Objective:To explore the relationship between the longitudinal change trajectory of white blood cell (WBC) and new-onset type 2 diabetes mellitus(T2DM).Methods:It was a prospective cohort study. A total of 2 792 people who underwent health examinations at the Health Management Center of the Affiliated Hospital of Qingdao University from January 2019 to December 2023 for five consecutive years and met the research standards were selected as the study subjects. Group-based trajectory modeling (GBTM) was established. The target population was divided into three groups based on the longitudinal change trajectory of WBC: low-stable group, medium-stable group and high-stable group. The cumulative incidence of T2DM in the three groups were analyzed. Multivariate Cox proportional risk regression models were used to analyze the correlation between different WBC trajectory groups and the risk of T2DM in total population, males and females. A restricted cubic spline regression (RCS) model was used to analyze the dose-response relationship between baseline WBC and risk of T2DM.Results:The cumulative incidence rate of T2DM in low-stable group, medium-stable group and high-stable group increased gradually, which was 2.5%, 5.3% and 6.9%, respectively ( χ2=19.024, P<0.001). After adjusting for multiple confounding factors in the Cox proportional hazards regression model, no significant difference in the incidence risk of T2DM among the three WBC trajectory groups in males; While the hazard ratios in the high-stable and medium-stable group in women was 2.852(95% CI: 1.067-7.628) and 2.588 (95% CI: 1.133-5.912), respectively, when compared with that in the low-stable group (both P<0.05). RCS curve analysis showed a linear relationship between WBC and the risk of T2DM in female ( Pnon-linear=0.956), when the WBC count was>5.53×10 9/L, the risk of T2DM increased with the rise of WBC. Conclusion:Higher WBC trajectory is positively correlated with the risk of new-onset T2DM in female health examination population.

Objective:To compare the changes in pelvic floor electrophysiology and imaging in female patients with myofascial pelvic pain (MFPP), and to explore the characteristics and significance of these changes.Methods:A total of 49 MFPP patients who were admitted to the of Dalian Women′s and Children′s Medical Center (Group) from January 2019 to October 2021 were randomly selected as the research group, and 41 healthy women during the same period were selected as the control group. Both groups filled in the center′s medical history and general condition survey form. French PHENIX series pelvic floor muscle potential detection instrument was used to detect the resting vaginal muscle potential and maximum muscle potential of the two groups. The static tension, dynamic tension and pelvic floor muscle contraction force of the two groups were measured by French PHENIX series electronic tensioning apparatus with 5° and 10° opening respectively. Two dimensional transperineal ultrasound and three dimensional transvaginal ultrasound produced by B-K Company in Denmark were used to measure the length between the lower margin of the bladder neck from the symphysis pubis and the bladder neck and the bladder bottom (BND, BSD), the diameter of the genital tract hiatus and the angle of the anus and rectum. The area, anterior-posterior diameter, transverse diameter and different damage degrees of levator ani levator were measured.Results:The resting muscle potential of the study group was higher than that of the control group: 2 μV vs. 1 μV ( P<0.05); the maximum vaginal myopotential was higher than that of the control group: 7 μV vs. 6 μV ( P<0.05). The static tension, dynamic tension and contractile force: 204 g/m 2 vs. 175 g/m 2, 450 g/m 2 vs. 410 g/m 2 and 237 g/m 2 vs. 51 g/m 2 of pelvic floor muscle in the study group were higher than those in the control group when the tensioner was opened for 5° ( P<0.05). In resting state, BND, BSD and reproductive tract hiatus diameter in the study group were smaller than those in the control group: 14.0 mm vs. 16.7 mm, 15.3 mm vs. 19.7 mm, 46.7 mm vs. 49.5 mm ( P<0.05). The anal angle was greater than that of the control group: 129° vs. 112° ( P<0.05). The anal right angle in the study group was greater than that in the control group: 113° vs. 109° ( P<0.05). In the resting state, the area of levator ANI hiatus: 10.1 cm 2 vs. 11.6 cm 2, anterior and posterior diameters: 44.2 mm vs. 47.4 mm, transverse diameters and the defect scores of levator ani in the study group were all smaller than those in the control group ( P<0.05). Conclusions:MFPP presents with persistent pelvic floor muscle spasm and loss of coordination. MFPP can be treated by spasmolysis of pelvic floor muscle and fascia, which provides reference value for clinical treatment.

Genicular nerve block is usually used for the treatment of chronic pain of knee osteoar-thritis,which can effectively relieve knee pain and preservemotor function.With the rapid development of ultrasound technology,ultrasound-guided genicular nerve block can improve the accuracy of nerve block and reduce block-related complications.This article reviews the research progress of ultrasound-guided genicular nerve block in three aspects:anatomy,operation methods and clinical application.

