Objective To explore the clinical features of fulminant type 1 diabetes mellitus (FT1DM). Methods The clinical data of 6 patients with FT1DM who were hospitalized in Jinshan Hospital of Fudan University from April 2020 to August 2024 were retrospectively analyzed. Their data were compared with that of 30 patients diagnosed with non-fulminant type 1 diabetes mellitus (NFT1DM) and diabetic ketosis or diabetic ketoacidosis (DKA) who were admitted to the hospital during the same period. The clinical characteristics of FT1DM were summarized. Results All 6 patients with FT1DM were male, with a disease course of 2.00 (1.75, 4.00) d. Three cases exhibited a history of prior infection, four tested positive for glutamic acid decarboxylase antibody (GADA), and five developed severe DKA. The glycated hemoglobin A_1C (HbA_1C) was (6.30±0.67) %, fasting C-peptide (FCP) was 0.07 (0.03, 0.15) ng/mL, 2-hour postprandial C-peptide (2h-CP) was 0.09 (0.03, 0.16) ng/mL. At discharge, all 6 patients received 4-injection insulin regimen, with a dose (0.69±0.15) U·kg⁻¹·d⁻¹. The body mass index (BMI), blood glucose/HbA_1C, blood potassium/HbA_1C, fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (2h-PG), high-sensitivity C-reactive protein (hs-CRP), alanine aminotransferase (ALT), serum creatinine, and blood potassium levels in the FT1DM group were higher than those in the NFT1DM group (P＜0.05), while HbA_1C and glycated albumin (GA) levels were lower than NFT1DM group (P＜0.05). Conclusions FT1DM usually presents with an acute onset of DKA, may be accompanied by a history of preceding infection, and GADA can be positive. Patients with FT1DM have elevated blood glucose/HbA_1C, blood potassium/HbA_1C, FPG, 2h-PG, hs-CRP, ALT, serum creatinine, blood potassium levels, and require insulin therapy, while the HbA_1C and GA levels are lower.

Background With the widespread application of ionizing radiation technology in non-medical fields, the number of non-medical radiation workers has steadily increased over the years. Individual dose monitoring serves as a crucial measure to safeguard the occupational health of non-medical radiation workers, as it can accurately identify occupational health risks and optimize radiation protection strategies. Objective To analyze the individual monitoring data of radiation workers from partial non-medical sectors in Shanghai from 2016 to 2023, to obtain the status of occupational radiation exposure and to provide a reference basis for non-medical radiation hygiene supervision and protection management. Methods The study subjects consisted of radiation workers from non-medical institutions in Shanghai who recieved individual dose monitoring at a Class-A radiation health technical service institution between 2016 and 2023. Under the Specifications for individual monitoring of occupational external exposure (GBZ 128-2019), thermoluminescence dosimetry was used for measuring personal dose equivalent, H_p(10), of various occupations encompassing industrial irradiation, industrial radiography, radioisotope production, accelerator operation, other industrial applications, education, and veterinary medicine. Kruskal-Wallis H test was used for comparison among multiple groups, Bonferroni method was adopted for pairwise comparison, and Mann-Kendall test was conducted for trend analysis to analyze the per-capita annual effective dose and its variation over time across different occupational categories of radiation workers. Results A total of 13728 person-times of non-medical radiation workers were monitored from 2016 to 2023, accumulating a collective effective dose of 3025.69 person-mSv. The per-capita annual effective dose M(P₂₅, P₇₅) was 0.14(0.08, 0.25) mSv. There were statistically significant differences in the per-capita annual effective dose of radiation workers in different years (H=874.826, P< 0.05). Similarly, significant variations were identified among various occupational categories (H=115.569, P< 0.05). Among them, the per-capita annual effective dose of radiological workers engaged in the production of radioactive isotopes was the highest, at 0.21(0.14, 0.32) mSv, followed by those in veterinary medicine, at 0.17 (0.11, 0.61) mSv; the difference between these two groups was not statistically significant (Z=1.231, P > 0.05), but both were significantly higher than those in other occupational categories (Z=3.913, 9.761, P<0.05). The veterinary medicine category had the highest proportion of monitored individuals with annual effective dose exceeding 1 mSv to the total number of monitored individuals(NR₁), reaching 17.12%, and the industrial radiography category showed the highest proportion of workers exposed to more than the annual investigation level 5 mSv to the total number of monitored individuals (NR₅), at 0.16%. Conclusion From 2016 to 2023, the overall individual doses of some non-medical radiation workers in Shanghai remain low, indicating well-controlled radiation levels in workplaces and low exposure risks. It is necessary to focus on radiation workers engaged in radioisotope production, veterinary medicine and industrial radiography.

