Objective: To explore the risk factors associated with depression in type 2 diabetes mellitus (T2DM) patients with erectile dysfunction (DMED). Methods: A total of 60 male DMED patients in Kangning Hospital Affiliated to Wenzhou Medical University were enrolled.They were divided into group A (DMED with depression, 40 cases) and group B (DMED without depression, 20 cases) according to the results of self-rating depression scale (SDS). The comorbidity rate of DMED and depression was calculated.Baseline index, blood glucose control index, sex hormone index and blood lipid biochemical index were compared between the two groups.Pearson correlation analysis was used to judge the correlation between SDS scale scores and the indicators.Finally, these indicators were substituted into logistic regression analysis to find out the factors that may cause the comorbidity of DMED and depression. Results: The age of the patients in group A was older than that in group B[(55.95±6.33)years vs.(44.15±5.08)years, t=7.242, P=0.000], the course of T2DM in group A was longer than that in group B [(10.28±0.94)years vs.(4.38±0.60)years, t=29.467, P=0.000]. The fast plasma glucose (FPG)[(10.24±1.55)mmol/L vs.(8.22±1.15)mmol/L, t=5.153, P=0.000], fasting insulin (FIns) [(21.34±2.58)mU/L vs.(17.35±2.13)mU/L, t=5.967, P=0.000] and glycosylated hemoglobin (HbAlc) [(8.75±1.05)% vs.(6.55±0.84)%, t=8.146, P=0.000] in group A were higher than those in group B. Testosterone (TT) level in group A was lower than that in group B [(1.89±0.24)ng/mL vs.(2.46±0.31)ng/mL, t=-7.855, P=0.000]. The luteinizing hormone (LH) [(12.95±1.14)U/L vs.(8.53±0.70)U/L, t=18.515, P=0.000] and follicle-stimulating hormone (FSH) [(19.55±1.83)U/L vs.(15.40±1.47)U/L, t=8.808, P=0.000] in group A were higher than those in group B. Pearson analysis showed that the SDS scale score was positively correlated with age, T2DM duration, FPG, Fins, HbAlc, LH, FSH (r=0.310, 0.503, 0.465, 0.583, 0.676, 0.355, 0.540, P=0.002, 0.008, 0.017, 0.022, 0.030, 0.026, 0.011), and negatively correlated with TT level (r=-0.713, P=0.028). Logistic regression analysis showed that the age, the course of T2DM and TT were the independent risk factors which caused the comorbidity of DMED and depression. Conclusion In male T2DM patients, the independent risk factors for DMED with depression are age, long duration, and low TT level.

Objective: To evaluate the effectiveness of the SHARP intervention model for increasing students’ moderate to vigorous physical activity (MVPA) levels,and to provide a reference for physical activity enriching intervention among middle schools students’. Methods: One-year interventional teaching was carried out in 6 schools selected in the terms of scale and demographics from Nanjing City, Jiangsu Province. Data were collected during physical education (intervention group 105, control group 113; pre-intervention 119, post-intervention 99) data for 218 students. MVPA was assessed at baseline and post-intervention using the Observed Health and Coaching Time System(SOFIT). Interviews with 19 teachers were conducted with intervention schools to explore teachers’ views on interventions. Results: The two-way analysis of variance showed that the intervention of the SHARP model had a significant impact on MVPA, VPA, and motor skills of middle school students. Proportion of the average MVPA class time of the intervention school students(62.80±9.11), and the average proportion of the VPA class time of the intervention school(24.33±12.55), the average class time for intervention in the school’s mastery of skills(32.34±11.78)(t=-7.46, -4.82, -12.08, P<0.01). The MVPA of students in control school remained relatively constant while the VPA decreased. Classroom teaching capability improved significantly in intervention schools, which was further confirmed by teacher interviews. Conclusion The SHARP intervention model can effectively increase the MVPA level of middle school students.

Objective:To evaluate the clinical efficacy of Sini-Jia-Huanglian Decoction on chronic heart failure (CHF) with qi deficiency and blood stasis syndrome. Methods:A total of 100 patients with CHF and qi deficiency and blood stasis syndrome in Handan Mingren hospital from January 2018 to June 2019 who met the inclusion criteria were divided into two groups according to the random number table method, 50 cases in each group. The control group was treated with conventional western medicine therapy, and the treatment group was treated with Sini-Jia-Huanglian Decoction on the basis of the control group. Both groups were treated for 30 days. TCM syndrome score was performed before and after treatment. The level of N-terminal-pro-B-type natriuretic peptide (NT-proBNP) was detected by radioimmunoassay. The levels of peptide and galectin 3 (Gal-3) were detected by ELISA. The exercise tolerance was measured by 6-minute walking test, the clinical efficacy was tevaluated. Results:The total effective rate of the treatment group was 92.0% (46/50), and the control group was 76.0% (38/50), there was significant difference between the two groups ( χ2=4.762, P=0.029). After treatment, the scores of shortness of breath, palpitation, dyspnea, dizziness, chest pain and total scores in the treatment group were significantly lower than those in the control group ( t values were 4.257, 8.493, 8.211, 4.481, 5.500, 6.977, respectively, all Ps<0.01). After treatment, the levels of NT-proBNP (2 349.61 ± 683.50 ng/L vs. 3 026.27 ± 714.35 ng/L, t=4.840), and peptide (12.16 ± 3.43 ng/L vs. 17.52 ± 3.98 ng/L, t=7.214) and Gal-3 (3.01 ± 0.82 μg/L vs. 3.94 ± 0.93 μg/L, t=5.304) in the treatment group were significantly lower than those in the control group ( P<0.01), and the walking distance of 6 minutes (450.66 ± 79.25 m vs. 384.49 ± 70.16 m, t=4.421) was significantly longer than that of the control group ( P<0.01). Conclusions:The Sini-Jia-Huanglian Decoction can improve the heart function and clinical symptoms of CHF patients with qi deficiency and blood stasis syndrome, and improve the clinical efficacy.

Purpose/Significance User portraits of doctors offering free medical advice in online live streaming are constructed and further used to analyze the behavioral characteristics of various types of doctors,so as to provide references for improving the effect of live streaming and their influence.Method/Process A sample of 1 816 doctors who offer free medical advice on the Haodf.com platform is used for clustering analysis to generate different doctor group portraits by using the two-step clustering algorithm.Then an evaluation system for live streaming influence is constructed to explore the differences in online influence among doctors with different styles of live streaming.Result/Conclusion Three types of doctor group portraits are identified,including knowledge-sharing,self-promotional and sociable.There are significant differences in their online influence and three dimensions of live streaming effects including activeness,reputation,and hotness among different doctor groups.Comparative analysis is further performed to find potential solutions for enhancing their live streaming influence.

Humans ; Arthroplasty, Replacement, Knee/adverse effects* ; Surgical Wound Infection/etiology* ; Retrospective Studies ; Risk Factors ; Arthroplasty, Replacement, Hip/adverse effects* ; Prosthesis-Related Infections/etiology*

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.