Objective To explore the development trajectory and root cause of kinesiophobia in patients with diabetic peripheral neuropathy.Methods By the convenience sampling method,240 diabetic peripheral neuropathy patients who were hospitalized in the Department of Endocrinology of a tertiary A hospital in Jiangsu Province from May 2022 to November 2022 were selected.The baseline data of the patients are collected using a general questionnaire,the Tampa Scale for Kinesiophobia,the Chinese version of the Multidimensional Fatigue Inventory-20,the Pittsburgh Sleep Quality Index,the Social Support Rate Scale,and the Numerical Rating Scale for Pain.At the time of discharge,and at 3,6,and 12 months post-discharge,the level of kinesiophobia in the patients is assessed.The growth mixture model was used to classify the trajectory of kinesiophobia and analyze its root causes.Results Ultimately,227 patients in this study completed the survey.The trajectories of kinesiophobia in patients with diabetic peripheral neuropathy were divided into 3 latent classes:persistent high kinesiophobia group(22.5％),moderate kinesiophobia decline group(44.9％)and persistent low kinesiophobia group(32.6％).The results of multivariate Logistic regression analysis showed that age,frequency of hypoglycemia,complications,sleep quality,fall history within a year,pain and fatigue score were influencing factors of the latent classes of kinesiophobia trajectories in patients with DPN(P＜0.05).Conclusion Within 12 months after discharge,the kinesiophobia of patients with diabetic peripheral neuropathy shows population heterogeneity.Medical staff should give targeted interventions according to the developmental trajectories of kinesiophobia and root cause analysis.

OBJECTIVE To summarize the procedural management practice of hospital infection review for new medical technologies and projects so as to provide references for other medical institutions.METHODS The data with the respect to review of new technologies and projects were collected from Zhejiang Provincial Hospital of Chinese Medicine between 2018 and 2023,and the process of review and management practice were summarized.The potential risk for infection was evaluated by establishing the evaluation indexes for nosocomial infection man-agement of new technologies and projects and conducting procedural management of the review so as to make clear of the corresponding prevention and control measures.The tracking closed-loop management was carried out for the new technologies and projects that have been already implemented.RESULTS Totally 629 items of new medical technologies and projects were involved in the review and tracking closed-loop management,including 499(79.33％)medical technologies and pharmacy-related projects and 130(20.67％)nursing.The result of review showed that there were 606(96.34％)items with'approval',14(2.23％)items with'approval after revision',3(0.48％)items with'approval after reexamination,and 6(0.95％)items with'disapproval'.The result of risk as-sessment indicated that there were 5(0.79％)items of high-risk projects and 624(99.21％)items of low-risk pro-jects.There was no severe nosocomial infection or infection cluster incident during the tracking of clinical applica-tion of the approved items.CONCLUSION The risk of nosocomial infection has been controlled from the origin through the practice,which further standardizes the clinical application of the new technologies and projects and provides evidence for normalized application of the new technologies and projects in the medical institutions.

Alcoholic liver disease(ALD)is a liver disease caused by long-term heavy drinking and one of the most common causes of liver-related morbidity and mortality.According to Chinese medicine,the development of ALD is mainly related to alcoholism,and the evolution of its pathology is a gradually aggravating process.Wine-heat injures the liver,without obvious organic lesions at the initial stage,and as the disease progresses to different stages,internal dampness appears,dampness depresses and transforms into heat,and Qi stagnation and blood stasis are gradually aggravated,which affects the functions of various internal organs,directly or indirectly,and creates a complex mechanism of crosstalk between the liver and other organs,which leads to the pathological condition of This leads to the pathological state of multi-organ dysfunction.Modern research has found that long-term alcohol abuse not only causes direct damage to the liver,but also leads to progression to end-stage liver disease by altering the intestinal barrier function and intestinal microbial community,and producing kidney damage and cardiac function.This article reviewed recent studies on the interactions between the liver and other organs in light of the Chinese and Western pathogenesis of alcoholic liver disease and the theory of organ crosstalk,and introduces potential strategies for the treatment of alcoholic liver disease,which will provide a reference for the discovery of new therapeutic avenues.