Objective:To explore the effect and safety of local spraying tranexamic acid after thyroidectomy.Methods:Randomized double-blind placebo-controlled study method was used. Sixty-four patients underwent scheduled thyroidectomy from December 2022 to August 2023 in Baotou Cancer Hospital were selected. The patients were divided into tranexamic acid group and control group by random digits table method with 32 cases each. Before closing the wound during surgery, 16 ml of tranexamic acid injection with concentration of 25 mg/ml was used to wash the wound and 1 ml of tranexamic acid injection (tranexamic acid 100 mg) used to locally spray in tranexamic acid group; 16 ml of the sterile water for injection was used to wash the wound and 1 ml of sterile water for injection was used locally spray in control group, and then the drainage tube was clipped for 20 min. The neck drainage volume on the first to fourth day after surgery and complication were recorded; the C-reactive protein level before and after surgery was detected.Results:Two patients in each group withdrew from the study midway. The drainage volume on the first, second and third day and total drainage volume in tranexamic acid group were significantly lower than those in control group: (29.10 ± 8.04) ml vs. (38.50 ± 8.67) ml, (18.00 ± 7.33) ml vs. (27.20 ± 10.66) ml, (10.70 ± 5.75) ml vs. (14.60 ± 6.83) ml and (69.20 ± 24.48) ml vs. (96.70 ± 31.90) ml, and there was statistical difference ( P<0.01); there was no statistical difference in the drainage volume on the fourth day after surgery between two groups ( P>0.05). There was no statistical difference in C-reactive protein before and after surgery between two groups ( P>0.05). There was 1 case of fever (body temperature 37.5 ℃) in the control group, and there were no complications such as intermuscular thrombosis, venous thrombosis, incision infection and delayed wound healing in both groups. Conclusions:Local application of tranexamic acid after thyroidectomy can reduce postoperative drainage volume and does not increase the risk of thrombosis, infection and delayed healing.

Trace elements (TEs), also known as micronutrients in biology, are trace components required by the human body, accounting for 0.005% to 0.01% of body weight. Although TEs are present in small quantities in the human body, they play significant roles in cellular metabolism, enzyme activity regulation, immune function, nerve conduction, and bone health. In this review, the effects of TEs (zinc, iron, magnesium, selenium, copper, chromium, and manganese) for modulating biological functions on organisms are comprehensively analyzed and summarized. The mechanisms of various TEs in immune system, enzymatic reaction, oxidative stress, physical growth, and blood glucose regulation are deeply discussed, emphasizing the indispensable role of TEs in maintaining normal physiological functions of body. In addition, the future research directions of TEs are also prospected, including the mechanism of action, intake, metabolism, and storage of TEs at the cellular level. This review will provide useful information to further understand the biological effects and the application of TEs.

[摘 要] 目的：构建负载二氧化锰（MnO2）纳米颗粒的可得然（Cur）复合水凝胶MnO2@Cur（简称MGel），研究其对黑色素瘤B16-F10细胞的杀伤效果。方法：采用热诱导法制备Cur水凝胶（Gel），物理负载MnO2构建MGel，表征其宏观和微观形貌，检测其机械性能、降解性能以及光热转换性能等理化性能，并研究其联合PTT对小鼠皮肤黑色素瘤B16-F10细胞的光热杀伤效果。结果：MGel具有优异的机械和可降解性能，抗拉伸强度达（127.97±3.60）kPa、抗压缩强度达（151.44±5.23）kPa，28 d降解率约58.17%。MGel负载MnO2纳米片（粒径约180 nm）获得优异的光热转换性能，负载1.0 mg/mL MnO2的MGel在1.0 W/cm2的808 nm NIR光照4 min后到达最高温度50 ℃。细胞毒性实验和Calcein-AM/PI荧光双染色实验表明，MGel联合PTT有效杀伤B16-F10黑色素瘤细胞，NIR光照使得MGel组细胞存活率降低至（4.68±0.66）%（P<0.000 1）。结论：MGel复合水凝胶具备优异的机械性能、可降解性能以及光热转换性能，其联合PTT能有效杀伤肿瘤细胞，可能成为一种有效治疗黑色素瘤的新手段。

