Abstract Type 2 diabetes mellitus (T2DM) has become a worldwide epidemic, which poses a great threat to the global healthcare system. Based on review of publications pertaining to T2DM health management in urban communities, this article focuses on the health management models of T2DM in foreign urban communities, including insurance companies and medical institutions, self-management plans, community management, community and home hybrid services, artificial intelligence + big data management, social media and online community management, precision health management, and proposes suggestions for T2DM health management in Chinese urban communities based on currently available national management models, including increasing the standardization of the management level, improving the supporting facilities of professional talents, mobilizing social forces to support, improving the scientific and technological level of management tools, strengthening the advantages of traditional Chinese medicine and exploring novel personalized models, so as to provide insights into promoting the sustainable development of T2DM health management in Chinese urban communities.

Objective To investigate the distribution characteristics of serum pepsinogen (PG) in healthy people and its reference interval establishment .Methods 3 753 healthy people were enrolled and divided into <45-year old ,45- <60-year old and ≥60-year old group according to their ages .Double antibody sandwich enzyme-linked immunosorbent assay was used to detect PG Ⅰ ,Ⅱ . Results Detection results of serum PG Ⅰ ,PGⅡ and PGⅠ /PGⅡ of male and female healthy people in different age group showed a skewed distribution(P<0 .05) .Serum PGⅠ and PGⅠ /PGⅡlevels of females were significantly higher than males(P<0 .01) .In the same age group ,difference of serum PGⅡ levels between males and females was not statistically significant (P>0 .05) .In the same gender ,pairwise comparison of PGⅠlevels was conducted in different age groups ,and the difference showed no statistical sig-nificance(P>0 .05) .PGⅡlevel increased with age increasing (P<0 .01) while PGⅠ /PGⅡlevel increased with age reducing (P<0 .05) .Percentile method was adopted to determine the 95% reference interval ,the bilateral reference intervals (P2 .5 - P97 .5 ) was taken for PGⅠ ,unilateral upper limit(≤ P95 ) for PGⅡ and unilateral limit (≥ P5 ) for PGⅠ /PGⅡ .Conclusion The establishment of serum PG Ⅰ ,PG Ⅱ ,PG Ⅰ /PG Ⅱ reference intervals of healthy people provides a basis for the prevention and treatment for stomach disease .

Objective: To evaluate the accuracy and clinical value of fractional lfow reserve (FFR) determined by CT coronary angiography (CTA) in relevant patients. Methods: A total of 43 patients treated in our hospitals from 2013-10 to 2015-10 were retrospectively studied. There were 29 (67.40%) with male gender, the average age was (60.2±10.1) years. The patients received CTA at 1 week prior coronary angiography (CAG), the interval between CTA and CAG was (5.4±1.6) days. FFR was measured by both CAG and CTA (FFRCT) in selected target vessel which was deifned as maximal diameter reduction 50% to 70%. The imaging data were recorded and compared, FFRCT was calculated. Results: 48 vessels from 43 patients were eligible for analysis as target vessels. FFRCT vas evaluated based on the gold criteria of FFR. FFRCT had the diagnostic accuracy at 83.3%, sensitivity 75.0%, speciifcity 89.3% and positive predictive value was 83.3%, negative predictive value was 83.3% respectively. FFR and FFRCT showed obvious correlation (r=0.704,P<0.001); Bland-Altman analysis presented good concordance with 95% limits of agreement for FFRCTand FFR value ranged from -0.12 to 0.16, and 95.8% of the points (46/48) fell in the 95% limit of agreement, Receiver operating characteristic curve indicated that AUC of FFRCT was 0.871 (95% CI 0.770-0.973). Conclusion: CTA could accurately assess FFR, and FFRCT might be used in guiding the treatment for patients with intermediate coronary stenosis in clinical practice.

ABSTRACT:The guinea pigs were immunized by the Brucella vaccine through intradermal injections and the skin scratch respectively ,and then the immune effects of the two ways were evaluated .Serum samples were collected one month after the last injection and detected for the total IgG titer by interval ELISA .Cell‐mediated immune was evaluated by late‐onset hyper‐sensitivity .The guinea pigs were challenged with Brucella melitensis M5 ,and then were killed to isolated M5 from spleen of each guinea pig to compare the protective effects of two methods of immunization .The ELISA results showed that both of the two methods of immunization could induce strong humoral immune response ,and DTH response to Br‐PPD antigen were 100%in both methods .No significant difference in the immune protective effect of two methods was detected .Results of humoral im‐munity ,cellular immunity and protective effect showed the same effect by intradermal injections and skin scratches .

