BACKGROUND:Carboxylesterase 1 and inflammatory factors play a crucial role in regulating lipid metabolism and glucose homeostasis.However,the effects of different exercise intensity interventions on carboxylesterase 1 and inflammatory factors in skeletal muscle of type 2 diabetic rats remain to be revealed. OBJECTIVE:To investigate the effects of different exercise intensity interventions on carboxylesterase 1 and inflammatory factors in skeletal muscle of type 2 diabetic rats. METHODS:Thirty-two 8-week-old male Sprague-Dawley rats were randomly divided into normal control group(n=12)and modeling group(n=20)after 1 week of adaptive feeding.Rat models of type 2 diabetes mellitus were prepared by high-fat diet and single injection of streptozotocin.After successful modeling,the rats were randomly divided into diabetic control group(n=6),moderate-intensity exercise group(n=6)and high-intensity intermittent exercise group(n=6).The latter two groups were subjected to treadmill training at corresponding intensities,once a day,50 minutes each,and 5 days per week.Exercise intervention in each group was carried out for 6 weeks.After the intervention,ELISA was used to detect blood glucose and blood lipids of rats.The morphological changes of skeletal muscle were observed by hematoxylin-eosin staining.The mRNA expression levels of carboxylesterase 1 and inflammatory cytokines were detected by real-time quantitative PCR.The protein expression levels of carboxylesterase 1 and inflammatory cytokines were detected by western blot and immunofluorescence. RESULTS AND CONCLUSION:Compared with the normal control group,fasting blood glucose,triglyceride,low-density lipoprotein cholesterol,insulin resistance index in the diabetic control group were significantly increased(P<0.01),insulin activity was decreased(P<0.05),and the mRNA and protein levels of carboxylesterase 1,never in mitosis gene A related kinase 7(NEK7)and interleukin 18 in skeletal muscle tissue were upregulated(P<0.05).Compared with the diabetic control group,fasting blood glucose,triglyceride,low-density lipoprotein cholesterol,and insulin resistance index in the moderate-intensity exercise group and high-intensity intermittent exercise group were down-regulated(P<0.05),and insulin activity was increased(P<0.05).Moreover,compared with the diabetic control group,the mRNA level of NEK7 and the protein levels of carboxylesterase 1,NEK7 and interleukin 18 in skeletal muscle were decreased in the moderate-intensity exercise group(P<0.05),while the mRNA levels of carboxylesterase 1,NEK7,NOD-like receptor heat protein domain associated protein 3 and interleukin 18 and the protein levels of carboxylesterase 1 and interleukin 18 in skeletal muscle were downregulated in the high-intensity intermittent exercise group(P<0.05).Hematoxylin-eosin staining showed that compared with the diabetic control group,the cavities of myofibers in the moderate-intensity exercise group became smaller,the number of internal cavities was reduced,and the cellular structure tended to be more intact;the myocytes of rats in the high-intensity intermittent exercise group were loosely arranged,with irregular tissue shape and increased cavities in myofibers.To conclude,both moderate-intensity exercise and high-intensity intermittent exercise can reduce blood glucose,lipid,insulin resistance and carboxylesterase 1 levels in type 2 diabetic rats.Moderate-intensity exercise can significantly reduce the expression level of NEK7 protein in skeletal muscle,while high-intensity intermittent exercise can significantly reduce the expression level of interleukin 18 protein in skeletal muscle.In addition,the level of carboxylesterase 1 is closely related to the levels of NEK7 and interleukin 18.

Objective To explore the trajectory of psychological symptom clusters in pregnant women with assisted reproductive technology(ART),and analyze the influencing factors of each trajectory subgroups,in order to provide a theoretical basis for the management of psychological health during pregnancy in pregnant women with ART.Methods A total of 205 pregnant women who had conceived using ART were sampled from the obstetrics clinic of a tertiary hospital in Nanjing from August 2023 to April 2024 using a convenient sampling method.The baseline data were assessed by general information questionnaire,Symptom Checklist-90,Distress Disclosure Index and Positive Psychological Capital Questionnaire at 10-14 weeks gestation,and the follow-up information was assessed by Symptom Checklist-90 at 22-26 weeks of gestation and 34-38 weeks of gestation.Exploratory factor analysis was used to extract symptom clusters;the latent class growth mixture model was used to identify the track categories;the multiple logistic regression analysis was used to analyze the influencing factors of the track.Results 180 cases were finally included.By exploratory factor analysis,5,4 and 5 factors were extracted at 3 time points respectively.Trajectories of psychological symptom clusters in pregnant women with ART is divided into 3 potential classes:low level-slow relieving group(28.89％),high level-significant increasing group(6.11％),medium level-slow increasing group(65.00％).Logistic regression analyses showed that duration of infertility,number of ART,literacy,pain self-expression and positive psychological capital were influential factors in the potential categories of psychological symptom clusters in pregnant women conceived with ART(all P＜0.05).Conclusion The trajectory of psychological symptom clusters in pregnant women with ART was divided into 3 potential classes.Medical workers could develop corresponding interventions based on the influencing factors and implement comprehensive and efficient symptom management.

