Objective To explore the predictive effect of serum 25-hydroxyvitamin D3 [25(OH)D3] and blood lipid metabolism indexes on the occurrence of osteoporosis in type 2 diabetes mellitus (T2DM). Methods Totally 98 patients with T2DM in the hospital from January 2022 to January 2024 were classified into osteoporosis group (38 cases) and non-osteoporosis group (60 cases) by means of concurrent osteoporosis status. The levels of serum 25(OH)D3 and blood lipid metabolism indexes [high density lipoprotein (HDL), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), VLDL] were measured in study subjects. The association of serum 25(OH)D3 and blood lipid metabolism indexes with osteoporosis was explored by Logistic regression analysis. The predictive value of serum 25(OH)D3 and blood lipid metabolism indexes on osteoporosis was analyzed by receiver operating characteristic curve (ROC). Results Serum 25(OH)D3 and HDL levels in the osteoporosis group were lower while TG and LDL levels were higher than those in the non-osteoporosis group (P<0.05). The differences in the levels of TC and VLDL were insignificant between groups (P>0.05). After logistic regression analysis, the levels of serum 25(OH)D3, HDL, TG and LDL were closely related to the occurrence of osteoporosis (P<0.05). ROC curve indicated that the area under the curve (AUC), sensitivity and specificity of combined prediction of osteoporosis by serum 25(OH)D3, HDL, TG, and LDL were 0.943, 92.11% and 85.00%, and the efficiency of combined prediction was better than that of each index alone (P<0.05). Conclusion The levels of serum 25(OH)D3, HDL, TG and LDL in T2DM are closely related to osteoporosis. Early combined monitoring of the indicators can provide reference value for clinical prediction of osteoporosis occurrence in patients with T2DM.

ObjectiveTo investigate the variation of drug resistance genes in human immunodeficiency virus (HIV)-1 strains in Huzhou City, Zhejiang Province, so as to provide a basis for guiding the adjustment of treatment plans for ADIS patients or patients infected with HIV. MethodsA total of 555 samples were collected from 396 newly diagnosed HIV/AIDS patients who did not receive antiviral treatment from 2021 to 2023, in addition to 159 HIV/AIDS patients who received antiviral treatment for at least twelve months but failed during the same period.Reverse transcription polymerase chain reaction (RT-PCR) and nested polymerase chain reaction (nested PCR) were used to amplify the pol region gene of HIV-1. Lastly, the sequenced data were submitted to the HIV resistance database of Stanford University in the United States for resistance gene mutation analysis. ResultsDrug resistance mutations were detected in samples from 97 newly diagnosed HIV/AIDS patients and 77 patients with failed treatment, with the main subtypes being CRF01AE and CRF07-BC. The mutation rates of drug resistance genes in the patients untreated and patients with failed treatment were 24.49% (97/396) and 48.43% (77/159), respectively. Drug resistance gene mutations against protease inhibitor (PI), nucleotide reverse transcriptase inhibitor (NRTI), and non-nucleoside reverse transcriptase inhibitor (NNRTI) were detected both in the untreated and failed treatment group. The drug resistance rates of untreated and failed treatment patients were 10.61% (42/396) and 45.28% (72/159), respectively. ConclusionThe pre-treatment drug resistance rate of HIV-1 strains in Huzhou City is at a moderate level, and which is at a relatively low level nationwide after antiviral treatment. The resistance genes in the region exhibit diverse and complex characteristics, and the prevalence of drug resistance is in the process of upward and evolution compared to the monitoring results in the previous years. It is necessary to continue to monitor the occurrence and development of drug resistant strains, and to adjust treatment plans in time to prevent the occurrence of transmissible drug resistance.

