Crosslinking ionic oligomers as conformable precursors to calcium carbonate.

Inorganic materials have essential roles in society, including in building construction, optical devices, mechanical engineering and as biomaterials1-4. However, the manufacture of inorganic materials is limited by classical crystallization5, which often produces powders rather than monoliths with continuous structures. Several precursors that enable non-classical crystallization-such as pre-nucleation clusters6-8, dense liquid droplets9,10, polymer-induced liquid precursor phases11-13 and nanoparticles14-have been proposed to improve the construction of inorganic materials, but the large-scale application of these precursors in monolith preparations is limited by availability and by practical considerations. Inspired by the processability of polymeric materials that can be manufactured by crosslinking monomers or oligomers15, here we demonstrate the construction of continuously structured inorganic materials by crosslinking ionic oligomers. Using calcium carbonate as a model, we obtain a large quantity of its oligomers (CaCO3)n with controllable molecular weights, in which triethylamine acts as a capping agent to stabilize the oligomers. The removal of triethylamine initiates crosslinking of the (CaCO3)n oligomers, and thus the rapid construction of pure monolithic calcium carbonate and even single crystals with a continuous internal structure. The fluid-like behaviour of the oligomer precursor enables it to be readily processed or moulded into shapes, even for materials with structural complexity and variable morphologies. The material construction strategy that we introduce here arises from a fusion of classic inorganic and polymer chemistry, and uses the same cross-linking process for the manufacture the materials.

Role of Carbon Nanotube Wetting Transparency in Rapid Water Transport for a Nanopore Membrane.

A carbon nanotube (CNT) may facilitate near-frictionless water transport within it. In this work, we elucidate the slip flow characteristics for a CNT embedded in a silicon nitride matrix using the molecular dynamics (MD) method. We reveal that the wetting transparency of a CNT, the transmission of the membrane matrix wetting property over a CNT, cannot be ignored. Due to the effect of CNT wetting transparency, the orientation flip behavior of water molecules should be the primary cause of the entrance and exit losses, which is a dominant factor influencing the interfacial friction coefficient for the thin CNT membrane. The relationship between the friction coefficient and pore size follows a logarithmic function, which agrees well with the reported experimental data. Our findings bridge the gap between the MD prediction and experimental observation for water transport in a CNT membrane and provide a clear understanding of the mechanism behind its ultrafast flow performance.

Construction of Intelligent Responsive Drug Delivery System and Multi-Mode Imaging Based on Gold Nanodots.

Cancer remains a formidable global problem with a high mortality rate. There are many effective anti-cancer drugs in clinical use, among which paclitaxel (PTX) has good effects on non-small cell lung cancer, ovarian cancer, and breast cancer. However, when applied to the clinic, PTX still has many limitations, such as poor water solubility, drug resistance, and side effects on healthy tissues. A gold nanodots-paclitaxel-polylysine (AuNDs-PTX-PLL) core-shell nano-system of integrated diagnosis and treatment is constructed to achieve intelligent responsive drug delivery. On the one hand, the problem of poor water-solubility and drug resistance of PTX are solved. On the other hand, the nano-system has an excellent intelligent response effect. Drugs can only be released in the weakly acidic environment of the tumor, which reduces the damage and side effects to normal tissues. Moreover, the nano-system can be used for real-time tracking and auxiliary diagnosis for the tumor through the multi-mode imaging mode, such as fluorescence, photoacoustic, and computed tomography to achieve accurate visualization. The photothermal effect of AuNDs is beneficial to promote the release of drugs. The nano-system integrates multi-mode imaging, chemotherapy, intelligent drug release in tumor weakly acidic environment, and has excellent practical application prospects in tumor diagnosis and treatment.

Rational Design of a Replication-Competent and Inheritable Magnetic Viruses for Targeting Biomedical Applications.

Infection with live-attenuated vaccines always inevitably induces side effects that reduce their safety. This study suggests a concept of magnetic virus produced by genetically modifying viral surfaces with Fe3 O4 nanoparticles (NPs) to control their tropisms. An iron-affinity peptide is designed to be displayed on the viral surface protein (VP1) of human enterovirus type 71 (EV71), a typical nonenveloped picornavirus, as the model. The modified EV71 can self-bind with Fe3 O4 NPs under physiological conditions, resulting in novel EV71-Fe3 O4 hybrid materials. This rationally engineered EV71 with Fe3 O4 retains its original biological infectivity, but its tropism can be precisely controlled by magnetism. Both in vitro and in vivo experiments demonstrate that EV71-Fe3 O4 can infect only a desired area within the limit of the applied magnetic field, which effectively reduces its pathological damage. More importantly, this characteristic of EV71 can be inherited due to the gene-induced coassembly of viruses and NPs. This achievement provides a proof of concept in virus vaccine improvement by a combination of gene modification and material incorporation, leading to great potential for biomedical developments.

