Objective This study aims to explore the effects of aerobic exercise intervention combined with probiotics on metabolic indicators and cardiopulmonary function in obese patients with type 2 diabetes mellitus and metabolic syndrome(T2 DM-MS). Methods From August 2022 to August 2024, 163 T2 DM-MS patients who visited the Department of General Practice at First Hospital of Shanxi Medical University were assigned into a test group(aerobic exercise intervention combined with probiotics) and a control group(probiotics alone) using a random number table method, with 80 patients in each group. The changes in clinical parameters, blood glucose indicators, metabolic indicators, lung function, and heart function were compared between the two groups. Results After treatment, waist circumference and blood pressure decreased in both groups, with the test group showing significantly lower values than the control group(t/P = 2.260/0.025, 2.613/0.010,2.279/0.024, 2.195/0.030). There was no significant change in BMI in the control group before and after treatment(P >0.05),while BMI in the test group decreased and was significantly lower than that in the control group(t/P = 1.988/0.049). FPG,Hb A1c, and 2 hPG decreased in both groups after treatment, with significantly lower levels in the test group compared to the control group(t/P = 5.128/<0.001, 4.727/<0.001, 3.499/0.001). After treatment, TC, TG, and LDL-C in the test group decreased and were significantly lower than those in the control group(t/P = 2.235/0.027, 3.292/<0.001, 4.997/<0.001), while HDL-C levels increased and were significantly higher than those in the control group(t/P = 2.412/0.017). After treatment, forced vital capacity(FVC), forced expiratory volume in one second(FEV1), and maximum voluntary ventilation(MVV) in the test group increased and were significantly higher than those in the control group. No statistically significant differences were observed in these pulmonary function indicators in the control group before and after intervention. After treatment, left ventricular ejection fraction(LVEF) in the test group increased(and was significantly higher than that in the control group), while left ventricular end-diastolic diameter(LVEDD) and left ventricular end-systolic diameter(LVESD) decreased(and were significantly lower than those in the control group). Compared with before intervention, no statistically significant differences were observed in various cardiac function indicators in the control group. Conclusion Aerobic exercise intervention combined with probiotics can significantly improve glucose and lipid metabolism indicators and cardiopulmonary function in patients with T2 DM-MS,providing new insights for comprehensive intervention of this disease.

Objective To explore the relationship between promoter methylation of ATP-binding cassette transporter G1(ABCG1) gene and the onset of diabetic kidney disease(DKD). Methods A retrospective analysis was conducted on the test results of 60 blood samples collected from the Affiliated Hospital of Inner Mongolia Medical University between December 2023 and December 2024. The samples were divided into three groups: 20 patients with DKD(DKD group), 20 patients with type 2 diabetes mellitus(DM group), and 20 healthy individuals(healthy control group). Clinical data and biochemical indicators of each group were collected. The methylation level of the ABCG1 gene promoter in serum was detected using the bisulfite sequencing method. Differences in the aforementioned indicators among the three groups were compared. Logistic regression analysis and receiver operating characteristic(ROC) curve analysis were applied to explore the correlation between the methylation level of the ABCG1 gene promoter and the occurrence of DKD in patients with type 2 diabetes mellitus. Results Compared with the healthy control group, the levels of Hb A1cand FPG were increased, and HDL was decreased in both the DM group and the DKD group(F/P = 65.357/<0.001, 33.140/<0.001, 11.634/<0.001). In the DKD group, LDL, SCr,and BUN were increased, and e GFR was decreased(t/P = 3.125/0.003, 3.186/0.003, 3.317/0.002,-4.348/<0.001). Compared with the DM group, SCr and BUN were increased, and e GFR was decreased in the DKD group(t/P = 3.047/0.004, 2.534/0.016,3.353/0.002). There were no statistically significant differences in TC, TG, LDL, HDL, Hb A1c, and FPG between the DM group and the DKD group(all P >0.05). The methylation levels of the ABCG1 gene promoter region in the three groups decreased progressively, and the difference was statistically significant(χ2= 7.381, P <0.05). Compared with the healthy control group, ABCG1 promoter methylation in the DKD group was significantly decreased(χ2= 6.160,P <0.05), while there was no statistically significant difference in ABCG1 methylation in the DM group(χ2= 1.938,P >0.05). In addition, when comparing the DM group with the DKD group, there was no statistically significant difference in ABCG1 promoter methylation(χ2=2.297, P >0.05). Elevated LDL and decreased e GFR were independent risk factors for the development of DKD in patients with type 2 diabetes, while increased methylation level of the ABCG1 gene promoter was a protective factor [OR(95%CI) = 10.738(1.139-101.238), 0.818(0.694-0.964), 0.001(0.000-0.195)]. The AUCs for predicting the occurrence of DKD in patients with type 2 diabetes using LDL, e GFR, ABCG1 gene promoter methylation, and their combination were 0.712, 0.835, 0.650,and 0.951, respectively. The combination of the three was superior to each individual predictor(differences were compared using the De Long method)(Z/P = 3.353/0.001,1.949/0.041,5.401/<0.001). Conclusion Demethylation of the ABCG1 gene promoter may be involved in the pathogenesis of DKD, and detection of the methylation level of the ABCG1 gene promoter may be helpful for the diagnosis of DKD.

