Objective To strengthen nursing awareness and attention,and improve the quality of medication and nursing care,Meta-analysis was used to evaluate the occurrence of sodium-glucose transporter 2 inhibitor related ketoacidosis.Methods Relevant randomized controlled trials were searched in 6 databases,such as CNKI,PubMed,Embase,and the Clinical trial platform,and the literature was screened based on inclusion and exclusion criteria.The search time was from the establishment of databases to January 2023.Revman 5.4.1 was used for quality evaluation and Meta-analysis.Results 24 randomized controlled trials were included.The Meta-analysis results showed that sodium-glucose transporter 2 inhibitors increased the incidence of ketoacidosis(RR=2.52,95％CI[1.82,3.49],P＜0.001).Subgroup analysis showed that the sodium-glucose transporter 2 inhibitors increased the incidence of ketoacidosis in patients with type 2 diabetes(RR=2.42,95％CI[1.70,3.43],P＜0.001),cardiovascular disease(RR=2.32,95％CI[1.59,3.39],P＜0.001),and chronic kidney disease(RR=2.82,95％CI[1.73,4.58],P＜0.001).Cargliflozin(RR=3.21,95％CI[1.43,7.18],P=0.005),Daggliflozin(RR=2.73,95％CI[1.51,4.93],P＜0.001),and Sogliflozin(RR=1.92,95％CI[1.06,3.50],P=0.030)increased the incidence of ketoacidosis,while Engliflozin(RR=1.80,95％CI[0.79,4.11],P=0.160)did not have a significant effect.When the eGFR of patients≤60(mUmin/1.73m2)(RR=2.74,95％CI[1.63,4.60],P＜0.001),the duration of medication≤ 12 month(RR=3.31,95％CI[1.79,6.12],P＜0.001),or the duration of medication＞12 month(RR=2.19,95％CI[1.23,3.91],P=0.008),the sodium-glucose transporter 2 inhibitors increased the occurrence of ketoacidosis.Conclusion For patients receiving sodium-glucose transporter 2 inhibitors treatment regardless of whether they are complicated with diabetes,especially those with heart and kidney diseases,in the early and middle stages of medication,with eGFR ≤60 ml/(min·1.73m2),and those with other susceptibility factors,we should strengthen the observation of patients'medication,optimize medication care,and early identify and intervene in the occurrence of ketoacidosis.

Objective To evaluate the correlation between residual cholesterol(RC)and pre-diabetes(Pre-DM)conversion.Methods The data of this research came from the SENSIBILE-Cohort study,which included 2741 individuals with Pre-DM and followed up for 3 years.RC=TC-HDL-C-LDL-C.Logistic regression analysis was used to identify the factors influencing the progression of Pre-DM to DM and the return to normal blood glucose,while multiple linear regression analysis was used to identify the influencing factors for RC.Results During a 3-year follow-up period,1659 cases(60.5%)of the Pre-DM population maintained Pre-DM status,351 cases(12.8%)progressed to DM,and 731 cases(26.7%)returned to normal blood glucose.Logistic regression analysis showed that when defining Pre-DM according to ADA diagnostic criteria,high RC was the influencing factor for Pre-DM progression to DM and return to normal BG in the unadjusted model.After adjusting for age,gender,nationality,BMI,SBP,smoking,drinking,SUA,TG,exercise and meat diet,high RC may reduce the likelihood of Pre-DM returning to normal blood glucose,but RC is not a contributing factor to the progression of Pre-DM to DM.Multiple linear regression analysis shows that SBP,DBP,2 hPG,triglyceride/glucose index,Chinese visceral fat index,and lipid accumulation products are the influencing factors for RC.Conclusions High RC reduces the likelihood of Pre-DM returning to normal blood glucose.RC is not a contributing factor to the progression of Pre-DM to DM.

