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Zinc deficiency during pregnancy is common and has been significantly associated with adverse pregnancy outcomes such as spontaneous preterm birth(PTB),recurrent abortion(RA),low birth weight(LBW),small-for-gestational-age infant(SGA),preeclampsia(PE),and gestational diabetes mellitus(GDM).Unfortunately,there is no specific biomarkers which are sensitive,easy-to-collect and detect available for the clini-cal evaluation of zinc nutritional status.However,recent studies have identified metallothionein and the ratio of oleic acid to dihydroxymethyl gamma-linolenic acid(LA/DGLA)as potentially candidates of biomarkers.This article focuses on summarizing and discussing the progress of domestic and international researches on zinc deficiency dur-ing pregnancy and adverse pregnancy outcomes,potential zinc biomarkers,and zinc deficiency treatments,aiming at providing ideas for perinatal nutritional guidance.
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Strontium(Sr)is a trace element naturally found in the human skeletal system.In recent years,the po-tential impact of strontium on bone and cardiovascular health has called significant attention,particularly during pregnancy,when alterations in mineral metabolism may affect the health of both the mother and the fetus.This com-prehensive review assesses the current understanding of the role of strontium as a nutritional substance during preg-nancy,its effects on maternal health and fetal development,and its potential associations with pregnancy complica-tions such as preeclampsia,gestational hypertension,and lactation-induced osteoporosis.The review also summarizes the possible effects of strontium deficiency,excess,and supplementation,and provides information for developing prenatal nutrition supplementation guideline.
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Objective To investigate the effects of comprehensive nutrition management on glycolipid metabolism and pregnancy outcomes in patients with gestational diabetes mellitus(GDM).Methods A total of 121 pregnant women with GDM at 24-28 weeks gestation who were registered in the obstetrics department of 6 sub-central hospi-tals in China from May 2021 to July 2021 were included in this study and were randomly divided into intervention group(n=74)and control group(n=47).The intervention group received intensive comprehensive nutrition man-agement,including at least 6 outpatient interventions,individualized nutrition management and a half-day standard-ized outpatient education on gestational diabetes mellitus,continuous dynamic blood glucose monitoring and micro-blood glucose monitoring,and routine check of glycated albumin and urine every 4 weeks.Body weight,body com-position and diet and exercise implementation procedures and fetal development as well as complications were recor-ded.The control group received conventional nutritional guidance.The two groups were compared for difference in blood glucose related indicators at 37 weeks of gestation,weight gain before delivery,some lipid metabolism indica-tors,pregnancy outcomes,and oral glucose tolerance test(OGTT)at 42 days postpartum.Results Compared with the control group,the level of prenatal fasting blood glucose(P=0.006),intravenous plasma glucose(P=0.009)and blood ketone(P = 0.044)in the intervention group was significantly reduced.There was no significant difference in weight gain and weight attainment rate between the two groups.The 2-hour postpartum OGTTs of preg-nant women in the intervention group(P=0.006)were significantly lower than those in the control group,and the incidence of preeclampsia and postpartum blood loss were lower than those in the control group but no statistical difference was found.For newborns,the incidence of macrosomia(P=0.042)and planation(P=0.048)in the in-tervention group was slightly lower than that in the control group,and the results were statistically different.Other adverse pregnancy outcomes were not statistically different between the two groups.Conclusions Intensive compre-hensive nutrition management has a positive impact on the control of the blood glucose in pregnant women and im-proves the maternal and neonatal outcomes of women with GDM.
