Objective:To investigate the status of hypoglycemia fear, diabetes distress, self-regulatory fatigue and self-management in type 2 diabetes patients. The chain mediating effects of self-regulated fatigue and psychological distress on hypoglycemic fear and self-management were investigated.Methods:The Hypoglycemia Fear Survey-Worry Subscale (CHFSII-WS), Diabetes Distress Scale (DDS), Self-Regulatory Fatigue Scale (SRF-S) and Summary of Diabetes Self-Care Activities (SDSCA) were used to investigate the type 2 diabetes patients from the department of Endocrinology of the First Affiliated Hospital in Jinzhou Medical University. And constructed the structural equation model.Results:The scores of fear of hypoglycemia in type 2 diabetes patients were positively correlated with psychological pain and self-regulating fatigue ( r=0.739, 0.625, P<0.05), but negatively correlated with self-management level ( r=-0.602, P<0.05). The psychological pain score was positively correlated with the self-regulating fatigue score ( r=0.669, P<0.05) and negatively correlated with the self-management level score ( r=-0.609, P<0.05). The score of self-regulation fatigue was negatively correlated with the score of self-management ( r=-0.596, P<0.05). Pathway analysis showed that hypoglycemia fear could directly affect self-management behavior, indirectly predict self-management level through self-regulation fatigue and psychological pain respectively, and negatively affect self-management behavior through chain mediation of self-regulation fatigue and psychological pain ( χ2/ df=3.079, GFI=0.920, CFI=0.961, NFI=0.943, IFI=0.961, RMSEA=0.078). Conclusions:The Self-regulated fatigue and psychological distress acts as the chain mediators of hypoglycemic fear and self-management in patients with type 2 diabetes.

Objective:To investigate the inhibitory effect of probiotics on cholesterol gallstone formation in mice fed a high-fat diet and its impact on leptin and intestinal flora.Methods:Forty 8-week-old female C57BL/6J SPF mice were obtained. After one week of adaptive feeding, the mice were randomly assigned to G-NS group ( n=10), G-Probiotics group ( n=10), L-NS group ( n=10), and L-Probiotics group ( n=10). The G-NS group and G-Probiotics group were fed with standard diet, while the L-NS group and L-Probiotics group received lithogenic diet. Additionally, the G-Probiotics group and L-Probiotics group received a probiotic solution (5×10 9 CFU/ml, 0.1 mL/10 g) by gavage, once daily for 8 weeks. The G-NS group and L-NS group received an equal volume of normal saline by gavage. After 8 weeks, the stone formation rate of mice was observed, the serum leptin, total cholesterol (TC) and low-density lipoprotein cholesterol (LDL) contents of mice were detected, feces were collected and DNA was extracted to analyze the diversity and abundance of intestinal flora in mice. Count data were presented as percentages, Fisher′s exact probability test was used for comparisons, and measurement data with normal distribution were presented as mean±standard divation ( ± s). One-way ANOVA was applied for inter-group comparisons, and the K-W rank sum test was utilized to analyze inter-group differences in the intestinal microbiota section. Results:No gallstone was found in the G-NS group and G-Probiotics group. The stone formation rates of the L-NS group and the L-Probiotics group were 100% and 60%, respectively, with statistical significance ( P<0.05). In the G-NS group, L-NS group, G-Probiotics group and L-Probiotics group the serum total cholesterol (TC) content were (2.03±0.34) mmol/L, (4.75±0.76) mmol/L, (1.64±0.49) mmol/L and (3.66±0.62) mmol/L, the serum low-density lipoprotein (LDL) cholesterol content was (0.57±0.10) mmol/L, (1.55±0.29) mmol/L, (0.73±0.37) mmol/L and (1.06±0.16) mmol/L, the serum leptin content was (6.77±0.76) μg/L, (19.24±3.97) μg/L, (3.21±1.32) μg/L and (11.67±1.05) μg/L. Comparison of serum TC and LDL: L-NS group was higher than G-NS group, L-NS group was higher than L-Probiotics group, L-Probiotics group was higher than G-Probiotics group, the difference was statistically significant ( P<0.01). Comparison of serum leptin showed that L-NS group was higher than G-NS group and L-Probiotics group, G-NS group and L-Probiotics group was higher than G-Probiotics group, the difference was statistically significant ( P<0.01). Compared with the control group, the intestinal flora diversity of mice in the simple high-fat diet group decreased, the relative abundance of harmful bacteria increased, and the relative abundance of beneficial bacteria decreased. After probiotics intervention, the intestinal flora diversity increased, the relative abundance of beneficial bacteria increased, and the relative abundance of harmful bacteria decreased. Conclusion:Probiotics can lower leptin levels and alleviate leptin resistance, decrease serum TC and LDL levels, and reduce cholesterol levels in bile, thus reducing cholesterol buildup in the gallbladder and preventing stone formation.