OBJECTIVE: To observe the clinical efficacy of acupoint thread-embedding therapy of regulating governor vessel, dispersing lung, and suppressing reflux for gastroesophageal reflux cough (GERC). METHODS: A total of 120 GERC patients were randomly assigned to an observation group (60 cases, 1 case dropped out) and a control group (60 cases, 1 case was eliminated). The observation group received acupoint thread-embedding treatment at positive response points of governor vessel. If no such points were detected, the following acupoints were used: Dazhui (GV14), Fenghu (Extra), Shendao (GV11), Lingtai (GV10), and Zhiyang (GV9). Treatment was administered once every two weeks. The control group received oral rabeprazole enteric capsules at 20 mg twice daily. All the treatment was given for 6 weeks. Clinical outcomes were assessed using cough symptom score, reflux disease questionnaire (RDQ) score, and Leicester cough questionnaire (LCQ) score before and after treatment in the two groups. Clinical efficacy was also compared between the two groups. RESULTS: After treatment, both groups showed decreased cough symptom scores and the each item scores and total scores of RDQ (P<0.001), and increased LCQ scores (P<0.001) compare with those before treatment. The observation group exhibited lower cough symptom score and chest pain, reflux and total score of RDQ, and higher LCQ score compared to those in the control group (P<0.05). The total effective rate in the observation group was 94.9% (56/59), which was higher than 84.7% (50/59) in the control group (P<0.05). CONCLUSION Acupoint thread-embedding therapy of regulating governor vessel, dispersing lung, and suppressing reflux could effectively alleviate cough and reflux symptoms in patients with GERC and improve their quality of life.
Humans ; Acupuncture Points ; Gastroesophageal Reflux/physiopathology* ; Male ; Female ; Cough/physiopathology* ; Middle Aged ; Aged ; Acupuncture Therapy ; Adult ; Treatment Outcome ; Lung/physiopathology* ; Meridians

Objective:To evaluate clinical efficacy of Xuanbai Chengqi Decoction in the treatment of severe pneumonia with gastrointestinal dysfunction of syndrome of lung heat and fu-organ excess; To discuss its effects on short chain fatty acid (SCFA)/G protein coupled receptor 43 (GPR43) axis.Methods:It was a randomized controlled trial. From January 2020 to January 2022, 60 hospitalized patients with severe pneumonia complicated with gastrointestinal dysfunction (syndrome of lung heat and fu-organ excess) in the Intensive Care Department and Emergency Intensive Care Unit of Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine were selected as the observation subjects. They were divided into experimental group and control group according to random number table method, with 30 cases in each group. Patients in the control group were treated with conventional Western medicine, while patients in the experimental group received Xuanbai Chengqi Decoction combined with conventional Western medicine. Both groups were treated continuously for 7 days and followed up for 28 days. TCM syndrome scores were evaluated before and after treatment. Clinical Pulmonary Infection Score (CPIS) was used to assess pulmonary infection, Gastrointestinal Dysfunction Score (GIDS) was used to assess the degree of gastrointestinal dysfunction, and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was used to assess the prognosis. ELISA was used to detect levels of procalcitonin (PCT), IL-6, CRP, D-lactate (D-LA), short chain fatty acids (SCFA), and G protein coupled receptor 43 (GPR43). The fully automated blood analyzer (flow cytometry) was used to detect white blood cells (WBC) and the proportion of neutrophils (N%). Indirect bladder pressure measurement method was used to measure the intra-abdominal pressure of patients. During treatment, the adverse reactions or events were recorded. Patients were followed up for 28 days and the 28-day mortality rate was recorded.Results:The total effective rate was 73.33% (22/30) in the experimental group and 40.00% (12/30) in the control group, with statistical significance ( χ2=6.79, P<0.05). After treatment, TCM syndrome scores, CPIS, GIDS, and APACHEⅡ score in the experimental group were lower than those in the control group ( t values were 2.84，3.34，2.75，3.05，respectively， P<0.01), serum PCT [(0.35 ± 0.11) μg/L vs. (0.64 ± 0.10) μg/L, t=2.45], IL-6 [(19.33 ± 3.54) ng/L vs. (60.13 ± 15.01) ng/L, t=2.98], N% [(78.84 ± 2.09)% vs. (83.30±2.31)%, t=3.43], and CRP [(28.43 ± 6.38) mg/L vs. (54.48 ± 9.03) mg/L, t=4.02], intra-abdominal pressure [(9.11 ± 2.55) mmHg vs.(11.70 ± 3.02) mmHg, t=7.78] and D-LA [(0.11±0.05) mmol/L vs. (0.18±0.12) mmol/L, t=6.45] in the experimental group were lower than those in the control group ( P<0.05 or P<0.01). After treatment, serum SCFA [(48.18 ± 36.31) μmol/L vs. (35.10 ± 19.32)μmol/L, t=1.95] and GPR43 [(1 254.61 ± 437.40) ng/L vs. (990.15 ± 403.03) ng/L, t=2.13] in the experimental group were higher than those in the control group ( P<0.05). The 28-day mortality rates of the experimental group and the control group were 20.00% (6/30) and 46.67% (14/30) respectively, with statistical significance ( χ2=4.80, P<0.05). During the trial, there were no serious adverse reactions or adverse events in either group. Conclusion:Xuanbai Chengqi Decoction can effectively treat severe pneumonia complicated with gastrointestinal dysfunction. The mechanism may involve the up-regulation of SCFA/GPR43 axis.

