Objective: To examine the association between parent-child communication frequency about school related matters and depressive symptom risk among children and adolescents and to characterize its dose response pattern, so as to provide a reference for family intervention and school mental health promotion. Methods: Data were obtained from the 2022 China Family Panel Studies(CFPS), conducted from May to December 2022. A total of 1 896 children and adolescents aged 10-15 years were included. The 8 item Center for Epidemiologic Studies Depression Scale (CES-D8) was adopted to assess depressive symptoms among children and adolescents. Data on the parent-child communication frequency about school related matters was obtained from CFPS Child Proxy Questionnaire. Multivariable Logistic regression, sensitivity analyses, and exploratory segmented regression were performed. Results: A total of 375 participants were screened positive for depressive symptoms, with a prevalence of 19.8%. The prevalence decreased from 23.3% in the "never" group to 10.6% in the "very often" group ( χ 2=19.30, P <0.05). In the fully adjusted model, the point estimate for the "very often" group suggested lower odds of a positive screen ( OR =0.52), and the test for trend was statistically significant ( P =0.03). The association was more pronounced among children aged 10-12 years ( OR=0.31, 95%CI=0.11-0.86, P <0.05). Sensitivity analyses yielded directionally consistent results, but the statistical evidence was weakened ( OR=0.83, P trend =0.08). Dose response analysis showed a statistically significant overall association between parent-child communication frequency about school related matters and depressive symptom risk ( P =0.04), with no significant departure from linearity ( P = 0.14 ). Among the prespecified cut points, exploratory segmented regression showed relatively better model fit at an ordinal frequency score of 4.5, between "often" and "very often" (likelihood ratio test P =0.03). However, the overall test for nonlinearity was not statistically significant ( P =0.14), and the finding should therefore be interpreted as exploratory. Conclusion More frequent parent-child communication about school related matters is associated with lower depressive symptom risk, suggesting that routine communication about such matters may help reduce the risk of depressive symptoms in children and adolescents.

Objective: To develop machine learning identification models for the relatively high risk of social-emotional problems among Chinese school-aged children, and compare internal validation performances across different algorithms, so as to provide reference for preliminary identification of relatively high risk in school-aged children s social-emotional problems. Methods: Based on the 2022 proxy-reported data for children from the China Family Panel Studies (CFPS), a total of 3 575 children aged 6-15 years from 2 709 families who completed the survey between May and December 2022 were included. Relatively high risk of social-emotional problems was defined using a composite score constructed from 12 social emotional related items in the CFPS 2022 general questionnaire. Data were split approximately 7∶3 (modeling group: 2 503, validation group: 1 072) by household identifier (ID) to ensure all children from the same family were assigned to the same dataset. Candidate variable selection, missing value imputation parameter fitting, least absolute shrinkage and selection operator (LASSO) feature screening, model training, and hyperparameter tuning were performed within the development set, while internal validation was conducted in the validation set. Weighted AUC, Brier score, sensitivity, specificity, calibration curves, and decision curves were compared across Logistic regression, random forest (RF), gradient boosting decision trees (GBDT), support vector machines (SVM), and extreme gradient boosting (XGBoost). The Shapley additive explanations (SHAP) method was used for exploratory interpretation of the RF model, which achieved the highest AUC value in the validation set. Results: A total of 941 (26.3%) were classified as having relatively high risk of social emotional problems. A total of 659 and 282 high risk cases were in the modeling group and validation group, respectively, with no cross set split of households. LASSO retained 10 features. In the validation set, the RF model achieved the highest AUC of 0.672 (95% CI =0.624-0.717) and a Brier score of 0.184. The Logistic regression model achieved a validation AUC of 0.670 (95% CI =0.624-0.716). The incremental AUC gain of RF over Logistic regression was 0.002 (family cluster paired bootstrap 95% CI =-0.016 to 0.020, P =0.856). Following household ID splitting, all models showed moderate internal validation performance. Although RF achieved the highest numerical value, its incremental gain over Logistic regression was limited. Conclusion The model can serve as a reference for preliminary identification research on the relatively high risk of social emotional problems in school aged children, though its stability and applicability require further validation in external samples.

