R-Napropamide Potentially Regulates Cadmium Accumulation in Arabidopsis Shoots through Transport Channel Modulation.

Heavy metal contamination in soils poses a significant environmental threat to human health. This study examines the effects of the chiral herbicide napropamide (NAP) on Arabidopsis thaliana, focusing on growth metrics and cadmium (Cd) accumulation. R-NAP does not adversely affect plant growth compared to the control, whereas S-NAP significantly reduces root length and fresh weight. Notably, R-NAP markedly increases Cd accumulation in the shoots, exceeding levels observed in the control and S-NAP. This increase coincides with reduced photosynthetic efficiency. Noninvasive electrode techniques reveal a higher net Cd absorption flux in the root mature zone under R-NAP than S-NAP, although similar to the control. Transcriptomic analysis highlights significant stereoisomer differences in Cd transporters, predominantly under R-NAP treatment. SEM and molecular docking simulations support that R-NAP primarily upregulates transporters such as HMA4. The results suggest careful management of herbicides like R-NAP in contaminated fields to avoid excessive heavy metal buildup in crops.

TRNR: Task-Driven Image Rain and Noise Removal with a Few Images Based on Patch Analysis.

The recent success of learning-based image rain and noise removal can be attributed primarily to well-designed neural network architectures and large labeled datasets. However, we discover that current image rain and noise removal methods result in low utilization of images. To alleviate the reliance of deep models on large labeled datasets, we propose the task-driven image rain and noise removal (TRNR) based on a patch analysis strategy. The patch analysis strategy samples image patches with various spatial and statistical properties for training and can increase image utilization. Furthermore, the patch analysis strategy encourages us to introduce the N-frequency-K-shot learning task for the task-driven approach TRNR. TRNR allows neural networks to learn from numerous N-frequency-K-shot learning tasks, rather than from a large amount of data. To verify the effectiveness of TRNR, we build a Multi-Scale Residual Network (MSResNet) for both image rain removal and Gaussian noise removal. Specifically, we train MSResNet for image rain removal and noise removal with a few images (for example, 20.0% train-set of Rain100H). Experimental results demonstrate that TRNR enables MSResNet to learn more effectively when data is scarce. TRNR has also been shown in experiments to improve the performance of existing methods. Furthermore, MSResNet trained with a few images using TRNR outperforms most recent deep learning methods trained data-driven on large labeled datasets. These experimental results have confirmed the effectiveness and superiority of the proposed TRNR. The source code is available on https://github.com/Schizophreni/MSResNet-TRNR.

The Capping Protein β-Subunit Mediates Fusicoccin-induced Stomatal Movement in Arabidopsis / 中国生物化学与分子生物学报

Actin dynamics in guard cells play a critical role in stomatal movement. Remodeling of actin arrays is triggered by different biotic and abiotic stimuli, which requires precise control. However, the molecular mechanism underlying this process is not well understood. Here we investigated whether and how the capping protein (CP) regulates actin filaments during fusicoccin (FC) -induced stomatal opening. We found that both stomatal opening and F-actin rearrangement are sensitive in the Capping Protein β-subunit (CPB) cpb-3 mutants, which resulted in its hypersensitivity to drought stress. The leaves detached from cpb-3 had a higher water loss rate (63. 45%) than from the wild type (48. 99%), and the stomatal aperture of cpb-3 was about 20% greater than in the wild type. After 1 h of FC treatment, the proportion of cpb-3 guard cells with radial actin arrays increased to 65. 5% dramatically, while only approximately 47. 2% guard cells in WT exhibited transversely oriented actin filaments. Moreover, the record of transmembrane Ca

Epidemiological characteristics analysis and incidence trend prediction of gonorrhea in Hubei Province in 2010-2021 / 公共卫生与预防医学

