The aim of this study is to evaluate the effectiveness of a smart non-invasive blood glucose monitor prototype during pregnancy through clinical validation.The monitor utilizes near-infrared spectroscopy combined with AI big data analysis of photoelectric volumetric pulse wave data to achieve non-invasive monitoring of blood glucose in women during pregnancy.The research team developed a monitor that employs a sensing chip,effectively overcoming the problems of weak signals and individual differences in non-invasive blood glucose monitoring.The user experience is enhanced by visualizing the test results on the accompanying cell phone APP(application)of the smart non-invasive pregnancy blood glucose monitor.Clinical validation revealed that the non-invasive monitoring data for pregnant women aged 20～30 years significantly differed from those obtained via traditional blood glucose measurement methods,whereas no significant difference(P<0.05)was observed for pregnant women aged 31～42 years.The study concluded that further calibration of the monitor and an expansion of the sample size are necessary to enhance consistency with invasive glucose monitoring results.

Objective To establish an intelligent detection algorithm model for acute promyelocytic leukemia(M3 model)based on a contrast large model using machine learning statistical software and validate its effectiveness.Methods The data from 8 256 outpa-tients and inpatients who underwent complete blood cell analysis at Peking Union Medical College Hospital were retrieved and analyzed using the laboratory information system(LIS)and hospital information system(HIS).A M3 screening model was established and vali-dated using the data from outpatients and inpatients who underwent complete blood cell analysis at our hospital from July to October 2023.Results The M3 model demonstrated potential application value in screening for M3 disease in complete blood cell analysis,which showed certain efficacy in screening for neutrophil toxicity changes,particularly in identifying two cases of blue-green inclusion bodies in neutrophils.Conclusion The M3 model exhibited low specificity for M3 diagnosis.Future research should focus on increas-ing the number of M3-positive cases to optimize the model,ensuring high sensitivity while improving specificity.This model will provide assistance for the intelligent review of complete blood cell analysis.

The obstruction of post-insulin receptor signaling is the main mechanism of insulin-resistant diabetes. Progestin and adipoQ receptor 3 (PAQR3), a key regulator of inflammation and metabolism, can negatively regulate the PI3K/AKT signaling pathway. Here, we report that gentiopicroside (GPS), the main bioactive secoiridoid glycoside of Gentiana manshurica Kitagawa, decreased lipid synthesis and increased glucose utilization in palmitic acid (PA) treated HepG2 cells. Additionally, GPS improved glycolipid metabolism in streptozotocin (STZ) treated high-fat diet (HFD)-induced diabetic mice. Our findings revealed that GPS promoted the activation of the PI3K/AKT axis by facilitating DNA-binding protein 2 (DDB2)-mediated PAQR3 ubiquitinated degradation. Moreover, results of surface plasmon resonance (SPR), microscale thermophoresis (MST) and thermal shift assay (TSA) indicated that GPS directly binds to PAQR3. Results of molecular docking and cellular thermal shift assay (CETSA) revealed that GPS directly bound to the amino acids of the PAQR3 NH₂-terminus including Leu40, Asp42, Glu69, Tyr125 and Ser129, and spatially inhibited the interaction between PAQR3 and the PI3K catalytic subunit (P110α) to restore the PI3K/AKT signaling pathway. In summary, our study identified GPS, which inhibits PAQR3 expression and directly targets PAQR3 to restore insulin signaling pathway, as a potential drug candidate for the treatment of diabetes.

