Objective:To investigate the relationship between non-alcoholic fatty liver disease(NAFLD) and hepatic fibrosis and skeletal muscle mass in patients with type 2 diabetes mellitus(T2DM).Methods:A total of 685 T2DM patients diagnosed at the Endocrinology department of Lanzhou University First Hospital, from April 2022 to May 2023, were divided into NAFLD and Non-NAFLD groups, and the NAFLD group was further categorized into fibrosis and non-fibrosis based on aspartate aminotransferase(AST) /alanine aminotransferase(ALT) level. The differences in appendicular skeletal muscle mass(ASM), appendicular skeletal muscle mass index(ASMI), and the prevalence of muscle mass loss were compared across groups. The correlations between ASMI and NAFLD, as well as liver fibrosis were analyzed by binary logistic regression.Results:Among male T2DM patients, those with NAFLD had lower ASMI levels and a higher prevalence of muscle mass reduction compared to non-NAFLD group. Among female T2DM patients, those with NAFLD had lower levels of ASM and ASMI, and a higher prevalence of muscle mass reduction compared to non-NAFLD group. ASMI levels in both male and female T2DM patients were independently negatively correlated with NAFLD risk( OR=-0.696, 95% CI 0.579-0.837; OR=-0.757, 95% CI 0.629-0.911). In NAFLD patients, ASM and ASMI levels were lower in those with liver fibrosis compared to those without fibrosis; however, the prevalence of muscle mass reduction did not differ significantly. Among male NAFLD patients, ASMI levels were independently negatively correlated with the risk of liver fibrosis( OR=-0.726, 95% CI 0.537-0.983), while no correlation was found in female patients. Conclusion:Reduced muscle mass is independently associated with the risk of NAFLD in both male and female T2DM patients. In males, reduced muscle mass is also independently related to the risk of liver fibrosis.

Objective To explore the relationship between serum iron(SI)metabolism and glucose and lipid metabolism in patients with type 2 diabetes mellitus(T2DM).Methods A total of 170 T2DM patients hospitalized in the Department of Endocrinology,Lanzhou University First Hospital from 2019 to 2021 were included.During the same period,30 healthy individuals from physical examination center were selected as the normal control(NC)group.Based on HbA1c control,T2DM patients were divided into subgroups with good blood glucose control(H1,HbA1c＜7%,n=39),poor glucose control(H2,7%＜HbA1c＜9%,n=63)and very poor glucose control(H3,HbA1c＞9%,n=68).According to the level of blood lipids,T2DM patients were divided into subgroups with normal blood lipids(L1,n=36)and high blood lipids(L2,n=134).Results Compared with NC group,age,SBP,DBP,BMI,serum ferritin(SF),FPG,FIns,HOMA-IR,TyG,TG,LDL-C and SUA increased inT2DM group(P＜0.05),while SI,TF,total iron binding capacity(TIBC),DI,HDL-C and eGFR decreased(P＜0.05).The levels of TF and TIBC in H3 subgroup were lower than those in H1 subgroup(P＜0.05).LDL-C of L2 subgroup was higher than that of L1 subgroup(P＜0.05),while HDL-C was lower than that of L1 subgroup(P＜0.05).Pearson correlation analysis showed that SF was positively correlated with HbA1c,TyG,TG and SUA(P＜0.05),and negatively correlated with HDL-C and eGFR(P＜0.05).TF was positively correlated with HDL-C and eGFR(P＜0.05),but negatively correlated with age,SBP,DBP,TyG and SUA(P＜0.05).Multiple linear regression analysis showed that SF and FPG were influencing factors for HbA1c in T2DM patients.Conclusion SI metabolism is closely related to glucose and lipid metabolism in T2DM patients.

Objective:To analyze the preliminary explorations and practical effects of strengthening the process management of nursing special projects in a tertiary general hospital, so as to explore the refined management strategy of hospital projects and provide reference for improving the management level of the research project.Methods:This article takes a series of refined measures taken by the hospital in the process management of nursing special projects from August 2016 to August 2021 as the research example, including setting up subject directions around key disciplines, setting application conditions at different levels, standardizing selection procedures, strengthening mid-term assessments, strictly controlling final acceptance, establishing integrity files, and promoting the transformation of scientific achievements, etc. and these measures are deeply analyzed and discussed.Results:Through a series of measures, the hospital nursing team has significantly improved in terms of research paper publication, patent authorization, approval of projects above the bureau level, and nursing specialties ranking of Chinese hospital Science and Technology Evaluation Metrics (STEM) in the past six years.Conclusions:By strengthening the process management of nursing special research project, the construction level of nursing disciplines has been significantly improved, and the development of nursing disciplines has been greatly promoted.

