Objective: To investigate the current status of benefit finding among young and middle-aged patients with type 2 diabetes mellitus (T2DM) and analyze its influencing factors, so as to provide a reference for improving the level of benefit finding in this population. Methods: From November 2022 to May 2023, young and middle-aged patients with T2DM aged 18-59 years hospitalized in the endocrinology departments of 2 tertiary hospitals in Hengyang City, Hunan Province were selected as survey subjects by a convenience sampling method. Basic demographic information was collected using a general questionnaire survey. Benefit finding, resourcefulness, and stigma were evaluated using the Benefit Finding Scale, the Chinese Version of the Resourcefulness Scale, and the Type 2 Diabetes Stigma Assessment Scale, respectively. A multiple linear regression model was used to analyze the influencing factors of benefit finding among young and middle-aged patients with T2DM. Results: A total of 305 young and middle-aged patients with T2DM were investigated, including 222 males (72.79%) and 83 females (27.21%). There were 231 cases aged 45-59 years, accounting for 75.74%. The scores for benefit finding, resourcefulness, and stigma were (42.86±6.06), (75.12±11.30), and (41.20±10.10), respectively. Multiple linear regression analysis showed that young and middle-aged patients with T2DM who were male (β′=0.088), aged 18-<45 years (β′=0.083), absence of diabetes complications (β′=0.124), and had higher resourcefulness scores (β′=0.679) had higher levels of benefit finding, while patients with higher stigma scores (β′=-0.097) had lower levels of benefit finding. Conclusion The level of benefit finding among young and middle-aged patients with T2DM was moderate, and was related to gender, age, diabetes complications, resourcefulness, and stigma.

Objective: To report the antibody identification, blood management during pregnancy and the monitoring process of fetal hemolytic disease of fetus and newborn (HDFN) in a pregnant woman with a history of blood transfusion and pregnancy who developed anti-Jr . Methods: Saline tube technique and anti-human globulin technique were used for maternal blood typing, unexpected antibody screening and identification, as well as for determining antibody titer and IgG subclasses. PCR-SSP was employed for genotyping of 18 blood group systems. Next-generation sequencing (NGS) was utilized for gene sequencing of 38 blood group systems. Sanger sequencing was applied to verify rare blood group mutations detected by NGS and to investigate the corresponding rare blood group genes in family members. Blood preparation was achieved through anemia management in prenatal clinics and autologous blood collection during pregnancy. The newborn underwent the three primary tests for HDFN and plasma IgG subclass testing. Results: The pregnant woman's blood type was B, RhD positive, with a positive unexpected antibody screen, and the antibody identification pattern was consistent with a high-frequency antigen antibody. Gene sequencing revealed a homozygous ABCG2 c.376C>T mutation in the woman, resulting in the Jr(a-) phenotype, and anti-Jr antibody was present in her plasma. No compatible Jr(a-) blood was found among family members. The maternal anti-Jr IgG titer remained stable at 256 during pregnancy, with no detectable IgG1 or IgG3 subclasses against the Jr antigen. A total of 800 mL of autologous blood was collected in two stages during pregnancy. The newborn was B, RhD positive, Jr(a+), with a positive unexpected antibody screen (anti-Jr ). IgG subclass typing detected no IgG1 or IgG3. The direct antiglobulin test was positive, while the acid elution test was negative. Conclusion: The combination of serology and blood group genetic analysis provides a diagnostic basis for identifying antibodies to high-frequency antigens. Managing perinatal anemia and implementing staged autologous blood storage can secure blood supply for the perioperative period. IgG antibody subclass typing offers a reference for clinical assessment and prevention of HDFN.

Objective To explore the correlation of body mass index,urinary protein and tumor necrosis factor-like weak inducer of apoptosis(sTWEAK)during pregnancy with the severity of preeclampsia and pregnancy outcome.Methods A total of 63 patients with preeclampsia who were examined in Xingtai People's Hospital from April 2022 to April 2023 were enrolled in the study,33 patients with mild preeclampsia were included in the mild group and 30 patients with severe preeclampsia were included in the severe group.Physi-cal characteristics,urinary protein and sTWEAK levels between the groups were recorded,and the patients were followed up to explore the correlation with pregnancy outcome.Results The systolic and diastolic blood pressure of patients in the mild group were lower than those in the severe group,and the plasma albumin was higher than that in the severe group(P＜0.05).There was no statistically significant difference in pre preg-nancy weight and pre pregnancy body mass index between the mild and severe groups of patients(P＞0.05).The delivery weight and weight gain during pregnancy in the mild group were lower than those in the severe group(P＜0.05).The 24-hour urinary protein quantification in the mild group was lower than that in the se-vere group,and the sTWEAK expression level was higher than that in the severe group(P＜0.05).The pre pregnancy weight,pre pregnancy body mass index,delivery weight,and weight gain during pregnancy in the good pregnancy outcome group were all lower than those in the adverse pregnancy outcome group(P＜0.05).The 24-hour urinary protein quantification in the good pregnancy outcome group was lower than that in the adverse pregnancy outcome group,and the sTWEAK expression level was higher than that in the adverse pregnancy outcome group(P＜0.05).Receiver operating characteristic(ROC)curve analysis revealed that the area under the curve(AUC)of pre pregnancy body mass index,pre pregnancy weight,delivery weight,gestational weight gain,24-hour urinary protein quantification,and sTWEAK expression levels for predicting adverse pregnancy outcomes in patients were 0.906,0.690,0.919,0.664,0.908,and 0.793,respectively.The AUC for predicting adverse pregnancy outcomes in patients by combining pre pregnancy body mass index,de-livery weight,24-hour urinary protein quantification,and sTWEAK expression level was 0.932.Conclusion Body mass index,urinary protein and sTWEAK levels during pregnancy are closely associated with the severity of pre-eclampsia and pregnancy outcomes,and these indicators may help identify high-risk pregnant women early and take appropriate interventions to improve pregnancy outcomes.

