Objective:To assess the goal fulfillment in terms of blood glucose, blood pressure, blood lipid, and the composite indicator of these three in patients with diabetes who received intensified treatment at Peking Union Medical College Hospital and regular follow-up for 12 months, analyze the influencing factors, and explore the comprehensive management model for intensive diabetes treatment outpatient services.Methods:This study was a prospective, observational cohort study. The diabetes patients who received long-term regular follow-up at the intensive diabetes treatment outpatient clinic of Peking Union Medical College Hospital from 2012 to 2023 were selected as the research subjects. They were followed up and clinical data were collected at the 1st, 3rd, 6th, 9th, and 12th months of follow-up. The study assessed the goal fulfillment rates in terms of blood glucose, blood pressure, blood lipid, and the composite indicator of these three, with the goals of glycated hemoglobin (HbA1c)<7%, blood pressure<130/80 mmHg, and low-density lipoprotein cholesterol (LDL-C)<2.6 mmol/L. The study also analyzed the impact of factors, including gender, age, type of diabetes, duration of diabetes, body mass index, comorbidities, complications, and treatment regimens, on the outcomes of comprehensive diabetes management.Results:A total of 232 patients were included in the study, of whom 210 were with type 2 diabetes (90.5%), 13 with type 1 diabetes (5.6%), 5 with latent autoimmune diabetes of the adult (2.2%), 3 with diabetes after total pancreatectomy (1.3%), and 1 with mitochondrial diabetes (0.4%). After 3 months of intensified management, the goal fulfillment rates of blood glucose (67.7% vs. 34.1%, Kappa=0.336, P<0.001), blood pressure (53.4% vs. 37.5%, Kappa=0.159, P=0.001), blood lipid (59.1% vs. 39.2%, Kappa=0.198, P<0.001), and the composite indicator (20.7% vs. 3.0%, Kappa=0.177, P<0.001) were significantly increased. Continued treatment at 6, 9, and 12 months showed stable and sustained increases in the goal fulfillment rates of blood glucose, blood pressure, blood lipid, and the composite indicator. Logistic regression analysis showed that baseline hyperglycemia ( P=0.002), disease duration ≥5 years ( P<0.001), smoking ( P=0.009), alcohol consumption ( P=0.038), presence of diabetic complications ( P=0.001), combination therapy with oral antidiabetic drugs and insulin ( P<0.001), and use of antiplatelet drugs ( P=0.037) were risk factors for uncontrolled HbA1c. Baseline hypertension ( P<0.001), alcohol consumption ( P=0.030), and comorbid dyslipidemia ( P=0.028) were risk factors for uncontrolled blood pressure. Baseline uncontrolled LDL-C ( P=0.020) and non-use of statins ( P<0.001) were risk factors for uncontrolled blood lipid. Conclusions:Among patients with the long-term follow-up at our intensive diabetes treatment clinic, the goal fulfillment rates of blood glucose, blood lipid, blood pressure, and the composite indicator of these three are relatively higher. However, it is still necessary to improve patient compliance as much as possible, emphasize weight management, and persist on the comprehensive diabetes treatment.

Objective This study aimed to develop an experimental animal platform for evaluating the feasibility and safety of intelligent acupuncture robots and to lay the foundation for further research.Methods Six 2-month-old Guangxi Bama miniature pigs were used as experimental subjects for acupuncture verification after anesthesia.First,manual acupuncture verification was carried out.Six acupoints were selected for each experimental animal and the needles were left for 20 min after the lifting,inserting,and twisting manipulation.Before and after controls were included.The experiment was carried out for 28 days,and each experiment was conducted once every 2 days for a total of 10 times.After verification of manual acupuncture,a point 10 mm from each of the six selected acupoints was selected,with a total of 12 points,and acupuncture operations were carried out on the experimental animals using the intelligent acupuncture module of the acupuncture robot at different frequencies and angles,to further verify the stability and feasibility of the animal platform.Results Routine safety-related blood indicators and blood biochemistry indicators after the procedure were normal and stable compared with those before the procedure.The average heart rate of the animals was 124 beats/min,the average blood pressure was 87/36 mmHg,and the average body temperature of was 36℃at a room temperature of 25℃,with no significant change in body temperature during and after the experiment.On the basis of this experimental platform,acupuncture manipulation using the intelligent acupuncture module of the acupuncture robot was completed successfully,with no abnormalities related to acupuncture such as bending,breaking,or stagnation of needles during the experimental process,and the experimental animals showed no obvious abnormalities.Conclusions This study established a stable experimental animal platform for evaluating the feasibility and safety of acupuncture carried out by intelligent acupuncture robots,based on the existing experimental method of miniature pigs.These result lay a foundation for further research related to the use of intelligent acupuncture robots.