OBJECTIVE: To compare the clinical effect of conventional acupuncture combined with pricking and cupping at Jianbo area and conventional acupuncture in the treatment of scapulohumeral periarthritis of frozen stage. METHODS: A total of 66 patients with scapulohumeral periarthritis of frozen stage were randomly divided into a combination group (31 cases) and an acupuncture group (35 cases, 1 case dropped off). Both groups were given functional exercise. Patients in the acupuncture group were treated with acupuncture at Jianyu (LI 15), Jianliao (TE 14), Binao (LI 14) and ashi point on the affected side, once every other day, three times a week, for a total of 4 weeks. On the basis of treatment in the acupuncture group, the patients in the combination group were treated with pricking and cupping at Jianbo area (the area surrounded by the 3 acupoints of Tianzong [SI 11], Naoshu [SI 10] and Jianzhen [SI 9]), once a week for 4 weeks. The University of California-Los Angeles (UCLA) shoulder joint score, visual analogue scale (VAS) score before treatment, after treatment and after 6 months of treatment completion (follow-up) and tenderness threshold before and after treatment, and the clinical effects of the two groups after treatment and in follow-up were evaluated. RESULTS: In the two groups, after treatment and in follow-up, the UCLA shoulder joint scores were higher than those before treatment (P<0.05), and the VAS scores were lower than those before treatment (P<0.05). In the combination group, after treatment and in follow-up, the UCLA shoulder joint score was higher than that of the acupuncture group (P<0.05), and the VAS score was lower than that of the acupuncture group (P<0.05). After treatment, the tenderness thresholds of the two groups were higher than those before treatment (P<0.05), and the tenderness threshold in the combination group was higher than that in the acupuncture group (P<0.05). After treatment and in follow-up, the cured and markedly effective rate of the combination group was 48.4% (15/31) and 51.6% (16/31) respectively, which was higher than 23.5% (8/34) and 23.5% (8/34) of the acupuncture group (P<0.05). CONCLUSION Pricking and cupping in Jianbo area combined with conventional acupuncture can improve shoulder joint function and relieve shoulder joint pain in patients with scapulohumeral periarthritis of frozen stage, and the curative effect is better than that of single conventional acupuncture.
Humans ; Periarthritis/therapy* ; Acupuncture Therapy ; Shoulder Pain/therapy* ; Shoulder Joint ; Acupuncture Points ; Treatment Outcome

Objective To analyze the trend of death level and the probability of premature death caused by chronic obstructive pulmonary disease (COPD) in Jinshan District of Shanghai from 1980 to 2020, and to provide reference for the formulation of prevention and control measures of COPD. Methods The death cases of COPD in Jinshan District from 1980 to 2020 were collected through the death cause registration information system. The crude mortality, standardized mortality, age group mortality, early death probability and annual change percentage in different periods were calculated. Results From 1980 to 2020, the crude mortality of COPD in Jinshan District was 154.38/100 000, and the standardized mortality was 82.66/100,000. In the past 41 years, the standardized mortality of COPD showed a downward trend in males and females (APC=-1.79%, -2.52%, P<0.001). In the same period, the mortality of COPD in subjects aged 30-69 years old and subjects aged 70 years old and above also decreased (APC=-8.79%, -4.79%, P<0.001), and the probability of premature death caused by COPD showed a downward trend in males and females (APC=-9.61%, -10.71%, P<0.001). Conclusion The mortality rate and the probability of premature death of COPD in Jinshan District have decreased in the past 41 years. However, COPD is still one of the major chronic diseases that pose a serious threat to the health of residents in Jinshan District. Comprehensive prevention and treatment measures should be taken to reduce the mortality and the probability of premature death of COPD.

