OBJECTIVE To study the interventional effect and mechanism of 1，8-cineole on pancreatic β cell ferroptosis induced by type 2 diabetes. METHODS In vitro ferroptosis model was established in pancreatic β cells of mice by using high glucose. The effects of low-dose and high-dose 1，8-cineole （0.25， 0.5 μmol/L） on the level of Fe2+ in pancreatic β cells were investigated. The effects of 1，8-cineole （0.5 μmol/L） combined with ferroptosis inducer Erastin （20 μmol/L） and ferroptosis inhibitor Ferrostatin-1 （20 μmol/L） on the protein expressions of glutathione peroxidase-4 （GPX4） and cyclooxygenase-2 （COX2） were also detected. The type 2 diabetes model mice were established by feeding high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin. The effects of low-dose and high-dose 1，8-cineole （50， 200 mg/kg） on the pathological morphology of pancreatic tissue， the content of iron as well as the protein expressions of GPX4 and COX2 were investigated. RESULTS The results of the cell experiment showed that compared with the model group， pretreatment with 1，8-cineole significantly reduced intracellular Fe2+ levels and upregulated GPX4 protein expression， while downregulated COX2 protein expression in pancreatic β cells （P＜0.05）. After combining with Ferrostatin-1， the expression trends of the above two proteins were the same， while there was no statistically significant difference after combining with Erastin. The results of animal experiments showed that compared with the model group， after intervention with 1，8-cineole， the structure of the pancreatic islets in mice recovered intact and their morphology improved； the iron content of pancreatic tissue and protein expression of COX2 were decreased significantly （P＜0.05）， while protein expression of GPX4 was increased significantly （P＜0.05）. CONCLUSIONS 1，8-cineole could ameliorate pancreatic β cell injury induced by diabetes， the mechanism of which may be related to reducing intracellular iron deposition and regulating ferroptosis-related proteins.

Objective To investigate the effect of the sling massage exercise on postpartum pelvic girdle pain(PPGP). Methods From March,2022 to May,2023,56 patients with PPGP in Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine were randomly divided into control group(n=28)and observation group(n=28).Both groups received routine physical therapy and healthy education,while the control group received exer-cise therapy and the observation group received sling massage exercise,for six weeks.They were assessed with Visual Analog Scale(VAS),Pelvic Girdle Questionnaire(PGQ)and active straight leg raise(ASLR)test before and after treatment,and measured resting and contraction thickness of transversus abdominis with ultrasound;and integrated electromyography(iEMG),root mean square(RMS),median frequency(MF)and mean power fre-quency(MPF)of pelvic floor muscles with surface electromyography. Results After treatment,the total effective rate was 96.43%in the observation group and 78.57%in the control group(Z=2.728,P<0.05).All the indexes improved in both groups(|t|>2.080,P<0.05)except resting thickness of transverse abdominis muscle,and improved more in the observation group than in the control group(|t|>2.161,P<0.05). Conclusion The sling massage exercise can alleviate pain,enhance the stability of the core muscle group,and improve load transfer and quality of life,better than exercise therapy.

Objective:To investigate the change and clinical significance of serum Cathepsin K (Cathe K), 25 hydroxyvitamin D (25 (OH) D) and matrix gla protein (MGP) in postmenopausal patients with osteoporosis.Methods:Sixty postmenopausal patients with osteoporosis admitted to the hospital from May. 2020 to May. 2023 were selected as the study group, and 75 simple menopausal women were selected to the control group at the same period. Serum Cathe K, 25 (OH) D and MGP levels of the subjects were determined by enzyme-linked immunosorbent assay (ELISA). Bone metabolism indexes [N-terminal propeptide of typeⅠprecollagen (PINP), β isomer of the C-terminal telopep-tide of typeⅠcollagen ( β-CTX), bone alkaline phosphatase, (BALP) and osteocalcin (OC) ] were detected. The levels of Cathe K, 25 (OH) D and MGP and bone metabolism indexes were compared and their correlation was analyzed by Pearson correlation. The predictive value of Cathe K, 25 (OH) D and MGP levels in osteoporosis were analyzed and their effects on osteoporosis were analyzed by multiple Logistic regression. Results:Serum Cathe K in the study group was higher [ (27.27±4.82) μg/L vs. (20.84±4.17) μg/L], 25 (OH) D and MGP were lower [ (25.81±5.33) ng/mL, (7.26±1.53) ng/mL vs. (31.62±5.92) ng/mL, (10.75±2.31) ng/mL] ( t=5.22, P<0.001; t=4.88, P<0.05; t=7.58, P<0.05) ; The bone metabolism indexes PINP, β-CTX and OC in the study group were higher, while BALP was lower; Pearson correlation analysis showed that Cathe K was positively correlated with PINP, β-CTX and OC, and negatively correlated with BALP ( r=0.53, 0.45, 0.61, -0.75, P<0.05) ; 25 (OH) D was negatively correlated with PINP, β-CTX, OC, and positively correlated with BALP ( r=-0.41, -0.63, -0.43, 0.38, P<0.05) ; MGP was positively correlated with PINP, β-CTX and OC, and negatively correlated with BALP ( r=-0.77, -0.59, -0.61, 0.52, P<0.05) ; The area under the curve of serum Cathe K, 25 (OH) D and MGP for predicting osteoporosis were 0.715, 0.694 and 0.789, respectively. Conclusion:The abnormal levels of serum Cathe K, 25 (OH) D and MGP in postmenopausal patients with osteoporosis can be used to predict the occurrence of osteoporosis, and are closely related to the bone metabolism indexes of patients, which can provide a reference for the treatment of patients.

