Objective Exploring the clinical application value of long chain non-coding RNA(lncRNA)H19 in peripheral blood mononuclear cells(PBMCs)in type 2 diabetes mellitus(T2DM)patients with osteoporosis(OP).Methods A total of 176 patients with T2DM admitted to the Department of Endocrinology of the First People's Hospital of Lianyungang City from December 2022 to June 2023 were selected.They were divided into OP group(n=100)and simple T2DM group(n=76)according to the results of bone mineral density(BMD)determination by dual-energy X-ray.General data and biochemical indicators were compared between the two groups.The correlation between lncRNA H19 and other clinical indicators was analyzed by Spearman correlation analysis and the influencing factors for T2DM with OP were analyzed by logistic regression.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of lncRNA H19 in T2DM with OP.Results Compared with T2DM group,the proportion of females,age,HbA1c,TC and TGF-β1 were higher(P<0.05),while BMI,SUA,BMD and lncRNA H19 were lower in OP group(P<0.05).Spearman correlation analysis showed that lncRNA H19 expression level was positively correlated with BMI,SUA and BMD(P<0.05),and negatively correlated with age,HbA1c and TGF-β1(P<0.05).Logistic regression analysis showed that age,BMI,TC,TGF-β1 and lncRNA H19 were the influencing factors for T2DM combined with OP(P<0.05).ROC curve analysis showed that the AUC of lncRNA H19 in the diagnosis of T2DM with OP was 0.839,the sensitivity was 76.3%,and the specificity was 86.0%.Multiple linear regression analysis showed that age,TGF-β1 and OP were the influencing factors for lncRNA H19(P<0.05).Conclusion LncRNA H19 expression decreased in PBMCs in patients with T2DM with OP,which may participate in the occurrence and development of T2DM with OP through glucose metabolism and lncRNA H19/TGF-β1 pathway.

Objective:Based on the statistical data of the comprehensive evaluation of professional degree graduate students by the guiding physicians, to conduct an empirical study on the quality of the enrollment of master of stomatology professional degree graduate students.Methods:A total of 67 master of stomatology professional degree graduate students from Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University were comprehensively evaluated by their guiding physicians when they went out the department. SPSS 25.0 software was used for t test and variance analysis. Results:The average score of 67 students was (91.39±3.55) points. There was good reliability and validity for the comprehensive evaluation index. Among the methods of promotion and exemption, unified examination, 7-year transfer to "5 + 3" of our school and enrollment of students from Hong Kong, Macao and Taiwan regions, the comprehensive evaluation total score of 7-year transfer to "5 + 3" of our school was the highest. The comprehensive evaluation results of the students with high initial scores were slightly higher than those students with low scores. The students who studied in the "Double First-class" universities and were with the fourth round of subject assessment grade A and grade B had better performances.Conclusion:We should attach importance to enrollment quality, through various channels to attract quality students and actively explore ways to improve the quality of graduate students. Meanwhile, we should make efforts to strengthen training quality and to build scientific comprehensive evaluation system for specialized degree graduate students. The connotation of "medicine-education collaboration" will be further deepened. And the training and development of oral medicine applied high-level medical talents will be promoted.

Objective:To observe the clinical efficacy of autologous platelet rich gel (APG) in the treatment of type 2 diabetic foot (DF) patients and the effect of APG on the expression of metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) in peripheral blood mononuclear cells (PBMCs).Methods:A total of 62 patients with DF admitted to the Affiliated Hospital of Kangda College of Nanjing Medical University from February 2021 to May 2022 were randomly divided into a control group (30 cases) and an observation group (32 cases) using a random number table method. The control group received ultrasound debridement and dressing change treatment, while the observation group received ultrasound debridement combined with APG treatment. After 6 weeks of treatment, the effective rate, transcutaneous oxygen partial pressure (TcPO 2), and serum tumor necrosis factor- α (TNF-α), interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), hypoxia inducible factor α (HIF-1 α)and the level of MALAT1 expression in PBMCs of the two groups of patients were observed. The Pearson correlation analysis was used to investigate the relationship between the expression change of MALAT (△ MALAT1) and the total effective rate of treatment. Results:The total effective rate of the observation group was higher than that of the control group [93.75%(30/32) vs 73.33%(22/30), P<0.05]. After treatment, the systolic blood pressure (SBP), diastolic blood pressure (DBP), cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FPG), glycosylated hemoglobin (HbA 1c), urinary microalbumin/creatinine (UACR), uric acid (UA), white blood cells (WBC), TNF- α and IL-6 of both groups had decreased compared to before; HIF-1 α, VEGF and MALAT1 increased compared to before treatment (all P<0.05); After treatment, there was a statistically significant difference in UA, HIF-1α, VEGF, and MALAT1 between the observation group and the control group (all P<0.05). Pearson correlation analysis showed that Δ MALAT1 in DF patients was negatively correlated with TNF -α ( r=-0.61, P=0.02), IL-6 ( r=-0.52, P=0.04), WBC ( r=-0.53, P=0.03), and positively correlated with VEGF ( r=0.58, P=0.03) and HIF-1α ( r=0.54, P=0.03). The total effective rate of DF treatment was higher in the high change group of△ MALAT [88.37%(38/43) vs 73.68%(14/19), P<0.05]. There was no statistically significant difference in the incidence of adverse reactions between the two groups ( P>0.05). Conclusions:APG can significantly upregulate the expression of MALAT, improve wound tissue blood perfusion, wound angiogenesis, and inflammatory response, promote ulcer healing, and changes in MALAT expression can help determine the prognosis of DF.

