Objective To compare the influence between self-monitoring of blood gluocose(SMBG)combined with digital diabetes management and traditional management mode on the related clinical indexes in the patients with type 2 diabetes mellitus(T2DM).Methods A total of 100 patients with T2DM treated in the endocrinology and metabolism outpatient department of this hospital from January 2022 to June 2022 and meeting the inclusion criteria of this study were successively included.They were divided into the experimental group and control group.The experimental group was managed by SMBG combined with digital diabetes man-agement mode,while the control group adopted the traditional management mode,the outpatient clinic follow up once a month.After 6 months of follow-up,fasting blood glucose,glycosylated hemoglobin(HbA1c),low density lipoprotein cholesterol(LDL-C)and urinary microalbumin/creatinine ratio(UACR)were compared between the two groups.Results The FBG,HbA1c,LDL-C,and UACR of the experimental group decreased after intervention when compared with baseline.Compared with the control group,the FBG[8.7(7.7,9.2)mmol/L vs.10.8(8.8,12.7)mmol/L,Z=-4.660,P＜0.001],HbA1c[6.3％(5.3,7.8)％vs.8.5％(7.2,10.0)％,Z=-5.130,P＜0.001],LDL-C[2.6(1.8,3.1)mmol/L vs.3.3(2.6,4.0)mmol/L,Z=-4.112,P＜0.001],UACR[16.1(3.5,46.5)mg/g vs.58.4(11.9,108.0)mg/g,Z=-2.220,P=0.026]for patients in the expriemental group after intervention were significantly decreased.Conclusion SMBG combined with digital diabetes management model can significantly improve the clinical indicators of patients.

Congenital defects and genetic diseases in the fetus are the focus of prenatal screening and prenatal diagnosis. Obstetrics and gynecology, pediatrics, medical imaging (ultrasound and magnetic resonance imaging), clinical laboratory, pathology, and other disciplines are mostly involved in this multidisciplinary work on maternal and infant health care, which aims to prevent birth defects in strict accordance with laws, regulations, and pertinent industry standards, such as the Notice of the National Health Commission on Issuing the Basic Standards for Prenatal Screening Technical Medical Institutions and the Basic Standards for Prenatal Diagnosis Technical Medical Institutions (Guowei Maternal and Child Letter [2019] No. 297). To further support the implementation of prenatal screening and diagnosis work and streamline workflow, this study has compiled the timing, inspection, and testing procedures of various projects in each link from the standpoint of the disease clinical laboratory diagnostic pathway. This approach improves communication amongst various disciplines in prenatal screening and diagnosis work and offers clinical service quality, and it also helps improve the standard of the birth population and prevent and controll severe birth defects.

Congenital defects and genetic diseases in the fetus are the focus of prenatal screening and prenatal diagnosis. Obstetrics and gynecology, pediatrics, medical imaging (ultrasound and magnetic resonance imaging), clinical laboratory, pathology, and other disciplines are mostly involved in this multidisciplinary work on maternal and infant health care, which aims to prevent birth defects in strict accordance with laws, regulations, and pertinent industry standards, such as the Notice of the National Health Commission on Issuing the Basic Standards for Prenatal Screening Technical Medical Institutions and the Basic Standards for Prenatal Diagnosis Technical Medical Institutions (Guowei Maternal and Child Letter [2019] No. 297). To further support the implementation of prenatal screening and diagnosis work and streamline workflow, this study has compiled the timing, inspection, and testing procedures of various projects in each link from the standpoint of the disease clinical laboratory diagnostic pathway. This approach improves communication amongst various disciplines in prenatal screening and diagnosis work and offers clinical service quality, and it also helps improve the standard of the birth population and prevent and controll severe birth defects.

Objective:To explore the remodeling of brain function 2 years after anterior cruciate ligament reconstruction (ACLR) and its relationship with functioning and behavior.Methods:Forty-eight volunteers who had received ACLR from the same surgeon were divided into a coping and a non-coping group, each of 17. Another 14 health volunteers formed the control group. Resting-state functional magnetic resonance imaging was used to record blood oxygen level-dependent signals from the members of all three groups in the 0.01 to 0.08Hz band. One-way analysis of variance was applied to the differences in low frequency amplitude (ALFF) observed.Results:The results of multiple comparisons with Gaussian random field theory correction showed that the differences in bilateral putamen ALFF values among the three groups were statistically significant. The signals from the right cerebellar area 8 and the bilateral putamen were significantly stronger among the non-coping group on average. Pearson correlation analysis showed that the ALFF values from the right cerebellar 8 region were positively and significantly more correlated with the symmetry of a subject′s Y balance function test results in the coping group compared with the non-coping group.Conclusions:Subcortical brain function remodeling occurs in ACLR patients returning to exercise after surgery, and a Y-balance function test can indirectly reflect such remodeling. That can provide a basis for designing programs for rehabilitating advanced brain functions.

