Objective To investigate the effect of the rs3765467 polymorphism of glucagon-like peptide-1 receptor(GLP-1R)gene on the efficacy of Liraglutide(Lir)in patients with type 2 diabetes mellitus(T2DM)and metabolic associated fatty liver disease(MAFLD).Methods A total of 281 patients with T2DM from May 2022 to May 2023 were selected,including 125 patients with simple T2DM(T2DM group)and 156 patients with T2DM combined with MAFLD(T2DM+MAFLD group).120 healthy individuals during the same period were selected as the control(NC)group.The related indexes of glucose and lipid metabolism were detected.The polymorphism of GLP-1R gene rs3765467 was detected.Results BMI,FPG,HbA1c,HOMA-IR and TG in each group increased in turn(P<0.05),while the distribution frequency of genotype GG and allele G decreased in turn(P<0.05).TC and LDL-C in T2DM and T2DM+MAFLD groups were higher than those in NC group(P<0.05).TC and TG levels in genotype GA/AA patients were significantly higher than those in genotype GG patients(P<0.05).Compared with before treatment,the levels of BMI,FPG,HbA1c,HOMA-IR,TC,TG and LDL-C in T2DM patients with MAFLD were significantly decreased after Lir treatment(P<0.05).There was no significant difference in BMI and related indexes of glucose and lipid metabolism in GG and GA/AA patients before and after Lir treatment(P>0.05).Conclusions The distribution frequency of GG and G allele at rs3765467 of GLP-1R gene is reduced in T2DM patients with MAFLD.The carrying of allele A was associated with increased TC and TG levels,but did not affect the efficacy of Lir in reducing weight and improving glycolipid metabolism.

Objective To analyze the factors influencing iodine nutritional status in pregnant women dur-ing pregnancy,based on thyroid function and thyroid autoantibody levels,and to explore the association between iodine nutritional abnormalities and pregnancy outcomes.Methods A total of 838 pregnant women who underwent routine prenatal checkups at Qinghai Provincial People's Hospital between January 2021 and June 2023 were pro-spectively enrolled in this study.All participants were followed until delivery.Seven cases were lost to follow-up,resulting in a final sample size of 831 participants.Among them,276 were in the first trimester,384 in the second trimester,and 171 in the third trimester.Data on urinary iodine concentration(UIC),urinary creatinine(UCr),thyroid function indicators,and thyroid autoantibodies were collected.Based on their iodine nutritional status,the participants were categorized into either the iodine-sufficient group or the iodine-abnormal group(including iodine-deficient,iodine-hyper-sufficient,and iodine-excessive subgroups).This study analyzed the iodine nutritional sta-tus of pregnant women during different gestational periods,compared thyroid function indices,prevalence of thy-roid diseases,and the positivity rates of thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb),and thyroid-stimulating hormone receptor antibody(TRAb)among different iodine status groups.Additionally,ad-verse pregnancy outcomes were compared across groups.Multivariate logistic regression analysis was conducted to identify risk factors associated with iodine abnormalities during pregnancy,and a predictive model was developed to assess its potential predictive value.Results Among the 831 pregnant women included in the study,373 cases(44.89％)exhibited iodine sufficiency,while 458 cases(55.11％)presented with iodine abnormalities,including 282 cases of iodine deficiency,144 cases of iodine hypersufficiency,and 32 cases of iodine excess.No statistically significant differences were observed in the iodine nutritional status across different trimesters(P>0.05).The se-rum level of thyroid-stimulating hormone(TSH)was significantly higher in the iodine abnormal group compared to the iodine sufficient group(P<0.05).Additionally,the iodine abnormal group demonstrated higher positivity rates of TPOAb alone,TGAb,and TRAb,as well as increased incidence of thyroid dysfunction and total adverse pregnancy outcomes compared to the iodine sufficient group(all P<0.05).These adverse indicators were also sig-nificantly elevated in the iodine-deficient,iodine super-sufficient,and iodine overdose subgroups compared to the iodine sufficient group(P<0.05).Elevated serum TSH levels and the presence of TPOAb,TGAb,and TRAb were identified as risk factors for iodine abnormalities during pregnancy(P<0.05).The predictive model con-structed for identifying iodine abnormalities in pregnant women demonstrated an area under the curve(AUC)of 0.876,with a sensitivity of 72.27％and a specificity of 89.01％.Conclusions The prevalence of iodine nutritional abnormalities among pregnant women during pregnancy was high,with most cases presenting iodine deficiency.These abnormalities were associated with thyroid function,thyroid autoimmunity,and pregnancy outcomes,but showed no significant correlation with gestational age.Furthermore,the prediction model developed based on iden-tified risk factors demonstrated effective performance in predicting iodine nutritional abnormalities during preg-nancy.

