Objective:The status quo and related factors of human papillomavirus (HPV) infection in multiple parts of men who have sex with men (MSM) in Tianjin were analyzed.Methods:Using the cross-sectional survey method, a total of 600 MSM were recruited in Tianjin from September to December 2023, including 200 (18-26 years old), 300 (27-45 years old), and 100 (≥46 years old) stratificaed by age group. Questionnaire survey was used to collect knowledge and behavioral information related to demography and STD prevention and treatment. Exfoliated cells from genital, perianal and oral cavity were collected for HPV typing detection. Logistic regression model was used to analyze the related factors of HPV infection.Results:The infection rate of HPV was 53.67% (322/600) in MSM, with high-risk type as 41.17% (247/600), low-risk type as 27.17% (163/600). The infection rate of HPV in both multiple and single types was 26.83% (161/600).The infection rates of genotypes covered by nine-valent HPV vaccine, quadrivalent HPV vaccine and bivalent HPV vaccine were 36.83% (221/600), 25.17% (151/600) and 9.50% (57/600), respectively.The infection rates of genital HPV, high-risk or low-risk types were 24.67% (148/600), 16.67% (100/600) and 11.00% (66/600), respectively. The infection rates of perianal HPV, high-risk or low-risk types were 42.00% (252/600), 30.17% (181/600) and 20.50% (123/600), respectively. The infection rates of oral HPV high-risk and low-risk types were 3.17% (19/600), 2.33% (14/600) and 1.17% (7/600), respectively. Divorce or widowhood (a OR=2.38, 95% CI: 1.26-4.50), history of homosexual anal intercourse in the past 6 months (a OR=2.28, 95% CI: 1.00-5.50), and use of dependent drugs (including new psychoactive substances) (a OR=1.62, 95% CI: 1.02-2.58) were risk factors for genital HPV infection. College degree/university degree or above (a OR=0.36, 95% CI: 0.16-0.81) was a protective factor for perianal HPV infection, and a history of drug dependence (a OR=1.85, 95% CI: 1.19-2.88) was a risk factor. Conclusions:MSM in Tianjin was a high-risk group for HPV infection, and the HPV infection in the perianal area was more severe than in the genital area and oral area.Marital status, education level, history of homosexual anal sex in the past 6 months, and history of drug dependence were related factors of HPV infection among MSM.