Detection of Various Biomarkers and Enzymes via a Nanocluster-Based Fluorescence Turn-on Sensing Platform.

The profiling of disease-related biomarkers is an essential procedure for the accurate diagnosis and intervention of metabolic disorders. Therefore, the development of ultrasensitive and highly selective fluorogenic biosensors for diverse biomarkers is extremely desirable. There is still a considerable challenge to prepare nanocluster-based fluorescence turn-on probes capable of recognizing multiple biomolecules. We herein provide a novel nanocluster-based chemical information processing system (CIPS) for the programmable detection of various metabolites and enzymes. This CIPS consists of biocatalytic reactions between substrates and their respective oxidases to generate H2O2, which was then employed to synthesize bright fluorescent silver nanoclusters (Ag NCs). Utilizing this system, we are able to accurately probe a series of substrates/corresponding oxidases with high sensitivity and specificity, including glucose/glucose oxidase, uric acid/uric acid oxidase, sarcosine/sarcosine oxidase, choline/choline oxidase, xanthine/xanthine oxidase, and lactic acid/lactic acid oxidase. Furthermore, this metabolite profiling CIPS can be integrated with binary logic operations, which create an intelligent tool for the high-throughput screening of various diseases in vitro (e.g., diabetes, gout, prostate cancer, cardiovascular disease, and lactic acidosis).

Nanoparticle Counting by Microscopic Digital Detection: Selective Quantitative Analysis of Exosomes via Surface-Anchored Nucleic Acid Amplification.

Exosomes are nanosized vesicles secreted by cells, with a lipid bilayer membrane and protein and nucleic acid contents. Here, we present the first method for the selective and quantitative analysis of exosomes by digital detection integrated with nucleic acid-based amplification in a microchip. An external biocompatible anchor molecule conjugated with DNA oligonucleotides was anchored in the lipid bilayer membrane of exosomes via surface self-assembly for total exosome analysis. Then, specific antibody-DNA conjugates were applied to label selective exosomes among the total exosomes. The DNA-anchored exosomes were distributed into microchip chambers with one or fewer exosomes per chamber. The signal from the DNA on the exosomes was amplified by a rapid isothermal nucleic acid detection assay. A chamber with an exosome exhibited a positive signal and was recorded as 1, while a chamber without an exosome presented a negative signal and was recorded as 0. The 10100101 digital signals give the number of positive chambers. According to the Poisson distribution, the exosome stock concentration was calculated by the observed fraction of positive chambers. The findings showed that nanoscale particles can be digitally detected via DNA-mediated signal amplification in a microchip with simple microscopic settings. This approach can be integrated with multiple types of established nucleic acid assays and provides a versatile platform for the quantitative detection of various nanosomes, from extracellular vesicles such as exosomes and enveloped viruses to inorganic and organic nanoparticles, and it is expected to have broad applications in basic research areas as well as disease diagnosis and therapy.

Ratiometric fluorescence detection of trace water in organic solvents based on aggregation-induced emission enhanced Cu nanoclusters.

A fast, sensitive, and convenient dual-emission water detector was robustly fabricated. This detector was prepared with blue fluorescent carbon dots (CDs) and red fluorescent Cu nanoclusters (NCs), and showed two well-resolved and intensity-comparable fluorescence peaks under a single excitation wavelength. Moreover, it showed strong red fluorescence in organic solvent due to the aggregation-induced emission enhancement (AIEE) properties of the Cu NCs, but the red fluorescence was gradually quenched with an increasing amount of water, whereas the blue fluorescence remained constant. The differences in response result in a continuous fluorescence color change from red to blue that can be clearly observed by the naked eye. Thus, as-prepared Cu NC-based dual-emission nanomaterials can be used for ratiometric fluorescence detection of trace amounts of water in organic solvents by taking advantage of the water sensitivity of their fluorescence intensity ratios (red/blue) and their low detect limits (<0.02% v/v). These studies demonstrate that a novel and sensitive dual-emission ratiometric water detector has been found, which shows promise for application in environmental monitoring, food inspection, and life science.

