BACKGROUND:Exercise has a regulatory effect on intestinal flora and glucose metabolism,but the effects of high-intensity intermittent exercise on intestinal flora and glucose metabolism in patients with type 2 diabetes mellitus are unclear. OBJECTIVE:To investigate the effects of high-intensity intermittent exercise on glucose metabolism and intestinal flora in patients with type 2 diabetes mellitus. METHODS:Eleven patients with type 2 diabetes mellitus were recruited,among which,two were lost to the follow-up and nine were finally enrolled.High-intensity intermittent exercise intervention was conducted 3 times per week for 6 continuous weeks.Fasting blood and fecal samples were collected before and after the intervention.Glucose metabolism indexes were detected in the blood samples,and intestinal flora was detected in the fecal samples.Changes in glucose metabolism indexes and intestinal flora indexes of the patients with type 2 diabetes mellitus before and after the intervention were compared. RESULTS AND CONCLUSION:After 6 weeks of high-intensity intermittent exercise intervention,fasting blood glucose and glycosylated serum protein levels in patients were significantly reduced(P<0.05),and fasting insulin,although not significantly changed,was decreased compared with before intervention.Alpha diversity analysis showed that the diversity(Shannon index),richness(Chao index)and coverage(Coverage index)did not change significantly.Venn diagrams showed that the relative abundance of Bacteroidetes,Actinobacteria,Proteobacteria,and Fusobacteria in the intestinal flora of the patients increased,and the relative abundance of Firmicutes decreased,and a significant decrease was seen in Ruminococcus_torques and Ruminococcus_gnavus in the Firmicutes,which were both positively correlated with the abnormalities of the glycemic metabolism-related indicators,as well as with other disease development.All these findings indicate that high-intensity intermittent exercise intervention has an improvement effect on the glycemic metabolism-related indexes of patients with type 2 diabetes mellitus,and the abundance of beneficial flora in the intestinal tract increases,and the abundance of harmful flora decreased,enhancing the stability of the intestinal flora in patients.

ObjectiveTo investigate the infestation of bedbugs in a staff dormitory in Jiading District, Shanghai, to explore the measures to dispose Cimex lectularius linnaeus, so as to provide a scientific basis for the prevention and control of bedbugs. MethodsThe infestation of bedbugs in the dormitory of the company was determined through field investigation, accompanied by scientific guidance under the comprehensive control measures and an effect evaluation of the control results. ResultsA total of 114 rooms distributed in 3 dormitory buildings were investigated, with an average infestation rate of 42.11%, of which building B has the highest infestation rate of 51.52%. Six bedbug specimens were collected by visual inspection in the room, and all of them were identified as Cimex lectularius linnaeus. After a series of comprehensive control measures including environmental cleanup, aerosol elimination, replacement of wooden beds with iron frame beds, and purchase of all-inclusive mattress, the bedbug infestation rate dropped to 5.26%. ConclusionComprehensive control can effectively prevent the breeding and spread of bedbugs. Dissemination and education effort should be strengthened in case of the occurrence of bedbug infestation, together with an implementation of long-term and continuous surveillance and monitoring.

Objective:Utilizing the principles of mechanical vibrations dissections and low-temperature coagulation of harmonic scalpel, and combining the magnifying effect of 3D thoracoscopy and the advantage of low trauma, we used harmonic scalpel to harvest the left internal mammary artery (LIMA) under thoracoscopy, and explored the feasibility and early effect of harmonic scalpel in minimally invasive coronary artery bypass grafting (MICABG).Methods:A total of 488 patients who underwent MICABG from July 2021 to December 2023 in Dong E Hospital were collected. Among them, 347 patients was harvested using harmonic scalpel under thoracoscopy. Following anastomosis, the blood flow and pulsatility index (PI) from the graft to the target vessel were determined using a transit time flow meter (MiraQ, Medistim, Norway), and patency was checked. Data from 347 patients were analyzed.Results:All 347 patients were performed under non-extracorporeal circulation and successful graft patency was achieved in all patients. Analysis of 79 patients revealed a median time to LIMA acquisition of 32 min and a median length of acquisition of 15 cm. No graft-related events or complications occurred in any of the patients, and 2 patients died postoperatively. During a median follow-up of 12.1 months, only one patient experienced graft occlusion necessitating intervention.Conclusion:The utilization of harmonic scalpel for LIMA harvesting in MICABG is feasible and yields stable early results.

