Objective:To construct an early warning model for gestational diabetes mellitus (GDM) based on baseline data, vitamin D (VitD) , and thyroid function status.Methods:A prospective study was conducted to select 126 patients with GDM (GDM group) and 126 pregnant women without GDM (control group) admitted to the Obstetrics Department of Qinhuangdao First Hospital from Jan. 2022 to May. 2024. The single-factor and multi-factor LASSO Logistic regression analysis was used to analyze the influencing factors of the risk of GDM. Based on the results of the multi-factor analysis, an early warning model for GDM was constructed, evaluated, and validated.Results:Age, pre-pregnancy body mass index (BMI) , family history of diabetes, thyroid function, low density lipoprotein (LDL-C) , triglyceride (TG) , VitD, fasting plasma glucose (FPG) , glycated hemoglobin (HbA1c) and blood uric acid were compared, and the differences were statistically significant ( P < 0.05) . LASSO Logistic regression analysis showed that family history of diabetes, hypothyroidism, pre-pregnancy BMI, TG, VitD, FPG, HbA1c and blood uric acid were independently correlated with the risk of GDM ( P < 0.05) . A GDM early warning model was constructed based on the results of multiple factors, with a C-index of 0.876, indicating good predictive performance; The model evaluation and validation results show that the model has good internal and external calibration, high consistency between predicted values and actual observed values, and good predictive value and discrimination in external data sets. Conclusions:Baseline data such as hypothyroidism, VitD, and pre-pregnancy BMI are independent factors that affect the occurrence of GDM. The early warning model for GDM based on these indicators has good predictive performance and clinical applicability, and can be used as an effective model for early prediction of GDM in clinical practice, as well as guiding clinical prevention and treatment efforts.

Objective:To study the epidemic characteristics and healthcare-seeking behavior of dengue fever cases in Zhejiang Province, and to provide a scientific basis for developing dengue fever prevention and control strategies.Methods:Data on dengue fever epidemic in Zhejiang Province from January to December 2024 were collected from the Information System for China Disease Control and Prevention and individual case reports. Descriptive epidemiological methods were used to analyze the distribution by the three dimensions (time, region, and population), healthcare-seeking behavior, importation sources, and laboratory test results of dengue fever cases in Zhejiang Province.Results:From January to December 2024, Zhejiang Province reported a total of 289 dengue fever cases (including 25 foreigners), with an incidence rate of 0.44/100 000, including one severe case and no death, and 13 were local, 108 were domestically imported, and 168 were internationally imported. The epidemic had affected 70 districts (counties, cities) across all 11 cities in the province. Cases were reported monthly, with the peak incidence concentrated from July to November. The age of dengue fever cases was 38 (30, 48) years old, ranging from 2 to 75 years old, with a higher incidence in the 30 - 39 age group (31.14%, 90/289). The male-to-female ratio was 1.86 ∶ 1.00 (188 ∶ 101). Occupational distribution was predominantly commercial service workers (28.03%, 81/289). The number of healthcare-seeking for local cases was 2 (1, 2) times, ranging from 1 to 6 times. The number of healthcare-seeking for imported cases was 1 (1, 2) times, ranging from 1 to 4 times. The interval between the onset and diagnosis of local cases was 3.5 (1.0, 5.0) days, ranging from 0 to 6 days. The interval between the onset and diagnosis of imported cases was 3(1, 4) days, ranging from 0 to 6 days. Domestically imported cases originated from Guangdong Province (102 cases), Yunnan Province (3 cases), Hunan Province (1 case), with 2 cases had unknown original provinces. Internationally imported cases mainly came from Indonesia (33 cases), Thailand (22 cases), Laos (18 cases). Serotyping of dengue virus was determined for 283 cases, with 157 cases of type Ⅰ, 88 cases of type Ⅱ, 34 cases of type Ⅲ, and 4 cases of type Ⅳ.Conclusions:The dengue fever cases in Zhejiang Province in 2024 is primarily international importation, the interval between the onset and diagnosis of local cases is relatively long. Prevention and control efforts should strengthen surveillance and early warning based on dengue fever's epidemic characteristics, and reinforcing port quarantine, mosquito vector control, and health education for high-risk populations.

