Objective To investigate the characteristics of post-transplantation diabetes mellitus and analyze its risk factors. Methods Extensive survey was carried out to understand the characteristics of post-transplantation diabetes mellitus in patients who received kidney grafting from February 1984 to December 2006. Results Three hundred forty-four post-transplantatian diabetes mellitus patients from 1872 ones after kidney grafting were found from February 1984 to December 2006. The prevalence of new onset post-transplant diabetes mellitus and impaired fasting glucose in kidney allograft recipients were 18. 4% and 12. 7% respectively, being significantly higher than that in general population and other inpatients. The options of immunosuppressants were significantly associated with the prevalence of post-transplantation diabetes mellitus. By multivariate logistic regression analysis, the baseline characteristics of the post transplantation diabetes mellitus patients were significantly associated with increased age(OR: 1. 309, P = 0. 049), elevated level of the triglyceride (OR: 1. 311, P = 0. 005), treatment with taerolimus (FK506) (OR: 1. 522, P = 0. 008), and large dose of intravenous pulsed prednisolane(OR: 1. 239, P = 0. 011), as compared with patients without post-transplantation diabetes mellitus. Besides, the number of patients with at least one acute rejection episode was significantly greater in the post-transplantation diabetic patients. Mycophenolate mofetil (OR: 0. 716, P = 0. 028) and diltiazem (OR: 0. 737, P =0. 015) were associated with lower risk of post-transplantation diabetes mellitus. Conclusions High prevalence of abnormal glucose metabolism in renal allograft recipients during hospitalization was observed. Many risk factors contributed to the development of post transplantation diabetes mellitus.

AIM:To explore the effect of Delta-like ligand 4 (Dll4)-Notch signaling pathway blockade on the development of Thelper 17(Th17) cells in the asthmatic mice.METHODS:Male BALB/c mice were randomly divided into 5 groups:control group, asthma group, normal saline group, anti-Dll4 antibody group, and immunoglobulin G group.The protein expression of Dll4 was detected by immunohistochemical staining.The proportion of Th17 cells in mouse spleen isolated CD4+ T cells was measured by flow cytometry.The protein expression of Th17 transcription factor retinoid-related orphan receptor γt (RORγt) was determined by Western blot.The serum level of interleukin (IL)-17 was measured by enzyme-linked immunosorbent assay (ELISA).RESULTS:The expression of Dll4 in the lung tissues from asthma group significantly increased as compared with anti-Dll4 antibody group.The proportion of Th17 cells in CD4+ T cells was significantly down-regulated, and the protein expression of RORγt in the lung tissues was significantly reduced in anti-Dll4 antibody group compared with asthma group (P<0.05).Moreover, the serum level of IL-17 in anti-Dll4 antibody group was significantly reduced compared with asthma group (P<0.01).CONCLUSION:The blockade of Dll4-Notch signaling pathway inhibits the differentiation of Th17 cells in asthmatic mice.

Nitrogen-doped carbon nanoparticles (N-CNPs) with a fluorescence quantum yield of 15.1％ were prepared from sucrose and urea in oleic acid medium by a one-pot solvothermal method.A new approach for quick,sensitive,and selective determination of free chlorine in water was developed based on fluorescence quenching of N-CNPs.There existed a good linear correlation between the fluorescence quenching and the concentration of ClO-in the range of 0.05-25.00 μmol/L.The limit of detection (LOD,S/N =3) was estimated to be 23 nmol/L.This method can be applied to the determination of free chlorine in real water samples.

Objective To explore the clinical manifestations,imaging findings,pathological classification and treatment of congenital cystic adenomatoid malformation (CCAM)of the lung.Methods The clinical features,imaging findings,pathology information,diagnosis,treatment method and its prognosis of children with CCAMconfirmed by ope-ration and pathology were retrospectively analyzed in Yuying Children′s Hospital Affiliated to Wenzhou Medical Univer-sity from August 2006 to August 201 4.Results Eleven patients were boys and 4 patients were girls.One case had a-symptomatic clinical features,1 2 cases had pulmonary infection,1 case had recurrent chest pain,and 1 case had de-pressed deformity in sternum inferior segment.Chest CT scanning indicated that 9 cases had multiple gas cysts at unila-teral side of lung,among which 1 case was of funnel chest and pulmonary sequestration,1 case of huge cyst containing air and fluid at inferior lobe of left lung,and 4 cases of high density lung shadow;CT examination indicated that 1 case had recurrent chest pain and eventration of diaphragm of the right side combined with pulmonary sequestration.All ca-ses were treated by surgical resection,of whom 1 case was given cystectomy and sequestrectomy,diaphragmatic plication respectively,1 case complicated with funnel chest disease underwent lesion pulmonary lobectomy,sequestrectomy and minimally invasive corrective surgery in pectus excavatum (Nuss surgery),and the remaining 1 2 cases received lesion pulmonary lobectomy.All of 1 5 cases recovered well without complications.Pathological classification type of CCAMin-cluded 1 1 cases of type Ⅰ,3 cases of type Ⅱ and 1 case of type Ⅲ,among which 2 cases had pulmonary sequestration. Conclusions CCAMis a rare disease which can be discovered along with pulmonary infection.Multiple gas cysts are the most common imaging findings and the preoperative diagnosis of CCAM is mostly based on chest CT examination. Type Ⅰ and type Ⅱ are the most common pathological classification.The surgical resection should be given early surgi-cal resection and the prognosis is usually good.

