Objective To investigate the expression of serum exosomal long non-coding RNA X chromo-some inactivation specific transcript(LncRNA XIST)and microRNA(miR)-130a-3p in gestational diabetes mellitus(GDM)patients and its relationship with pregnancy outcome.Methods A total of 149 GDM patients(GDM group)and 149 healthy pregnant women(control group)admitted to the hospital from January 2021 to January 2024 were selected.Serum exosomal LncRNA XIST,miR-130a-3p and glucose and lipid metabolism indexes of the two groups were detected and compared.The correlation of LncRNA XIST and miR-130a-3p levels with glycolipid metabolism indexes was analyzed by Pearson method.Univariate and multivariate Logis-tic regression models were used to analyze the influencing factors of pregnancy outcomes in GDM patients.Re-ceiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of serum exosomal Ln-cRNA XIST and miR-130a-3p levels alone and in combination for pregnancy outcomes in GDM patients.Results Serum exosomal LncRNA XIST levels,fasting insulin(FINS),fasting blood glucose(FBG),insulin resistance index(HOMA-IR),2-hour postprandial glucose(2 hPG),total cholesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)levels in GDM group were higher than those in control group(P＜0.05),and the levels of miR-130a-3p and high density lipoprotein cholesterol(HDL-C)were lower than those in the control group(P＜0.05).LncRNA XIST was positively correlated with FINS,FBG,HOMA-IR,2 hPG,TC,TG and LDL-C,and negatively correlated with HDL-C(P＜0.05).miR-130a-3p was negatively correlated with FINS,FBG,HOMA-IR,2 hPG,TC,TG and LDL-C,and positively correlated with HDL-C(P＜0.05).Among the 149 GDM patients,43 cases showed adverse pregnancy outcome,accounting for 28.86％.The increase level of FBG,the increase level of LncRNA XIST and the increase of HOMA-IR were risk factors for adverse pregnancy outcome in GDM patients,while the increase of miR-130a-3p was a protec-tive factor.The ROC curve analysis showed that the predictive efficacy of combined detection was superior to that of single indicator detection.Conclusion The serum exosomal LncRNA XIST of GDM patients is highly expressed,and miR-130a-3p is lowly expressed,and the combined detection of the above indexes has a high predictive value for pregnancy outcome.

Objective:To explore the technique methods and clinical application value of β-electrode (a plasma needle shape electrode) assisted laparoscopic repair of complex vesicovaginal fistula (VVF).Methods:Clinical data of one patient with complex VVF admitted to Chinese PLA General Hospital in April 2025 was retrospectively analyzed. A 36-year-old female presented with urinary leakage 2 months after hysterectomy. Computed tomography urography excluded ureterovaginal fistula. Cystoscopy revealed a 2 cm fistula on the posterior bladder wall with both ureteral orifices adjacent to the fistula edge. The procedure involved two steps: first, transurethral β-electrode pretreatment was performed to protect the ureteral orifices and create a passage from the bladder to the abdominal cavity. Then, laparoscopic separation, suture closure of the fistula, and omental flap coverage were conducted.Results:Total operation time was 180 min (the time of β- electrode operation was 30 min) with intraoperative estimated blood loss of 50 mL. The catheter was removed 3 weeks postoperatively, and the patient voided well without leakage during 4-month follow-up.Conclusions:β- electrode assisted laparoscopic repair of complex VVF have the advantage of precise manipulation, minimal invasion and rapid recovery. No similar technique have been reported domestically or internationally. This technique provides a new approach for the treatment of complex VVF.

