Objective To investigate the expression levels of serum microRNA-15a(miR-15a),microRNA-195-5p(miR-195-5p),and microRNA-33(miR-33)in pregnant women with gestational diabetes mellitus(GDM)and to explore their associations with maternal and neonatal outcomes.Methods The research subjects were selected from 208 patients with GDM who completed delivery at our hospital between September 2021 and October 2024.Based on maternal pregnancy outcomes,the subjects were categorized into either the poor maternal outcome group or the good maternal outcome group.Similarly,they were classified into the poor perinatal outcome group and the good perinatal outcome group according to perinatal outcomes.Clinical data and serum levels of fasting plasma glucose(FPG),miR-15a,miR-195-5p,and miR-33 were collected and compared between groups with different maternal and perinatal outcomes.Multivariate logistic regression analysis was conducted to identify risk factors associated with adverse maternal and perinatal outcomes among GDM patients.Additionally,the predictive value of these biomarkers for adverse maternal and perinatal outcomes was evaluated using receiver operating characteristic(ROC)curve analysis.Results Among 208 patients with GDM,81 experienced adverse maternal pregnancy outcomes(38.94％).Of the 192 newborns,51 cases were associated with adverse perinatal outcomes,resulting in an incidence rate of 26.56％.Multivariate logistic regression analysis revealed that a high insulin resistance index(OR=2.197),poor glycemic control(OR=2.482),a history of adverse pregnancy or childbirth(OR=2.838),elevated FPG levels(OR=1.910),increased serum expression of miR-15a(OR=1.988),miR-195-5p(OR=2.273),and miR-33(OR=2.479)were independent risk factors for adverse maternal pregnancy outcomes in GDM patients(P<0.05).The area under the receiver operating characteristic curve(AUC)for the combined detection of miR-15a,miR-195-5p,and miR-33 was higher than that of FPG alone in predicting maternal pregnancy outcomes,with the combined detection showing the highest AUC(P<0.05).Similarly,multivariate logistic regression results also indicated that elevated levels of the aforementioned biomarkers—insulin resistance index(OR=2.155),poor glycemic control(OR=2.408),history of adverse pregnancy or childbirth(OR=2.838),FPG(OR=2.018),miR-15a(OR=2.197),miR-195-5p(OR=2.246),and miR-33(OR=3.043)—were independent risk factors for adverse perinatal outcomes in GDM patients(P<0.05).The AUC for combined detection of miR-15a,miR-195-5p,and miR-33 was significantly higher than that of FPG alone in predicting perinatal outcomes,with the combination yielding the highest predictive accuracy(P<0.05).Conclusions Patients with GDM are at increased risk of adverse maternal and perinatal outcomes.Elevated insulin resistance index,poor glycemic control,a history of adverse pregnancy or childbirth,and increased serum levels of miR-15a,miR-195-5p,and miR-33 were identified as independent risk factors for adverse pregnancy outcomes in individuals with gestational diabetes.The individual measurement of miR-15a,miR-195-5p,and miR-33,as well as their combined detection,demonstrated greater predictive value for pregnancy outcomes in GDM patients compared to FPG alone,with the combined detection showing the highest predictive accuracy.

