Objective To investigate the changes of blood lipid and glycosylated hemoglobin (HbA1c) levels in obese type 2 diabetes (T2DM) patients and their relationship with insulin resistance (Homa-IR). Methods A total of 120 cases of T2DM newly diagnosed in Motuo County, Tibet from February to October 2022 were selected as the observation group. According to BMI, the patients were divided into diabetes normal weight group (46 cases), overweight group (43 cases) and obesity group (31 cases); 145 healthy subjects were selected as the control group. The levels of HbA1c, fasting blood glucose (FPG), fasting insulin (FINS), serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL-C), and low-density lipoprotein (LDL-C) were detected in the study subjects, and Homa-IR and Homa-β indices were calculated. The height, weight, and abdominal circumference were measured. The differences in the levels of the above indicators between the observation group patients and the control group, as well as among various subgroups within the observation group were compared. The influencing factors of Homa-IR in obese T2DM patients were analyzed. Results Compared with the control group, a significant increase in BMI, abdominal circumference, blood pressure, HbA1c, FBG, FINS, TC, TG, LDL-C, UA, visceral fat area, and the levels of Home-IR and Home-β was found in the observation group (all P<0.05). There were significant differences in BMI, abdominal circumference, and the levels of FINS, Homa IR, Homa-β, and HbA1c in diabetes patients with different BMI (all P<0.05). Correlation analysis showed that TG levels in obese T2DM patients in the observation group were significantly correlated with HbA1c (r=0.396, P=0.027), Homa-IR (r=0.405, P=0.024), and Home-β (r=-0.401, P=0.025); LDL-C was significantly correlated with Homa-IR (r=0.411, P=0.022) and Homa-β (r=-0.412, P=0.021); HbA1c was significantly positively correlated with BMI (r=0.371, P=0.040). Conclusion Insulin resistance is closely related to TG, LDL-C, and BMI in obese T2DM patients from the Motuo ethnic minority of Tibet, suggesting that these factors may play a role in the occurrence of T2DM.

Bone remodeling and bone regeneration are essential for preserving skeletal integrity and maintaining mineral homeostasis.T cells,as key members of adaptive immunity,play a pivotal role in bone remodeling and bone regeneration by producing a range of cytokines and growth factors.In the physiological state,T cells are involved in the maintenance of bone homeostasis through interactions with mesenchymal stem cells,osteoblasts,and osteoclasts.In pathological states,T cells participate in the pathological process of different types of osteoporosis through interaction with estrogen,glucocorticoids,and parathyroid hormone.During fracture healing for post-injury repair,T cells play different roles during the inflammatory hematoma phase,the bone callus formation phase and the bone remodeling phase.Targeting T cells thus emerges as a potential strategy for regulating bone homeostasis.This article reviews the research progress on related mechanisms of T cells immunity involved in bone remodeling and bone regeneration,with a view to providing a scientific basis for targeting T cells to regulate bone remodeling and bone regeneration.

Objective To unravel the possible mechanism of the role of recombinant human high mobility group box 1 (rhHMGB1) protein in regulating the angiogenesis of endothelial cells. Methods Endothelial cells were divided into the control group, bone marrow mesenchymal stem cells (MSC) supernatant group and rhHMGB1 group. The proliferation and survival of endothelial cells were detected by cell counting kit(CCK)-8 assay. The relative expression levels of vascular endothelial growth factor (VEGF), Yes-associated protein (YAP), CD31 and hypoxia inducible factor (HIF)-1α proteins were determined by Western blot. The relative expression levels of VEGF, YAP, CD31 and HIF-1α messenger RNA (mRNA) were detected by real-time fluorescent quantitative polymerase chain reaction (RT-qPCR). The migration ability of endothelial cells was assessed by Transwell chamber test. The localization of YAP was detected by immunofluorescence staining. Results Compared with the control group, the migration rate of endothelial cells was increased in the rhHMGB1 group (P < 0.05), and the cell migration rate was enhanced over time. Compared with the control group, the relative expression levels of VEGF and p-YAP proteins were up-regulated in the MSC supernatant group, and the differences were statistically significant (both P < 0.05). Compared with the control group, the relative expression levels of VEGF and HIF-1α proteins, VEGF and CD31 mRNA and YAP and p-YAP proteins were up-regulated, and YAP/p-YAP ratio was increased in the rhHMGB1 group, and the differences were statistically significant (all P < 0.05). Compared with the MSC supernatant group, the relative expression levels of CD31 mRNA and YAP protein were up-regulated, and the YAP/p-YAP ratio was increased in the rhHMGB1 group, and the differences were statistically significant (all P < 0.05). Conclusions Exogenous high-concentration rhHMGB1 may promote the migration ability of endothelial cells and up-regulate the expression levels of angiogenesis-related proteins by regulating the recruitment of YAP to the nucleus.

