Objective:To investigate the association between fasting blood glucose (FBG) variability and the risk of developing gestational diabetes mellitus.Methods:Ninety patients with gestational diabetes mellitus admitted to Jiaxing Maternity and Child Health Care Hospital between January 2022 and April 2023 were included in this study. Based on the blood glucose results obtained from the 75 g oral glucose tolerance test, these patients were divided into two groups: the normal blood glucose group (Group A, n = 56) and the elevated blood glucose group (Group B, n = 34). Multivariate logistic binary regression analysis was conducted to identify independent risk factors for gestational diabetes mellitus. Additionally, an analysis was conducted to investigate the association between long-term fasting blood glucose standard deviation (SD FBG), coefficient of variation (CV FBG), average successive variability of fasting blood glucose (ASV FBG), and the severity of gestational diabetes mellitus. Results:The FBG levels [(6.83 ± 1.03) mmol/L vs. (4.62 ± 0.58) mmol/L], 1-hour postprandial blood glucose [(13.03 ± 1.39) mmol/L vs. (11.42 ± 1.04) mmol/L], and 2-hour postprandial blood glucose [(10.23 ± 1.51) mmol/L vs. (9.42 ± 0.74) mmol/L] between the two groups ( F = 887.43, 144.76, 10.39, all P < 0.05). Furthermore, the glycated hemoglobin levels were significantly elevated in Group B [(7.19 ± 1.01) mmol/L] compared with Group A [(5.03 ± 0.42) mmol/L, t =14.15, P < 0.05). When compared with Group A, patients in Group B exhibited significantly higher values for ASV FBG [(0.58 ± 0.23) mmol/L vs. (0.36 ± 0.26) mmol/L], SD FBG [(0.55 ± 0.38) mmol/L vs. (0.41 ± 0.21) mmol/L], and CV FBG [(9.43 ± 2.45) mmol/L vs. (6.94 ± 1.31) mmol/L] ( t = 4.06, 2.25, 6.28, all P < 0.05). Additionally, the age and pre-pregnancy body mass index were significantly higher in Group B compared with Group A ( t = 3.82, 7.53, both P < 0.05). Age, pre-pregnancy body mass index, fasting blood glucose, 1-hour postprandial blood glucose, 2-hour postprandial blood glucose, glycated hemoglobin, ASV FBG, SD FBG, and CV FBG were identified as risk factors for severe gestational diabetes mellitus ( OR = 1.230, 1.887, 301.406, 3.957, 1.947, 41.861, 5.421, 2.057, all P < 0.05). Furthermore, SD FBG, ASV FBG, and CV FBG were positively correlated with the severity of gestational diabetes mellitus ( r = 0.234, 0.555, 0.408, all P < 0.05). Conclusion:Fasting blood glucose variability is positively correlated with the risk of developing gestational diabetes mellitus. Age, pre-pregnancy body mass index, fasting blood glucose, 1-hour postprandial blood glucose, 2-hour postprandial blood glucose, glycated hemoglobin, ASV FBG, SD FBG, and CV FBG are also risk factors affecting the severity of gestational diabetes mellitus.

Objective To construct the etoposide (VP-16)combined with cisplatin (DDP) chemotherapy scheme (EP chemotherapy scheme)resistant small cell lung cancer (SCLC)cell line H446/EP and to identify the drug resistance characteristics and explore the mechanism.Methods NCI-H446 cells were treated with increasing concentrations of VP-16 and DDP to construct an H446/EP cell line.H446/EP and NCI-H446 cells were used as the research objects.The cell viability was detected by MTT assay,and the resistance index (RI)of H446/EP cells was calculated.Cell cloning assay and Incucyte cell proliferation (label-free)assay were used to detect cell proliferation ability.Transcriptome sequencing was performed to analyze the enrichment of differentially expressed genes (DEGs)in the 2 cell lines.Western blotting was applied to detect the protein expression levels of drug resistance,DNA damage repair (DDR),and autophagy markers.Results MTT assay showed that the resistance index (RI)of H446/EP cells to VP-16,DDP,and DOX were 6.14,3.43,and 1.96,respectively.The results of cell cloning assay and Incucyte cell proliferation assay indicated that the proliferation ability was significantly higher in the H446/EP cells than the NCI-H446 cells (P<0.01).Transcriptome sequencing and pathway enrichment analysis displayed that the DEGs between H446/EP and NCI-H446 cells were enriched in tumor chemoresistance,DDR,and autophagy pathways.Western blot results showed the expression levels of MRP1,BCRP,RAD51,γ-H2AX,and LC3-Ⅱ/LC3-Ⅰ were significantly increased,and that of p62 was obviously decreased in the H446/EP cells when compared with the NCI-H446 cells (P<0.05).Conclusion An EP chemotherapy-resistant H446/EP cell line is successfully constructed.Stronger proliferation ability,increased expression of efflux transporters,and enhanced DDR and autophagy may be the mechanisms of the resistance of SCLC to EP chemotherapy scheme.

