【Objective】 To investigate the practice and benefit of national standardized management of type 2 diabetes in Yulin City. 【Methods】 We recruited the adult type 2 diabetes patients who sought medical help at our hospital from May 2020 to October 2022 as subjects. We collected their basic information (sex and age); measured height, weight, waist and hip circumference, and blood pressure; calculated body mass index (BMI); and detected blood glucose, c-peptide, HbA1c, biomarkers, urinary microalbumin, sensory nerve conduction velocity of lower limbs, ABI, and subcutaneous and visceral fat at the time of MMC recruited and the end of six months. T test and Mann-Whitney U rank sum test were used for measurement data and χ² test or Fisher’s exact probability method for counting data to analyze the data. 【Results】 After 6 months, the levels of fasting blood glucose, postprandial blood glucose, HbA1c, and visceral and subcutaneous fat in all the patients decreased, but the level of fasting c-peptide increased compared with the baseline (all P<0.05). Secondly, compared with the baseline, the control rate of HbA1c (35.21% vs. 13.71% ) and the comprehensive control rate (13.97% vs. 7.26% ) were both significantly increased at six months (P<0.05). Thirdly, after 6 months, the levels of fasting blood glucose, postprandial blood glucose, HbA1c, TG, TC, and UA were decreased more, while the fasting c-peptide and postprandial c-peptide were increased more in the patients of the HbA1c standard group (HbA1c<7% ) than those of the non-standard group. 【Conclusion】 The multiple benefits of blood glucose, blood lipid, uric acid and islet function can be achieved by taking type 2 diabetes patients into MMC. Meanwhile, the rates of HbA1c control and comprehensively reaching the standard are significantly increased. Therefore, MMC can explore a new way for the management of type 2 diabetic patients in this area.

BACKGROUND: Vaccination has been shown effective in controlling the global coronavirus disease 2019 (COVID-19) pandemic and reducing severe cases. This study was to assess the flare and change in disease activity after COVID-19 vaccination in patients with stable rheumatoid arthritis (RA). METHODS: A prospective cohort of RA patients in remission or with low disease activity was divided into a vaccination group and a non-vaccination group based on their COVID-19 vaccination status. Each of them was examined every 3 to 6 months. In the vaccination group, disease activity was compared before and after vaccination. The rates of flare defined as disease activity scores based on 28-joint count (DAS28) >3.2 with ΔDAS28 ≥0.6 were compared between vaccination and non-vaccination groups. RESULTS: A total of 202 eligible RA patients were enrolled. Of these, 98 patients received no vaccine shot (non-vaccination group), and 104 patients received two doses of vaccine (vaccination group). The median time interval from pre-vaccination visit to the first immunization and from the second dose of vaccine to post-vaccination visit was 67 days and 83 days, respectively. The disease activity scores at pre-vaccination and post-vaccination visits in the vaccination group patients were similar. At enrollment, gender, RA disease course, seropositivity, and disease activity were comparable across the two groups. Flare was observed in five (4.8%) of the vaccination group patients and nine (9.2%) of the non-vaccination group patients at post-vaccination assessment ( P  = 0.221). In terms of safety, 29 (27.9%) patients experienced adverse events (AEs) after vaccination. No serious AEs occurred. CONCLUSIONS COVID-19 vaccinations had no significant effect on disease activity or risk of flare in RA patients in remission or with low disease activity. Patients with stable RA should be encouraged to receive the COVID-19 vaccination.
Humans ; Arthritis, Rheumatoid ; Cohort Studies ; COVID-19/prevention & control* ; COVID-19 Vaccines/adverse effects* ; East Asian People ; Prospective Studies ; Vaccination/adverse effects*

Objective: To establish a rapid detection method for Salmonella based on the combination of enzymatic recombinase amplification (ERA) and lateral flow chromatography (LF), so as to provide technical support for the on-site detection of Salmonella. Methods: Specific ERA primers and probes were designed based on the highly conserved flagella gene fimY in Salmonella. The primers were screened using capillary electrophoresis, and the probes were designed according to the amplification range of the screened primers. The amplification temperature and time were optimized to establish the amplification method, and the product was detected using LF strips. A standard strain of Salmonella was used to verify the sensitivity, 10 other gut bacteria were used to to verify the specificity and sensitivity, and the nucleic acid of the actual Salmonella strains was amplified to verify the detectability. Results: After screening for Salmonella-specific primers using capillary electrophoresis, the minimum detection concentration was 5 copies/μL under the amplification temperature of 37 ℃ and reaction time of 20 minutes. This method had a positive amplification result for Salmonella nucleic acid, and the amplification results of 10 other gut bacteria were all negative, with good specificity. Conclusion This method provides a possibility for on-site point of care testing of Salmonella infection.

