Objective:To investigate the impact of abnormal patterns of 75 g oral glucose tolerance test (OGTT) in the second trimester on the risk of large for gestational age (LGA) newborn deliveries.Methods:General clinical data and OGTT results of 66 290 pregnant women who received regular prenatal care and delivered in Guangdong Maternal and Child Health Hospital from December 24, 2016 to July 26, 2022 were collected. According to the results of OGTT, the pregnant women were divided into 8 groups: normal blood glucose group (normal fasting blood glucose, 1-hour and 2-hour after oral glucose, 54 518 cases), gestational diabetes mellitus (GDM) 0 group (only abnormal fasting blood glucose, 1 430 cases), GDM 1 group (only abnormal blood glucose at 1-hour after oral glucose, 2 150 cases), GDM 2 group (only abnormal blood glucose at 2-hour after oral glucose, 3 736 cases), GDM 0+1 group (both fasting blood glucose and 1-hour after oral glucose were abnormal, 371 cases), GDM 0+2 group (both fasting blood glucose and 2-hour after oral glucose were abnormal, 280 cases), GDM 1+2 group (abnormal blood glucose at 1-hour and 2-hour after oral glucose, 2 981 cases) and GDM 0+1+2 group (abnormal fasting blood glucose, 1-hour and 2-hour after oral glucose, 824 cases). Multivariate logistic regression was used to analyze the effects of different abnormal OGTT patterns on LGA. In addition, the blood glucose measurements at the three time points of OGTT were combined and used as continuous variables in the receiver operating characteristic (ROC) curve to evaluate the predictive value of each blood glucose measurement mode for LGA and the area under the curve (AUC) was compared.Results:(1) Multivariate logistic regression analysis showed that the risks of LGA were significantly increased in GDM 0 group ( OR=1.76, 95% CI: 1.50-2.08; P<0.001), GDM 0+1 group ( OR=2.29, 95% CI: 1.72-3.04; P<0.001), and GDM 0+1+2 group ( OR=1.98, 95% CI: 1.61-2.43; P<0.001). (2) ROC curve analysis showed that fasting blood glucose, 1-hour after oral glucose, 2-hour after oral glucose, fasting+1-hour after oral glucose, fasting+2-hour after oral glucose, 1-hour+2-hour after oral glucose, and fasting+1-hour+2-hour after oral glucose had certain predictive value for LGA (all P<0.001). The AUC of fasting blood glucose measurement was higher than that of 2-hour blood glucose measurement in predicting LGA, and the difference was statistically significant ( P<0.05). There was no significant difference in the AUC between fasting blood glucose and other blood glucose measurement modes for predicting LGA (all P>0.05). Conclusions:In the abnormal OGTT patterns, pregnant women with abnormal fasting blood glucose, abnormal fasting+1-hour after oral glucose, and abnormal fasting+1-hour+2-hour after oral glucose have an increased risk of LGA. Fasting blood glucose measurement is of great significance for the prediction of LGA, and could be used as an optimal indicator to evaluate the risk of LGA in clinical practice.