Prevention of Cyanobacterial Blooms Using Nanosilica: A Biomineralization-Inspired Strategy.

Cyanobacterial blooms represent a significant threat to global water resources because blooming cyanobacteria deplete oxygen and release cyanotoxins, which cause the mass death of aquatic organisms. In nature, a large biomass volume of cyanobacteria is a precondition for a bloom, and the cyanobacteria buoyancy is a key parameter for inducing the dense accumulation of cells on the water surface. Therefore, blooms will likely be curtailed if buoyancy is inhibited. Inspired by diatoms with naturally generated silica shells, we found that silica nanoparticles can be spontaneously incorporated onto cyanobacteria in the presence of poly(diallyldimethylammonium chloride), a cationic polyelectrolyte that can simulate biosilicification proteins. The resulting cyanobacteria-SiO2 complexes can remain sedimentary in water. This strategy significantly inhibited the photoautotrophic growth of the cyanobacteria and decreased their biomass accumulation, which could effectively suppress harmful bloom events. Consequently, several of the adverse consequences of cyanobacteria blooms in water bodies, including oxygen consumption and microcystin release, were significantly alleviated. Based on the above results, we propose that the silica nanoparticle treatment has the potential for use as an efficient strategy for preventing cyanobacteria blooms.

Remote Activation of Disarmed Thioglycosides in Latent-Active Glycosylation via Interrupted Pummerer Reaction.

S-glycosides, S-2-(2-propylthio)benzyl (SPTB) glycosides, were converted to the corresponding oxidized glycosyl donors, S-2-(2-propylsulfinyl)benzyl (SPSB) glycosides, by simple and selective oxidation. Treatment of disarmed SPSB donor and various acceptors with triflic anhydride provided the desired glycosides in good to excellent yields. Meanwhile, observation of thiosulfinate, thiosulfonate, and disulfide suggested that the leaving group was activated via an interrupted Pummerer reaction. The disarmed SPSB thioglycosyl donors could be selectively activated in the presence of various thioglycosides with remote activation mode. Finally, two natural hepatoprotective glycosides, Leonoside E and Leonuriside B, were efficiently synthesized in a convergent manner with this newly developed method.

Interrupted Pummerer Reaction in Latent-Active Glycosylation: Glycosyl Donors with a Recyclable and Regenerative Leaving Group.

Latent O-glycosides, 2-(2-propylthiol)benzyl (PTB) glycosides, were converted into the corresponding active glycosyl donors, 2-(2-propylsulfinyl)benzyl (PSB) glycosides, by a simple and efficient oxidation. Treatment of the PSB donor and various acceptors with triflic anhydride provided the desired glycosides in good to excellent yields. The leaving group, which was activated by an interrupted Pummerer reaction, can be recycled (PSB-OH) and regenerated as the precursor (PTB-OH). A natural hepatoprotective glycoside, leonoside F, was efficiently synthesized in a convergent [3+1] manner with this newly developed method. The present total synthesis also led to a structural revision of this phenylethanoid glycoside.

Stereoselective synthesis of α-linked 2-deoxy glycosides enabled by visible-light-mediated reductive deiodination.

2-Deoxy sugars and their derivatives occur abundantly in many pharmaceutically important natural products. However, the construction of specific 2-deoxy-glycosidic bonds remains as a challenge. Herein, we report an efficient way to prepare 2-deoxy-α-glycosides by glycosylation of 2-iodo-glycosyl acetate and subsequent visible-light-mediated tin-free reductive deiodination. We have successfully applied the postglycosylational-deiodination strategy in the synthesis of more than 30 mono-, di-, tri-, tetra- and pentadeoxysaccharides with excellent stereoselectivity and efficiency. This method has also been applied to the synthesis of a 2-deoxy-tetrasaccharide containing four α-linkages.

Differences of individual gray matter networks between MCI patients who converted to AD within 3 Years and nonconverters.

