Objective To explore the correlation between tongue features of type 2 diabetes patients with coronary heart disease and glycosylated hemoglobin,liver function,blood lipids,C-reactive protein,so as to provide reference for related research.Methods Using the TFDA-1 tongue imaging device to collect patients'tongue images,experts will interpret the tongue images and extract objective parameters of the tongue images through the intelligent auxiliary diagnosis system of traditional Chinese medicine tongue diagnosis;Record patient laboratory indicators and use SPSS statistical software to analyze the correlation between tongue image distribution characteristics,tongue image parameter characteristics,and laboratory indicators using Spearman method.Results 702 patients with type 2 diabetes and coronary heart disease were included.In terms of glycated hemoglobin indicators,bruising parameters are positively correlated with HbA1c,while tongue tip RGB values are negatively correlated with HbA1c.In terms of liver function indicators,tongue edge redness,tongue tip and tongue texture R value are positively correlated with ALT and AST;Red tongue tip,tooth marks on the tongue,etc.are positively correlated with ALT;Fat tongue is positively correlated with AST.In terms of blood lipid indicators,parameters such as tooth mark tongue and tooth mark are positively correlated with TG;The parameters of white coating and tongue coating area are positively correlated with LDL-C;Thin coating is positively correlated with HDL-C,while thick coating is negatively correlated with HDL-C;Red tongue is negatively correlated with TCHO.In terms of C-reactive protein,red tongue,tip red,and edge red are positively correlated with CRP;The GB value of tongue root and tongue substance is negatively correlated with CRP.Conclusion Type 2 diabetes patients with coronary heart disease have tongue picture distribution,tongue shape parameters,tongue color parameters,coating color parameters and HbA1c,ALT,AST,TCHO,TG,HDL-C,LDL-C,CRP indicators in varying degrees of correlation.The combination of patients'tongue picture and laboratory indicators is helpful to clarify the diagnosis and prognosis of type 2 diabetes with coronary heart disease.

OBJECTIVE To explore the association of postoperative urinary tract infections with peripheral blood in-tercellular adhesion molecule-1(ICAM-1)gene polymorphisms in the patients with menopausal stress urinary in-continence.METHODS A total of 132 patients with menopausal stress urinary incontinence who received mid-ure-thral suspension surgery in the Third People's Hospital Affiliated to Fujian University of Traditional Chinese Med-icine from Sep.2020 to Sep.2023 were recruited as the research subjects and were divided into the infection group with 25 cases and the non-infection group with 107 cases according to the status of postoperative urinary tract in-fections.The distribution of pathogens isolated from the infection group was statistically analyzed.The peripheral blood ICAM-1 gene polymorphisms and the levels of soluble triggering receptor expressed on myeloid cells(sTREM-1),high-mobility group box 1(HMGB1)and monocyte chemoattractant protein-1(MCP-1)were ob-served and compared between the two groups.The values of the three markers in diagnosis of the postoperative u-rinary tract infections in the patients with menopausal stress urinary incontinence were analyzed.RESULTS Totally 34 strains of pathogens were isolated from the 25 patients of the infection group,21(61.76％)of which were gram-negative bacteria,Escherichia coli(11 strains,32.35％)was the predominant species of the gram-negative bacteria.The frequencies of KK genotype at K469E locus of ICAM-1 gene and K allele of the infection group were higher than those of the non-infection group,while the frequencies of EE genotype and E allele of the infection group were lower than those of the non-infection group(P＜0.05).There were significant differences in the levels of serum sTREM-1,HMGB1 and MCP-1 between the infection group and the non-infection group(P＜0.05);the MCP-1 level of the infection group was(63.68±20.63)pg/ml,higher than that of the non-infection group(t=6.472,P＜0.001).The area under the curve(AUC)value of the single detection of the three markers was lower in diagnosis of the postoperative urinary tract infections in the patients with menopausal stress urinary in-continence than that of the joint detection of the three markers(P＜0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the menopausal stress urinary incontinence patients with postoperative urinary tract infections.The patients show the increased expressions of sTREM-1,HMGB1 and MCP-1;the joint detection of the three markers has more advantages in auxiliary diagnosis of the postoperative u-rinary tract infections.The susceptibility to the postoperative urinary tract infections is associated with the ICAM-1 gene polymorphisms.