Objective:To investigate the impacts of Glaucocalyxin A on myocardial inflammation and immune function in dia-betes rats by regulating cyclic guanosine monophosphate-adenosine monophosphate synthase(cGAS)/stimulator of interferon genes(STING)pathway.Methods:STZ was injected intraperitoneally to model diabetes in rats,after successful modeling,the rats were divided into model group,low-dose Glaucocalyxin A group[10 mg/(kg·d)],high-dose Glaucocalyxin A group[20 mg/(kg·d)]and H-151(750 nmol/d)group,control group was also set up,with 10 rats in each group,the model group and control group were given the same volume of physiological saline for 4 weeks.The fully automated biochemical analyzer was applied to detect TG,TC,HDL-C and LDL-C levels;flow cytometry was applied to detect the levels of CD4+T,CD8+T,CD4+T/CD8+T in the serum of rats in each group;ELISA was applied to detect the levels of TNF-α,IL-6 and IL-1β in myocardial tissue;HE staining was applied to observe pathologi-cal changes in rat myocardium;TUNEL staining was applied to observe the apoptosis of myocardial cells;Western blot was applied to detect the levels of Bcl-2,Bax,cGAS and STING pathway proteins.Results:The myocardial cells of rats in the control group were ar-ranged neatly and structurally intact;compared with the control group,the myocardial cells of rats in the model group were arranged in a disordered manner,with unclear nuclear structure and infiltration of inflammatory cells,the levels of serum TG,TC,CD8+T,myo-cardial tissue TNF-α,IL-6 and IL-1β,myocardial cell apoptosis rate,and the protein expression levels of Bax,cGAS and STING in rats were obviously increased,the levels of HDL-C,CD4+T,CD4+T/CD8+T,and the protein expression level of Bcl-2 were obviously reduced(P<0.05);compared with the model group,the pathological damage status of myocardial cells in the low and high doses Glau-cocalyxin A groups and H-151 group was obviously reduced,the levels of serum TG,TC,CD8+T,myocardial tissue TNF-α,IL-6 and IL-1β,myocardial cell apoptosis rate,and the protein expression levels of Bax,cGAS,and STING in rats were obviously reduced,the levels of HDL-C,CD4+T,CD4+T/CD8+T,and the protein expression level of Bcl-2 were obviously increased(P<0.05);compared with the high-dose Glaucocalyxin A group,there was no statistically obvious difference in all detection indicators in the H-151 group(P>0.05).Conclusion:Glaucocalyxin A may reduce myocardial inflammation and improve immune function in diabetes rats by inhi-biting cGAS-STING signaling pathway.