OBJECTIVE To study the moderation effect of water extract of Farfarae Flos on blood lipid and glucose regulation in obese mice. METHODS Chemical method was used to identify the components of the water extract of Farfarae Flos. The contents of total terpenes in the water extract of the Farfarae Flos were determined by UV-VIS spectrophotometry. The mice were randomly divided into blank group, model group, orlistat group, and low-dose, medium-dose, and high-dose groups of water extract of Farfarae Flos. The blank group was fed with ordinary diet, while the other groups were fed with high-fat and high-sugar diet to establish an obese animal model, and they were administration while molding for 45 d. At the end of the experiment, the contents of serum triglyceride(TG), cholesterol(CHO), high-density lipoprotein-C(HDL-C), low-density lipoprotein-C(LDL-C), glucose(GLU), and glycosylated serum protein(GSP) were detected. Hematoxylin-eosin(HE) and oil red O staining were used to observe the morphological changes and lipid droplet distribution of liver tissue in mice. RESULTS There were flavonoids and terpenoids in the water extract of the flower. Compared with the blank group, the levels of TG, CHO, LDL-C, GLU and GSP in the model group were significantly increased(P<0.05 or P<0.01), HDL-C was significantly decreased(P<0.05), and the area of lipid droplets in the liver was significantly increased(P<0.01). Compared with the model group, TG, LDL-C, CHO, GLU and GSP levels in the Farfarae Flos water extract groups were significantly decreased, HDL-C was increased, and lipid droplet accumulation were reduced. Compared with the model group, the blood lipid and blood glucose levels in the treatment groups were significantly decreased, among them, the high-dose group of the water extract of Farfarae Flos had the best effect. CONCLUSION The water extract of farfara can improve glucose and lipid metabolism in obese mice by reducing blood lipids, CHO, and improving the pathological morphology of liver tissue.

Objective:By reviewing and analyzing the patent of Traditional Chinese Medicine compound for the prevention and treatment of chronic complications of diabetes, this paper aims to analize the patent of Traditional Chinese Medicine compound and medication rules for the prevention and treatment of diabetes complications with data mining technology.Methods:Based on data mining technology, this paper searched for the patent of Traditional Chinese Medicine compound that could prevent and treat chronic complications of diabetes with SOOIP (Intellectual Property Big Data Center) website, and analyzed the application trends, number , categories, etc. Then IBM SPSS Modeler 18.0 software was used for correlation analysis, and finally the medication and compatibility of the Chinese medicine prescriptions are summarized.Results:There were all together 307 patents, and the number of patent applications for the prevention and treatment of chronic complications of diabetes with Chinese medicines has increased before 2015. Most patents in classification belongs to A61P. China accounts for the majority of the global total applications, of which Shandong province accounts the most. The applicants are mostly individuals and enterprises. The categories commonly used in patent applications are mainly oral drug combinations; The Astragali Radix, Puerariae lobatae Radix, Rehmanniae Radix, Coptidis Rhizoma, Salviae miltiorrhizae Radix et Rhizoma are the most commonly used application. The Traditional Chinese Medicine patent mostly has sweet taste, warm in property, and channel-tropism of medicine is mostly liver, as well as the liver is most associated with bitterness in taste. The commonly used couplet medicines are Puerariae lobatae Radix-Astragali Radix, Puerariae lobatae Radix-Rehmanniae Radix, Astragali Radix-Coptidis Rhizoma. Conclusion:The number of such patents applied for in China is small, and the regional development is unbalanced; Data mining technology can be used to discover the compatibility rule of Chinese patent prescription prescription for diabetes prevention and treatment, so as to provide reference for clinical optimization of prescription, improvement of curative effect and development of new drugs for treatment of diabetic complications.