Objective:To investigate the correlation between 25-hydroxyvitamin D3 (25 (OH) D3), insulin-like growth factor 1 (IGF-1) and glycolipid metabolism in patients with diabetes 2 mellitus (T2DM), as well as their predictive value in retinopathy.Methods:A total of 120 T2DM patients admitted to Linyi Central Hospital of Shandong Province from Oct. 2020 to Oct.r 2023 were selected as the study objects (defined as the study group). Another 120 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group. Serum 25 (OH) D3, IGF-1, fasting blood glucose (FBG), 2 h plasma glucose (2 hPG) ) and lipid levels (triglycerides) were compared between the two groups. The levels of TG, total cholesterol (TC) and serum 25 (OH) D3 and IGF-1 were analyzed by Pearson correlation analysis. At the same time, the patients in the study group were divided into diabetic group with retinopathy (DR Group, 40 cases) and non-retinopathy group (NDR group, 80 cases) according to the status of retinopathy. Multivariate analysis was used to analyze the risk factors affecting the occurrence of retinopathy in T2DM patients, and receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of serum 25 (OH) D3 and IGF-1 levels in the occurrence of retinopathy in T2DM patients.Results:The level of serum 25 (OH) D3 was (36.15±4.25) nmol/L in the study group, lower than that in the control group (51.24±5.32) nmol/L ( P<0.05), and the level of IGF-1 was (30.26±4.52) mg/L was in the study group, higher than that in the control group ( P<0.05). The levels of FBG, 2 hPG, TG and TC in the study group were (8.67±2.52) mmol/L, (11.36±2.43) mmol/L, (2.05±0.72) mmol/L, (5.05±1.54) mmol/L respectively, higher than those in the control group [ (5.02±0.42) mmol/L, (6.32±0.54) mmol/L, (1.21±0.32) mmol/L, (3.42±0.68) mmol/L] ( P<0.05). Pearson correlation analysis showed that serum 25 (OH) D3 levels were negatively correlated with FBG, 2 hPG, TG and TC levels in T2DM patients ( r=-0.762, -0.782, -0.736, -0.721, P<0.05). Serum IGF-1 levels were positively correlated with the levels of FBG, 2 hPG, TG and TC in T2DM patients ( r=0.741, 0.756, 0.715, 0.698, P<0.05). Family history of diabetes in DR group, FBG, 2 hPG, TG, TC, IGF-1 levels was 35.00%, (9.31±2.49) mmol/L, (12.52±2.34) mmol/L, (2.76±0.61) mmol/L, (5.92±1.42) mmol/L, (37.89±4.41) mg/L respectively, higher than those in NDR group [16.25%, (8.35±2.15) mmol/L, (10.78±1.75) mmol/L, (1.69±0.52) mmol/L, (4.62±1.31) mmol/L, (26.45±4.06) mg/L] ( P<0.05). 25 (OH) D3 in DR group was (30.21±3.51) nmol/L, lower than that in NDR group (39.12±3.85) nmol/L ( P<0.05). Logistic regression analysis showed that family history of diabetes mellitus, duration of diabetes mellitus, 25 (OH) D3, IGF-1, FBG, 2hPG, TG and TC levels were all risk factors for the occurrence of retinopathy in elderly T2DM patients ( P<0.05). ROC curve analysis showed that AUC and sensitivity of 25 (OH) D3 and IGF-1 combined to predict retinopathy in elderly T2DM patients were 0.854 and 92.50%, respectively, higher than that of 25 (OH) D3 and IGF-1 alone ( P<0.05) . Conclusion:Serum 25 (OH) D3 and IGF-1 levels are abnormally expressed in elderly patients with T2DM, and there is a close relationship between glucose and lipid metabolism in elderly patients with T2DM, and the combined detection of these indicators has a higher predictive value for the occurrence of DR In elderly patients with T2DM.

BACKGROUND: The relationship between the elevation of cardiac troponin and the increase of mortality and hospitalization rate in patients with heart failure with reduced ejection fraction is clear. This study investigated the association between the extent of elevated levels of high-sensitivity cardiac troponin I (hs-cTnI) and the prognosis in heart failure with preserved ejection fraction patients. METHODS: A retrospective cohort study consecutively enrolled 470 patients with heart failure with preserved ejection fraction from September 2014 to August 2017. According to the level of hs-cTnI, the patients were divided into the elevated level group (hs-cTnI >0.034 ng/mL in male and hs-cTnI >0.016 ng/mL in female) and the normal level group. All of the patients were followed up once every 6 months. Adverse cardiovascular events were cardiogenic death and heart failure hospitalization. RESULTS: The mean follow-up period was 36.2 ± 7.9 months. Cardiogenic mortality (18.6% [26/140] vs. 1.5% [5/330], P <0.001) and heart failure (HF) hospitalization rate (74.3% [104/140] vs. 43.6% [144/330], P <0.001) were significantly higher in the elevated level group. The Cox regression analysis showed that the elevated level of hs-cTnI was a predictor of cardiogenic death (hazard ratio [HR]: 5.578, 95% confidence interval [CI]: 2.995-10.386, P <0.001) and HF hospitalization (HR: 3.254, 95% CI: 2.698-3.923, P <0.001). The receiver operating characteristic curve demonstrated that a sensitivity of 72.6% and specificity of 88.8% for correct prediction of adverse cardiovascular events when a level of hs-cTnI of 0.1305 ng/mL in male and a sensitivity of 70.6% and specificity of 90.2% when a level of hs-cTnI of 0.0755 ng/mL in female were used as the cut-off value. CONCLUSION Significant elevation of hs-cTnI (≥0.1305 ng/mL in male and ≥0.0755 ng/mL in female) is an effective indicator of the increased risk of cardiogenic death and HF hospitalization in heart failure with preserved ejection fraction patients.
Humans ; Male ; Female ; Troponin I ; Stroke Volume ; Retrospective Studies ; Biomarkers ; Heart Failure ; Prognosis

