Objective:To explore the relationship between body composition and the risk of gestational diabe-tes mellitus(GDM)in pregnant women.Methods:90 pregnant women with spontaneous pregnancy of singleton who underwent routine prenatal examination in our hospital were selected as GDM group,and 219 pregnant women with normal singleton in the same period as control group(NGT).The body composition was determined by bioimpedance method at 24-28 weeks of gestation.The relationship between body mass index(BMI),per-centage of body fat(FMP),percentage of fat-free body weight(FFMP),extracellular/intracellular fluid(ECW/ICW),body fat index(FMI)and GDM were analyzed.The levels of circulating adiponectin,fatty acid binding pro-tein 4(FABP4),leptin and fasting insulin(FINS)were measured by enzyme linked immunosorbent assay(ELISA)method,and their relationship with various indicators of human body composition was analyzed.Results:①Adi-ponectin in GDM group was lower than that in NGT group,while leptin was higher than that in control group(P＜0.05).②The FMP,ECW/ICW and FMI in GDM group were significantly higher than those in control group(P＜0.05).Univariate regression analysis showed that BMI,FMP,FMI and ECW/ICW before pregnancy were the risk factorsof GDM(OR＞1,P＜0.05),FFMP,MP,PP and M/F was the protective factor of GDM(OR＜1,P＜0.05).Multivariate analysis showed that only FMP was significantly correlated with the risk of GDM,which was an independent risk factor(OR＞1,P＜0.05).③In GDM group,HOMA-IR was positively correlated with FMI(r＞1,P＜0.05)and negatively correlated with PP(r＜1,P＜0.05).④The ROC curve showed that the diagnostic value of pre-pregnancy BMI、FMP、ECW/ICW and FMI in GDM was similar.There was no significant difference in pre-pregnancy BMI,FMP and FMI(P＞0.05),but they were slightly better than ECW/ICW(P＜0.001).Conclu-sions:Body composition during pregnancy is related to the risk of gestational diabetes.The increase in FMP is associated with an increased risk of developing GDM.The higher the FMP,the higher the risk of GDM.The diag nostic efficacy of BMI,FMP and FMI in GDM is Similar.

【Objective】 To analyze the serological characteristics and molecular mechanism of a novel B subtype allele 803delC. 【Methods】 ABO blood group was detected by serological method. Sequence-specific primer polymerase chain reaction (PCR-SSP) was used to detect ABO blood group genes. The coding region of exon 1-7 of ABO gene was detected by Sanger sequencing to determine the mutation site. 【Results】 Serological identification of patients was with forward O-type and reverse B-type. The result of PCR-SSP genotyping was A/O. There was A gene, which was not consistent with serological results. Further Sanger double-strand sequencing revealed that the C-base was deleted at position 803 of exon 7 on the basis of ABO^*B. 01/ABO^*O. 01.01. The mutation eventually leads to the amino acid substitution of p. Ala268Gly and p. Phe269Ser and the production of new open reading frame starting at position 269, with the new open reading frame No.20 amino acid being stop codon, resulted in the termination of B gene expression. Further single-strand sequencing of the ABO gene revealed that the mutation was located in the ABO^*B. 01 gene. The mutation was submitted to the NCBI database with the number OR343908. 【Conclusion】 A new ABO allele leading to B variant has been found in Chinese population. Genetic detection can be used to identify the ambiguous blood group with discrepancy between forward and reverse blood grouping.

Objective To evaluate the effect of standardized lipid-lowering therapy in acute stroke patients via high-resolution magnetic resonance vessel wall imaging(HRMR-VWI)to follow-up the characteristics changes of intracranial atherosclerotic plaques.Methods Twenty-two acute stroke patients(65 plaques)were enrolled,and their clinical and imaging data were collected on admission and after standardized lipid-lowering therapy(355-370 days).Diffusion weighted imaging(DWI),three-dimensional time of flight magnetic resonance angiography(3D-TOF-MRA),and HRMR-VWI were performed in all patients.According to the changes in non-high density lipoprotein(non-HDL),all patients were divided into the effective lipid-lowering group and the ineffective lipid-lowering group.The demographic information,plaques characteristics and the effect of standardized lipid-lowering therapy of all patients were compared.Results One(2.33％)plaque in the effective group showed reverse remodeling and four(18.18％)new plaques in the anterior circulation in the ineffective group.Patients in the effective group were significantly better than those in the ineffective group in terms of plaque thickness,load,remodeling index(RI),and the rate of increase in plaque thickness,load,stenosis,and RI,with statistically significant difference(P＜0.05).There was no statistical significance in the rate of stenosis between the two groups.Conclusion Standardized lipid-lowering therapy has differences in the prognosis of acute stroke patients,and HRMR-VWI may be conducive to individualized assessment of the lipid-lowering effect.

