Objective:To investigate the relationship between adiponectin (ADIPOQ) gene polymorphism and postpartum type 2 diabetes mellitus (T2DM) in pregnant women with gestational diabetes mellitus (GDM).Methods:A retrospective study was conducted on 236 GDM postpartum women admitted to the Affiliated Hospital of Jining Medical College from June 2020 to June 2021 as observation subjects. They were divided into a T2DM group and a non T2DM group based on the occurrence of T2DM after delivery. The clinical data of the two groups were compared. The double deoxygenation end termination method was used to detect the single nucleotide polymorphism (SNP) of the ADIPOQ gene, and the four loci rs17366568, rs822395, rs1501299, and rs2241766 were classified. The relationship between ADIPOQ genotype polymorphism and postpartum T2DM was analyzed using a logistic regression model.Results:The G allele carrying the rs2241766 locus in ADIPOQ gene was negatively correlated with the occurrence of T2DM ( OR=0.71, 0.68, P<0.05). Compared with T2DM patients with TT genotype, the GT+ GG genotype at the rs2241766 locus had a lower risk of occurrence for gestational age ≥2 and HbA 1c>85%. Similarly, T2DM patients with pre pregnancy body mass index (BMI)>25 kg/m 2 were more likely to be carriers of the rs2241766 TT genotype ( P=0.026). The (GT+ TT) genotype carrying the T allele at the rs1501299 locus was a protective factor for gestational age and HbA 1c in T2DM patients. Conclusions:The rs2241766 and rs1501299 polymorphisms of the ADIPOQ gene are associated with susceptibility to postpartum T2DM in GDM women. Individuals with rs2241766 and rs1501299 mutant genotypes belong to the high-risk population for T2DM.

Objective:To explore the risk factors for post-stroke anxiety and depression, and analyze the therapeutic effect of Jiangqi Dayu Decoction on on post-stroke anxiety and depression.Methods:A total of 201 patients with post-stroke anxiety and depression admitted to the Wuhan First Hospital from October 2019 to October 2022 were selected and included in the anxiety and depression group. They were randomly divided into a control group ( n=100, treated with conventional western medicine) and an observation group ( n=101, treated with Jiangqi Dayu decoction on the basis of conventional western medicine) using a random number table method. The clinical efficacy, Hamilton Anxiety Scale (HAMA) scores, Hamilton Depression Scale (HAMD) scores, norepinephrine (NE), brain derived neurotrophic factor (BDNF), 5-hydroxytryptamine (5-HT), and adverse reactions were compared between the control group and the observation group. During the same period, 50 patients without anxiety and depression after stroke were selected and included in the non anxiety and depression group. The general information and laboratory indicators of patients in the non anxiety and depression group were compared with those in the anxiety and depression group. Univariate and multivariate logistic regression models were used to analyze the risk factors for anxiety and depression after stroke. Results:The total effective rate of clinical efficacy in the observation group was significantly higher than that in the control group (95.05% vs 76.00%) ( P<0.05). After treatment, the HAMA and HAMD scores of both groups were lower than before treatment (all P<0.05), and the serum levels of BDNF, NE, and 5-HT were higher than before treatment (all P<0.05); After treatment, the HAMA and HAMD scores of the observation group were lower than those of the control group (all P<0.05), and the serum levels of BDNF, NE, and 5-HT were higher than those of the control group (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups ( P>0.05). The age, proportion of females, National Institutes of Health Stroke Scale (NIHSS) score, proportion of family care<7, and number of comorbidities>2 were significantly higher in the anxiety and depression group than those in the non anxiety and depression group (all P<0.05). The education level and per capita monthly income of families were significantly lower than those in the non anxiety and depression group (all P<0.05). The body mass index (BMI), smoking history, drinking history, white blood cells, total cholesterol, and glycated hemoglobin of both groups were significantly higher There was no statistically significant difference in disease type and stroke site (all P>0.05). The multivariate logistic regression model showed that high NIHSS score, low per capita monthly income, female gender, family care score<7 points, and the number of comorbidities>2 were risk factors for post-stroke anxiety and depression (all P<0.05). Conclusions:NIHSS score, per capita monthly income of families, gender, family care level, and the number of comorbidities can all affect the occurrence of post-stroke anxiety and depression. Jiangqi Dayu decoction has a good therapeutic effect on patients with post-stroke anxiety and depression, helping to improve anxiety and depression symptoms. It upregulates NE, BDNF, and 5-HT levels, has high safety, and is worth promoting.

