Objective:To investigate the correlations among diabetes-related distress, self-management behavior, empowerment, and glycated hemoglobin (HbA1c) levels in patients with type 2 diabetes mellitus (T2DM) .Methods:A convenience sampling method was used to recruit a total of 1 927 hospitalized patients with T2DM from the Endocrinology Departments of five tertiary general hospitals in Hainan, Jiangsu, and Henan Provinces between December 2022 and December 2023. General demographic and clinical data were collected. The Problem Areas in Diabetes 5 (PAID-5), the Summary of Diabetes Self Care Activities (SDSCA), and the Diabetes Empowerment Scale-Short Form (DES-SF) were used to evaluate patients' psychological distress, self-management behaviors, and empowerment levels. Pearson correlation analysis was performed to examine the relationships among diabetes-related distress, empowerment, self-management behaviors, and HbA1c levels.Results:Pearson correlation analysis showed that diabetes-related distress was negatively correlated with empowerment ( r=-0.119, P<0.001) and the total score of self-management behavior ( r=-0.106, P<0.001), and positively correlated with HbA1c levels ( r=0.103, P<0.001). Empowerment was positively correlated with self-management behavior ( r=0.538, P<0.001) and negatively correlated with HbA1c levels ( r=-0.170, P<0.001). Self-management behavior was negatively correlated with HbA1c levels ( r=-0.165, P<0.001) . Conclusions:Diabetes-related distress, empowerment, and self-management behavior are all associated with glycemic control. Future research and interventions should focus on enhancing patients' self-management abilities, strengthening empowerment, and providing psychological support in order to improve glycemic outcomes and offer a more comprehensive and effective management approach for patients with T2DM.

Objective:To investigate the correlations among diabetes-related distress, self-management behavior, empowerment, and glycated hemoglobin (HbA1c) levels in patients with type 2 diabetes mellitus (T2DM) .Methods:A convenience sampling method was used to recruit a total of 1 927 hospitalized patients with T2DM from the Endocrinology Departments of five tertiary general hospitals in Hainan, Jiangsu, and Henan Provinces between December 2022 and December 2023. General demographic and clinical data were collected. The Problem Areas in Diabetes 5 (PAID-5), the Summary of Diabetes Self Care Activities (SDSCA), and the Diabetes Empowerment Scale-Short Form (DES-SF) were used to evaluate patients' psychological distress, self-management behaviors, and empowerment levels. Pearson correlation analysis was performed to examine the relationships among diabetes-related distress, empowerment, self-management behaviors, and HbA1c levels.Results:Pearson correlation analysis showed that diabetes-related distress was negatively correlated with empowerment ( r=-0.119, P<0.001) and the total score of self-management behavior ( r=-0.106, P<0.001), and positively correlated with HbA1c levels ( r=0.103, P<0.001). Empowerment was positively correlated with self-management behavior ( r=0.538, P<0.001) and negatively correlated with HbA1c levels ( r=-0.170, P<0.001). Self-management behavior was negatively correlated with HbA1c levels ( r=-0.165, P<0.001) . Conclusions:Diabetes-related distress, empowerment, and self-management behavior are all associated with glycemic control. Future research and interventions should focus on enhancing patients' self-management abilities, strengthening empowerment, and providing psychological support in order to improve glycemic outcomes and offer a more comprehensive and effective management approach for patients with T2DM.

Objective To investigate the key genes associated with ferroptosis in peri-implantitis and explore the potential mecha-nisms regulating peri-implantitis.Methods Several datasets were obtained from the GEO database.Differential expressed genes were screened,and GO and KEGG analyses were performed.A PPI network was constructed using the STRING website.Key genes were val-idated using a test set,and the diagnostic value of key genes was determined.The content and proportion of 22 immune cells in peri-im-plantitis tissues were obtained through immune infiltration analysis.Key genes were validated by qRT-PCR and Western Blot(WB).Results There were 1 138 differential genes between peri-implantitis tissues and normal gingival tissues,of which 29 were related to ferroptosis.The gene expression in peri-implantitis tissues mainly involved processes such as immune response activation.Five key genes in the ferroptosis-related differential genes,namely SOX2,GJA1,IL1B,GPX2 and CHAC1,were differentially expressed in peri-implantitis tissues and had high diagnostic value.Immune infiltration analysis showed significant changes in immune cells such as memory B cells and plasma cells in peri-implantitis tissues.qRT-PCR and WB confirmed significant differential expression of mRNA and the protein transcribed by key genes.Conclusion Differential genes between peri-implantitis and ferroptosis are screened using bioinformatics analysis and biological validation,providing new insights into the study on peri-implantitis.

