ObjectiveTo analyze the impact of diabetes-related deaths on the probability of premature mortality and life expectancy in Minhang District of Shanghai from 2004 to 2023, and to provide reference data for the optimization of targeted prevention and control strategies. MethodsAll death cases involving diabetes among the registered residents of Minhang District from 2004 to 2023 were collected. The probability of premature mortality and life expectancy was computed using the abridged life table method. The average annual percent change (AAPC) was calculated with Joinpoint 4.9.0.0. The Arriaga decomposition method was employed for statistical analyses of the influence of cause-specific and age-specific mortality related to diabetes on life expectancy. ResultsThe total number of diabetes-related mortality, crude mortality, and standardized mortality for both males and females in Minhang District from 2004 to 2023 exhibited an increasing trend (P<0.001). The primary causes of death among diabetes-related cases were cardiovascular disease (37.68%), diabetes mellitus (31.95%), and malignant tumor (17.80%). From 2004 to 2023, probability of premature mortality to diabetes-related diseases demonstrated a rising trend (P<0.001), contrasting with the declining trend observed in the overall population (P=0.001). Males showed a significant upward trajectory (P<0.001), while females displayed a stable pattern. Among the diseases exerting considerable influence, cardiovascular disease and malignant tumor revealed a marked increase over time (P<0.001), whereas diabetes mellitus maintained a stable trend; both factors negatively impacted the reduction in probability of premature mortality. From 2004 to 2023, diabetes-related mortality reduced life expectancy among residents by an average of 1.22 years (-49.89%), indicating a negative impact; the reduction was 1.41 years in males and 0.90 years in females. The age groups exhibiting greater negative contributions differed by genders, namely males aged 50‒54 years and females aged 70‒74 years. Cardiovascular disease, diabetes mellitus, and malignant tumor contributed significantly to this decline (-0.46 years, -0.42 years, -0.20 years, respectively), with male experiencing higher negative contributions than females. ConclusionIn Minhang District, the rising mortality associated with diabetes-related diseases negatively impact both the reduction of the probability of premature mortality and the increase in life expectancy. This trend is primarily attributed to the rapid escalation of mortality and younger age demographic of male residents, which warrants significant attention. It is recommended that, based on the enhancement of case management, efforts should be directed towards the targeted prevention and control of risk factors and high-risk populations.

Objective:To identify serum metabolic markers for early prediction and diagnosis of gestational diabetes mellitus (GDM).Methods:A retrospective case-control study was conducted.The study subjects were from pregnant women enrolled in the Birth Cohort Study of the Women′s Hospital, Zhejiang University, from1 November 2018 to 30 March 2020.100 cases of GDM (GDM group, Age 36.03±3.91) and 150 non-GDM pregnant women matched for clinical information (control group, Age35.49±3.46) were retrospectively selected for the study. Fasting serum samples were collected at 15-20 weeks of gestation (prior to GDM diagnosis, T1 period) and 24-28 weeks of gestation (during GDM diagnosis, T2 period). Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used to quantify GDM-related serum metabolic small molecules, including 1, 5-anhydroglucitol, 3-hydroxybutyric acid, phenylalanine, and isoleucine. These molecules, along with basic clinical information (age, gestational week, BMI) and standard biochemical indicators (FPG), were used to develop predictive models for the early detection of GDM at T1 and the diagnosis of GDM at T2. Statistical analysis was performed using t-tests or Mann-Whitney U-tests.Result:The results of the targeted quantitative validation study indicate: At the T1 stage, the level of 1, 5-anhydroglucitol was found to be significantly lower ( P=0.001) in the GDM group compared to the control group. Conversely, the level of isoleucine was significantly higher ( P=0.027) in the GDM group. There were no significant differences in the levels of 3-hydroxybutyrate and phenylalanine between the two groups ( P>0.05). The combination of the 4 metabolites yielded the highest predictive value (AUC) for GDM at T1, with an AUC of 0.670 (95% CI: 0.602-0.739), P<0.001.At the T2 stage, the GDM group had significantly lower levels of 1, 5-anhydroglucitol ( P<0.05) and significantly higher levels of 3-hydroxybutyric acid and isoleucine ( P<0.05) than the control group, with no significant differences in phenylalanine levels ( P=0.626). The combination of the four metabolites had the highest diagnostic value (AUC) for GDM, 0.717 (95% CI 0.651-0.783), P<0.001.The analysis of seven different combinations of GDM prediction/diagnostic models created by combining four metabolites with basic clinical information and routine biochemical indicators showed: We found that the AUC value of the GDM diagnostic model built with FPG, BMI, pre-pregnancy BMI, age, gestational week, and the 4 metabolite indicators in T2 stage was the best, 0.794 (95% CI 0.736-0.851), P<0.001, with a sensitivity of 72%;The best AUC value for the GDM prediction model built with the same indicators at T1 was 0.711(95% CI 0.646-0.776), P<0.001, with a sensitivity of 77%. Conclusions:Four metabolic small molecules, 1, 5-anhydroxyglucitol, 3-hydroxybutyric acid, phenylalanine, and isoleucine, were integrated with clinical indicators (FPG) and clinical information (age, gestational week, BMI) to develop a predictive model for GDM at gestation (T1) and a diagnostic model for GDM at gestation (T2), demonstrating promising clinical prediction and diagnostic capabilities. 1, 5-Anhydroglucitol, 3-hydroxybutyric acid, phenylalanine, and isoleucine show potential as valuable markers for the prediction and diagnosis of GDM.