Objective:To investigate the treatment efficacy of adjuvant anti-VEGF/VEGFR targeted therapy in patients with non-metastatic (cM 0) non-clear cell renal cell carcinoma and tumor thrombus (nccRCC-VTT). Methods:This retrospective study enrolled 26 patients who underwent radical nephrectomy combined with inferior vena cava tumor thrombectomy at Peking University Third Hospital from January 2014 to July 2021. Patients were divided into adjuvant therapy group (10 cases) and control group (16 cases)based on the use of postoperative targeted therapy. The distribution of baseline clinical characteristics in the adjuvant therapy group and the control group were as follows: gender (6 males and 4 females in the adjuvant therapy group, 12 males and 4 females in the control group, P=0.66), age (56.2±18.5 years old in the adjuvant therapy group; 54.6±14.5 years old in the control group; P=0.80), BMI(24.0±3.5 in the adjuvant therapy group; 24.3±3.3 in the control group; P=0.80), presence of clinical symptoms (8 cases in the adjuvant therapy group; 15 cases in the control group; P=0.54), tumor laterality(6 cases on the left and 4 cases on the right in the adjuvant therapy group; 6 cases on the left and 10 cases on the right in the control group; P=0.42), location of tumor thrombus (2 cases with renal vein tumor thrombus and 8 cases with inferior vena cava tumor thrombus in the adjuvant therapy group; 2 cases with renal vein tumor thrombus and 14 cases with inferior vena cava tumor thrombus in the control group; P=0.67), ASA classification (2 cases in ASA class 1 and 8 cases in ASA class 2 in the adjuvant therapy group; 2 cases in ASA class 1 and 14 cases in ASA class 2 in the control group; P=0.63), surgical approach (7 minimally invasive surgeries and 3 open surgeries in the adjuvant therapy group; 9 minimally invasive surgeries and 7 open surgeries in the control group; P=0.68), conversion to open surgery (2 cases in the adjuvant therapy group; 2 cases in the control group; P=0.63), operation time [287.5(222.2, 456.0) minutes in the adjuvant therapy group; 344.0(287.8, 482.5) minutes in the control group; P=0.34), blood loss [400.0(250.0, 600.0)ml in the adjuvant therapy group; 575.0(175.0, 800.0)ml in the control group; P=0.63), Clavien-Dindo classification of postoperative complications (8 cases with no postoperative complications, 2 cases with level 1-2 complications, and 0 cases with level ≥3 complications in the adjuvant therapy group; 10 cases with no postoperative complications, 4 cases with level 1-2 complications, and 2 cases with level ≥3 complications in the control group; P=0.68), postoperative hospital stay (8.5 [5.5, 11.5] days in the adjuvant therapy group; 7.5 [6.0, 13.0] days in the control group; P=1.00), maximum tumor diameter[ (9.2±2.7)cm in the adjuvant therapy group; (8.9±3.3)cm in the control group; P=0.81], sarcomatoid differentiation (0 cases in the adjuvant therapy group; 1 case in the control group; P=1.00), perinephric fat invasion (2 cases in the adjuvant therapy group; 7 cases in the control group; P=0.40), tumor necrosis (6 cases in the adjuvant therapy group; 5 cases in the control group; P=0.23), pathological subtype (1 case of PRCC type 1, 6 cases of PRCC type 2, and 3 cases of TFE3 rearrangement RCC in the adjuvant therapy group; 2 cases of PRCC type 1, 10 cases of PRCC type 2, and 1 case each of oncocytic PRCC, TFE3 rearrangement RCC, FH-deficient RCC, and unclassified RCC in the control group; P=0.72), WHO/ISUP nuclear grade (10 cases of grades 3-4 in the adjuvant therapy group; 4 cases of grades 1-2 and 12 cases of grades 3-4 in the control group; P=0.14), invasion of tumor thrombus into the vessel wall (5 cases in the adjuvant therapy group; 5 cases in the control group; P=0.43), T stage (1 case of T 3a, 3 cases of T 3b, 5 cases of T 3c, and 1 case of T 4 in the adjuvant therapy group; 1 case of T 3a, 4 cases of T 3b, 10 cases of T 3c, and 1 case of T 4 in the control group; P=1.00), and positive lymph nodes metastasis(3 cases in the adjuvant therapy group; 0 cases in the control group; P<0.05). The recommended doses for sunitinib, axitinib, and pazopanib are 50mg qd, 5mg q12h, and 800mg qd, respectively. The primary endpoint of this study was disease-free survival (DFS), and the secondary endpoint was overall survival (OS). Statistical analyses were performed using R v4.2.2. Confounding factors were adjusted using propensity score weighting. Results:The median follow-up time for DFS was 29 months in the adjuvant therapy group and not reached in the control group, while median follow-up time for OS was 28 and 26 months, respectively. In the univariate Cox regression analysis, there were no statistically significant difference in the impact of all baseline characteristics and exposure factors on DFS and OS between the two groups. In survival analysis, there were no significant difference between DFS and OS curves of patients in the adjuvant therapy group and the control group (DFS, P=0.62; OS, P=0.74). The median DFS of patients in the adjuvant therapy group and the control group were 17 and 19 months, respectively, while the median OS was 43 and 27 months. After adjusting for confounding factors, the median DFS of patients in the adjuvant therapy group and the control group were 26 and 12 months, respectively, and the median OS remained 43 and 27 months, with no significant difference (DFS, P=0.81; OS, P=0.40). Conclusion:There is currently a lack of definitive evidence for survival benefit from adjuvant anti-VEGF/VEGFR targeted therapy in patients with cM0 nccRCC-VTT after surgery.

