Effects of Insulin Combined with Traditional Chinese Medicine Assisted Comprehensive Nursing Intervention on Oxidative Stress State, Cell Adhesion Factor, and Pregnancy Outcome of Patients with Gestational Diabetes Mellitus.

Objectives: The changes of oxidative stress state, cell adhesion factor (sICAM-1) level, blood glucose, and blood lipid of patients with gestational diabetes mellitus (GDM) assisted by insulin combined with traditional Chinese medicine (TCM) prescription were detected to explore the effect of TCM treatment on maternal and infant outcomes of GDM. Methods: A total of 60 patients diagnosed with GDM from January 2019 to December 2019 were selected. Among them, 30 patients were treated with insulin combined with TCM prescription (control group), and 30 patients were treated with nursing intervention based on control group (study group). Serum of maternal vein and fetal umbilical vein was collected. The contents of superoxide dismutase (SOD) and lipid oxide (MDA) were determined. The content of intercellular adhesion factor (ICAM-1) was measured, and the differences of fasting blood glucose (FPG), glycosylated hemoglobin (HbA1c), triglyceride (TG), cholesterol (CHO) and low density lipoprotein (LDL-C) between 2 groups were compared. The incidence of maternal and infant adverse outcomes was assessed. Results: After treatment, blood glucose indexes in 2 groups were decreased, and the study group was lower than the control group. After treatment, LDL-C, TC and TG in 2 groups were lower than before, and the study group was lower than the control group. HDL-C was higher than before treatment, and the study group was higher than the control group. After treatment, oxidation-related substances SOD and GSH-Px in 2 groups were higher than before, and those in study group were higher than those in control group. ROS and MDA were lower than before treatment, and the level of sICAM-1 in the study group was significantly higher than that in the control group. Clinical application of insulin combined with TCM prescription assisted comprehensive nursing intervention in the treatment of gestational diabetes, pregnancy outcome is improved. Conclusions: Oxidative stress imbalance exists in GDM and the causes of adverse pregnancy outcomes are closely related to oxidative stress and vascular endothelial injury. TCM can improve the oxidative stress imbalance and the pregnancy outcome of patients with GDM from the perspective of reducing vascular endothelial injury. Comprehensive nursing intervention for pregnant women with GDM can optimize the outcome of pregnancy and is worthy of clinical application.

Increased matrix stiffness promotes tumor progression of residual hepatocellular carcinoma after insufficient heat treatment.

Aggravated behaviors of hepatocellular carcinoma (HCC) will occur after inadequate thermal ablation. However, its underlying mechanisms are not fully understood. Here, we assessed whether the increased matrix stiffness after thermal ablation could promote the progression of residual HCC. Heat-treated residual HCC cells were cultured on tailorable 3D gel with different matrix stiffness, simulating the changed physical environment after thermal ablation, and then the mechanical alterations of matrix stiffness on cell phenotypes were explored. Increased stiffness was found to significantly promote the proliferation of the heat-treated residual HCC cells when the cells were cultured on stiffer versus soft supports, which was associated with stiffness-dependent regulation of ERK phosphorylation. Heat-exposed HCC cells cultured on stiffer supports showed enhanced motility. More importantly, vitamin K1 reduced stiffness-dependent residual HCC cell proliferation by inhibiting ERK phosphorylation and suppressed the in vivo tumor growth, which was further enhanced by combining with sorafenib. Increased matrix stiffness promotes the progression of heat-treated residual HCC cells, proposing a new mechanism of an altered biomechanical environment after thermal ablation accelerates HCC development. Vitamin K1 plus sorafenib can reverse this protumor effect.