Objective To analyze the effectiveness of the digital medicine boosting county-town-village linkage diabetes mellitus(DM)management model.Methods A total of 135 patients with T2DM from 9 villages in 3 towns of Longyou County from June to September 2021 were selected and randomly grouped into a control(Con,n=45)group and an intervention(Exp,n=90)group at a ratio of 1∶2 by village.The Con group implements routine management.The Exp group implemented the internet+boosting county-town-village linkage DM management model.Both groups were followed up for one year.The body mass index(BMI),waist circumference(WC),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),hemoglobin A1c(HbA1c),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),triglycerides(TG),urine albumin/creatinine ratio(UACR),management compliance,and the proportion of new DM complications were compared between the two groups.Results All patients in the Con group completed follow-up,8 patients in the Exp group were lost to follow-up,and 82 patients were finally included.After the intervention,BMI,WC,SBP,DBP,FPG,HbA1c,TC,TG,LDL-C and UACR were significantly decreased in both groups(P<0.05),while HDL-C and DM self-management scale(SDSCA)scores increased(P<0.05).In Exp group,SBP,DBP,FPG,HbA1c,TC,TG,LDL-C and UACR were lower than those in Con group(P<0.05),while HDL-C and SDSCA scores and the compliance rates of FPG,HbA1c,TC,TG were higher than those in Con group(P<0.05).There was no statistically significant difference in the changes of medication methods,the incidence of diabetic kidney disease and diabetic peripheral neuropathy between the two groups(P>0.05).Conclusions The digital medicine boosting county-town-village linkage DM management model,which helps achieve glycolipid standards and opens up new ideas for the management of diabetes in rural areas.

Objective To analyze the effectiveness of the digital medicine boosting county-town-village linkage diabetes mellitus(DM)management model.Methods A total of 135 patients with T2DM from 9 villages in 3 towns of Longyou County from June to September 2021 were selected and randomly grouped into a control(Con,n=45)group and an intervention(Exp,n=90)group at a ratio of 1∶2 by village.The Con group implements routine management.The Exp group implemented the internet+boosting county-town-village linkage DM management model.Both groups were followed up for one year.The body mass index(BMI),waist circumference(WC),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),hemoglobin A1c(HbA1c),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),triglycerides(TG),urine albumin/creatinine ratio(UACR),management compliance,and the proportion of new DM complications were compared between the two groups.Results All patients in the Con group completed follow-up,8 patients in the Exp group were lost to follow-up,and 82 patients were finally included.After the intervention,BMI,WC,SBP,DBP,FPG,HbA1c,TC,TG,LDL-C and UACR were significantly decreased in both groups(P<0.05),while HDL-C and DM self-management scale(SDSCA)scores increased(P<0.05).In Exp group,SBP,DBP,FPG,HbA1c,TC,TG,LDL-C and UACR were lower than those in Con group(P<0.05),while HDL-C and SDSCA scores and the compliance rates of FPG,HbA1c,TC,TG were higher than those in Con group(P<0.05).There was no statistically significant difference in the changes of medication methods,the incidence of diabetic kidney disease and diabetic peripheral neuropathy between the two groups(P>0.05).Conclusions The digital medicine boosting county-town-village linkage DM management model,which helps achieve glycolipid standards and opens up new ideas for the management of diabetes in rural areas.

