not-yet-known not-yet-known not-yet-known unknown Abstract Few studies have investigated blood glucose levels and complication management in elderly patients with type 2 diabetes (T2D) at community hospitals in China. The objective of this study was to investigate the factors influencing blood glucose control in elderly patients with T2D and assess the adherence of doctors in community hospitals to the latest diabetes guidelines regarding the use of glucose-lowering medications. This study involved 1150 elderly patients (age≥65 years) with diabetes to assess blood glucose control, complications management, and adherence of medication according to the guidelines of American Diabetes Association. To evaluate blood glucose control, different glycated haemoglobin targets were assigned according to patient characteristics and health status (including comorbidities and cognitive status). Univariate and multivariate logistic regression analyses were used to investigate the factors affecting glucose control. Among the 1150 participants, 351 (30.52%) had poor glucose control. Frailty (odds ratio [OR]:0.393; 95% confidence interval [CI]:0.195-0.789; P=0.009), male sex (OR:1.472; 95% CI:1.131-1.915, P=0.004), and insulin treatment (OR:4.364; 95% CI:3.151-6.042; P<0.001) were significantly associated with poor blood glucose control in patients treated with glucose-lowering medications. The proportion of patients without frailty with poor control was higher than those with frailty (31.28% vs. 17.46%, respectively). In conclusion, blood glucose control in elderly Chinese patients with T2D is poor and influenced by frailty, sex, and insulin treatment. Hence, it is crucial to enhance the implementation of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists in Chinese community hospitals and strengthen the differentiation of updated guidelines within these healthcare settings.

An improved understanding of the molecular actions underpinning bone marrow stromal cell (BMSC) differentiation could highlight new therapeutics for osteoporosis (OP). Current evidence indicates that microRNAs (miRNAs) exert critical roles in many biological systems, including osteoblast differentiation. In this study, we examined miR-468-3p effects on osteogenic differentiation (OD). Distinct miR-468-3p reductions were identified during OD. MiR-468-3p also suppressed BMSC OD in gain- and loss-of-function assays, while it negatively regulated Runx2 as shown by molecular, protein, and bioinformatics approaches. When Runx2 was inhibited by small-interfering RNA (siRNA), the inhibitory effects of miR-468-3p toward BMSC osteogenesis were considerably reversed. Also, silenced miR-468-3p in ovariectomized (OVX) and sham mice augmented bone mass (BM) and bone formation (BF) and improved trabecular (Tb) microarchitecture. Therefore, miR-468-3p is a novel Runx2 regulator with key physiological action in BF and OD.

Obsessive-compulsive disorder (OCD) is a challenging psychiatric condition with limited treatment responses to standard therapies like selective serotonin reuptake inhibitors and cognitive-behavioral therapy. This letter to the Editor is intended to raise awareness within the scientific community about the potential use of N-acetylcysteine (NAC) as an alternative treatment, targeting the glutamatergic system dysfunctions and the inflammatory cytokines implicated in OCD. Preliminary studies suggest that NAC, at doses of 2,000-3,000 mg daily, can significantly alleviate OCD symptoms. Despite its promise and favourable safety profile, further research is imperative to establish optimal dosages and long-term efficacy. To date, the lack of suitable pharmaceutical forms with appropriate dosages hinders its empirical clinical application. In conclusion, NAC offers a potential adjunctive treatment for OCD, meriting more rigorous investigation.

Purpose: This study aimed to examine the effects of Empagliflozin on the mice model of HFD/STZ-induced T2DM and liver fibrosis, and the correlations with gut microbiota. Methods: The HFD/STZ-induced T2DM and liver fibrosis mice were treated with Empagliflozin for 6 weeks. After the intervention, OGTT and IPGTT were performed to assess glucose tolerance and insulin resistance in mice. The histological chemistry and indicators of liver pathology and liver fibrosis were assessed. Moreover, 16S rRNA amplicon sequencing for gut microbiota was performed to explore the changes of gut bacterial composition. And we analyzed the correlation between alterations in intestinal microbial composition and liver fibrosis score or glucose metabolic indicators. Results: 6-week Empagliflozin intervention improved glucose metabolism, and attenuated liver fibrosis in HFD/STZ-induced mice, which might be related to the alterations of gut microbiota. Furthermore, the abundance of Lactobacillus was increased, while Ruminococcus and Adlercreutzia were reduced in Empagliflozin-treated mice, which were positively associated with liver fibrosis and glucose metabolism in correlation analysis. Conclusion: Empagliflozin ameliorated glucose metabolic dysfunction and liver fibrosis in HFD/STZ-induced mice, whose effects might be due to the beneficial balance of gut microbiota composition. Our study provided evidence and highlighted improvement of gut-liver axis by inhibition of SGLT2 in T2DM and liver fibrosis.