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Objective:With the help of SWOT(S: internal strengths, W: internal weaknesses, O: external opportunities, T: external threats)analysis, to explore the internal and external conditions of internet-based cognitive behavioral therapy applied to improve the negative emotions of patients with coronary heart disease, and to propose development strategies.Methods:SWOT analysis was used to analyze and sort out the internal strengths and internal weaknesses, external opportunities and external threats of internet-based cognitive behavioral therapy in improving the negative emotions of patients with coronary heart disease.Results:The internal strengths of internet-based cognitive behavioral therapy in improving the negative emotions of patients with coronary heart disease were significant therapeutic effect, strong operability and high cost-effectiveness. The internal weaknesses included excessive dependence on patients′ treatment enthusiasm, and a lack of psychological training among nurses. The external opportunities included demand support, technical support, and theoretical support. The external threats were the lack of large-scale empirical research and the risk of patient personal information leakage.Conclusions:In the clinical application of internet-based cognitive behavioral therapy to improve the negative emotions of patients with coronary heart disease, both strengths and weaknesses coexist, and opportunities and threats coexist. Only by taking strengths of opportunities to overcome weaknesses, improve the autonomy and enthusiasm of patients in treatment, and increase the psychological training of medical staff, can internet-based cognitive behavioral therapy be further promoted in the clinical application of improving the negative emotions of patients with coronary heart disease.
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Objective:To explore the level of knowledge,belief,practice,and influencing factors of tolerance to enteral nutrition(EN)among nursing staff in intensive care units(ICU).Methods:A total of 70 nursing staff who worked in the ICU of our hospital from Jan 2022 to Dec 2022 were selected as the research subjects.The current level of nurses'knowledge,belief,and practice was evaluated using the"ICU Nurse EN Tolerance Knowledge,Belief,and Practice Scale"and a general information questionnaire was self-designed.Linear regression analysis was conducted to analyze the influencing factors of ICU nursing staff's knowledge,belief,and conduct of EN tolerance.Results:The score of ICU Nurse EN Tolerance Knowledge,Belief,and Practice Scale in 70 ICU nursing staff was(72.85±6.94).The scores for knowledge,attitude,and behavior dimensions were(10.69±2.11),(13.65±2.61),and(48.51±4.69),respectively.The results of linear regression analysis showed that working experience<5 years,non-EN group members,and low self-efficacy were influencing factors(P<0.05)on the knowledge,belief and practice of EN tolerance of ICU nursing staff.The equation was Y=65.162+5.077X1+ 6.551X2+10.218X3.Conclusion:The knowledge,belief and practice level of EN tolerance of ICU nursing staff may be affected by working years,self-efficacy,and whether they are members of EN study group.
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Objective:To explore the genetic etiology and clinical phenotype of Feingold syndrome due to chromosome 2p24.3p24.2 microdeletion.Methods:The clinical data of a child admitted to Henan Provincial People′s Hospital in November 2021 and diagnosed as Feingold syndrome type 1 (FGLDS1) associated with chromosome 2p24.3p24.2 microdeletion were collected. The clinical and genetic variation characteristics of the patient were summarized, and 10 patients with chromosome 2p microdeletion reported until November 2022 were reviewed.Results:The boy was 12 years and 5 months old. He presented with backward physical development, motor development retardation, low intelligence, special body and facial appearance, finger developmental deformity and other manifestations, accompanied by hyperactivity and aggressive behavior, impulsive irritability, self-injury and other behavior problems. The proband showed normal chromosome karyotype; the genome-wide copy number variant sequencing and trio-whole exome sequencing revealed a 2.61 Mb deletion at chromosome 2p24.3p24.2 region, and 10 genes including MYCN gene (exons 1 to 3) in the deleted region.The same deletion was not found in either of his parents. The genetic features of 11 cases (including this case) with chromosome 2p microdeletion were summarized, all of whom had insufficient haploid dosage of the MYCN gene due to chromosome 2p microdeletion, and the clinical manifestations of these 11 patients matched the clinical diagnosis of FGLDS1. Conclusion:The proband is consistent with the clinical presentation of the typical Feingold syndrome, and the haploinsufficiency of the MYCN gene due to the microdeletion of chromosome 2 is the genetic etiology of the proband.
