Objective:To analyze the hearing outcomes of high-risk children of diabetic mothers, especially in the subtypes of pre-pregnancy diabetes and gestational diabetes, in order to provide some reference for clinical practice. Methods:The basic characteristics and hearing levels of children whose mothers had a history of diabetes during pregnancy and underwent audiological diagnosis and evaluation at our hospital's Children's Hearing Diagnosis Center from January 2003 to June 2024 were analyzed. T-tests, Wilcoxon rank-sum tests, and chi-square tests were used for inter-group comparisons, with a significance level set at P<0.05. Results:A total of 285 children（570 ears） of diabetic mothers were included. Hearing loss was found in 310 ears, and the incidence of hearing loss was 54.39%（310/570）. The mean ABR threshold in the pregestational diabetes group was（50.01±29.29） dB HL, while that in the gestational diabetes group was（44.13±26.19） dB HL. The degree of hearing loss in the pregestational diabetes group was more severe than that in the gestational diabetes group（χ²=10.000, P=0.019）. Conclusion:Maternal history of diabetes may be one of the risk factors for hearing loss in their offspring, and the risk of hearing loss in children whose mothers had diabetes before pregnancy may be higher than that in the gestational diabetes group. It is suggested that the clinical practice should pay attention to the monitoring and follow-up management of the hearing status of such children, so as to improve the auditory outcomes of children born to diabetic mothers.
Humans ; Female ; Pregnancy ; Diabetes, Gestational ; Hearing Loss/etiology* ; Child ; Pregnancy in Diabetics ; Risk Factors ; Child, Preschool ; Mothers ; Male

BACKGROUND:Large deep burn wounds are often accompanied by scar hyperplasia after healing,requiring transplantation of medium-thickness skin for repair,and the medium-thickness skin slices taken generally reach below the papillary layer of the dermis.If not handled correctly,complications such as delayed healing,ulceration,and post-healing pain and itching in the donor area can easily occur.Therefore,the repair of wounds in the donor area should be emphasized.OBJECTIVE:To observe the safety and practicability of autologous scalp repair of skin donor area in patients with deep burns and scarring.METHODS:Sixty patients with deep burn and scar hyperplasia admitted to the Burn Department of Zhengzhou First People's Hospital from January 2021 to September 2023 were selected as the study subjects.They all needed medium-thickness skin transplantation and repair,and were divided into study group(n=30)and control group(n=30)according to random systematic sampling method.The skin was taken from the patient's own medium-thickness skin on the leg or back.In the study group,the skin donor area was repaired with self-blade thick scalp replantation,and in the control group,the skin donor area was repaired with absorbent dressing.The wound healing rate and the time to complete epithelialization of the wound were observed and compared in the two groups 6 days after surgery.The pain of dressing change at 3 and 6 days after surgery and scar hyperplasia in the skin donor area at 6 months after surgery were compared between two groups.RESULTS AND CONCLUSION:Compared with the control group,the time to complete epithelialization of the wound was significantly lower in the study group(P<0.05),and the wound healing rate was significantly higher in the study group(P<0.05),the pain score for dressing change at 3 and 6 days after surgery was significantly lower in the study group(P<0.05),and the scar hyperplasia rate,scar score and itch score were also significantly lower in the study group(P<0.05)at 6 months after surgery.In conclusion,autologous scalp repair of the medium-thickness skin donor area can accelerate wound healing and reduce scar hyperplasia.

NK cells are essential components of innate immune system and play crucial roles in combating tumors and infec-tions by directly eliminating target cells and supporting other immune cells.However,tumors and chronic infections often result in exhaustion of NK cells,which diminishes their effector functions and hampers their ability to control progression of tumors and infec-tions.NK cell exhaustion is accompanied by alterations in surface receptors,cytokines and transcription factors.A comprehensive investigation into characteristics of NK cell exhaustion not only enhances our understanding of fundamental biological properties of NK cells but also facilitates development of novel immunotherapy approaches utilizing NK cells.This article provides an overview of cur-rent understanding of NK cell exhaustion,including its characterization and relevant knowledge,and explores its potential applica-tions in immunotherapy.

NK cells are essential components of innate immune system and play crucial roles in combating tumors and infec-tions by directly eliminating target cells and supporting other immune cells.However,tumors and chronic infections often result in exhaustion of NK cells,which diminishes their effector functions and hampers their ability to control progression of tumors and infec-tions.NK cell exhaustion is accompanied by alterations in surface receptors,cytokines and transcription factors.A comprehensive investigation into characteristics of NK cell exhaustion not only enhances our understanding of fundamental biological properties of NK cells but also facilitates development of novel immunotherapy approaches utilizing NK cells.This article provides an overview of cur-rent understanding of NK cell exhaustion,including its characterization and relevant knowledge,and explores its potential applica-tions in immunotherapy.

