Insulin secretion by islet β cells is a fundamental component in glucose homeostasis.Chronic meta-bolic stress causes β cell dysfunction as manifested by reduced cell mass and impaired insulin secretion,which contributes to the pathogenesis of type 2 diabetes(T2D).In the last decade,it has been putatively accepted that β cell dedifferentia-tion is a key pathological mechanism for β cell failure.β cell dedifferentiation is referred as the progressive process that β cells lose their identity and dedifferentiate into non-functional endocrine progenitor-like cells.Typically,aldehyde dehy-drogenase 1 family member A3(ALDH1A3)is a marker of β cell dedifferentiation.Chronic hyperglycemia can lead to de-differentiation of mature β cells,the mechanism of which involves oxidative stress and some key factors.β cell dedifferen-tiation is reversible,therefore,to intervene this process may represent a promising approach to the restoration of β cell function.In this review,we update the recent progress in the pathophysiology of β cell dedifferentiation to provide new strategy for the prevention and treatment of T2D.

Objective: To explore the related factors of myopia among children and adolescents in Yunnan Province, and to predict and evaluate the influencing factors, so as to provide a scientific theoretical basis for the prevention and control of myopia. Methods: From March 9 to 14, 2023, 848 students from 6 primary and secondary schools in Dali and Lijiang of Yunnan Province were selected by multi stage stratified random cluster sampling method for visual acuity detection and questionnaire survey on myopia related factors. Multivariate Logistic regression analysis was used to establish a Nomogram prediction model for the selected influencing factors. Results: The overall myopia rate of the respondents was 68.3%, the myopia rate of boys (63.4%) was lower than that of girls (72.9%), and the myopia rate of primary school students (46.7%) was lower than that of junior high school students (81.1%), and the difference was statistically significant（ χ 2=8.71, 108.07, P <0.05). Daily eye exercises, activities outside the teaching building during recess, having daily sleep time of 7-9 and >9 h, having both parents without myopia were negatively correlated with the occurrence of myopia in children and adolescents in Yunnan Province ( OR=0.64, 0.63, 0.56, 0.28, 0.48, P < 0.05 ). The reading and writing time after school ≥3 h per day and parents unrestricted time to play video games were positively correlated with myopia ( OR=1.94, 1.78, P <0.05). Based on the influencing factors, a Nomogram prediction model was established to quantitatively evaluate the risk of myopia. The results showed that greater risk for myopia was associated with sleep duration, parental history of myopia, and the time spent reading and writing after school every day. Conclusion Both genetic factors and environmental factors are related to myopia in children and adolescents. The prediction model of nomogram is beneficial for screening high risk factors of myopia and taking corresponding prevention and treatment measures.

ObjectiveTo observe the clinical effect of Qingxin Zishen decoction on hot flashes after endocrine therapy for prostate cancer and explore its therapeutic mechanism. MethodA total of 60 patients who met the criteria and were admitted to Jiangsu Province Hospital of Chinese Medicine from December 2021 to December 2022 were collected and randomly divided into a treatment group and a control group， with 30 cases in each group. The treatment group was treated with Qingxin Zishen decoction， while the control group was only given routine nursing. The observation period of this study was eight weeks. The improvement of hot flash frequency， hot flash degree， hot flash score， ISS score， and TCM syndrome score were observed in the two groups before and after treatment. The changes of serum endothelin-1 （ET-1）， nitric oxide （NO）， calcitonin gene-related peptide （CGRP）， prostate specific antigen （PSA）， and testosterone were detected. ResultIn terms of efficacy， after treatment， the frequency， degree， and score of hot flashes， ISS score， and TCM syndrome score decreased in the treatment group （P<0.05）. Compared with the control group， all indicators were better in the treatment group （P<0.05）. In terms of laboratory indicators， after treatment， the serum NO level in the treatment group was increased. ET-1 level was decreased. The ratio of ET-1/NO was decreased， and the CGRP level was decreased （P<0.05）. However， testosterone and PSA levels were not significantly changed . Compared with the control group， after treatment， the serum NO level in the treatment group was higher， and the level of ET-1 was lower. The ratio of ET-1/NO and the CGRP level were lower （P<0.05）. There were no significant differences in testosterone and PSA levels between the two groups. ConclusionQingxin Zishen decoction can significantly improve hot flashes in patients with prostate cancer after endocrine therapy. The mechanism of Qingxin Zishen decoction may be to improve the vasomotor function by regulating the expression level of vasomotor factors， so as to treat hot flashes.

Objective To assess ocular biometric parameters among primary and secondary school students from Naxi,Bai and Han ethnic groups in Yunnan Province.Methods The school-based study was conducted in October 2020.A total of 724 second-,third-and seventh-graders were selected from Dali and Lijiang,where Bai and Naxi ethnic groups inhabit,using a stratified cluster sampling method to receive questionnaire surveys and eye examinations.Non-cycloplegic spherical equivalent(SE),axial length(AL),anterior chamber depth(ACD),corneal radius of curvature(CR),central corneal thickness(CCT),white-to-white(WTW)distance,and the AL/CR ratio were measured.Covariance analysis was used to examine the differences in SE and ocular biometric parameters in terms of ethnicity,sex and grade,while Pearson correlation was used to test the associations among the said indicators.Results There were no significant differences in daily outdoor time,screen time and sleep time among the three ethnic groups regardless of grades(all P＞0.05).The mean CCT of Naxi students was lower than that of Han and Bai students[grade 2 and grade 3:(542.48±39.76)μm vs.(553.81±31.83)μm and(559.27±32.79)μm;grade7:(538.86±34.91)μm vs.(547.41±33.55)μm and(548.26± 32.98)μm,all P＜0.05],while no significant differences were found in the other ocular biometric parameters among the three ethnic groups(all P＞0.05).Among the seventh-graders,the SE,AL and AL/CR ratio of Naxi students were signifi-cantly different from those of Han and Bai students(all P＜0.05).The AL,CR,ACD,CCT,WTW distance,and mean SE were lower in girls than in boys(all P＜0.05).Compared with grade 2 and grade 3,students of grade 7 had longer AL,deeper ACD and thinner CCT(all P＜0.05),while no significant differences were found in CR and WTW distance(all P＞0.05).Correlation analysis showed that the AL/CR ratio was highly correlated with SE(r=-0.78,P＜0.05).Conclu-sion Multiethnic primary and secondary school students may face similar environmental risks.Yet,disparities in ocular biometric parameters caused by ethnicity,sex and age should be noted.

Hepatocellular carcinoma （HCC） with biliary duct tumor thrombus （BDTT） is currently not common in clinical practice and is easily misdiagnosed， and previously， it was often considered an advanced stage of the disease with a poor prognosis， making its treatment challenging. However， in-depth studies in recent years have gradually deepened our understanding of this disease， leading to significant changes in diagnostic and treatment concepts. Currently， comprehensive treatment， mainly surgery， is used for treatment， but there is still controversy over the selection of clinical treatment strategies. This article provides a detailed discussion on surgical methods and prognosis， in order to provide a reference for clinical treatment options.