Objective To analyze the correlation between inflammatory factors and bone mineral density(BMD)as well as β-C-terminal telopeptide of type I collagen(β-CTX)in postmenopausal patients with type 2 diabetes mellitus(T2DM),and to evaluate the diagnostic efficacy of the inflammatory factors in postmenopausal T2DM patients with osteoporosis(OP).Methods A total of 538 postmenopausal women with T2DM,hospitalized in the Department of Endocrinology at the Third People's Hospital of Yunnan Province from October 1,2023 to August 31,2024,were screened,and 181 were ultimately included in the study.Based on bone mineral density,they were divided into the osteopenia group(86 patients,-2.51,B>0),while BMI was an independent protective factor for the occurrence of OP(OR<1,B<0);(4)ROC curve analysis showed that CRP,IL-6,NLR,MLR,and SII all demonstrated diagnostic efficacy for postmenopausal T2DM patients with osteoporosis,among which the combined detection model of CRP,IL-6,and SII exhibited the highest diagnostic efficacy.Conclusion Inflammatory markers are correlated with bone mineral density and β-CTX levels,and may have predictive value for diagnosing osteoporosis in postmenopausal T2DM patients.

Objective To explore the application of standardized patients (SP) in practice course of diagnostics.Methods The two classes of 135 students majoring in clinical medicine were selected as research.After the practical course in inquiry,the questionnaires were used to compare the teaching effect between the traditional teaching and SP teaching.Meanwhile,the students evaluated and gave feedback on SP work.Results The questionnaires on teaching effect showed that 127 (94.8％) students believed that the SP teaching method could stimulate interest in inquiry,125 students (93.3％) thought it could increase the understanding and memory of the inquiry content.127 students (94.8％) thought it could improve the application ability of the inquiry method,128 students (95.5％) thought it could improve inquiry techniques,129 students (96.3％) thought it could enhance expression ability,89 students (66.4％) thought it could enhance cooperation with their classmates,117 students (87.3％) thought it could enhance the confidence in communication,115 students (85.8％) thought it could improve their ability in independent thinking and self-study,126 students (94.0％) thought it could improve the learning effect,117 (87.3％) students thought it could develop their clinical thinking ability,116 students (86.6％) thought it could improve the satisfaction to teaching form,111 students (82.8％) thought it could develop the ability to answer patients' problems in a manner which is easy for patients to understand,and 126 (94.0％) students thought it could improve the ability to interact with patients.All issues were significantly better than the traditional teaching method Compared with the traditional teaching method,the students' choices on various items have statistically significant differences (P＜0.05).Conclusion Applying SP teaching to the practice courses of diagnostics is helpful to improve the teaching effect and cultivate students' clinical thinking ability.Thus,it is a promising teaching method in medical undergraduate education and worthy of further discussion and popularization.

Objective To systematically evaluate the efficacy and bleeding risk of new oral anticoagulants (NOAC)in treatment for acute venous thromboembolism (VTE). Methods Randomized controlled trials (RCT)about NOAC treatment for VTE in related databases collected up to December 2017 were searched. The literature in accordance with the inclusion criteria were selected and evaluated. The outcome measures included recurrence rate of VTE,all-cause mortality,incidence of hemorrhea or incidence of clinically relevant non-major (CRNM)bleeding. The results of RCT in accordance with inclusion criteria were combined using network meta-analysis. The effect measures were expressed in odds ratio (OR)with its corresponding 95% confidence interval (CI). Results A total of 9 RCT comprising 27 827 patients and 5 anticoagulant drugs (rivaroxaban,apixaban,edoxaban,dabigatran,and warfarin)were enrolled in the study. The quality evaluation showed that 4 of 9 RCT's bias risks were low,2 were uncertain,and 3 were high. Network meta-analysis results showed that neither the differences of recurrence rate of symptomatic VTE nor that of all-cause mortality among the patients with acute VTE using 5 different anticoagulant drugs were statistically significant. The results of surface under the cumulative ranking probability (SUCRA) showed that apixaban had the highest probability of having the optimal curative effect in decreasing symptomatic recurrence rate and all-cause mortality (SUCRA:69.0%,77.1%),followed by rivaroxaban (SUCRA:60.7%,51.4%). About the safety of the drugs,the risk of hemorrhoea induced by apixaban was lower than that induced by dabigatran and edoxaban (dabigatran vs. apixaban,OR＝2.36,95%CI:1.16-4.83;edoxaban vs. apixaban,OR＝2.64,95%CI:1.36-5.13). The risk of CRNM bleeding associated with apixaban was lower than that associated with rivaroxaban and edoxaban (edoxaban vs. apixaban,OR ＝1.67,95%CI:1.26-2.20;rivaroxaban vs. apixaban,OR ＝2.09,95%CI:1.59-2.74). The risk of CRNM bleeding associated with dabigatran was lower than that due to edoxaban and rivaroxaban (edoxaban vs. dabigatran, OR＝1.36,95%CI:1.01-1.84;rivaroxaban vs. dabigatran,OR ＝1.71,95%CI:1.27-2.30). The results of SUCRA showed that the probability of hemorrhoea induced by apixaban was the lowest (SUCRA:98.2%),followed by rivaroxaban,dabigatran,edoxaban,and warfarin;the probability of CRNM bleeding induced by apixaban was the lowest (97.0%),then followed by dabigatran,edoxaban,rivaroxaban,and warfarin. Conclusions For adult patients with new-onset or relapsed acute VTE,the efficacy of NOAC and warfarin were similar. The risk of bleeding with NOAC treatment was significantly lower than that with warfarin,of which,apixaban had the highest probability of having the best efficacy and the lowest risk of bleeding.