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Objective To investigate the correlation between plasma inflammatory factors [IL-1β, IL-6, IL-10, IL-12, IL-17, IL-23, TNF-α, TGF-β, IFN-γ, C-reactive protein (CPR) CCL-5] and hand-foot syndrome in colorectal cancer patients after taking capecitabine. Methods 35 colorectal cancer patients treated with capecitabine were collected and the degree of severity was divided according to the hand-foot syndrome grading diagnostic criteria. The concentrations of inflammatory factors in plasma were determined by ELISA kits. Results The standard curve of all inflammatory cytokines were linear (r>0.9900), and plasma concentrations of inflammatory cytokines in patients with colorectal cancer were determined. The concentration of TNF-α changed obviously, which had reference value. Conclusion The concentrations of different inflammatory factors were different and the concentration of TNF-α was closely correlated with the severity of hand-foot syndrome.
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OBJECTIVE To analyze the implementation of insulin centralized volume-based procurement policy (hereinafter referred to as “centralized procurement”) in our hospital and its effect on the use of insulin products in clinical. METHODS The manufacturer, specifications, usage, sales amount and agreed purchase volume of insulin products in our hospital before (July 4, 2021 to January 3, 2022) and after (July 4, 2022 to January 3, 2023) the centralized procurement were collected. The defined daily dose (DDD) method was used to calculate defined daily doses (DDDs), defined daily cost (DDC), the progress of procurement completion and actual cost saving. RESULTS After the centralized procurement, the number of insulin products had increased from 20 to 29 in our hospital; except for the Insulin degludec/aspart injection in our hospital’s original insulin catalog that had not been centrally purchased, all other existing varieties had been included in centralized procurement catalog. The use of Insulin aspart 30 injection produced by Novo Nordisk (China) Pharmaceutical Co., Ltd. always ranked the first place in the list of usage and DDDs before and after the centralized procurement. The sales amount of Insulin glargine injection produced by Ganli Pharmaceutical Co., Ltd. and Tonghua Dongbao Pharmaceutical Co., Ltd. increased significantly due to the significant increase in usage. The centralized procurement of Degu insulin injection from Novo Nordisk (China) Pharmaceutical Co., Ltd. had achieved a relatively high completion rate in our hospital’s original insulin catalog, while the completion rate for new varieties was low. After the centralized procurement, our hospital actually saved a total of 1 388 582.66 yuan in expenses. CONCLUSIONS After the centralized procurement, the selection and usage of insulin varieties in our hospital are reasonable, which saves patients’ insulin treatment costs, and reduces economic pressure on patients and society.
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Objective:To assess the association of appendicular skeletal muscle mass(ASM) to fat mass(FM) ratio in early pregnancy with the risk of gestational diabetes mellitus (GDM).Methods:A total of 468 pregnant women who visited the Nutritional Department of Peking Union Medical College Hospital or Shunyi Maternal and Child Care Service Center in 2018 and 2019 were recruited. Detailed information and clinical data were collected. The body components were measured using the bioelectrical impedance analysis (BIA) method during early pregnancy (< 14 weeks) and the ASM to FM ratio was calculated. The patients were divided into the GDM group and normal glucose tolerance (NGT) group according to the results of the oral glucose tolerance test (OGTT) performed during 24-28 weeks. Binary logistics regression was used to explore the correlation between the ASM/FM ratio and the risk of GDM. The receiver operator characteristic (ROC) curve of subjects was used to evaluate the predictive value of ASM/FM ratio for GDM and the cut-off value was reported.Results:Compared to the NGT group, the ASM and FM in early pregnancy in the GDM group were significantly higher, while the ASM/FM ratio was significantly lower. A lower ASM/FM ratio in early pregnancy was one of the risk factors of developing GDM. The cut-off value of the ASM/FM ratio was 0.809. The area under the ROC curve for predicting GDM increased from 68.1% to 72.3% when ASM/FM ratio was incorporated, with a significant difference by Delong test ( P = 0.006). Conclusion:Inadequate muscle mass would increase the risk of GDM and the ASM/FM ratio could serve as a predictor of GDM.
