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.

Dyslipidemia is one of the common metabolic disorders in type 2 diabetes mellitus,often coexisting with insulin resistance and central obesity to form metabolic syndrome,significantly increasing the risk of macrovascular and microvascular complications in diabetic patients.Non-high-density lipoprotein cholesterol(non-HDL-C)refers to the sum of cholesterol contained in other lipopro-teins except high-density lipoprotein cholesterol(HDL-C).In recent years,the importance of non-HDL-C in the management of diabetic complications has garnered increasing attention,and it has been established as a major lipid-lowering target along with low-density lipoprotein cholesterol(LDL-C)in the latest expert consensus on lipid management for Chinese diabetic patients.Clinical studies have demonstrated that non-HDL-C is closely associated with residual cardiovascular risk and recurrent stroke risk in diabetic patients,as well as carotid plaque vulnerability and the development of peripher-al arterial disease.Additionally,non-HDL-C is also closely related to diabetic nephropathy and reti-nopathy in type 2 diabetes mellitus,and achieving long-term control of non-HDL-C levels can reduce the risk of chronic kidney disease.This article summarized the relationship between non-HDL-C and complications of type 2 diabetes mellitus and elucidated its significance as a future clinical therapeutic target.

Objective:To analyze the influencing factors related to the prognosis of delayed replantation of avulsed permanent teeth.Methods:A retrospective study was conducted on the clinical data of 35 patients with 38 affected teeth underwent delayed replantation of permanent teeth.According to the prognosis after 12 to 108 months of follow-up,the replantation results of the cases were divided into-success,survival and failure groups.Survival curves were plotted using Kaplan-Meier method,Log-Rank test was used for univariate analysis,and Cox proportional risk regression models were used for multivariate analysis to assess the effects of gender,age,degree of tooth development,mode of tooth preservation and mode of endodontic treatment on the survival rate of replanted teeth.Results:Of the 38 replanted teeth,3 were successful,28 remained and 10 failed.The 9-year cumulative survival rate of the replanted teeth was 34.7％.The results showed that there were no statistically significant differences in the survival rate of the replanted teeth in the groups with different sex,age,degree of tooth development and the mode of preservation of avulsed teeth(P＞0.05).There were statistically significant differences in the cumulative survival rate of the replanted teeth among the groups with different endodontic treatment(P＜0.01),which showed that the cumulative survival rate in the root canal filling group＞continuous root canal sealing group＞pulp preserva-tion treatment group.Conclusion:For the delayed replantation of avulsed premanent teeth,survival prognosis of the teeth treated with pulp preservation is poor,early pulp extraction and root canal filling are recommended.

Organoids are three-dimensional cell complexes formed by stem cells or tumor cells cultured and self-organized in vitro,which have higher simulation in morphology and function than the traditional two-dimensional cell drug screening model.However,the conventional organoid culture technology based on matrigel dome in culture dish or well plate has the problems of low throughput and time-consuming,which limits the application of high-throughput organoid drug screening.Therefore,a series of microfluidic high-throughput organoid culture and drug screening technologies have been developed.From the perspective of microfluidic technology,this paper reviews the current application of high-throughput organoid drug screening in three aspects:organoid culture,drug delivery and result detection.According to the different forms of organoid culture units,organoid culture techniques are divided into three categories:microfluidic droplets,microwells,and micropillars.According to the structure and working mode of drug delivery system,drug delivery system is divided into microchannel network and drug droplet array.According to the different forms of information obtained,high-throughput results detection methods can be divided into four categories:microplate reader,microscope,high-content imaging analyzer and chip sensor.Based on the above technologies,the application of typical organoid drug screening is introduced.Finally,the summary and prospect of organoid drug screening are presented.

