[Nomogram analysis of risk factors for diabetic neuropathy in primary type 2 diabetic mellitus patients in Zhejiang Province].

Objective: To investigate the risk factors of diabetic nephropathy (DN) in primary type 2 diabetes mellitus (T2DM) patients and to quantitatively analyze the risk of DN by nomogram modeling. Methods: A total of 1 588 primary T2DM patients from 17 townships and streets in Zhejiang Province were enrolled from June 2018 to August 2018 in this cross-sectional study, with an average age of (56.8±10.1) years (50.06% male) and a mean disease duration of 9 years. The clinical data, biochemical test results, and fundus photographs of all T2DM patients were collected, and logistic regression analysis was used to screen the risk factors of DN. Then, a nomogram model was used to quantitatively analyze the risk of DN. Results: DN occurred in 27.71% (440/1 588 cases) primary type 2 diabetes patients. Hemoglobin A1c (HbA1c) (OR=1.159, 95%CI 1.039-1.292), systolic blood pressure (OR=1.041, 95%CI 1.031-1.051), serum creatinine (Scr) (OR=1.011, 95%CI 1.004-1.017), serum globulin (GLOB) (OR=1.072, 95%CI 1.039-1.105), diabetic retinopathy (DR) (OR=1.463, 95%CI 1.073-1.996), education level of more than junior high school (OR=2.018, 95%CI 1.466-2.777), and moderate-intensity exercise (OR=0.751, 95%CI 0.586-0.961) were influencing factors of DN. Nomogram model analysis showed that the total score of each factor of DN ranged from 64-138 points, and the corresponding risk rate ranged from 0.1-0.9. The nomogram model also predicted a C-index value of 0.753 (95%CI 0.726-0.781) and an area under the receiver operating characteristic curve of DN of 0.753. Internal verification of the C-index reached 0.738. The model displayed medium predictive power and could be applied in clinical practice. Conclusions: HbA1c, systolic blood pressure, Scr, GLOB, DR, and more than a junior high school education are independent risk factors of DN. Nomogram modeling can more intuitively evaluate the risk of DN in primary T2DM patients.

Association of genetic variants in the Sirt1 and Nrf2 genes with the risk of metabolic syndrome in a Chinese Han population.

BACKGROUND: Metabolic syndrome (MetS) is a complex of interrelated risk factors, including central adiposity, increased blood pressure, hyperglycemia, elevated triglyceride levels and low high-density lipoprotein. Few studies have reported the genetic variants in the Sirt1 and Nrf2 genes (Sirt1 rs7895833 A > G, Sirt1 rs2273773 C > T and Nrf2 rs6721961 C > A) that increase the risk of type 2 diabetes mellitus and are correlated with some glycemic and metabolic traits in the Chinese Han population. METHODS: Our study recruited 141 individuals with MetS and 549 individuals without MetS to investigate the associations between three single nucleotide polymorphisms (SNPs) of Sirt1 and Nrf2 and the risk of MetS in a Chinese Han population using the PCR-CTPP method. RESULTS: This research showed that the risk of MetS was 2.41 times higher for the AA genotype (P = 0.038) and 1.94 times higher for the AG genotype (P = 0.016) compared with carriers of the GG genotype. The serum levels of low-density lipoprotein cholesterol and HOMA-IR were significantly higher (P < 0.05) in carriers of the AA genotype of Sirt1 rs7895833 than in carriers of the AG and GG genotypes in the general population. The serum level of total cholesterol in the AA genotype was lower (P = 0.033) than that in the other two genotypes. However, the genotype frequencies of Sirt1 rs2273773 and Nrf2 rs6721961 in the MetS group were not significantly different from those in the control subjects, and those two genetic variants were not correlated with metabolic traits. CONCLUSIONS: These results underscore the contributions of SNPs of Sirt1 rs7895833 to MetS susceptibility as well as glycemic and metabolic traits in a Chinese population.

[Clinical characteristics of "classical" and "non-classical" paraneoplastic neurological syndrome].

Objective: To explore the clinical features of classical and non-classical paraneoplastic neurological syndrome (PNS). Methods: From 2015 to 2020, 48 cases of definite PNS admitted to the First Affiliated Hospital of University of Science and Technology of China were retrospectively collected, and classification, clinical characteristics, onconeural antibodies and primary tumors were analyzed. The included cases were divided into classical and non-classical groups according to Graus criteria, and the differences of clinical characteristics, onconeural antibodies, combined tumors, time of diagnosis and mortality were compared between the two groups. Results: Among the 48 confirmed patients, 21 (43.8%) were positive for well-characterized onconeural antibodies. There were 28 cases (58.3%) and 20 cases (41.7%) in classic and non-classical PNS groups, respectively. No significant differences of age, sex, clinical involvement site, characteristic positive antibody type, tumor diagnosis rate and follow-up mortality were found between the two groups (all P>0.05). The time of diagnosis in the non-classical PNS group was 3.0 (2.0, 6.5) months, which was significantly longer than that in the classical PNS group 1.0(0.6, 3.0) months (P<0.05). Meanwhile, the combination rate of non-characteristic antibodies in the classical PNS group (10 cases, 35.7%) was significantly higher than that in the non-classical PNS group (1 case, 5.0%) (P=0.016). During the follow-up, 39 patients (81.3%) with tumor were confirmed, and 29 patients (60.4%) were diagnosed with PNS before the tumor was found. Conclusions: The"non-classical"PNSs are common in clinical settings. Diagnosis may be delayed due to the nonclassical symptoms of the patients. When patients have clinical symptoms related to PNS, onconeural antibodies should be detected and the relevant tumors should also be screened. Patients have positive antibodies but with no tumors should be closely followed up for more than 5 years.

