Objective: To evaluate the dietary quality of residents in Wenzhou City, Zhejiang Province, so as to provide the basis for future health education and nutrition intervention programs. Methods: A stratified multi-stage random sampling method was used to select residents aged 18 years and older in 6 counties (cities, districts) of Wenzhou City as the study subjects, “24-hour dietary review for 3 consecutive days” was adopted to collect dietary intake, and the diet balance index (DBI_16) scoring method was applied to evaluate the dietary quality. Results: This study analyzed the dietary quality of 406 residents in Wenzhou City, including 197 males (48.52%) and 209 females (51.48%). The majority of the residents were aged 18-44 years (254 residents, 62.56%). The median DBI total score was -31 (interquartile range, 8), and 404 residents had insufficient dietary intake, accounting for 99.51%. The median DBI positive score was 5 (interquartile range, 6), and 288 residents had appropriate dietary intake, accounting for 70.94%. The median DBI negative score was 37 (interquartile range, 6), and 210 residents had a high level of insufficient dietary intake, accounting for 51.72%. Five dietary patterns, namely A, B, C, E and F, were identified, with pattern B being the most dominant, accounting for 75.62% of the total (307 individuals). Patterns D, H, I and G were not observed. Conclusions The dietary quality of the residents surveyed indicates the existence of dietary imbalances, mainly manifesting as inadequate intake. It is recommended to strengthen nutritional and health guidance.

Objective:To investigate the value and clinical significance of fasting plasma glucose (FPG) in early pregnancy (8-12 gestational weeks) as a predictor of gestational diabetes mellitus (GDM) among women with different pre-pregnancy body mass index (pre-BMI) categories.Methods:A retrospective study was conducted including 9 710 singleton pregnant women (FPG levels in early pregnancy ≤5.6 mmol/L) who underwent prenatal screening and delivery in Yuyao People's Hospital from January 2020 to December 2022. Participants were stratified based on their pre-BMI as follows: <18.5 ( n=1 406), ≥18.5 to <25.0 ( n=7 162), ≥25.0 to <30.0 ( n=978), and ≥30.0 kg/m 2 ( n=164). Within each pre-BMI category, women were further divided into four groups based on FPG levels in early pregnancy (<4.5, ≥4.5 to <4.8, ≥4.8 to <5.1, and ≥5.1 mmol/L). Univariate and multivariate logistic regression analysis were used to identify risk factors for GDM, and receiver operating characteristic (ROC) curve was applied to evaluate the efficacy of FPG in early pregnancy based on different pre-BMI in predicting GDM. Results:The overall incidence of GDM in the singleton pregnancy women with FPG levels in early pregnancy ≤5.6 mmol/L was 12.3% (1 197/9 710). For a pre-BMI of <18.5 kg/m 2, the ORs with 95% CIs for GDM within the different FPG categories (<4.5, ≥4.5 to <4.8, ≥4.8 to <5.1, and ≥5.1 mmol/L) were 0.041 (95% CI: 0.015-0.409), 1.834 (95% CI: 1.089-3.088), 6.779 (95% CI: 4.041-11.371), and 13.723 (95% CI: 5.560-33.871), respectively. For pre-BMI of ≥18.5 to <25.0 kg/m 2, the respective the ORs with 95% CIs were 0.048 (95% CI: 0.012-0.203), 2.573 (95% CI: 2.091-3.168), 9.023 (95% CI: 7.240-11.245), and 9.158 (95% CI: 6.484-12.937). For pre-BMI of ≥25.0 to <30.0 kg/m 2, the ORs with 95% CIs were 0.108 (95% CI: 0.053-0.446), 1.698 (95% CI: 1.064-2.654), 7.537 (95% CI: 5.285-13.080), and 9.994 (95% CI: 5.613-18.218). For pre-BMI of ≥30.0 kg/m 2, the ORs with 95% CIs were 0.098 (95% CI: 0.072-1.015), 2.888 (95% CI: 0.911-9.157), 13.674 (95% CI: 3.480-53.736), and 20.509 (95% CI: 6.674-63.019). The optimal cutoff value of FPG in early pregnancy for GDM prediction was 4.7 mmol/L with an area under the curve of 0.752, the risk of GDM significantly increased with FPG levels ≥4.7 mmol/L in early pregnancy across all pregnant women ( OR=17.356, 95% CI: 13.757-21.896, P<0.001). Conclusions:In the singleton pregnancy women with FPG levels in early pregnancy ≤5.6 mmol/L, FPG in early pregnancy is an independent risk factor for the occurrence of GDM; for pregnant women stratified by the same pre-BMI, the risk of developing GDM increases progressively with the rise of FPG in early pregnancy. FPG in early pregnancy has a certain value in predicting the occurrence of GDM.

