To analyze inpatient mortality cases in a tertiary general hospital in Beijing based on diagnosis-related groups (DRG), with the aim of providing references for healthcare quality management.

ObjectiveTo explore the medication patterns of Professor Zhang Farong in treating type 2 diabetes mellitus （T2DM） and the clinical efficacy of his core prescription. MethodsClinical case records of T2DM treated by Professor Zhang Farong were collected to establish a prescription database. Frequency statistics， visual analysis， and factor analysis were employed to investigate the characteristics and principle of the prescriptions， and a core prescription was derived. A randomized controlled trial was conducted， enrolling 60 T2DM patients with the dampness-heat syndrome. The patients were allocated into an observation group （core prescription + metformin） and a control group （metformin alone）， with both groups undergoing a 12-week treatment course. Changes in TCM symptom scores， glucose metabolism indicators ［fasting plasma glucose （FPG）， 2-hour postprandial blood glucose （2 hPG）， and glycated hemoglobin （HbA1c）］， pancreatic function indicators ［fasting C-peptide （FCP）， 2-hour postprandial C-peptide （2 hCP）， and area under the C-peptide curve （AUCcp）］， and lipid profiles were measured before and after treatment. The adverse reactions were observed and recorded. ResultsA core prescription named modified Gegen Qinlian Decoction was formulated， comprising Puerariae Lobatae Radix， Coptidis Rhizoma， Scutellariae Radix， Astragali Radix， Lycii Cortex， Mori Cortex， Jineijin Endothelium Corneum Gigeriae Galli， Rehmanniae Radix Praeparata， Atractylodis Rhizoma， Polygonati Rhizoma， and Pogostemonis Herba. The clinical trial results showed that both groups had significantly decreased FPG， 2 hPG， and HbA1c （P0.05）， and the observation group outperformed the control group in recovering the level of HbA1c （P0.05）. After treatment， both groups had declined TCM symptoms scores （P0.05）， and the declines in the observation group were larger than those in the control group （P0.05）. After treatment， the TC and LDL-C levels declined in the observation group （P 0.05）， while the lipid levels showed a decreasing trend with no statistically significant difference in the control group. After treatment， both groups showed increases in FCP and AUCcp （P0.05）， and the 2 hCP in both groups presented a recovering trend with no statistically significant difference. There was no statistically significant difference in the incidence of adverse reactions between the two groups. ConclusionModified Gegen Qinlian Decoction embodies Professor Zhang Farong's academic philosophy of treating consumptive thirst by tonifying the spleen and kidney， replenishing Qi and Yin， clearing deficiency and heat， unblocking stasis in collaterals， and addressing both deficiency and stasis. The combination of the core prescription with metformin alleviates clinical symptoms in T2DM patients with the dampness-heat syndrome， demonstrating potential effects in restoring pancreatic islet function， regulating blood glucose， and improving lipid profiles. It serves as a therapeutic option for T2DM in the patients with the dampness-heat syndrome under syndrome differentiation， meriting broader clinical application.

BACKGROUND: Parental myopia is an important risk factor for myopia in Chinese children and adolescents. This study aimed to assess the influence of parental myopia and the severity of myopia on offspring and to evaluate whether adopting healthy lifestyles can mitigate the effects of parental myopia on offspring. METHODS: This cross-sectional study analyzed data from children and adolescents aged 6-17 years with complete vision assessments and parental history of myopia from six provinces in China during 2013-2014. Parental demographic information, children's outdoor activity time, sleep time, and sedentary time were collected via questionnaire. Parental myopia was classified as no myopia, paternal myopia, maternal myopia, and both. The offspring were categorized into 10 groups based on parental myopia prescription. Associations of the above factors with myopia in children and adolescents were evaluated by logistic regression analysis. RESULTS: Among 40,864 children and adolescents (50.3% boys and 49.7% girls), 22,537 (55.2%) were diagnosed with myopia. In comparison to offspring devoid of parental myopia, children with one parent affected by myopia exhibited odds ratio (OR) of 1.75 (95% confidence interval [CI]: 1.62-1.88) for myopia, while those with both parents affected showed OR of 2.27 (95% CI: 2.02-2.55) after adjusted for lifestyle factors. The likelihood of myopia in offspring increased with increasing severity of parental myopia, with a 3.08-fold increase in risk observed when both parents presented high myopia. Nonetheless, children adhering to two or more healthy lifestyle factors demonstrated a diminished risk of myopia compared with those with fewer than two lifestyle factors, especially among offspring of non-myopic or mildly myopic parents. CONCLUSIONS Parental myopia has a dose-dependent association with their offspring. Healthy lifestyles may reduce the impact of parental factors on myopia in offspring. The observed associations suggest that although the genetic burden of parental myopia cannot be ignored, healthy lifestyles and nurturing are also very important.
Humans ; Myopia/epidemiology* ; Child ; Male ; Female ; Adolescent ; Cross-Sectional Studies ; China/epidemiology* ; Parents ; Surveys and Questionnaires ; Risk Factors