Objective:To explore the effect of rehabilitation training based on the theory of reaching standards in patients with cervical cancer.Methods:From January 2018 to December 2019, convenience sampling was used to select 80 patients with cervical cancer in the Department of Gynecology of Ningbo Women & Children's Hospital as the research object. According to the random number table method, the patients were divided into observation group and control group with 40 cases each. The control group carried out routine nursing, and the intervention group conducted rehabilitation training based on the theory of reaching standards on this basis. The General Self-Efficacy Scale (GSES) and Quality of Life Core Questionnaire of European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) were used to evaluate the intervention effect.Results:Before the intervention, there was no significant difference in the total scores of GSES and EORTC QLQ-C30 in each field between the two groups of patients ( P>0.05) . After the intervention, the total score of GSES of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.05) . The scores of physical functioning, role functioning, emotional functioning, cognitive functioning, and global health in EORTC QLQ-C30 of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . The scores of fatigue, pain, insomnia, diarrhea, and constipation were lower than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Rehabilitation training based on the theory of reaching standards can improve the self-efficacy of patients with cervical cancer and the quality of life of patients.

Objective To describe the epidemiological characteristics on the supplement of folic acid in progestation and early pregnancy,and to probe the protective effects of supplement of folic acid in early pregnancy against pregnant depression,in Ma’anshan city,Anhui province. Methods In this cohort study,5 150 subjects who had their first antenatal examination at Ma’anshan Maternal and Child Care Centers were recruited under informed consent,from October 2008 to October 2010. All the information were collected through questionnaires in the first,second and third trimesters respectively. A“Center for Epidemiological Studies Depression Scale(CES-D)”was used to assess the mood of depression in the second questionnaire. Single factor analysis and the unconditional multivariate logistic regression were applied to analyze the association of supplement folic acid in peri-conceptional period and pregnancy depression. Results In the study,the prevalence of those who had never taken the supplement folic acid but only the supplement folic acid in progestation and supplement in the first-trimester,or supplement in the peri-conceptional period were 27.3%,0.5%,27.4%and 17.9%,respectively. The incidence of pregnancy depression was 4.8%(247/5 150). Data from logistic regression analysis showed that,supplement of folic acid only in the first-trimester or in the peri-conceptional period were negatively associated with pregnancy depression even after adjustment for potential confounders. The adjusted odds ratio were 0.63(95%CI:0.44-0.90) and 0.61(95%CI:0.39-0.95)respectively. Conclusion Supplement of folic acid in peri-conceptional period could be a preventive factor for pregnancy depression.

On January 1st 2018, a male 44 years old diabetic patient with subcutaneous soft tissue infection in right thigh was admitted to our hospital. The patient repeatedly used the same needle to inject insulin subcutaneously in the unsterilized right thigh, and his blood glucose was badly controlled in the long term. Severe subcutaneous soft tissue infection of the right thigh occurred after his fatigue, accompanied with ketoacidosis. Then he received conservative treatment in the local hospital for one month, but the infection persisted. After being transferred to our hospital, we highly suspected the diagnosis of necrotizing fasciitis according to previous test indicators and local B-ultrasound results, but suggestion of aggressive surgery was refused. So we treated him with conservative therapies using sensitive antibiotics and supportive remedies. The patient was basically healed after treatment of 1 month and he was recovered well during the follow-up 2 months after discharged from our hospital. This case emphasizes the importance of standard injection of insulin and early diagnosis of severe subcutaneous soft tissue infection.

