Objective To investigate the effect of vitamin D(VD)on intestinal flora in spontaneously diabetic rats.Methods Zucker diabetic fatty rats(ZDF rats)were randomised to control(Con)group,VD control(VD)group,model(T2DM)group,and VD intervention(VD+T2DM)group.Fasting blood glucose profiles and oral glucose tolerance levels were determined in rats of each group.16S rDNA sequencing was used to assess changes in rat intestinal flora.OTU analysis(Venn diagram),α diversity analysis(chao1,observed species,PD whole tree,and shannon and simpson),βdiversity analysis(principal coordinate analysis(PCoA)),flora structure,and colony species variability analysis(linear discriminant analysis and influence factor(LEfSe)analysis)were also performed.Results VD intervention significantly improved fasting blood glucose levels and insulin resistance in T2DM rats(P＜0.05).α diversity showed no significant differences in chao1,observed species,PD whole tree,and shannon and simpson indices between T2DM and VD+T2DM groups(P＞0.05).β diversity analysis showed that the VD+T2DM group had more species similarity to the Con group than the T2DM group.The dominant bacteria of rat intestinal flora in each group were significantly different.In comparison to the T2DM group,the VD+T2DM group showed a decrease in abundance of Bacteroidetes and increases in abundances of Firmicutes and Clostridium XIVa.Conclusions VD improves fasting glucose elevation and insulin resistance in T2DM rats.VD improves the structure of intestinal flora,decreases Bacteroidetes,and elevates Firmicutes and Clostridium XIVa abundances in T2DM rats.

Biliary fibrosis (BF) is the result of pathological repair of bile tract injury, characterized by thickening and sclerosis of the bile duct wall and progressive stricture of the lumen, which may ultimately lead to serious adverse outcomes such as biliary obstruction, biliary cirrhosis, liver failure, and hepatobiliary malignancies. Current research describes BF as a pathological feature of certain bile tract diseases, lacking a systematic summary of its etiology, pathophysiology, molecular mechanisms, and treatment. BF is a common but easily neglected disease state in biliary system, which may promote the development and progression of hepatobiliary diseases through abnormal repair mechanism after pathological biliary tract injury. Based on the latest research progress from both domestic and international perspectives, the authors review the concept, clinical manifestation, etiology, pathogenesis, and therapeutic strategies of BF to provide a reference for clinical physicians.

Objective: To investigate the longitudinal association of plasma Irisin concentrations with changes in blood pressure (BP) levels among children,and to assess the moderating effect of physical activity (PA) or sedentary behavior (SB) on the relationship between Irisin levels and BP. Methods: Based on a cohort study, a cluster sampling method was used to select 3 651 school aged children from five schools in Guangzhou in 2017 at the baseline survey and follow up in 2019. Both at baseline and during follow up, PA and SB were assessed by validated questionnaires, and BP levels were measured by an electronic sphygmomanometer. A final sample of 521 children were enrolled based on the PA and SB at baseline. Plasma Irisin concentrations were measured by ELISA at baseline. Logistic regression analysis was recruited for exploring the associations of plasma Irisin concentrations with changes in BP. Moderating effects of PA and SB on the relationship between Irisin concentrations and BP were estimated using stratified analysis. Results: Logistic regression analysis indicated that there was no significant association between Irisin concentrations and changes in BP levels among children ( OR =0.98, P >0.05). After stratification for SB, Irisin levels in the low SB subgroup were inversely associated with changes in diastolic blood pressure ( OR=0.87, 95%CI=0.77-0.98, P =0.02). In addition, SB level had a moderating effect on the relationship between Irisin levels and the DBP changes ( P =0.01). Conclusion Increased Irisin concentration is associated with the decrease of DBP level among low SB children. Furthermore, SB level shows moderating role in the relationship between Irisin concentrations and changes in DBP levels.

Objective:To evaluate the effect of the improved team-based learning (TBL) teaching method in the undergraduate probation course of ophthalmology based on the goal of cultivating excellent doctors.Methods:The undergraduates of clinical medicine were randomly divided into experimental group and control group. The control group ( n=50) was given conventional ophthalmology probation teaching, while the experimental group ( n=50) was given ophthalmology probation teaching of improved TBL teaching method. The theoretical examination performance and skill assessment results of students in the two groups were compared, and the subjective evaluation of the students on the teaching was also compared. SPSS 23.0 was used to conduct t-test and Wilcoxon's rank sum test. Results:The theoretical examination performance of experimental group (29.68±4.52) was better than that of control group (27.84±4.33), with significant differences ( P<0.05); the skill assessment results of experimental group (32.88±5.05) were also better than those of the control group (30.88±6.99), with significant differences ( P<0.05); the subjective evaluation of teaching effect in each item of experimental group was better than that of control group ( P<0.05). Conclusion:The improved TBL teaching method can not only improve students' theoretical knowledge and experimental skills, but also improve students' self-study and teamwork ability, which will provide a feasible educational reform plan for achieving the goal of cultivating excellent doctors.