Objective To evaluate the effect of exercise-diet behavior intervention based on the transtheoretical model in patients undergoing weight loss surgery.Methods By convenience sampling,72 patients undergoing weight loss surgery in a tertiary general hospital in Xinxiang City,Henan Province from February 2021 to October 2022 were selected as the research subjects.By a random number table method,they were divided into a test group and a control group,with 36 cases in each group.The test group received exercise-diet behavior intervention based on the trans-theoretical model,while the control group received conventional intervention.The intervention began on the first day after admission and ended 6 months after surgery.The body mass index,body fat,lean body mass,diastolic blood pressure,systolic blood pressure,fasting blood glucose,insulin resistance index(HOMA-IR),Health Promoting Lifestyle Profile-Ⅱ(HPLP-Ⅱ)score,and Short-Form-36 Health Survey(SF-36)score were compared between the 2 groups before and after surgery for 3 and 6 months,as well as the complications within 6 weeks after surgery.Results The results of repeated measures analysis of variance showed that there was an interaction between the 2 groups in terms of anthropometric measurements,blood pressure and blood glucose,HPLP-Ⅱ scores,and SF-36 scores,with statistically significant differences(P＜0.001).After 6 months of surgery,the body mass index(23.32±2.32),body fat(24.10±3.46)kg,and lean body mass(41.64±3.24)kg in the test group were lower than(27.32±3.64),(28.46±4.18)kg,and(46.68±4.65)kg in the control group,and the differences were statistically significant(P＜0.001).At 3 and 6 months after operation,the diastolic blood pressure,systolic blood pressure,fasting blood glucose and HOMA-IR of the test group were lower than those of the control group,and the differences were statistically significant(P＜0.05).The HPLP-Ⅱ score of the test group was higher than that of the control group at 3 and 6 months after operation(P＜0.001).The SF-36 score of the test group was significantly higher than that of the control group at 6 months after operation(P＜0.05).The incidence of complications in the test group was 2.56％,which was not significantly different from 19.44％in the control group(P＞0.05).Conclusion The exercise-dietary behavior intervention based on the transtheoretical model can promote the formation of healthy behaviors in patients undergoing weight loss surgery,maintain weight loss effects,improve blood pressure and blood glucose levels,and enhance the quality of life of patients.

Objective: To explore the fear of evaluation in college student with social anxiety, in order to reveal the existence of implicit fear of evaluation and its relationships with explicit fear of evaluation. Methods: A total of 490 college students, selected from Fuzhou University by using convenience cluster sampling method, were surveyed with Interaction Anxiousness Scale (IAS). Finally, 65 valid subjects have completed the Implicit Association Test. Results: Social anxiety students explicit fear of evaluation was significantly higher than those of non social anxiety college students, including positive and negative ( t =7.03, 5.66 , P <0.01). There were significant differences between self positive evaluation of college students social anxiety (1 019.26±124.44 ms) and self neutral evaluation (909.78±175.20 ms)( t =5.67, P <0.05). In two groups of college students, there were significant differences between self negative evaluation[(1 142.54±157.06, 1 120.88± 216.33 )ms] and self neutral evaluation[(921.53±161.28, 783.72±140.74)ms]( t =9.17, 12.33, P <0.01). Implicit fear of evaluation were found to exist among students with social anxiety and without social anxiety. There was a low correlation between explicit and implicit fear of evaluation between social anxiety students and non social anxiety students( P >0.05); There was no significant gender difference between implicit and explicit fear of evaluation( P > 0.05 ). Conclusion Social anxiety college students have explicit and implicit fear of evaluation, with separate and independent effects.

Objective: To explore the relationship between weight change and the changes in blood pressure, blood glucose and blood lipid profiles in middle-aged and elderly Chinese people. Methods: All participants were from the Dongfeng-Tongji cohort study. The study included 16 606 middle-aged and elderly Chinese people with complete information in the baseline survey in 2008 and the first follow-up survey in 2013. We collected the data on demographic characteristics, lifestyle, history of diseases and medication, and the results of medical health examinations, including height, weight, blood pressure, fasting blood glucose and lipid profiles. We divided the weight change into five groups, moderate or above weight loss (<-8.0%), slight weight loss (-8.0%, -3.1%), weight maintenance (-3.0%, 3.0%), slight weight increased (3.1%, 8.0%), and moderate or above weight increased (>8.0%). Generalized linear regression model was used to analyze the relationship between weight change and the changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and triglyceride (TG). Subgroup analyses were used to explore the influences of gender, age and baseline BMI level on the relationship between weight change and the above-mentioned metabolic indicators. Results: The average age of participants in baseline survey was (62.19±7.28) years with a range of 45 to 89 years. During the five-year period, there were 18.86% (2 633), 28.03% (4 655), 35.87% (5 956), 13.96% (2 319), 6.28% (1 043) people with moderate or above weight loss, slight weight loss, weight maintenance, slight weight increased, and moderate or above weight increased, respectively. Regression analyses showed that body weight change were positively correlated with changes in SBP, DBP, FBG, TC, LDL-C and TG, and negatively correlated with change in HDL-C (all linear trend P values were<0.05); As every 10% of weight changed, the β (95%CI) of changes in SBP (mmHg) (1 mmHg=0.133 kPa), DBP (mmHg), FBG (mmol/L), TC (mmol/L), LDL-C (mmol/L), HDL-C (mmol/L) and TG (mmol/L) were 4.94 (4.32, 5.55), 2.50 (2.11, 2.88), 0.05 (0.02, 0.08), 0.13 (0.11, 0.16), 0.14 (0.12, 0.16), -0.05 (-0.07, -0.04) and 0.16 (0.14, 0.18), respectively. Furthermore, subgroup analyses showed that weight change can lead to greater changes in blood pressure in older and overweight or obesity elderly people (all P for interaction<0.05). Conclusion Weight loss was beneficial for middle-aged and elderly people to improve the blood pressure, blood glucose and blood lipid profiles, regardless of the weight at the baseline, while weight gain was not.

