Objective To investigate the relationships between serum concentration of RBP-4 and inflammatory factors,insulin resistance in patients with gestational diabetes mellitus.Methods20 patients newly diagnosed with impaired glucose tolerance (IGT),27 patients newly diagnosed with gestational diabetes mellitus(GDM) and 50 subjects with normal glucose tolerance(NGT) were enrolled in this cross-sectional study.Additionally,another subset analysis was performed,subjects were divided on the basis of BMI into normal weight (NW) and overweight or obesity (OW/OB).Serum RBP-4 was measured with ELISA;serum concentrations of hs-CRP,free fatty acids (FFA),triglyeride(TG),total cholesterol (TC) and insulin were measured in fasting status.Insulin resistance was assessed by HOMA-IR.ResultsLn(HOMA-IR) and the concentrations of FFA,ln(hs-CRP) in IGT or in GDM were significantly higher than that of NGT(P＜0.05).In the group of OW/OB,FFA[(0.90±0.31)mmol/L vs (0.71±0.28)mmol/L,t＝2.73,P＜0.05)],ln(hs-CRP)(0.62±1.00 vs -0.17±1.07,t＝2.90,P＜0.05),ln(HOMA-IR),lnRBP(0.56±0.27 vs 0.30±0.14,t＝2.86,P＜0.05)were significantly higher than that of NW.In the group of GDM,lnRBP-4 showed a positive relationship with FFA (r＝0.231,P＜0.05)and ln(hs-CRP) (r＝0.237,P＜0.05).There was a positive relationship between lnRBP-4 and FFA(r＝0.371,P＜0.05) or ln(hs-CRP)(r＝0.247,P＜0.05) in the group of OW/OB,but no association in the group of NGT,IGT or NW.There was no relationship between lnRBP-4 and ln(HOMA-IR) in IGT,GDM and NW,while in the group of NGT and OW/OB,lnRBP-4 showed a positive relationship with ln(HOMA-IR) (r＝0.276,0.290,P＜0.05).In a multiple linear regression analysis,ln(hs-CRP),FFA or ln(HOMA-IR) was not the independent factor of lnRBP-4 in any group.ConclusionsIn patients with gestational diabetes mellitus,lnRBP-4 may be a new marker of inflammation.

Thirty-five patients with ketosis-prone diabetes (KPD) and 38 patients with newly-diagonosed common type 2 diabetes mellitus (DM) were treated with insulin for 3 months.The results showed that the existing insulin resistance in patients with KPD was mild as compared with common type 2 DM, and the recovery of insulin sensitivity was less marked in patients with KPD after blood glucose was well controlled.

With the process of China’s aging population intensifying， palliative care， as an important guarantee for improving the quality of life of terminally ill patients， is receiving more and more social attention， and the demand is constantly increasing. Palliative care needs versatile professionals， and general education can enhance people’s awareness and understanding of it， enabling more people to understand， accept， and participate in palliative care. With the advancement of knowledge and technology in palliative care， the traditional cramming education models are no longer able to meet the actual needs. Therefore， there is an urgent need to innovate palliative care education strategies. By analyzing the current problems in the general education of palliative care in China， this paper proposed thoughts and suggestions for general and innovative education of palliative care in several aspects， such as establishing general and innovative education systems and evaluation systems of palliative care， diversifying educational contents and methods， strengthening medical staffs training， promoting diversified student groups， and strengthening the popularization of palliative care knowledge among the public.