Objective To explore the mechanism of electroacupuncture in improving lipid metabolism in polycystic ovary syndrome(PCOS)based on metabolomics combined with transcriptomics.Methods Eight-een SD rats were divided into the control group,the PCOS group and the electroacupuncture group,with 6 rats in each group.The PCOS group and the electroacupuncture group used intragastric letrozole to establish the PCOS model.After the model was established,the electroacupuncture group was intervened with electroacu-puncture,while the control group was only given sodium carboxymethyl cellulose by gavage.Observed the changes in body weight and estrous cycle of the three groups,detected the sex hormones,blood lipids,liver function,ovarian morphology,plasma metabolism and liver function indicators of the three groups.Metabolo-mics was used to analyze the differences in metabolites in plasma,the differences in gene expression in the liv-er were detected by RT-qPCR.Results Weight gain and estrous cycle disorder occurred in the PCOS group,and the ovarian morphology showed a thinning of the granulosa cell layer,with a significant reduction in the number of corpus luteum and mature follicles.Meanwhile,sex hormones were abnormal(total testosterone and androgen levels were increased,estradiol and progesterone levels were decreased),dyslipidemia occurred(TC,TG,LDL-C were increased,HDL-C level was decreased),and liver function was abnormal(AST,total protein,ALB,TBIL were increased).The electroacupuncture group significantly reduced weight.It improved the estrous cycle,and the granulosa cell layer of the ovary thickened,with a significant increasing in the num-ber of corpus luteum and mature follicles.Meanwhile,sex hormone levels were improved(androgen and total testosterone levels were decreased,estradiol level was increased),lipid balance(TC,TG,LDL-C levels were reduced,HDL-C level was increased)and liver function(AST,total protein,ALB,and TBIL levels were de-creased)was restored.Transcriptomics suggested that electroacupuncture down-regulated the expression of cytochrome P450(CYPs)family genes related to steroid hormones and lipid metabolism,and the results were confirmed by RT-qPCR.Combined omics analysis revealed that electroacupuncture might mainly exert its effect on improving lipid metabolism disorders in PCOS rats through the linoleic acid metabolic pathway.Con-clusion Electroacupuncture can regulate lipid metabolism in rats with PCOS.

Objective To explore the effectiveness of multimodal comprehensive diabetes management teaching in the standardized training of endocrinology residents.Methods Fifty-nine resident physicians rotating through the endocrinology department from March to October 2024 were selected.They underwent a multimodal comprehensive diabetes management teaching model that integrated standardized theoretical instruction,case dis-cussions,teaching ward rounds,practical operations,and interdisciplinary pharmaceutical education.The effec-tiveness of this teaching model was evaluated through multiple dimensions using a comprehensive diabetes man-agement evaluation form,Mini-Clinical Evaluation Exercise(Mini-CEX)scale,and satisfaction surveys.Results After two months of multimodal standardized training,the results showed:1)The resident physicians demonstra-ted significant improvements in all aspects of comprehensive diabetes management(P＜0.05).2)The Mini-CEX scores of the resident physicians generally reached excellent levels(P＜0.05).3)Both the resident physicians and teaching faculty showed significantly higher satisfaction with the comprehensive diabetes management program after the training(P＜0.05).Conclusions Multimodal comprehensive diabetes management teaching is effective in enhancing the standardized diagnosis and treatment abilities of resident physicians in the endocrinology depart-ment regarding diabetes.

