Objective:To explore the value of serum matrix metalloproteinase-1 (matrix metalloproteinase-1), and phosphatase and tensin hmmlogydeleted on ten (PTEN), in predicting osteoporosis (OP) in women with gestational diabetes mellitus (GDM) .Methods:The clinical data of.218 pregnant women with GDM treated in Linyi People’s Hospital from Sep. 2019 to Feb. 2023 were retrospectively collected and included in the GDM group. Another 98 healthy pregnant women who underwent physical examination during the same period were selected as the control group. Age, body mass index (BMI), blood glucose related indexes and serum MMP-1 and PTEN levels were compared between the two groups. According to the occurrence of osteoporosis (OP) in the second and third trimester of pregnancy, the GDM group was divided into OP group and non-OP group. Logistic regression analysis was used to explore the influencing factors of OP in pregnant women with GDM in the second and third trimesters. ROC curve was drawn to analyze the predictive value of serum MMP-1 and PTEN levels for osteoporosis in GDM pregnant women in the second and third trimesters.Results:Body mass index (BMI), fasting blood glucose (FBG), glycated hemoglobin A1c (HbA1c) and serum MMP-1 and PTEN levels in GDM group were higher than those in control group, but BUA, SOS and SI were lower than those in control group ( t=6.18, 12.68, 9.91, 11.42, 7.70, 5.63, 5.76, 9.84, all P<0.05). Among 218 GDM women, 29 cases had OP and 189 cases did not have OP. There were no significant differences in fasting blood glucose, glycosylated hemoglobin, blood calcium, blood magnesium, or blood phosphorus between the two groups (statistical value: 0.96, 0.86, 1.35, 1.06, 0.49, P>0.05). Logistic regression analysis showed that age, abnormal increase of MMP-1 and PTEN levels were independent risk factors for OP in GDM women in the second and third trimesters [ OR (95% CI) =1.260 (1.103-1.440) ,1.075 (1.031-1.120) ,1.055 (1.023-1.089), all P<0.05]. ROC curve showed that the AUC of MMP-1 and PTEN in predicting OP in GDM pregnant women in the second and third trimesters were 0.824 and 0.777, respectively. The AUC of the combination of the two in predicting OP in GDM pregnant women in the second and third trimesters was 0.933, and the specificity and sensitivity were 83.04% and 93.48%, respectively, which were higher than those of single detection. Conclusions:MMP-1 and PTEN in early pregnancy may play a potential role in the prediction of OP in pregnant women with GDM. Close monitoring of MMP-1 and PTEN levels may provide new ideas for the clinical diagnosis and treatment of OP high-risk patients.

Objective:To understand the current status of gastroscopy in diagnosing gastric lesions in general population, and to recommend the optimal age for the first gastroscopy and intervals for repeated gastroscopy.Methods:The gastroscopy records of residents aged 18-80 years in Yinzhou District of Ningbo, Zhejiang Province, between April 2010 and December 2021 were analyzed retrospectively. The detections of gastric lesions across different years, age and genders were described. Goodness of fit tests were applied to compare the differences in detection rates of different lesions in first-time endoscopy in different age groups and different populations. Generalized additive models were used to fit the trend of age specific gastric lesion detection rate explore the optimal age for gastroscopy. The appropriate gastroscopy intervals were determined according to the progress of the gastric lesions detected in repeated gastroscopy.Results:A total of 237 751 participants with 344 398 gastroscopy records were included in analyses. A total of 5 597 cases of chronic atrophic gastritis (CAG), 9 796 cases of intestinal metaplasia (IM), 165 cases of low-grade intraepithelial neoplasia (LGIN), 52 cases of high-grade intraepithelial neoplasia (HGIN) and 435 cases of gastric cancer were detected by the first gastroscopy. The overall detection rate of gastric lesions increased significantly in age group 45-70 years, and remained stable after 70 years old, with LGIN and HGIN showing notable increases at 50 and 55 years old, respectively. Repeated gastroscopy detected CAG, IM, LGIN, and HGIN at a higher rate compared with the first gastroscopy. Normal/superficial gastritis progressed in 3-5 years, whereas CAG or more severe lesions progressed in 1-6 years.Conclusion:Gastroscopy is recommended for general population aged 45 years and above. Furthermore, gastroscopy can be performed every 3-5 years for individuals with normal endoscopy results and once a year for patients with CAG or more severe gastric lesions.

