BACKGROUND: The role of inflammation in the development of gestational diabetes mellitus (GDM) has recently become a focus of research. The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI), novel indices, reflect the body's chronic immune-inflammatory state. This study aimed to investigate the associations between the SII or SIRI and GDM. METHODS: A prospective birth cohort study was conducted at Beijing Obstetrics and Gynecology Hospital from February 2018 to December 2020, recruiting participants in their first trimester of pregnancy. Baseline SII and SIRI values were derived from routine clinical blood results, calculated as follows: SII = neutrophil (Neut) count × platelet (PLT) count/lymphocyte (Lymph) count, SIRI = Neut count × monocyte (Mono) count/Lymph count, with participants being grouped by quartiles of their SII or SIRI values. Participants were followed up for GDM with a 75-g, 2-h oral glucose tolerance test (OGTT) at 24-28 weeks of gestation using the glucose thresholds of the International Association of Diabetes and Pregnancy Study Groups (IADPSG). Logistic regression was used to analyze the odds ratios (ORs) (95% confidence intervals [CIs]) for the the associations between SII, SIRI, and the risk of GDM. RESULTS: Among the 28,124 women included in the study, the average age was 31.8 ± 3.8 years, and 15.76% (4432/28,124) developed GDM. Higher SII and SIRI quartiles were correlated with increased GDM rates, with rates ranging from 12.26% (862/7031) in the lowest quartile to 20.10% (1413/7031) in the highest quartile for the SII ( Ptrend <0.001) and 11.92-19.31% for the SIRI ( Ptrend <0.001). The ORs (95% CIs) of the second, third, and fourth SII quartiles were 1.09 (0.98-1.21), 1.21 (1.09-1.34), and 1.39 (1.26-1.54), respectively. The SIRI findings paralleled the SII outcomes. For the second through fourth quartiles, the ORs (95% CIs) were 1.24 (1.12-1.38), 1.41 (1.27-1.57), and 1.64 (1.48-1.82), respectively. These associations were maintained in subgroup and sensitivity analyses. CONCLUSION The SII and SIRI are potential independent risk factors contributing to the onset of GDM.
Humans ; Female ; Pregnancy ; Diabetes, Gestational/immunology* ; Prospective Studies ; Adult ; Inflammation/immunology* ; Glucose Tolerance Test ; Birth Cohort

Objective:To explore the association between sublingual microcirculatory perfusion vessel proportion (PPV), high mobility group protein B1 (HMGB1), and sepsis-induced coagulopathy (SIC), and to identify early predictive markers for clinical intervention.Methods:A total of 66 septic patients admitted to the Respiratory Intensive Care Unit (RICU) between November 2021 and May 2024 were enrolled. Based on SIC diagnosis within 24 hours of admission, patients were categorized into SIC ( n=36) and non-SIC ( n=30) groups. Clinical parameters, including prothrombin time (PT), activated partial thromboplastin time (APTT), sublingual PPV, and serum HMGB1 levels (measured at 0 h and 6 h), were analyzed. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to identify independent predictors. Results:Compared with the non-SIC group, the SIC group demonstrated significantly prolonged PT ( P<0.05) and APTT ( P<0.05), elevated 0 h lactate levels, and increased 6 h HMGB1. Spearman analysis revealed a positive correlation between 6 h PPV and platelet count ( P<0.05), while an inverse correlation was observed with 6 h PT ( P<0.05). Multivariate regression identified APTT, 6 h PPV, and 6 h HMGB1 as independent predictors of SIC. ROC analysis yielded AUC values of 0.732 for APTT, 0.802 for 6 h PPV, and 0.765 for 6 h HMGB1. The combination of 6 h PPV and HMGB1 further improved predictive accuracy (AUC=0.873). Conclusions:Prolonged APTT, decreased 6 h PPV, and elevated 6h HMGB1 are key indicators of SIC. Integrated assessment of these markers enhances early risk stratification in septic patients, facilitating timely clinical intervention.

