Objective: To examine the relationship between self-management behaviors and time perspective among patients with comorbid diabetes, so as to provide the evidence for improving self-management behaviors among patients with comorbid diabetes. Methods: The patients with comorbid diabetes who were registered in the chronic disease health management system of Minhang District, Shanghai Municipality in 2021, followed up regularly, and lived in Meilong Town were recruited. Demographic information and family history of diabetes were collected through questionnaire surveys. Time perspective and self-management behaviors were assessed using the Zimbardo Time Perspective Inventory and Diabetes Self-Management Behavior Scale, respectively. The relationship between self-management behaviors and time perspective was analyzed using a multivariable ordinal logistic regression model. Results: A total of 907 patients with comorbid diabetes were enrolled, including 472 males (52.04%) and 435 females (47.96%). There were 652 cases aged 65 years and above, accounting for 71.89%. In terms of the types of time perspective, 280 patients were future-oriented (30.87%), 236 were balanced (26.02%), 162 were sensation-seeking (17.86%), 123 were fatalistic (13.56%), and 106 were negative (11.69%). In terms of the self-management behaviors, 46 patients were good (5.07%), 643 were moderate (70.89%), and 218 were poor (24.04%). Multivariable ordinal logistic regression analysis showed that after adjusting for age, gender, educational level, marital status, occupation status, monthly income, and family history of diabetes, the patients with comorbid diabetes who had a future-oriented time perspective had better self-management behaviors (OR=1.874, 95%CI: 1.204-2.915). Conclusion The self-management behaviors among patients with comorbid diabetes are moderate to poor, and patients with a future-oriented time perspective can better engage in self-management behaviors.

Acute lung injury （ALI） refers to the rapid onset of dyspnea, hypoxemia, and diffuse alveolar damage induced by various direct and indirect injurious factors, representing one of the clinically common diseases with a high mortality rate. However, there is currently a lack of specific therapeutic interventions targeting their underlying pathological mechanisms. Western medical treatment primarily relies on supportive care, and the existing pharmacological agents for ALI are predominantly corticosteroids, which, while efficacious, often accompany severe adverse effects. Recent research has revealed that numerous active components in Traditional Chinese Medicine （TCM） exhibit remarkable efficacy in the prevention and treatment of ALI, providing new insights into the therapeutic approaches for ALI. In this article, the pathological mechanisms of ALI and the roles and mechanisms of active components from TCM in the prevention and treatment of ALI were reviewed, aiming to provide a theoretical basis for the development of new drugs for the prevention and treatment of ALI.

Objective: To investigate the trajectories of fasting blood glucose fluctuations and their influencing factors among patients with comorbidity of type 2 diabetes mellitus (T2DM), so as to provide the basis for strengthening blood glucose management in this population. Methods: In October 2023, data of patients diagnosed with comorbid T2DM from January to October 2021, including demographic information, lifestyle, health status and fasting blood glucose were collected through the chronic disease health management system of Minhang District, Shanghai Municipality. Fasting blood glucose fluctuation trajectories were analyzed by group-based trajectory model established based on fasting blood glucose values from January 2021 to October 2023. Influencing factors of fasting blood glucose fluctuation trajectories among patients with comorbidity of T2DM were analyzed using a multinomial logistic regression model. Results: A total of 907 patients with comorbidity of T2DM were enrolled, including 472 males (52.04%) and 435 females (47.96%). There were 652 cases aged ≥65 years, accounting for 71.89%. The group-based trajectory model analysis identified three trajectory groups: a low-level stable group (492 cases, 54.24%), a medium-level stable group (287 cases, 31.64%), and a high-level decreasing group (128 cases, 14.11%). Multinomial logistic regression analysis showed that, compared with the low-level stable group, patients with comorbidity of T2DM who had an education level of junior high school or below (OR=1.420, 95%CI: 1.011-1.995) or college degree or above (OR=2.109, 95%CI: 1.249-3.560), as well as those who engaged in regular exercise (OR=1.387, 95%CI: 1.017-1.893), were more likely to be in the medium-level stable group. Patients with comorbidity of T2DM who were overweight or obese (OR=1.675, 95%CI: 1.116-2.513) or had dyslipidemia (OR=3.195, 95%CI: 1.642-6.216) were more likely to be in the high-level decreasing group. Conclusions From January 2021 to October 2023, the fasting blood glucose levels of patients with comorbidity of T2DM exhibited three fluctuating trajectories: low-level stability, medium-level stability, and high-level decline. Compared with the low-level stable group, the medium-level stable group was mainly influenced by educational level and regular exercise. The high-level decline group was primarily affected by overweight/obesity and dyslipidemia.

