Objective To evaluate the clinical effectiveness of extended profundaplasty for treatment of critical leg ischemia. Methods Twenty-five legs (stage Ⅲ and Ⅳ in Fontaine′s classification) of 23 patients with critical leg ischemia caused by extensive occlusion of the distal arteries were reviewed during past 12 years. All patients underwent extended profundaplasty and were evaluated by clinical observation of API, tcPO 2, PSaO 2, Treadmill test, NIRS and ultrasound perioperatively. Results Fourteen legs in 13 patients had a favorable outcome, seven legs in 6 patients had an improvement on their symptom and sign, three legs in 3 patients underwent below knee and one case medio-tarsal amputation during the periods of 7 months to 7 years follow-up. Conclusion The extended profundaplasty is simple, less invasive, safe and effective for the treatment of limb-threatening ischemia.

Objective To study the correlation of pregnancy -induced hypertension in the case of indexing syndrome and pregnancy outcome,and to explore their clinical applicability.Methods 30 cases of birth mothers with pregnancy -induced hypertension were selected.According to the severity of hypertension,the patients were divided into the severe pregnancy -induced hypertension group,the moderate pregnancy -induced hypertension and the mild gestational hypertension group.The different levels of pregnancy -induced hypertension maternal outcome indicators, and different maternal outcomes in the two groups were analyzed and compared.Results Preterm birth (58.3%), cesarean section (66.7%),gestational age (33.6 ±2.8)weeks,baby weight (2 330.3 ±652.3)g of pregnancy -in-duced hypertension group were significantly higher than moderate pregnancy -induced hypertension group[18.2%, 18.2%,(36.6 ±3.7)weeks and (2 892.6 ±761.4)g],the differences were statistically significant (χ2 =3.884 5,χ2 =5.490 0,t =2.204 8,t =1.907 1,all P <0.05).The eclampsia (41.7%),postpartum hemorrhage (58.36%), acute renal failure (41.7%)of pregnancy -induced hypertension group were significantly less than the moderate (9.1%,18.2%,9.1%),mild maternal gestational hypertension group (0.0%,14.3%,0.0%),the differences were statistically significant(χ2 =3.158 6,χ2 =3.884 5,χ2 =3.158 6,all P <0.05).Those of moderate maternal gestational hypertension group were significantly higher than the mild gestational hypertension group,the differences were statistically significant (P <0.05).Conclusion Pregnancy -induced hypertension syndrome has significant effect on pregnancy outcomes,the severity degree of pregnancy -induced hypertension is positively correlated with pregnancy outcomes,so early prevention of pregnancy -induced hypertension can increase overall maternal prognosis.

Objective To evaluate the therapeutic effect of mini-incision surgery for the treatment of varicose vein of lower extremities. Methods 106 limbs of 95 paitnets with varicose vein underwent saphenectomy combined with ligation of communicating veins by way of mini-incision from November 1997 to April 2001. The ascending venography and StethoDoppler examination were performed preoperatively in all of the patients. Results Venous reflux in deep vein of lower extremities were at grade 0 in 62 limbs, at grade Ⅰ in 28 limbs and at grade Ⅱ in 16 limbs demonstrated by ascending venography with Valsalva test. StethoDoppler examination showed that valve insufficiency of great saphenous vein at saphenofemoral junction was in 99 limbs, the insufficiency of small saphenous vein at saphenopopliteal in 5 limbs and incompetent perforating vein in all of the limbs. Postoperative course was uneventful, the average hospitalization days after operation were 2.8 days and no recurrent varicose veins occurred in all the patients during the follow-up period lasting 1-30 months. Conclusions With the help of preoperative StehoDoppler examination, the mini-incision surgery for the treatment of varicose vein of lower extremities is safe, simple, effective and lower costs.

Fourteen neonatal diabetes mellitus(NDM)patients were recruited. 9 patients were treated with glyburide and the other 5 with insulin. ABCC8, KCNJ11, and INS genes were sequenced in 6 of them. Gene mutations were found in 2, 1, and 1 cases in these genes, respectively. One case with 6q24 hypomethylation and another without known mutation were also found. 8 out of 9 patients treated with glyburide reached euglycemia(88.9%). The other 5 patients with insulin therapy either died or lost contact. The results suggest that glyburide therapy is effective in neonatal diabetes mellitus, while insulin therapy may contribute to poor compliance.