In order to realize the quantitative assessment of muscle strength in hand function rehabilitation and then formulate scientific and effective rehabilitation training strategies, this paper constructs a multi-scale convolutional neural network (MSCNN) - convolutional block attention module (CBAM) - bidirectional long short-term memory network (BiLSTM) muscle strength prediction model to fully explore the spatial and temporal features of the data and simultaneously suppress useless features, and finally achieve the improvement of the accuracy of the muscle strength prediction model. To verify the effectiveness of the model proposed in this paper, the model in this paper is compared with traditional models such as support vector machine (SVM), random forest (RF), convolutional neural network (CNN), CNN - squeeze excitation network (SENet), MSCNN-CBAM and MSCNN-BiLSTM, and the effect of muscle strength prediction by each model is investigated when the hand force application changes from 40% of the maximum voluntary contraction force (MVC) to 60% of the MVC. The research results show that as the hand force application increases, the effect of the muscle strength prediction model becomes worse. Then the ablation experiment is used to analyze the influence degree of each module on the muscle strength prediction result, and it is found that the CBAM module plays a key role in the model. Therefore, by using the model in this article, the accuracy of muscle strength prediction can be effectively improved, and the characteristics and laws of hand muscle activities can be deeply understood, providing assistance for further exploring the mechanism of hand functions .
Neural Networks, Computer ; Humans ; Hand Strength/physiology* ; Support Vector Machine ; Muscle Strength/physiology* ; Hand/physiology* ; Convolutional Neural Networks

OBJECTIVE: To measure and analyze the occlusal force and contact in children with mixed dentition, and to preliminarily provide baseline data on the occlusion of individual normal occlusion children with mixed dentition. METHODS: A cross-sectional study was conducted, including 20 children with mixed dentition and individual normal occlusion, consisting of 12 boys and 8 girls, aged 6.5-9.8 years. The Dental Prescale Ⅱ occlusal analysis system was used to measure the occlusal force and contact at the intercuspal position, including the maximum occlusal force (N) and the occlusal contact area (mm²) of the entire dentition, and the left and right sides, average occlusal pressure (MPa), maximum occlusal pressure (MPa), and to determine the position of the center of occlusal force. The gender differences in maximum occlusal force, average occlusal pressure, and occlusal contact area were analyzed, the bilateral symmetry of occlusion in children with mixed dentition and individual normal occlusion was compared, and the correlation between occlusal data and age, height, weight, and body mass index (BMI) was analyzed. RESULTS: (1) The average maximum occlusal force of the entire dentition in the 20 children with mixed dentition at the intercuspal position was (869.18±106.64) N, the average occlusal contact area was (25.19±2.89) mm², the average occlusal pressure was (34.37±5.98) MPa, and the maximum occlusal pressure M(P₂₅, P₇₅) was 120 (120, 120) MPa; (2) There was no statistically significant difference in the maximum occlusal force, average occlusal pressure, maximum occlusal pressure, and occlusal contact area between the left and right sides (P>0.05); (3) At the intercuspal position, the average occlusal contact area for 12 boys and 8 girls was (26.71±3.91) mm² and (21.62±3.08) mm² respectively, and the average maximum occlusal force was (911.92±145.05) N and (769.47±116.45) N respectively, with statistically significant differences (P < 0.05), while there was no statistically significant difference in the average occlusal pressure between boys and girls (P>0.05); (4) The maximum occlusal force at the intercuspal position was weakly correlated with age (r=0.219, P=0.046), and strongly positively correlated with the occlusal contact area (r=0.949, P < 0.001), while the average occlusal pressure, maximum occlusal pressure, and occlusal contact area were not correlated with age, height, weight, or BMI; (5) The center of occlusal force in the 20 children with mixed dentition and individual normal occlusion was located in the molar region, with 7 children having the maximum occlusal pressure point only in the first permanent molar region, 10 children having it in both the deciduous molar region and the first permanent molar region, and 3 children having it only in the deciduous molar region. CONCLUSION In children with mixed dentition and individual normal occlusion, the maximum occlusal force, occlusal contact area, average occlusal pressure, and maximum occlusal pressure at the intercuspal position show good bilateral symmetry; there are gender differences in the maximum occlusal force and occlusal contact area, with boys having greater values than girls; the maximum occlusal force is positively correlated with the occlusal contact area.
Humans ; Child ; Male ; Bite Force ; Female ; Dentition, Mixed ; Cross-Sectional Studies ; Dental Occlusion