Purpose: The interval between neoadjuvant chemotherapy (NAC) and surgery for locally advanced breast cancer (LABC) remains controversial. At the same time, the prognostic effect of delayed surgery in patients with poor responses is currently unclear. Methods: Data was collected from patients who had poor responses to NAC and underwent modified radical surgery from January 2013 to December 2018. The interval from completion of NAC to surgery was divided into two groups: a longer (greater than four weeks) or shorter (four weeks or less) interval. The associations of these interval groups with overall survival (OS) and recurrence-free survival (RFS) were evaluated by multivariable Cox models adjusting for the existing prognostic factors. Propensity score matching (PSM) was used to minimize election bias. Results: A total of 1,229 patients (mean age, 47.2 ± 8.9 years; median follow-up duration, 32.67 [6.57–52.63] months) were included. The 5-year OS rates were 73.2% and 60.8% in the shorter (n = 171) and longer interval group (n = 1,058), respectively, while the 3-year RFS rates were 80.8% and 71.7%, respectively. In multivariate Cox analysis, the longer interval was associated with an increased risk of mortality (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.01–2.02; p = 0.046) and recurrence (HR, 1.50; 95% CI, 1.12–1.99; p = 0.006).There was an interaction between the molecular subtype and the surgery interval for OS (pinteraction = 0.014) and RFS (pinteraction = 0.027). After PSM, no significant difference in OS (p = 0.180) and RFS (p = 0.069) was observed between the two groups. Conclusion Among LABC patients with a poor response, those with a longer interval between NAC and surgery had worse OS and RFS. The results indicate that these patients should receive modified radical surgery timely, which may in turn improve their prognosis.

Objective To explore the effects of lung rehabilitation using Spiro-tiger training apparatus on the respiratory mechanics and airway remodeling in patients with chronic obstructive pulmonary disease(COPD)in stable stage.Methods Ninety-three stable COPD patients admitted to Nanxiang Branch of Shanghai Ruijin Hospital were randomly divided into control group(46 cases)and observation group(47 cases).Control group was treated with the training for pursed lips breathing and abdominal breathing,and observation group was trained with Spiro-tiger training apparatus in addition to the treatment given to control group.Both groups were intervened continuously for 9 weeks.The two groups were compared in terms of respiratory mechanics(respiratory frequency,tidal volume,minute ventilation,and peak respiratory pressure),airway remodeling[matrix metalloproteinase-9(MMP-9),vascular endothelial growth factor(VEGF),and transforming growth factor-β1(TGF-β1)],and lung function[forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),and FEV1/FVC],blood gas analysis indexes[arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2)],6-minute walking distance(6MWD)and health status[Borg scale and St.George's respiratory questionnaire(SGRQ)].The patients were followed up for 6 months,and the incidence of acute exacerbation of COPD was recorded.Results After 9 weeks of intervention,compared with control group,observation group had lower peak respiratory frequency and respiratory pressure,and higher tidal volume(P<0.05).There was no significant difference in minute ventilation between two groups(P>0.05).The levels of MMP-9,VEGF,TGF-β1 and PaCO2 were lower,and FVC,FEV1,FEV1/FVC and PaO2 were higher in observation group than in control group(P<0.05).Observation group had longer 6MWD,and lower Borg score and SGRQ score as compared with control group(P<0.05).After 6-month follow-up,the incidence of COPD acute exacerbation in observation group was lower than that in control group(4.26%vs19.57%,P<0.05).Conclusion Lung rehabilitation using Spiro-tiger training apparatus can effectively improve respiratory mechanics,lung function,blood gas analysis indexes and health status in stable COPD patients,alleviate airway remodeling,and avoid acute exacerbation of COPD.

Alcoholic liver disease(ALD)is the most frequent liver disease worldwide,resulting in severe harm to personal health and posing a serious burden to public health.Based on the reported antioxidant and anti-inflammatory capacities of scutellarin(SCU),this study investigated its protective role in male BALB/c mice with acute alcoholic liver injury after oral administration(10,25,and 50 mg/kg).The results indicated that SCU could lessen serum alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels and improve the histopathological changes in acute alcoholic liver;it reduced alcohol-induced malondialdehyde(MDA)content and increased glutathione peroxidase(GSH-Px),catalase(CAT),and superoxide dismutase(SOD)activity.Furthermore,SCU decreased tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and IL-1β messenger RNA(mRNA)expression levels,weakened inducible nitric oxide synthase(iNOS)activity,and inhibited nucleotide-binding oligomerization domain(NOD)-like receptor protein 3(NLRP3)inflammasome activation.Mechanistically,SCU suppressed cytochrome P450 family 2 subfamily E member 1(CYP2E1)upregulation triggered by alcohol,increased the expression of oxidative stress-related nuclear factor erythroid 2-related factor 2(Nrf2)and heme oxygenase-1(HO-1)pathways,and suppressed the inflammation-related degradation of inhibitor of nuclear factor-κB(NF-κB)-α(IκBα)as well as activation of NF-κB by mediating the protein kinase B(AKT)and p38 mitogen-activated protein kinase(MAPK)pathways.These findings demonstrate that SCU protects against acute alcoholic liver injury via inhibiting oxidative stress by regulating the Nrf2/HO-1 pathway and suppressing inflammation by regulating the AKT,p38 MAPK/NF-κB pathways.

