Abstract:Objective：To explore the role and mechanism of S100A4 nuclear localization in pancreatic cancer（PC）metastasis. Methods：The expression of S100A4 in the PC cells，especially in the nucleus，was quantified by immunohistochemistry and HALO digital pathology precision analysis platform using the tissue microarray of PC. Statistical analysis was conducted to assess the correlations of each detection index with various clinical parameters and survival rates. Molecular structure informatic analysis， plasmid construction，and transfection were used to create different gene regulation cell research models. Techniques such as nuclear and cytoplasmic extraction，co-immunoprecipitation，Western blotting，wound healing assay，transwell assay，and cleavage under targets and tagmentation（CUT&Tag）assay were used to study the role and mechanism of S100A4 nuclear localization in PC metastasis. Results：High expression and the nuclear localization of S100A4 were positively correlated with T and N stages and poor prognosis in PC. The nuclear localization of S100A4 in PC cells was regulated by small ubiquitin-related modifier（SUMO） modification. Ubiquitin conjugating enzyme 9 mediated the binding of S100A4 to SUMO1 at K22 and K96 sites in PC cells，and deSUMOylation was achieved by sentrin-specific protease 1，dynamically balancing the SUMOylation level of S100A4. Regulating the SUMOylation of the S100A4 protein altered the metastatic ability of PC cells in vitro. The results of CUT&Tag sequencing confirmed that S100A4 nuclear localization was involved in the regulation of gene network related to tumor metastasis. Conclusion：S100A4 nuclear localization may indicate poor prognosis in PC and serve as a crucial basis for clinical decision making. Identifying methods to block or inhibit S100A4 nuclear localization may provide a new approach to suppress PC metastasis，especially the early metastasis， and improve the prognosis of PC patients.

Abstract:Objective：To explore the role and regulation mechanism of leptin in senescence of mouse cardiomyocytes（MCM）. Methods：The mRNA expression levels of senescence related indicators p16，p21，and senescence-associated secretory phenotype （SASP）in leptin stimulated MCM were examined by qPCR；the protein expressions of p16，p21，γ-H2AX，PI3K，AKT，p-PI3K，and p-AKT were detected by Western blot；the senescence of MCM was detected by β-galactosidase staining. PI3K inhibitor（LY294002） was pretreated for 2 h and then stimulated with leptin，the mRNA and protein levels of p16 and p21 were detected by qPCR and Western blot；the mRNA levels of SASP were examined by qPCR；MCM senescence was detected by β-galactosidase staining. Results： In MCM stimulated by leptin，the mRNA and protein levels of p16 and p21，as well as the protein level of γ-H2AX increased，the mRNA levels of SASP[（interleukin，IL）-1β，tumor necrosis factor（TNF）-α、IL-6，monocyte chemoattractant protein（MCP）-1]were up -regulated，the phosphorylation levels of proteins in PI3K/AKT signaling pathway increased；and β-galactosidase staining showed the senescence of MCM. When pretreated with PI3K inhibitor for 2 h，the mRNA and protein levels of p16 and p21，as well as the protein level of γ-H2AX were down-regulated，and the expressions of SASP mRNA were down-regulated，the senescence of MCM was alleviated. Conclusion：Leptin regulates the progression of MCM senescence by activating PI3K/AKT signaling pathway and promoting SASP（IL-1β，TNF-α，IL-6 and MCP-1）secretion.