Tumors exhibit abnormal glucose metabolism, consuming excessive glucose and excreting lactate, which constructs a tumor microenvironment that facilitates cancer progression and disrupts immunotherapeutic efficacy. Currently, tumor glucose metabolic dysregulation to reshape the immunosuppressive microenvironment and enhance immunotherapy efficacy is emerging as an innovative therapeutic strategy. However, glucose metabolism modulators lack specificity and still face significant challenges in overcoming tumor delivery barriers, microenvironmental complexity, and metabolic heterogeneity, resulting in poor clinical benefit. Nanomedicines, with their ability to selectively target tumors or immune cells, respond to the tumor microenvironment, co-deliver multiple drugs, and facilitate combinatorial therapies, hold significant promise for enhancing immunotherapy through tumor glucose metabolic reprogramming. This review explores the complex interactions between tumor glucose metabolism-specifically metabolite transport, glycolysis processes, and lactate-and the immune microenvironment. We summarize how nanomedicine-mediated reprogramming of tumor glucose metabolism can enhance immunotherapy efficacy and outline the prospects and challenges in this field.

Electrical impedance tomography(EIT)is an emerging imaging technology developed at the end of the last century,which has outstanding advantages such as non-invasiveness,non-radiation,smart,low cost and easy operation.This article reviews the development,principles and clinical application of electrical impedance tomo-graphy in diagnosis,decision-making of clinical management of acute respiratory distress syndrome.The article also provides suggestions for the future development of EIT in terms of more clinical research,improving technical accu-racy,cost/effectiveness and training of staff.

Objective To investigate the expression levels and the clinical significance of upstream tran-scription factor 2(USF2)and ubiquitin-specific protease 10(USP10)in peripheral blood of patients with sep-sis combined with acute kidney injury(AKI).Methods A total of 259 patients with sepsis were selected from Jilin Provincial People's Hospital from January 2018 to December 2022.Patients were divided into AKI group(107 cases)and non AKI(NAKI)group(152 cases)according to whether they had AKI or not.General clini-cal data were collected and the expression levels of USF2 and USP10 in peripheral blood were detected.Pear-son analysis was used to investigate the correlation between USF2,USP10,and renal function.Binary Logistic regression analysis was used to investigate the factors influencing sepsis patients with AKI.Receiver operating characteristic(ROC)curve was drown to analyze the value of USF2 and USP10 in diagnosing AKI in patients with sepsis.Results The expression level of serum USF2 in AKI group was higher than that in NAKI group,and the difference was statistically significant(P＜0.05),while the serum USP10 expression level in AKI group was lower than that in NAKI group,and the difference was statistically significant(P＜0.05).In AKI group,USF2 expression was positively correlated with urea nitrogen(BUN),serum creatinine(Scr)and Cys-tatin C(CysC)(P＜0.05),while USP10 expression was negatively correlated with BUN,Scr and CysC(P＜0.05).High sequential organ failure assessment(SOFA)score,septic shock and high expression of USF2 were risk factors for AKI in sepsis patients(P＜0.05),and high expression of USP10 was protective factor(P＜0.05).The area under the curve(AUC)of single detection of USF2 and USP10 for diagnosing AKI in patients with sepsis was 0.742(95％CI:0.676-0.808)and 0.781(95％CI:0.724-0.839),respectively.The AUC of the combination of USF2 and USP10 for diagnosing AKI in patients with sepsis was 0.907(95％CI:0.865-0.948),which was higher than that of single detection(P＜0.05).Conclusion Increased expression of USF2 and decreased expression of USP10 in peripheral blood of patients with sepsis are associated with in-creased risk of AKI and decreased renal function.

