Background::While type 2 diabetes mellitus (T2DM) is considered a putative causal risk factor for coronary artery disease (CAD), the intrinsic link underlying T2DM and CAD is not fully understood. We aimed to highlight the importance of integrated care targeting both diseases by investigating the phenotypic and genetic relationships between T2DM and CAD.Methods::We evaluated phenotypic associations using data from the United Kingdom Biobank ( N = 472,050). We investigated genetic relationships by leveraging genomic data conducted in European ancestry for T2DM, with and without adjustment for body mass index (BMI) (T2DM: Ncase/ Ncontrol = 74,124/824,006; T2DM adjusted for BMI [T2DM adjBMI]: Ncase/ Ncontrol = 50,409/523,897) and for CAD ( Ncase/ Ncontrol = 181,522/984,168). We performed additional analyses using genomic data conducted in multiancestry individuals for T2DM ( Ncase/ Ncontrol = 180,834/1,159,055). Results::Observational analysis suggested a bidirectional relationship between T2DM and CAD (T2DM→CAD: hazard ratio [HR] = 2.12, 95% confidence interval [CI]: 2.01–2.24; CAD→T2DM: HR = 1.72, 95% CI: 1.63–1.81). A positive overall genetic correlation between T2DM and CAD was observed ( rg = 0.39, P = 1.43 × 10 -75), which was largely independent of BMI (T2DM adjBMI–CAD: rg = 0.31, P = 1.20 × 10 –36). This was corroborated by six local signals, among which 9p21.3 showed the strongest genetic correlation. Cross-trait meta-analysis replicated 101 previously reported loci and discovered six novel pleiotropic loci. Mendelian randomization analysis supported a bidirectional causal relationship (T2DM→CAD: odds ratio [OR] = 1.13, 95% CI: 1.11-1.16; CAD→T2DM: OR = 1.12, 95% CI: 1.07-1.18), which was confirmed in multiancestry individuals (T2DM→CAD: OR = 1.13, 95% CI: 1.10-1.16; CAD→T2DM: OR = 1.08, 95% CI: 1.04-1.13). This bidirectional relationship was significantly mediated by systolic blood pressure and intake of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, with mediation proportions of 54.1% (95% CI: 24.9-83.4%) and 90.4% (95% CI: 29.3-151.5%), respectively. Conclusion::Our observational and genetic analyses demonstrated an intrinsic bidirectional relationship between T2DM and CAD and clarified the biological mechanisms underlying this relationship.

[Purpose]To analyze the incidence and mortality of thyroid cancer in Gansu cancer registration areas in 2019 and the trends from 2010 to 2019.[Methods]The data of thyroid can-cer from 2010 to 2019 were collected from 23 cancer registries in Gansu Province and the data quality was evaluated.The crude incidence/mortality rates,age-standardized incidence/mortality rates by Chinese standard population(ASIRC,ASMRC)and world standard population(ASIRW,ASMRW)and cumulative rate(0～74 years old)were calculated.The annual percentage change(APC)and average annual percentage change(AAPC)were calculated with Joinpoint software to analyze the trends of the incidence and mortality from 2010 to 2019.[Results]In 2019,the crude incidence of thyroid cancer was 6.89/105,the ASIRC was 5.50/105,the ASIRW was 5.33/105 and the cumulative rate(0～74 years old)was 0.48％in 2019.The crude mortality rate of thy-roid cancer was 0.42/105,ASMRC was 0.27/105,ASMRW was 0.31/105,cumulative rate(0～74 years old)was 0.03％.Incidence and mortality rates gradually increasing at age 30 and 55,re-spectively,reaching the peaks in the 45～49 and 60～64 age groups,respectively.Chengguan Dis-trict of Lanzhou City had the highest incidence rate,and Gulang County had the highest mortality rate.From 2010 to 2019,the AAPC of ASIRC of thyroid cancer was 17.12％(95％CI:7.52％～30.42％,P＜0.05)showing an upwards trend;while that of ASMRC was-3.64％(95％CI:-15.67％～10.10％,P＞0.05)showing a downward trend,but the change was not statistically significant.[Conclusion]The overall incidence of thyroid cancer in Gansu cancer registration areas is on the rise,and the prevention of high-risk groups should be strengthened.