Abstract:Objective：To compare the therapeutic of Tirzepatide and Liraglutide in improving metabolic associated fatty liver disease （MAFLD）in db/db mice. Methods：Db/db mice were used as the MAFLD model. Total 21 db/db mice were divided into the model group，Liraglutide group and Tirzepatide group，and 7 db/m mice were used as the control group. Mice in Liraglutide and Tirzepatide groups received intraperitoneal injections of 10 nmol/kg of Liraglutide and Tirzepatide daily for 10 consecutive weeks. The other two groups were intraperitoneally injected with the same volume of normal saline. After 10 weeks，the fasting blood glucose（FBG），glycated haemoglobin A1c（HbA1c）and body weight of mice in each group were compared. The levels of serum total cholesterol（TC）， triglyceride（TG），low-density lipoprotein-cholesterol（LDL-C），high-density lipoprotein-cholesterol（HDL-C），alanine aminotransferase （ALT）and aspartate aminotransferase（AST）in each group were compared. HE staining and oil red O staining were used to compare the liver pathological changes and lipid deposition in each group. Western blot and RT -PCR were used to detect the expressions of inflammatory factors and fibrosis mediators in the liver tissues of mice in each group. Western blot was used to detect the insulin signaling pathway and glucose metabolism related protein expression differences. Results：Compared with the model group，the levels of FBG，HbA1c，body weight，TC，TG，LDL-C，ALT and AST in the Liraglutide group decreased by 56%，32%，20%，19%，22%，39%， 26% and 28%，respectively，while HDL-C increased by 25%. In Tirzepatide group，FBG，HbA1c，body weight，TC，TG，LDL-C，ALT， and AST decreased by 69%，40%，30%，31%，35%，57%，46% and 38%，respectively，while HDL-C increased by 61%. HE staining and oil red O staining showed that the liver of the model group showed obvious hepatocyte steatosis，balloon -like degeneration and vacuolization，and a large number of lipid droplets were accumulated in hepatocytes. The hepatocyte steatosis and liver fat deposition of the two intervention groups were improved，and the effect of Tirzepatide was better than that of Liraglutide. Western blot and RT-PCR results showed that two drug intervention groups markedly reduced the expressions of inflammatory factors and fibrosis mediators，at the same time，the two drugs increased insulin metabolic pathways related protein expression and decreased the glucose metabolism related protein expression，and Tirzepatide was more effective than Liraglutide in improving the above indicators. Conclusion： Tirzepatide can improve glucose and lipid metabolism disorders，reduce body weight，improve liver injury，reduce liver fat deposition， and delay liver inflammation and fibrosis in MAFLD mice by activating insulin-related signaling pathway and reducing gluconogenemia，and its comprehensive efficacy is better than that of Liraglutide，which may provide a new treatment for MAFLD.

Abstract:Objective：To investigate the effects and potential mechanisms of liraglutide（Li）on macrophages polarization induced by silica（SiO₂）. Methods：Macrophages were divided into five groups：the control group，SiO₂ group，SiO₂+Li（10 nmol/L）group，SiO₂+Li （100 nmol/L）group，and SiO₂+Li（1 000 nmol/L）group. The cytotoxicity of Li on the macrophages was assessed using the CCK-8 assay； levels of interleukin（IL）-1β，IL-10 and transforming growth factor（TGF）-β1 in each group were measured by ELISA. Western blot was used to determine the expression levels of NOD-like receptor protein 3（NLRP3），cysteinyl aspartate specific proteinase（Caspase- 1）p20，and arginase-1（Arg-1）. Mitochondrial membrane potential in the macrophages was detected by using JC-1 fluorescent probe staining. Reactive oxygen species（ROS）levels in the macrophages from all groups were measured by using DCFH-DA probe. Results： Compared with the control group，the SiO₂ group showed significantly increased protein levels of NLRP3，Caspase-1 p20，and Arg-1，as well as elevated secretion of IL-1β，IL-10，and TGF-β1（all P ＜ 0.010）. Compared with the SiO₂ group，the SiO₂+Li（10 nmol/L），SiO₂+Li （100 nmol/L），and SiO₂+Li（1 000 nmol/L）groups showed decreased protein levels of NLRP3，Caspase-1 p20，and Arg-1，and reduced secretion of IL-1β，IL-10，and TGF-β1（all P ＜ 0.05）. The mitochondrial membrane potential in the SiO₂ group was lower than that in the Control group；however，it increased in the SiO₂+ Li（10 nmol/L），SiO₂+ Li（100 nmol/L），and SiO₂+ Li（1 000 nmol/L）groups compared to the SiO₂ group. The relative fluorescence intensity of ROS in the SiO₂ group was higher than that in the Control group，with statistically significant differences. Compared with the SiO₂ group，the relative fluorescence intensity of ROS in the SiO₂+Li（10 nmol/L）， SiO₂+Li（100 nmol/L），and SiO₂+Li（1 000 nmol/L）groups gradually decreased，with statistically significant differences. Conclusion：Li may inhibit SiO₂ -induced M2 macrophage polarization by improving SiO₂ -induced mitochondrial dysfunction，reducing ROS oxidative stress，and preventing NLRP3 inflammasome activation.

