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.

In line with the rising global incidence of cancer,tumor metastasis has become the leading cause of mortality among cancer patients.Formation of the pre-metastatic niche(PMN)creates an optimal microenvironment for tumor cell colonization and metastasis,thus facilitating tumor dissemination.In this context,cancer-associated fibroblasts(CAFs)have garnered significant attention as a result of their multifaceted roles in tumor progression.CAFs enhance the formation of the PMN and promote the invasive behavior of tumor cells by remodeling the extracellular matrix,inducing epithelial-mesenchymal transition,stimulating angiogenesis and modulating the tumor immune microenvironment.These processes not only expedite metastasis but also enable tumor immune evasion.This paper reviews the fundamental mechanisms and functions of CAFs in tumor metastasis,examines their potential applications in cancer research and therapy,and offers new perspectives and directions for the development of anti-tumor metastasis strategies.

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.

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.

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.

Objective:To investigate the characteristics of cardiopulmonary exercise testing and risk factors for decreased aerobic capacity in children with non-acute asthma exacerbations, to assess their cardiopulmonary health and to provide a basis for improvement.Methods:A case-control study.Sixty-one children with non-acute asthma exacerbations treated at the Outpatient Department of Children′s Hospital of Soochow University from October 2022 to December 2023 and 22 control children during the same period were included.Binary Logistic regression was employed to assess risk factors for decreased aerobic capacity in children with asthma.Results:Among the included 61 children with non-acute asthma exacerbations, there were 33 cases in the chronic persistent phase (chronic persistent phase group) and 28 in the clinical remission phase(clinical remission group).There were 22 children in the control group.During the peak exercise phase of the cardiopulmonary exercise testing, the mean kilogram body weight oxygen uptake (VO 2/kg), the percentage of predicted kilogram body weight oxygen uptake, and metabolic equivalents (Met) in the chronic persistent phase group were lower than those in the control and clinical remission phase groups.The mean VO 2/kg recovery from the cardiopulmonary exercise testing in the first minute in the chronic persistent phase group was lower than that in the control and clinical remission phase groups.The median Met and ventilation per minute recovery in the chronic persistent phase group were lower than those in the control group.The median heart rate recovery in asthma children was lower than that in control children.The percentage of cardiopulmonary exercise testing abnormalities was higher in asthma children with symptoms after excise than that in asthma children without symptoms after excise.The percentage of decreased ventilation efficiency in asthma children with symptoms after excise was higher than that in asthma children without symptoms after excise.Multivariate regression analysis showed that a higher body mass index (BMI) ( OR=1.577, 95% CI: 1.113-2.235, P=0.010) and a higher peak respiratory reserve ( OR=1.103, 95% CI: 1.018-1.195, P=0.017) were risk factors of decreased aerobic capacity.The risk of decreased aerobic capacity in the chronic persistent phase was 7.949 times higher than that in the clinical remission phase ( OR=7.949, 95% CI: 1.290-48.996, P=0.025). Conclusions:The aerobic capacity is decreased and ventilatory recovery is slower in children with chronic persistent asthma than those in healthy children.The heart rate recovery in asthma children is slower than that in healthy children.A high BMI, a high peak respiratory reserve, and chronic persistence of asthma are independent risk factors for decreased aerobic capacity in children with non-acute asthma exacerbations.asthma.

Objective:To develop a training curriculum targeting the core competences of neurosurgery nurses, so as to provide a reference for standardized training of neurosurgery nurses and to strengthen their professionality.Methods:Centering on the core competences required for neurosurgery nurses, we formed the curriculum framework based on the cell structure-inspired concept proposed by the School of Nursing of The Hong Kong Polytechnic University, and determined the contents through a literature analysis and two rounds of questionnaire-based Delphi consultations with 16 experts. We increased, reduced, or modified the items and dimensions, and finally estabilished the curriculum for neurosurgery nurse training. SPSS 18.0 software was used to analyze the general information of experts, coordination coefficient, variation coefficient, full mark ratio, and mean importance value. Categorical data were described as frequencies and percentages, and continuous data were described as mean±standard deviation. Ranked data were analyzed by using the chi-square test.Results:In the two rounds of expert consultations, questionnaires were both 100.00% returned, and the coefficients of expert authority were 0.873 and 0.888, respectively. The coordination coefficient of curriculum modules and curriculum contents were 0.416 and 0.221, respectively ( P<0.001). For individual items across the curriculum modules, the mean importance value was 3.188-3.938, the variation coefficient was 0.063-0.178, and the full mark ratio was 0.250-0.875. For content items, the mean importance value was 3.250-4.000, the variation coefficient was 0-0.238, and the full mark ratio was 0.375-1.000. The established clinical practice-directed curriculum for neurosurgery nursing training included 6 course modules (anatomy and physiology of the nervous system, neurosurgery patient evaluation and monitoring, neurosurgery disease nursing, commonly used neurosurgery nursing techniques, nursing management, and scientific research basis) and 77 content items. Conclusions:The established training curriculum targeting the core competences for neurosurgery nurses is reliable, which can provide a reference for standardized training of neurosurgery nurses.