Objective:To investigate the carriage status of Neisseria meningitidis ( Nm) among the healthy population in Hebei Province for the prevention and control of meningitis. Methods:From 2015 to 2022, throat swabs were collected from health people, which were selected by cluster random sampling in 11 cities of Hebei.The positive rate of Nm was detected by bacterial culture. The serogroups of isolated strains were identified.The laboratory detection results of Nm strains, combined with epidemiological survey data, were synthetically analyzed. Results:A total of 20 245 people were investigated; 249 strains of Nm were isolated; the overall Nm carriage rate was 1.23%. The carriage rate was significantly higher in men than in women(χ 2=28.831, P<0.05). The positive rates of Nm in different age groups were significantly different(χ 2=428.018, P<0.05), with the highest rates in the 15-19 year-old group(4.90%, 149/3 042). The positive rates of Nm were significantly different in different regions(χ 2=177.512, P<0.05), with the highest positive rate of Nm in Xingtai, Shijiazhuang, Chengde and Baoding city in sequence. Among the isolated Nm strains, ungroupable serogroups, serogroup B, serogroup C, and serogroup W accounted for 71.49%(178/249), 13.65%(34/249), 6.83%(17/249) and 4.42%(11/249), respectively. Conclusions:The carriage rate of Nm among healthy population is generally low in Hebei Province. It is recommended to continue to strengthen monitoring, pay attention to the changes and distribution characteristics of Nm, and formulate scientific and targeted prevention and control measures of meningococcal disease.

Macrophages are important cell types involved in skin wound healing. In this article, recent advances in macrophage-mediated regulation of skin wound healing and the abnormal polarization of macrophages in diabetic refractory wounds are reviewed. Studies have shown that macrophages in skin wounds can be categorized into two types, M1 and M2. These two types exhibit different functions, including anti-inflammatory effects, angiogenesis promotion, fibroblast promotion and tissue shaping. The dysfunctions of macrophages, cytokine secretion and epigenetic modifications in diabetes mellitus can lead to abnormal polarization of macrophages. Targeting the regulation of macrophage polarization may be an effective approach to addressing skin refractory wounds.

Macrophages are important cell types involved in skin wound healing. In this article, recent advances in macrophage-mediated regulation of skin wound healing and the abnormal polarization of macrophages in diabetic refractory wounds are reviewed. Studies have shown that macrophages in skin wounds can be categorized into two types, M1 and M2. These two types exhibit different functions, including anti-inflammatory effects, angiogenesis promotion, fibroblast promotion and tissue shaping. The dysfunctions of macrophages, cytokine secretion and epigenetic modifications in diabetes mellitus can lead to abnormal polarization of macrophages. Targeting the regulation of macrophage polarization may be an effective approach to addressing skin refractory wounds.

Idiopathic pulmonary fibrosis (IPF) is a progressive disease with unknown etiology and limited therapeutic options. Activation of fibroblasts is a prominent feature of pulmonary fibrosis. Here we report that lncRNA DACH1 (dachshund homolog 1) is downregulated in the lungs of IPF patients and in an experimental mouse model of lung fibrosis. LncDACH1 knockout mice develop spontaneous pulmonary fibrosis, whereas overexpression of LncDACH1 attenuated TGF-β1-induced aberrant activation, collagen deposition and differentiation of mouse lung fibroblasts. Similarly, forced expression of LncDACH1 not only prevented bleomycin (BLM)-induced lung fibrosis, but also reversed established lung fibrosis in a BLM model. Mechanistically, LncDACH1 binding to the serine/arginine-rich splicing factor 1 (SRSF1) protein decreases its activity and inhibits the accumulation of Ctnnb1. Enhanced expression of SRSF1 blocked the anti-fibrotic effect of LncDACH1 in lung fibroblasts. Furthermore, loss of LncDACH1 promoted proliferation, differentiation, and extracellular matrix (ECM) deposition in mouse lung fibroblasts, whereas such effects were abolished by silencing of Ctnnb1. In addition, a conserved fragment of LncDACH1 alleviated hyperproliferation, ECM deposition and differentiation of MRC-5 cells driven by TGF-β1. Collectively, LncDACH1 inhibits lung fibrosis by interacting with SRSF1 to suppress CTNNB1 accumulation, suggesting that LncDACH1 might be a potential therapeutic target for pulmonary fibrosis.