Objective:To discuss the effects of Buzhong Yiqi Decoction medicated serum combined with cisplatin on the expression of Nrf2 and its effects of downstream antioxidant proteins in human pulmonary adenocarcinoma A549/DDP cells.Methods:Totally 60 rats were divided into blank group, low-dosage group, medium-dosage group, and high-dosage group using a random number table method, with 15 rats in each group. The low-, medium-, and high-dosage groups were orally administered with 3.29, 6.57, and 13.13 g/kg Buzhong Yiqi Decoction for gavage, once a day, for 7 days. 1 hour after the last administration, blood was collected from the abdominal aorta to prepare the serum containing Buzhong Yiqi Decoction. A549/DDP cells were divided into 5 groups: blank group (rat serum), model group (rat serum+cisplatin), low-dosage group (low-dosage Buzhong Yiqi Decoction medicated serum+cisplatin), medium-dosage group (medium-dosage Buzhong Yiqi Decoction medicated serum +cisplatin), and high-dosage group (high-dosage Buzhong Yiqi Decoction medicated serum+cisplatin). And 24 h after the Buzhong Yiqi Decoction intervention, CCK-8 method was used to detect the IC 50 of cisplatin in each group. The fluorescence expression intensity of p-Nrf2 in A549/DDP cells of each group was determined by confocal fluorescence localization method. The mRNA relative expression of Nrf2 in A549/DDP cells of each group was detected by RT-qPCR. The relative expressions of Nrf2, p-Nrf2, GPX4, PRX1 and SOD in A549/DDP cells of each group were detected by Western blot. Results:Compared with the model group, the IC 50 of A549/DDP cells to cisplatin decreased in the low-, medium-, and high-dosage groups ( P<0.01); the fluorescence intensity of p-Nrf2 decreased ( P<0.01); the level of Nrf2 mRNA decreased ( P<0.01); the protein expressions of Nrf2, p-Nrf2, SOD, PRX1, and GPX4 were down-regulated ( P<0.01), with the effect being more significant in the medium- and high-dosage groups ( P<0.05). Conclusion:Buzhong Yiqi Decoction medicated serum can improve cisplatin resistance in human pulmonary adenocarcinoma cancer by inhibiting the active expression of Nrf2 in A549/DDP cells and down-regulating the target genes of SOD, PRX1 and GPX4 in vivo.

Objective:To investigate the effects of Buzhong Yiqi Decoction on the expressions of multidrug resistance-related protein (MRP), lung resistance-related protein (LRP), and P-glycoprotein (P-gp) in transplantation tumor of A549 tumor-bearing nude mice.Methods:A549 cells were cultured to establish xenograft models of tumor-bearing nude mice. According to the random number table method, they were divided into blank control group, cisplatin group, cisplatin + Buzhong Yiqi Decoction low-dosage group, cisplatin + Buzhong Yiqi Decoction medium-dosage group, cisplatin + Buzhong Yiqi Decoction high-dosage group. After 25 days of corresponding drug intervention, the mRNA expressions of MRP, LRP and P-gp in transplantation tumors were detected by Real-Time PCR, and Western blot was used to detect the expressions of MRP, LRP and P-gp proteins in xenograft tissues in each group.Results:Compared with blank control group, the mRNA and protein expressions of MRP, LRP and P-gp in cisplatin group were significantly down-regulated ( P<0.05). Compared with cisplatin group, the mRNA and protein expressions of MRP, LRP and P-gp in the cisplatin + Buzhong Yiqi Decoction low-dosage group, cisplatin + Buzhong Yiqi Decoction medium-dosage group, cisplatin+Buzhong Yiqi Decoction high-dosage group decreased ( P<0.05). Conclusion:Buzhong Yiqi Decoction can inhibit the expressions of MRP, LRP and P-gp in transplantation tumor of A549 tumor-bearing nude mice and without dosage dependence.

