Objective To explore the fasting blood glucose (FBG) variation trends and the prevalence of impaired fasting blood glucose(IFG)among medical staff in Beijing, 2009-2015.Methods A prospective cohort study, using seven years of follow-up data, was conducted in a large-scale tertiary hospital in Beijing.A total of 1 284 medical staff aged 35 to 60 years were recruited.We divided them into 4 groups according to age and occupational categories,and the level of FBG was tested at the same time each year. Results The number of medical staff who completed all 7 annual FBG tests was 403. There was a stepwise increase in the levels of FBG (4.92 mmol/L, 5.26 mmol/L, and 5.60 mmol/L in the years 2009, 2012,and 2015,respectively;F=100.643,P<0.001).An increasing trend in the prevalence of IFG was also evident (3.7%, 7.7%, and 13.4% in the years 2009, 2012, and 2015, respectively; χ2=39.099, P<0.001). Compared with baseline levels(in 2009),the average levels of FBG and the prevalence of IFG in men and women, as well as in all occupational classes (doctors, nurses, technicians, and other medical employees), were significantly elevated by the year 2015 (all P<0.05). The levels of FBG in male medical staff were higher than that in female medical staff,in both 2009 and 2015(both P<0.001).Conclusion The trend of increasing FBG levels and IFG cases in medical staff,especially in men,has been a problem for hospitals. Health policy action is urgently needed to deflate the IFG bubbles.

Objective To determine the safety and effectiveness of double balloon catheter for labor induction in women with previous cesarean section. Methods This was a retrospective case-control study. Data from Shenzhen maternal and child healthcare hospital and Shenzhen Longgang District Maternal and Child Healthcare Hospital between 2015. 01. 01 to 2018. 12. 31 were used. A total of 156 term pregnant women, with previous one low segment cesarean section (CS) and balloon catheter for labour induction were included as case group. A total of 156 term pregnant women with previous one low segment CS and sponta-neous onset of labor were included as control group. The vaginal delivery rate and maternal and infant out-comes were compared between the two groups. Results There was no significant difference in CS rate, va-ginal assisted rate and vaginal spontaneous rate between the two groups ( 20. 51％ vs 15. 38％, 8. 97％ vs 5. 77％, 70. 51％ vs 78. 85％ respectively, P >0. 05 ) . And there were no significant difference in the rates of intrauterine infection, uterine rupture, postpartum hemorrhage, blood transfusion, maternal and in-fant mortality and neonatal transfer between the two groups. Conclusions Our study indicates that induc-tion of labor with double balloon catheter is effective and safe in term pregnant women with previous one low segment CS. Women with previous CS and indications for labour induction should be informed about vaginal birth success rates and the alternative of elective repeat CS needs to be discussed.

Objective:To provide a basis for its diagnosis and treatment for clinicians by analyzing the clinical manifestations, imaging features and surgical efficacy of primary intraspinal paraganglioma.Methods:The clinical data of 6 patients with intraspinal paraganglioma from April 2014 to January 2021 in Xiangyang Central Hospital were retrospectively analyzed, and all patients were treated with microsurgery via a posterior median approach.Results:All 6 patients achieved total tumor resection, and the postoperative pathological diagnosis was paraganglioma. Among them, 1 patient′s tumor located inside and outside the cervical spinal canal without destruction of the vertebral body; 1 patient′s tumor located lumbosacral canal with destruction of the vertebral body; the others 4 patients′ tumor located within the lumbar spinal canal. The patients were followed up for 12 to 120 months after surgery, with a median follow-up time of 61.5 months. MRI examination was performed at the last follow-up, and no recurrence was observed. The patients underwent MRI examination at the last follow-up, and none of the patients recurred.Conclusions:The intraspinal paraganglioma is a rare tumor, and nonfunctional benign tumors are predominant. Its clinical and imaging manifestations lack specificity and are often difficult to diagnose before surgery. Surgical resection, especially complete resection, has a better prognosis, and the effectiveness of adjuvant therapy is uncertain.

