Objective:To analyze the effect of joint management of type 2 diabetes mellitus (T2DM) between specialty and community under the model of National Diabetes Prevention and Control Center (DPCC).Methods:A total of 2 527 T2DM patients managed by DPCC Pingshan Center of Shenzhen from January 1, 2022 to December 31, 2024 were retrospectively included. After management, the rate of downturn, reexamination rate, blood pressure compliance rate, metabolic indicators (waist circumference, body mass index, fasting blood glucose, glycosylated hemoglobin, blood lipids) and screening rate of chronic complications of diabetes (atherosclerotic cardiovascular disease, microvascular disease, diabetic peripheral neuropathy) were analyzed. Those included 2022 ( n=564), 2023 ( n=1 477), and 2024 ( n=2 527). Results:The downturn rate in 2022, 2023 and 2024 increased year by year (22.8% vs 67.2% vs 89.9%, P<0.01), and the review rate (41.1% vs 62.2% vs 52.7%, P<0.01), complication screening rate (51.6% vs 85.3% vs 62.2%, P<0.01), blood pressure compliance rate (53.1% vs 78.0% vs 67.2%, P<0.01), body mass index compliance rate (13.2% vs 17.3% vs 28.6%, P<0.01), fasting blood glucose meeting rate (46.4% vs 60.2% vs 68.5%, P<0.01), glycated hemoglobin meeting rate (58.4% vs 63.2% vs 45.6%, P<0.01) were relatively improved. Waist circumference compliance rate (30.6% vs 27.7% vs 21.6%) and blood lipid compliance rate (33.6% vs 35.5% vs 31.9%) were not significantly improved, and the review rate, blood pressure compliance rate and complication screening rate in 2024 were lower than those in 2023 and higher than those in 2022. Conclusions:The combined management of type 2 diabetes under the DPCC model has significant effects on improving the down-conversion rate, rediagnosis rate, blood pressure compliance rate, metabolic index compliance rate and the screening rate of diabetes-related chronic complications in patients with diabetes. At the same time, it was also found that with the progress of hierarchical diagnosis and treatment, the review rate, complication screening rate, blood pressure, waist circumference, blood lipid and glycosylated hemoglobin reached the standard of patients decreased compared with the previous situation, which needs to be further analyzed and improved.

Objective:To systematically retrieve, evaluate, extract, and integrate the best evidence on sleep disordered breathing (SDB) assessment and intervention in stroke patients to inform clinical practice.Methods:Based on the "6S" evidence model, the literature on SDB assessment and intervention in stroke patients was searched top-down on clinical decision-making websites, guideline websites, professional association websites, and databases. The search period was from the establishment of the database to September 1, 2024. The evidence-based team was formed to select the corresponding tool for quality assessment based on the type of literature. The evidence was also summarized using the Joanna Briggs Institute Center for Evidence-Based Health Care quality level of evidence and grade of recommendation.Results:A total of twenty papers were included, including six expert consensus, six guidelines, four clinical decision-making, two evidence summaries, and two systematic reviews. Eighteen pieces of evidence were summarized around four aspects of assessment, treatment, adherence, and health education.Conclusions:The assessment and intervention of SDB in stroke patients is multifaceted. It is recommended that healthcare professionals dynamically observe the actual condition of patients when applying the evidence to scientifically assess and manage SDB in stroke patients.