The clinical data of 120 patients admitted to our hospital with renal stones treated by flexible ureteroscopy (FURS) and the imaging-related data measured by virtual reality technology were retrospectively analysed. The results of the univariate analysis showed that stone surface area (S), renal pelvis volume (P), length of calyces funnel (L), pelvic calyceal height (H) and essence of stone (E) were closely related to stone-free rate. The H. L.P.E.S. score was constructed to predict stone-free rate after FURS based on the above factors, and the area under the receiver aperating characteristic curve for the H. L.P.E.S. and S. O.L.V.E. scoring systems was 0.921 and 0.754 respectively.The H. L.P.E.S. scoring system has higher predictive value.

Objective To establish S.O.L.V.E.nephrolithometry scoring system,and to evaluate value of S.O.L.V.E.scoring system for predicting the stone-free rate (SFR) of flexible ureteroscopy (FURS).Methods Five reproducible variables were included in S.O.L.V.E.scoring system,such as stone surface area (S),obstruction (O),length of calyces funnel (L),visible number of calyces (V) and essence of stone (E).Variables were measured based on preoperative non-contrast computed tomography of urography.Clinical data of 392 patients who underwent FURS for upper urinary tract stones in our department from January,2017 to Jnne,2018 were retrospectively analyzed.The total study population consisted of 258 male and 134 female patients.The mean age was (49.5 ± 12.6) years old,ranged from 15 to 85 years.There were 292 patients in stone-fiee group,including 197 male and 95 female patients.The average age was (49.2 ± 12.8) years old.37 patients had previous history of renal stone surgery.Median body mass index was 24.7 kg/m2 (18.1-29.0 kg/m2) and median value of preoperative serum creatinine was 72.5 μmol/L (48.9-84.8 μmol/L).The number of patients,whose stone located in the left side and right side were 155 and 137,respectively.The number of patients,whose stones located in ureter,renal pelvis,lower calyceal and non-lower calyceal were 19,16,87,170,respectively.There were 100 patients in non-stone free group,61 men and 39 women.The average age was (50.4 ± 12.0) years old.15 patients had previous history of renal stone surgery.Median body mass index was 25.0 kg/m2 (18.5-28.8 kg/m2) and median value of preoperative serum creatinine was 73.8 μmol/L (46.5-92.5 μnol/L).The number of patients,whose stone located in the left side and right side were 51 and 49,respectively.The number of patients,whose stones located in ureter,renal pelvis,lower calyceal and non-lower calyceal were 7,4,27,62,respectively.The correlation of S.O.L.V.E.scoring system and stone-free rate,postoperative hospital stay,surgical complications,operation time were analyzed.Receiver operating characteristic curves were drawn to detect predictive value of S.O.L.V.E.scoring system for SFR of FURS.Results All cases FURS were performed successfully and the SFR was 74.5％ (292/392).Among the variables of the S.O.L.V.E.scoring system in the stone-free group and the non-stone free group,item S were (82.6 ± 69.8) mm2 and (172.6±133.7)mm2,respectively.The item L were (12.7 ± 15.8) mm and (23.9 ± 15.3)mm,respectively.The item V were (0.6 ± 0.7) and (1.3 ± 0.8),respectively.The item E were (817.1 ± 285.5) HU and (902.4 ± 256.1) HU,respectively.The difference was statistically significant (P ＜ 0.01).The item O was (17.7 ± 10.9) mm and (19.3 ± 13.1) mm,respectively,no statistical significance was found (P =0.242).The mean score was 6.3 (ranging 4-11) in this c ohort.The patients were divided into low score (4-5) group,moderate score (6-8) group and high score (9-11) group due to S.O.L.V.E.scoring system,and the stone-free rates were 93.5％ (130/139),70.5％ (153/217) and 37.5％ (9/36),respectively (P ＜0.01).The operation time of low,moderate,andi high score group were (31.6 ± 10.9),(42.3 ± 18.3),and (58.0 ± 19.2) min,respectively.Additionally,the score was correlated with the operation time(P ＜0.01),but not with postoperative hospital stay (P =0.133),intraoperative bleeding (P =0.185) and postoperative infectious fever (P =0.839).In logistic regression model analysis,the stone surface area,length of calyces funnel,number of involved calyces were significantly correlated with SFR (P ＜ 0.01).The obstruction degree and essence of stone were not associated with SFR (P ＞ 0.05).The area under receiver operating characteristic curve of S.O.L.V.E.score was 0.782,higher than that of each variable in S.O.L.V.E.scoring system(S,O,L,V,E were 0.738,0.535,0.698,0.735,0.593,respectively).Conclusions The stone surface area,length of calyces funnel,number of involved calyces were significantly correlated with SFR.The S.O.L.V.E.nephrolithometry scoring system can predict SFR after FURS accurately,and provide assistance for making clinical decisions.