Objective:To investigate the predictive performance of triglyceride and triglyceride glucose (TyG) index in the first trimester for the onset of gestational diabetes mellitus (GDM).Methods:Pregnant women who visited Beijing Chaoyang Maternal and Child Health Care Hospital and Beijing Haidian Maternal and Child Health Care Hospital from 2019 to 2022 were prospectively included. Concurrently, 78 healthy non-pregnant women who visited the Department of Endocrinology of Peking Union Medical College Hospital were included. The clinical characteristics and laboratory biomarkers including fasting blood glucose and blood lipid profiles were collected at the first visit in early pregnancy. Oral glucose tolerance test (OGTT) was performed at 24-28 weeks of gestation for GDM screening. Multivariate Logistic regression analysis was used to determine the association between biomarkers in early pregnancy and the risk of GDM. The receiver operating characteristic curve was used to evaluate the predictive performance and to identify the optimal cut-off value of triglyceride and TyG index in the first trimester for the risk of GDM.Results:A total of 1 677 pregnant women were included in this study, and the prevalence of GDM in our cohort was 19.6%. Compared with women who did not develop GDM, women with GDM showed an older maternal age, higher pre-pregnancy body mass index, and increased levels of laboratory biomarkers including fasting blood glucose, fasting insulin, total cholesterol, triglyceride, low-density lipoprotein cholesterol, TyG index, and Homeostasis Model Assessment of Insulin Resistance ( P<0.001). Logistic regression analysis showed that both triglyceride and TyG index in the first trimester were independent risk factors for GDM. The optimal cut-off values of triglyceride and TyG index for predicting the risk of GDM were 0.93 mmol/L and 8.10, respectively. The predictive performance can be further improved if maternal age and pre-pregnancy BMI are included. Conclusion:Triglyceride and TyG index in early pregnancy are closely associated with the risk of GDM, and can be used as early predictors of GDM.

[Purpose]To investigate the trends of incidence and age at onset of uterine corpus can-cer in Jiangsu cancer registration areas from 2009 to 2019.[Methods]The continuous monitoring data of uterine corpus cancer from 2009 to 2019 were collected from 16 cancer registries in Jiang-su Province.The crude incidence rate,the age-standardized incidence rate by Chinese standard population(ASIRC),crude and adjusted mean age,and standardized age-specific incidence composition were calculated.The average annual percentage change(AAPC)were analyzed by the Joinpoint regression model.The linear regression model was used to analyze the relationship be-tween mean age at onset and year.The standardized age-specific incidence composition in 2009 and 2019 were compared.[Results]The ASIRC of uterine corpus cancer in all registration areas and in rural areas of Jiangsu Province showed upward trends with AAPC of 1.78％and 2.38％,re-spectively(P＜0.05),but not showed in the urban areas(AAPC=1.30％,P＞0.05).The crude mean age at onset increased from 56.48 years old in 2009 to 58.26 years old in 2019 with an average annual growth of 0.173 years old(P=0.001).After the population structure standardized,the trends disappeared in all registration areas.[Conclusion]From 2009 to 2019,the standardized incidence rates of uterine corpus cancer were on rise in Jiangsu cancer registration areas,especially in the age group of 50 to 59 years old.

