Objective: To examine the relationship between self-management behaviors and time perspective among patients with comorbid diabetes, so as to provide the evidence for improving self-management behaviors among patients with comorbid diabetes. Methods: The patients with comorbid diabetes who were registered in the chronic disease health management system of Minhang District, Shanghai Municipality in 2021, followed up regularly, and lived in Meilong Town were recruited. Demographic information and family history of diabetes were collected through questionnaire surveys. Time perspective and self-management behaviors were assessed using the Zimbardo Time Perspective Inventory and Diabetes Self-Management Behavior Scale, respectively. The relationship between self-management behaviors and time perspective was analyzed using a multivariable ordinal logistic regression model. Results: A total of 907 patients with comorbid diabetes were enrolled, including 472 males (52.04%) and 435 females (47.96%). There were 652 cases aged 65 years and above, accounting for 71.89%. In terms of the types of time perspective, 280 patients were future-oriented (30.87%), 236 were balanced (26.02%), 162 were sensation-seeking (17.86%), 123 were fatalistic (13.56%), and 106 were negative (11.69%). In terms of the self-management behaviors, 46 patients were good (5.07%), 643 were moderate (70.89%), and 218 were poor (24.04%). Multivariable ordinal logistic regression analysis showed that after adjusting for age, gender, educational level, marital status, occupation status, monthly income, and family history of diabetes, the patients with comorbid diabetes who had a future-oriented time perspective had better self-management behaviors (OR=1.874, 95%CI: 1.204-2.915). Conclusion The self-management behaviors among patients with comorbid diabetes are moderate to poor, and patients with a future-oriented time perspective can better engage in self-management behaviors.

Acute lung injury （ALI） refers to the rapid onset of dyspnea, hypoxemia, and diffuse alveolar damage induced by various direct and indirect injurious factors, representing one of the clinically common diseases with a high mortality rate. However, there is currently a lack of specific therapeutic interventions targeting their underlying pathological mechanisms. Western medical treatment primarily relies on supportive care, and the existing pharmacological agents for ALI are predominantly corticosteroids, which, while efficacious, often accompany severe adverse effects. Recent research has revealed that numerous active components in Traditional Chinese Medicine （TCM） exhibit remarkable efficacy in the prevention and treatment of ALI, providing new insights into the therapeutic approaches for ALI. In this article, the pathological mechanisms of ALI and the roles and mechanisms of active components from TCM in the prevention and treatment of ALI were reviewed, aiming to provide a theoretical basis for the development of new drugs for the prevention and treatment of ALI.

Objective: To investigate the trajectories of fasting blood glucose fluctuations and their influencing factors among patients with comorbidity of type 2 diabetes mellitus (T2DM), so as to provide the basis for strengthening blood glucose management in this population. Methods: In October 2023, data of patients diagnosed with comorbid T2DM from January to October 2021, including demographic information, lifestyle, health status and fasting blood glucose were collected through the chronic disease health management system of Minhang District, Shanghai Municipality. Fasting blood glucose fluctuation trajectories were analyzed by group-based trajectory model established based on fasting blood glucose values from January 2021 to October 2023. Influencing factors of fasting blood glucose fluctuation trajectories among patients with comorbidity of T2DM were analyzed using a multinomial logistic regression model. Results: A total of 907 patients with comorbidity of T2DM were enrolled, including 472 males (52.04%) and 435 females (47.96%). There were 652 cases aged ≥65 years, accounting for 71.89%. The group-based trajectory model analysis identified three trajectory groups: a low-level stable group (492 cases, 54.24%), a medium-level stable group (287 cases, 31.64%), and a high-level decreasing group (128 cases, 14.11%). Multinomial logistic regression analysis showed that, compared with the low-level stable group, patients with comorbidity of T2DM who had an education level of junior high school or below (OR=1.420, 95%CI: 1.011-1.995) or college degree or above (OR=2.109, 95%CI: 1.249-3.560), as well as those who engaged in regular exercise (OR=1.387, 95%CI: 1.017-1.893), were more likely to be in the medium-level stable group. Patients with comorbidity of T2DM who were overweight or obese (OR=1.675, 95%CI: 1.116-2.513) or had dyslipidemia (OR=3.195, 95%CI: 1.642-6.216) were more likely to be in the high-level decreasing group. Conclusions From January 2021 to October 2023, the fasting blood glucose levels of patients with comorbidity of T2DM exhibited three fluctuating trajectories: low-level stability, medium-level stability, and high-level decline. Compared with the low-level stable group, the medium-level stable group was mainly influenced by educational level and regular exercise. The high-level decline group was primarily affected by overweight/obesity and dyslipidemia.