Objective To observe the effect of electroacupuncture on corneal Toll-like receptor 4(TLR4)-mediated inflammatory signaling pathway in diabetic dry eye rats and to explore the mechanism of electroacupuncture in the treat-ment of diabetic dry eye.Methods A type 2 diabetic rat model was established in 32 healthy male Sprague-Dawley(SD)rats by intraperitoneal injection of streptozotocin(30 mg·kg-1)for 12 weeks after feeding with high-sugar and high-fat di-et for 4 weeks.Twenty-five successfully modeled diabetic dry eye rats were randomly divided into the model group(non-in-tervention),electroacupuncture group(the"Jingming","Cuanzhu","Sizhukong","Taiyang"and"Tongziliao"acupoints were treated with acupuncture,and then"Cuanzhu"and"Tongzilao"acupoints were treated with electroacupuncture,15 min for each time,once a day),sham acupuncture group(blunt-tip needle pricking was performed at the same acupoints as the electroacupuncture group),and fluorometholone group(1 g·L-1fluorometholone eye drops were used in both eyes at 8 o'clock,13 o'clock,and 18 o'clock,1 drop each time),with 6 rats in each group,lasting for 2 weeks.Another 6 healthy male SD rats were selected as a blank group.Random blood glucose,tear film breakup time(BUT),tear secre-tion,corneal fluorescein staining(FL)score,and corneal touch threshold(CTT)of rats in each group were detected be-fore modeling,after modeling,and after the intervention.Hematoxylin and Eosin(HE)staining was performed to observe the corneal morphologic changes in each group.Immunofluorescence histochemical staining was adopted to detect the cor-neal TLR4-positive expression in each group.The TLR4,phosphorylated nuclear factor-kappa P65(P-NF-KB P65),inter-leukin(IL)-1β,and IL-18 expression levels in the cornea were detected by Western blot.Results After modeling,com-pared with the blank group,BUT,tear secretion and CTT decreased and FL increased in all experimental groups,and the differences were statistically significant(all P＜0.01).After the intervention,compared with the model group,FL de-creased,and BUT,tear secretion and CTT increased in the electroacupuncture group,and the differences were statistically significant(all P＜0.05).Corneal HE staining showed that after the intervention,the corneal surface of rats in the model group and sham acupuncture group was not smooth,and the corneal epithelial cells were thickened and disorganized;the corneal surface of rats in the electroacupuncture group and fluorometholone group was smooth,and the corneal epithelial cells were arranged neatly.After the intervention,compared with the blank group,the corneal TLR4 expression of rats in all other groups was elevated,and the differences were statistically significant(all P＜0.05);compared with the model group,the corneal TLR4 expression of rats in the electroacupuncture group and fluorometholone group was reduced(both P＜0.01).Compared with the blank group,corneal TLR4,P-NF-κBP65,IL-1β and IL-18 protein expressions increased in the model group and sham acupuncture group(all P＜0.05);compared with the model group,these expressions decreased in the electroacupuncture group and the fluorometholone group(all P＜0.05).Conclusion Electroacupuncture can im-prove the ocular surface signs and inhibit the expressions of TLR4,P-NF-κB P65,IL-1 β,and IL-18 in the cornea of type 2 diabetic dry eye rats,and its mechanism of action may be related to the regulation of TLR4-mediated inflammatory signaling pathway,which inhibits ocular surface inflammation in diabetic dry eye rats.

Objective To study the infection of multidrug-resistant organism(MDRO)in elderly pa-tients with catheter-associated urinary tract infection(CAUTI)and analyze the infection factors.Methods The medi-cal records of 175 elderly patients with CAUTI admitted to Jiangsu Province Hospital from January 2021 to July 2022 were selected,the distribution of MDRO infection in elderly patients with CAUTI was analyzed,and the influencing factors of MDRO infection were analyzed.The predictive value of independent risk factors for rele-vant nosocomial infections was analyzed by receiver operating characteristics(ROC)curves.Results Among the 175 elderly patients with CAUTI,87 cases(49.71％)developed MDRO infection and were included in the MDRO infection group),and 88 cases(50.29％)had no MDRO infection and were included in the non-MDRO infection group.A total of 432 MDRO pathogens were detected in the MDRO infection group,inclu-ding 415 strains of Gram-negative bacteria,accounting for 96.06％,186 strains of carbapenem-resistant Acine-tobacter baumannii(43.06％),147 strains of carbapenem-resistant Klebsiella pneumoniae(34.03％),79 strains of carbapenem-resistant Pseudomonas aeruginosa(18.29％)and 3 strains of carbapenem-resistant Escherichia coli(0.69％).There were 17 strains of Gram-positive bacteria(3.94％),all of which were methi-cillin-resistant Staphylococcus aureus.Multivariate analysis showed that the use of carbapenems,tigecycline,polymyxin,and days of central venous intubation were considered as independent risk factors.The area under the curve of MDRO infection was 0.883.Conclusion For elderly patients with CAUTI,it is necessary to take strict antimicrobial management measures,master the indications of antimicrobial application,shorten the hos-pitalization time of patients and reduce the incidence of MDRO infection.

