AIM:To investigate the characteristics of corneal endothelial cells(CEC)and nuclear density(ND)in cataract patients with type 2 diabetes and to assess the impact of blood glucose related indicators.METHODS: A total of 187 cases(187 eyes)that underwent cataract surgery at our hospital from July 2023 to July 2024 were enrolled. CEC were measured using a non-contact specular microscope. ND was measured through IOLMaster 700. A total of 187 participants were further stratified based on glycosylated hemoglobin(HbA1c)and fasting blood glucose(FBG)levels. Correlation analyses and multiple linear regression analyses were used to elucidate the association between diabetic status and ocular parameters. We measured the concentrations of ascorbic acid(AA)in the aqueous humor of 52 participants.RESULTS: Compared to the control group, the diabetic group exhibited larger maximum endothelial cell size, lower endothelial cell density(ECD), a reduced proportion of hexagonal cells, higher ND, and lower corneal vertex equivalent spherical power(Scv; P<0.05). Correlation analysis revealed those changes of CEC and ND were significantly associated with the level of FBG, HbA1c, and the duration of diabetes(P<0.05). Among 52 participants, diabetic patients had lower levels of AA in their aqueous humor, indicating a diminished antioxidant ability.CONCLUSION:Diabetic state can significantly influence corneal maximum cell size, hexagonal cell ratio and ND in cataract patients, potentially linked to a decrease in total antioxidant capacity of the aqueous humor.

The continuous emergence of SARS-CoV-2 variants as well as other potential future coronavirus has challenged the effectiveness of current COVID-19 vaccines. Therefore, there remains a need for alternative antivirals that target processes less susceptible to mutations, such as the formation of six-helix bundle (6-HB) during the viral fusion step of host cell entry. In this study, a novel high-throughput screening (HTS) assay employing a yeast-two-hybrid (Y2H) system was established to identify inhibitors of HR1/HR2 interaction. The compound IMB-9C, which achieved single-digit micromolar inhibition of SARS-CoV-2 and its Omicron variants with low cytotoxicity, was selected. IMB-9C effectively blocks the HR1/HR2 interaction in vitro and inhibits SARS-CoV-2-S-mediated cell-cell fusion. It binds to both HR1 and HR2 through non-covalent interaction and influences the secondary structure of HR1/HR2 complex. In addition, virtual docking and site-mutagenesis results suggest that amino acid residues A930, I931, K933, T941, and L945 are critical for IMB-9C binding to HR1. Collectively, in this study, we have developed a novel screening method for HR1/HR2 interaction inhibitors and identified IMB-9C as a potential antiviral small molecule against COVID-19 and its variants.

Objective:To establish and assess the quality control and improvement system for metabolic and bariatric surgery in Beijing.Methods:Based on relevant documents from the National Health Commission and the Beijing Municipal Health Commission,and referencing the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) by the American Society for Metabolic and Bariatric Surgery,a quality control system was developed under the Beijing Quality Control and Improvement Center of Metabolic and Bariatric Surgery. The system incorporated on-site evaluations,data registration,and specialized training. From May to December 2023,on-site assessments were conducted at 21 hospitals in Beijing performing bariatric surgery,evaluating personnel qualifications,infrastructure,clinical workflows,and postoperative follow-up. A quality control database was created to collect real-time surgical data,and training was provided for data entry and professional skills. Assessment results were classified as excellent,qualified,or needing improvement,with rectification suggestions offered and follow-up visits conducted to track progress.Results:All 21 hospitals achieved a 100% compliance rate for surgical indications, 16 (76.2%) met standardized surgical operation criteria,and 14 (66.7%) had standardized postoperative management. However,only 5 (23.8%) achieved a 12-month postoperative follow-up rate of ≥60%,and 4 (19.1%) had established specialized databases. Key challenges included insufficient specialized staffing (19.1%), lack of multidisciplinary collaboration (47.6%), inadequate equipment (57.1%), and low follow-up rates (57.1%). The database collected data from over 2 000 patients across 111 fields. After rectification, specialized database coverage rose to 61.9% (13 hospitals). Multi-level training programs developed backbone physicians and specialized nurses,significantly addressing the shortage of specialized personnel.Conclusion:The quality control system established in this study,through the integration of on-site evaluation,data registration,and specialized training,effectively enhances the standardization of surgical practices and data management capabilities.

