The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.

Objective:To investigate the effect of helicobacter pylori (Hp) infection and gastric polyps on colorectal cancer lesions.Methods:The clinical data of 2 034 patients with colorectal polyps and 118 patients with colorectal cancer detected by gastroscopy and colonoscopy examination in General Hospital of Beijing Jingmei Group from January 2020 to June 2021 were retrospectively analyzed. A total of 178 patients without colorectal polyps in the same period were treated as controls to analyze Hp infection and gastric polyps in patients with different ages, genders and pathological types.Results:The age and the proportion of male patients in colorectal cancer group were higher than those in the control group and colorectal polyps group (all P < 0.05). The Hp infection rates of the control group, colorectal polyps group and colorectal cancer group were 20.8% (37/178), 23.0% (467/2 034) and 27.1% (32/118), respectively, and the differences were statistically significant (all P > 0.05). Among 2 034 cases of colorectal polyps, there were 612 cases of inflammatory polyps, 371 cases of proliferative polyps and 1 051 cases of adenomatous polyps. The infection rates of Hp in the three kinds of colorectal polyps were 24.5% (150/612), 22.4% (83/371) and 22.3% (234/1 051), respectively. The incidence of patients with gastric polyps in the 3 groups was 34.6% (212/612), 38.3% (142/371) and 39.3% (413/1 051), respectively, and the differences were statistically significant (all P > 0.05). The age of the three colorectal polyps groups was significantly different from that of the control group and colorectal cancer group (all P < 0.05) except for inflammatory polyps and proliferative polyps groups. The proportion of female in three kinds of colorectal polyps combined with gastric polyps was higher than that in male patients (all P < 0.05). The age of Hp positive patients in the control group, different types of colorectal polyps groups and colorectal cancer group was lower than that in negative patients, but there was a statistically significant difference only in adenomatous polyps group ( P = 0.002). The age of patients with different types of colorectal polyps combined with gastric polyps was older than that of those without gastric polyps, and the age of patients with colorectal cancer combined with gastric polyps was younger than that of those without gastric polyps (all P < 0.05). There was no assocaiton of Hp infection and gastric polyps with colorectal polyps and colorectal cancer (all P > 0.05). Conclusions:Hp infection may promote the early occurrence of colorectal adenomatous polyps. There is no evidence that gastric polyps are associated with the risk of colorectal polyps. Female patients with colorectal polyps have a higher risk of gastric polyps.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Objective:We study the clinical effect of (Traditional Chinese Medicine) TCM psychological sleep regulation technique in treating insomnia with deficiency of heart and gallbladder qi.Methods:A total of 60 patients from the Sleep Medicine Special Outpatient Department of Guang’anmen Hospital of China Academy of Chinese Medical Sciences, who met the inclusion criteria from June 2020 to March 2021, were divided into 2 groups with 30 in each group, by random number table method. The treatment group were treated with TCM psychological sleep regulation technology. The control group were treated with Zopiclone tablets for 4 weeks. We used the Insomnia Severity Index (ISI) to assess the severity of insomnia, the self-developed TCM syndrome to assess the severity of symptoms, and the Dysfunctional Beliefs and Attitudes Scale to assess the unreasonable cognition related to sleep before and after treatment. The Treatment Emergent Symptom Scale (TESS) was used to assess the safety of the 2 groups in the 4th week of treatment.Results:The total effective rate was 77.7% (23/30) in the treatment group and 80.0% (24/30) in the control group. There was no significant difference between the two groups ( χ2=0.098, P=0.754). After treatment, the score of TCM syndromes in the treatment group (5.15 ± 2.66 vs. 8.98 ± 2.05, t=-1.552) was significantly lower than that of the control group ( P<0.05), and the DBAS-30 score (125.84 ± 20.57 vs. 82.89 ± 21.64, t=2.445) was significantly higher than that of the control group ( P<0.05). Conclusions:TCM psychological sleep control technology can improve the clinical symptoms of patients with insomnia, and heart and gallbladder qi deficiency. The efficacy is similar to that of Zopiclone, and it is superior to western medicine in improving beliefs and attitudes of sleep.

Objective To investigate the correlation between Helicobacter pylori (Hp) infection and blood lipid metabolism and atherosclerosis.Methods From October 2015 to October 2020,200 cases of Hp positive subjects were observed as observation group and 200 cases of Hp negative subjects as the control group,all subjects were blood lipid levels of vascular ultrasound and other related checks.Results The levels of total cholesterol (TC) (5.68± 1.46 mmol/L),triglyceride (TG) (1.58 ± 0.76 mmol/L) and low density lipoprotein cholesterol (LDL-C),and the difference was statistically significant (t=6.12,7.69,5.64,all P＜0.05).The detection rate of carotid atherosclerotic plaque in the observation group was 66.00 ％,which was significantly higher than that in the control group (49.50％),the difference was statistically significant (x2=29.61,P＜0.05),and the observation group.The detection rate of stable plaque was 44.5 ％,which was significantly higher than that of the control group 22.5％,the difference was statistically significant (x2 =21.73,P＜0.05).Conclusion Hp infection can affect the level of lipid metabolism in patients,which is an important factor in the occurrence and development of atherosclerosis.