Objective To explore clinical value of the expression levels of cell surface transmembrane glycoprotein molecule 44(CD44)mRNA,cell surface transmembrane glycoprotein molecule 24(CD24)mRNA,and protein in the placenta of severe preeclampsia(SPE)patients.Methods The SPE patients who were delivered by cesarean section in the Second People's Hospital of Liaocheng from June 2019 to June 2022 were further divided into 45 patients in early onset SPE group(gestational age≤34 weeks)and 55 patients in late onset SPE group(gestational age＞34 weeks)according to the different gestational age.The control group consisted of 100 normal cases in the same period.The expression of CD44 and CD24 in placenta of SPE patients was detected by fluorescent quantitative PCR and immunohistochemistry,Pearson method was used to analyze the difference of their expression levels and their correlation with the clinical characteristics of SPE disease,and multivariate logistic regression was used to analyze the influencing factors of SPE.Results Compared with the control group,the expression levels of CD44 mRNA(0.55±0.12 vs 1.02±0.33)and CD24 mRNA(0.68±0.19 vs 1.05±0.11)in SPE placental tissues decreased significantly,the differences were statistically significant(t=13.385,16.853,P＜0.05).The immunohistochemical staining results showed that CD44 and CD24 were mostly negative or weakly positive in the SPE group placental tissue,while they were mostly positive in the control group,the positive rates of CD44 and CD24 in the SPE placental tissue were lower than those in the control group,and the differences were statistically significant(χ2=9.696,14.346,P＜0.05).Compared to the early onset SPE group,the expression levels of CD44(0.65±0.17 vs 0.42±0.11)and CD24(0.77±0.23 vs 0.58±0.13)mRNA in placental tissue of late onset SPE were higher,and the differences were statistically significant(t=7.830,4.932,P＜0.05).Compared with the control group,the BMI,systolic blood pressure,diastolic blood pressure,urinary protein,Cr,LDH and BUN were significantly increased in SPE group(t=5.360～30.241,all P＜0.05).In SPE group,the gestational age was earlier,the MPV and ALB were lower,the newborn's birth length was shorter,and the body weight than control group,the differences were statistically great(t=3.232～11.109,all P＜0.05).The expression of CD44 and CD24 in SPE placenta was positively correlated(r=0.698,P＜0.05),the expression of CD44 in SPE placenta was positively correlated with CD24,gestational week of delivery,MPV and neonatal birth length(r=0.611,0.639,0.612,0.465,all P＜0.05),and was negatively correlated with systolic blood pressure,urinary protein and LDH(r=-0.604,-0.569,-0.593,all P＜0.05).The expression of CD24 was positively correlated with gestational age,MPV and newborn birth length(r=0.605,0.584,0.640,all P＜0.05),and was negatively correlated with systolic blood pressure,urinary protein and LDH(r=-0.637,-0.593,-0.561,all P＜0.05).The results of logistic regression analysis showed that MPV(95％CI:1.429～4.350),urinary protein(95％CI:1.529～2.709),and LDH(95％CI:1.425～3.932)were all independent risk factors for SPE(all P＜0.05).High levels of CD44(95％CI:0.561～0.940)and CD24(95％CI:0.495～0.814)were independent protective factors for SPE(P＜0.05).Conclusion The low expression levels of CD44 and CD24 in placenta of SPE patients are independent protective factors of SPE,which can provide direction for the follow-up treatment of SPE.

