Objective:To analyze the influence of midwifeled accompanyon the psychological status and delivery outcomes of gestational diabetes patients, and to provide reference for the implementation of clinical intervention programs for gestational diabetes patients.Methods:A semi-randomized controlled trial was adopted.Convenience sampling method was used to select 120 gestational diabetes patients admitted to Langfang People′s Hospital from March 2021 to September 2023, and they were divided into control group and experimental group according to the admission order. Both groups were given intraspinal delivery analgesia, while the control group was combined with routine midwifery management, and the experimental group was combined with a midwife led accompany. Intervention lasted until 2 h postpartum in both groups, and follow-up for 1 month. The delivery indicators, psychological status, delivery outcome and satisfaction of the two groups were compared.Results:Finally, 120 gestational diabetes patients were included, 60 patients in the control group, aged (28.73 ± 2.79) years, and 60 patients in the experimental group, aged (27.98 ± 1.09) years. The first and second stages of labor in the experimental group were (416.35 ± 29.87) and (60.95 ± 7.44) min, respectively, which were shorter than (501.33 ± 37.59) and (80.28 ± 8.95) min in the control group, and the differences were statistically significant ( t = 13.71, 12.87, both P<0.05). The blood glucose during delivery and 2 h postpartum hemorrhage was (6.81 ± 0.10) mmol/L and (236.18 ± 37.58) ml, respectively, lower than (7.48 ± 0.45) mmol/L and (325.70 ± 59.88) ml in the control group, the differences were statistically significant ( t = 11.26, 9.81, both P<0.05). After 1 month of follow-up, the scores of Self-rating Anxiety Scale and Self-rating Depression Scale of the experimental group were (30.86 ± 2.55) and (21.45 ± 2.67) points, which were lower than (42.19 ± 3.86) and (42.97 ± 3.15) points in the control group, and the scores of Psychological Resilience Scale were (71.22 ± 6.54) points, which was higher than that of the control group (55.38 ± 6.06) points, the differences were statistically significant ( t = 18.97, 40.37, 13.76, all P<0.05). After intervention, the incidence rates of lateral resection and postpartum hemorrhage in the experimental group were 28.3%(17/60) and 5.0%(3/60), respectively, lower than 48.3%(29/60) and 18.3%(11/60) in the control group, and the total satisfaction rate of the experimental group was 93.3%(56/60), higher than 80.0% (48/60) of the control group. The differences were statistically significant ( χ2 = 5.08, 5.18, 4.62, all P<0.05). Conclusions:The midwife led accompany could shorten the labor process of gestational diabetes patients, reduce their blood glucose during delivery and the amount of blood 2 h postpartum, and improve their psychological status and delivery outcomes, which was conducive to improving patient satisfaction.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the efficacy of video-assisted teaching ward rounds for typical cases of oph-thalmology in clinical practice for medical undergraduates.Methods A total of 45 students from clinical medicine in Peking Union Medical College were enrolled.They were randomly divided into the experimental group(23 students)and control group(22 students).Primary angle closure glaucoma(PACG)was selected as the learning content,the experimental group was trained by video-assisted teaching ward rounds,while the control group was trained by internship in outpatient clinic.All students joined the test of typical case PACG and a ques-tionnaire survey was implemented for the experimental group.Results The average score of experimental group was higher than control group[(84.30±4.53)vs.(78.05±5.76),t＝4.05,P＜0.001].For video-assisted teaching ward rounds,in experimental group,86.9%(20/23)students believed it was more practical,95.6%(22/23)students thought it was very helpful and 91.3%(21/23)students considered it was conductive to im-prove interest of learning and clinical thinking ability.Conclusions Video-assisted teaching ward rounds improves students'understanding memory of ophthalmic typical cases,which is a potential supplement teaching method in clinical practice training of ophthalmology for medical undergraduates.