Objective:To investigate the application value of a multi-dimensional digital moni-toring platform for perioperative period in gastric cancer patients.Methods:The retrospective cohort study was conducted. The clinical data of 50 patients who underwent laparoscopic radical gastrec-tomy in The Affiliated Hospital of Nanjing University of Chinese Medicine from July 2022 to January 2024 were collected. There were 35 males and 15 females, aged (64±12)years. All patients followed the concept of enhanced recovery after surgery, and the multi-dimensional digital monitoring platform based on wearable monitoring equipment was used to implement perioperative management measures. Observation indicators: (1) results of heart rate variability (HRV) monitoring; (2) results of blood glucose and blood oxygen monitoring; (3) results of exercise and sleep monitoring; (4) results of body composition monitoring. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(IQR). Repeated measurement data were analyzed using the repeated ANOVA. Measurement data with skewed distri-bution were transformed to normal distribution by SPSS transformation function before testing. For comparison between pre- and postoperation, paired sample t test was used for measurement data with normal distribution, and nonparametric Wilcoxon signed rank sum test was used for measure-ment data with skewed distribution. Results:(1) Results of HRV monitoring. From preoperation to the third day after surgery, the standard deviation normal to normal heart beat of 50 patients was changed from(103±26)ms to(101±36)ms, the mean of the standard deviations of normal to normal heart beat calculated per 5 min segment was changed from (45±16)ms to(33±12)ms, the number of pairs of adjacent NN intervals differing by more than 50 ms in the entire recording was changed from 6.02%(4.96%) to 5.79%(4.20%), the low frequency power was changed from 376.78(468.96)ms 2 to 742.79(525.20)ms 2, the high frequency power was changed from 273.61(273.58)ms 2 to 397.48(164.87)ms 2, the ratio of low frequency power to high frequency power was changed from 1.6±0.5 to 1.6±0.6, showing significant differences in above indicators before and after operation ( F=34.43, 26.15, 24.58, 5.51, 6.11, 6.02, P<0.05). (2) Results of blood glucose and blood oxygen monitoring. From preoperation to the third day after surgery, the blood glucose of 50 patients was changed from 6.75(2.05)mmol/L to 6.90(2.63)mmol/L, showng a significant difference before and after operation ( F=45.84, P<0.05). The blood oxygen was changed from 97.00%(5.00%) to 97.50%(3.00%), showing no significant difference before and after operation ( F=2.25, P>0.05). (3) Results of exercise and sleep monitoring. From preoperation to the third day after surgery, the number of steps fo 50 pati-ents was changed from 3 043(1 224) to 1 473(767), sleep duration was changed from(8.2±1.1)hours to(7.3±0.8)hours, sleep score was changed from 80±10 to 78±5,showing significant differences in above indicators before and after operation ( F=716.46, 29.02, 47.32, P<0.05).(4) Results of body composition monitoring. The body weight of 50 patients was changed from (63±8)kg to(61±8)kg before and after operation, body fat rate was changed from 24%±8% to 22%±9%, muscle mass was changed from 43 (12)kg to 41(17)kg, body mass index was changed from (23.0±2.6)kg/m 2 to(22.1±2.5)kg/m 2, showing significant differences in above indicators before and after operation ( t=8.19, 3.00, Z=-2.78, t=7.34, P<0.05), while there was no significant difference in basal metabolic indicators from (1 390±134)kcal to (1 379±139)kcal before and after operation ( t=1.02, P>0.05). Conclusion:The multi-dimensional digital monitoring platform for preoperative period can accurately monitor the perioperative stress level and evaluate the postoperative recovery of gastric cancer patients, which can present the visual results.