Expression and characterization of the cyp19a gene and its responses to estradiol/letrozole exposure in Chinese soft-shelled turtle (Pelodiscus sinensis).

Cytochrome P450 aromatase (CYP19) catalyzes the conversion of androgens to estrogens and is critical in sex differentiation. CYP19 exists as the ovarian type and brain type. Herein, we cloned the full-length ovarian cyp19a gene from the Chinese soft-shelled turtle, Pelodiscus sinensis (pscyp19a). We determined the distribution of pscyp19a in adult tissue and evaluated its expression during embryonic development, following treatment with 17ß-estradiol (E2) or letrozole (LE). The pscyp19a complementary DNA is 2,285 bp in length and comprises a 1,512 bp open reading frame that encodes a protein of 503 AA. The nucleotide sequence and amino acid of pscyp19a shared significant identity with other vertebrate sequences. Expression of pscyp19a was high in the ovary (p < 0.01), and exhibited modest expression in the female brain and intestine. Expression of pscyp19a displayed significant differences between sexes during early embryo development stages; expression increased gradually during embryonic development in females, but the opposite trend was observed in males. Female embryos treated with different concentrations of E2 and LE displayed altered pscyp19a expression compared with untreated individuals, and E2 clearly induced pscyp19a expression. These results indicate that pscyp19a gene plays important roles in early developmental stages in Chinese soft-shelled turtle, and may assist future studies on sex differentiation and sex control in this and similar species.

[Clinical analysis of seven cases of myeloid sarcoma].

Objective: To investigate the clinical manifestations, pathological features, diagnosis and treatment of myeloid sarcoma, and to improve the understanding of myeloid sarcoma. Methods: The clinical data, diagnosis and treatment of 7 patients with myeloid sarcoma were retrospectively analyzed. Results: Of the 7 patients with myeloid sarcoma, 1 was male and 6 were female. In most patients, the local compression symptoms caused by painless local masses or masses were the first manifestations. One patient had lesions involving the cervix and vaginal bleeding was the first symptom. The lesions were extensive with 19 sites involved. The positive proportion of immunohistochemical staining was 6/6 for CD43, 6/7 for MPO, 4/5 for CD117, 4/4 for LCA, 3/5 for CD34 and 2/2 for CD99. Lymphocyte markers CD3 and CD20 were negative in all 7 patients. Conclusions: Myeloid sarcoma is a rare hematological malignancy. Early diagnosis and active treatment are the key to improve prognosis. Current treatments include systemic chemotherapy, surgical resection, radiation therapy, and hematopoietic stem cell transplantation.

An improved prognostic parameter for non-Hodgkin's lymphoma based on the combination of three serum tumor markers.

We aimed to evaluate the prognostic value of the combination of three serum tumor markers (LDH, beta2-M and CA 125) in patients with non-Hodgkin's lymphoma (NHL). Clinical and pathological variables including the levels of these markers were measured in 415 NHL patients. Statistical analysis showed that increased levels of all three markers were associated with stage, B symptoms, effusions, bone marrow involvement, and International Prognostic Index (IPI) in NHL patients (p<0.05). Overall survival and event-free survival rates were associated not only with LDH but also with beta2-M and CA125 (p<0.001). Response to treatment and overall survival rates were different in three groups with elevated LDH; in particular, the combination of three or two elevated markers seemed to identify a group of patients at higher risk of treatment failure and/or relapse than the group with a high LDH level only. Furthermore, multiple Cox regression analysis showed that IPI score complemented by the additional serum markers beta2-M and CA125 was a better prognosticator of overall and event-free survival than LDH alone. This result suggests that if the combination of three elevated serum tumor markers is included as a parameter in the IPI instead of LDH alone, the prognostic value of IPI can be improved.

[Observation on the clinical application effects of skin distractor on the treatment of scars].