[Purpose]To analyze the incidence and mortality of gastric cancer in 2019 in Gansu cancer registration areas and the trend from 2010 to 2019.[Methods]The data of gastric cancer reported by 23 cancer registries in Gansu Province were collected.The crude incidence and mor-tality rates,standardized incidence and mortality rates by Chinese and world standard population(ASIRC,ASIRW and ASMRC,ASMRW)and cumulative rate were calculated.The annual percentage change(APC)and the average annual percentage change(AAPC)were calculated with Joinpoint regression model.[Results]In 2019,the crude incidence of gastric cancer was 48.54/105,the ASIRC was 31.30/105,and the ASIRW was 34.40/105.The cumulative rate(0～74 years old)was 3.95％.The crude mortality rate of gastric cancer was 29.12/105,the ASWRC was 18.29/105,the ASMRW was 20.74/105,the cumulative rate(0～74 years old)was 2.13％.Gastric cancer accounted for 17.93％of all cancer new cases in Gansu Province in 2019,and accounted for 21.52％of all cancer deaths,both ranking the first of all cancers in the province.The AAPC of ASIRC was-5.85％(95％CI:-7.94％～-3.20％),and the AAPC of ASMRC was-6.12％(95％CI:-7.32％～-4.73％).For regional distributions,Lintan County had the highest incidence rate,Ganzhou District had the highest mortality rate,Qingcheng County had the lowest incidence rate and Baiyin District had the lowest mortality rate.[Conclusion]The incidence and mortality of gastric cancer in Gansu Province have been decreasing,however,the prevention and control strategies of gastric cancer should be continuously earried out in the province and strengthened screening for high risk population.

Objective To investigate the effect of ultrasound-guided anterior quadratus lumborum block at lateral supra-arcuate ligament on postoperative analgesia and inflammation response in elderly patients undergoing robot-assisted laparoscopic radical prostatectomy.Methods A total of 60 elderly patients who had undergone robot-assisted laparoscopic radical prostatectomy from June 2022 to June 2023 were randomly divided into a group of ultra-sound-guided anterior quadratus lumborum block at lateral supra-arcuate ligament combined with general anesthesia(observation group,n = 30)and a general anesthesia group(control group,n = 30).Both groups received patient-controlled intravenous analgesia after surgery.The first compression time of an analgesic pump and the numbers of effective compression and remedial analgesia were recorded.The VAS scores at postsurgical hours 2,12,24,and 48 during rest and coughing were recorded.Interleukin-6(IL-6)and systemic immunoinflammatory index(SII)at one day before surgery and two hours,one day and three days after surgery were recorded.Anal exhaust time,length of postoperative hospital stay and occurrence of adverse reactions were recorded.Results The observation group,as compared with the control group,had significantly longer first compression time of an analgesic pump and had fewer numbers of effective compressions and remedial analgesic administrations(P<0.05).The VAS scores during rest and coughing in the observation group were lower than those in the control group at postsurgical hours 2,12,24,and 48(P<0.05).As compared with one day before surgery,both IL-6 and SII in the two groups increased at 2 hours,1,and 3 days after surgery,but the changes in the observation group were lower than those in the control group(P<0.05).As compared with the control group,the observation group had shorter anal exhaust time and length of postoperative hospital stay,and a lower incidence of adverse reactions(P<0.05).Conclusions Ultrasound-guided anterior quadratus lumborum block at lateral supra-arcuate ligament can provide better postoperative analgesia,reduce inflammatory response and accelerate postoperative recovery in elderly patients undergoing robot-assisted laparoscopic radical prostatectomy.

