Objective To explore the relationship of visceral fat area (VFA) with glucolipid metabolism indexes and insulin resistance (IR) in patients with type 2 diabetes mellitus (T2DM) complicated with obesity. Methods A total of 315 T2DM patients with obesity who were admitted to the hospital from April 2022 to August 2025 were retrospectively selected. The VFA of all patients was measured by bioelectrical impedance analysis method. According to VFA, the patients were classified into VFA≥100 cm² group (n=204) and VFA<100 cm² group (n=111). The glucolipid metabolism indexes [fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), triacylglycerol (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)] and IR index [homeostasis model assessment of insulin resistance based on C-peptide (HOMA-IR(CP))] were detected and compared between both groups of patients. Spearman correlation method was utilized to analyze the correlation between VFA and glucolipid metabolism indexes and HOMA-IR(CP). The independent related factors of VFA were explored by logistic regression analysis. Results According to VFA results of 315 patients after admission, 204 cases (64.76%) had VFA≥100 cm² and 111 cases (35.24%) had VFA<100 cm². Compared with the VFA<100 cm² group, the FPG, HbA1c, TG, TC, LDL-C and HOMA-IR(CP) in the VFA≥100 cm² group were higher (P<0.05) while the HDL-C was lower (P<0.05). Spearman correlation revealed that VFA≥100 cm² was positively correlated with FPG, HbA1c, TG, TC, LDL-C and HOMA-IR(CP) (P<0.001), and was negatively correlated with HDL-C (P<0.001). After logistic regression analysis, it was found that FPG, TG, HDL-C, HOMA-IR(CP) and body mass index (BMI) were independent related factors of VFA≥100 cm² (P<0.05). Conclusion VFA is closely related to glucolipid metabolism and IR in T2DM patients with obesity. FPG, TG, HDL-C, HOMA-IR(CP) and BMI are independent related factors affecting VFA≥100 cm². However, given the cross-sectional design of this study, the causal timing of this association cannot be determined and needs to be further verified by prospective cohort studies.

The 20th National Congress of the Communist Party of China emphasized the expansion of international scientific and technological exchanges and cooperation. Against this backdrop, the radiological health research institutions bear important responsibilities in the field of international radiological health. As a key institution in the industry, the National Institute for Radiological Protection (NIRP), Chinese Center for Disease Control and Prevention shoulders the important mission of promoting international exchanges in radiation health in China. A case study was conducted on the NIRP using data of official overseas visits from 2010 to 2024. The SWOT analysis was used to comprehensively and systematically examine the strengths, weaknesses, opportunities, and challenges of NIRP in international cooperation and exchanges. To effectively enhance the depth and scope of international exchanges, this article proposes a series of innovative optimization strategies such as establishing dedicated personnel positions to ensure efficient handling of affairs, implementing stringent approval procedures to guarantee the rationality and compliance of overseas visits, strengthening pre-departure training to improve the professionalism of outbound personnel, conducting follow-up evaluations to continuously refine management practices, and centralizing the management of official passports to ensure their secure use. This article aims to provide practical optimization strategies for the management of official overseas visits for NIRP and other similar institutions, promote international exchanges and cooperation in the field of radiation health, and help China play a more important role in the global radiation health field.

