To investigate the correlation between vitamin D nutritional status and insulin resistance in pubertal adolescents.

To investigate body composition and associated factors in adolescents undergoing long-term regular sports training.

Aim To explore the correlation between carotid atherosclerosis(CAS)and neutrophil/lymphocyte ratio(NLR)in patients with early morning hypertension,and to construct a line chart model to predict the risk of CAS in patients with hypertension in the morning.Methods 255 patients with early morning hypertension hospitalized in the Affiliated Hospital of Chengde Medical College from October 2019 to November 2022 were collected,and their basic data,blood routine and blood biochemical indexes were collected.All selected patients need to improve 24-hour ambulatory blood pressure monitoring and carotid artery color ultrasound detection.According to the presence or absence of CAS,all selected patients were divided into morning hypertension with CAS group(n=197)and morning hypertension without CAS group(n=58).Multivariate Logistic regression analysis was used to explore the risk factors of early morning hypertension with CAS,and to construct and verify an individual line chart model to predict the risk of early morning hypertension pa-tients with CAS.Results The age,NLR,neutrophils(NE),monocytes(MO),white blood cell(WBC),total cho-lesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol(LDLC)increased in the early morning hyperten-sion with CAS group compared with those in the morning hypertension group without CAS,while the HDLC decreased(P＜0.05).The results of multivariate Logistic regression analysis showed that the age,NLR and TC were higher in the early morning hypertension with CAS group than those in the early morning hypertension without CAS group,while HDLC was lower;Age,NLR and TC were independent risk factors of early morning hypertension with CAS,while HDLC was inde-pendent protective factors of morning hypertension with CAS.Based on the results of multivariate Logistic regression anal-ysis,an individualized line chart model for predicting early morning hypertension with CAS was constructed.The area un-der the ROC curve of the line chart model was 0.853(95％CI:0.802-0.904,P＜0.01).The result of Hosmer Leme-show fit test was x2=1.665(P＞0.05).Conclusions There was a positive correlation between NLR and morning hy-pertension with CAS,and NLR was an independent risk factor for morning hypertension with CAS.The individualized line chart model based on age,NLR,TC and HDLC can effectively predict the risk of hypertension with CAS in the early morn-ing,which provides a theoretical basis for early detection and prevention of atherosclerosis.

Objective:To explore the effectiveness of Acute Care of the Elderly(ACE)model and its existing problems in the clinical practice for older adults with acute clinical conditions.Methods:Using the random number table method, a random number sequence was generated, and the patients admitted to the Department of Geriatrics of Shenzhen Nanshan Hospital due to acute diseases From January 2019 to September 2021 were enrolled in the ACE model intervention group(160 cases)and the control group(77 cases)in a 2: 1 ratio.The inclusion criteria were based on disease severity, frailty assessment, and activity of daily living(ADL)assessment.The intervention time was 1-3 weeks.Outcomes of the patients include ADL, hospitalization days, hospitalization expenses, drug proportion, human resource investments, adverse events, 30-day readmission rate, and 1-year mortality.Results:There were no significant difference in baseline indicators such as frailty index and ADL score between the two groups at admission.The ADL score(Barthel index)of the ACE group was significantly improved compared with the control group at discharge(81.71±14.23 vs.70.9±23.89, P<0.001)and at 30 days after discharge(85.84±15.25 vs.68.29±30.91, P<0.001). The hospital cost[(12 735.81±6 541.41)￥ vs.(16 391.54±12 962.34)￥, P=0.002], drug proportion(21.34% vs.28.93 %, P=0.036)and 30-day readmission rate(13.1% vs.23.4%, P=0.037)of the ACE group were significantly lower compared to the control group.The human resource input(32.97±6.72 vs.25.03±5.31, P=0.008)and patient satisfaction(98.23% vs.90.66%, P=0.031)in the ACE group were significantly higher than those of the control group.(4)The incidence of adverse events during hospitalization was significantly lower in the ACE group than in the control group in terms of aspiration(0.63% vs.20.8%, P<0.001), falls(0 vs.10.4%, P<0.001), incontinence dermatitis(0 vs.3.9%, P=0.033), and 1-year mortality(6.3% vs.24.7%, P<0.001). There was no significant difference in the average length of stay(8.98±4.25 vs.10.03±5.32, P=0.101), pressure sores(13.01±4.77 vs.13.27±4.89, P=0.364), DVT risk score(8.53±2.79 vs.8.89±2.76, P=0.340)and medical staff satisfaction(73% vs.80%, P=0.240)between the two groups. Conclusions:The ACE model helps to reduce the disability rate of elderly patients with frailty, adverse events during hospitalization, save drug costs, and improve patient satisfaction.It is worth promoting in geriatric practice, but its localization management details and processes still face many challenges.