Forty two resident general practitioners (GPs) attending obstetrics and gynecology course in Beijing Hospital were divided into trial group and control group with 21 in each group. The 2-hour study content uterine fibroids was taught by the same teacher. For control group the traditional classroom teaching mode was used, while for the trial group the WeChat-based flipped classroom model was used. The teaching effectiveness was evaluated by means of paper examination, critical examination and questionnaire survey. The average scores and the clinical reasoning scores of trial were significantly higher than those of control group [(90.5±3.4) vs. (82.5±4.2) points and (94.5±1.5) vs. (84.5±2.0) points; t=4.28, P<0.05 and t=5.01, P<0.05, respectively]. Compared with the control group, the trial group presented more learning interest, higher learning efficiency and self-learning ability; and also the ability of expression and communication was improved, the ability of teamwork and the ability of analyzing and solving problems was enhanced more markedly in trial group (all P<0.05). The result indicates that WeChat-based flipped classroom teaching model can improve the learning efficiency in general practice residency training.

Objective:To explore the clinical characteristics of children with Streptococcus pneumoniae cellulitis. Methods:The bacterial culture information management system in 18 children′s hospitals from January 2012 to December 2017 were reviewed.Among 1 138 children diagnosed with invasive pneumococcal disease(IPD), 7 cases were hospitalized with cellulitis.Clinical information was collected and analyzed.Results:Seven cases of Streptococcus pneumoniae cellulitis accounted for 0.6%(7/1 138 cases) of 1 138 IPD cases in 18 hospitals.There were 5 males and 2 females.The onset age was from 1 month to 6 years old, and the median age was 2 years old.There were 4 cases in rural areas and 3 cases in urban areas.Langerhans cell histiocytosis (LCH) was found in 1 case.Clinical manifestations: fever, local swelling and pain with infection.The focus of cellulitis: orbital cellulitis in 2 cases, buccal infection in 2 cases, upper extremity, head and buttock infection in 1 case, respectively.At the beginning of the disease: 2 cases of orbital cellulitis were accompanied by nasosinusitis and suppurative otitis media, 1 case was treated with acute periapical inflammation, 1 case was 10 months after chemotherapy.Type of infection: 6 cases were complicated with bloodstream infection, 2 cases with bacterial meningitis and 1 case with pneumonia.Other culture results: 6 cases of Streptococcus pneumoniae were cultured in peripheral blood, 2 cases were positive in local pus culture.Drug sensitivity test: 6 cases were sensitive to Penicillin and Cephalosporin (Cefotaxime/Ceftriaxone), 1 case was resistant.Treatment: 3 patients were treated with Cephalosporins alone, 2 cases with Cephalosporins and Penicillins, 2 cases with Vancomycin and Meropenem for meningitis, 3 cases with local abscess by incision and drainage, 2 cases with meningitis in Intensive Care Unit, and 1 case with endotracheal intubation and ventilator assisted ventilation.The average length of stay was 14.3 days(5-41 days). Discharge outcome: 6 cases improved and 1 case died. Conclusions:Cellulitis is a rare type of infection in children with IPD.It is mainly found in the head, face and around the orbit.It may be accompanied by bloodstream infection or bacterial meningitis.Most of them have a good prognosis.

