Objective:To explore the distribution of Traditional Chinese Medicine constitution among patients with impaired awareness of hypoglycemia (IAH) and identify risk factors for IAH in patients with diabetes mellitus, to develop a risk prediction model. The aim is to validate the models′ predictive accuracy to facilitate early prevention and treatment of IAH.Methods:A case control study employing convenience sampling model was conducted on 1351 hospitalized patients with diabetes mellitus in the endocrinology departments of Changshu Hospital Affiliated to Nanjing University of Chinese Medicine and Affiliated Hospital of Jiangsu University, between August 2021 and December 2023. Traditional Chinese medicine constitution types were determined using the Traditional Chinese Medicine Constitution Classification and Judgment (ZYYXH/T157-2009). Data were divided into training and test sets at a ratio of 7∶3. Two prediction models were developed: Model 1, a conventional IAH prediction model for patients with diabetes mellitus, and Model 2, an IAH prediction model for patients with diabetes mellitus incorporating traditional Chinese medicine constitution. Nomograms were drawn for both models. The Hosmer-Lemeshow goodness-of-fit test, calibration curve, receiver operating characteristic (ROC) curve, and area under the curve (AUC) were calculated to evaluate the effectiveness of models 1 and 2. The improvement in prediction performance between Models 1 and 2 was assessed using Delong test, AUC, net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA).Results:The study included 1 283 patients with diabetes mellitus, including 578 males and 705 females, aged (59.61 ± 14.09) years. The incidence of IAH among patients with diabetes mellitus was 20.50% (263/1283), with yang deficiency constitution being the most prevalent traditional Chinese medicine constitution type, at 47.53% (125/263). Multivariate analysis revealed that age, body mass index, course of diabetes, neurological hypoglycemia symptoms, hypoglycemia symptoms and severe hypoglycemia history were the influencing factors of Model 1 (all P<0.05); age, body mass index, neurological hypoglycemic symptoms, hypoglycemic symptoms, history of severe hypoglycemia, and traditional Chinese medicine constitution were the influencing factors of Model 2 (all P<0.05). The Hosmer-Lemeshow goodness-of-fit test showed a good fit of Model 2 [training set ( χ2=8.48, P>0.05), test set ( χ2=3.92, P>0.05)]. The Delong test results showed that the AUC for Model 2 was 0.96 for both the training and test sets, significantly higher than the AUCs of the 0.90 and 0.91 for Model 1 ( Z=-7.27, -3.70, both P<0.01). Furthermore, NRI was 0.66 ( 95%CI 0.53-0.79, P<0.01) and IDI was 0.02 (95% CI 0.01-0.03, P<0.05) for Model 2. Comparative analysis of clinical utility demonstrated that the net benefit of Model 2 for predicting IAH in patients with diabetes mellitus surpassed that of Model 1 across threshold probabilities ranging from 5% to 100%. Conclusions:The study constructed a nomogram prediction model included traditional Chinese medicine constitution with good predictive performance for IAH in patients with diabetes mellitus, and is of significant clinical value for identifying high-risk IAH populations.IAH patients mainly have a biased constitution, indicating that medical staff can reduce the incidence of IAH by improving the patients′ constitution.