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Objective:To explore any effect of pelvic floor muscle training and/or attention training on pelvic floor function and women′s symptoms of stress urinary incontinence (SUI).Methods:Fifty incontinent women were divided into a control group ( n=25) and an experimental group ( n=25). Both groups received conventional pelvic muscle rehabilitation training, but the experimental group was additionally provided with attention training for 6 weeks. Before and after the 6 weeks of treatment, both groups were evaluated using surface electromyography of the pelvic floor. The short form of the International Urinary Incontinence Advisory Committee′s urinary incontinence questionnaire (ICIQ -SF) was used to assess the severity of incontinence and quality of life (I-QOL). Results:Before the treatment there was no significant difference between the 2 group′s pelvic floor myographs, nor in their average ICIQ-SF and I-QOL scores. After the treatment, however, compared with the control group, significant improvement was observed in experimental group′s peak amplitude during rapid contraction, average EMG in tonic contraction and endurance contraction. Their average ICIQ-SF and I-QOL scores were also better.Conclusion:Supplementing pelvic floor muscle training with attention training can effectively improve the urinary continence and the life quality of women with stress urinary incontinence.
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OBJECTIVE To provide reference for clinically safe and rational drug use through mining and analyzing adverse drug event (AE) signals induced by valproic acid (VPA). METHODS Reporting Odds Ratio (ROR) and Bayesian Confidence Propagation Neural Network (BCPNN) methods of Measures of Disproportionality were performed to mine and analyze the data of VPA-related AE reports in the US FDA Adverse Event Reporting System (FAERS) database from the first quarter of 2013 to the fourth quarter of 2022. RESULTS A total of 1 253 (ROR) and 1 109 (BCPNN) valid signals of preferred terms (PT) were obtained after data processing by the two analysis methods, involving 27 system organs (SOC), mainly focusing on nervous system disorders, psychiatric disorders, general disorders and administration site conditions. Signals that did not appear in the instruction were associated with 2 SOCs: ear and labyrinth disorders, infections and infestations. CONCLUSIONS As a first-line broad-spectrum anti-epileptic drug, attention should also be paid to eye toxicity and infection risk in the clinical application in addition to paying attention to common adverse events in the instruction.
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Objective:Hyperoxia is a necessary therapy in some neonatal diseases, and long-term therapeutic hyperoxia may induce severe damaging effects on intestinal epithelial cells.The aim of this study was to investigate whether hyperoxia could promote the expression of ASK1 and P38 in intestinal epithelial cells through ROS.Methods:The human colon adenocarcinoma cell line Caco-2 cells were treated with different concentrations of H 2O 2(100 μmol/L, 200 μmol/L and 400 μmol/L)and 85% oxygen in vitro.The expression of ASK1 was detected by immunofluorescence, and the expression of P38 and p-P38 were detected by Western Blot and Real-time PCR. Results:With the increase of H 2O 2 concentration, the fluorescence intensity of ASK1 increased.The fluorescence intensity of ASK1 in the hyperoxia group was significantly stronger than that of the control group and the H 2O 2 groups.With the increase of H 2O 2 concentration(100 μmol/L、200 μmol/L、400 μmol/L), the expression of P38 protein(0.21±0.02, 0.28±0.13, 0.44±0.07)and p-P38 protein(0.09±0.02, 0.19±0.03, 0.37±0.07)gradually increased.The expression of P38 mRNA in 200 μmol/L and 400 μmol/L H 2O 2 groups(4.03±0.68、3.94±0.71)was significantly higher than that in 100 μmol/L H 2O 2 group(3.05±0.47)( P<0.01). The expressions of P38 protein, p-P38 protein and P38 mRNA in the hyperoxia group were significantly higher than those in the H 2O 2 group( P<0.01). Compared with the control group, the expressions of P38 protein, p-P38 protein and p38 mRNA in the hyperoxia group and H 2O 2 groups increased significantly( P<0.01). Conclusion:The expression of ASK1 and P38 in intestinal epithelial cells increased significantly under hyperoxia, which indicated that hyperoxia might activate ASK1 and thereby regulate the expression of downstream P38 through ROS, resulting in intestinal epithelial cells damage.
