This paper reported a type 1 diabetes patient who had severe diabetic nephropathy, retinopathy, hypertension, and hypothyroidism before pregnancy. The patient's blood glucose control was poor before pregnancy, and the complications were not properly treated. This was an unintended pregnancy, with a pre-pregnancy glycated hemoglobin A1c of 7.8% and early pregnancy urine protein of 3.81-4.53 g/24 h. Considering the patient's poor blood glucose control before pregnancy and the lack of proper treatment for multiple complications including nephropathy, a multidisciplinary consultation at an external hospital recommended termination of the pregnancy. However, the patient was determined to continue the pregnancy and was referred to Peking University First Hospital. Through strict blood glucose control, monitoring and evaluation of complications, and comprehensive management, the patient's blood glucose and blood pressure were well controlled during pregnancy. Regular monitoring of urine protein, renal function, and ocular fundus was conducted. At 31 weeks and 4 days of gestation, the patient's 24-hour urine protein significantly increased. After promoting fetal lung maturity, a cesarean section was performed at 34 weeks and 1 day of gestation, resulting in a successful delivery with good maternal and neonatal outcomes. At the 42-day postpartum follow-up, the patient's blood glucose and blood pressure were stable, urine protein returned to pre-pregnancy levels, and the infant was in good general condition.

This article addresses the critical importance of recognizing and differentiating maternal heart rate artifact (MHRA) during cardiotocography for improving pregnancy outcomes. MHRA occurs when fetal monitors erroneously identify and display maternal heart rate signals as fetal heart rate, potentially masking genuine fetal distress or leading to unnecessary medical interventions. The analysis examines MHRA incidence, risk factors, and associations with adverse perinatal outcomes, highlighting increased misinterpretation risks during the second stage of labor and maternal tachycardia. Through representative cases, we emphasize the clinical value of recognizing MHRA warning signs, including sudden "normalization" of fetal heart rate patterns and contraction-synchronous accelerations. The review synthesizes evidence supporting effective differentiation strategies that combine pulse oximetry for maternal heart rate monitoring with real-time ultrasonography. Finally, integrating international guidelines with clinical practice, we propose that multimodal monitoring and novel technology applications represent key approaches for reducing misinterpretation and enhancing cardiotocography quality.

This paper reported a type 1 diabetes patient who had severe diabetic nephropathy, retinopathy, hypertension, and hypothyroidism before pregnancy. The patient's blood glucose control was poor before pregnancy, and the complications were not properly treated. This was an unintended pregnancy, with a pre-pregnancy glycated hemoglobin A1c of 7.8% and early pregnancy urine protein of 3.81-4.53 g/24 h. Considering the patient's poor blood glucose control before pregnancy and the lack of proper treatment for multiple complications including nephropathy, a multidisciplinary consultation at an external hospital recommended termination of the pregnancy. However, the patient was determined to continue the pregnancy and was referred to Peking University First Hospital. Through strict blood glucose control, monitoring and evaluation of complications, and comprehensive management, the patient's blood glucose and blood pressure were well controlled during pregnancy. Regular monitoring of urine protein, renal function, and ocular fundus was conducted. At 31 weeks and 4 days of gestation, the patient's 24-hour urine protein significantly increased. After promoting fetal lung maturity, a cesarean section was performed at 34 weeks and 1 day of gestation, resulting in a successful delivery with good maternal and neonatal outcomes. At the 42-day postpartum follow-up, the patient's blood glucose and blood pressure were stable, urine protein returned to pre-pregnancy levels, and the infant was in good general condition.