Objective:To accurately identify the relationship between the arterial radiomics score (rad-score) and pathologic superior mesenteric vein (SMV) resection margin in patients with pancreatic head cancer.Methods:The clinical data of 181 patients with pathologically confirmed pancreatic head cancer, who underwent multi-slice computed tomography (MDCT) within one month of resection in the First Affiliated Hospital of Naval Medical University between January 2016 and December 2018 were collected. Based on the pathology of SMV resection margin, the patients were divided into SMV negative margin group ( n=127) and SMV positive margin group ( n=54). The clinical, pathological and radiological features were compared between two groups. 3D slicer software was used to draw the region of interest in each layer of the primary CT arterial images for tumor segmentation. Rython package was applied to extract the radiomics features of pancreatic tumors after segmentation and the extracted features were reduced and chosen using the least absolute shrinkage and selection operator (Lasso) logistic regression algorithm. Lasso logistic regression formula was applied to calculated the arterial rad-score. Univariate and multivariate logistic regression models were used to analyze the association between the arterial rad-score and SMV resection margin. ROC was drawn and AUC, sensitivity, specificity and accuracy for diagnosing the SMV resection margin were calculated. The clinical usefulness of arterial rad-score for diagnosing SMV resection margin was determined by decision curve analysis (DCA). Results:There were statistical differences on LVSI and the touching angle of tumor and SMV/portal vein (PV) between SMV negative margin group and SMV positive margin group (all P<0.001). A total of 1 029 arterial radiomics CT features were obtained, and 14-selected arterial phase features associated with SMV resection margin were determined after being reduced by the Lasso logistic regression algorithm. Univariate analysis showed that the arterial radiomics score, LVSI, the touching angle of tumor and SMV/PV were all correlated with SMV resection margin (all P<0.001). Multivariate analyses confirmed that patients with high arterial radiomics score had a 3.63-fold risk of positive resection margin compared with that with low arterial radiomics score, and a higher arterial rad-score was associated with a higher risk of SMV positive resection margin ( P<0.0001). At the cut-off value of -0.711, AUC of the arterial rad-score for diagnosing SMV resection margin was 0.838, and the sensitivity, specificity and accuracy was 77.8%, 75.6% and 76.24%. Decision curve analysis demonstrated that the percentage of the arterial radiomics score for predicting the positive SMV resection margin was >0.02, and the application of the arterial radiomics score could benefit the patients. Conclusions:The arterial rad-score was strongly correlated with SMV resection margin of pancreatic cancer, and can accurately predict SMV resection margin and provide a new tool for preoperative noninvasive evaluation of the SMV resection margin.

Objective:To explore the differential diagnosis of pancreatic acinar cell carcinoma (PACC) and pancreatic ductal adenocarcinoma (PDAC) based on multidetector computed tomography (MDCT) features.Methods:The clinical, pathological and MDCT imaging data of 26 patients with pathologically confirmed PACC and 145 patients with pathologically confirmed PDAC who underwent MDCT from November 2013 to April 2021 were retrospectively studied. The differences of MDCT features including tumor location, tumor size, common pancreatic duct and bile duct dilatation, pancreatitis, lymph node metastasis, cyst, pancreatic parenchyma atrophy, duodenal involvement, bile ductal and vascular involvement between the two groups were compared. Univariate analysis and multivariate analysis by logistic regression models were performed to identify the independent predictive factors for PACC.Results:The tumor size, bile duct dilatation, lymph node metastasis, pancreatic parenchyma atrophy and vascular involvement were significantly different between PACC group and PDAC group (all P value<0.05). Multivariate analysis revealed that the tumor size ( OR=1.07, 95% CI 1.028-1.15, P=0.001), lymph node metastasis ( OR=0.23, 95% CI 0.065-0.800, P=0.02), pancreatic parenchyma atrophy ( OR=0.15, 95% CI 0.048-0.490, P=0.002) were closely associated with PACC. Conclusions:The tumor size, bile duct dilatation, lymph node metastasis, pancreatic parenchyma atrophy and vascular involvement evaluated by MDCT had a certain value in differentiating PACC from PDAC, and the tumor size, lymph node metastasis and pancreatic parenchyma atrophy were independent predictors for the diagnosis of PACC.