Tumor metastasis depends on the dynamic balance of the actomyosin cytoskeleton. As a key component of actomyosin filaments, non-muscle myosin-IIA disassembly contributes to tumor cell spreading and migration. However, its regulatory mechanism in tumor migration and invasion is poorly understood. Here, we found that oncoprotein hepatitis B X-interacting protein (HBXIP) blocked the myosin-IIA assemble state promoting breast cancer cell migration. Mechanistically, mass spectrometry analysis, co-immunoprecipitation assay and GST-pull down assay proved that HBXIP directly interacted with the assembly-competent domain (ACD) of non-muscle heavy chain myosin-IIA (NMHC-IIA). The interaction was enhanced by NMHC-IIA S1916 phosphorylation via HBXIP-recruited protein kinase PKCβII. Moreover, HBXIP induced the transcription of PRKCB, encoding PKCβII, by coactivating Sp1, and triggered PKCβII kinase activity. Interestingly, RNA sequencing and mouse metastasis model indicated that the anti-hyperlipidemic drug bezafibrate (BZF) suppressed breast cancer metastasis via inhibiting PKCβII-mediated NMHC-IIA phosphorylation in vitro and in vivo. We reveal a novel mechanism by which HBXIP promotes myosin-IIA disassembly via interacting and phosphorylating NMHC-IIA, and BZF can serve as an effective anti-metastatic drug in breast cancer.

Objective:To understand the real experience and feeling of Intensive Care Unit (ICU) nurses after delirium assessment using Cornell Assessment of Pediatric Delirium (CAPD) , so as to provide reference and evidence for improving pediatric ICU delirium assessment.Methods:Using the purposive sampling method, a total of 11 ICU nurses who used CAPD for pediatric delirium assessment in a ClassⅢ Grade A children's specialized hospital in Shanghai from February to April 2020 were selected as the research objects. Phenomenological research method in qualitative research was used to conduct face-to-face and semi-structured in-depth interviews with the research subjects. Colaizzi 7-step analysis method was used to collect and sort the data and analyze and refine the topics.Results:ICU nurses' cognition in pediatric delirium assessment could be classified into four themes, including changes of ICU nurses' cognition of pediatric delirium assessment, obstacles to pediatric delirium assessment, promoting factors for pediatric delirium assessment, and ICU nurses' concern about the collaborative intervention of medical team after the positive delirium assessment.Conclusions:The main manifestations of ICU nurses in this study are the lack of understanding of the evaluation of delirium, the obstacles encountered in the evaluation process, and the lack of collaboration between the medical and nursing team. In order to improve the convenience and accuracy of ICU nurses' assessment of delirium, it is recommended to strengthen the training of medical staff for delirium, gradually optimize the obstacles to the implementation of the assessment, encourage the cooperation of medical teams and develop a delirium assessment process in line with children's ICU according to the working situation and mode of ICU.

Objective:To construct a cross-cultural nursing quality sensitive indicator system, so as to provide a basis for the hospital's cross-cultural nursing quality evaluation and monitoring.Methods:Based on the Donabedian model and the sunrise model, this study adopted the literature analysis method and the research team discussed preliminary screening indicators. From May to June 2020, 15 nursing and medical experts from a university hospital in Shanghai were selected as the subject of the consultation by using the method of convenience sampling. The Delphi method was used to conduct two rounds of expert consultations to determine the content of sensitive indicators of cross-cultural nursing quality.Results:The positive coefficients of the two rounds of consultations were 100%, and the authority coefficients were 0.883 and 0.893. The constructed cross-cultural nursing quality sensitive indicators included 3 first-level indicators and 20 second-level indicators.Conclusions:The cross-cultural nursing quality sensitive indicator constructed based on the Delphi method is scientific and representative, which can provide a reference for nursing quality evaluation and continuous quality improvement evaluation.

Pain management in Post Anesthesia Care Unit (PACU) after general anesthesia is getting more and more attention, but there is still a problem of under-assessment. This article reviews the current status and common assessment tools of pain assessment in PACU after general anesthesia at home and abroad. It is found that accurate assessment of the pain degree and characteristics of patients in PACU after general anesthesia is helpful for timely evaluation and adjustment of patients' perioperative analgesia plan.

Objective:To explore the effect of application of painless wards in Department of Orthopedics on pain and anxiety of patients after orthopedic surgery.Methods:According to overall sampling method, 520 patients who underwent orthopedic surgery in Affiliated Hangzhou First People's Hospital to Zhejiang University School of Medicine from March 2018 to March 2019 were selected and they were randomly divided into the control group and the observation group, with 260 cases in each group. Patients in both groups were admitted to the painless ward after surgery. The control group was given routine nursing in the painless ward while the observation group was given aromatherapy on this basis. The Visual Analogue Scale (VAS) score and Self-rating Anxiety Scale (SAS) score on day 1, 3, and 7 after surgery were compared between the two groups.Results:VAS and SAS scores of the two groups showed a decreasing trend with time after surgery, and VAS and SAS scores of the observation group on day 1, 3 and 7 after surgery were lower than those of the control group. The differences were statistically significant ( P<0.05) . Conclusions:Application of aromatherapy in painless wards in Department of Orthopedics can furtherly reduce the degree of postoperative pain and anxiety of orthopedic patients and promote the rapid postoperative rehabilitation.