Objective:To investigate the effect of a single-trial transcranial direct current stimulation(tDCS) of the dorsolateral prefrontal cortex (DLPFC) on fairness-related decision-making behavior.Methods:From September 2018 to February 2019, a total of 60 healthy participants between the ages of 18 and 45 were enrolled.Then, the participants were randomly divided into 3 groups with 20 in each group to receive left anode stimulation/right cathode stimulation (left anode /right cathode group), left cathode/right anode stimulation (left cathode /right anode group) or bilateral control electrodes (sham stimulation group) on the bilateral dorsolateral prefrontal cortices (DLPFC), respectively.After tDCS, the participants immediately completed the ultimatum game (UG) task as responders and a fairness questionnaire in turn.SPSS 22.0 statistical software was used to analyze the data with repeated measurement ANOVA and nonparametric test.Results:In the UG task, there was no significant difference in the acceptance rate among the three groups of participants as responders (all P>0.05). When analyzing the acceptance rate facing different proposers (" computer" and " human" ) under different fairness levels in the three stimulus types through the paired samples Wilcoxon test, it was found that the acceptance rate of the sham stimulation group to the extremely unfair proposals proposed by the human opponent was lower than that proposed by the computer(0.28 (0, 0.67), 0.44 (0.33, 0.89), Z=-2.14, P=0.032), while there was no difference in acceptance rates (both P>0.05) in the face of fair or unfair proposals proposed by computer and human opponents.The acceptance rate of the left cathode /right anode group to the unfair(0.90 (0.50, 1.00), 1.00 (0.70, 1.00), Z=-1.90, P=0.046)or extremely unfair(0.44 (0, 1.00), 0.89 (0.50, 1.00), Z=-2.73, P=0.006) proposals proposed by human opponents was significantly lower than the proposals proposed by computer opponent, and there was no differences in acceptance rate when facing fair proposals proposed by computer and human opponents ( P> 0.05). There were no significant differences in acceptance rates in the left anode /right cathode group when faced with fair, unfair, and extremely unfair schemes proposed by computer and human opponents (all P>0.05). For fairness questionnaire scores, a repeated measurements ANOVA showed that the interaction effect between group and proposer types was not significant ( F(2, 54)=2.037, P=0.140), and the group main effect was not significant ( F(1, 54)=0.165, P=0.848), but the proposer type main effect was significant ( F(1, 54)=6.363, P=0.015), indicating that the fairness questionnaire score in the face of the human opponents was lower than when facing the computer opponents( P<0.05). Conclusion:Although a single-trial tDCS on bilateral DLPFC has no significant effect on the overall acceptance rate of fairness-related decision-making, it affects the decision-making of unfair distribution scheme proposed by human or computer.

Objective:To investigate the quality of life in patients with early-stage extra-nodal NK/T cell lymphoma of nasal type (ENKTL) arising from the upper aerodigestive tract, who had remained progression-free survival (PFS) for over 3 months after definitive intensity-modulated radiation therapy (IMRT), and to analyze the factors related to main adverse symptoms.Methods:276 patients who received IMRT from March, 2012 to June, 2021 were included. There were 201 males and 75 females with a median age of 41.5 years (range: 13-81 years) upon diagnosis. Consistent target delineation schemes and similar dose gradients were adopted for IMRT, with a median prescribed dose of 54.6 Gy/26F. Cross-sectional investigation was performed with a modified EORTC QLQ-H&N35 questionnaire, the incidence and severity of adverse symptoms, severity of disease and their influencing factors at each time-point during their survival were statistically analyzed.Results:The median age of patients at the investigation was 46.2 years, and the median PFS after IMRT was 47.2 months (range: 3.1-115.7 months). The most common adverse symptoms included nasal symptoms (incidence rate 63.8%), dry mouth (50%), tooth diseases (47.1%), smell and taste alteration, and sexual apathy, etc. Most symptoms were mild (the average standardized score was 5.50, the full score of 100 indicating the most severe), and could be relieved remarkably over survival time, but some symptoms, such as tooth diseases and sexual apathy, were more obvious and recurred for several years. Age and anti-PD-1 immune therapy influenced the symptom scores, and tooth diseases were closely correlated with dry mouth. Conclusion:The quality of life in patients with early-stage ENKTL after definitive IMRT is high, and the most significant symptoms include nasal symptoms, tooth diseases, and sexual apathy, etc. , which need to be mitigated with more studies.

Objective To analyze the relationship between ferritin, carbohydrate antigen (CA)125, CA153, lactic dehydrogenase (LDH), albumin and progression and prognosis of Sj?gren's syndrome with inter-stitial pneumonitis (pSS-IP). Methods Five hundred and twenty-seven primary pSS patients from 2011 to 2017 were analyzed retro-spectively. According to the lung imaging and clinical features, they were divided into groups. The differences of ferritin, CA125, CA153, LDH and albumin (ALB) levels in each group were analyzed by Mann-Whitney U test. Logistic regression was used to analyze the risk factors of pSS complicated with interstitial pneumonitis. Results ① Among the 527 pSS patients, 206 (39.1％) were diagnosed with IP. Compared with 321 patients without interstitial pneumonitis (pSS-N-IP), ferritin, CA125, CA153 and LDH in pSS-IP were relatively higher [189(116, 380) ng/ml vs 138(75, 258) ng/ml, Z=-3.777, P<0.05;19(12, 36) U/ml vs 12(9, 19) U/ml, Z=-5.974, P<0.05;22(12, 34) U/ml vs 9(6, 14) U/ml, Z=-4.582, P<0.05;206(165, 258) U/L vs 161(139, 195) U/L, Z=-8.770, P<0.05], while albumin was lower [34(31, 37) g/L vs 36(34, 39) g/L, Z=5.210, P<0.05]. ② pSS-IP were divided into pSS-IP progression group (46 cases) and pSS-IP stable group (60 cases) according to their lung imaging characteristics. Compared with pSS-IP stabilization group, pSS-IP progression group had higher ferritin [254(129, 693) ng/ml vs 161(104, 259) ng/ml, Z=-2.437, P<0.05]. ③ Logistic regres-sion analysis showed that there was correlation between ferritin and the progress of pSS-IP (OR=1.002). Conclusion Ferritin, CA125, CA153, LDH, albumin are related to pSS-IP. Ferritin isrelated to the progress of pSS-IP, and is a risk factor for the progress of pSS-IP.

