Knowledge-attitude-practice model is widely used in the self-management of type-2 diabetes.Through proper education,patients can gain diabetic knowledge as well as positive attitude on glucose control.By regulating diet,exercise,self glucose monitoring and medication compliance,diabetic patients are able to control blood glucose more effectively,and have less complications and higher quality of life.Researches on the application and effectiveness of various diabetic knowledge,attitude and self-management behavior scales are reviewed in this article.

To investigate the anticancer effects of ring C in 18β-glycyrrhetinic acid (GA), a series of GA derivatives featured with 9(11)-ene moiety in ring C were designed and synthesized. The structures were confirmed by IR, LC-MS and 1H NMR. Their inhibitory effects towards human prostate cancer PC-3 and leukemia HL-60 cell lines were determined. Most of the derivatives displayed stronger antiproliferative activities than GA. Particularly, compound 14 showed promising anticancer activity with the GI50 values of 4.48 µmol · L(-1) and 1.2 µmol · L(-1) against PC-3 and HL-60 cells respectively, which is worth further study.

Objective: To investigate the sonographic features of appendicitis in preterm infants. Methods: A total of 28 cases of premature infants with acute appendicitis diagnosed by bedside abdominal ultrasound in the First Hospital of Jilin University from November 2012 to January 2019 were recruited. Basic clinical information, abdominal ultrasound images, surgical results, management and outcomes were collected and analyzed. Descriptive statistical methods were used for data analysis. Results: Among the 28 cases, 21 (75.0%) were males and seven (25.0%) were females. All of them were diagnosed as having acute appendicitis with perforation according to the bedside ultrasound. Five (17.8%) presented direct signs of appendicitis, i.e. partial structure of the appendix and perforation site. The other 23 (82.2%) showed indirect signs, including heterogeneous echotexture or hypoechoic patterns between the liver and right kidney in six cases, heterogeneously hypoechoic areas between the bowels in the right lower abdomen in seven cases, and dissociative effusion between the bowels in the right lower abdomen with poor sound transmission and disorder of surrounding intestinal structure in ten cases. Twenty-one out of the 28 cases (75.0%) exhibited bowel wall thickening at right lower abdomen, absence of intestinal peristalsis and effusion echoes between the intestines with poor sound transmission. Emergent surgeries were performed and diagnoses of appendicitis with perforation were confirmed. All the 21 cases were discharged after full recovery. Seven cases (25.0%) showed confined cystic images and received conservative treatment. One of them developed adhesive intestinal obstruction during follow-ups and underwent surgical treatment, during which local formations of wrapping after appendiceal perforation and obstruction due to surrounding intestinal adhesion were observed. The other six cases recovered after conservative management with gradually reduced peritoneal effusion, normal omental echo patterns and improved inflammatory indicators and abdominal symptoms, and no ileus occurred during follow-ups after discharge. Conclusions Symptoms of appendicitis in preterm infants are non-specific, and perforation is more likely to be seen. Bedside ultrasonography mainly shows indirect signs of appendicitis, and direct signs in some infants. Bedside ultrasound can be an essential tool for the diagnosis of these conditions with high accuracy.

Endothelial cell injury is a major contributor to cardiovascular diseases.The 2,3,5,4’-Tetrahydroxystilbene-2-O-β-D-Glucoside (TSG) contributes to alleviate human umbilical vein endothelial cells (HUVECs) injury through mechanisms still know a little. This study aims to clarify the TSG effects on gene expression (mRNA and microRNA) related to oxidative stress and endoplasmic reticulum stress induced by H2O2 in HUVECs. We found that TSG significantly reduced the death rate of cells and increased intracellular superoxide dismutase activity. At qRT-PCR, experimental data showed that TSG significantly counteracted the expressions of miR-9-5p, miR-16, miR-21, miR-29b, miR-145-5p, and miR-204-5p. Besides, TSG prevented the expression of ATF6 and CHOP increasing. In contrast, TSG promoted the expression of E2F1. In conclusion, our results point to the obvious protective effect of TSG on HUVECs injury induced by H2O2, and the mechanism may through miR16/ATF6/ E2F1 signaling pathway.