Objective:To investigate whether the inhibitory effect of berberine (BBR) on inflammation and apoptosis of human dental pulp stem cells (hDPSCs) induced by lipopolysaccharide (LPS) is related to its upregulation of microRNA (miR)-23a.Methods:The 3rd to 4th generation hDPSCs with good growth were taken and randomly divided into the blank control group, LPS group, LPS+ BBR group, LPS+ miR-NC mimics group, LPS+ miR-23a mimics group, and LPS+ BBR+ miR-23a inhibitors group according to the experimental requirements. The expression levels of miR-23a mRNA in each group were detected by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR), and the expression levels of interleukin-1 β(IL-1β), interleukin-6 (IL-6), and tumor necrosis factor -α (TNF-α) in the cell supernatants of each group were detected by enzyme-linked immunosorbent assay (ELISA). The apoptosis rate of cells in each group was detected by flow cytometry, and the expression level of Cleaved caspase-3 of apoptosis-related proteins in each group was detected by Western blot.Results:Compared with the LPS group, different concentrations of LPS+ BBR groups could significantly reduce the expression levels of cellular inflammatory factors IL-1β, IL-6, TNF-α, apoptosis rate, and apoptotic protein Cleaved caspase 3 in a dose-dependent manner (all P<0.05). Compared with the LPS group, the expressions of the cellular inflammatory factors IL-1β, IL-6, TNF-α, apoptosis rate and apoptotic protein Cleaved caspase in the LPS+ miR-23a mimics group, the LPS+ BBR group and the LPS+ BBR+ miR-23a inhibitors group were lower (all P<0.05). Compared with the LPS+ miR-NC mimics group, the cellular inflammatory factors IL-1β, IL-6, TNF-α, apoptosis rate and the expression of apoptotic protein Cleaved caspase 3 in the LPS+ miR-23a mimics group and the LPS+ BBR group were all lower (all P<0.05). Compared with the LPS+ BBR group, the inflammatory factors IL-1β, IL-6, TNF-α, apoptosis rate and the expression of apoptotic protein Cleaved caspase 3 in the LPS+ BBR+ miR-23a inhibitors group were all higher (all P<0.05). Conclusions:BBR can inhibit the inflammatory and apoptotic responses of LPS-induced hDPSCs, which is related to its upregulation of miR-23a expression.

Objective:To investigate whether the inhibitory effect of berberine (BBR) on inflammation and apoptosis of human dental pulp stem cells (hDPSCs) induced by lipopolysaccharide (LPS) is related to its upregulation of microRNA (miR)-23a.Methods:The 3rd to 4th generation hDPSCs with good growth were taken and randomly divided into the blank control group, LPS group, LPS+ BBR group, LPS+ miR-NC mimics group, LPS+ miR-23a mimics group, and LPS+ BBR+ miR-23a inhibitors group according to the experimental requirements. The expression levels of miR-23a mRNA in each group were detected by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR), and the expression levels of interleukin-1 β(IL-1β), interleukin-6 (IL-6), and tumor necrosis factor -α (TNF-α) in the cell supernatants of each group were detected by enzyme-linked immunosorbent assay (ELISA). The apoptosis rate of cells in each group was detected by flow cytometry, and the expression level of Cleaved caspase-3 of apoptosis-related proteins in each group was detected by Western blot.Results:Compared with the LPS group, different concentrations of LPS+ BBR groups could significantly reduce the expression levels of cellular inflammatory factors IL-1β, IL-6, TNF-α, apoptosis rate, and apoptotic protein Cleaved caspase 3 in a dose-dependent manner (all P<0.05). Compared with the LPS group, the expressions of the cellular inflammatory factors IL-1β, IL-6, TNF-α, apoptosis rate and apoptotic protein Cleaved caspase in the LPS+ miR-23a mimics group, the LPS+ BBR group and the LPS+ BBR+ miR-23a inhibitors group were lower (all P<0.05). Compared with the LPS+ miR-NC mimics group, the cellular inflammatory factors IL-1β, IL-6, TNF-α, apoptosis rate and the expression of apoptotic protein Cleaved caspase 3 in the LPS+ miR-23a mimics group and the LPS+ BBR group were all lower (all P<0.05). Compared with the LPS+ BBR group, the inflammatory factors IL-1β, IL-6, TNF-α, apoptosis rate and the expression of apoptotic protein Cleaved caspase 3 in the LPS+ BBR+ miR-23a inhibitors group were all higher (all P<0.05). Conclusions:BBR can inhibit the inflammatory and apoptotic responses of LPS-induced hDPSCs, which is related to its upregulation of miR-23a expression.