Objective:To analyze the correlation between sex hormone levels and micropenis after mild hypospadias surgery in children.Methods:A case control study was carried out.The clinical data of 71 children aged 1 to 13 years who underwent mild hypospadias surgery at the First Affiliated Hospital of Xinxiang Medical University from April 2022 to April 2024 were analyzed.Preoperatively, the children were divided into a mild hypospadias group (Group A) and a mild hypospadias with micropenis group (Group B) based on the stretched penile length (SPL).Prolactin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone, and testosterone (TES) levels of the 2 groups were measured.Multivariate Logistic regression analysis was used to construct a risk prediction model.The discrimination capability of the model was evaluated using the receiver operating characteristic (ROC) curve.SPL and sex hormone levels were measured again 6 months after surgery.The children were divided into a normal penile group (Group AA) and a micropenis group (Group BB) after mild hypospadias according to SPL.Multivariate Logistic regression analysis was used to construct a risk prediction model, which was evaluated using the ROC curve.Results:The levels of FSH, LH and TES in group A before the operation were 3.28(2.02, 4.46) IU/L, 0.53(0.25, 0.79) IU/L and 25.24(17.94, 36.67) ng/dL, respectively, and those in group B were 1.42(1.10, 1.84) IU/L, 0.14(0.09, 0.23) IU/L and 15.73 (12.92, 17.00) ng/dL, respectively.The difference was all statistically significant (all P<0.05).Multivariate Logistic regression analysis showed statistical significance ( OR=0.515, 95% CI: 0.271-0.977; OR=0.035, 95% CI: 0.002-0.542; OR=0.883, 95% CI: 0.796-0.980).The area under the ROC curve (AUC) of the prediction model was 0.906, with a sensitivity of 75.00% and a specificity of 95.74%.The levels of FSH, LH and TES in the postoperative AA group were 2.97 (1.88, 4.28) IU/L, 0.46 (0.23, 0.78) IU/L and 20.92 (17.34, 33.27) ng/dL, respectively.The median levels of FSH, LH and TES in the BB group were 1.52 (1.27, 1.82) IU/L, 0.17 (0.12, 0.26) IU/L and 15.08(11.68, 16.68) ng/dL, respectively.The difference was all statistically significant (all P<0.05).Multivariate Logistic regression analysis showed statistical significance ( OR=0.484, 95% CI: 0.236-0.992; OR=0.061, 95% CI: 0.004-0.939; OR=0.891, 95% CI: 0.795-0.999).The AUC of the prediction model constructed was 0.877, with a sensitivity of 94.12% and a specificity of 68.52%. Conclusions:Lower FSH, LH and TES levels are risk factors for the micropenis after mild hypospadias surgery, and preoperative hormone levels have higher predictive value.

Objective:To investigate whether kisspeptin can influence the maternal-fetal interface regulatory T cells(Treg),thereby participating in the pathogenesis of recurrent spontaneous abortion(RSA).Methods:Normal pregnancy(NP)and RSA mice models were established,where NP mice received a tail vein injection of PBS(NP-PBS group),and RSA mice received a tail vein in-jection of PBS(RSA-PBS group)and active fragment of kisspeptin KP10(RSA-KP10 group),observing embryo absorption rates.Im-munohistochemistry was employed to assess expressions of kisspeptin and Foxp3 in mice uterine tissues.Peripheral blood Treg cells were isolated and expanded through magnetic bead separation.Intervention with KP10 and KP234(kisspeptin receptor antagonist)was administered,and flow cytometry was used to detect levels of IL-10 and TGF-β1 secretion by Treg cells,as well as differences in proliferation and apoptosis.RNA-Seq transcriptomic sequencing was conducted on uterine tissues from RSA-PBS group and RSA-KP10 group of mice.Differentially expressed genes(DEGs)were subjected to GO,KEGG and GSEA enrichment analyses.Results:Embryo absorption rate in RSA mice was higher than that in NP mice,the embryo absorption rate was decreased after tail vein injec-tion of KP10.Expressions of kisspeptin and Foxp3 in uterus of RSA mice was lower than that in NP mice,while increased after injec-tion of KP10.Kisspeptin could modulate the secretion of IL-10 and TGF-β1 by Treg cells,influencing their proliferation without affect-ing apoptosis.Enrichment analysis results showed that DEGs were mainly enriched in reproductive structure development,IL-17,and TGF-β signaling pathways.Conclusion:Kisspeptin can influence both the quantity and function of Treg cells,offering a new theoreti-cal foundation for investigating the pathogenesis and treatment of RSA.

Objective:To investigate impact of PD-L2 gene knockout on splenic immune phenotype of C57BL/6 mice.Methods:Body weight of female and male wild-type(WT)and PD-L2 gene knockout(KO)mice aged 3～12 weeks were continuously measured.Tissue structure differences in heart,liver,spleen,lung,kidney,thymus,ovary,uterus and testis of four groups of mice were observed by HE staining.Urease UV rate method was employed to measure urea level in mouse serum,and creatinine concentra-tion in serum was determined by creatine oxidase method.Flow cytometry was used to assess proportions of immune cells and cytokine differences in spleens of mice.Results:PD-L2 gene knockout had no apparent effect on body weight or organ structure of mice.Serum urea and creatinine levels were higher in female KO mice compared to WT mice,but no significant differences were observed among males.Female KO mice exhibited reduced proportions of CD4+T cells,CD8+T cells,Treg,NK cells and dendritic cells(DC)in spleen compared to WT mice.Conversely,proportions of Tfh,B cells,plasma cells,na?ve B cells and B2 cells were elevated,proin-flammatory cytokines such as IL-17,IL-6 and IL-22 were increased,while anti-inflammatory cytokines like IL-10 and IL-4 were decreased.Differences among male mice were either not significant or absent.Conclusion:PD-L2 gene knockout primarily affects splenic immune phenotype of female mice,leading to increased inflammatory responses and weakened immune suppression after knockout.