Objective:To explore the clinical application value of vector flow mapping (VFM) in assessment of early cardiac dysfunction in aortic stenosis (AS) patients with normal left ventricular ejection fraction (LVEF).Methods:The clinical study consisted of 37 patients with various degrees of AS (LVEF>50%) from October 2015 to February 2017 in Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, including 16 mild to moderate ones (AS1 group ) and 21 severe ones ( AS2 group ). A group of 35 age- and gender-matched healthy volunteers were selected as control group. Using Hitachi Aloka Prosound F75 color Doppler ultrasound diagnostic system, general two-dimensional parameters of left ventricular structure and function were measured. Furthermore, standard dynamic apical long axis view color Doppler flow images during 3 completed cardiac cycles were acquired for DAS-RS1 off-line workstation.Based on time-flow curve(T-F curve) of left ventricle, ECG, and the open-close of valves, the diastole period of left ventricle was divided into the isovolumic relaxation phase(P1), rapid filling phase(P2), slow filling phase(P3), atria contract phase (P4), and total diastolic phase(P0); the systole period was divided into isovolumetric contraction phase (P5), rapid ejecting phase(P6), slow ejecting phase(P7), and total systolic phase(P8). The left ventricular energy loss (EL) of three groups were acquired in all phases.Results:Left ventricular EL: ①Three peaks of EL appeared in P2, P4 and P6 respectively and total diastolic EL was almost equal to systolic. ②Compared with control group, the EL values of AS1 group increased in all phases, but only in P4, P7 and P0 with significant differences ( P<0.05). ③Compared with the other two groups, the EL values in AS2 group increased significantly in all phases of AS2 group ( P<0.01). Correlation analysis: ①For control group and AS group, there were both significant positive correlations between P0-EL, P8-EL and LVMI ( r=0.561, 0.585; 0.635, 0.652 respectively; P<0.01). ②There were both significant positive correlations between P2-EL and E, e′( r=0.623, 0.537; 0.576, 0.502 respectively; P<0.01), while P4-EL and A( r=0.482, 0.555, P<0.01). ③There were both significant positive correlations between P0-EL, P8-EL and E/e′( r=0.480, 0.459; 0.673, 0.590 respectively; P<0.01) and negative correlations between P0-EL, P8-EL and LVEF ( r=-0.537, -0.596; -0.569, -0.625 respectively; P<0.01). Conclusions:Quantitative evaluation of left ventricular EL by VFM technique is expected to provide a sensitive indicator for evaluating the cardiac structure and functional status in AS patients with normal LVEF.

Objective:To explore the therapeutic effects of biofeedback therapy of perineal surface on stress urinary incontinence(SUI) in elderly women.Methods:A total of 87 elderly women with SUI treated at the outpatient clinics of Beijing Hospital and Yunnan First People's Hospital between January 2018 and December 2019 were recruited in this prospective cohort study.All participants were therapeutically divided into the perineal BF group(n=53)and the intravaginal BF group(n=34), based on the voluntary selection.In the intravaginal BF group, 3/34 cases dropped out of the study, and finally in 31 cases the treatment was completed.All patients were treated with biofeedback for 8 weeks with twice treatment per week.The quality of life was assessed by the incontinence impact questionnaire scores.Patients underwent the 1-hour pad-weighing test, pelvic floor muscle assessment and quality of life assessment by incontinence impact questionnaire(ⅡQ-7)scores before and after treatment.The effective rate of treatment, adverse reactions and treatment satisfaction scores were compared between the two groups.Results:The urine leakage and scores of ⅡQ-7 questionnaire were significantly improved after versus before 8 weeks of treatment in the perineal BF group[(4.65±2.33) g vs.(11.02±4.85) g, (7.96±5.11) scores vs.(4.34±2.66) scores, t=8.62 and 4.58, P<0.001], and in the intravaginal BF group[(3.85±1.89) g vs.(12.43±3.96) g, (3.81±1.23) scores vs.(8.29±5.01) scores, t=10.89 and 4.84, P<0.001]. Compared with before treatment, the grading of pelvic floor muscle strength was improved after treatment, but had no significant difference in the perineal BF group(3.93±2.77 vs.2.98±2.10, t=1.99, P=0.056)and in the intravaginal BF group(4.51±3.38 vs.3.07±2.02, t=2.04, P=0.051). There was no significant difference in the urine leakage, grading of pelvic floor muscle strength and scores of ⅡQ-7 questionnaire between two groups( P>0.05). The effective rate of treatment had no significant difference between the perineal and intravaginal BF groups(81.13% or 43/53 vs.83.87% or 26/31, χ2=0.10, P=0.750). The incidences of adverse effects were higher(20.59% or 7/34 vs.1.89% or 1/53, χ2=8.68, P=0.003)and the comfort levels during treatment assessed by visual analog scale(VAS)scores were lower in the intravaginal BF group than in the perineal BF group[(8.11±2.93) scores vs.(9.88±3.84) scores, t=2.95, P=0.004]. The main adverse effects included pain or discomfort, vaginal bleeding and increased vaginal discharge in the intrasvaginal BF treatment group. Conclusions:The perineal BF method is as effective as intravaginal BF in female stress urinary incontinencetreatmentin elderly women, and has fewer adverse effects.