Objective: Here we aimed to explore the differences in individual gray matter (GM) networks at baseline in mild cognitive impairment patients who converted to Alzheimer's disease (AD) within 3 years (MCI-C) and nonconverters (MCI-NC). Materials and methods: Data from 461 MCI patients (180 MCI-C and 281 MCI-NC) were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI). For each subject, a GM network was constructed using 3D-T1 imaging and the Kullback-Leibler divergence method. Gradient and topological analyses of individual GM networks were performed, and partial correlations were calculated to evaluate relationships among network properties, cognitive function, and apolipoprotein E (APOE) €4 alleles. Subsequently, a support vector machine (SVM) model was constructed to discriminate the MCI-C and MCI-NC patients at baseline. Results: The gradient analysis revealed that the principal gradient score distribution was more compressed in the MCI-C group than in the MCI-NC group, with scores for the left lingual gyrus, right fusiform gyrus and left middle temporal gyrus being increased in the MCI-C group (p < 0.05, FDR corrected). The topological analysis showed significant differences in nodal efficiency in four nodes between the two groups. Furthermore, the regional gradient scores or nodal efficiency were found to be significantly related to the neuropsychological test scores, and the left middle temporal gyrus gradient scores were positively associated with the number of APOE €4 alleles (r = 0.192, p = 0.002). Ultimately, the SVM model achieved a balanced accuracy of 79.4% in classifying MCI-C and MCI-NC patients (p < 0.001). Conclusion: The whole-brain GM network hierarchy in the MCI-C group was more compressed than that in the MCI-NC group, suggesting more serious cognitive impairments in the MCI-C group. The left middle temporal gyrus gradient scores were related to both cognitive function and APOE €4 alleles, thus serving as potential biomarkers distinguishing MCI-C from MCI-NC at baseline.

γδ T cells: Major advances in basic and clinical research in tumor immunotherapy.

ABSTRACT: γδ T cells are a kind of innate immune T cell. They have not attracted sufficient attention because they account for only a small proportion of all immune cells, and many basic factors related to these cells remain unclear. However, in recent years, with the rapid development of tumor immunotherapy, γδ T cells have attracted increasing attention because of their ability to exert cytotoxic effects on most tumor cells without major histocompatibility complex (MHC) restriction. An increasing number of basic studies have focused on the development, antigen recognition, activation, and antitumor immune response of γδ T cells. Additionally, γδ T cell-based immunotherapeutic strategies are being developed, and the number of clinical trials investigating such strategies is increasing. This review mainly summarizes the progress of basic research and the clinical application of γδ T cells in tumor immunotherapy to provide a theoretical basis for further the development of γδ T cell-based strategies in the future.

Structural Characteristics and Cementitious Behavior of Magnesium Slag in Comparison with Granulated Blast Furnace Slag.

Magnesium slag is a type of industrial solid waste produced during the production of magnesium metal. In order to gain a deeper understanding of the structure of magnesium slag, the composition and microstructure of magnesium slag were investigated by using characterization methods such as X-ray fluorescence, particle size analysis, X-ray diffraction, Fourier transform infrared spectroscopy and scanning electron microscopy. In addition, the state of Si occurrence in magnesium slag was analyzed using a solid-state nuclear magnetic resonance technique in comparison with granulated blast furnace slag. An inductively coupled plasma-optical emission spectrometer and scanning electron microscope with energy dispersive X-ray spectroscopy were used to characterize their cementitious behavior. The results show that the chemical composition of magnesium slag mainly includes 54.71% CaO, 28.66% SiO2 and 11.82% MgO, and the content of Al2O3 is much lower than that of granulated blast furnace slag. Compared to granulated blast furnace slag, magnesium slag has a larger relative bridging oxygen number and higher [SiO4] polymerization degree. The cementitious activity of magnesium slag is lower compared to that of granulated blast furnace slag, but it can replace part of the cement to obtain higher compressive strength. Maximum compressive strength can be obtained when the amount of magnesium slag replacing cement is 20%, where the 28-day compressive strength can be up to 45.48 MPa. This work provides a relatively comprehensive analysis of the structural characteristics and cementitious behavior of magnesium slag, which is conducive to the promotion of magnesium slag utilization.

Morphological Reconstruction for Variable Wing Leading Edge Based on the Node Curvature Vectors.

Precise morphology acquisition for the variable wing leading edge is essential for its bio-inspired adaptive control. Therefore, this study proposes a morphological reconstruction method for the variable wing leading edge, utilizing the node curvature vectors-based curvature propagation method (NCV-CPM). By establishing a strain-arc curvature function, the method fundamentally mitigates the impact of surface curvature angle on curvature computation accuracy at sensing points. We introduce a technique that uses high-order curvature fitting functions to determine the curvature vectors of arc segment nodes. This method reduces cumulative errors in curvature computation linked to the linear interpolation-based curvature propagation method (LI-CPM) at unattached sensor positions. Integrating curvature-strain functions aids in wing leading-edge strain field reconstruction, supporting structural health monitoring. Additionally, a particle swarm algorithm optimizes the sensing point distribution, reducing network complexity. This study demonstrates significantly enhanced morphological reconstruction accuracy compared to those obtained with conventional LI-CPM.

