Objective To analyze the association between lifestyle and the risk of type 2 diabetes(T2D)among adult residents.Methods The data was sourced from the Shanghai Suburban Adult Cohort and Biobank.A total of 42 096 adult residents who had not developed T2D were recruited from four districts of Shanghai(Songjiang,Jiading,Minhang,and Xuhui)between 2016 and 2019.The follow-up ended on Feb 28,2023.A structured questionnaire was used to collect information on six lifestyle-related items,including smoking,alcohol consumption,BMI,waist circumference(WC),physical activity,and diet.The unhealthy lifestyle scores(UHLS)were calculated by counting the number of all the unhealthy lifestyle items,with a range of 0-6.New-onset T2D events diagnosed by physicians were obtained through the medical information system.Cox proportional hazards regression model and restricted cubic spline model were utilized to evaluate the association between unhealthy lifestyles and the risk of T2D incidence.Results About 28.1%of the participants led 4-6 unhealthy lifestyles.A total of 1 752 new T2D cases were identified during 218 513.4 person-years of follow-up.Analysis of single unhealthy lifestyle showed that abnormal WC(HR=1.5,95%CI:1.4-1.7)and abnormal BMI(HR=1.3,95%CI:1.2-1.5)were associated with an increased risk of T2D.Compared with individuals with a UHLS of 0-1,those with a UHLS of 3 and 4-6 had 30%(95%CI:1.1-1.6)and 50%(95%CI:1.2-1.8)higher risks of T2D,respectively.Each additional unhealthy lifestyle was associated with a 10%increase in T2D incidence risk(HR=1.1,95%CI:1.1-1.2).Conclusion The risk of T2D in adult residents increases with the cumulative number of unhealthy lifestyles.Adult residents with abnormal WC or BMI,or have three or more unhealthy lifestyles accumulated,will increase the risk of new-onset T2D.

To adapt to the immune environment and the stress of antimicrobial exposure,Klebsiella pneumoniae can evolve into resistance to multiple antimicrobial agents in the hosts.However,less attention has been paid to the genetic evolution in vivo from antimicrobial susceptibility to resistance.This paper reviews the adaptive evolu-tion of drug resistance and virulence of K.pneumoniae in patients in current clinical practice.The potential mecha-nisms of the evolution of resistance to carbapenems,ceftazidime-avibactam,tigecycline and colistin in human hosts were mainly summarized.

To adapt to the immune environment and the stress of antimicrobial exposure,Klebsiella pneumoniae can evolve into resistance to multiple antimicrobial agents in the hosts.However,less attention has been paid to the genetic evolution in vivo from antimicrobial susceptibility to resistance.This paper reviews the adaptive evolu-tion of drug resistance and virulence of K.pneumoniae in patients in current clinical practice.The potential mecha-nisms of the evolution of resistance to carbapenems,ceftazidime-avibactam,tigecycline and colistin in human hosts were mainly summarized.

Recent studies have shown that the physiological homeostasis of oral mucosal cells is regulated by the circadian clock.Dis-ruption or dysfunction of the circadian clock is closely associated with the development of oral squamous cell carcinoma(OSCC).Research based on the circadian clock offers a novel perspective on the pathogenesis and therapeutic strategies for OSCC.However,there is current-ly limited research on this topic,and people generally have insufficient understanding and recognition of the circadian clock.Given the complexity and challenges of circadian clock which is the fourth dimension of medical research,we organize relevant experts based on summarizing the current research results of circadian clock in the pathogenesis and precision diagnosis and treatment of OSCC,combining the scientific principles of the circadian clock's role and their long-term research experience,then summarizes and recommends the con-sensus opinions for the research of circadian clock in the pathogenesis mechanism and precision diagnosis and treatment of human OSCC,with the hope of providing guidance for the basic research and clinical application of circadian clock or circadian rhythm in the pathogene-sis mechanism and precision diagnosis and treatment of oral and maxillofacial squamous cell carcinoma.

The principe of electrical impedance tomography(EIT)was described,and the research progress of EIT technology in the field of gesture recognition was reviewed from the aspects of hardware system and gesture recognition algorithm.The challenges of EIT technology applied in the field of gesture recognition were analyzed,and the future development trends were envisioned.[Chinese Medical Equipment Journal,2025,46(4):93-99]