Objective To compare the efficiency of nomogram and different machine learning algo-rithms for constructing the dental caries predictive models for middle-aged and elderly people.Methods The multi-stage stratified random sampling method was used to select 510 middle-aged and elderly people from Nanning City,Guigang City and Chongzuo City as the research subjects for conducting the questionnaire sur-vey and oral cavity examination.The univariate analysis and Lasso regression were used to screen the related variables,and the multivariate logistic regression analysis was used to determine the final independent influen-cing factors.Based on the salient features,the nomogram predictive model was established,and the seven ma-chine learning algorithms,including linear discriminant analysis (LDA),partial least squares (PLS),range Doppler algorithm (RDA),generalized linear models (GLM),random forest (RF),support vector machine (SVM) kernel function (SVM-Radial),and SVM linear kernel function (SVM-Linear),were used to construct the seven kinds of dental caries risk predictive models.The area under the receiver operating characteristic (ROC) curve (AUC) was adopted to evaluate the predictive performance of various models and the predictive performance of models constructed using different variable screening methods.Results The detection rate of dental caries in middle-aged and elderly people was 71.18％.After feature screening,the five predictive factors were ultimately retained,which were the age (OR=0.945,95％CI:0.917-0.973),brushing frequency (OR=0.688,95％CI:0.475-0.997),whether having teeth cleaning in the past one year (OR=0.303,95％CI:0.103-0.890),number of remaining teeth (OR=1.062,95％CI:1.038-1.087) and oral health assess-ment tool (OHAT) score (OR=1.363,95％CI:1.234-1.505).The results of comparison of various models showed that the predictive model constructed by the RF algorithm performed the best,the median of AUC was 0.747,followed by the nomogram,and the median of AUC was 0.733.The median of AUCs in the predic-tion model constructed by single factor+Lasso+multivariate logistic (Lasso+logistic) screening independent variables were higher than those constructed by RF algorithm screening independent variables.ConclusionBased on Lasso+logistic screening variables,RF provide more reliable predictive efficiency in predicting dental caries in middle-aged and elderly people than nomogram and the other machine learning algorithms.

BackgroundDepression presents a significant risk to the physical and mental health of the elderly. The relationship between sleep and depressive symptoms has become a major research focus. However， previous research findings on this relationship have yielded inconsistent conclusions. ObjectiveTo explore the relationship between sleep duration and depressive symptoms in the elderly， in order to provide insights into the prevention of depressive symptoms and delaying their progression in the elderly. MethodsData analysis involved 8 210 adults aged 60 years or older， utilizing data from the 2018 China Health and Retirement Longitudinal Study （CHARLS） survey. Participants were categorized into two groups those with depressive symptoms and those without- based on the Center for Epidemiologic Studies Depression-10 Scale （CESD-10） criteria. Logistic regression and restricted cubic spline models were used to analyze the association between sleep duration and depressive symptoms. ResultsThe 318 people with depressive symptoms were detected among the 8 210 elderly participants， with an average sleep duration of （6.14±2.05） hours per night. Restricted cubic spline models showed a non-linear association between sleep duration and depressive symptoms （χ²=412.670，P<0.01）. After adjusting for confounding factors， compared to the elderly with a sleep duration 7~7.9 hours， the risk of depressive symptoms in the elderly was 2.971 times higher （95% CI： 2.560~3.449， P<0.01） in those with a sleep duration <6 hours， 1.372 times higher （95% CI： 1.161~1.621， P<0.01） in those with 6~6.9 hours， and 1 185 times higher （95% CI： 1.009~1.393， P<0.05） in those with ≥8 hours. Subgroup analysis showed no correlation between sleep duration ≥8 hours and the risk of depressive symptoms across genders and the 60~69 age group （P>0.05）. ConclusionThere was an approximately nonlinear association between sleep duration and depressive symptoms， with differences by gender and age.［Funded by Sichuan Applied Psychology Research Center， Chengdu Medical College （number， CSXL-22226）］