OBJECTIVE: To study the plasma concentration and pharmacokinetics of 3, 29-Dibenzoyl Karounitriol (3, 29-DK) from sustained- release pellets and extracts of Trichosanthes at different time points in rats using high-performance liquid chromatography- tandem mass spectrometry (LC-MS/MS). METHODS: Healthy male SD rats were given a single gavage of Trichosanthes sustained-release pellets or Trichosanthes extract, and orbital blood samples were taken at different time points within 48 h after drug administration in the pellet group and within 5 h in Trichosanthes extract group for determination of the plasma concentrations of 3, 29-DK using LC-MS/MS. The standard curve of 3, 29-DK content was established, and the specificity, minimum detection limit, precision and accuracy, extraction recovery, stability and matrix effect of LC-MS/MS analysis were assessed. The mean plasms levels of 3, 29-DK at different time points after the drug administration were determined and its pharmacokinetic parameters were calculated using Das 2.0 software. RESULTS: LC-MS/MS analysis showed a good linearity of 3, 29-DK concentration within the range of 0.5-32 ng/mL, and the results of methodological validation confirmed the validity of this method for biological sample determination. Trichosanthes sustained-release pellets and Trichosanthes extract showed significant differences in their AUC, AUC, MRT, MRT, t and T of 3, 29-DK after administration in rats ( < 0.05). CONCLUSIONS Trichosanthes sustained-release pellets are capable of sustained-release of 3, 29-DK in rats, and thus provides a basis for the study of new dosage forms of Trichosanthes.
Animals ; Area Under Curve ; Benzoates ; pharmacokinetics ; Chromatography, Liquid ; Delayed-Action Preparations ; Male ; Rats ; Rats, Sprague-Dawley ; Reproducibility of Results ; Tandem Mass Spectrometry ; Trichosanthes ; chemistry

OBJECTIVE: To study the plasma concentration and pharmacokinetics of 3, 29-Dibenzoyl Karounitriol (3, 29-DK) from sustained- release pellets and extracts of Trichosanthes at different time points in rats using high-performance liquid chromatography- tandem mass spectrometry (LC-MS/MS). METHODS: Healthy male SD rats were given a single gavage of Trichosanthes sustained-release pellets or Trichosanthes extract, and orbital blood samples were taken at different time points within 48 h after drug administration in the pellet group and within 5 h in Trichosanthes extract group for determination of the plasma concentrations of 3, 29-DK using LC-MS/MS. The standard curve of 3, 29-DK content was established, and the specificity, minimum detection limit, precision and accuracy, extraction recovery, stability and matrix effect of LC-MS/MS analysis were assessed. The mean plasms levels of 3, 29-DK at different time points after the drug administration were determined and its pharmacokinetic parameters were calculated using Das 2.0 software. RESULTS: LC-MS/MS analysis showed a good linearity of 3, 29-DK concentration within the range of 0.5-32 ng/mL, and the results of methodological validation confirmed the validity of this method for biological sample determination. Trichosanthes sustained-release pellets and Trichosanthes extract showed significant differences in their AUC, AUC, MRT, MRT, t and T of 3, 29-DK after administration in rats ( < 0.05). CONCLUSIONS Trichosanthes sustained-release pellets are capable of sustained-release of 3, 29-DK in rats, and thus provides a basis for the study of new dosage forms of Trichosanthes.
Animals ; Chromatography, High Pressure Liquid ; Delayed-Action Preparations ; Male ; Rats ; Rats, Sprague-Dawley ; Reproducibility of Results ; Tandem Mass Spectrometry ; Trichosanthes