Objective:To investigate the relationship between inherited protein S deficiency (PSD) and cerebral venous sinus thrombosis (CVST) by phenotype and gene mutation analysis of 2 inherited PSD pedigrees with nonsense mutations.Methods:Retrospective analysis of clinical and imaging data of 2 patients diagnosed with CVST who were treated in the Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University in July and October 2023 was carried out. The peripheral blood samples were collected from proband 1 and her family members (3 subjects, 2 generations in total), and proband 2 and his family members (8 subjects of 3 generations in total). Their protein S (PS) activity (PS:A), the content of total PS antigen (TPS:Ag) and free PS antigen (FPS:Ag) were measured for definite diagnosis. Polymerase chain reaction was done in all 15 exons of the active PROS1 gene and its 5′ and 3′ untranslated regions and the amplification products were analyzed by direct sequencing. The results were compared with human PROS1 reference sequences, using Chromas software to find the mutation sites. Results:The proband 1 is a female, and the proband 2 is a male. Both of them had young onset and the clinical presentation of CVST. The PS:A level was reduced to 29% in the proband 1 and reduced to about 35% in her mother; PS:A was reduced to 21%-27% in the proband 2 and his 6 family members; a decline in the same proportion of TPS:Ag and FPS:Ag was found in the 2 probands and their family members, therefore they were primarily diagnosed as typeⅠPSD. Gene analysis showed that the proband 1 and her mother had a nonsense mutation of c.1680T>A in exon 14 (p.Tyr560 *) of the PROS1 gene; the proband 2 and his 6 family members had a nonsense mutation of c.1687C>T in exon 14 (p.Gln563 *) of the PROS1 gene. Conclusion:The reduced protein S levels in PSD patients and their family members may be associated with the p.Tyr560 * and p.Gln563 * nonsense mutations of the PROS1 gene, and the clinical manifestations of CVST in PSD patients may be related to these 2 nonsense mutations.

Objective This study aims to compare the accuracy of self-developed universal implant guide(SDG),3D printed digital guide(DG),and free hand(FH)simulated implantation in the posterior tooth area of dental models.Methods Ten junior dentists were selected to place three implants in the 35,37,and 46 tooth sites of the mandibular models(35,36,37,and 46 missing teeth)by using SDG,DG,and FH,and the process was repeated again to take the av-erage value.Cone beam computed tomography(CBCT)was used to evaluate the global coronal deviation,global apical deviation,depth deviation,and angular deviation between the actual position and preoperative planned position.Re-sults The coronal deviation and apical deviation of the three implant sites in the SDG group were not significantly dif-ferent from those in the two other groups(P>0.05).The depth deviation and angular deviation in the SDG group were smaller than those in the DG group(P<0.05)and FH group(P<0.05),respectively.All deviations at site 37 in the SDG group were not different from those at site 35(P>0.05),while the depth and angular deviation at site 37 in the DG group were higher than those at site 35(P<0.05).Conclusion The precision of the self-developed universal dental im-plant guide can meet the requirements of clinical posteri-or implantation.

Objective To analyze the domestic antibody drug safety and risk research status,the latest research hotspots and frontiers in the current ten years.Methods CiteSpace 6.2.R2 software was used to analyze all literature related to the safety and risk of antibody drugs in CNKI,WanFang data and Vip database from 2012 to 2022.Results A total of 2 773 pieces of literature were obtained from the three databases,which were imported into CiteSpace after deduplication,and finally,1 870 pieces were included in the analysis.In the past decade,the number of articles published in the field of antibody drugs safety and risk research has remained at about 100 articles per year from 2012 to 2019,since 2020,the number of articles published has started to increase,and the annual number of articles published has increased to around 300 articles from 2021 to 2022.The network graph of domestic institutional cooperation showed that there was a lack of cooperation among the research institutions of antibody drug safety and risk research,mainly due to the fact that hospitals were conducting research in this field,and the types of research subjects were relatively single.The author collaboration network graph showed that the core teams in this research field,such as Li Bo,Yang Yanwei,and Lin Zhi,had the closest collaboration,while there was less collaboration among high-yield authors,additionally,some experts and scholars conducted research on their own as individuals or small groups,the research focused on adverse reactions,safety,bevacizumab,Rituximab,Meta-analysis,etc.Conclusion In the past decade,domestic research has mainly focused on the clinical efficacy and safety of antibody drugs,with few scholars exploring the risk of antibody drugs,therefore,in the future,it is necessary to pay attention to the research on the risks of antibody drugs.

Atrial fibrillation (AF) is the most common supraventricular arrhythmia, characterized by high morbidity and mortality.The mechanism of AF is not very clear, and there is still a lack of effective radical treatments.Therefore, the prevention of AF is particularly important.Different dietary patterns are closely related to the occurrence and development of AF.This study reviewed the relationships of different dietary factors such as the Mediterranean diet, the Dietary Approaches to Stop Hypertension (DASH diet), fish and ω-3 polyunsaturated fatty acids, olive oil, nuts, caffeine, chocolate, alcohol, fried food and salt with the occurrence of AF, and explored its mechanism of action.