Abstract:Objective：To explore the effects and possible mechanisms of the arsenic trioxide（ATO）and small molecule tyrosine kinase inhibitor ponatinb on KG-1 cells in vitro. Methods：Effects of ATO and ponatinib on proliferation of KG-1 cells were detected by CCK -8，and the apoptosis was assessed by Annexin V - FITC. Reverse transcription quantitative polymerase chain reaction（q - PCR） analysis was used to detect the expression of apoptosis - related genes. Western blott was performed to explore the expression levels of apoptosis-related proteins，fibroblast growth factor receptor 1（FGFR1）and phosphorylated signal molecules. Results：①Both ATO and ponatinib effectively inhibited cell proliferation by dose dependent manners. The combination of the two drugs exhibited higher proliferation inhibition rate，less colony formation and more cell apoptosis compared to the single drug treatment. ②Compared with the DMSO group，treatment with either ATO or ponatinib led to significant down-regulation of Bcl-2，up-regulation of Bax and Caspase-3 （P ＜ 0.05）. The combination of the two drugs up-regulated the expression of Bax and Caspase-3 more than single drug treatment（both P ＜ 0.01）. ③Punatinib significantly inhibited the expression of FGFR1 gene and protein（both P ＜ 0.01），and the addition of ATO did not decrease FGFR1 expression further. Signaling pathway studies showed that ATO significantly inhibited the phosphorylation of MAPK，m - TOR，and STAT5，but had no significant effect on the phosphorylation of PI3K/AKT and STAT3. Ponatinib markedly inhibited the phosphorylation of STAT3/5，and FGFR1 expression（both P ＜ 0.001），but had no significant effect on the phosphorylation of PI3K/AKT and MAPK. The phosphorylation level of STAT3 was further down-regulated by the combination of the two drugs compared with ATO or pratinib monotherapy（both P ＜ 0.01）. Conclusion：ATO and ponatinib may inhibit KG - 1 cell proliferation and colony formation and induce cell apoptosis through different mechanisms. The combination of the two drugs can further enhance the inhibitory effect on KG-1 cells.

Abstract:Objective：To study the clinical value of the collapse angle of flow - volume（F - V）curve in assessment of clinical phenotype and severity of chronic obstructive pulmonary disease（COPD）patients. Methods：A total of 101 subjects who underwent pulmonary function tests from December 2021 to December 2022 at the First Affiliated Hospital of Nanjing Medical University were selected for this study. Subjects in the angle group were 33 stable COPD patients with collapse angle of F -V curve. The non -angle group including 38 cases of stable COPD patients without collapse angle，who matched with the angle group in forced expiratory volume in the first second as a percentage of predicted value（FEV₁%pred）. The control group including 30 subjects without previous cardiopulmonary disease and had normal lung function. Basic information，clinical symptom scores（CAT score，mMRC score），pulmonary function parameters and daily exercise finger pulse oxygen parameters were collected and compared among the groups. Multifactorial logistic regression was used to analyze the factors associated with the collapse angle of F-V curve. The predictive value of the collapse angle of F - V curve for acute exacerbation of COPD within one year of follow - up was analyzed by receiver operating characteristic（ROC）curve. Results：Pulmonary function was severely impaired in the angle group，with FEV₁ and forced vital capacity （FVC）of 0.91±0.24 and 2.11±0.63，respectively. CAT score，mMRC score，and ΔSpO₂ of the angle group were higher than those of the non-angle group and the control group. SpO_2L of the angle group after walking exercise was lower than that of the non-angle group and the control group（P ＜ 0.05）. CAT score ≥12，mMRC score ≥2，and ΔSpO₂≥13% were main related factors of the emergence of the collapse angle of F-V curve. The area under the ROC curve of the collapse angle of F-V curve for predicting the acute exacerbation of COPD was 0.777. The sensitivity and specificity of prediction were the best when the angle was ＜129.1°，which were 72.73% and 67.35%，respectively. Conclusion：When the collapse angle of F-V curve appears in patients with COPD，their lung function is often severely impaired. They are more prone to post-activity hypoxemia and acute exacerbations. Therefore，attention should be paid to the presence of the collapse angle of F -V curve in the pulmonary function report of COPD，in order to recognize the high - risk group of COPD as early as possible.

