Objective To investigate the relationship of different types of gestational diabetes mellitus (GDM) and pregnancy outcomes.Methods A total of 4090 cases,who received prenatal examination and delivered in Peking University First Hospital and performed a 75 g oral glucose tolerance test (75 g OGTT) at 24-28 gestational weeks,from January.1st,2011 to Jul 31st,2012,were divided into 2groups.Normal blood glucose group:the result of OGTT (fasting plasma glucose,1 hour glucose and 2 hour glucose) was normal; Gestational diabetes mellitus group (GDM group):the result of OGTT was abnormal at any time point.GDM group were separated into A,B and C.GDM A means fasting plasma glucose annormal but others were normal,GDM B:fasting plasma glucose,1 hour and/or 2 hour glucose abnormal,GDM C:fasting plasma glucose normal.To analyse the effect of different number of abnormal result of OGTT on pregnancy outcomes,GDM group were divided into Ⅰ,Ⅱ and Ⅲ.GDM Ⅰ means one abnormal blood glucose of OGTT result,GDM Ⅱ:two abnormal blood glucose and GDM Ⅲ:three abnormal blood glucose.We analyzed the pregnant outcomes of each group.Results (1) Among the 4090 cases,858 cases (21.98％) were diagnosed as GDM (GDM group),and 82 cases (9.6％,82/858) were treated with insulin,other 3232 cases with normal blood glucose (normal blood glucose group).In GDM group,the rate of cesarean section (51.9％,445/858),premature delivery (8.4％,72/858) and LGA (5.9％,51/858)were respectively significantly higher than those of normal blood glucose group [(43.5％,1406/3232),(5.8％,189/3232) and (4.2％,137/3232)] (P ＜ 0.05).But,there was no statistically significant differences for the rate of macrosomia (P ＞ 0.05) between the GDM group (6.8％,58/858) and normal blood glucose group (6.2％,199/3232).(2)In the GDM group,GDM A was 317 cases (36.9％),GDM B 239 cases (27.8％),GDM C 302 cases (35.2％).The incidence of Macrosomia and LGA in GDM B was significantly higher than that in GDM C and normal blood glucose group (P ＜ 0.05).Comparing with GDM A,there was no statistically significance in GDM B and GDM C (P ＞ 0.05).(3)In GDM group,GDM Ⅰ was 521 cases (60.7％),GDM Ⅱ203 cases (15.6％),GDM Ⅲ 134 cases (23.7％).Compared with the normal blood glucose group,GDM Ⅲ had a significantly higher incidence of macrosomia and LGA and cesarean section(P ＜ 0.01) ;and GDM Ⅱ had only a significantly higher incidence of cesarean section (P ＜ 0.01).(4) Among the 4090 cases,there were 1118 patients (27.3 ％) whose fasting blood glucose was below 4.4 mmol/L,of which 55 cases were diagnosed as GDM.There were 4 premature infants and 1 macrosomia.Conclusions The GDM group with more than FBG ≥5.1 mmol/L had a higher incidence of adverse pregnancy uutcomes,it suggested that we should pay more attention and take actively intervented;the pregnant woman is not recommended for 75g OGTT detection when fasting blood glucose was below 4.4 mmol/L because of the low rate of GDM and adverse pregnancy outcomes among them.

Objective To explore the nutritional status of radical gastrectomy patients during the late course of chemotherapy and its main influencing factors, providing reference for the development of targeted nursing intervention. Methods The Scored Patient-Generated Subjective Global Assessment, The Chemotherapy Side Effects of Patients with Gastric Cancer Questionnaire were used to collect clinical data that received complete chemotherapy after radical surgery from September 2014 to March 2016. Results A total of 103 cases finally involved in this study. The incidence of malnutrition in patients during pre-chemotherapy and late course of chemotherapy was 45.63%(47/103) and 73.79%(76/103) respectively, and there was significant difference (χ2=16.97, P<0.05). The nutritional assessment score, the hemoglobin levels and body mass index of patients pre-chemotherapy was (3.64±0.78) points, (124.11± 21.78) g/L, (21.29±2.77) kg/m2 , (8.07±3.75) points, (108.54±11.68) g/L, (20.29±2.68) kg/m2 late course of chemotherapy and there were significant differences(t =-11.74, 6.39, 2.63, all P<0.05). The symptom of depression was at a higher level 65.05%(67/103), patients with anorexia in late course of chemotherapy accounted as much as 75.73%(78/103). Logistic regression analysis showed that educational level, loss of appetite and parenteral nutrition were the main factors which influenced the nutritional status of patients during the late course of chemotherapy. Conclusions With the increase in the number of chemotherapy, the nutritional status of the patient is getting worse. The study suggests medical personnel should pay more attention to the patients with low educational level, give patients and their families targeted diet counseling, correct the mistaken conceptions thus enhance their understanding of dietary knowledge. Strengthening the management of complications during chemotherapy, reducing the adverse factors that affect the patient′s nutritional status to improve the nutritional status of patients.