Objective: To investigate the incidence density of adult sleep disorders (SD) in Yinzhou District, Ningbo City, Zhejiang Province from 2017 to 2023, so as to provide insights into formulating the control measures of SD. Methods: The electronic health records of permanent residents aged 18 years and over in Yinzhou District from 2017 to 2023 were collected through the Yinzhou Regional Health Information Platform. New cases of SD were diagnosed for the first time a year after establishing health records. The incidence density was estimated using Poisson distribution. The temporal, population and regional distribution characteristics of new cases of SD were analyzed using a descriptively epidemiological method. Results: From 2017 to 2023, there were 1 255 129 permanent residents aged 18 years and over in Yinzhou District, with a total observed person-time of 6 292 884 person-years and a median of 5.67 (interquartile range, 3.74) person-years. There were 165 490 new cases of SD, including 67 095 males (40.54%) and 98 385 females (59.46%). The incidence density of SD in Yinzhou District from 2017 to 2023 was 26.30/1 000 person-years, with no significant trend observed (P>0.05). The incidence density of SD was higher in females than in males (29.63/1 000 person-years vs. 22.57/1 000 person-years, P<0.05). The highest incidence density of SD was observed in individuals aged 70 to <80 years (63.30/1 000 person-years), and the lowest was in individuals aged 18 to <30 years (7.24/1 000 person-years). The incidence density of SD in individuals aged 30 years and over was higher than that in individuals aged 18 to <30 years (all P<0.05). The incidence density of SD was 32.03/1 000 person-years in individuals with junior high school education or below, which was higher than individuals with senior high school/technical secondary school education (25.93/1 000 person-years) and college degree and above (18.87/1 000 person-years, all P<0.05). Dongliu Street, Dongjiao Street, and Baihe Street had relatively higher incidence densities of SD, at 45.11/1 000 person-years, 42.87/1 000 person-years and 40.16/1 000 person-years, respectively. Conclusions From 2017 to 2023, there was no significant trend in the incidence density of SD in Yinzhou District. Higher incidence density were observed in females, the elderly, and individuals living in central urban areas.

Objective To investigate the application of low-dose computed tomography virtual colonoscopy(LDCTVC)in colorec-tal tumor.Methods Forty-seven colorectal tumor were given low-dose CT abdominal scan(low-dose group),15 patients with normal body mass index(BMI)who received routine-dose CT abdominal scan at the same period(routine-dose group).Volume CT dose index(CTDIvol),dose length product(DLP),virtual colonoscopy and optical colonoscopy results were recorded.Results The effective dose with normal BMI was(2.86±0.47)mSv and(4.87±1.15)mSv in the low-dose and routine-dose groups,respectively.The CTDIvol and DLP between the two groups were statistically significant(P＜0.05).There were 14 cases of true positive,4 cases of false positive,5 cases of false negative and 24 cases of true negative in the low-dose group.The sensitivity,specificity and Kappa value of LDCTVC in the diagnosis of colorectal mucosal lesions were 73.7％,85.7％,and 0.6.Conclusion LDCTVC can reduce the effective dose by 50％and has a good diagnostic value for colorectal mucosal lesions,which can make up for the deficiency of colonoscopy and make accurate judgment of extra-mucosal lesions of the bowel wall.

Hepatocellular carcinoma (HCC) has the features of high incidence rate, low survival rate, poor treatment outcome, and complex pathogenesis. In recent years, many studies have shown that long non-coding RNA (lncRNA) MALAT1 is upregulated in HCC and can promote the proliferation, invasion, and metastasis of HCC cells, and it can also guide the diagnosis, prognostic evaluation, and treatment of HCC in clinical practice. This article reviews the current status of research on lncRNA MALAT1 in HCC and discusses its expression pattern, mechanism of action, and clinical significance in predicting and monitoring the progression of HCC, so as to gain a deep understanding of the role of lncRNA MALAT1 in the progression of HCC. It is pointed out that lncRNA MALAT1 is expected to become a potential biomarker for the diagnosis and prognostic evaluation of HCC and may be used as a therapeutic target in clinical practice.

Objective:To explore the surgical method and therapeutic effect of repairing thumb pulp defect with pedicled transposition of radial proper palmar digital artery flap of middle finger.Methods:Since June, 2006 to May, 2020, 17 cases(17 fingers) with thumb pulp defect were repaired by pedicled transposition of radial proper palmar digital artery flap of middle finger. The sizes of flap ranged from 1.5 cm × 1.5 cm to 4.2 cm × 2.0 cm. The antegrade pedicled flap of radial proper palmar digital artery of middle finger was used in 2 cases and the retrograde pedicled flap of middle finger was used in 15 cases. After the flap was resected, the donor sites were covered with a medium thickness skin graft transferred from the wrist or elbow. The skin graft did not need to be packed. The dorsal branch of the digital nerve was included in the flap and it was anastomosed with the proper nerve of the injured thumb stump. After 16-22 days of the operation, the pedicles were cut off. The patients were instructed to perform digit function exercise after the pedicle was cut off. After the operation, the patients were included in regularly follow-up through outpatient visit, telephone or WeChat interview. The appearance and sensation of the thumb and finger pulps and the function recovery of the thumb and finger joints were observed through the followed-ups.Results:All 17 flaps and donor site skin grafts survived over 3 to 32 months of follow-up. The flaps achieved good texture and natural appearance. The TPD recovered to 5~11 mm. According to the Michigan Hand Function Questionnaire, all the 17 patients were very satisfied with the overall appearance and function of the hands. According to TAM, the 17 cases were all in excellent.Conclusion:Repairing thumb pulp defect with radial proper palmar digital artery pedicled flap of middle finger, the flap resection is simple, and the donor site is hidden. The appearance and texture of flap is good. It is a safe, effective and good method.