Objective To investigate the relationship between serum sirtuin 1(Sirt1) and methyltransferase-like 3(METTL3) levels and the clinical staging and prognosis of patients with diabetic foot(DF). Methods A total of 206 DF patients admitted to the Department of Burns and Plastic Surgery of Ningxia Hui Autonomous Region People' s Hospital from January 2023 to January 2025 were prospectively selected as the DF group. Additionally, 103 healthy individuals during the same period were selected as the healthy control group in a 2:1 ratio. Serum levels of Sirt1 and METTL3 were measured using enzyme-linked immunosorbent assay. DF patients were classified into grades 0(n = 39), 1(n = 36), 2(n = 42), 3(n = 51), and 4(n = 38) based on clinical grading. Spearman correlation analysis was used to assess the correlation between serum Sirt1,METTL3 levels and clinical grade in DF patients. Based on 6-month prognosis, DF patients were divided into poor and good prognosis subgroups. Factors influencing prognosis and the predictive value of serum Sirt1 and METTL3 levels were analyzed.Results Compared with the control group, serum Sirt1 and METTL3 levels were significantly lower in the DF group(t =12.188, 14.765, both P < 0.001). Serum Sirt1 and METTL3 levels progressively decreased from grade 0 to grade 4(F =1607.455, 2264.970, both P <0.001). In DF patients, serum Sirt1 was positively correlated with METTL3, while both were negatively correlated with clinical grade(r = 0.719,-0.774,-0.723, all P <0.001). The poor prognosis rate among the 206 DF patients was 34.95%(72/206). Prolonged duration of diabetes, clinical grade 4, and elevated glycated hemoglobin(HbA1c) were identified as independent risk factors for poor prognosis in DF patients, while higher Sirt1 and higher METTL3 levels were independent protective factors [OR(95%CI) = 1.259(1.062-1.492), 8.413(2.230-31.746), 2.549(1.443-4.502), 0.598(0.472-0.757), 0.757(0.677-0.848)]. The area under the ROC curve(AUC) for predicting poor prognosis in DF patients using serum Sirt1 level, METTL3 level, and their combination were 0.805, 0.796, and 0.892, respectively. The combined prediction of Sirt1 and METTL3 showed greater value for predicting poor prognosis in DF patients than either biomarker alone(Z = 3.594, 3.580,both P <0.001). Conclusion Decreased serum levels of Sirt1 and METTL3 are associated with increased clinical grade and poor prognosis in DF patients. The combination of serum Sirt1 and METTL3 levels demonstrates high efficacy in predicting prognosis.