Objective:To explore the effects of cognitive conflict teaching in nursing undergraduate teaching from the perspective of ideological and political education.Methods:The new undergraduate nursing students of Changzhi Medical College admitted in 2019 and 2020 were selected by convenience sampling. The 145 nursing students enrolled in 2020 were included into the research group, while the 145 nursing students enrolled in 2019 were matched by SPSS software as the control group. Nursing students in the research group received cognitive conflict teaching from the perspective of ideological and political education, while those in the control group was given conventional cognitive conflict teaching. The scores of socialist core values, professional identity, caring ability, and humanistic quality were compared between the two groups.Results:After one year of teaching, the scores of socialist core values, professional identity, caring ability, and humanistic quality of nursing students in the research group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Cognitive conflict teaching from the perspective of ideological and political education can improve nursing students' socialist core values, professional identity, caring ability, and humanistic quality, and realize the effective integration of ideological and political education with professional theoretical knowledge.

ObjectiveTo investigate the status and influencing factors of medication adherence in patients with severe mental disorders in Zhengzhou， so as to provide references for the formulation of prevention and treatment measures for severe mental disorders. MethodsFrom March to June 2021， a stratified multistage cluster sampling method was applied to select 342 patients from the National Information System for Severe Mental Disorders in Zhengzhou. The general demographic data of patients were collected via self-designed questionnaire， and the medication status was investigated， then the influential factors were summarized. The differences in influential factors of medication adherence were compared between the medication adherence group and the medication non-adherence group. Thereafter， Logistic regression analysis was applied to explore the factors influencing medication adherence. ResultsA total of 320 patients were included in the final analysis， altogether 76.56% of patients （n=245） complied with medication. The differences between patients in the medication adherence group and those in the medication non-adherence group were statistically significant in terms of residence， occupation， and outpatient chronic disease reimbursement （χ²=14.015， 7.502， 13.106， P<0.05 or 0.01）. In the questionnaire of influential factors on medication adherence， there were statistically significant differences in the scores of lack of insight， stigma and drug-related factors between the two groups （Z=7.588， 2.379， 2.893， P<0.05 or 0.01）. Outpatient chronic disease reimbursement was a protective factor for medication adherence （OR=2.727， 95% CI： 1.320~5.634， P<0.01）， while rural residence （OR=0.465， 95% CI： 0.221~0.977， P<0.05） and lack of insight （OR=0.398， 95% CI： 0.286~0.553， P<0.01） were risk factors for medication adherence. ConclusionPatients with severe mental disorders in Zhengzhou have a high rate of medication adherence， moreover， the outpatient chronic disease reimbursement， lack of insight and residence may be influencing factors for medication adherence in patients with severe mental disorders.

Objective:According to the requirements of high-quality development of public hospitals, to explore the innovative incentive path for medical youth based on the two-factor theory, and provide a reference for promoting the high-quality development of public hospitals.Methods:Using the literature analysis method, the two-factor theory, hospital scientific research incentive mechanism, and scientific research incentive mechanism for young talents were investigated. Meanwhile, combining the two-factor theory and practical experience, the problems that existed in the innovation incentive policy of public hospitals for young medical talents were analyzed, and the corresponding countermeasures were proposed to build the innovation incentive path of young medical talents under the two-factor theory.Results:Based on analyzing the demand characteristics of young medical talents, managers should distinguish health care factors and incentive factors, and implement incentives from both aspects. Provide incentives through improving the personal sense of achievement, creating a personal growth environment, and promoting professional titles to stimulate young talents' innovation motivation; implement health care factors from aspects of working conditions, material benefits, salary levels, etc.Conclusions:As a new concept of development, high-quality development is not only reflected in scientific and technological innovation-driven, but also in the innovation of management mechanisms so that institutional innovation becomes the driving force for high-quality development.

Objective:To establish the high-level clinical research platform to promote scientific and technological innovation ability in hospitals.Methods:Summarize and share the practical experience of integrating and optimizing the construction of scientific research platform in our hospital, this paper aimed to illustrate the important role of scientific research platform in promoting the innovation ability of science and technology in hospital.Results:According to the construction practice of clinical research platform in our hospital, the planning of clinical research platform should be guided by clinical needs and application. At the same time, having better understandings of relevant national policies, as well as the overall national development strategy layout play important roles in establishing a high-starting point clinical research platform from the very beginning.Conclusions:Accordingly, the key factors to improve the hospital's scientific and technological innovation ability mainly include the construction of scientific research platform, the cultivation of dominant and characteristic disciplines, the cultivation of innovative talents, the cross-disciplinary cooperation, the transformation of innovative achievements and the innovative management mechanism, among which the construction of high-level scientific research platform is the most basic guarantee to enhance the scientific and technological innovation ability.