Objective To evaluate the efficacy and safety of pelvic arterial embolization (PAE) in women with intractable primary postpartum hemorrhage (PPH). Methods Clinical data of 36 cases were analyzed retrospectively in which women underwent PAE for intractable primary PPH in Peking Union Medical College Hospital between Jan 2006 and Jan 2015. The success rate of PAE were measured and possible predictive risk factors associated with treatment failure were analyzed. The complications secondary to PAE were also recorded. Results (1)The etiology of PPH. Among the 36 cases, 21 patients delivered viginally (Group VD) and 15 received cesarean section (Group CS). The most frequent cause of PPH was uterine atony (72%, 26/36). The less common causes were placental problems (28%, 10/36), genital tract trauma (6%, 2/36) and coagulation defects (3%, 1/36) in turn. Three patients (8%, 3/36) had combined causes.(2)Interventions before PAE. Uterotonic medications were used in all patients. 31 patients received carboprost methylate suppositorites,27 received carbetocin and 31 received carboprost tromethamine. Besides, 20 patients received one or more surgical interventions before PAE. PAE was performed when these interventions failed. (3) Characteristics of PAE. Altogether 78 arteries were embolized in 36 cases. Embolization of bilateral uterine arteries was performed in 31 cases, right internal iliac artery and bilateral inferior epigastric arteries were embolized in one case. Right internal pudendal artery, bilateral uterine arteries and bilateral internal iliac arteries were embolized in one case. And bilateral uterine arteries, bilateral internal iliac arteries were embolized in one case. In the other 2 cases, bilateral internal iliac arteries were embolized.(4)Efficacy of PAE. The overall technical success rate of PAE was 100%(36/36), while the clinical success rate was 94%(34/36). All patients survived.(5)Complications of PAE. 15 patients were transferred to ICU after PAE for 1 to 7 days. Except self-limited fever, no puncture site hematoma, buttock necrosis or vessel rupture was observed. The effect on menstrual cycle and fertility were followed in 25 patients. 17 (68%, 17/25) reported resumption of normal menses and 8 (32%, 8/25) reported amenorrhea. Three pregnancies after PAE were observed. Conclusion PAE is a safe and effective treatment for intractable primary PPH which can prevent hysterectomy and preserve fertility of patients.

Objective To clarify the effects of Xinfukang containing-serum on stromal cell-derived factor-1α (SDF-1α) translation and protein secretion of bone marrow stem cells (BMSCs).Methods BMSCs were isolated and amplified using bone marrow culture method,and were identified by flow cytometry.mRNA and protein secretion of SDF-1α were detected by quantitative PCR (q-PCR) and enzyme linked immunosorbent assay (ELISA),respectively.Results The expression of SDF-1α mRNA were significantly increased after 72 h in drug-containing serum,and SDF-1α mRNA in the experimental group was approximately 200 times as that in the control group (P＜0.05).Secretion of SDF-1 α in the experimental group (277.561 1 ± 15.651 8) pg/ml was nearly doubled compared with that in the control group (153.107 1±14.765 1) pg/ml (P＜0.05).Conclusions BMSCs from whole bone marrow adherent culture have high purity,and drug-containing serum can promote BMSCs to express SDF-1 α mRNA and secretion of SDF-1 α.

Objective To investigate the prevalence and severity degree of post traumatic stress disorder(PTSD), anxiety and depression, and to explore the different mental profile in different groups involved with an earthquake. Methods 26 days after 8.0 grade earthquake in Wenchuan, psychological rescue team of State Administration of Traditional Chinese Medicine went to some communities in Deyang and Mianzhu area of Sichuan province. In this period, a total of 119 survivors, including students(42), teacher(40) and masses(37), were investigated through impact of event scale (IES), self-rating anxiety scale (SAS) and self-rating depression scale(SDS). Results①The detection rate of score over 19 in IES in 3 groups (students, teacher and masses) were 69％, 80％ and 91.9％, respectively. There was significant difference among these 3 groups (F=5.611, P=0.005<0.01) in respect of severity degree of PTSD. ②The values of severity degree of anxiety in 3 groups were significant higher than normal value (P<0.001, all). There was also significant difference among these 3 groups (F=3.376, P=0.038<0.05) in respect of severity degree of anxiety, with the masses group being significant higher than student and teacher group (P=0.029, P=0.022, respectively). ③The values of severity degree of depression in these 3 groups were significant higher than normal value (P<0.05, all). But there was no significant difference (F= 0.670, P=0.514) among these 3 groups. ConclusionThe results suggested the importance to assess PTSD, anxiety and depression in post-disaster area, especially PTSD and anxiety evaluations in the masses group.