Xianghua Ma

Background: Continuous glucose monitoring systems (CGMS) are widely used in diabetes care, but their reliability for standardized food glycemic index (GI) measurement remains unclear. Most previous studies used capillary blood rather than venous glucose as the reference. Objective: This study aimed to verify the consistency between the CGMS and standardized venous sampling methods for measuring postprandial incremental area under the curve (IAUC) and GI values. Methods: This study was conducted in accordance with the Chinese GI testing standard WS/T 652–2019. Three measurement methods were compared: venous sampling (Method A), CGMS with all data points adopted (Method B), and CGMS data aligned with the standard venous time points (Method C). One-way analysis of variance (ANOVA) and Lin’s concordance correlation coefficient (CCC) were used for statistical analysis. The Parkes Error Grid analysis was employed to ascertain the clinical acceptability of glucose discrepancies within low, medium, and high concentration strata. Results: The 12 enrolled participants (six males and six females) had a mean age of 29.50 ± 10.12 years, mean BMI of 21.5 ± 1.7 kg/m ² , mean HbA1c of 5.07 ± 0.21%, and all lipid, glycemic, hepatic and renal function indicators were within normal reference ranges. For 120-min IAUC, the mean values were 186.93 ± 87.29 (Method A), 166.00 ± 76.46 (Method B) and 164.24 ± 77.48 (Method C). ANOVA showed no significant inter-method difference ( F = 1.178, p = 0.311). CCC analysis with Method A as the reference revealed good agreement: CCC = 0.8818 (95% CI: 0.8068–0.9289) for A vs. B and CCC = 0.8727 (95% CI: 0.7921–0.9234) for A vs. C, with a high Pearson’s ρ (>0.91) and bias correction factors (Cb, >0.95 fot both). For GI values (n = 12 for each method), the mean values were 55.07 ± 15.57 (Method A), 54.28 ± 12.24 (Method B) and 53.68 ± 15.04 (Method C). ANOVA showed no significant inter-method difference ( F = 0.028, p = 0.972), and CCC analysis indicated moderate agreement (CCC ≈ 0.79) with minimal systematic bias (Cb > 0.97). Conclusion: CGMS methods demonstrate good-to-moderate concordance with standardized venous testing for IAUC and GI determination. CGMS may represent a feasible, non-invasive alternative for food GI evaluation in nutritional and diabetes-related research among healthy individuals.

Objective: To investigate the prevalence of borderline elevated total cholesterol (TC) and elevated cholesterol, and to examine TC levels across different population groups among new adult inpatients in Jiangsu Province. Methods: A multi-center cluster sampling method was employed to randomly select 23 hospitals from 12 cities in Jiangsu Province between October 2020 and June 2021, with 200 patients randomly selected from each hospital. Serum TC concentrations were determined using the homogeneous method. Results: A total of 4503 patients participated in the survey. The overall prevalence of borderline elevated TC and elevated cholesterol was 24.9%. The prevalence was 22.1% in males, significantly lower than the 28.7% observed in females. Age-specific prevalence followed an inverted U-shape, ranging from 11.2% (80–99 years) to a peak of 31.6% (45–49 years), with intermediate rates such as 15.7% (18–24) and 29.9% (60–64). Females and residents of Southern, Central, and Northern Jiangsu had respective risks 1.37, 1.57, 1.45, and 1.54 times higher for developing borderline elevated TC and elevated cholesterol. Patients with neurological and circulatory diseases had a 42% and 19% lower risk of developing borderline elevated TC and elevated cholesterol, respectively, with all P -values < 0.05. Conclusion: The study found that among newly hospitalized adult patients in Jiangsu Province, the prevalence of borderline-high and high TC followed an inverted U-shaped pattern with age—rising at first and then falling—and was lower than the national levels reported. The prevalence of borderline-high and high TC was significantly associated with sex, region, and comorbid neurological and circulatory system diseases.

