ObjectiveTo investigate the relationship between the non-fasting triglyceride and glucose （TyG） index and hyperglycemia in pregnancy during the third trimester in high altitudes. MethodsThis study selected clinical and laboratory data of 774 Tibetan singleton pregnant women who delivered at Chaya People's Hospital of Qamdo city in Xizang autonomous region， from January 2023 to April 2025. The non-fasting TyG index was calculated from non-fasting triglyceride （TG） and random plasma glucose （PG）. Based on the tertiles of the non-fasting TyG index values， the individuals were split into three groups （corresponding to non-fasting TyG index of 8.89 and 9.21， respectively）. The baseline clinical characteristics， lipid levels and the occurrence of developing hyperglycemia in pregnancy were compared among the three groups. Statistical analyses were performed using ANOVA， Kruskal-Wallis H test， Chi-square test， or Fisher exact test and the relationship between the non-fasting TyG index and hyperglycemia in pregnancy were examined using multivariate logistic regression models and curve fitting. ResultsA total of 774 Tibetan singleton pregnant women were included， with a average age of 27.3 ± 6.1 years， a pre-delivery body mass index （Pre-BMI） of （25.2±2.3）kg/m² ， a proportion of 26.7% （207/774） primigravid women， the mean non-fasting TyG index was 9.1 ± 0.4。Thirty pregnant women were diagnosed with hyperglycemia in pregnancy， with a detection rate of 3.9% （30/774）. Statistically significant differences in serum total cholesterol （TC）， TG， low-density lipoprotein cholesterol （LDL-C） and high-density lipoprotein cholesterol （HDL-C） levels were identified when comparing different non-fasting TyG groups （all P values <0.05）. Subsequent trend test analysis indicated that the levels of TC， TG， LDL-C， and PG gradually increased with elevated the non-fasting TyG index （ F_{trend TC}=95.61， P<0.001； F_{trend TG}=1 051.91， P<0.001； F_{trend LDL-C} = 97.20， P < 0.001； F_{trend TG}=195.20； P<0.001）. After adjustment for maternal age， pre-delivery BMI， altitude， TC， LDL-C， and HDL-C， multivariate Logistic regression models revealed independent positive associations between non-fasting TyG index and hyperglycemia in pregnancy （Model 1： OR=2.72， 95% CI： 1.13-6.53， P=0.026； Model 2： OR=2.56， 95% CI： 1.01-6.50， P=0.048； Model 3： OR=2.72， 95% CI： 1.06-6.97， P=0.037； Model 4： OR=4.02， 95% CI： 1.42-11.40， P=0.009） and the incident of hyperglycemia in pregnancy showed an increasing tendency as increasing with the non-fasting TyG index， however， this association did not statistical significance （P _trend >0.05）. Curve fitting by restricted cubic splines （RCS） were used to assess linearity between non-fasting TyG and hyperglycemia in pregnancy， and there was a linear dose-response relationship between non-fasting TyG and hyperglycemia in pregnancy （P _{for non-linear} = 0.515）. ConclusionNon-fasting TyG index in the third trimester is a risk factor for hyperglycemia in pregnancy among the Tibetan singleton pregnant women at high altitudes and there was a possible linear dose-response relationship between the non-fasting TyG index and hyperglycemia in pregnancy.

Transient receptor potential vanilloid-1(TRPV1) channel is a non-selective ligand-gated cationic channel with multiple activation mechanisms in the transient receptor potential subfamily. In recent years, a large number of studies have found that TRPV1 plays an important role in the field of cardiovascular diseases such as hypertension and atherosclerosis. With the in-depth study of traditional Chinese medicine, it has been found that Chinese medicine monomers and their active components can activate or inhibit TRPV1 channels, which has certain potential in the study of cardiovascular diseases. In this paper, the role of TRPV1 channel in cardiovascular diseases and the research progress of traditional Chinese medicine prevention and treatment of cardiovascular diseases based on TRPV1 channel are reviewed, in order to provide new ideas for prevention and treatment of cardiovascular system diseases.