Objective: To explore the association between waist circumference and beverage consumption behaviors among junior high school students, so as to provide a theoretical basis for improving their nutritional status. Methods: Using a multi stage cluster random sampling method, 1 611 junior high school students aged 13-15 years from Yushan, Yanshan, Yiyang, and Wannian counties in Shangrao City, Jiangxi Province, were selected for a survey in September 2021 through questionnaires and waist circumference measurements. Stratified analyses were conducted by sex, t-test and analysis of variance (ANOVA) were used to compare waist circumference across groups, and analysis of covariance (ANCOVA) was applied to examine the associations between different types of beverage consumption and waist circumference. Results: Boarding students had significantly greater average waist circumference than day students[boys:(71.86±9.24, 69.69±12.19)cm；girls:(66.53±13.30, 64.63±11.90)cm； t =2.69, 2.08, both P < 0.05 ]. Among boys, waist circumference differed significantly by vigorous physical[vigorous physical:(69.71±9.53)cm; non vigorous exercise:(71.53±12.99)cm]( t=-2.31, P <0.05). Boys waist circumference also differed significantly by consumption frequency (high and medium,low,none) of milk containing beverages[(71.83±7.40, 69.92±9.98, 72.29±13.90)cm], functional beverages[( 73.36± 11.87, 65.97±10.46, 70.71±10.55)cm] and purified water beverages[(69.36±10.87, 71.93±12.15, 71.50±10.09)cm]( F =4.06, 5.93, 4.85, all P <0.05). Girls waist circumference also differed significantly by consumption frequency (high and medium,low,none) of milk containing beverages[(68.81±5.55, 66.59±13.02, 65.36±11.69)cm, F=9.67, P <0.01]. After controlling for the confounding variables, ANCOVA results indicated that the consumption of milk containing beverages, functional beverages and Purified water beverages were significantly associated with waist circumference of boys ( F =3.79, 5.26, 5.08, all P < 0.05 ). Milk containing beverages were significantly associated with waist circumference of girls ( F=4.17, P <0.05). Conclusion The consumption frequency of milk containing beverages and functional beverages by junior high school students is positively correlated with their waist circumference.

Pathological vascular remodeling is a hallmark of various vascular diseases. Previous research has established the significance of andrographolide in maintaining gastric vascular homeostasis and its pivotal role in modulating endothelial barrier dysfunction, which leads to pathological vascular remodeling. Potassium dehydroandrographolide succinate (PDA), a derivative of andrographolide, has been clinically utilized in the treatment of inflammatory diseases precipitated by viral infections. This study investigates the potential of PDA in regulating pathological vascular remodeling. The effect of PDA on vascular remodeling was assessed through the complete ligation of the carotid artery in C57BL/6 mice. Experimental approaches, including rat aortic primary smooth muscle cell culture, flow cytometry, bromodeoxyuridine (BrdU) incorporation assay, Boyden chamber cell migration assay, spheroid sprouting assay, and Matrigel-based tube formation assay, were employed to evaluate the influence of PDA on the proliferation and motility of smooth muscle cells (SMCs). Molecular docking simulations and co-immunoprecipitation assays were conducted to examine protein interactions. The results revealed that PDA exacerbates vascular injury-induced pathological remodeling, as evidenced by enhanced neointima formation. PDA treatment significantly increased the proliferation and migration of SMCs. Further mechanistic studies disclosed that PDA upregulated myeloid differentiation factor 88 (MyD88) expression in SMCs and interacted with T-cadherin (CDH13). This interaction augmented proliferation, migration, and extracellular matrix deposition, culminating in pathological vascular remodeling. Our findings underscore the critical role of PDA in the regulation of pathological vascular remodeling, mediated through the MyD88/CDH13 signaling pathway.
Mice ; Rats ; Animals ; Myeloid Differentiation Factor 88/metabolism* ; Vascular Remodeling ; Cell Proliferation ; Vascular System Injuries/pathology* ; Carotid Artery Injuries/pathology* ; Molecular Docking Simulation ; Muscle, Smooth, Vascular ; Cell Movement ; Mice, Inbred C57BL ; Signal Transduction ; Succinates/pharmacology* ; Potassium/pharmacology* ; Cells, Cultured ; Diterpenes ; Cadherins