Objective:To investigate the association between anti-rituximab antibodies (ARA) and relapse after rituximab (RTX) therapy in children with frequently relapsing or steroid-dependent nephrotic syndrome (FRNS or SDNS).Methods:A retrospective cohort study was conducted. Clinical and laboratory data were collected from 48 FRNS or SDNS children treated with RTX in the Department of Pediatrics, General Hospital of Eastern Theater Command, between April 2024 and October 2024. Data included RTX dosing frequency, relapse events, peripheral CD20? B-cell counts, and ARA levels. With a 6-month observation period after the last RTX therapy, the children were divided into an ARA-positive group and an ARA-negative group based on ARA test results. Chi-square test, independent sample t-test, or Mann-Whitney U test were used to compare relapse rates and laboratory indicators between the two groups. The predictive value of ARA levels for relapse was evaluated using univariate receiver operating characteristic (ROC) curve analysis. Results:Among the 48 children (36 males, 12 females), the age of disease onset was 3.5 (2.0, 6.0) years, the ages at the first and last RTX treatments were 7.0 (5.0, 12.0) years and 9.5 (7.0, 13.0) years, respectively. The overall ARA positive rate was 29% (14/48). The relapse rate in the ARA-positive group was significantly higher than that in the negative group ( P<0.05). The ARA level was 0.01 (0.01, 5.88) μg/L, and all 12 children with ARA levels >5.88 μg/L relapsed. ROC curve analysis showed that ARA levels predicted relapse after RTX treatment in FRNS or SDNS children with an area under the curve (AUC) of 0.73, sensitivity of 0.50, specificity of 1.00, and an optimal cut-off value of 5.02 μg/L. All children received single-dose RTX therapy, with no significant difference in treatment frequency between the two groups ( P>0.05). At 3 months after the last rituximab therapy, CD20? B cell counts were significantly higher in the ARA-positive group ( P<0.05). During follow-up, 15% (7/48) of the children experienced infusion-related adverse reactions, with no significant difference in incidence between the two groups ( P>0.05). Conclusion:ARA is significantly associated with relapse in FRNS or SDNS children after RTX therapy.

Objective To explore the effect of artificial pleural effusion combined with radiofrequency ablation in patients with phrenic top liver cancer.Methods A total of 92 patients with liver tumors at top of the diaphragm were prospectively selected and divided into the control group(46 cases,radiofrequency ablation)and the observation group(46 cases,radiofrequency ablation+artificial pleural effusion)by the random number table method.Clinical outcomes one month after treatment,time to first surgical ablation,serum alpha-fetoprotein(AFP)levels and complications before treatment and one month after treatment were compared.Both groups were followed up for 2 years after the operation,and survival conditions of patients were compared.Results Enhanced MRI or enhanced CT at 1 month after surgery in the 2 groups showed that the complete tumor ablation rate was lower in the control group than that in the observation group(76.09%vs.93.48%,P＜0.05).The surgical ablation time of the observation group was shorter than that of the control group[(9.64±1.22)min vs.(11.15±1.47)min,P＜0.05].The survival rates were higher in the observation group than those in the control group at 1 year(82.61%vs.58.70%)and 2 years(71.74%vs.47.83%)after treatment(P＜0.05).Serum AFP levels decreased in both groups after treatment,and those were lower in the observation group than those in the control group(P＜0.05).The total complication rate of the observation group was lower than that of the control group(8.70%vs.23.91%,P＜0.05).The follow-up period of 92 patients ranged from 7 to 29 months,with a mean of(20.17±4.61)months.The local tumor progression rate was higher in the control group than that in the observation group during the follow-up period(36.96%vs.10.87%,P＜0.05).Conclusion Artificial pleural effusion combined with radiofrequency ablation can effectively improve the clinical efficacy and survival rate of patients with liver cancer,reduce the level of serum AFP and decrease the occurrence of complications.

