Objective To investigate the correlation between insulin resistance, serum uric acid (SUA) and blood lipids levels and diabetic kidney disease (DKD) with renal damage in patients with type 2 diabetes mellitus (T2DM). Methods A retrospective analysis was conducted on the clinical case data of 320 T2DM patients admitted to the hospital from January 2021 to December 2023. According to the urinary albumin/creatinine ratio (UACR), the above patients were divided into T2DM group (UACR<30 mg/g, 136 cases), mild DKD group (UACR of 30 mg/g-300 mg/g, 106 cases) and moderate-to-severe DKD group (UACR>300 mg/g, 78 cases). The clinical baseline data, insulin resistance index (HOMA-IR), SUA, and blood lipids (total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C)) were collected and compared among the three groups. Spearman analysis was performed to analyze the correlation between HOMA-IR, SUA, blood lipids and occurrence of renal damage. Results Compared with the T2DM group, the levels of UACR, HOMA-IR, SUA, TC and TG in the mild DKD group and the moderate-to-severe DKD group were higher, and the levels the above indicators in the moderate-to-severe DKD group were higher than those in the mild DKD group (P<0.05). Spearman correlation test results indicated that HOMA-IR, SUA, TC and TG were positively correlated with renal damage in patients with T2DM (r=0.486, 0.537, 459, 0.472, P<0.05). Conclusion The changes of insulin resistance, SUA and blood lipids are closely related to the occurrence and development of DKD in patients with T2DM, which can be used to evaluate their renal damage and grading.

Objective To discuss the application value of comfort medical mode in patients with uterine fibroids receiving interventional embolization therapy during hospitalization.Methods A total of 27 patients with uterine fibroids,who received interventional embolization at the Third Affiliated Hospital of Zhengzhou University of China,were enrolled in this study.The patient's basic data,including age,the sum of the maximum diameter of the measurable uterine fibroids and the hemoglobin level at admission,were collected.After admission and before discharge,the self-efficacy scale score,Becker anxiety scale score,and positive and negative emotions scale score were determined in all the patients.According to the different medical management mode adopted during the hospitalization,the patients were divided into study group(n=14)and control group(n=13).Comfort medical mode guided by quantitative evaluation strategy was employed for the patients of the study group,while conventional management mode was adopted for the patients of the control group.SPSS 26.0 software was used for data analysis.Measurement data within group were analyzed by independent sample t-test,and measurement data between groups were analyzed by paired sample t-test,and P＜0.05 was defined as a statistically significant difference.Results There were no statistically significant differences in the basic data between the two groups,and no statistically significant differences in the self-efficacy scale score,Becker anxiety scale score,and positive and negative emotions scale score at admission existed between the two groups.In the study group,the self-efficacy score and positive emotion score at discharge were strikingly higher than those at admission(P＜0.001),and the anxiety degree and negative emotion score at discharge were obviously lower than those at admission(P＜0.001).In the control group,the scores of the above-mentioned scales at discharge did not differ from those at admission.Conclusion The comfort medical mode guided by quantitative evaluation strategy has better clinical effect in patients with uterine fibroids receiving interventional embolization therapy,it can improve patient's comfortableness degree during hospitalization period.

Objective To explore the clinical application value of modified and optimized en-hanced recovery after surgery(ERAS)management in the perioperative period of patients undergoing robot-assisted laparoscopic radical prostatectomy(RLRP).Methods A total of 100 RLRP patients were selected as the research subjects and randomly divided into conventional group(receiving con-ventional ERAS management)and research group(receiving modified and optimized ERAS manage-ment)using the random number table method,with 50 cases in each group.Perioperative indicators,the use of anesthetic drugs,and the levels of physiological stress indicators[cortisol(Cor),norepi-nephrine(NE),plasma renin activity(PRA)]and coagulation function indicators[prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT)]before and after surgery were compared between the two groups.The incidence of postoperative complications and the readmis-sion rate within 30 days after surgery were also statistically analyzed.Results The intraoperative fluid infusion volume in the research group was less than that in the conventional group.The postoperative time to get out of bed,time to first flatus,pelvic drainage tube retention time,and hospital stay in the research group were horter than those in the conventional group(P＜0.05).The incidence of intraoperative hypothermia in the research group was lower than that in the conventional group,with statistically significant differences(P＜0.05).The doses of propofol and cisatracurium in the re-search group were less than those in the conventional group,with statistically significant differences(P＜0.05).After surgery,the levels of Cor,NE and PRA in both groups were higher than those before surgery,but they were lower in the research group than those in the conventional group,with statistically significant differences(P＜0.05).After surgery,the TT,PT and APTT in both groups were longer than those before surgery,but they were shorter in the research group than those in the conventional group,with statistically significant differences(P＜0.05).The overall incidence of complications in the research group was lower than that in the conventional group,with a statistically significant difference(P＜0.05).There was no statistically significant difference in the readmission rate within 30 days after surgery between the two groups(P＞0.05).Conclusion Modified and optimized ERAS management can effectively promote rapid postoperative recovery in RLRP patients,reduce the doses of anesthetic drugs and fluid infusion volume,alleviate physiological stress respon-ses,improve the body's coagulation function,and reduce the risk of complications.

Objective: To investigate the effects and mechanisms of Astragalus Polysacharin(APS) on the proliferation and metastasis of breast cancer cells by regulating miR-107 and miR-346-mediated macrophage polarization in breast cancer-derived exosomes. Methods: Forty 8-week-old female BALB/c mice were selected and breast cancer xenograft models and 4T1 transplanted tumor models were established. The mice were divided into the control group and the APS group. The APS group mice received daily intragastric administration of APS for 25 days, while the control group mice were given the same amount of normal saline. After all treatments were completed, the mice were euthanized, and tumor tissues were isolated. Western blot and flow cytometry were used to detect the expressions of proliferating cell nuclear antigen(PCNA), Ki-67, CD206, CD163, inducible nitric-oxide synthase(iNOS), and CD86. The apoptosis of single-cell suspensions in tumor tissues was analyzed. Human breast cancer cell line MDA-MB-231 was cultured and stimulated with APS, and exosomes from the cell culture medium were collected. The proliferation, migration, and invasion of cells were detected by CCK-8 assay, scratch assay, permeability chamber cell invasion assay, and qRT-PCR. Differentially expressed genes were screened by bioinformatics. Results : By measuring the expressions of molecules related to breast cancer cell proliferation and metastasis, it was shown that APS treatment reduced the expressions of proliferation-related proteins(PCNA and Ki-67) and metastasis-related proteins(Vimentin) in MDA-MB-231 xenograft tumor tissues; and the polarization of tumor-associated macrophages was observed. APS treatment of 4T1 transplanted tumor tissues could reduce the number of M2 macrophages and increase the number of M1 macrophages, resulting in a decrease in the ratio of M2/M1 macrophages and an increase in cell apoptosis in 4T1 transplanted tumor tissues. The expressions of related proteins iNOS and CD86 increased, and CD206 and CD163 decreased. After APS treatment, the exosomes produced by MDA-MB-231 reduced the polarization of M2 macrophages and affected the expressions of miR-107 and miR-346. Conclusion APS inhibits the polarization of M2 macrophages by regulating the expression of miR-107 or miR-346 in breast cancer cell-derived exosomes, ultimately inhibiting the proliferation and metastasis of breast cancer cells.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.