Objective To analyze the structure of CD36,search the possible B cell epitopes and prepare multi-antigen peptides(MAP)with B cell epitopes,so as to provide a preliminary experimental basis for the preparation of CD36 antibod-ies using MAP with B cell epitopes.Methods The potential B cell epitopes of CD36 were analyzed by bioinformatics meth-ods,including physical and chemical properties,secondary structure,potential phosphorylation and glycosylation sites.Eight-branch MAP with CD36 B cell epitopes were synthesized by FMOC using polylysine as the core matrix.The purity of MAPs was analyzed by reverse high-performance liquid chromatography chromatography(RP-HPLC),and the molecular weight of MAPs was determined by mass spectrometry.Results CD36 is a stable and hydrophilic alkaline protein,with multiple phosphorylation and glycosylation sites and strong antigenicity,and its secondary structure is mainly characterized by irregular curls.Four potential B cell epitopes were obtained and 4 MAPs containing potential B cell epitopes were pre-pared.RP-HPLC analysis showed that the purity of the MAPs were above 85%,and the molecular weight of 3 MAPs was consistent with the expected theoretical molecular weight.Conclusion CD36 on platelet has strong antigenicity.MAPs con-taining CD36 B cell epitopes can provide the experimental basis for the preparation and related research of CD36 antibodies.

Objective To design an enhanced postoperative recovery checklist for the patients who had surgery for laryngeal cancer,hence to instruct the patient with a standard procedure in rehabilitation.Methods A total of 72 patients who had surgery for laryngeal cancer in our department from April 2020 and April 2021 were enrolled as study subjects for a controlled study before and after surgery of different patients.A total of 37 patients who had surgery between April and September 2020 were assigned in the control group,while another 37 patients who had the surgery between October 2020 and April 2021 were assigned in the trial group.Patients in the control group were managed with a routine enhanced perioperative recovery plan,and those in the trial group were managed with the checklist,which was drafted by modification and improvement of the routine enhanced perioperative recovery plan through literature reviews and expert consultations.The two groups were compared in terms of the standardised rate of enhanced recovery compliance,medical staff satisfaction,average hospital-stay and patient satisfaction.Results The trial group showed significant improvement in comparison with the control group in terms of the standardised rate of enhanced recovery compliance(93.28%versus 84.08%),score of satisfaction level[(95.57±2.25)versus(92.60±2.49)],score of doctor satisfaction[(35.75±0.89)versus(32.88±1.50)],and the score of nurse satisfaction[(35.45±1.10)versus(33.00±1.30)](all P<0.05).The average hospital-stay in the trial group was significantly shorter than that in the control group[(9.89±3.32)days versus(12.60±4.33)days](P<0.05).Conclusion The designed checklist can improve the standardised rate of enhanced recovery compliance,the satisfaction of both medical staff and patients and facilitate the recovery of patient.

OBJECTIVE To explore the protective mechanism of amifostine on acute radiation injury mice. METHODS Thirty C57BL/6J mice were randomly divided into normal control group， model group and amifostine group （150 mg/kg）， with 10 mice in each group. Thirty minutes before irradiation， the mice in the amifostine group were intraperitoneally injected with amifostine； normal control group and model group were given constant volume of normal saline intraperitoneally； then acute radiation injury was induced by 4 Gy X-ray radiation in both model group and amifostine group. The white blood cell count （WBC）， platelet count and red blood cell （RBC） count in mice were detected 2 hours before irradiation and on days 1， 4， 7， 10 and 14 after irradiation； the changes in the proportion of WBC （neutrophils， lymphocytes and monocytes） on the 7th day after irradiation were analyzed. The 16S rRNA high-throughput sequencing was used to analyze the structure of gut microbiota in mice feces on the 7th day after irradiation， then its correlation with WBC was analyzed. RESULTS The counts of WBC on the 1st， 4th， 7th and 10th day after irradiation， platelet count on the 10th day after irradiation and RBC count on the 1st day after irradiation in the amifostine group were significantly higher than those in model group （P＜0.05）. Compared with normal control group，β diversity of gut microbiome showed significant change， relative abundance of Firmicutes increased and that of Bacteroidetes decreased in model group. Amifostine could reverse the change in β diversity of gut microbiome， and the relative abundance of Bacteroidetes and Firmicutes. The model group consisted of four distinct species， namely Allobaculum， Erysipelotrichia， Erysipelotrichales and Erysipelotrichaceae， which were significantly negatively correlated with the proportion of peripheral blood lymphocytes （P＜0.01）； amifostine group consisted of two distinct species， namely Lactobacillus murinus and L. crispatus， which were significantly negatively correlated with the proportion of neutrophils （P＜0.05）. CONCLUSIONS Amifostine significantly improves irradiation-induced injury by regulating dysbiosis of LY201816） gut microbiota.