Engineered probiotics can serve as therapeutics based on their ability of produce recombinant immune-stimulating properties. In this study, we built the recombinant Bacillus subtilis WB800 expressing antimicrobial peptide KR32 (WB800-KR32) using genetic engineering methods and investigated its protective effects of nuclear factor-E2-related factor 2 (Nrf2)‍-Kelch-like ECH-associated protein 1 (Keap1) pathway activation in intestinal oxidative disturbance induced by enterotoxigenic Escherichia coli (ETEC) K88 in weaned piglets. Twenty-eight weaned piglets were randomly distributed into four treatment groups with seven replicates fed with a basal diet. The feed of the control group (CON) was infused with normal sterilized saline; meanwhile, the ETEC, ETEC+WB800, and ETEC+WB800-KR32 groups were orally administered normal sterilized saline, 5×10¹⁰ CFU (CFU: colony forming units) WB800, and 5×10¹⁰ CFU WB800-KR32, respectively, on Days 1‍‒‍14 and all infused with ETEC K88 1×10¹⁰ CFU on Days 15‍‒‍17. The results showed that pretreatment with WB800-KR32 attenuated ETEC-induced intestinal disturbance, improved the mucosal activity of antioxidant enzyme (catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx)) and decreased the content of malondialdehyde (MDA). More importantly, WB800-KR32 downregulated genes involved in antioxidant defense (GPx and SOD1). Interestingly, WB800-KR32 upregulated the protein expression of Nrf2 and downregulated the protein expression of Keap1 in the ileum. WB800-KR32 markedly changed the richness estimators (Ace and Chao) of gut microbiota and increased the abundance of Eubacterium_rectale_ATCC_33656 in the feces. The results suggested that WB800-KR32 may alleviate ETEC-induced intestinal oxidative injury through the Nrf2-Keap1 pathway, providing a new perspective for WB800-KR32 as potential therapeutics to regulate intestinal oxidative disturbance in ETEC K88 infection.
Animals ; Swine ; Enterotoxigenic Escherichia coli ; Kelch-Like ECH-Associated Protein 1 ; Bacillus subtilis ; NF-E2-Related Factor 2 ; Antioxidants ; Oxidative Stress

Objective To analyze the spatial distribution characteristics of tuberculosis in rural areas of Nanning City from 2010 to 2018, and explore the clustering areas, and to provide evidence for tuberculosis prevention and treatment. Methods The database of tuberculosis epidemics in rural areas of Nanning City from 2010 to 2018 was established by ArcGIS 10.8. The spatial distribution map was drawn, and global autocorrelation, local autocorrelation and hotspot analysis were conducted. Results The spatial distribution map of the average annual reported incidence rates in rural areas of Nanning from 2010 to 2018 showed that the towns with high average annual incidence rates were Jinchai Town and Yangqiao Town. Global autocorrelation analysis showed that the Moran's I index from 2010 to 2018 was 0.18 (Z=2.33, P=0.02), suggesting that tuberculosis in rural areas of Nanning had spatial clustering in the regional distribution. Local autocorrelation analysis showed that tuberculosis in rural areas of Nanning had high-high clustering, low-low clustering, high-low clustering and low-high clustering patterns. Among them, Jinchai Town and Lidang Yao Township were high-high clustering areas. Litang Town, Xinfu Town and Taoxu Town were low-low clustering areas. Local hotspot analysis showed that ^“hotspot^” areas included Jinchai Town, Yangqiao Town and Lidang Yao Township. Conclusion There is a spatial clustering of tuberculosis epidemics in rural areas of Nanning. The high-incidence areas include Jinchai Town, Yangqiao Town and Lidang Yao Township, and the low-incidence areas include Litang Town, Xinfu Town and Taoxu Town.

