Objective: To establish a risk prediction model for diabetic peripheral neuropathy (DPN) among patients with type 2 diabetes mellitus (T2DM), so as to provide a basis for DPN prevention and control. Methods: T2DM inpatients aged 18-65 years admitted to the department of endocrinology and metabolism at Affiliated Hospital Shandong Second Medical University from April to December 2024 were selected as study subjects. Age, T2DM duration, hypertension history, 25-hydroxyvitamin D, serum C-peptide, and high density lipoprotein cholesterol (HDL-C) were collected through electronic medical records. Risk predictors of DPN among T2DM patients were screened using multivariable logistic regression model, and a nomogram was established. The receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis were employed to evaluate the discrimination, calibration and clinical utility of the nomogram, respectively. Results: A total of 598 T2DM patients were enrolled, including 359 (60.03%) males and 239 (39.97%) females. The median age was 54.50 (interquartile range, 15.00) years, the median T2DM duration was 6.00 (interquartile range, 9.00) years. There were 262 cases of T2DM patients with DPN, accounting for 43.81%. Multivariable logistic regression identified hypertension history (OR=3.260, 95%CI: 2.220-4.790), alcohol use history (OR=2.150, 95%CI: 1.390-3.310), diabetes complications (OR=0.430, 95%CI: 0.270-0.680), T2DM duration (OR=1.040, 95%CI: 1.010-1.070), body mass index (OR=1.130, 95%CI: 1.070-1.200), 25-hydroxyvitamin D (OR=0.930, 95%CI: 0.910-0.960), and HDL-C (OR=0.400, 95%CI: 0.230-0.720) as risk predictors for DPN among T2DM patients. The area under the ROC curve of the established risk prediction model was 0.774 (95%CI: 0.737-0.812), with a sensitivity of 0.710 and a specificity of 0.723. The calibration curve after repeated sampling calibration approached the standard curve. Decision curve analysis showed that when the risk threshold probability was 0.2 to 0.4, the model demonstrates favorable clinical applicability. Conclusion The risk prediction model established in this study has favorable discrimination, calibration, and clinical utility, can effectively predict the risk of DPN among T2DM patients aged 18-65 years.

In the context of the development of transplant oncology, it is of great clinical significance to find a drug with both antitumor and immunosuppressive effects for liver transplantation patients with hepatocellular carcinoma (HCC). The antitumor effect of ginkgolic acid (GA) has been confirmed, and some studies suggest that GA may also have an immunosuppressive effect. The immunosuppressive effect of GA was evaluated by histopathology, T-cell subpopulation, and cytokine detection in rat liver transplantation and mouse cardiac transplantation models, and transcriptomic and metabolomic analysis was used to explore the underlying mechanism of the GA immunosuppressive effect. Metabolites, activation, and ferroptosis markers of CD8⁺ T cells were detected in vivo and in vitro. Based on rat liver transplantation and mouse cardiac transplantation models, the immunosuppressive effect of GA was first confirmed by histopathology, T-cell subpopulation, and cytokine detection. In the mouse cardiac transplantation model, transcriptomics combined with metabolomics demonstrated for the first time that GA inhibited lactate dehydrogenase A (LDHA) expression and pyruvate metabolism in CD8⁺ T cells. It was confirmed in vivo and in vitro that GA inhibited pyruvate metabolism of CD8⁺ T cells through LDHA, inhibiting their activation and inducing ferroptosis. Overexpression of LDHA partially reversed the effect of GA on the metabolism, activation, and ferroptosis of CD8⁺ T cells in vitro. GA mediates metabolic reprogramming through LDHA to inhibit the activation and induce ferroptosis of CD8⁺ T cells to exert an immunosuppressive effect, which lays an experimental foundation for the future clinical application of its immunosuppressive effect.

Objective: To explore the intervention effects of high intensity interval training (HIIT) on glucose metabolism, cortisol (Cor), and sleep quality among college students with comorbid depressive symptoms and obesity, so as to provide a reference for improving sleep quality among college students with comorbid depressive symptoms and obesity. Methods: In March 2023, 45 college students with comorbid depressive symptoms and obesity were recruited and randomly assigned to an exercise group ( n =23) and a control group ( n =22) by random number table method. The exercise group received HIIT intervention for 12 weeks, three times a week, while the control group received no intervention. Blood samples were collected from participants to measure fasting insulin (FINS), fasting blood glucose (FBG), homeostatic model assessment of insulin resistance (HOMA-IR), Cor, and Pittsburgh Sleep Quality Index (PSQI) before and after intervention. Statistical analysis was performed using t-test, repeated measures analysis of variance (ANOVA), simple effect analysis. Results: The repeated measures ANOVA revealed statistically significant time×group interaction effects for body composition (weight, body mass index, percentage of body fat, fat mass, waist to hip ratio), depressive symptoms, PSQI scores and its subdimensions (subjective sleep quality, sleep onset time, sleep efficiency, sleep disorders, daytime dysfunction), as well as FBG, FINS, and HOMA-IR between the exercise group and control group before and after intervention ( F =7.10-53.38, all P <0.05). Simple effect analysis showed that compared to the control group, the exercise group demonstrated significant improvements in body composition (body mass index, fat mass, waist to hip ratio), depressive symptoms, PSQI scores and its sub dimensions (subjective sleep quality, sleep onset time, sleep efficiency, sleep disorders, daytime dysfunction), FBG, FINS, HOMA-IR, and Cor (all P <0.05). Conclusion HIIT can improve the sleep quality of college students with comorbid depressive symptoms and obesity by enhancing glucose metabolism and regulating Cor levels.