Objective:To compare the effectiveness of a new virtual reality (VR) working memory test system with that of the traditional E-prime working memory test system in terms of evaluating executive function in cognitive rehabilitation.Methods:Two experienced rehabilitation therapists tested 30 healthy subjects. The average reaction time and accuracy of the traditional and the VR-based working memory test systems in completing the 2-back task were compared. The usability and user experience of the VR-based working memory test system were also evaluated using the system usability scale (SUS), a simulator discomfort scale (SSQ) and semi-structured interviews.Results:There was no significant difference in the average reaction time and accuracy of the 30 subjects between the two different tests. The SUS score of the VR working memory test was at the " Good-Excellent" level, and the SSQ scores demonstrated that no significant discomfort was observed. In the interviews the VR working memory test system was described as easy to operate and as having a strong sense of immersion.Conclusions:The VR-based working memory test system has good usability and user acceptance, and can provide subjects with an immersive and persona-lized test scenario. Therefore, it can be used as a tool for testing working memory.

Objective:To compare the effectiveness of a new virtual reality (VR) working memory test system with that of the traditional E-prime working memory test system in terms of evaluating executive function in cognitive rehabilitation.Methods:Two experienced rehabilitation therapists tested 30 healthy subjects. The average reaction time and accuracy of the traditional and the VR-based working memory test systems in completing the 2-back task were compared. The usability and user experience of the VR-based working memory test system were also evaluated using the system usability scale (SUS), a simulator discomfort scale (SSQ) and semi-structured interviews.Results:There was no significant difference in the average reaction time and accuracy of the 30 subjects between the two different tests. The SUS score of the VR working memory test was at the " Good-Excellent" level, and the SSQ scores demonstrated that no significant discomfort was observed. In the interviews the VR working memory test system was described as easy to operate and as having a strong sense of immersion.Conclusions:The VR-based working memory test system has good usability and user acceptance, and can provide subjects with an immersive and persona-lized test scenario. Therefore, it can be used as a tool for testing working memory.

Objective:Utilizing the principles of mechanical vibrations dissections and low-temperature coagulation of harmonic scalpel, and combining the magnifying effect of 3D thoracoscopy and the advantage of low trauma, we used harmonic scalpel to harvest the left internal mammary artery (LIMA) under thoracoscopy, and explored the feasibility and early effect of harmonic scalpel in minimally invasive coronary artery bypass grafting (MICABG).Methods:A total of 488 patients who underwent MICABG from July 2021 to December 2023 in Dong E Hospital were collected. Among them, 347 patients was harvested using harmonic scalpel under thoracoscopy. Following anastomosis, the blood flow and pulsatility index (PI) from the graft to the target vessel were determined using a transit time flow meter (MiraQ, Medistim, Norway), and patency was checked. Data from 347 patients were analyzed.Results:All 347 patients were performed under non-extracorporeal circulation and successful graft patency was achieved in all patients. Analysis of 79 patients revealed a median time to LIMA acquisition of 32 min and a median length of acquisition of 15 cm. No graft-related events or complications occurred in any of the patients, and 2 patients died postoperatively. During a median follow-up of 12.1 months, only one patient experienced graft occlusion necessitating intervention.Conclusion:The utilization of harmonic scalpel for LIMA harvesting in MICABG is feasible and yields stable early results.