Objective To investigate the nutritional status of patients with chemotherapy after radical gastrectomy and to provide dietary guidance and nutritional support for patients in time. Methods Patients who received chamotherary after radical gastrectomy inthe Gastrointestinal Surgery of the First Affiliated Hospital of Zhengzhou University from September 2014 to March 2016 were included in the study. The nutritional status was assessed by unified training investigators within 48 h after hospitalization. The questionnaires of Scored Patient-Generated Subjective Global Assessment (PG-SGA) and the Chemotherapy Side Effects of Patients with Gastric Cancer Questionnaire were used to investigatethe patients by trained investigators. Results The scores of the nutritional status of patients with different stages of chemotherapy were 6.107 ± 2.947, 6.505 ± 3.134, 8.068 ± 3.748, which was statistically significant (F=10.202, P<0.01). The incidence of anorexia was the highest rate of diet-related symptoms, the rate of early, mid-term and later chemotherapy rates were 34.95%(36/103), 56.31%(58/103), and 75.73%(78/103) respectively. Patients acquired the diet knowledge mainly from medical staff. The proportions of early, middle and later stages of chemotherapy were 92.23% (95/103), 79.61% (82/103), 75.73%(78/103). Conclusions With the increase of chemotherapy times, the nutritional status of patients with radical gastrectomy is getting worse. The results suggested that medical staff should provide an effective basis dietary guidance in time, improving the patients′nutritional status and clinical outcomes.

Objective To observe the influence of nutrition cognition and behavior intervention of family caregivers on nutritional status of gastric cancer patients during chemotherapy. Methods We selected 100 patients who received complete chemotherapy at the Department of gastrointestinal surgery from September 2015 to February 2017.Each patient selected 1 family caregiver.It was divided into the control group and the intervention group by the draw method.The control group carried out routine nursing measures.The intervention group carried out nutritional cognitive behavior intervention.The effects of cognitive behavior intervention were investigated by observing the scores of PG-SGA,albumin, prealbumin in gastric cancer patients and the scores of nutrition knowledge,attitude and practice in family caregivers. Results The scores of nutrition knowledge, attitude and practice of the control group and the intervention group were respectively 44.17 ± 9.35 and 46.50 ± 9.32, and the difference was statistically significant(t=15.02, P<0.05).There was significant difference in PG-SGA score, hemoglobin and BMI in patients with gastric cancer patients (P<0.05). There was no significant difference in the incidence of malnutrition and prealbumin in patients with gastric cancer patients (P>0.05). Conclusion Nutrition cognition and behavior intervention can effectively improve the nutritional cognition of family caregivers, improve the nutritional status of gastric cancer patients during chemotherapy, and promote the rehabilitation of patients with gastric cancer and improve their quality of life.

Objective To investigate and analyze the nutritional knowledge needs and cognitive level of the main family caregivers of patients with gastric cancer. Methods A total of 208 patients who underwent radical resection of gastric cancer and received complete chemotherapy at the Department of gastrointestinal surgery from September 2015 to February 2017 were selected.Each patient selected 1 family caregivers.A questionnaire survey was conducted among 208 family caregivers, including general information, nutritional knowledge needs questionnaire, nutrition knowledge, attitude and practice and so on. Results The total score of nutrition knowledge, attitude and practice among the family caregivers of patients with gastric cancer was (41.11 ± 9.33) points. The score of nutrition knowledge was (6.26 ± 1.87) points. The score of nutrition attitude was (15.45±4.75) points.The score of nutrition practice was (17.47± 4.45) points .There was a significant positive correlation between nutrition knowledge and attitude(r=0.88, P<0.05), knowledge and practice (r=0.766, P<0.01), attitude and practice (r=0.186, P<0.01) by using Pearson correlation.Family caregivers had a strong demand for nutrition knowledge. 37.5％(78/208) of family caregivers chose to cooperate with doctors and nurses to carry out nutrition knowledge. 51.4％(107/208) of family caregivers preferred bedside individualized guidance. Conclusions Family caregivers have a strong demand for nutrition knowledge,but the nutrition cognition level is poor. Health care providers should strengthen the education on patients and family caregivers' knowledge of nutrition, improve the nutrition knowledge level of caregivers and care ability.

OBJECTIVES: The results of elastic imaging in evaluating the function and histopathological changes of allogeneic renal transplantation are contradictory, one of the important reasons may be that there are differences in human parameters related to kidney transplantation among individuals. The purpose of this study is to explore the related human body parameters on shear-wave elastography (SWE) effects on quantitative stiffness of graft cortex. METHODS: From March 2021 to November 2021, a total of 63 patients with allogeneic kidney transplantation in the Department of Ultrasonography, Third Xiangya Hospital, Central South University, were selected to collect the parameters of two-dimensional, color Doppler and SWE. The subjects were divided into a <20% group and a 20%-30% group according to the variation of cortical hardness measurement. Mann Whitney U test was used to compare the differences in relevant human parameters, and Spearman rank correlation was used to analyze the correlation between relevant human parameters and cortical hardness of transplanted kidney. RESULTS: There was no significant difference between the 2 groups in age, sex, postoperative time, resistance index of interlobar artery, SCr, blood uric acid, ratio of fat layer to muscle layer, and BMI (all P>0.05). Compared with the <20% group, the patients in the 20%-30% group had smaller cortical hardness of the transplanted kidney, greater total distance between the transplanted kidney and the skin surface, and thicker fat layer or muscle layer in front of the transplanted kidney (all P<0.05). The age of patients, the total distance from the transplanted kidney to the skin surface, the thickness of fat layer and muscle layer, the ratio of fat layer to muscle layer, BMI, and the variation of cortical hardness were significantly negatively correlated with the cortical hardness of the transplanted kidney (all P<0.05). CONCLUSIONS Human parameters relevant to kidney transplantation affect the accuracy of SWE in measuring the cortical hardness of the transplanted kidney. It is very important to obtain the highly stabile elastic measurement value and interpret the elastic measurement results according to different levels of human body related parameters in combination with individual conditions.
Humans ; Kidney Transplantation ; Elasticity Imaging Techniques/methods* ; Kidney ; Ultrasonography/methods* ; Transplantation, Homologous