Objective To explore the correlation between tongue features of type 2 diabetes patients with coronary heart disease and glycosylated hemoglobin,liver function,blood lipids,C-reactive protein,so as to provide reference for related research.Methods Using the TFDA-1 tongue imaging device to collect patients'tongue images,experts will interpret the tongue images and extract objective parameters of the tongue images through the intelligent auxiliary diagnosis system of traditional Chinese medicine tongue diagnosis;Record patient laboratory indicators and use SPSS statistical software to analyze the correlation between tongue image distribution characteristics,tongue image parameter characteristics,and laboratory indicators using Spearman method.Results 702 patients with type 2 diabetes and coronary heart disease were included.In terms of glycated hemoglobin indicators,bruising parameters are positively correlated with HbA1c,while tongue tip RGB values are negatively correlated with HbA1c.In terms of liver function indicators,tongue edge redness,tongue tip and tongue texture R value are positively correlated with ALT and AST;Red tongue tip,tooth marks on the tongue,etc.are positively correlated with ALT;Fat tongue is positively correlated with AST.In terms of blood lipid indicators,parameters such as tooth mark tongue and tooth mark are positively correlated with TG;The parameters of white coating and tongue coating area are positively correlated with LDL-C;Thin coating is positively correlated with HDL-C,while thick coating is negatively correlated with HDL-C;Red tongue is negatively correlated with TCHO.In terms of C-reactive protein,red tongue,tip red,and edge red are positively correlated with CRP;The GB value of tongue root and tongue substance is negatively correlated with CRP.Conclusion Type 2 diabetes patients with coronary heart disease have tongue picture distribution,tongue shape parameters,tongue color parameters,coating color parameters and HbA1c,ALT,AST,TCHO,TG,HDL-C,LDL-C,CRP indicators in varying degrees of correlation.The combination of patients'tongue picture and laboratory indicators is helpful to clarify the diagnosis and prognosis of type 2 diabetes with coronary heart disease.

OBJECTIVE To explore the association of postoperative urinary tract infections with peripheral blood in-tercellular adhesion molecule-1(ICAM-1)gene polymorphisms in the patients with menopausal stress urinary in-continence.METHODS A total of 132 patients with menopausal stress urinary incontinence who received mid-ure-thral suspension surgery in the Third People's Hospital Affiliated to Fujian University of Traditional Chinese Med-icine from Sep.2020 to Sep.2023 were recruited as the research subjects and were divided into the infection group with 25 cases and the non-infection group with 107 cases according to the status of postoperative urinary tract in-fections.The distribution of pathogens isolated from the infection group was statistically analyzed.The peripheral blood ICAM-1 gene polymorphisms and the levels of soluble triggering receptor expressed on myeloid cells(sTREM-1),high-mobility group box 1(HMGB1)and monocyte chemoattractant protein-1(MCP-1)were ob-served and compared between the two groups.The values of the three markers in diagnosis of the postoperative u-rinary tract infections in the patients with menopausal stress urinary incontinence were analyzed.RESULTS Totally 34 strains of pathogens were isolated from the 25 patients of the infection group,21(61.76％)of which were gram-negative bacteria,Escherichia coli(11 strains,32.35％)was the predominant species of the gram-negative bacteria.The frequencies of KK genotype at K469E locus of ICAM-1 gene and K allele of the infection group were higher than those of the non-infection group,while the frequencies of EE genotype and E allele of the infection group were lower than those of the non-infection group(P＜0.05).There were significant differences in the levels of serum sTREM-1,HMGB1 and MCP-1 between the infection group and the non-infection group(P＜0.05);the MCP-1 level of the infection group was(63.68±20.63)pg/ml,higher than that of the non-infection group(t=6.472,P＜0.001).The area under the curve(AUC)value of the single detection of the three markers was lower in diagnosis of the postoperative urinary tract infections in the patients with menopausal stress urinary in-continence than that of the joint detection of the three markers(P＜0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the menopausal stress urinary incontinence patients with postoperative urinary tract infections.The patients show the increased expressions of sTREM-1,HMGB1 and MCP-1;the joint detection of the three markers has more advantages in auxiliary diagnosis of the postoperative u-rinary tract infections.The susceptibility to the postoperative urinary tract infections is associated with the ICAM-1 gene polymorphisms.

