Objective To investigate muscle mass reduction and the effect of exercise training intervention in non-obese patients with type 2 diabetes (T2DM). Methods A total of 324 non-obese patients with T2DM admitted to the First Affiliated Hospital of Xinjiang Medical University were enrolled from February 2023 to February 2025. Dual-energy X-ray absorptiometry was adopted to detect and analyze the data of appendicular skeletal muscle index (ASMI). Non-obese T2DM patients were classified into an observation group (n=162, receive sports training intervention) and a control group (n=162, receiving routine exercise intervention) by adopting random number grouping criteria. Both groups were intervened for 3 months. The muscle mass indicators [ASMI, body mass index (BMI), and body fat rate], exercise ability [6-minute walking distance (6MWD), grip strength, and one-leg standing time], metabolic indicators [fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), and homeostasis model assessment insulin resistance index (HOMA-IR)], and quality of life [Diabetes Quality of Life Scale (DQOL)] were compared between the two groups to evaluate the effectiveness of sports training intervention. Results A total of 324 non-obese T2DM patients were enrolled, including 123 cases with reduced muscle mass (37.96%). There were no significant differences in the baseline data and the proportion of patients with muscle mass reduction between the two groups before intervention (P>0.05). After intervention, the ASMI, 6MWD, grip strength, and one-leg standing time in the observation group were higher or longer than those of the control group (P<0.05), while the body fat rate, FPG, HbA1c, HOMA-IR and DQOL scores were lower than those of the control group (P<0.05). Conclusion The incidence of muscle mass reduction is relatively high among non-obese T2DM patients, and exercise training intervention has significant effects on improving muscle mass, metabolic status, exercise capacity and quality of life in non-obese T2DM patients.

ObjectiveTo analyze the clinicopathological features of patients with comorbidities of chronic hepatitis B （CHB） and steatotic liver disease （SLD）， to investigate the impact of hyperglycemia on the risk of liver fibrosis and end-stage liver diseases （ESLD）， and to provide a basis for the clinical management of such population. MethodsA total of 668 adult patients with CHB-SLD confirmed by liver biopsy in The Fifth Medical Center of Chinese PLA General Hospital from January 2011 to December 2019 were enrolled， and a retrospective cohort was established with the time of liver biopsy as the baseline and the onset of ESLD as the endpoint. All patients were followed up to March 31， 2024. Propensity score matching （PSM） was performed at a ratio of 1∶4 to balance baseline features between groups， resulting in 82 patients in the hyperglycemia group and 281 in the non-hyperglycemia group. The two groups were compared in terms of metabolic profiles， laboratory markers， and histopathological features. The Mann-Whitney U test was used for comparison of non-normally distributed quantitative data between two groups. The chi-square test or Fisher exact test was used for comparison of categorical data between two groups. A multivariate Logistic regression analysis was used to investigate the influencing factors for advanced fibrosis （AF）， and the Kaplan-Meier survival analysis and the Cox proportional-hazards regression model were used to determine the influencing factors for the development of ESLD. ResultsCompared with the non-hyperglycemia group， the hyperglycemia group had a significantly higher number of factors for metabolic disorders， a significantly higher degree of hepatic steatosis， and a significantly higher detection rate of AF （all P<0.05）. The multivariate Logistic regression analysis showed that hyperglycemia was a risk factor for AF （odds ratio = 1.753， 95% confidence interval ［CI］： 1.017　—　3.023， P=0.043）. The survival analysis showed that hyperglycemia increased the risk of ESLD （χ²=4.340， P=0.037）. The multivariate Cox regression analysis confirmed that hyperglycemia was a significant metabolic risk factor for ESLD in patients with AF （adjusted hazard ratio=3.208， 95%CI： 1.201　—　8.568， P=0.020）. ConclusionHyperglycemia can increase the risk of AF and ESLD in CHB-SLD patients. Clinical monitoring and active management should be strengthened for patients who have already developed AF and hyperglycemia.