Objective To observe the relationship between functional connectivity(FC)of frontoparietal network(FPN)and cognitive function in patients with cerebral small vessel disease(CSVD)using resting-state functional MRI(rs-fMRI).Methods rs-fMRI of 50 CSVD patients with cognitive impairment(CI group),65 CSVD patients with normal cognition(NC group)and 60 healthy controls(HC group),as well as outcomes of neuropsychological tests were retrospectively analyzed.Brain regions with different FC of FPN were compared among 3 groups and between each 2 groups.Partial correlation analysis was used to evaluate the correlations of FC of brain regions value being statistically different between CI and NC groups and cognitive scores.Results Significant differences of FC in bilateral cingulate gyrus,left middle frontal gyrus,right supramarginal gyrus,right inferior parietal lobule and right medial superior frontal gyrus were found among groups(FWE correction,all P＜0.05).Compared with NC group,FC of left cingulate gyrus decreased,of right inferior frontal gyrus and right medial superior frontal gyrus increased in CI group(FWE correction,all P＜0.05).The decreased FC value of left cingulate gyrus was negatively correlated with clock drawing test score in CSVD patients(r=-0.159,P=0.049).Conclusion CSVD patients with or without CI had extensive abnormal FC of FPN,and the left cingulate gyrus was associated with patient's cognitive function.

Objective To observe the efficacy of gray-scale ultrasound-based radiomics for differentiating peripheral pulmonary adenocarcinoma and squamous cell carcinoma.Methods Data of 88 patients with single peripheral lung adenocarcinoma and 58 patients with single peripheral lung squamous cell carcinoma proved pathologically with puncture biopsy and clearly visualized with lung ultrasound were retrospectively analyzed.The patients were divided into training set(n=103)and test set(n=43)at the ratio of 7:3.Based on gray-scale ultrasound of training set,radiomics features associated with differential diagnosis of peripheral lung adenocarcinoma and lung squamous cell carcinoma were extracted and screened.Using 4 different classifiers,including support vector machine(SVM),linear discriminant analysis(LDA),logistic regression(LR)and the least absolute shrinkage and selection operator combined with logistic regression(LASSO-LR),4 corresponding radiomics models were obtained,and the relative best models were selected according to their performances under 10-fold cross validation.The receiver operating characteristic curves were drawn,the areas under the curve(AUC)were calculated to evaluate the differentiating efficacy of each model,and DeLong test was used for the comparison.The differentiating accuracy of models were obtained under the best cutoff value with the maximum Youden index.Results The AUC of SVM,LDA,LR and LASSO-LR radiomics models for differentiating peripheral lung adenocarcinoma and lung squamous carcinoma in test set was 0.864,0.867,0.880 and 0.844,respectively,and no significant difference was found among 4 models(all P＞0.05).Under the best cutoff value of each model,the corresponding accuracy of SVM,LDA,LR and LASSO-LR radiomics models for differentiating peripheral lung adenocarcinoma and lung squamous cell carcinoma was 86.05％,83.72％,88.37％and 86.05％,respectively.Conclusion Radiomics models based on gray-scale ultrasound could be used to differentiate peripheral lung adenocarcinoma and lung squamous cell carcinoma.