There are many discussions and researches on the positive role of security and negative role of insecurity. However, from the view of biology and evolution, insecurity should be exist when people were born. It makes human to think, then produce relevant behaviors. Just these thinking and behaviors produce culture, maintain psychological individual balance and realize personal value.

Objective:To investigate the clinical significance of epidermal growth factor receptor(EGFR),proliferating cell nuclear antigen(PCNA),laminin(LN)and type IV collagen expression in salivary adenoid cystic carcinoma(SACC).Methods:EGFR gene in 78 cases of SACC with complete clinical data was detected by fluorescence in situ hybridization(FISH)technique,the expression of EGFR,PCNA,LN and type IV collagen protein was detected by immunohistochemistry technique(IHC),their correlation with the clin-icopathological parameters was analysed by SPSS 13.00 software.Results:EGFR gene amplification levels(69.2%)was positively related to the ratio of EGFR protein positive expression(7 1 .8%),the expression of EGFR,PCNA,LN and type IV collagen was posi-tively related to the clinical pathological parameters(P<0.05).There was a positive correlation between EGFR and PCNA expression (P<0.05),a negative correlation between LN protein and type IV collagen protein expression(P<0.05).Conclusion:EGFR gene is amplified in SACC.EGFR,PCNA,LN and type IV collagen take part in the occurrence and development of SACC.

Objective To summarize the outcome of nasopharyngeal carcinoma ( NPC) treated by helical tomotherapy in the Chinese PLA general hospital. Methods Between September 2007 and August 2010, 121 newly diagnosed NPC patients were treated by radiotherapy with Tomotherapy system, with ( n =90) or without ( n = 31) concurrent chemotherapy or molecular target therapy. The prescription dose was 70 - 74 Gy/33f to primary tumor and positive lymph node planning target volume,60. 0 - 62. 7 Gy/33f to high risk planning target volume, and 52 -56 Gy/33f to low risk planning target volume. Acute side-effects were evaluated with RTOG/EORTC criteria. Results The remission rate of primary lesion and positive lymph nodes was 95. 0％ and 99. 0％ , respectively. The follow-up rate was 100％ . The number of patients with 1 ,2 and 3 years followed-up were 99 , 49 , and 7. The 1-, 2-and 3-year local relapse-free survival rates were 97. 30％ , 97. 3％ and 97. 3％ , respectively. The 1-,2-and 3-year nodal relapse-free survival rates were 100％ , 100％ and lOO％, respectively. The 1-, 2-and 3-year distant metastasis-free survival rates were 98. 4％ , 96. 3％ and 96. 3％ , respectively. The 1-, 2-and 3-year overall survival rates were 96. 5％ ,92. 6％ and 86. 8％ , respectively. Acute toxicities of skin, oral mucosa and xerostomia with grade 0,1,2 and 3 were 5. 0％ , 74. 4％ , 15. 7％ and 4. 9％ ; 0. 8％ , 37. 2％ , 57. 9％ and 4. 1％ ; 3. 3％ , 53. 7％ ,43. 0％ and 0％ , respectively. Xerostomia restored with time, no grade 2 or more xerostomia was observed 1 year after radiation therapy. Concurrent chemotherapy significantly increased incidence of mucositis,esophagitis and tracheitis. Conclusion Helical tomotherapy is efficient, secure and effective modality for the treatment of nasopharyngeal carcinoma.

Objective To investigate the immunization effect of influenza A/H1N1 vaccine in health care workers (HCW) in Inner Mongolia Greater Khingan Mountains area. Methods Five hundred and five HCW who received A/H1N1 influenza vaccination (immunized group) and 129 staffs who didn't receive the vaccination (unimmunized group) were randomly sampled for semiquantitative testing of serum H1N1 antibody (IgG) levels by enzyme-linked immunosorbent assay (ELISA).Results were analyzed and stratified by age, sex, occupation and the time interval between the time of vaccination and serum sample collection. The antibody positive rates of the two groups were compared by x2test. Results There were 401 (79. 4%) HCW whose H1N1 antibody were positive and 50 (9.9%) whose antibody were weak positive among 505 immunized HCW. While among 129 unimmunized HCW, there were 59 (45.7%) whose antibody were positive and 15 (11.6%) whose antibody were weak positive. The seroconversion rates of specific antibody were not significantly different among the different age groups after receiving A/H1N1 influenza vaccine (P＞ 0.05).However, there were statistical differences of the seroconversion rates among different sex groups (men 95.7% vs women 87.4% in immunized group, x2=6.40, P＜0.05; and men 73.3% vs women 52.5% in unimmunized group, x2 =4.07, P＜0.05) and different occupation groups (doctor 86.0% vs nurse 94.5% in immunized group, x2 = 9. 16, P＜0.01; and doctor 43. 8% vs nurse 75.0% in unimmunized group, x2=12.61, P＜0.01 ). The seroconversion rate was 81.5% after 80 to 89 days of vaccination, which was significantly lower than those after 30 to 39, 50 to 59 days and 60 to 69 days of vaccination, which was 100.0%, 94.7% and 93.6%, respectively (x2 =3.96, P ＜0.05; x2=7.15, P ＜0. 01; x2 = 9. 98, P＜0. 01). Conclusions A/H1N1 influenza vaccination can induce effective immune response in HCW in Greater Khingan Mountains area of Inner Mongolia. However,the level of specific antibody significantly reduces after 80 to 89 days of vaccination.