Objective: To investigate the current status of benefit finding among young and middle-aged patients with type 2 diabetes mellitus (T2DM) and analyze its influencing factors, so as to provide a reference for improving the level of benefit finding in this population. Methods: From November 2022 to May 2023, young and middle-aged patients with T2DM aged 18-59 years hospitalized in the endocrinology departments of 2 tertiary hospitals in Hengyang City, Hunan Province were selected as survey subjects by a convenience sampling method. Basic demographic information was collected using a general questionnaire survey. Benefit finding, resourcefulness, and stigma were evaluated using the Benefit Finding Scale, the Chinese Version of the Resourcefulness Scale, and the Type 2 Diabetes Stigma Assessment Scale, respectively. A multiple linear regression model was used to analyze the influencing factors of benefit finding among young and middle-aged patients with T2DM. Results: A total of 305 young and middle-aged patients with T2DM were investigated, including 222 males (72.79%) and 83 females (27.21%). There were 231 cases aged 45-59 years, accounting for 75.74%. The scores for benefit finding, resourcefulness, and stigma were (42.86±6.06), (75.12±11.30), and (41.20±10.10), respectively. Multiple linear regression analysis showed that young and middle-aged patients with T2DM who were male (β′=0.088), aged 18-<45 years (β′=0.083), absence of diabetes complications (β′=0.124), and had higher resourcefulness scores (β′=0.679) had higher levels of benefit finding, while patients with higher stigma scores (β′=-0.097) had lower levels of benefit finding. Conclusion The level of benefit finding among young and middle-aged patients with T2DM was moderate, and was related to gender, age, diabetes complications, resourcefulness, and stigma.

OBJECTIVE To explore the antidepressant mechanism of Wenyang jieyu granules （WYJYG） via the NOD-like receptor thermal protein domain associated protein 3 （NLRP3）/apoptosis-associated speck-like protein containing a CARD （ASC）/Caspase-1 pathway. METHODS A rat model of depression was established by chronic unpredictable mild stress combined with single-housing for 42 consecutive days.The experiment set up blank group， model group， MCC950 （NLRP3 inflammasome inhibitor） group （10 mg/kg）， fluoxetine group （positive control，2.08 mg/kg），low-dose WYJYG（3.78 g/kg） and high-dose WYJYG group （7.56 g/kg），with 10 rats in each group. From the 22nd day of the experiment， rats in the fluoxetine group， low-dose and high-dose WYJYG groups were intragastrically administered with the corresponding drugs and intraperitoneally injected with an equal volume of normal saline. Rats in the MCC950 group were intraperitoneally injected with MCC950 at the corresponding concentration and intragastrically administered with an equal volume of distilled water. Rats in the blank group and model group were given an equal volume of distilled water by gavage and an equal volume of normal saline by intraperitoneal injection. All interventions were performed once a day for 21 consecutive days. Behavioral tests were conducted once a week. After the last administration， the contents of ASC， ionized calcium binding adaptor molecule 1 （Iba1）， interleukin-1β （IL-1β）， and IL-18 in hippocampal tissues were detected. The protein expressions of NLRP3， cluster of differentiation 68 （CD68）， Caspase-1， B-cell lymphoma-2 （Bcl-2）， and Bcl-2-associated X protein were determined， and neuronal apoptosis was observed. RESULTS After the last administration， compared with the model group， the open-field activity time was significantly prolonged （ P ＜0.05）， and the latency to feed in a novel environment was significantly shortened （ P ＜0.05） in rats of the high-dose WYJYG group. In hippocampal tissue， the contents of ASC， Iba1， IL-1β， and IL-18， as well as the protein expression levels of NLRP3， Caspase-1， and CD68， and the positive rate of neuronal apoptosis were all significantly decreased/downregulated （ P ＜0.05）. Bcl-2 protein expression was significantly upregulated （ P ＜0.05）， and the density of neuronal apoptosis-positive cells was significantly reduced （ P ＜0.05）. CONCLUSIONS WYJYG play on antidepressant role by inhibiting the NLRP3/ASC/Caspase-1 pathway， reducing microglia-mediated neuroinflammation， and inhibiting hippocampal neurons apoptosis.