Objective:To explore the strategy of prostate biopsy in patients with prostate specific antigen(PSA)gray zone based on prostate imaging reporting and data system (PI-RADS).Methods:The clinical data of 427 patients who underwent transperineal prostate biopsy in the First Affiliated Hospital of Nanjing Medical University from January 2020 to December 2022 were retrospectively analyzed. The median age was 66 (61, 72) years old. The median PSA was 6.62 (5.46, 8.19) ng/ml. The median PSA density (PSAD) was 0.15 (0.11, 0.21) ng/ml 2. The median prostate volume (PV) was 43.68 (31.12, 56.82) ml. PSA velocity (PSAV) data were available in 65 patients with negative MRI examination(PI-RADS <3), and the median PSAV was 1.40 (0.69, 2.89) ng/(ml· year). Among the patients with positive MRI(PI-RADS≥3), there were 174 patients with only 1 lesion and 83 patients with ≥2 lesions. A total of 170 patients with negative MRI underwent systematic biopsy, and 257 patients with positive MRI underwent systematic combined targeted biopsy. The PI-RADS score, regions of interest(ROI), PSAD, f/tPSA and PSAV were analyzed to explore the biopsy strategy for patients with PSA gray area based on bpMRI imaging. Results:Of the 427 patients included in the study, 194 were positive and 233 were negative. Among the patients with positive biopsy pathology, 140 cases were clinically significant prostate cancer (CsPCa). Among the MRI-negative patients, there were 33 cases with PSAV ≥1.4 ng/(ml·year), and 10 cases of prostate cancer and 6 cases of CsPCa were detected by systematic biopsy.In 32 cases with PSAV <1.4 ng/(ml·year), 3 cases of prostate cancer and 0 case of CsPCa were detected by systematic biopsy. The sensitivity of systematic biopsy for the diagnosis of prostate cancer and CsPCa in patients with PSAV≥1.4 ng/(ml·year) were 76.9% (10/13) and 100.0% (6/6) respectively, the specificity were 55.8% (29/52) and 54.2% (32/59) respectively, the negative predictive value were 90.6% (29/32) and 100.0% (32/32) respectively, and the positive predictive value were 30.3% (10/33) and 18.2% (6/33) respectively. In MRI-positive patients with PI-RADS 3, the prostate cancer detection rates of targeted biopsy combined with systematic biopsy, systematic biopsy and targeted biopsy were 41.7% (45/108), 32.4% (35/108) and 35.2% (38/108), respectively ( P=0.349). The detection rates of CsPCa were 27.8% (30/108), 21.3% (23/108) and 25.0% (27/108), respectively ( P=0.541). In patients with PI-RADS 4-5 and PSAD > 0.15 ng/ml 2, the detection rates of CsPCa in targeted biopsy combined with systematic biopsy, systematic biopsy and targeted biopsy were 67.8% (61/90), 58.9% (53/90) and 67.8% (61/90), respectively ( P=0.354). Conclusions:For MRI-negative patients, all CsPCa could be detected by perineal systematic biopsy when PSAV ≥1.4 ng/(ml·year), and active observation could be performed when PSAV <1.4 ng/(ml·year). For MRI-positive patients, targeted combined systemic biopsy was required when PI-RADS score was 3, and targeted biopsy only could be performed when PI-RADS score ≥4 and PSAD >0.15 ng/ml 2, otherwise targeted combined systemic biopsy was required.