Abstract:Objective：To investigate the effect of ventricular septal scars on the capture of left bundle branch during left bundle bracn pacing（LBBP）by cardiac magnetic resonance imaging（CMR）. Methods：A retrospective analysis was conducted on 52 patients intendea for LBBP，who were divided into a failure group and a success group based on whether the capture of left bundle branch was achieved. Segmental score of septal scarring was performed using CMR. Results：The score of the upper ventricular septal scar was an independent predictor of the success of LBBP capture. When the scar of the upper ventricular septum was less than 25%，the success rate of LBBP capture was 100%. Howerver，when the scar was equal to or more than，the failure rate of LBBP capture was 100%. Conclusion：Evaluating upper ventricular septal scars using CMR helps predict the success of LBBP capture，providing a reliable reference for the smooth execution of the surgery.

Abstract:Objective：To explore the evaluation value of neutrophil to lymphocyte ratio（NLR）in the prognosis of Mycoplasma pneumoniae pneumonia（MPP）. Methods：A retrospective analysis was applied to 2 375 hospitalized children with MPP in Suqian Hospital Affiliated to Xuzhou Medical University from January 2019 to December 2023. According to the severity of the condition，the children were divided into severe MPP（SMPP）group（n=125）and non-SMPP group（n=2 250），or into refractory MPP（RMPP）group （n=451）and non-RMPP group（n=1 924）. The basic information and clinical data of all pediatric patients were collected to assess the prognostic value of NLR in SMPP and RMPP. Results：NLR was an independent predictor of SMPP（OR=1.188，95% CI：1.123-1.299， P=0.033）. Compared with children with a low NLR，children with a high NLR had a higher incidence of SMPP（P ＜ 0.001）. NLR was also an independent predictor of RMPP（OR=1.320，95%CI：1.145-1.432，P ＜ 0.001）. Children with a high NLR were more likely to develop SMPP and RMPP as well as had higher ICU hospitalization rate，total fever duration，longer hospital stays，and higher hospitalization costs，compared those with a low NLR（P ＜ 0.001）. Conclusion：NLR may be used to independently predict the prognosis of MPP and provide guidance for early treatment of SMPP and RMPP.