Objective To explore the predictive effect of empowerment and theory of planned behavior(TPB)on the four core behaviors of type 2 diabetes mellitus(T2DM)self-management,and analyze the influence path of TPB model and behavioral intention on the four core behaviors.Methods A total of 500 T2DM patients who were hospitalized in the Endocrinology Department of three tertiary general hospitals in different provinces from December 2022 to May 2023 were selected for investigation.Hierarchical multiple regression analysis was used to explore the predictive effects of empowerment and TPB models on self-management behaviors.Bootstrap method was used to analyze the influence path of TPB model and behavior intention on self-management behaviors.Results Empowerment had a predictive effect on self-management behavior,which was improved after the addition of TPB,with medication R2=0.194,blood glucose monitoring R2=0.308,regular diet R2=0.337 and regular exercise R2=0.343,respectively.Mediation effect analyses revealed that attitude,subjective norm,and perceived behavioral control were observed to predict behavior intention across the four behaviors,and the three except through the behavior intention indirectly affect behavior,can also directly affect the behavior.Conclusions Empowerment can predict self-management behavior,and adding TPB to this can improve the prediction effect.Attitude,subjective norms and perceived control can indirectly or directly affect self-management behavior through behavioral intention.

Objective To investigate the effect of different serum sodium levels on heart function and prognosis in very elderly patients with heart failure. Methods Totally 152 elderly patients(aged ≥ 85 years)with hyponatremia were enrolled.Based on the serum sodium level ,they were divided into mild(125 mmol/L ≤ Na+ < 135 mmol/L) ,moderate(125 mmol/L ≤ Na+ < 135 mmol/L) ,and severe hyponatremia(Na+ < 115 mmol/L)groups ,and 76 patients with normal blood sodium level(Na+ ≥ 135 mmol/L)were selected as control group. The general data ,levels of serum creatinine and N-terminal pro-brain natriuretic peptide (NTproBNP)and prognosis were compared among the above groups. Results Compared with the control group ,patients with severe hyponatremia were much older ,with more diuretics administration ,higher level of serum creatinine , lowerlevelofeGFRandleftventricularejectionfractions[(38.1±3.9)％ vs.(45.2±9.7)％ ].There were higher incidences of coronary atherosclerotic heart disease [72.4％ (n=21)vs. 56.6％ (n=43)] ,diabetes[41.4％ (n=12)vs. 23.7％ (n=18)] ,chronic renal insufficiency [22.6％ (n=8)vs. 11.8％ (n=9)] ,stroke[20.6％ (n=6)vs. 9.2％ (n=7)]in patients with severe hyponatremia compared with other groups. The severe hyponatremia group showed significantly higher levels of NTproBNP [(4823. 9 ± 588. 1 )ng/L v s. (1124. 4 ± 349. 1 )ng/L ,(1836. 2 ± 369. 3 )ng/L ,(2894. 1 ± 687. 3 )ng/L ]and higher rates of mortality [27.6％ (n=8) vs.5.3％ (n=4) ,7.6％ (n=6) ,13.6％ (n=6)]as compared to the control group ,mild and moderate hyponatremia groups. Furthermore ,length of stay in hospital were markedly longer in patients with severe hyponatremia than those with mild and moderate hyponatremia[(11.1 ± 7.1)d vs. (19.6 ± 5.7)d ,(16.1 ± 4.2)d] . Conclusions Hyponatremia is a common type of electrolyte disorder in very elderly patients with heart failure ,and severe hyponatremia may predictand increased risk of death.