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The therapy of relapsed/refractory lymphoma is still a challenge, and high-dose chemotherapy combined with autologous stem cell transplantation, new drugs and cellular immunotherapy are the main treatment options. In recent years, the emergence of reduced intensity conditioning allogeneic hematopoietic stem cell transplantation (allo-HSCT) and alternative donor have made allo-HSCT become a valuable option for relapsed/refractory lymphoma. The features of the disease, patients' clinical characteristics, selection of alternative donors, conditioning regimen and the management of transplantation-related complications affect the survival of patients after transplantation. The data of allo-HSCT in the treatment of relapsed/refractory lymphoma are mainly derived from retrospective reports of various transplantation centers, and a large number of prospective clinical trials are desperately needed to explore. There are still no consensus for the selection criteria of transplant patients, the timing of transplantation, the selection of graft source and transplantation conditioning. This paper reviews the current progress of the application of allo-HSCT in relapsed/refractory lymphoma.
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Objective:This study aimed to investigate the influence of staple food type on glucose levels in women with gestational diabetes mellitus (GDM).Methods:The drawing lots method was used for randomized grouping. The subject inclusion criteria were being a pregnant woman and diagnosed with GDM at 24-28 weeks gestation. Anyone with severe internal or external disease, previous abnormal glucose metabolism, smoking history, multiple pregnancies, or poor compliance was excluded. Twenty pregnant women were enrolled and were randomized to receive meals and snacks consisting of wholegrain flour products and tuber vegetables (control group) or wholegrain rice (intervention group) for 4 weeks. In the administration of the meals, energy supply, energy distribution, and nutrient level were matched between the two groups. A continuous glucose monitoring system was used for monitoring glucose level, and postprandial glycemia (incremental area under the curve) was measured after lunch and dinner.Results:A total of 17 women with GDM completed the study (8 in group A and 9 in group B). After the dietary intervention, the compliance rate of blood glucose in groups A and B was (89.20±6.06)% and (90.61±5.25)%, and glycated albumin was (12.46±0.84)% and (12.46±0.84)%, respectively ( P>0.05). Moreover, there were no significant differences in cesarean section rate or perinatal complications between the two groups. The incremental area under the curve of glucose within 2 hours after lunch [(137.3±84.4) vs(111.0±78.9)] and dinner [(137.0±87.7) vs (111.0±74.8)] were both significantly lower in the intervention group compared with the control group, which indicates a more stable postprandial glucose response to GDM with wholegrain rice. Conclusion:The intervention diet used in this study showed good glucose control for GDM pregnancies; a diet with wholegrain rice as the staple food led to more stable postprandial glucose response than a diet with wholegrain flour products and tuber vegetables as the staple food.