Objective:To develop and validate a structure for broadening the Bragg peak to improve the efficiency and conformality of particle radiotherapy.Methods:Techniques of random stacking and regular stacking were employed to fabricate the mesh-stacked porous structure (MPS). In each layer of the grid, the thickness, line width and spacing were set at 0.1 mm, 0.1 mm and 0.5 mm, respectively, resulting in a total size of 10 cm ×10 cm. Monte Carlo code FLUKA was performed to simulate the transportation of 196 MeV/u carbon ion beam and a 105 MeV proton beam through the MPS. Dose distribution, fluence homogeneity, and modulation stability of the modulated beams were evaluated. Moreover, the modulation effect of MPS in clinical radiotherapy plans for nasopharyngeal carcinoma (63 Gy in 21 fractions), lung cancer (77 Gy in 22 fractions) and prostate cancer (70.4 Gy in 16 fractions) was also evaluated, respectively.Results:The MPS was capable of broadening the Bragg peak width by 1.73 mm for proton beams and 2.95 mm for carbon ion beams. For different entrance positions, regular stacking of more than 10 layers could reduce the modulation power difference of MPS to within 5%. For MPS with 30 layers of regular stacking, the modulated fluence homogeneity could achieve a value of less than 3% by transporting 18 cm distance in air. When comparing to the clinically used ripple filters, MPS reduced the isocenter spot size of proton beams by 0.91 mm. In the comparison study of the treatment plan for nasopharyngeal carcinoma, the use of MPS could shorten the treatment time by 213 s (37%) and reduce the maximum dose to the brainstem by 3.28 Gy (7.5%).Conclusions:MPS effectively broadens the Bragg peak of particle beams and improves the efficiency of clinical radiotherapy. Regularly stacked MPS demonstrates robust modulation stability, and the modulated beam achieves relatively well fluence homogeneity, making it a promising clinical application for closer to the patients and reducing lateral scattering.

AIM:To explore the effect of tomatidine(TA)on lipopolysaccharide(LPS)-induced nerve cell in-jury and the underlying mechanism.METHODS:The neuroinflammation model was induced by treating SH-SY5Y cells with LPS.These cells were divided into control(CON),LPS,and LPS+TA groups.The LPS group was treated with 5 μg/mL LPS for 24 h to establish an inflammatory model.The LPS+TA group was first treated with 5 μmol/L tomatidine for 24 h and then co-cultured with 5 μg/mL LPS for 24 h.Cell viability was detected using the CCK-8 assay.RT-qPCR was used to detect the mRNA expression of inflammatory factors tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β).The protein expression of transcription factor EB(TFEB),p-TFEB,P62,and microtubule-associated protein 1 light chain 3(LC3)expression was detected through Western blot.TFEB localization and cleaved caspase-3 expression were detected through immunofluorescence.The cell apoptosis rate was detected through flow cytometry.RESULTS:(1)Compared with the CON group,the LPS group exhibited significant increases in IL-1β and TNF-α mRNA levels(P＜0.05),the cell apoptosis rate,and the p-TFEB level(P＜0.01).By contrast,P62,LC3-Ⅱ/LC3-Ⅰ,and TFEB protein ex-pression levels decreased significantly(P＜0.05),and TFEB was mainly localized in the cytoplasm.(2)Compared with the LPS group,tomatidine treatment significantly decreased the p-TFEB protein expression level(P＜0.01),increased the TFEB protein expression level(P＜0.01),and promoted the TFEB protein to migrate into the nucleus.After treatment of tomatidine,the LC3-Ⅱ/LC3-Ⅰ protein expression level significantly increased(P＜0.05),and the cell apoptosis rate signifi-cantly decreased(P＜0.01).In addition,the TNF-α mRNA level significantly decreased after tomatidine treatment(P＜0.01).CONCLUSION:Tomatidine improves autophagy dysfunction,inflammatory reaction,and cell apoptosis induced by LPS via activating the transcription factor EB.