Objective:To explore the influence of a midwife-led group health care model on primiparas′ self-efficacy and quality of life.Methods:The study included 200 primiparas who registered with the obstetrics department of our hospital between January and December 2019. The puerperas were divided into two groups with 100 cases each according to the random number table method. The control group received routine health care during pregnancy. The T-test and χ 2 test were used, while the observation group received midwifery-led group health care during pregnancy. The scores of maternal role adaptability, self-efficacy, weight control, delivery mode, breastfeeding, mental state, and quality of life was compared between the two groups. Results:After nursing, the mother′s role adaptability (63.14±9.38) and self-efficacy (34.16±2.89) scores in the observation group were higher than those in the control group (52.89±8.41 and 31.28±2.43, respectively) ( t=8.136, 7.627, P<0.05). The weight gain of the observation group in the third trimester [(3.68±1.22) kg] was less than that of the control group [(5.49±1.76) kg] ( t=8.452, P<0.05). The vaginal natural delivery rate of the observation group was 91% higher than the 71% of the control group (χ2=12.966, P<0.05), the cesarean section rate of the observation group was 9% lower than the 29% of the control group (χ2=12.966, P<0.05), and the exclusive breastfeeding rate in the observation group was higher than that in the control group ( χ2 =6.258, P<0.05). After nursing, the SAS (40.74±4.93) and SDS scores (42.16±5.07) of the observation group were lower than those of the control group (47.10±5.27 and 48.59±5.42, respectively) ( t=8.813, 8.664, P<0.05), and the four-dimension quality of life scores of the observation group were higher than those of the control group ( t=7.293, 7.406, 7.357, 8.767, P<0.05). Conclusion:A midwife-led group pregnancy care model can effectively enhance the self-efficacy of primiparas and improve their quality of life.

The cultivation of interdisciplinary talents for life science is still in the state of exploration. The 4I training mode includes four key elements, interdisciplinary course setting, integration of cross project, instruction and administration across whole research and innovational evaluation at the end. Based on the 4I training mode, systematic and targeted design and arrangement would enhance the training level of interdisciplinary talents of life science in universities.

Objective To explore the application and effect of SPOC platform in medical immunol-ogy teaching. Methods The teaching reform class of Grade 2015 (41students) of Changzhi Medical College was taken as the experimental group, while the parallel class of imaging (37 students), preventive specialty (40 students), Class Nine of clinical medicine (37 students) and oral specialty (39 students) were randomly selected as the control group. "SPOC learning platform + traditional teaching" method was used for teach-ing and learning in the course of the test group. The traditional teaching method was utilized in the control one. For this type of teaching activity, a questionnaire survey was carried out among the students in the reform class, and the final exam score was used as the measure standard. The data were analyzed by SPSS 17.0 software. Results The results demonstrated that the students preferred to learn on the SPOC platform for mobile phones, and the number was significantly higher than that of learning through the computers. Students in the reform class basically liked this type of learning, and their final exam scores were more significant difference than the other classes in the same grade (t'=15.21, P=0.000). The classes in the experimental group and the control group were taken as the research objects, and the rank-sum test was performed, which was statistically significant ( χ2=81.65, P=0.000). Then, the two groups were compared in different classes: the statistical difference between the teaching reform class and image 1502 (t'=11.52, P=0.000), prevention 1502 (t'=7.38, P=0.000), clinical medicine 1509 (t'=8.93, P=0.000), oral 1501 class (t'=8.93, P=0.000) were found. The questionnaire survey demonstrated that 90.24% (37 students) of the reform class liked this form of learning and at the same time, it was suggested that the learning content on the platform should be further linked to the clinical practice and combined with scientific research to expand the students' thinking. Conclusion The SPOC learning platform has turned over the teaching of medical immunology and improved students' motivation and interests in learning.

Objective To study the impacts of pre-pregnancy maternal BMI and gestational weight gain(GWG)on pregnancy outcomes. Methods We adopted a prospective cohort study with cluster sampling in single pregnant women,who were not with hypertension,diabetes,hyperlipidemia or other diseases in the previous history,neither did they have diseases of heart,liver,kidney,thyroid etc. related to current pregnancy. Those pregnant women who visited the prenatal nutrition clinic under‘informed consent’were surveyed with questionnaire to track their peri-natal complications,delivery mode and neonate birth outcomes etc. Pearson and partial correlations,chi-square test and binary logistic regression were used to study the association between pre-pregnancy maternal BMI,GWG and pregnancy outcomes. Results A total of 623 pregnant women were recruited in the cohort,with 592(95%)of them eligible for analysis. Results from the Multivariate Logistic Regression analysis indicated that,after controlling the potential confounding factors,when compared to women with pre-pregnancy BMI between 18.5 and 24.0,the odds ratios(ORs)for low birth ponderal index(PI) were 2.34[95%confidence interval(CI),1.24-4.42)]among those with BMI<18.5,respectively,while 2.73(1.12-6.68)for high birth PI among those with BMI>24.0. Similarly,when compared to pregnant women with normal GWG(defined as weight gain range from P15 to P85 by stratification of pre-pregnancy BMI),low GWG(P85)appeared the risk factor for high birth weight,high birth PI,and gestational diabetes mellitus,with ORs as 3.83(1.74-8.44),2.39(1.14-5.01) and 2.21(1.07-4.55),respectively. Conclusion Low or high pre-pregnancy maternal BMI and GWG were associated with adverse pregnancy outcomes.