Objective:To explore the diagnostic value of the combined detection of v-Kirsten Ras viral oncogene homolog(KRAS),transmembrane protein 243(TMEM243),cell division cycle protein 42(CDC42)and RAS like family 11 member B(RASL11B)for different types of Hashimoto's thyroiditis(HT).Methods:From January 2023 to December 2024,a total of 185 HT patients who received detection in Hebei Yanda Hospital were selected by using a random number table method,and they were divided into three groups according to HT type,which included the euthyroid HT group(65 cases),the hypothyroid HT group(60 cases)and the hyperthyroidism HT group(60 cases).Another 65 healthy individuals who underwent physical examination during the same period were selected as the healthy control group.An analyzer of enzyme-linked immunosorbent assay(ELISA)was used to measure and analyze the levels of KRAS,TMEM243,CDC42 and RASL11B in the four groups.Differences in autoantibody levels among different HT patients were compared.Logistic regression analysis was conducted to assess influence factors for HT.A nomogram model was constructed to realize visual presentation on the basis of the influence factors.Receiver operating characteristic(ROC)curves were adopted to assess the diagnostic efficacy of antibodies for subjects in the four groups.Results:The KRAS,TMEM243,CDC42 and RASL11B levels in the three HT groups were significantly higher than those in the healthy control group(F=906.962,840.078,830.290,846.182,P<0.05),respectively.Multivariate logistic regression analysis showed that KRAS,TMEM243,CDC42 and RASL11B were risk factors for HT(OR=4.071,1.424,1.026,1.031,P<0.05).The area under curve(AUC)of the ROC curve of the combined detection of four indicators of autoantibodies was 0.975,which sensitivity and specificity were respectively 94.05%and 92.31%.Conclusion:There were overexpression of KRAS,TMEM243,CDC42 and RASL11B in HT patients,especially,the overexpression of hyperthyroidism HT patients is more significant.The combined detection of the four indicators of autoantibody has favorable performance and clinical reference value in diagnosing HT.

Objective:To explore the diagnostic value of the combined detection of v-Kirsten Ras viral oncogene homolog(KRAS),transmembrane protein 243(TMEM243),cell division cycle protein 42(CDC42)and RAS like family 11 member B(RASL11B)for different types of Hashimoto's thyroiditis(HT).Methods:From January 2023 to December 2024,a total of 185 HT patients who received detection in Hebei Yanda Hospital were selected by using a random number table method,and they were divided into three groups according to HT type,which included the euthyroid HT group(65 cases),the hypothyroid HT group(60 cases)and the hyperthyroidism HT group(60 cases).Another 65 healthy individuals who underwent physical examination during the same period were selected as the healthy control group.An analyzer of enzyme-linked immunosorbent assay(ELISA)was used to measure and analyze the levels of KRAS,TMEM243,CDC42 and RASL11B in the four groups.Differences in autoantibody levels among different HT patients were compared.Logistic regression analysis was conducted to assess influence factors for HT.A nomogram model was constructed to realize visual presentation on the basis of the influence factors.Receiver operating characteristic(ROC)curves were adopted to assess the diagnostic efficacy of antibodies for subjects in the four groups.Results:The KRAS,TMEM243,CDC42 and RASL11B levels in the three HT groups were significantly higher than those in the healthy control group(F=906.962,840.078,830.290,846.182,P<0.05),respectively.Multivariate logistic regression analysis showed that KRAS,TMEM243,CDC42 and RASL11B were risk factors for HT(OR=4.071,1.424,1.026,1.031,P<0.05).The area under curve(AUC)of the ROC curve of the combined detection of four indicators of autoantibodies was 0.975,which sensitivity and specificity were respectively 94.05%and 92.31%.Conclusion:There were overexpression of KRAS,TMEM243,CDC42 and RASL11B in HT patients,especially,the overexpression of hyperthyroidism HT patients is more significant.The combined detection of the four indicators of autoantibody has favorable performance and clinical reference value in diagnosing HT.

BACKGROUND:Large deep burn wounds are often accompanied by scar hyperplasia after healing,requiring transplantation of medium-thickness skin for repair,and the medium-thickness skin slices taken generally reach below the papillary layer of the dermis.If not handled correctly,complications such as delayed healing,ulceration,and post-healing pain and itching in the donor area can easily occur.Therefore,the repair of wounds in the donor area should be emphasized.OBJECTIVE:To observe the safety and practicability of autologous scalp repair of skin donor area in patients with deep burns and scarring.METHODS:Sixty patients with deep burn and scar hyperplasia admitted to the Burn Department of Zhengzhou First People's Hospital from January 2021 to September 2023 were selected as the study subjects.They all needed medium-thickness skin transplantation and repair,and were divided into study group(n=30)and control group(n=30)according to random systematic sampling method.The skin was taken from the patient's own medium-thickness skin on the leg or back.In the study group,the skin donor area was repaired with self-blade thick scalp replantation,and in the control group,the skin donor area was repaired with absorbent dressing.The wound healing rate and the time to complete epithelialization of the wound were observed and compared in the two groups 6 days after surgery.The pain of dressing change at 3 and 6 days after surgery and scar hyperplasia in the skin donor area at 6 months after surgery were compared between two groups.RESULTS AND CONCLUSION:Compared with the control group,the time to complete epithelialization of the wound was significantly lower in the study group(P<0.05),and the wound healing rate was significantly higher in the study group(P<0.05),the pain score for dressing change at 3 and 6 days after surgery was significantly lower in the study group(P<0.05),and the scar hyperplasia rate,scar score and itch score were also significantly lower in the study group(P<0.05)at 6 months after surgery.In conclusion,autologous scalp repair of the medium-thickness skin donor area can accelerate wound healing and reduce scar hyperplasia.