Objective:To explore the application effect of remazolam besylate in elderly hip fracture surgery and its impact on anesthesia recovery quality and bone metabolism indicators.Methods:A total of 100 elderly patients with hip fractures admitted to Ningde Hospital from January 2021 to April 2022 were selected, all of whom underwent hip replacement surgery. According to the random number table method, they were divided into an observation group ( n=50) and a control group ( n=50). We observed the use of drugs such as remifentanil besylate combined with sufentanil for anesthesia induction and remifentanil combined with other drugs for anesthesia maintenance; The control group received anesthesia induction with drugs such as midazolam combined with sufentanil, and anesthesia maintenance with drugs such as remifentanil. Comparisons were made between the analgesic effects of anesthesia, the quality of anesthesia recovery, and the levels of hemodynamic and bone metabolism indicators at different time points between the two groups. Results:The postoperative recovery time, eye opening time, and extubation time of the observation group were shorter than those of the control group (all P<0.05); The total incidence of restlessness and coughing was lower in the control group than in the control group ( P<0.05); There was no statistically significant difference in the levels of serum osteocalcin (BGP), parathyroid hormone (PTH), and bone alkaline phosphatase (BALP) between the two groups after treatment (all P>0.05); The heart rate (HR) and mean arterial pressure (MAP) of the observation group during skin cutting (T 2) and 5 minutes after extubation (T 3) were lower than those of the control group (all P<0.05), and SpO 2 was higher than that of the control group ( P<0.05). The excellent rate of anesthesia and analgesic effect in the observation group was significantly higher than that in the control group ( P<0.05). Conclusions:Remazolam besylate has a good clinical effect in hip surgery, and the quality of anesthesia recovery is relatively high, but it has little effect on the postoperative bone metabolism indicators.

Objective:To investigate the impact of a pain management model based on clinical pathway (CP) refinement on postoperative pain relief, recovery, and cognitive function in patients undergoing orthopedic joint surgery.Methods:A total of 150 orthopedic joint surgery patients admitted to Handan Central Hospital from February 2018 to January 2021 were selected. They were randomly divided into an observation group (treated with a pain management model based on CP refinement) and a control group (treated with conventional pain management) using a random number table method, with 75 patients in each group. We compared the differences in pain relief, recovery, cognitive function, and postoperative complication rates between two groups of patients.Results:The Visual Analogue Scale (VAS) scores of the observation group patients at 2, 6, 12, and 24 hours after surgery were lower than those of the control group, and the differences were statistically significant (all P<0.05). 24 hours after surgery, the Japanese Orthopaedic Association (JOA) scores of both groups of patients decreased compared to before treatment, and the angle of straight leg elevation test increased compared to before treatment (all P<0.05). In addition, the JOA scores of the observation group were lower than those of the control group, and the angle of straight leg elevation test was greater than that of the control group, with statistical significance (all P<0.05). 24 hours after surgery, the Mini-mental State Examination (MMSE) scores of both groups of patients increased (all P<0.05), and the MMSE scores of the observation group were higher than those of the control group, with statistical significance (all P<0.05). The incidence of postoperative nausea and vomiting in the observation group was significantly lower than that in the control group, and the difference was statistically significant (all P<0.05). Conclusions:The analgesic model based on CP refined management has improved the postoperative analgesic effect, recovery, and cognitive function of patients undergoing orthopedic joint surgery. It is recommended to promote it clinically.