Objective To construct and evaluate a disulfidptosis-related genes(DRGs)prognostic risk model for hepatocellular carcinoma(HCC)based on the cancer genome atlas(TCGA)database.Methods The expression of 15 DRGs in 371 HCC samples and 50 adjacent cancer samples in the TCGA database was analyzed using bioinformatics methods,and then gene ontology(GO)functional annotation,Kyoto encyclopedia of genes and genomes(KEGG)enrichment analysis and Kaplan-Meier(KM)survival analysis were performed.Statistical significant DRGs were screened through univariate COX regression analysis,and key DRGs were selected through LASSO regression analysis and multivariate COX regression analysis to construct a prognostic risk model.HCC patients were divided into high-risk and low-risk groups based on risk scores,and the KM survival curves and time-dependent receiver operator characteristic(ROC)curves were created to validate and evaluate prognostic risk models.Results Compared with the adjacent cancer samples,FLNA,MYH9,TLN1,ACTB,MYL6,CAPZB,DSTN,ACTN4,SLC7A11,INF2,CD2AP,PDLIM1,and FLNB were all upregulated in the 15 DRGs of HCC samples,and the differences were significant(t=1 793～6 310,all P<0.001).According to GO functional annotation and KEGG enrichment analysis,DRGs were closely related to biological processes or pathways related to actin cytoskeleton and cell adhesion.The results of KM survival analysis showed that the survival rate of the high expression group of SLC7A11,INF2,CD2AP,MYL6,and ACTB were lower than that of the low expression group[HR=1.46(1.03～2.07)～1.93(1.36～2.75),all P<0.05].Univariate COX regression analysis,LASSO analysis,and multivariate COX regression analysis were used to construct a prognostic risk model,with risk score=(0.247×SLC7A11)+(0.289×INF2)+(0.076×CD2AP)+(0.06×MYL6).The risk score of the sample in this model was calculated,and the higher the risk score,the more HCC patients with poor prognosis.KM survival analysis showed that the overall survival rate of the high-risk group was lower than that of the low-risk group.The AUC values for 1,3,and 5 years were 0.709,0.661,and 0.648,respectively.Multivariate COX regression analysis showed that SLC7A11[HR=1.832(1.274～2.636),P=0.001]was an independent prognostic risk factor.Conclusion The prognostic risk model was constructed by four DRGs,which has a certain role in predicting the prognosis of HCC patients.

ObjectiveTo investigate the current status and influencing factors of hand hygiene practices among primary healthcare workers， and to provide a reference for improving hand hygiene behavior in primary healthcare institutions. MethodsA self-designed questionnaire was used to conduct a survey among medical staff of seven community health service centers in Jiading District， Shanghai， using a cluster random sampling method. The data collected were subjected to descriptive statistics， reliability and validity tests， correlation analysis， and structural equation model fitting. ResultsA statistical difference in hand hygiene compliance was found among medical staff with varying occupational types and educational levels （P<0.05）， and medical staff in clinical departments exhibited higher levels of hand hygiene compliance （P<0.05）. In the health belief model， among the core variables， healthcare workers’ perceived benefits， perceived barriers， and self-efficacy had a direct impact on hand hygiene behavior， with direct effect values of 0.341， -0.152， and 0.234， respectively. Meanwhile， cues to action and perceived severity of COVID-19 infection indirectly affected hand hygiene behavior， with an indirect effect value of 0.066 and 0.062， respectively. ConclusionHealthcare workers generally exhibit a high degree of hand hygiene compliance， but there are variations in hand hygiene scores among healthcare workers with different characteristics. Enhancing healthcare worders’ perception of benefits， action cues， and self-efficacy while reducing perceived barriers can effectively improve their hand hygiene behavior.