Objective:To conduct quality evaluation and content analysis of adult postoperative nausea and vomiting (PONV) guidelines, so as to provide reference for management of clinical PONV.Methods:Web of Science, Embase, PubMed, UpToDate, SinoMed, Wanfang Database, China National Knowledge Infrastructure, VIP, domestic and foreign clinical practice guidelines and related professional association websites were systematically searched, and the search period was from database establishment to May 6, 2022. Four researchers independently evaluated the guidelines that met the inclusion and exclusion criteria using a clinical guideline research and evaluation system, and summarized the recommendations of the guidelines.Results:Finally, a total of 15 guidelines were included in this study. The overall quality evaluation of the guide was 3 A-level recommendations and 12 B-level recommendations. The average standardization percentages for 6 areas were 81.57% for scope and purpose, 49.91% for participants, 65.38% for rigor, 89.54% for clarity, 34.86% for applicability and 55.42% for independence. A total of 18 recommendations were summarized from five aspects, such as team and organizational management, PONV risk assessment, baseline risk reduction, multimodal prevention of PONV and effectiveness evaluation and monitoring.Conclusions:The guidelines for PONV management mainly come from foreign countries. It is recommended that clinical personnel should learn from foreign guidelines and combine them with domestic clinical situations to localize the recommended opinions and guide the development of clinical practice.

Sterol-regulatory element binding proteins (SREBPs) are the key transcriptional regulators of lipid metabolism. The activation of SREBP requires translocation of the SREBP precursor from the endoplasmic reticulum to the Golgi, where it is sequentially cleaved by site-1 protease (S1P) and site-2 protease and releases a nuclear form to modulate gene expression. To search for new genes regulating cholesterol metabolism, we perform a genome-wide CRISPR/Cas9 knockout screen and find that partner of site-1 protease (POST1), encoded by C12ORF49, is critically involved in the SREBP signaling. Ablation of POST1 decreases the generation of nuclear SREBP and reduces the expression of SREBP target genes. POST1 binds S1P, which is synthesized as an inactive protease (form A) and becomes fully mature via a two-step autocatalytic process involving forms B'/B and C'/C. POST1 promotes the generation of the functional S1P-C'/C from S1P-B'/B (canonical cleavage) and, notably, from S1P-A directly (non-canonical cleavage) as well. This POST1-mediated S1P activation is also essential for the cleavages of other S1P substrates including ATF6, CREB3 family members and the α/β-subunit precursor of N-acetylglucosamine-1-phosphotransferase. Together, we demonstrate that POST1 is a cofactor controlling S1P maturation and plays important roles in lipid homeostasis, unfolded protein response, lipoprotein metabolism and lysosome biogenesis.

Objective:To explore the clinical effect of phase Ⅰ cardiac rehabilitation exercise on patients with acute myocardial infarction after percutaneous transluminal coronary intervention (PCI).Methods:Convenient sampling method was adopted, totally 84 acute myocardial infarction patients after PCI was randomized into an observation group and control group. Both groups accepted general nursing care. The observation group also accepted the phase Ⅰ cardiac rehabilitation exercise. Cardiac ultrasonic, the 6-minute walk test were used to evaluate the patients′ cardiac function and exercise tolerance, the SF-12 were used to evaluate the quality of life.Results:After repeated measurement ANOVA, before the intervention, there was no significant difference in cardiac function and quality of life between the two groups ( P>0.05); before discharge, the 6-minute walk distance of the observation group was longer than that of the control group, and the difference was significant( F value was 5.279, P=0.024). At 1 month after discharge, there were significant differences in the LVEF( F value was 8.119, P=0.006) and 6-minute walking distance( F value was 9.829, P=0.002) between the two groups ( P<0.05), analysis of the six items of SF-12 including general health( F value was 6.905, P=0.010), physical functioning( F value was 10.595, P=0.002), role physical( F value was 11.168, P=0.001), bodily pain( F value was 12.548, P=0.001), mental health( F value was 7.362, P=0.008) and vitality( F value was 13.692, P<0.001) having shown significant differences between the two groups. At 3 months after discharge, there were significant differences in the LVEF( F value was 11.156, P=0.001), 6-minute walk distance( F value was 16.554, P<0.001)and quality of life in all dimensions between the two groups ( P<0.05). Conclusion:Phase Ⅰ cardiac rehabilitation exercise can improve cardiac function and the quality of life in patients with acute myocardial infarction undergoing PCI, and enhance the exercise tolerance.