Objective To investigate the expression levels of serum microRNA-15a(miR-15a),microRNA-195-5p(miR-195-5p),and microRNA-33(miR-33)in pregnant women with gestational diabetes mellitus(GDM)and to explore their associations with maternal and neonatal outcomes.Methods The research subjects were selected from 208 patients with GDM who completed delivery at our hospital between September 2021 and October 2024.Based on maternal pregnancy outcomes,the subjects were categorized into either the poor maternal outcome group or the good maternal outcome group.Similarly,they were classified into the poor perinatal outcome group and the good perinatal outcome group according to perinatal outcomes.Clinical data and serum levels of fasting plasma glucose(FPG),miR-15a,miR-195-5p,and miR-33 were collected and compared between groups with different maternal and perinatal outcomes.Multivariate logistic regression analysis was conducted to identify risk factors associated with adverse maternal and perinatal outcomes among GDM patients.Additionally,the predictive value of these biomarkers for adverse maternal and perinatal outcomes was evaluated using receiver operating characteristic(ROC)curve analysis.Results Among 208 patients with GDM,81 experienced adverse maternal pregnancy outcomes(38.94％).Of the 192 newborns,51 cases were associated with adverse perinatal outcomes,resulting in an incidence rate of 26.56％.Multivariate logistic regression analysis revealed that a high insulin resistance index(OR=2.197),poor glycemic control(OR=2.482),a history of adverse pregnancy or childbirth(OR=2.838),elevated FPG levels(OR=1.910),increased serum expression of miR-15a(OR=1.988),miR-195-5p(OR=2.273),and miR-33(OR=2.479)were independent risk factors for adverse maternal pregnancy outcomes in GDM patients(P<0.05).The area under the receiver operating characteristic curve(AUC)for the combined detection of miR-15a,miR-195-5p,and miR-33 was higher than that of FPG alone in predicting maternal pregnancy outcomes,with the combined detection showing the highest AUC(P<0.05).Similarly,multivariate logistic regression results also indicated that elevated levels of the aforementioned biomarkers—insulin resistance index(OR=2.155),poor glycemic control(OR=2.408),history of adverse pregnancy or childbirth(OR=2.838),FPG(OR=2.018),miR-15a(OR=2.197),miR-195-5p(OR=2.246),and miR-33(OR=3.043)—were independent risk factors for adverse perinatal outcomes in GDM patients(P<0.05).The AUC for combined detection of miR-15a,miR-195-5p,and miR-33 was significantly higher than that of FPG alone in predicting perinatal outcomes,with the combination yielding the highest predictive accuracy(P<0.05).Conclusions Patients with GDM are at increased risk of adverse maternal and perinatal outcomes.Elevated insulin resistance index,poor glycemic control,a history of adverse pregnancy or childbirth,and increased serum levels of miR-15a,miR-195-5p,and miR-33 were identified as independent risk factors for adverse pregnancy outcomes in individuals with gestational diabetes.The individual measurement of miR-15a,miR-195-5p,and miR-33,as well as their combined detection,demonstrated greater predictive value for pregnancy outcomes in GDM patients compared to FPG alone,with the combined detection showing the highest predictive accuracy.

Objective To investigate the current status of unplanned readmission to the ICU in neurosurgical patients and to study its influencing factors,aiming to inform the construction of targeted nursing interventions for medical staff.Methods From January 2020 to September 2022,the relevant data of patients transferred out from the ICU of a tertiary-level hospital in Beijing were retrospectively analyzed.After using propensity score matching,a sample with balanced covariates between groups was obtained,and single-factor and Logistic regression analyses were used to study the influencing factors of unplanned readmission to the ICU in neurosurgical patients.Results The data of a total of 4 789 patients were included,and 159 patients(3.32％)had unplanned readmission to the ICU.Respiratory failure and pulmonary infection were the main respiratory complications causing unplanned readmission to the ICU in neurosurgical patients.Logistic regression analysis showed that the duration of mechanical ventilation,the length of the first stay in the ICU,tracheal intubations ≥2 times,presence of cerebrospinal fluid drainage tube or lumbar drainage tube,existence of mild to moderate consciousness disorder at discharge from ICU,low white blood cell count,and low hemoglobin count were independent influencing factors for unplanned readmission to ICUs in neurosurgical patients(P＜0.05).Conclusion Medical staff should pay attention to the high-risk group of unplanned return to the ICU,assess the risk of transfer in a timely manner,carry out targeted nursing measures and strengthen the quality of nursing care to reduce the incidence of unplanned retum to the ICU in neurosurgical patients.