Objective:To investigate the clinical effect of minimally invasive scar release combined with autologous microfat graft in the treatment of facial depressed scar.Methods:From September 2015 to May 2019, a total of 11 patients who had facial depressed scar were treated with minimally invasive scar release combined with autologous microfat graft in Huaihe Hospital of Henan University. Needle scar separator or 10 ml syringe needle was inserted under skin to release scar adhesion thoroughly. Microfat was harvested from the abdomen, which was separated and purified, and then evenly transplanted into the stripped space (0.5 cm wider than the edge of scar) under the scar with a 1 ml syringe. The severity of scar was evaluated pre-operation, 3-month post-operation and 6-month post-operation, using Vancouver Scar Scale score and Stony Brook Scar Evaluation Scale score to evaluate the efficacy. Using Visual Analogue Scale score to evaluate patient satisfaction. Analyses were performed using SPSS Statistics 25.0, and measurement data were expressed as Mean±SD if they conformed to normality and homogeneity of variance. One-way ANOVA was used for multi-time point data, and the Bonferroni test was performed for pairwise comparison. P<0.05 was considered a statistically significant difference. Results:The depression of scars disappeared immediately after treatment. 6 months after treatment, the surface of the scars was flat, the color and elasticity were close to adjacent normal skin, and the texture of the scars was soft. All patients were followed up for 6 months without recurrence, and 11 patients were satisfied. In Vancouver Scar Scale score, the pre-operation score was 7.27±1.10, the 3-month post-operation score was 2.64±0.81 and the 6-month post-operation score was 0.91±0.54, showing a significant difference ( F=467.98, P<0.001). Pairwise comparison result show that comparing the pre-operation score with 3 or 6 months post-operation score, showing a significant difference ( P<0.001). The comparison between 3 and 6 months post-operation score also showing a significant difference ( P<0.001). In Stony Brook Scar Evaluation Scale score, the pre-operation score was (2.00±0.89), the 3-month post-operation score was 4.45±0.69 and the 6-month post-operation score was 4.45±0.69, showing a significant difference ( F=67.00, P<0.001). Pairwise comparison result show that comparing pre-operation score with 3 or 6 months post-operation score, showing a significant difference ( P<0.001). The comparison between 3 and 6 months post-operation score also showing a significant difference ( P=0.006). The 6-month post-operation Visual Analogue Scale score was 95.0±6.74. Conclusions:Minimally invasive scar release combined with autologous microfat graft in the treatment of facial depressed scar can avoid the post-surgery scar formation and adhesion, and improve the color and texture of the facial hypertrophic scar. This method can be carried out under local anesthesia, with simple procedure and exact effect.