ObjectiveTo investigate the effect and mechanism of Polygonatum neutral polysaccharides from sibiricum （PSP-NP） on colon injury in mice with chronic obstructive pulmonary disease （COPD）. MethodsMale C57BL/6J mice were randomly divided into a control group， a COPD model group， and a PSP-NP group. The COPD model was established using smoke exposure combined with intranasal LPS administration. The PSP-NP group was simultaneously treated daily with 200 mg/kg of PSP-NP via intragastric gavage， while the other groups received an equal volume of saline. HE staining was used to observe the pathological changes in the colon. ELISA was employed to detect the levels of LPS in serum and the expressions of ZO-1， Occludin， IL-6， and TNF-α in colon tissue. UPLC-MS was used to detect the types and contents of bile acids in colonic content， and to screen for differential bile acids. Differential microbial flora were identified using 16S rRNA gene sequencing， and correlation analysis was conducted with differential bile acids. PSP-NP was combined with the differential bile acids cholic acid （CA）， and deoxycholic acid （DCA） in vitro to analyze the binding capacity of PSP-NP for CA and DCA. PSP-NP was applied to NCM460 normal colonic epithelial cells cultured in CA and DCA. Cell migration ability was assessed using the scratch assay， and the mRNA expression levels of inflammatory cytokines TNF-α， IL-6， and NF-κB were measured by RT-qPCR. ResultsPSP-NP effectively improved colonic damage in COPD model mice， enhanced mechanical barrier function， alleviated inflammatory response， and regulated abnormal changes in colonic flora and bile acid metabolism. Correlation analysis further revealed that PSP-NP regulated colonic bile acid metabolism and reduced the redundancy of secondary bile acids by increasing the relative abundance of Bacteroidota， Verrucomicrobiota， Bacteroides， and Akkermansia， while decreasing the relative abundance of Lactobacillus and Bifidobacterium. Notably， in vitro binding assays demonstrated that PSP-NP bound to differential bile acids DCA and CA， with the strongest binding capacity for DCA at 58.2%. In cellular functional studies， DCA inhibited the migration ability of colonic epithelial cells NCM460 and significantly increased the relative mRNA expression levels of inflammatory factors TNF-α， IL-6， and NF-κB. Importantly， co-treatment with PSP-NP significantly ameliorated the impact of DCA on NCM460 cells. ConclusionsPSP-NP may significantly improve colonic damage in COPD model mice. The mechanism may involve the regulation of colonic bile acid metabolism and bile acid profiles through both microbial modulation and direct binding， thereby reducing the damage caused by secondary bile acids such as DCA to colonic epithelial cells.

Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.