Background::As a non-invasive and effective diagnostic method for small intestinal bacterial overgrowth (SIBO), wild-use of breath test (BT) has demonstrated a high comorbidity rate in patients with diarrhea-predominant irritable bowel syndrome (IBS-D) and SIBO. Patients overlapping with SIBO respond better to rifaximin therapy than those with IBS-D only. Gut microbiota plays a critical role in both of these two diseases. We aimed to determine the microbial difference between IBS-D overlapping with/without SIBO, and to study the underlying mechanism of its sensitivity to rifaximin.Methods::Patients with IBS-D were categorized as BT-negative (IBSN) and BT-positive (IBSP). Healthy volunteers (BT-negative) were enrolled as healthy control. The patients were clinically evaluated before and after rifaximin treatment (0.4 g bid, 4 weeks). Blood, intestine, and stool samples were collected for cytokine assessment and gut microbial analyses.Results::Clinical complaints and microbial abundance were significantly higher in IBSP than in IBSN. In contrast, severe systemic inflammation and more active bacterial invasion function that were associated with enrichment of opportunistic pathogens were seen in IBSN. The symptoms of IBSP patients were relieved in different degrees after therapy, but the symptoms of IBSN rarely changed. We also found that the presence of IBSN-enriched genera ( Enterobacter and Enterococcus) are unaffected by rifaximin therapy. Conclusions::IBS-D patients overlapping with SIBO showed noticeably different fecal microbial composition and function compared with IBS-D only. The better response to rifaximin in those comorbid patients might associate with their different gut microbiota, which suggests that BT is necessary before IBS-D diagnosis and use of rifaximin.Registration::Chinese Clinical Trial Registry, ChiCTR1800017911.

In order to improve the quality of medical equipment after-sales service quality and improve the quality of medical equipment maintenance, this paper discusses the establishment of an evaluation index system to evaluate the quality of ultrasonic diagnostic equipment. From the three aspects of maintenance results, maintenance process and maintenance coverage, the quality of the post-maintenance quality of hospital ultrasound diagnostic equipment manufacturers is objectively evaluated.
Commerce ; Diagnostic Equipment ; Equipment and Supplies, Hospital ; Maintenance ; Materials Management, Hospital

Taking the Wechat public service platform of Administration of Traditional Chinese Medicine of Yunnan- Yunnan Zhongyi as an example,the paper uses the Importance-performance Analysis (IPA) and corresponding analysis method,from the users' satisfaction perspective,evaluates 28 satisfaction indicators,discusses the relationship between the importance recognition of health Wechat of Traditional Chinese Medicine (TCM) and user characteristic,so as to propose the development of individual TCM health information recommendation and strengthen the effective interaction of platform users.

Objective To explore the value of diffusion tensor imaging (DTI) in differential diagnosis of intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC).Methods Fifty-two patients including 20 patients with ICC (ICC group) and 32 patients with HCC (HCC group) confirmed by histopathological examination were recruited in the study.All the patients were performed MR exams on a 1.5T scanner in a protocol containing the routine T1WI,T2WI,DWI and DTI.The values of ADC,fractional anisotropy (FA),diffusion coefficient (D) were blindly reviewed and analyzed by two experienced observers,and were compared between two groups.The ROC curve was used to evaluate the di agnostic efficiency.Results The border clear percentage of ICC group (9/20,45.00％) had no significant difference compared with that of HCC group (15/32,46.88％;x2 =0.02,P=0.90),the detection rate of bile duct expansion in ICC group (11/20,55.00％) was higher than that in HCC group (4/32,12.50％;x2=10.83,P=0.001).Theintraclasscor relation coefficient value of ADC,D and FA in the ICC group and HCC group were all more than 0.90.The mean FA of ICCgroup (0.45±0.16) were significantly higher than that of HCC group (0.30±0.13;P=0.001),while the mean ADC and D values in ICC and HCC groups had no significant difference (both P＞0.05).The area under the ROC curve of FA was 0.76.And when FA=0.31,there was a higher sensitivity (85.0％) in identifying ICC and HCC.Conclusion The FA of DTI shows a stronger capability than the ADC and D values in differentiating the ICC from HCC.

Objective To investigate the management and prevention of the complications of sigmoid rectal pouch for urinary division after radical cystectomy. Methods The clinical data of 34 patients who underwent a sigmoid rectal pouch procedure were analyzed retrospectively, and the clinical experience was summarized in the management and prevention of the complications of sigmoid rectal pouch for diversion. Results Twenty-six patients were followed up for 2 months to 11 years, and 10 patients lost in follow-up. The early follow-up results were as follows:3 patients had postoperative high fever with unilateral the kidney water, 1 patient had retropubic bleeding and need to stop bleeding, 3 patients suffered from wound split open and were performed relaxation suture, and 1 patient had sigmoid colon rectum bladder fistula 10d after operation. The late follow-up results were as follows:1 patient had urethral neoplasms recurrence, 5 patients developed distance metastases, and 5 patients developed nocturnal incontinence and worn safety pad. There were no hyperchloremic acidosis requiring clinical treatment, hydronephrosis as well as retrograde pelvis infection. Conclusions The operation of sigmoid rectal pouch for urinary division is fairly simple, with no serious complication. It is a better alternative diversion procedure, and should be accepted gradually by patients and surgeons.