ObjectiveTo evaluate the effects of Tongnaoyin on the blood-brain barrier status and neurological impairment in acute ischemic stroke （AIS） patients with the syndrome of phlegm-stasis blocking collaterals by dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI）. MethodsA total of 63 patients diagnosed with AIS in the Jiangsu Province Hospital of Chinese Medicine from October 2022 to December 2023 were enrolled in this study. According to random number table method，the patients were assigned into a control group （32 cases） and an observation group （31 cases）. The control group received conventional Western medical treatment，and the observation group took 200 mL Tongnaoyin after meals，twice a day from day 2 of admission on the basis of the treatment in the control group. After 7 days of treatment，the patients were examined by DCE-MRI. The baseline data for two groups of patients before treatment were compared. The National Institute of Health Stroke Scale （NIHSS） score and modified Rankin Scale （mRS） score were recorded before treatment and after 90 days of treatment for both groups. The rKtrans，rKep，and rVe values were obtained from the region of interest （ROI） of the infarct zone/mirror area and compared between the two groups. ResultsThere was no significant difference in the NIHSS or mRS score between the two groups before treatment. After 90 days of treatment，the NIHSS and mRS scores declined in both groups，and the observation group had lower scores than the control group （P<0.05）. After treatment，the rKtrans and rVe in the observation group were lower than those in the control group （P<0.01）. ConclusionCompared with conventional Western medical treatment alone，conventional Western medical treatment combined with Tongnaoyin accelerates the repair of the blood-brain barrier in AIS patients，thereby ameliorating neurological impairment after AIS to improve the prognosis.

OBJECTIVE: To observe the clinical efficacy of different acupuncture methods in the treatment of ankylosing spondylitis (AS) at different stages. METHODS: Thirty-two patients with AS were treated with acupuncture at ashi points (tendon focus), triple acupuncture method was used in the acute phase, accompanied needling method was used in the remission phase, once a day, 5 times a week for 4 weeks. The Bath ankylosing spondylitis disease activity index (BASDAI) score, Bath ankylosing spondylitis functional index (BASFI) score and TCM symptom grade quantitative standard score before and after treatment were observed, and the efficacy was evaluated. RESULTS: After treatment, the BASDAI score, BASFI score and TCM symptom grade quantitative standard score were reduced compared with those before treatment (P<0.01), the effective rate was 96.9% (31/32). CONCLUSION Different acupuncture methods in the treatment of AS at different stages could improve signs and symptoms, such as pain, activity limitation and morning stiffness.
Humans ; Spondylitis, Ankylosing/physiopathology* ; Acupuncture Therapy/methods* ; Male ; Female ; Adult ; Middle Aged ; Young Adult ; Acupuncture Points ; Treatment Outcome

The small intestine is essential for digestion, nutrient absorption, immune regulation, and microbial balance. Its epithelial lining, containing specialized cells like Paneth cells and tuft cells, is crucial for maintaining intestinal homeostasis. Paneth cells produce antimicrobial peptides and growth factors that support microbial regulation and intestinal stem cells, while tuft cells act as chemosensors, detecting environmental changes and modulating immune responses. Along with immune cells such as intraepithelial lymphocytes, innate lymphoid cells, T cells, and macrophages, they form a strong defense system that protects the epithelial barrier. Disruptions in this balance contribute to chronic inflammation, microbial dysbiosis, and compromised barrier function-key features of inflammatory bowel disease, celiac disease, and metabolic syndromes. Furthermore, dysfunctions in the small intestine and immune cells are linked to systemic diseases like obesity, diabetes, and autoimmune disorders. Recent research highlights promising therapeutic strategies, including modulation of epithelial and immune cell functions, probiotics, and gene editing to restore gut health and address systemic effects. This review emphasizes the pivotal roles of small intestinal epithelia and immune cells in maintaining intestinal homeostasis, their involvement in disease development, and emerging treatments for intestinal and systemic disorders.
Humans ; Intestinal Mucosa/cytology* ; Intestine, Small/cytology* ; Animals ; Inflammatory Bowel Diseases/immunology* ; Celiac Disease/immunology* ; Paneth Cells/immunology*