Objective Taking the Digestive Medical Coordinated Development Center of Beijing Municipal Administration of Hospitals (hereinafter referred to as the "Digestive Medical Coordinated Development Center") as an example ,this paper aims to ex-plore the idea of building a collaborative development system of medical disciplines dominated by advantageous disciplines .Methods Summarizing the construction experience of the Digestive Medical Coordinated Development Center to illustrate the significance ,identify existed challenges and construction pathways of the center .Results The Digestive Medical Coordinated Development Center has built a series of public service platforms for its member institutions ,and improved the system and incentive mechanism to gather the develop-ment synergy of the center .Conclusions Based on the advantages of the collectivized management of Beijing Municipal Administration of Hospital ,the Digestive Medical Coordinated Development Center advances synchronously in the dimensions of scientific research , medical treatment ,information construction and talent ,as well as formed its own development characteristics and accumulated valuable experience for the construction of discipline collaboration center of municipal hospitals .

Objective To compare the hepatotoxicity of matrine (MT) and oxymatrine (OMT) and explore the severity and characteristics of their toxicity, and to preliminarily elucidate their toxic mechanisms. Methods Liver cell line LO-2 cells were treated with acetaminophen (APAP), matrine and oxymatrine for 24 h, and the IC values, the contents of enzymes in the liver cells, the pathological changes, the contents of malondialdehyde (MDA) and glutathione (GSH) and the cell apoptosis rate were detected. In addition, adult zebrafish were treated with APAP, matrine and oxymatrine for 96 h, and the LC50 values, the pathological morphology of the liver cells, the contents of MDA and GSH and the apoptosis rate were detected. Meanwhile, the expression of oxidative stress-related gene, zgc: 136383, and the apoptosis-related genes, EIF4EBP3 and zgc: 123120, was also detected. Results Matrine and oxymatrine had toxic effects on liver cells in vitro. The IC50 value of matrine was 5. 3 mmol/L, and that of oxymatrine was ＞ 19 mmol/L. The contents of alanine aminotransferase (ALT), alkaline phosphatase (ALP), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) in the liver cells treated with matrine or oxymatrine were increased, and the cells appeared swollen, with an increase in the MDA level and a decrease in the GSH level. The cell apoptosis rate was also increased (P ＜ 0. 05). Furthermore, matrine and oxymatrine had toxic effects on the zebrafish. The LC50 value of matrine was 0. 41 mmol/L, and that of oxymatrine was ＞3. 8 mmol/L. The hepatocytes of zebrafish treated with matrine and oxymatrine appeared vacuolization in a mild to moderate degree, with an increase of the MDA content and a decrease of the GSH content. The cell apoptosis rate was increased (P ＜0. 05 for all). Expression of the oxidative stress-related gene zgc: 136383 (P ＜ 0. 05) and the apoptosis-resistant gene EIF4EBP3 (P ＜ 0. 05) was down-regulated by matrine, but that of the apoptosis-promoting gene zgc: 123120 was up-regulated (P ＜ 0. 05). Conclusions Results of the experiments using liver cells in vitro are consistent with those using the in vivo zebrafish model. Matrine (MT) and oxymatrine (OMT) both have hepatotoxicity, with similar toxic characteristics, and the toxicity of matrine is greater than oxymatrine. The mechanism of their hepatotoxicity is related with oxidative stress and cell apoptosis. Matrine reduces lipid transportation and activates oxidative stress reactions through down-regulation of gene zgc: 136383. In addition, matrine induces apoptosis in the liver cells via up-regulation of the apoptosis-promoting gene zgc: 123120 and down-regulation of the apoptosis-resistant gene EIF4EBP3.

