To explore the effects of different exercise prescriptions on glycemic metabolism in East Asian patients with type 2 diabetes mellitus (T2DM) and to compare the differences in the impact of population characteristics and exercise components on glycemic metabolism.

To investigate the correlation between vitamin D nutritional status and insulin resistance in pubertal adolescents.

Establishing a natural population prospective cohort represents a sophisticated systematic project that spans multiple disciplines and research directions, requiring comprehensive consideration of diverse factors. Both international and domestic practices have accumulated substantial experience and achievements in this field. These prospective cohorts are typically developed through collaborative efforts among research institutions, generating systematic insights into construction backgrounds, objectives, design frameworks, implementation strategies, and management protocols. This study conducts an in-depth investigation into the current status of natural population prospective cohort development globally and domestically, systematically summarizing progress in development history, current status, and research advancements. The findings aim to inform strategic planning in China’s related domains, thereby facilitating the advancement of natural population prospective cohort research.

OBJECTIVE To investigate the selection strategy for recipient vessels in free flap reconstruction of head and neck defects.METHODS A retrospective analysis was conducted on 96 patients who underwent 99 free flap reconstructions for head and neck defects between January 2020 and December 2024.Recipient vessel selection,flap survival,and postoperative complications were analyzed based on defect location and flap type.RESULTS In 99 cases microvessel anastomosis,the recipient arteries were superior thyroid artery in 49 branches,facial artery in 28 branches,superficial temporal artery in 14 branches,lingual artery in 5 branches.external carotid artery in 1 branch,transverse cervical artery in 1 branch,and superior laryngeal artery in 1 branch.Venous anastomosis was performed in 104 branches,with 94 cases in 1 venous anastomosis and 5 cases in 2 venous anastomoses.The recipient veins selected were facial vein in 62 branches,external jugular vein in 21 branches,superficial temporal vein in 12 branches,retromandibular vein in 3 branches,middle thyroid vein in 2 branches,internal jugular vein in 2 branches,middle temporal vein in 1 branch,and superior thyroid vein in 1 branch.Complete flap necrosis occurred in 5 cases,and partial necrosis occurred in 4 cases.When the recipient vessels were deficient,the lingual artery was chosen in 3 cases,the facial artery in 1 case,the external jugular vein in 3 cases,the internal jugular vein with end-to-side anastomosis in 1 case,and the common facial vein with end-to-side anastomosis in 1 case.CONCLUSION In free flap reconstruction for head and neck defects,the superior thyroid artery,facial artery,and superficial temporal artery are commonly used as recipient arteries,while the facial vein,external jugular vein,and superficial temporal vein are frequently selected as recipient veins.When recipient vessels are scarce,the ipsilateral lingual artery,transverse cervical artery,and main trunk of the internal jugular vein can serve as alternative recipient vessels.

OBJECTIVE To explore the application of the facial artery musculomucosal(FAMM)flap for the reconstruction of head and neck defects.METHODS A retrospective analysis of 9 patients with head and neck defects reconstructed with the FAMM at the Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,between May 2019 and March 2024.Data regarding defect location,flap size,and postoperative complications were analyzed.RESULTS The defect locations among the nine patients were as follows:hard palate(3 cases),soft palate(2 cases),nasal septum and columella(1 case),oropharyngeal lateral wall(1 case),retromolar region and oropharyngeal lateral wall(1 case),and lower lip(1 case).The FAMM flap sizes ranged from 1.5 cm×2.5 cm to 4 cm×6 cm.Primary closure of the donor site was achieved by direct intermittent suturing in 7 cases;one case was repaired using acellular dermal matrix,and 1 case was repaired using a buccal fat pad graft.Postoperatively,eight flaps survived completely,while 1 flap experienced necrosis.None of the patients developed trismus or malocclusion.CONCLUSION The FAMM flap is suitable for reconstructing defects of the hard palate,soft palate,lower lip or oropharyngeal lateral wall.With reliable blood supply and an intraoral donor site,it offers relatively favorable aesthetic outcomes and is worthy of widespread adoption.

Objective To investigate the clinical characteristics in an elderly patient with sellar multiple myeloma.Methods Clinical features,laboratory data and radiologic profile of an elderly patient with sellar multiple myeloma were collected.Results The patient was an 85-year-old male.The main clinical manifestations were fatigue,poor appetite and polyuria.Laboratory examinations showed a significant decrease in blood sodium,several anterior pitu-itary hormones and an increase in total protein,mass of pituitary lesion and concentration of prolactin.During etio-logical screening,it was found that the blood immunoglobulin G(IgG)level was significantly increased,the blood M protein was positive and the bone marrow smear showed myeloma cells accompanied by multiple osteolytic lesions in the bones of the whole body.Considering the diagnosis of multiple myeloma,the pituitary lesion was likely to be the extra-medullary involvement.Conclusions The intrasellar plasmacytoma is not common.The disease onset is insidious with clinical features and imaging findings lacking specificity.Therefore,diagnosis relies on biopsy which poses risks for elderly patients and increases diagnostic challenges leading to misdiagnosis.