Objective:To analyze the detection rate of hyperuricemia (HUA) and the distribution of serum uric acid (SUA) levels by multiple correlation analysis in middle-aged and elderly population receiving health examination.Methods:In this cross-sectional study, the study object were 25 587 middle-aged and elderly people who receiving health examination in Nanfang Hospital from January to December in 2014. According to the latest diagnostic criteria, the population was divided into HUA and non-HUA groups. Furthermore, the subjects were divided into 4 groups with the level of SUA (Q 1: SUA<313 μmol/L, Q 2:313 μmol/L≤SUA<375 μmol/L, Q 3:375 μmol/L≤SUA<440 μmol/L, Q 4: SUA≥440 μmol/L). According to the data types, two independent sample t test, Mann-Whitney U test, Chi-square test and multiple correspondence analysis were used for statistical analysis. Results:The mean age of the study subjects was (54.78±8.80) years with 16 570 males (64.8%) and 9 017 females (35.2%). The overall detection rate of HUA was 31.5%, and it was higher in men (43.1%) than in women (10.1%). The body mass index(BMI), systolic blood pressure, diastolic blood pressure, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG) and fasting blood glucose (FBG) in the HUA group were all higher than those in the non-HUA group (all P<0.001); and high-density lipoprotein cholesterol (HDL-C) was lower than that in the non-HUA group( P<0.001). In multiple correspondence analysis, Cronbach′s α coefficients of the first dimension and the second dimension was 0.608 and 0.237, respectively. Further analysis was performed stratified by gender, it indicated that 45-<55 years old male and overweight were closely associated with the Q 3 group, fatty liver and hyperlipidemia were closely associated with Q 4 group; the 55-<65 years old female, hyperlipidemia, fatty liver and obesity were closely associated with the Q 3 group, while hyperglycemia and hypertension were closely associated with the Q 4 group. Conclusion:The detection rate of HUA in middle-aged and elderly population receiving health examination was high, and the detection rate of HUA in male was higher than that in female. SUA levels are higher in middle-aged and elderly men who have fatty liver and hyperlipidemia. While SUA levels are higher in middle-aged and elderly women who have hyperglycemia and hypertension.

Psoriasis is characterized by abnormal proliferation of keratinocytes, as well as infiltration of immune cells into the dermis and epidermis, causing itchy, scaly and erythematous plaques of skin. The understanding of this chronic inflammatory skin disease remains unclear and all available treatments have their limitations currently. Here, we showed that IMMH002, a novel orally active S1P modulator, desensitized peripheral pathogenic lymphocytes to egress signal from secondary lymphoid organs and thymus. Using different psoriasis animal models, we demonstrated that IMMH002 could significantly relieve skin damage as revealed by PASI score and pathological injure evaluation. Mechanistically, IMMH002 regulated CD3 T lymphocytes re-distribution by inducing lymphocytes' homing, thus decreased T lymphocytes allocation in the peripheral blood and skin but increased in the thymus. Our results suggest that the novel S1P agonist, IMMH002, exert extraordinary capacity to rapidly modulate T lymphocytes distribution, representing a promising drug candidate for psoriasis treatment.

Objective:To explore the application effect of five-in-one anti-cancer support model in patients with breast neoplasms.Methods:A total of 70 patients who were admitted to the Fourth Ward of Department of Breast Surgery in Harbin Medical University Cancer Hospital from May to September 2019 were selected as research objects by using the convenient sampling method. According to the random number table method, they were randomly divided into the study group and the control group, with 35 cases in each group.The control group was given routine nursing, while the study group was given five-in-one anti-cancer support model nursing. The depression, anxiety, social isolation, social support and quality of life scores of patients of the two groups were evaluated before and after the intervention.Results:After intervention, the depression scores of patients in the study group were lower than those in the control group. The total score of quality of life, score of social and family status and score of functional status in the study group were lower than those in the control group. The differences were statistically significant ( P<0.05) . Conclusions:The five-in-one anti-cancer support model is adopted to design body, mind, spirit, and social relaxation courses that meet the characteristics of breast cancer patients to meet their psychological and social needs, which has certain clinical significance.

Objective:To analyze the sleep quality before treatment and related risk factors of sleep disorder in patients with nasopharyngeal carcinoma (NPC). Methods: Totally 143 patients first diagnosed as nasopharyngeal carcinoma were selected [ average age (43 ± 10) years, 100 males and 43 females] in a NPC ward of one hospital, the Chinese version of Pittsburgh Sleep Quality Index (PSQI, total score ＞ 5 diagnosed as sleep disorder) was used to investigate the sleep quality before treatment, and the logistic regression analysis was used to analyze related factors of the sleep disorder before treatment Results: The rate of sleep disorder was 50.3％. The logistic regression analysis showed that age was a risk factor of sleep disorder before treatment in patients with NPC (OR = 1.04, 95％ CI: 1.01-1.08), while gender, culture degree, clinical stage, body mass index were not correlated with sleep disorder (Ps＞0.05). Conclusion: It suggests that patients with NPC may have a higher incidence of sleep disorder before treatment, and older patients may be more prone to pre-treatment sleep disorder.