Objective:To retrieve, evaluate, integrate the evidence of Traditional Chinese Medicine (TCM) nursing appropriate technology for chemotherapy-induced nausea and vomiting at home and abroad, and summarized the relevant best evidence to provide evidence-based basis practice for the clinical standard management of chemotherapy-induced nausea and vomiting and improved the treatment efficiency of patients' symptoms.Methods:The study evidence on TCM nursing appropriate technology for chemotherapy-induced nausea and vomiting systemically retrieved in the websites and databases,included13 guidelines and evidence summary websites, namely National Guideline Clearinghouse, New Zealand Guidelines Group, Medlive, etc; 6 Oncology Professional Association Websites, namely British Columbia Cancer Agency, Cancer Care Ontario, National Comprehensive Cancer Network, Oncology Nursing Society, European Society for Medical Oncology, American Society of Clinical Oncology;11 electronic databases, namely CNKI, VIP, WanFang, CBM, PubMed, Web of Science, Embase, etc; supplementary searched expert consensus and practice guidelines for cancer diagnosis and treatment including evidence-based decision-making, guidelines, evidence summaries, best/recommended practices, systematic reviews, expert consensus, and government documents. The literature retrieval period was from the database construction to January, 2023. The guidelines individually evaluated by 3 researchers, and the remaining literature independently evaluated by 2 researchers. The literature that met the criteria extracted and graded. Finally, the expert group integrated the evidence and summarized the evidence topics.Results:A total of 12 articles were involved, included 2guidelines,2 evidence summaries,3 expert consensuses, and 5 systematic reviews. Finally,4 evidence topics and 20 pieces of best evidence were formed, included applicable population, efficacy, safety and intervention measure .Conclusions:The best evidence of TCM nursing appropriate technology treatment of chemotherapy-induced nausea and vomiting provided evidence resources for clinical transformation, for traditional Chinese medicine and integrated Chinese and western medicine nursing group to provide clinical decision-making basis, and according to the principle of syndrome differentiation to form personalized practice scheme, effectively improved patients' symptoms, promote the recovery of patients.

Objective:To investigate the effect of levothyroxine withdrawal before radioiodine therapy on blood lipids and renal function in patients with differentiated thyroid carcinoma (DTC) after operation.Methods:From Mar. 2020 to Apr. 2022, 214 patients with differentiated thyroid cancer were enrolled in the General Surgery Department, Linyi Central Hospital, Shandong Province. All patients stopped taking levothyroxine sodium after total thyroidectomy. The thyroid function index, blood lipid index and renal function index were measured and compared before and after drug withdrawal (before operation) and after drug withdrawal (before radioiodine treatment). The patients were divided into groups according to the duration of drug withdrawal (drug withdrawal group for 3 weeks, drug withdrawal group for 4 weeks), and the differences of thyroid function index, blood lipid index, and renal function index among patients with different drug withdrawal time were compared. The measurement data in accordance with normal distribution were compared between groups, and independent sample t-test was performed. Results:The levels of free thyroxin T4 (FT 4) and free triiodothyronine (FT 3) in DTC patients decreased significantly ( t=57.60, 71.74,all P<0.001), and the levels of thyroid-stimulating hormone (TSH) increased significantly ( t=102.15, P<0.001). After drug withdrawal, the serum lipid index [triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL), low density lipoprotein (LDL) ] and renal function index [blood urea nitrogen (BUN), serum creatinine (SCR) ] of DTC patients increased significantly ( t=20.17, 42.50, 12.13, 30.73, 16.09, 43.73, all P<0.001). The levels of FT 3 and FT 4 in the 4-week group were significantly lower than those in the 3-week group ( t=7.75 and 10.07, both P<0.001), and TSH was significantly higher than that in the 3-week group ( t=26.46, P<0.001). The levels of TG, LDL, HDL, TC, BUN and Scr in the 4-week group were significantly higher than those in the 3-week group ( t=10.13, 10.29, 8.53, 11.47, 10.54, 8.55, all P<0.001). Correlation analysis showed that the levels of FT 3 and FT 4 in DCT patients were negatively correlated with the levels of TG, LDL, HDL, TC, BUN and Scr ( r=-0.256, -0.189, -0.249, -0.314, -0.352, -0.231, -0.342, -0.259, -0.304, -0.216, -0.391, -0.271, P=0.011, 0.029, 0.007, 0.004, 0.015, 0.036, 0.002, 0.009, 0.019, 0.017, 0.016, 0.003), and the levels of TSH were correlated with TG, LDL, HDL, TC and BUN Scr level was positively correlated ( r=0.257, 0.308, 0.219, 0.311, 0.251, 0.271, P=0.006, 0.013, 0.032, 0.004, 0.006, 0.014) . Conclusion:Stopping levothyroxine sodium before radioactive iodine treatment after DTC can easily lead to dyslipidemia and decreased renal function in patients, and the longer the withdrawal time is, the more obvious the changes of blood lipids and renal function in patients, and the withdrawal time should be shortened in clinical treatment.