Enhanced Antioxidative Capacity Transfer between Sow and Fetus via the Gut-Placenta Axis with Dietary Selenium Yeast and Glycerol Monolaurate Supplementation during Pregnancy.

This study aims to investigate the impact of dietary supplementation with selenium yeast (SeY) and glycerol monolaurate (GML) on the transfer of antioxidative capacity between the mother and fetus during pregnancy and its underlying mechanisms. A total of 160 sows with similar body weight and parity of 3-6 parity sows were randomly and uniformly allocated to four groups (n = 40) as follows: CON group, SeY group, GML group, and SG (SeY + GML) group. Animal feeding started from the 85th day of gestation and continued to the day of delivery. The supplementation of SeY and GML resulted in increased placental weight and reduced lipopolysaccharide (LPS) levels in sow plasma, placental tissues, and piglet plasma. Furthermore, the redox balance and inflammatory markers exhibited significant improvements in the plasma of sows fed with either SeY or GML, as well as in their offspring. Moreover, the addition of SeY and GML activated the Nrf2 signaling pathway, while downregulating the expression of pro-inflammatory genes and proteins associated with inflammatory pathways (MAPK and NF-κB). Vascular angiogenesis and nutrient transportation (amino acids, fatty acids, and glucose) were upregulated, whereas apoptosis signaling pathways within the placenta were downregulated with the supplementation of SeY and GML. The integrity of the intestinal and placental barriers significantly improved, as indicated by the increased expression of ZO-1, occludin, and claudin-1, along with reduced levels of DLA and DAO with dietary treatment. Moreover, supplementation of SeY and GML increased the abundance of Christensenellaceae_R-7_group, Clostridium_sensus_stricto_1, and Bacteroidota, while decreasing levels of gut microbiota metabolites LPS and trimethylamine N-oxide. Correlation analysis demonstrated a significant negative relationship between plasma LPS levels and placental weight, oxidative stress, and inflammation. In summary, dietary supplementation of SeY and GML enhanced the transfer of antioxidative capacity between maternal-fetal during pregnancy via gut-placenta axis through modulating sow microbiota composition.

Organo-Ptii Complexes for Potent Photodynamic Inactivation of Multi-Drug Resistant Bacteria and the Influence of Configuration.

PtII based organometallic photosensitizers (PSs) have emerged as novel potent photodynamic inactivation (PDI) reagents through their enhanced intersystem crossing (ISC) processes. Currently, few PtII PSs have been investigated as antibacterial materials, with relatively poor performances reported and with structure-activity relationships not well described. Herein, a pair of configurational isomers are reported of Bis-BODIPY (4,4-difluoro-boradizaindacene) embedded PtII PSs. The cis-isomer (cis-BBP) displayed enhanced 1O2 generation and better bacterial membrane anchoring capability as compared to the trans-isomer (trans-BBP). The effective PDI concentrations (efficiency > 99.9%) for cis-BBP in Acinetobacter baumannii (multi-drug resistant (MDR)) and Staphylococcus aureus are 400 nM (12 J cm-2) and 100 nM (18 J cm-2), respectively; corresponding concentrations and light doses for trans-BBP in the two bacteria are 2.50 µM (30 J cm-2) and 1.50 µM (18 J cm-2), respectively. The 50% and 90% minimum inhibitory concentration (MIC50 and MIC90) ratio of trans-BBP to cis-BBP is 22.22 and 24.02 in A. baumannii (MDR); 21.29 and 22.36 in methicillin resistant S. aureus (MRSA), respectively. Furthermore, cis-BBP displays superior in vivo antibacterial performance, with acceptable dark and photoinduced cytotoxicity. These results demonstrate cis-BBP is a robust light-assisted antibacterial reagent at sub-micromolecular concentrations. More importantly, configuration of PtII PSs should be an important issue to be considered in further PDI reagents design.

Microalgae-material hybrid for enhanced photosynthetic energy conversion: a promising path towards carbon neutrality.