Objective:To explore the incidence and risk factors of postoperative cardiovascular events in older orthopedic patients.Methods:The clinical data of 316 older patients undergoing orthopedic surgery from May 2018 to December 2021 in Xuanwu Hospital, Capital Medical University were retrospectively analyzed. The independent risk factors of postoperative cardiovascular events in elderly orthopedic surgery patients were analyzed.Results:Among the 316 elderly orthopedic surgery patients, 10 patients experienced postoperative cardiovascular events (event group), and 306 patients did not experience postoperative cardiovascular events (non-event group). There were no statistical differences in gender composition, age, operation method, American Association of Anesthesiologists (ASA) classification, operation time, postoperative hospital stay, nutritional status, weakness degree, ability of daily life (ADL) and the proportions of percutaneous coronary intervention (PCI) + coronary artery bypass grafting (CABG) + old myocardial infarction (OMI), hypertension, diabetes, atrial fibrillation, old cerebral infarction, peripheral artery stenosis between two groups ( P>0.05). The proportion of coronary heart disease in event group was significantly higher than that in non-event group: 6/10 vs. 19.93% (61/306), and there was statistical difference ( P<0.01). Multivariate Logistic regression analysis result showed that coronary heart disease was the independent risk factor of postoperative cardiovascular complications in older orthopedic patients ( OR = 4.63, 95% CI 1.22 to 17.56, P<0.05). Conclusions:Accompanying coronary heart disease can increase the incidence of postoperative cardiovascular events in older orthopedic patients, but cardiovascular events do not prolong the length of hospital stay.

As a disease that requires long-term treatment, the safety of treatment is particularly important in the treatment of inflammatory bowel disease (IBD). Numerous studies have shown that diet can alter the intestinal barrier, IBD susceptibility gene expression, immune function, and microbial metabolites by influencing the balance of gut microbes. Diet is therefore one of the key environmental factors that affect the symptoms and recurrence of IBD. The resistant starch diet can increase the viscosity of feces, promote the proliferation of colon symbiotic bacteria and generate a large number of short-chain fatty acids, which is highly correlated with the course of IBD. This article reviewed the progress of resistant starch in treatment of IBD.

Objective:To study the neurodevelopmental status of very/extremely low birth weight preterm infants with gestational age less than 32 weeks at the corrected age of 1 year.Methods:Preterm infants admitted to the Neonatology Department after birth at Guangzhou Women and Children′s Medical Center from January 2015 to December 2018 and followed up regularly to the high-risk infants clinic for at least 1 year after discharge were selected as the research subjects.According to the birth weight(BW), preterm infants were divided into very/extremely low birth weight group(BW<1 500 g), low birth weight group(1 500 g

Scar, especially pathological scar, not only cause cosmetic concerns, but also affect the physiological function of related tissues or organs, leading to malformation and dysfunction, that will seriously affect the quality of patients’ life. Nowadays, there are many ways to prevent and improve scar. Local topical medicine such as silicone-based products and plant extracts, become more and more popular with patients because of convenience and reasonable price. In this review, the topical agents for the prevention and improvement of scar, and their therapeutic mechanisms were summarized, providing ideas for the treatment of scar with topical agents.

Scar, especially pathological scar, not only cause cosmetic concerns, but also affect the physiological function of related tissues or organs, leading to malformation and dysfunction, that will seriously affect the quality of patients’ life. Nowadays, there are many ways to prevent and improve scar. Local topical medicine such as silicone-based products and plant extracts, become more and more popular with patients because of convenience and reasonable price. In this review, the topical agents for the prevention and improvement of scar, and their therapeutic mechanisms were summarized, providing ideas for the treatment of scar with topical agents.

Objective:To investigate the difference of physical growth and neurodevelopmen between small for gestational age (SGA) preterm infants and appropriate for gestational age (AGA) preterm infants, and to promote follow-up management and early intervention in SGA preterm infants after discharge.Methods:Preterm infants, who were born at Guangzhou Women and Children′s Medical Center and received regular follow-up management after discharge in high-risk infants outpatient, were enrolled in this study from January 2015 to December 2018.According to gestational age and birth weight, the participants were divided into SGA group and AGA group.Height, weight, head circumference and Gesell outcomes of infants were observed at 6 months and 12 months of corrected age.Results:A total of 144 preterm infants were included in the study, including 63 cases in SGA group and 81 cases in AGA group. Height, weight and head circumference of the SGA group at 6 months and 12 months of corrected age were all lower than the AGA group ( P<0.05). In addition, adaptability, great movement, language, personal social interaction and development quotient in the SGA group were all lower than those in the AGA group at 6 months of corrected age ( P<0.05), while fine movement was not statistically significant ( P>0.05). At 12 months of corrected age, there were no statistically significant differences in adaptability, macro motor, fine motor, language, social interaction and development quotient between the two groups ( P>0.05). Conclusion:The physical growth of SGA preterm infants falls for behind that of AGA preterm infants.It is still unable for SGA preterm infants to achieve catch-up growth at 12 months of corrected age, their catch-up period may take longer, but the neurodevelopment can reach the same level of preterm AGA.The clinician should pay more attention to the follow-up management and early intervention after discharge.