OBJECTIVES: The magnesium depletion score (MDS) is considered more reliable than traditional approaches for predicting magnesium deficiency in humans. We explored the associations of MDS and dietary magnesium intake with diabetes. METHODS: We obtained data from 18,853 participants in the National Health and Nutrition Examination Survey 2011-2018. Using multivariate regression and stratified analysis, we investigated the relationships of both MDS and magnesium intake with diabetes. To compute prevalence ratios (PRs), we employed modified Poisson or log-binomial regression. We characterized the non-linear association between magnesium intake and diabetes using restricted cubic spline analysis. RESULTS: Participants with MDS ≥2 exhibited a PR of 1.26 (95% confidence interval [CI], 1.19 to 1.34) for diabetes. Per-standard deviation (SD) increase in dietary magnesium intake was associated with a lower prevalence of diabetes (PR, 0.91; 95% CI, 0.87 to 0.96). Subgroup analyses revealed a positive association between MDS ≥2 and diabetes across all levels of dietary magnesium intake, including the lowest (PR, 1.35; 95% CI, 1.18 to 1.55), middle (PR, 1.23; 95% CI, 1.12 to 1.35), and highest tertiles (PR, 1.25; 95% CI, 1.13 to 1.37; pinteraction<0.001). Per-SD increase in magnesium intake was associated with lower diabetes prevalence in participants with MDS <2 (PR, 0.92; 95% CI, 0.87 to 0.98) and those with MDS ≥2 (PR, 0.91; 95% CI, 0.84 to 0.98; pinteraction=0.030). CONCLUSIONS MDS is associated with diabetes, particularly among individuals with low magnesium intake. Adequate dietary magnesium intake may reduce diabetes risk, especially in those with high MDS.

Objective:To explore the association between different feeding patterns, emotional states, and salivary oxytocin (OT) levels during breastfeeding.Methods:From January to December 2019, 153 pairs of 3-month-old infants and their mothers were recruited from 4 maternal and child health hospitals in Chongqing, Liuzhou, Dalian and Hangzhou in China.Saliva samples were collected from the mothers at the first 5 minutes of feeding, 5 minutes during feeding, and 10 minutes after feeding.Edinburgh postnatal depression scale (EPDS) was used to evaluate maternal depression.Infants were divided into exclusive breastfeeding group and artificial feeding group according to feeding patterns.ELISA of salivary oxytocin was performed by ELISA kits, and the OT levels measured at the 3 time points were converted using linear interpolation.Area under the curve with respect to ground(OTAUCG) was used to represent the total concentration of salivary OT during the mother's breastfeeding.SPSS 25.0 software was used for statistical analysis.Multiple linear regression analysis and two factors analysis of variance were used to explore the association between different feeding methods, emotional state and salivary oxytocin during breastfeeding.Results:The results of the two factors analysis of variance showed that the interaction between feeding pattern and mother's emotion was not significant ( F=2.440, P=0.120), the main effect of mother's emotion was not significant ( F=0.380, P=0.539), and the main effect of feeding style was significant ( F=3.350, P=0.021). The level of OTAUCG under pure breastfeeding ((151 561.47±75 738.11) pg/mL) was higher than that under artificial feeding ((122 269.03±65 029.88) pg/mL), and the difference was statistically significant ( P=0.02). There was no statistically significant difference in OTAUCG levels between mothers with normal emotions ((146 106.37±75 106.76) pg/mL) and mothers with depressed emotions ((129 079.56±67 565.87) pg/mL) ( P=0.221). Multiple stepwise regression analysis showed that artificial feeding had a negative predictive effect on maternal salivary OT levels compared to exclusive breastfeeding( β=-0.211, t=-2.513, P=0.013). Conclusion:Feeding pattern is a factor that affects the mother's salivary OT level, and breastfeeding can improve the mother's OT level.

Objective:To develop an age-appropriate and disease-specific social adaptation measurement tool for adolescents infected with HIV in the context of Chinese culture, and to test its reliability and validity.Methods:Through literature review and consultation with 8 experts, this study constructed the conceptual framework of social adaptation of adolescents infected with HIV and formulated the dimensions and items of the scale. The convenient sampling method was adopted, and questionnaires were distributed online and offline at Beijing Ditan Hospital, Xuzhou Center for Disease Control and Prevention and Yunnan Provincial Infectious Disease Hospital from October 2020 to February 2021 for questionnaire validity testing. A preliminary age-specific and disease-adaptable Social Adaptation Scale for HIV Infected Adolescents was prepared using methods such as project analysis and reliability and validity testing.Results:The scale consisted of 3 dimensions of cognition, emotion and will, 5 variables, and a total of 23 items. The Cronbach's α coefficient of the scale was 0.856, and the split reliability was 0.836. The item-level content validity index ( I- CVI) of the scale was 0.750-1.000, the scale-level content validity index ( S- CVI) was 0.940, and the scale score and subjective well-being scale score were positivelycorrelated ( P<0.05) . Factor analysis extracted 5 common factors, and the cumulative explanatory variable was 61.156%. Conclusions:The scale has good reliability, validity and feasibility, which can be used as an evaluation tool for social adjustment of HIV-infected adolescents in China.