Based on the underlying mechanism of acupuncture therapy for intracerebral hemorrhage(ICH),we discussed the research on the pathological mechanism of ICH and the effect of acupuncture therapy in recent 20 years,from primary and secondary brain injury.It was concluded that acupuncture had an intervention effect on multiple links such as hematoma compression,brain edema,oxidative stress,nerve cell death and cerebral blood flow changes.However,there were still problems such as less in vivo research,lack of thinking on syndrome differentiation and insufficient research on the quantity effect and overall regulation of acupuncture.

Objective:To systematically evaluate and integrate the exercise experience of overweight or obese pregnant women during pregnancy, in order to provide basis for the formulation of standardized exercise programs for this population.Methods:We searched databases including PubMed, Cochrane Library, Web of Science, CINAHL, Embase, Ovid, PsycINFO, Chinese Biomedical Literature Database, VIP, Wanfang and China National Knowledge Infrastructure, from their inception to August 16, 2023, to collect qualitative studies on the exercise experience of overweight or obese pregnant women during pregnancy. The quality of included studies was evaluated according to Joanna Briggs Institute Critical Appraisal Tool for qualitative studies in Australia. The results were integrated by integrating methods.Results:A total of 11 studies were included. Sixty-one complete findings were grouped according to similarities to form 9 new categories. These categories resulted in 3 synthesized findings. Pregnant women with overweight or obesity were affected by promoting and hindering factors; careful balance of exercise risk and benefit for overweight or obese pregnant women during pregnancy; expectations and needs of overweight or obese pregnant women for exercise during pregnancy.Conclusions:Overweight or obese pregnant women highly rated the benefits and importance of exercise, but their participation and adherence to exercise is challenging. Medical staff should pay attention to the exercise experience of overweight or obese pregnant women during pregnancy, understand the driving factors and obstacles of exercise for overweight or obese pregnant women, in order to provide standardized and personalized exercise guidance programs for overweight or obese pregnant women.

Objective:To retrieve, evaluate and summarize relevant evidence on communication strategies for families with perinatal loss, and to provide an evidence-based basis for communication practice among clinical health professionals.Methods:The system searches for evidence related to the loss of family doctor-patient communication strategies during the perinatal period in computer decision support systems such as UpToDate, BMJ Best Clinical Practice, International Guidelines Network, UK National Institute for Health and Clinical Excellence, PubMed, Web of Science, CINAHL, China National Knowledge Infrastructure, Wanfang Data, as well as in Chinese and English databases and related websites.The search was conducted between January 2012 and December 2022. The literature ′s quality and extracted evidence were independently evaluated by two researchers according to professional judgement. Results:A total of 13 articles were included, including 1 clinical decision, 2 guidelines, 4 national standards, 2 expert consensus, and 4 systematic reviews. 30 pieces of evidence have been summarized across five aspects, comprising communication environment, communication skills, timing and key points of communication, communication for special populations, and system-level communication support.Conclusions:This study summarizes the relevant evidence on communication strategies for family doctor-patient communication strategies for perinatal loss. Clinical professionals should carefully select and apply relevant evidence based on available medical resources and parental preferences, Develop and implement practical standards for family doctor-patient communication strategies for perinatal loss at the system level, further harmonize communication behaviors, and improve communication quality.