Background: Globally, there is limited literature exploring the relationship between nutritional risk screening, nutritional assessment, nutritional intervention, and HDL-C levels. This study analyzes the relationship between HDL-C levels, nutritional risk screening, assessment, and intervention among newly admitted patients in Jiangsu Province.Methods: Between October 2020 and June 2021, this study randomly selected 23 hospitals from 12 cities in Jiangsu Province using a stratified cluster sampling method. For nutritional assessment, the study used NRS2002 for risk screening.Results: 4,190 patients were assessed, revealing a low HDL-C prevalence rate of 30.7%. The prevalence exhibited an “N” shaped distribution with age. The prevalence of low HDL-C among patients assessed at nutritional risk was 34.6%, 1.228 times higher than that of patients without nutritional risk. In terms of nutritional assessment, patients with constipation, severe infection, chronic kidney disease, fever, high CRP, and hypoalbuminemia significantly increased risks of low HDL-C by 1.432, 2.496, 1.543, 3.056, 1.794, and 2.703 times, respectively. Patients with a history of esophageal stricture, malignant tumors, and closed head injuries reduced the risks of low HDL-C by 60.9, 23.3, and 78.8%, respectively. Additionally, patients with nausea and vomiting, pancreatic insufficiency, severe infection, fever, and hypoalbuminemia decreased HDL-C levels by 0.156 mmol/L, 1.465 mmol/L, 0.403 mmol/L, 0.301 mmol/L, and 0.250 mmol/L, respectively. Regarding nutritional intervention, compared to patients who did not receive intervention, those receiving parenteral nutrition significantly lowered HDL-C levels at 1.014 mmol/L, with an increased risk of low HDL-C by 2.048 times. All Ps <0.05.Conclusion: Nutritional risk, nausea and vomiting, constipation, pancreatic insufficiency, severe infection, chronic kidney disease, fever, high CRP, hypoalbuminemia, and receiving parenteral nutrition are associated with lower HDL-C levels in patients. A history of esophageal stricture, malignant tumors, and closed head injury is associated with higher HDL-C levels in patients.

Background: To collect the published trials of probiotics in the treatment of diarrhea and to strictly evaluate and systematically analyze the efficacy of probiotics use for the prevention and treatment of patients with diarrhea. Methods: We searched domestic and foreign literature published between January 2016 and July 2022 to find randomized control trials that used probiotics to treat diarrhea. Only studies published in English were considered. The quality of the included literatures was assessed by using the methods provided in the Cochrane Handbook. Valid data were extracted and analyzed by meta- analysis using the Software RevMan5.2. Results: Total 16 trials and 1585 patients were included. The results of the meta- analysis showed that in comparison with the simple Western medicine treatment group or placebo, the added use of probiotics could improve stool frequency, stool morphology, and related irritable bowel syndrome symptoms. Conclusion: The added use of probiotics can further improve clinical outcomes in the patients with diarrhea; however, the implementation of larger and higher quality clinical trials is necessary to verify this conclusion.

Adrenocortical carcinoma (ACC) is a rare malignancy with dismal prognosis. Hypoxia is one of characteristics of cancer leading to tumor progression. For ACC, however, no reliable prognostic signature on the basis of hypoxia genes has been built. Our study aimed to develop a hypoxia-associated gene signature in ACC. Data of ACC patients were obtained from TCGA and GEO databases. The genes included in hypoxia risk signature were identified using the Cox regression analysis as well as LASSO regression analysis. GSEA was applied to discover the enriched gene sets. To detect a possible connection between the gene signature and immune cells, the CIBERSORT technique was applied. In ACC, the hypoxia signature including three genes (CCNA2, COL5A1, and EFNA3) was built to predict prognosis and reflect the immune microenvironment. Patients with high-risk scores tended to have a poor prognosis. According to the multivariate regression analysis, the hypoxia signature could be served as an independent indicator in ACC patients. GSEA demonstrated that gene sets linked to cancer proliferation and cell cycle were differentially enriched in high-risk classes. Additionally, we found that PDL1 and CTLA4 expression were significantly lower in the high-risk group than in the low-risk group, and resting NK cells displayed a significant increase in the high-risk group. In summary, the hypoxia risk signature created in our study might predict prognosis and evaluate the tumor immune microenvironment for ACC.

Background: An electronic system that automatically collects medical information can realize timely monitoring of patient health and improve the effectiveness and accuracy of medical treatment. To our knowledge, the application of artificial intelligence (AI) in medical service quality assessment has been minimally evaluated, especially for clinical nutrition departments in China. From the perspective of medical ethics, patient safety comes before any other factors within health science, and this responsibility belongs to the quality management system (QMS) within medical institutions. Objective: This study aims to evaluate the QMS for clinical nutrition in Jiangsu, monitor its performance in quality assessment and human resource management from a nutrition aspect, and investigate the application and development of AI in medical quality control. Methods: The participants for this study were the staff of 70 clinical nutrition departments of the tertiary hospitals in Jiangsu Province, China. These departments are all members of the Quality Management System of Clinical Nutrition in Jiangsu (QMSNJ). An online survey was conducted on all 341 employees within all clinical nutrition departments based on the staff information from the surveyed medical institutions. The questionnaire contains five sections, and the data analysis and AI evaluation were focused on human resource information. Results: A total of 330 questionnaires were collected, with a response rate of 96.77% (330/341). A QMS for clinical nutrition was built for clinical nutrition departments in Jiangsu and achieved its target of human resource improvements, especially among dietitians. The growing number of participating departments (an increase of 42.8% from 2018 to 2020) and the significant growth of dietitians (t(93.4)=-0.42; P=.02) both show the advancements of the QMSNJ. Conclusions: As the first innovation of an online platform for quality management in Jiangsu, the Jiangsu Province Clinical Nutrition Management Platform was successfully implemented as a QMS for this study. This multidimensional electronic system can help the QMSNJ and clinical nutrition departments achieve quality assessment from various aspects so as to realize the continuous improvement of clinical nutrition. The use of an online platform and AI technology for quality assessment is worth recommending and promoting in the future.