Objective:To analyze the preliminary explorations and practical effects of strengthening the process management of nursing special projects in a tertiary general hospital, so as to explore the refined management strategy of hospital projects and provide reference for improving the management level of the research project.Methods:This article takes a series of refined measures taken by the hospital in the process management of nursing special projects from August 2016 to August 2021 as the research example, including setting up subject directions around key disciplines, setting application conditions at different levels, standardizing selection procedures, strengthening mid-term assessments, strictly controlling final acceptance, establishing integrity files, and promoting the transformation of scientific achievements, etc. and these measures are deeply analyzed and discussed.Results:Through a series of measures, the hospital nursing team has significantly improved in terms of research paper publication, patent authorization, approval of projects above the bureau level, and nursing specialties ranking of Chinese hospital Science and Technology Evaluation Metrics (STEM) in the past six years.Conclusions:By strengthening the process management of nursing special research project, the construction level of nursing disciplines has been significantly improved, and the development of nursing disciplines has been greatly promoted.

Objective:This study aimed to evaluate the efficacy of decitabine (DAC) and identify factors influencing treatment responses in patients with primary immune thrombocytopenia (ITP) who had failed glucocorticoid therapy.Methods:Clinical data of 61 patients with glucocorticoid-resistant ITP who received DAC therapy (5 mg·m -2·d -1×3 d via intravenous infusion) for at least three cycles with 3-4-week intervals at the Department of Hematology, Qilu Hospital of Shandong University, from November 2015 to June 2021 were analyzed retrospectively. Results:The 61 patients comprised 20 males and 41 females, with a median age of 45 years (range: 15-81 years). Among them, 43 patients were glucocorticoid-dependent (glucocorticoid-dependent group), while 18 patients were glucocorticoid-resistant (glucocorticoid-resistant group). Following DAC treatment, 12 patients (19.67% ) achieved complete response (CR), and 16 patients (26.23% ) exhibited response (R), resulting in an overall response (OR) rate of 45.90% (28/61). Comparison between the OR group ( n=28) and the non-response (NR) group ( n=33) revealed significant differences in responses to glucocorticoids (dependent or resistant) and platelet counts before treatment ( χ2=8.789, P=0.003; z=-2.416, P=0.016). The glucocorticoid-dependent group showed higher platelet counts than the glucocorticoid-resistant group after the second and third cycles of DAC treatment ( P=0.032, 0.024). Moreover, the OR rates after the first, second, and third cycles of DAC treatment in the glucocorticoid-dependent group were all higher than those in the glucocorticoid-resistant group ( P=0.042, P=0.012, P=0.029). A significant correlation was observed between glucocorticoid dependence and responses to DAC treatment ( OR=9.213, 95% CI 1.937-43.820, P=0.005) . Conclusion:DAC demonstrates definitive efficacy with mild adverse effects in a subset of patients with glucocorticoid-resistant primary ITP. Glucocorticoid dependence and higher platelet counts before treatment are associated with a favorable response to DAC therapy.

