Objective To explore the relationship of visceral fat area (VFA) with glucolipid metabolism indexes and insulin resistance (IR) in patients with type 2 diabetes mellitus (T2DM) complicated with obesity. Methods A total of 315 T2DM patients with obesity who were admitted to the hospital from April 2022 to August 2025 were retrospectively selected. The VFA of all patients was measured by bioelectrical impedance analysis method. According to VFA, the patients were classified into VFA≥100 cm² group (n=204) and VFA<100 cm² group (n=111). The glucolipid metabolism indexes [fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), triacylglycerol (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)] and IR index [homeostasis model assessment of insulin resistance based on C-peptide (HOMA-IR(CP))] were detected and compared between both groups of patients. Spearman correlation method was utilized to analyze the correlation between VFA and glucolipid metabolism indexes and HOMA-IR(CP). The independent related factors of VFA were explored by logistic regression analysis. Results According to VFA results of 315 patients after admission, 204 cases (64.76%) had VFA≥100 cm² and 111 cases (35.24%) had VFA<100 cm². Compared with the VFA<100 cm² group, the FPG, HbA1c, TG, TC, LDL-C and HOMA-IR(CP) in the VFA≥100 cm² group were higher (P<0.05) while the HDL-C was lower (P<0.05). Spearman correlation revealed that VFA≥100 cm² was positively correlated with FPG, HbA1c, TG, TC, LDL-C and HOMA-IR(CP) (P<0.001), and was negatively correlated with HDL-C (P<0.001). After logistic regression analysis, it was found that FPG, TG, HDL-C, HOMA-IR(CP) and body mass index (BMI) were independent related factors of VFA≥100 cm² (P<0.05). Conclusion VFA is closely related to glucolipid metabolism and IR in T2DM patients with obesity. FPG, TG, HDL-C, HOMA-IR(CP) and BMI are independent related factors affecting VFA≥100 cm². However, given the cross-sectional design of this study, the causal timing of this association cannot be determined and needs to be further verified by prospective cohort studies.

Objective:To explore the effectiveness of find-organize-clarify-understand- select-plan-do-check-act (FOCUS-PDCA) cycle management in improving the accuracy of Nutritional Risk Screening 2002 (NRS 2002) scoring in inpatients.Methods:This study was a retrospective study. Data from a continuous quality improvement project, namely Improving the Accuracy of Nutritional Risk Screening for Inpatients from People's Hospital of Longhua in 2021 were selected. The NRS 2002 scores of newly admitted patients from 8 departments with relatively high nutritional risk (departments of gstroenterology, neurology, nephrology, respiratory medicine, oncology and hematology, neurosurgery, gastrointestinal surgery, and critical care medicine) from April 10, 2021 to April 29, 2021 (before intervention) were collected. The NRS 2002 scores were evaluated by a multidisciplinary nutrition support team in terms of accuracy and error types. Possible issues in the process of nutritional screening were analyzed and mitigated using the FOCUS-PDCA cycle management method. The NRS 2002 scores from July 18, 2021 to August 8, 2021 (after intervention) were collected in real time to summary the data on accuracy and error types and to evaluate the effect of FOCUS-PDCA.Results:The accuracy of NRS 2002 score in the 8 departments was increased from 52.97% (294/555) to 81.13% (473/583) after intervention, and the difference was statistically significant ( χ2=102.606, P<0.001). The accuracy of nutritional status impairment score was 64.14% before intervention, compared with 90.57% after intervention ( χ2=114.484, P<0.001). The accuracy of disease severity score was 78.56%, compared with 89.54% after intervention( χ2=25.736, P<0.001). The false-negative rate was 68.02% before intervention and 31.87% after intervention, and the difference was statistically significant ( χ2=31.501, P<0.001). Conclusion:FOCUS-PDCA can improve the accuracy of NRS 2002 scoring in inpatients, reduce the risk of failing to identify patients at nutritional risk, and contribute to further nutritional diagnosis and treatment.

Hyperlipidemia refers to abnormal transport of lipids and metabolic disorders in the blood,which can easily cause cardiovascular diseases.At present,there are many adverse reactions and poor tolerance of chemical drugs.Traditional Chinese medicine and minority medicine have a long history and rich clinical experience,which have the advantages of low cost,convenience,high efficiency and little side effects.To provide reference for clinicians and researchers,the clinical research of traditional Chinese medicine and ethnic medicine in the prevention and treatment of hyperlipidemia was summarized.