A quail-origin subtype of the influenza virus was isolated from a human-infecting H7N9 subtype of the avian influenza virus found in a live poultry market and was given the name A/Quail/Hangzhou/1/ 2013 (H9N2). We analyzed the whole genome of this virus and its biologic characteristics. Sequence analyses suggested that the: HA and NS genes belonged to a CK/BJ/1/94-like lineage; NA, NP, PA and PB1 genes belonged to a SH/F/98-like lineage; M and PB2 genes belonged to a G1-like lineage. Analyses of key amino acids showed that the cleavage site in HA protein was PSRSSR ↓ GL, and that the HA protein had a human receptor-binding site with Leu226. Deletion of amino acids 69 - 73 was detected in the stalk of NA protein, the M2 protein had an Asn31 mutation, and the NS1 protein had two mutations at Ser42, Ala149. The intravenous pathogenicity of this virus was 0.36. A study in chickens suggested that all inoculated birds shed the virus from the trachea and cloaca on the third day post-infection (p. i. ) until 11 days. All chickens that had direct contact shed the virus on the second day p. i. until 8 days. Results of virus reisolation suggested that lung and tracheal tissues could shed the virus in 5 days, whereas the other organs could shed the virus in 3 days. These results suggest that this virus strain is H9N2 subtype LPAIV, whose lineage is prevalent in mainland China. This research provides evidence on how to monitor and prevent the H9N2 subtype of the avian influenza virus.
Animals ; Chick Embryo ; Chickens ; China ; Genotype ; Influenza A Virus, H9N2 Subtype ; classification ; genetics ; isolation & purification ; Influenza in Birds ; virology ; Phylogeny ; Quail ; virology

Objective To investigate the characteristics of activation-induced cytidine deaminase (AID) expression level in de novo acute leukemia (AL) patients, chronic myeloid leukemia chronic phase (CML-CP), chronic myeloid leukemia blastic crisis (CML-BC) patients and leukemia cell lines. Methods The expression level of AID mRNA was measured in 89 cases of newly-diagnosed acute lymphoblastic leukemia (ALL) patients, 79 cases of de novo acute myeloid leukemia (AML) patients, 5 cases of CML-BC patients, 5 cases of CML-CP patients and leukemia cell lines NB4, THP-1, KG-1, Raji, K562 by real-time quantitative reverse transcriptase polymerase chain reaction (RT-PCR), bone marrow mononuclear cells of 16 normal healthy donors were used as the control group. Results The expression levels of AID mRNA in 89 cases of ALL and 79 cases of AML were 0.006-7 463.175 and 0.005-69.107, the median expression levels were 3.785 and 1.812, the expression level of AID mRNA in the normal control group was 0.146-4.707, and the median expression level was 1.483, respectively. The AID expression levels of ALL, B-ALL, Burkitt leukemia, M4 patients and Raji cells were significantly higher than those of the normal control group (all P <0.05). Nevertheless, the AID mRNA expression levels of M3 patients and NB4, KG-1 cells were lower than those of the normal control group (all P <0.05). Furthermore, the AID mRNA expression levels of K562 cell were strikingly higher than that of the CML-CP patients (P<0.001), so were those of CML-BC, chronic myeloid leukemia myeloid blast crisis (CML-MBC), chronic myeloid leukemia lymphoblastic blast crisis (CML-LBC) patients. Conclusion AID gene shows high expression level in B-ALL, Burkitt leukemia and M4, low expression level in M3 and KG-1 cells, and obvious high expression level in CML-BC.

Objective To describe and analyze the clinical and laboratory findings in a group of children diagnosed with scleroderma at Beijing Children's Hospital in the last 10 years.Methods The clinical charts of children with scleroderma in the Rheumatology Department at Beijing Children's Hospital,between January 2002 and October 2013 were reviewed.All of them fulfilled the classification criteria for juvenile sclerodema,both systemic scleroderma (SSc) and localized scleroderma (LS) types.T test was used for comparison between the two groups.Results Forty-six patients were enrolled and were diagnosed as scleroderma.Seven patients(15％) suffered from SSc and 39 patients(85％) were LS.Mean age-at-onset of LS was (5±4) years old.The male to female ratio was 1.2:1.Mean age-at-onset of SSc was (9±4) years old.All patients were female.The lesions found in LS were linear scleroderma (54％),mixed morphea (36％),generalized morphea (8％),and panclerotic morphea (3％).Twenty-six patients had internal organs involved.Three patients with nerve system involvement was found in en coup de sabre (ECDS).Systemic involvement included lung and gastrointestinal tract primarily.The heart,nerve system,kidney,eye involvement was also found.One girl had SSc combined with renal crisis.Antinuclear antibodies were positive in 77％ of LS patients and 100％ of SSc patients.Rheumatic factor was positive in 6 patients (15％),5 patients had joint involvement.Tests for anti-Scl-70 antibodies were positive in 5 (71％) patients with SSc.The most common drugs used were methotrexate and prednisone.Conclusion In this study,LS is common in children.SSc is more severe than LS.Multi-center and large sample study is needed to know the characteristics of juvenile scleroderma in China.