Mass spectrometry(MS)is one of the core technology in the field of clinical laboratory,which has a series of advantages include high sensitivity,high specificity,and the simultaneous analysis of multi-components.It shows great potential in metabolite detection,proteomic analysis,etc.,which can provide new pathways for early diagnosis and personalized treatment of complex diseases.In recent years,the research of MS technique appears rapid development trend in the field of clinical laboratory.This paper systematically combed the application status and research progress of MS techniques in clinical laboratory,which include mass spectrometry imaging(MSI),matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF MS),inductively coupled plasma mass spectrometry(ICP-MS),cytometry by time-of-flight(CyTOF),and liquid chromatography-tandem mass spectrometry(LC-MS/MS).It focused on their practical applications in disease diagnosis,efficacy assessment,and prognosis judgment,and it anatomized the faced bottlenecks and problems of current technique.Based on the frontline technological trends,it explore the innovative directions of integrating MS technique with emerging bioinformatics,microfluidics,etc.,so as to provide theoretical basis and practical reference for promoting the standardized and intelligent development of MS technique in clinical laboratory,and help its wide application in clinical diagnosis and treatment.

Mass spectrometry(MS)is one of the core technology in the field of clinical laboratory,which has a series of advantages include high sensitivity,high specificity,and the simultaneous analysis of multi-components.It shows great potential in metabolite detection,proteomic analysis,etc.,which can provide new pathways for early diagnosis and personalized treatment of complex diseases.In recent years,the research of MS technique appears rapid development trend in the field of clinical laboratory.This paper systematically combed the application status and research progress of MS techniques in clinical laboratory,which include mass spectrometry imaging(MSI),matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF MS),inductively coupled plasma mass spectrometry(ICP-MS),cytometry by time-of-flight(CyTOF),and liquid chromatography-tandem mass spectrometry(LC-MS/MS).It focused on their practical applications in disease diagnosis,efficacy assessment,and prognosis judgment,and it anatomized the faced bottlenecks and problems of current technique.Based on the frontline technological trends,it explore the innovative directions of integrating MS technique with emerging bioinformatics,microfluidics,etc.,so as to provide theoretical basis and practical reference for promoting the standardized and intelligent development of MS technique in clinical laboratory,and help its wide application in clinical diagnosis and treatment.

This article addresses the critical importance of recognizing and differentiating maternal heart rate artifact (MHRA) during cardiotocography for improving pregnancy outcomes. MHRA occurs when fetal monitors erroneously identify and display maternal heart rate signals as fetal heart rate, potentially masking genuine fetal distress or leading to unnecessary medical interventions. The analysis examines MHRA incidence, risk factors, and associations with adverse perinatal outcomes, highlighting increased misinterpretation risks during the second stage of labor and maternal tachycardia. Through representative cases, we emphasize the clinical value of recognizing MHRA warning signs, including sudden "normalization" of fetal heart rate patterns and contraction-synchronous accelerations. The review synthesizes evidence supporting effective differentiation strategies that combine pulse oximetry for maternal heart rate monitoring with real-time ultrasonography. Finally, integrating international guidelines with clinical practice, we propose that multimodal monitoring and novel technology applications represent key approaches for reducing misinterpretation and enhancing cardiotocography quality.

Objective Reliability and validity of the Chinese version of disability attitude scales(DAS-CN)toward disabled persons were created and tested to provide an assessment instrument for measuring the attitude of medical staff toward disabled persons in China.Methods Authorised by the author of DAS in August 2020,based on BRISLIN translation model,the English version of DAS was translated into Chinese followed by back translation,cultural debugging and then put it into pre-experiment in September 2020.The reliability and validity of the finalised DAS-CN were further tested in a survey with 400 randomly selected medical staff in rehabilitation from 8 general hospitals in Jinzhou,Panjin,Yingkou and Fushun in Liaoning Province,China by using the convenience sampling method in March 2021.Results A total of 357 surveyees completed the survey.The localised DSA-CN was composed of 4 dimensions with a total of 20 items,including 4 items in clinical knowledge and skills,4 in clinical responsibility,8 in clinical behaviour and 4 in emotional response.The Cronbach α coefficient of the scales was 0.943,with the split-half reliability and test-retest reliability at 0.824 and 0.899,respectively.The Cronbach α coefficient of each dimension was 0.843～0.944,and the split half reliability was 0.854～0.904.The test-retest reliability ranged from 0.701 to 0.913.The KMO value of exploratory factor analysis was 0.921.The Bartrett spherical test value was 5534.981(P<0.01).The total explanatory rate of variation was 73.050%.Conclusion The Chinese version of Disability Attitude Scales(DSA-CN)has good reliability and validity.Therefore,DSA-CN can be used as an instrument in investigation of the current status about the attitudes towards the disabled persons among the medical staff in China.