Objective:To investigate the effects of low-dose ropivacaine combined with sufentanil on the onset time of anesthesia and postoperative rectal traction reflectance in patients undergoing mixed hemorrhoid surgery.Methods:A total of 96 patients who underwent mixed hemorrhoid surgery at the General Hospital of the Southern Theater Command of the Chinese People′s Liberation Army from January 2020 to June 2021 were selected. They were randomly divided into a control group and an observation group using a random number table method, with 48 cases in each group. The control group was anesthetized with low-dose ropivacaine; The observation group was anesthetized with low-dose ropivacaine combined with sufentanil. The anesthesia effect, hemodynamic changes, pain score, bleeding score, postoperative rectal traction reflectance, and incidence of adverse reactions were compared between two groups of patients.Results:Compared with the control group, the observation group had a shorter onset time of anesthesia ( P<0.05) and a longer duration of anesthesia maintenance ( P<0.05). Before surgery, there was no statistically significant difference in heart rate and mean arterial pressure between the two groups of mixed hemorrhoid patients (all P>0.05); After surgery, both groups of patients had an increase in heart rate, a decrease in mean arterial pressure, and a more significant change in the control group (all P<0.05). Before surgery, there was no statistically significant difference in Visual Analogue Scale (VAS) scores and bleeding scores between the two groups of mixed hemorrhoid surgery patients (all P>0.05); After 1 day of surgery, the VAS score and bleeding score of both groups of patients were significantly reduced (all P<0.05), and the observation group showed a more significant decrease (all P<0.05). The postoperative recovery rate of anal contraction in the observation group was higher than that in the control group ( P<0.05), and the rectal traction reflectance was lower than that in the control group ( P<0.05). The total incidence of adverse reactions in the observation group was significantly lower than that in the control group (χ 2=4.667, P<0.05). Conclusions:The combination of low-dose ropivacaine and sufentanil has a definite anesthetic effect on patients undergoing mixed hemorrhoid surgery. It can improve the onset time of anesthesia and postoperative rectal traction reflectivity, alleviate patient pain, and has high safety.

Objective:To explore the correlation between serum 25 hydroxyvitamin D [25(OH)D] levels and readmission in patients with chronic aplastic anemia (AA).Methods:A total of 105 patients with chronic AA who were hospitalized at the Fuyang People′s Hospital Affiliated to Anhui Medical University from January 2020 to December 2022 were selected. The serum 25(OH)D level was measured using chemiluminescence method, and it was divided into low value group and high value group based on the average value. We compared the clinical data differences between two groups of patients, used logistic multivariate analysis to identify the risk factors for readmission in chronic AA patients, and used the Kaplan Meier method to plot curves to compare the differences in readmission rates and readmission intervals between the two groups.Results:The difference in the interval between readmission between patients in the low value group (<19.39 ng/ml) and those in the high value group (≥19.39 ng/ml) was statistically significant [(2.61±1.03)months vs (3.27±1.32)months, P<0.05]. A higher level of serum 25(OH)D was a protective factor in reducing the risk of readmission ( OR: 0.739; 95% CI: 0.569-0.962) and prolonging the interval between readmission (Log Rank=0.004, Breslow=0.01, Tarone-Ware=0.005; P<0.05) in chronic patients, while long course of illness was a risk factor for readmission ( OR=3.432, P=0.006). Patients in the low value group who had accumulated the use of vitamin D supplements for ≥3 weeks had a significantly longer interval between readmission ( P<0.001). Conclusions:Abnormal reduction of serum 25(OH)D levels can shorten the interval between readmission and increase the risk of readmission in chronic AA patients.