Aim To study the relationship between white blood cell count and clinical classification in patients with coronary heart disease and its clinical significance.Methods A total of 301 patients diagnosed with coronary heart disease in the Second Affiliated Hospital of Harbin Medical University from January 2022 to December 2023 were se-lected as the research subjects,and divided into stable angina pectoris(SAP)group and acute coronary syndrome(ACS)group based on their clinical manifestations and results of electrocardiogram,the differences of general data,biochemical indexes and cardiovascular indexes between the two groups were compared.Spearman correlation analysis was used to an-alyze the relationship between white blood cell count,neutrophil count and cardiovascular related indicators,including tro-ponin Ⅰ,N-terminal pro-brain natriuretic peptide(NT-proBNP),ejection fraction,left ventricular end-diastolic diameter(LVEDD),left atrial diameter,Gensini score,etc.ROC curve was employed to determine the cut-off point for diagno-sing ACS and SAP classification of coronary heart disease based on white blood cell count,and dividing patients into a group with normal white blood cell level and a group with above normal white blood cell level based on this cut-off point,the differences between the two groups were compared.Results The ratio of hyperlipidaemia history,white blood cell count,neutrophil count,C-reactive protein,platelet count,total cholesterol(TC),low density lipoprotein cholesterol(LDLC),troponin 1,NT-proBNP and Gensini score in the ACS group were significantly higher than those in the SAP group(all P＜0.05),while the ratio of aspirin use,the ratio of statin use,and ejection fraction in the ACS group were low-er than those in the SAP group(all P＜0.05).Spearman correlation analysis results showed that white blood cell count was positively correlated with C-reactive protein(r=0.443,P＜0.001),troponin Ⅰ(r=0.333,P＜0.001),NT-proBNP(r=0.245,P＜0.001)and Gensini score(r=0.341,P＜0.001),but negatively correlated with LVEDD(r=-0.212,P＜0.001).Similarly,neutrophil count was positively correlated with C-reactive protein(r=0.430,P＜0.001),troponin Ⅰ(r=0.325,P＜0.001),NT-proBNP(r=0.292,P＜0.001)and Gensini score(r=0.353,P＜0.001),but negatively correlated with LVEDD(r=-0.175,P=0.002).The cut-off point of white blood cell count in the diagnosis of ACS was 9.35×109 L-1(sensitivity was 56.7％,specificity was 93.1％).The patients were divided into normal white blood cell level group(n=202)and above normal white blood cell level group(n=99).Hyperlipidemia,smoking history,TC,LDLC,C-reactive protein,troponin Ⅰ,NT-proBNP and Gensini scores in above normal white blood cell level group were significantly higher than those in the normal white blood cell level group(all P＜0.05),while LVEDD was lower than that in the normal white blood cell level group(all P＜0.05).Conclusion White blood cell count can easily identify the high-risk type of coronary heart disease,and the cut-off point for the diagnosis of ACS is 9.35×109 L-1.

Aim To study the relationship between white blood cell count and clinical classification in patients with coronary heart disease and its clinical significance.Methods A total of 301 patients diagnosed with coronary heart disease in the Second Affiliated Hospital of Harbin Medical University from January 2022 to December 2023 were se-lected as the research subjects,and divided into stable angina pectoris(SAP)group and acute coronary syndrome(ACS)group based on their clinical manifestations and results of electrocardiogram,the differences of general data,biochemical indexes and cardiovascular indexes between the two groups were compared.Spearman correlation analysis was used to an-alyze the relationship between white blood cell count,neutrophil count and cardiovascular related indicators,including tro-ponin Ⅰ,N-terminal pro-brain natriuretic peptide(NT-proBNP),ejection fraction,left ventricular end-diastolic diameter(LVEDD),left atrial diameter,Gensini score,etc.ROC curve was employed to determine the cut-off point for diagno-sing ACS and SAP classification of coronary heart disease based on white blood cell count,and dividing patients into a group with normal white blood cell level and a group with above normal white blood cell level based on this cut-off point,the differences between the two groups were compared.Results The ratio of hyperlipidaemia history,white blood cell count,neutrophil