Objective:To investigate the association of muscle mass loss with atherosclerosis in elderly patients with type 2 diabetes mellitus(T2DM).Methods:A total of 322 patients with T2DM aged≥60 years old were divided into muscle mass loss group( n=152) and non-muscle mass loss group( n=170) according to their appendicular skeletal muscle mass index(ASMI). All participants underwent physical examination, dual-energy X-ray absorptiometry check, carotid and lower extremity ultrasound, as well as laboratory tests. Results:Among 322 patients, 49(15.22%) patients were suffered from sarcopenia and 152(47.2%) patients with reduced muscle mass. The carotid and lower extremity atherosclerosis grades in the muscle mass loss group were significantly higher than those in the non-muscle mass loss group( P<0.05), with lower body mass index(BMI), T-score, ASMI, uric acid, and homeostasis model assessment of insulin resistance index( P<0.05). Multivariate logistic regression analysis showed that carotid atherosclerosis and lower extremity atherosclerosis were risk factors for muscle mass loss while BMI and 25-(OH)D 3 were protective factors for muscle mass loss. There existed a consistency in carotid atherosclerosis grade and lower extremity atherosclerosis grade of elderly patients with T2DM( P<0.01). Conclusion:Atherosclerosis has a predictive value for early sarcopenia in elderly patients with T2DM.

Objective To analyze the time of removing setons by observing 30 cases of the infliximab (IFX)combined drainage setons therapy in the treatment of perianal fistulising Crohn's disease.Methods Thirty patients of perianal fistulising Crohn's disease of Department of Colorectal Surgery,Jiangsu Prorince Hospital of TCM in Aug.2015 to Jul.2017 were treated with drainage setons followed by intravenous IFX injections according to the standard,and setons were removed after the third injection of IFX.The method of repeated measurement were adopted to record.Clinical symptoms,perianal manifestations,laboratory indexes,healing rate and general linear model and nonparametric test of SPSS 23.0 software were used for statistical analysis.Results The differences of WBC,CRP,ESR,HB,PLT,BMI,CDAI and PDAI between post treatment and pretreatment were statistically significant (P ＜ 0.05).WBC,CRP and ESR will rerise at some time after removing the rubber band (sixth week).The closure rate of fistular at the 14th week was 53.3％,and after the follow-up in the ward at 22th week and 30th week,the clinical efficacy of fistular was not statistically significant (P ＞0.05) at the 14th week,22th week and 30th week.Conclusion IFX combined drainage setons which was removed when the induction therapy finished can induce Crohn's disease remission,improve laboratory index and promote fistula closure.the clinical efficacy in short time was stable.

Objective To evaluate the efficacy of infliximab combined with sphincter-sparing surgery in treatment of perianal Crohn's disease.Methods Clinical data of 49 patients with perianal Crohn's disease (3 cases with nonfistulizing perianal Crohn's disease and 46 cases with fistulizing perianal Crohn's disease) receiving infliximab combined with sphincter-sparing surgery in Jiangsu Province Hospital of TCM from May 2010 to June 2014 were analyzed retrospectively.The situation of fistula closure was assessed.C-reactive protein and perianal disease activity index were estimated by Wilcoxon method.Results No patient was failed to respond to primary treatment.patients (26/46) had a complete response to treatment,28.3％ patients (13/46) had a partial response and 15.2％ patients (7/46) had lost response to treatment;2 cases of anal ulcer healing;No other perianal lesion occurred in 1 case of verrucous skin.At final follow-up,CRP was decreased to [4.5 (1.5,15.9)] mg/Lfrom [16.9(6.6,35.6)] mg/L(Z=-3.994,P=0.00);PDAI was decreased to[1(0,4.5)]from [7(4.5,10.5)] (Z=-6.100,P=0.00).Conclusion Infliximab combined with sphincter-sparing surgery is effective for perianal Crohn's disease.

Objective:To investigate the effect of individualized positive end-expiratory pressure (PEEP) on postoperative lung complications in patients undergoing cardiac valve replacement.Methods:Sixty-four patients of both sexes, aged 40-70 yr, with body mass index of 18-26 kg/m 2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with New York Heart Association class Ⅱ or Ⅲ, undergoing elective cardiac valve replacement (single or double) from July to October 2020, were enrolled in this study.The patients were divided into 2 groups ( n=32 each) using a random number table method: control group (group C) and individualized PEEP group (group P). After recruitment maneuver, group C was set with a fixed PEEP of 4 cmH 2O, group P was titrated using a PEEP-step method, and PEEP was set at 4 cmH 2O after admission to intensive care unit (ICU). Before induction of anesthesia (T 0), before recruitment maneuver (T 1), at 20 min after PEEP ventilation (T 2), at 2 h after surgery (T 3), and at 24 h after surgery (T 4), arterial blood samples were taken for determination of serum interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) concentrations.The hemodynamic indicators (heart rate, mean arterial pressure and central venous pressure) at T 1-T 4 were recorded.Pulmonary complications were diagnosed according to clinical manifestations, imaging and blood gas analysis during the postoperative hospitalization.The postoperative length of hospital stay, extubation time and duration of ICU stay were recorded. Results:PEEP in group P [(6.1±1.4)cmH 2O] was significantly higher than that in group C ( P<0.05). Compared with group C, the concentrations of serum IL-6 and TNF-α at T 3 were significantly decreased, central venous pressure at T 2 was increased, and the incidence of postoperative pulmonary complications was decreased ( P<0.05), and no significant change was found in the length of hospital stay, extubation time and duration of ICU stay in group P ( P>0.05). Conclusion:Early application of individualized PEEP after termination of cardiopulmonary bypass can decrease the risk of postoperative pulmonary complications in patients undergoing cardiac valve replacement.