Objective To analyze the correlation of serum levels of GAT A-binding protein 3(GATA-3),T cell immunoglobulin domain and mucin domain protein-3(Tim-3)and retinoid-related orphan nuclear receptor gamma t(RORγt)with cardiac function and myocardial injury in-dicators in patients with coronary heart disease(CHD)and angina pectoris.Methods A retrospec-tive analysis was performed on 120 CHD patients with angina pectoris(observation group)in our hospital from December 2020 to December 2023.They were divided into stable angina subgroup(53 cases)and unstable angina subgroup(67 cases)according to the results of electrocardiography and coronary angiography.Another 120 healthy individuals taking physical examination in our hospital during the same period were subjected and served as the control group.ELISA was used to detect the serum levels of GATA-3,Tim-3 and RORγt.Left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),and left ventricular short-axis shortening rate(FS)were measured by echocardio-graphy.Creatine kinase(CK)and creatine kinase isoenzyme(CK-MB)were detected by biochemi-cal analyzer,and troponin Ⅰ(cTnⅠ)and heart fatty acid binding protein(H-FABP)were detected by electrochemiluminescence immunoassay.Pearson analysis was applied to analyze the correlation the correlation of serum levels of GATA-3,Tim-3 and RORγt with cardiac function and myocar-dial injury indicators.ROC curve was plotted to analyze the predictive value of the above three in-dicators for unstable angina.Results The serum levels of Tim-3 and ROR y t were significantly higher,and that of GATA-3 was obviously lower in the observation group than the control group(397.14±78.42 ng/L vs 246.45±56.81 ng/L,P＜0.01;93.18±19.94 ng/L vs 35.72±7.79 ng/L,P＜0.01;38.21±9.45 ng/L vs 71.62±14.98 ng/L,P＜0.01).The LVEDD and LVESD values were notably higher,while the LVEF and LVFS values were remarkably lower in the observation group than the control group(P＜0.01).The observation group has statistically higher cTnⅠ,CK,CK-MB,and H-FABP levels than the control group(P＜0.01).In the CHD patients with angina pectoris,serum GATA-3 level was positively correlated with LVEF and LVFS,and negatively with LVEDD,LVESD,cTnⅠ,CK,CK-MB,and H-FABP;Tim-3 and RORγt were negatively corre-lated with LVEF and LVFS,and positively with LVEDD,LVESD,cTnⅠ,CK,CK-MB,and H-FABP(P＜0.01).The AUC value of GATA-3,Tim-3,and RORγt alone and in combination in predicting unstable angina was 0.859,0.827,0.780,and 0.921,respectively,with that of combina-tion significantly higher than that of above indicators alone(Z=1.993,3.021,4.532,P=0.036,0.007,0.001).Conclusion As the disease progresses in CHD patients with angina pectoris,serum levels of Tim-3 and RORγt are increasing,while that of GATA-3 is decreasing,and all of them are closely associated with heart function and myocardial injury indicators.

Gastric cancer remains one of the most prevalent and lethal malignancies of the digestive tract worldwide,underscoring the urgent need for more effective targeted therapeutic strategies.Poly(ADP-ri-bose)polymerase(PARP)inhibitors have demonstrated remarkable efficacy in tumors with homologous recombination repair(HRR)deficiency;however,their clinical application in gastric cancer remains limited.Clinical evidence suggests that patients harboring Helicobacter pylori infection in combination with HRR gene mutations exhibit a significantly elevated risk of developing gastric cancer,thereby supporting the potential benefit of PARP inhibition in this setting.In this study,a kinase inhibitor library was screened in combination with the PARP inhibitor olaparib in gastric cancer cells.And we identify the cy-clin-dependent kinase 8/19(CDK8/19)inhibitor Senexin A as a compound that synergistically enhances the cytotoxic effect of PARP inhibition(P<0.05).Phenotypic validation using CCK-8 and colony for-mation assays demonstrated that the combination treatment significantly suppressed cellular proliferation and clonogenic potential compared to either monotherapy(P<0.0001).Mechanistically,alkaline comet assays revealed a significant increase in DNA damage in the combination treatment group relative to either single-agent group(P<0.0001),suggesting that the synergistic effect results from the exacerbation of DNA damage via impaired DNA repair mechanisms.In addition,treatment with CDK8/19 inhibitors a-lone markedly increased the formation of γH2AX and 53BP1 foci in irradiated gastric cancer cells(P<0.0001),indicating inhibition of DNA damage repair pathways.Transcriptome sequencing further re-vealed that CDK8/19 inhibition impacts critical cellular pathways,including DNA repair,cell cycle reg-ulation,and RNA splicing.Co-immunoprecipitation assays confirmed that inhibition of CDK8/19 kinase activity significantly reduces the phosphorylation level of PARP1,suggesting a potential regulatory inter-action.Immunohistochemical analysis of tumor and adjacent non-tumor tissues from gastric cancer pa-tients demonstrated that CDK8 is significantly overexpressed in tumor tissues,supporting its potential as both a prognostic biomarker and a therapeutic target.Collectively,this study elucidates a mechanistic ba-sis by which CDK8/19 inhibition enhances the sensitivity of gastric cancer cells to PARP inhibitors.These findings provide a strong rationale for the combined use of CDK8/19 and PARP inhibitors as a tar-geted therapeutic strategy and offer promising translational implications for advancing personalized medi-cine in gastric cancer treatment.