Objective To investigate the relationship of benign prostatic hyperplasia(BPH) with abnormal glucose and lipid metabolism in the elderly. Methods A total of 152 elderly patients with BPH were selected as study subjects. The levels of fasting plasma glucose (FPG), 2-hour postprandial glucose (2 hPG), fasting insulin (FINS), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), blood uric acid (UA), and prostate-specific antigen (PSA) were measured. Their systolic blood pressure (SBP) and diastolic blood pressure (DBP) were also measured. Prostate volume (PV) and annual prostate growth rate were calculated, and the International Prostate Symptom Score (IPSS) was assessed. Based on blood glucose, blood lipids, and IPSS, the patients were divided into normal blood glucose group(99 cases) and hyperglycemia group(53 cases), normal blood lipid group(112 cases) and dyslipidemia group(40 cases), and moderate symptom group(91 cases) and severe symptom group(61 cases). The clinical characteristics of patients in each group were compared, and the relationships of abnormal glucose and lipid metabolism with the severity of lower urinary tract symptoms in patients with BPH were analyzed. Results Compared with the normal blood glucose group, patients in the hyperglycemia group had higher age, SBP, annual prostate growth rate, IPSS, and levels of FPG, 2 hPG, FINS, and PSA, larger PV, and lower HDL-C level (P < 0.05). Compared with the normal blood lipid group, patients with BPH in the dyslipidemia group had higher age, SBP, annual prostate growth rate, IPSS, and levels of FPG, FINS, TC, TG, LDL-C, and UA, larger waist circumference and PV, and lower HDL-C level (P < 0.05). Compared with the moderate symptom group, patients in the severe symptom group had higher age, BMI, SBP, annual prostate growth rate, and FPG levels, higher incidence rates of hyperglycemia and dyslipidemia, larger PV, and lower HDL-C levels (P < 0.05). Multivariate Logistic regression analysis indicated that age ≥70 years, SBP ≥140 mmHg, hyperglycemia, dyslipidemia, increased PV, and elevated annual prostate growth rate were all independent risk factors for the occurrence of severe lower urinary tract symptoms in patients with BPH (P < 0.05). Conclusion Elderly BPH is closely related to abnormal glucose and lipid metabolism, and abnormal glucose and lipid metabolism are risk factors for the exacerbation of lower urinary tract symptoms.

To investigate the therapeutic effect and mechanism of Qingwen Baiduyin on acute lung injury （ALI） in mice induced by lipopolysaccharide （LPS）. MethodA total of 144 C57BL/6 mice were randomly divided into the following groups： a normal group， a model group （LPS， 5 mg·kg^-1）， a dexamethasone group （5 mg·kg^-1）， and low-， medium-， and high-dose Qingwen Baiduyin groups （14.105， 28.21， 56.42 g·kg^-1）. The mice were treated once daily for 5 days. One hour after the final administration， the ALI model was established by intratracheal instillation of LPS， and samples were collected at 6 h and 24 h after modeling. The arterial blood gas index of mice was analyzed. The total protein content， total cell count， Evans blue dye （EBD） content， and lung tissue wet-to-dry weight ratio （W/D） of bronchoalveolar lavage fluid （BALF） were measured. Hematoxylin-eosin （HE） staining was performed to assess the pathological changes in mouse lung tissue. Western blot was used to detect the expression levels of key proteins in the Janus kinase 1/signal transducer and activator of transcription 1/interferon regulatory factor 1 （JAK1/STAT1/IRF1） signaling pathway in lung tissue. ResultCompared with the normal group， the model group showed reduced arterial oxygen pressure （pO₂）， oxygen saturation （SO₂）， and lung tissue W/D （P<0.05， P<0.01）， increased carbon dioxide pressure （pCO₂）， total protein content， total cell count， EBD content， interferon-γ （IFN-γ）， tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， chemokine CXC ligand 1 （CXCL1）， chemokine CXC ligand 2 （CXCL2）， chemokine CXC ligand 9 （CXCL9）， and chemokine CXC ligand 10 （CXCL10） content （P<0.05， P<0.01）， thickening of the alveolar walls， fusion of alveolar cavities， and infiltration of inflammatory cells in lung tissue， increased proportion of M1 macrophage polarization and lung cell apoptosis （P<0.05）， and increased protein expression levels of JAK1， phosphorylated JAK1 （p-JAK1）， inducible nitric oxide synthase （iNOS）， STAT1， phosphorylated STAT1 （p-STAT1）， IRF1， gasdermin D （GSDMD）， and mixed lineage kinase domain-like protein （MLKL） （P<0.05， P<0.01）. Compared with the model group， Qingwen Baiduyin significantly increased pO₂， SO₂， and lung tissue W/D （P<0.05， P<0.01）， improved the pathological changes in lung tissue， and reduced pCO₂， total protein content， total cell count， EBD content， IFN-γ， TNF-α， IL-1β， CXCL1， CXCL2， CXCL9， and CXCL10 content， proportion of M1 macrophage polarization， and protein expression levels of JAK1， p-JAK1， iNOS， STAT1， p-STAT1， IRF1， GSDMD， and MLKL （P<0.05， P<0.01）. ConclusionQingwen Baiduyin can improve the lung inflammatory response and reduce lung cell apoptosis in mice with ALI by inhibiting the JAK1/STAT1/IRF1 signaling pathway， thereby exerting a lung-protective effect.