Objective:To investigate and analyze the psychological stress status and influencing factors of medical staff in comprehensive grade A hospitals.Methods:This was a cross-sectional survey using a convenient sampling method. A questionnaire survey was conducted among 2 048 staff members of the Affiliated Hospital of Qingdao University from February 25 to June 16, 2022. The questionnaires included the Self-rating Stress Questionnaire (SSQ-53), the Self-rating Anxiety Scale, and the Self-rating Depression Scale. A total of 2 048 questionnaires were distributed and 2 048 were collected. Among them, 2 006 (97.95%) were valid questionnaires, and 2 006 medical staff were ultimately included in the analysis. According to the results of the scale, they were divided into the increased psychological stress group and the non increased psychological stress group. Descriptive analysis, independent sample t-test/chi-square test, correlation analysis, and other methods were used to analyze the psychological stress status of medical staff and the distribution of related factors, and multivariate logistic regression was used to analyze their influencing factors. Results:A total of 310 (15.5%) out of 2 006 study subjects showed increased psychological stress. Women had a statistically significant increase in physical (14.7% vs 8.0%, χ2=12.40, P<0.001) and emotional dimensions (18.2% vs 13.5%, χ2=5.04, P=0.025) of stress compared to men. The level of psychological stress was positively correlated with anxiety and depression ( r=0.810, 0.749, respectively, P<0.001). Univariate analysis showed that those who were women ( χ2=6.76, P=0.009), with low education backgrounds ( Z=-2.50, P=0.012), nurses ( χ2=15.72, P<0.001), or working in emergency departments ( χ2=13.64, P=0.009) had a higher rate of increased psychological stress, while the serum calcium level in the increased psychological stress group was lower than that in the non increased psychological stress group ( t=2.82, P=0.005). Multivariate analysis showed that low educational backgrounds ( OR=2.238, 95% CI: 1.090-4.597, P=0.028) and working in emergency department ( OR=1.589, 95% CI: 1.012-2.493, P=0.044) were independent risk factors for increased psychological stress of medical staff. Working in administrative and logistics departments ( OR=0.466, 95% CI: 0.229-0.950, P=0.036) and serum calcium level ( OR=0.213, 95% CI: 0.059-0.760, P=0.017) were negatively correlated with increased psychological stress. Conclusions:In comprehensive grade A hospitals, medical staff working in the emergency department or with lower educational backgrounds face greater psychological stress. Serum calcium level is negatively correlated with increased psychological stress, but the causal relationship needs further study.

Objective:To examine whether the mixed infection rate in pertussis infants is significantly higher than that in non-pertussis infants with respiratory tract infection, to explore the mixed infection pathogen distribution in pertussis infants, and to provide reference for clinical diagnosis and treatment.Methods:A case-control study was conducted on 118 nasopharyngeal swabs collected from infants who applied for clinical pertussis etiological testing (culture and specific nucleic acid detection of Bordetella pertussis) in Beijing Children′s Hospital, Jiaxing Maternity and Child Health Care Hospital and Wuhu No.1 People′s Hospital from August 2018 to January 2021.According to the pertussis etiological testing results, the patients were divided into the pertussis group (65 cases) and non-pertussis group (53 cases). Thirty-three pairs of cases were matched according to age, onset season and city.All nasopharyngeal swabs were tested for infections of other pathogens using FilmArray RP2, which can detect 21 respiratory infection pathogens.The mixed infection rate was compared between groups by Chi- square test. Results:According to the FilmArray RP2 test results, 56.9%(37/65) cases in pertussis group and 15.1%(8/53) cases in the non-pertussis group were positive for multiple pathogens, and the difference was statistically significant ( χ2=21.651, P<0.001). The top 5 mixed infection pathogens in pertussis infants were human rhinovirus/enterovirus (HRV/EV) (38.5%, 25/65), parainfluenza virus (PIV) (18.5%, 12/65), respiratory syncytial virus (RSV) (10.8%, 7/65), coronavirus (Cov) (10.8%, 7/65), and adenovirus (ADV) (7.7%, 5/65). The mixed infection rates of the pertussis group in spring, summer, autumn and winter were 46.2% (6/13), 58.3%(14/24), 55.6%(5/9), and 63.2%(12/19), respectively.Comparison of matched and unmatched cases achieved similar results. Conclusions:Among clinical suspected pertussis infant specimens, the mixed infection rate in confirmed cases is tremendously higher than that in non-pertussis infants.The main mixed infection pathogens in pertussis infants are HRV/EV, PIV, RSV, Cov, and ADV.Mixed infection in pertussis children commonly occurs in four seasons, with the highest incidence in winter.

