Objective To explore the relationship between serum Niemann-pick type C1 like protein1(NPC1L1)and propro-tein convertase subtilisin/kexin type 9(PCSK9)levels and the risk of type 2 diabetes mellitus(T2DM)in Mongolian residents.Methods A total of 72 Mongolian patients with T2DM treated in Peking University Cancer Hospital,Inner Mongolia Hospital and the Affiliated Hospital of Inner Mongolia Medical University from June 2022 to June 2024 were selected as the T2DM group,and 81 healthy people in the same period were selected as the control group.LASSO model and multivariate Logistic regression model were used to screen the risk factors of disease onset.Multiple linear regression was used to analyze the correlation between NPC1L1 and PCSK9 levels and insulin function.Restricted cubic spline(RCS)model was used to analyze the dose-response relationship between NPC1L1 and PCSK9 levels and the incidence of T2DM,and explored the interaction between NPC1L1 and PCSK9 levels on the incidence of T2DM.Results NPC1L1(3.11±0.80 ng/L)and PCSK9(10.63±0.79 ng/L)in T2DM group were significantly higher than those in the control group(0.52±0.22 ng/L,3.21±0.17 ng/L),and the differences were statisti-cally significant(t=27.982,82.443,all P<0.05).NPC1L1(OR=2.458,95%CI=2.364～2.594,P<0.05)and PCSK9(OR=2.905,95%CI=2.541～3.528)were risk factors for T2DM(all P<0.001).The results of multiple linear regression analysis showed that as NPC1L1 and PCSK9 levels increased,FINS,HbA1c,C-P and OGTT levels also increased accordingly.With the increase of NPC1L1 and PCSK9 levels,insulin function also decreased(all P<0.05).The results of RCS model showed that with the increase of NPC1L1 and PCSK9 levels,the probability of T2DM incidence also increased(χ2=22.334,25.537,all P<0.001).No significant interaction was found between NPC1L1,PCSK9 levels and islet function indexes(P>0.05).Conclusion The levels of NPC1L1 and PCSK9 are closely related to the risk of T2DM in Mongolian residents.With the increase of NPC1L1 and PCSK9 levels,the incidence probability of T2DM increases.

Objective To investigate the application value of positive lateral pelvic lymph nodes combined with T2 mapping in the pathological grade and clinical stage of rectal cancer.Methods Eighty patients with rectal cancer diagnosed by pathology were selected as the study subjects.Among them,26 cases were well differentiated,21 cases were moderately differentiated,and 33 cases were poorly differentiated.According to the clinical stage,there were 17 cases of T1 stage,16 cases of T2 stage,20 cases of T3 stage and 27 cases of T4 stage.The differences in positive lateral pelvic lymph nodes and T2 value in different pathological grades and clinical stages of rectal cancer were compared.Pearson correlation analysis was used to evaluate the correlation between positive lateral pelvic lymph nodes and T2 value and pathological grade and clinical stage of rectal cancer.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of positive lateral pelvic lymph nodes and T2 value in the pathological grade of rectal cancer.Results There were significant differences in positive lateral pelvic lymph nodes and T2 value in different pathological grades and different clinical stages(P<0.05).The positive lateral pelvic lymph nodes was negatively correlated with T2 value(P<0.05).The T2 value was negatively correlated with pathological grade(P<0.05).The T2 value was also negatively correlated with clinical stage(P<0.05).The area under the curve(AUC)[95%confidence interval(CI)]of positive lateral pelvic lymph nodes combined with T2 value in the diagnosis of pathological grade and clinical stage were 0.800(0.635-0.957)and 0.779(0.583-0.981),respec-tively,demonstrated the highest diagnostic performance when used in combination.Conclusion The positive lateral pelvic lymph nodes combined with T2 mapping is helpful to evaluate the degree of differentiation and clinical stage of rectal cancer patients,which can provide valuable references for clinical treatment decisions and prognosis assessment of patients.