Objective:To evaluate the effect of anterior quadratus lumborum block at the lateral supra-arcuate ligament on the postoperative pulmonary function in patients undergoing robot-assisted laparoscopic radical prostatectomy under general anesthesia.Methods:Seventy-two American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ patients, aged 50-80 yr, with body mass index of 18.5-27.9 kg/m 2, scheduled for elective robot-assisted laparoscopic radical prostatectomy under general anesthesia, were divided into 2 groups ( n=36 each) using a random number table method: control group and observation group. After induction of general anesthesia, observation group underwent anterior quadratus lumborum block at the lateral supra-arcuate ligament under ultrasound guidance, with 20 ml of 0.375% ropivacaine administered on each side. Control group only received total intravenous anesthesia. Postoperative analgesia was provided by patient-controlled intravenous analgesia until 48 h after operation, and intravenous dezocine was administered as rescue analgesic when the visual analogue scale score at rest≥4. Pulmonary function was assessed at 1 day before surgery and 1-7 days after surgery. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV 1), maximal mid-expiratory flow rate (FEF 25%-75%), and time to recovery of 80% predicted pulmonary function were recorded. Arterial blood gas analysis was performed at 1 day before surgery and 1-3 days after surgery, and SpO 2, PaO 2 and PaCO 2 were recorded. The consumption of intraoperative remifentanil, effective pressing times of patient-controlled analgesia, and the number of patients required rescue analgesia were recorded. Postoperative pulmonary complications within 7 days after operation and re-hospitalization within 30 days were recorded. The time to first flatus, postoperative length of hospital stay and occurrence of adverse reactions (dizziness, nausea, vomiting) within 3 days after surgery were also recorded. Results:Compared with control group, FVC, FEV 1 and FEF 25%-75% were significantly increased postoperatively, the time to recovery of 80% FVC, FEV 1 and FEF 25%-75% was shortened, postoperative SpO 2 and PaO 2 were increased, postoperative PaCO 2 was decreased, the consumption of intraoperative remifentanil, effective pressing times of patient-controlled analgesia, and the number of patients required rescue analgesia were reduced, the postoperative time to first flatus and length of hospital stay were shortened, and the incidence of adverse reactions and pulmonary complications was decreased ( P<0.05). Conclusions:Anterior quadratus lumborum block at the lateral supra-arcuate ligament can improve postoperative pulmonary function, reduce adverse reactions, and promote early recovery for the patients undergoing robot-assisted laparoscopic radical prostatectomy under general anesthesia.

Objective To investigate the effect of patient's body shape and image acquisition mode on the radiation dose and image quality in percutaneous coronary angiography.Methods A total of 40 patients,who received selective percutaneous coronary angiography at the Ningbo Medical Center Lihuili Hospital of China between January 2022 and June 2023,were selected for this study.The patients were randomly divided into conventional group(including 11 males and 9 females,using coronary angiography mode to make image acquisition)and low-dose group(including 14 males and 6 females,using electrophysiological mode to make image acquisition).The patient's basic information,body size data,and the various radiation dose data were collected.The image quality rating scale for assessing the image quality was formulated.The independent sample t-test and Mann-Whitney U test were used for the comparison between the two groups.Pearson correlation analysis method was used to make correlation analysis.Results The larger the patient's chest circumference was,the higher the radiation dose would be,there was a positive linear relationship between the patient's chest circumference and the radiation dose.All the radiation dose parameters in the low-dose group were significantly lower than those in the conventional group(P＜0.01),and its reduction percentage was 48.51％-60.74％.No statistically significant difference in image quality score existed between the two groups(P＞0.0l),and in both groups the image quality was rated as good or better,meeting the requirements of intervention procedures.Conclusion In percutaneous coronary angiography the radiation dose is influenced by multiple factors including patient's body shape,image acquisition mode,exposure time,etc.Optimizing the image acquisition mode can remarkably reduce the radiation dose while maintaining the image quality and protecting the health of patients and operators.(J Intervent Radiol,2024,33:599-603)