Objective:To analyze the disease burden of colorectal cancer (CRC) among young and middle-aged people in China from 1990 to 2021, and to explore the influence of age, period and cohort on the incidence and mortality of CRC in young and middle-aged people of China.Methods:Data on CRC in patients aged 40-59 years in China from 1990 to 2021 were extracted from the Global Burden of Disease Study 2021 (GBD 2021) database. Statistics such as incidence rate, mortality rate, disability-adjusted life years (DALY), and their corresponding age-standardized rates were calculated to analyze the CRC incidence and mortality in different age and sex groups of young and middle-aged Chinese young people from 1990 to 2021. The Joinpoint regression model was used to analyze the CRC incidence, the mortality and the DALY rate, as well as to calculate the annual percentage change (APC) and the average annual percentage change (AAPC). The effects of three independent factors, namely age, period and cohort, on the incidence and mortality of CRC in young and middle-aged people of China were analyzed and evaluated through the age-period-cohort model.Results:From 1990 to 2021, there was a remarkable upward trend in the incidence, mortality, and DALY of CRC among Chinese young and middle-aged adults. In 2021, the number of incidence cases of CRC among young and middle-aged people in China reached 181 000, and the number of deaths reached 57 900, which were 236.80% and 75.48% higher than those in 1990 (53 800 and 33 000, respectively). During the same period, DALY increased by 62.59%, with the 55-59 age group having the largest increase at 83.35%. From 1990 to 2021, the age-standardized incidence rate (ASIR) increased by 49.04%, rising from 25.51/100 000 to 38.02/100 000, and the age-standardized mortality rate (ASMR) declined by 28.75%, decreasing from 17.01/100 000 to 12.12/100 000, respectively. The increase in ASIR was the greatest among the 40-44 age group, reaching 57.31%, while the decline in ASMR was the most significant among the 50-54 age group, amounting to 30.18%. However, the DALY rate declined by 26.66%, from 673.52/100 000 to 493.94/100 000. The decline in DALY was the greatest among the 50-54 age group, reaching 28.26%. Joinpoint regression model analysis showed that, from 1990 to 2021, the incidence of CRC in Chinese young and middle-aged adults rose on average by 1.32% annually, and the increase was higher in men (1.87%) than that in women (0.36%). The mortality rate showed a downward trend, with an average annual decline of 1.10%, with a higher decline in women than in men (-2.14% vs. -0.50%). The DALY rate showed a downward trend, with an average annual decline of 1.00%, and more decline in women than in men (-2.06% vs. -0.41%). All of these trends were statistically significant (all P<0.001). The age-period-cohort model analysis showed that, the net drift of CRC incidence was 1.21% (1.02%-1.41%) per year among Chinese young and middle-aged adults between 1990 and 2021, while the net drift in mortality was -1.40% (-1.59%--1.21%) per year. The impact of age on CRC incidence and mortality intensified with advancing age. Incidence attributable to age rose from 12.66% (11.90%- 13.46%) in the 40-44 age group to 56.68% (54.37%-59.08%) in the 55-59 age group. Similarly, mortality attributable to age increased from 6.47% (6.12%-6.85%) in the 40-44 age group to 25.74% (24.58%-26.96%) in the 55-59 age group. In all age groups, the role of CRC incidence and mortality attributable to age was higher in men than in women. Period effects on the RR value of CRC incidence showed a declining trend followed by an upward trend, with the highest risk during 2015-2019 ( RR=1.36, 95% CI: 1.28-1.43), using 2000-2004 as the reference. For mortality, period effects exhibited a declining trend, with the highest risk during 1990-1994 ( RR=1.23, 95% CI: 1.15-1.32), using 2000-2004 as the reference. Cohort effects indicated that later birth cohorts had higher incidence risks, with the highest incidence observed in the 1973-1977 birth cohort ( RR=1.30, 95% CI: 1.16-1.45), using the 1953-1957 birth cohort as the reference. Conversely, later birth cohorts had lower mortality risks, with the lowest mortality in the 1973-1977 birth cohort ( RR=0.78, 95% CI: 0.69-0.88), using the 1953-1957 birth cohort as the reference. Conclusions:From 1990 to 2021, the changes in the disease burden of CRC among young and middle-aged people in China are manifested as an increase in standardized incidence rate and a decrease in standardized mortality rate. Meanwhile, there are gender differences in the trend of temporal changes. Age, period and cohort all have a significant impact on the incidence and mortality trends of colorectal cancer in young and middle-aged people. Research on the etiology of CRC should be strengthened, and targeted prevention and control strategies should be formulated.