Objective:To analyze the effects of seasonal autoregressive integrated moving average model (SARIMA), generalized additive model (GAM), and long-short term memory model (LSTM) in fitting and predicting the incidence of hemorrhagic fever with renal syndrome (HFRS), so as to provide references for optimizing the HFRS prediction model.Methods:The monthly incidence data of HFRS from 2004 to 2017 of the whole country and the top 9 provinces with the highest incidence of HFRS (Heilongjiang, Shaanxi, Jilin, Liaoning, Shandong, Hebei, Jiangxi, Zhejiang and Hunan) were collected in the Public Health Science Data Center (https://www.phsciencedata.cn/), of which the data from 2004 to 2016 were used as training data, and the data from January to December 2017 were used as test data. The SARIMA, GAM, and LSTM of HFRS incidence in the whole country and 9 provinces were fitted with the training data; the fitted model was used to predict the incidence of HFRS from January to December 2017, and compared with the test data. The mean absolute percentage error ( MAPE) was used to evaluate the model fitting and prediction accuracy. When MAPE < 20%, the model fitting or prediction effect was good, 20%-50% was acceptable, and > 50% was poor. Results:From the perspective of overall fitting and prediction effect, the optimal model for the whole country and Heilongjiang, Shaanxi, Jilin, Liaoning and Jiangxi was SARIMA ( MAPE was 19.68%, 20.48%, 44.25%, 19.59%, 23.82% and 35.29%, respectively), among which the fitting and prediction effects of the whole country and Jilin were good, and the rest were acceptable. The optimal model for Shandong and Zhejiang was GAM ( MAPE was 18.29% and 21.25%, respectively), the fitting and prediction effect of Shandong was good, and Zhejiang was acceptable. The optimal model for Hebei and Hunan was LSTM ( MAPE was 26.52% and 22.69%, respectively), and the fitting and prediction effects were acceptable. From the perspective of fitting effect, GAM had the highest fitting accuracy in the whole country data, with MAPE = 10.44%. From the perspective of prediction effect, LSTM had the highest prediction accuracy in the whole country data, with MAPE = 12.23%. Conclusions:SARIMA, GAM, and LSTM can all be used as the optimal models for fitting the incidence of HFRS, but the optimal models fitted in different regions show great differences. In the future, in the establishment of HFRS prediction models, as many alternative models as possible should be included for screening to ensure higher fitting and prediction accuracy.

Objective:To study the relationship between maternal hemoglobin concentration, anemia rate in the third trimester and the altitudes, pregnancy outcomes among pregnant women in Tibet rural areas.Methods:This prospective study collected clinical and laboratory data of 390 Tibetan pregnant women who delivered after 28 gestational weeks at Chaya People's Hospital, Changdu city, Tibet autonomous region, from May 2020 to March 2021. Blood routine examination was performed at admission and 24-72 h postpartum using an automatic hematologic analyzer. According to the hemoglobin standard adjusted for altitude by World Health Organization (WHO), the association between pregnancy outcomes and maternal hemoglobin levels and anemia rate before and after adjustment were analyzed using Mann-Whitney U one-way analysis of variance, Chi-square, Pearson correlation, and Spearman correlation tests. Results:(1) In these women, the mean actual hemoglobin concentration in the third trimester was (121±16) g/L, and the prevalence of anemia and microcytic hypochromic anemia was 23.8% (93/390) and 20.3% (79/390), respectively. (2) After adjustment, the mean hemoglobin concentration was (93±17) g/L, and the prevalence of anemia and microcytic hypochromic anemia was 84.4% (329/390) and 30.5% (119/390), respectively. (3) Actual hemoglobin levels showed an increasing tendency as the altitude rose. At the altitude of 3 000-3 500 m, >3 500-4 000 m, and >4 000 m, the mean hemoglobin levels were (118±15) g/L, (119±17) g/L, and (124±16) g/L, respectively ( Ftrend=7.38, P=0.007). However, the prevalence of anemia and microcytic hypochromic anemia did not differ significantly between different altitude ( P>0.05). (4) Corrected hemoglobin levels were negatively associated with the altitude ( r=－0.31, P<0.001). At the altitude of 3 000~3 500 m, 3 500~4 000 m and >4 000 m, the mean corrected hemoglobin levels were (100±15) g/L, (92±17) g/L, and (87±18) g/L, respectively ( Ftrend=30.36, P<0.001). The prevalence of anemia increased with altitude ( χ2trend=15.44, P<0.001), but no association was observed between microcytic hypochromic anemia and altitudes ( P>0.05). (5) No association was found between actual or corrected anemia in the third trimester and adverse pregnancy outcomes, nor the hemoglobin level before or after adjustment and neonatal birth weight. Conclusions:In Tibet rural areas, the mean actual hemoglobin level in pregnant women tends to increase with the altitude. However, the prevalence of anemia and microcytic hypochromic anemia remains high and more attention should be paid to iron supplementary during pregnancy. After adjusting hemoglobin concentration based on WHO standard, more women were diagnosed as having anemia during pregnancy in this area, and the applicability of the diagnostic criteria for Tibetan residents requires further investigations.