【Objective】 To observe the therapeutic effects of Axitinib, a tyrosine kinase receptor inhibitor, on liver fibrosis. 【Methods】 In vivo, CCL4 was injected intraperitoneally to induce liver fibrosis in mice. After modeling, Axitinib-carboxymethyl cellulose (Axitinib-CMC) solution or CMC solution were administered by gavage. After 2 weeks of modeling, 4 weeks of modeling, 1 week of treatment and 2 weeks of treatment, the mice were killed and their liver tissues were stained by HE, Masson and α - SMA immunohistochemistry. In vitro, human hepatic stellate cell line (LX2) and human normal liver cell line (LO2) were intervened with different concentrations of Axitinib-CMC solution. MTT assay was performed 48 h and 72 h after the intervention. Flow cytometry was used to observe the apoptosis of the two cell lines. Western blotting was used to detect the expressions of Fas, Caspase-8, Caspase-3 and Bcl-2 proteins. 【Results】 HE and Masson staining results showed that CCL4 could induce liver fibrosis in the mice, and the degree of liver fibrosis was more severe in the 4-week than that in the 2-week treatment group. After treatment with Axitinib, the collagen staining area and the positive expression level of α-SMA were significantly lower than those in 4-week group and CMC treatment control group (P<0.05). In vitro, Axitinib could effectively inhibit the viability of hepatic stellate cell line LX2 and promote its apoptosis. Meanwhile, the expressions of pro-apoptotic proteins Fas, Caspase-8 and Caspase-3 increased, while the expression of apoptosis suppressor gene Bcl-2 decreased. However, the above changes were not found in control hepatocyte line LO2. 【Conclusion】 Axitinib exerts an anti-fibrosis effect by inducing apoptosis of hepatic stellate cells, and has no significant effect on normal hepatocytes.

Objective To observe the effect of nurse-patient's co-participation on the bladder function exercise after cervical cancer surgery, and to explore the influence of nurse-patient's co-participation on bladder function recovery in cervical cancer patients. Methods A total of 117 patients with cervical cancer who underwent surgical treatment in the First Affiliated Hospital of Zhengzhou University from January 2014 to January 2017 were selected and randomly divided into control group (n=58) and observation group (n=59) by the random number table method. Routine nursing was given to both groups, on the basis of which the observation group adopted nurse-patient's co-participation management method to exercise the bladder function, and the recovery status of cervical cancer patients' bladder function after surgery was compared between the two groups. Results The residual urine volume of the observation group was less than 100% and the proportion of spontaneous urination was significantly higher than that of the control group. The proportion of reattached catheter was significantly lower than that of the control group (P<0.05). The patients in the observation group had less exhaust time and fewer hospitalization days than the control group, and the difference was statistically significant (P< 0.05). The incidence of urinary retention in the observation group (8.47%) was significantly lower than that in the control group (20.69%), and the first extubation success rate of the observation group (91.52%) was significantly higher than that of the control group (63.79%), with a statistical difference (P<0.05). Conclusions The nurse-patient's co-participation can improve the effect of postoperative bladder function recovery in patients with cervical cancer, and significantly reduce the incidence of complications.

Objective To explore ultrasound performances and misdiagnostic causes of aggressive fibromatosis (AF).Methods Ultrasound performance and misdiagnostic causes of 45 patients (47 tumors) with AF confirmed by histopathology were analyzed retrospectively.Results Of 45 patients,ultrasound showed lesions of varying size,and the maximum diameter of 36 masses (36/47,76.60％) were more than 3 cm;37 masses (37/47,78.72％) were irregular pale leaf;45 masses (45/47,95.74％) had no complete capsule;45 masses (45/47,95.74％) were shown as interogeneous internal echo mixed with hyperechoic area in the hypoechoic internal;29 cases were diagnosed correctly,16 cases were misdiagnosed,the diagnostic accordance rate was 64.44％ (29/46).Conclusion AF has certain ultrasonic characteristics.Combined with the patient's medical history and physical sign,ultrasound can significantly improve the preoperative detection rate and diagnostic accuracy of AF.

Objective To evaluate the clinical value of high-resolution ultrasound for predicting the extracapsular extension (ETE) of papillary thyroid cancer (PTC).Methods A total of 151 nodules with PTC in 116 patients confirmed by surgery and pathology were enrolled.The ultrasonographic characteristics were retrospectively analyzed,and the percentage of the perimeter of the nodule that abutted the thyroid capsule (A) were observed.Taking A≥1％,A≥25 ％ and A≥ 50％ as cutoff value respectively,the ETE of PTC was predicted.Results Of the 151 nodules with PTC,ETE presented in 59 (59/151,39.07％),while no ETE (non-ETE) was observed in 92 (92/151,60.93％).Nodules in the thyroid parenchyma (A0) which could be observed with ultrasound was 84 (84/151,55.63％),and 1％≤A＜25％,25％≤A＜50％andA≥50％ was 25 (25/151,16.56％),15 (15/151,9.93％),and 27 (27/151,17.88％),respectively.There were statistically significant differences of nodules between the non-ETE and ETE when A≥1％,A≥25 ％ and A≥50％ (all P ＜0.01).Taking A=50％ as the cutoff value for predicting the presence of ETE,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value was 37.29％ (22/59),94.57％ (87/92),72.19％ (109/151),81.48％ (22/27) and 70.16％ (87/124),respectively.Conclusion High frequency ultrasonography can effectively predict whether PTC has been invaded,which provides important reference information for preselected surgical approach and prognosis of patients.