count,C-reactive protein,platelet count,total cholesterol(TC),low density lipoprotein cholesterol(LDLC),troponin 1,NT-proBNP and Gensini score in the ACS group were significantly higher than those in the SAP group(all P＜0.05),while the ratio of aspirin use,the ratio of statin use,and ejection fraction in the ACS group were low-er than those in the SAP group(all P＜0.05).Spearman correlation analysis results showed that white blood cell count was positively correlated with C-reactive protein(r=0.443,P＜0.001),troponin Ⅰ(r=0.333,P＜0.001),NT-proBNP(r=0.245,P＜0.001)and Gensini score(r=0.341,P＜0.001),but negatively correlated with LVEDD(r=-0.212,P＜0.001).Similarly,neutrophil count was positively correlated with C-reactive protein(r=0.430,P＜0.001),troponin Ⅰ(r=0.325,P＜0.001),NT-proBNP(r=0.292,P＜0.001)and Gensini score(r=0.353,P＜0.001),but negatively correlated with LVEDD(r=-0.175,P=0.002).The cut-off point of white blood cell count in the diagnosis of ACS was 9.35×109 L-1(sensitivity was 56.7％,specificity was 93.1％).The patients were divided into normal white blood cell level group(n=202)and above normal white blood cell level group(n=99).Hyperlipidemia,smoking history,TC,LDLC,C-reactive protein,troponin Ⅰ,NT-proBNP and Gensini scores in above normal white blood cell level group were significantly higher than those in the normal white blood cell level group(all P＜0.05),while LVEDD was lower than that in the normal white blood cell level group(all P＜0.05).Conclusion White blood cell count can easily identify the high-risk type of coronary heart disease,and the cut-off point for the diagnosis of ACS is 9.35×109 L-1.

Objective:To analyze the clinical features and magnetic resonance imaging of non-malignant patients assigned to Prostate Imaging Reporting And Data System (PI-RADS) 5 score.Methods:We performed a retrospective review of 289 patients who underwent magnetic resonance ultrasound targeted combined system biopsy with PI-RADS 5 lesions in the First Affiliated Hospital of Nanjing Medical University between May 2019 and July 2021. The median age 72 (66, 77)years, median body mass index 24.4(22.3, 27.1)kg/m 2, median prostate volume (PV) 37.39(29.39, 48.86) ml, median PSA 22.24(10.91, 62.69) ng/ml, and median PSAD 0.53(0.30, 1.52)ng/ml 2 were recorded. According to the biopsy pathological results, all patients were divided into benign lesion group and prostate cancer group. PSA, PSAD, PV, and apparent diffusion coefficient (ADC) values were compared, and magnetic resonance imaging and clinical characteristics of patients with biopsy benign lesions were analyzed. Results:There were 11 cases (3.8%) with benign lesion and 278 cases (96.2%) with prostate cancer. The characters of 11 negative biopsy cases were displayed as follows: median age 69(66, 79)years, median body mass index 22.0(21.0, 25.5)kg/m 2, median PV 62.90(38.48, 71.96)ml, median PSA 5.55(2.99, 20.52)ng/ml, median PSAD 0.16(0.07, 0.24) ng/ml 2, median ADC 714.47(701.91, 801.26)×10 -6 mm 2/s, abnormal digital rectal and amination in 5 cases, smoking in 7 cases, and alcohol consumption in 4 cases. The median PV [62.90(38.48, 71.96) vs. 37.21(29.22, 47.82)ml, P<0.01], the PSA value [5.55(2.99, 20.52) vs. 23.53(11.14, 65.98)ng/ml, P<0.01], and the PSAD value [0.16(0.07, 0.24) vs. 0.58(0.31, 1.57)ng/ml 2, P<0.01] were significantly different between benign condition group and prostate carcinoma group. Benign condition group included 5 chronic prostatitis, 2 acute prostatitis (1 with focal adenocarcinoma), 2 granulomatous inflammation, and 2 tuberculous granulomatous inflammation. In 7 benign cases, PSA was less than 10 ng/ml, combined with frequent urination, urgency of urination and incontinence were founded. In 8 benign cases, the area of lesion was more than 50% of the total prostate area in the axial position and the imaging of magnetic resonance were diffused, with regular shape and uniform signal. The imaging of symmetrical distribution was in 6 cases. Conclusions:The benign condition with PI-RADS 5 lesions included chronic prostatitis, acute prostatitis, granulomatous inflammation and tuberculous granulomatous inflammation, among which prostatitis was the most common cause. The PSA value were less than 10 ng/ml in most benign cases, with symptoms such as frequent urination, urgency of urination and incontinence. The imaging of magnetic resonance were diffused, symmetrically distributed, with regular shape and uniform signal.