MicroRNA-223 (miR-223) is located on chromosome X, and is highly conserved in the process of evolution. In recent years, many studies have shown that miR-223 is abnormally expressed in a variety of digestive system tumors, such as esophageal cancer, gastric cancer, liver cancer, pancreatic cancer and colorectal cancer. MiR-223 can participate in the proliferation, apoptosis and invasion of tumor cells through a variety of signal pathways, which is expected to become a marker for the diagnosis and prognosis of digestive system tumors.

Severe acute pancreatitis is a common clinical acute abdominal disease, characterized by acute onset, rapid progression, high risk, poor prognosis and so on. Due to the high mortality of this disease, it has been the focus and difficulty of clinical research. The traditional treatment of severe acute pancreatitis mainly include fasting and parenteral nutrition. However, recently, international and national consensus suggest that early enteral nutrition is fit for severe acute pancreatitis, although the timing of early enteral nutrition has been controversial. The article summarizes the optimal timing of early enteral nutrition for severe acute pancreatitis.

Objective To assess pregnancy outcome and pregnancy related concerns in Takayasu arteritis (TA) patients.Methods We analyzed 68 female patients with TA retrospectively from Xijing hospital.Data on the number of pregnancies,births and pregnancy outcomes before and after disease onset were retrieved from medical charts,patient questionnaires and the department of Obstetrics in Xijing Hospital.Data on pregnancy related concerns were gathered from patient questionnaires.Results Altogether,68 women in the TA study cohort had 106 pregnancies,73 (in 41 patients) before disease onset and 33 (in 28 patients) after disease onset.There were no difference in the frequencies of miscarriages,induced abortions and maternal complications before and after TA onset.Pregnancy related hypertension was seen in 4.7％ of the TA patients compared to 2.0％ (x2=1.238,P＞0.05) of the reference cohort from the department of Obstetrics in Xijing Hospital and preeclampsia/eclampsia in 4.7％ of the TA patients compared to 2.8％ of the reference cohort (x2=1.835,P＞0.05).The mean gestational age at delivery in pregnancies after TA onset was (37±6) weeks compared to (39±4) weeks in the reference cohort (x2=14.665,P＜0.01).Caesarian sections were more frequent in deliveries after TA onset (36％) than in the reference cohort (15％) (x2=13.322,P＜0.01).86％ of the TA patients had pregnancy related concerns.Of these concerns,72％ was about passing the disease to offsprings.Conclusion In this population based TA cohort,the maternal and fetal outcomes are favorable.Pregnancy related concerns are very popular in TAK patients.

Objective: To explore the relation between platelet-to-lymphocyte ratio (PLR) or neutrophil-to-lymphocyte ratio (NLR) with disease activity in Takayasu arteritis (TA) patients. Methods: Present retrospective study involved 289 patients with TA, who were hospitalized in our department between January 2010 and October 2017, and 280 age and gender matched healthy controls,who underwent thealth examination in our health examination center during the same period (control group). TA patients were further divided into active and inactive groups (180 and 109 cases respectively) according to Kerr scores. The clinical data were compared between groups. Pearson correlation analysis was used to evaluate the relationship between PLR or NLR and disease activity (Kerr score or C-reactive protein or erythrocyte sedimentation rate). Receiver operating characteristic (ROC) curve was employed to judge the cut-off value of disease activity for TA patients. Results: PLR and NLR were significantly higher in TA group than in control group(137.33 (97.38, 193.37) vs. 120.55 (96.86, 144.60) and 2.38 (1.76, 3.57) vs. 1.66 (1.35, 2.08) , respectively, all P<0.001). PLR and NLR were significantly higher in active TA group than in inactive TA group (163.43 (123.64, 224.15) vs. 110.53 (84.22, 147.24) and 2.59 (1.96, 3.94) vs. 1.95 (1.53, 2.86) respectively, all P<0.001). PLR and NLR of active group were significantly decreased after 6 months treatment (164.05 (123.29, 226.29) vs. 104.67 (77.22, 138.43) and 2.58 (1.96, 3.91) vs. 2.15 (1.67, 2.60) respectively, all P<0.001). PLR was positively correlated with Kerr score (r=0.439, P<0.001), C-reactive protein (r=0.328, P<0.001) and erythrocyte sedimentation rate (r=0.410, P<0.001). NLR also exhibited a positive relationship with Kerr score (r=0.235, P<0.001), C-reactive protein (r=0.169, P=0.005) and erythrocyte sedimentation rate (r=0.123, P=0.037). A PLR level of 176.709 was shown to be the best predictive cut-off value for TA disease activity (sensitivity 44.6%, specificity 93.0%, and area under the curve=0.766).A NLR level of 2.128 was shown to be the best predictive cut-off value for TA disease activity (sensitivity 70.9%, specificity 47.7%, and area under the curve=0.691). Conclusion PLR and NLR are useful markers for predicting disease activity of TA patients.