Objective:To investigate the impacts of Glaucocalyxin A on myocardial inflammation and immune function in dia-betes rats by regulating cyclic guanosine monophosphate-adenosine monophosphate synthase(cGAS)/stimulator of interferon genes(STING)pathway.Methods:STZ was injected intraperitoneally to model diabetes in rats,after successful modeling,the rats were divided into model group,low-dose Glaucocalyxin A group[10 mg/(kg·d)],high-dose Glaucocalyxin A group[20 mg/(kg·d)]and H-151(750 nmol/d)group,control group was also set up,with 10 rats in each group,the model group and control group were given the same volume of physiological saline for 4 weeks.The fully automated biochemical analyzer was applied to detect TG,TC,HDL-C and LDL-C levels;flow cytometry was applied to detect the levels of CD4+T,CD8+T,CD4+T/CD8+T in the serum of rats in each group;ELISA was applied to detect the levels of TNF-α,IL-6 and IL-1β in myocardial tissue;HE staining was applied to observe pathologi-cal changes in rat myocardium;TUNEL staining was applied to observe the apoptosis of myocardial cells;Western blot was applied to detect the levels of Bcl-2,Bax,cGAS and STING pathway proteins.Results:The myocardial cells of rats in the control group were ar-ranged neatly and structurally intact;compared with the control group,the myocardial cells of rats in the model group were arranged in a disordered manner,with unclear nuclear structure and infiltration of inflammatory cells,the levels of serum TG,TC,CD8+T,myo-cardial tissue TNF-α,IL-6 and IL-1β,myocardial cell apoptosis rate,and the protein expression levels of Bax,cGAS and STING in rats were obviously increased,the levels of HDL-C,CD4+T,CD4+T/CD8+T,and the protein expression level of Bcl-2 were obviously reduced(P<0.05);compared with the model group,the pathological damage status of myocardial cells in the low and high doses Glau-cocalyxin A groups and H-151 group was obviously reduced,the levels of serum TG,TC,CD8+T,myocardial tissue TNF-α,IL-6 and IL-1β,myocardial cell apoptosis rate,and the protein expression levels of Bax,cGAS,and STING in rats were obviously reduced,the levels of HDL-C,CD4+T,CD4+T/CD8+T,and the protein expression level of Bcl-2 were obviously increased(P<0.05);compared with the high-dose Glaucocalyxin A group,there was no statistically obvious difference in all detection indicators in the H-151 group(P>0.05).Conclusion:Glaucocalyxin A may reduce myocardial inflammation and improve immune function in diabetes rats by inhi-biting cGAS-STING signaling pathway.

Objective To analyze the factors influencing iodine nutritional status in pregnant women dur-ing pregnancy,based on thyroid function and thyroid autoantibody levels,and to explore the association between iodine nutritional abnormalities and pregnancy outcomes.Methods A total of 838 pregnant women who underwent routine prenatal checkups at Qinghai Provincial People's Hospital between January 2021 and June 2023 were pro-spectively enrolled in this study.All participants were followed until delivery.Seven cases were lost to follow-up,resulting in a final sample size of 831 participants.Among them,276 were in the first trimester,384 in the second trimester,and 171 in the third trimester.Data on urinary iodine concentration(UIC),urinary creatinine(UCr),thyroid function indicators,and thyroid autoantibodies were collected.Based on their iodine nutritional status,the participants were categorized into either the iodine-sufficient group or the iodine-abnormal group(including iodine-deficient,iodine-hyper-sufficient,and iodine-excessive subgroups).This study analyzed the iodine nutritional sta-tus of pregnant women during different gestational periods,compared thyroid function indices,prevalence of thy-roid diseases,and the positivity rates of thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb),and thyroid-stimulating hormone receptor antibody(TRAb)among different iodine status groups.Additionally,ad-verse pregnancy outcomes were compared across groups.Multivariate logistic regression analysis was conducted to identify risk factors associated with iodine abnormalities during pregnancy,and a predictive model was developed to assess its potential predictive value.Results Among the 831 pregnant women included in the study,373 cases(44.89％)exhibited iodine sufficiency,while 458 cases(55.11％)presented with iodine abnormalities,including 282 cases of iodine deficiency,144 cases of iodine hypersufficiency,and 32 cases of iodine excess.No statistically significant differences were observed in the iodine nutritional status across different trimesters(P>0.05).The se-rum level of thyroid-stimulating hormone(TSH)was significantly higher in the iodine abnormal group compared to the iodine sufficient group(P<0.05).Additionally,the iodine abnormal group demonstrated higher positivity rates of TPOAb alone,TGAb,and TRAb,as well as increased incidence of thyroid dysfunction and total adverse pregnancy outcomes compared to the iodine sufficient group(all P<0.05).These adverse indicators were also sig-nificantly elevated in the iodine-deficient,iodine super-sufficient,and iodine overdose subgroups compared to the iodine sufficient group(P<0.05).Elevated serum TSH levels and the presence of TPOAb,TGAb,and TRAb were identified as risk factors for iodine abnormalities during pregnancy(P<0.05).The predictive model con-structed for identifying iodine abnormalities in pregnant women demonstrated an area under the curve(AUC)of 0.876,with a sensitivity of 72.27％and a specificity of 89.01％.Conclusions The prevalence of iodine nutritional abnormalities among pregnant women during pregnancy was high,with most cases presenting iodine deficiency.These abnormalities were associated with thyroid function,thyroid autoimmunity,and pregnancy outcomes,but showed no significant correlation with gestational age.Furthermore,the prediction model developed based on iden-tified risk factors demonstrated effective performance in predicting iodine nutritional abnormalities during preg-nancy.