Objective: To analyze the HIV detection results through different detection routes in Jiading District, Shanghai Municipality from 2009 to 2023, so as to provide the reference for improving HIV detection measures. Methods: Data pertaining to HIV detection in Jiading District from 2009 to 2023 was collected through the HIV/AIDS Comprehensive Control System of Chinese Disease Prevention and Control Information System. The number of HIV detection and HIV positive rates through detection routes including voluntary counseling and testing (VCT) clinics, sexually transmitted disease (STD) clinics, pre-operation and blood transfusion (products), premarital and antenatal periods, other clinical outpatients and other populations were described. Results: A total of 1 729 347 HIV tests were conducted in Jiading District from 2009 to 2023, with an average annual growth rate of 7.55%. A total of 1 125 HIV positive cases were confirmed, with an HIV positive rate of 6.51/104. The number of HIV detection conducted in VCT clinics, STD clinics, pre-operation and blood transfusion (products), premarital and antenatal periods, other clinical outpatients and other populations were 11 516, 112 880, 692 609, 635 770, 196 315 and 80 257, respectively. The main detection routes were pre-operation and blood transfusion (products) as well as premarital and antenatal periods, accounting for 40.05% and 36.76%, respectively. The HIV positive rates in VCT clinics, STD clinics, pre-operation and blood transfusion (products), premarital and antenatal periods, other clinical outpatients and other populations were 336.05/104, 21.79/104, 2.93/104, 0.35/104, 10.95/104 and 6.48/104, respectively. The HIV positive rate in VCT clinics was higher than that in other detection routes (all P<0.001). Conclusions From 2009 to 2023, the number of HIV tests increased in Jiading District, mainly through pre-operation and blood transfusion (products) as well as premarital and antenatal periods. The HIV positive rate was the highest in VCT clinics.

Objective:To compare the clinical effects of endoscopic thyroidectomy using the modified gasless transaxillary approach (TA group) and transsubclavian approach (TS group) in the treatment of cN0 papillary thyroid carcinoma (PTC) .Methods:A total of 190 PTC patients (mean age 39.88±9.35 years,38 males, 152 females), who underwent unilateral thyroidectomy in the Department of Thyroid Surgery, the First Hospital of Jilin University from Oct. 2020 to Oct. 2022 were retrospectively analyzed, including 65 cases in TA group, 43 cases in TS group and 82 cases through traditional neck approach (TN group). The endoscopic group (TA+TS) consists of the TA group and the TS group. Comparative analyses were performed on operation time, full exposure rate of central compartment, postoperative hospitalization time, postoperative drainage, hospitalization costs, the number of dissected lymph nodes and postoperative complications. The t-test or Wilcoxon rank sum test, the χ2 test or the exact probability method were used for statistical analysis. Results:All endoscopic operations were successfully completed without conversion to traditional neck approach. ① Compared with the TN group, the endoscopic group (TA+TS) had longer operation time[TN group =74.5 (65-87) min, (TA+TS) group =102 (89-121) min, P<0.001], lower full exposure rate of central compartment (TN group=100%, (TA+TS) group=89.8%, P=0.008), more postoperative drainage[TN group=60 (45-76) ml, (TA+TS) group =100 (80-130) ml, P<0.001], higher hospitalization costs[TN group=￥23638 (22158-25901), (TA+TS) group =￥26967 (25572-28284), P<0.001], and higher parathyroid autotransplantation rate (TN group=4.9%, (TA+TS) group =50.9%, P<0.001). There were no significant differences in the number of dissected lymph nodes, the number of metastatic lymph nodes, preoperative and postoperative parathyroid hormone (PTH) ( P>0.05). ② Compared with the TS group, the TA group had longer operation time[TA group=110 (97-127) min, TS group=89 (80-111) min, P<0.001], lower full exposure rate of central compartment (TA group=83.1%, TS group=100%, P=0.012), longer postoperative hospitalization time[TA group=3 (3-4) d, TS group=3 (3-3) d, P=0.002], more postoperative drainage[TA group=110 (82-140) ml,TS group=95 (65~120) ml, P=0.046] and higher hospitalization costs (TA group=￥27510±2578,TS group=￥26609±1878, P=0.038). There were no significant differences in the number of dissected lymph nodes, the number of metastatic lymph nodes, preoperative and postoperative PTH, and parathyroid autotransplantation between the two groups ( P>0.05) . Conclusions:Endoscopic thyroidectomy through axillary/subclavian approach is safe and feasible for the treatment of cN0 PTC. There was no significant difference in the number of dissected central lymph nodes compared with conventional surgery, and the incision was well concealed. In comparison, transsubclavian endoscopic surgery has better clinical application value, with shorter operation time, higher full exposure rate of central compartment and faster postoperative recovery.