OBJECTIVE: To evaluate the effectiveness of double joystick technique assisted closed reduction and Kirschner wire internal fixation in the treatment of Gartland type Ⅲ supracondylar fractures of the humerus (SCFH) in children. METHODS: A retrospective study was conducted on 28 cases of Gartland type Ⅲ SCFH with complete data available, who underwent closed reduction and Kirschner wire internal fixation with the double joystick technique between August 2022 and July 2024. There were 23 boys and 5 girls, with an average age of 6.4 years (range, 1-12 years). All fractures resulted from falls and were classified as extension-type. X-ray film showed the radial displacement of the distal fragment in 15 cases and unlar displacement in 13 cases. The interval from injury to operation was 3-36 hours (mean, 19.5 hours). X-ray film re-examination was conducted to evaluate the fracture healing, and the Baumann angle of affected elbow joint and carrying angle of bilateral elbow joints were measured. Elbow joint function was evaluated using the range of motion (flexion and extension) and the Flynn criteria. The above indicators were compared between affected and healthy sides. RESULTS: All operation were successfully completed. The operation time ranged from 15 to 40 minutes (mean, 25.2 minutes). The length of hospital stay was 2-5 days (mean, 3.5 days). All patients were followed up 3-24 months (mean, 11.8 months). X-ray film confirmed fracture healing in all patients, with a mean healing time of 5.4 weeks (range, 4-6 weeks). At last follow-up, the Baumann angle of the affected elbow joint was (73.50±3.46)°, and the carrying angle and the range of motion in flexion and extension of the affected elbow joint were significantly less than the contralateral side (P<0.05). According to the Flynn criteria, the elbow joint function of the affected elbow was evaluated as excellent in 25 cases and good in 3 cases, with an excellent and good rate of 100%. CONCLUSION The double joystick technique is a safe and effective method which can facilitate the closed reduction and Kirschner wire internal fixation of Gartland type Ⅲ SCFH in children without increasing risk of complications.
Humans ; Male ; Female ; Humeral Fractures/diagnostic imaging* ; Fracture Fixation, Internal/instrumentation* ; Child ; Retrospective Studies ; Bone Wires ; Child, Preschool ; Fracture Healing ; Treatment Outcome ; Infant ; Elbow Joint/physiopathology* ; Range of Motion, Articular ; Closed Fracture Reduction/methods*

Objective:To investigate the clinical efficacy and safety of ultrasound-guided thyroid injection of dexamethasone in the treatment of subacute thyroiditis (SAT).Methods:This is a randomized controlled study involving 32 patients with SAT who received treatment at Endocrinology Clinic of Heilongjiang Provincial Hospital between June 2022 and March 2023. The patients were randomly divided into an observation group and a control group ( n = 16 per group) using a random number table method. The observation group received ultrasound-guided injection of dexamethasone (5 mg per injection, once a week) into the thyroid lesion, while the control group was treated with oral prednisone acetate tablets (5 mg per dose, three times a day). Both groups were treated for 4 weeks. The clinical efficacy, time taken for body temperature to return to normal, time for pain resolution, time for goiter regression, time for thyroid function to normalize, as well as recurrence rates and adverse reactions, were compared between the two groups. Results:The response rate in the observation group was 100% (16/16), which was significantly higher than that in the control group [75% (12/16), χ2 = 4.57, P = 0.033]. The time taken for body temperature to return to normal, the time for goiter regression, and the time for goiter regression in the observation group were (3.5 ± 3.6) days, (7.4 ± 2.5) days, and (11.6 ± 7.4) days, respectively, which were significantly shorter than those in the control group [(6.1 ± 3.2) days, (9.9 ± 3.5) days, (16.9 ± 6.8) days, t = -2.16, -2.33, -2.11, all P < 0.05]. After 4 weeks of treatment, the observation group showed significantly lower body mass index, fasting blood glucose, and serum triglyceride levels compared to the control group ( t = -2.07, -2.46, -2.13, all P < 0.05). The recurrence rate in the observation group was 0%, which was significantly lower than that in the control group [25% (4/16), χ2 = 4.57, P = 0.033]. Conclusions:The efficacy and safety of ultrasound-guided local thyroid injection of dexamethasone for the treatment of SAT are superior to those of the oral treatment regimen.