Abstract:Objective：To explore the predictive value of serum homocysteine（Hcy），25-hydroxy vitamin D（25-OHD），and uterine artery blood flow parameters for preeclampsia（PE）during early pregnancy. Methods：In this prospective cohort study，2 200 pregnant women who underwent prenatal examinations and delivered at the Affiliated Lianyungang Hospital of Xuzhou Medical University between November 2021 and May 2023 were included. Serum Hcy and 25 - OHD levels were measured during regular prenatal examination at 11-13 ^{+ 6} weeks of gestation，along with ultrasound assessment of uterine artery blood flow parameters，such as peak systolic velocity/end diastolic velocity（S/D），pulsatility index（PI），and resistance index（RI）. These participants were categorized into a PE group（141 cases）and a control group（2 059 cases）according to whether developed PE by the 20th week of gestation. Two independent sample student’s t-test and Chi-square test were used to compare the general clinical and pregnancy outcomes data，Hcy， 25-OHD，and uterine artery blood flow parameters between the two groups. The multivariate logistic regression analysis was employed to identify independent risk factors for PE. The receiver operating characteristic（ROC）curve analysis was used to evaluate the predictive value of the markers used along or in combination for PE. A PE risk nomogram was developed using R software，with calibration curves internally validating the nomogram prediction model. Results：There was no statistically significant difference in the maternal age，gestational weeks of detection，reproductive history，and PE history between the PE group and the control group（P ＞ 0.05）. Both the systolic blood pressure and diastolic blood pressure in the PE group were higher than those in the control group，while both the gestational week of delivery and the neonatal weight were lower than those in the control group（P ＜ 0.05）. Serum Hcy levels， S/D，PI，and RI were higher in the PE group than in the control group，whereas the levels of 25-OHD were lower in the PE group than in the control group（all P ＜ 0.001）. The multivariate logistic regression analysis indicated that Hcy（OR=2.58，95%CI：2.03-3.27），S/D （OR=1.56，95%CI：1.33- 1.84），PI（OR=2.06，95%CI：1.45- 2.94）and RI（OR=2.97，95%CI：1.68- 5.24）were independent risk factors for PE，while 25-OHD was an independent protective factor（OR=0.80，95%CI：0.72-0.88）. The ROC curve analysis showed that the optimal cut-off values for predicting PE were 6.65 μmol/L for Hcy，23.43 μg/L for 25-OHD，2.93 for S/D，1.26 for PI，and 0.85 for RI，with the sensitivity of 0.908，0.699，0.752，0.844，and 0.589，respectively，and the specificity of 0.783，0.915，0.574，0.578，and 0.891，respectively. The performance of these markers used in combination for predicting PE was superior，with an area under the curve of 0.967（95%CI：0.956-0.979），the sensitivity of 0.969，and the specificity of 0.865. The internal validation showed that the calibration curve of the nomogram approximated both the original curve and the ideal curve，with a concordance index of 0.966（95%CI： 0.656-0.993），suggesting a high model fit. Conclusion：The PE risk nomogram，constructed based on serum Hcy，25-OHD，and the uterine artery blood flow parameters of S/D，PI and RI in early pregnancy，provides a good predictive value for PE and may offer guidance for early clinical screening or prediction of PE.

Abstract:Objective：To evaluate the relationship between pregnancy and the growth of ground glass nodules（GGNs）through a single-center retrospective cohort analysis. Methods：Clinical and radiologic data of 44 pregnant women who underwent pre-and post- pregnancy chest CT scans due to pulmonary GGNs were retrospectively reviewed. Based on imaging characteristics，the GGNs were divided into the pure GGNs（PGGNs），heterogeneous GGNs（HGGNs），and part solid nodules（PSN）. The size of a GGN was determined as the maximum diameter in axial chest CT images，and the observation interval was the time between pre - and post - pregnancy chest CT scans. Growth of a GGN was defined as an increase of 2 mm in the maximum diameter，an increase of 2 mm in the solid composnent，or the appearance of new solid component. Results：Among the 44 pregnant women，70 GGNs were detected， including 66 PGGNs and 4 HGGNs. Of these，43 GGNs had a diameter of ＜ 6 mm，22 were between 6.0 and 7.9 mm，4 were between 8.0 and 9.9 mm，and 1 GGN was ≥10 mm. No growth of pulmonary GGNs was observed at a median observing interval of 779 days （ranging from 337 to 2 795 days）. Conclusion：Pregnancy is unlikely to cause the growth of pulmonary PGGNs with a small diameter. Therefore，women of child-bearing age who plan to become pregnant need not be overly concerned about the growth of such GGNs.

