APN: (6.03±0.78)mg/L vs.(9.16±0.97)mg/L, t=26.995, P<0.001; CRP: (46.12±2.87)mg/L vs.(39.36±3.21)mg/L, t=17.608, P<0.001; IL-6: (8.76±1.42)mg/L vs.(5.04±1.22)mg/L, t=25.238, P<0.001; FPG: (6.27±0.98)mmol/L vs.(5.62±1.05)mmol/L, t=5.106, P<0.001; FINS: (24.07±4.25)mIU/L vs.(15.84±4.46)mIU/L, t=15.235, P<0.001; HOMA-IR: (6.68±0.68)vs.(3.96±0.84), t=27.217, P<0.001; ISI: (-5.03±0.84)vs.(-4.57±0.97), t=3.963, P<0.001] and the healthy controls [CK-MB: (25.33±4.61)μg/L vs.(20.04±4.52)μg/L, t=7.280, P<0.001; cTnⅠ: (7.96±0.98)μg/L vs.(4.04±0.95)μg/L, t=24.482, P<0.001; Mb: (91.07±15.21)g/L vs.(194.23±14.79)g/L, t=42.067, P<0.001; APTT: (34.02±6.12)s vs.(40.89±6.02)s, t=7.090, P<0.001; PT: (14.32±1.21)s vs.(10.94±1.15)s, t=16.326, P<0.001; AT-Ⅲ: (144.62±18.35)s vs.(225.31±19.64)s, t=26.249, P<0.001; ACT: (135.84±15.21)s vs.(161.32±15.77)s, t=10.342, P<0.001; HMGB1: (25.61±3.84)μg/mL vs.(6.72±3.78)μg/mL, t=29.484, P<0.001; APN: (6.03±0.78)mg/L vs.(12.54±0.82)mg/L, t=44.604, P<0.001; CRP: (46.12±2.87)mg/L vs.(7.64±2.52)mg/L, t=79.626, P<0.001; IL-6: (8.76±1.42)mg/L vs.(2.22±1.29)mg/L, t=35.249, P<0.001; FPG: (6.27±0.98)mmol/L vs.(5.15±0.96)mmol/L, t=6.989, P<0.001; FINS: (24.07±4.25)mIU/L vs.(10.64±3.96)mIU/L, t=19.751, P<0.001; HOMA-IR: (6.68±0.68)vs.(2.44±0.66), t=33.705, P<0.001; ISI: (-5.03±0.84)vs.(-3.94±0.79), t=7.460, P<0.001]. The incidence of acute cerebral infarction complicated with myocardial infarction was negatively correlated with APN and AT-Ⅲ(APN: r=-0.405, P=0.001; AT-Ⅲ: r=-0.554, P<0.001), and positively correlated with HMGB1 and HOMA-IR(HMGB1: r=0.624, P=0.005; HOMA-IR: r=0.667, P<0.001). Conclusion:There is a significant negative correlation between the occurrence of acute cerebral infarction complicated with MI and the level of APN, and positive correlations between HMGB1 and insulin resistance.

Objective:To understand the 10-year risk of ischemic cardiovascular disease (ICVD) in hypertensive patients in communities in Shenzhen, and to provide baseline data for the comprehensive implementation of community-based hypertension health management measures based on ICVD risk assessment.Methods:From July 2017 to June 2018, 200 community health service centers in 10 districts of Shenzhen were selected by multi-stage random sampling to investigate hypertensive patients in communities aged≥35. After the patients who met the inclusion criteria signed the informed consent form, the demographic characteristics, physical examination, and laboratory tests were conducted. The absolute risk of ICVD in 10 years was evaluated by using the ICVD risk assessment module from the Shenzhen community health service information system. According to the China 10-year risk for ICVD score tables, recommended by the Chinese cardiovascular disease prevention guidelines, the risk grade of ICVD was estimated and analyzed. In addition, the relative risk was used to eliminate the influence of gender and age, and the single sample t-test was used for comparisons with the larger population. Results:30 015 hypertensive patients from communities were investigated, including 16 165 (53.86%) males and 13 850 (46.14%) females, aged 35-102 years, with a median age of 59.0. 6 405 (21.34%), 5 771 (19.23%) and 17 839 (59.43%) were at high, medium and low risk of ICVD, respectively. The absolute risk was 3.77%, 95% CI (3.72%-3.82%). The risk grades of ICVD in 10 years was different as per gender, age, marital status, population type， smoking, family history of hypertension, history of diabetes mellitus, systolic blood pressure, body mass index, and total cholesterol level, P values were all<0.001. The risk grades of ICVD in males, married patients, floating populations, having a total cholesterol <5.20 mmol/L, non-smokers, non-diabetics, and having a family history of hypertension were lower than that of other characteristics, and increased with age, systolic blood pressure, and body mass index. Further analysis of 15 652 patients aged 35-59 years old showed that the 10-year risk of ICVD in patients with hypertension in communities was slightly higher than that of the larger population, and the relative risk was 1.27, 95% CI (1.25-1.28), t=37.648, P<0.001. In males, relative risk was 0.94, 95% CI (0.93-0.95), t= 9.906, P<0.001, and there were no significant trend changes among age groups. In females, relative risk was 2.05, 95% CI (2.01-2.09), t=72.207, P<0.001, and increased with age. Conclusion:The 10-year risk of ICVD in hypertensive patients is often at a high level in Shenzhen, so it is necessary to carry out the risk assessment of ICVD in the community. The effect of community hypertension health management on reducing the risk of ICVD may vary between genders. The risk of ICVD in male patients is lower than that of males in the larger population, but in female patients it is still much higher.