Objective To investigate the effect of the rs3765467 polymorphism of glucagon-like peptide-1 receptor(GLP-1R)gene on the efficacy of Liraglutide(Lir)in patients with type 2 diabetes mellitus(T2DM)and metabolic associated fatty liver disease(MAFLD).Methods A total of 281 patients with T2DM from May 2022 to May 2023 were selected,including 125 patients with simple T2DM(T2DM group)and 156 patients with T2DM combined with MAFLD(T2DM+MAFLD group).120 healthy individuals during the same period were selected as the control(NC)group.The related indexes of glucose and lipid metabolism were detected.The polymorphism of GLP-1R gene rs3765467 was detected.Results BMI,FPG,HbA1c,HOMA-IR and TG in each group increased in turn(P<0.05),while the distribution frequency of genotype GG and allele G decreased in turn(P<0.05).TC and LDL-C in T2DM and T2DM+MAFLD groups were higher than those in NC group(P<0.05).TC and TG levels in genotype GA/AA patients were significantly higher than those in genotype GG patients(P<0.05).Compared with before treatment,the levels of BMI,FPG,HbA1c,HOMA-IR,TC,TG and LDL-C in T2DM patients with MAFLD were significantly decreased after Lir treatment(P<0.05).There was no significant difference in BMI and related indexes of glucose and lipid metabolism in GG and GA/AA patients before and after Lir treatment(P>0.05).Conclusions The distribution frequency of GG and G allele at rs3765467 of GLP-1R gene is reduced in T2DM patients with MAFLD.The carrying of allele A was associated with increased TC and TG levels,but did not affect the efficacy of Lir in reducing weight and improving glycolipid metabolism.

Objective To analyze the nucleic acid testing(NAT)results of voluntary blood donors in Hainan and evalu-ate the residual risk in the window period of NAT for hepatitis B virus(HBV),hepatitis C virus(HCV)and human immu-nodeficiency virus(HIV).Methods A retrospective analysis on the NAT results of voluntary blood donors at our center from January 2012 to December 2022 was conducted.The new infection rate-window period residual risk model was used to assess the residual risk of HBV,HCV and HIV among blood donors.Results From January 2012 to December 2022,a-mong the blood donated by voluntary blood donors in Hainan,45.02％(522 684/1 161 042)were collected from first-time donors,54.98％(638 358/1 161 042)were from repeat donors(including regular donors),and 30.48％(354 227/1 162 042)were from regular donors.The total reactive rate of NAT was 0.19％(2 151/1 161 042).After NAT,the residual risk in the window period of HBV,HCV and HIV was 62.54 per million,0.431 per million and 0.791 per million,respective-ly.Conclusion The implementation of NAT among voluntary blood donors in Hainan significantly reduces the residual risk of HCV,and the residual risk of HBV,HCV and HIV transmission in the window period is at a relatively low level.

The aim of this study was to evaluate the safety and immunogenicity of the first domestic ACYW135 meningococcal conjugate vaccine and a control vaccine named AC group meningococcal conjugate vaccine for 3 months (90-119 days) infants. From February 2017 to June 2018, a randomized, blinded, and similar vaccine-controlled clinical trial design was adopted at the Henan Vaccine Clinical Research Base. The subjects were 3 months old healthy infants, a total of 720, based on a 1∶1 ratio. The random allocation table for entry was randomly assigned to the experimental group and the control group. According to the 3, 4, and 5 month-old vaccination procedures, the subjects were vaccinated with test vaccine (ACYW135 group meningococcal conjugate vaccine) and control vaccine (group A group C meningococcal polysaccharide conjugate vaccine), of which 720 were given the first dose, 696 were given the second dose (test group: 346; control group: 350), and 692 were given the third dose (test group: 344; Control group: 348). The overall adverse reaction rate of the test vaccine was 21.90% (230 cases), which was lower than the 32.04% (339 cases) of the control vaccine (<0.001). The incidence of systemic adverse reactions was 19.52% (205 cases), which was lower than that of the control vaccine (27.69%) (293 cases) (<0.001). The local adverse reaction rate was 3.04% (32 cases), which was lower than the control group (7.84%) (83 cases) (<0.001). The graded adverse reaction test vaccine was 0.57% (6 cases), which was lower than the control group of 2.36% (25 cases) (<0.001). The positive conversion rate of anti-bacterial serum antibodies showed that there was no significant difference between the test vaccine group A (91.42%), C (88.76%) and the control vaccine (92.92%) (87.02%) (>0.05). Group Y and W135 was 88.17% (298 cases), 99.41% (336 cases), respectively. The GMT results showed that the test vaccine group A was 56.24, the control vaccine was 57.43 (>0.05); the group C test vaccine (43.53) was higher than the control group (27.28) (<0.001). The group Y and W135 are 89.22 and 140.66, respectively. Among them, the proportion of the group C GMT antibody ≥ 1∶128 for test vaccine (31.07%, 105 cases) was higher than the control vaccine (16.22%, 55 cases) (<0.001). ACYW135 group meningococcal conjugate vaccine has more safety and immunogenicity after application to 3 month old infants.
Antibodies, Bacterial ; Humans ; Infant ; Meningococcal Vaccines ; adverse effects ; immunology ; Vaccines, Conjugate