Objective: To explore the clinical effect and safety of minor liver resection for hilar cholangiocarcinoma (HC) of Bismuth-Corlette type Ⅲ and Ⅳ. Methods: From May 2007 to May 2017, the clinical data of 108 patients with Bismuth-Corlette type Ⅲ and Ⅳ HC underwent hepatectomy were collected and analyzed retrospectively.There were 56 males and 52 females, aged (57.2±5.3) years (ranged 48-76 years) .Among the 108 cases, there were 51 cases of type Ⅲa, 40 cases of type Ⅲb and 17 cases of type Ⅳ. Small-scale hepatectomy (≤3 hepatectomy) was performed in 70 cases, including 8 cases of 4b segment resection, 28 cases of 4b segment+5 segment resection, and 34 cases of partial 4 segment+partial 7 segment+partial 1 segment resection. Large-scale hepatectomy was performed in 38 cases (>3 segments) , of which 30 cases were treated with 2 segments+3 segments+4 segments+1 segment, and 8 cases were treated with 5 segments+7 segments+8 segments+1 segment. t′ test was used to analyze the data which did not conform to the normal distribution, and χ² test was used to calculate the incidence of postoperative complications and the 1, 3, and 5-year cumulative overall survival rate. Results: (1) The operation time of minor liver resection group ((180±25)minutes) was shorter than that of major liver resection group ((210±35)minutes) (t′=4.676, P<0.05) , the amount of blooding operation time of minor liver resection group ((310±80)ml) was less than that of major liver resection group ((500±110)ml)in the operation (t′=9.385, P<0.05) , and the difference was statistically significant. (2) The incidence of complications was lower in minor liver resection group and major liver resection group, and the difference was statistically significant (χ²=5.230, P<0.05) . (3) The actual 1-, 3- and 5-year survival rates were 87.1%, 58.4%, 30.0% and 84.2%, 57.9%,31.6%, respectively. There were no significant differences in survival rates in two groups in 1-, 3- and 5-year survival rates (χ²=0.177, P=0.674; χ²=0.005, P=0.946; χ²=0.029, P=0.865) . Conclusions Compared to patients with major liver resection, Minor liver resection for selected patients with HC of Bismuth-Corlette Ⅲ and Ⅳaccording to our criteria achieved better long-term outcomes. Chen′s biliojejunostomy is a simple, effective and safe method, which can be widely used when there are multiple biliary intestinal anastomosese.

Objective To investigate the relationship of blood concentration of tacrolimus with efficacy and safety in treatment of patients with myasthenia gravis.Methods The clinical data of 74 patients with myasthenia gravis admitted in our hospital from January 2013 to December 2015 were analyzed retrospectively.The blood concentrations of tacrolimus were determined by chemiluminescence microparticle immunoassay.Treatment effects were evaluated with clinical relative scoring in China.Results There were 41 men and 33 women in 74 patients with the mean age of (56.7 ± 15.8) years.According to the Osserman classification,there were 7 cases of type Ⅰ,18 cases of type Ⅱ b,27 cases of type Ⅱ a,5 cases of type Ⅲ and 17 cases of type Ⅳ.Forty seven patients underwent thymectomy,including 9 cases of thymoma and 38 cases of hyperplasia.Patients were followed up for (28.1 ± 14.5)days,and the effective rate was 74 ％ (55/74).There was no significant correlation between tacrolimus blood concentration and clinical efficacy.The incidence of adverse reaction of tacrolimus was 22％ (16/74),and the incidence of adverse reactions increased with the increase of blood concentration.Conclusion Tacrolimus is effective in treatment of myasthenia gravis.The correlation of blood concentration of tacrolimus with the clinical efficacy needs to be further studied,but certainly,the monitoring of blood concentration can reduce the incidence of adverse reactions.

Objeetive To explore the relationship between metabolic syndrome and benign prostatic hyperplasia in health management.Methods A total of 5 721 patients of prostate hyperplasia was collected and divided into two groups according to metabolic syndrome.The height, weight, body mass index (BMI), and arterial blood pressure were measured.The serum PSA, cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), postprandial blood glucose, uric acid (UA) prostate specific antigen (PSA), and free prostate specific antigen (fPSA) were monitored.The volume of prostate was measured with ultrasound.The difference was analyzed between two groups of metabolic syndrome components and the volume of prostate.The correlation between various indicators of metabolic syndrome and prostate hyperplasia and prostate volume were analyzed.Health intervention was made to observe the changes of prostate volume and symptoms in the patients with metabolic syndrome for one year.Results BMI, TG, TC, BG, prostate volume, and serum PSA were higher in the patients with metabolic syndrome than in the control group.There was significant correlation between hyperlipidemia, benign prostatic hyperplasia and diagnosis of hypertension.Prostate volume was positively correlated with obesity, hypertension, high-density lipoprotein and metabolic syndrome.After health intervention, the indicators of metabolic syndrome decreased, and the symptoms of benign prostatic hyperplasia were relieved.Conclusions Reduced obesity, hypertension, low highdensity lipoprotein and the metabolic syndrome and prostate volume were positively related.Metabolic syndrome and prostatic hyperplasia exists certain relationship.The metabolic syndrome health interventions will be necessary to manage the health of prostate hyperplasia, thus delays the occurrence and development of prostate hyperplasia disease.

