Objective To analyze the economic cost of self-monitoring of gestational diabetes mellitus, and provide a basis for measuring the economic burden of gestational diabetes mellitus, and to provide a reference for the formulation of intervention development and the adjustment of resource allocation. Methods The individual economic cost of self-monitoring for gestational diabetes mellitus was measured based on a decision tree model, and the total economic cost of self-monitoring for gestational diabetes mellitus in Beijing was estimated. The uncertainty of the model parameters was analyzed using one-way sensitivity analysis. Results The average individual economic cost of gestational diabetes self-monitoring was 1184 RMB, and the individual cost incurred by choosing different types of blood glucose meters ranged from 403 to 18 000 RMB. The average individual economic cost of finger-stick blood glucose monitoring was 606 RMB and the average individual economic cost of continuous glucose monitoring was 2 374 RMB. The total economic cost of gestational diabetes self-monitoring in Beijing was 23.818 0 million RMB, and the total economic cost incurred by choosing different types of blood glucose meters ranged from 0.292 5 to 9.027 9 million RMB. The proportion of the finger-stick blood glucose monitoring had the greatest impact on the robustness of the results. Conclusion Finger-stick blood glucose monitoring is still the dominant self-monitoring method and is less costly than continuous glucose monitoring. Self-monitoring of pregnant women with gestational diabetes mellitus incurs certain economic cost and causes an economic burden on society.

Objective:To investigate the impact of the size of the liver tumor diameter on the prognosis of patients with hepatitis B-related hepatocellular carcinoma (HCC)-inducing acute-on-chronic liver failure (HBV-HCC/ACLF).Method:A retrospective cohort study was conducted. Clinical data of patients with hepatitis B-related acute-on-chronic liver failure (HBV-ACLF) diagnosed according to the Asia-Pacific Association for the Study of the Liver (APASLT) guidelines who were admitted to the Fifth Medical Center of PLA General Hospital between January 2016 and January 2021 were collected. The patients were enrolled in the HBV-HCC/ACLF group (116 cases) and the HBV-ACLF group (348 cases). General information, medical history, biochemical parameters, complications, and liver cancer status were collected. Clinical data and prognoses at 28 days and 12 months of follow-up were compared between the two groups. Factors influencing mortality in the HBV-HCC/ACLF group were analyzed to determine the prognostic significance of tumor diameter. The t test, χ 2 test, and multivariate logistic regression analysis were used to analyze factors influencing mortality. Receiver operating characteristic (ROC) curves were used to assess the sensitivity and specificity of tumor diameter for 28-day prognosis, and Kaplan-Meier curves were used for survival analysis. Result:There were statistically significant differences in the 28-day mortality rate [(55.17%, 64/116) vs. (38.51%, 134/348)] and 12-month mortality rate [(78.45%, 91/116) vs. (55.75%, 194/348)] between the HBV-HCC/ACLF group and the HBV-ACLF group ( P<0.05). The area under the ROC curve analysis for HBV-HCC/ACLF patients indicated that the tumor diameter was 0.707 (95% CI: 0.615-0.788). The survival group (52 cases) and the mortality group (64 cases) were divided into the HBV-HCC/ACLF group based on 28-day mortality. Univariate analysis showed that the levels of aspartate aminotransferase (AST), alkaline phosphatase, creatinine, alpha-fetoprotein, white blood cell count, international normalized ratio, model for end-stage liver disease score, acute kidney injury (AKI), the occurrence of infections and complications, and others were all significantly higher in the mortality group compared to the survival group ( P<0.05).The mortality group had a larger tumor diameter than the survival group ( P<0.01). The incidence of portal vein tumor thrombosis and distant liver cancer metastasis was also higher in the survival group ( P<0.01). The mortality group had a higher rate of HCC-related minimally invasive treatment within three months before ACLF diagnosis than the survival group ( P<0.01). AST levels, infection, size of tumor diameter, and minimally invasive treatment within three months before onset were independent risk factors for 28-day mortality in the HBV-HCC/ACLF group. The optimal significant value for tumor diameter affecting prognosis was 3.3 cm, with a sensitivity of 67.19% and a specificity of 73.08%. Patients with liver tumor diameters >3.3 cm had significantly lower 28-day survival rates than those with a tumor diameter ≤3.3 cm [(24.56%, 14/57) vs. (64.41%, 38/59)]. Eighty case analyses had the same findings in patients who had not previously received any therapy. Conclusion:Patients with HBV-HCC/ACLF had a high 28-day mortality rate, and the size of the tumor diameter is important in determining the 28-day prognosis.

Objective:To explore the construction of a core competency evaluation indicator system for pediatric surgery operating room specialist nurses.Methods:The evaluation indicator system was constructed by reviewing literature, analyzing semi-structured interview results, and examining the characteristics of training specialized nurses in pediatric surgery operating rooms, as well as combining the characteristics of pediatric surgery and multi-source data. The research group discussed and proposed a preliminary core competency evaluation indicator system for specialized nurses in pediatric surgery operating rooms. This study used the Delphi expert inquiry method to conduct two rounds of expert consultation and ultimately established the core competency evaluation indicator system for pediatric surgery operating room specialist nurses. The expert positivity coefficient was represented by the questionnaire response rate, and the expert authority coefficient was calculated using the judgment coefficient and familiarity degree. The coefficient of variation and Kendall's W coefficient were used to measure the degree of coordination of expert opinions. Results:The effective response rates for the two rounds of expert consultation were 100.00% and 95.24%, respectively. The authority coefficients of the two rounds of expert consultation were 0.92 and 0.90, respectively. The coefficients of variation of indicators at various levels were less than 0.25. The Kendall's W coefficients for the first-, second-, and third-level indicators in the first and second rounds of expert consultation were 0.516-0.664 and 0.652-0.711, respectively ( P<0.001). The final core competency evaluation indicator system for pediatric surgery operating room specialist nurses included 3 first-level indicators, 15 second-level indicators, and 52 third-level indicators. Conclusions:The core competency evaluation indicator system for pediatric surgery operating room specialist nurses constructed in this study provides a scientific and practical guidance for training pediatric surgery operating room specialist nurses in China.