OBJECTIVE To explore the expression levels of microribonucleic acid-21(miR-21)and helper T cell(Th)1/Th2 cytokines in peripheral blood of the asthma children complicated with respiratory tract infections of vi-ruses and analyze the significance.METHODS A total of 90 asthma children with respiratory tract infections of vi-ruses(the infection group)and 43 asthma children without respiratory tract infections of viruses(the no infection group)who were treated in the 904th Hospital of the Joint Logistics Support Force of The People's Liberation Ar-my of China were enrolled in the study,and the clinical data were collected from the enrolled patients.The distri-bution of viruses from the children of the infection group was analyzed.The levels of peripheral blood miR-21,Th1 cytokines[interferon-γ(IFN-γ),interleukin(IL)-2]and Th2 cytokines[IL-4,IL-5]were compared between the two groups.The children of the infection group were divided into the mild group,the moderate group and the severe group according to the severity of disease.The levels of the above indexes were compared among the chil-dren with the various degree of illness condition.The association of the illness condition with miR-21,IFN-γ,IL-2,IL-4 and IL-5 was analyzed.RESULTS Respiratory syncytial virus was dominant among the respiratory tract vi-ruses in the infection group,accounting for 32.22％.The levels of IFN-γ and IL-2 of the infection group were low-er than those of the no infection group(P＜0.05),the levels of miR-21,IL-4 and IL-5 of the infection group were higher than those of the no infection group(P＜0.05).The levels of IFN-γ and IL-2 of the severe group were lower than those of the mild group and the moderate group(P＜0.05),while the levels of miR-21,IL-4 and IL-5 of the severe group were higher than those of the mild group and the moderate group(P＜0.05);the levels of IFN-γ and IL-2 of the moderate group were lower than those of the mild group(P＜0.05),and the levels of miR-21,IL-4 andIL-5 of the moderate group were higher than those of the mild group(P＜0.05).Spearman correlation analysis showed that the illness condition of the children was positively correlated with miR-21,IL-4 and IL-5(P＜0.05),which was negatively correlated with IFN-γ and IL-2(P＜0.05).CONCLUSIONS The respiratory tract infections of viruses may aggravate the abnormal rise of peripheral blood miR-21 and the imbalance of Th1/Th2.The above indexes are closely associated with the illness condition of the children.

Aim To investigate the protective effect of Shengmai Yin on myocardial ischemia/reperfusion in-jury(MI/RI)in vitro and in vivo and to unravel the underlying mechanism.Methods SD rats were divid-ed into the sham group,model group,and Shengmai Yin group(SM).Rat MI/RI model was established.Cardiac function,infarct area,pathological changes,cardiomyocyte apoptosis,macrophage infiltration,and serum cTnT and CK-MB levels were measured.The mRNA and protein expressions of Calpain-1 and Cal-pain-2 were assessed.The hypoxia/reoxygenation(H/R)model was constructed in H9c2 cells.The active ingredients of Shengmai Yin were screened using net-work pharmacology and verified by CCK-8.In the car-diomyocytes H/R model,Fluo-4 AM staining was used to detect the changes of Ca2+levels.Results Com-pared with model group,LVEF and LVFS of Shengmai Yin-treated rats increased,myocardial infarction area was reduced,while myocardial tissue injury was allevi-ated.Myocardial apoptosis rate and the number of macrophages were reduced.Similarly,cTnT and CK-MB levels decreased.In addition,the expression lev-els of Calpain-1 and Calpain-2 mRNA and protein de-creased in the SM treatment group.Under the H/R model,all the active ingredients of Shengmai decoction had protective effects on cardiomyocytes,and the treat-ment could reduce the level of Ca2+in cardiomyocytes.Conclusions Shengmai Yin has protective effects on MI/RI in rats.This effect may be related to the de-crease in Ca2+levels,as well as Calpain-1 and Calap-in-2 mRNA and protein expression.

Objective To explore the effect of artificial pleural effusion combined with radiofrequency ablation in patients with phrenic top liver cancer.Methods A total of 92 patients with liver tumors at top of the diaphragm were prospectively selected and divided into the control group(46 cases,radiofrequency ablation)and the observation group(46 cases,radiofrequency ablation+artificial pleural effusion)by the random number table method.Clinical outcomes one month after treatment,time to first surgical ablation,serum alpha-fetoprotein(AFP)levels and complications before treatment and one month after treatment were compared.Both groups were followed up for 2 years after the operation,and survival conditions of patients were compared.Results Enhanced MRI or enhanced CT at 1 month after surgery in the 2 groups showed that the complete tumor ablation rate was lower in the control group than that in the observation group(76.09%vs.93.48%,P＜0.05).The surgical ablation time of the observation group was shorter than that of the control group[(9.64±1.22)min vs.(11.15±1.47)min,P＜0.05].The survival rates were higher in the observation group than those in the control group at 1 year(82.61%vs.58.70%)and 2 years(71.74%vs.47.83%)after treatment(P＜0.05).Serum AFP levels decreased in both groups after treatment,and those were lower in the observation group than those in the control group(P＜0.05).The total complication rate of the observation group was lower than that of the control group(8.70%vs.23.91%,P＜0.05).The follow-up period of 92 patients ranged from 7 to 29 months,with a mean of(20.17±4.61)months.The local tumor progression rate was higher in the control group than that in the observation group during the follow-up period(36.96%vs.10.87%,P＜0.05).Conclusion Artificial pleural effusion combined with radiofrequency ablation can effectively improve the clinical efficacy and survival rate of patients with liver cancer,reduce the level of serum AFP and decrease the occurrence of complications.