Objective By analyzing the anti-tumor innovative drug policies text in China,this study aimed to explore the focus and shortcomings of policies related to anti-tumor innovative drugs,and provide the reference for future policy formula-tion and optimization in the field of anti-tumor innovative drug.Methods By accessing the official websites of relevant minis-tries and subordinate institutions such as the Central Committee of the Communist Party of China,the State Council of the People's Republic of China,the National Health Commission of the People's Republic of China,and National Medical Products Administra-tion,and using the keywords"cancer","tumor","anti-tumor drug",and"innovative drug",etc,the national level policies related to the anti-tumor innovative drugs from January 1,2005,to December 31,2022,were collected.Based on a two-dimensional analy-sis framework of policy tools and stakeholders,the collected policy texts were classified,encoded,and statistically analyzed.Results A total of 30 policy texts were involved,and a total of 90 policy codes were generated.There were 24,43,and 23 codes for demand-based policy tools,environmental policy tools,and supply-based policy tools,accounting for 26.67%,47.78%,and 25.56%,respectively.Based on policy tools and stakeholders,a total of 183 codes were generated,with government departments,pharmaceutical enterprises,medical institutions,and patients having 70,36,54,and 23 codes respectively,accounting for 38.25%,19.67%,29.51%,and 12.57%.Conclusions China had the highest proportion of environmental policy tools in the application of innovative anti-tumor drug policies,while supply-oriented and demand-oriented policy tools were underutilized,resulting in an overall imbalance in application;The distribution pattern of stakeholders was not coordinated,with government departments and medical institutions having higher attention than pharmaceutical enterprises and patients..It was necessary to reasonably promote the collaborative application of anti-tumor innovative drug policy tools,scientifically plan the layout of anti-tumor innovative drug policy sub-tools,and balance the interests of all stakeholders to ensure the efficient implementation of the policies.

Objective To compare the analgesic effect, duration and incidence of adverse reactions of liposome bupivacaine (LB) and bupivacaine hydrochloride after intercostal nerve block in single-port thoracoscopic lung surgery. Methods In Department of Thoracic Surgery of the First Affiliated Hospital of Xinxiang Medical University between September 2023 and March 2024, 228 patients who needed to undergo thoracoscopic lung surgery were selected and divided into two groups by random number table method: a group B with bupivacaine hydrochloride (n=118), and a group LB with LB (n=110). Intraoperative intercostal nerve block was performed under endoscopy, and the time of first use of analgesic drugs after surgery, cumulative use of opioids 72 h after surgery, incidence of postoperative nausea and vomiting, length of stay and other indicators were evaluated and recorded. Results Visual analogue scale (VAS) scores at 4 h, 8 h, 12 h, 24 h, 48 h and 72 h in the LB group were significantly lower than those in the group B (P<0.05). The total number of activities within 48 h after surgery in the group B was significantly lower than that in the LB group (P<0.05), and the postoperative hospitalization stay in the LB group was shorter than that in the group B, but the difference was not statistically significant. There was no statistical difference between the two groups in postoperative adverse reactions. Conclusion Intercostal nerve block with LB during single-port thoracoscopic lung surgery can significantly reduce postoperative pain, improve quality of life, and promote recovery of the patients. It is worthy of clinical application.

