Objective Through the detection of the levels of serum betatrophin,anthropometric and biochemical indices,to determine the alteration of betatrophin levels in patients with polycystic ovary syndrome (PCOS) and the relationship between betatrophin levels and metabolic indexes such as 25-hydroxy vitamin D3 [25 (OH) D3].Methods The study group was composed of 24 women with PCOS and 20 age-natched healthy women as controls.Following general physical examination of the subjects,anthropometrie measurements were performed (height,weight,waist circumference,hip circumference).Body mass index (BMI) and waist-hip ratio were calculated;25 (OH) D3,Ca2+,fasting blood glucose,fasting insulin,triglycerides,high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C) were also measured and homeostasis model assessment of insulin resistance (HOMA-IR) were evaluated in all subjects.Serum betatrophin levels were examined with an enzyme-linked immunosorbent assay (ELISA).Using independent sample T test to compare the differences between groups,the linear correlation analysis was performed to study the correlation of betatrophin with anthropometric and biochemical indices,the influencing factors of betatrophin were analyzed by multiple linear regression.Results Circulating betatrophin levels [(0.341±0.034) ng/ml vs.(0.810±0.162) ng/ml,t=4.271,P＜0.001] and HDL-C [(1.014±0.321) mmol/L vs.(1.419±0.287) mmol/L,t=2.218,P＜0.05] significantly decreased in women with PCOS compared with controls,and BMI [(27.691±4.392) kg/m2 vs.(23.310±4.781) kg/m2,t=-2.073,P＜0.05],fasting blood glucose [(5.950±0.411) mmol/L vs.(4.883±0.314) mmol/L,t=-2.142,P＜ 0.05],HOMA-IR [(4.946 ± 0.741) vs.(3.387± 0.397),t=-2.493,P＜0.05],triglycerides [(1.510± 0.848) mmol/L vs.(1.037±0.402) mmol/L,t=-2.223,P＜0.05],LDL-C [(3.431±0.479) mmol/L vs.(2.396±0.435) mmol/L,t=-2.433,P＜0.05] were obviously increased.Moreover,there was a postive correlation between betatrophin and HOMA-IR (r=0.425,P＜0.05) as well as 25(OH)D3 (r=0.577,P＜0.05) and Ca2+ (r=0.448,P＜0.05),while the betatrophin was negatively related to BMI (r=-0.451,P＜0.05),triglycerides (r=-0.454,P＜0.05),LDL-C (r=-0.551,P＜0.05).Circulating betatrophin levels were higher when 25 (OH) D3 levels were beyond 35 nmol/L in PCOS patients [(0.539±0.092) ng/ml vs.(0.199±0.031) ng/ml,t=3.072,P＜0.001],and the multiple linear regression analysis showed that the main factors affecting the levels of betatrophin were BMI (OR=-0.260),HOMA-IR (OR=0.218),25(OH)D3 (OR=0.238),and glycerol (OR=-0.162).Conclusion It is speculated that betatrophin may be a valuable predictive factor of PCOS because betatrophin is closely associated with insulin resistance,lipid metabolism disorders and the lack of 25-hydroxy vitamin D3 in PCOS patients.

Objective To understand the status and demand of prenatal education for 94 pregnant women's spouses in rural areas of Wenzhou in order to provide the evidence for carrying out the prenatal education among pregnant women's spouse.Methods Ninety-four pregnant women's spouses in rural areas of Wenzhou were chosen according to the convenience sampling method , and received the self-designed questionnaire on the knowledge and demand of prenatal care .Results 94 pregnant women spouse , in pregnant women during pregnancy had attended prenatal education 26 (27.66%), did not attend antenatal education 59 (62.77%); Pregnant women hadn't accepted the prenatal education and spouse in maternal health care , women's maternal physiological changes , scores of neonatal care comparative differences are statistically significant (P<0.05);26 pregnant women spouse received prenatal education situation of prenatal education content is given priority to with maternal care , accounted for 73.08%, teaching mode is given priority to with interpretation, and more than half of the free classes for; 88.29% of people think it necessary to attend antenatal education; Pregnant women spouse would like to have prenatal education through formal medical institutions.The most preferred knowledge is maternal care .Conclusions The degree of awareness of perinatal care was at low level in pregnant women's spouses,we should strengthen prenatal education for pregnant women's spouses in the rural areas , and attract more spouses to attend the prenatal education through the fee waivers and innovative approach to education .

