Objective The aim of this study was to investigate the prognostic value of body composition indicators in evaluating the development risk of gestational diabetes mellitus(GDM).Methods A total of 1431 pregnant women who were registered and underwent prenatal examinations in the Clinical Nutrition Department of Guizhou Hospital of Beijing Jishuitan Hospital were selected in this study from January 2018 to September 2021.Among them,263 participants were diagnosed with GDM(GDM group),and 1168 healthy individuals underwent physical examinations were enrolled as Con group.Results The GDM detection rate was 18.38%(263/1431).Logistic regression analysis showed that age and percent body fat were risk factors for the development of GDM.The area under the ROC curve of percent body fat for GDM prediction was 0.732,with sensitivity,specificity of 67.7%,68.3%.Conclusions High percentage of body fat during pregnancy is a risk factor for the development of GDM in late pregnancy,and the risk of developing diabetes during pregnancy can be predicted by the percentage of body fat index.

TROP-2, a tumor-associated antigen, has been implicated in the progression of various epithelial tumors. Due to its favorable expression profile, TROP-2 has emerged as a promising target for antibody-drug conjugates (ADCs) based anti-tumor therapies. Although ADCs have shown efficacy in cancer treatment, their application in solid tumors is hindered by their high molecular weight, poor tumor penetration, and release of cytotoxic molecules. Therefore, a recombinant immunotoxin was developed based on a shark-derived variable domain of immunoglobulin new antigen receptor (VNAR) antibody. VNARs are only one-tenth the size of IgG antibodies and possess remarkable tissue penetration capabilities and high stability. In this study, a shark VNAR phage display library was created, leading to the identification of shark VNAR-5G8 that targets TROP-2. VNAR-5G8 exhibited a high affinity and cellular internalization ability towards cells expressing high levels of TROP-2. Epitope analysis revealed that VNAR-5G8 recognizes a hidden epitope consisting of CRD and TY-1 on TROP-2. Subsequently, VNAR-5G8 was fused with a truncated form of Pseudomonas exotoxin (PE38) to create the recombinant immunotoxin (5G8-PE38), which exhibited significant anti-tumor activity in vitro and in vivo. Overall, this study highlights the promise of 5G8-PE38 as a valuable candidate for cancer therapy.

OBJECTIVE： To study the anti-gout effect of aqueous extract from the stems and leaves of Erythropalum scandens （ASLE）. METHODS： The mice were randomly divided into normal group， model group， allopurinol group （positive control， 5 mg/kg）， ASLE low-dose， medium-dose and high-dose groups （1 300， 2 600， 5 200 mg/kg， by raw material； similarity hereinafter）， with 10 mice in each group. Except for normal group， other groups were given potassium oxonate intragastrically to induce hyperuricemia model. One hour after modeling， normal group and model group were given constant volume of normal saline intragastrically； administration group was given relevant medicine intragastrically， once a day， for consecutive 7 d. One hour after last administration， the levels of serum uric acid （SUA） and serum creatinine （Scr） were detected by colorimetry assay. Another mice were randomly divided into normal group， model group， indomethacin group （positive control， 7.5 mg/kg）， ASLE low-dose， medium-dose and high-dose groups， with 10 mice in each group. Normal group and model group were given constant volume of normal saline intragastrically； administration group was given relevant medicine intragastrically， once a day， for consecutive 7 d. After last administration， except for normal group， the mice were given sodium microcrystalline urate via toes to induce gouty arthritis model. Before and 1， 2， 4， 6， 8 h after modeling， the circumference of the same part of the inflamed limbs and toes of mice in each group was measured by wire binding method， and the degree of toe swelling was calculated. The number of white blood cell （WBC）， neutrophil （NEU） and lymphocyte （LYM） were detected by animal hematology analyzer. The levels of SUA and Scr were measured by colorimetry assay. The content of NO in toe tissue was determined by Griess method. RESULTS： The experimental results of hyperuricemia model showed that the levels of SUA and Scr in mice were significantly higher in model group than those in normal group （P＜0.01）. Compared with model group， above indexes of mice were decreased significantly in administration group （P＜0.05 or P＜0.01）. The experimental results of gouty arthritis model showed that the level of SUA， the degree of toe swelling （2-8 h）， the number of WBC， NEU and LYM， NO content in model group were increased significantly， compared with normal group （P＜0.05 or P＜0.01）. Compared with model group， the levels of SUA and Scr （ASLE groups）， the degree of toe swelling [indomethacin group， ASLE high-dose group （2-8 h）， ASLE low-dose group （2， 6 h）， ASLE medium-dose group （6 h）]， the number of WBC and NEU （administration groups）， the number of LYM （indomethacin group） and NO content （administration groups except for ASLE low-dose group） were decreased significantly in administration groups （P＜0.05 or P＜0.01）. CONCLUSIONS： The anti-gout effect of ASLE may be associated with promoting uric acid metabolism， anti-inflammatory and improving renal function.

Prior to the formation of new metastases,a large number of cancer cells released from the primary tumor enter the dormancy period.Once the dorruancy is broken,tumor cells will recover the capability of proliferation.In recent years,various hypotheses and mechanisms of tumor metastasis have been studied.Primary tumor resection is considered to be an important factor to break tumor dormancy state.It is recognized as an important reason to promote tumor metastasis.The improvement of surgical technique and further study on the mechanism of dormancy may provide new ideas for the treatment of metastatic tumor.