Objective To investigate the influencing factors for the short-term prognosis of patients with alcohol-related liver diseases-acute-on-chronic liver failure(ALD-ACLF)comorbid with infection.Methods A total of 89 ALD-ACLF patients with infection who were admitted to the Fifth Medical Center of PLA General Hospital from January 2019 to December 2021 were enrolled as subjects,and related clinical data were collected at baseline(time of patient enrollment).According to the 28-day survival status of patients,they were divided into survival group with 53 patients and death group with 36 patients,and baseline clinical data were compared between the two groups.The t-test was used for comparison of normally distributed continuous data between groups,and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between groups;the chi-square test was used for comparison of categorical data between groups.A non-conditional Logistic regression analysis was used to perform the multivariate analysis.The Z-test was used for comparison of the area under the ROC curve(AUC),and the diagnostic value of the model was assessed.Results Compared with the survival group,the death group had significantly higher hemoglobin(t=-2.397,P=0.019),alanine aminotransferase(Z=-3.437,P=0.001),gamma-glutamyl transpeptidase(Z=-2.617,P=0.009),creatinine(Z=-3.938,P<0.001),blood urea nitrogen(Z=-3.423,P=0.001),NH3(Z=-4.406,P<0.001),international normalized ratio(Z=-3.428,P=0.001),C-reactive protein(Z=-2.128,P=0.033),procalcitonin(Z=-2.441,P=0.015),Model for End-Stage Liver Disease(MELD)score(t=-4.817,P<0.001),incidence rate of acute kidney injury(χ2=21.602,P<0.001),incidence rate of pulmonary infection(χ2=4.866,P=0.027),and incidence rate of shock(χ2=16.285,P<0.001),as well as significantly lower albumin(Z=-2.473,P=0.013)and incidence rate of abdominal infection(χ2=5.897,P=0.015).The multivariate analysis showed that NH3(odds ratio[OR]=1.027,95%confidence interval[CI]:1.006-1.049,P=0.012),MELD score(OR=1.103,95%CI:1.011-1.203,P=0.027],and the incidence rate of shock(OR=6.326,95%CI:1.533-26.101,P=0.011)were independent risk factors for 28-day mortality in ALD-ACLF patients comorbid with infection.Based on these factors,a predictive model was established as Y=0.027×NH3+0.098×MELD score+1.845×shock-4.111.The ROC curve analysis showed that the new model had an AUC of 0.861,a sensitivity of 77.78%,and a specificity of 88.68%,while MELD score had an AUC of 0.776,a sensitivity of 77.78%,and a specificity of 67.92%,suggesting that the new model had a significantly higher diagnostic value than MELD score(Z=2.136,P=0.032 6).Conclusion ALD-ACLF patients with infection tend to have a poor short-term prognosis,and MELD score,NH3,and shock are influencing factors for the short-term prognosis of such patients.The combination of these three factors has a high value in predicting short-term prognosis.

Objective:To explore the role and molecular mechanisms of S100A6 protein in neonatal meningitis caused by Streptococcus agalactiae. Methods:Human brain microvascular endothelial cells (HBMECs) were used as an in vitro experimental model, and siRNA was employed to construct S100A6 gene knockdown HBMECs strain. The S100A6 gene overexpression cell line was established by lentiviral transfection method. Western blot was used to detect the expression level of S100A6 protein in HBMECs after Streptococcus agalactiae infection, and the change in intracellular inflammatory cytokine protein levels after S100A6 gene knockdown or overexpression. A neonatal bacterial meningitis model was established by injecting Streptococcus agalactiae suspension into the cisterna magna of neonatal Sprague-Dawley (SD) rats. HE staining was used to observe pathological changes in brain tissue; immunohistochemistry was used to detect the expression and distribution of S100A6 protein in brain tissue; Western blot and ELISA were used to measure S100A6 protein levels in cerebrospinal fluid (CSF). Results:Compared with the control group, the intracellular S100A6 protein level in HBMECs increased significantly following Streptococcus cgalactiae infection. After S100A6 gene knockdown, the invasion rate of Streptococcus agalactiae into the HBMECs was significantly reduced ( P<0.01), while intracellular TNF-α and IL-6 protein levels were elevated markedly ( P<0.01). In contrast, overexpression of S100A6 gene increased the invasion rate ( P<0.01) and notably decreased TNF-α and IL-6 protein levels ( P<0.001). In the neonatal SD rat bacterial meningitis model, HE staining revealed substantial neutrophil infiltration in brain tissue after Streptococcus agalactiae infection. Immunohistochemistry showed extensive deposition of S100A6 protein around the meninges, and significant expression of S100A6 protein was also detected in CSF. Conclusions:S100A6 protein is crucial in mediating neonatal meningitis caused by Streptococcus agalactiae infection. S100A6 gene knockdown promotes the production of intracellular inflammatory cytokines and reduces Streptococcus agalactiae invasion into cells, thereby alleviating bacteria-induced cellular damage. Additionally, the increased expression of S100A6 protein in brain tissue and CSF after Streptococcus agalactiae infection suggests its potential as a diagnostic biomarker for bacterial meningitis.