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Objective@#To investigate the relationship between serum glutamate levels and severity of retinopathy of prematurity (ROP) in children and its impact on the prognosis.@*Methods@#A total of 92 children with ROP who were screened and treated at Henan Provincial Eye Hospital from June 2017 to June 2018 and 50 healthy preterm infants screened at Henan Provincial Eye Hospital were selected for clinical control study.Ninety-two children with ROP were divided into the mild ROP group and the severe ROP group according to the stage of lesions, and they were divided into the progressive group and the spontaneous regression group according to whether the disease was progressive.The severity of ROP and prognosis were analyzed by measuring serum glutamate levels in 1 week and 6 weeks after birth.@*Results@#The serum glutamate concentration in the severe ROP group was the highest in the first week after birth[(122.08±14.55) mmol/L] and in the 6th week after birth [(107.13±13.20) mmol/L], followed by the mild ROP group[(98.60±14.48) mmol/L, (85.41±14.49) mmol/L] separately, and the lowest in the control group[(68.52±7.69) mmol/L, (54.97±6.31) mmol/L] separately, and there were significant differences among the 3 groups (all P<0.05). Pearson correlation analysis showed that serum glutamate concentration was positively correlated with the severity of ROP at 1 week and 6 weeks after birth (r=0.869, 0.875, all P<0.05). The levels of serum glutamate at the first week after birth and at the 6th week after birth in the progressive group [(107.18±17.62) mmol/L, (92.94±16.21) mmol/L]were significantly higher than those in the spontaneous regression group[(131.53±10.22) mmol/L, (118.82±8.18) mmol/L], and there were significant differences between the 2 groups (all P<0.05). The area under the curve(AUC) values of serum glutamate concentration at 1 week after birth and 6 weeks after birth were 0.855 and 0.936, respectively, according to the receiver operating characteristic(ROC) curve, while the optimal critical values of serum glutamate concentration at 1 week and 6 weeks after birth were 117.83 mmol/L (sensitivity was 0.909, specificity was 0.728) and 106.69 ng/L (sensitivity was 1.000, specificity was 0.790), respectively.@*Conclusions@#The serum glutamate concentration was positively correlated with the severity of ROP infants in 1 week and 6 weeks after birth.The optimal threshold of serum glutamate concentration in 1 week and 6 weeks after birth was more sensitive and specific in predicting the progression of retinopathy, and had higher value in evaluating the prognosis of the infants.
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Objective To investigate the relationship between serum glutamate levels and severity of retinopathy of prematurity (ROP) in children and its impact on the prognosis.Methods A total of 92 children with ROP who were screened and treated at Henan Provincial Eye Hospital from June 2017 to June 2018 and 50 healthy preterm infants screened at Henan Provincial Eye Hospital were selected for clinical control study.Ninety-two children with ROP were divided into the mild ROP group and the severe ROP group according to the stage of lesions,and they were divided into the progressive group and the spontaneous regression group according to whether the disease was progressive.The severity of ROP and prognosis were analyzed by measuring serum glutamate levels in 1 week and 6 weeks after birth.Results The serum glutamate concentration in the severe ROP group was the highest in the first week after birth [(122.08 ± 14.55) mmol/L] and in the 6th week after birth [(107.13 ± 13.20) mmol/L],followed by the mild ROP group[(98.60 ± 14.48) mmol/L,(85.41 ± 14.49) mmol/L] separately,and the lowest in the control group[(68.52 ±7.69) mmol/L,(54.97 ± 6.31) mmol/L] separately,and there were significant differences among the 3 groups (all P < 0.05).Pearson correlation analysis showed that serum glutamate concentration was positively correlated with the severity of ROP at 1 week and 6 weeks after birth (r =0.869,0.875,all P < O.05).The levels of serum glutamate at the first week after birth and at the 6th week after birth in the progressive group [(107.18 ± 17.62) mmol/L,(92.94 ±16.21) mmol/L] were significantly higher than those in the spontaneous regression group[(131.53 ± 10.22) mmol/L,(118.82 ± 8.18) mmol/L],and there were significant differences between the 2 groups (all P <0.05).The area under the curve(AUC) values of serum glutamate concentration at 1 week after birth and 6 weeks after birth were 0.855and 0.936,respectively,according to the receiver operating characteristic(ROC) curve,while the optimal critical valuesof serum glutamate concentration at 1 week and 6 weeks after birth were 117.83 mmol/L (sensitivity was 0.909,specificity was 0.728) and 106.69 ng/L (sensitivity was 1.000,specificity was 0.790),respectively.Conclusions The serum glutamate concentration was positively correlated with the severity of ROP infants in 1 week and 6 weeks after birth.The optimal threshold of serum glutamate concentration in 1 week and 6 weeks after birth was more sensitive and specific in predicting the progression of retinopathy,and had higher value in evaluating the prognosis of the infants.