Objective To investigate the current status of unplanned readmission to the ICU in neurosurgical patients and to study its influencing factors,aiming to inform the construction of targeted nursing interventions for medical staff.Methods From January 2020 to September 2022,the relevant data of patients transferred out from the ICU of a tertiary-level hospital in Beijing were retrospectively analyzed.After using propensity score matching,a sample with balanced covariates between groups was obtained,and single-factor and Logistic regression analyses were used to study the influencing factors of unplanned readmission to the ICU in neurosurgical patients.Results The data of a total of 4 789 patients were included,and 159 patients(3.32％)had unplanned readmission to the ICU.Respiratory failure and pulmonary infection were the main respiratory complications causing unplanned readmission to the ICU in neurosurgical patients.Logistic regression analysis showed that the duration of mechanical ventilation,the length of the first stay in the ICU,tracheal intubations ≥2 times,presence of cerebrospinal fluid drainage tube or lumbar drainage tube,existence of mild to moderate consciousness disorder at discharge from ICU,low white blood cell count,and low hemoglobin count were independent influencing factors for unplanned readmission to ICUs in neurosurgical patients(P＜0.05).Conclusion Medical staff should pay attention to the high-risk group of unplanned return to the ICU,assess the risk of transfer in a timely manner,carry out targeted nursing measures and strengthen the quality of nursing care to reduce the incidence of unplanned retum to the ICU in neurosurgical patients.

Objective:To explore the effect of smoking on the sleep quality of military pilots.Methods:A questionnaire survey was conducted among military pilots who underwent a modified physical examination in Air Force Medical Center. The pilots were divided into smoking group and non-smoking group according to whether they smoked or not, and the Pittsburgh Sleep Quality Index (PSQI) was used to assess their sleep quality. The difference in sleep quality was compared between 2 groups.Results:A total of 665 questionnaires were issued, of which 627 were valid, with an effective rate of 94.29%. There were 291 pilots in smoking group and 336 in non-smoking group. The average sleep time of 627 military pilots was (7.58±0.70) h, and the average PSQI score was (2.93±0.09) points. The PSQI score of the smoking group was (3.28±0.14) points, and the PSQI score of the non-smoking group was (2.63±0.10) points, and the difference between 2 groups was significant ( Z=-3.17, P=0.002). Among the factors of the PSQI scale, there were significant differences in sleep onset time, sleep time, sleep efficiency, sleep disorder and daytime dysfunction between the smoking group and the non-smoking group ( Z=-5.85, -2.47, -1.98, -2.18, -1.98, P<0.001,=0.014, 0.049, 0.029, 0.049), and there was no statistically significance in sleep quality and hypnotic drugs intake ( Z=-1.65, -0.94, P=0.098, 0.347). Conclusions:Smoking can affect the sleep quality of military pilots, and it is necessary to actively carry out propaganda and education to persuade pilots away from smoking and maintain physical health.

Objective:To explore the effect of smoking on the sleep quality of military pilots.Methods:A questionnaire survey was conducted among military pilots who underwent a modified physical examination in Air Force Medical Center. The pilots were divided into smoking group and non-smoking group according to whether they smoked or not, and the Pittsburgh Sleep Quality Index (PSQI) was used to assess their sleep quality. The difference in sleep quality was compared between 2 groups.Results:A total of 665 questionnaires were issued, of which 627 were valid, with an effective rate of 94.29%. There were 291 pilots in smoking group and 336 in non-smoking group. The average sleep time of 627 military pilots was (7.58±0.70) h, and the average PSQI score was (2.93±0.09) points. The PSQI score of the smoking group was (3.28±0.14) points, and the PSQI score of the non-smoking group was (2.63±0.10) points, and the difference between 2 groups was significant ( Z=-3.17, P=0.002). Among the factors of the PSQI scale, there were significant differences in sleep onset time, sleep time, sleep efficiency, sleep disorder and daytime dysfunction between the smoking group and the non-smoking group ( Z=-5.85, -2.47, -1.98, -2.18, -1.98, P<0.001,=0.014, 0.049, 0.029, 0.049), and there was no statistically significance in sleep quality and hypnotic drugs intake ( Z=-1.65, -0.94, P=0.098, 0.347). Conclusions:Smoking can affect the sleep quality of military pilots, and it is necessary to actively carry out propaganda and education to persuade pilots away from smoking and maintain physical health.