Objective Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is the leading cause of hospitalization and death in patients with chronic obstructive pulmonary disease (COPD). Exploring the prognostic factors of AECOPD patients will assist in optimizing treatment strategies and standardizing disease management. Methods This study retrospectively collected the clinical data of 664 patients with AECOPD admitted to the Respiratory Department of Dongzhimen Hospital of Beijing University of Chinese Medicine from January 2013 to September 2019. The 3-year survival rate and treatment of the patients were investigated. According to whether the patients died,they were divided into a non-survivors group and a survivors group,and clinical data such as basic information,comorbidities,and auxiliary examination results were compared between the two groups. Incorporating clinical experience of researchers and previous research evidence,a secondary screening of variables was conducted to ultimately determine the covariates to be included in the multifactorial Cox proportional hazards regression model,and the factors affecting the 3-year survival rate of the patients were analyzed. Results A total of 664 cases were included in this study,including 362 males and 302 females,with an average age of (77.25±6.89) years old. The 3-year all-cause mortality rate of older hospitalized patients with AECOPD was 20.48％(136 patients). Older age (HR:1.071,95％CI:1.040-1.102,P<0.001);smoking history (HR:1.788,95％CI:1.173-2.723,P=0.007);Charlson comorbidity index (HR:1.209,95％CI:1.029-1.421,P=0.022);lower arterial partial pressure of oxygen (HR:1.014,95％CI:1.006-1.022,P<0.001);higher brain natriuretic peptide(HR:1.001,95％CI:1.000-1.001,P=0.025);cor pulmonale(HR:1.896,95％CI:1.235-2.908,P=0.004);respiratory failure (HR:2.437,95％CI:1.378-4.311,P=0.003);TCM syndrome differentiation elements,including kidney (HR:1.639,95％CI:1.055-2.546,P=0.028) and fluid retention (HR:2.512,95％CI:1.653-3.816,P<0.001),were independent risk factors for 3-year all-cause death of older hospitalized patients with AECOPD. Long-term regular use of bronchiectasis (HR:0.474,95％CI:0.324-0.695,P<0.001) was an independent protective factor for 3-year all-cause death. Conclusion The 3-year survival rate of elderly hospitalized patients with AECOPD is relatively low,with the TCM syndrome elements manifested as lung-kidney qi deficiency,yang deficiency with water retention,and blood stasis obstruction. Patients with moderate to severe impairment of lung function due to COPD have an increased risk of death within 3 years. Therefore,for such patients,nourishing lung-kidney qi,resolving phlegm and water retention,activating blood circulation to remove blood stasis and dredging collaterals,combined with regular use of bronchodilators,may help improve their 3-year survival rate.

From the perspective of state differentiation and treatment， it is believed that the pathogenesis of acute respiratory distress syndrome （ARDS） is that evil poisons injured the lungs， and the lung qi suddenly collapsed， then blocked and exhausted， and the qi failure to control blood and liquid， then the fluids overflow outside the vessels， and damp phlegm， stasis， and toxins became knotted up in the body， which ultimately leads to qi dysfunction， and a series of symptom arise， so qi impairment is the principal mechanism of ARDS. A combination of Chinese and Western medicine was proposed to treat ARDS by combining tangible qi and intangible qi， using Chinese herbal medicine to boost qi and relieve collapse， percolate and drain dampness with bland medicinals， resolve toxins and dissolve stasis， and regulate qi， and combining with Western medicine to assist qi circulation to improve qi's consolidation， propulsion， and transformation， so as to make the evil qi go away， the positive qi restored， the viscera qi circulated， qi， blood， yin， and yang connected， and the activities of life maintained， and thus to achieve the goal of treating ARDS by integrated Chinese medicine and Western medicine.