Objective: To explore the association between waist circumference and beverage consumption behaviors among junior high school students, so as to provide a theoretical basis for improving their nutritional status. Methods: Using a multi stage cluster random sampling method, 1 611 junior high school students aged 13-15 years from Yushan, Yanshan, Yiyang, and Wannian counties in Shangrao City, Jiangxi Province, were selected for a survey in September 2021 through questionnaires and waist circumference measurements. Stratified analyses were conducted by sex, t-test and analysis of variance (ANOVA) were used to compare waist circumference across groups, and analysis of covariance (ANCOVA) was applied to examine the associations between different types of beverage consumption and waist circumference. Results: Boarding students had significantly greater average waist circumference than day students[boys:(71.86±9.24, 69.69±12.19)cm；girls:(66.53±13.30, 64.63±11.90)cm； t =2.69, 2.08, both P < 0.05 ]. Among boys, waist circumference differed significantly by vigorous physical[vigorous physical:(69.71±9.53)cm; non vigorous exercise:(71.53±12.99)cm]( t=-2.31, P <0.05). Boys waist circumference also differed significantly by consumption frequency (high and medium,low,none) of milk containing beverages[(71.83±7.40, 69.92±9.98, 72.29±13.90)cm], functional beverages[( 73.36± 11.87, 65.97±10.46, 70.71±10.55)cm] and purified water beverages[(69.36±10.87, 71.93±12.15, 71.50±10.09)cm]( F =4.06, 5.93, 4.85, all P <0.05). Girls waist circumference also differed significantly by consumption frequency (high and medium,low,none) of milk containing beverages[(68.81±5.55, 66.59±13.02, 65.36±11.69)cm, F=9.67, P <0.01]. After controlling for the confounding variables, ANCOVA results indicated that the consumption of milk containing beverages, functional beverages and Purified water beverages were significantly associated with waist circumference of boys ( F =3.79, 5.26, 5.08, all P < 0.05 ). Milk containing beverages were significantly associated with waist circumference of girls ( F=4.17, P <0.05). Conclusion The consumption frequency of milk containing beverages and functional beverages by junior high school students is positively correlated with their waist circumference.

Objective:To investigate the response of mandibular condylar chondroprogenitors to flow fluid shear stress(FFSS).Methods:Chondroprogenitors were in vitro cultured and stimulated with FFSS that can cause cell degeneration,and treated with sec-ond-generation high-throughput RNA sequencing.Differential gene expression was screened using DESeq2 software for gene ontology(GO)functional enrichment analysis,kyoto encyclopedia of genes and genomes(KEGG)pathway enrichment analysis and protein-protein interaction(PPI)network analysis.qRT-PCR was performed to validate the core genes screened by PPI.Results:A total of 1996 differentially expressed genes were obtained,mainly including inflammatory response and cell cycle related molecules.Among them,Actal,Atf3,Ccl2,116,Nfkbia,Ret and Vcaml were identified as the core genes.Conclusion:FFSS stimulation affects chondroprogenitor function by acting on inflammatory responses and cell cycle-related signaling pathways in chondroprogenitors.