Objective:To evaluate the value of B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E mutation detection in the differentiating malignant from benign with Bethesda system for reporting thyroid cytopathology (BSRTC) categories Ⅰ and Ⅲ nodules. Methods:From January 2019 to December 2020, a total of 264 nodules from 263 patients (79 males, 184 females; median age 46 years) were retrospectively enrolled and all patients underwent BRAF V600E mutation detection, fine-needle aspiration cytology (FNAC) and thyroid nodulectomy in the Affiliated Drum Tower Hospital of Nanjing University Medical School. Thirteen nodules of 12 patients had repeat aspirate samples and 51 nodules were examined with multiple genes assay in formalin fixed paraffin embedded tissues. Taken the postoperative histopathological results as the gold standard, the diagnostic efficiency of BRAF V600E mutation was analyzed by comparing the results of multiple genes assay and BRAF V600E mutation detection of repeated puncture samples. Results:Of 264 nodules, 230 were malignant (papillary thyroid cancer (PTC)) and 34 were benign, with BSRTC categories Ⅰ (nondiagnostic) and Ⅲ (follicular lesion) nodules of 58 and 206. The sensitivities of BRAF V600E mutation detection in BSRTC categories Ⅰ and Ⅲ nodules were 77.1%(37/48) and 78.0%(142/182), the specificities were 9/10 and 91.7%(22/24), the positive predictive values were 97.4%(37/38) and 98.6%(142/144), the negative predictive values were 45.0%(9/20) and 35.5%(22/62), and the accuracy rates were 79.3%(46/58) and 79.6%(164/206). The diagnostic concordance of BRAF V600E mutation detection was 90.2%(46/51) in the preoperative and postoperative samples of 51 nodules with preoperative BRAF V600E wild type but postoperative pathology confirmed as PTC and was 11/13 in repeat puncture samples. Conclusion:BRAF V600E mutation detection is an effective diagnostic method for BSRTC categories Ⅰ and Ⅲ nodules.

Objective To explore the clinical experience and surgical method of the repairment of frontal plantar tissue defects by using "tennis racket"-like flap with the medial plantar retrograde,and to study the reliability in the clinical application of the medial plantar retrograde flap.Methods From June 2011 to June 2016,"tennis racket"-like flap with the medial plantar retrograde was used to repair the frontal plantar tissue defects in 10 cases.The cutting range of flap was from 3.5 cm × 2.0 cm to 8.0 cm x 4.0 cm in size;in all patients the donor area was covered by skin grafts.Results All flaps survived and wounds healed by first intention.In 10 patients the donor sites healed primarily with a straight scar,and the appearance and texture of the flaps were satisfactory.All patients were followed up from 6 to 24 months (mean 12 months).According to the Chinese foot function evaluation standard trial evaluation,the outcomes were excellent in 9 cases,good in 7 cases,and medium in 2 cases.Conclusions "Tennis racket"-like flap with the medial plantar retrograde is less anatomic variation with reliable blood supply,and sensory recovery is quick;the donor site is a small crater and cicatrial contractures are light;the cost is low.All patients are treated on one session and therefore it is an ideal method for the repairment of frontal plantar tissue defects.

Objective To study the expression characteristics of Let-7 genes in breast cancer.Methods Twenty-eight patients with breast cancer were randomly selected,and their cancer tissue and adjacent normal tissue were collected.TRIzol was used to extract the total RNA and real-time quantitative PCR was used to detect the relative gene expression levels.Results The expression of precursor Let-7 in cancer tissue was (9.65 ± 2.31),which was lower than that in normal tissue (10.05 ± 2.81),P =0.048.Precursor Let-7 had dependence relationship with the long menstruation (b =0.816,P =0.029).The menarche age showed a positive correlation with precursor Let-7 in normal tissue (r =0.502,P =0.048) and a negative correlation in cancer tissue (r =-0.484,P =0.049) Conclusions The expression of precursor Let-7 in cancer tissue is lower than that in normal tissue.The period of menstruation is a protective factor to breast cancer.