Objective To compare the efficacy of pan-retinal, sectoral, and ischemic area-targeted laser photocoagulation in the treatment of proliferative diabetic retinopathy(PDR). Methods A prospective cohort study was conducted, enrolling 88 PDR patients admitted to the Department of Ophthalmology, Bengbu Third People' s Hospital from November 2021 to April 2025. According to the laser photocoagulation treatment area, patients were divided into the pan-retinal photocoagulation(PRP) group(n = 28), the sectoral group(n = 30), and the ischemic area-targeted group(n = 30). Best corrected visual acuity(BCVA) was measured using the international standard visual acuity chart; central macular thickness(CMT) and foveal avascular zone(FAZ) area were measured by optical coherence tomography(OCT), and retinal nerve fiber layer(RNFL) thickness in the inferior, nasal, superior, and temporal quadrants around the optic disc was also measured. All measurements were taken preoperatively and 1 month postoperatively. The incidence of postoperative complications was recorded and compared among the groups. Results At 1 month postoperatively, BCVA(LogMAR) improved significantly in all three groups compared to preoperative levels(t = 10.552, 10.232, and 8.822, respectively; all P <0.05). A significant difference in BCVA(LogMAR) was observed among the three groups(F = 11.825, P < 0.05). Pairwise comparisons revealed that the sectoral group achieved the lowest Log MAR values(indicating the best visual acuity), followed by the PRP group, while the ischemic areatargeted group showed the highest values(all P <0.05). Postoperative CMT decreased in all three groups compared to preoperative levels(t = 12.745, 15.551, 8.972, all P <0.05), with a statistically significant difference in CMT among the three groups(F =26.019,P <0.001). Pairwise comparisons showed the order of reduction was: sectoral group < PRP group < ischemic area-targeted group(all P <0.05). In contrast, no significant differences were found in FAZ area before and after laser treatment in any group(all P >0.05). After surgery, RNFL thickness in the inferior, nasal, superior, and temporal quadrants decreased in all three groups compared to preoperative levels, with the order of reduction being: sectoral group < PRP group < ischemic area-targeted group(all P <0.05). The complication rates in the sectoral group(3.33%) and ischemic area-targeted group(6.67%) were significantly lower than that in the PRP group(28.57%)(χ2= 9.850,P = 0.007). Conclusion Sectoral retinal laser photocoagulation is more conducive to improving visual acuity, reducing central macular thickness and retinal nerve fiber layer thickness in all quadrants in PDR patients, and is associated with a lower risk of complications, demonstrating safety and reliability.

Objective To analyze the expression of serum thioredoxin-1(Trx1) and programmed cell death factor 4(PDCD4) in sepsis patients and their relationship with 28-day survival. Methods The clinical data of 146 patients with sepsis admitted to the Department of Intensive Care Medicine of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2018 to December 2021(study group) and 146 volunteers who underwent physical examinations in the hospital at a 1:1 ratio during the same period(healthy control group) were retrospectively collected. Patients in the study group were divided into the simple sepsis subgroup(112 cases) and the septic shock subgroup(34 cases) according to disease severity, and into the survival subgroup(106 cases) and the death subgroup(40 cases) according to 28-day survival status. Enzyme-linked immunosorbent assay was used to detect serum levels of Trx1 and PDCD4 in all subjects. Point-biserial correlation analysis was used to investigate the correlation between serum Trx1, PDCD4 levels and the severity of sepsis. Cox regression analysis and receiver operating characteristic(ROC) curve analysis were used to evaluate the relationship and predictive value between serum Trx1 and PDCD4 levels and 28-day survival in sepsis patients. Results Compared with the healthy control group, serum PDCD4 levels were significantly increased and serum Trx1 levels were significantly decreased in the study group(t/P = 43.407/<0.001, 8.867/<0.001). Compared with the simple sepsis subgroup, the septic shock subgroup showed significantly increased serum PDCD4 levels and decreased serum Trx1 levels(t/P = 3.320/< 0.001, 5.106/< 0.001).Point-biserial correlation analysis showed that serum Trx1 levels were negatively correlated with disease severity, while serum PDCD4 levels were positively correlated with disease severity(r/P =-0.441/<0.001, 0.303/<0.001). High APACHE Ⅱ score,high CRP level, and high serum PDCD4 level at admission were independent risk factors for 28-day survival in sepsis patients,while high serum Trx1 level was an independent protective factor [HR(95%CI) = 1.106(1.033-1.184), 1.014(1.004-1.023),1.078(1.029-1.128), 0.770(0.653-0.907)]. The AUCs for serum Trx1, PDCD4, and their combination in predicting 28-day survival in sepsis patients were 0.814, 0.807, and 0.886, respectively. The combined predictive value was significantly better than that of either marker alone(Z/P = 1.670/0.047, 1.787/0.035). Conclusion Serum Trx1 levels are decreased and PDCD4 levels are increased in sepsis patients. The expression levels of both markers are correlated with disease severity and 28-day survival. Combined detection of Trx1 and PDCD4 provides improved predictive value for 28-day survival in sepsis patients.