Abstract:Objective：To explore the effect of lean tissue mass（LTM）/adipose tissue mass（ATM）ratio on left ventricular hypertrophy（LVH）in non -dialysis patients with chronic kidney disease（CKD）. Methods：417 non -dialysis patients with CKD were included and divided into a normal left ventricular（Non-LVH）group with 240 patients and a left ventricular hypertrophy（LVH）group with 177 patients according to the left ventricular mass index（LVMI）. Baseline data and laboratory indicators were collected，along with echocardiography and bioelectrical impedance analysis results. Baseline data and LTM/ATM ratio were compared between the two groups. Multivariate logistic regression analysis was used to determine the risk factors for LVH in non - dialysis CKD patients. The receiver operator characteristic（ROC）curve was drawn to evaluate the predictive value of LTM/ATM ratio for LVH. Results：The prevalence of hypertension，age，female ratio，and systolic blood pressure in the LVH group were significantly higher than those in the Non - LVH group，while BMI，hemoglobin，albumin，and eGFR were significantly lower than those in the Non - LVH group，all with statistical differences. The LTM，lean tissue index and LTM/ATM ratio in the LVH group were lower than those in the Non-LVH group， and there was no difference in volume load between the two groups. Multivariate logistic regression analysis showed that age，BMI， systolic blood pressure，hemoglobin，and LTM/ATM ratio - gender were all independent risk factors for LVH in non - dialysis CKD patients. The area under the ROC curve of LTM/ATM ratio - gender combined with hemoglobin in predicting LVH was 0.769.Conclusion：A low LTM/ATM ratio is a risk factor for LVH in nondialysis CKD patients，and this ratio has predictive value for the occurrence of LVH in such patients.

Abstract:More and more studies have shown that the autonomic nervous system plays a crucial role in the development of various cancers. Cancer cells secrete various neuroactive molecules，including neurotrophic factors，chemokines，neural cell adhesion molecules，and axon guidance molecules，to alter the tumor microenvironment and recruit surrounding autonomic nerves to the tumor tossies. Alternatively，cancer cells reprogram sympathetic nerves or promote the migration of neural progenitor cells into the tumor tissues to differentiate into sympathetic nerves，thus increasing autonomic innervation. Moreover，cancer cells act on nerve fibers through exosomes，promoting peripheral nerve infiltration. The interactions among various substances in the tumor microenvironment create a suitable environment for the occurrence of perineural infiltration. During this process，the sympathetic nervous system promotes cancer progression and poses challenges to antitumor therapy by enhancing chemotherapy resistance. In contrast，the parasympathetic nervous system exhibits both tumor-promoting and antitumor properties. Therefore，this review primarily summarizes the interactions between cancer and the autonomic nervous system，as well as the role of neuroactive molecules in cancer progression， and proposes potential nervous system-related antitumor treatment strategies.

Abstract:Ischemic heart disease stands as the primary cause of mortality among diabetic patients. Despite advancements in vascular reconstruction and thrombolytic therapy that restore myocardial blood flow，these patients often experience poor cardiac function recovery and a higher mortality rate. This makes myocardial ischemia/reperfusion（I/R）injury a significant therapeutic challenge. Researches indicate that，under diabetic or obese conditions，adipocytes release extracellular vesicles（EVs）containing a variety of biomolecules，including RNA，proteins，adipocytokines，and mitochondria. These EVs play a pivotal role in maintaining systemic metabolic homeostasis. Importantly，adipocyte - derived EVs facilitate communication with diabetic hearts and play a regulatory role in myocardial I/R injury. This review summarizes recent studies on the modulatory effects of adipocyte -derived EVs on diabetic myocardial I/R injury，highlighting potential underlying mechanisms.

Abstract:Head and neck cancer is one of the common malignant tumors，and most patients are diagnosed in the middle or late stages of the disease. Therefore，early diagnosis，accurate staging，and efficacy monitoring are the key to optimizing treatment strategies and improving prognosis of head and neck cancer. Integrated positron emission tomography/magnetic resonance imaging（PET/MRI） combines molecular function and anatomical structure imaging，harnessing the complementary advantages of PET and MRI. By combining the metabolic information of PET with the excellent soft tissue contrast of MRI，it truly achieves multimodal imaging，which is of significant clinical importance in the diagnosis，treatment，and monitoring of tumors. This review mainly focuses on the application and progress of PET/MRI in the diagnosis，staging，monitoring of efficacy，prognosis prediction，and development of radiotherapy plans for head and neck cancer.

