Objective To investigate the relationship between the serum red blood cell distribution width(RDW)to albumin(ALB)ratio,the expression of family with sequence similarity 19 member A5(FAM19A5)and leukocyte cell-derived chemotaxin 2(LECT2)with the glucose and lipid metabolism indexes in type 2 diabetes mellitus(T2DM)patients with metabolic syndrome(MS).Methods A total of 119 patients with T2DM were selected as the study group,and patients were divided into the MS group(67 cases)and the non-MS group(52 cases)based on whether they were complicated with MS.Meanwhile,93 healthy individuals who underwent physical examinations in our hospital during the same period were selected as the control group.RDW was detected by an automatic blood cell analyzer,and ALB was detected by an automatic biochemical analyzer.The ratio of RDW to ALB(RAR)was calculated.The serum levels of FAM19A5 and LECT2 were detected by enzyme-linked immunosorbent assay(ELISA).The correlation between serum and glycolipid metabolism indicators was analyzed by Pearson's method.The diagnostic value of serum RAR,FAM19A5 and LECT2 for MS in T2DM patients was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the control group,the study group exhibited significantly higher levels of total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C),fasting blood glucose(FBG),serum RAR,FAM19A5 and LECT2,while high-density lipoprotein cholesterol(HDL-C)was significantly lower(P＜0.05).Compared to the non-MS group,body mass index(BMI),duration of T2DM,history of hypertension,blood pressure,waist circumference,TG,fasting insulin(FINS),FBG,glycated hemoglobin(HbA1c),homeostasis model assessment-insulin resistance(HOMA-IR),serum RAR,FAM19A5 and LECT2 were significantly increased,and HDL-C was decreased in the MS group(P＜0.05).Serum RAR,FAM19A5 and LECT2 were positively correlated with TG,FINS,FBG,HbA1c and HOMA-IR,and which was negatively correlated with HDL-C(P＜0.05).The area under the curve(AUC)for the diagnosis of T2DM patients with MS using RAR,FAM19A5 and LECT2 individually were 0.821,0.807 and 0.793,respectively,and the combined AUC was 0.952,indicating that the combined diagnostic efficacy of RAR,FAM19A5 and LECT2 was superior to their individual efficacies(P＜0.05).Conclusion Serum levels of RAR,FAM19A5 and LECT2 are elevated in T2DM patients with MS.These biomarkers exhibit a strong association with indices of glucose and lipid metabolism.The combination of these three markers has significant clinical diagnostic value for T2DM patients with MS.

Objective To explore the current research status,research hotspots,and development trends of clinician's post-competency in China using CiteSpace visualization analysis,thus providing insights into establishing professional teams and assisting in the high-quality development of hospitals.Methods Relevant literature on clinician post-competency was retrieved from the China National Knowledge Infrastructure(CNKI)database.The CiteSpace software was employed to create visualization maps of the publication volume,authors,and keywords of the relevant research.This analysis included author collaboration net-works,keyword co-occurrence,clustering,and burst analysis.Results A total of 710 articles meeting the inclusion criteria were retrieved.Research on clinician post-competency in China demonstrated a general upward trend from 2013 to 2024.Howev-er,collaboration among authors and institutions remained relatively limited.The primary research hotspots focused on fields such as medical education,teaching reform,and training models.The research frontier encompassed topics like reform of teaching modes,evaluation of post-competency among traditional Chinese medicine practitioners,and competency studies utilizing the Del-phi method.Conclusion Research on clinician post-competency in China grows rapidly,garnering increasing attention.To fur-ther advance this field,researchers should enhance collaboration and communication,conduct systematic investigations into re-search hotspots and cutting-edge issues,and continuously refine medical talent education and evaluation mechanisms.These ef-forts will provide a valuable foundation for promoting the high-quality development of hospitals.

DeepSeek,a domestically developed generative artificial intelligence(AI)tool,is experiencing rapid growth within China's technological landscape.With its core advantages of open-source accessibility,cost-efficiency,vertical scenario specialization,and Chinese linguistic contextualization,it has been reconfiguring medical education.This development brings nu-merous innovative opportunities to postgraduate medical education,particularly in standardized training of resident physicians.On one hand,DeepSeek creates new possibilities for participants in residency training regarding knowledge acquisition,assisted learning,and teaching methodologies.On the other hand,its implementation raises concerns such as inadequate development of higher-order thinking skills,lack of realistic doctor-patient communication simulations,and diminished roles of clinical instruc-tors.Hospitals with a resident physician training base should promptly adapt to the new situation and move embrace intelligent de-velopment.By addressing the challenges posed by DeepSeek while fully utilizing emerging technologies,they can drive the high-quality development of standardized resident physician training.