Objective To analyze the association between lifestyle and the risk of type 2 diabetes(T2D)among adult residents.Methods The data was sourced from the Shanghai Suburban Adult Cohort and Biobank.A total of 42 096 adult residents who had not developed T2D were recruited from four districts of Shanghai(Songjiang,Jiading,Minhang,and Xuhui)between 2016 and 2019.The follow-up ended on Feb 28,2023.A structured questionnaire was used to collect information on six lifestyle-related items,including smoking,alcohol consumption,BMI,waist circumference(WC),physical activity,and diet.The unhealthy lifestyle scores(UHLS)were calculated by counting the number of all the unhealthy lifestyle items,with a range of 0-6.New-onset T2D events diagnosed by physicians were obtained through the medical information system.Cox proportional hazards regression model and restricted cubic spline model were utilized to evaluate the association between unhealthy lifestyles and the risk of T2D incidence.Results About 28.1%of the participants led 4-6 unhealthy lifestyles.A total of 1 752 new T2D cases were identified during 218 513.4 person-years of follow-up.Analysis of single unhealthy lifestyle showed that abnormal WC(HR=1.5,95%CI:1.4-1.7)and abnormal BMI(HR=1.3,95%CI:1.2-1.5)were associated with an increased risk of T2D.Compared with individuals with a UHLS of 0-1,those with a UHLS of 3 and 4-6 had 30%(95%CI:1.1-1.6)and 50%(95%CI:1.2-1.8)higher risks of T2D,respectively.Each additional unhealthy lifestyle was associated with a 10%increase in T2D incidence risk(HR=1.1,95%CI:1.1-1.2).Conclusion The risk of T2D in adult residents increases with the cumulative number of unhealthy lifestyles.Adult residents with abnormal WC or BMI,or have three or more unhealthy lifestyles accumulated,will increase the risk of new-onset T2D.

Objective:To investigate the relationship between 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography(18F-FDG PET/CT)and tumor markers and the prognosis of patients with differentiated thyroid cancer(DTC)treated with surgery combined with iodine-131,and to construct a nomogram prediction model.Methods:The clinical data of 134 patients with DTC who underwent surgery combined with iodine-131 treatment in our hospital from January 2021 to January 2023 were retrospectively analyzed.According to the prognosis after 1 year of treatment,they were divided into a good prognosis group(n=106)and a poor prognosis group(n=28).The general data,18F-FDG PET/CT related parameters[maximum standardized uptake value(SUVmax),metabolic volume(MTV),total lesion gly-colysis(TLG)]and serum tumor markers[thyroglobulin(Tg),thyroglobulin antibody(TgAb)]levels were compared between the two groups.Pearson correlation coefficient was used to analyze the correlation between the related parameters and the tumor marker levels.Logistic multivariate analysis was used to analyze the influencing factors of DTC prognosis.Re-ceiver operating characteristic curve(ROC)was used to analyze the predictive efficacy of related parameters combined with tumor markers on poor prognosis.Anomogram prediction model for poor prognosis was constructed and the predic-tive efficacy of the model was evaluated.Results:The proportion of stage Ⅲ-Ⅳ,the proportion of total resection and the levels of thyroid stimulating hormone(TSH),SUVmax,MTV,TLG,Tg and TgAb in the poor prognosis group were higher than those in the good prognosis group,and the differences were statistically significant(P<0.05).Pearson correlation co-efficient showed that SUVmax,MTV,TLG and Tg,TgAb levels were positively correlated with tumor markers(P<0.05).Lo-gistic analysis showed that after adjusting for confounding variables,SUVmax,MTV,TLG,Tg and TgAb were independent influencing factors for the poor prognosis of DTC(P<0.05).ROC analysis showed that the combination of SUVmax,MTV,TLG,Tg and TgAb was significantly better than each parameter alone in predicting poor prognosis(P<0.05).The nomo-gram prediction model was constructed.ROC evaluation showed that the model had good prediction performance.K-fold cross validation showed that the model had stable performance and good generalization ability.Conclusion:The 18F-FDG PET/CT related parameters SUVmax,MTV,TLG and tumor markers Tg and TgAb are all independent factors affecting the poor prognosis of DTC patients treated with surgery combined with iodine-131.The prognostic nomogram prediction model based on the above factors has good predictive efficacy and can be used to guide clinical decision-making.

Objective To investigate the work capability need of offshore workers,and then to construct the evaluation indicator system of work capability for different positions of offshore workers.Methods Literature search,cluster analysis,key events,weight calculation and expert assessment were applied in this study.Results After the indicator screening,weight calculation and expert verification,the work capability evaluation indicator system was established,which contained 5 dimensions and 24 items.The indicators were sequenced according to the weight calculation,and the coefficient of variation of each indicator was less than 20%.Conclusion The construction of the work capability evaluation indicator system for different positions of offshore workers not only improves the content of the offshore job performance evaluation system,but also meets the demand for enhancing offshore operation support.It has greatly practical significance and promotion value.