Objective Investigate the clinical efficacy of treating retreated smear-positive tuberculosis patients with conventional anti-tuberculosis chemotherapy combined with levofloxacin. Methods Divide 60 retreated smear-positive tuberculosis patients registered in our hospital between October 2012 and October 2014 into two groups using random number table method: levofloxacin group and conventional treatment group. Each group contains 30 patients that were treated for 9 months , and the efficacy the both treatment methods were compared. Results The sputum conversion rate in the levofloxacin group is 93.33% and 96.67% after treating for 6 months and 9 months , respectively; which are substantial higher than that of the conventional treatment group with sputum conversion rate of 70% and 73.33% after 6 months and 9 months of treatment , respectively (P < 0.05). The absorption rate of the levofloxacin group is significantly higher than that of the conventional treatment group (P < 0.05). The cavity improvement rate of the levofloxacin group is 73.33%, which is significantly higher than that of the conventional treatment group (33.33%) (P < 0.05). The clinical efficacy of the LVFX group is substantially higher than the routine treatment group (P < 0.05). The overall effectiveness of LVFX group reached 100% , which is significantly higher than that of the conventional treatment group (86.67%) (P < 0.05). Conclusions Levofloxacin combined with conventional anti-tuberculosis chemotherapy can effectively improve the clinical efficacy in the treatment of tuberculosis.

We received a patient who repeated unconsciousness due to excrescence locking bicuspid aortic valve. He experienced unconsciousness and treatments with anti infection, surgical operation, valve replacement and recovery. It was a rare case, which made us realize that the heart color Doppler ultrasound should be regularly performed in patients with aortic valve abnormalities. Once patients were found to have infective endocarditis combined with the valve vegetations, they should be formally treated as soon as possible.
Aortic Valve ; abnormalities ; physiopathology ; Echocardiography, Doppler, Color ; Endocarditis, Bacterial ; diagnosis ; Heart Valve Diseases ; physiopathology ; Humans ; Male ; Unconsciousness ; etiology

Objective To investigate the incidence, imaging and clinical characteristics in elderly patients with coronary artery ectasia (CAE). Methods A retrospective analysis was conducted on patients with CAE who underwent coronary angiography between January 2006 and December 2012. According to age, the enrolled patients were divided into two groups (elderly group, age≥ 65 years; non-elderly group, age < 65 years). The clinical feature, imaging characteristics and the 5-year survival rate of the two groups were compared.Results The preva-lence of CAE in elderly patients was 0.33%. Patients in elderly group were found to have significantly higher proportion of female (30.1%vs. 10.1%,P< 0.001), three-vessel disease (60.5%vs. 45.2%,P = 0.003) and localized ectasia (55.0%vs. 40.2%,P = 0.003). In addition, body mass index (20.90 ± 2.71 kg/m2vs. 22.31 ± 2.98 kg/m2,P < 0.001) and percentage of current smokers (45.0%vs. 64.6%,P < 0.001) were significantly lower in elderly group. Cumulative survival curves demonstrated reduced 5-year cumulative survival at the follow-up in the elderly group compared with the non-elderly group (88.0%vs. 96.0%,P = 0.002). But the 5-year event free survival rate failed to show a significant difference between the two groups (31.0%vs. 35.0%,P= 0.311).ConclusionThe prevalence of CAE in elderly patients was 0.33%, which was about 1/3 of the entire numbers of CAE patients. There were significant differences between the elderly and the non-elderly patients with CAE in terms of coronary artery disease risk factors and coronary artery ectatic characteristics. CAE might be asso-ciated with increased mortality risk in the elderly.

ObjectiveTo investigate the status and explore methods to improve the quality of diabetic education for young and middle-aged patients.MethodsOutpatients took part in diabetic education program and young and middle-aged diabetic patients that visited the eastern district of affiliated hospital of Qingdao university medical college from May 1st,2010 to Oct.30th,2010 were investigated with questionnaire for their diabetic education status and demands.ResultsA total of 381 patients were enrolled in this study.59.1％ clinical diabetic education program participants were aged 60 or older and only 40.9％ were aged 20 to 59 years,of whom 66.7％ had been diagnosed with diabetes more than 5 years and only 33.3％ had been diagnosed with diabetes less than 5 years.According to the survey of 101 young and middle-aged diabetic patients,only 16.8％ patients younger than 60 took part in different kinds of diabetic education programs but about 95％ young and middle aged patients wished to participate in diabetic education programs.ConclusionYoung and middle-aged diabetic patients have received much less diabetic education than elderly patients.Diabetic education for young and middle-aged patients needs to be strengthened urgently.