Objective:To investigate the efficacy of Tanzhuo Decoction in the treatment of early diabetic nephropathy in patients with type 2 diabetes mellitus and its effect on cystatin C (Cys-C), C-reactive protein (CRP), urinary albumin excretion rate (UAER), and creatinine clearance rate (CCr). Methods:Eighty patients with type 2 diabetes mellitus complicated by early diabetic nephropathy who received treatment at Maanshan Hospital of Traditional Chinese Medicine from 2019 to 2021 were included in this randomized controlled study. They were divided into a control group ( n = 40) and a treatment group ( n = 40) using the random number table method. Patients in the control group received conventional therapy including blood glucose and blood pressure control, while those in the treatment group received Tangzhuo Decoction in addition to the same treatment as that given to the control group. Both groups of patients were treated for 30 days. The clinical efficacy as well as pre- and post-treatment Cys-C, CRP, UAER, and CCr were compared between the two groups. Results:The total response rate in the treatment group was 92.5% (37/40), which was significantly higher than 75.0% (30/40) in the control group ( χ2 = 4.50, P < 0.05). After treatment, Cys-C, CRP, and UAER in the treatment group were (2.04 ± 0.08) mg/L, (3.97 ± 1.71) mg/L, and (91.18 ± 18.68) μg/min, respectively, which were significantly decreased compared with those before treatment ( t = 12.14, 5.59, 4.73, all P < 0.05). After treatment, CCr in the treatment group was (56.3 ± 5.01) mL/min, which was significantly increased compared with that before treatment ( t = -8.56, P < 0.05). After treatment, Cys-C, CRP, and UAER in the control group were (2.17 ± 0.04) mg/L, (4.66 ± 1.47) mg/L, and (103.93 ± 22.62) μg/min, respectively, which were significantly decreased compared with those before treatment ( t = 4.05, 5.00, 2.24, all P < 0.05). After treatment, CCr in the control group was (45.9 ± 4.9) mL/min, which was significantly increased compared with that before treatment ( t = -3.98, P < 0.05). There were significant differences in Cys-C, UAER, and CCr between the treatment and control groups ( t = -7.42, -2.29, 7.82, all P < 0.05). Conclusion:Tanzhuo Decoction for the treatment of early diabetic nephropathy in patients with type 2 diabetes mellitus has a definite effect. It can effectively reduce levels of Cys-C and UAER, reduce inflammatory reactions, improve kidney function, and delay the progression of kidney injury.

Objective To discuss the application of prospective quality management in quality control of indwelling needle .Methods Twelve wards carried out the nurse grading management and set up prospective quality control management system , which was charged by a three-grading system of responsible nurse-responsible nursing group leader-head nurse .The intravenous indwelling needle was intervened under the consult of the professional guidance .The usage and maintenance of the indwelling needle before and after applying the prospective quality control management system were compared .Results The usage of the indwelling needle was decreased from 53.6%to 31.3%.The difference was significant (χ2 =45.099,P<0.01).The incidence of bad conditions of the maintenance was significantly decreased (P<0.01).Conclusions Every level of nursing staff is responsible for the prospective quality control management system , which can improve the participation of quality control and shorten the management extent .The system is oriented from clinical practical problems , so as to improve the control efficiency , and the usage and maintenance quality has been improved obviously .

Objective To explore the association between BMI and the risk of developing cardiac surgery associated acute kidney injury (CS-AKI),mortality of AKI and AKI requiring renal replacement therapy (AKI-RRT) after cardiac surgery.Methods Clinical data of patients undergoing cardiac surgery from January 2011 to December 2015 in Zhongshan Hospital of Fudan University were prospectively collected.Patients were divided into four groups according to BMI classification of Chinese population.Adjustment for selection bias was further assessed using propensity score method (PSM) to evaluate the role of BMI in the development of AKI.Results A total of 8442 patients were enrolled,among which 1092 patients successfully matched through PSM.The AKI incidences were respectively 30.3％,33.3％,38.6％ and 46.8％ in four BMI groups (P ＜ 0.01) before PSM.The AKI incidences were respectively 31.9％,35.2％,42.5％ and 42.9％ in four BMI groups (P=0.016) after PSM.The risk of developing AKI increased by 19.9％ as the BMI increased per 5 kg/m2 (95％ CI:1.070-1.344,P=0.002).The hospital mortality of patient (overall,AKI,AKI-RRT) in four groups was not statistically different after PSM (P ＞ 0.05),but overweight group always had the lowest mortality.Conclusions BMI is a risk factor for AKI after cardiac surgery,and the AKI incidence increases with increasing BMI in a certain range.