Objective To evaluate and compare the imaging quality and diagnostic accuracy of two types of scanning techniques of 256-slice spiral CT angiography, prospective electrocardiogram(ECG)-gated sequence and non ECG-gated high-pitch sequence, used respectively for patients with Stanford type A aortic dissection (AAD) at the root of ascending aorta.Methods A retrospective study was conducted. Sixty-eight patients with AAD were definitely diagnosed by CT angiography were admitted to the Fifth Central Hospital of Tianjin from August 2015 to July 2017, and they were divided into two groups according to different scanning methods: 36 cases of AAD underwent prospective ECG-gated CT angiography (CTA) and 32 patients underwent non ECG-gated high-pitch CTA. A 3-grade scoring system was used to interpret the image quality of the aortic sinus, aortic valve junction zone and coronary artery opening. The CT value and noise value (SD) of aortic root were measured, the image signal to noise ratio (SNR) was calculated and compared with the discovery in exploratory operation; the patients' CTA imaging quality and the coincidence rate of lesion type diagnosis were compared between the two groups.Results All aortic CTA images could meet the diagnostic requirements. The imaging quality scores of aortic sinus, arotic valve junction zone and coronary artery opening images in ECG-gated CTA group were higher than those in non ECG-gated high-pitch CTA group (aortic sinus: 2.94±0.23 vs. 1.89±0.67, sinuscanal junction zone: 2.94±0.23 vs. 1.83±0.70, coronary artery opening images: 2.86±0.35 vs. 1.31±0.52, allP < 0.01); comparisons between the ECG-gated CTA group and non- ECG-gated CTA group in objective indexes, CT value, arotic SD value and SNR at the root of ascending aorta showed there were no statistically significant differences [the value of CT (HU): 425.20±94.38 vs. 439.29±86.78, the SD value of aorta (HU): 22.85±9.40 vs. 26.40±9.41, SNR: 21.23±8.16 vs. 19.70±9.98, allP > 0.05]. The coincidence rate between the diagnosis of AAD at the root of ascending aorta and the discovery in the exploratory operation in ECG-gated CTA group was higher than that in non ECG-gated CTA group [94.4% (34/36) vs. 68.8% (22/32),P < 0.01].Conclusion The diagnostic accuracy and image quality of AAD root of ascending aorta in prospective ECG-gated CTA group were significantly higher than those in non ECG-gated CTA group.