Objective To investigate the correlation between the proportion of peripheral blood follicular T helper cells(Tfh cells)and intracellular interleukin-21(IL-21)content with blue light retinal injury.Methods Brown Norway(BN)rats were randomly divided into 4 groups and were exposed to blue light for 3 hours a day to establish retinal light damage model.According to the duration of illumination,the rats was divided into 0 days(control group),3 days(3 d group),7 days(7 d group)and 14 days(14 d group).The proportion of Tfh cells and content of IL-21 in Tfh cells in peripheral blood of each group was detected by flow cytometry and ELISA sepa-rately after illumination.Electroretinogram(ERG)was used to evaluate retinal function.The changes of fundus in rats were observed by fundus photography.The thickness of outer nuclear layer of retina was analyzed by HE staining.Results After retinal blue light injury,with the extension of illumination time,the proportion of Tfh cells in peripheral blood and intracellular IL-21 content both increased(P<0.05).ERG showed that retinal function decreased after light damage and aggravated with the extension of illumination time,the latency and ampli-tudes of A-wave and B-wave increased and decreased respectively(P<0.05).The retinal fundus of rats showed depigmentation in 3 d,and the retinal vessels became thinner and exudate with the extension of illumination time.HE staining showed that the outer nuclear layer of retina(ONL)became thinner(P<0.05).Correlation analy-sis indicated that the proportion of Tfh cells in peripheral blood and the intracellular IL-21 content could jointly reflect the degree of injury(P<0.000 1),and the proportion of Tfh cells in peripheral blood was negatively corre-lated with ONL thickness and the amplitude of a and b waves,positively correlated with the peak time of a and b waves,(P<0.0001).Conclusion The proportion of Tfh cells in peripheral blood and the intracellular IL-21 content were increased after blue light damage to retina,and were significantly increased with the extension of light time with a certain correlation.

Objective:To investigate the feasibility and efficacy of transcystic injection of indocyanine green during laparoscopic cholecystectomy (LC) surgery in the treatment of patients with gallbladder stones combined with liver cirrhosis.Methods:The clinical data of 96 patients with cirrhosis who underwent LC for gallbladder stones with cholecystitis attacks in the Department of Hepatobiliary and Pancreatic Surgery of the Second People′s Hospital of Changzhou City from January 2018 to May 2022 were retrospectively analyzed. All patients were diagnosed by clinical history and auxiliary examination before surgery and underwent cholecystectomy according to their groups, which were divided into fluorescence group ( n=49) and white light group ( n=47) according to whether ICG was used or not, where the fluorescence group underwent LC in fluorescence mode after direct intraoperative injection of ICG via gallbladder. The two groups were compared in terms of identification time of the three tubes, operation time, intraoperative bleeding, intraoperative injury, intraoperative open abdomen and blood transfusion, postoperative drainage time, postoperative hospitalization time, postoperative complications and changes in infection and liver function indexes before and after surgery. The measurement data obeying normal distribution were expressed as mean±standard deviation( ± s), and independent sample t-test was used for comparison between groups. The measurement data obeying the skewed distribution were expressed by M( Q1, Q3), and the Mann-Whitney U test was used for comparison between groups. Count data were expressed as rates (%), and the chi-square test or Fisher′s exact probability method was used for comparison between groups. Results:The procedure was successfully performed in both groups, and the identification of triple-tube time, operative time, intraoperative bleeding, postoperative drainage time, postoperative hospital stay, postoperative ALT, postoperative GGT, and postoperative TBIL in the fluorescent group were (14.96±1.49) min, (52.14±7.36) min, 5(5, 10) mL, (1.61±0.61) d, (2.37±0.49) d, 31.5(22.0, 44.8) U/L, 38.0(21.0, 91.5) U/L, 18.0(11.5, 22.8) μmol/L, and (29.87±3.37) min, (84.36±13.25) min, 10(10, 20) mL, (2.70±0.69) d, (3.15±0.42) d, 45.0(28.0, 64.8) U/L, 73.0(32.0, 132.0) U/L, 23.0(16.1, 29.3) μmol/L in the white light group and the differences were statistically significant compared with the two groups( P<0.05). In the fluorescence group, there was no intraoperative injury and no cases of intraoperative opening, and there were 2 cases of postoperative complications, while in the white light group, there were 2 cases of intraoperative injury, 1 case of intraoperative opening, and 5 cases of postoperative complications, and there were no cases of blood transfusion in both groups. There was no statistically significant difference between the fluorescence group and the white light group when comparing the preoperative laboratory indexes of both groups ( P>0.05). When comparing the first postoperative white blood cell count, C-reactive protein, aspartate aminotransferase, and alkaline phosphatase indexes in the fluorescence group and the white light group, there was no statistically significant difference between the two groups ( P>0.05). Conclusion:When LC is performed in patients with symptomatic gallbladder stones combined with cirrhosis, intraoperative injection of indocyanine green via the gallbladder to visualize the gallbladder and bile duct structures is simple and easy to perform, and the safe and efficient dissection of extrahepatic bile ducts and gallbladder bed speeds up the procedure while reducing postoperative trauma.