BACKGROUND:Distal tibial tuberosity-high tibial osteotomy is a surgical treatment for knee osteoarthritis,but there is still a lack of clinical studies on its effect on ankle joints. OBJECTIVE:To observe the effects of distal tibial tuberosity-high tibial osteotomy on ankle angle on coronal plane of the radiography of the full length of lower limb in weight loading. METHODS:Data of 40 patients(41 knees)with distal tibial tuberosity-high tibial osteotomy from March 2021 to March 2022 were retrospectively analyzed,including 31 females and 9 males,20 left knees and 21 right knees,aged 49-75 years,mean(63.44±6.57)years.The radiographic data of the full length of the lower limb in weight loading were collected before,week 2 and week 48 postoperatively.Hip-knee-ankle angle,talar tilt angle,tilt angle of the ankle,tibiocrural angle,and tibial articular surface angle were measured before and after surgery. RESULTS AND CONCLUSION:(1)Hip-knee-ankle angle improved from(-6.24±3.69)° before operation to(2.59±3.49)° week 2 postoperatively and(2.15±3.49)° week 48 postoperatively.The tilt angle of the ankle changed from(-7.90±3.11)° before operation to(-2.51±2.59)° week 2 postoperatively and(-2.46±2.42)° week 48 postoperatively,with statistically significant difference(P<0.001).(2)There was no significant difference in talar tilt angle,tibiocrural angle,and tibial articular surface angle before and week 2 postoperatively.(3)No significant difference in the angle changes was detected between week 2 and week 48 postoperatively.(4)It is indicated that distal tibial tuberosity-high tibial osteotomy can not only correct genu varus but also improve ankle angle.This result remains stable after 48 weeks of weight-bearing activities.

Intensive cancer treatment with drug combination is widely exploited in the clinic but suffers from inconsistent pharmacokinetics among different therapeutic agents.To overcome it,the emerging nanomedicine offers an unparalleled opportunity for encapsulating multiple drugs in a nano-carrier.Herein,a two-step super-assembled strategy was performed to unify the pharmacokinetics of a pep-tide and a small molecular compound.In this proof-of-concept study,the bioinformatics analysis firstly revealed the potential synergies towards hepatoma therapy for the associative inhibition of exportin 1(XPO1)and ataxia telangiectasia mutated-Rad3-related(ATR),and then a super-assembled nano-pill(gold nano drug carrier loaded AZD6738 and 97-110 amino acids of apoptin(AP)(AA@G))was con-structed through camouflaging AZD6738(ATR small-molecule inhibitor)-binding human serum albumin onto the AP-Au supramolecular nanoparticle.As expected,both in vitro and in vivo experiment results verified that the AA@G possessed extraordinary biocompatibility and enhanced therapeutic effect through inducing cell cycle arrest,promoting DNA damage and inhibiting DNA repair of hepatoma cell.This work not only provides a co-delivery strategy for intensive liver cancer treatment with the clinical translational potential,but develops a common approach to unify the pharmacokinetics of peptide and small-molecular compounds,thereby extending the scope of drugs for developing the advanced com-bination therapy.

Brain-computer interface(BCI)devices are crucial tools for neural stimulation and recording,offering broad prospects in the diagnosis and treatment of neurological disorders.Furthermore,magnetic resonance imaging(MRI)is an effective and non-invasive technique for capturing whole-brain signals,providing detailed information on brain structures and activation patterns.Integrating the neural stimulation/recording capabilities of BCI devices with the non-invasive detection function of MRI is considered highly significant for brain function analysis.However,this combination imposes specific requirements on the magnetic and electronic performance of neural interface devices.The interaction between BCI devices and MRI is initially explored.Subsequently,potential safety risks arising from their combination are summarized and organized.Starting from the source of these hazards,such as the metallic electrodes and wires of BCI devices,the issues are analyzed,and current research countermeasures are summarized.In conclusion,the regulatory oversight of BCI's magnetic resonance safety is briefly discussed,and suggestions for enhancing the magnetic resonance compatibility of related BCI devices are proposed.