Diabetes is a very complex endocrine disease whose common feature is the increase in blood glucose concentration. Persistent hyperglycemia can lead to blindness, kidney and heart disease, neurodegeneration, and many other serious complications that have a significant impact on human health and quality of life. The number of people with diabetes is increasing yearly. The global diabetes prevalence in 20-79 year olds in 2021 was estimated to be 10.5% (536.6 million), and it will rise to 12.2% (783.2 million) in 2045. The main modes of intervention for diabetes include medication, dietary management, and exercise conditioning. Medication is the mainstay of treatment. Marketed diabetes drugs such as metformin and insulin, as well as GLP-1 receptor agonists, are effective in controlling blood sugar levels to some extent, but the preventive and therapeutic effects are still unsatisfactory. Peptide drugs have many advantages such as low toxicity, high target specificity, and good biocompatibility, which opens up new avenues for the treatment of diabetes and other diseases. Currently, insulin and its analogs are by far the main life-saving drugs in clinical diabetes treatment, enabling effective control of blood glucose levels, but the risk of hypoglycemia is relatively high and treatment is limited by the route of delivery. New and oral anti-diabetic drugs have always been a market demand and research hotspot. Inhibitor cystine knot (ICK) peptides are a class of multifunctional cyclic peptides. In structure, they contain three conserved disulfide bonds (C3-C20, C7-C22, and C15-C32) form a compact “knot” structure, which can resist degradation of digestive protease. Recent studies have shown that ICK peptides derived from legume, such as PA1b, Aglycin, Vglycin, Iglycin, Dglycin, and aM₁, exhibit excellent regulatory activities on glucose and lipid metabolism at the cellular and animal levels. Mechanistically, ICK peptides promote glucose utilization by muscle and liver through activation of IR/AKT signaling pathway, which also improves insulin resistance. They can repair the damaged pancrease through activation of PI3K/AKT/Erk signaling pathway, thus lowering blood glucose. The biostability and hypoglycemic efficacy of the ICK peptides meet the requirements for commercialization of oral drugs, and in theory, they can be developed into natural oral anti-diabetes peptide drugs. In this review, the structural properties, activity and mechanism of ICK pattern peptides in regulating glucose and lipid metabolism were summaried, which provided a reference for the development of new oral peptides for diabetes.

Objective It screens the main factors influencing the choice of the governance structure of the medical alliances,and discusses the matching relationship between the type of governance structure and the performance of the medical alliances,which provides a reference for further promoting the medical alliances.Methods The text coding analysis of interview data from hospital administrators of 54 medical institutions was analyzed using the rooting theory,and 150 medical alliances were selected for questionnaire surveys using convenience sampling to analyze the performance of the medical alliances and the relationship with the choice of the type of governance structure using descriptive statistics,nonparametric tests,factor analysis,and multivariate linear regression.Results The results show that the following factors affect the selection of the governance structure of medical alliances:asset specificity,transaction frequency and uncertainty;regardless of the type of governance structure of the medical alliances,asset specificity and uncertainty both significantly and positively influence the performance of medical alliances.Under the governance structure of the property-type alliance,transaction frequency has no statistically significant effect on the performance of the medical alliances.Conclusion Enhancing the positive impact of asset exclusivity and uncertainty on the performance of medical alliances.

Objective It screens the main factors influencing the choice of the governance structure of the medical alliances,and discusses the matching relationship between the type of governance structure and the performance of the medical alliances,which provides a reference for further promoting the medical alliances.Methods The text coding analysis of interview data from hospital administrators of 54 medical institutions was analyzed using the rooting theory,and 150 medical alliances were selected for questionnaire surveys using convenience sampling to analyze the performance of the medical alliances and the relationship with the choice of the type of governance structure using descriptive statistics,nonparametric tests,factor analysis,and multivariate linear regression.Results The results show that the following factors affect the selection of the governance structure of medical alliances:asset specificity,transaction frequency and uncertainty;regardless of the type of governance structure of the medical alliances,asset specificity and uncertainty both significantly and positively influence the performance of medical alliances.Under the governance structure of the property-type alliance,transaction frequency has no statistically significant effect on the performance of the medical alliances.Conclusion Enhancing the positive impact of asset exclusivity and uncertainty on the performance of medical alliances.