Objective To compare five public deep venous thrombosis(DVT)risk assessment models(RAM)in patients with acute cerebral hemorrhage,and to select one suitable assessment tool,with which medical staff are able to carry out effective individualized prevention accordingly in time.Methods In this retrospective study,256 in-patients with acute cerebral hemorrhage in the Neurology Department of the First Affliated Hospital of Wenzhou Medical University from January to December 2020 were randomly enrolled.The researchers applied five models and record the scores,including Padua RAM,Caprini RAM,Wells DVT RAM,Autar RAM and acute stroke DVT-RAM.The data were summarized and analyzed with SPSS 25.0 and R4.1.The predictive values of above RAMs are compared separately by TOPSIS(technique for order preference by similarity solution)to find out a suitable tool.Results Predictive value(Ci)ranking of five DVT-RAMs,Autar RAM,Padua RAM,Caprini RAM,acute stroke DVT-RAM and Wells DVT RAM,by TOPSIS were 0.681,0.636,0.385,0.363,0.315.Conclusion According to comprehensive comparison by TOPSIS,Autar RAM was the suitable assessment model to assess the DVT risk of patients with acute cerebral hemorrhage.It is suggested that medical staff apply the Autar risk assessment model to predict the risk of DVT in patients with acute cerebral hemorrhage.

Objective:To assess and compare the performance of limiting-antigen avidity enzyme immunoassay (LAg-Avidity EIA) and pooling PCR in the surveillance for recent infection rates of HIV-1 in men who have sex with men (MSM).Methods:Blood samples were collected from MSM selected through snowball sampling method in sentinel surveillance in 13 prefectures of Yunnan province from 2016 to 2017. The samples were tested for HIV-1 antibody. The confirmed positive samples were tested by LAg-Avidity EIA. The negative samples were tested by pooling PCR. The recent infection rates of HIV-1 were estimated by the algorithm based on LAg-Avidity EIA and pooling PCR respectively. The two results were compared.Results:During 2016-2017, a total of 5 363 blood samples were collected from MSM, in which 407 samples were HIV-1 positive (including 177 positive tested previously) and 4 956 samples were HIV-1 negative. A total of 211 samples(91.7%) were tested by LAg-Avidity EIA, 69 were confirmed to be recent infections. A total of 4 469 samples were tested by pooling PCR, 8 were confirmed to be acute infections. The recent infection rates of HIV-1 from 2016 to 2017 estimated by LAg-Avidity EIA were 3.36% and 4.84%, and the recent infection rates estimated by pooling PCR were 3.27% and 3.02% respectively. The differences in recent infection rates of HIV-1 estimated by the two algorithms were not significant.Conclusions:The recent infection rates of HIV-1 estimated by LAg-Avidity EIA and pooling PCR in sentinel surveillance in MSM in Yunnan had good consistency from 2016 to 2017. Using the two methods might have a better stability in continuous surveillance for recent infection rates of HIV-1.

