Objective To analyze the influence of medication compliance of chronic type 2 diabetes management patients on disease control in two communities in Kunming.Methods A total of 138 patients with type 2 diabetes who were included in chronic disease management in Guandu and Xiaobanqiao communities of Kunming were selected from December 2021 to September 2022.Basic information collection and HbAlc and other related tests were improved.A questionnaire survey of 8-item Morisliy medication adherence scale(MMAS-8)was conducted to analyze the levels of HbAlc and other indexes of three groups with high(group A),medium(group B),and low(group C)adherence,and to conduct statistical analysis.Results Group A accounted for 22.5%,group B for 44.9%,and group C for 32.6%.There were significance differences in urinary albumin creatinine ratio(UACR),HbA1c and blood creatinine among the three groups(P<0.05).The levels of UACR,HbAlc and serum creatinine in group A were lower than those in group B and group C,and there was a negative correlation between UACR,HbAlc and serum creatinine and medication compliance rate(P<0.05).Conclusion In the Guandu Community and Xiaobanqiao community of Kunming,only 22.5%of patients with chronic type 2 diabetes had high medication compliance.The higher the compliance,the lower the level of UACR,HbAlc and serum creatinine,there is a correlation between the two,suggesting that medication compliance should be regarded as one of the key points in the management of chronic diabetes mellitus in the community,and the intervention of patients'medication compliance should be strengthened.

Objective To investigate the effect of dioscin on uric acid(UA)-induced oxidative stress injury of human renal tubular epithelial cells(HK-2)and its molecular mechanism.Methods HK-2 cells were cultured and divided into four groups:blank group(normal group),model group(uric acid-stimulation modeling),condition control group(UA+DMSO)and dioscin group(UA+dioscin).Oxidative stress injury model was induced by UA in HK-2 cells.Cells viability was detected by CCK-8.ROS level was detected by flow cytometry.Real-time PCR was used to detect the expressions of glycogen synthase kinase 3β(GSK3β),nuclear factor erythroid 2-related factor 2(Nrf2)and heme oxygenase 1(HO-1)at mRNA level,and Western Blot was used to detect the expressions of phosphorylated glycogen synthesis kinase 3β(p-GSK3β),GSK3β,Nrf2 and HO-1 at protein level.Results After stimulation by UA,HK-2 cells viability was obviously decreased,and ROS level was significantly increased(all P＜0.001).When treated with dioscin,HK-2 cells viability was obviously increased,and the ROS level of HK-2 cells was significantly decreased(all P＜0.001).The expressions of Nrf2 and HO-1 decreased at the protein and mRNA levels after stimulation with UA.But the expressions of Nrf2 and HO-1 significantly increased after treated with dioscin(all P＜0.001).Compared with the blank group,the p-GSK3β/GSK3β ratio in the model group decreased significantly at the protein level,but the p-GSK3β/GSK3β ratio increased after treated with dioscin(all P＜0.001).Conclusion Dioscin can alleviate UA-induced oxidative stress injury in HK-2 cells.The mechanism might be that dioscin can promote phosphorylation of GSK3β,and activate Nrf2/HO-1 pathway.

Objective:To investigate the correlation between the clinical features and endoscopic ultrasound-guided portal pressure gradient (EUS-PPG) in patients with cirrhosis.Methods:A total of 148 patients with cirrhosis and portal hypertension who underwent EUS-PPG measurement at the Third Xiangya Hospital of Central South University from March 15, 2022 to June 20, 2023 were selected. The clinical data of patients collected before EUS-PPG measurement were analyzed. Variations in the EUS-PPG across different clinical data subgroups were analyzed. Multivariate linear regression analysis was used to explore the independent factors influencing EUS-PPG.Results:The EUS-PPG was significantly elevated in patients exhibiting red signs (16.62±5.33 mmHg VS 13.44±5.34 mmHg, t=3.616, P<0.001), gastroesophageal varices (15.78±5.30 mmHg VS 9.70±4.77 mmHg, t=4.247, P<0.001), hepatic encephalopathy (20.83±7.52 mmHg VS 14.92±5.35 mmHg, t=2.606, P=0.010), thrombocytopenia (15.66±5.39 mmHg VS 13.29±5.83 mmHg, t=2.136, P=0.034), hypoproteinemia (16.13±5.86 mmHg VS 14.12±5.03 mmHg, t=2.230, P=0.027), and an increased international normalized ratio (16.25±6.00 mmHg VS 14.40±5.11 mmHg, t=2.022, P=0.045). Conversely, the EUS-PPG was significantly reduced in patients with a history of splenectomy and devascularization (13.17±5.88 mmHg VS 15.73±5.34 mmHg, t=-2.379, P=0.019). The EUS-PPG in patients with varying degrees of ascites (no VS slight VS moderate or severe: 13.40±5.48 mmHg VS 15.90±5.49 mmHg VS 16.69±5.17 mmHg, F=5.188, P=0.007) and different Child-Pugh classifications (A VS B VS C: 14.07±5.05 mmHg VS 15.69±5.74 mmHg VS 17.64±5.99 mmHg, F=3.066, P=0.049) increased gradually. Multivariable linear regression analysis showed that red signs ( β=2.44, t=2.732, P=0.007), gastroesophageal varices ( β=4.45, t=2.990, P=0.003), ascites ( β=1.75, t=2.368, P=0.019), and hepatic encephalopathy ( β=5.82, t=2.644, P=0.009) were independent factors for the elevated EUS-PPG. Conclusion:There is a significant correlation between EUS-PPG and the clinical features related to the severity of cirrhotic portal hypertension, which indicates the feasibility of EUS-PPG in evaluating cirrhotic portal hypertension.