Based on the isolation and identification of Nosema ceranae(N.ceranae)in honeybees,this study optimized the synthesis method of nano-FeS derived from albumen and explored in vitro and in vivo antifungal effects against N.ceranae.Pathogens were isolated from infected honeybee colonies and identified as N.ceranae using morphological and molecular biology techniques.In vitro experiments were conducted to confirm the antifungal effects of nano-FeS against N.ceranae and elucidate the mechanism.In vivo experiments were carried out to validate the therapeutic effects of nano-FeS against N.ceranae infection.Nano-FeS was synthesized using the solvothermal method with an optimal scheme determined through orthogonal experiments,with an average par-ticle size of 75 nm.Flow cytometry and fluorescence staining experiments confirmed that nano-FeS induced apoptosis and necrosis in N.ceranae.After N.ceranae was exposed to nano-FeS,intracellu-lar iron accumulation,disruption of the glutathione and glutathione peroxidase antioxidant system,and subsequent ROS accumulation were observed,ultimately leading to lipid peroxidation of cell membranes.In vivo experiments demonstrated reduced mortality and decreased spore counts in the midgut of honeybees fed with nano-FeS.Transcriptome analysis and qPCR revealed the impact of nano-FeS on gene expression in the N.ceranae infected honeybee midgut.This study presented a promising alternative antifungal agent for N.ceranae infection in honeybees and elucidated the an-tifungal mechanism of nano-FeS related to ferroptosis.Additionally,the study found a positive cor-relation between the mass concentration of nano-FeS and its antifungal effectiveness against N.ceranae.

Objective To construct a prognostic risk model for colorectal cancer(CRC)with good prediction ability based on upda-ted ferroptosis-related genes.Methods Transcriptome levels,clinical information and updated ferroptosis-related genes of CRC pa-tients were downloaded from UCSC Xena and FerrDb V2databases.The genes related to prognosis were screened out by R language and univariate COX regression analysis,and the final prognostic risk model was established by LASSO regression combined with multivariate COX regression analysis.Then,survival analysis and the predictive power of the model were assessed by R language"survival"package,"timeROC"package and COX regression.Results There were 8differentially expressed ferroptosis-related genes including NEDD4L,TIMP1,KIF20A,GDF15,ENO3,TERT,MS4A15,HOTAIR which composed of the prognostic risk model.The model divided the CRC patients into two groups,and the difference in survival prognosis was between the two groups was statistically significant(P＜0.05).The area under the receiver operating characteristic(ROC)curves of the model in 1,3 and 5 year were 0.732,0.702 and 0.738,respective-ly.The results of GO and KEGG analysis showed that the genes between the two groups were enriched in pathways and functions such as tumor process,inflammatory response,and even immunity.Immune-related functions,immune cell infiltration,and immune check-points were significantly different between high and low risk groups(P＜0.05).Conclusion The prognostic model constructed based on 8differentially expressed ferroptosis-related genes has an independent prognostic effect on CRC,providing a new way to predict the prog-nosis of CRC.