Objective:To analyze the correlation between sex hormone levels and micropenis after mild hypospadias surgery in children.Methods:A case control study was carried out.The clinical data of 71 children aged 1 to 13 years who underwent mild hypospadias surgery at the First Affiliated Hospital of Xinxiang Medical University from April 2022 to April 2024 were analyzed.Preoperatively, the children were divided into a mild hypospadias group (Group A) and a mild hypospadias with micropenis group (Group B) based on the stretched penile length (SPL).Prolactin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone, and testosterone (TES) levels of the 2 groups were measured.Multivariate Logistic regression analysis was used to construct a risk prediction model.The discrimination capability of the model was evaluated using the receiver operating characteristic (ROC) curve.SPL and sex hormone levels were measured again 6 months after surgery.The children were divided into a normal penile group (Group AA) and a micropenis group (Group BB) after mild hypospadias according to SPL.Multivariate Logistic regression analysis was used to construct a risk prediction model, which was evaluated using the ROC curve.Results:The levels of FSH, LH and TES in group A before the operation were 3.28(2.02, 4.46) IU/L, 0.53(0.25, 0.79) IU/L and 25.24(17.94, 36.67) ng/dL, respectively, and those in group B were 1.42(1.10, 1.84) IU/L, 0.14(0.09, 0.23) IU/L and 15.73 (12.92, 17.00) ng/dL, respectively.The difference was all statistically significant (all P<0.05).Multivariate Logistic regression analysis showed statistical significance ( OR=0.515, 95% CI: 0.271-0.977; OR=0.035, 95% CI: 0.002-0.542; OR=0.883, 95% CI: 0.796-0.980).The area under the ROC curve (AUC) of the prediction model was 0.906, with a sensitivity of 75.00% and a specificity of 95.74%.The levels of FSH, LH and TES in the postoperative AA group were 2.97 (1.88, 4.28) IU/L, 0.46 (0.23, 0.78) IU/L and 20.92 (17.34, 33.27) ng/dL, respectively.The median levels of FSH, LH and TES in the BB group were 1.52 (1.27, 1.82) IU/L, 0.17 (0.12, 0.26) IU/L and 15.08(11.68, 16.68) ng/dL, respectively.The difference was all statistically significant (all P<0.05).Multivariate Logistic regression analysis showed statistical significance ( OR=0.484, 95% CI: 0.236-0.992; OR=0.061, 95% CI: 0.004-0.939; OR=0.891, 95% CI: 0.795-0.999).The AUC of the prediction model constructed was 0.877, with a sensitivity of 94.12% and a specificity of 68.52%. Conclusions:Lower FSH, LH and TES levels are risk factors for the micropenis after mild hypospadias surgery, and preoperative hormone levels have higher predictive value.

China emerges as a major country in nuclear energy development and the application of nuclear and radiologic technology. The diagnosis and treatment of acute radiation syndrom (ARS) caused by external irradiation represent a core function in the country′s medical rescue of nuclear and radiological emergencies. Clinically, ARS manifests hematopoietic, gastrointestinal, cutaneous, and central nervous system syndromes, with specific clinical manifestations, signs, severity, and prognosis strongly correlated with radiation dose. China has established a number of national and provincial centers for treating radiation-induced damage. Nevertheless, most medical staff have limited experience in ARS treatment. This consensus presents a summary of recent experience in treating ARS of China. In combination with recommendations from international organizations such as the World Health Organization (WHO), this consensus proposes key evidence of critical clinical issues of ARS, covering all links in the rescue of external irradiation-induced ARS. Initially, clinical diagnosis, syndromes, and severe degrees should be determined based on clinical symptoms and dose estimates. It is necessary to normalize clinical treatment measures for hematopoietic recovery, gastrointestinal injury treatment, infection control, symptomatic treatment, and multi-organ function preservation. To this end, this consensus offers cautions. This consensus provides principles of treatment with traditional Chinese medicine, psychological intervention, and follow-up. Additionally, it highlights multidisciplinary collaboration. It is recommended that this consensus be applied in relevant treatment centers.

Objective:To investigate impact of PD-L2 gene knockout on splenic immune phenotype of C57BL/6 mice.Methods:Body weight of female and male wild-type(WT)and PD-L2 gene knockout(KO)mice aged 3～12 weeks were continuously measured.Tissue structure differences in heart,liver,spleen,lung,kidney,thymus,ovary,uterus and testis of four groups of mice were observed by HE staining.Urease UV rate method was employed to measure urea level in mouse serum,and creatinine concentra-tion in serum was determined by creatine oxidase method.Flow cytometry was used to assess proportions of immune cells and cytokine differences in spleens of mice.Results:PD-L2 gene knockout had no apparent effect on body weight or organ structure of mice.Serum urea and creatinine levels were higher in female KO mice compared to WT mice,but no significant differences were observed among males.Female KO mice exhibited reduced proportions of CD4+T cells,CD8+T cells,Treg,NK cells and dendritic cells(DC)in spleen compared to WT mice.Conversely,proportions of Tfh,B cells,plasma cells,na?ve B cells and B2 cells were elevated,proin-flammatory cytokines such as IL-17,IL-6 and IL-22 were increased,while anti-inflammatory cytokines like IL-10 and IL-4 were decreased.Differences among male mice were either not significant or absent.Conclusion:PD-L2 gene knockout primarily affects splenic immune phenotype of female mice,leading to increased inflammatory responses and weakened immune suppression after knockout.