Objective To systematically evaluate the efficacy and bleeding risk of new oral anticoagulants (NOAC)in treatment for acute venous thromboembolism (VTE). Methods Randomized controlled trials (RCT)about NOAC treatment for VTE in related databases collected up to December 2017 were searched. The literature in accordance with the inclusion criteria were selected and evaluated. The outcome measures included recurrence rate of VTE,all-cause mortality,incidence of hemorrhea or incidence of clinically relevant non-major (CRNM)bleeding. The results of RCT in accordance with inclusion criteria were combined using network meta-analysis. The effect measures were expressed in odds ratio (OR)with its corresponding 95% confidence interval (CI). Results A total of 9 RCT comprising 27 827 patients and 5 anticoagulant drugs (rivaroxaban,apixaban,edoxaban,dabigatran,and warfarin)were enrolled in the study. The quality evaluation showed that 4 of 9 RCT's bias risks were low,2 were uncertain,and 3 were high. Network meta-analysis results showed that neither the differences of recurrence rate of symptomatic VTE nor that of all-cause mortality among the patients with acute VTE using 5 different anticoagulant drugs were statistically significant. The results of surface under the cumulative ranking probability (SUCRA) showed that apixaban had the highest probability of having the optimal curative effect in decreasing symptomatic recurrence rate and all-cause mortality (SUCRA:69.0%,77.1%),followed by rivaroxaban (SUCRA:60.7%,51.4%). About the safety of the drugs,the risk of hemorrhoea induced by apixaban was lower than that induced by dabigatran and edoxaban (dabigatran vs. apixaban,OR＝2.36,95%CI:1.16-4.83;edoxaban vs. apixaban,OR＝2.64,95%CI:1.36-5.13). The risk of CRNM bleeding associated with apixaban was lower than that associated with rivaroxaban and edoxaban (edoxaban vs. apixaban,OR ＝1.67,95%CI:1.26-2.20;rivaroxaban vs. apixaban,OR ＝2.09,95%CI:1.59-2.74). The risk of CRNM bleeding associated with dabigatran was lower than that due to edoxaban and rivaroxaban (edoxaban vs. dabigatran, OR＝1.36,95%CI:1.01-1.84;rivaroxaban vs. dabigatran,OR ＝1.71,95%CI:1.27-2.30). The results of SUCRA showed that the probability of hemorrhoea induced by apixaban was the lowest (SUCRA:98.2%),followed by rivaroxaban,dabigatran,edoxaban,and warfarin;the probability of CRNM bleeding induced by apixaban was the lowest (97.0%),then followed by dabigatran,edoxaban,rivaroxaban,and warfarin. Conclusions For adult patients with new-onset or relapsed acute VTE,the efficacy of NOAC and warfarin were similar. The risk of bleeding with NOAC treatment was significantly lower than that with warfarin,of which,apixaban had the highest probability of having the best efficacy and the lowest risk of bleeding.