Objective:To explore the mediating effects of resilience and depression on the relationship between social support and self-neglect.Methods:From July to October 2020, a cross-sectional survey was conducted among 549 empty-nest community-dwelling elderly in the community using the social support rating scale, Connor and Davidson resilience scale, geriatric depression scale and elderly self-neglect scale. SPSS 22.0 and AMOS 24.0 were used for data analysis, including descriptive analysis, correlation analysis and structural equation modeling.Results:The scores of social support, resilience and self-neglect of the empty-nest elderly were (38.63±7.47), (64.30±14.57) and (3.72±2.67) respectively, and 31.70% (174/549) of the subjects had depressive symptoms. The score of self-neglect was negatively correlated with the score of social support ( r=-0.597, P<0.01) and resilience ( r=-0.557, P<0.01), and positively correlated with depression score ( r=0.675, P<0.01). The score of social support was positively correlated with resilience score ( r=0.531, P<0.01) and negatively correlated with depression ( r=-0.597, P<0.01). Social support could affect self-neglect directly ( β=-0.485, P<0.05), and it could also influence self-neglect indirectly through the partial mediating effect of resilience ( β=-0.451, P<0.05). The mediating effect of resilience and depression accounted for 12.18% and 36.00% of the total effects respectively. Conclusion:Social support could influence self-neglect directly or indirectly through resilience and depression. The empty-nesters should be encouraged to participate more in social activities so as to improve their resilience, reduce the occurrence of self-neglect.

Objective:To explore the correlation between psychological resilience, self-neglect and depression among community empty-nest elderly people, and to analyze the mediating role of depression between psychological resilience and self-neglect.Methods:This study was a cross-sectional study. From July to October 2020, a stratified multi-stage sampling was used to select 560 community empty-nest elderly people from 6 community health service centers in Qingdao as the research object. The survey was carried out using the General Information Questionnaire, the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC) , the simplified version of the Geriatric Depression Scale, and the Geriatric Self-neglect Scale. Pearson correlation was used to analyze the correlation between variables. The structural equation model was constructed using AMOS 24.0. A total of 560 questionnaires were distributed, and 549 valid questionnaires were recovered, with the valid recovery rate of 98.04%.Results:Among 549 empty-nest elderly people, the total score of Chinese version of CD-RISC was (64.30±14.57) , and the average score of the Geriatric Self-neglect Scale was (3.72±2.67) . There were 174 elderly people (31.70%) with depressive symptoms. The total score and the scores of each dimension of the Chinese version of the CD-RISC in the community empty-nest elderly people were negatively correlated with the total score of the simplified version of the Geriatric Depression Scale ( P<0.01) . Except for the dimension of safety self-neglect, the scores of other dimensions and the total score of the Geriatric Self-neglect Scale were negatively correlated with the total score and the scores of each dimension of the Chinese version of the CD-RISC ( P<0.01) , and were positively correlated with the total score of the simplified version of the Geriatric Depression Scale ( P<0.01) . Depression played a mediating role between the psychological resilience and self-neglect of empty-nest elderly in the community, and the mediating effect accounted for 53.85% of the total effect. Conclusions:Psychological resilience of community empty-nest elderly can directly affect self-neglect, and can also indirectly affect self-neglect through depression. Attention should be paid to the improvement of the psychological resilience of the empty-nest elderly in the community, to reduce the occurrence of self-neglect, and to promote their healthy aging.