Objective:To explore the risk factors of chronic postoperative inguinal pain for laparoscopic trans-abdominal preperitoneal hernia repair and establish a nomogram prediction model for it.Methods:The clinical data of 576 patients who underwent laparoscopic trans-abdominal preperitoneal hernia repair for inguinal pain at the First Hospital of Lanzhou University from January 2015 to December 2020 were analyzed retrospectively. According to different postoperative outcomes, patients were divided into chronic pain group ( n=54) and non-chronic pain group ( n=522), compared two groups of patients in the material, including gender, age, BMI, smoking history, history of drinking, hypertension, diabetes, chronic bronchitis, abdominal surgery history, history of inguinal hernia, hernia type, the hernial sac size, prophylactic use of antibiotics, VAS score, mesh fixation techniques, operation time, length of stay. Measurement data with normal distribution were expressed as ( ± s) and independent sample t test was used for comparison between groups. Measurement data with skewed distribution were expressed as M( Q1, Q3), and the Mann-Whitney U test was used for comparision between groups. Chi-square test was used to compare the measurement data of counting data.Multivariate logistic regression was used to analyze the independent risk factors for chronic postoperative inguinal pain. R software was used to establish the drawing of the nomogram prediction model, and the consistency index, calibration chart and area under the receiver operating characteristic curve was used to evaluate the predictive ability of the nomogram prediction model. Results:According to the results of the Logistic regression analysis, age≤45 years ( OR=2.202, 95% CI: 1.080-4.491), BMI≥24 kg/m 2 ( OR=2.231, 95% CI: 1.204-4.134), hernial sac≤5 cm ( OR=2.623, 95% CI: 1.309-5.257), recurrent hernia ( OR=2.769, 95% CI: 1.118-6.860), preoperative pain ( OR=4.121, 95% CI: 2.004-8.476), suture fixation ( OR=2.204, 95% CI: 1.151-4.219)and Postoperative acute pain (VAS>3) ( OR=5.814, 95% CI: 2.532-13.350) were independent risk factors for chronic postoperative inguinal pain ( P<0.05). Based upon the above independent risk factors, the nomogram prediction model was established and verified. The area under the curve of the nomogram prediction model was 0.779 (95% CI: 0.718-0.840, P<0.01). After internal verification, the concordance index value of the prediction model was 0.779. Conclusion:age≤45 years, BMI ≥24 kg/m 2, hernial sac≤5 cm, recurrent hernia, preoperative pain, suture fixation and Postoperative acute pain (VAS>3) are independent risk factors for chronic postoperative inguinal pain for laparoscopic trans-abdominal preperitoneal hernia repair, the nomogram prediction model has a good accuracy and discrimination with a high value of clinical application.

Objective:To systematically review the effects of probiotics supplementation on the prevention and treatment of gestational diabetes mellitus (GDM).Methods:Computerized literature search (CNKI, Wanfang, CBM, VIP, PubMed, Web of science, Embase, and Cochrane Library) as well as manual search was conducted to collect relevant studies. Data were extracted from qualified literature per pre-defined selection criteria and the risk of bias was evaluated. Systematic review was conducted using Stata 11.0 and Revman 5.3 software.Results:Six studies were included in the systematic review of the prevention effects of probiotics on GDM. The results showed that probiotics supplementation was not associated with the incidence of GDM ( RR=0.84, 95% CI: 0.53~1.34). Moreover, probiotics supplementation may be not associated with the level of glucose, either. Twelve studies were included in the systematic review of the treatment effects of probiotics on GDM. The results showed that in GDM patients, probiotics supplementation could decrease the levels of fasting blood glucose ( WMD=-2.06, 95% CI: -3.95~-0.17), fasting serum insulin ( SMD=-0.61, 95% CI: -0.79~-0.42), insulin resistance index as assessed by homeostatic model assessment ( WMD=-0.64, 95% CI: -0.86~-0.43), triglycerides ( WMD=-21.96, 95% CI: -36.15~-7.78), total cholesterol ( WMD=-10.63, 95% CI: -19.43~-1.83), high-sensitivity C-reactive protein ( SMD=-0.77, 95% CI: -1.00, -0.53), and cesarean section rate ( RR=0.57, 95% CI: 0.38~0.83). Conclusions:Probiotics supplementation could not prevent the onset of GDM but seems beneficial in the treatment of GDM. More studies are needed in the future to explore the effects of probiotics supplementation on GDM.