Objective:To investigate the clinical efficacy and safety of ultrasound-guided thyroid injection of dexamethasone in the treatment of subacute thyroiditis (SAT).Methods:This is a randomized controlled study involving 32 patients with SAT who received treatment at Endocrinology Clinic of Heilongjiang Provincial Hospital between June 2022 and March 2023. The patients were randomly divided into an observation group and a control group ( n = 16 per group) using a random number table method. The observation group received ultrasound-guided injection of dexamethasone (5 mg per injection, once a week) into the thyroid lesion, while the control group was treated with oral prednisone acetate tablets (5 mg per dose, three times a day). Both groups were treated for 4 weeks. The clinical efficacy, time taken for body temperature to return to normal, time for pain resolution, time for goiter regression, time for thyroid function to normalize, as well as recurrence rates and adverse reactions, were compared between the two groups. Results:The response rate in the observation group was 100% (16/16), which was significantly higher than that in the control group [75% (12/16), χ2 = 4.57, P = 0.033]. The time taken for body temperature to return to normal, the time for goiter regression, and the time for goiter regression in the observation group were (3.5 ± 3.6) days, (7.4 ± 2.5) days, and (11.6 ± 7.4) days, respectively, which were significantly shorter than those in the control group [(6.1 ± 3.2) days, (9.9 ± 3.5) days, (16.9 ± 6.8) days, t = -2.16, -2.33, -2.11, all P < 0.05]. After 4 weeks of treatment, the observation group showed significantly lower body mass index, fasting blood glucose, and serum triglyceride levels compared to the control group ( t = -2.07, -2.46, -2.13, all P < 0.05). The recurrence rate in the observation group was 0%, which was significantly lower than that in the control group [25% (4/16), χ2 = 4.57, P = 0.033]. Conclusions:The efficacy and safety of ultrasound-guided local thyroid injection of dexamethasone for the treatment of SAT are superior to those of the oral treatment regimen.

Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.

Objective:To analyze the use of medicare antiviral drugs (ART) and related factors among HIV-infected people in Ningbo City.Methods:The retrospective data was collected related to infection and treatment of HIV-infected people in ART in Ningbo up to February 2023 through the National Infectious Disease Surveillance System. Binary logistic regression was used to analyze the factors related to medicare antiviral drug use in HIV-infected people. R 4.2.2 software was used for statistical analysis.Results:A total of 6 433 HIV-infected people with ART records were collected, among which 5 783 were in ART. The prevalence of medicare drugs use among people in ART was 24.8% (1 435/5 783, 95% CI: 23.7%-25.9%). Beilun District (8.7%, 43/497) and Fenghua District (5.7%, 14/247) had the lowest level in medicare drugs use. Among people in ART using medicare or out‐of‐pocket drugs, the prevalence of those who had at least one viral load test in the last year (84.9%, 1 352/1 593) was significantly lower than that of those using free drugs (91.4%, 3 829/4 190) ( χ2=52.50, P<0.001). The results of multivariate logistic analysis showed that the factors influencing medicare drug use included low educational level (junior high school and below: a OR=0.24, 95% CI:0.17-0.34), farmer or worker (farmer: a OR=0.60, 95% CI: 0.39-0.91; worker: a OR=0.42, 95% CI: 0.27-0.64), low monthly income (<3 000 Yuan: a OR=0.29, 95% CI: 0.18-0.45), the longer interval time between diagnosis and treatment (≥21 days: a OR=0.47, 95% CI: 0.30-0.74). Conclusions:Significant regional differences on the prevalence of medicare antiviral drugs use in HIV-infected people exist in Ningbo City. Follow-up management program of patients should be improved to strengthen patient compliance to mobilize medicare drug promotion. Meanwhile, publicity of medicare drugs should be strengthened for farmers or workers with low education level and patients with delayed treatment.