Objective:To evaluate the detection performance of left ventricular ejection fraction (LVEF) in patients with chronic renal failure (CRF) by an artificial intelligence (AI) model based on yolox framework integrating left ventricular segmentation and critical point detection.Methods:From January 2019 to June 2023, a total of 4 284 echocardiographic images of 2 000 adults aged 18-80 years without segmental wall motion abnormalities, structural heart disease, cardiac surgery or cardiomyopathy were collected in Henan Provincial People′s Hospital to delineate the endocardial membrane, as a training set, an AI model based on yolox framework integrating left ventricular segmentation and critical point detection was established. The images were divided into the training set( n=1 675) and the test set( n=325) in a ratio of about 5∶1. All 228 echocardiographic images of 100 normal adult volunteers who were treated in Henan Provincial Chest Hospital from May 2020 to May 2021 were collected as external test set validation. All 792 echocardiographic images of 204 patients treated in Henan Provincial People′s Hospital from April 2019 to June 2023 were continuously enrolled to evaluate the measurement efficiency of AI model. Spearman correlation statistical method was used to analyze the consistency of AI model measurement with manual measurement and TomTec software measurement methods of 3 senior echocardiographic professionals. Subjects were divided into clear image group, unclear image group, normal LVEF group and reduced LVEF group, the differences of general data between the two groups were compared. The correlation coefficient(ICC) within the group was calculated to analyze the consistency, so as to evaluate the model performance. Results:LVEF measured by AI model was significantly correlated with both manual measurement and TomTec model measurement ( rs=0.834, 0.826; all P<0.01). ICC values of the clear image group and the unclear image group were 0.96 and 0.97, respectively. ICC values for all subjects, normal LVEF group and reduced LVEF group were 0.96, 0.90 and 0.96, respectively. Conclusions:The AI model based on yolox framework integrating left ventricular segmentation and critical point detection has good diagnostic performance in the automatic measurement of LVEF in patients with CRF.

In September 2020, three pulmonary tuberculosis cases were identified during school physical examinations at a senior high school in a district (School B) of Hangzhou City. Immediate epidemiological surveys were performed by local district and Hangzhou Center for Disease Control and Prevention, and a pulmonary tuberculosis outbreak involving 9 cases in 6 schools were identified. All cases were once Grade 9 students in Class of 2019 at a junior high school (School A), and the source of infection might be a laboratory-confirmed cases (index case) in this class reported in April, 2019. Following exposure to index case, other cases developed disease onset or were screened after entering senior high schools. In November, 2020, tuberculin skin test and chest X-ray scan were performed to screen pulmonary tuberculosis among 43 students and teachers in a class of Grade 9 in Class of 2019 at School A, and 17 students strongly positive for tuberculin skin test were given prophylactic therapy. No pulmonary tuberculosis case were identified until June 2021. It is suggested that early epidemiological surveys facilitates the identification of the epidemiological correlation between cases. Active search for individuals with common exposure history and prophylactic therapy are required if a possible outbreak is found, which is helpful to avoid the spread of the outbreak.