Objective:This study aimed to compare short-chain fatty acid (SCFA) levels in saliva between patients with laryngopharyngeal reflux disease (LPRD) and healthy controls, and to explore the relationship between these SCFAs and the salivary microbiota.Methods:A retrospective case-control study was conducted, enrolling 36 patients with laryngopharyngeal reflux disease (LPRD) who visited the Department of Otorhinolaryngology Head and Neck Surgery, the Eighth Medical Center, Chinese PLA General Hospital between February and November 2023. All patients were diagnosed via pharyngeal pH monitoring. The LPRD group included 30 males and 6 females, aged 20-53 years (30.61±7.83 years). In addition, 39 healthy volunteers were recruited as the control group, comprising 25 males and 14 females, aged 18–58 years (28.64±7.97 years). Unstimulated mixed saliva samples were collected from all participants. Concentrations of eight SCFAs (acetic acid, propionic acid, isobutyric acid, butyric acid, valeric acid, isovaleric acid, hexanoic acid, and heptanoic acid) in saliva were quantified using gas chromatography-mass spectrometry (GC-MS). Salivary DNA was extracted, followed by amplification and sequencing of the 16S rRNA gene to analyze the microbiota composition at the genus level. The SCFA concentrations and the differences in bacterial species between the LPRD and control groups were compared, and the correlation between SCFA concentrations and the relative abundance of different bacterial genera in the salivary microbiota was analyzed. All statistical analyses were performed using R version 3.6.1 and SPSS version 26.0, while, microbiome analyses were conducted using R language.Results:Salivary hexanoic acid concentration was significantly higher in the LPRD group than in the control group [(29.50±19.61) ng/ml vs. (10.15±3.65) ng/ml; t=-2.72, P<0.05]. Significant differences in the relative abundance of 17 bacterial genera were observed between the two groups ( P<0.05), including Prevotella, Butyrivibrio, Streptococcus, and Actinomyces. Correlation analysis revealed that hexanoic acid concentration was significantly positively correlated with the abundance of Butyrivibrio (γ=0.73, P<0.05) and Streptococcus (γ=0.78, P<0.05), while showing a significant negative correlation with Actinomyces (γ=-0.73, P<0.05). Conclusion:Elevated salivary hexanoic acid levels may be associated with the development of LPRD. Dysbiosis of the salivary microbiota might contribute to LPRD pathogenesis by altering the concentrations of SCFA, particularly hexanoic acid.

Objective:To evaluate clinical outcomes of occlusion-guided vascularized folded fibula flap reconstruction with delayed implant restoration for mandibular defects after benign tumor resection.Methods:A total of 12 patients with benign mandibular tumors underwent free folded fibula flap reconstruction at the First Affiliated Hospital of Bengbu Medical University between January 2020 and December 2023, including 7 males and 5 females, aged 21-52 years. Six months after mandibular reconstruction, the internal fixation titanium plates were removed, and dental implants were placed using a preoperatively fabricated occlusal guide, followed by second-stage implant surgery and prosthetic restoration. Mandibular CT scans were obtained 6 months after reconstruction to compare the fitting accuracy between the preoperative virtual design and the actual reconstructed mandible. The implant stability quotient (ISQ) was measured 3 months after implant placement. Masticatory efficiency and Enneking lower limb function scores were evaluated at the following time points: before tumor surgery (T1), before implant placement (T2), 6 months (T3) and 9 months (T4) after implant crown restoration. One-way repeated measures ANOVA was used to analyze the masticatory efficiency and lower limb function scores.Results:The free folded fibula grafts were successfully performed via an intraoral approach in all 12 patients, with a 100% of survival rate. Mandibular defects included Brown class I in 6 cases, class II in 2 cases, and class III in 4 cases. A total of 42 implants were placed with successful osseointegration. The ISQ measured at 3 months post-placement was 64.10±4.18. At 6 months postoperatively, morphological analysis comparing the preoperative virtual surgical design with the actual postoperative reconstructed mandible revealed a reconstruction accuracy of 84.27%±4.23%. Significant differences were observed in Enneking scores and masticatory efficiency across all four time points (all P<0.001). Masticatory function showed significant improvement at T4 compared that at T2 [(88.06±3.66)% vs. (65.44±3.82)%, P<0.05]. Conclusion:Occlusal function-guided mandibular reconstruction with vascularized folded fibula flap after removal of benign mandibular tumors is a reliable method, which is associated with minimal donor-site morbidity and enables patients to restore precise occlusion and to achieve favorable masticatory efficiency.