Objective To analyze the epidemiological characteristics and incidence trend of gonorrhea in Hubei Province, and to provide reference for scientific formulation of prevention and control measures. Methods Based on the surveillance data of gonorrhea from 2010 to 2021, three-way distribution and ARIMA model were used for data analysis and incidence prediction. Results From 2010 to 2021, the reported incidence rate fluctuated between 3.01/100 000-7.07/100 000, and the average annual reported incidence rate was 4.62/100 000. The reported incidence rate showed the characteristics of “first fall and then rise, and then fall and rise again”, and the peak incidence period was from June to December. The male to female ratio of reported cases was 5.78:1, and the number of reported cases in the age group of 20-39 years old accounted for 62.43% of the total number of cases. The reported cases were mainly housework and unemployed, farmers, and unknown occupation. The severity of the regional incidence was divided into 5 categories by the Q-type clustering, and the most serious category included Shennongjia Forest District, Huangshi City, and Wuhan City. The ARIMA model predicted the incidence rate to be in good agreement with the actual incidence rate, with a predicted number of 3 343 cases in 2022. Conclusion At present, gonorrhea in Hubei Province is still at a high prevalence level. There are obvious differences in gender, age, occupation, and regional distribution. The ARIMA model is suitable for predicting the incidence of gonorrhea, and it is predicted that the incidence will increase slightly in 2022.

Spatial clustering and dynamic change of mumps in Hubei Province in 2010-2020 / 公共卫生与预防医学

Objective To explore spatial clustering of mumps in Hubei Province during 2010-2020, and to provide evidence for mumps prevention and control. Methods The surveillance data of mumps during 2010-2020 in Hubei Province was obtained from the national infectious diseases reporting information system. Trend surface analysis and spatial autocorrelation analysis of mumps incidences at county/district levels were performed using ArcGIS10.5 software. Results Mumps incidence rates in Hubei Province during 2010-2018 ranged from 8.70 per 100 000 to 44.99 per 100 000. The trend surface analysis showed that mumps incidences gradually decreased from west to east, and was low in the middle and high at the north-south direction. Global spatial autocorrelation showed that there were positive spatial correlations in every year except 2012 and 2014 (Morans I> 0, P <0.05). Local autocorrelation analysis showed that the hotspots of mumps incidences varied every year from 2010 to 2020. Conclusions According to the spatial analysis, mumps incidences had obvious spatial clustering in Hubei Province. The hotspots were mainly concentrated in the northwestern region of Hubei, but the hot spots also extended to the urban areas of eastern, central and northern Hubei. It is necessary to take appropriate prevention and control measures in the high-incidence areas.

Degradation of SARS-CoV-2 receptor ACE2 by the E3 ubiquitin ligase Skp2 in lung epithelial cells / 医学前沿

An unexpected observation among the COVID-19 pandemic is that smokers constituted only 1.4%-18.5% of hospitalized adults, calling for an urgent investigation to determine the role of smoking in SARS-CoV-2 infection. Here, we show that cigarette smoke extract (CSE) and carcinogen benzo(a)pyrene (BaP) increase ACE2 mRNA but trigger ACE2 protein catabolism. BaP induces an aryl hydrocarbon receptor (AhR)-dependent upregulation of the ubiquitin E3 ligase Skp2 for ACE2 ubiquitination. ACE2 in lung tissues of non-smokers is higher than in smokers, consistent with the findings that tobacco carcinogens downregulate ACE2 in mice. Tobacco carcinogens inhibit SARS-CoV-2 spike protein pseudovirions infection of the cells. Given that tobacco smoke accounts for 8 million deaths including 2.1 million cancer deaths annually and Skp2 is an oncoprotein, tobacco use should not be recommended and cessation plan should be prepared for smokers in COVID-19 pandemic.

Degradation of SARS-CoV-2 receptor ACE2 by tobacco carcinogen-induced Skp2 in lung epithelial cells

An unexpected observation among the COVID-19 pandemic is that smokers constituted only 1.4-18.5% of hospitalized adults, calling for an urgent investigation to determine the role of smoking in SARS-CoV-2 infection. Here, we show that cigarette smoke extract (CSE) and carcinogen benzo(a)pyrene (BaP) increase ACE2 mRNA but trigger ACE2 protein catabolism. BaP induces an aryl hydrocarbon receptor (AhR)-dependent upregulation of the ubiquitin E3 ligase Skp2 for ACE2 ubiquitination. ACE2 in lung tissues of non-smokers is higher than in smokers, consistent with the findings that tobacco carcinogens downregulate ACE2 in mice. Tobacco carcinogens inhibit SARS-CoV-2 Spike protein pseudovirions infection of the cells. Given that tobacco smoke accounts for 8 million deaths including 2.1 million cancer deaths annually and Skp2 is an oncoprotein, tobacco use should not be recommended and cessation plan should be prepared for smokers in COVID-19 pandemic.