PURPOSE: The purpose of this study is to investigate the impact of transitional care by a nurse-led multidisciplinary team (MDT) on clinical outcomes and quality of life of patients with ankylosing spondylitis. METHODS: A randomized control study design was used. Subjects were allocated randomly to an experimental group and a control group. The experimental group received intensive transitional care by a nurse-led MDT, whereas the control group received routine nursing care. Disease activity, spinal mobility, comprehensive function, health service utilization, and quality of life were assessed at the baseline and at six months with the Bath Ankylosing Spondylitis Metrology Index, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), a health service utilization questionnaire and version 2 of the Short Form-36 health survey. RESULTS: Compared with the baseline, the BASDAI, BASFI, emergency visits, hospitalizations, hospitalization days, and bodily pain, vitality, mental health, total score, and average score of version 2 of the Short Form-36 health survey were improved in the experimental group (p < .05), whereas only bodily pain, vitality, and role-emotional were improved in the control group p < .05). At six months, the experimental group exhibited significantly more improvement on the BASDAI, BASFI, hospitalizations, all domains except Role-physical as well as total score and average score p < .05) compared with the control group. CONCLUSION: A MDT-based nurse-led transitional care improves clinical outcomes and quality of life of patients with ankylosing spondylitis. Future research should be carried out on modes of follow-up and family support.
Baths ; Emergencies ; Follow-Up Studies ; Health Services ; Health Surveys ; Hospitalization ; Humans ; Mental Health ; Nursing Care ; Patient Care Team ; Quality of Life ; Spondylitis, Ankylosing ; Transitional Care

Objective To investigate the relationship between histological chorioamnionitis (HCA),funisitis (FV) and lung injury in preterm infants.Method Data of preterm infants with gestational age of less than 34 weeks,who were born in our Hospital and admitted to the neonatal ward during the period of October 2015 to August 2016 were retrospectively collected.According to reports of placenta pathologies,participants were assigned into three groups,non-infection group,HCA group and HCA + FV group.Demographic and infectious characteristics,duration of respiratory support,partial pressure of oxygen (PaO2) and pulmonary function testing results at corrected gestational age 40 weeks were compared among groups.Result A total of 151 preterm infants were included,with 33 cases in noninfection group,61 cases in HCA group and 57 cases in HCA + FV group.Non-invasive ventilation duration and number of days in room air in HCA + FV groups were both longer than those in the non-infection group [0 (0,66) h vs.0 (0,0) h,65 (0,176) h vs.0 (0,8) h].The duration of invasive ventilation and total ventilation days in HCA + FV group were longer than those of the other two groups [0 (0,4) h vs.0 (0,0) and 0 (0,0) h,0 (0,99) h vs.0 (0,0) and 0 (0,52) h],the differences were statistically significant (P ＜ 0.05).However,there was no significant difference of PaO2 after 0.5 hour respiratory support among the three groups (P ＞ 0.05).Pulmonary functional parameters,such as respiratory frequency,VPEF/TE,VPEF/VE,VPEF and TPEF,gradually decreased with the degree of inflammatory progress,but there was no statistically significant difference (P ＞ 0.05).Conclusion HCA and FV are highly associated with premature lung injury.The worse the placental inflammation is,the longer respiratory support duration will be needed or required.However,HCA and FV may have no significant effect on lung function.