Objective To investigate the expression of lncRNA HOTAIR, HOTAIR, CRNDE and AFAP1-AS1 in lung cancer patients with bone metastasis (LCWBM), and to elucidate the diagnostic value of lncRNAs for LCWBM. Methods Serum was collected from 38 LCWBM patients and 38 lung cancer without bone metastasis (LCWOBM) patients. Questionnaires were used to collect basic information of patients. Fasting peripheral venous blood of patients was collected to separate serum. qRT-PCR was used to measure the expression levels of four serum lncRNAs, and their diagnostic value for LCWBM was analyzed. Results The expression of serum HOTAIR was decreased in LCWBM patients, compared with LCWOBM patients (P < 0.05); the AUC of serum HOTAIR diagnosing LCWBM was 0.722 (sensitivity was 70.0%, specificity was 81.3%). And the level of serum HOTTIP was significantly increased in LCWBM patients, compared with LCWOBM patients (P < 0.05); AUC of serum HOTTIP diagnosing LCWBM was 0.784 (sensitivity was 100.0%, specificity was 45.5%). The AUC of serum HOTAIR combined with HOTTIP diagnosing LCWBM was 0.818 (sensitivity, specificity, positive predictive value and negative predictive value were 87.5%, 72.7%, 70.0% and 88.9%, respectively). Conclusion Serum lncRNA HOTAIR and HOTTIP might be potential diagnostic biomarkers for bone metastases in lung cancer patients.

AIM: To reveal that the targeted regulation of TGF-β1 by miR-21-5P is the key mechanism that mediates the activation of myocardial fibroblasts, and to clarify the intervention ofRadix Angelica Sinensis and Radix Hedysari ultrafiltration on the mechanism of miR-21-5P targeting to regulate TGF-β1 effect. METHODS: (1) The cells were randomly divided into normal group and irradiation group. The irradiation group received 6Gry single irradiation, and then RT-PCR was used to detect miR-21-5P, and Western Blot was used to detect the expression of α-SMA and TGF-β1. (2) The cells were randomly divided into normal group, irradiation group, miR-21-5P

Objective:To compare the ability of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio and triglyceride-glucose index (TyG) in identifying nonalcoholic fatty liver disease (NAFLD).Methods:A total of 11 524 eligible subjects who underwent physical examination in the Affiliated Hospital of Qingdao University from January to December in 2018 were selected in this research. The correlation between TG/HDL-C, TyG and NAFLD was analyzed by using binary logistic regression. The receiver operating characteristic (ROC) curves of TyG and TG/HDL-C were drawn for identifying NAFLD in male and female, and their diagnostic value for NAFLD was compared.Results:The prevalence of NAFLD increased with TG/HDL-C and TyG. After adjusting for confounding factors, when compared with that in the first quartile group of TG/HDL-C, the odds ratios (OR) and 95% confidence intervals ( CI) of NAFLD risk in the second, third and fourth quartile groups of TG/HDL-C was 2.380 (2.039-2.779), 3.902 (3.342-4.555) and 7.903 (6.745-9.259), respectively. Compared with that in the first quartile group of TyG, the OR (95% CI) of NAFLD risk in the second, third and fourth quartile groups of TyG was 2.243 (1.923-2.617), 3.918 (3.363-4.565) and 9.002 (7.676-10.559), respectively. The area under the curve (AUC) of TG/HDL-C and TyG in identifying NAFLD in male was 0.746 and 0.744, respectively, and there was no significant difference between the two indexes ( P=0.509 1). The AUCs of TG/HDL-C and TyG in identifying NAFLD in female was 0.785 and 0.799, respectively, and the difference was statistically significant ( P<0.001). The cut-off point of TG/HDL-C for identifying NAFLD in male was 1.02, and the cut-off point of TyG for identifying NAFLD in female was 8.55. Conclusions:TG/HDL-C and TyG are closely related to NAFLD in adults. There is no difference between TG/HDL-C and TyG in evaluating NAFLD in male, while TyG is better than TG/HDL-C in evaluating NAFLD in female.

Objective To analyze the effect and application value of continuation nursing in the management of pelvic organ prolapse (POP) patients. Methods From June 2016 to December 2017, 50 patients with POP who were treated with pessary were randomly divided into study group and control group by randomized comparison digital table. The study group was followed by family continuation care. The nursing guidance was compared at the time of enrollment, 3 months and 6 months after enrollment, and the difference between the two groups in terms of disease awareness, daily behavioral ability, psychological state and complications were compared. Results The study group was significantly better than the control group in terms of disease awareness, daily behavioral ability, psychological state and satisfaction rate of nursing services (t=13.2667-19.8533,χ2=0.12-4.56, P<0.05). Conclusion The application of pessary in the treatment of POP patients in the home management can be used to reduce complications and improve the quality of life of patients. It has application and promotion value.