Objective:To investigate dietary patterns under social jet lag in pregnant women with gestational diabetes mellitus (GDM) and analyze its relationship with blood glucose control and delivery outcomes, to provide a reference for comprehensive management of pregnant women with GDM.Methods:A cross-sectional study method was used to select pregnant women with GDM during their stay in the obstetrics ward of the Obstetrics and Gynaecology Hospital of Nanjing Medical University from October 2022 to December 2023 as the study population. Social jet lag and dietary information were collected using Simplified Food Frequency Questionnaire and Self-assessment Questionnaire on Social Jet Lag. Spearman correlation analysis was used to analyze the correlation between dietary patterns and blood glucose control as well as delivery outcomes. Receiver operating characteristic curve was used to analyze the predictive performance of social jet lag, dietary patterns and fasting blood glucose for cesarean section.Results:A total of 350 pregnant women with GDM were included, 140 pregnant women with social time lag, aged (31.97 ± 3.88) years old; 210 pregnant women without social time lag, aged (32.32 ± 3.91) years old. The plant-based dietary pattern factor, fast food dietary pattern factor, and the intakes of protein, fat, and carbohydrates of pregnant women with social jet lag were -0.06 (-0.25, 0.32) and 0.08 (-0.43, 0.66), (119.57 ± 89.77) g, (82.69 ± 59.48) g, (228.77 ± 140.18) g, compared with pregnant women without social jet lag [-0.21 (-0.39, 0.08), -0.24 (-0.57, 0.07), (86.29 ± 47.75) g, (57.31 ± 37.86) g, (170.79 ± 85.56) g], the differences were statistically significant ( Z=-2.39, -2.86, t=81.43, 90.78, 88.34, all P<0.05). The social jet lag of GDM women was positively correlated with plant-based dietary patterns, fast food dietary patterns, fasting blood glucose, glycated hemoglobin and cesarean section ( r values were 0.19-0.24, all P<0.05). The plant-based dietary pattern of pregnant women with GDM was negatively correlated with fasting blood glucose and cesarean section ( r=-0.17, -0.24, both P<0.05), while the fast food dietary pattern was positively correlated with fasting blood glucose and cesarean section ( r=0.20, 0.19, both P<0.05). The area under the curve in the combined prediction of multiple factors such as social jet lag, plant-based dietary pattern, fast food dietary pattern and fasting blood glucose for the outcome of cesarean section during pregnancy was 0.742. Conclusions:The dietary structure of GDM women with social jet lag is unreasonable, consume more carbohydrates, sugar, and fats, which are associated with poor glycemic control and increased cesarean section rate. Medical staff should be alerted to social jet lag preferences and dietary intake of GDM and include them in the risk assessment of adverse outcomes of GDM, give timely correction and strengthen management, which can provide a reference for early preventive interventions for GDM with different risk stratification.

Objective:To systematically evaluate and integrate the exercise experience of overweight or obese pregnant women during pregnancy, in order to provide basis for the formulation of standardized exercise programs for this population.Methods:We searched databases including PubMed, Cochrane Library, Web of Science, CINAHL, Embase, Ovid, PsycINFO, Chinese Biomedical Literature Database, VIP, Wanfang and China National Knowledge Infrastructure, from their inception to August 16, 2023, to collect qualitative studies on the exercise experience of overweight or obese pregnant women during pregnancy. The quality of included studies was evaluated according to Joanna Briggs Institute Critical Appraisal Tool for qualitative studies in Australia. The results were integrated by integrating methods.Results:A total of 11 studies were included. Sixty-one complete findings were grouped according to similarities to form 9 new categories. These categories resulted in 3 synthesized findings. Pregnant women with overweight or obesity were affected by promoting and hindering factors; careful balance of exercise risk and benefit for overweight or obese pregnant women during pregnancy; expectations and needs of overweight or obese pregnant women for exercise during pregnancy.Conclusions:Overweight or obese pregnant women highly rated the benefits and importance of exercise, but their participation and adherence to exercise is challenging. Medical staff should pay attention to the exercise experience of overweight or obese pregnant women during pregnancy, understand the driving factors and obstacles of exercise for overweight or obese pregnant women, in order to provide standardized and personalized exercise guidance programs for overweight or obese pregnant women.