Objective:To explore the distribution of Traditional Chinese Medicine constitution among patients with impaired awareness of hypoglycemia (IAH) and identify risk factors for IAH in patients with diabetes mellitus, to develop a risk prediction model. The aim is to validate the models′ predictive accuracy to facilitate early prevention and treatment of IAH.Methods:A case control study employing convenience sampling model was conducted on 1351 hospitalized patients with diabetes mellitus in the endocrinology departments of Changshu Hospital Affiliated to Nanjing University of Chinese Medicine and Affiliated Hospital of Jiangsu University, between August 2021 and December 2023. Traditional Chinese medicine constitution types were determined using the Traditional Chinese Medicine Constitution Classification and Judgment (ZYYXH/T157-2009). Data were divided into training and test sets at a ratio of 7∶3. Two prediction models were developed: Model 1, a conventional IAH prediction model for patients with diabetes mellitus, and Model 2, an IAH prediction model for patients with diabetes mellitus incorporating traditional Chinese medicine constitution. Nomograms were drawn for both models. The Hosmer-Lemeshow goodness-of-fit test, calibration curve, receiver operating characteristic (ROC) curve, and area under the curve (AUC) were calculated to evaluate the effectiveness of models 1 and 2. The improvement in prediction performance between Models 1 and 2 was assessed using Delong test, AUC, net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA).Results:The study included 1 283 patients with diabetes mellitus, including 578 males and 705 females, aged (59.61 ± 14.09) years. The incidence of IAH among patients with diabetes mellitus was 20.50% (263/1283), with yang deficiency constitution being the most prevalent traditional Chinese medicine constitution type, at 47.53% (125/263). Multivariate analysis revealed that age, body mass index, course of diabetes, neurological hypoglycemia symptoms, hypoglycemia symptoms and severe hypoglycemia history were the influencing factors of Model 1 (all P<0.05); age, body mass index, neurological hypoglycemic symptoms, hypoglycemic symptoms, history of severe hypoglycemia, and traditional Chinese medicine constitution were the influencing factors of Model 2 (all P<0.05). The Hosmer-Lemeshow goodness-of-fit test showed a good fit of Model 2 [training set ( χ2=8.48, P>0.05), test set ( χ2=3.92, P>0.05)]. The Delong test results showed that the AUC for Model 2 was 0.96 for both the training and test sets, significantly higher than the AUCs of the 0.90 and 0.91 for Model 1 ( Z=-7.27, -3.70, both P<0.01). Furthermore, NRI was 0.66 ( 95%CI 0.53-0.79, P<0.01) and IDI was 0.02 (95% CI 0.01-0.03, P<0.05) for Model 2. Comparative analysis of clinical utility demonstrated that the net benefit of Model 2 for predicting IAH in patients with diabetes mellitus surpassed that of Model 1 across threshold probabilities ranging from 5% to 100%. Conclusions:The study constructed a nomogram prediction model included traditional Chinese medicine constitution with good predictive performance for IAH in patients with diabetes mellitus, and is of significant clinical value for identifying high-risk IAH populations.IAH patients mainly have a biased constitution, indicating that medical staff can reduce the incidence of IAH by improving the patients′ constitution.

Objective To analyze the policies and theories, and built the theoretical framework and methods to provide policy support and service development for the development of community-based physical activity and rehabilitation for people with disabilities based on WHO Community-based Rehabilitation (CBR) Guidelines.Methods The relevant policies at home and abroad were analyzed using policy research and literature research methods, and the functions of community-based physical activity were systematically analyzed based on the framework of WHO CBR Guidelines.Results The community-based physical activity can empower people with disabilities in the fields of health, rehabilitation, education, life, and social integration.Conclusion Based on WHO CBR Guidelines, the theory and policy framework of community-based physical activity for people with disabilities has been developed. It is benefit to promote the implementation of the National "Healthy China 2030 Outline" and the "National Fitness Program" to develop community-based physical activity for PWDs, to strengthen guidance and support services for community-based physical activity and to integrate physical activity and rehabilitation at community level for people with disability. It is also to achieve inclusive community development.

Objective:To explore the usage of system dynamics analyzing the influencing factors of total health expenditure(THE),forecast the trends of total health expenditure based on the method of System Dynamics and put forward relative countermeasures.Methods:According to the literature and expert consultation,the population,elderly,GDP,government health expenditures,drug costs and the number of health workers per thousand population were the important factors for THE.These factors were incorporated into system dynamics model for total health expenditure and conducted the simulation.Results:Based on the examination,the simulation results highly corresponded to historical data (2002-2014) and the official forecast (2015-2020),which showed that the model had good stability and reliability.The simulation results showed that steadily increasing total health expenditure would reach 7 457.12 billion yuan in 2025.Conclusion:The system dynamics approach had superior characteristics to other projection methods in terms of stability and reliability.In order to control the irrational growth of total health expenditure,it needed to increase the prevention investment,decrease the incidence of chronic diseases;sustainably improve the reform of public hospitals,implement the basic drug system;change the income-oriented performance appraisal to realize the labor value of medical staffs.