Objective To analyze the effect of trametes robiniophila on the apoptosis and the expressions of invasion and metastasis related matrix metalloproteinase 2 (MMP-2) and MMP-9 in human gastric carcinoma poorly differentiated cell line MKN-45 and medium differentiated cell line SGC-7901.Methods Human gastric carcinoma cell lines MKN-45 and SGC-7901 incubated with trametes robiniophila at the different concentrations [0 (the negative control group), 5, 10, and 20 mg/ml] for 24 h. When bifluorescently stained with acridine orange-ethidium bromide (AO-EB), morphology was observed by using microscopy. Flow cytometry was used to test the apoptosis ratio after 24, 48, and 72 h. Reverse transcription polymerase chain reaction (RT-PCR) was applied to analyze the expressions of mRNA of MMP-2 and MMP-9 after 24 h, and the absorbance values of the bands after gel electrophoresis were used as their expression levels. Results Under the fluorescence microscope, the cells of the negative control group were green (normal cells), and the membrane was even in size and integrity. The proportion of apoptotic and necrotic cells was increased with the concentration enrichment of trametes robiniophila. The apoptotic cells were yellow, and their cell membrane lost integrity. Apoptotic bodies were found in cancer cells, and cell membrane showed bud projection. The nuclei of the apoptotic cells showed brightly condensed chromatin or fragmented. Chromatin was strongly stained and located in karyotheca. The necrotic cells were dyed red with integrity of size. The apoptotic ratio of MKN-45 cell line induced by trametes robiniophila after 24 h was (6.5 ±0.8)％, (14.6±1.0)％, (18.0±1.1)％, and (23.1±1.2)％, respectively (F= 333.972, P< 0.01) in negative control group and 5, 10, and 20 mg/ml trametes robiniophila group. After 48 h, the apoptotic ratio was (7.3 ±1.2)％, (18.3 ± 1.6)％, (24.5±1.3)％, and (27.2±1.7)％, respectively (F= 528.432, P= 0.001); after 72 h, the apoptotic ratio was (7.5 ±0.9)％, (50.2 ±1.6)％, (58.0 ±1.9)％, and (69.0 ±1.4)％, respectively (F= 3814.238, P< 0.01). After SGC-7901 cell line induced by trametes robiniophila for 24 h, the apoptotic ratio was (12.9 ±1.0)％, (19.4 ± 1.2)％, (22.0±1.7)％, and (23.0±1.9)％, respectively (F= 120.190, P< 0.01) in negative control group and 5, 10, and 20 mg/ml trametes robiniophila group. For 48 h, the apoptotic ratio was (10.2 ±1.3)％, (40.9 ±1.4)％, (51.6 ±1.9)％, and (66.2 ±1.9)％, respectively (F= 1281.342, P< 0.01). For 72 h, the apoptotic ratio was (27.4 ±1.8)％, (49.7 ±1.4)％, (65.1 ±1.4)％, and (69.0 ±2.0)％, respectively (F= 1112.767, P< 0.01). The induction of apoptosis showed time and dose dependence (both P< 0.01). There was a trendency that the apoptotic ratio of SGC-7901 cell line was higher than that of the MKN-45 cell line at the same condition. RT-PCR showed that mRNA relative expression level of MMP-2 was 0.64±0.02, 0.49±0.01, 0.36±0.02, and 0.32±0.01, respectively (F= 274.321, P< 0.01) of negative control group and 5, 10, and 20 mg/ml trametes extract group after the effect of trametes extract on gastric cancer MKN-45 cell line. The relative expression level of MMP-9 in MKN-45 cell line was 0.71±0.01, 0.54±0.02, 0.47±0.02, and 0.39±0.02, respectively (F=203.948, P< 0.01). The expression level of MMP-2 in SGC-7901 cell line was 0.64±0.01, 0.42±0.02, 0.34± 0.20, and 0.29±0.01, respectively (F= 305.877, P< 0.01), while the mRNA expression level of MMP-9 was 0.65 ±0.15, 0.47 ±0.01, 0.44 ±0.01, and 0.39 ±0.02, respectively (F= 265.259, P< 0.01). Compared with the negative control group, the expression levels of MMP-2 and MMP-9 of the two cell lines were both decreased, after incubated with trametes robiniophila at the different concentrations (all P< 0.05), and with the addition of concentration, the expression levels of MMP-2 and MMP-9 were decreased. Conclusion Trametes robiniophila can induce the apoptosis of human gastric carcinoma cell lines MKN-45 and SGC-7901 in vitro and can inhibit the expressions of MMP-2 and MMP-9 and the effect of trametes robiniophila may be related with the differentiation degree.