Objective To design an enhanced postoperative recovery checklist for the patients who had surgery for laryngeal cancer,hence to instruct the patient with a standard procedure in rehabilitation.Methods A total of 72 patients who had surgery for laryngeal cancer in our department from April 2020 and April 2021 were enrolled as study subjects for a controlled study before and after surgery of different patients.A total of 37 patients who had surgery between April and September 2020 were assigned in the control group,while another 37 patients who had the surgery between October 2020 and April 2021 were assigned in the trial group.Patients in the control group were managed with a routine enhanced perioperative recovery plan,and those in the trial group were managed with the checklist,which was drafted by modification and improvement of the routine enhanced perioperative recovery plan through literature reviews and expert consultations.The two groups were compared in terms of the standardised rate of enhanced recovery compliance,medical staff satisfaction,average hospital-stay and patient satisfaction.Results The trial group showed significant improvement in comparison with the control group in terms of the standardised rate of enhanced recovery compliance(93.28%versus 84.08%),score of satisfaction level[(95.57±2.25)versus(92.60±2.49)],score of doctor satisfaction[(35.75±0.89)versus(32.88±1.50)],and the score of nurse satisfaction[(35.45±1.10)versus(33.00±1.30)](all P<0.05).The average hospital-stay in the trial group was significantly shorter than that in the control group[(9.89±3.32)days versus(12.60±4.33)days](P<0.05).Conclusion The designed checklist can improve the standardised rate of enhanced recovery compliance,the satisfaction of both medical staff and patients and facilitate the recovery of patient.

Pathological vascular remodeling is a hallmark of various vascular diseases. Previous research has established the significance of andrographolide in maintaining gastric vascular homeostasis and its pivotal role in modulating endothelial barrier dysfunction, which leads to pathological vascular remodeling. Potassium dehydroandrographolide succinate (PDA), a derivative of andrographolide, has been clinically utilized in the treatment of inflammatory diseases precipitated by viral infections. This study investigates the potential of PDA in regulating pathological vascular remodeling. The effect of PDA on vascular remodeling was assessed through the complete ligation of the carotid artery in C57BL/6 mice. Experimental approaches, including rat aortic primary smooth muscle cell culture, flow cytometry, bromodeoxyuridine (BrdU) incorporation assay, Boyden chamber cell migration assay, spheroid sprouting assay, and Matrigel-based tube formation assay, were employed to evaluate the influence of PDA on the proliferation and motility of smooth muscle cells (SMCs). Molecular docking simulations and co-immunoprecipitation assays were conducted to examine protein interactions. The results revealed that PDA exacerbates vascular injury-induced pathological remodeling, as evidenced by enhanced neointima formation. PDA treatment significantly increased the proliferation and migration of SMCs. Further mechanistic studies disclosed that PDA upregulated myeloid differentiation factor 88 (MyD88) expression in SMCs and interacted with T-cadherin (CDH13). This interaction augmented proliferation, migration, and extracellular matrix deposition, culminating in pathological vascular remodeling. Our findings underscore the critical role of PDA in the regulation of pathological vascular remodeling, mediated through the MyD88/CDH13 signaling pathway.
Mice ; Rats ; Animals ; Myeloid Differentiation Factor 88/metabolism* ; Vascular Remodeling ; Cell Proliferation ; Vascular System Injuries/pathology* ; Carotid Artery Injuries/pathology* ; Molecular Docking Simulation ; Muscle, Smooth, Vascular ; Cell Movement ; Mice, Inbred C57BL ; Signal Transduction ; Succinates/pharmacology* ; Potassium/pharmacology* ; Cells, Cultured ; Diterpenes ; Cadherins

OBJECTIVE To explore the protective mechanism of amifostine on acute radiation injury mice. METHODS Thirty C57BL/6J mice were randomly divided into normal control group， model group and amifostine group （150 mg/kg）， with 10 mice in each group. Thirty minutes before irradiation， the mice in the amifostine group were intraperitoneally injected with amifostine； normal control group and model group were given constant volume of normal saline intraperitoneally； then acute radiation injury was induced by 4 Gy X-ray radiation in both model group and amifostine group. The white blood cell count （WBC）， platelet count and red blood cell （RBC） count in mice were detected 2 hours before irradiation and on days 1， 4， 7， 10 and 14 after irradiation； the changes in the proportion of WBC （neutrophils， lymphocytes and monocytes） on the 7th day after irradiation were analyzed. The 16S rRNA high-throughput sequencing was used to analyze the structure of gut microbiota in mice feces on the 7th day after irradiation， then its correlation with WBC was analyzed. RESULTS The counts of WBC on the 1st， 4th， 7th and 10th day after irradiation， platelet count on the 10th day after irradiation and RBC count on the 1st day after irradiation in the amifostine group were significantly higher than those in model group （P＜0.05）. Compared with normal control group，β diversity of gut microbiome showed significant change， relative abundance of Firmicutes increased and that of Bacteroidetes decreased in model group. Amifostine could reverse the change in β diversity of gut microbiome， and the relative abundance of Bacteroidetes and Firmicutes. The model group consisted of four distinct species， namely Allobaculum， Erysipelotrichia， Erysipelotrichales and Erysipelotrichaceae， which were significantly negatively correlated with the proportion of peripheral blood lymphocytes （P＜0.01）； amifostine group consisted of two distinct species， namely Lactobacillus murinus and L. crispatus， which were significantly negatively correlated with the proportion of neutrophils （P＜0.05）. CONCLUSIONS Amifostine significantly improves irradiation-induced injury by regulating dysbiosis of LY201816） gut microbiota.