Objective:To explore the consistency of peripheral whole blood and venous serum procalcitonin (PCT) levels, and the value of peripheral whole blood PCT in evaluating pediatric bacterial infection.Methods:This multicenter cross-sectional parallel control study was conducted in 11 children′s hospital. All the 1 898 patients older than 28 days admitted to these hospitals from March 2018 to February 2019 had their peripheral whole blood and venous serum PCT detected simultaneously with unified equipment, reagent and method. According to the venous serum PCT level, the patients were stratified to subgroups. Analysis of variance and chi-square test were used to compare the demographic characteristics among groups. And the correlation between the peripheral blood and venous serum PCT level was investigated by quantitative Pearson correlation analysis.The PCT resultes were also converted into ranked data to further test the consistency between the two sampling methods by Spearman′s rank correlation test. Furthermore, the ranked data were converted into binary data to evaluate the consistency and investigate the best cut-off of peripheral blood PCT level in predicting bacterial infection.Results:A total of 1 898 valid samples were included (1 098 males, 800 females),age 27.4(12.2,56.7) months. There was a good correlation between PCT values of peripheral whole blood and venous serum ( r=0.97 , P<0.01). The linear regression equation was PCT?venous serum=0.135+0.929×PCT peripheral whole blood. However, when stratified to 5 levels, PCT results showed diverse and unsatisfied consistency between the two sampling methods ( r=0.51-0.92, all P<0.01). But after PCT was converted to ordinal categorical variables, the stratified analysis showed that the coincidence rate of the measured values by the two sampling methods in each boundary area was 84.9%-97.1%. The dichotomous variables also showed a good consistency (coincidence rate 96.8%-99.3%, Youden index 0.82-0.89). According to the severity of disease, the serum PCT value was classified into 4 intervals（<0.5、0.5-<2.0、2.0-<10.0、≥10.0 μg/L）, and the peripheral blood PCT value also showed a good predictive value (AUC value was 0.991 2-0.997 9). The optimal cut points of peripheral whole blood PCT value 0.5、1.0、2.0、10.0 μg/L corresponding to venous serum PCT values were 0.395, 0.595, 1.175 and 3.545 μg/L, respectively. Conclusions:There is a good correlation between peripheral whole blood PCT value and the venous serum PCT value, which means that the peripheral whole blood PCT could facilitate the identification of infection and clinical severity. Besides, the sampling of peripheral whole blood is simple and easy to repeat.

The purification of parasite-infected erythrocytes from whole blood containing leucocytes is crucial for many downstream genetic and molecular assays in parasitology. Current methodologies to achieve this are often costly and time consuming. Here, we demonstrate the successful application of a cheap and simple Non-Woven Fabric (NWF) filter for the purification of parasitized red blood cells from whole blood. NWF filtration was applied to the malaria-parasitized blood of three strains of mice, and one strain of rat, and to Babesia gibsoni parasitized dog blood. Before and after filtration, the white blood cell (WBC) removal rates and red blood cell (RBC) recovery rates were measured. After NWF filter treatment of rodent malaria-infected blood, the WBC removal rates and RBC recovery rates were, for Kunming mice: 99.51%±0.30% and 86.12%±8.37%; for BALB/C mice: 99.61%±0.15% and 80.74%±7.11%; for C57 mice: 99.71%±0.12% and 84.87%±3.83%; for Sprague-Dawley rats: 99.93%±0.03% and 83.30%±2.96%. Microscopy showed WBCs were efficiently removed from infected dog blood samples, and there was no obvious morphological change of B. gibsoni parasites. NWF filters efficiently remove leukocytes from malaria parasite-infected mouse and rat blood, and are also suitable for filtration of B. gibsoni-infected dog blood.