Objective To explore the effects of eugenol combined with traditional Chinese medicine Wuxing music(EUG+MUSIC)on skin inflammation,behavioral characteristics,hormone and neurotransmitter levels,and the intestinal microbiota in a mouse model of 2,4-dinitrofluorobenzene(DNFB)-induced atopic dermatitis(AD).Methods A mouse model of AD was established by induction with DNFB for 21 consecutive days;throughout the study,changes in dorsal skin lesions and scratching behavior were recorded in mice and changes in dorsal skin lesions and pruritus were recorded.Mice underwent open-field,elevated 0 maze,tail-suspension,and forced-swimming tests on days 19 and 20.The mice were then sacrificed on day 21 and the organ index was calculated.Serum levels of immunoglobulin E,interleukin(IL)-4,and IL-10 were determined by enzyme-linked immunosorbent assay.Pathological changes in back-skin sections were detected by hematoxylin-eosin(HE)and toluidine blue staining,and brain levels of corticosterone,dopamine,and serotonin were measured.The composition of the intestinal microbiota was analyzed by 16S rRNA gene sequencing.Results The skin lesion score and skin inflammatory cell infiltration were significantly reduced in the EUG+MUSIC group.Regarding the behavioral tests,mice in the EUG+MUSIC group showed more active locomotion,an increased desire to explore unfamiliar environments,and increased struggling time in stressful situations.Brain levels of serotonin,dopamine,and corticosterone were also increased in the EUG+MUSIC group.16S rRNA gene sequencing showed that DNFB affected the diversity of the intestinal microbiota in AD mice,while EUG+MUSIC treatment remodeled the gut microbial composition,including increasing the relative abundance of gut microbes such as Ligilactobacillus and Lachnospiraceae and decreasing Parabacteroides and Bacteroides spp.Spearman's analysis showed significant correlations among altered gut microbiota,AD-associated skin manifestations,and anxiety-and depressive-like behaviors arising from comorbidities.Conclusions Eugenol combined with traditional Chinese medicine five-elements music therapy may have a positive effect on comorbid anxiety-and depression-like behaviors by regulating the intestinal microbiota and improving the behavioral performance in mice with AD,thus providing new ideas and method for improving AD and its associated anxiety-and depressive behaviors.

Objective To explore the effects of eugenol combined with traditional Chinese medicine Wuxing music(EUG+MUSIC)on skin inflammation,behavioral characteristics,hormone and neurotransmitter levels,and the intestinal microbiota in a mouse model of 2,4-dinitrofluorobenzene(DNFB)-induced atopic dermatitis(AD).Methods A mouse model of AD was established by induction with DNFB for 21 consecutive days;throughout the study,changes in dorsal skin lesions and scratching behavior were recorded in mice and changes in dorsal skin lesions and pruritus were recorded.Mice underwent open-field,elevated 0 maze,tail-suspension,and forced-swimming tests on days 19 and 20.The mice were then sacrificed on day 21 and the organ index was calculated.Serum levels of immunoglobulin E,interleukin(IL)-4,and IL-10 were determined by enzyme-linked immunosorbent assay.Pathological changes in back-skin sections were detected by hematoxylin-eosin(HE)and toluidine blue staining,and brain levels of corticosterone,dopamine,and serotonin were measured.The composition of the intestinal microbiota was analyzed by 16S rRNA gene sequencing.Results The skin lesion score and skin inflammatory cell infiltration were significantly reduced in the EUG+MUSIC group.Regarding the behavioral tests,mice in the EUG+MUSIC group showed more active locomotion,an increased desire to explore unfamiliar environments,and increased struggling time in stressful situations.Brain levels of serotonin,dopamine,and corticosterone were also increased in the EUG+MUSIC group.16S rRNA gene sequencing showed that DNFB affected the diversity of the intestinal microbiota in AD mice,while EUG+MUSIC treatment remodeled the gut microbial composition,including increasing the relative abundance of gut microbes such as Ligilactobacillus and Lachnospiraceae and decreasing Parabacteroides and Bacteroides spp.Spearman's analysis showed significant correlations among altered gut microbiota,AD-associated skin manifestations,and anxiety-and depressive-like behaviors arising from comorbidities.Conclusions Eugenol combined with traditional Chinese medicine five-elements music therapy may have a positive effect on comorbid anxiety-and depression-like behaviors by regulating the intestinal microbiota and improving the behavioral performance in mice with AD,thus providing new ideas and method for improving AD and its associated anxiety-and depressive behaviors.