Objective:To learn about the knowledge, attitude and behavior of brucellosis and brucellosis infection in Tongyu County, Jilin Province, and to provide a reference for the formulation of prevention and control measures in relocated poverty alleviation and relocation areas.Methods:Using a multi-stage sampling method, three townships, Xianghai Township, Wulanhua Town and Xinhua Town were selected in Tongyu County, where the incidence of brucellosis is high in Jilin Province; then Miren, Huimin, Longjing, Xinfeng and Dayou villages from the three townships were surveyed. A face-to-face questionnaire survey was conducted among the villagers to collect the knowledge, attitude and behavior of brucellosis; and blood samples were collected from the villagers according to the principle of informed consent for brucellosis serological tests, and according to the "Diagnostic criteria for Brucellosis (WS 269-2007)" for diagnosis.Results:A total of 274 questionnaires were distributed and 244 valid questionnaires were collected with a recovery rate of 89.05%. Among them, 233 people had heard of brucellosis, accounting for 95.49%. The total awareness rate of knowledge related to brucellosis prevention and control was 39.29% (2 205/5 612), of which the total awareness rate of "knowledge related to brucellosis prevention" was 71.99% (527/732), and the total awareness rate of "knowledge related to human infection with brucellosis" was 38.08% (1 115/2 928), and the total awareness rate of "knowledge about brucellosis in animals" was 28.84% (563/1 952). A total of 90.13% (21/233) people supported the brucellosis prevention and control plan (such as free screening for brucellosis, publicity and education, immunization, culling, etc.), and 61.54% (48/78) of the people would take the initiative to buy protective equipment. The contact rates of livestock through assisted feeding and slaughtering were 27.46% (67/244) and 11.48% (28/244), respectively, and the total protection rates of sheep pens cleaning and slaughtering were 30.91% (102/330) and 21.43% (30/140), respectively. In terms of brucellosis infection, a total of 1 confirmed case, 1 latent infection and 37 suspected cases were found.Conclusions:The awareness rate of "knowledge related to brucellosis prevention" in Tongyu County is generally good, but the awareness rate of "knowledge about brucellosis in animals" is low, and the protection rate of some brucellosis prevention and control behaviors is poor. Health and epidemic prevention departments should carry out targeted health education, improve and optimize propaganda methods in order to improve the protection level of the general population and reduce the risk of brucellosis infection.

The progressive destruction of condylar cartilage is a hallmark of the temporomandibular joint (TMJ) osteoarthritis (OA); however, its mechanism is incompletely understood. Here, we show that Kindlin-2, a key focal adhesion protein, is strongly detected in cells of mandibular condylar cartilage in mice. We find that genetic ablation of Kindlin-2 in aggrecan-expressing condylar chondrocytes induces multiple spontaneous osteoarthritic lesions, including progressive cartilage loss and deformation, surface fissures, and ectopic cartilage and bone formation in TMJ. Kindlin-2 loss significantly downregulates the expression of aggrecan, Col2a1 and Proteoglycan 4 (Prg4), all anabolic extracellular matrix proteins, and promotes catabolic metabolism in TMJ cartilage by inducing expression of Runx2 and Mmp13 in condylar chondrocytes. Kindlin-2 loss decreases TMJ chondrocyte proliferation in condylar cartilages. Furthermore, Kindlin-2 loss promotes the release of cytochrome c as well as caspase 3 activation, and accelerates chondrocyte apoptosis in vitro and TMJ. Collectively, these findings reveal a crucial role of Kindlin-2 in condylar chondrocytes to maintain TMJ homeostasis.
Aggrecans/metabolism* ; Animals ; Cartilage, Articular/metabolism* ; Chondrocytes/pathology* ; Cytoskeletal Proteins/metabolism* ; Mice ; Muscle Proteins/metabolism* ; Osteoarthritis/pathology* ; Temporomandibular Joint/pathology*