Objective:To analyze the effect of joint management of type 2 diabetes mellitus (T2DM) between specialty and community under the model of National Diabetes Prevention and Control Center (DPCC).Methods:A total of 2 527 T2DM patients managed by DPCC Pingshan Center of Shenzhen from January 1, 2022 to December 31, 2024 were retrospectively included. After management, the rate of downturn, reexamination rate, blood pressure compliance rate, metabolic indicators (waist circumference, body mass index, fasting blood glucose, glycosylated hemoglobin, blood lipids) and screening rate of chronic complications of diabetes (atherosclerotic cardiovascular disease, microvascular disease, diabetic peripheral neuropathy) were analyzed. Those included 2022 ( n=564), 2023 ( n=1 477), and 2024 ( n=2 527). Results:The downturn rate in 2022, 2023 and 2024 increased year by year (22.8% vs 67.2% vs 89.9%, P<0.01), and the review rate (41.1% vs 62.2% vs 52.7%, P<0.01), complication screening rate (51.6% vs 85.3% vs 62.2%, P<0.01), blood pressure compliance rate (53.1% vs 78.0% vs 67.2%, P<0.01), body mass index compliance rate (13.2% vs 17.3% vs 28.6%, P<0.01), fasting blood glucose meeting rate (46.4% vs 60.2% vs 68.5%, P<0.01), glycated hemoglobin meeting rate (58.4% vs 63.2% vs 45.6%, P<0.01) were relatively improved. Waist circumference compliance rate (30.6% vs 27.7% vs 21.6%) and blood lipid compliance rate (33.6% vs 35.5% vs 31.9%) were not significantly improved, and the review rate, blood pressure compliance rate and complication screening rate in 2024 were lower than those in 2023 and higher than those in 2022. Conclusions:The combined management of type 2 diabetes under the DPCC model has significant effects on improving the down-conversion rate, rediagnosis rate, blood pressure compliance rate, metabolic index compliance rate and the screening rate of diabetes-related chronic complications in patients with diabetes. At the same time, it was also found that with the progress of hierarchical diagnosis and treatment, the review rate, complication screening rate, blood pressure, waist circumference, blood lipid and glycosylated hemoglobin reached the standard of patients decreased compared with the previous situation, which needs to be further analyzed and improved.

Objective:To systematically retrieve, evaluate, extract, and integrate the best evidence on sleep disordered breathing (SDB) assessment and intervention in stroke patients to inform clinical practice.Methods:Based on the "6S" evidence model, the literature on SDB assessment and intervention in stroke patients was searched top-down on clinical decision-making websites, guideline websites, professional association websites, and databases. The search period was from the establishment of the database to September 1, 2024. The evidence-based team was formed to select the corresponding tool for quality assessment based on the type of literature. The evidence was also summarized using the Joanna Briggs Institute Center for Evidence-Based Health Care quality level of evidence and grade of recommendation.Results:A total of twenty papers were included, including six expert consensus, six guidelines, four clinical decision-making, two evidence summaries, and two systematic reviews. Eighteen pieces of evidence were summarized around four aspects of assessment, treatment, adherence, and health education.Conclusions:The assessment and intervention of SDB in stroke patients is multifaceted. It is recommended that healthcare professionals dynamically observe the actual condition of patients when applying the evidence to scientifically assess and manage SDB in stroke patients.

Hepatic venous pressure gradient (HVPG) is the "gold standard" for the diagnosis of portal hypertension, which could be applied in the evaluation of liver cirrhosis. Combined use of HVPG with model for end-stage liver disease (MELD) scoring system may more accurately match the donors and recipients undergoing liver transplantation for liver cirrhosis, select the appropriate timing of surgery, and provide guidance for bridging treatment for patients on the waiting list for liver transplantation. Besides, HVPG may also predict clinical prognosis of liver transplant recipients, and provide evidence for early detection and intervention of potential complications. Therefore, the value of HVPG in preoperative evaluation and prognosis prediction of liver transplant recipients was reviewed, aiming to provide guidance for clinical diagnosis and treatment of liver transplant recipients before and after surgery.

Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.

A 47-year-old female patient with Helicobacter pylori (HP) infection received anti-HP regimen, including pantoprazole enteric coated tablets 40 mg orally twice daily, amoxicillin capsules 1 g orally twice daily, and furazolidone tablets 0.1 g orally thrice daily. The patient had previously taken amoxicillin capsules and pantoprazole enteric coated tablets several times without adverse reactions. On the 12th day after receiving anti-HP treatment, the patient developed fever, shortness of breath, body temperature of 38.3 ℃, and conjunctival hemorrhage of the right eyeball. Laboratory tests showed that percentage of eosinophils was 0.08. Chest CT showed interstitial pulmonary edema in bilateral lungs and a small amount of effusion in the right pleural cavity. Acute lung injury associated with furazolidone was considered. Furazolidone was stopped. The patient received glucocorticoid and symptomatic treatments. Six days later, the patient′s symptoms such as fever and shortness of breath were relieved and the conjunctival hemorrhage in the right eye was absorbed; laboratory test showed that percentage of eosinophils was 0.008; the chest CT showed that the interstitial pulmonary edema in bilateral lungs was more absorbed than before and the pleural effusion on the right side was basically absorbed.