Magnetic separation(MS)is frequently used to enrich specific targets from biological sam-ples,which is commonly performed using antibodies coupled immunomagnetic beads(IMBs).However,due to the high cost of antibodies and difficulties in the process of releasing captured targets,IMBs have limitations for large-scale enrichment of targeted bioproducts.The specificities and affinities of aptamers towards their targets are in line with antibodies,but with characteristic of significantly lower costs of prep-aration,simpler structures,and higher chemical stability.In this study,taking advantages of the distinct adsorption features of graphene for single-stranded and double-stranded nucleic acids,we designed a novo system as bioseparation method that could display aptamers on graphene surfaces to enrich targets and then manipulate their release.This system mainly includes two units.Take CD63 aptamer as an exam-ple:double-stranded oligonucleotides scaffold attached to the graphene surface for CD63 aptamer exhibi-tion;and a single-stranded oligonucleotide complementary to the scaffold bipod sequence to desorb the captured targets from graphene.In this study,firstly,using graphene oxide(GO)paper as a graphene surface,we fluorescently labeled scaffolds or CD63 proteins and compared the fluorescence intensity difference on the GO paper before and after scaffold or CD63 protein release.Subsequently,a novo mate-rial,amino-modified graphene-shelled iron-nitrogen magnetic beads were introduced to carry the scaffold,and used to capture CD63 proteins from cell lysates.The results indicate that this scaffold can display the aptamer on the graphene surface for CD63 protein capture and controlled release.Using selected modified graphene magnetic beads carried with the scaffold,we achieved the capture of CD63 proteins from cell ly-sates.This system is expected to enrich various proteins such as CD63,or capture exosomes by hooking membrane proteins.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To analyze the influence of 5E rehabilitation mode on cardiac function,exercise capacity,self-man-agement ability and quality of life(QOL)in patients with coronary heart disease(CHD)after percutaneous coronary inter-vention(PCI).Methods:A total of 123 patients diagnosed with CHD in our hospital from April 1,2022 to April 1,2023 were selected and divided into control group(n=61,received routine nursing mode)and observation group(n=62,5E re-habilitation nursing mode was adopted on the basis of control group)using random number table method.Both groups were continuously intervened for three months.Cardiac function,exercise capacity,self-management level and QOL were compared between the two groups before and after intervention.Results:After intervention,compared with control group,there were significant rise in SV[(69.66±4.86)ml vs.(75.94±5.29)ml],CI[(3.11±0.30)L·min-1·m-2 vs.(3.39±0.36)L·min-1·m-2],LVEF[(57.22±5.82)％vs.(68.54±5.31)％],MET[(4.36±0.64)vs.(5.09±0.86)],6min walking distance[(296.52±18.72)m vs.(359.33±19.75)m],scores of CSMS[(89.32±11.85)points vs.(112.31±9.63)points],CQQC[(111.56±9.27)points vs.(139.50±7.59)points]in observation group,P=0.001 all;and significant reductions in LVEDd[(52.12±4.84)mm vs.(41.28±4.74)mm],LVESd[(48.39±3.82)mm vs.(42.26±3.57)mm],BNP level[(99.63±6.31)pg/ml vs.(60.52±7.11)pg/ml],propor-tion of NYHA class Ⅲ(25.00％vs.10.00％)in observation group,P＜0.05 or＜0.01.Conclusion:The application of 5E rehabilitation nursing can significantly improve cardiac function,enhance exercise capacity,strengthen the self-man-agement behavior and improve quality of life in postoperative clinical nursing of patients with coronary heart disease after percutaneous coronary intervention,which has high clinical application value.

Objective To investigate the relationship and potential pathways between metal(loid)exposure and the risk of polycystic ovary syndrome(PCOS)in women of childbearing age. Methods This case-control study included 200 patients with PCOS(cases)and 896 non-PCOS controls with the age of 25-37 years.The concentrations of 29 metal(loid)s in the follicular fluid(FF)and clinical indicators in the serum were measured in all participants.Logistic regression analysis and mediation analysis were conducted to evaluate the associations between metal(loid)exposure and PCOS risk and investigate the possible roles of clinical indicators,respectively. Results Logistic regression analysis revealed an association between high copper levels in FF and increased PCOS risk(highest vs.lowest quartile:adjusted odds ratio=2.94,95%confidence interval:1.83-4.72).A high luteinizing hormone/follicle-stimulating hormone ratio and elevated levels of testosterone and anti-Müllerian hormone(AMH)were strongly associated with increased PCOS risk induced by high copper exposure.The mediation analysis indicated a mediating effect of AMH in the association between copper exposure and PCOS risk. Conclusion Copper may affect PCOS risk through the hypothalamic-pituitary-ovarian axis,mediated by AMH.Copper exposure and internal AMH levels are important indicators for early warning of PCOS development.

At present,there are many difficulties in the diagnosis and treatment of acute vestibular syndrome(AVS).For example,complex and difficult identification of the cause of disease,uneven diagnosis and treatment levels of clinical doctors,weak humanistic care awareness,lack of communication skills,intrinsic affinity and other reasons,which make it difficult for AVS patients in the process of diagnosis and treatment,and cannot receive timely and effective treatment,resulting in an exacerbation of doctor-patient conflicts.Therefore,it is recommended to explore new paths of AVS diagnosis and treatment work using the humanistic care concept,respect each other between doctors and patients,build a team of medical staff with the value orientation of"humanistic care",and promote the organic unity of theory and practice of"humanistic care",with a view to better promoting the implementation of AVS diagnosis and treatment work,helping more patients rebuild confidence,enhancing quality of life,and improving the doctor-patient relationship.