Hyperlipidemia refers to abnormal transport of lipids and metabolic disorders in the blood,which can easily cause cardiovascular diseases.At present,there are many adverse reactions and poor tolerance of chemical drugs.Traditional Chinese medicine and minority medicine have a long history and rich clinical experience,which have the advantages of low cost,convenience,high efficiency and little side effects.To provide reference for clinicians and researchers,the clinical research of traditional Chinese medicine and ethnic medicine in the prevention and treatment of hyperlipidemia was summarized.

Objective:To explore the effectiveness of find-organize-clarify-understand- select-plan-do-check-act (FOCUS-PDCA) cycle management in improving the accuracy of Nutritional Risk Screening 2002 (NRS 2002) scoring in inpatients.Methods:This study was a retrospective study. Data from a continuous quality improvement project, namely Improving the Accuracy of Nutritional Risk Screening for Inpatients from People's Hospital of Longhua in 2021 were selected. The NRS 2002 scores of newly admitted patients from 8 departments with relatively high nutritional risk (departments of gstroenterology, neurology, nephrology, respiratory medicine, oncology and hematology, neurosurgery, gastrointestinal surgery, and critical care medicine) from April 10, 2021 to April 29, 2021 (before intervention) were collected. The NRS 2002 scores were evaluated by a multidisciplinary nutrition support team in terms of accuracy and error types. Possible issues in the process of nutritional screening were analyzed and mitigated using the FOCUS-PDCA cycle management method. The NRS 2002 scores from July 18, 2021 to August 8, 2021 (after intervention) were collected in real time to summary the data on accuracy and error types and to evaluate the effect of FOCUS-PDCA.Results:The accuracy of NRS 2002 score in the 8 departments was increased from 52.97% (294/555) to 81.13% (473/583) after intervention, and the difference was statistically significant ( χ2=102.606, P<0.001). The accuracy of nutritional status impairment score was 64.14% before intervention, compared with 90.57% after intervention ( χ2=114.484, P<0.001). The accuracy of disease severity score was 78.56%, compared with 89.54% after intervention( χ2=25.736, P<0.001). The false-negative rate was 68.02% before intervention and 31.87% after intervention, and the difference was statistically significant ( χ2=31.501, P<0.001). Conclusion:FOCUS-PDCA can improve the accuracy of NRS 2002 scoring in inpatients, reduce the risk of failing to identify patients at nutritional risk, and contribute to further nutritional diagnosis and treatment.

Objective To investigate the value of MRI of the sternal end of clavicle in bone age assessment in Chinese population,especially its applicability in the determination of criminal responsible age.Methods A total of 431 patients aged from 10.00 to 29.99 years with neck or chest MRI were retrospectively collected.According to the Schmeling grading method,the epiphyseal development of the clavicle MRI was divided into five grades.The consistency of methods was evaluated.The correlation and general descriptive analysis between MRI grades and age was analyzed.The sex difference was analyzed.Curve fitting was used to establish a nonlinear model between age and grades.Results The grades of clavicle MRI showed a significant age-related trend(Figure 2),and the correlation was 0.861(0.887 in males and 0.840 in females).Except for grade 1,there was no significant difference between males and females in other grades.The minimum age of male grade 3 was greater than 14 years old,and the minimum age of female grade 3 was greater than 16 years old.The minimum age in grade 4 and grade 5 was over 18 years old in both sexes.The best curve fitting model was cubic model for both sexes(R2=0.805 for men and 0.722 for women).Conclusion Clavicle MRI can be used for the assessment of bone age in Chinese population.Complete epiphyseal plate closure can be used as a reliable indicator for the determination of age at 18 years old,and it is expected to achieve radiation-free forensic bone age assessment.

China emerges as a major country in nuclear energy development and the application of nuclear and radiologic technology. The diagnosis and treatment of acute radiation syndrom (ARS) caused by external irradiation represent a core function in the country′s medical rescue of nuclear and radiological emergencies. Clinically, ARS manifests hematopoietic, gastrointestinal, cutaneous, and central nervous system syndromes, with specific clinical manifestations, signs, severity, and prognosis strongly correlated with radiation dose. China has established a number of national and provincial centers for treating radiation-induced damage. Nevertheless, most medical staff have limited experience in ARS treatment. This consensus presents a summary of recent experience in treating ARS of China. In combination with recommendations from international organizations such as the World Health Organization (WHO), this consensus proposes key evidence of critical clinical issues of ARS, covering all links in the rescue of external irradiation-induced ARS. Initially, clinical diagnosis, syndromes, and severe degrees should be determined based on clinical symptoms and dose estimates. It is necessary to normalize clinical treatment measures for hematopoietic recovery, gastrointestinal injury treatment, infection control, symptomatic treatment, and multi-organ function preservation. To this end, this consensus offers cautions. This consensus provides principles of treatment with traditional Chinese medicine, psychological intervention, and follow-up. Additionally, it highlights multidisciplinary collaboration. It is recommended that this consensus be applied in relevant treatment centers.