Objective: To analyze the urinary iodine status of urban and rural residents in some areas of Gansu Province and its related influencing factors, and to provide certain references for scientific iodine intake of urban and rural residents in Gansu Province. Methods: Subjects in Gansu Province with normal thyroid function were recruited in the investigation of thyroid diseases and iodine nutritional status, conducted a questionnaire survey and measured height, weight, waist circumference, collected 1 urine sample, and tested their urinary iodine levels. The urinary iodine levels of different groups were compared based on different gender, region, age, body weight, the waist, and salt intaking. The affecting factors of urinary iodine levels were analyzed by multiple linear regression models. Results: Totally 1 964 subjects were recruited, including 1 099 males, and 865 females. The age was (41.23 ± 14.75) years old. The median urinary iodine of the selected group was 225.60 (158.80, 311.58) μg/L. The urinary iodine level of rural residents was significantly higher than that of urban residents [μg/L: 249.80 (180.58, 336.88) vs 206.25 (148.03, 280.33), Z=-8.015, P < 0.05], and there was no significant difference between the urinary iodine levels of male and female [μg/L: 222.40 (161.60, 298.90) vs 230.60 (158.00, 326.40), P > 0.05]. The composition ratio of < 100 μg/L group in rural areas was lower than that in urban areas (5.14% vs 8.27%, χ²= 7.45, P < 0.05), and the composition ratio of ≥300 μg/L group was higher than that in urban areas (34.93% vs 21.51%, χ²= 43.87, P < 0.05). The composition ratio of ≥300 μg/L group in male was lower than that in female (24.57% vs 31.21%, χ²= 10.73, P < 0.05). The multiple linear regression analysis showed that lived in rural areas, age, moderate and severe salt intaking, student, and weight were independently correlated with urinary iodine levels (β= 0.074, -0.001, 0.059, 0.034, 0.096, -0.003, P < 0.05). And the urinary iodine levels were decreased with age and weight increased (P < 0.05). Conclusions At present, the iodine nutrition level of urban and rural residents in some areas of Gansu Province is generally over the adequate level. The urinary iodine level of rural residents is higher than that of urban residents. In the future, we should pay attention to the impact of different living areas, salt intaking and body weight on urinary iodine levels to prevent thyroid diseases.

Objective: To verify the safety and efficacy of IONTRIS particle therapy system (IONTRIS) in clinical implementation. Methods: Between 6.2014 and 8.2014, a total of 35 patients were enrolled into this trial: 31 males and 4 females with a median age of 69 yrs (range 39-80). Ten patients had locally recurrent head and neck tumors after surgery, 4 cases with thoracic malignancies, 1 case with hepatocellular carcinoma, 1 case with retroperitoneal sarcoma, and 19 cases with non-metastatic prostate carcinomas. Phantom dose verification was mandatory for each field before the start of radiation. Results: Twenty-two patients received carbon ion and 13 had proton irradiation. With a median follow-up time of 1 year, all patients were alive. Among the 16 patients with head and neck, thoracic, and abdominal/pelvic tumors, 2, 1, 12, and 1 cases developed complete response, partial response, stable disease, or disease progression, respectively. Progression-free survival rate was 93.8% (15/16). Among the 19 patients with prostate cancer, biological-recurrence free survival was 100%. Particle therapy was well tolerated in all 35 patients. Twenty-five patients (71.4%) experienced 33 grade 1 acute adverse effects, which subsided at 1 year follow-up. Six (17.1%) patients developed grade 1 late adverse effects. No significant change in ECOG or body weight was observed. Conclusions IONTRIS is safe and effective for clinical use. However, long term follow-up is needed to observe the late toxicity and long term result.

Objective Discipline construction is the core for the development of a hospital and international cooperation and exchange play an important role in promoting discipline construction.This paper summarized the experiences of carrying out international cooperation and exchange in the hospital discipline construction.Methods Analyzed the exploration,practice and its effect in promotion of hospital discipline construction regarding to international cooperation in recent years.Results The international cooperation and exchange have effectively promoted the development of hospital disciplines,for instance,introduction and training of talents,organizing and holding of high-level international conferences,establishment of international academic journals and the joint construction of academic platforms.Conclusions In accordance with the requirements of discipline development strategy,the hospital can improve the overall level of discipline construction rapidly by carrying out all-dimensional cooperation with international top medical institutions.