Objective:To systematically review, assess, extract, and summarize the most effective evidence on non-pharmacological traditional Chinese medicine interventions for promoting pulmonary rehabilitation in stable patients with chronic obstructive pulmonary disease, aiming to provide a theoretical foundation for clinical nurses to implement traditional Chinese medicine nursing interventions.Methods:According to the "6S" evidence model, relevant evidence on non-pharmacological traditional Chinese medicine interventions for stable chronic obstructive pulmonary disease was retrieved from domestic and foreign databases, guideline websites and professional society websites, including clinical decisions, guidelines, evidence summaries, systematic reviews, expert consensus, etc. The retrieval time was from January 1, 2018 to August 10, 2023. Two researchers evaluated the quality of the included literature, and extracted data and summarized evidence.Results:A total of 23 articles were included, including 6 guideline, 1 evidence summary, 7 systematic reviews, 8 Meta analysis and 1 expert consensus. The 37 evidences were summarized from 11 aspects, including target population, intervention focus, moxibustion therapy, acupoint sticking therapy, transcutaneous electrical acupoint stimulation, acupuncture therapy, acupoint injection therapy, traditional Chinese exercises, diet therapy, follow-up procedures, safety considerations.Conclusions:This study summarizes the evidences of traditional Chinese medicine non-drug pulmonary rehabilitation in the stable stage of chronic obstructive pulmonary disease. When applying the evidence in clinical practice, the traditional Chinese medicine nursing ability of nurses and the actual situation of patients should be fully considered to formulate an individualized traditional Chinese medicine nursing plan.

Cardiomyopathy is a group of heterogeneous myocardial diseases with a variety of specific phenotypes that can lead to cardiovascular death or progressive heart failure in severe cases.Because of the severity and complexity of these diseases,the search for new regulatory mechanisms to prevent and treat cardiomyopathy is particularly urgent.Iron death is a form of programmed cell death that differs from other forms of iron dependence and is characterized by the accumulation of iron-dependent lipid peroxides.Studies have shown that iron death can be involved in the occurrence and progression of cardiomyopathy through different signaling pathways.Therefore,targeted regulation of iron death is a new strategy to prevent cardiomyopathy.In this paper,the mechanism of iron death and its important role in cardiomyopathy were reviewed to find the potential relationship between iron death and cardiomyopathy and provide more ideas for the treatment of various cardiomyopathies in the future.

Objective To analyze the role of the key items list in the quality control of running medical records by com-paring the improvements of the quality of medical records,and to explore more effective ways of quality management of medical records.Methods Based on the goal setting theory and influencing factors of goal incentive utility,a list of key items for medi-cal record quality management was formulated,which was implemented in a children's hospital in Tianjin since April 2023.A to-tal of 4 823 operating medical records were collected from June 2022 to September 2023,and the defect rates of quality control items were compared by using statistical methods.Results After the implementation of the key items list,the average score of operating medical records was improved,and the defect rate decreased from 13.63％to 7.94％.Moreover,the defect rates of admission records,first-trip records,senior physician rounds records,consultation records,and surgical records decreased from 4.25％,3.07％,8.26％,and 10.56％to 1.61％,1.56％,4.41％,and 5.06％.Conclusion The implementation of key i-tems list management can effectively improve the quality of running medical records,reduce the defects of medical records,and improve the effects of medical record management.

Radiotherapy can cause functional and morphological changes in the brain tissues of patients with primary or metastatic malignant brain tumors, leading to radiation-induced brain injury. However, the pathogenesis of radiation-induced brain injury has not yet been unanimously determined, and its research advances and treatment protocols are yet to be elucidated and improved. In this study, we explore the pathogenesis of radiation-induced brain injury from the perspective of vascular injury, inflammatory reactions, neuronal dysfunction, glial cell injury, and gut microbiota and reviewed the advances in research on its treatment and prevention. The purpose is to provide a reference and theoretical basis for the research and clinical diagnosis and treatment of radiation-induced brain injury.