ObjectiveTo explore the effects of Baihu Jia Renshen Tang （BHRS） on the related molecules on the phosphatidylinositol-3-kinase/protein kinase B（PI3K/Akt）signaling pathway in the liver of MKR diabetic model mice. MethodThirty 6-week-old MKR mice were selected and fed on a high-fat diet for four weeks，followed by intraperitoneal injection of streptozotocin（STZ）for the diabetes model establishment. The model was properly induced in the case of the fasting blood glucose （FBG） of ≥11.1 mmol·L^-1. After modeling，the mice were randomly divided into a model group，a BHRS group （12.09 g·kg^-1·d^-1），and a metformin group （0.065 g·kg^-1·d^-1），with 10 mice in each group. Ten FVB mice were assigned to the control group. The mice in the groups with drug intervention were continuously administered correspondingly for 28 days. After administration，the mice were sacrificed，followed by the oral glucose tolerance test （OGTT） and FBG detection. Serum very low-density lipoprotein（VLDL）content was determined by semi-quantitative enzyme-linked immunosorbent assay （ELISA）. Four indexes related to blood lipid were determined by the biochemistry analyzer. Liver tissues were subjected to pathological examination by hematoxylin-eosin（HE）staining. Western blot was used to detect the protein expression of PI3K，Akt，phosphorylated（p）-PI3K，p-Akt，forkhead box protein O1 （FoxO1），insulin receptor（InsR），and insulin receptor substrate-2（IRS-2） in liver tissues of mice. Real-time polymerase chain reaction（Real-time PCR） was used to detect the mRNA expression of PI3K，Akt，FoxO1，InsR，and IRS-2 in liver tissues of mice. ResultCompared with the control group，the model group showed poor general conditions，abnormal glucose tolerance （P<0.05），increased FBG （P<0.01），abnormal blood lipid metabolism，increased serum total cholesterol （TC），triglyceride（TG），low-density lipoprotein cholesterol（LDL-C），and VLDL （P<0.05），decreased level of high-density lipoprotein cholesterol（HDL-C）（P<0.05），fatty degeneration and obvious pathological changes of liver cells，reduced protein expression of PI3K，Akt，p-PI3K/PI3K，p-Akt/Akt，IRS-2，and InsR in liver tissues（P<0.05），increased protein expression of FoxO1（P<0.05），decreased mRNA expression of PI3K，Akt，IRS-2，and InsR in liver tissues （P<0.05），and increased FoxO1 mRNA expression（P<0.05）. Compared with the model group，the BHRS group showed improved general conditions and glucose and lipid metabolism （P<0.05），improved pathological state of liver cells，increased protein expression of PI3K，Akt，p-PI3K/PI3K，p-Akt/Akt，IRS-2，and InsR in liver tissues（P<0.05），decreased protein expression of FoxO1（P<0.05），increased mRNA expression of PI3K，Akt，IRS-2，and InsR in liver tissues （P<0.05），and reduced FoxO1 mRNA expression（P<0.05）. ConclusionBHRS can effectively reduce blood glucose，regulate blood lipid metabolism，and improve the pathological state of the liver in MKR diabetic mice，and its mechanism of action may be related to the regulation of the activity of molecules on the PI3K/Akt signaling pathway.