Objective: To explore the mechanism of advanced glycation end products (AGEs) on diabetic endothelial cell damage based on monocyte⁃macrophage exosomes (Exos)/microRNA⁃92a ( miR⁃92a) . Methods: Twenty apolipoprotein E ⁃deficient (ApoE - / - ) mice were randomly divided into two groups : injury group (n = 10) and injury + STZ group ( n = 10 ) . The injury + STZ group established a diabetes model induced by streptozotocin (STZ) . All animals underwent partial left carotid artery (PLCA) ligation. The carotid arteries were collected , the number of M1 macrophages was detected by immunohistochemistry , and the level of AGEs was analyzed by ELISA.Microvascular endothelial cell line bEnd. 3 cells were treated with conditioned medium (CM) of AGEs treated RAW264. 7 cells or Exos derived from RAW264. 7 , followed by evaluations of the cell barrier function and mitochondrial function. Results : There was an increased number of M1 macrophages in carotid atherosclerotic tissues of diabetic mice and in AGEs treated RAW264. 7 cells. CM or Exos significantly induced barrier dysfunction , reactive oxygen species (ROS) accumulation and mitochondrial dysfunction in vascular endothelial cells in vitro. In addition , bioinformatics analysis showed that miR⁃92a was up⁃regulated in Exos derived from macrophages stimulated by AGEs. Experimentally , Exos participated in CM⁃induced barrier dysfunction , ROS accumulation and mitochondrial dysfunction in bEnd. 3 cells by transferring miR⁃92a. Finally , a series of rescue experiments further confirmed that Exos regulated the barrier dysfunction and mitochondrial function in vascular endothelial cells through miR⁃92a. Conclusion The expression of AGEs and the number of M1 macrophages in diabetic ApoE - / - mice increase , and AGEs stimulates Exos from macrophages could impair the barrier function and mitochondrial function in vascular endothelial cells by delivering miR⁃92a in vitro.

The pathogenesis of nonalcoholic fatty liver disease (NAFLD) remains unclear, and currently no effective drugs have been approved for the treatment of NAFLD. Polygonum cuspidatum is a natural traditional Chinese medicine with a long history of application, and studies have shown that it plays an important role in the treatment of NAFLD. This article summarizes related research findings in the active components of Polygonum cuspidatum applied in the treatment of NAFLD, and it is found that the active components of Polygonum cuspidatum can improve insulin resistance, exert an anti-oxidative stress effect, regulate lipid metabolism, improve endoplasmic reticulum stress, and alleviate inflammatory infiltration by regulating the signaling pathways including Nrf2, AMPK, NF-κB, SIRT1, and PPARα, thereby exerting a preventive and therapeutic effect on NAFLD, so as to provide a basis and ideas for developing drugs for NAFLD and exploring related mechanisms.

Humans ; COVID-19 ; Quarantine ; Renal Dialysis ; SARS-CoV-2 ; Hospitals

Objective:To translate Career Success in Nursing Scale (CSNS) into Chinese and evaluate the reliability and validity of it.Methods:According to the translation principle of Brislin questionnaire, the English version of CSNS was translated, back-translated and culturally adjusted to determine the simplified Chinese version of CSNS items and form the Chinese version of CSNS. A total of 1 489 nurses from China-Japan Friendship Hospital were selected as the research objects from May to June 2021. The general information questionnaire and simplified Chinese version of CSNS were used to investigate them. Internal consistency and split-half reliability coefficient were used to evaluate the reliability of the scale. Pearson correlation analysis was used to analyze the correlation between each dimension and the relationship between each dimension and the total scale. A total of 1 489 questionnaires were collected and 1 434 valid questionnaires were collected, with an effective recovery rate of 96.3%.Results:The Chinese version of CSNS included 4 dimensions, such as "desired career development" "providing quality care" "effective self-regulation" and "fit between human and organization" , with a total of 39 items. The expert content validity was 0.984. The results of exploratory factor analysis showed that the cumulative variance contribution rate of the four common factors was 74.71%. The Cronbach's α coefficient of the total scale was 0.985 and the Cronbach's α coefficient of each dimension was 0.955-0.979. The split-half reliability of the total scale was 0.986 and the split-half reliability of each dimension was 0.957-0.979. The test-retest reliability of the scale was 0.966.Conclusions:The Chinese version of CSNS scale has good reliability and validity, which can be used to evaluate the psychological characteristics of nurses' career success.