Objective:To explore high-risk sexual behaviors of HIV/AIDS and related factors in young students in Guangzhou.Methods:A cross-sectional survey was conducted in 5 different types of Guangzhou colleges by convenience sampling with minimum number of classes per grade and 600 samples per school from September to November 2021. The R 4.2.2 software was used to consolidate databases. Simultaneously, a logistic regression model and a decision tree algorithm model, stratifying by whether sexual behaviors had occurred before, were constructed. In each layer, the prediction performance of the two models was evaluated through area under receiver operating characteristic and the confusion matrix, and then the model with high prediction performance was retained.Results:A total of 7 346 students were surveyed. The proportion of the respondents reporting sexual experience were 9.08% (667/7 346), in whom 26.24% (175/667) had risky sexual activity in the past year. The decision tree algorithm model performs well in predicting whether high-risk sexual behaviors have occurred in the past year. When the complexity parameter value is 0.018, and nsplit reaches 4, which means there are 5 leaf nodes in the model, the cross error of the tree will be the smallest. The first best grouping variable in the decision tree was whether to use condoms throughout the first sexual behavior. If condoms were used at their sexual debut, but homosexual practices have occurred in the past year, the probability of risky sexual behavior will increase. If homosexual practices have not occurred in the past year, but the age of sexual debut was below 18 years old while the period of HIV education was after high school, the probability of risk sexual behavior will also increase.Conclusions:AIDS-related risky behaviors of young students still deserved attention. The experience of sexual debut and whether AIDS-related health education has been received before the sexual debut were significant predictors for the occurrence of high-risk sexual behavior. The decision tree algorithm model has particular applicability for predicting and screening potential risk populations.

Objective To compare the efficacy and safety between hypofractionated radiotherapy(HyRt)and conventional radiotherapy after breast-conserving surgery.Methods This study was a single-center,prospective,randomized controlled study.Eighty-three patients with pTis-T2N0M0 breast cancer admitted to Tangshan People's Hospital from May 2017 to May 2019 were included.The patients received breast-conserving surgery+sentinel lymph node biopsy(SLNB).After surgery,they were treated with intensity modulated radiation therapy(IMRT).According to random table method,patients were divided into HyRt group(n=41)and conventional radiotherapy group(n=42).The dose of organs at risk,treatment efficacy,treatment failure modes,and radiotherapy related adverse reactions were analyzed in the two groups.The radiotherapy-related adverse reactions were evaluated according to NCI CTC AE Version 3.0,including radiation dermatitis,radiation pneumonia,breast/skin fibrosis,pulmonary fibrosis,etc.Results Eighty-three patients with breast cancer were included,with a median age of 44(26-67)years.There was no statistically significant difference in clinical parameters such as age(P=0.443),TNM stage(P=0.335),molecular typing(P=0.333),degree of differentiation(P=0.617),and pathological type(P=0.127)between the two groups of patients.Compared with conventional radiotherapy group,the V5(25.6％vs.33.8％,P=0.015),V20(13.3％vs.17.2％,P=0.042),and the mean radiation dose(MLD;7.4 Gy vs.10.4 Gy,P=0.020)of the affected lung of HyRt group significantly decreased.Only 3 patients in this study experienced distant metastasis,and no regional lymph node metastasis or local recurrence was observed.There was no significant difference in PFS rate at 2 years between HyRt group and conventional radiotherapy group(94.4％vs.85.2％,P=0.818).Compared with conventional radiotherapy group,the incidence of≥grade Ⅱ irradiation dermatitis in HyRt group was significantly reduced(2.4％vs.21.4％,P=0.015).There was no difference in the incidence of grade Ⅰ breast/skin fibrosis(19.5％vs.14.3％,P=0.570)between the two groups,and no grade Ⅲ radiotherapy-related side effects were observed in the two groups.Conclusions Compared with conventional radiotherapy with simultaneously integrated boosting-intensity modulated radiotherapy,the patients who received HyRt after breast-conserving surgery for early-stage breast cancer have good tolerance and low incidence of adverse reactions.HyRt can be used as the first option of radiation therapy.

Objective: To understand the prevalence of HIV testing and related factors among young students who had sex in Guangdong Province, in order to provide evidence for relevant education programs and HIV testing promotion in young students. Methods: From September to December 2022, a convenient sampling method was used to select 48 749 young students from 16 universities and mechanic colleges in 6 cities including Guangzhou, Shantou, Maoming, Huizhou, Dongguan, and Zhongshan in Guangdong Province for online questionnaire survey. A total of 2 971 students who ever had sexual experiences were screened out, and the HIV testing situation and related factors were investigated by using the questionnaire designed by AIDS Prevention and Education Project for College Students of China STD and AIDS Prevention Association.The influencing factors of HIV testing were analyzed using Chi square test and multiple Logistic regression model. Results: Among students who had sexual experiences, 11.92% (354/2 971) were tested for HIV. The results of multivariate Logistic regression analysis showed that among young sexual students, using psychoactive substances during sexual activity in the last 1 year ( OR =7.70), having first sex with the same sex ( OR =3.87), having commercial sex ( OR =2.37), having heard of PEP ( OR =2.20), having a high level of self assessed understanding of HIV testing ( OR =1.73), inconsistent use of condoms ( OR =1.56), being aware of HIV infection ( OR =1.53), being aware of HIV knowledge ( OR =1.51) were more likely to test for HIV, and females ( OR =0.39) were less likely to test for HIV ( P < 0.05). Conclusions The proportion of HIV testing is low among sexually active young students in Guangdong Province. Targeted interventions should be tailored to promote HIV testing coverage.