Objective:To evaluate the safety and efficacy of Toumai ? endoscopic robotic system in radical prostatectomy. Methods:This study was a single-center phase Ⅲ randomized controlled study. From June 2020 to January 2021, patients with prostate cancer who met the inclusion criteria in Changhai Hospital Affiliated to Naval Military Medical University were divided into the experimental group and the control group by random table method. Inclusion criteria included aged 18 to 80 years, pathologically diagnosed as prostate cancer, clinical stage ≤T 2N 0M 0. Exclusion criteria included patients requiring emergency surgery, having serious cardiovascular diseases and cannot tolerate surgery, having participated in other investigational drug or device clinical trials within the last 3 months. The experimental group used Toumai ? laparoscopic robotic system, and the continence group used the Da Vinci robotic system. The patients in both groups underwent radical prostatectomy via a transabdominal approach, which was performed by two surgeons. The clinical characteristics between the two groups were compared, related adverse events were recorded, and PSA and urinary continence were followed up one month after the operation. Results:A total of 44 patients were enrolled in this study, including 22 cases in the experimental group and 22 cases in the control group. The mean age of patients in the trial group and the control group was (67.7±7.5) years and (66.4±6.3) years, respectively. The median PSA at diagnosis was 10.5 (7.7, 23.7) ng/ ml and 13.5 (8.9, 24.7) ng/ ml, respectively. Biopsy Gleason score of 6, 7, 8 and 9 in experimental group were 13.6% (3/22), 68.2% (15/22), 4.5% (1/22) and 13.6% (3/22), respectively, and in the control group were 4.5% (1/22), 59.1% (13/22), 22.7% (5/22) and 13.6% (3/22) respectively. The middle risk and high risk group in the experimental group was 50.0% (11/22), 50.0% (11/22), and the control group was 36.4% (8/22), 63.6% (14/22). There was no statistical difference between the two groups.The operations in both groups were successfully performed. There were no conversions to open or laparoscopic surgeries, and no Clavien-Dindo grade Ⅲcomplications. There was no significant difference in the estimated blood loss during the operation [(109.1±51.6)ml vs.(94.5±51.6)ml] and the blood transfusion rate [9.1%(2/22)vs. 4.5%(1/22)] in both groups. The operation time was significantly higher in the experimental group than that in the control group [164.5(130.5, 214.3) min vs. 88.0(65.3, 110.5)min, P<0.001]. The positive rate of surgical margin was 13.6% (3/22) in the experimental group and 36.4% (8/22) in the control group, respectively, showing no significant difference. The pathologic stages of pT 2, pT 3a and pT 3bin experimental group were 63.6% (14/22), 13.6% (3/22) and 22.7% (5/22), respectively, while those in control group were 36.3% (8/22), 40.9% (9/22) and 22.7% (5/22), respectively, showing no significant difference. The recovery rates of urine control in the experimental group and the control group were 22.7% (5/22) and 22.7% (5/22), respectively. The median PSA in the experimental group and the control group were 0.055 (0.021, 0.103) ng/ ml and 0.032 (0.010, 0.089) ng/ ml, respectively, with no statistical difference. Conclusions:The Toumai ? endoscopic robotic system can successfully perform radical prostatectomy, based on insignificant difference from Da Vinci robotic system in safety and efficacy. The short-term follow-up showed that tumor control and urinary continence have recovered well in the test group. The long-term effect of the new system on tumor control and functional recovery after radical prostatectomy needs further multi-center studies.

Objective:To determine the level of anti-measles antibody in healthy population aged 1-14 years old in Shanghai， and project the risk of measles incidence in adult population in the future， which may provide evidence for enhancing the measles immunization strategy. Methods:A cross-sectional study was conducted to collect the serum of healthy people aged 1-14 years old in an urban district hospital in Shanghai. Serum concentration of anti-measles IgG antibody was examined by enzyme-linked immunosorbent assay （ELISA） and dynamics of IgG antibody was compared. Results:The prevalence of anti-measles antibody in healthy people aged 1-14 years old was determined to be 95.29%， and the antibody protection rate was 61.86%. There was no significant difference in the distribution of antibody between men and women （P>0.05）. However， there was statistical difference in the distribution of antibody among different age groups （P<0.05）， in which the antibody showed a decreasing trend with age， especially after the age of 10 years. The lowest prevalence of anti-measles antibody and protection rate were observed in the population aged 13-14 years old， which were 87.41% and 22.96%， respectively. The GMT was 2.667 1 （equal to the concentration of anti-measles IgG antibody being 464.62 mIU/mL）. According to the fitting model Ŷ =3.217-0.04X（R²=0.943，P<0.05）， the antibody protection rate was projected to decrease to zero in the population aged 19-20 years old， whereas the anti-measles antibody was to zero in the population aged 29-30 years old . Conclusion:As there is almost no natural infection of measles，the anti-measles antibody after measles vaccine immunization showed a linearly decreasing trend with age after measles immunization．It is recommended that people aged 10-15 years should be administered intensive immunization for prevention of adults measles，which could be incorporated into current measles immunization strategies.