Objective:To explore the effect of early essential newborn care technology during cesarean section on early health outcomes of mothers and infants and breast feeding.Methods:This study was a randomized controlled study. From October 2020 to August 2021, 104 delivery women and their newborns who were scheduled for full-term cesarean section in Peking University First Hospital were selected as the study subject. The subjects were randomly divided into control group and intervention group, 52 cases in each group. The control group received routine nursing of the newborn after cesarean section, while the intervention group received early essential newborn care technology after cesarean section. The amount of postpartum hemorrhage, hospital stay, Apgar score at one and five minutes after birth, the incidence of abnormal conditions within 90 minutes after birth, the time of umbilical cord shedding, the time of the first feeding sign of the newborn, the success rate of early initiation of breastfeeding and the implementation of breast feeding at discharge were compared between the two groups.Results:There was no statistical difference between the two groups in the amount of postpartum hemorrhage within two hours, the amount of postpartum hemorrhage within two to 24 hours and the number of days in hospital ( P>0.05) . There was no statistical difference between the two groups in Apgar scores at one and five min after birth ( P>0.05) . There was no statistical difference between the two groups in the occurrence of re-attraction, respiratory abnormalities, resuscitation, Neonatal Intensive Care Unit (NICU) transfer and other abnormalities within 90 minutes after birth ( P>0.05) . There was no statistical difference in the time of umbilical cord shedding between the two groups ( P>0.05) , and no umbilical infection occurred. The first foraging reflex in the intervention group was earlier than that in the control group, and the success rate of early initiation of breastfeeding was higher than that in the control group, and the differences was statistically significant ( P<0.05) . There was no statistical difference in the implementation of breast feeding between the two groups at discharge ( P>0.05) . Conclusions:It is safe and feasible to implement early essential newborn care technology during cesarean section, and it can effectively promote early initiation of breastfeeding, which is of great significance for breast feeding and has the value of clinical promotion.

【Objective】 To study the annual financial expenditure in blood stations with different scales, and to establish the regression equation between blood collection units and total expenditure. 【Methods】 The annual total expenditure, the per capita cost of serving population, as well as the collection units of whole blood and apheresis platelet of 24 blood stations were collected. The financial expenditure required for collecting 10 000U blood was calculated.The statistical analysis was carried out with SPSS statistical software. 【Results】 From 2017 to 2020, the total annual financial expenditure of 24 blood stations showed an upward trend. The total expenditure among blood stations was different. The per capita cost of servicing population in the areas where the 24 blood stations were located had been increasing year by year. The 24 blood stations were divided into two grades according to the blood collection volume as 50 000 U, and the relationship equation between the blood collection volume and the annual total expenditure had been established. After testing, each equation was effective(P<0.05); There was no difference in the financial expenditure required for collecting 10 000U blood among blood stations with different scales. 【Conclusion】 From 2017 to 2020, the blood stations with an annual collection volume more than 50 000 U demonstrated a higher financial expenditure and the per capita cost of serving population than those <50 000 U. The blood collection volume of blood stations is significantly correlated with the annual total expenditure and the per capita cost of serving population.

