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To investigate the fear of hypoglycaemia in patients with type 2 diabetes mellitus (T2DM), to identify factors related to this fear, and thus to provide evidence for clinical assessment. A total of 385 patients with T2DM who were admitted to the departments of endocrinology in five tertiary grade-A hospitals in Chongqing, China were included in this study. A questionnaire for general information and a Chinese version of Hypoglycemia Fear Survey (HFS) were used to collect the data. The average total score on the HFS was 71.67 ± 17.06 (HFS-W was 38.15 ± 10.57; HFS-B was 33.52 ± 9.54).The three items with the highest average score for HFS-W were not recognising low blood glucose (BG), not having food available, experiencing a hypoglycaemic episode alone, and for HFS-B were eating large amount of snacks, measuring BG six or more times per day, and keeping BG > 150 mmol/L. Regressions showed that number of hospitalisations for T2DM, receiving health education on diabetes, age and hypoglycaemia history because of T2DM were associated with fear of hypoglycaemia (all p  < 0.05). Fear of hypoglycaemia in hospitalised patients with T2DM was strongly associated with diabetes health education, hospitalisation for diabetes, age, and hypoglycaemia history. Medical professionals should attach importance to the specific psychological interventions, health education on diabetes and the early prevention of hypoglycaemia or diabetic complications for patients with T2DM to reduce the fear of hypoglycaemia and improve their health status.

Ethnopharmacological relevance: The genus Polygonatum Tourn, ex Mill. contains numerous chemical components, such as steroidal saponins, polysaccharides, flavonoids, alkaloids, and others, it possesses diverse pharmacological activities, such as anti-aging, anti-tumor, immunological regulation, as well as blood glucose management and fat reducing properties. Aim of the review: This study reviews the current state of research on the systematic categorization, chemical composition, pharmacological effects, and processing changes of the plants belonging to the genus Polygonatum, to provide a theoretical foundation for their scientific development and rational application. Materials and methods: The information was obtained by searching the scientific literature published between 1977 and 2022 on online databases (including PubMed, CNKI, SciFinder, and Web of Science) and other sources (such as the Chinese Pharmacopoeia 2020 edition, and Chinese herbal books). Results: The genus Polygonatum contains 79 species, and 233 bioactive chemical compounds were identified in them. The abundance of pharmacological activities, such as antioxidant activities, anti-fatigue activities, anti-inflammatory activities, etc., were revealed for the representatives of this genus. In addition, there are numerous processing methods, and many chemical constituents and pharmacological activities change after the unappropriated processing. Conclusions: This review summarizes the taxonomy classification, chemical composition, pharmacological effects, and processing of the plants belonging to the genus Polygonatum, providing references and research tendencies for plant-based drug development and further clinical applications.

A neutral Polygonatum cyrtonema polysaccharide (NPCP) was isolated and purified from Polygonatum cyrtonema by various chromatographic techniques, including DEAE-52 and Sephadex-G100 chromatography. The structure of NPCP was characterized by HPLC, HPGPC, GC-MS, FT-IR, NMR, and SEM. Results showed that NPCP is composed of glucose (55.4%) and galactose (44.6%) with a molecular weight of 3.2 kDa, and the sugar chain of NPCP was →1)-α-D-Glc-(4→1)-β-D-Gal-(3→. In vitro bioactivity experiments demonstrated that NPCP significantly enhanced macrophages proliferation and phagocytosis while inhibiting the M1 polarization induced by LPS as well as the M2 polarization induced by IL-4 and IL-13 in macrophages. Additionally, NPCP suppressed the secretion of IL-6 and TNF-α in both M1 and M2 cells but promoted the secretion of IL-10. These results suggest that NPCP could serve as an immunomodulatory agent with potential applications in anti-inflammatory therapy.