Objective:To investigate the clinical effect of minimally invasive scar release combined with autologous microfat graft in the treatment of facial depressed scar.Methods:From September 2015 to May 2019, a total of 11 patients who had facial depressed scar were treated with minimally invasive scar release combined with autologous microfat graft in Huaihe Hospital of Henan University. Needle scar separator or 10 ml syringe needle was inserted under skin to release scar adhesion thoroughly. Microfat was harvested from the abdomen, which was separated and purified, and then evenly transplanted into the stripped space (0.5 cm wider than the edge of scar) under the scar with a 1 ml syringe. The severity of scar was evaluated pre-operation, 3-month post-operation and 6-month post-operation, using Vancouver Scar Scale score and Stony Brook Scar Evaluation Scale score to evaluate the efficacy. Using Visual Analogue Scale score to evaluate patient satisfaction. Analyses were performed using SPSS Statistics 25.0, and measurement data were expressed as Mean±SD if they conformed to normality and homogeneity of variance. One-way ANOVA was used for multi-time point data, and the Bonferroni test was performed for pairwise comparison. P<0.05 was considered a statistically significant difference. Results:The depression of scars disappeared immediately after treatment. 6 months after treatment, the surface of the scars was flat, the color and elasticity were close to adjacent normal skin, and the texture of the scars was soft. All patients were followed up for 6 months without recurrence, and 11 patients were satisfied. In Vancouver Scar Scale score, the pre-operation score was 7.27±1.10, the 3-month post-operation score was 2.64±0.81 and the 6-month post-operation score was 0.91±0.54, showing a significant difference ( F=467.98, P<0.001). Pairwise comparison result show that comparing the pre-operation score with 3 or 6 months post-operation score, showing a significant difference ( P<0.001). The comparison between 3 and 6 months post-operation score also showing a significant difference ( P<0.001). In Stony Brook Scar Evaluation Scale score, the pre-operation score was (2.00±0.89), the 3-month post-operation score was 4.45±0.69 and the 6-month post-operation score was 4.45±0.69, showing a significant difference ( F=67.00, P<0.001). Pairwise comparison result show that comparing pre-operation score with 3 or 6 months post-operation score, showing a significant difference ( P<0.001). The comparison between 3 and 6 months post-operation score also showing a significant difference ( P=0.006). The 6-month post-operation Visual Analogue Scale score was 95.0±6.74. Conclusions:Minimally invasive scar release combined with autologous microfat graft in the treatment of facial depressed scar can avoid the post-surgery scar formation and adhesion, and improve the color and texture of the facial hypertrophic scar. This method can be carried out under local anesthesia, with simple procedure and exact effect.

Objective To investigate the mechanism of rapamycin inhibiting the differentiation and proliferation of newborn porcine pancreatic adult stem cells, and to explore the therapeutic methods that may effectively reduce the side effects of rapamycin. Method Porcine NPCCs were treated with rapamycin alone or in combination with IGF-Ⅱ, and the caspase-3 and [ 3 H ]-thymidine uptake assays were performed to detect apoptosis and proliferation. The expression of insulin, PDX-1, NeuroD/Beta2, and Foxo1, a downstream transcription factor of IGF-Ⅱ, were analyzed by RT-PCR and Western blot to evaluate the differentiation ability of pancreatic adult stem cells. Results The NPCCs treated with rapamycin inhibited the proliferation ofβ-cells, increased apoptosis, reduced insulin secretion, inhibited the expression of PDX-1 and NeuroD/Beta2, and decreased the expression of IGF-Ⅱ. Foxo1 expression and induction of Foxo1 from the cytoplasm to the nucleus of the ectopic. The combined treatment of rapamycin and IGF-Ⅱcan reduce the side effects of rapamycin, inhibit the decrease ofβ-cell number and insulin content, repair the expression of insulin, PDX-1, NeuroD/Beta2, inhibit Foxo1 expression and intracellular ectopic. Conclusion Aberrant expression of IGF-Ⅱ and Foxol genes is the key inducing factor of rapamycin inhibiting the proliferation and differentiation of NPCCs, and IGF-Ⅱtreatment can effectively reduce the side effects of rapamycin on NPCCs differentiation.

Ninety-one patients over 60 year old with type 2 diabetes mellitus(T2DM) were selected from our outpatient department. The patients of experimental group uploaded their blood glucose data detected with glucometers, and obtained integrated management called " Mobile Health(M-health)" management such as medicines,diet,exercise from medical groups. The patients of control group got medical care in a traditional way without receiving other interventions. Regular follow-up was conducted in 2 groups every 3 months. The results showed that 3 months later,postprandial 2h plasma glucose in the experimental group was significantly improved compared with that of control group (P<0.05). Six months later, postprandial 2h plasma glucose and HbA1Clevels in the experimental group showed a decline comparing to the baseline, showing a statistical significance compared with control group(P<0.05). These results suggest that smartphone-based telemedicine is helpful of blood glucose control in elderly T2DM patients.