Objective:To investigate the current status and influencing factors of decision anxiety in guardians of children with acute appendicitis under Endoscopic retrograde appendicitis therapy (ERAT) background, and to provide reference for the development of targeted intervention programs for decision anxiety.Methods:Convenient sampling method was used to select 254 guardians of children with acute appendicitis treated in the Department of Pediatrics, Second Affiliated Hospital of PLA Air Force Medical University from February 2023 to April 2024. A cross-sectional survey was conducted using the General Data Questionnaire, the State-Trait Anxiety Inventory Form Y-State anxiety subscale and the Preparation for Decision Making Scale. Multiple linear regression was used to analyze the influencing factors in guardians of children with acute appendicitis.Results:Among the guardians of 254 children with acute appendicitis, 156 were males and 98 were females, aged (37.44 ± 3.63) years old. The decision anxiety score of guardians of children with acute appendicitis was (52.49 ± 6.54). The results of multiple linear regression showed that age of children, gender of guardian, education level of guardian, per capita monthly income of family, decision making tendency and decision preparation were the main influencing factors of decision anxiety in guardians of children with acute appendicitis ( t values were -7.07-3.58, all P<0.05), which could explain 64.4% of the total variation. Conclusions:The decision anxiety in guardians of children with acute appendicitis is at a high level. Medical staff should provide targeted decision guidance, improve decision assistance programs and provide more effective decision support for guardians of children with acute appendicitis.

Objective:To investigate the prevalence,related factors,and career implications of occupational burnout among resident physicians during standardized training in Inner Mongolia.Methods:This cross-sectional study used convenience sampling to enroll 2 891 resident physicians,assessing them with a self-developed general information questionnaire,socio-psychological scales,and a universal burnout inventory.Latent profile analysis clas-sified participants based on burnout dimensions,while logistic regression models examined the factors influencing burnout and their relationship with career choices.Results:Resident physicians were divided into low(59.0％),moderate(28.9％),and high(12.1％)burnout subgroups.Logistic regression showed that,compared to the low burnout group,significant risk factors included professional master's students(OR=0.44),working＞70 hours weekly(OR=0.63),＞4 night shifts monthly(OR=0.66),anxiety(mild OR=0.49;moderate OR=0.26;se-vere OR=0.14),depression(mild OR=0.38;moderate OR=0.24;severe OR=0.11),insomnia(mild OR=0.51;moderate OR=0.44;severe OR=0.38),low social support(OR=0.23),and low happiness index(OR=0.42).Male residents(OR=1.25)were less likely to experience burnout.High burnout residents were 5.11 times more likely to quit the medical profession.Conclusion:Training intensity and socio-psychological factors signifi-cantly contribute resident physicians' burnout levels,with severe burnout increase career attrition.

Objective To explore the relationship between serum Niemann-pick type C1 like protein1(NPC1L1)and propro-tein convertase subtilisin/kexin type 9(PCSK9)levels and the risk of type 2 diabetes mellitus(T2DM)in Mongolian residents.Methods A total of 72 Mongolian patients with T2DM treated in Peking University Cancer Hospital,Inner Mongolia Hospital and the Affiliated Hospital of Inner Mongolia Medical University from June 2022 to June 2024 were selected as the T2DM group,and 81 healthy people in the same period were selected as the control group.LASSO model and multivariate Logistic regression model were used to screen the risk factors of disease onset.Multiple linear regression was used to analyze the correlation between NPC1L1 and PCSK9 levels and insulin function.Restricted cubic spline(RCS)model was used to analyze the dose-response relationship between NPC1L1 and PCSK9 levels and the incidence of T2DM,and explored the interaction between NPC1L1 and PCSK9 levels on the incidence of T2DM.Results NPC1L1(3.11±0.80 ng/L)and PCSK9(10.63±0.79 ng/L)in T2DM group were significantly higher than those in the control group(0.52±0.22 ng/L,3.21±0.17 ng/L),and the differences were statisti-cally significant(t=27.982,82.443,all P<0.05).NPC1L1(OR=2.458,95%CI=2.364～2.594,P<0.05)and PCSK9(OR=2.905,95%CI=2.541～3.528)were risk factors for T2DM(all P<0.001).The results of multiple linear regression analysis showed that as NPC1L1 and PCSK9 levels increased,FINS,HbA1c,C-P and OGTT levels also increased accordingly.With the increase of NPC1L1 and PCSK9 levels,insulin function also decreased(all P<0.05).The results of RCS model showed that with the increase of NPC1L1 and PCSK9 levels,the probability of T2DM incidence also increased(χ2=22.334,25.537,all P<0.001).No significant interaction was found between NPC1L1,PCSK9 levels and islet function indexes(P>0.05).Conclusion The levels of NPC1L1 and PCSK9 are closely related to the risk of T2DM in Mongolian residents.With the increase of NPC1L1 and PCSK9 levels,the incidence probability of T2DM increases.