Objective:To explore the influencing factors of clinically significant prostate cancer (CsPCa) in patients with PI-RADS score 3.Methods:The data of 133 consecutive patients with the PI-RADS score 3 from January 2019 to December 2020 were retrospectively analyzed. All patients underwent 4-needle transperineal targeted biopsy and 12-needle systematic prostate biopsy (SB). The overall age was 66 (60-72) years, and the overall PSA value was 8.22 (5.95-11.41) ng/ml. All patients underwent multiparametric magnetic resonance imaging (mpMRI), and PI-RADS v2.0 score was 3. Patients were divided into two mutually exclusive groups: non CsPCa group and CsPCa group. The differences of lesion location, laterality, focality and sequence parameters of mpMRI between the two groups were compared, and multivariate binary logistic regression was used to analyze the independent predictors of PI-RADS score 3 in patients with CsPCa.Results:Biopsy results showed 57 cases of prostate cancer, including 41 cases of CsPCa, and 76 cases of non-prostate cancer. The detection rate of prostate cancer was 46.62 %(57/133), and the detection rate of CsPCa was 30.83 %(41/133). There were 41 cases in CsPCa group and 92 cases in non CsPCa group. There was no significant difference between CsPCa group and non CsPCa group in age [66 (58-70) years vs. 66 (60-72) years], body mass index [24.22 (21.82-25.71) kg/m 2 vs. 23.71 (21.99-26.12) kg/m 2], PSA [9.39 (6.35-12.55) ng/ml vs. 7.67 (5.83-10.51) ng/ml], abnormal rate of rectal digital examination [21.95% (9/41) vs. 9.78% (9/92)] (all P > 0.05). There was significant difference in PSAD [0.40 (0.16-0.65) ng/ml 2 vs. 0.17 (0.12-0.24) ng/ml 2] ( P<0.05). In MRI, PI-RADS=3 lesions were mainly located in the transitional zone [46.62 %(62/133)]. In CsPCa group, MRI lesions were located in peripheral zone in 16 cases, transitional zone in 19 cases, and both areas in 6 cases. There were 16 cases on the right, 15 cases on the left and 10 cases on both sides. The lesions were diffused in 19 cases and localized in 22 cases. In the non CsPCa group, 41 lesions were located in the peripheral zone, 43 in the transitional zone, and 8 in both areas. There were 26 cases on the right, 35 cases on the left and 31 cases on both sides. The lesions were diffuse in 56 cases and localized in 36 cases. There was no significant difference in lesion location, side and diffusion degree between the two groups ( P> 0.05). Compared with the non CsPCa group, the positive rate of all MRI sequences in CsPCa group was higher (82.93% vs. 40.22%, P < 0.001), the positive rate of T2 weighted imaging (T2WI) was higher (92.68% vs. 75.00%, P = 0.018), the positive rate of diffusion weighted imaging (DWI) was higher (90.24% vs. 56.52%, P < 0.001), the maximum diameter was larger[(0.67(0.30-1.19)mm vs. 0.48(0.20-0.62)mm, P < 0.001], and the apparent diffusion coefficient (ADC) was lower[0.70(0.61-0.87) vs. 1.10(0.86-1.50), P < 0.001]. Concurrently, PSAD and lesion ADC were important predictors of CsPCa in logistic regression model [mean 10 fold cross validation AUC: 0.78(95% CI 0.65-0.88)]. Conclusions:Most of the MRI lesions in patients with PI-RADS 3 were located in the transitional zone, and the MRI lesions in CsPCa were more obvious and diffusion limited. PSAD and ADC values are independent predictors for the diagnosis of CsPCa in patients with PI-RADS score 3, and the log 2PSAD-ADC prediction model is helpful to find CsPCa from patients with PI-RADS score 3 and protect patients from unnecessary biopsy.