Since the National Health Commission launched the pilot work of " Internet+ nursing service" in 2019, medical institutions at all levels in China keep innovating their nursing service models to provide targeted high-quality care for discharged patients or special groups suffering from diseases and poor mobility. In April 2021, a tertiary hospital in Qingdao carried out the " Internet+ " whole course management practice with specialized nurses as the main service subjects, which center on discharged patients as the main service objects. By estabusing a management team and the construction of " Internet+ " information exchange platform, the hospital implemented the whole course of disease management process including patients′ pre-hospital management, in-hospital estimate, and post-hospital follow-up rehabilitation, to provide specialized nursing services such as PICC dressing change care, stoma care, and mother and infant care for patients at home. By February 2022, the " Internet+ " whole course management service had expanded to 50 kilometers away from hospital, with a total of 1 181 specialized nursing services. This management highlighted the characteristics of specialized nursing services in tertiary hospitals, accurately matched the needs of patients, reflected the concept of holistic care, and provided references for the rapid promotion of the development of " Internet+ nursing service" in China.

Objective:To explore the related factors of muscle mass loss in patients with type 2 diabetes mellitus, and to provide evidence for prevention of sarcopenia in type 2 diabetic patients.Methods:A cross-sectional survey was used to select type 2 diabetic patients admitted to the Department of Endocrinology, Affiliated Hospital of Qingdao University from January 2019 to August 2019. All subjects underwent dual-energy X-ray absorptiometry check. According to the diagnostic criteria of the Asian Working Group for Sarcopenia (AWGS), the subjects were divided into a muscle reduction group and a non-muscle reduction group. Data including age, gender, body mass index, course of disease, blood index, urinary albumin-creatinin ration (UACR), and appendicular skeletal muscle index (ASMI) were collected. The relevant clinical data of viscera fat/subcutaneous fat (VAT/SAT), percentage of abdominal fat/percentage of hip fat (A/G), grip strength, and pace were analyzed for the related factors of muscle mass loss in type 2 diabetic patients.Results:A total of 369 patients with type 2 diabetes were enrolled, including 42 patients with sarcopenia (an incidence rate of 11.38%), and 155 patients with reduced muscle mass (an incidence of 42.01%). Age, systolic blood pressure, high density lipoprotein-cholesterol, UACR, VAT/SAT, and A/G in the muscle reduction group were higher than those in the non-muscle reduction group ( P<0.05). The parameter of body mass index, homeostasis model assessment for insulin resistance, estimated glomerular filtration rate (eGFR), ASMI, and grip strength were lower in the muscle reduction group than in the non-muscle reduction group ( P<0.05). Multivariate logistic regression analysis showed age, UACR, A/G, and VAT/SAT were risk factors for muscle loss, body mass index, eGFR, and grip strength were protective factors for muscle mass reduction. Conclusion:It is of great practical significance for type 2 diabetic patients, especially those with advanced age, central obesity, low body mass index, low grip strength, low glomerular filtration rate, and high UACR to perform an early screening and to begin an early intervention.

Objective:To provide information reference for resource allocation and decision-making in related fields, the cost-effectiveness of HIV input among men who have sex with men (MSM) in Ningbo. Different intervention coverages were compared.Methods:Taking MSM as the target population, data were collected and modeled by Optima HIV for the corresponding HIV health output and the budget under different intervention coverages.Results:According to the estimated size of the MSM population, which was 19 584 in Ningbo in 2020, if the coverage of 2020 baseline intervention is maintained in the next ten years, the number of HIV cases, new HIV infections, and HIV-related deaths among this population will show an upward trend. It is estimated that from 2021 to 2030, 7.9% of new infections and 1.7% of deaths can be avoided and the relevant funding investment comed to 2.4 time the baseline if the intervention coverage rate expanded to 3.0 times the 2020 baseline. After the coverage rate of intervention expanded to 3 times the baseline, it continued to grow, the health effect did not increase.Conclusions:At present, expanding the baseline coverage of HIV-related intervention projects among MSM in Ningbo and increasing capital investment will still reverse HIV-related death and reduce new infections. Moreover, there is a saturation point of the intervention effect. Researchers and policymakers must explore more effective interventions/combinations to obtain more significant health outcomes.

Lycopene, as a high value-added terpene compound, has been widely concerned by researchers at home and abroad. Firstly, the ability of lycopene synthesis of Saccharomyces cerevisiae model strains S288c and YPH499 was analyzed and compared. The results showed that YPH499 was more suitable for lycopene synthesis as yeast chassis. Subsequently, the effects of constitutive promoters GPDpr, TEF1pr and inducible promoters GAL1pr, GAL10pr on Lycopene synthesis were compared. The results showed that when GPDpr and TEF1pr were used as promoters of crtE, crtB and crtI in lycopene synthesis pathway, the production of lycopene was 15.31 mg/L after 60 h fermentation in shaking flask. When GAL1pr and GAL10pr were used as promoters, the production was 123.89 mg/L, which was 8.09 times higher. In addition, the methylvaleric acid (MVA) pathway was further modified to overexpress the key enzyme gene of N-terminal truncation, tHMG1 (3-hydroxy-3-methylglutaryl coenzyme A reductase). The lycopene production was 265.68 mg/L, and the yield per cell was 72.79 mg/g. The Saccharomyces cerevisiae strain designed and constructed in this study can express lycopene in high yield per cell, thus could be used in the industrial production of lycopene after further construction and optimization.
Biosynthetic Pathways ; genetics ; Fermentation ; Industrial Microbiology ; Lycopene ; metabolism ; Saccharomyces cerevisiae ; genetics ; metabolism ; Species Specificity