Objective The aim of this study was to explore the correlation between the methylation status of microRNA let-7a-3 in esophageal squamous cell carcinoma(ESCC)and the expression of insulin-like growth factor 2(IGF-Ⅱ).Methods The methylation specific PCR(qMSP)was used to detect the methylation status of let-7a-3 in 83 cases of esophageal cancer and corre-sponding adjacent normal tissues.The enzyme linked immunosorbent assay(ELISA)was used to detect the expression of IGF-Ⅱ in plasma.Results The degree of let-7a-3 methylation in cancer tissues of 83 patients with ESCC was significantly higher than that in normal tissues adjacent to cancer(P<0.001).The expression of IGF-Ⅱ in the plasma of 83 patients with ESCC was positively corre-lated with the methylation degree of let-7a-3,which was statistically significant(r=0.600,P<0.001).Conclusion microRNAlet-7a-3 may participate in the occurrence and progression of ESCC by regulating the methylation of downstream molecules,which is of great significance for understanding the mechanisms of ESCC development and providing a basis for the diagnosis and prognosis of ESCC.

Objective:To compare the effectiveness and safety of all-suture anchors and single-row suture anchors for rotator cuff repair.Methods:A prospective randomized controlled study was conducted to analyze the clinical data of 50 patients with rotator cuff tear admitted to Second Affiliated Hospital of Zhejiang University School of Medicine between July 2019 and September 2021. They were divided into two groups according to the random table: 25 patients to receive repair with single-row suture anchors (control group) and the other 25 with all-suture anchors (trial group). Visual Analogue Scale (VAS), University of California, Los Angeles (UCLA) shoulder score, American Shoulder and Elbow Surgeons (ASES) score and shoulder range of motion were compared between the two groups before surgery, at 3 months after surgery and at the last follow-up. The rotator cuff retear rate of the two groups was evaluated according to Sugaya classification at 6 months after surgery. Breakage or anchor loosening during surgery, healing of incision and presence of infections or neurological complications after surgery, and change of the anchor position and periosteal reaction at the insertion site at 3 and 6 months after surgery were observed in the two groups.Results:A total of 50 patients with rotator cuff tear were involved in this study, including 17 males and 33 females, aged 40-73 years [(59.1±10.3)years]. All patients were followed up for 6-9 months [(6.7±1.0)months]. The differences in VAS, UCLA shoulder score, ASES score, and shoulder range of motion between the two groups were statistically insignificant before surgery (all P>0.05). The VAS at 3 months after surgery and at the last follow-up in the control group was 2.0 (2.0, 4.0)points and 2.0 (0.0, 2.0)points, respectively, with no statistical differences from 2.0 (2.0, 2.0)points and 2.0 (0.0, 2.0)points in the trial group (all P>0.05). In the control group, the UCLA shoulder score and ASES score at 3 months after surgery and the ASES score at the last follow-up were (25.1±4.5)points, 78.8 (71.6, 85.8)points and 85.8 (85.8, 93.0)points, respectively, with no statistical differences from (26.8±4.7)points, 85.8 (82.3, 85.8)points, and 92.8 (85.8, 100.0)points in the trial group (all P>0.05). At the last follow-up, the UCLA shoulder score of the control group was (29.2±3.9)points, which was lower than that of the trial group [(31.6±2.4)points] ( P<0.05). The differences in shoulder motion between the two groups at 3 months after surgery and at the last follow-up were not statistically significant (all P>0.05). The VAS, UCLA shoulder score, and ASES score at 3 months after surgery and at the last followup in both groups were significantly improved compared to their preoperative values (all P<0.05); further improvements were observed at the last follow-up compared with those at 3 months after surgery (all P<0.05). The rotator cuff retear rate at 6 months after surgery was 16.7% (4/24) in the control group, not statistically different from 4.3% (1/23) in the trial group ( P>0.05). There were no incidences of anchor loosening or breakage during surgery. All incisions were healed after surgery, with no infections or neurological complications. No grades II to III periosteal reactions at the anchor insertion sites were observed in either group at 3, 6 months after surgery. The percentage of patients with grade 0 periosteal reaction at the anchor insertion site at 3 months after surgery was 4.2% (1/24) in the control group, significantly lower than 30.4% (7/23) in the trial group ( P<0.05). Conclusion:All-suture anchors and single-row suture anchors are effective in rotator cuff repair, but the former results in better shoulder function and fewer periosteal reactions in the anchor insertion site in the early stage.

Objective:To develop a simple, practical and repeatable ultrasound method to locate the muscle at the trigger point of female myofascial pelvic pain(MPP), which can provide imaging reference for clinical precision treatment.Methods:A total of 113 patients with suspected MPP who came to the Women′s Hospital School of Medicine Zhejiang University from September 1, 2021 to April 20, 2023 were prospectively selected. The gynecologist performed internal examination with index finger on some pelvic floor muscles (puborectalis, pubococcygeus, iliococcygeus, coccygeus) and pelvic wall muscles (piriformis and obturator internus) respectively, searched for the muscles where the pain trigger point was located, and scored the pain by referring to visual analogue scale (VAS) and numerical rating scale (NRS), and then referred the patients to the ultrasound department. The ultrasound doctor used transvaginal ultrasound to display the above muscle groups in real time for observation and appropriate pressure. The muscle where the painful trigger point was located was found through tenderness and the pain score was performed. The two scores were compared for consistency and difference analysis.Results:The trigger point was clear and of good reproducibility. For the location and score of pain trigger points located in bilateral puborectalis, pubococcygeus and coccygeus, there was a strong consistency between the tenderness guided by vaginal ultrasound probe and clinical palpation (the consistency rate was ≥70%), and there was no significant difference in the pain scores of the trigger points located in the puborectalis muscle and coccygeal muscle between the two methods ( P>0.05), and there was statistically significant difference in the pain scores of the trigger points located in the other pelvic floor and pelvic wall muscles (all P<0.05). At the same time, ultrasonic examination made up for the deficiency of clinical palpation in the evaluation of piriformis muscle. Conclusions:The present method for finding the trigger point of MPP guided by the ultrasound probe is a new non-invasive, safe, simple and practical imaging method, which can provide a new imaging reference for the clinical diagnosis of MPP and the formulation of treatment strategies.