Virtual reality (VR) is considered to be a promising therapeutic technology for the rehabilitation of upper extremities (UEs) post-stroke. Recently, we designed and then implemented a neuroscientifically grounded VR protocol for the rehabilitation of patients with stroke. The system provides unilateral and bilateral limb mirroring exercises in a fully immersive virtual environment that may stimulate and activate the mirror neuron system in the brain to help patients for their rehabilitation. Twelve patients with subacute stroke underwent the newly implemented VR treatment in addition to conventional rehabilitation for 8 consecutive weekdays. The treatment effect on brain reorganization and motor function was investigated using resting-state fMRI (rs-fMRI) and the Fugl-Meyer assessment for Upper Extremity (FM-UE), respectively. Fifteen healthy controls (HCs) also underwent rs-fMRI scanning one time. The study finally obtained usable data from 8 patients and 13 HCs. After the intervention, patients demonstrated significant improvement in their FM-UE scores (p values < 0.042). Voxel-wise functional connectivity (FC) analysis based on the rs-fMRI data found that HCs showed widespread bilateral FC patterns associated with the dominant hemispheric primary motor cortex (M1). However, the FC patterns in patients revealed intra-hemispheric association with the ipsilesional M1 seed and this association became visible in the contra-hemisphere after the intervention. Moreover, the change of FC values between the bilateral M1 was significantly correlated with the changes in FM-UE scores (p values < 0.037). We conclude that unilateral and bilateral limb mirroring exercise in an immersive virtual environment may enhance cortical reorganization and lead to improved motor function.

The smoke from tunnel fires spreads over long distances and is difficult to vent. Smoke accumulation leads to high temperatures, low visibility, and high concentrations of toxic gases, which greatly hinders the evacuation of people inside the tunnel. In this paper, a representative extra-long highway tunnel—Chengkai Tunnel—is selected as the engineering background, and a tunnel model is built using FDS and Pathfinder software to simulate the fire scenario and evacuation scenario under different longitudinal wind speeds. The concept of safe evacuation reliability is proposed to describe the relationship between the ASET (available safe egress time) and the RSET (required safe egress time). The simulation results show that with the increase in longitudinal wind speed, the ASET upstream of fire source increases first and then remains unchanged, while ASET downstream of fire source increases first and then decreases. The ASET upstream of the fire source is affected by visibility, while the ASET downstream of the fire source is affected by visibility when the wind speed is low, and is affected by temperature as the wind speed increases. The bottleneck effect is an important reason for the long evacuation time of people. The blockage time is a power function of the evacuation movement time, and increasing the width of the cross passage can improve the evacuation efficiency of the tunnel. The increase in the number of evacuees will reduce the reliability of the safe evacuation of personnel. Among all simulated scenarios, a longitudinal wind speed of 2.5 m/s has the highest safe evacuation reliability, with 0.79, 0.92, and 0.99 for scenarios R1, R2, and R3, respectively. Excessive wind speed reduces the safe evacuation reliability downstream of the fire source.

This study investigated two low-alloy steels with the same alloying elements in different contents. The relationship between the structure and properties of the oxide scale formed on the surface of the billet at 950–1200 °C was studied. The enrichment of Si and Cr alloy elements at the interface of the steel matrix and oxide scale to form a spinel-structure compound under the same heating process reduced the oxidation kinetics of the oxide scale. The relationship between the adhesion strength of the scale and the substrate of steels was quantitatively characterized at different temperatures using a pull-type adhesion tester. The results showed that the adhesion strength of the oxide scale depended on the difference between the elastic modulus of the substrate. The interfacial constraint coordination deformation ability of the oxide scale was worse for a larger difference. The mixed phase of Fe 2 SiO 4 /FeO and FeCr 2 O 4 /FeO reached the melting point and melted when the heating temperature exceeded 1200 °C. Subsequently, the liquid phase was immersed into the lattice void of the matrix metal under external forces. Consequently, the external stress was dispersed, and the peeling effect of the oxide scale was inhibited.