Objective:To construct an early warning model for gestational diabetes mellitus (GDM) based on baseline data, vitamin D (VitD) , and thyroid function status.Methods:A prospective study was conducted to select 126 patients with GDM (GDM group) and 126 pregnant women without GDM (control group) admitted to the Obstetrics Department of Qinhuangdao First Hospital from Jan. 2022 to May. 2024. The single-factor and multi-factor LASSO Logistic regression analysis was used to analyze the influencing factors of the risk of GDM. Based on the results of the multi-factor analysis, an early warning model for GDM was constructed, evaluated, and validated.Results:Age, pre-pregnancy body mass index (BMI) , family history of diabetes, thyroid function, low density lipoprotein (LDL-C) , triglyceride (TG) , VitD, fasting plasma glucose (FPG) , glycated hemoglobin (HbA1c) and blood uric acid were compared, and the differences were statistically significant ( P < 0.05) . LASSO Logistic regression analysis showed that family history of diabetes, hypothyroidism, pre-pregnancy BMI, TG, VitD, FPG, HbA1c and blood uric acid were independently correlated with the risk of GDM ( P < 0.05) . A GDM early warning model was constructed based on the results of multiple factors, with a C-index of 0.876, indicating good predictive performance; The model evaluation and validation results show that the model has good internal and external calibration, high consistency between predicted values and actual observed values, and good predictive value and discrimination in external data sets. Conclusions:Baseline data such as hypothyroidism, VitD, and pre-pregnancy BMI are independent factors that affect the occurrence of GDM. The early warning model for GDM based on these indicators has good predictive performance and clinical applicability, and can be used as an effective model for early prediction of GDM in clinical practice, as well as guiding clinical prevention and treatment efforts.

Hearing loss is the most prevalent disabling disease. Cochlear implantation（CI） serves as the primary intervention for severe to profound hearing loss. This consensus systematically explores the value of genetic diagnosis in the pre-operative assessment and efficacy prognosis for CI. Drawing upon domestic and international research and clinical experience, it proposes an evidence-based medicine three-tiered prognostic classification system（Favorable, Marginal, Poor）. The consensus focuses on common hereditary non-syndromic hearing loss（such as that caused by mutations in genes like GJB2, SLC26A4, OTOF, LOXHD1） and syndromic hereditary hearing loss（such as Jervell & Lange-Nielsen syndrome and Waardenburg syndrome）, which are closely associated with congenital hearing loss, analyzing the impact of their pathological mechanisms on CI outcomes. The consensus provides recommendations based on multiple round of expert discussion and voting. It emphasizes that genetic diagnosis can optimize patient selection, predict prognosis, guide post-operative rehabilitation, offer stratified management strategies for patients with different genotypes, and advance the application of precision medicine in the field of CI.
Humans ; Cochlear Implantation ; Prognosis ; Hearing Loss/surgery* ; Consensus ; Connexin 26 ; Mutation ; Sulfate Transporters ; Connexins/genetics*

Intestinal fibrosis is a significant clinical challenge in inflammatory bowel diseases, but no effective anti-fibrotic therapy is currently available. Glucagon receptor (GCGR) and glucagon-like peptide 1 receptor (GLP1R) are both peptide hormone receptors involved in energy metabolism of epithelial cells. However, their role in intestinal fibrosis and the underlying mechanisms remain largely unexplored. Herein GCGR and GLP1R were found to be reduced in the stenotic ileum of patients with Crohn's disease as well as in the fibrotic colon of mice with chronic colitis. The downregulation of GCGR and GLP1R led to the accumulation of the metabolic byproduct lactate, resulting in histone H3K9 lactylation and exacerbated intestinal fibrosis through epithelial-to-mesenchymal transition (EMT). Dual activating GCGR and GLP1R by peptide 1907B reduced the H3K9 lactylation in epithelial cells and ameliorated intestinal fibrosis in vivo. We uncovered the role of GCGR/GLP1R in regulating EMT involved in intestinal fibrosis via histone lactylation. Simultaneously activating GCGR/GLP1R with the novel dual agonist peptide 1907B holds promise as a treatment strategy for alleviating intestinal fibrosis.