Objective: To explore clinical application effects of skin distractor on the treatment of scars and to observe effects of skin distractor with different pull speeds on different parts scars of human body. Methods: One hundred and four patients with scars, conforming to the study criteria, were hospitalized in our unit from January 2014 to June 2015. Patients were divided into 2 mm/d group and 4 mm/d group according to the random number table, with 52 patients in each group. After admission, skin distractors were pasted on scars in face and neck, trunk, and extremities of patients in 2 groups, with inner edges of pasteboards close to outside edges of longer sides of scars. Skin distractors in 2 mm/d group and 4 mm/d group were pulled to scars axis direction as speeds of 2 mm/d and 4 mm/d, respectively. Pull time equals values of pull speeds divided by width of scars. Scars were resected after finishing pulling. Immediately after scars resection, skin distractors were pasted again with inner edges of pasteboards close to outside edges of longer sides of incision and removed when stitches were taken out. Scars of patients were scored by Vancouver Scar Scale (VSS), and Patient and Observer Scar Assessment Scale (POSAS) was used to record scores of patient scar assessment scale (PSAS), observer scar assessment scale (OSAS) and overall scores of patients and observers of scars of patients before and one year after scars resection. Data were processed with χ(2) test, independent samples t test, paired samples t test, independent samples non-parametric rank-sum test and paired samples non-parametric rank-sum test. Results: (1) Scores of all scars of patients in 2 groups before scars resection were close (with t values from -1.384 to 0.622, P values above 0.05), obviously higher than those of one year post scars resection (with t values from 11.085 to 24.835, P values below 0.01). Scores of scars in face and neck, trunk and extremities in 2 groups before scars resection were close (with Z values from -1.651 to -0.035, t values from -1.549 to 0.219, P values above 0.05), significantly higher than those of one year post scar resection (with Z values from -2.992 to -2.555, t values from 8.739 to 19.076, P values below 0.01). (2) Scores of all scars of patients in 2 mm/d group of one year post scars resection were lower than those in 4 mm/d group (with t values from -2.583 to -2.018, P values below 0.05). PSAS scores of scars in face and neck and trunk in 2 mm/d group of one year post scars resection were lower than those in 4 mm/d group (with Z values respectively -2.385 and -2.198, P values below 0.05), other scores of scars in face and neck and trunk of patients in 2 groups of one year post scars resection were close (with Z values from -1.841 to -0.363, P values above 0.05). VSS scores, PSAS scores, OSAS scores, patients' overall scores, and observers' overall scores in 2 mm/d groups were (4.6±0.8), (28±4), (28±4), (4.7±0.7), (4.8±1.4) points, respectively, lower than those in 4 mm/d group[(5.2±0.8), (32±4), (31±6), (5.5±1.2), (5.5±1.0) points, respectively, with t values from -3.712 to -2.105, P<0.05 or P<0.01]. Conclusions: Skin distractor has better effects on the treatment of scars, and treatment effects of skin distractor in extremities pulled by 2 mm/d are better than those pulled by 4 mm/d.

Selective laser sintering of biocompatible polymers for applications in tissue engineering.

The ability to use biological substitutes to repair or replace damaged tissues lead to the development of Tissue Engineering (TE), a field that is growing in scope and importance within biomedical engineering. Anchorage dependent cell types often rely on the use of temporary three-dimensional scaffolds to guide cell proliferation. Computer-controlled fabrication techniques such as Rapid Prototyping (RP) processes have been recognised to have an edge over conventional manual-based scaffold fabrication techniques due to their ability to create structures with complex macro- and micro-architectures. Despite the immense capabilities of RP fabrication for scaffold production, commercial available RP modelling materials are not biocompatible and are not suitable for direct use in the fabrication of scaffolds. Work is carried out with several biocompatible polymers such as Polyetheretherketone (PEEK), Poly(vinyl alcohol) (PVA), Polycaprolactone (PCL) and Poly(L-lactic acid) (PLLA) and a bioceramic namely, Hydroxyapatite (HA). The parameters of the selective laser sintering (SLS) process are optimised to cater to the processing of these materials. SLS-fabricated scaffold specimens are examined using a Scanning Electron Microscope (SEM). Results observed from the micrographs indicate the viability of them being used for building TE scaffolds and ascertain the capabilities of the SLS process for creating highly porous scaffolds for Tissue Engineering applications.

Visual enantiomeric recognition using chiral phenolphthalein derivatives.

[structure: see text] Optically active artificial host molecules 2-5 based on a phenolphthalein skeleton have been prepared for visual enantiomeric recognition of alanine derivatives 8 and 9. The receptor 3 discriminates (R)-8 and (R)-9 from (S)-8 and (S)-9, respectively, to develop a purple color.

[Analysis of prognostic factors of Hodgkin's disease with Cox model].

The authors presented the application of the Cox proportional hazards stepwise regression procedure in prognostic factor analysis of Hodgkin's disease. The data of 233 patients in our hospital from 1966 to 1989 were collected. There were 19 Variates used for univariate and multivariate analysis. The result showed that seven variates were important prognostic factors of Hodgkin's disease, namely; short-term effect, doses of treatment, pathological type, short breath, elevated ESR, clinical stage and lymph node enlargement. Among them, the probability of achieving complete remission (CR) after initial treatment is a favorable prognostic factor. Moreover, the rate of CR is consistently associated with clinical stage doses etc. It is important to make great efforts to avoid misdiagnosis. Early diagnosis and sufficient doses of medication are the crucial points for prolonged Survival.

Diffraction halo function of partially coherent speckle photography.

We studied the diffraction halo function of partially coherent speckle photography, using the theory of partial coherence of light and speckle statistics. Numerical calculations were made on the basis of the derived expression. It was shown that the anisotropic coherence of the illumination induced by the source could lead to the inhomogeneity of the halo distribution. An experiment was performed to prove the theoretical predictions.