Objective It screens the main factors influencing the choice of the governance structure of the medical alliances,and discusses the matching relationship between the type of governance structure and the performance of the medical alliances,which provides a reference for further promoting the medical alliances.Methods The text coding analysis of interview data from hospital administrators of 54 medical institutions was analyzed using the rooting theory,and 150 medical alliances were selected for questionnaire surveys using convenience sampling to analyze the performance of the medical alliances and the relationship with the choice of the type of governance structure using descriptive statistics,nonparametric tests,factor analysis,and multivariate linear regression.Results The results show that the following factors affect the selection of the governance structure of medical alliances:asset specificity,transaction frequency and uncertainty;regardless of the type of governance structure of the medical alliances,asset specificity and uncertainty both significantly and positively influence the performance of medical alliances.Under the governance structure of the property-type alliance,transaction frequency has no statistically significant effect on the performance of the medical alliances.Conclusion Enhancing the positive impact of asset exclusivity and uncertainty on the performance of medical alliances.

Objective It screens the main factors influencing the choice of the governance structure of the medical alliances,and discusses the matching relationship between the type of governance structure and the performance of the medical alliances,which provides a reference for further promoting the medical alliances.Methods The text coding analysis of interview data from hospital administrators of 54 medical institutions was analyzed using the rooting theory,and 150 medical alliances were selected for questionnaire surveys using convenience sampling to analyze the performance of the medical alliances and the relationship with the choice of the type of governance structure using descriptive statistics,nonparametric tests,factor analysis,and multivariate linear regression.Results The results show that the following factors affect the selection of the governance structure of medical alliances:asset specificity,transaction frequency and uncertainty;regardless of the type of governance structure of the medical alliances,asset specificity and uncertainty both significantly and positively influence the performance of medical alliances.Under the governance structure of the property-type alliance,transaction frequency has no statistically significant effect on the performance of the medical alliances.Conclusion Enhancing the positive impact of asset exclusivity and uncertainty on the performance of medical alliances.

Objective It screens the main factors influencing the choice of the governance structure of the medical alliances,and discusses the matching relationship between the type of governance structure and the performance of the medical alliances,which provides a reference for further promoting the medical alliances.Methods The text coding analysis of interview data from hospital administrators of 54 medical institutions was analyzed using the rooting theory,and 150 medical alliances were selected for questionnaire surveys using convenience sampling to analyze the performance of the medical alliances and the relationship with the choice of the type of governance structure using descriptive statistics,nonparametric tests,factor analysis,and multivariate linear regression.Results The results show that the following factors affect the selection of the governance structure of medical alliances:asset specificity,transaction frequency and uncertainty;regardless of the type of governance structure of the medical alliances,asset specificity and uncertainty both significantly and positively influence the performance of medical alliances.Under the governance structure of the property-type alliance,transaction frequency has no statistically significant effect on the performance of the medical alliances.Conclusion Enhancing the positive impact of asset exclusivity and uncertainty on the performance of medical alliances.

Objective It screens the main factors influencing the choice of the governance structure of the medical alliances,and discusses the matching relationship between the type of governance structure and the performance of the medical alliances,which provides a reference for further promoting the medical alliances.Methods The text coding analysis of interview data from hospital administrators of 54 medical institutions was analyzed using the rooting theory,and 150 medical alliances were selected for questionnaire surveys using convenience sampling to analyze the performance of the medical alliances and the relationship with the choice of the type of governance structure using descriptive statistics,nonparametric tests,factor analysis,and multivariate linear regression.Results The results show that the following factors affect the selection of the governance structure of medical alliances:asset specificity,transaction frequency and uncertainty;regardless of the type of governance structure of the medical alliances,asset specificity and uncertainty both significantly and positively influence the performance of medical alliances.Under the governance structure of the property-type alliance,transaction frequency has no statistically significant effect on the performance of the medical alliances.Conclusion Enhancing the positive impact of asset exclusivity and uncertainty on the performance of medical alliances.