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Objective:To investigate the clinical effect of ozone combined with sodium hyaluronate injection in the treatment of knee osteoarthritis and its effect on inflammatory factors and hemorheology in patients.Methods:146 patients with knee osteoarthritis who received treatment in our hospital from October 2016 to February 2019 were selected and divided into observation group and control group according to the random number table method, 73 cases in each group.In the experimental group, intra-articular injection of sodium hyaluronate combined with ozone was used, while in the control group, glucosamine hydrochloride tablets were routinely taken and intra-articular injection of sodium hyaluronate was performed. Patients in both groups were treated once a week for 5 consecutive weeks for a course of treatment. General data of patients in the two groups were analyzed, and the efficacy, visual analogue scale (VAS) score and hospital for special surgery knee score (HSS) before and after treatment, levels of inflammatory factors and changes in hemorheology indexes were compared between the two groups.Results:There was no significant difference in general data between the two groups ( P>0.05). Before treatment, there was no significant difference in VAS score and HSS score between the two groups ( P>0.05). After treatment, VAS score and HSS score in the two groups were significantly decreased and increased respectively ( P<0.05). Compared with the control group, VAS score was significantly decreased and HSS score was significantly increased in the observation group after treatment ( P<0.05). The total effective rate in the observation group was higher than that in the control group, and the difference between the two groups was statistically significant ( P<0.05). Before treatment, there was no significant difference in the levels of inflammatory factors vascular endothelial growth factor (VEGF), tumor necrosis factor (TNF-α), interleukin (IL)-1β, IL-6, hypersensitive C-reactive protein (hs-CRP) and matrix metalloproteinase (MMP)-13 in the articular fluid between the two groups ( P>0.05). After treatment, the above indexs in the observation group were significantly lower than those in the control group ( P<0.05). After treatment, the levels of inflammatory cytokines in the articular fluid of the two groups were lower than before ( P<0.05). There was no significant difference in hemorheology indexes between the two groups before treatment ( P>0.05), and the two groups were significantly improved after treatment, and the degree of improvement in the observation group was significantly better than that in the control group ( P<0.05). Conclusions:Ozone combined with sodium hyaluronate intra-articular injection is more effective in the treatment of knee osteoarthritis, which can effectively reduce the level of inflammatory factors and inflammatory response, improve hemorheology, and then reduce the pain of patients, improve the knee joint function.
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Objective:To evaluate the association of maternal nutrition status in the first trimester with gestational diabetes mellitus (GDM) and macrosomia.Methods:378 pregnant women who took prenatal care in Shunyi Women′s and Children′s Hospital of Beijing Children′s Hospital were enrolled in the study. Blood samples were collected at first prenatal visit (<12 gestation weeks) to measure the level of hemoglobin and iron status indexes including serum iron, ferritin, transferrin, total iron binding capacity, iron saturation, transferrin saturation. The incidence of GDM and macrosomia were collected and Logistic regression was used to evaluate the associations of maternal nutrients status in the first trimester with GDM and macrosomia.Results:The incidence rate of GDM was16.9%,the incidence of anemia and iron deficiency in the first trimester were2.4% and 2.5%, respectively. After adjustment for variables such as maternal age, pre-pregnancy BMI, family history of diabetes, and parity, Logistic regression showed that in the first trimester, iron saturation>50% ( OR=0.238, 95% CI 0.068-0.831), transferrin saturation>50% ( OR=0.08, 95% CI 0.010-0.677) were protective factors of GDM; iron saturation 25%-50% ( OR=0.361, 95% CI 0.143-0.908); transferrin saturation 25%-50% ( OR=0.383, 95% CI 0.165-0.891); ferritin>30 ng/ml ( OR=0.418, 95% CI0.186-0.939) were protective factors of macrosomia. Conclusion:Maternal iron status in the first trimester might be associated with GDM and macrosomia. Thus, maternal iron status assessment in the first trimester is necessary.