Objective To study the prevalence of cigarettes and e-cigarettes, and to analyze its influencing factors among high school students in Wenzhou. Methods:A self-administered questionnaire survey was conducted among a total of 3 785students from senior high schools and vocational high schools in Wenzhou from September to November in 2020, who were selected by stratified cluster sampling. Their demographic information and the use of tobacco [including the use of cigarettes, e-cigarettes (currently smoking and smoking attempt), and the dual use of them] were asked in the questionnaire of “Global Youth Tobacco Survey”(GYTS). Proportion and rate were used to describe their demographic characteristics and smoking prevalence. Chi-square test was used to compare the difference in smoking prevalence of the high school students with selected characteristics. Multinomial logistic regression was used to analyze the influencing factors of tobacco use among the participants.Results:Among the 3 785 questionnaires, 3 740 were completed, and effective rate was 98.80%. The smoking attempt rate, current smoking rate, e-cigarette attempt rate, e-cigarette using rate, and dual using rate of the high school students in Wenzhou were 11.79% (441/3 740), 2.57% (96/3 740), 10.00% (374/3 740), 2.86% (107/3 740), 0.99% (37/3 740), respectively. Male students, vocational high school students, the students whose parents smoking showed higher smoking attempt rate, current smoking rate, e-cigarette attempt rate than female student, senior high school students and those parents who don′t smoke, respectively (all P<0.05). Best friend smoking [6.076 (2.872-12.855); 4.630 (2.656-8.071)], vocational high school [3.226 (1.877-5.546); 2.238 (1.432-3.496)] were risk factors for e-cigarette and the cigarettes use, belief that whether smoking or not does not make any difference in social activities [0.160 (0.077-0.331); 0.193 (0.096-0.387)], or smoking in social activities makes people more uncomfortable [0.037 (0.018-0.077); 0.155 (0.083-0.288)] were protective factors of e-cigarette and the cigarettes use. Additionally, passive smoking in past week [2.194 (1.129-4.262)], free tobacco products received [2.836 (1.018-7.905)], seeing smoking in campus [2.072 (1.111-3.863)] were all risk factors, while belief that smoking makes young people less attractive [0.280 (0.116-0.676)], not having been to tobacco retail outlets and unexposed to tobacco advertising or promotion [0.241 (0.123-0.473)] can protect senior middle school student away from cigarette. As to e-cigarette, boys were the risk factors [1.831 (1.100-3.050)]; as opposed to being a risk factor for cigarette use [1.942 (1.084-3.478)], rural area was a protective factor for e-cigarette use [0.639 (0.410-0.994)] among high school students in Wenzhou. Conclusions:High school students have relatively low rates of smoking cigarettes and e-cigarette in Wenzhou. Vocational students, best friend smoking are risk factors of e-cigarette and the cigarettes, beliefs that whether smoking or not does not make any difference or smoking makes people more uncomfortable in social activities are protective factors.

Objective: To investigate the differential expression of serum-and-glucocorticoid-inducible-kinase-2 (SGK2) in hepatocellular carcinoma (HCC) and normal liver tissues and the related mechanism mediating signal transduction of GSK-3 β / β catenin in HCC cells. Methods: Twenty pairs of matched HCC and normal tissues were collected and the situation of expression of SGK2 mRNA was detected by real-time fluorescence quantitative PCR. Western blot was used to detect the levels of SGK2 protein in human HCC cell lines (Huh-7, SMMC-7721) and normal human liver cell line (L02). SGK2 siRNA was used to transfect human HCC cell lines (SMMC-7721 and Huh-7), and then the protein expression levels of GSK-3 β/ β - catenin was successfully detected with the above-mentioned transfected cell line by western blot. Measurement data were expressed as mean ± standard deviation (±s), and the Student t -test was used as the statistical method. Results: SGK2 mRNA expression was up-regulated in all 20 HCC samples than that of the expression of matched normal liver tissues. SGK2 protein levels were significantly higher in Huh-7 and SMMC-7721 than normal human liver cell lines (P < 0.01). The downregulation of SGK2 expression in human HCC cell lines (SMMC-7721 and Huh-7) had inhibited the expression of unphosphorylated GSK-3 β. In addition, the downregulation of SGK2 expression in HCC cell lines had decreased the dephosphorylation of β - catenin to prevent degradation of the β - catenin proteasome. Conclusion SGK2 is overexpressed in HCC and mediates GSK-3β/β- catenin signaling in HCC cells.