Objective To evaluate the clinical value of cardiovascular dual-phase scan of 256-slice spiral CT in diagnosis of left atrial appendage (LAA) thrombus before radiofrequency ablation in patients with atrial fibrillation. Methods A prospective study was conducted. Thirty-six patients with atrial fibrillation being prepared to undergo radiofrequency ablation admitted to the Fifth Central Hospital of Tianjin from October 2015 toJuly 2016 were enrolled, they were scanned using dual-phase cardiovascular protocol of 256-slice spiral CT, and then trans-esophageal echocardiography (TEE) was performed for the definite diagnose of thrombus. In the first phase of cardiac CT, the intelligent tracking method was used to determine the delayed time; in the second phase cardiac CT scan, 85 seconds was confirmed as the delayed time; TEE as the golden standard was used to evaluate the value of dual-phase CT in definite diagnosis of LAA thrombus.Results LAA low density filling defect was discovered in 5 patients in the first phase CT scan, the CT scan in the second phase, the filling defect still existed, and the diagnosis of LAA thrombus in 3 patients was made (of them 2 cases after TEE examination were diagnosed definitely as LAA thrombus, and the echo in 1 case was smoke-like on TEE, being at pre-thrombus status), 2 cases were confirmed as pseudo-filling defects (afterwards, their diagnosis was confirmed as pre-thrombus status because the echo shown on TEE was smoke-like). Two patients were confirmed as true thrombi on TEE, and there were 3 patients diagnosed as pre-thrombus state by TEE because of their echo smoke-like. TEE was used as the golden standard for diagnosis of thrombus, the following indexes could be calculated: in the first phase, the sensitivity of using CT scan to diagnose LAA thrombus was 100.0%, the specificity 91.2%, positive predictive value (PPV) 40.0%, and negative predictive value (NPV) 100.0%; while in the second phase of using CT scan for diagnosis of LAA thrombus, the above indexes were 100.0%, 97.1%, 66.7%, 100.0% respectively; the CT Kappa coefficient of the second-phase was larger than that of the first-phase CT (0.898 vs. 0.739), the difference being statistically significant (P < 0.05).Conclusions Dual-phase cardiovascular protocol of CT can detecte of LAA thrombus/pre-thrombus state, the PPV is significantly elevated after the second phase of CT scan for diagnosis of thrombus, and the consistency between the second phase CT diagnosis of thrombus and TEE diagnosis is higher than that between the first phase CT and TEE, therefore, using dual-phase cardiovascular protocol of 256-slice spiral CT in diagnosis of LAA thrombus in patients with atrial fibrillation before radiofrequency ablation has relatively high application value.

Objective To assess the capability of serum and urine neutrophil gelatinase-associated lipocalin (NGAL) in predicting acute kidney injury (AKI) in septic patients.Methods From July 1, 2014 through December 31, 2014, a prospective observational study of septic patients without AKI was carried out in Renmin Hospital, Tianjin Hospital, and Nankai Hospital, Tianjin.The patients with AKI which was developed after admission to intensive care unit (ICU) were assigned to AKI group and the patients without AKI were assigned to non-AKI group.Clinical data and serum and urine sample were collected at the admission, and at 12, 24, 36, 48, 60, 72 ,84 and 96 hours after admission for detecting creatinine and NGAL.The measurement data accorded with normal distribution were used for t test or variance analysis of repeated measures;comparison of measurement data in non-normal distribution was carried out using the Mann-Whitney U test or Fridman test;comparison of count data was performed using Fisher exact probability method.ROC curve of serum or urine NGAL was plotted and the diagnostic values of serum or urine NGAL in predicting AKI were assessed by calculation of the area under the receiver operating characteristic curve (AuROC).Results Fifty septic patients were included.Thirty-five patients were in AKI group and fifteen in non-AKI group.The median age of AKI group was 73 and the median age of non-AKI group was 60 (IQR, 47-82).The urine NGAL (uNGAL) concentration in AKI group was higher than that in non-AKI group at the every interval and serum NGAL (sNGAL) was higher in AKI group than that in non-AKI group at only first twointervals.The uNGAL showed the capability of prediction for AKI progression at the 48 hour (AuROC=0.83,95% CI:0.70-0.97), 36 hours (AuROC=0.75,95%CI:0.59-0.91), 24 hours (AuROC=0.83,95%CI:0.70-0.95), 12 hours (AuROC=0.73,95%CI:0.60-0.88) prior to AKI occurred.The sNGAL showed capability of prediction at the 48 hours (AuROC=0.69,95%CI:0.51-0.88), 36 hours (AuROC=0.69,95%CI:0.52-0.87) prior to AKI occurred.Conclusions The sNGAL and uNGAL both were useful biomarker that predicted development of AKI in early stage.But the performance of sNGAL was slightly inferior to that of uNGAL for predicting development of AKI.