Objective:To adapt and validate the Chinese version of the Supervisory Relationship Questionnaire(SRQ)and evaluate its psychometric properties among supervisees.Methods:Item analysis,exploratory factor anal-ysis(EFA)and confirmatory factor analysis(CFA)were conducted on data from 888 supervisees recruited via on-line platform.Test-retest reliability over a four-week interval was examined in a randomly selected subset of 70 su-pervisees.An additional sample of 367 supervisees completed the Supervisory Relationship Scale(SRS)to evaluate criterion validity.Results:The revised SRQ contained 65 items and 6 factors.Both exploratory factor analysis and confirmatory factor analysis supported six-factor structure(safe base,structure,commitment,reflective education,role model and formative feedback),explaining 66.52％of the variance,with factor loadings of the items ranging from 0.58 to 0.83.The revised SRQ had six factors with good fit indices(x2/df=1.31,GFI=0.81,NFI=0.87,CFI=0.97,TLI=0.90,IFI=0.91,RMSEA=0.03,SRMR=0.05).The scores of the revised SRQ were positively correlated with the scores of SRS(ICC=0.96,P＜0.01).The Cronbach α coefficient of the revised SRQ was 0.97,and the test-retest reliability coefficient(ICC)was 0.74.Conclusion:The SRQ-C demonstrates sound psy-chometric properties,including structural validity,criterion-related validity,internal consistency,and temporal stabil-ity.It is a reliable and valid instrument for assessing supervisory relationships from the supervisee perspective.

A 57-year-old male patient with lung adenocarcinoma accompanied by brain metastasis received radiotherapy and chemotherapy with poor efficacy. Subsequently, he was given camrelizumab at a dose of 200 mg intravenously once every 21 days, combined with intermittent chemotherapy or targeted drug therapy. After 22 months, the patient developed right eye pain with visual loss. Slit lamp examination showed a transverse oval shallow ulcer with clear boundary, clean surface and a maximum diameter of about 6 mm in the center of the cornea of the right eye, with positive fluorescein staining. Immune-related corneal ulcers due to camrelizumab were considered. Camrelizumab was discontinued, and the patients′ ocular symptoms were gradually improved after systemic and local glucocorticoid and corneal repair drugs were given. Seven months later, due to the patient did not follow the doctor′s advice to replace eye drops, overuse of glucocorticoid occurred, resulting in perforation of the original ulcer. The glucocorticoid-containing eye drops was discontinued, the patient underwent amniotic membrane grafting combined with amniotic membrane patching on the right eye, and the patient's condition was improved.

Objective To investigate the effects of microRNA-34a(miR-34a-5p)on the progression of chronic lymphocytic leukemia(CLL)through the Wnt/β-catenin signaling pathway.Methods Human chronic B-cell leukemia MEC-1 cells were selected for experimentation.MEC cells were divided into two groups,group one:the p53 agonist group and the control group;group two:the control group,the miR-34a-5p mimic group and its corresponding negative control,the miR-34a-5p inhibitor group and its corresponding negative control,as well as the miR-34a-5p inhibitor+Wnt inhibitor XAV-939 group.The expression levels of miR-34a-5p in each group were measured using real-time fluorescence quantitative PCR(qPCR).Cell proliferation was assessed by CCK-8 assay,while cell migration ability was evaluated using Transwell migration assay.Dual-luciferase reporter assay was employed to validate the targeting relationships between p53 and miR-34a-5p,as well as between miR-34a-5p and Wnt1.Western blot analysis was used to detect the protein expressions of β-catenin and Cyclin D1,which were key components of the Wnt/β-catenin signaling pathway.Results In MEC-1 cells:① compared with the control group,there was a increased miR-34a-5p expression and inhibited cell proliferation in the p53 agonist group(P＜0.05).Dual-luciferase reporter assay confirmed a negative regulatory correlation between miR-34a-5p and p53.② the miR-34a-5p mimic group showed significantly upregulated miR-34a-5p expression compared to the control group,leading to suppressed cell proliferation,reduced migration capability and decreased protein expressions of β-catenin and Cyclin D1(P＜0.05).Conversely,the miR-34a-5p inhibitor group demonstrated significantly downregulated miR-34a-5p expression,resulting in enhanced cell proliferation,increased migratory capacity and upregulated protein levels of β-catenin and Cyclin D1 compared to those of the control group(P＜0.05).③ A targeting relationship was observed between miR-34a-5p and Wnt1.④ Compared with the miR-34a-5p inhibitor group,the XAV-939 group exhibited significantly upregulated miR-34a-5p expression,markedly decreased numbers of migrated cells and substantially reduced protein expression levels of β-catenin and Cyclin D1(P＜0.05).Conclusion miR-34a plays the role of a tumor suppressor gene in CLL.Overexpression of miR-34a can inhibit the Wnt/β-catenin signaling pathway,reduce the proliferation activity and migration ability of cells,and promote cell apoptosis.