Objective:To explore the application value of humanistic literacy and clinical practice ability training in postgraduate courses of geriatrics.Methods:Postgraduates in Zhejiang University School of Medicine were taken as research objects. The teaching curriculum combining humanistic literacy and clinical practice ability training was set as the course of experimental group, and the teacher-led teaching course was set as the course of control group. The questionnaire survey was conducted to the evaluate the teaching effect among the postgraduates from three aspects: classroom situation, knowledge application and ability training. SPSS 17.0 was used for t-test. Results:The teaching of combining humanistic literacy and clinical practice ability training in classroom atmosphere, participation, teacher-student communication, helping memory, knowledge comprehension, knowledge application, collaboration ability, expression ability, organizational ability, knowledge acquisition ability, and autonomous learning ability scores of the experimental group were (3.96±0.20), (3.92±0.28), (3.75±0.44), (3.92±0.28), (3.96±0.20), (3.96±0.20), (3.83±0.38), (3.92±0.28), (3.79±0.41), (3.88±0.34), and (3.83±0.38), which were better than those of the control group, especially in classroom atmosphere, participation, knowledge application, expression ability, and autonomous learning ability.Conclusion:The combination of humanistic literacy and clinical practice ability training can significantly improve the classroom atmosphere of geriatric postgraduate courses, enhance students' medical humanistic literacy, familiarize students with the core skills of geriatrics, and improve students' ability to express and learn independently.

Objective:To understand knowledge, belief, practice level of insulin injection and influencing factors of behavior of clinical nurses in tertiary general hospitals, so as to provide the basis for formulating targeted training programs for insulin injection.Methods:Using the convenient sampling method, a total of 169 clinical nurses in the adult ward of a tertiary general hospital were selected as the research objects in May 2020. The self-made basic information questionnaire and Insulin Injection Knowledge, Belief and Practice Questionnaire were used for investigation. Binary Logistic regression analysis was used to investigate the influencing factors of insulin injection behavior of clinical nurses.Results:Among 169 clinical nurses, the awareness rate of guidelines was 82.84% (140/169) , 95.86% (162/169) of nurses had patient education experience, the incidence rate of insulin injection needle stab injury was 14.79% (25/169) , and 90.53% (153/169) of nurses had the need to receive insulin injection system training. The total scores of knowledge, belief and practice dimensions of the Insulin Injection Knowledge, Belief and Practice Questionnaire for clinical nurses were respectively 60.00 (45.00, 70.00) , 50.00 (49.00, 50.00) and 85.00 (82.00, 85.00) , and the total score of the questionnaire was 189.00 (178.50, 200.50) . The results of binary Logistic regression analysis showed that knowing the guidelines, receiving insulin injection operation training and insulin injection needle stick experience were the influencing factors of insulin injection behavior ( P<0.05) . Conclusions:Clinical nurses in tertiary general hospitals have a high level of insulin injection beliefs and behaviors and there are still deficiencies in insulin injection knowledge. In the training work related to clinical insulin injection, attention should be paid to strengthening and maintaining the belief and behavior of standardized insulin injection, emphasizing the safety of insulin injection, and combining with the technical guidelines and specifications of insulin injection, improving the knowledge reserve and application ability of insulin injection of clinical nurses.