Objective To detect the effects of siRNA targeting CDX2 gene expression on of BCR-ABL, caspase and Bax expressions, and the mechanisms thereof. Methods According to the earlier experiments, siRNA specifically targeting CDX2 gene (CDX2-siRNA) and the negative control sequence (CDX2-siRNA-NC) were selected, and then were transfected into K562 cells by Roche X-tremeGENE HP DNA Transfection Reagent. The flow cytometry analysis was used to detect the effects of siRNA on cell apoptosis. The expressions of BCR-ABL, caspase-9, Bax mRNA and protein were tested by RT-PCR and Western blot assay. Results MTT and flow cytometry analysis showed that after the silence of CDX2 gene expression, the proliferation of K562 cells was prohibited and the apoptotic rate of K562 cells was distinctly increased compared with that of normal cell group, but the negative control group had no significant change. According to the RT-PCR and Western blot assay, in comparison with the normal cell group and the negative control group, the expression levels of BCR-ABL mRNA and protein were obviously decreased, and the difference was statistic significance. On the other hand, the expressions of caspase-9 and Bax mRNA and protein were significantly higher than those of other two groups (P<0.05). Conclusion CDX2-siRNA can promote apoptosis of K562 cells obviously, and the mechanism is related with the down-regulation of BCR-ABL and the up-regulation of caspase-9 and Bax.

Background and purpose:miR-196a2 functions as an oncogene during tumor initiation and pro-gression. The up-regulation promotes tumor cell proliferation, invasion and metastasis. Therefore, it is promising to be an important tumor biomarker. The aim of this study was to investigate whether rs11614913, a gene polymorphic site ofmiR-196a2, is associated with the risk of leukemia.Methods:A case-control analysis was employed. Bone marrow or periph-eral blood was collected from 210 leukemia patients diagnosed from Jan. 2009 to Jul. 2015 in Yantaishan Hospital (case group) as well as 250 healthy people who were physically examined during the same period (control group). Polymerase chain reaction-restriction fragment length polymorphism (PCR-PFLP) was used to detect the genotype of rs11614913. Application test was used to compare the difference in the frequency of each genotype between case group and control group. The odds ratio (OR) of SNP allelic genes was calculated using logistic regression analysis and 95%CI represented the risk of leukemia for each genotype.Results:The distribution differences in the frequency of T/T, C/C, C/T genotype of miR-196a2 rs11614913 between case group and control group were statistically significant (P<0.05). The risk of leukemia for individuals who carried mutant homozygous C/C was 2.661-fold higher than those carried wild-type homozygous T/T, and the difference was statistically significant (P<0.05).Conclusion:ThemiR-196a2 gene polymorphic site rs11614913 was associated with the risk of leukemia. Mutant homozygous C/C or C allelic gene carrying was probably a risk factor for leukemia.

AIM:ToobservetheeffectofcepharanthineonhumanlungadenocarcinomaLTEP-a-2cellgrowth, and to explore the changes of related microRNA ( miRNA) expression in the cells .METHODS:LTEP-a-2 cells were trea-ted with cepharanthine at concentrations of 0μmol/L, 10μmol/L, 20μmol/L and 40μmol/L.The growth inhibition rate was detected by MTT assay , and the cell morphological changes were observed under light microscope .The cell apoptosis was analyzed by flow cytometry .The expression of let-7c, miR-34a and miR-34b was measured by real-time PCR.RE-SULTS:Cepharanthine inhibited the cell activity of LTEP-a-2 cells in a dose-dependent manner .With the increase in cepharanthine concentration , the pyknosis of the cells was visible under the inverted microscope .Flow cytometry analysis found that different concentrations of cepharanthine induced the increase in the apoptotic rates of LTEP -a-2 cells.The re-sults of real-time PCR showed that the cepharanthine also increased the expression of let -7c, miR-34a and miR-34b.CON-CLUSION:Cepharanthine inhibits the growth of LTEP-a-2 cells, and induces apoptosis .Cepharanthine increases the ex-pression of let-7c, miR-34a and miR-34b, indicating that these miRNAs in LTEP-a-2 cells has the function as tumor sup-pressor genes .