Objective:To evaluate the efficacy of Tui Na therapy combined with self-made Jianpi-Tiaogan Decoction in the treatment of anorexia in children. Methods:A total of 92 patients with pediatric anorexia in our hospital from January 2018 to June 2019 who met the inclusion criteria were divided into 2 groups by random number table method, with 46 patients in each group. The control group was treated with the Tui Na therapy mainly by manipulating on the abdomen and pushing the spleen, and the treatment group was given the self-made Jianpi-Tiaogan Decoction on the basis of the treatment of the control group. Both groups were treated for 4 weeks. The TCM syndrome scores were performed, serum Leptin and Ghrelin levels were measures by enzyme linked immunosorbent assay, serum neuropeptide Y (NPY) was measured by radioimmunoassay, contents of blood zinc and salivary amylase ptyalase were measured by flame atomic absorption spectrometry and Western blot, and D-xylose absorption test was carried out respectively before and after treatment. And the clinical efficacy was evaluated. Results:The total effective rate was 91.3% (42/46) in the treatment group and 73.9% (34/46) in the control group. The difference between the two groups was statistically significant ( χ2=4.821, P=0.028). After treatment, the scores of anorexia, antifeedance, irritability, agitation, hiccup and belching, fullness of chest and flank, thin shape, sleep difficulty and total score in the treatment group were significantly lower than those in the control group ( t values were 6.782, 7.524, 9.100, 5.643, 4.796, 6.066, 4.069, 3.197, 5.073, respectively, all Ps<0.01). After treatment, the serum NPY (133.7 ± 12.4 ng/L vs. 105.6 ± 10.8 ng/L, t=11.589) and Ghrelin (329.6 ± 26.1 ng/L vs. 275.4 ± 25.0 ng/L, t=12.211) levels in the treatment group were significantly higher than those in the control group ( P<0.01), but Leptin (21.7 ± 4.0 g/L vs. 25.2 ± 4.3 g/L, t=4.042) was significantly lower than that of the control group ( P<0.01). After treatment, blood zinc (9.9 ± 2.5 mol/L vs. 8.7 ± 2.3 mol/L, t=2.396), salivary amylase ptyalase content (23.5 ± 4.2 U/L vs. 17.9 ± 3.6 U/L, t=6.866), D-xylose absorption test (0.9 ± 0.4 ng/L vs. 0.7 ± 0.3 ng/L, t=2.713) were significantly higher than those in the control group ( P<0.05 or P<0.01). Conclusions:Tui Na therapy combined with self-made Jianpi-Tiaogan Decoction can improve TCM syndromes of children, regulate the levels of NPY, Leptin and Ghrelin, and improve clinical efficacy.

Objective:To explore the application of systemic comprehensive geriatric assessment (CGA) nursing model in the blood glucose control management of elderly patients with type 2 diabetes mellitus.Methods:Using the convenient sampling method, a total of 52 elderly patients with type 2 diabetes mellitus who were admitted to the First Affiliated Hospital of Zhengzhou University before the implementation of systematic CGA nursing model (September 2017 to June 2018) were selected as the control group and 52 elderly patients with type 2 diabetes mellitus who were admitted after the implementation of systematic CGA nursing model (July 2018 to April 2019) were selected as the observation group. The control group was given routine nursing intervention, while the observation group was given systematic CGA nursing model on the basis of the control group. The indexes of glucose metabolism were compared between the two groups before and after intervention. The Chinese versions of Summary of Diabetes Self-Care Activities (SDSCA) and Self-Rated Health Measurement Scale (SRHMS) were used to compare the intervention effects of the two groups.Results:After 3 months of intervention, fasting blood glucose (8.31±1.25) mmol/L, 2-hour postprandial blood glucose (7.47±0.82) mmol/L and glycosylated hemoglobin (7.36±0.87) % in the observation group were all lower than those in the control group, and the differences were statistically significant ( t=4.771, 11.795, 3.619; P<0.05) . After intervention, scores of blood glucose monitoring (80.82±23.54) , foot care (87.13±18.94) , diet (97.59±12.43) , exercise (78.65±12.54) and compliance behavior (59.07±8.35) in SDSCA of the observation group were higher than those in the control group, and the differences were statistically significant ( t=3.965, 3.236, 4.386, 6.174, 13.534; P<0.05) . After intervention, scores of three subscales including mental health, physical health and social health of SRHMS in the observation group were respectively (124.38±10.18) , (143.73±7.52) , (87.28±10.06) , were higher than those of control group, and the differences were statistically significant ( t=8.606, 5.632, 5.881; P<0.05) . Conclusions:The application of CGA nursing model in the nursing of elderly patients with type 2 diabetes mellitus can improve the self-management ability of patients, promote their blood glucose control and benefit their physical and mental health.