Endothelial cell injury is a major contributor to cardiovascular diseases.The 2,3,5,4’-Tetrahydroxystilbene-2-O-β-D-Glucoside (TSG) contributes to alleviate human umbilical vein endothelial cells (HUVECs) injury through mechanisms still know a little. This study aims to clarify the TSG effects on gene expression (mRNA and microRNA) related to oxidative stress and endoplasmic reticulum stress induced by H2O2 in HUVECs. We found that TSG significantly reduced the death rate of cells and increased intracellular superoxide dismutase activity. At qRT-PCR, experimental data showed that TSG significantly counteracted the expressions of miR-9-5p, miR-16, miR-21, miR-29b, miR-145-5p, and miR-204-5p. Besides, TSG prevented the expression of ATF6 and CHOP increasing. In contrast, TSG promoted the expression of E2F1. In conclusion, our results point to the obvious protective effect of TSG on HUVECs injury induced by H2O2, and the mechanism may through miR16/ATF6/ E2F1 signaling pathway.

Objective:To analyze the value of the modified 5-factor frailty index in assessing postoperative complications and mortality in elderly hip fracture patients.Methods:In this retrospective study, clinical data were collected of hip fracture patients aged 60 years and above surgically treated at Beijing Luhe Hospital affiliated to Capital Medical University between January 2015 and December 2019.Patients' group assignment was based on whether the modified frailty index score was ≤1 or ≥2, and a post-surgery follow-up was conducted for survival at 30 days, 1 year, 2 years, and 4 years, which was analyzed by the Kaplan-Meier method.Multivariate Cox regression analysis was used to identify factors affecting death in elderly patients.Results:A total of 1 208 patients were included, with 890 in the group with the index score ≤1 and 318 in the group with the index score ≥2.There was no difference in mortality at 30 days(1.6% or 14/890 vs.1.9% or 6/318, P=0.707), 1-year(11.3% or 99/874 vs.11.6% or 36/310, P=0.917), 2-years(19.7% or 168/852 vs.24.3% or 73/300, P=0.099)and 4-years(44.0% or 238/541 vs.51.5% or 106/206, P=0.071). The incidence of postoperative complications in the group with the score ≥2 was higher(14.8% or 47/318 vs.9.7% or 86/890, P=0.012), including the incidence of stroke(6.3% or 20/318 vs.1.8% or 16/890, P<0.001)and the incidence of postoperative pneumonia(6.0% or 19/318 vs.3.1% or 28/890, P=0.029), and the differences were statistically significant.Multivariate Cox regression analysis showed that age, being female, the Charlson comorbidity index score and low hemoglobin at admission were risk factors for 1-year, 2-year and 4-year mortality post-surgery(all P<0.05), while the modified frailty index score had no correlation with postoperative mortality. Conclusions:A modified frailty index ≥2 is predictive of increased risk of postoperative pneumonia and stroke in patients with hip fractures, but is not correlated with the risk of postoperative mortality.

Objective:To investigate the stability of fat emulsions after the preparation of parenteral nutrient solution under different storage conditions.Methods:Standardized parenteral nutrient solution was used to prepare a total of 24 bags of nutrient solution with the same formula, except for that Group A (12 bags) contains 20% of medium and long chain fat emulsion (C6-24) while Group B contains 20% of C8-24. The preparations were stored under 2-8℃, 23-25℃, and 35-37℃ and were examined at 24h, 48h and 72h after preparation. The appearance, average size of fat particles, pH value of nutrient solution, and lipid peroxidation were investigated.Results:After storage at 4℃, 25℃ and 36℃ for 24h, 48h and 72h respectively, both groups of preparations showed no obvious change in appearance. There was no significant difference in pH ( P>0.05) nor lipid peroxidation ( P>0.05). Conclusion:Both kinds of fat emulsion are stable in terms of pH value, fat particle size and lipid peroxidation, and can be used for patients receiving intravenous nutrition support.