Objective:To establish and assess the quality control and improvement system for metabolic and bariatric surgery in Beijing.Methods:Based on relevant documents from the National Health Commission and the Beijing Municipal Health Commission,and referencing the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) by the American Society for Metabolic and Bariatric Surgery,a quality control system was developed under the Beijing Quality Control and Improvement Center of Metabolic and Bariatric Surgery. The system incorporated on-site evaluations,data registration,and specialized training. From May to December 2023,on-site assessments were conducted at 21 hospitals in Beijing performing bariatric surgery,evaluating personnel qualifications,infrastructure,clinical workflows,and postoperative follow-up. A quality control database was created to collect real-time surgical data,and training was provided for data entry and professional skills. Assessment results were classified as excellent,qualified,or needing improvement,with rectification suggestions offered and follow-up visits conducted to track progress.Results:All 21 hospitals achieved a 100% compliance rate for surgical indications, 16 (76.2%) met standardized surgical operation criteria,and 14 (66.7%) had standardized postoperative management. However,only 5 (23.8%) achieved a 12-month postoperative follow-up rate of ≥60%,and 4 (19.1%) had established specialized databases. Key challenges included insufficient specialized staffing (19.1%), lack of multidisciplinary collaboration (47.6%), inadequate equipment (57.1%), and low follow-up rates (57.1%). The database collected data from over 2 000 patients across 111 fields. After rectification, specialized database coverage rose to 61.9% (13 hospitals). Multi-level training programs developed backbone physicians and specialized nurses,significantly addressing the shortage of specialized personnel.Conclusion:The quality control system established in this study,through the integration of on-site evaluation,data registration,and specialized training,effectively enhances the standardization of surgical practices and data management capabilities.

Objective:Based on the needs of advanced nursing practice development, to establish an indicator system of role function of position of oncology genetic nurses suitable for our national condition, and to provide a basis for position establishing of nocology genetic nurses.Methods:Initial indexes were generated through the literature review and semi-structured interviews. From September to December 2022, two rounds of expert consultations and analytic hierarchy process were conducted to establish the evaluation index for role function of position of oncology genetic nurses.Results:A total of 43 experts were included in the study, the response rates of 2 rounds were 93.62%(44/47) and 97.73%(43/44), and the authority coefficients of the experts were 0.821 and 0.853. The Kendall′s coefficients of concordance for the 2 rounds of consultations were 0.100-0.150 (all P<0.01) and 0.101-0.237 (all P<0.01). Finally, the role function system of position for oncology genetic nurses was formed, which consisted of 5 first-level indexes, 17 second-level indexes and 86 third-level indexes. Conclusions:The system of role function of position for oncology genetic nurses is reasonable, scientific and reliable, professional and specific, which can provide a theoretical reference for the development of advanced nursing practice on hereditary oncology in China.

Coronary microvascular dysfunction （CMD） is one of the important causes of myocardial ischemia and non-obstructive coronary artery ischemic symptoms. However， effective diagnostic methods and targeted treatment strategies for CMD are currently lacking. According to traditional Chinese medicine （TCM）， the comorbidity theory of "blood-vessel-cardiac collaterals" plays a central role throughout the entire development process of CMD. It suggests that in the clinical diagnosis and treatment of CMD， the treatment of blood， vessels， and cardiac collaterals should not be neglected. In light of this， insect medicines， known for their efficacy in promoting blood circulation， resolving stasis， and alleviating spasms， hold promise as a potential treatment for CMD. However， there is currently no research or summary on the use of insect medicines for the treatment of CMD. Therefore， this article took the comorbidity theory of "blood-vessel-cardiac collaterals" as the starting point and divided the pathogenesis of CMD into five evolution stages： Beginning in the blood （changes in blood components and hemorheology）， progressing in the vessels （atheromatous plaque formation and unstable plaques）， occurring in the cardiac collaterals （microvascular endothelial damage and microvascular constriction and spasms）， ending in the cardiac collaterals （microvascular remodeling）， and resulting in energy metabolism disorders throughout the process， so as to explore the pathogenesis and evolution of CMD. In addition， based on the modern pharmacological research on insect medicines， this article discussed the clinical application of insect medicines in the treatment of CMD from four aspects： Promoting blood circulation and removing blood stasis to relieve vessels' obstruction， relieving spasms to alleviate pain， combating poison with poison to disperse stagnation， and tonifying cardiac collaterals to nourish the heart， which aims to provide a theoretical basis for the use of TCM in treating CMD， broaden the scope of medication， and improve clinical efficacy.