Objective To investigate the current status of cleaning,disinfection,and sterilization management of dental instruments in medical institutions in Henan Province,analyze potential issues in hospital infection control,and propose targeted nursing strategies.Methods A convenience sampling method was used to survey the cleaning,disinfection,and sterilization management of dental instruments in 352 medical institutions in Henan Province from February to April 2024.A self-made questionnaire was designed,covering aspects such as the handling model and personnel configuration for dental instruments,training for cleaning,disinfection,and sterilization personnel,configuration and maintenance of cleaning and disinfection equipment,use and management of small pressure steam sterilizers,and reprocessing status of dental instruments.Results A total of 352 questionnaires were distributed,with 348 valid responses.Among the 34 primary medical institutions,only 10(29.41％)had a centralized cleaning,disinfection,and sterilization model for dental instruments;13(38.24％)had dedicated personnel for cleaning,disinfection,and sterilization of dental instruments;25(73.53％)were equipped with pressure water guns.Compari-sons among medical institutions of different levels showed statistically significant differences(P＜0.001).In the 348 medical institutions,194(55.75％)arranged pre-job training for nursing personnel;143(41.09％)performed mainte-nance on cleaning and disinfection equipment once a year;52(14.94％)did not perform pre-treatment on contaminated dental instruments after use.Among the 104 institutions using small pressure steam sterilizers,21(20.19％)used Type N small pressure steam sterilizers.Conclusion The centralized management rate of dental instruments and the basic equipment configuration rate in primary medical institutions in Henan Province are relatively low.There are issues such as insufficient personnel training,neglect of equipment maintenance,improper management of small pressure steam sterilizer usage,and incomplete reprocessing procedures in medical institutions at all levels.It is recommended that nursing managers further strengthen the training of nurses in the disinfection supply center,standardize the cleaning,disinfection,and sterilization workflow for dental instruments,in order to prevent and control hospital infections.

The endoplasmic reticulum quality control(ERQC)system is a core mechanism for maintaining cellular homeostasis,which primarily mediates the degradation of misfolded proteins in the endoplasmic reticulum(ER)through the ER-associated degradation(ERAD)and ER autophagy(ER-phagy)pathways.Tripartite motif 13(TRIM13)is a protein located on the ER membrane,which plays a critical role in ERAD via its E3 ubiquitin ligase activity.TRIM13 also acts as a non-classical ER-phagy receptor to mediate the occurrence of ER-phagy.TRIM13 has recently received extensive attention in the field of ERQC.Here we review the structure and function of TRIM 13 and the mechanisms by which it contributes to ERQC,and summarize its abnormal expression and regulatory role in diseases,with the aim of providing new strategies for the treatment of related diseases.

The endoplasmic reticulum quality control(ERQC)system is a core mechanism for maintaining cellular homeostasis,which primarily mediates the degradation of misfolded proteins in the endoplasmic reticulum(ER)through the ER-associated degradation(ERAD)and ER autophagy(ER-phagy)pathways.Tripartite motif 13(TRIM13)is a protein located on the ER membrane,which plays a critical role in ERAD via its E3 ubiquitin ligase activity.TRIM13 also acts as a non-classical ER-phagy receptor to mediate the occurrence of ER-phagy.TRIM13 has recently received extensive attention in the field of ERQC.Here we review the structure and function of TRIM 13 and the mechanisms by which it contributes to ERQC,and summarize its abnormal expression and regulatory role in diseases,with the aim of providing new strategies for the treatment of related diseases.