ObjectiveTo investigate the possible mechanism of Buzhong Yulin Decoction （补中愈淋汤） in the prevention and treatment of recurrent urinary tract infection. MethodsThe mouse models of recurrent urinary tract infection were established by uropathogenic Escherichia coli （UPEC） strain UTI89 by bladder perfusion， and the successful mouse models were randomly divided into a model group， an antibiotic group， and a low- and high-dose Buzhong Yulin Decoction group， with six mice in each group. In addition， 5 C57BL/6 mice without modelling were taken as blank group. The low- and high-dose Buzhong Yulin Decoction groups received 0.1 ml/10 g of decoction by gavage， with concentrations of 1.3 g/ml and 5.2 g/ml， respectively； the antibiotic group received 0.1 ml/10 g of levofloxacin hydrochloride solution with 5 mg/ml by gavage； the blank and model groups received 0.1 ml/10 g of distilled water by gavage. Each group was gavaged once a day for 7 consecutive days. The total number of urine marks， the number of central urine marks， and the total urine volume of the urine marks were observed by the urine marking test； HE staining was used to observe the histopathological changes in the bladder of mice； serum levels of the inflammatory factors interleukin 1β （IL-1β）， interleukin 6 （IL-6） and tumour necrosis factor α （TNF-α） were detected by ELISA； the morphology of the epithelial cells of bladder was observed by scanning electron microscopy； immunofluorescence assay to detect bladder tissue anti-UroPlakin 3A protein level and UPEC bacterial load； the spread plate method to detect urinary bacterial load and bacterial load of bladder epithelial cells； RT-PCR method to detect Ras-related protein Rab-11A （RAB11A） and Ras-related protein Rab-27B （RAB27B） mRNA level in bladder tissue； immunoblotting to detect microtubule-associated protein 1 light chain3 （LC3） and P62 protein levels in bladder tissue. ResultsCompared with the blank group， the bladder epithelial cell layers were lost and showed abnormal morphology in mice of the model group； bladder tissue UroPlakin 3A protein and RAB11A and RAB27B mRNA levels reduced， the total number of urine marks， the number of central urine marks， bladder tissue UPEC bacterial load， urinary bacterial load， bacterial load in bladder epithelial cells， serum IL-1β， IL-6， and TNF-α levels， and LC3 and P62 protein levels in bladder tissue all elevated （P＜0.05 or P＜0.01）. Compared with the model group， the bladder epithelial cell layers were intact and the morphology of epithelial cells were regular in the low- and high-dose Buzhong Yulin Decoction groups； the average surface area of bladder epithelial cells reduced， the levels of UroPlakin 3A protein and RAB11A and RAB27B mRNA in bladder tissues elevated， and total number of urine marks， the number of central urine marks， bladder tissue UPEC bacterial load， urinary bacterial load， bacterial load in bladder epithelial cells， serum IL-1β， IL-6， and TNF-α levels， and P62 protein levels in bladder tissue all reduced （P＜0.05 or P＜0.01）， but LC3 protein levels showed no statistically significant （P＞0.05）. In the antibiotic group， the bladder epithelial cells were partially missing and the morphology of epithelial cells was abnormal. Compared with the antibiotic group， the average surface area of the bladder epithelial cells in the mice increased in the low- and high-dose Buzhong Yulin Decoction groups， the bacterial load of the bladder epithelial cells decreased， and the P62 protein level of the bladder tissue decreased （P＜0.05）. When comparing between the low- and high-dose Buzhong Yulin Decoction groups， the differences in each index were not statistically significant （P＞0.05）. ConclusionBuzhong Yulin Decoction may prevent and treat recurrent urinary tract infection by repairing the bladder mucosal barrier， increasing RAB11A and RAB27B level and enhancing autophagy in bladder tissues， thereby facilitating bacterial clearance from bladder epithelial cells and reducing the bacterial load of bladder epithelial cells.