Objective To investigate the relationship between the serum red blood cell distribution width(RDW)to albumin(ALB)ratio,the expression of family with sequence similarity 19 member A5(FAM19A5)and leukocyte cell-derived chemotaxin 2(LECT2)with the glucose and lipid metabolism indexes in type 2 diabetes mellitus(T2DM)patients with metabolic syndrome(MS).Methods A total of 119 patients with T2DM were selected as the study group,and patients were divided into the MS group(67 cases)and the non-MS group(52 cases)based on whether they were complicated with MS.Meanwhile,93 healthy individuals who underwent physical examinations in our hospital during the same period were selected as the control group.RDW was detected by an automatic blood cell analyzer,and ALB was detected by an automatic biochemical analyzer.The ratio of RDW to ALB(RAR)was calculated.The serum levels of FAM19A5 and LECT2 were detected by enzyme-linked immunosorbent assay(ELISA).The correlation between serum and glycolipid metabolism indicators was analyzed by Pearson's method.The diagnostic value of serum RAR,FAM19A5 and LECT2 for MS in T2DM patients was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the control group,the study group exhibited significantly higher levels of total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C),fasting blood glucose(FBG),serum RAR,FAM19A5 and LECT2,while high-density lipoprotein cholesterol(HDL-C)was significantly lower(P＜0.05).Compared to the non-MS group,body mass index(BMI),duration of T2DM,history of hypertension,blood pressure,waist circumference,TG,fasting insulin(FINS),FBG,glycated hemoglobin(HbA1c),homeostasis model assessment-insulin resistance(HOMA-IR),serum RAR,FAM19A5 and LECT2 were significantly increased,and HDL-C was decreased in the MS group(P＜0.05).Serum RAR,FAM19A5 and LECT2 were positively correlated with TG,FINS,FBG,HbA1c and HOMA-IR,and which was negatively correlated with HDL-C(P＜0.05).The area under the curve(AUC)for the diagnosis of T2DM patients with MS using RAR,FAM19A5 and LECT2 individually were 0.821,0.807 and 0.793,respectively,and the combined AUC was 0.952,indicating that the combined diagnostic efficacy of RAR,FAM19A5 and LECT2 was superior to their individual efficacies(P＜0.05).Conclusion Serum levels of RAR,FAM19A5 and LECT2 are elevated in T2DM patients with MS.These biomarkers exhibit a strong association with indices of glucose and lipid metabolism.The combination of these three markers has significant clinical diagnostic value for T2DM patients with MS.

DeepSeek,a domestically developed generative artificial intelligence(AI)tool,is experiencing rapid growth within China's technological landscape.With its core advantages of open-source accessibility,cost-efficiency,vertical scenario specialization,and Chinese linguistic contextualization,it has been reconfiguring medical education.This development brings nu-merous innovative opportunities to postgraduate medical education,particularly in standardized training of resident physicians.On one hand,DeepSeek creates new possibilities for participants in residency training regarding knowledge acquisition,assisted learning,and teaching methodologies.On the other hand,its implementation raises concerns such as inadequate development of higher-order thinking skills,lack of realistic doctor-patient communication simulations,and diminished roles of clinical instruc-tors.Hospitals with a resident physician training base should promptly adapt to the new situation and move embrace intelligent de-velopment.By addressing the challenges posed by DeepSeek while fully utilizing emerging technologies,they can drive the high-quality development of standardized resident physician training.

Objective To explore the current research status,research hotspots,and development trends of clinician's post-competency in China using CiteSpace visualization analysis,thus providing insights into establishing professional teams and assisting in the high-quality development of hospitals.Methods Relevant literature on clinician post-competency was retrieved from the China National Knowledge Infrastructure(CNKI)database.The CiteSpace software was employed to create visualization maps of the publication volume,authors,and keywords of the relevant research.This analysis included author collaboration net-works,keyword co-occurrence,clustering,and burst analysis.Results A total of 710 articles meeting the inclusion criteria were retrieved.Research on clinician post-competency in China demonstrated a general upward trend from 2013 to 2024.Howev-er,collaboration among authors and institutions remained relatively limited.The primary research hotspots focused on fields such as medical education,teaching reform,and training models.The research frontier encompassed topics like reform of teaching modes,evaluation of post-competency among traditional Chinese medicine practitioners,and competency studies utilizing the Del-phi method.Conclusion Research on clinician post-competency in China grows rapidly,garnering increasing attention.To fur-ther advance this field,researchers should enhance collaboration and communication,conduct systematic investigations into re-search hotspots and cutting-edge issues,and continuously refine medical talent education and evaluation mechanisms.These ef-forts will provide a valuable foundation for promoting the high-quality development of hospitals.