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Objective:To evaluate the effect of leptin on pyroptosis in hippocampal cells during brain injury in a rat model of orthotopic liver transplantation (OLT).Methods:Fifty-four clean-grade male Sprague-Dawley rats, aged 12 weeks, weighing 200-250 g, were divided into 3 groups( n=18 each)by a random number table method: sham operation group (S group), OLT-induced brain injury group (Liver group) and leptin group (Lep group). The model of OLT was established according to the " two-cuff" technique in anesthetized rats in Liver and Lep groups.The perihepatic ligament was only isolated and freed in S group.Leptin 1 mg/kg was intraperitoneally injected immediately after portal vein occlusion in Lep group.The equal volume of normal saline was intraperitoneally injected at the same time point in S group and Liver group.Twelve rats in each group were selected on day 3 after surgery and sacrificed, and the hippocampal tissues were obtained for examination of the pathological changes (with a light microscope) and for determination of the expression of NOD-like receptor protein 3 (NLRP3), caspase-1, interleukin-1beta (IL-1β), IL-18 and gasdermin D (GSDMD) mRNA (by real-time polymerase chain reaction) and expression of NLRP3, caspase-1, IL-1β, IL-18 and GSDMD (by Western blot). Morris water maze test was performed in the remaining 6 rats in each group on day 30 after surgery. Results:Compared with S group, the count of viable neurons in hippocampi was significantly decreased, the expression of NLRP3, caspase-1, IL-1β, IL-18 and GSDMD protein and mRNA was up-regulated, the time of staying at the platform quadrant was shortened, and the escape latency was prolonged in Liver and Lep groups ( P<0.05). Compared with Liver group, the count of viable neurons in hippocampi was significantly increased, the expression of NLRP3, caspase-1, IL-1β, IL-18 and GSDMD protein and mRNA was down-regulated, the time of staying at the platform quadrant was prolonged, and the escape latency was shortened in Lep group ( P<0.05). The pathological changes of hippocampal tissues were significantly attenuated in Liver group when compared with Lep group. Conclusion:The mechanism by which leptin reduces brain injury is related to inhibiting pyroptosis in hippocampal cells in a rat model of OLT.
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<p><b>OBJECTIVE</b>To evaluate the effect and clinical value of auricular point sticking for the diagnosis and treatment of vasospasm and vagus reflex during radial artery puncture, including radial artery spasm (RAS) and coronary artery spasm (CAS).</p><p><b>METHODS</b>A total of 480 patients were randomized into an observation group (224 cases) and a control group (256 cases). Percutaneous coronary intervention and usual care in perioperative period were used in the control group. Auricular point sticking was began to apply 12 h before percutaneous coronary intervention in the observation group at Jiaogan (AH), Shenmen (TF), Pizhixia (AT), Neifenmi (CO), Xin (CO), Shen (CO), Shenshangxian (TG), 1 min a time every point, once every 2 h, 12 h before and after operation. The incidences of vasospasm and vagus reflex during piercing process were compared, and the usage ratios of vasoactive agent were recorded, including glyceryl trinitrate, dopamine and atropine injections.</p><p><b>RESULTS</b>The incidence of angiospasm was 4.9% (11/224) in the observation group, which was lower than 13.3% (34/256) in the control group (<0.01). The incidence of vagal reflex of the observation group was 7.1% (16/224), which was lower than 19.5% (50/256) of the control group (<0.01). The usage ratios of glyceryl trinitrate, atropine and dopamine injections were 3.6% (8/224), 7.1% (16/224), 6.3% (14/224) respectively in the observation group, which were lower than 14.8% (38/256), 15.6% (40/256), 15.2% (39/256) in the control group (all<0.01). .</p><p><b>CONCLUSION</b>Auricular point sticking achieves effect for the diagnosis and treatment of vasospasm and vagus reflex during radial artery puncture.</p>