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

BACKGROUND: It has been pointed out that perioperative hypothermia can increase the incidence of coagulation, acidosis, stroke, sepsis, pneumonia and myocardial infarction, so it is of great significance to monitor and maintain normal body temperature during perioperative period. OBJECTIVE: To design a medical carbon fiber thermostatic heating pad to prevent perioperative hypothermia and reduce complications. METHODS: The carbon fiber heating technology and medical equipment standard are combined and integrated into many advanced technologies. The system mainly consisted of power supply conversion, operation system, computer control system, PWM control and output, various heating pads and temperature controlling measurement system. A total of 200 patients undergoing epidural anesthesia in Zhengzhou First People's Hospital were randomly divided into two groups: the observation group (n=100) was treated with the medical carbon fiber thermostatic heating pad (adjusting temperature 38-40 oC), and the control group (n=100) with common quilt. The body temperature and shivering were monitored before operation, 10, 30 and 60 minutes after anesthesia, and 2 hours after operation. RESULTS AND CONCLUSION: (1) The heating pad had the characteristics of explosion proof, power purification, shielding isolation, output protection, computer control, and PWM modulation. (2) In clinical application, there was no skin irritation and skin allergy reaction in the observation group. (3) During operation, the body temperature of the observation group was relatively stable, and there was no significant difference in the body temperature in the observation group before and at 2 hours after operation (P> 0.05). However, the fluctuation of body temperature in control group was visible and showed a downward trend, and the body temperature in the control group showed a significant difference before and 2 hours after operation (P < 0.05). The body temperature of 10, 30, 60 minutes after anesthesia and 2 hours after operation was significantly higher in the observation group than the control group (P < 0.05). (4) The postoperative incidence of shivering in the control group was significantly higher than that in the observation group (18％ vs. 5％, P < 0.05). To conclude, the medical carbon fiber thermostatic heating pad is advanced in technology, safe and reliable in use, providing a new way for the prevention of perioperative shivering.

Objective: To monitor the antimicrobial resistance and drug-resistance genes of Yersinia enterocolitis, Y. intermedia and Y. frederiksenii recovered from retailed fresh poultry of 4 provinces of China. Methods: The susceptibility of 25 isolated Yersinia spp. to 14 classes and 25 kinds of antibiotics was determined by broth microdilution method according to CLSI (Clinical and Laboratory Standards Institute). The antibiotic resistance genes were predicted with antibiotic resistance genes database (ARDB) using whole genome sequences of Yersinia spp. Results: In all 22 Y. enterocolitis tested, 63.7% (14 isolates), 22.8% (5 isolates), 4.6% and 4.6% of 1 isolates exhibited the resistance to cefoxitin, ampicillin-sulbactam, nitrofurantoin and trimethoprim-sulfamethoxazole, respectively. All the 25 isolates were multi-drug resistant to more than 3 antibiotics, while 64.0% of isolates were resistant to more than 4 antibiotics. A few Y. enterocolitis isolates of this study were intermediate to ceftriaxone and ciprofloxacin. Most Yersinia spp. isolates contained antibiotic resistance genes mdtG, ksgA, bacA, blaA, rosAB and acrB, and 5 isolates recovered from fresh chicken also contained dfrA1, catB2 and ant3ia. Conclusion The multi-drug resistant Yersinia spp. isolated from retailed fresh poultry is very serious in the 4 provinces of China, and their contained many kinds of drug-resistance genes.

Objective To evaluate the clinical results of posteromedial supine approach plus anterolateral approach for treatment of posteromedial condylar tibial plateau split fracture combined with lateral compartment depression.Methods A retrospective analysis was done on 48 cases of posteromedial condylar tibial plateau split fracture with lateral compartment depression operated through posteromedial supine plus anterolateral approaches from February 2011 through March 2013.There were 37 men and 11 women,aged 15-67 years (mean,42.5 years).Fracture occurred at the left side in 31 cases and at the right side in 17 cases.Interval between injury and operation ranged from 5 to 16 days (mean,8.7 days).Reconstructive or T-shaped plates were used for posteromedial condylar split tibial plateau fracture.Anatomical or locking compression plates were used for lateral compartment depression,but autogenous ilium bone grafting was performed laterally when bone defect was obvious.Results Average operation time was 2.8 hours (range,2-3.5 hours) and average length of stay was 21 days (range,12-45 days).All cases were followed up for mean 12.8 months (range,5-25 months).All fracture healed from 4 to 8 months (mean,6.7 months).Mean Rasmussen score for radiological results was 16.9 points (range,16-18 points) immediately after operation.Hospital for special surgery (HSS) knee score averaged 86.4 points (range,76-95 points) 8 months after bone healed,indicating the excellent results in 27 cases,good in 16 cases,fair in 4 cases and poor in 1 case with a good to excellent rate of 90％.At the last follow-up,postoperative knee range of motion averaged-5°-135°.All incisions healed primarily without vascular nerve injury and implant loosing or breakage.There was an extension lag in 1 case with knee range of motion of 20°-130° and osteoarthritis in 1 case,but both were improved with non-operation therapy.Conclusion Posteromedia] supine plus anterolateral approaches are suitable for posteromedial condylar tibial plateau split fracture with lateral compartment depression,for the combined approaches gain advantages of easy operation,good reduction,rigid fixation,few soft-tissue complications and satisfactory clinical results.