Objective To investigate the blood lipid levels in the population undergoing physical check-up population in Hangzhou dis-trict using the laboratory Big Data for providing references in disease prevention.Methods The test results of blood lipid levels of the individuals undergoing health check-up at a certain hospital from January 2022 to October 2023 were collected,excluding the abnormal positive resultss.SPSS 25.0 software was used to calculate the median(M),25th percentile(P25)and 75 Percentile(P75)grouped by gender and age in 10-year intervals.TMC was used to calculate 2.5th percentile(P25)and 97.5th percentile(P97 5),and GAMLSS was used to draw the age-continuous percentile charts.Results Gender differences in blood lipid levels were observed.The levels of total cholesterol(TC),triglycerides(TG),and low-density lipoprotein cholesterol(LDL-C)in males were higher than those of fe-males in the age of 19 to 49 groups.However,the levels of TC and LDL-C in females were higher than those of males in the age of 50 to 90 groups.TG levels in females were higher than those of males in the age of 60 to 90 groups.High-density lipoprotein cholesterol(HDL-C)levels in females were higher than those in males.TG level in males at ages of 40 to 49 reached peak,while females reached the peak of TG level at ages of 70 to 79.The LDL-C level in males at ages 40 to 49 reached the peak,while females reached the peak of LDL-C level at ages 60 to 69.Blood lipid levels were associated with age.The levels of TG,TC in female and LDL-C in female showed particularly significant changes,first increasing and then decreasing with age.Conclusion Blood lipid levels are closely relat-ed to gender and age.Personalized lipid management should be conducted,considering the factors of gender and age.

Objective To explore the value of peripheral blood stress disorder related indexes in the differential diagnosis of acute abdomen.Methods 300 patients with acute abdominal pain admitted from January 2018 to June 2020(abdominal pain group).Proline peptidase activity,total oxidant status level(TOS),total antioxidant status level(TAS)and oxidative stress index(OSI)in peripheral blood were detected upon admission.According to the treatment outcome,the patients were divided into surgical treatment group(ST group,99 cases),non-surgical treatment group(MT group,102 cases)and non-specific abdominal pain group(NSAP group,99 cases).100 volunteers who underwent physical examination in our hospital were the control group.Univariate and multivariate Logistic regression were used to analyze the independent predictors of surgical treatment.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of TOS and proline peptidase levels in surgical abdominal pain.Results(1)Peripheral blood TAS level[(36.84±10.08)μmol Trolox equiv./L VS(25.51±7.34)μmol Trolox equiv./L],OSI level[(3.68±1.77)VS(2.48±0.89)]and proline peptidase activity[(1 013.58±296.84)U/L vs.(842.65±147.25)U/L]in patients with abdominal pain group were higher than those in control group Group(P＞0.05).There was no significant difference in TOS level in peripheral blood between abdominal pain group and control group[(1.10±0.22)μmol H2O2 equiv./L vs.(1.06±0.24)μmol H2O2 equiv./L](P＞0.05).(2)TAS level[(41.06±9.75)μmol Trolox equiv./L vs.(34.81±10.50)μmol Trolox equiv./L vs.(26.95±6.57)μmol Trolox equiv./L]and proline peptidase activity[(1 207.58±254.12)U/L vs.(998.65±248.96)U/L vs.(873.65±132.04)U/L]in ST group were significantly higher than those in MT group And NSAP group.The OSI level of ST group was significantly higher than that of NSAP group[(3.90±3.87)vs.(2.42±0.65)],with statistical significance(P＞0.05),but there was no statistical significance compared with MT group(3.85±1.08)(P＞0.05).(3)Multifactorial Logistic regression analysis showed that plasma TOS level(OR=1.383)and proline peptidase level(OR=1.235)were independent predictors of surgical treatment in patients with emergency abdominal pain.The higher the plasma TOS level and proline peptidase level,the higher the risk of surgical treatment.(4)ROC curve analysis showed that the area under ROC curve(AUC)of plasma TOS for diagnosing surgical abdominal pain was 0.652,and the optimal diagnostic value was 39.65 μmol H2O2 equiv./L.The AUC of proline peptidase was 0.664,and the best diagnostic value was 1 696.58 U/L.The AUC of combined diagnosis was 0.813,the sensitivity was 78.25％,and the specificity was 59.65％.Conclusion In emergency,plasma proline protease activity and TOS levels have certain reference significance for determining whether patients need urgent surgical treatment.