A 47-year-old female patient with Helicobacter pylori (HP) infection received anti-HP regimen, including pantoprazole enteric coated tablets 40 mg orally twice daily, amoxicillin capsules 1 g orally twice daily, and furazolidone tablets 0.1 g orally thrice daily. The patient had previously taken amoxicillin capsules and pantoprazole enteric coated tablets several times without adverse reactions. On the 12th day after receiving anti-HP treatment, the patient developed fever, shortness of breath, body temperature of 38.3 ℃, and conjunctival hemorrhage of the right eyeball. Laboratory tests showed that percentage of eosinophils was 0.08. Chest CT showed interstitial pulmonary edema in bilateral lungs and a small amount of effusion in the right pleural cavity. Acute lung injury associated with furazolidone was considered. Furazolidone was stopped. The patient received glucocorticoid and symptomatic treatments. Six days later, the patient′s symptoms such as fever and shortness of breath were relieved and the conjunctival hemorrhage in the right eye was absorbed; laboratory test showed that percentage of eosinophils was 0.008; the chest CT showed that the interstitial pulmonary edema in bilateral lungs was more absorbed than before and the pleural effusion on the right side was basically absorbed.

Objective:To investigate the safety and therapeutic effect of Shakubatrivalsartan in the treatment of pediatric dilated cardiomyopathy.Methods:Clinical information, treatment and prognosis of 5 cases with dilated cardiomyopathy in the First Affiliated Hospital of Xinxiang Medical University from June 2018 to December 2020 were retrospectively analyzed, and relevant literatures were reviewed.Results:A total of 5 cases of children with dilated cardiomyopathy were analyzed, including 3 males and 2 females with age of 12-17 years.Their median left ventricular ejection fraction (LVEF), left ventricular end diastolic dimension (LVDd), N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were 37% (20%-41%), 61 mm (59-67 mm), and 13 250 ng/L (12 310-21 823 ng/L), respectively.The median conventional treatment time was 5 months (1-12 months), in which, the condition of heart failure gradually progressed, and the median LVEF, LVDd and NT-proBNP levels were reduced to 33% (19%-37%), 61 mm (60-74 mm), 13 144 ng/L (8 086-15 137 ng/L). After less than 3 months of follow-up following conventional treatment plus Shakubatrivalsartan, NT-proBNP level significantly decreased in 5 cases.Besides, 4 cases had improved cardiac function, and the other one′s improvement was not obvious.The blood pressure of 5 cases decreased at varying degrees after medication of Shakubatrivalsartan, which should be closely monitored during drug titration.No adverse reactions were reported.Conclusions:Shakubatrivalsartan for the treatment of pediatric dilated cardiomyopathy is safe and effective, which can alleviate or reverse the process of myocardial remodeling and improve cardiac ejection fraction, thus improving the prognosis.

Objective: To explore the relationship among self-regulatory focus and depression, anxiety symptoms and suicidal risks of medical college students. Methods: A total of 2 251 freshmen were recruited from a medical university by convenienee sampling methood. A cross-sectional questionnaire survey using Regulatory Focus Questionnaire (RFQ), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Beck Hopelessness Scale (BHS), Psychache Scale (PAS), and Suicide Behaviors Questionnaire-Revised (SBQ-R) was conducted. Results: The prevalence rate of freshmen’s depression symptoms was as high as 20.4%, the prevalence rate of anxiety symptoms was 11.2%, and the risk of suicide increased by 5.85 times among students with depression-anxiety comorbid symptoms. Girls reported higher prevention focused scores than boys, as well as higher anxiety symptoms and suicidal risks(t=4.84,2.18,5.57,P<0.05). College students with a prevention focused self-regulation style had significantly higher scores on depression, anxiety symptoms and suicidal risks than those with a promotion focused regulatory style, the effect sizes of the differences were moderate or large (Cohen’s d>0.50). Conclusion Self-regulatory focus plays an important role in emotional health. The pursuit of promotion goals is beneficial to mental health, while the pursuit of prevention goals is more likely to be associated with depression, anxiety symptoms and a higher risk of suicide.