Objective:To investigate the expression of zinc finger protein 580 (ZNF580) in oxygen-glucose deprivation (OGD) model of SH-SY5Y cell line and its overexpression on the apoptosis of hypoxic-ischemic neurons and the possible mechanism.Methods:The study was divided into two parts: (1) Human neuroblastoma SH-SY5Y cell line was cultured and divided into the model group and control group. The model group was incubated at 37 ℃ for 6 h in a three-gas incubator of 95% N 2, 5% CO 2, and 0.1% O 2 to establish OGD model, and proteins were extracted at 6, 12, and 24 h after OGD. The expression of ZNF580 was quantified by Western blot. (2) Effects of ZNF580 overexpressed with lentivirus transfection on the apoptosis and cleaved caspase-3 expression: Cells were collected from the control group and model group 24 h after OGD. Overexpressed ZNF580 cells were constructed by lentivirus transfection as the overexpression group and then treated with OGD. Flow cytometry was used to detect the apoptosis rate in the three groups and Western blot was used to detect the expression of cleaved caspase-3. Two independent sample t-test, one-way variance analysis, and LSD- t for pairwise comparison were used for statistical analysis. Results:(1) ZNF580 expression was significantly increased at 6, 12, and 24 h after OGD compared with the control group (1.36±0.05, 2.12±0.07, 1.69±0.05 vs 1.00, LSD- t=9.20, 28.26, and 19.21, all P<0.001). (2) Apoptosis rates of the control, model, and overexpression groups were (1.07±0.56)%, (21.51±1.65)%, and (3.42±0.93)%, respectively, and relative expression levels of cleaved caspase-3 were 1.00, 2.47±0.59, and 1.70±0.25, respectively. Compared with the control group, apoptosis rate and cleaved caspase-3 relative expression level were significantly increased in the model group (LSD- t=21.98 and 8.17, both P=0.001), while the two figures were significantly decreased in the overexpression group when compared with the model group (LSD- t=19.45, P=0.001; LSD- t=4.28, P=0.005). Conclusion:Hypoxia and ischemia could lead to the overexpression of ZNF580, which may reduce the apoptosis of hypoxic-ischemic neurons by inhibiting the expression of cleaved caspase-3 and affecting its enzymatic activation.