Comparative study of ARIMA model and seasonal index model in the prediction of mumps in Hubei Province / 公共卫生与预防医学

Objective To establish an ARIMA model and a seasonal index model to predict the trend of mumps, compare the advantages and disadvantages of the two models, and to provide a scientific basis for the prevention and control of mumps. Methods ARIMA model and seasonal index model were established based on the monthly incidence of mumps in Hubei Province from 2008 to 2019. Results The average annual incidence rate from 2008 to 2019 was 28.89 / 100,000. April-July was the month of high incidence. The established ARIMA model and seasonal index model were （1-1.070B+0.441B2-0.291B3）*（1-B12）*Xt=（1-0.611B12）*Ɛt and Xt=（2.802-0.006t）*St. The average relative errors of the ARIMA model and the seasonal index model were 11.49% and 20.86%, respectively. Conclusion The ARIMA model and the seasonal index model both have good applicability in predicting the onset time characteristics and trend of mumps. However, while the ARIMA model demonstrated more advantages in fitting the annual change trend, the seasonal index model is better in fitting the monthly change trend. The two models can be used in combination to predict the trend of mumps.

Epidemiological characteristics and trend prediction of scarlet fever in Hubei Province from 2010 to 2018 / 中华疾病控制杂志

Objective To provide reference for formulating scarlet fever prevention and control strategies by analyzing the epidemiological characteristics and predicting the incidence trend of scarlet fever. Methods Spearman correlation analysis, clustering analysis, seasonal index model and seasonal ARIMA model were used for analysis and prediction. Results The average annual incidence of scarlet fever in 2010-2018 was 1.37/100 000, and there was a positive correlation between annual incidence and year (rs=0.817,P=0.007). April-June and November-December were high incidence months. The clustering analysis was significant(F=4795.30，P<0.001), showing that the high-incidence areas are Shennongjia, Yichang, Enshi, Wuhan. Reported cases were concentrated in 1-14 years old, mainly for students, child care children and scattered children. The incidence rate of males was higher than that of females. The optimal model is ARIMA(0,1,1)(0,1,0)12. The prediction showed that the monthly incidence characteristics of 2019 were consistent with previous years, and the annual incidence rate was 10.22/100 000(95% CI:2.33/100 000-30.43/100 000), which was higher than the incidence of 2018. Conclusions The incidence of scarlet fever in Hubei Province is generally on the rise from 2010 to 2018. The incidence is bimodal. Students are the main disease group. The incidence rate of males is higher. The incidence is mainly concentrated in the mountainous areas of southwest and capital cities. The ARIMA model has a good applicability in the prediction of scarlet fever. The incidence level will continue to rise in 2019, and it is necessary to strengthen monitoring and control measures with reference to epidemiological characteristics.

Reflection on the management of infectious disease information reporting during the COVID-19 outbreak / 公共卫生与预防医学

Objective Summarize the characteristics of infectious disease reporting management, reflect on the exposed problems, and make reference suggestions under the situation of COVID-19. Methods In-depth analysis through literature research and practical demonstration. Results The functions of each department, organic integration, unified management, communication from top to bottom, upgrade and perfection, and information sharing can give full play to the early warning role of infectious disease surveillance. Conclusion The infectious disease reporting management system should be perfected and upgraded from top to bottom and from the inside out.

Recent advances of miRNAs in the development and clinical application of gastric cancer / 中华医学杂志(英文版)

Gastric cancer (GC) is one of the most common malignant tumors. The mechanism of how GC develops is vague, and therapies are inefficient. The function of microRNAs (miRNAs) in tumorigenesis has attracted the attention from many scientists. During the development of GC, miRNAs function in the regulation of different phenotypes, such as proliferation, apoptosis, invasion and metastasis, drug sensitivity and resistance, and stem-cell-like properties. MiRNAs were evaluated for use in diagnostic and prognostic predictions and exhibited considerable accuracy. Although many problems exist for the application of therapy, current studies showed the antitumor effects of miRNAs. This paper reviews recent advances in miRNA mechanisms in the development of GC and the potential use of miRNAs in the diagnosis and treatment of GC.