Objective:To retrieve, evaluate and summarize relevant evidence on communication strategies for families with perinatal loss, and to provide an evidence-based basis for communication practice among clinical health professionals.Methods:The system searches for evidence related to the loss of family doctor-patient communication strategies during the perinatal period in computer decision support systems such as UpToDate, BMJ Best Clinical Practice, International Guidelines Network, UK National Institute for Health and Clinical Excellence, PubMed, Web of Science, CINAHL, China National Knowledge Infrastructure, Wanfang Data, as well as in Chinese and English databases and related websites.The search was conducted between January 2012 and December 2022. The literature ′s quality and extracted evidence were independently evaluated by two researchers according to professional judgement. Results:A total of 13 articles were included, including 1 clinical decision, 2 guidelines, 4 national standards, 2 expert consensus, and 4 systematic reviews. 30 pieces of evidence have been summarized across five aspects, comprising communication environment, communication skills, timing and key points of communication, communication for special populations, and system-level communication support.Conclusions:This study summarizes the relevant evidence on communication strategies for family doctor-patient communication strategies for perinatal loss. Clinical professionals should carefully select and apply relevant evidence based on available medical resources and parental preferences, Develop and implement practical standards for family doctor-patient communication strategies for perinatal loss at the system level, further harmonize communication behaviors, and improve communication quality.

Objective:To investigate dietary patterns under social jet lag in pregnant women with gestational diabetes mellitus (GDM) and analyze its relationship with blood glucose control and delivery outcomes, to provide a reference for comprehensive management of pregnant women with GDM.Methods:A cross-sectional study method was used to select pregnant women with GDM during their stay in the obstetrics ward of the Obstetrics and Gynaecology Hospital of Nanjing Medical University from October 2022 to December 2023 as the study population. Social jet lag and dietary information were collected using Simplified Food Frequency Questionnaire and Self-assessment Questionnaire on Social Jet Lag. Spearman correlation analysis was used to analyze the correlation between dietary patterns and blood glucose control as well as delivery outcomes. Receiver operating characteristic curve was used to analyze the predictive performance of social jet lag, dietary patterns and fasting blood glucose for cesarean section.Results:A total of 350 pregnant women with GDM were included, 140 pregnant women with social time lag, aged (31.97 ± 3.88) years old; 210 pregnant women without social time lag, aged (32.32 ± 3.91) years old. The plant-based dietary pattern factor, fast food dietary pattern factor, and the intakes of protein, fat, and carbohydrates of pregnant women with social jet lag were -0.06 (-0.25, 0.32) and 0.08 (-0.43, 0.66), (119.57 ± 89.77) g, (82.69 ± 59.48) g, (228.77 ± 140.18) g, compared with pregnant women without social jet lag [-0.21 (-0.39, 0.08), -0.24 (-0.57, 0.07), (86.29 ± 47.75) g, (57.31 ± 37.86) g, (170.79 ± 85.56) g], the differences were statistically significant ( Z=-2.39, -2.86, t=81.43, 90.78, 88.34, all P<0.05). The social jet lag of GDM women was positively correlated with plant-based dietary patterns, fast food dietary patterns, fasting blood glucose, glycated hemoglobin and cesarean section ( r values were 0.19-0.24, all P<0.05). The plant-based dietary pattern of pregnant women with GDM was negatively correlated with fasting blood glucose and cesarean section ( r=-0.17, -0.24, both P<0.05), while the fast food dietary pattern was positively correlated with fasting blood glucose and cesarean section ( r=0.20, 0.19, both P<0.05). The area under the curve in the combined prediction of multiple factors such as social jet lag, plant-based dietary pattern, fast food dietary pattern and fasting blood glucose for the outcome of cesarean section during pregnancy was 0.742. Conclusions:The dietary structure of GDM women with social jet lag is unreasonable, consume more carbohydrates, sugar, and fats, which are associated with poor glycemic control and increased cesarean section rate. Medical staff should be alerted to social jet lag preferences and dietary intake of GDM and include them in the risk assessment of adverse outcomes of GDM, give timely correction and strengthen management, which can provide a reference for early preventive interventions for GDM with different risk stratification.

Based on the underlying mechanism of acupuncture therapy for intracerebral hemorrhage(ICH),we discussed the research on the pathological mechanism of ICH and the effect of acupuncture therapy in recent 20 years,from primary and secondary brain injury.It was concluded that acupuncture had an intervention effect on multiple links such as hematoma compression,brain edema,oxidative stress,nerve cell death and cerebral blood flow changes.However,there were still problems such as less in vivo research,lack of thinking on syndrome differentiation and insufficient research on the quantity effect and overall regulation of acupuncture.