ObjectiveTo analyze the trend and influencing factors of low birth weight (LBW) among newborns in Chongming District of Shanghai from 2008 to 2022, so as to provide references for the development of intervention measures reducing the rate of LBW. MethodsBirth surveillance data of Chongming District of Shanghai from 2008 to 2022 were collected and organized, and the annual percentage change (APC) of LBW was calculated by using Joinpoint 5.0.2 software for trend change analysis. Logistic regression analysis was used to analyze the influencing factors of LBW. ResultsThe overall incidence of LBW was 3.71% in Chongming District, Shanghai from 2008 to 2022. Joinpoint trend analysis showed that the incidence of LBW in Chongming District had an upward trend (APC=5.49%, 95%CI: 3.31%‒7.72%, P<0.001).Multivariate logistic regression analysis showed that preterm birth, multiple births, female infants, birth defects, first pregnancy, primiparity, and a young father age (<20 years) were risk factors for LBW in Chongming District. Among the term infants, female infants, birth defects, and first pregnancy were risk factors for LBW (P<0.05). Female infants, birth defects, first pregnancy, primiparity, advanced maternal age (≥35 years), and a young father age (<20 years) were risk factors in singleton neonates. ConclusionThe incidence of LBW among newborns is on the rise in Chongming District of Shanghai. Therefore, high risk groups need to be identified, and prenatal check-ups and pregnancy care should be strengthened to reduce the risk of neonatal LBW.

Objective A Nomogram model of cognitive frailty was constructed and validated in hospitalized older adults,providing a reference for early screening,intervention and personalized management of cognitive frailty.Methods A convenience sampling approach was employed to recruit 322 elderly inpatients from a tertiary hospital in Beijing between October 2024 and February 2025 as study participants,and data were collected using the General Information Questionnaire,the Short Form-Mini-Nutritional Assessment,the Asens Insomnia Scale,the Activity of Daily Living Rating,the Self-Rating Anxiety Scale,the Geriatric Depression Scale-15,the Social Support Rating Scale,the Frailty Phenotype scale,the Subjective Cognitive Decline Questionnaire-9,the Mini-Mental State Examination,and the Clinical Dementia Rating.Lasso-Logistic regression was used to screen the variables,R software was used to draw the nomogram model;Bootstrap method was used for internal validation.Results Lasso-Logistic regression screened 8 predictors of age,depression,anxiety,support utilization,nutritional status,literacy,physical activity,and chronic pain,with an area under the subject operating characteristic curve of 0.830(95％CI:0.787-0.873),a sensitivity of 0.764,a specificity of 0.730,an accuracy of 0.748,and a calibrated curve,Brier score,and Hosmer-Lemeshow test(P=0.774)all showed that the model fit was good.Conclusion The Lasso-Logistic regression-based nomogram model of cognitive frailty in hospitalized older adults has good predictive performance and clinical utility,and can be used as a reference for early identification and intervention of cognitive decline in hospitalized older adults.

A total of 269 non-diabetic chronic kidney disease (CKD) patients were enrolled in this study. Among them, 175 patients (65.1%) were assigned to the control group and received conventional therapy with maximally tolerated doses of renin-angiotensin-aldosterone system inhibitors, while 94 patients (34.9%) were assigned to the dapagliflozin group and received oral dapagliflozin 10 mg/day in addition to the conventional therapy. The results showed that the urine protein quantity in the dapagliflozin group was lower than those in the control group at 3, 6, 12, 18, and 24 months of follow-up (all P<0.05), and the blood albumin level was higher than those in the control group at 18 and 24 months of follow-up (all P<0.05). The Kaplan-Meier survival curve analysis results showed that the cumulative renal survival rate of the dapagliflozin group was significantly higher than that of the control group (Log-rank test, χ2=5.078, P=0.024). Multivariable Cox regression analysis results revealed that using dapagliflozin was independently associated with a reduced risk of the composite endpoint in non-diabetic CKD patients ( HR=0.400, 95% CI 0.163-0.983, P=0.046). There was no statistical difference in adverse reactions between the two groups (all P>0.05). It is indicated that dapagliflozin has a renal protective effect independent of hypoglycemic action and good safety.