Development history and prospects of disease control informatization in Hubei / 公共卫生与预防医学

Objective To sort out the development history of disease control informatization in Hubei, and provide reference for the establishment of the "Hubei model" of disease control informatization. Methods To understand the development process through data access and site investigation. Result Hubei CDC has built a provincial and municipal two-level data center; built a full-coverage security network; built a full traceable immune planning system; built a provincial, city, and county three-level video conference system; established a professional disease Control the information team. Conclusion The "Hubei model" of disease control informationization has a solid foundation. It will adhere to the development concept of people as the core, business as the problem-oriented, big data as the means, multi-point trigger as the benchmark, and network security as the foundation. Play the role of technical support and information leadership in the control business.

Effect of Quyu Chencuo Formula () on Renal Fibrosis in Obstructive Nephropathy Rats / 中国结合医学杂志

OBJECTIVE@#To observe the effect of Quyu Chencuo Formula (, QCF) on renal fibrosis in rats with obstructive nephropathy.@*METHODS@#Twenty-four rats were randomly divided into three groups, 4 for sham operation as the control group, 10 for unilateral ureteral obstruction (UUO) model group, and the rest 10 for QCF treating UUO model group. All rats were sacrificed under 3% pentobarbital (50 mg/kg) anesthesia on the 14th day after surgery, then the right kidney samples of rats were harvested for hematoxylin eosin (HE) staining and Masson staining to observe the renal pathological changes. Immunohistochemistry and Western blotting were used to examine the expression of transforming growth factor β1 (TGF-β1), and real-time polymerase chain reaction (RT-PCR) was employed to examine the expressions of TGF-β1, α-smooth muscle actin (α-SMA) and E-cadherin mRNA.@*RESULTS@#HE and Masson staining showed that the renal interstitial of the rats in the control group had no significant fibrotic lesion; in the model group, there were obvious interstitial fibrosis; for the QCF group, there were epithelial cell necrosis, infiltration of lymphocytes and mononuclear cells, aggravated interstitial fibrosis in varied degrees, but the pathological changes were less in the QCF group than in the model group. The immunohistochemistry and Western blotting results showed that the TGF-β1 expression was increased significantly in the model group, while decreased significantly in the QCF group (P<0.05); RT-PCR showed that the mRNA expression of α-SMA and TGF-β1 increased significantly in the model group, while both were significantly decreased in the QCF group compared with the model group (P<0.05). The mRNA expression of E-cadherin was decreased significantly in the model group, and it was significantly increased in the QCF group as compared with the model group (P<0.05).@*CONCLUSION@#QCF may improve renal fibrosis by regulating the expressions of TGF-β1, α-SMA and E-cadherin, and prevent the progress of kidney fibrosis.

The brain imaging studies of obstructive sleep apnea: evidence from resting-state EEG and fMRI / 生理学报

Obstructive sleep apnea (OSA) is a common clinic sleep disorder, and characterized by obstruction of upper airway during sleep, resulting in sleep fragmentation and intermittent hypoxemia. We reviewed the brain imaging studies in OSA patients compared with healthy subjects, including studies of functional magnetic resonance imaging (fMRI) and electroencephalography (EEG). The resting-state EEG studies showed increased power of δ and θ in the front and central regions of the cerebral cortex in OSA patients. While resting-state fMRI studies demonstrated altered large-scale networks in default-mode network (DMN), central executive network (CEN) and salience network (SN). Evidence from resting-state studies of both fMRI and EEG focused on the abnormal activity in prefrontal cortex (PFC), which is correlated with OSA severity. These findings suggested that the PFC may play a key role in the abnormal function of OSA patients. Finally, based on the perspectives of treatment effect, multimodal data acquisition, and comorbidities, we discussed the future research direction of the neuroimaging study of OSA.

The antidepressant effect and mechanism of traditional Chinese formula Yueju Pill based on drug pair / 中国药理学通报

Aim To explore the antidepressant mecha-nism and laws of traditional Chinese formula Yueju Pill by taking drug pair as the breakthrough point. Meth-ods On the basis of anti-depressant activities of Yueju Pill, the combination of different herbs was obtained by the successively disassembling, and the key drug pair was obtained through the acute administration of Yueju Pill in mice. In addition, chronic unpredictable mild stress model was established to further verify the anti-depressant effect of key drug pair, and to explore its molecular mechanism. Results The drug pair of zhizi and chuanxiong was necessary to anti-depression effect of Yueju Pill, and the immobility time of TST and FST was significantly reduced. As expected, the expres-sions of IL-6 and TNF-a and p-NF-kBp65, P-IkBa were obviously lower than those in model group, but the expressions of BDNF and TrkB were up-regulated than those in model group. Conclusions The drug pair of zhizi and chuanxiong is necessary for traditional Chinese formula Yueju Pill for the antidepressant effect. It is assumed that the antidepressant effect and mechanism of zhizi and chuanxiong are connected with cytokine IL-6, TNF-a and protein expressions of p-NF-kBp65, P-IkBa, and BDNF.