【Objective】 To evaluate the clinical characteristics and risk factors of adverse transfusion reactions (ATR) in Chinese adults, and to provide evidence-based medical evidence for early prevention. 【Methods】 The controlled trial (CT) of risk factors for ATR in Chinese adults were collected through PubMed, Embase, Cochrane Library, CNKI, CMB, VIP and Wanfang database, and the retrieval time was from the establishment of those databases to January 31, 2021 Literature was selected and extracted by 2 researchers according to inclusion and exclusion criteria. Meta-analysis was performed by RevMan5.3 software. 【Results】 A total of 28 049 patients in 12 literature were included, 1 190 patients were included into the ART group and 26 859 into the non-ART group. Meta-analysis results showed that the incidence of ART was 1.63% (410/24 361), mainly allergic reaction (43.90%, 188/410) and non-hemolytic fever (40%, 164/410). Primary hematologic disease (OR=27.11, 95%CI=21.64~33.96, P<0.01), allergy history(OR=15.52, 95% CI=2.20~109.38, P<0.01), transfusion history(OR=9.36, 95% CI=7.77 ~11.28, P<0.01), numbers of blood transfusion > 2 (OR=7.06, 95% CI=5.64~8.84, P<0.01), >30 min interval between blood issuing and transfusion (OR=3.40, 95% CI=2.88~4.00, P<0.01), transfusion of plasma (OR=2.67, 95%CI=2.20~3.25, P<0.01) and cryoprecipitate (OR=1.43, 95%CI=1.21~1.68, P<0.01) were risk factors for ART, while the transfusion of red blood cells/white blood cells/platelets (OR=0.29, 95% CI=0.24~0.35, P<0.01) was the protective factor. Sensitivity analysis showed that the results were stable. 【Conclusion】 According to the correlation intensity, the risk factors for ART in Chinese adults from high to low are primary blood disease, history of allergy, transfusion history, numbers of blood transfusion >2, >30 min interval between blood issuing and transfusion, transfusion of plasma and cryoprecipitates, while transfusion of red blood cells/white blood cells/platelets was the protective factor.

Objective? To understand the attitude toward hospice care and its infLuencing factors among undergraduate nursing students majoring in TraditionaL Chinese Medicine (TCM), and to provide basis for nursing educators to formuLate hospice care training strategies. Methods? Using convenient sampLing method, a totaL of 827 undergraduate nursing students from 3 TCM universities in Shandong, Shanxi and He'nan provinces were seLected as subjects from September to October 2018. The generaL information questionnaire and the Chinese version of FrommeLt Attitude Toward Care of the Dying (FATCOD) were used. MuLtipLe Linear regression was used to anaLyze infLuencing factors. ResuLts? The totaL score of FATCOD among the 827 undergraduate TCM nursing students was (101.32±9.15). Univariate Linear regression resuLts showed that gender, singLe-chiLd status, wiLLingness to choose nursing major, attitudes toward nursing, the situation where students discussed death with famiLy, experience with funeraLs, experience with terminaL reLatives, wiLLingness to take care terminaL patients were aLL factors that couLd affect the attitudes toward hospice care among nursing students (t/F=-3.066,-2.783, 3.289, 12.577, 10.638, 2.680, -2.251, 8.697;P＜0.05). MuLtipLe Linear regression anaLysis resuLts showed that gender, singLe-chiLd status, attitudes toward nursing, wiLLingness to take care terminaL patients, experience with funeraLs, the situation where students discussed death with famiLy, experience with terminaL reLatives have an impact on the attitude toward hospice care (P＜ 0.05). ConcLusions? The attitude toward hospice care among undergraduate TCM nursing students needs to be further improved. Educators shouLd adopt various methods of teaching to carry out death education according to the infLuencing factors, and to cuLtivate proper perception of death and improve the enthusiasm for hospice care.