The medical assistance system plays a backup role in China's multi-level medical security system,and has achieved important phased results in improving the accessibility and affordability of medical services for disadvantaged groups.However,there is still insufficient protection for medical assistance in China,and the phenomenon of"poverty caused by illness and returning to poverty due to illness"still exists.Therefore,it summarizes and analyzes the current development status of China's medical assistance system by reviewing national policy documents and analyzing local situations,summarizes and analyzes the existing problems,and proposes countermeasures and suggestions.

Objective It aims to investigate the current status of patient trust in physicians among inpatients at tertiary public hospitals in China and to analyze the factors influencing this trust.The goal is to provide insights for enhancing patient trust and improving doctor-patient relationships.Methods Relying on the third"third party evaluation of national action to improve medical services"project,it surveyed inpatients from 136 tertiary public hospitals across 31 provinces(including autonomous regions and municipalities)and the Xinjiang Production and Construction Corps.A total of 21 092 inpatient questionnaires were returned.Data obtained were statistically analyzed using R software version 4.3.2.Results The trust level in attending physicians among inpatients at tertiary public hospitals in China was found to be 98.37％.Influential factors on this trust level included patient occupation,annual family income,type and region of the hospital and so on.Conclusion Overall,the level of trust in physicians among inpatients at tertiary public hospitals in China is high,though regional differences exist.It should pay attention to non-medical factors such as inpatient ward environment and hospital service quality.Improving these aspects can enhance the overall patient experience,further improve doctor-patient relationships.

The medical assistance system plays a backup role in China's multi-level medical security system,and has achieved important phased results in improving the accessibility and affordability of medical services for disadvantaged groups.However,there is still insufficient protection for medical assistance in China,and the phenomenon of"poverty caused by illness and returning to poverty due to illness"still exists.Therefore,it summarizes and analyzes the current development status of China's medical assistance system by reviewing national policy documents and analyzing local situations,summarizes and analyzes the existing problems,and proposes countermeasures and suggestions.

Objective It aims to investigate the current status of patient trust in physicians among inpatients at tertiary public hospitals in China and to analyze the factors influencing this trust.The goal is to provide insights for enhancing patient trust and improving doctor-patient relationships.Methods Relying on the third"third party evaluation of national action to improve medical services"project,it surveyed inpatients from 136 tertiary public hospitals across 31 provinces(including autonomous regions and municipalities)and the Xinjiang Production and Construction Corps.A total of 21 092 inpatient questionnaires were returned.Data obtained were statistically analyzed using R software version 4.3.2.Results The trust level in attending physicians among inpatients at tertiary public hospitals in China was found to be 98.37％.Influential factors on this trust level included patient occupation,annual family income,type and region of the hospital and so on.Conclusion Overall,the level of trust in physicians among inpatients at tertiary public hospitals in China is high,though regional differences exist.It should pay attention to non-medical factors such as inpatient ward environment and hospital service quality.Improving these aspects can enhance the overall patient experience,further improve doctor-patient relationships.

The medical assistance system plays a backup role in China's multi-level medical security system,and has achieved important phased results in improving the accessibility and affordability of medical services for disadvantaged groups.However,there is still insufficient protection for medical assistance in China,and the phenomenon of"poverty caused by illness and returning to poverty due to illness"still exists.Therefore,it summarizes and analyzes the current development status of China's medical assistance system by reviewing national policy documents and analyzing local situations,summarizes and analyzes the existing problems,and proposes countermeasures and suggestions.

Objective It aims to investigate the current status of patient trust in physicians among inpatients at tertiary public hospitals in China and to analyze the factors influencing this trust.The goal is to provide insights for enhancing patient trust and improving doctor-patient relationships.Methods Relying on the third"third party evaluation of national action to improve medical services"project,it surveyed inpatients from 136 tertiary public hospitals across 31 provinces(including autonomous regions and municipalities)and the Xinjiang Production and Construction Corps.A total of 21 092 inpatient questionnaires were returned.Data obtained were statistically analyzed using R software version 4.3.2.Results The trust level in attending physicians among inpatients at tertiary public hospitals in China was found to be 98.37％.Influential factors on this trust level included patient occupation,annual family income,type and region of the hospital and so on.Conclusion Overall,the level of trust in physicians among inpatients at tertiary public hospitals in China is high,though regional differences exist.It should pay attention to non-medical factors such as inpatient ward environment and hospital service quality.Improving these aspects can enhance the overall patient experience,further improve doctor-patient relationships.

The medical assistance system plays a backup role in China's multi-level medical security system,and has achieved important phased results in improving the accessibility and affordability of medical services for disadvantaged groups.However,there is still insufficient protection for medical assistance in China,and the phenomenon of"poverty caused by illness and returning to poverty due to illness"still exists.Therefore,it summarizes and analyzes the current development status of China's medical assistance system by reviewing national policy documents and analyzing local situations,summarizes and analyzes the existing problems,and proposes countermeasures and suggestions.