Objective:To quantify any correlation between serum levels of omega-3 polyunsaturated fatty acids (ω3-PUFAs) and post-stroke cognitive impairment (PSCI).Methods:The clinical data of 77 patients hospitalized after a first stroke were analyzed. The Minimum Mental State Examination (MMSE) was used to divide them into impaired (PSCI) and unimpaired (non-PSCI) cohorts. The serum levels of ω3-PUFAs, α-linolenic acid (ALA), eieosapentaenoic acid (EPA) and dueosahexenoie acid (DHA) were compared between the two groups and correlated with the individuals′ MMSE scores.Results:The average ALA, EPA, DHA and total ω3-PUFAs levels of PSCI group were in most cases significantly lower than those of the non-PSCI group. Spearman correlation analysis showed that serum DHA level was a weak positive predictor of the MMSE scores (R=0.32, P≤0.05). Logistic regression analysis indicated that low serum DHA level was an independent risk factor for PSCI ( P≤0.01). Conclusions:Cognitively impaired stroke survivors tend to have lower serum ω3-PUFAs levels than those without cognitive impairment. There is a weak positive correlation between serum DHA levels and MMSE scores. Low serum DHA level is an independent risk factor for PSCI. The serum level of ω3-PUFAs is of high value in the auxiliary diagnosis and evaluation of PSCI.

Objective:To explore the effects of teaching with standardized patients and trauma simulators in surgical debridement training.Methods:Forty-two undergraduate medical students were randomly divided into research group ( n=21) and control group ( n=21) during surgical debridement training in clinical skills simulation training courses. The research group received training using standardized patients combined with trauma simulators, while the control group received training using the simulated teaching method. After training, an examination test and a questionnaire survey were conducted to investigate whether the teaching method under study improved students' doctor-patient communication skills, humanistic care skills, and clinical operational skills. SPSS 20.0 was used to perform the t test and chi-square test. Results:The research group had significantly higher scores in debridement procedures [(65.63±2.58) vs. (62.92±3.88)], communication [(18.62±0.67) vs. (12.71±1.89)], and humanistic care [(8.52±0.51) vs. (6.33±1.11)] than the control group (all P<0.05). The survey results showed that medical students were more satisfied with the teaching method with standardized patients and trauma simulators, believing that it could improve doctor-patient communication skills, humanistic care skills, and clinical practice levels ( P<0.05). Conclusion:The teaching method with standardized patients and trauma simulators can improve training effects, which is worth promotion.

Gastric cancer is a common malignant tumor of digestive tract, and its prognosis varies greatly with different stages of the tumor. In recent years, more and more evidence shows that artificial intelligence (AI) technology has excellent performance in imaging diagnostic applications, with remarkable diagnostic effects and broad prospects. AI not only improves the accuracy of diagnosis and staging of gastric cancer, but also has great application value in pathological assessment, adjuvant therapy and prognosis prediction. This article systematically reviews domestic and foreign literature to explore the application progress of AI in gastric cancer imaging.

Gastric cancer is a common malignant tumor of digestive tract, and its prognosis varies greatly with different stages of the tumor. In recent years, more and more evidence shows that artificial intelligence (AI) technology has excellent performance in imaging diagnostic applications, with remarkable diagnostic effects and broad prospects. AI not only improves the accuracy of diagnosis and staging of gastric cancer, but also has great application value in pathological assessment, adjuvant therapy and prognosis prediction. This article systematically reviews domestic and foreign literature to explore the application progress of AI in gastric cancer imaging.

Lactic acid, a widespread metabolite in the tumor microenvironment, is mainly produced by tumor cells that undergo aerobic glycolysis. Lactic acid is closely related to the occurrence and development of tumor. It not only serves as a substrate to supply energy to tumor cells, but also acts as a signaling molecule to activate multiple pathways to promote invasive and metastasis, angiogenesis and immune escape of tumor cells. In-depth research on the mechanism of action of lactic acid in the occurrence and development of tumor and related therapeutic progress will help to find drug targets for treatment of tumor and improve prognosis of patients.

Colorectal cancer is one of the most common malignant tumors, liver metastasis is the main factor affecting the prognosis of patients with colorectal cancer. Exosomes as lipid bilayer microvesicles widely existing in a variety of biological fluids, can promote the occurrence and development of colorectal cancer liver metastasis by inducing M2 macrophage polarization, regulating the activity of cancer-associated fibroblasts and enhancing drug resistance of tumor cells, plays an important role in the diagnosis, treatment and prognosis of colorectal cancer liver metastasis. To explore the mechanism of exosomes in colorectal cancer liver metastasis and related treatment progress, in order to find new drug targets to improve the prognosis of patients.

Postoperative hydrocephalus is one of the most common complications in resection of lateral ventricle trigone tumor, which can seriously affect the prognoses of patients. Possible influencing factors include tumor resection degrees, postoperative meningitis, intraoperative intraventricular hemorrhage, and cerebrospinal fluid drainage tube placement, but the specific mechanism is still unclear. In this paper, the influencing factors and possible mechanisms of hydrocephalus after lateral ventricle trigone tumor are reviewed as follows.