Objective:To explore the application value of multimodal MRI imaging in early neurological deterioration (END) and clinical prognosis prediction of acute ischemic stroke (AIS).Methods:A total of 200 AIS patients admitted to the Chengde Central Hospital from October 2019 to October 2022 were selected as the study subjects. Based on whether END occurred within 7 days of enrollment, there were 40 cases in the occurrence group and 160 cases in the non occurrence group. The influencing factors of END occurrence in AIS patients and the predictive value of multimodal magnetic resonance imaging (MRI) parameters on END were analyzed; According to the modified Rankin (mRS) score, patients were divided into good prognosis and poor prognosis groups, and the impact of multimodal MRI imaging parameters on the risk of poor prognosis in AIS patients was analyzed.Results:There were statistically significant differences in the apparent diffusion coefficient (ADC), cerebral blood flow (CBF), and their differences before and after thrombolysis in multimodal MRI imaging parameters between the END group and the non END group, as well as in the National Institutes of Health Stroke Scale (NIHSS) score at admission, age, and time from onset to admission (all P<0.05). The difference between ADC and CBF before and after thrombolysis, time from onset to admission, NIHSS score at admission, and age were all independent influencing factors for the occurrence of END in AIS patients (all P<0.05). The area under the curve (AUC) of the combined prediction of the difference between ADC and CBF before and after thrombolysis for the occurrence of END in AIS patients was 0.924, which was higher than that predicted by a single indicator ( P<0.05). The incidence of poor prognosis in patients with END was significantly higher than that in patients without END ( P<0.05). The risk of poor prognosis in AIS patients with a difference of less than <45.83×10 -9 mm 2/s before and after ADC thrombolysis was 3.136 times higher than that in patients with ≥45.83×10 -6 mm 2/s. The risk of poor prognosis in AIS patients with a difference of less than 10.52 ml/(min·100 g) before and after ADC thrombolysis was 2.640 times higher than that in patients with ≥10.52 ml/(min·100 g). Conclusions:Multimodal MRI imaging can be used for END evaluation in AIS patients and can provide reference for clinical prognosis evaluation.

Objective:To analyze the impact and diagnostic value of apoB/apoA1 on lupus nephritis (LN) and its renal dysfunction.Methods:A total of 134 patients diagnosed with systemic lupus erythematosus (SLE) at the Taihe Hospital of Anhui University of Traditional Chinese Medicine from July 2019 to January 2023 were selected and divided into LN group ( n=82) and simple SLE group ( n=52). According to the glomerular filtration rate (e-GFR), LN was divided into a group with normal renal function ( n=42) and a group with renal insufficiency ( n=40). We compared the differences in clinical data between different groups and analyzed the diagnostic value of apoB, apoA1, and apoB/apoA1 for LN and its renal insufficiency. Results:The results of binary logistic regression analysis showed that apoB/apoA1, SLE disease activity index (SLEDAI), anti double stranded DNA (dsDNA), complement 3 (C3), and albumin (ALB) were independent influencing factors for LN ( OR=4.033, 1.179, 3.148, 0.374, 0.879, all P<0.05). The area under the curve (AUC) of apoB, apoA1, and apoB/apoA1 for diagnosing LN were 0.623, 0.662, and 0.742, respectively. The diagnostic efficacy of apoB/apoA1 was higher than that of apoB and apoA1, and the differences are statistically significant (all P<0.05). Regardless of whether confounding factors were adjusted or not, apoB/apoA1 were all risk factors for LN with e-GFR>60 ml/(min·1.73 m 2), e-GFR 30-60 ml/(min·1.73 m 2), and e-GFR<30 ml/(min·1.73 m 2) (all P<0.05). ApoB/apoA1, anti dsDNA, C3, and ALB were all independent influencing factors for renal insufficiency LN ( OR=3.778, 2.669, 0.415, 0.884, all P<0.05). The AUC for diagnosing renal insufficiency LN in apoB, apoA1, and apoB/apoA1 were 0.623, 0.640, and 0.730, respectively. The diagnostic efficacy of apoB/apoA1 was higher than that of apoB and apoA1, and the differences were statistically significant (all P<0.05). Conclusions:ApoB/apoA1 is an independent influencing factor for the occurrence of LN and renal insufficiency LN, and has good diagnostic value for LN and renal insufficiency LN.