Objective: To study the effects of Porphyromonas gingivalis (P. g) infection with I, II and IV fimA genotypes on the expression of IL-1beta, IL-6 and TNF-alpha in human umbilical vein endothelial cells (HUVECs). Methods : HUVECs infected with different fimA genotypes were divided into the fimA type I stimulation group, fimA type II stimulation group, fimA type IV stimulation group. In addition, a positive control group (E. coli LPS stimulation) and negative control group (cell culture medium only) were included. Cell proliferation was detected by MTT assay, and cell apoptosis was detected by flow cytometry. IL-1β, IL-6, TNF-α levels in the supernatant of HUVECs after P. g stimulation were assessed by ELISA at 2 h, 6 h and 24 h. Results : HUVECs were infected by P. g with fimA type I,fimA type II and LPS for 24 h. Cell proliferation was inhibited compared with the negative control group (P < 0.05), but there was no significant difference in the apoptosis rate between P. g infection and the negative control group. IL-1β levels in cell culture supernatants were higher at 2th than 6 and 24 h after stimulation of HUVECs with different fimA genotypes, while the IL-6 levels were higher at 24 h than the other time, while the TNF-α levels were no significant difference at every time. After fimA type II and IV P. g infection, IL-1β, IL-6, and TNF-α levels were increased compared with fimA type I P. g (P < 0.05). Conclusion Different P. g fimA genotypes have different effects on stimulating HUVECs to induce dysfunction. Here, fimA type II and IV P. g exhibit a strong ability to upregulate the secretion of IL-1β, IL-6 and TNF-alpha.

Objective:To analyze the accuracy of lung ultrasound and chest X-ray in the diagnosis of neonatal pulmonary disease.Methods:We prospectively collected newborns that needed chest X-ray examination to diagnose pulmonary disease from twelve neonatal intensive care units across the country between June 2019 and April 2020.Each newborn was examined by lung ultrasound within two hours after chest X-ray examination.All chest X-ray and lung ultrasound images were independently read by a radiologist and a sonographer.When there was a disagreement, a panel of two experienced physicians made a final diagnosis based on the clinical history, chest X-ray and lung ultrasound images.Results:A total of 1 100 newborns were enrolled in our study.The diagnostic agreement between chest X-ray and lung ultrasound(Cohen′s kappa coefficient=0.347) was fair.Lung ultrasound(area under the curve=0.778; 95% CI 0.753-0.803) performed significantly better than chest X-ray(area under the curve=0.513; 95% CI 0.483-0.543) in the diagnosis of transient tachypnea of the newborn( P<0.001). The accuracy of lung ultrasound in diagnosing neonatal respiratory distress syndrome, meconium aspiration syndrome, pneumonia and neonatal pulmonary atelectasis was similar to that of chest X-ray. Conclusion:Lung ultrasound, as a low-cost, simple and radiation-free auxiliary examination method, has a diagnostic accuracy close to or even better than that of chest X-ray, which may replace chest X-ray in the diagnosis of some neonatal lung diseases.It should be noted that both chest X-ray and lung ultrasound can only be used as auxiliary means for the diagnosis of lung diseases, and it is necessary to combine imaging with the clinical history and presentation.

Objective To identify signals of adverse events associated with vaccines in electronic medical record data. Methods Data cleaning was performed on electronic medical records and vaccination data in Gansu Province from 2020 to 2022. Signal identification was performed using Apriori algorithm and Empirical Bayes Gamma-Poisson Shrinker (GPS) with stratification by gender and age group. Results A total of 33 statistical signals were identified, with 7 signals identified by the Apriori method and 26 signals identified by the GPS method. No overlapping signals were found between the two methods at two different signal thresholds. Conclusion The vaccine safety signals identified by GPS and Apriori in electronic medical records are reliable and accurate, but further research is needed to determine the correlation between the vaccine safety signals recognized by GPS algorithms.