Objective:To investigate changes in the expression of immunohistochemical (IHC) markers and factors associated with the effect of chemotherapy before and after neoadjuvant chemotherapy (NAC).Methods:A retrospective study included 200 breast cancer patients treated with NAC between January 2016 and December 2018. We analyzed the changes in the expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and Ki-67 in pre- and post-treated samples and the predictive factors of NAC.Results:Among the 200 cases, 16 cases were luminal A, 108 cases were luminal B, 36 cases were HER2 +subtype, and 40 cases were basal-like. Twenty-five patients (12.50%) achieved pathological complete remission (PCR).There were significant differences in PR and Ki-67 before and after NAC but there were no differences in ER and HER2.In univariate analysis, factors associated with PCR were tumor less than 5 cm( P=0.009), non-luminal breast cancer ( P=0.001), ER negative( P=0.001), PR negative ( P=0.029) and HER2 positive( P=0.001). Tumor less than 5 cm [ P=0.020, OR=2.581, 95% CI (1.207, 5.753)], ER negative [ P=0.011, OR=2.264, 95% CI (1.207, 4.248)] and HER2 positive[ P=0.007, OR=2.412, 95% CI (1.275, 4.561)] remained predictive variables in multivariate analysis after correction for the other variables. Conclusions:The expression of Ki-67 decreases after NAC. Negative PR and ER and positive HER2 status are related to the efficacy of pCR for breast cancer, and have guiding significance for the prognosis evaluation of NAC.

Objective:To evaluate the effect of two kinds of anterior maxillary segmental osteotomies on nasal morphology.Methods:30 patients with bimaxillary protrusion were included at from Tianjin Stomatological Hospital Between January 2015 and December 2017. There were 8 males and 22 females aged from 19 to 32 years old, the patients were randomly divided into the traditional operation group and modified operation group according to the order of treatment. 20 patients underwent traditional anterior maxillary osteotomy while 10 patients underwent modified osteotomy. Pre- and post-operative 1-year CBCT data of 30 patients were imported in Proplan CMF software, to reconstruct the 3D model of the nose and select characteristic landmarks. Three locating planes and 3D point measurement system were established, Relevant indices consisted of nasolabial angle, upper and lower nasolabial angle, nasal tip angle, nasal tip inclination, nasal columella inclination, nasal height, depth of nasal tip, vertical nasal tip position, nasal alar base width, inner canthic diameter, nasal columella height, bilateral nasal axis angle, nostril area and the comparison between two groups were conducted using paired-samples t test, the effect of two surgical methods on nasal morphology were evaluated. Results:There were statistically significant differences between the nasolabial angle, nasal columella inclination, nasal height, nasal alar base width between preoperative group(113.74°±9.42°, 120.06°±7.73°)and postoperative group (121.93°±4.05°, 129.86°±7.63°), whereas no significant difference among nasal tip angle, nasal tip inclination, vertical nasal tip position, nasal columella height, bilateral nasal axis angle and nostril area in traditional operative group. However, in the modified operation group, there were statistically significant differences in the nasolabial angle, vertical nasal tip position between preoperative group [110.75°±1.67°and(11.87±1.39) mm] and postoperative group [122.42°±6.95° and(11.16±1.02) mm], whereas no significant difference among other measurement items.Conclusions:Compared with the traditional osteotomies, the modified method has little influence on the nasal morphology after operation, meanwhile achieve good surgical result. However, the modified surgical method has its own indications, flexible application can obtain the best surgical result and patient satisfaction.