Dental Caries is a kind of chronic oral disease that greatly threaten human being's health. Though dentists and researchers struggled for decades to combat this oral disease, the incidence and prevalence of dental caries remain quite high. Therefore, improving the disease management is a key issue for the whole population and life cycle management of dental caries. So clinical difficulty assessment system of caries prevention and management is established based on dental caries diagnosis and classification. Dentists should perform oral examination and establish dental records at each visit. When treatment plan is made on the base of caries risk assessment and carious lesion activity, we need to work out patient‑centered and personalized treatment planning to regain oral microecological balance, to control caries progression and to restore the structure and function of the carious teeth. And the follow-up visits are made based on personalized caries management. This expert consensus mainly discusses caries risk assessment, caries treatment difficulty assessment and dental caries treatment plan, which are the most important parts of caries management in the whole life cycle.
Consensus ; Dental Care ; Dental Caries/prevention & control* ; Humans ; Prevalence

The morbidity of scoliosis in adolescents in China is about 3%-5%, 80%-85% of the patients are adolescent idiopathic scoliosis (AIS), whose etiology is unknown. Scoliosis is a structural spine disease occurring during puberty or before skeletal maturation. Scoliosis has a greatly negative impacton not only the growth and development of adolescent spine, but also the mental health of adolescents. Ocular disease is a common clinical disease in which the eye ball and its accessory structures have structural abnormalitiesordys function. Ocular disease snotonly bring in convenience to patients's life, but also may induce diseases in other organs. Recent studies have shown that various ocular diseases may have a potential impact on scoliosis, and quite a fewof patients with certain ocular diseases have higher incidence rate of scoliosis. Therefore, in this article, the etiological relationship between eye diseases and scoliosis will be summarized, which provides guidance and direction for the etiological research of scoliosis and eye diseases. After sorting out, we found that the relationship between ophthalmic diseases and scoliosis mainly concentrated in the following four aspects: choroidal thickness and scoliosis, Goldenhar syndrome, gene level and strabismus. Among them, the genetic relationship is the most complex, about 40 kinds of gene or chromosome abnormalities have been found to cause ocular diseases and scoliosis; Goldenhar syndrome, also known as oculo-auriculo-vertebral spectrum, first revealed the relationship between ocular diseases and scoliosis, but the current statistical relationship is still very vague. There are few studies on choroidal thickness and strabismus at home and abroad, which are statistical studies, only revealing the relationship between choroidal thickness and scoliosis, and there are many defects in the study of choroidal thickness, which need further research.

It is an important measure to establish an effective communication mechanism for filling in the front page of medical records to ensure the good operation of diagnosis-related groups. Taking cerebral infarction as an example, the authors carried out the pilot work of multidisciplinary cooperation mode based on disease types around its coding axis. The multi-disciplinary assistance model could provide a good platform for communication and learning among multiple disciplines, break the barriers between disciplines, improve the quality of the front page and medical record writing of clinicians, and improve the quality and efficiency of coders′ coding.

Objective To analyze the relationship between cystatin C(Cys C) and homocysteine(Hcy) in patients with early diabetic nephropathy.Methods48 cases of T2DM patients from June 2013 to December 2015 in our hospital for treatment were chosen as the observation group, including 30 patients with early diabetic nephropathy patients as the observation group 1, 18 cases of T2DM patients as the observation group 2, were selected in our hospital physical examination of 28 healthy persons as control group,serum Cys C and Hcy levels were measured at the same time, urinary albumin / creatinine ratio (Ualb/cr) was measured in the observation group, test results of three groups were analyzed and compared.ResultsThe serum Cys C and Hcy in the observation group were significantly higher than the control group, and Cys C and Hcy levels in observed 1 group were significantly higher than that observed in the 2 group, the difference was statistically significant in the observation group, serum Cys C and Hcy level was positively correlated with Ualb/cr.ConclusionThe relationship between Cys C and Hcy levels and early diabetic nephropathy has very important significance in the early diagnosis of diabetic nephropathy, can effectively improve the rate of diagnosis of early diabetic nephropathy patients.