OBJECTIVE To explore the effect of Xuanbai Chengqi Decoction on respiratory and oxygenation functions and the ex-pression levels of serum aquaporin(AQP)1 and AQP5 in patients with severe pneumonia complicated with gastrointestinal dysfunction of lung heat and fu-organ repletion type.METHODS 60 patients with severe pneumonia complicated with gastrointestinal dysfunc-tion of lung heat and fu-organ repletion type were randomly divided into control group and treatment group,with 30 cases each.The control group received standardized Western medicine treatment,and the treatment group was treated with Xuanbai Chengqi Decoction in addition to the control group.Both groups were treated for 7 d.The respiratory rate and oxygenation index,mechanical ventilation u-tilization rate,the clinical score including CURB-65 and CPIS scores,TCM syndrome score,gastrointestinal function indicators inclu-ding intra-abdominal pressure,serum gastrin(GAS)and vasoactive intestinal peptide(VIP),AQP1 and AQP5 levels were compared between the two groups before and after treatment.Ventilation utilization and ICU hospitalization days during treatment were compared between the two groups.RESULTS After treatment,compared with the control group,the respiratory rate,TCM syndrome score and intra-abdominal pressure in the treatment group were decreased significantly(P<0.05,P<0.01);meanwhile,the oxygenation index and the levels of serum GAS,AQP1 and AQP5 were increased significantly(P<0.05,P<0.01).CONCLUSION Xuanbai Chengqi Decoction can significantly improve clinical symptoms such as respiratory and oxygenation functions in patients,and its mechanism may be related to the regulation of AQP1 and AQP5.

In order to continuously promote the construction of party conduct and clean governance in the new era and the fight against corruption,using information technology such as blockchain to promote the disciplinary inspection work of public hos-pitals is an effective way to adapt to the new situation and requirements.By utilizing the decentralized,transparent and trustwor-thy,privacy and security protection technology features of blockchain,it can be applied to the disciplinary inspection work of public hospitals,such as in the application of anti-corruption archives,case clues,medical ethics and ethics evaluation,and an-ti-corruption risk prevention and control,to improve the efficiency of disciplinary inspection work in public hospitals and promote the high-quality development of disciplinary inspection work in public hospitals.

Objective:To explore the effects of semaglutide on glucolipid metabolism and bone metabolism in patients with type 2 diabetes mellitus (T2DM).Methods:A total of 96 T2DM patients treated in the Second People′s Hospital of Hefei from May 2022 to May 2023 were divided into the study group (48 cases) and the control group (48 cases) by treatment methods. The patients in the study group were treated with semaglutide, and the patients in the control group were treated with metformin, respectively, they were treated for 12 weeks. The levels of glucolipid metabolism, body mass index (BMI), bone metabolism, serum levels of adipocytokine 13 (apelin-13), feeding inhibitory factor 1 (nesfatin-1) and chemerin were compared between the two groups before and after treatment, and the incidence of adverse reactions was recorded.Results:After treatment, the improvement of glucolipid metabolism index in the study group were better than those in the control group ( P<0.05). After treatment, the BMI in the study group was lower than that in the control group: (24.26 ± 1.08) kg/m 2 vs. (25.40 ± 1.36) kg/m 2, there was statistical difference ( P<0.05). After treatment, the levels of total type Ⅰ collagen amino terminal lengthening peptide (TPINP) and bone gla protein (BGP) in the study group were higher than those in the control group and β C-terminal telopeptide of type Ⅰcollagen (β-CTX) was lower than that in the control group: (48.50 ± 9.27) μg/L vs. (44.85 ± 8.20) μg/L, (20.73 ± 6.34) μg/L vs. (18.05 ± 6.20) μg/L, (0.30 ± 0.10) μg/L vs.(0.36 ± 0.08) μg/L, there were statistical differences ( P< 0.05). After treatment, the levels of serum apelin-13 in the study group was higher than that in the control group, while the levels of nesfatin-1 and chemerin were lower than those in the control group: (1 500.43 ± 153.36) ng/L vs. (1 350.24 ± 142.30) ng/L, (3.06 ± 0.65) μg/L vs. (3.75 ± 0.78) μg/L, (9.85 ± 2.46) μg/L vs. (11.37 ± 2.34) μg/L, there were statistical differences ( P<0.05). The incidence of adverse reactions between the two groups had no statistical difference ( P>0.05). Conclusions:Semaglutide can significantly improve glucolipid metabolism, bone metabolism, decrease BMI, nesfatin-1 and chemerin levels, and increase apelin-13 level in T2DM patients.