Objective:To compare the value of NoSAS score, STOP-BANG questionnaire (SBQ) and Epworth Sleepiness Scale (ESS) in assessing the risk of obstructive sleep apnea hypopnea syndrome (OSAHS) in patients with respiratory disease (RD).Methods:The clinical data, NoSAS, SBQ and ESS scores of 190 patients who underwent overnight polysomnography (PSG) were collected. According to the receiver operating characteristic (ROC) curve, with different apnea-hypopnea index (AHI) as the judgment cutoff, the sensitivity, specificity, positive predictive value, negative predictive value, diagnostic odds ratio (DOR) and accuracy of the three scales were compared.Results:With AHI ≥5 times/h as the cutoff, the area under the ROC curve (AUC) of NoSAS and SBQ were 0.833 and 0.729, respectively, indicating that both have predictive value for mild OSAHS. Among them, NoSAS had a larger DOR value (16.150), indicating that NoSAS had the higher accuracy in assessing the risk of mild OSAHS. When AHI>15 times/h was used as the cutoff, the AUC value of NoSAS was 0.704, indicating that it has predictive value for moderate OSAHS. When AHI>30 times/h was used as the cutoff, the AUC value (0.706) and DOR value (6.527) of SBQ were high, indicating that it has predictive value and good accuracy for severe OSAHS. The SBQ is more sensitive than NoSAS and ESS when evaluating patients at high risk for OSAHS ( SBQ≥3). Conclusions:When evaluating the risk of mild and moderate OSAHS in RD patients, NoSAS is better than SBQ and ESS, and when evaluating severe OSAHS, SBQ is better than NoSAS and ESS. In clinical work, appropriate predictive tools should be selected according to the actual situation to assess the risk of OSAHS, so as to formulate and implement early intervention plans based on the assessment results.

Objective:To explore the effect of nurse-led management model in adherence of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) who underwent non-invasive mechanical ventilation.Methods:92 patients with severe OSAHS diagnosed by polysomnography(PSG) and treated with non-invasive mechanical ventilation in Tianjin medical university general hospital from September 2019 to August 2020 were enrolled. The patients were divided into intervention group (45 cases) and control group (47 cases) by random number table. Then, basing on routine treatment and subsequent visit, the patients in intervention group received regular telephone follow-up interviews within one week of ventilator purchasing, and the interview was based on a standard telephone follow-up manuscript designed by Duffy and lasted for six months. The patients in control group received routine nursing treatment and regular subsequent visit, and were not followed up by telephone, but were encouraged to have telephone consultation. The Epworth sleepiness scale(ESS) scores of the two groups before and after the intervention and the compliance of non-invasive mechanical ventilation of the two groups after the intervention were compared.Results:After the intervention, the ESS scores of the two groups were lower than those before the intervention ( P<0.001), and the ESS scores of the intervention group were lower than those of the control group ( P<0.001). After the intervention, the compliance of noninvasive mechanical ventilation in the intervention group was better than that in the control group ( P<0.001). Conclusions:The nurse-led management model in combination with telephone follow-up can improve the sleepiness of patients and the adherence of using non-invasive mechanical.

Breast cancer is a malignant tumor originating from breast epithelial tissue. Ferroptosis is a novel type of programmed cell death which differs from apoptosis and necrosis. Research found that the accumulation of lipid peroxides in cells, a crucial process of ferroptosis, can be induced by multiple mechanisms. The ferroptosis regulation is closely related to the occurrence and development of breast cancer, and it induced by drugs is a potential and valuable research direction in breast cancer.

OBJECTIVE: To investigate the status of subjective well-being (SWB) for medical staffs who contact with patients directly in a tertiary hospital.
 METHODS: Staffs from a tertiary hospital in Hunan province were investigated the SWB Scale (SWBS-cc20) from 2012 to 2014.
 RESULTS: The scores of SWB for medical staffs are high (81.67±12.33). Among the 10 sub-dimensions of SWB, medical staffs performed the best in family atmosphere, personal growth, and interpersonal adaptation, while performed the worst in physical health, mental health and material contentment. Title, job nature, education and occupation significantly affected the status of SWB. Staffs who directly connected with patients have less scores of SWB than those who do not (t=-4.80, P<0.001). Moreover, they perform better in contentment (OR=0.079, 95% CI 1.278 to 2.214, P<0.001), but worse in mental health (OR=1.315, 95% CI 1.023 to 1.690, P<0.05) and physical health (OR=1.313, 95% CI 1.029 to 1.677, P<0.05).
 CONCLUSION Medical staffs have high scores of SWB. Staffs who directly connected with patients have less scores of SWB than those who do not. Moreover, they perform better in contentment, but worse in mental health and physical health.
Humans ; Medical Staff ; Mental Health ; Tertiary Care Centers