Objective:To develop a triplex real-time fluorescent quantitative reverse transcription-polymerase chain reaction (RT-PCR) assay for dengue virus (DENV), yellow fever virus (YFV) and chikungunya virus (CHIKV), so as to achieve the rapid detection of these three viruses.Methods:The complete genome sequences of DENV(Ⅰ, Ⅱ, Ⅲ, Ⅳ), YFV and CHIKV were retrieved from Global Shared Database for comparative analysis, estimate its conservative region, specific primers and probes were designed, then a triplex real-time RT-PCR assay was developed. The specificity was evaluated by other viral nucleic acids. The sensitivity was evaluated by in vitro transcribed RNAs of DENV, YFV and CHIKV. The repeatability of the method was evaluated by independent repeated experiments with different concentrations of viral nucleic acids. DENV detection method was validated with dengue patient serum. YFV and CHIKV detection methods were validated with simulated positive samples. The sera from healthy people were used for negative validation. Results:This method has no cross-reaction with other viral nucleic acids. The limit of detection (LOD) of DENV (Ⅰ、Ⅱ、Ⅲ、Ⅳ), YFV and CHIKV in vitro transcribed RNAs were less than 21.55 copies/PCR, 21.25 copies/PCR, 21.85 copies/PCR, 22.75 copies/PCR, 22 copies/PCR, 45.65 copies/PCR. The standard deviation of Ct values of each concentration was less than 0.5 and the coefficient of variation was less than 3%. The positive rate of clinical and simulated positive samples was 100%, and the negative rate of healthy serum was 100%. Conclusions:A triplex real-time fluorescent quantitative RT-PCR assay for DENV, YFV and CHIKV detection was established, and proved to be specific, sensitive and repetitive.

Objective:To describe the epidemiological characteristics of mobile phone use in early pregnancy, and to explore the relationship between pregnancy mobile use and infant sleep-wake behavior.Methods:During February 2015 to August 2016, 2 212 subjects who had their first antenatal examination at Maanshan Maternity and Child Health Hospital were recruited in this cohort study and followed until postpartum for 6 months. Information of phone use was collected through questionnaire in the third trimester. There were 1 779 pregnant reported hours of mobile phone use in the questionnaire. A total of 1 951 parent reported the night-wake times. Data on night-wake behavior in infants was collected during the 6 months study. Questionnaires were completed by parents when taking the physical examination. More than 3 times per night was defined as the night-wake frequency. Unconditional multivariate logistic regression was applied to analyze the association of pregnancy time of mobile phone use and the infant night-wake frequencies.Results:In this cohort study, the average age of 2 212 pregnant women was (26.95±3.82) years, with 1 983 of them were followed up to the time of delivery. The incidence of night-wake frequency was 28.3 % (553/1 951) among these 6-month-old infants. After adjusted for feeding factors in the first trimester, frequencies of using the phone as "3 to 4 hour per day" and "5 hour and above per day" were both positively associated with the frequencies of night-wake behavior in infants. The adjusted OR (95 %CI) were 1.49 (1.07-2.07) and 1.79 (1.31-2.46), respectively. Conclusions:The mobile phone use during pregnancy was associated with night-wake of infants. Mobile phone should be rationally used during pregnancy.

Objective To analyze the effect of preoperative nutritional status on the intraoperative un-expected hypothermia in elderly patients with laparoscopic gastrointestinal tumor radical operation and its risk factors.Methods The clinical case data in 282 elderly patients with laparoscopic gastrointestinal tumor radical surgery in the Fourth Affiliated Hospital of Nanjing Medical University from February 2021 to December 2023 were analyzed retrospectively.The mini nutritional assessment short form(MNA-SF)was adopted to e-valuate the preoperative nutritional status of the patients.The intraoperative unexpected hypothermia occur-rence were statistically analyzed.The univariate and multivariate logistic regression was used to analyze the in-fluencing factors.Results Among 282 patients,104 cases(36.88％)had unexpected hypothermia during op-eration.The incidence rate of intraoperative unexpected hypothermia in the patients with complicating malnu-trition or malnutritional risk was significantly higher than that in the patients with normal nutritional status(P＜0.05).The multivariate logistic regression analysis showed that the age ≥70 years old,body mass index(BMI)＜18.5 kg/m2,progressive weight loss appearance before surgery,preoperative MNA-SF score＜12 points,CO2 pneumoperitoneum time＞4 h and complicating hypoalbuminemia were the independent risk fac-tors for intraoperative unexpected hypothermia occurrence in the elderly patients with laparoscopic gastroin-testinal tumor radical operation(P＜0.05),while the use of heating device for initiatively maintaining tem-perature during surgery was the protective factor for avoiding intraoperative unexpected hypothermia occur-rence(P＜0.05).Conclusion The elderly patients with poor nutritional status undergoing laparoscopic gas-trointestinal tumor radical surgery are more likely to develop unexpected hypothermia.There are many influ-encing factors,so close attention should be paid to.