Impact of atmospheric particulate matter at different period of gestation on low birth weight: a meta-analysis / 中华预防医学杂志

Objective@#To analyze the influence of atmospheric particulate matters (PM2.5 and PM10) on low-birth-weight (LBW) infants at different periods of gestation.@*Methods@#We conducted a systematic literature search for 2 471 articles related to particulate matter and LBW published from January 1st 2000 to January 1st 2016 using the PubMed, Cochrane Library, Web of Science, Science Direct, Chinese Web of Knowledge, Wanfang and Weipu, and the keywords were" air pollution" , "adverse birth outcomes" , "adverse pregnancy outcomes" , "low birth weight/LBW" . According to criteria, 27 literatures were selected and included. Metafor package of the R 3.1.1 Software was used to check the heterogeneity and merge the effect value of the selected literatures, and sensitivity analysis and publication bias were detected and adjusted.@*Results@#A total of 2 471 studies selected form the databases, 27 enrolled in this analysis according to the inclusion and exclusion criteria. Each 10 μg/m3 increase in PM2.5 was associated with combined OR values of 1st trimester, 2nd trimester, 3rd trimester and entire gestation at 1.02(95% CI: 0.87-1.19), 1.03 (95% CI: 0.91-1.16) , 1.07 (95%CI: 1.04-1.11) and 1.09 (95%CI: 1.04-1.15), respectively. And 10 μg/m3 increase in PM10 was associated with combined OR values of 1st trimester, 2nd trimester, 3rd trimester and entire gestation at 1.66 (95%CI: 1.06-2.61), 1.58 (95%CI:1.28-1.95) , 1.38 (95%CI: 1.23-1.56) and 1.04 (95%CI: 0.99-1.09), respectively. After adjusting the bias of publication, each 10 μg/m3 increase in PM2.5 was associated with the risk of low birth weight at 1.11 (95%CI: 1.02-1.21).@*Conclusion@#This meta analysis supports an adverse impact of maternal exposure to particulate air pollution on low birth weight, varying in effects by exposure period.

Experimental research on bletilla carrying exogenous basic fibroblast growth factor that promotes wound healing / 中国组织工程研究

BACKGROUND: Bletilla bletilla striata gelatin (BSG) is found to remarkably promote the growth of granulation tissue and capillary vessels, as well as the expression of vascular endothelial growth factor in the wound tissue in rabbits with full-thickness skin defect of the back. Basic fibroblast growth factor (bFGF) remarkably promotes the growth of collagen fibers and the growth and dilation of capillary vessels in the wound tissue in rabbits with full-thickness skin defect of the back. However, BSG is easy to decompose under normal temperature, affecting fulfillment of its functions. OBJECTIVE: To explore the effect of BSG carrying exogenous bFGF on wound healing. METHODS: Forty healthy rabbits were used to make animal models of full-thickness back skin defects, and then randomly divided into four groups, namely, group BSG+bFGF, group bFGF, group BSG and group saline. Rats in each group were subjected to the corresponding treatment once a day until the wound was completely healed. Wound healing time was recorded. Wound healing rate was detected at 3 and 10 days after modeling. Real-time PCR and western blot assay were used to detect the expression of vascular endothelial growth factor, α-smooth muscle actin and type I collagen at mRNA and protein levels at 7 days after modeling. RESULTS AND CONCLUSION: The wound healing time in the BSG+bFGF group was shortened by 4.5, 3.0 and 2.8 days as compared with the normal saline group, BSG group and bFGF group, respectively (P < 0.05). The wound healing rates in the BSG+bFGF group were also higher than those in the other groups at 3 and 10 days after modeling (P< 0.05). Findings from both PCR and western blot assay showed higher expression of vascular endothelial growth factor and α-smooth muscle actin and lower expression of type I collagen in the BSG+bFGF group than the other three groups at 7 days after modeling (P < 0.05). To conclude, BSG carrying exogenous bFGF can promote wound healing, and the underlying mechanism may be to promote vascular endothelial growth factor and inhibit type I collagen.