OBJECTIVE To summarize the procedural management practice of hospital infection review for new medical technologies and projects so as to provide references for other medical institutions.METHODS The data with the respect to review of new technologies and projects were collected from Zhejiang Provincial Hospital of Chinese Medicine between 2018 and 2023,and the process of review and management practice were summarized.The potential risk for infection was evaluated by establishing the evaluation indexes for nosocomial infection man-agement of new technologies and projects and conducting procedural management of the review so as to make clear of the corresponding prevention and control measures.The tracking closed-loop management was carried out for the new technologies and projects that have been already implemented.RESULTS Totally 629 items of new medical technologies and projects were involved in the review and tracking closed-loop management,including 499(79.33％)medical technologies and pharmacy-related projects and 130(20.67％)nursing.The result of review showed that there were 606(96.34％)items with'approval',14(2.23％)items with'approval after revision',3(0.48％)items with'approval after reexamination,and 6(0.95％)items with'disapproval'.The result of risk as-sessment indicated that there were 5(0.79％)items of high-risk projects and 624(99.21％)items of low-risk pro-jects.There was no severe nosocomial infection or infection cluster incident during the tracking of clinical applica-tion of the approved items.CONCLUSION The risk of nosocomial infection has been controlled from the origin through the practice,which further standardizes the clinical application of the new technologies and projects and provides evidence for normalized application of the new technologies and projects in the medical institutions.

Objective To explore the development trajectory and root cause of kinesiophobia in patients with diabetic peripheral neuropathy.Methods By the convenience sampling method,240 diabetic peripheral neuropathy patients who were hospitalized in the Department of Endocrinology of a tertiary A hospital in Jiangsu Province from May 2022 to November 2022 were selected.The baseline data of the patients are collected using a general questionnaire,the Tampa Scale for Kinesiophobia,the Chinese version of the Multidimensional Fatigue Inventory-20,the Pittsburgh Sleep Quality Index,the Social Support Rate Scale,and the Numerical Rating Scale for Pain.At the time of discharge,and at 3,6,and 12 months post-discharge,the level of kinesiophobia in the patients is assessed.The growth mixture model was used to classify the trajectory of kinesiophobia and analyze its root causes.Results Ultimately,227 patients in this study completed the survey.The trajectories of kinesiophobia in patients with diabetic peripheral neuropathy were divided into 3 latent classes:persistent high kinesiophobia group(22.5％),moderate kinesiophobia decline group(44.9％)and persistent low kinesiophobia group(32.6％).The results of multivariate Logistic regression analysis showed that age,frequency of hypoglycemia,complications,sleep quality,fall history within a year,pain and fatigue score were influencing factors of the latent classes of kinesiophobia trajectories in patients with DPN(P＜0.05).Conclusion Within 12 months after discharge,the kinesiophobia of patients with diabetic peripheral neuropathy shows population heterogeneity.Medical staff should give targeted interventions according to the developmental trajectories of kinesiophobia and root cause analysis.

Alcoholic liver disease(ALD)is a liver disease caused by long-term heavy drinking and one of the most common causes of liver-related morbidity and mortality.According to Chinese medicine,the development of ALD is mainly related to alcoholism,and the evolution of its pathology is a gradually aggravating process.Wine-heat injures the liver,without obvious organic lesions at the initial stage,and as the disease progresses to different stages,internal dampness appears,dampness depresses and transforms into heat,and Qi stagnation and blood stasis are gradually aggravated,which affects the functions of various internal organs,directly or indirectly,and creates a complex mechanism of crosstalk between the liver and other organs,which leads to the pathological condition of This leads to the pathological state of multi-organ dysfunction.Modern research has found that long-term alcohol abuse not only causes direct damage to the liver,but also leads to progression to end-stage liver disease by altering the intestinal barrier function and intestinal microbial community,and producing kidney damage and cardiac function.This article reviewed recent studies on the interactions between the liver and other organs in light of the Chinese and Western pathogenesis of alcoholic liver disease and the theory of organ crosstalk,and introduces potential strategies for the treatment of alcoholic liver disease,which will provide a reference for the discovery of new therapeutic avenues.

Objective To explore the potential categories of self-management behavior in prediabetes patients and analyze the influencing factors of different potential categories.Methods A convenient sampling method was used to select pre-diabetic patients treated in physical examination centers and endocrinology outpatient clinics in 2 tertiary A hospitals in Jiangsu Province from September 2022 to June 2023.General data questionnaire,Prediabetic Disease Knowledge Questionnaire,Prediabetes Self-management Scale,Diabetes Self-efficacy Scale and Social Support Rating Scale were used for investigation.Results A total of 445 subjects were included in this study,with an average age of(44.92±4.98)years.4 potential categories of self-management behavior were identified,namely low self-management(16.4％),static self-management(19.1％),dynamic self-management(25.6％)and high self-management(38.9％).Occupational status,marital status,family per capita monthly income,family history of diabetes,disease knowledge,self-efficacy and social support were the influencing factors of self-management behavior in prediabetes patients(P＜0.05).Conclusion There are significant category characteristics of self-management behavior in patients with prediabetes.Medical staff can identify the category characteristics and influencing factors early,and provide bases for medical staff to formulate targeted clinical intervention measures to help patients improve their self-management level.