ObjectiveTo develop a systematic case management model based on the International Classification of Functioning, Disability and Health (ICF) Vocational Rehabilitation Core Set (VR-CS) and explore its application pathways and efficacy in vocational rehabilitation. The 13 core categories of VR-CS are applied in vocational rehabilitation case management practices, utilizing comprehensive functional assessments to design and implement structured and individualized case management plans. This, in turn, seeks to enhance individuals' vocational independence, social participation and overall quality of life. MethodsThis study adopted a combined approach of theoretical research and empirical case analysis. Based on the 13 core categories of VR-CS, a comprehensive vocational assessment was conducted across three dimensions: body function and structure, activities and participation, and environmental factors. The study theoretically analyzed how to develop and implement holistic and individualized vocational rehabilitation plans, along with dynamic monitoring processes. Three types of typical vocational rehabilitation cases were examined, including individuals with major depressive disorder, high-functioning autism and mild cognitive impairment, to illustrate the evidence and effectiveness of VR-CS-based case management. ResultsThe VR-CS-based case management method, grounded in the ICF bio-psycho-social model, constructed an integrated and individualized case management system. This system combined the assessment and analysis of vocational rehabilitation needs, goal setting and planning, multidisciplinary team intervention, individualized interventions, process monitoring and dynamic adjustments, return-to-work activities, and long-term follow-up services.The case management model developed through VR-CS demonstrated significant and systematic efficacy in promoting vocational independence and social participation. This study provided a detailed analysis of the primary methods and steps involved in designing and implementing case management and elaborates on the practical applications of this model from the three representative cases. At the body function and structure level, case management included the evaluation of energy and drive functions (b130), high-level cognitive training (b164), and the enhancement of exercise tolerance (b455). Case management focused on accurately setting short- and long-term goals around functional limitations and needs. Dynamic monitoring during interventions ensured timely adjustments to intervention measures. This process improved physical endurance and cognitive function, enhanced sustained work capacity in complex vocational environments. At the activities and participation level, the focus was on skill acquisition (d155), stress management and psychological adjustment (d240), and the cultivation of complex interpersonal communication abilities (d720). Individuals engaged in regular professional skills training, role-playing and simulated work scenarios to progressively enhance vocational adaptability and social interaction skills. Through this process, individuals acquired practical skills, gradually boosting self-efficacy and vocational confidence, thereby facilitating the reshaping of their social roles. At the environmental and personal factors level, case management pathways involved active participation from immediate family (e310), positive shifts in societal attitudes (e460), and the effective utilization of health and employment policy resources (e580, e590). By integrating social and community resources comprehensively, the program created a more inclusive and supportive rehabilitation environment. By designing and implementing systematic case management programs, individuals showed significant improvements in psychological well-being, vocational adaptability and social interaction skills. The majority of cases achieved stable employment or continued participation in social activities following the intervention. ConclusionVR-CS provides a systematic, multidimensional and person-centered case management framework. This framework applies the bio-psycho-social model, analyzing individuals' primary functional impairments and vocational rehabilitation needs from the perspectives of body functions, psychological states and environmental factors. On this basis, a comprehensive, targeted and holistic case management plan is developed and implemented. The VR-CS-based case management approach not only enhances vocational capabilities but also improves overall quality of life and social adaptability.

ObjectiveTo reconstruct the vocational rehabilitation service process based on the framework and tools of the International Classification of Functioning, Disability and Health (ICF), to establish a systematic and standardized vocational rehabilitation service system to achieve the integrated development of vocational rehabilitation and other rehabilitation services, and to improve the overall rehabilitation effect and quality of life of people with disabilities. By establishing a systematic and standardized vocational rehabilitation service system, it provides function-oriented, holistic rehabilitation services for the whole person. MethodsThis study adopted the ICF framework and tools to conduct a systematic analysis of the vocational rehabilitation process. Based on this, according to the functional characteristics and systematic application of ICF-based tools, a vocational rehabilitation process was constructed, including functional assessment and rehabilitation goal setting, rehabilitation plan formulation, implementation of multidisciplinary intervention, outcome evaluation and quality of life assessment, and long-term follow-up and support. ResultsBased on the ICF framework and the application of ICF tools, according to the characteristics and nature of work of vocational rehabilitation institutions for persons with disabilities, a five-step vocational rehabilitation process was constructed. The main activity content of each process was defined in detail, and the ICF tools used and the methods of application were determined. The reengineering of the vocational rehabilitation process significantly improved the efficiency and quality of multidisciplinary comprehensive rehabilitation. The ICF framework and tools were the conceptual framework and platform for communication and collaboration among multidisciplinary teams. According to different vocational rehabilitation processes, the normative application of ICF-based tools ensured the development and implementation of scientific and effective rehabilitation intervention programs. The use of ICF-based tools also integrated vocational rehabilitation with other rehabilitation services, and achieved synergy among different rehabilitation services and different rehabilitation institutions. ConclusionThis study reengineered the vocational rehabilitation process based on the ICF framework, and constructed an ICF-based vocational rehabilitation process including the following five key processes, namely functional assessment and rehabilitation goal setting, formulating personalized and holistic rehabilitation plan, multidisciplinary team implementing comprehensive intervention strategies, evaluations of outcome and quality of life, and long-term follow-up and support services. Using the ICF framework and tools, the vocational rehabilitation service process of rehabilitation institutions has been reengineered, and an integrated rehabilitation service system has been constructed to provide a function-oriented comprehensive rehabilitation model, so that people with disabilities could receive whole-person rehabilitation services throughout their life cycle. Establishing a common language and tools based on ICF can effectively improve communication and collaboration among professionals, and also provide standardized tools for cross-institutional service integration, which is conducive to achieve smooth collaboration and information sharing among different rehabilitation institutions, ensuring the smooth transition of people with disabilities between different rehabilitation stages and institutions, and ensuring the coherence and integrity of the rehabilitation process.