Adrenocortical carcinoma (ACC) is a rare malignant tumor with poor prognosis. Ferroptosis, a new form of cell death, differs from other forms of cell death and plays a vital role in tumor progress. Our study aimed to establish a ferroptosis-related signature with prognostic value in ACC. RNA-seq data and corresponding clinical characteristics for ACC were downloaded from TCGA and GEO databases. Genes included in ferroptosis risk signature were assessed by univariable and multivariable Cox regression analysis as well as lasso regression analysis. The prognostic value of the ferroptosis risk signature was assessed using K-M and ROC curves. Furthermore, we performed GSEA to discover the enriched gene sets in high-risk group. Additionally, TIMER website was applied to detect a possible connection between the signature and immune cells infiltration. ssGSEA was performed to evaluate scores of immune cells and immune-related pathways in two groups. A ferroptosis signature comprised of six genes (SLC7A11, TP53, HELLS, ACSL4, PCBP2, and HMGB1) was constructed to predict prognosis and reflect the immune infiltration in ACC. Patients in high-risk group were inclined to have worse prognosis. The ferroptosis model performed well in predicting prognosis and could be served as an independent indicator in ACC. GSEA revealed that gene sets correlated with biological processes including cell cycle, DNA replication, base excision repair, and P53 signaling pathway were highly enriched in high-risk group. In addition, we discovered that the expressional levels of hub genes were linked to six immune cells’ infiltration in ACC tumor. ssGSEA revealed that contents of most immune cells significantly decreased in the high-risk group. In conclusion, the novel ferroptosis risk signature could be useful in predicting prognosis and reflecting immune infiltration in ACC. It also brings us new insights into the possible value of targeting ferroptosis during the therapy of ACC.

BACKGROUND An electronic system that automatically collects medical information can realize timely monitoring of patient health and improve the effectiveness and accuracy of medical treatment. To our knowledge, the application of artificial intelligence (AI) in medical service quality assessment has been minimally evaluated, especially for clinical nutrition departments in China. From the perspective of medical ethics, patient safety comes before any other factors within health science, and this responsibility belongs to the quality management system (QMS) within medical institutions. OBJECTIVE This study aims to evaluate the QMS for clinical nutrition in Jiangsu, monitor its performance in quality assessment and human resource management from a nutrition aspect, and investigate the application and development of AI in medical quality control. METHODS The participants for this study were the staff of 70 clinical nutrition departments of the tertiary hospitals in Jiangsu Province, China. These departments are all members of the Quality Management System of Clinical Nutrition in Jiangsu (QMSNJ). An online survey was conducted on all 341 employees within all clinical nutrition departments based on the staff information from the surveyed medical institutions. The questionnaire contains five sections, and the data analysis and AI evaluation were focused on human resource information. RESULTS A total of 330 questionnaires were collected, with a response rate of 96.77% (330/341). A QMS for clinical nutrition was built for clinical nutrition departments in Jiangsu and achieved its target of human resource improvements, especially among dietitians. The growing number of participating departments (an increase of 42.8% from 2018 to 2020) and the significant growth of dietitians (t93.4=–0.42; P=.02) both show the advancements of the QMSNJ. CONCLUSIONS As the first innovation of an online platform for quality management in Jiangsu, the Jiangsu Province Clinical Nutrition Management Platform was successfully implemented as a QMS for this study. This multidimensional electronic system can help the QMSNJ and clinical nutrition departments achieve quality assessment from various aspects so as to realize the continuous improvement of clinical nutrition. The use of an online platform and AI technology for quality assessment is worth recommending and promoting in the future.

BACKGROUND:We developed a model based on ultrasound (US) features of thyroid nodules and cervical lymph nodes to distinguish papillary thyroid carcinomas (PTC) from benign thyroid nodules. MATERIAL AND METHODS:We retrospectively collected data on pre...