Abstract:Heart failure with preserved ejection fraction（HFpEF）is a significant challenge in the field of cardiovascular diseases. Inflammation，myocardial fibrosis，and coronary microcirculation dysfunction are the core pathophysiological mechanisms of HFpEF. As a key part of adaptive immune response，T cell subsets widely participate in the above process through various mechanisms，further aggravating the damage of myocardial structure and function，and ultimately leading to the development of HFpEF. This article provides a comprehensive review on the roles of immunity and inflammation in HFpEF，summarizes the characteristics and functions of different T cell subsets involved in HFpEF，and aims to explore novel biomarkers and potential therapeutic targets by targeting T cell subsets.

Abstract:Type 2 diabetes mellitus（T2DM）is a metabolic disorder characterized by hyperglycemia and insulin resistance，often leading to complications in multiple systems，including neuropathy，nephropathy，retinopathy，and bone diseases. Osteoporotic fractures are particularly concerning public health issues due to their high incidence，significant fatality rate，and substantial consumption of medical resources. Compared to non - diabetic individuals，patients with T2DM have an elevated risk of fragility fractures. Despite often having normal or increased bone density，the primary cause of this increased fracture risk is impaired bone mass. The mechanisms underlying increased bone fragility in T2DM patients are complex and multifactorial，involving obesity， hyperglycemia，insulin resistance，oxidative stress，microvascular complications，and the accumulation of advanced glycation end products. These factors can lead to alterations in bone metabolism，structure，and strength. Additionally，other factors，such as hypoglycemia and the associated increased risk of falls，as well as the direct effects of certain antidiabetic medications on bone and mineral metabolism，may further contribute to the heightened fracture risk in this population. This review provides a concise overview of the mechanisms by which these factors influence bone fragility in patients with T2DM.

Abstract:Objective：To understand the level of ideal cardiovascular health（ICVH）in Chinese population，analyze the relationship between ICVH score and the current prevalence of cardio-cerebrovascular disease（CVD），and provide evidence for developing effective strategies for CVD integrated health management among populations. Methods：A multi-stage cluster random sampling method was used to conduct a survey，physical examination，and laboratory tests on 21 815 permanent adult residents from 2 counties in Suqian City in 2019. The relationship between ICVH scores and disease progression were analyzed by the trend χ² test，and the relationship between CVD prevalence and the number of ideal ICVH indicators and score（non -）adjusted models was analyzed by multivariate logistic regression. Results：The prevalence rate of CVD among the residents was 45.7%. The average ICVH score was （8.60±2.24）points，with most residents achieving（3-4）index standards（57.5%）. The highest rate of achieving an ideal level for an individual ICVH indicator was for tobacco control（80.9%）and the lowest was for a healthy diet（0.1%）. Compared to the low ICVH score group（0-7 points），the moderate level（8-9 points）and the high level group（10-15 points）had a 38% and 69% lower likelihood of developing CVD[OR_{ICVH8- 9}=0.617（0.577-0.661），OR_ICVH10-15=0.308（0.286-0.331）]，respectively. Conclusion：The CVD burden among key populations in the surveyed area is realatively heavy，and the ICVH level is low. There is a negative correlation between ICVH levels and CVD risk. It is recommended to strengthen comprehensive interventions on poor dietary behavior，physical activity and blood pressure control.

Abstract:Objective：To explore the application of autoregressive integrated moving average（ARIMA）model based on paired test in predicting the incidence of hepatitis A in China，and put forward a new idea and method for evaluating the prediction effect of time series model. Methods：An ARIMA model was established for the monthly incidence of hepatitis A infectious diseases in China from January 2004 to December 2021，and the monthly incidence of hepatitis A infectious diseases from January to August 2022 was predicted. The prediction effect of the model was evaluated by paired t-test and error analysis. Results：The results of paired t-test showed that there was no significant difference between the monthly incidence of hepatitis A predicted by ARIMA（1，1， 0）（0，1，1）₁₂ model and the actual monthly incidence of hepatitis A（P ＞ 0.05），indicating that the model had good prediction ability，and the mean relative error and standard deviation of the prediction results were 3.86% and 3.25%. Conclusion：ARIMA product season model can accurately predict the incidence trend of hepatitis A in China. The paired test provides an objective basis for evaluating the prediction effect of time series model，and solves the problem of evaluating the prediction effect of time series model well.

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