Objective To investigate the relationships between mindfulness,anxiety and depression in surface warship soldiers and the mediating role of attentional control.Methods Chinese versions of State-Trait Anxiety Inventory ( STAI ) , Center for Epidemiologic Studies Depression Scale ( CES-D ) , Attentional Control Scale ( ACS) and the Five Facet Mindfulness Questionnaire ( FFMQ) were used to survey 475 sur-face warship soldiers. Single factor analysis of variance,correlation analysis and path analysis were conducted by SPSS 20.0 and Amos18.0. Results ①The scores of the state anxiety,trait anxiety and depression in the soldiers and noncommissioned officers were significantly higher than that of commissioned officers (P<0.05) . As for the state anxiety,trait anxiety,depression and attentional focusing,there were statistically significant differences among different educational levels (P<0.05) . Specifically,the lower educational level,the higher anxiety and depression,the lower control focusing. ② There were significant positive correlations among at-tentional focusing (27.12±4.43),attentional shifting (29.43±3.78) and mindfulness (120.27±11.16,r=0.49-0.51,P<0.01). State anxiety (38.65±10.07) was negatively correlated with attentional focusing,atten-tional shifting and mindfulness (r=-0.32--0.54, P<0.01). Similar results were observed for trait anxiety (41.28±8.79) and depression (9.97±10.13). ③Attentional focusing partially mediated the relationships be-tween state anxiety,trait anxiety,depression and mindfulness. Conclusion Anxiety and depression of sol-diers have obvious relationships with kinds of soldiers' rank and education level. Mindfulness and attentional control are vital protective factors for marine army's mental health. This study indicates that mindfulness may improve individuals' attentional focusing and attentional shifting,and ameliorate negative moods such as anx-iety and depression.

Objective To investigate the risk factors and establish the Cox's regression model and the personal prognosis index for the recurrence of ischemic stroke in 3-year follow-up.methods 1058 patients were retrospectively reviewed consecutively diagnosed with ischemic stroke admitted to the Neurology Department of the Hebei united University Affiliated Hospital from January 1,2013 to December 31,2013.Cases were followed up since the onset of ischemic stroke.The follow-up was finished in January 1,2016.Kaplan-Meier methods were used for recurrence rate description.Monovariant and multivariate Cox's proportional hazard regression model were used to analyze risk factors associated with recurrence.Thus,a recurrence model was set up.Result sDuring the period of follow-up,184 cases relapsed.The 1-year recurrence rate was 29.9 person-year,2-year recurrence rate was 46.6 person-year,3-year recurrence rate was 52.7 person-year.Monovariant and multivariant Cox's proportional hazard regression model showed that the independent risk factors associated with recurrence were age(X1)(RR=1.303;95%CI:1.019~1.666)history of heart disease(X2)(RR=1.788;95%CI:1.127~2.836),hypertension(X3)(RR=1.897;95%CI:1.097~3.280),diabetes(X4)(RR=1.674;95%CI:1.015~2.760),total cholesterol(X5)(RR=2.136;95%CI:1.396~3.266).The personal prognosis index(PI)of recurrence model was as the following: PI=0.265X1+0.581X2+0.640X3+0.515X4+0.759X5.Conclusion sAge,history of heart disease,hypertension,disease progression,and total cholesterol are the independent risk factors associated with recurrence of ischemic stroke.The recurrence model and the personal prognosis index equation are successful constructed.

Objective To observe the curative effects of Mailuoning oral liquid combined with Mecobalamin tablets in treating aged diabetic peripheral neuropathy (DPN).Methods Forty-nine patients with DPN were randomly divided into treatment group (n=25) and control group (n=24).The patients in two groups were given Mecobalamin tablets,and the treatment group was added treated with Mailuoning oral liquid.The period of treatment was 3 months.Scores of Toronto clinical scoring system (TCSS) and traditional Chinese medicine (TCM) symptoms quantitative scale were compared between the two groups.The curative effects of all the patients were judged by the TCM symptoms quantitative scores.Results The TCSS levels in two groups after treatment were both significantly lower than those before treatment (all P<0.05).The TCSS level after treatment in treatment group was significantly lower than that in control group (P<0.05).The TCM symptoms quantitative score after treatment in treatment group was significantly lower than that before treatment (P<0.05).The TCM symptoms quantitative score after treatment in treatment group was significantly lower than that in control group (P<0.05).The total effective rate in treatment group (88%) was significantly higher than that in control group (50%) (χ2=6.631,P=0.01).Conclusion Mailuoning oral liquid combined with Mecobalamin tablets is safe and effective for treating DPN.