Objective To investigate the impact of hyper-homocystinemia (Hcy)on cardiac remolding in spontaneously hypertensive rat(SHR)and the protective effects of folic and vitamin B12 on the remolding.Methods The seven-week-old SHR were divided into four groups according to different diet for 20 weeks.The control group was fed a perfect compound diet without methionine,the methionine group was fed a perfect compound diet added with 2 ％ methionine,the treatment group was fed as that of methionine group,but added with vitamin B12 0.09 mg/(kg.d)and folate 4 mg/(kg.d)in the last 12 weeks,the mixture group was fed as that of methionine group in the first 8 weeks,and as that of control group.At the end of the intervention period,plasma levels of Hcy and matrix metalloprotease(MMP)-9 were measured.The blood pressure was detected by the non-invasive blood pressure sensing device.The cardiac structure and function were detected using echocardiography and invasive hemodynamic method.Picro-sirius red(PSR)staining was used to check the fibrosis in paraffin embedding ventricle section.Results Plasma levels of Hcy and MMP-9 were increased in the methionine group,while there was no significant difference in plasma levels of Hcy and MMP-9 among the treatment group,the mixture diet group and control group.Rats in methionine group had the largest heart weight among four groups,and systolic blood pressure was lower in methionine group than in the control group(P＜0.05).Compared with the other three groups,the methionine group showed that the left ventricular end-diastolic pressure(LVEDP)was increased and-dp/dt maxwas decreased.Meanwhile,LVEDP and-dp/dt m,x had no significant difference between the control group,treatment group and mixture group.The methionine group showed the most severe decrease in the left ventricular fractional shortening(LVFS)and +dp/dt While LVFS and + dp/dt max had no statistical significance between the treatment group and control groups,but the mixture group had lower LVFS and +dp/dt max values as compared with the control group(both P＜0.05).Perivascular fibrosis was increased significantly in methionine group as compared with the other three groups,while the treatment and control groups had similar perivascular fibrosis,but the mixture group had higher perivascular fibrosis than did the control group,and had similar perivascular fibrosis to the treatment group.Fibrosis deposition in myocardium mesenchymal was similar to those observed in perivascular fibrosis,but the treatment group showed a more improvement of collagen deposition as compared with the mixture group.Conclusions Hyper-homocystinemia can accelerate systolic and diastolic dysfunction through accumulating fibrosis in myocardium and perivascular wall which lead to adverse cardiac remolding.Folate and vitamin B12 have protective effects on heart function by reversing the adverse changes through decreasing Hcy level.

Objective To explore the correlation of serum homocysteine(Hcy)levels and hypertrophy of left ventricle in very elderly hypertensive patients.Methods According to plasma Hcy levels,patients with essential hypertension (n=378) were divided into non H-type hypertension group (n=142) and H-type hypertension group (n=236). Height, weight, reg?ular medication, blood pressure, renal function, blood lipid profile and the concentration of plasma Hcy were recorded. Color Doppler ultrasonic equipment was used to determine the morphology and structure of left ventricle. The correlation between plasma Hcy and left ventricle remodeling was analyzed. Results The ratio of left ventricular hypertrophy was higher in H-type hypertension group than that in non H-type hypertension group(45.8%vs 24.6%,χ2=16.81,P<0.001). Patients in H-type hypertension group had higher systolic blood pressure, higher plasma level of Hcy and larger left ventricular posterior wall thickness(LVPWT), larger interventricular septal thickness (IVST) and increased left ventricular mass index (LVMI) compared to those in non H-type hypertension group(162.20 ± 14.97)vs(149.70 ± 5.06)mmHg,(19.76 ± 5.83)μmol/L vs (9.53±0.72)μmol/L,(9.77±2.35)vs(9.21±2.68)mm,(9.74±3.15)vs(8.51±2.42)mm,(118.64±39.38)vs(101.85±41.71)g/m2 respectively, all P<0.05). There was a positive correlation between LVMI and Hcy(r=0.381,P<0.001). Multivariable Lo?gistic regression analysis showed that hyperhomocysteinemia was an independent risk factor of LVMI. Conclusion High plasma Hcy level is an independent risk factor of LVMI, which works together with hypertension to promote left ventricular re?molding.