Objective To analysis the relationship of primary aldosteronism to insulin resistance and abnormal glucose metabolism in patients with primary aldosteronism.Methods One hundred and three patients were diagnosed as aldosterone-producing adenoma(APA),75 cases as idiopathic hyperaldosterenism(IHA),56 patients as metabolic syndrome(MS)in Peking Union Medical College Hospital from September 2003 to December 2005.All patients were accepted 3 h oral glucose tolerance test and calculated HOMA-insulin resistance index (HOMA-IR)by Homeostasis Model.Results The Insulin area under curve[INS_(AUC) 270.8(192.7,370.4)mU?L~(-1)?h~(-1)]、HOMA-IR[3.2(2.4,4.7)]and prevalence of insulin resistance(64.3%)were significantly higher in patients with MS as compared with APA[113.2(81.5,193.6)mU?L~(-1)?h~(-1),1.4(1.0,2.2),16.5%]and IHA[186.9(116.6,243.3)mU?L~(-1)?h~(-1),2.0(1.4,3.1),32.0%]groups (all P＜0.01);The INS_(AUC), HOMA-IR and prevalence of insulin resistance were significantly higher in patients with IHA than those with APA (P＜0.05 or P＜0.01).There was no difference between the prevalence of impaired glucose regulation(41.7%, 34.7%),diabetes mellitus(15.5%,16.0%)in patients with APA,IHA and those with MS(41.1%, 26.8%).Conclusion Insulin resistance is present in primary aldosteronism patients,and the prevalence of insulin resistance is higher in patients with IHA.

Objective To investigate the effects of vaspin on insulin resistants of 3T3-L1 adipocyte through the insulin receptor substrates (IRS) /phosphatidylinositol 3-kinase (PI3K) /protein kinase B (Akt) /glucose transporter (Glut) signaling pathway.Methods 3T3-L1 cells cultured by palmitic acid (PA) were used to establish insulin resistance models,which were divided into PA group,PA + 100 ng/ml vaspin group,PA+200 ng/ml vaspin group,PA+400 ng/ml vaspin group and PA+400 ng/ml vaspin+wortmannin (PI3K inhibitor) group.Glucose uptake and consumption were assessed by 2-deoxy H3-D-glucose incorporation and glucose oxidase-peroxidase respectively.IRS/PI3K/Akt/Glut signaling pathway was evaluated using reverse transcription polymerase chain reaction and Western blot analysis.Results Compared with PA group,glucose uptake and consumption increased gradually with the increasing of vaspin concentration in other groups (P ＜ 0.05).mRNA levels of IRS-1,Akt and Glut 4 increased gradually as vaspin concentration increasing (P＜0.05),and the ratios of p-IRS-1 to IRS-1,p-Akt to Akt and Glut 4 protein level also showed the same trends (P＜0.05).However,glucose uptake and consumption in PA+400 ng/ml vaspin+wortmannin group were less than that of PA +400 ng/ml vaspin group (P＜0.05).PA+400 ng/ml vaspin+wortmannin group showed lower mRNA and protein phosphorylation levels of IRS-1,Akt and Glut 4 (P＜0.05),and that the ratios of p-IRS-1 to IRS-1,p-Akt to Akt and Glut 4 protein levels decreased (P＜0.05).Conclusions Vaspin can improve the insulin sensitivity of 3T3-L1 adipocyte by activating IRS/PI3K/Akt/Glut signaling pathway.

OBJECTIVETo evaluate the prognosis and predictive values of preoperative Glasgow prognostic score (GPS) for adenocarcinoma of esophagogastric junction(AEG) patients.

METHODSA retrospective study of 322 AEG patients who received operation between January 2007 and March 2010 in Henan Provincial People's Hospital was performed. Clinical data, pathological characteristics, laboratory parameters and survival data were collected. The GPS was calculated based on C-reactive protein(CRP) and serum albumin(ALB) levels. Univariate and multivariate analysis were used to evaluate the prognostic value of GPS.

RESULTSAmong 322 patients, 0, 1, 2 of GPS were 192, 104 and 26 patients respectively. The median follow-up was 37 (4-73) months. In Kaplan-Meier analysis, median diseases-free survival (DFS) of GPS 0, 1, 2 was 47.0 (95% CI: 31.6-62.4), 15.0 (95% CI: 11.8-8.2) and 4.7 (95% CI: 3.8-5.6) months (P<0.01), and median overall survival (OS) was out of reach, 20.6 (95% CI: 15.8-25.4) and 7.0 (95% CI: 5.8-8.2) months (P<0.01). Univariate and multivariate analysis revealed that GPS was an independent predictor of DFS (P<0.01) and OS (P<0.01) of AEG.

CONCLUSIONGPS is an effective predictor of survival in AEG.

Adenocarcinoma ; C-Reactive Protein ; Disease-Free Survival ; Esophageal Neoplasms ; Esophagogastric Junction ; Humans ; Kaplan-Meier Estimate ; Prognosis ; Retrospective Studies ; Stomach Neoplasms