Objective:To evaluate the correlation and consistency between quantitative coronary flow fraction (QFR) and cardiac magnetic resonance imaging (CMR) in assessing myocardial ischemia in patients with coronary heart disease (CAD).Methods:A retrospective analysis was conducted on the data of coronary heart disease patients who underwent load CMR examination and coronary angiography at the Beijing Anzhen Hospital, Capital Medical University from August 2017 to March 2022. CMR examination includes cardiac cine, load/rest myocardial perfusion imaging, and delayed enhancement sequence. According to the results of CMR examination, the patient′s left ventricular myocardial segments were divided into normal segment group and abnormal segment group (further divided into ischemic segment group and infarcted segment group). On the basis of coronary angiography, an artificial intelligence based platform (AngioPlus system) was applied to calculate the preoperative coronary artery QFR value of patients undergoing percutaneous coronary intervention treatment. Kappa test was used to evaluate the consistency of QFR and CMR in diagnosing abnormal myocardium; Mann Whitney U test was used to compare the differences in QFR between groups; The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of QFR in diagnosing abnormal myocardium; Spearman correlation analysis was used to clarify the relationship between myocardial infarction area and QFR value of the supplying coronary artery in patients.Results:Among the 70 CAD patients enrolled, there were 60 males and 10 females, aged (54.1±11.1)years. At the vascular level, the consistency between QFR and CMR in diagnosing myocardial injury (including ischemia and infarction) is moderate (Kappa value=0.514). The sensitivity and specificity of detecting abnormal myocardial segments in CAD patients were 57% and 91%, respectively. The area under the curve (AUC) value of QFR predicting abnormal myocardium in CAD patients was 0.769, and the optimal cutoff value was QFR=0.865. At this time, the sensitivity and specificity of QFR predicting myocardial injury in CAD patients were 67.2% and 84.3%, respectively. The difference in vascular QFR between the normal segment group, ischemic segment group, and infarcted segment group was statistically significant ( P<0.001), with the infarcted segment group having significantly lower QFR values than the other two groups (all P<0.01). The range of myocardial infarction was negatively correlated with the QFR value of the supplying coronary artery ( r=-0.45, P<0.001). At the patient level, the consistency between QFR and CMR in diagnosing myocardial injury (including ischemia and infarction) was moderate (Kappa value=0.445), with a sensitivity of 74% and a specificity of 81% for diagnosing myocardial injury in CAD patients. Conclusions:Compared with CMR, QFR has better specificity in detecting myocardial injury in CAD patients. The QFR value of the infarcted segment group is significantly lower than that of the ischemic group and the normal group. The area of myocardial infarction is negatively correlated with the QFR value of the supplying coronary artery.

Objective:To investigate the effects of wza gene deletion in Klebsiella pneumoniae on capsule formation ability and bacteriophage sensitivity. Methods:The wza deletion mutant strain was constructed through a temperature-sensitive plasmid-mediated homologous recombination. The growth curves of W14 and Δ wza were detected by measuring the optical density OD 600. In order to analyze the effect of gene wza on bacterial capsule formation, wild-type strain W14 and Δ wza mutant strain were detected by transmission electron microscope, and their capsule contents were measured by quantifying the uronic acid contents. The plaque assay was used to detect bacterial sensitivity to bacteriophage in wild-type strain W14 and Δ wza mutant strain. The t test was used to compare whether there were differences in the contents of uronic acid in the capsules of wild-type strain W14 and Δ wza mutant strain. Results:The PCR results revealed that the Δ wza mutant strain was successfully constructed. Compared with wild-type strain W14, the growth curves of Δ wza on the solid plates demonstrated a slightly slower growth. However, no difference in growth was observed among wild-type strain W14 and Δ wza mutant strains in LB broth. The transmission electron microscope results showed that wza gene deletion resulted in the loss of capsule in bacteria. The uronic acid content assay suggested that the capsule content was significantly decreased in Δ wza mutant strain (45.963±2.795) μg/ml compared with wild-type strain W14 (138.800±5.201) μg/ml. There was a statistical difference between the two groups ( t=27.233, P<0.001). The plaque assay indicated that bacteria lost its sensitivity to bacteriophage when gene wza was deleted. Conclusion:Deletion of the wza gene impairs bacterial capsule formation ability and can affect bacterial sensitivity to bacteriophage phiW14.

Objective:To express and purify the phage depolymerase from hypervirulent Klebsiella pneumoniae (hv Kp) serotype K1 and validate its function. Methods:Phage that infected serotype K1-type hv Kp was isolated from hospital sewage. The biology and morphology of the phage were determined by plaque assay and transmission electron microscopy. The whole genome of the phage was sequenced by the Illumina HiSeq 2500 platform. The presence of depolymerase was determined by observing the plaque halo. Bioinformatic analysis and prokaryotic protein expression system were further used to predict and identify phage depolymerase. The depolymerase gene fragment was obtained by PCR and cloned into the pET28a expression vector, and the expression and purification of the depolymerase were completed in strain BL21. The depolymerase activities on the capsular polysaccharide of serotype K1-type hv Kp clinical isolates were detected by plaque assay and low-speed centrifugation assay. Results:A lytic phage (phiA2) that infected serotype K1-type hv Kp clinical isolate was isolated from hospital sewage. It was typical of the Caudovirales order and Autographiviridae family, and its whole genome was 43 526 bp in length and contained 51 coding domain sequences. The phage phiA2-derived depolymerase phiA2-dep was predicted, expressed and purified. The plaque assay and low-speed centrifugation assay indicated that the depolymerase phiA2-dep had good lytic activity on the capsular polysaccharide of serotype K1-type hv Kp clinical isolates. Conclusion:Depolymerase phiA2-dep can specifically degrade the capsular polysaccharide of serotype K1-type hv Kp, which has potential application value in treating bacterial infection.