BACKGROUND: Gestational diabetes mellitus (GDM) brings health issues for both mothers and offspring, and GDM prevention is as important as GDM management. It was shown that a history of GDM was significantly associated with a higher maternal risk for GDM recurrence. The incidence of GDM recurrence was unclear because of the incidence of second-child was low before 2016 in China. We aim to investigate the prevalence of GDM recurrence and its associated high-risk factors which may be useful for the prediction of GDM recurrence in China. METHODS: A retrospective study was conducted which enrolled participants who underwent regular prenatal examination and delivered twice in the same hospital of 18 research centers. All participants were enrolled from January 2018 to October 2018, where they delivered the second baby during this period. A total of 6204 women were enrolled in this study, and 1002 women with a history of GDM were analyzed further. All participants enrolled in the study had an oral glucose tolerance test (OGTT) result at 24 to 28 weeks and were diagnosed as GDM in the first pregnancy according to the OGTT value (when any one of the following values is met or exceeded to the 75-g OGTT: 0 h [fasting], ≥5.10 mmol/L; 1 h, ≥10.00 mmol/L; and 2 h, ≥8.50 mmol/L). The prevalence of GDM recurrence and development of type 2 diabetes mellitus were calculated, and its related risk factors were analyzed. RESULTS: In 6204 participants, there are 1002 women (1002/6204,16.15%) with a history of GDM and 5202 women (5202/6204, 83.85%) without a history of GDM. There are significant differences in age (32.43 ± 4.03 years vs. 33.00 ± 3.34 years vs. 32.19 ± 3.37 years, P  < 0.001), pregnancy interval (4.06 ± 1.44 years vs. 3.52 ± 1.43 years vs. 3.38 ± 1.35 years, P  = 0.004), prepregnancy body mass index (BMI) (27.40 ± 4.62 kg/m2vs. 23.50 ± 3.52 kg/m2vs. 22.55 ± 3.47 kg/m2, P < 0.001), history of delivered macrosomia (22.7% vs. 11.0% vs. 6.2%, P < 0.001) among the development of diabetes mellitus (DM), recurrence of GDM, and normal women. Moreover, it seems so important in the degree of abnormal glucose metabolism in the first pregnancy to the recurrence of GDM and the development of DM. There are significant differences in OGTT levels of the first pregnancy such as area under the curve of OGTT value (18.31 ± 1.90 mmol/L vs. 16.27 ± 1.93 mmol/L vs. 15.55 ± 1.92 mmol/L, P < 0.001), OGTT fasting value (5.43 ± 0.48 mmol/L vs. 5.16 ± 0.49 mmol/L vs. 5.02 ± 0.47 mmol/L, P < 0.001), OGTT 1-hour value (10.93 ± 1.34 mmol/L vs. 9.69 ± 1.53 mmol/L vs. 9.15 ± 1.58 mmol/L, P < 0.001), OGTT 2-hour value (9.30 ± 1.66 mmol/L vs. 8.01 ± 1.32 mmol/L vs. 7.79 ± 1.38 mmol/L, P < 0.001), incidence of impaired fasting glucose (IFG) (fasting plasma glucose ≥5.6 mmol/L) (31.3% vs. 14.6% vs. 8.8%, P < 0.001), and incidence of two or more abnormal OGTT values (68.8% vs. 39.7% vs. 23.9%, P < 0.001) among the three groups. Using multivariate analysis, the factors, such as age (1.07 [1.02-1.12], P = 0.006), prepregnancy BMI (1.07 [1.02, 1.12], P  = 0.003), and area under the curve of OGTT in the first pregnancy (1.14 [1.02, 1.26], P  = 0.02), have an effect on maternal GDM recurrence; the factors, such as age (1.28 [1.01-1.61], P  = 0.04), pre-pregnancy BMI (1.26 [1.04, 1.53], P = 0.02), and area under the curve of OGTT in the first pregnancy (1.65 [1.04, 2.62], P = 0.03), have an effect on maternal DM developed further. CONCLUSIONS The history of GDM was significantly associated with a higher maternal risk for GDM recurrence during follow-up after the first pregnancy. The associated risk factors for GDM recurrence or development of DM include age, high pre-pregnancy BMI, history of delivered macrosomia, the OGTT level in the first pregnancy, such as the high area under the curve of OGTT, IFG, and two or more abnormal OGTT values. To prevent GDM recurrence, women with a history of GDM should do the preconception counseling before preparing next pregnancy.
Adult ; Blood Glucose/metabolism* ; China/epidemiology* ; Diabetes Mellitus, Type 2/epidemiology* ; Diabetes, Gestational ; Female ; Fetal Macrosomia ; Glucose Intolerance ; Humans ; Male ; Pregnancy ; Retrospective Studies