Objective:To address a new classification method in term of the three-dimensional space of orbit and to present the different surgical approaches correspondingly.Methods:In a retrospect study from April of 2015 to June of 2018, 102 patients were performed lower eyelid blepharoplasty, including 20 males and 82 females, aged 21-65 years, with an average of 45.2 years. These patients were divided into five groups, which were described in term of three-dimensional structure of orbit, based on the following points: the presence and extent of herniated orbital fat, the presence of inferior orbitopalpebral sulcus, amount of excess skin, and the skin wrinkles in the lower eyelid. And then patients in different group were treated with different kinds of blepharoplasty. All patients in this study ranged in follow-up from 1 month to 12 months. With patients＇ permit, photographs and clinical information were taken to evaluate the preoperative and postoperative outcome.Results:In type 1, all the 32 cases healed well, no complications such as hematoma, infection and ectropion occurred. During the follow-up of more than 1 months, the overall effect was good, and the pouch-shaped appearance of lower eyelid pouch was significantly improved. In types 2, 8 cases had no complications, and the incision healed well; the patients were followed up for more than 3 months, the lower eyelid bag and lower eyelid skin relaxation were significantly improved, and the lower eyelid skin was tighter than before. In types 3, there were no complications in these 19 cases, and the incision was healed well. The patients were followed up for more than 3 months, the deformity of lower eyelid bag was improved obviously, and no obvious local bulge was found under static and dynamic expression. In type 4, there were no complications in all 34 cases, and the incision healed well; during the follow-up of more than 3 months, the lower eyelid pouch deformity and lower eyelid skin relaxation were greatly improved, except for 1 case with mild bulge (untreated). In type 5, 9 cases had no complications, and the incision healed well; during the follow-up of more than 3 months, the fold of the lower eyelid skin disappeared.Conclusions:Little information is available about classification of lower eyelid bags. And the exact surgical approach remains controversial and largely dependent upon surgeon preference and a patient＇s stated cosmetic desire. In this study, an objective classification based on clinical appearance combined with forming reasons of lower eye bags is little available, and the appropriate surgical approach remains controversial as well.