Objective:To explore the efficacy of single-plane bi-parameter magnetic resonance imaging (bpMRI) in the diagnosis of prostate cancer.Methods:The clinical data of 343 patients who underwent transperineal template prostate magnetic resonance-transrectal ultrasound (MRI-TRUS) cognitive fusion biopsy at the First Affiliated Hospital of Nanjing Medical University from January 2020 to July 2021 were retrospectively analyzed, with median age of [65.0(59.0, 72.0)] years, median body mass index (BMI) of [24.1(22.2, 25.6)]kg/m 2, median prostate volume (PV) of [41.7(29.1, 53.3)]ml, median PSA[6.9 (5.5, 8.4) ng/ml], median PSAD of[0.17(0.12, 0.22) ng/ml 2], and abnormal rate of digital rectal examination (DRE) [6.4%(22/343)]. All patients underwent initial biopsy and bi-parameter magnetic resonance imaging (bpMRI) examination before biopsy, and the images were interpreted using prostate image reporting and data system version 2.1 (PI-RADS v2.1). The detection rates of prostate cancer and clinically significant prostate cancer (csPCa) were compared between single-plane bpMRI and bpMRI. When PI-RADS≥3 score, MRI results were positive; when PI-RADS ≤2 score, MRI results were negative. Results:In the single-plane bpMRI group, 121 MRI results were negative and 222 were positive. Positive patients included 95 with PI-RADS 3 score, 94 with PI-RADS 4 score, and 33 with PI-RADS 5 score. In bpMRI group, 141 MRI results were negative and 202 were positive. Among the positive patients, 67 patients with PI-RADS 3 score, 102 patients with PI-RADS 4 score, and 33 patients with PI-RADS 5 score. The detection rates of single-plane bpMRI and bpMRI for prostate cancer were 22.3% (27/121) and 15.6% (22/141) in MRI negative cases[22.3% (27/121) and 15.6% (22/141), P=0.17], and PI-RADS scores with 3 points [35.8% (34/95) vs. 44.8% (30/67), P=0.25], 4 points [89.4% (84/94)vs. 90.2% (92/102), P=0.85] and 5 points [90.9% (30/33) vs. 93.9% (31/33), P=1.00] showed no significant difference in stratification. The detection rate of csPCa in the single-plane bpMRI group and bpMRI group was significantly different in the MRI negative cases [7.4% (9/121) and 2.1% (3/141), P=0.04]. PI-RADS scores with 3 points [22.1% (21/95) vs. 29.9% (20/67), P=0.27], 4 points [80.9% (76/94) vs. 79.4% (81/102), P=0.80] and 5 points [84.9% (28/33) vs. 90.9% (30/33), P=0.71] showed no significant difference in stratification. Conclusions:For those suspected of prostate cancer patients with PSA 4-10 ng/ml and PI-RADS score ≥3, single-plane bpMRI or bpMRI examination has the same efficacy in term of the detection rate of prostate cancer and csPCa.

To improve the oral bioavailability of insulin, an insulin-loaded enteric polymer-lipid hybrid nanoparticles(INS-NPs L100)was prepared using methoxy PEG-poly(D, L-lactide)(PEG-PLA), phospholipid s75 and Eudragit L100; in vitro and in vivo behaviors of INS-NPs L100 were evaluated. Insulin-loaded polymer-lipid hybrid nanoparticles(INS-NPs)were prepared by W/O/W double emulsion solvent evaporation method. INS-NPs formulation was optimized by single factor experiment using encapsulation efficiency, particle size, and in vitro release behavior of the corresponding INS-NPs L100 as evaluation indexes. The morphology, in vitro drug release profile and hypoglycemic effect of the INS-NPs L100 using the optimal INS-NPs and Eudragit® L100(used as enteric polymer)were assessed. The results showed that the encapsulation efficiency of the optimal INS-NPs was(62. 18±4. 51)%. The average particle size, PDI and Zeta potential was(225. 2±94. 3)nm, 0. 191±0. 068, and -(14. 84±1. 26)mV, respectively. The cumulative drug release from the INS-NPs L100 was only 8. 01% at 2 h in pH 1. 0 HCl solution, exhibiting a slow drug release behavior; while the drug release from INS-NPs L100 was 67. 31% at 6 h in phosphate buffer of pH 6. 8. Mereorer, after oral administration of INS-NPs L100 with a dose of 38 IU/kg, the blood glucose concentration of healthy rats was reduced to 76% of the initial values at 3. 5 h, exhibiting a sustained hypoglycemic effect. In summary, the INS-NPs L100 prepared in this study could effectively decrease the release rate of insulin in gastric juice, improve the stability of protein in the gastrointestinal tract, and provide a new approach for the oral administration of peptides and protein drugs.