Objective:To explore the effect of alternating food restriction on blood glucose, body mass index (BMI) and blood lipids in overweight or obesity patients with type 2 diabetes mellitus.Methods:A prospective cohort study was used. Three hundred overweight or obesity type 2 diabetes mellitus patients with stable blood glucose control from December 2021 to February 2022 in Nanxiang Hospital, Jiading District of Shanghai City were selected. The patients were divided into alternating food restriction group (adopting alternating food restriction therapy, giving balanced meal plates, reducing 30% of calories intake every other day), low carbohydrate high protein group (adopting low carbohydrate and high protein therapy, giving low carbohydrate and high protein reduction meal plates, reducing 15% of calories intake every day) and balanced diet group (adopting balanced diet therapy, giving balanced meal plates) by random digits table method with 100 cases each. All three groups received intervention treatment for 6 months. The height and body mass before intervention and the end of intervention and 6 months after intervention were measured, and the BMI was calculated. The levels of glycosylated hemoglobin (HbA 1c), fasting blood glucose (FBG), 2 h postprandial blood glucose (2 h PBG), triacylglycerol (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were measured. Results:At the end, 280 cases were completed the study. There were 90 cases in the alternating food restriction group, 90 cases in the low carbohydrate high protein group, and 100 cases in the balanced diet group. There were no statistical differences in HbA 1c, FBG, 2 h PBG, BMI, TG, TC and LDL-C before intervention among the three groups ( P>0.05). At the end of the intervention, the HbA 1c and FBG in alternating food restriction group and low carbohydrate high protein group were significantly lower than those in balanced diet group: (6.50 ± 0.39)% and (6.67 ± 0.30)% vs. (6.79 ± 0.32)%, (6.47 ± 0.61) and (6.80 ± 0.30) mmol/L vs. (6.94 ± 0.37) mmol/L, the indexes in alternating food restriction group were significantly lower than those in low carbohydrate high protein group, and there were statistical difference ( P<0.05); the 2 h PBG and BMI in alternating food restriction group and the low carbohydrate high protein group were significantly lower than those in balanced diet group: (8.83 ± 0.63) and (8.81 ± 0.70) mmol/L vs. (9.45 ± 0.85) mmol/L, (25.99 ± 2.13) and (26.53 ± 2.16) kg/m 2 vs. (27.24 ± 2.24) kg/m 2, and there were statistical differences ( P<0.05), there were no statistical differences in 2 h PBG and BMI between alternating food restriction group and the low carbohydrate high protein group ( P>0.05). Six months after intervention, the HbA 1c, 2 h PBG and BMI in alternating food restriction group were significantly lower than those in low carbohydrate high protein group and balanced diet group: (6.62 ± 0.29)% vs. (6.79 ± 0.19)% and (6.84 ± 0.23)%, (9.21 ± 0.53) mmol/L vs. (9.48 ± 0.66) and (9.55 ± 0.51) mmol/L, (25.60 ± 1.67) kg/m 2 vs. (27.26 ± 2.42) and (27.79 ± 2.49) kg/m 2, and there were statistical differences ( P<0.05), there were no statistical differences in HbA 1c, 2 h PBG and BMI between low carbohydrate high protein group and balanced diet group ( P>0.05). At the end of intervention and 6 months after intervention, there were statistical differences in TG, TC and LDL-C among the three groups ( P<0.05); among them, the TG in alternating food restriction group was significantly lower than that in low carbohydrate high protein group and the balanced diet group: (1.67 ± 0.70) mmol/L vs. (1.99 ± 0.89) and (2.49 ± 0.94) mmol/L, (1.70 ± 0.71) mmol/L vs. (2.04 ± 0.96) and (2.53 ± 1.08) mmol/L, and there were statistical differences ( P<0.05), there was no statistical difference in TG between the low carbohydrate high protein group and balanced diet group ( P>0.05). Conclusions:The alternating food restriction therapy in overweight or obesity patients with type 2 diabetes mellitus can not only reduce blood glucose, improve blood lipids, but also reduce BMI, and the overall effect is better than that of low carbohydrate high protein therapy.

Objective To explore the effect of using smart products (including smart phones, computers and other electronic products),as well as having hobbies on their cognitive function in pension agency elderly people,and analyze if there is certain protective effect on cognitive function by using smart products and having hobbies.So as to reduce the risk of mild cognitive impairment in the future. Methods By convenience sampling, 160 residents living in the nursing home of suzhou city (mean age 60 or higher) were selected, and demographic data were collected by using a homemade questionnaire, their cognitive function was investigated by using the Montreal Cognitive Assessment Scale. Results Single factor analysis showed that the score of the elderly who often use smart products in every cognitive field and overall cognitive function were superior to those who could not use smart products,the difference was statistically significant(t=-4.47--2.15,all P<0.05).The scores of the elderly with hobbies were higher in the overall cognitive function and the other six areas except the orientation, than those who had no hobby,and the differences were statistically significant(t=-6.80--1.81,all P<0.05).After adjusting for age,gender,body mass index(BMI),cultural level,often using smart products in total cognitive function in the elderly(t=4.842,P<0.01)and executive function(t=4.008,P<0.01),attention(t=3.045,P=0.003), abstract(t=2.135,P=0.034),delayed recall(t=3.759,P<0.01),the directional(t=2.866,P=0.005)of the five areas showed significant correlation. The total cognitive function of the elderly with hobbies (t=3.496, P = 0.001) and the visual spatial execution function (t=3.316, P = 0.001), naming (t=3.241, P =0.001), abstract (t=2.643, P = 0.009), and delayed recall (t=2.073, P= 0.04) were all significantly correlated.Conclusions Often using smart products and having certain hobbies are protective factors of cognitive function,build corresponding intervention plans for the future,by cultivating the elderly hobby, guiding the elderly using intelligent products and other measures to achieve successful aging, slow the cognitive decline,thus reducing the risk of mild cognitive impairment.