Objective: To understand the health literacy and relevant factors of cancer prevention consciousness in Chinese urban residents from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of demographic characteristics and cancer prevention consciousness focusing on nine common risk factors, including smoking, alcohol, fiber food, food in hot temperature or pickled food, chewing betel nut, helicobacter pylori, moldy food, hepatitis B infection, estrogen, and exercise. The logistic regression model was adopted to identify the influencing factors. Results: The overall health literacy of the cancer prevention consciousness was 77.4% (24 980 participants), with 77.4% (12 018 participants), 79.9% (6 406 participants), 77.2% (1 766 participants) and 74.5% (4 709 participants) in each group (P<0.001). The correct response rates for nine risk factors ranged from 55.2% to 93.0%. The multivariate logistic regression analysis showed that compared with community residents, people with primary school level education or below, and the number of people living together in the family <3, the cancer risk assessment/screening intervention population, cancer patients, those with junior high school level educationor above and the number of people living in the family ≥3 had better health literacy of the cancer prevention consciousness (all P values <0.05). Compared with females, 39 years old and below, government-affiliated institutions or civil servants, from the eastern region, males, older than 40 years, company or enterprise employees, and from the middle or western region had worse health literacy of the cancer prevention consciousness (all P values <0.05). Conclusion The health literacy of the cancer prevention consciousness in Chinese urban residents should be improved. The cancer screening intervention, gender, age, education, occupation, the number of people co-living in the family, and residential region were associated with the health literacy of the cancer prevention consciousness.

Objective: To understand the consciousness of the cancer early detection among urban residents and identify the influencing factors from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. Self-designed questionnaires were used to collect population, socioeconomic indicators, self-cancer risk assessment, regular participation in physical examination and other information. The multivariate logistic regression model was used to identify the factors of people who had not regularly participated in the regular physical examination in the past five years. Results: The self-assessment results of 32 357 residents showed that there were 27.54% (8 882) of total study population with self-reported cancer risk, 45.48% (14 671) without cancer risk and 26.98% (8 704) with unclear judgement on their own cancer risk. Among population with cancer risk, 79.84% (7 091) considered physical examination accounted. In the past five years, there were 21 105 (65.43%) residents participated in regular physical examination and 11 148 (34.56%) participated in non-scheduled one, respectively. The multivariate logistic regression analysis showed that compared with unmarried and western region residents, divorced, middle and eastern region residents had a stronger consciousness to participate in the regular physical examination (P<0.05). Compare with residents with annual household income less than 20 000 CNY in 2014, cancer risk assessment/screening intervention population, and self-assessment with cancer risk, residents with annual household income between 20 000 CNY and 59 000 CNY in 2014, occupational population, community residents, cancer patients, self-reported cancer-free risk, and self-assessment with unclear judgement of cancer risk were less likely to participate in the regular physical examination (all P values <0.05). Conclusion From 2015 to 2017, the Chinese urban residents had a acceptable consciousness of the cancer early detection. The marital status, annual household income, population group and self-assessment of cancer risk were related to the consciousness of the cancer early detection of people who had not participated in the regular physical examination in the past five years.

Objective: To understand the consciousness of the cancer early diagnosis among urban residents and identify the related factors from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The general demographic characteristics, the consciousness of the cancer early diagnosis (whether people would have a willingness or encourage their relatives/friends to confirm the abnormal results once which were detected from the physical examination) and other information were collected by using the self-designed questionnaire. The non-conditional logistic regression model was used to identify the relateol factors related to the consciousness of the cancer early diagnosis. Results: As for residents with abnormal result from the physical examination, 89.29% (28 802) of residents would choose to seek medical treatment for further diagnosis. If their relatives/friends had abnormal results from the physical examination, 89.55% (28 886) of residents would encourage their relatives/friends to confirm the diagnosis in time. The non-conditional logistic regression model analysis showed that compared with the public institution staff/civil servants, annual household income less than 20 000 CNY, the western region and the cancer risk assessment/screening intervention population, the company staff, annual household income about 40 000 CNY and more, and the residents from the middle and eastern region had a stronger consciousness to seek further diagnosis; while the unemployed residents and community residents were less likely to seek further diagnosis (P<0.05). Conclusions From 2015 to 2017, the Chinese urban residents had a good consciousness of the cancer early diagnosis. Occupation, annual household income, residential region and population group were related to the consciousness of the cancer early diagnosis.