Objective:Using a combination of 2D and 3D methods to evaluate the difference of lip changes between two maxillary anterior segmental osteotomy methods.Methods:30 patients who visited the Department of Orthognathic Surgery of Tianjin Stomatological Hospital from January 2015 to January 2017 with maxillary protrusion [8 males and 22 females, aged (25.0 ± 0.6) years old] were divided into two groups. One group was treated with cupar maxillary anterior segmental osteotomy. One group underwent modified method. 4 osseous tissue measurements, 8 soft tissue measurements and 7 lip measurements were collected in three-dimensional model, lateral cephalometric radiographs and frontal photos at one week before surgery and one year after surgery to observe the difference between the two groups in the lip area and calculate the retreat ratio of upper incisor to upper lip.Results:The wounds of all 30 patients were healed in one stage without infection and bone necrosis. There was no recurrence of the bone protrusion at 1 year after the operation. After treatment, the bone relationship was normal and the dental arch and occlusal curve were normal. The occlusion relationship and the lip-tooth relationship were good. The shape of the lower third of the face was significantly improved, and the relationship between nose, lips and chin was coordinated. The change of the horizontal position of the lip and the position of the neck of upper incisor tooth (UJ) had a significant positive correlation. In traditional group R= 0.768 and in modified group R= 0.771. The sella-nasion-A point decreased and the nasolabial angle increased in both groups. The difference was statistically significant before and after surgery ( P<0.05). The amount of retraction of the neck point and incision point of the upper incisor and the amount of retraction of the upper lip were significantly reduced. The difference before and after surgery was statistically significant ( P<0.05). There was an increase in the thickness of the upper lip before and after surgery, a decrease in the distance between the upper and lower lip, and a decrease in the distance between the upper incisor and the upper lip. The differences were statistically significant ( P<0.05) compared with those before surgery. The increase of upper lip height in the modified group was statistically significant ( P<0.05), but not in the traditional group. Upper lip height showed a statistically significant increase in the modified procedure group. The retreat ratios of the point Pro of incisor and the upper lip were 1.19∶1 and 0.81∶1 in traditional group and modified group. In frontal view, it was observed that the midline lip thickness became more significantly smaller although the limited change amount and the upper lip line tended to be M-type. Conclusions:These two surgical procedures have obvious effects on maxillary protrusion deformity. The change of the horizontal position of the lip and the position of the neck of upper incisor tooth (UJ) had a significant positive correlation. The lip height increased in modified group compared to traditional group.

Objective:To evaluate the effect of two kinds of anterior maxillary segmental osteotomies on nasal morphology.Methods:30 patients with bimaxillary protrusion were included at from Tianjin Stomatological Hospital Between January 2015 and December 2017. There were 8 males and 22 females aged from 19 to 32 years old, the patients were randomly divided into the traditional operation group and modified operation group according to the order of treatment. 20 patients underwent traditional anterior maxillary osteotomy while 10 patients underwent modified osteotomy. Pre- and post-operative 1-year CBCT data of 30 patients were imported in Proplan CMF software, to reconstruct the 3D model of the nose and select characteristic landmarks. Three locating planes and 3D point measurement system were established, Relevant indices consisted of nasolabial angle, upper and lower nasolabial angle, nasal tip angle, nasal tip inclination, nasal columella inclination, nasal height, depth of nasal tip, vertical nasal tip position, nasal alar base width, inner canthic diameter, nasal columella height, bilateral nasal axis angle, nostril area and the comparison between two groups were conducted using paired-samples t test, the effect of two surgical methods on nasal morphology were evaluated. Results:There were statistically significant differences between the nasolabial angle, nasal columella inclination, nasal height, nasal alar base width between preoperative group(113.74°±9.42°, 120.06°±7.73°)and postoperative group (121.93°±4.05°, 129.86°±7.63°), whereas no significant difference among nasal tip angle, nasal tip inclination, vertical nasal tip position, nasal columella height, bilateral nasal axis angle and nostril area in traditional operative group. However, in the modified operation group, there were statistically significant differences in the nasolabial angle, vertical nasal tip position between preoperative group [110.75°±1.67°and(11.87±1.39) mm] and postoperative group [122.42°±6.95° and(11.16±1.02) mm], whereas no significant difference among other measurement items.Conclusions:Compared with the traditional osteotomies, the modified method has little influence on the nasal morphology after operation, meanwhile achieve good surgical result. However, the modified surgical method has its own indications, flexible application can obtain the best surgical result and patient satisfaction.