Pharmacokinetics of five ginsenosides of Shexiang Baoxin pill in plasma of myocardial infarction rats / 中国中药杂志

Shexiang Baoxin pill(SBP) is widely used for treating coronary heart disease in clinic, with ginsenosides as its main effective component. This study was designed to investigate and compare the pharmacokinetic characteristics of five ginsenosides of five compounds after multiple oral administrations, ginseng extract(GE) and SBP in myocardial infarction rats. After intragastric administration to myocardial infarction rats, the plasma samples were analyzed by liquid chromatography tandem triple-quad mass spectrometry. The results showed that Cmax of five compounds in all groups were less than 200 μg•L⁻¹. Tmax of corresponding analytes between groups revealed that ginsenosides in both SBP and GE were absorbed faster than each of the five compounds, indicating that GE and compounds contain components promoting absorption of ginsenosides. The oral administration doses of ginsenosides in SBP were the least in all groups, but with the greatest AUC0-tand AUCINF, which indicated that ginsenosides in SBP had the best absorption in all groups after oral administration to myocardial infarction rats. This study also demonstrated that compound is the best form of traditional Chinese medicine.

Erythropoietin mobilizes renal progenitor cells to reduce ischemic reperfusion injury in rats with nephron-sparing surgery / 中华肾脏病杂志

Objective To investigate the effects of the erythropoietin (EPO) on ischemia reperfusion injury (IRI) in rats with nephron-sparing surgery (NSS). Methods Fifty-four Sprague Dawley rats were divided into 3 groups randomly after right kidney nephrectomy: Sham group, NSS group (PBS+NSS) and EPO group (EPO+NSS). During NSS, renal artery was clamped for 40 min to induce IRI. Sham group just adopted exposure renal artery without vascular clamped. Rats in NSS group were injected intraperitoneally with PBS for 3 days before NSS. Rats in EPO group were injected intraperitoneally with EPO for 3 days before NSS. After 12 h, 24 h, 72 h, blood sample and renal tissues were collected. The serum creatinine (Scr) and urea nitrogen (BUN) were evaluated. The pathology injury was evaluated by HE staining. The CD24/CD133 double-positived renal progenitor cells (RPCs) were tested by flow cytometry. The CD133 and PCNA protein were quantified by immunohistochemical staining. The expressions of Wnt7b and β-catenin protein were detected by Western blotting. Results Rats in NSS group had more elevated Scr, BUN and pathology injury scores 12 h, 24 h and 72 h after operation than those in Sham group (all P<0.05). Compared with those in the NSS group, the Scr and BUN in the EPO group were significantly lower 24 h after the surgery (all P<0.05), and the pathology injury score also decreased (P<0.05). The proportion of RPCs, expressions of CD133 and PCNA, and expressions of Wnt7b and β-catenin protein were significantly higher after 24 h of the surgery in NSS group than those in the Sham group (all P<0.05). While compared with those in the NSS group, the proportion of RPCs and expressions of CD133, PCNA, Wnt7b and β-catenin increased at the EPO group (all P<0.05). Conclusions EPO can reduce the IRI after NSS, and its mechanism may be related to the mobilization of the RPCs by the Wnt7b/β-catenin signal pathway.

Factors of insulin injection-related knowledge among registered nurses of internal medicine department of Grade 3 generalized hospitals in Shanghai / 现代临床护理

Objective To investigate the insulin injection-related knowledge of the registered nurses in first-class general hospitals in Shanghai and look into its influence factors. Methods Totally 331 nurses in the hospitals were enrolled in this study. Univariate and multivariate stepwise regression were used to analyze the factors which influenced the insulin injection-related . Results The aggregate score of insulin injection-related knowledge was 54.20 ± 7.64, and the score index was 67.75%. Multiple linear regression analysis showed that such factors as professional title and nursing experience and training in the endocrinology department were the main factors of insulin injection-related knowledge (all P<0.05). Conclusion We should enhance the training to promote the injection skills so that they can assist the patients to effectively control blood sugar and improve the quality of life.