Gouty arthritis （GA） is a metabolic disease caused by disorders of purine metabolism and/or abnormal excretion of uric acid in the body. Its pathogenesis is mostly related to dietary structure as well as excessive intake of protein， sugar and fat， and the clinical manifestations are joint redness， swelling， heat and pain， which seriously affect the daily life of patients. Therefore， it is urgent to carry out research on anti-GA drugs. Western drugs for the treatment of GA， such as colchicine， can relieve pain in the short term， but with obvious side effects in long-term treatment. Traditional Chinese medicine has definite efficacy and high safety in the treatment of GA and is more acceptable to patients than western medicine. Modern medical research has concluded that inflammatory factors， oxidative stress， apoptosis and intestinal dysbacteriosis are closely related to the pathogenesis of GA. In-depth research has found that single traditional Chinese medicine and its compounds can regulate Toll-like receptors/myeloid differentiation factor 88 （TLRs/MyD88） signaling pathway， NLR family pyrin domain containing 3 （NLRP3） inflammasome， nuclear transcription factor-κB （NF-κB） and other inflammatory signaling pathways， and further intervene in the downstream cytokines such as interleukin-1β （IL-1β）， interleukin-2 （IL-2）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， peroxisome proliferator-activated receptor γ （PPARγ）， nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor-α（IκB-α） and aspartate-specific cysteine protease 1 （Caspase-1） to reduce inflammatory factors and increase anti-inflammatory factors， thereby exerting the anti-GA role. Therefore， this paper summarized and elaborated the experiments of inflammatory response mediated by traditional Chinese medicines and their compounds via regulating inflammatory signaling pathways in recent years， which provides new ideas and theoretical basis for finding more related anti-inflammatory traditional Chinese medicines for the treatment of GA.

Objective: To investigate the prevalence and influencing factors of caries among Tibetan primary school students in Maqu County, Gansu Province, so as to provide insights into caries control among children living in ethnic minority areas. Methods: Tibetan primary school students at grades three to six were sampled from two primary schools in Maqu County using a multi-stage cluster sampling method. Primary school students' demographics, dietary habits and oral health habits were collected using questionnaire surveys, and the caries was tested. Factors affecting the development of caries were identified using a multivariable Poisson regression model. Results: A total of 378 Tibetan primary school students were tested, and there were 334 students with caries, with a caries prevalence rate of 86.30%, and a mean caries number of (4.72±2.69) teeth. Multivariable Poisson regression analysis showed that grade (grade 5, IRR=0.791, 95%CI: 0.706-0.886; grade 6, IRR=0.698, 95%CI: 0.593-0.822), frequency of vegetable intake (less than once daily, IRR=0.872, 95%CI: 0.778-0.978; once daily, IRR=0.769, 95%CI: 0.677-0.873; twice and more daily, IRR=0.571, 95%CI: 0.469-0.696), frequency of tooth brushing (once daily, IRR=0.814, 95%CI: 0.734-0.904; twice and more daily, IRR=0.606, 95%CI: 0.521-0.703) and frequency of oral examinations (IRR=0.736, 95%CI: 0.594-0.911) were influencing factors of caries. Conclusion The prevalence of caries is 86.30% among Tibetan primary school students at grades 3 to 6 in Maqu County, and age, dietary habit and oral health habit are factors affecting the development of caries.

Objective:Considering the large amount and poor quality of clinical data, this study aims to explore the establishment of high-quality research database and its role in real-world research by taking the establishment of lymphoma research database as an example.Methods:The expert opinions in the field of lymphoma were collected, and the relevant guidelines and standards were referenced to establish a standard medical knowledge dataset. The electronic diagnosis and treatment data of lymphoma patients treated in Peking University Cancer Hospital from February 2005 to December 2020 were retrospectively extracted, the deep Learning, natural language processing were adopted to build a dynamic intelligent information integration and processing system of " lymphoma database based on electronic medical record system - biological sample information database - extended genetic information database" .Results:The research database not only meets the research needs of clinical researchers, but also realizes the management of traces in the whole process of application, approval, traceability and analysis of hospital medical record data and biological sample data. The total number of research variables in the database was 668, and the structured variables accounted for 46.0%. On December 25, 2021, there were 68 687 lymphoma patients in the database, the ratio of male to female patients was 8/9, and the proportion of patients with ≥3 visits accounted for 23.0%. In addition, researchers can superimpose searches in the database according to the target conditions, display the targeted medical records according to research hypothesis, and then establish a research cohort, conducting statistical modeling, and mining data information.Conclusions:By integrating management processes and using new natural language artificial intelligence technology to establish a high-level evidence-based database, it is helpful for the interconnection and resource sharing of hospital information systems, so as to achieve the purpose of providing reliable and detailed data for real-world research.