Objective To evaluate the effectiveness of standardized management for patients with type 2 diabetes in Beijing Qinan community.Methods Total 484 patients with type 2 diabetes in Qinan community were under standardized management.A cross-sectional study on the effectiveness of diabetes management was conducted in December 2016 based on the health records and clinic medical records.Results The mean age was(71.2 ± 11.2) years,the duration of diabetes was (12.2 ± 7.8) years,the mean BMI was(24.76 ± 3.06) kg/m2 in 484 patients.The TC was(5.08 ± 3.27) mmol/L and LDL-C was(2.72 ±0.78)mmol in 383 patients.The rate of achieving the target level of fasting blood-glucose was 51.96％ (199/383);the rate of achieving glycosylated hemoglobin target was 60.08％ (155/258);and the rate of achieving quick fasting blood-glucose target was 51.49％ (52/101).There were 80.37％ (389/484) patients with clinic blood pressure ＜ 140/90 mmHg(1 mmHg =0.133 kPa),36.57％ patients (177/484) had normal BMI;and 17.83％ patients (46/258) with controlled clinic blood pressure,fasting blood glucose,glycosaylated hemoglobin and LDL-C.There were 53.79％ patients with LDL-C ＜ 2.6 mmol/L and 23.24％ with HDL-C ≥ 1.0 mmol/L.The patients with fasting glucose ＜ 7.8 mmol/L had lower LDL-C than the patients with fasting glucose ≥ 7.8 mmol/L,(F =4.42,P =0.04),The patients with fasting glucose ＜ 7.8mmol/L had higher HDL-C than the patients with fasting glucose ≥ 7.8 mmol/L (Z =-2.30,P =0.02).The rate of achieving glycosylated hemoglobin target was decreased with the increasing of disease duration (x2 =12.57,P =0.01).Conclusion The comprehensive target-reaching rate of type 2 diabetes patients with standardization management in Qinan community is relatively low.It is necessary to strengthen the control of blood lipid,body weight and blood pressure for improving the effectiveness of standardized management of diabetic patients.

Objective To explore the impact factors of postpartum depression.Methods A total of 257 patients from October 201 4 to April 201 5 were investigated with postpartum depression screening scale and self-designed questionnaire.The results were analyzed by statistical software.Results The total rate of postpartum depression was 1 4.4%.The education level,family relationship,newborn sex,perinatal knowledge learning,spousal relationship and delivery mode were independent factors for postpartum depression,which were statistically different between depression group and normal group (P <0.05 ).Conclusions Poor family relationship especially poor spousal relationship,low education level,lack of perinatal knowledge,female newborn and caesarean section increase the risk of postpartum depression.

[ ABSTRACT] AIM:To evaluate the clinical application of single nucleotide polymorphism array ( SNP array) in prenatal diagnosis for screening the abnormality of women with Down’ s syndrome ( DS) .METHODS:The amniotic fluid samples ( n=312) collected by amniocentesis for the DS screening abnormality women were tested by karyotyping and SNP array analysis, respectively.The findings of karyotyping and SNP array analysis were compared.RESULTS:Two cases of trisomy 21 were identified by karyotyping and SNP array analysis, but SNP array analysis failed to identify 6 cases of chro-mosome balanced structural rearrangement.SNP detected 176 cases copy number variants ( CNVs) in 303 cases normal karyotype were detected by SNP, including 106 benign CNVs, 61 variants of unknown significance (VOUS), 9 de novo CNVs, and none of them was pathogenic.The distribution difference of CNVs in DS screening positive group and DS screening positive plus advanced maternal age group was not statistically significant ( P>0.05) .Furthermore, we reported 14 kinds of CNVs for the first time in population.CONCLUSION:SNP array can further assure chromosome microdupli-cation/microdeletion.In normal karyotype fetus of prenatal diagnosis, SNP can detect some clinical significant CNVs.

AIM:Toinvestigatewhetherandhowhumanchorionicgonadotropin(HCG)treatmentameliorates endometriosis in the endometriotic rat model .METHODS:The rat model of endometriosis was established and the model rats were divided into 4 groups.The rats in HCG groups were treated with 19.4, 25.8 and 51.6 IU/100 g of HCG every day (low-dose HCG, medium-dose HCG and high-dose HCG, respectively).The rats in control group were treated with 0.9%NaCl.After 15 days (3 estrous cycles), the ectopic lesion volume and ultrastructural characteristics in eutopic and ectopic endometria were investigated .RESULTS: After HCG treatment , the volume of endometriotic lesions was signifi-cantly smaller than that before treatment .Numerous and mitochondrial , endoplasmic reticulum and ribosomes were ob-served in the cytoplasm of eutopic and ectopic endometrium before treatment .After treatment , some cell structures were not clear , and mitochondrial cristae decreased or disappeared partly .Some cells were densed and shrinkage , autophagosome in cytoplasm increased , and mitochondria and endoplasmic reticulum swelt .CONCLUSION:HCG therapy appears to be an effective treatment for endometriosis in rats attributed to its influence on cell metabolism dysfunction of eutopic and ectopic endometria .