Objective To observe the effect of brain-derived microvesicles (BDMVs) on cytoskeleton in human umbilical vein endothelial cells (HUVECs).Methods BDMVs were prepared in vitro and identified by transmission electron microscopy and particle size identification.HUVECs were co-cultured with PKH26-1abeled BDMVs for 0.5,1,and 2 h;flow cytometry was used to detect the phagocytosis of HUVECs for BDMVs at different time points.HUVECs cultured in vitro were divided into control group,BDMVs treatment group and nimodipine treatment group;cells in the BDMVs treatment group were given 1.5× 107/mL BDMVs;cells in the nimodipine treatment group were pretreated with 2 μg nimodipine (0.2 mg/mL) for 10 min,and then,given 1.5×107/mL BDMVs.After being stained with rhodamine-labeled phalloidin,the fluorescence intensity and number of stress fibers of fibroactin in HUVECs were observed by laser confocal microscopy.Results BDMVs had complete membrane structure with a diameter of 100-1000 nm under transmission electron microscopy.The proportion of cells phagocytizing BDMVs increased significantly with prolonged incubation time,enjoying significant differences (0.5h:22.7％±1.2％;1 h:52.3％±1.3％;2h:71.6％±1.9％,P＜0.05).Laser confocal microscopy showed that,as compared with the control group,the fluorescence intensity ofcytoskeletal protein was obviously increased and the number of stress fibers increased was obviously larger in the BDMVs treatment group.As compared with those in the BDMVs treatment group,the fluorescence intensity of cytoskeletal protein was decreased and the number of stress fibers was obviously smaller in the nimodipine group.Conclusion The role of BDMVs in phagocytosis of HUVECs becomes stronger as time being prolonged,and BDMVs phagocytosis leads to cytoskeletal remodeling,which can be partially blocked by nimodipine.

Objective:To observe the expressions of Th22 cells and IL-22 in peripheral blood of patients with Lupus nephritis (LN) and explore its significance.Methods: Patients of systemic lupus erythematosus (SLE) with no renal involvement (n=38),lupus nephritis (n=32) and healthy controls (n=10) were studied.Flow cytometry was utilized to quantify the percentage of Th22 cells in peripheral blood.Enzyme-linked immunosorbent assay was used to detect the levels of serum IL-22.The Th22 cells and The serum level of IL-22 among three groups were compared,and the correlation between Th22,IL-22 and SLE disease activity index score (SLEDAI) was analyzed.Results: Th22 cells in SLE group and LN group were significantly higher than those in healthy control group (P<0.01).Serum IL-22 level was also significantly higher than that of healthy control group (P<0.01);Th22 and IL-22 LN group were slightly higher than that in SLE group,but the difference was not significant (P>0.05).The proportion of Th22 cells and the level of IL-22 in LN group were positively correlated with the disease activity score SLEDAI.Conclusion: Th22 cells and IL-22 may play an important role in the pathogenesis of SLE and LN.

Objective To explore the clinical and sonographic characteristics of pancreatic acinar cell carcinoma (PACC).Methods The clinical data and abdominal sonographic findings of 13 cases of PACC identified with pathology were reviewed,including contrast-enhanced ultrasound (CEUS) images.There were 9 males and 4 females with the average of 53.9 years old.Symptoms included upper abdominal pain,nausea,chest distress and weight loss.Results The serum level of tumor maker was elevated in only 5 cases.Eight masses (61.5％) were located in the pancreatic body-tail,4 (30.8％) in the head,the whole pancreas was involved in 1 case.The mean maximal diameter was 8.0 cm.Four lesions (30.8％) presented as solid-cystic mass.Well-defined border was showed in 6 cases (60.0％).Exophytic type was observed in 5 cases (38.5％).Pancreatic ductal dilation was seen in 3 cases (23.1％),in which 2 cases showed obstruction of common biliary duct.Liver metastasis was assessed in 4 patients (30.8％),and lymph node metastasis in 3 cases (23.1％).Vessels were invaded in 4 cases (30.8％).In 2 cases by CEUS,one showed arterial iso-enhancement,the other with strong enhancement.Conclusion Certain characteristic clinical and ultrasonographic features could be revealed in PACC,as a sizable,exophytic,solid-cystic and relatively hypervascular mass with well-definded border.