Objective:To explore the diagnostic value of serum tumor marker detection for lung adenocarcinoma and its predictive value for postoperative recurrence.Methods:A total of 100 lung adenocarcinoma patients (modeling group) and 100 benign lung disease patients (control group) admitted to the Cangzhou Hospital of Integrated Traditional and Western Medicine from December 2018 to December 2020 were selected as the research subjects. In addition, 50 lung adenocarcinoma patients admitted from December 2016 to December 2017 were selected as the validation group. The serum carbohydrate antigen 125 (CA125) and carcinoembryonic antigen (CEA) levels of the modeling group and the control group were compared Levels of cytokeratin 21 fragment (CYFRA21-1), carbohydrate antigen 19-9 (CA19-9), and squamous cell carcinoma antigen (SCC-Ag). The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of CA125, CEA, CYFRA21-1, CA19-9, and SCC-Ag alone and in combination for lung adenocarcinoma; Single and multiple factor analyses were conducted to identify the risk factors for postoperative recurrence in lung adenocarcinoma patients; A column chart model for predicting postoperative recurrence in lung adenocarcinoma patients was constructed using R software, and a risk stratification system was constructed.Results:The average water levels of CA125, SCC-Ag, CEA, CYFRA21-1, and CA19-9 in the modeling group were significantly higher than those in the control group (all P<0.05). The ROC curve showed that the combined detection of CA125, CEA, CYFRA21-1, CA19-9, and SCC-Ag had high diagnostic value for lung adenocarcinoma, with an area under the curve (AUC) of 0.903 (95% CI: 0.865-0.954); Elevated levels of CEA, CA125, CA19-9, and CYFRA21-1 were independent risk factors for postoperative recurrence in lung adenocarcinoma patients (all P<0.05). Patients were divided into extremely low-risk group (total score<56 points), low-risk group (56 points≤total score<132 points), medium risk group (132 points≤total score<186 points), and high-risk group (total score≥186 points) through risk stratification. The survival curve results showed that there was a statistically significant difference in postoperative recurrence rate among patients with different risk stratification systems ( P<0.05). Conclusions:The combined detection of CA125, CEA, CYFRA21-1, CA19-9, and SCC-Ag has high diagnostic value for lung adenocarcinoma. Among them, CA125, CEA, CYFRA21-1, and CA19-9 have certain predictive value for postoperative recurrence in patients.

Objective:To explore the protective effect of 18α glycyrrhetinic acid (18α-GA) on acute ulcerative colitis (UC) induced by dextran sulfate sodium (DSS) in mice, providing theoretical and experimental basis for the clinical application of 18α-GA.Methods:Forty male C57BL/6J mice were randomly divided into 5 groups: DSS model group, positive drug control group, high, medium, and low dose groups of 18α-GA, with 8 mice in each group. The 5 groups of mice were continuously fed with 3% DSS solution for 7 days to establish an acute UC animal model. At the same time, each group was intraperitoneally injected with 100 mg/kg physiological saline, 100 mg/kg sulfasalazine, 40 mg/kg 18α-GA, 20 mg/kg 18α-GA, and 10 mg/kg 18α-GA daily. The weight of mice was measured and recorded daily, and the Disease Activity Index (DAI) of mice was evaluated. On the 8th day, the mice were euthanized and their colon length was measured; After slicing, the colon mucosa was observed and pathological scoring was performed; Western blot was used to detect the expression of NOD-like receptor thermal protein domain associated protein 3 (NLRP3) inflammasome pathway related proteins in colon tissue; Enzyme linked immunosorbent assay (ELISA) was used to determine the content of interleukin(IL)-1β in colon tissue.Results:Compared with the DSS model group, the weight loss amplitude of the 18α-GA high and medium dose groups was significantly smaller on the 7th day (all P<0.05); Colon length was longer (all P<0.05), the pathological score of colon mucosa was significantly lower (all P<0.05); The expression of GSDMD, cleaved caspase1, and IL-1β in colon tissue was significantly lower (all P<0.05); The 18α-GA high-dose group had lower DAI scores ( P<0.05); The expression of NLRP3 was lower in colon tissue ( P<0.05). Conclusions:18α-GA can improve DSS induced acute ulcerative colitis in mice by inhibiting the activation of NLRP3 inflammasome pathway.