Objective To investigate the effect of CYP3A5 genetic polymorphism on tacrolimus concentration in myasthenia gravis patients to explore the optimum doses for patients of different genotypes.Methods The CYP3A 5 genotypes of 95 myasthenia gravis patients treated with tacrolimus in our hospital from January 2013 to December 2015,were determined by fluorescence in situ hybridization and tacrolimus concentrations were determined by chemiluminescence microparticle immuno assay.The differences of tacrolimus concentrations/dosage (C/D) ratios,concentration and dosage oftacrolimus were compared among patients of different genotypes.Results There were 14 patients (14.74％) with CYP3A5*l*l,35 (36.84％) with CYP3A5*l*3 and46 (48.42％) with CYP3A5*3*3 in these 95 patients.The allele frequencies of *1 and *3 were 33.16％ and 66.84％,respectively.The C/D ratios of patients from the 3 groups were significantly different (F=24.860,P=0.000):the C/D ratio of CYP3A5*1/*1 patients was significantly lower than that of CYP3A5*1/*3 patients (P＜0.05),and that of CYP3A5*1/*3 carriers was significantly lower than that of CYP3A5*3/*3 patients (P＜0.05).The appropriate doses of tacrolimus of myasthenia gravis patients were different in different genotypes patients:the dose of patients with CYP3A5* 1* 1 was 4-5 mg/d,that of CYP3A5*3*3 was 2-3 mg/d,and that of CYP3A5*1*3 was between that of CYP3A5*1*1 and CYP3A5*3*3.Conclusions The polymorphism of CYP3A 5 genetic polymorphism has effect on plasma concentrations oftacrolimus in patients with myasthenia gravis.Clinical application ofpharmacogenetic studies will be helpful for individualization oftacrolimus appropriate dosage.

Objective To determine the prevalence and treatment of chronic obstructive pulmonary diseases (COPD) among citizens in Ningbo. Methods A multi-stage stratified random sampling was applied to select 8 neighborhoods and 3 villages out of 7 districts in Ningbo, people who were older than or equal to 40 years were enrolled as subjects. Information on the prevalence rate and treatment conditions of COPD was collected through respiratory symptoms and treatment questionnaire and lung function screening. Results A total of 5865 people were screened, 5674 of them met inclusion criteria and completed questionnaire and lung function test. Among whom, 3044 people were men (53.6%, the average age is 55.7±11.4), 2630 women (46.4%, the average age was 55.3 ± 10.7);473 of them were diagnosed with COPD, the overall prevalence rate was 8.3%, including 354 cases who had never been diagnosed as COPD, accounted for 74.8% of the total cases diagnosed with COPD, mainly in stage ⅠandⅡof the disease. There were statistically significant differences between diagnosed and undiagnosed patients in the overall COPD group and among different gender groups ( stagesⅠandⅡ) and (stagesⅢandⅣ). Among the 473 COPD cases, 119 (diagnostic yield 25.2%) of whom had been diagnosed with bronchitis, only 48 (41.2%of the diagnosed) received drug treatment, only 13 patients were treated regularly with medication. Conclusion The overall prevalence rate of COPD among those over 40 years of age in Ningbo was quite high and mainly had stagesⅠandⅡof the disease. The number of the diagnostic yield and those who received regular treatment are quite low. The current situation of diagnosis and treatment are far from satisfaction, management of COPD should be strengthened to reduce the burden for family and society.

OBJECTIVE:To observe therapeutic efficacy and safety of budesonide and formoterol in the treatment of acute exacerbation of mild to moderate asthma.METHODS:A total of 89 patients with acute exacerbation of mild to moderate asthma were randomized divded into study group (45 cases) and control group (44 cases).Study group was given Budesonide and formoterol dry powder inhalation,one inhalation,q6 h,gargling 5 times after inhalation,6 inhalation per day at most+Montelukast tablet 10 mg orally,once a day.Control group received Prednisone tablet 25 mg orally after breakfast,once a day,d1-5+Theophylline sustained-release capsule 0.2 g,twice a day+Montelukast tablet 10 mg,once a day in the evening.Both groups were treated for 5 d.Acute AQLQ score,FEV1,PEF％pred and SpO2 were observed in 2 groups before and after treatment,and the occurrence of ADR was recorded.RESULTS:Before treatment,there was no statistical significance in acute AQLQ score,FEV1,PEF％pred or SpO2 between 2 groups(P＞0.05).After treatment,acute AQLQ score,FEV1,PEF％pred and SpO2 of 2 groups were significantly higher than before treatment,with statistical significance (P＜0.05),but there was no statistical significance between 2 groups (P＞ 0.05).There was statistical significance in the incidence of ADR between 2 group(P＜0.05).CONCLUSIONS:Budesonide and formoterol can improve pulmonary ventilation function and prognosis in patients with acute exacerbation of mild to moderate asthma with good safety.