Objective:To explore the effect of scalp electroacupuncture (EA) on central pain sensitization in rats with knee osteoarthritis (KOA).Methods:Thirty-two 8-week-old female Sprague-Dawley rats were randomly divided into a blank control group, a model group, an electroacupuncture (EA) group and a sham EA group, each of 8. All of the rats except those in the control group had KOA induced through intra-articular monosodium iodoacetate injections in the right knee. Two weeks later the EA group rats began receiving daily head EA sessions 6 days/week for 2 weeks. The sham EA group received identical but non-therapeutic stimulation. The blank control and model groups received no EA intervention. Before the modelling and 3, 7, 14, 21 and 28 days later, all of the rats completed bipedal balance pain tests and mechanical allodynia evaluations. After the testing on day 28, all of the rats were euthanized for molecular analyses. Western blotting and immunohistochemistry were performed to examine protein expression of brain-derived neurotrophic factor (BDNF), tropomyosin receptor kinase B (TrkB), and cannabinoid receptor type 1 (CB1R) in both the periaqueductal gray (PAG) matter and spinal dorsal horns (SDHs). Serum levels of substance P (SP) and 5-hydroxytryptamine (5-HT) were also quantified using enzyme-linked immunosorbent assays.Results:Three days after successful modeling, the average weight-bearing capacity of the right hind limb in the model, sham EA and EA groups was significantly lower than that of the blank controls. It reached its lowest level on the 14th day after modeling. Concurrently, the pain responses in those three groups were significantly higher than among the controls, also peaking on the 14th day after modeling. After two weeks of electroacupuncture, the electroacupuncture group showed significant improvement in both right hind limb weight-bearing capacity and pain response compared to the model group. Meanwhile, the levels of BDNF and TrkB protein in the periaqueductal gray matter were significantly higher in the model group than among the blank controls, while the electroacupuncture group exhibited significantly reduced expression of BDNF and TrkB proteins compared to the model group, along with significantly increased CB1R protein expression. The model group showed significantly elevated expression of both BDNF and TrkB proteins in the spinal dorsal horn compared to the blank control group, while there were significant differences between the EA and model groups in the expression of BDNF, TrkB and CB1R proteins. Immunohistochemical analysis on day 28 revealed that the EA group had significantly fewer BDNF- and TrkB-positive cells in the PAG compared to the model group, with significantly more CB1R-positive cells. In the SDH, the model group exhibited significantly increased numbers of BDNF- and TrkB-positive cells compared to the blank control group, whereas significant differences were found between the EA and blank control groups in the numbers of BDNF-, TrkB- and CB1R-positive cells. Serum analysis on day 28 demonstrated that substance P and 5-hydroxytryptamine levels in the model, sham EA and EA groups were significantly higher than in the blank control group, on average. However, no significant differences were observed in serum SP and 5-HT levels between the EA and model groups.Conclusions:Scalp EA significantly alleviates central pain sensitization in KOA, at least in rats, potentially by suppressing BDNF and TrkB expression while upregulating CB1R expression in the PAG matter and the SDH.

Objective:To explore the effectiveness of find-organize-clarify-understand- select-plan-do-check-act (FOCUS-PDCA) cycle management in improving the accuracy of Nutritional Risk Screening 2002 (NRS 2002) scoring in inpatients.Methods:This study was a retrospective study. Data from a continuous quality improvement project, namely Improving the Accuracy of Nutritional Risk Screening for Inpatients from People's Hospital of Longhua in 2021 were selected. The NRS 2002 scores of newly admitted patients from 8 departments with relatively high nutritional risk (departments of gstroenterology, neurology, nephrology, respiratory medicine, oncology and hematology, neurosurgery, gastrointestinal surgery, and critical care medicine) from April 10, 2021 to April 29, 2021 (before intervention) were collected. The NRS 2002 scores were evaluated by a multidisciplinary nutrition support team in terms of accuracy and error types. Possible issues in the process of nutritional screening were analyzed and mitigated using the FOCUS-PDCA cycle management method. The NRS 2002 scores from July 18, 2021 to August 8, 2021 (after intervention) were collected in real time to summary the data on accuracy and error types and to evaluate the effect of FOCUS-PDCA.Results:The accuracy of NRS 2002 score in the 8 departments was increased from 52.97% (294/555) to 81.13% (473/583) after intervention, and the difference was statistically significant ( χ2=102.606, P<0.001). The accuracy of nutritional status impairment score was 64.14% before intervention, compared with 90.57% after intervention ( χ2=114.484, P<0.001). The accuracy of disease severity score was 78.56%, compared with 89.54% after intervention( χ2=25.736, P<0.001). The false-negative rate was 68.02% before intervention and 31.87% after intervention, and the difference was statistically significant ( χ2=31.501, P<0.001). Conclusion:FOCUS-PDCA can improve the accuracy of NRS 2002 scoring in inpatients, reduce the risk of failing to identify patients at nutritional risk, and contribute to further nutritional diagnosis and treatment.