Objective To study the curative effect of combing montelukast with inhaled corticosteroids in the treatment of cough variant asthma .Methods According to diagnosis standard guideline for diagnosis and treatment of cough in CVA,84 cases of CVA patients were chosen and divided into the treatment group (n=42)and the control group(n=42).The control group were treated with inhaled corticosteroid Budesonide .The treatment group was given monelukast based on the treatment in control group .And the clinical effects of two groups ,recurrence and the lung function index were observed .Results The total efficiency of treatment of the control group was 73.8%,and the treatment group was 95.0%.The total effective rate of observation group was apparently higher than that of the control group(χ2 =6.46,P<0.05).The lung function of the treatment group compared to the control group was significantly increased(t=2.873,P<0.05).Conclusion Montelukast combined with Glucocorticoid in the treatment of CVA can effectively improve the cure rate ,reduce the recurrence ,which can be widely used in clinical treatment .

BACKGROUND:The establishment of model is very crucial in the orthodontic tooth movement experiment. The selection of force and control ing of anchorage may greatly affect experimental results.
OBJECTIVE:To establish an animal model for orthodontic tooth movement.
METHODS:Twenty Wistar rats were included in this study. The root of incisor teeth at upper jaw was dril ed and then threaded with a ligature wire (0.3 mm diameter), therefore the alveolar bone and two incisor teeth were ligated. The first molar at right upper jaw was also ligated using a ligature wire (0.2 mm diameter). The experimental teeth were randomly divided into four groups. A Sental oy closed-coil spring (10 g, 25 g, 50 g) was placed between the maxil ary incisors and the maxil ary first molar, respectively. Taking the incisor as the anchorage, the molars were given a mesial movement, and control group received no force. On day 14, the dental pulp, dentin and enamin resorption was analyzed with Image-Pro Plus software.
RESULTS AND CONCLUSION:A light force (10 g Ni-Ti coil spring) produced irregular enamel resorption and narrowed periodontal membrane space, whereas heavy force (25 g Ni-Ti coil spring) produced irregular dentin and enamel resorption, even heavier force (50 g Ni-Ti coil spring) produced apparent resorption at dental root, which affected the dentin. No statistical difference of the relative depth of dentin resorption was found between the 10 g group and the control group (P>0.05). The data between other groups showed statistical y significant differences (P<0.05). The mechanical union of the incisors and the mandibular bone efficiently prevents the continuous eruption of the upper incisors, which maintains the anchorage stability. Using Ni-Ti coil spring, a stable, scientific and reliable model of orthodontic tooth movement can be established through mesial movement of the first molars. The optimal force of 10 g is used to move the rat first molar mesial y.

Objective To investigate the clinical characteristics in chronic severe hepatitis B patients with HbeAg-positive and HbeAs-negative.Methods A total of 95 chronic severe hepatitis B cases were retrospectively analyzed.The clinical information,hepatic function,hepatic fibrosis and HBV DNA in HBeAg-negative and HBeAgpositive groups were analyzed.Results of the 95 cases,54(57% ) were HBeAg-negative and 41(43% ) were HBeAg-positive.No significant differences were found on age,ALB,TB,CHE,indexes of hepatic fibrosis and the ratio of complications between HBeAg-negative group and HBeAg-positive group.Compared with HBeAg-positive group,there were significantly higher levels of ALT(198.25±215.37)U/L vs(400.37±413.59)U/L],AST[(254.78±269.16)U/L vs(578.14±600.23)U/L] and lower level of HBV DNA[(6.17×10~6±8.24×10~1)copies/ml vs (2.39×10~5±6.75×10~1) copies/ml] in HBeAg-negative group(P<0.05).The anteroposterior diameter of the left liver and the thickness of right liver were(65.12±12.43)mm and(95.37.±12.69)mm in the HBeAg positive fatal chronic severe hepatitis B before the terminal phase,vs(56.78±11.04)mm and(89.34.±9.23)mm in the HBeAg negative group,and the former is longer than the later(P<0.05).Conclusion Tissue injury is more serious and the level of HBV DNA is lower in HBeAg-negative patients than HBeAg-positive patients.Liver size of HBeAg negative group reduces more significantly than HBeAg positive group before terminal phase.