OBJECTIVEDiabetic nephropathy (DN) is the major cause of end-stage renal disease worldwide and its prevalence continues to increase. Currently, therapies for DN provide only partial renoprotection; hence new targets for therapeutic intervention need to be identified. In this review, we summarized the new target, sphingosine kinase-1/sphingosine 1-phosphate (SphK1/S1P) pathway, explored its potential therapeutic role in the prevention and treatment of DN.

DATA SOURCESMost relevant articles were mainly identified by searching PubMed in English.

STUDY SELECTIONMainly original articles and critical review articles by major pioneer investigators in this field were selected to be reviewed.

RESULTSSphK1/S1P pathway can be activated by hyperglycemia, advanced glycation end products, and many pro-inflammatory cytokines, which leads to fibronectin, transforming growth factor-β1 up-regulation and AP-1 activation. And then it could promote glomerular mesangial cells proliferation and extracellular matrix accumulation, mediating the initiation and progression of diabetic renal fibrosis.

CONCLUSIONSSphK1/S1P pathway is closely correlated with the pathogenesis of DN. The results suggest that SphK1/S1P pathway as a new target for clinically improving DN in future is of great prospect.

Diabetic Nephropathies ; enzymology ; metabolism ; Extracellular Matrix ; metabolism ; Humans ; Lysophospholipids ; metabolism ; Phosphotransferases (Alcohol Group Acceptor) ; metabolism ; Signal Transduction ; Sphingosine ; analogs & derivatives ; metabolism

Objective To explore the relationship between the characteristics of dynamic contrastenhanced MRI (DCE-MRI) and the stages of endometrial cancer.Methods A retrospective analysis of DCE-MRI manifestation in 55 patients with scratch-pathologically confirmed endometrial cancer was performed.All patients were divided into different groups according to differentiation,muscle layer infiltration,cervix involvement and metastasis.The enhanced rate,including the arterial phase relative signal increase ratio (ARSI％),the maximal relative signal increase ratio (MRSI％) and the signal enhancement ratio (SER％),was calculated at different time (i.e.16 s,32 s,48 s,64 s and 300 s),respectively.Time-intensity curves (TIC) of lesions were also obtained and divided into 4 subtypes.Two sample t test was performed to compare the MRSI％ among groups,and the Mann-Whitney U test was performed in ARSI％ and SER％ as well.Results The early phase enhanced rate of normal tissue was 894 ± 355,higher than that of tumor 716 ± 215 (t =-2.911,P ＜ 0.01).The delayed phase enhanced rate of normal tissue was 1111 ± 289,higher than that of tumor 803-± 289 (t =-4.926,P ＜ 0.01).ARSI％ of low differentiation group (n =16,M =1.07％) was higher than that of middle to high differentiation group (n =39,M=0.36％).ARSI％ of deep muscle layer infiltration group (n =19,M =0.76％) was higher than that of no muscle layer infiltration group (n =36,M =0.32％).ARSI％ of cervix involvement group (n =27,M =0.84％) was higher than that of no cervix involvement group (n =28,M =0.25％).SER％ of cervix involvement group (n =27,M =2.90％) was higher than that of no involvement group (n =28,M =1.40％) and SER％ of parauterine involvement and metastasis group (n =7,M =2.03％) was higher than that of uterine involvement group (n =48,M =1.60％).The differences between these groups were statistically significant (Z =-2.038,-2.260,-2.172,-2.695 and-2.621 respectively,P ＜ 0.05).Based on the TIC types,type Ⅰ occurred in 13 tumors (23.6％),type Ⅱ in 22 tumors (40％),type Ⅲ in 9 tumors (16.4％),and type Ⅳ in 11 tumors (20％).Conclusions Based on TIC curves,most of endometrial cancers showed significant enhancement which reflected of their rich blood supply.The parameters of DCE-MRI is helpful in staging of uterus tumors.