Objective: To establish a microbial limit test method for compound benzocaine gel.Methods: According to the general principles of Chinese Pharmacopoeia (2015 edition), method applicable experiments were performed respectively for the routine method, neutralization method and dilution & neutralization method.Using the recovery ratio of test bacteria as the index, the medium of dilution & neutralization method was adopted in the total aerobic microbial count and total combined yeasts and molds count, and the neutralization method was used for the control bacteria detection.The neutralizing agents were polysorbate 80 and lecithin.Results: The method of dilution & neutralization could eliminate the bacteriostasis of the drug, and the recovery ratio of each test bacteria was within the range of 0.5-2.0, which was in line with the requirements of Chinese Pharmacopoeia.Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus could be detected out in the positive control bacterial test,and bacteria were not detected out in the negative test.Conclusion: The method can be used for the microbial limit test for compound benzocaine gel.

Alkaloids ; Apoptosis ; HL-60 Cells ; Harringtonines ; Humans ; Quinolizines

Objective To investigate the expression of Musashi-2 and CD133 in colonic adenocarcinoma,and their correlation with the occurrence and development of colonic adenocarcinoma thereof. Methods The expressions of Musashi-2 and CD133 protein were detected by immunohistochemical method in 40 colonic adenocarcinoma samples and 15 normal colonic structure samples. The different histological types, TNM staging, lymph node metastasis, serous infiltration, distant metastasis and expressions of Musashi-2 and CD133 proteins in colonic adenocarcinoma tissues were analyzed. Results The positive expression rates of Musashi-2 and CD133 protein were 60%and 27.5%in 40 colonic adenocarcinoma samples and 26.7%and 0 in 15 normal colonic samples, which showed the significantly higher expression rates in colonic adenocarci-noma group than those of control group (χ2=4.850 and 5.156,P<0.05). There were significant differences in expressions of Musashi-2 proteins between different histological stages and TNM staging (P<0.05). The positive expression rate of Musa-hi-2 protein increased as the degree of differentiation decreased and TNM stage increased. There were significant differenc-es in expressions of CD133 proteins between different histological stages and lymph node metastasis (P<0.05). The positive expression rate of CD133 protein increased as the degree of differentiation decreased and lymph node metastasis occurred. Conclusion The expression of Musashi-2 and CD133 may be related with the initiation and development of colonic can-cer, which can be used as the stem cell markers of colonic adenocarcinoma for the further study.

OBJECTIVE: To improve the understanding of nasal NK/T-cell lymphoma by analyzing its phenotypic and clinicopathological features. METHOD: Twenty-three cases of nasal NK/T-cell lymphoma diagnosed between 2003 and 2007 in the department of pathology of Guilin Medical College were included in the study. The expression level of TIA-1, CD56, CD3, CD20, CK and EBV markers was determined by immunohistochemistry. The results were correlated with clinicopathological features. RESULT: 69.9% (16/23) of the nasal NK/T-cell lymphoma occurred in the nasal cavity. All the 23 cases displayed necrosis, ulceration and nose bleeding. 39.1% (9/23) showed angiodestructive growth pattern. 21.74% (5/23) were accompanied by squamous cell carcinoma-like epitheliomatous hyperplasia. All the cases were positive for TIA-1 and CD3. 95.7% (22/23) of the cases were positive for CD56, while 21.7% (5/23) were weakly positive for EBV. None of the cases was positive for either CD20 or CK. CONCLUSION Nasal NK/T-cell lymphoma is characterized by multiple clinicopathological features. Attention is needed to differentiate the tumor from inflammatory lesions and low grade squamous cell carcinoma. Understanding of various morphological and phenotypic features (i.e. expression of TIA-1, CD56 and CD3, and lack of CD20 and CK) is the key for the diagnosis of nasal NK/T-cell lymphoma.
Adolescent ; Adult ; Aged ; Humans ; Lymphoma, Extranodal NK-T-Cell ; pathology ; Middle Aged ; Nose Neoplasms ; pathology ; Young Adult