Objective The aim of this study is to explore the hypoglycemic effect of active components of Anoectochilus roxburghii on zebrafish models. Methods Anoectochilus roxburghii components were extracted and separated into three groups: the alcohol extraction group, macromolecular polysaccharide group (≥ 5 ×103) and small molecular polysaccharide group (＜5×103). Zebrafish embryos were exposed to 2% glucose solution (2% Glu) at 24 h to imitate acute hyperglycemia phenotype, and then treated with the three Anoectochilus roxburghii components. Based on this high-glucose model, the zebrafish embryos at 72 h were collected to detect the whole tissue glucose value. Furthermore, semi-quantitative PCR and whole mount in situ hybridization were performed to detect the expression of mRNA levels of glycometabolism-related genes. Results An acute diabetic zebrafish model was induced by high glucose stress. In this model, some key factors during glycometabolism such as insulin, pck-1 and pdx-1 were significantly affected, while the alcohol extracts of Anoectochilus roxburghii obviously reversed these abnormalities induced by high glucose stress, even to normal levels. Conclusions The alcohol extracts of Anoectochilus roxburghii has obvious hypoglycemic effect on diabetic zebrafish model. Our result suggest that Anoectochilus roxburghii has a potential application in the hypoglycemic drug screening.

Objective To investigate the effects of enteral nutritional emulsions on glucose and lipid metabolism in elderly patients with diabetes. Methods This randomized controlled trail recruited 80 elderly diabetic patients whose MNA-SF scores were between 0-11 with dysphagia or inability for oral feeding and who were randomized into a TPF-DM group ,a TPF-D group ,a TPF-T group ,and a TPF group.Glycolipid metabolism indexes and nutritional indexes were measured before intervention and at 1 m ,2 m and 3 m after intervention. Results Compared with baseline levels , FBG and HbA1c declined in the TPF-DM group[(5.70 ± 0.69)mmol/L vs .(7.90 ± 1.71)mmol/L and (6.39 ± 1.11)% vs .(7.92 ± 1.50)%,all P＜0.05]and the TPF-D group[(5.72 ± 1.12)mmol/L vs . (7.63 ± 1.73 )mmol/L and (6.86 ± 0.97 )% vs .(7.81 ± 1.04 )%,all P＜ 0.05 ]after 3 months of treatment ,but no significant difference was found between these two groups. The TPF-DM ,TPF-D , TPF-T groups showed significantly narrower fluctuation ranges of 24 h blood glucose levels after 3 months[(2.20 ± 0.88)mmol/L vs .(4.43 ± 2.07)mmol/L ,(2.94 ± 1.16)mmol/L vs .(4.22 ± 1.60) mmol/L ,(3.21 ± 1.64)mmol/L vs .(4.36 ± 1.88)mmol/L ,all P ＜ 0.05).Serum albumin levels increased in all four groups ,compared with baseline levels (all P＜0.05) ,but there was no significant difference between the groups(all P＞0.05). Furthermore ,the serum HDLC level increased in all four groups than baseline (all P＜ 0.05). Conclusions Enteral nutritional emulsions containing slow release starch and fructose ,dietary fibers and proper ω6 and ω3 ratio can stabilize blood sugar ,regulate blood lipids ,and improve nutritional status.

Objective The aim of this study was to explore the inhibitory effect of alcohol extracts of Narcissus bulb on melanogenesis in zebrafish embryos.Methods Zebrafish embryos were exposed to different concentrations of alcohol extracts of Narcissus (0, 50, 100, 200, and 500 μg/mL), and then the formation of melanin was observed.Furthermore, we measured the enzyme activity of tyrosinase (TYR), which plays a pivotal role in melanogenesis.Meanwhile, the spatial and temporal pattern of melanin-specific marker genes were detected.Arbutin (Ar) was used as a positive control in all these experiments.Results The treatment of alcohol extracts of Narcissus bulb inhibited melanogenesis in the zebrafish embryos in a dose-dependent manner.Furthermore, the mRNA expression levels of melanin-related genes such as tyrosinase (TYR), silver (SILV) and Mitfa were significantly reduced after treatment with different concentrations of Narcissus extracts by in-situ and semi-quantitative PCR.Finally, the enzyme activity of tyrosinase was also gradually decreased with increasing concentrations of the alcohol extracts.Conclusions Narcissus alcohol extracts can effectively inhibit the production of melanin in zebrafish embryos.This study provides potential evidence and approaches for the screening of natural whitening compounds using zebrafish models.