Objective To evaluate the clinical efficacy of enameloplasty sealant technique (EST) com-bined with fluoride releasing flowable resin in pit and fissure enamel caries.Methods A total of 247 young permanent molars diagnosed as early pit and fissure enamel caries from 125 children aged 6-12 years in Uru-mqi Stomatological Hospital were selected as the study subjects.They were divided into four groups:group A (conventional cleaning of pit and fissure+conventional sealant) 32 cases,62 teeth;group B (conventional cleaning of pit and fissure+fluorine releasing flowable resin) 29 cases,62 teeth;group C (EST+conven-tional sealant) 33 cases,62 teeth;group D (EST+fluorine releasing flowable resin) 31 cases,61 teeth.After 6 and 18 months of follow-up,the retention rate of sealants and rate of caries-free were compared among the various groups.Results After 6 months of follow-up,the retention rates of sealant in groups A,B,C and D were 75.00％,76.67％,93.33％ and 95.00％ respectively,and which after 18 months of follow-up were 45.76％,41.38％,71.93％ and 94.92％ respectively,and the differences were statistically significant (P<0.05).The results of further multiple comparisons showed that there were statistically significant differences in the retention rate of sealant between group A and group C,group B and group D after 6 and 18 months of follow-up (P<0.0083),moreover there was statistically significant difference in the retention rate of sealant between group C and group D after 18 months of follow-up (P<0.0083).After 18 months of follow-up,the rates of caries-free in groups A,B,C and D were 66.10％,63.79％,94.74％ and 98.31％,respectively.The re-sults of further multiple comparisons showed that the rates of caries-free between group A and group C,group B and group D were statistically significantly different (P<0.0083).Conclusion The retention rate of seal-ant and long-term caries prevention effect of adopting the EST in the treatment of pit and fissure enamel caries are superior to the conventional sealant technique.EST combining with fluorine releasing flowable resin could further increase the retention rate of sealant.

BACKGROUND: Management of gastric leak after sleeve gastrectomy (SG) is challenging due to its unpredictable outcomes. We aimed to summarize the characteristics of SG leaks and analyze interventions and corresponding outcomes in a real-world setting. METHODS: To retrospectively review of 15,721 SG procedures from 2010 to 2020 based on a national registry. A cumulative sum analysis was used to identify a fitting curve of gastric leak rate. The Kaplan-Meier method and log-rank tests were performed to calculate and compare the probabilities of relevant outcomes. The logistic regression analysis was conducted to determine the predictors of acute leaks. RESULTS: A total of 78 cases of SG leaks were collected with an incidence of 0.5% (78/15,721) from this registry (6 patients who had the primary SG in non-participating centers). After accumulating 260 cases in a bariatric surgery center, the leak rate decreased to a stably low value of under 1.17%. The significant differences presented in sex, waist circumference, and the proportion of hypoproteinemia and type 2 diabetes at baseline between patients with SG leak and the whole registry population ( P = 0.005, = 0.026, <0.001, and = 0.001, respectively). Moreover, 83.1% (59/71) of the leakage was near the esophagogastric junction region. Leakage healed in 64 (88.9%, 64/72) patients. The median healing time of acute and non-acute leaks was 5.93 months and 8.12 months, respectively. Acute leak (38/72, 52.8%) was the predominant type with a cumulative reoperation rate >50%, whereas the cumulative healing probability in the patients who required surgical treatment was significantly lower than those requring non-surgical treatment ( P = 0.013). Precise dissection in the His angle area was independently associated with a lower acute leak rate, whereas preservation ≥2 cm distance from the His angle area was an independent risk factor. CONCLUSIONS Male sex, elevated waist circumference, hypoproteinaemia, and type 2 diabetes are risk factors of gastric leaks after SG. Optimizing surgical techniques, including precise dissection of His angle area and preservation of smaller gastric fundus, should be suggested to prevent acute leaks.
Humans ; Male ; Retrospective Studies ; Diabetes Mellitus, Type 2/complications* ; Obesity, Morbid ; Anastomotic Leak/epidemiology* ; Gastrectomy/methods* ; Reoperation/methods* ; Registries ; Laparoscopy/methods* ; Treatment Outcome