Objective To explore the risk factors of apathy and correlations with cognitive function in patients with hypertension combined with cerebral small vessel disease(CSVD).Methods Totally 141 patients with hypertension combined with CSVD were prospectively enrolled and were divided into apathy group(n=43)and non-apathy group(n= 98)according to neuropsychiatric inventory-apathy scale(NPI-Apathy)scores.The general data,imaging marker scores and total imaging burden scores were compared between groups.In hypertension combined with CSVD patients,multivariate logistic regression analysis was performed to screen the independent risk factors of apathy,and Spearman correlation analysis was also performed to observe the correlation of apathy and cognitive function.Results The patients'age,high density lipoprotein cholesterol(HDL-C),Fazekas scores of lateral periventricular white matter hyper-intensity(WMH),cerebral microbleed of depth/infratentorial and total imaging burden scores of apathy group were all higher,while mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)scores were both lower than those of non-apathy group(all P＜0.05).HDL-C and Fazekas scores of lateral periventricular WMH were both independent risk factors for apathy(both P＜0.05),while NPI-Apathy scores were moderately negatively correlated with cognitive function in patients with hypertension combined with CSVD(r=-0.543,-0.484,both P＜0.001).Conclusion HDL-C and Fazekas scores of lateral periventricular WMH were both independent risk factors for apathy in patients with hypertension combined with CSVD.The more severe the apathy,the lower the cognitive function.

ObjectiveTo investigate the incidence of hypertension and its influencing factors in community-dwellers at risk for high blood pressure in Minhang District of Shanghai， and to provide scientific evidence for the community management. MethodsA retrospective cohort study was conducted using the electronic health records of community-dwellers at risk for high blood pressure in Minhang District， Shanghai from January 1， 2011 to December 31， 2017. The study end-point was the occurrence of hypertension，and the followup was finished in December 2021. A total of 17 265 community-dwellers at risk for high blood pressure were enrolled in our study. Log-rank test and Cox regression analysis were used to determine the influencing factors. ResultsAfter 6.04 years of follow-up， the hypertension incidence among community-dwellers at risk for high blood pressure in Minhang District of Shanghai was 25.5%. Family history of hypertension （HR=1.250， 95%CI： 1.168‒1.338）， family history of stroke （HR=1.295， 95%CI： 1.080‒1.553）， history of diabetes （HR=1.203， 95%CI： 1.076‒1.345）， daily smoking （HR=1.187， 95%CI： 1.087‒1.296）， overweight （HR=1.393， 95%CI：1.308‒1.484）， obesity（HR=1.903， 95%CI： 1.719‒2.106）， high values of normal blood pressure （HR=1.275， 95%CI： 1.195‒1.359） and advanced age （HR=1.033， 95%CI： 1.030‒1.036） were all risk factors. Emaciation （HR=0.649， 95%CI： 0.500‒0.840） was a protective factors. ConclusionBlood pressure monitoring should be strengthened for people elderly， with family history of hypertension， family history of stroke， diabetes or high values of normal blood pressure， so as to diagnose hypertension early. Timely intervention measures should be taken for community-dwellers with unhealthy lifestyles such as smoking， overweight and obesity.