Objective To study the effect of sitagliptin on insulin resistance and glucose variability in elderly patients with type 2 diabetes mellitus(T2DM) requiring high-dose insulin therapy.Methods A total of 100 elderly patients with T2DM failing to reach the standard application of large-dose insulin(＞60 U/d) treatment for three months or more [glycosylated hemoglobin (HbA1c) ＞8.0％] was randomly divided into sitagliptin group and pioglitazone group.Patients in sitagliptin group(50 cases) were treated with sitagliptin for oral use,100 mg each time,once a day,and patients in pioglitazone group(50 cases) were treated with pioglitazone for oral use,15 mg each time,once a day.The insulin dose was adjusted according to the blood glucose level in the two groups.Two groups were treated for 12 weeks.The indicators in both groups were compared,including fasting blood glucose (FBG),2 hours postprandial glucose (2hPG),glycosylated hemoglobin (HbA1c),24 hours glucose area under the curve (AUC),blood glucose coefficient of variation (CV),fasting C-peptide (FCP),2 hours postprandial C-peptide (2hPCP),fasting glucagon (FGG),2 hours postprandial glucagon(2 hFGG),cholesterol (TC),triglyceride (TG),systolic blood pressure (SBP),diastolic blood pressure(DBP),blood uric acid(BUA),daily insulin dosage(DID),body mass index(BMI),incidence of hypoglycemia and drug adverse reactions.Results After 12 weeks of treatment,the levels of FPG,2hPG,HbA1c,AUC,CV,FGG,2hFGG,TC,TG,SBP,DBP,DID and BMI in the sitagliptin group were significantly decreased than those before treatment(P＜0.05 or P＜0.01);The levels of FPG,2hPG,H bA1c,AUC,CV and BUA in the pioglitazone group were significantly decreased than those before treatment (P＜ 0.0 5 or P＜ 0.01);Compared with the pioglitazone group,the levels of 2 hPG,HbA1c,AUC,CV,FGG,2 hFGG,TC,TG,SBP,DBP,DID and BMI were significantly decreased in the sitagliptin group(all P＜0.05),and the levels of FCP and 2hPCP in the sitagliptin group were higher than those in the pioglitazone group(all P＜0.01).The incidence of hypoglycemia in the sitagliptin group was lower than that in the pioglitazone group(x2 =4.039,P =0.045).The incidence of adverse reactions in the sitagliptin group was lower than that in the pioglitazone grouP(x2 =3.979,P=0.043).Conclusion Sitagliptin combined with insulin is better than insulin combined with pioglitazone in elderly patients with T2DM requiring the application of high-dose insulin therapy,and the combining treatment could decrease insulin resistance,insulin dosage and the incidence of hypoglycemia.

Objective To discuss the MRI features of pyometra and its correlation with pathologic.Methods MRI and DWI data of 12 cases pyometra proved by surgery and pathology were analyzed retrospectively, and a comparision with pathologic findings was made.Mean ADC values were calculated.Results According to the homogeneity of MRI signal: Uniform signal type in 2 cases,T1WI showed slightly low signal,T2WI showed slightly high signal,DWI showed high signal,and the distribution of pus compositions is relatively uniform;Signal mixed type in 5 cases, T2 showed at the bottom of the pus or peripheral mixed slightly short signal, DWI showed mixed high signal, there was some sediment in the bottom of the pus;5 cases of liquid layer type, the upper displayed signal of water,and the lower signal was lower than the upper signal on T2WI, of which 3 cases showed uniform signal of the lower, DWI showed a uniform high signal, the distribution of pus compositions is uniform, the other 2 cases showed mixed signal of the lower, which was pyometra with bleeding,DWI showed high signal and low signal mixed together.The average ADC value of the 12 patients were 0.532×10-3 mm2/s.12 cases of uterine volume were increased, including 10 cases of uterine wall thinning, the other 2 cases with inflammatory invasion, the uterine wall thickening.8 cases with cervical cancer.5 cases with pelvic effusion.Conclusion MRI findings of pyometra are characteristic, its MRI manifestations and pathological components are highly correlated,and the ADC value is of great value in the diagnosis of pyometra.