Objective:To explore the clinical changes in levels of the new clinical marker serum hepatitis B virus (HBV) pregenomic RNA (pgRNA) in patients with chronic hepatitis B (CHB) with long-term antiviral therapy.Methods:100 CHB cases who were initially treated with nucleos(t)ide analogues (NAs) at Peking University First Hospital were included. The levels of alanine aminotransferase (ALT), HBV DNA, hepatitis B e-antigen (HBeAg), and hepatitis B surface antigen (HBsAg) during the follow-up period were measured. The TaqMan-based real-time quantitative PCR method was used to detect serum HBV pgRNA levels. The independent sample t-test and Mann-Whitney U test were used to compare continuous variables between groups, while Pearson's χ2 test and Fisher's exact test were used to compare categorical variables. Results:HBV pgRNA levels decreased significantly in patients who developed virological responses at 48 weeks ( n = 54) during subsequent treatment compared to those who did not ( n = 46). The HBV pgRNA level was lower in HBeAg-positive patients than in HBeAg-negative patients ( P < 0.05 or P < 0.01). Patients with higher HBV DNA and HBeAg-positivity levels at baseline had a higher HBV pgRNA level following antiviral therapy. There was no statistically significant difference in HBV pgRNA levels in patients with different HBV pgRNA levels at baseline after antiviral therapy. There was no correlation between serum HBV pgRNA and HBsAg at baseline, but there was a correlation after long-term antiviral therapy, while there was a weak correlation between HBV pgRNA and HBsAg at the fifth and ninth years of antiviral therapy ( r = 0.262, P = 0.031; r = 0.288, P = 0.008). Conclusion:HBV pgRNA levels were higher with higher HBV activity in CHB patients with long-term antiviral therapy.

Objective:To investigate the influencing factors of secondary osteoporosis in stroke patients with hemiplegia, and to construct a nomogram prediction model and evaluate it.Methods:The study subjects were 110 patients with hemiplegia after stroke who were treated in our hospital from Jun. 2019 to Jun. 2023, and were divided into osteoporosis group and non-osteoporosis group by bone mineral density detection. Clinical data and laboratory indicators were collected. Single factor analysis and binary Logistic multiple factor regression analysis were used to screen the influencing factors. R software (R3.3.2) and software package rms were used to construct the nomogram prediction model.Results:There were 52 patients with osteoporosis and 58 patients without osteoporosis. In the osteoporosis group, the proportion of female, unilateral anterior circulation multiple infarction and less sunlight was significantly higher than that in the non-osteoporosis group, with statistical significance ( χ2=8.27, 14.77 and 6.96, respectively, P<0.05). Systolic blood pressure (159.32±21.72 vs. 151.67±19.52), total cholesterol (4.29±0.50 vs. 3.57±0.42), LDL-C (2.87±0.33 vs. 2.04±0.31), Hcy (3.81±2.51 vs. The level of 112.33±2.47 was significantly higher than that of the non-osteoporosis group, and the difference was statistically significant ( t was 5.23, 8.38, 7.98 and 5.63, respectively, P<0.001). The level of albumin (38.15±5.21 vs. 33.26±5.73) was significantly lower than that of the non-osteoporosis group. The difference was statistically significant ( t=4.90, P<0.05). Binary Logistic regression analysis showed that female, higher total cholesterol, LDL-C, Hcy levels and less sun exposure were independent risk factors for secondary osteoporosis in stroke patients with hemiplegia ( P<0.05). ROC curve analysis results showed that the area under the curve of the established model to predict secondary osteoporosis in stroke hemiplegia patients was 0.891 (0.833-0.949), and the sensitivity and specificity were 80.8% and 79.3%, respectively. Conclusion:The categorization and consistency of the nomogram model based on the influencing factors of secondary osteoporosis in patients with stroke hemiplegia are good, which can provide a certain reference for the identification and early intervention of high-risk groups with stroke hemiplegia.