Background: Fatty acid-binding protein 4 (FABP4) has been demonstrated to be a predictor of early diabetic nephropathy. However, little is known about the relationship between FABP4 and diabetic retinopathy (DR). This study explored the value of FABP4 as a biomarker of DR in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 238 subjects were enrolled, including 20 healthy controls and 218 T2DM patients. Serum FABP4 levels were measured using a sandwich enzyme-linked immunosorbent assay. The grade of DR was determined using fundus fluorescence angiography. Based on the international classification of DR, all T2DM patients were classified into the following three subgroups: non-DR group, non-proliferative diabetic retinopathy (NPDR) group, and proliferative diabetic retinopathy (PDR) group. Multivariate logistic regression analyses were employed to assess the correlation between FABP4 levels and DR severity. Results: FABP4 correlated positively with DR severity (r=0.225, P=0.001). Receiver operating characteristic curve analysis was used to assess the diagnostic potential of FABP4 in identifying DR, with an area under the curve of 0.624 (37% sensitivity, 83.6% specificity) and an optimum cut-off value of 76.4 μg/L. Multivariate logistic regression model including FABP4 as a categorized binary variable using the cut-off value of 76.4 μg/L showed that the concentration of FABP4 above the cut-off value increased the risk of NPDR (odds ratio [OR], 3.231; 95% confidence interval [CI], 1.574 to 6.632; P=0.001) and PDR (OR, 3.689; 95% CI, 1.306 to 10.424; P=0.014). Conclusion FABP4 may be used as a serum biomarker for the diagnosis of DR.

Dysimmunity plays a key role in diabetes, especially type 1 diabetes mellitus. Islet-specific autoantibodies (ISAs) have been used as diagnostic markers for different phenotypic classifications of diabetes. This study was aimed to explore the relationships between ISA titers and the clinical characteristics of diabetic patients.

Dysimmunity plays a key role in diabetes, especially type 1 diabetes mellitus. Islet-specific autoantibodies (ISAs) have been used as diagnostic markers for different phenotypic classifications of diabetes. This study was aimed to explore the relationships between ISA titers and the clinical characteristics of diabetic patients.

Background: Dysimmunity plays a key role in diabetes, especially type 1 diabetes mellitus. Islet-specific autoantibodies (ISAs) have been used as diagnostic markers for different phenotypic classifications of diabetes. This study was aimed to explore the relationships between ISA titers and the clinical characteristics of diabetic patients. Methods: A total of 509 diabetic patients admitted to Department of Endocrinology and Metabolism at the Affiliated Hospital of Nantong University were recruited. Anthropometric parameters, serum biochemical index, glycosylated hemoglobin, urinary microalbumin/creatinine ratio, ISAs, fat mass, and islet β-cell function were measured. Multiple linear regression analysis was performed to identify relationships between ISA titers and clinical characteristics. Results: Compared with autoantibody negative group, blood pressure, weight, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), visceral fat mass, fasting C-peptide (FCP), 120 minutes C-peptide (120minCP) and area under C-peptide curve (AUCCP) of patients in either autoantibody positive or glutamate decarboxylase antibody (GADA) positive group were lower.Body mass index (BMI), waist circumference, triglycerides (TGs), body fat mass of patients in either autoantibody positive group were lower than autoantibody negative group. GADA titer negatively correlated with TC, LDL-C, FCP, 120minCP, and AUCCP.The islet cell antibody and insulin autoantibody titers both negatively correlated with body weight, BMI, TC, TG, and LDL-C. After adjusting confounders, multiple linear regression analysis showed that LDL-C and FCP negatively correlated with GADA titer. Conclusion Diabetic patients with a high ISA titer, especially GADA titer, have worse islet β-cell function, but less abdominal obesity and fewer features of the metabolic syndrome.