Photosynthetic energy conversion for high-energy chemicals generation is one of the most viable solutions in the quest for sustainable energy towards carbon neutrality. Microalgae are fascinating photosynthetic organisms, which can directly convert solar energy into chemical energy and electrical energy. However, microalgal photosynthetic energy has not yet been applied on a large scale due to the limitation of their own characteristics. Researchers have been inspired to couple microalgae with synthetic materials via biomimetic assembly and the resulting microalgae-material hybrids have become more robust and even perform new functions. In the past decade, great progress has been made in microalgae-material hybrids, such as photosynthetic carbon dioxide fixation, photosynthetic hydrogen production, photoelectrochemical energy conversion and even biochemical energy conversion for biomedical therapy. The microalgae-material hybrid offers opportunities to promote artificially enhanced photosynthesis research and synchronously inspires investigation of biotic-abiotic interface manipulation. This review summarizes current construction methods of microalgae-material hybrids and highlights their implication in energy and health. Moreover, we discuss the current problems and future challenges for microalgae-material hybrids and the outlook for their development and applications. This review will provide inspiration for the rational design of the microalgae-based semi-natural biohybrid and further promote the disciplinary fusion of material science and biological science.

In Situ Biomimetic Mineralization of Bone-Like Hydroxyapatite in Hydrogel for the Acceleration of Bone Regeneration.

A critical-sized bone defect, which cannot be repaired through self-healing, is a major challenge in clinical therapeutics. The combination of biomimetic hydrogels and nano-hydroxyapatite (nano-HAP) is a promising way to solve this problem by constructing an osteogenic microenvironment. However, it is challenging to generate nano-HAP with a similar morphology and structure to that of natural bone, which limits the improvement of bone regeneration hydrogels. Inspired by our previous works on organic-inorganic cocross-linking, here, we built a strong organic-inorganic interaction by cross-linking periosteum-decellularized extracellular matrix and calcium phosphate oligomers, which ensured the in situ mineralization of bone-like nano-HAP in hydrogels. The resulting biomimetic osteogenic hydrogel (BOH) promotes bone mineralization, construction of immune microenvironment, and angiogenesis improvement in vitro. The BOH exhibited acceleration of osteogenesis in vivo, achieving large-sized bone defect regeneration and remodeling within 8 weeks, which is superior to many previously reported hydrogels. This study demonstrates the important role of bone-like nano-HAP in osteogenesis, which deepens the understanding of the design of biomaterials for hard tissue repair. The in situ mineralization of bone-like nano-HAP emphasizes the advantages of inorganic ionic oligomers in the construction of organic-inorganic interaction, which provides an alternative method for the preparation of advanced biomimetic materials.

Identification of factors associated with fear of hypoglycemia using the capability, opportunity, motivation and behavior model in people with type 2 diabetes mellitus: a cross-sectional study.

AIMS: To examined the relationship between fear of hypoglycemia and certain variables in people with type 2 diabetes mellitus (T2DM) based on the Capability, Opportunity, Motivation, and Behavior model, combined with the context unique to people with diabetes to provide a basis for developing targeted nursing interventions. METHODS: In this cross-sectional study, 212 people with T2DM were recruited from February 2021 to July 2021. Data were collected using the Hypoglycaemia Fear Survey, Gold score, Patient Assessment of Chronic Illness Care (PACIC) scale and Diabetic Self-Management Attitudes Scale. Multiple linear regression analysis was performed to determine the predictors of fear of hypoglycemia using SPSS 26.0. RESULTS: The mean fear of hypoglycemia score was 74.88 ± 18.28 (range: 37.00-132.00). In people with T2DM, the frequency of blood glucose monitoring, the frequency of hypoglycemia in the past half-year, degree of understanding of hypoglycemia, impaired awareness of hypoglycemia, PACIC, and self-management attitude of diabetes were the influencing factors of fear of hypoglycemia (adjusted R2 = 0.560, F[21,190] = 13.800, P < 0.001). These variables explained 56.0% of the variance in the fear of hypoglycemia. CONCLUSIONS: The level of fear of hypoglycemia in people with T2DM was relatively high. In addition to paying attention to the disease characteristics of people with T2DM, medical staff should also pay attention to patients' own perception and handling ability of disease and hypoglycemia, attitude toward self-management behavior and external environment support, all of which have a positive effect on improving the fear of hypoglycemia in people with T2DM, optimizing the self-management level and improving quality of life.