Objective: To understand the public health emergency response capacity in primary and secondary schools, and to explore the problems and challenges in the prevention and control of public health emergency in primary and secondary schools for specific strategies. Methods: By using the stratified group sampling method, a questionnaire survey on general situation, knowledge, attitude and training, as well as public health emergencies response capacity among 2 988 teachers or leaders responsible for school emergency response in primary and secondary schools from Beijing, Chongqing and Yunnan. Results: Participants varied on their positions, titles, educational background and knowledge accuracy. Higher knowledge accuracy was associated with higher educational background ( χ 2=50.73-203.36, P < 0.05 ). The implementation of regular public health emergency related programs was poorly conducted in high schools (50.0%). Urban schools (42.0%) had higher proportion of qualified health care professionals than rural schools (18.2%), and private schools (48.5%) was higher than public schools (24.7%). The primary challenges included the shortage of guidance from professionals and the lack of related testing equipment (84.91%, 74.03%). Conclusion Although the ability of emergency handling of public health emergencies in schools in the three regions is advancing with the times, there are still many deficiencies, some omissions in the mastery of knowledge. It is suggested to inerease pre service and special training of school health work CDC should strengthen technical guidance and work supervision of infectious disease management in schools.

Objective:To analyze the occurrence characteristics of heat-related diseases in the 19th Hangzhou Asian Games beach volleyball events, strengthen the ability of prevention and early identification of heat-related diseases, and provide reference for the holding of large-scale outdoor events in summer and reasonable allocation of medical resources.Methods:The medical insurance of heat-related diseases of relevant personnel in the beach volleyball competition from September 19 to September 28, 2023 was retrospectively analyzed, and the incidence of heat-related diseases in the personnel involved in Asia was analyzed.Results:During the beach volleyball competition in Ningbo Region of the Hangzhou Asian Games, a total of 103 people were provided with health services in the medical service field (61 people had mild discomfort due to excessive outdoor temperature; Other cold, minor injury, bandage 42 people); Medical services provided 44 times (4 referrals). Among them, 11 cases were sports injury and trauma (29.5%), 11 cases were heat stroke and other related symptoms (25%), 6 cases were sunburn (13.6%), 10 cases were oral diseases of five senses (22.8%), 4 cases were upper respiratory tract infection (9.1%).Conclusions:The holding of large-scale outdoor events in summer should focus on heat-related diseases, and it is necessary to effectively do the corresponding planning work in advance in terms of reasonable allocation of medical resources and targeted training of professionals.

Objective:To identify the pathogenic characteristics of a suspected gonadal mosaicism Becker muscular dystrophy (BMD) family, and provide provide basis for pregnancy selection of similar families.Methods:A BMD family admitted to Hunan Jiahui Genetics Hospital from June 2012 to September 2019 was systematically reviewed. The medical history and family history of the proband were checked, and multiplex ligation-dependent probe amplification was used to detect the deletion/duplication of 79 exons of the Duchenne muscular dystrophy (DMD) gene in the proband, fetuses, and parents. Moreover, potential variants were verified by combining PCR amplification, short tandom repeat polymorphic linkage analysis, and real-time fluorescence quantitative PCR. High-quality embryos are screened for transplantation after preimplantation genetic testing for monogenic (PGT-M). And amniotic fluid was collected in the second trimester for prenatal diagnostic verification.Results:According to the phenotype analysis of the proband, the initial clinical diagnosis was BMD, and the exon 45-50 deletion in DMD gene was detected. The mutation was not detected in the mother′s peripheral blood, but when she was pregnant again, the prenatal diagnosis showed that the fetus had the same deletion mutation as the proband. Neither of two vitro embryos tested by PGT-M has the deletion mutation, then single embryo transfer was performed nor was pregnancy successful. After confirmation of prenatal diagnosis during pregnancy, a normal baby girl was born by full-term cesarean section.Conclusions:This BMD family was a family with two consecutive BMD homodeletion mutations, and the mutation of the DMD gene was not detected in the peripheral blood of the proband′s mother and two embryonic cells, suggesting that the mother may be a gonad chimeric carrier of this deletion mutation. The combined application of prenatal diagnosis and PGT-M provides a reference approach to effectively avoid the birth of similar children.