OBJECTIVETo study the impacts of pre-pregnancy maternal BMI and gestational weight gain(GWG) on pregnancy outcomes.

METHODSWe adopted a prospective cohort study with cluster sampling in single pregnant women, who were not with hypertension, diabetes, hyperlipidemia or other diseases in the previous history, neither did they have diseases of heart, liver, kidney, thyroid etc. related to current pregnancy. Those pregnant women who visited the prenatal nutrition clinic under 'informed consent' were surveyed with questionnaire to track their peri-natal complications, delivery mode and neonate birth outcomes etc. Pearson and partial correlations, chi-square test and binary logistic regression were used to study the association between pre-pregnancy maternal BMI, GWG and pregnancy outcomes.

RESULTSA total of 623 pregnant women were recruited in the cohort, with 592 (95%) of them eligible for analysis. Results from the Multivariate Logistic Regression analysis indicated that, after controlling the potential confounding factors, when compared to women with pre-pregnancy BMI between 18.5 and 24.0, the odds ratios (ORs) for low birth ponderal index (PI) were 2.34 [95% confidence interval (CI), 1.24-4.42)]among those with BMI<18.5, respectively, while 2.73 (1.12-6.68) for high birth PI among those with BMI > 24.0. Similarly, when compared to pregnant women with normal GWG(defined as weight gain range from P15 to P85 by stratification of pre-pregnancy BMI), low GWG (P 85)appeared the risk factor for high birth weight, high birth PI, and gestational diabetes mellitus, with ORs as 3.83(1.74-8.44), 2.39(1.14-5.01)and 2.21(1.07-4.55), respectively.

CONCLUSIONLow or high pre-pregnancy maternal BMI and GWG were associated with adverse pregnancy outcomes.

Adolescent ; Adult ; Birth Weight ; Body Weight ; Female ; Follow-Up Studies ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Outcome ; Prospective Studies ; Risk Factors ; Weight Gain ; Young Adult

Objective To investigate the application value of tenofovir alafenamide fumarate (TAF) in elderly patients with chronic hepatitis B (CHB) and its influence on bones and kidneys. Methods A total of 36 CHB patients, aged ≥60 years, who received TAF antiviral therapy in Qingdao Municipal Hospital, The Affiliated Hospital of Qingdao University, Qingdao Sixth People's Hospital, Chengyang People's Hospital, and Jimo People's Hospital from June 2021 to October 2022 were enrolled in this study, and all patients received TAF (25 mg/d) antiviral therapy. Related data were collected at baseline and weeks 24 and 48 of treatment, including virological indicators, biochemical parameters, urinary protein electrophoresis indices, transient elastography (FibroScan), and bone mineral density. Virological indicators included high-sensitivity HBV DNA quantification; biochemical parameters included total bilirubin, direct bilirubin (DBil), indirect bilirubin (IBil), alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase, total bile acid (TBA), glucose, blood urea nitrogen, creatinine, estimated glomerular filtration rate, and cystatin C (Cys C); urinary protein electrophoresis indices included urinary β2 microglobulin (β2-MG), urinary retinol (URBP), and urinary α1 microspherin (α1-MG). The paired t -test was used for comparison of normally distributed continuous data before and after treatment, and the Wilcoxon signed-rank test was used for comparison of non-normally distributed continuous data before and after treatment; the chi-square test or the Fisher's exact test was used for comparison of categorical data. Results A total of 36 CHB patients completed 24 weeks of follow-up. The complete virological response rate after 24 weeks of treatment was higher than that at baseline [83.3% (30/36) vs 77.8% (28/36), χ 2 =0.36, P =0.55], and there were significant reductions in DBil ( t =-2.42, P =0.02) and Cys C ( t =-4.34, P < 0.001) from baseline to week 24. A total of 18 CHB patients completed 48 weeks of follow-up. The complete virological response rate after 48 weeks of treatment was higher than that at baseline (94.4% vs 77.8%, χ 2 =2.22, P =0.34), and there were significant increases in IBil ( t =2.43, P =0.03), TBA ( Z =-2.24, P =0.03), and bone mineral density T score of lumbar vertebra ( t =2.92, P = 0.01) and femoral neck ( t =2.42, P =0.03) and a significant reduction in liver stiffness measurement ( t =-2.31, P =0.03). There were no significant changes in β2-MG, URBP, and α1-MG after treatment (all P > 0.05). Conclusion TAF has a good antiviral effect in CHB patients aged ≥60 years and can help more CHB patients achieve complete virological response, without causing damage to the kidney, and it can also improve bone mineral density and liver fibrosis degree.