Objective: To investigate the correlation between the levels of calcitonin gene-related peptide α (CGRPα) and the poor responses to the treatment of phenylephrine in pregnant women with hypotension during caesarean section under intraspinal anesthesia. Methods : A total of 87 pregnant women who underwent intraspinal anesthesia cesarean section were recruited . They were grouped according to the presence or absence of hypotension after anesthesia and the response to ephedrine and Phe . As to Anesthesia-0 group , pregnant women had no hypo- tension , 35 cases (40. 2% ) ; Anesthesia-1 group , pregnant women had hypotension and good response to ephed- rine treatment , 12 cases (13 . 8% ) ; Anesthesia-2 group , pregnant women had hypotension and had poor response to ephedrine treatment , 6 cases (6. 9% ) ; Anesthesia-3 group , pregnant women had hypotension and good response to Phe treatment , 8 cases (9. 2% ) ; Anesthesia-4 group , pregnant women had hypotension and no response to Phe treatment , 26 cases (29. 9% ) . The levels of CGRPαin serum and placental tissues of pregnant women were deter- mined by ELISA . The rats pregnant normally. A hypotension rat model was established by intragastric administra- tion of risserpine . 50 rats were randomly divided into control group , model group , pregnancy group , model + preg- nancy group , model + pregnancy + phenylephrine group , with 10 rats in each group . Body weight of the rats was continuously monitored during the 2nd to 6th week of risserpine administration . Systolic blood pressure was meas- ured at the end of the 6th induction week . And the peripheral blood sample and placental tissues were collected and the levels of CGRPαwere determined . Results : The detection of CGRPαlevels in the pregnant women serum and placental tissues showed that compared with Anesthesia-0 group , CGRPαlevels in Anesthesia-1-4 groups serum were higher (P < 0. 05) . Compared with Anesthesia-3 group , serum CGRPαlevels in Anesthesia-4 group were higher (P < 0. 05) . Compared with Anesthesia-2 group , CGRPαlevels in Anesthesia-4 group serum were higher (P < 0. 05) . Compared with Anesthesia-0 group , tissues CGRPαlevels in Anesthesia-4 group were higher (P < 0. 05) . Compared with Anesthesia-3 group , CGRPαlevels in Anesthesia-4 group tissues were higher (P < 0. 05) . Compared with Anesthesia-2 group , CGRPαlevels in Anesthesia-4 group tissues were higher ( P < 0. 05) . From the 2nd to 6th week of hypotension modeling induction , compared with pregnancy group , body weight decreased in the model + pregnancy group and the model + pregnancy + phenylephrine group (P < 0. 05) . There was no signifi- cant difference in baseline systolic blood pressure among all groups (P > 0. 05) . At the end of the 6th week , com- pared with pregnancy group , systolic blood pressure decreased in model + pregnancy group and model + pregnancy + phenylephrine group(P < 0. 05) ; the levels of CGRPαin serum and placental tissues increased ( P < 0. 05) . Compared with model + pregnancy group , systolic blood pressure increased in model + pregnancy + phenylephrine group (P < 0. 05) . Conclusion The poor response of pregnant women with hypotension during caesarean section under intraspinal anesthesia to the treatment of phenylephrine may be related to the increased levels of CGRPαin placenta and peripheral blood .

Objective To investigate the effect of long-chain non-coding ribonucleic acid maternal expression 3(MEG3)on high glucose-induced pancreatic islet β-cell injury through the transforming growth factor-β-Smad 2/3 signaling pathway.Methods INS-1 rat insulinoma cells were divided into normal control(Con)group,HG group,negative control(si-NC)group,HG+si-NC group,siRNA targeting MEG3(si-MEG3)group,HG+si-MEG3 group,HG+si-MEG3+TGF-β-Smad2/3 signaling pathway inhibitor(HG+si-MEG3+LY2109761)group.Cell viability was detected by cell counting kit-8(CCK-8).The mRNA expression of MEG3 and pyroptosis-associated markers was detected by qRT-PCR.Autophagic vesicles were tested by transmission electron microscopy,and expression of autophagy-associated proteins and pyroptosis-associated proteins was detected by Western blot and immunofluorescence.TGF-β-Smad2/3 protein expression was detected by Western blot.Results Glucose downregulated MEG3 mRNA expression in a dose-dependent manner.Compared with si-NC group,p-Smad2,TGF-β1,Beclin1,LC3-II/LC3-I,NLRP3,GSDMD-N,IL-1β,ASC,and c-Caspase1 protein expression was elevated(P<0.05),and cell viability was decreased in HG+si-NC group(P<0.05).Compared with the HG+si-NC group,TGF-β1,NLRP3,GSDMD-N,IL-1β,ASC,c-Caspase1 protein expression was elevated(P<0.05),and p-Smad2,cell viability,Beclin1,and LC3-II/LC3-I were decreased in the HG+si-MEG3 group(P<0.05).Compared with HG+si-MEG3 group,NLRP3,GSDMD-N,IL-1β,ASC,and c-Caspase1 protein expression was elevated(P<0.05),and cell viability,p-Smad2,TGF-β1,Beclin1,and LC3-II/LC3-I protein expression was decreased in HG+si-MEG3+LY2109761 group(P<0.05).Conclusions MEG3 regulates autophagy and pyroptosis in pancreatic β-cells through the TGF-β-Smad2/3 signaling pathway.