Objective:To study the application effect of the Benner's theory stratified training based on the "Protect the World" platform for nurses specialized in neurological rehabilitation.Methods:A total of 70 nurses who underwent on-the-job training for neurorehabilitation nursing specialists in 2023 were divided into control group ( n=35) and observation group ( n=35) based on random odd and even numbers to receive different training methods. The control group received routine nursing training, while the observation group received Benner's theory stratified training based on the "Protect the World" platform. The theoretical and skill assessment scores, job competency, and satisfaction scores of two groups of nurses were compared before and after training. SPSS 25.0 was used for t-test and chi-square test. Results:Before training, there were no significant differences between the two groups of nurses in terms of theory scores [(88.35±4.41) vs. (89.43±4.07)] and skill assessment scores [(89.22±3.27) vs. (88.43±3.16)]. After training, the theoretical and skill assessment scores were significantly higher in the observation group as compared with the control group [(95.51±5.01) vs. (90.24±4.99) and (95.15±4.24) vs. (91.13±4.33), both P<0.05]. After training, the competency scores and total scores of education guidance, management function, diagnostic function, assistance role, and intervention treatment were significantly higher in the observation group than in the control group ( P<0.05). The satisfaction survey scores were significantly higher in the observation group than in the control group ( P<0.05). Conclusions:The Benner's theory stratified training based on the "Protect the World" platform can improve the theoretical and skill assessment scores of nurses specialized in neurological rehabilitation. This approach significantly boosts their overall professional competence and holds considerable potential for broader adoption.

Objective To investigate the effect of endoscopic prebiopsy forceps on the detection rate of polyps in the right semicolon.Method Clinical data of 148 patients diagnosed and treated from March 2022 to December 2022 who were detected as polyps in the right semicolon by general electronic colonoscopy were collected,and clinical data of the patients who underwent endoscopic prebiopsy forceps were re-examined and the patients underwent endoscopic treatment within 1 month.The differences in general data,polyp number detected,polyp size,morphology and pathological diagnosis between the two groups were analyzed and compared.Results 168 polyps were detected in the right semicolon in the general colonoscopy group,and 41 polyps were missed in reexamination using endoscopic prebiopsy forceps,with a missed diagnosis rate of 19.62%.The detection rate of<5 mm polyps was higher in the endoscopic prebiopsy forceps group than that of general colonoscopy group,the difference was statistically significant(P<0.05).The polyps in the two groups were mainly wide-basal type,and the pathological properties were mainly tubular adenoma,there was no statistical significance among all groups(P>0.05).No complications such as bleeding and perforation occurred in the two groups.Conclusion Endoscopic prebiopsy forceps can significantly improve the detection rate of polyps in the right semicolon,in particular,the intraoperative search for disappeared preoperatively identified intestinal polyps,as well as smaller diameter intestinal polyps,which is worthy of further clinical promotion.

Background Schizophrenia patients often face high level of stigma and low level of self-esteem,significantly hindering their recovery.Mindfulness-based intervention has proven be effective in reducing stigma and improving self-esteem.However,traditional mindfulness intervention typically involve high costs and require long-term professional involvement.Objective To explore the effects of blended mindfulness interventions on stigma and self-esteem in patients with stable schizophrenia,so as to provide references for reducing stigma,enhancing self-esteem and promoting recovery.Methods Patients receiving outpatient treatment at the Third Hospital of Daqing from June 2022 to January 2023,who met the diagnostic criteria for schizophrenia in the International Classification of Diseases,tenth edition(ICD-10)and were in a stable phase,were recruited for the study(n=84).According to the random number table method,participants were randomly assigned to study group and control group,with 42 cases in each group.Both groups received treatment with the second-generation antipsychotic medications,while the study group additionally received blended mindfulness intervention for 8 weeks,with sessions lasting 45～60 minutes,three times a week.Both groups were evaluated with Five Facet Mindfulness Questionnaire(FFMQ),Internalized Stigma of Mental Illness Inventory(ISMI)and Rosenberg Self-Esteem Scale(RSES)at baseline and after 8-week intervention.Covariance analysis was used to compare the FFMQ,ISMI and SES scores between two groups after 8-week intervention.Results After 8-week intervention,there were statistically significant differences between two groups in total FFMQ scores,as well as in the observation,acting with awareness,non-judgment and non-reactivity subscale scores(F=50.680,12.952,13.567,22.799,14.043,P<0.01).Statistically significant differences were observed in total ISMI scores,and in the alienation,stereotype endorsement,discrimination experience,stigma resistance and social withdrawal subscale scores(F=513.125,148.990,125.055,75.996,154.850,54.125,P<0.01).The difference in RSES scores between two groups was also statistically significant(F=19.478,P<0.01).Conclusion Blended mindfulness intervention may help improve the mindfulness and self-esteem in stable schizophrenia patients while reducing stigma.