Objective To establish the reference intervals of neutrophil to lymphocyte ratio(NLR),mono-cyte to lymphocyte ratio(MLR)and platelet to lymphocyte ratio(PLR)in different genders and age groups in northern Chinese adults.Methods The data were analyzed according to the Clinical and Laboratory Stand-ards Institute C28-A3.Outliers were checked and judged according to the Dixon method.Subgroups were di-vided according to gender or age factors,and reference intervals were established for different subgroups.Ref-erence intervals were expressed as two-sided 95％percentiles.Results The reference intervals of NLR,MLR and PLR were 0.90-3.82,0.09-0.33 and 71.20-246.87,respectively.The results showed that NLR and PLR in men were lower than those in women(P＜0.001),while MLR in men was significantly higher than that in women(P＜0.001).Linear trend plots showed that NLR,MLR and PLR changed significantly in dif-ferent genders and age groups.In men,NLR and MLR increased with age,while PLR gradually increased and reached the peak before 50 years old,and gradually decreased after 50 years old.In women,NLR and MLR showed the lowest values at 50-＜60 years old,while PLR reached the peak at about 50 years old.The refer-ence intervals established by the model set were verified,and the percentages beyond the reference intervals were less than 10％in different genders and age groups.Conclusion The reference intervals of NLR,MLR and PLR in different genders and age groups of healthy adults in northern China are established in the study.

Background::T-cell-mediated immunity is crucial for the effective clearance of viral infection, but the T-cell-mediated immune responses that are induced by booster doses of inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in people living with human immunodeficiency virus (PLWH) remain unclear.Methods::Forty-five PLWH who had received antiretroviral therapy (ART) for more than two years and 29 healthy controls (HCs) at Beijing Youan Hospital were enrolled to assess the dynamic changes in T-cell responses between the day before the third vaccine dose (week 0) and 4 or 12 weeks (week 4 or week 12) after receiving the third dose of inactivated SARS-CoV-2 vaccine. Flow cytometry, enzyme-linked immunospot (ELISpot), and multiplex cytokines profiling were used to assess T-cell responses at the three timepoints in this study.Results::The results of the ELISpot and activation-induced marker (AIM) assays showed that SARS-CoV-2-specific T-cell responses were increased in both PLWH and HCs after the third dose of the inactivated SARS-CoV-2 vaccine, and a similar magnitude of immune response was induced against the Omicron (B.1.1.529) variant compared to the wild-type strain. In detail, spike-specific T-cell responses (measured by the ELISpot assay for interferon γ [IFN-γ] release) in both PLWH and HCs significantly increased in week 4, and the spike-specific T-cell responses in HCs were significantly stronger than those in PLWH 4 weeks after the third vaccination. In the AIM assay, spike-specific CD4 + T-cell responses peaked in both PLWH and HCs in week 12. Additionally, significantly higher spike-specific CD8 + T-cell responses were induced in PLWH than in HCs in week 12. In PLWH, the release of the cytokines interleukin-2 (IL-2), tumour necrosis factor-alpha (TNF-α), and IL-22 by peripheral blood mononuclear cells (PBMCs) that were stimulated with spike peptides increased in week 12. In addition, the levels of IL-4 and IL-5 were higher in PLWH than in HCs in week 12. Interestingly, the magnitude of SARS-CoV-2-specific T-cell responses in PLWH was negatively associated with the extent of CD8 + T-cell activation and exhaustion. In addition, positive correlations were observed between the magnitude of spike-specific T-cell responses (determined by measuring IFN-γ release by ELISpot) and the amounts of IL-4, IL-5, IL-2 and IL-17F. Conclusions::Our findings suggested that SARS-CoV-2-specific T-cell responses could be enhanced by the booster dose of inactivated COVID-19 vaccines and further illustrate the importance of additional vaccination for PLWH.