Objective To explore the effectiveness of integrating virtual simulation technology with case-based learning(CBL)in the teaching of clinical blood transfusion testing technology.Methods From January to June 2024,99 undergraduate students majoring in medical laboratory science at our university were selected and divided into an observation group(50 students)and a control group(49 students)based on their classes.The control group followed a traditional theoretical teaching model,while the observation group employed virtual simulation technology combined with CBL.Results The study compared as-sessment scores for theory learning,practical skills,case analysis,and comprehensive quality,teaching effects such as coordina-tion and cooperation abilities,self-efficacy measured by the GSES scale,and teaching satisfaction between the two groups.The results indicated that the observation group had significantly higher scores in all assessment categories,teaching effect abilities,and total GSES scores compared to the control group(P＜0.05).The total teaching satisfaction rate in the observation group reached 100%,significantly higher than the 80% in the control group(P＜0.05).Conclusion The integration of virtual simu-lation technology with CBL innovates the teaching model for clinical blood transfusion testing courses,effectively enhancing students'professional skills and comprehensive quality,boosting self-efficacy,and achieving high student satisfaction,demon-strating significant potential for broader application.

Tracheal intubation is the most commonly used way to establish artificial airway in intensive care unit patients, and it is the premise of respiratory support and treatment, the success of extubation is an important basis to measure the prognosis of patients. Influenced by many factors, extubation of patients may fail, resulting in prolonged hospitalization, increased medical expenses and increased incidence of complications. This article reviews the literature at home and abroad, and summarizes the main mechanism, risk factors and prevention strategies of extubation failure in intensive care unit patients, aiming at improving the recognition ability of clinical medical staff for extubation failure and providing reference for clinical management and follow-up research.

Objective To explore the effectiveness of integrating virtual simulation technology with case-based learning(CBL)in the teaching of clinical blood transfusion testing technology.Methods From January to June 2024,99 undergraduate students majoring in medical laboratory science at our university were selected and divided into an observation group(50 students)and a control group(49 students)based on their classes.The control group followed a traditional theoretical teaching model,while the observation group employed virtual simulation technology combined with CBL.Results The study compared as-sessment scores for theory learning,practical skills,case analysis,and comprehensive quality,teaching effects such as coordina-tion and cooperation abilities,self-efficacy measured by the GSES scale,and teaching satisfaction between the two groups.The results indicated that the observation group had significantly higher scores in all assessment categories,teaching effect abilities,and total GSES scores compared to the control group(P＜0.05).The total teaching satisfaction rate in the observation group reached 100%,significantly higher than the 80% in the control group(P＜0.05).Conclusion The integration of virtual simu-lation technology with CBL innovates the teaching model for clinical blood transfusion testing courses,effectively enhancing students'professional skills and comprehensive quality,boosting self-efficacy,and achieving high student satisfaction,demon-strating significant potential for broader application.

Objective To investigate the effect of long-chain non-coding ribonucleic acid maternal expression 3(MEG3)on high glucose-induced pancreatic islet β-cell injury through the transforming growth factor-β-Smad 2/3 signaling pathway.Methods INS-1 rat insulinoma cells were divided into normal control(Con)group,HG group,negative control(si-NC)group,HG+si-NC group,siRNA targeting MEG3(si-MEG3)group,HG+si-MEG3 group,HG+si-MEG3+TGF-β-Smad2/3 signaling pathway inhibitor(HG+si-MEG3+LY2109761)group.Cell viability was detected by cell counting kit-8(CCK-8).The mRNA expression of MEG3 and pyroptosis-associated markers was detected by qRT-PCR.Autophagic vesicles were tested by transmission electron microscopy,and expression of autophagy-associated proteins and pyroptosis-associated proteins was detected by Western blot and immunofluorescence.TGF-β-Smad2/3 protein expression was detected by Western blot.Results Glucose downregulated MEG3 mRNA expression in a dose-dependent manner.Compared with si-NC group,p-Smad2,TGF-β1,Beclin1,LC3-II/LC3-I,NLRP3,GSDMD-N,IL-1β,ASC,and c-Caspase1 protein expression was elevated(P<0.05),and cell viability was decreased in HG+si-NC group(P<0.05).Compared with the HG+si-NC group,TGF-β1,NLRP3,GSDMD-N,IL-1β,ASC,c-Caspase1 protein expression was elevated(P<0.05),and p-Smad2,cell viability,Beclin1,and LC3-II/LC3-I were decreased in the HG+si-MEG3 group(P<0.05).Compared with HG+si-MEG3 group,NLRP3,GSDMD-N,IL-1β,ASC,and c-Caspase1 protein expression was elevated(P<0.05),and cell viability,p-Smad2,TGF-β1,Beclin1,and LC3-II/LC3-I protein expression was decreased in HG+si-MEG3+LY2109761 group(P<0.05).Conclusions MEG3 regulates autophagy and pyroptosis in pancreatic β-cells through the TGF-β-Smad2/3 signaling pathway.

Tracheal intubation is the most commonly used way to establish artificial airway in intensive care unit patients, and it is the premise of respiratory support and treatment, the success of extubation is an important basis to measure the prognosis of patients. Influenced by many factors, extubation of patients may fail, resulting in prolonged hospitalization, increased medical expenses and increased incidence of complications. This article reviews the literature at home and abroad, and summarizes the main mechanism, risk factors and prevention strategies of extubation failure in intensive care unit patients, aiming at improving the recognition ability of clinical medical staff for extubation failure and providing reference for clinical management and follow-up research.