As a secreted glycoprotein,Dickkopf-1 (DKK1) is closely related to tumor metastasis,and it is highly or lowly expressed in tumor.The high expression of DKK1 promotes the metastasis of a variety of malignant tumors including liver cancer,gastric cancer,non-small cell lung cancer and breast cancer.Recent studies have found that DKK1 is inextricably bound up with the latent metastasis of tumor.

Objective To explore the effect of calories supplement or protein supplement on the skeletal muscle in the elderly.Methods The ambulatory elderly (≥65 yrs) with reduced handgrip strength and/or gait speed were enrolled,who did not suffer from any neurological or arthritic disease impairing mobility,or any severe pulmonary or heart disease,or chronic kidney failure.The subjects were recruited with their written informed consent from clinical practices in five hospitals in China.The subjects were randomized to control group(n=26),nutrition supplementation (Nutren 400 kcal/ d) group (n=27) or protein supplementation(Biopro Protein 20 g/d) group (n=21).All the subjects were given healthy lifestyle education.The physical performances i.e.gait speed and handgrip strength were measured at baseline and at 2 and 3 months of followed up.Lean soft tissue mass (muscle mass) was measured by BIA at baseline and at 3 months of follow-up.Results A total of 74 subjects completed the trial,including 26 in controls,27 in Nutren,and 21 in protein group.At the end of the trial,the changes from baseline in appendicular muscle mass were-490.0 g (95％CI:-801.9--245.5,P=0.001)in control group,90.0 g (95％CI:-346.8--442.0,P=0.241) in Nutren group,and 290.0 g (95％CI:-746.6-20.1,P=0.007) in protein group.There were no significant difference in above indices among the three groups (P=0.051),except between Nutren group and control group (P=0.020).The handgrip strength and gait speed in the three groups were improved obviously as compared with those at baseline,but not statistically significant between different groups.Conclusions Caloric supplementation group may have greater effect in maintaining muscle mass than the protein supplement group in the elderly.Both the caloric supplement and the protein supplement produce no additional effect on muscular function as compared with healthy lifestyle education.

Objective To analyze the clinical characteristics and prognosis of the overlap syndrome of dementia,depression and delirium coexistence in two or three of them (the 2D's or 3D's) in elderly patients,in order to raise awareness.Methods Clinical data of 16 patients aged ＞65 years diagnosed with the 2D's or 3D's admitted to Peking Union Medical College Hospital from 2010 to 2014 were analyzed and relevant literatures were reviewed.Results Patients with the 2D's or 3D' s accounted for 10％ of the elderly demented patients and 3％ of the elderly depressive patients.16 patients [11 females and 5 males,median age 82 years and mean age (80±6) years] were enrolled,with 7 cases of dementia with depression,6 cases of delirium superimposed on dementia,2 cases of the 3D's,and 1 case of coexisting depression and incident delirium.The Charlson comorbidity index of the 16 patients was (3.0± 1.5).(4.0± 1.6) kinds of geriatric syndromes were found,and the most common were falls (62％),sleep disorders (56％),frailty (50％),polypharmacy (43 ％),and malnutrition (37％).Disability was identified in 14 (88％) patients on admission.Delirium was observed in 9 patients (56 ％),with 7 cases of hyperactive delirium and 2 cases of hypoactive delirium.Coexisting underlying dementia was identified after episodes of delirium in 6 cases.16 patients all received corresponding intervention during hospitalization period.During a mean follow-up period of (15±13) months,62 ％ of the patients had more impaired physical function (ADL score reduction≥ 1),and 43％ of the patients had more impaired cognitive function (MMSE score reduction≥3).Two patients were transferred to long-term care facilities and one patient died during follow-up.The readmission rate was 50％ within 1 year after discharge.Conclusions The domestic report of overlap syndrome of dementia,depression and delirium is rare.Patients with the coexistence of the 2D's or 3D's are more commonly combined with geriatric syndromes,which results in further cognitive and physical function impairment with a higher re-admission rate.We should pay attention to the follow-up in elderly patients with delirium for screening dementia.

Objective To investigate the prevalence of malnutrition and nutritional support and interventions in geriatric inpatients.Methods The elderly patients (aged ≥ 65 years)from the geriatric demonstration ward were consecutively enrolled from July 2010 to January 2012.MiniNutritional Assessment-short form (MNA-SF) was performed after admission,and data of nutritional support were collected.Results A total of 179 patients were enrolled in this study.According to MNA-SF,42 cases (23.5％)were rated as malnutrition,and 55 cases (30.7％) were rated as at risk of malnutrition.Totally,45 patients received nutritional support.50.0％ (21/42) patients with malnutrition,and 29.1％ (16/55) patients at risk of malnutrition received nutritional support.As to the route of nutrition therapy,the ratio of the enteral to parenteral to combination of enteral and parental nutrition was 4.4 ∶ 1.0 ∶ 1.0.Conclusions The incidence of malnutrition is high in the geriatric inpatients,and routine nutritional risk screening and assessment are essential for the elderly patients.Nutritional support and other comprehensive treatment are in great need,and the enteral nutrition is appropriate and preferred.