Background: The incidence density of metabolic dysfunction-associated fatty liver disease (MAFLD) and the effect of a healthy lifestyle on the risk of MAFLD remain unknown. We evaluated the prevalence and incidence density of MAFLD and investigated the association between healthy lifestyle and the risk of MAFLD. Methods: A cross-sectional analysis was conducted on 37,422 participants to explore the prevalence of MAFLD. A cohort analysis of 18,964 individuals was conducted to identify the incidence of MAFLD, as well as the association between healthy lifestyle and MAFLD. Cox proportional hazards regression was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) with adjustments for confounding factors. Results: The prevalence of MAFLD, non-alcoholic fatty liver disease, and their comorbidities were 30.38%, 28.09%, and 26.13%, respectively. After approximately 70 thousand person-years of follow-up, the incidence densities of the three conditions were 61.03, 55.49, and 51.64 per 1,000 person-years, respectively. Adherence to an overall healthy lifestyle was associated with a 19% decreased risk of MAFLD (HR, 0.81; 95% CI, 0.72 to 0.92), and the effects were modified by baseline age, sex, and body mass index (BMI). Subgroup analyses revealed that younger participants, men, and those with a lower BMI experienced more significant beneficial effects from healthy lifestyle. Conclusion Our results highlight the beneficial effect of adherence to a healthy lifestyle on the prevention of MAFLD. Health management for improving dietary intake, physical activity, and smoking and drinking habits are critical to improving MAFLD.

Objective To explore the coronary flow reserve(CFR)in patients with coronary slow flow(CSF)and the diagnostic value of non-invasive myocardial work indices derived from echocardiography for CSF.Methods A retrospective study was conducted on 65 patients who underwent coronary angiography at the Zhongshan Hospital(Xiamen Branch),Fudan University due to angina pectoris,coronary artery risk factors,or electrocardiographic abnormalities from August 2020 to November 2023.Patients were divided into two groups based on the corrected TIMI frame count(cTFC):the CSF group(n=35)and the normal coronary blood flow velocity group(control group,n=30).Both groups underwent an adenosine triphosphate(ATP)drug load test to measure their coronary flow reserve(CFR).Conventional indices and myocardial work indices via echocardiography and two-dimensional speckle-tracking imaging(2D-STI)were acquired:left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF),E/e'ratio,global longitudinal strain(GLS),global constructive work(GCW),global wasted work(GWW),global work index(GWI),and global work efficiency(GWE).Receiver operating characteristic(ROC)curves were used to evaluate the diagnostic value of myocardial work indices for CSF.Results There was no significant difference in CFR values between the two groups,but the proportion of CSF group with CFR less than 2 was higher than that of the control group(P=0.023).Compared with the control group,the CSF group showed significantly lower levels of GLS,GWI,and GCW(P＜0.05).ROC curve analysis revealed that the GLS diagnostic threshold for CSF was-19.5%,with a sensitivity of 64.7%,specificity of 78.6%,and AUC of 0.793.Among the myocardial work indices,the AUC of GWI was the highest(0.825),with a sensitivity of 88.2% and specificity of 75.0% .Conclusions Some CSF patients retain coronary microcirculatory blood flow reserve function,but the proportion of patients with reduced CFR function is increasing.The left ventricular myocardial work indices can identify early myocardial work abnormalities and monitor myocardial ischemic damage in CSF patients.

BACKGROUND:It has been hypothesized that PANoptosis may be involved in the pathologic process of osteoporosis,but there have been no studies addressing the mechanisms of PANoptosis genes in osteoporosis. OBJECTIVE:To analyze the biological mechanism of PANoptosis regulators in the occurrence and development of osteoporosis. METHODS:The GSE56815 dataset was obtained from the Gene Expression Omnibus database and PANoptosis genes were extracted for differential analysis.The key genes of PANoptosis were screened by random forest tree model to construct a disease risk prediction model.Consensus clustering algorithm,single sample genome enrichment analysis and immune infiltration analysis were used to explore the differences between different PANoptosis molecular subtypes.Herbal drugs that regulate the key genes of PANoptosis were predicted through Coremine medical database,a medical ontology information retrieval platform. RESULTS AND CONCLUSION:Based on the four PANoptosis key genes(CASP1,CASP10,MEFV,and TNF),the diagnostic markers of osteoporosis were determined,and the risk prediction model was constructed and verified.Osteoporosis was divided into two different PANoptosis subtypes(clusters A,B and gene clusters A,B),and the PANoptosis scores of cluster B and gene cluster B were higher than those of cluster A and gene cluster A,respectively.Traditional Chinese drugs such as ginseng which can regulate the key genes of PANoptosis were predicted by the Coremine medical database.