Objective To investigate the effects of microRNA-34a(miR-34a-5p)on the progression of chronic lymphocytic leukemia(CLL)through the Wnt/β-catenin signaling pathway.Methods Human chronic B-cell leukemia MEC-1 cells were selected for experimentation.MEC cells were divided into two groups,group one:the p53 agonist group and the control group;group two:the control group,the miR-34a-5p mimic group and its corresponding negative control,the miR-34a-5p inhibitor group and its corresponding negative control,as well as the miR-34a-5p inhibitor+Wnt inhibitor XAV-939 group.The expression levels of miR-34a-5p in each group were measured using real-time fluorescence quantitative PCR(qPCR).Cell proliferation was assessed by CCK-8 assay,while cell migration ability was evaluated using Transwell migration assay.Dual-luciferase reporter assay was employed to validate the targeting relationships between p53 and miR-34a-5p,as well as between miR-34a-5p and Wnt1.Western blot analysis was used to detect the protein expressions of β-catenin and Cyclin D1,which were key components of the Wnt/β-catenin signaling pathway.Results In MEC-1 cells:① compared with the control group,there was a increased miR-34a-5p expression and inhibited cell proliferation in the p53 agonist group(P＜0.05).Dual-luciferase reporter assay confirmed a negative regulatory correlation between miR-34a-5p and p53.② the miR-34a-5p mimic group showed significantly upregulated miR-34a-5p expression compared to the control group,leading to suppressed cell proliferation,reduced migration capability and decreased protein expressions of β-catenin and Cyclin D1(P＜0.05).Conversely,the miR-34a-5p inhibitor group demonstrated significantly downregulated miR-34a-5p expression,resulting in enhanced cell proliferation,increased migratory capacity and upregulated protein levels of β-catenin and Cyclin D1 compared to those of the control group(P＜0.05).③ A targeting relationship was observed between miR-34a-5p and Wnt1.④ Compared with the miR-34a-5p inhibitor group,the XAV-939 group exhibited significantly upregulated miR-34a-5p expression,markedly decreased numbers of migrated cells and substantially reduced protein expression levels of β-catenin and Cyclin D1(P＜0.05).Conclusion miR-34a plays the role of a tumor suppressor gene in CLL.Overexpression of miR-34a can inhibit the Wnt/β-catenin signaling pathway,reduce the proliferation activity and migration ability of cells,and promote cell apoptosis.

Intraocular ointment is conventionally placed on the eye to prevent infection after cataract surgery. The purpose of this study is to report a case and conduct a systematic review of a rare occurrence of the entry of intraocular ointment after cataract surgery. PubMed, Scopus, Embase, CNKI, WANFANG data, China Science and Technology Journal Database and Chinese Medical Journal Full-text Database were systematically searched from their commencement to 30th October 2023, and 19 literatures were screened out and 31 cases of intraocular ointment after surgery were collected. Among the 31 patients, the age of presentation ranged from 55 to 87 years with a median of 73, males accounted for 45.2% and females accounted for 32.3%. The length of the incision was generally 3.2 mm. Most of the patients detected ointment within 3 days post-operation and presented without complications(45.2%). The most common ocular manifestations were corneal edema, glaucoma and uveitis. Early postoperative follow-up is very important. Presence of anterior chamber ointment is a rare complication after cataract surgery, but it can lead to severe vision loss if not detected and treated on time. When patients complain of foreign body sensation in the in the eye after cataract surgery, ophthalmologists need to take a kin interest and examine the eye for early detection of ointment for appropriate intervention and prevent further complications.