ObjectiveTo investigate the correlation of the serum levels of aminotransferases and their ratios with liver inflammation activity in pediatric chronic hepatitis B （pCHB） patients， and to provide a basis for selecting the dominant population for treatment. MethodsThis study was conducted among 1 267 pCHB patients who were admitted to The Fifth Medical Center of Chinese PLA General Hospital from January 2010 to August 2022 and these patients did not receive antiviral therapy. The patients were analyzed in terms of demographic features， blood routine， blood biochemistry， HBV serological markers， and liver biopsy data. According to liver inflammation activity based on liver biopsy， the patients were divided into no or mild inflammation activity （G0‍ ‍—‍ ‍G1） group and significant inflammation activity （G2‍ ‍—‍ ‍G4） group. The serum levels of aminotransferases and their ratios were compared between groups， and their correlation with liver inflammation activity in pCHB patients was analyzed. Additionally， the patients were stratified by the age， and the relationship between serum aminotransferase levels and liver inflammation activity was analyzed in each age group. For comparison of continuous data between two groups， the independent samples t-test was used when the data were normally distributed， while the Mann-Whitney U test was used when the data were not normally distributed； the chi-square test was employed for comparison of categorical data between two groups. A Spearman’s correlation analysis was performed for correlation assessment. ResultsAmong the 1 267 pCHB patients， there were 468 （36.9%） in the G0‍ ‍—‍ ‍G1 group and 799 （63.1%） in the G2‍ ‍—‍ ‍G4 group， and there were significant differences between the two groups in the levels of aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， AST/ALT ratio， gamma-glutamyl transpeptidase （GGT）， total bilirubin， direct bilirubin， HBeAg quantification， low-density lipoprotein， and platelet count （PLT） （all P<0.05）. The correlation analysis showed that liver inflammation activity was negatively correlated with PLT and low-density lipoprotein （both P<0.05） and was positively correlated with GGT， total bilirubin， direct bilirubin， and HBeAg titer （all P<0.05）， while it was not significantly correlated with ALT， AST， and AST/ALT ratio （all P>0.05）. In the 0‍ ‍—‍ ‍12 years group， the 13‍ ‍—‍ ‍18 years male group， and the 13‍ ‍—‍ ‍18 years female group， liver inflammation activity aggravated with the increases in the serum levels of ALT and AST， and there were significant differences between groups （all P<0.05）. In the 0‍ ‍—‍ ‍12 years group， there was a significant difference in significant liver inflammation activity between the AST/ALT ratio >1 group and the AST/ALT ratio ≤1 group （P<0.001）. Among the 1 267 patients， 447 （35.28%） had an ALT level of <2×upper limit of normal （ULN）， among whom 196 （43.85%） had G≥2 liver inflammation， accounting for 15.47% of all children enrolled. ConclusionLiver inflammation activity is not significantly correlated with ALT， AST， and AST/ALT ratio in pCHB patients， suggesting that the serum levels of aminotransferases cannot truly reflect liver inflammation activity in pCHB patients with an aminotransferase level of <2×ULN. In clinical practice， liver biopsy should be performed for children with an aminotransferase level of <2×ULN to clarify whether antiviral therapy should be performed.