Four cases of Pentalogy of Cantrell were diagnosed by prenatal ultrasonography and confirmed by autopsy after labor induction.There were 1 case of complete Pentalogy of Cantrell and 3 cases of incomplete Pentalogy.In 3 cases of incomplete Pentalogy of Cantrell,1 case presented with high umbilical cord prolapse,extraspectoral heart,partial defect of the lower part of the sternum,partial defect of the pericardium,single umbilical artery and cervical lymphatic cyst;1 case presented with high umbilical cord prolapse,extraspectoral heart,thoracic fissure and ventricular septal defect;and 1 case presented with umbilical cord,extraspectoral heart,partial inferior sternal segment defect,ventricular septal defect and bilateral clubfoot varus.In l case of complete Pentalogy of Cantrell,there were high umbilical cord bulge,extraspectoral heart,chest fissure and inferior segment defect,anterior diaphragm and pericardium defect,total forebrain deformity,right 12th ribs loss and ventricular septal defect.Ectopic heart and omphalocele are typical echographic features of Pentalogy of Cantrel and prenatal ultrasonography is of important value in early diagnosis of this congenital malformation.

OBJECTIVETo analyze the characteristics of germline mutations of adenomatous polyposis coli (APC) gene in pedigrees affected with familial adenomatous polyposis (FAP).

METHODSGenomic DNA was extracted from peripheral blood samples from members of the 13 FAP pedigrees. Multiplex ligation-dependent probe amplification (MLPA) was used to detect large fragment deletions of the APC gene. Subsequently, potential mutation was screened from all exons of the APC gene with PCR amplification and direct sequencing.

RESULTSGermline mutations have been identified in 5 FAP pedigrees, which included c.3184_3187delCAAA, c.5432C>T, c.3925_3928delAAAA and c.3925_3929del AAAAG(in two pedigrees). Small deletional mutations were found primarily in the area of AAAAG tandem repeat sequences.

CONCLUSIONC.3925_3929 located in AAAAG tandem repeats is probably the hot spot for APC gene mutations, which are mostly deletional mutations, especially the 5 bp base deletion at codon 1309.

Adenomatous Polyposis Coli ; genetics ; Adenomatous Polyposis Coli Protein ; genetics ; Adult ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; Female ; Humans ; Male ; Molecular Sequence Data ; Pedigree ; Sequence Deletion

Objective To discuss clinical efficacy of shuxuetong in treatment of pulmonary fibrosis. Methods Selected 60 cases with pulmonary fibrosis and they were divided into control group of 30 cases treated by prednisone and study group of 30 cases treated by shuxuetong based on treatment of prednisone. Lung function, arterial blood gas and lung CT were compared. Results The efficiency of study group was higher than control group (P<0.01). FEV1 of study group after treatment was higher than before treatment, and was higher than control group after treatment(P all<0.05). PaO2 of study group after treatment improved apparently, and was higher than control group (P<0.05). Conclusion Clinical effi-cacy and lung function of mild, moderate pulmonary fibrosis patients are improved with treatment of shuxuetong based on prednisone.