Objective:To understand the infection status of HCV and Treponema pallidum (TP) in HIV/AIDS cases in Yunnan province,and identify the risk factors. Methods:Between January 1 and June 30 in 2020,a cross-sectional survey was conducted in Yunnan. Two enzyme-linked immunosorbent assay (ELISA) kits were used to detect anti-HCV, the positive results of both two kits indicated HCV infection. ELISA and syphilis toluidine red untreated serum test were applied to identify TP infection. Both Excel 2016 and SPSS 22.0 software were used for statistical analysis, and logistic regression model was conducted to identify the relevant factors of HCV and TP infection.Results:A total of 5 922 HIV/AIDS cases were included in this study, the infection rates of HCV and TP were 6.5% (383/5 922) and 5.8% (344/5 922) respectively. The co-infection rate of HCV and TP was 0.4% (22/5 922). The risk for HCV infection in HIV/AIDS cases was higher in younger age groups compared with age group ≥50 years (15-19:a OR=3.53;20-29:a OR=3.02;30-39:a OR=2.91;40-49:a OR=3.61), in males than in females (a OR=2.31), in the married and unmarried than in the divorced or widowed (married:a OR=1.61;unmarried:a OR=1.63), in other ethnic groups than in Han ethnic group (a OR=1.70), in people with lower education level than in people with education level of college and above (primary school degree and below:a OR=4.69;middle school:a OR=3.96), in people living in the central and western Yunnan than in people living in eastern Yunnan (central Yunnan:a OR=2.46; western Yunnan:a OR=7.08), in injection drug users than in MSM (a OR=131.08). The risk of TP infection in HIV/AIDS cases was higher in people with education level of college and primary school than in middle school degree (primary school and below:a OR=1.73;college and above:a OR=1.77), in people with other occupations than in farmers (a OR=1.39), in people living in eastern Yunnan than in people living in western Yunnan (a OR=1.75); in MSM than in people with heterosex (a OR=9.75). Conclusions:A certain proportion of HIV/AIDS cases reported between January and June in 2020 in Yunnan were co-infected with HCV and TP, many factors were associated with the co-infection. It is suggested to strengthen HCV and TP tests in HIV/AIDS cases and conduct active treatment of the co-infection.

Objective:To investigate the impact of the destruction of dorsal motor nucleus of the vagus(DMV)on lower esophageal sphincter pressure in a rat model of acute esophagitis.Methods:A total of 40 male Sprague-Dawley(SD)rats were randomly divided into four groups: the control group, sham group, DMV destruction group, DMV destruction + vagal stimulation group.Two weeks after DMV destruction or sham operation, hydrochloric acid with pepsin was perfused into the esophagogastric junction of rats for 90 min, and lower esophageal sphincter pressure was measured before and after operation and 60 min after acid perfusion.Rats in the control group received assessment of lower esophageal sphincter pressure directly.Rats in the DMV destruction + vagus stimulation group were given electric current stimulation for 30 minutes before and after 15 min of esophageal acid perfusion.Rats were sacrificed after 60 min of the acid perfusion.The esophagus was prepared for hematoxylin and eosin(HE)staining, and the degree of inflammation and the expression of inflammatory cytokines were examined.Results:In the DMV destruction group, lower esophageal sphincter pressure decreased 2 weeks after DMV destruction compared with pre-destruction levels(25.9±8.8 cmH 2O vs.34.0±8.9 cmH 2O, P<0.05), and lower esophageal sphincter pressure decreased after 60 min of acid perfusion compared with pre-destruction levels(18.6±3.6 cmH 2O vs.25.9±8.8 cmH 2O, P<0.01). In the DMV destruction + vagus stimulation group, lower esophageal sphincter pressure increased after vagus nerve stimulation(22.3±2.9 cmH 2O vs.18.6±3.6 cmH 2O, P<0.05). There was no significant difference in lower esophageal sphincter pressure in the sham group before and after sham operation, while the pressure increased after acid perfusion(30.0± 9.5 cmH 2O vs.37.8±5.8 cmH 2O, P<0.05). The degree of inflammation in the lower esophagus was aggravated and the expression of tumor necrosis factor-α, interleukin(IL)-6, IL-1β and prostaglandin E2 in esophageal tissues increased in the DMV destruction group compared with the sham group( P<0.01). The inflammation degree and the expression of inflammatory factors in the lower esophagus improved after vagal nerve stimulation compared with pre-stimulation levels( P<0.01). Conclusions:DMV destruction decreases lower esophageal sphincter pressure and aggravates esophageal inflammation and injury in a rat model of acute esophagitis.Vagus nerve stimulation can strengthen the pressure of the lower esophageal sphincter and improve the inflammation of the lower esophageal segment.