Objective:To explore the value of nursing checklist in posterior surgery for thoracolumbar fracture with general anesthesia under prone position.Methods:A retrospective case series study was conducted to analyze the clinical data of 106 patients with thoracolumbar fracture admitted to Sir Run Run Shaw Hospital，Zhejiang University School of Medicine from June 2018 to May 2020. There were 80 males and 26 females，with age range of 25-57 years［（48.6 ± 11.9）years］. Segments of injury were located at T 11 in 18 patients，at T 12 in 26，at L 1 in 21，at L 2 in 25 and at L 3 in 16. All patients were treated with thoracolumbar posterior screw fixation under general anesthesia. Of all，51 patients received conventional postural nursing from June 2018 to May 2019（control group），and 55 patients received prone position nursing scheme for general anesthesia on the basis of conventional postural nursing from June 2019 to May 2020（verification group）. The incidence of postoperative complications including stress injury，brachial plexus injury，ulnar nerve injury and ocular discomfort as well as length of hospital stay and patients’ satisfaction were compared between the two groups. Visual analogue scale（VAS）and Oswestry disability index（ODI）were also used to measures outcome at postoperative 3 months. Results:All patients were followed up for 8-12 months［（10.5±0.9）months］. Verification group and control group showed significant differences in the incidence of stress injury（4%∶29%），brachial plexus injury（4%∶16%）and ocular discomfort consisiting of tears（2%∶12%），foreign body sensation（0%∶4%）and dryness（4%∶16%）（ P < 0.05），not in ulnar nerve injury and blurred vision. Length of hospitalization in verification group was（7.0±1.3）days，significantly shorter than that in control group［（9.9±1.9）days］（ P < 0.05）. Satisfaction of patients in verification group and control group was 85%（47/55）and 69%（35/51），respectively（ P < 0.05）. At 3 months postoperatively，VAS in verification group［（1.9 ± 0.8）points］was significantly lower than that in control group［（3.5±1.1）points］（ P < 0.05），and ODI was similar between the two groups（ P > 0.05）. Conclusions For patients with thoracolumbar fracture treated by posterior surgery with general anaesthesia under prone position，nursing checklist helps reduce occurrence of the related complication，shorten length of hospital stay，improve patient satisfaction，reduce postoperative pain and promote rehabilitation.

ObjectiveTo investigate the status quo of parental perception and its influencing factors in parents with children undergoing invasive treatment for congenital heart disease(CHD), and to provide evidence for the development of targeted interventions. MethodsBy convenience sampling, from January to September of 2018, 200 fathers or mothers whose children underwent invasive treatment for CHD in a Class ⅢGrade A hospital in Changchun were selected as participants in the study. The Parental Perception Vulnerability Scale, the Self-rating Anxiety Scale (SAS), and the Social Support Scale (SSRS) were used to investigate the participants. ResultsA total of 200 questionnaires were distributed and 185 valid questionnaires were retrieved. The 185 parents of the sick children achieved a total score of (5.59±2.66) points in the Parental Perception Vulnerability Scale. Whether the sick child was the only child of the parents was the influencing factor of the parents' perception vulnerability (P＜0.05). The parents' age, relationship with the sick children, educational level, family monthly income, degree of social support were the influencing factors of parental perception vulnerability in CHD children's parents(P＜ 0.05). ConclusionsWhether the sick child was the only child of the parents or not, the parents' age, relationship with the sick children, educational level, family monthly income, degree of social support were the influencing factors of parental perception vulnerability in CHD children's parents, therefore, the medical staff should pay more attention to the above population group.

Objective    To evaluate the clinical role of video-assisted mediastinoscopy and its safety and effectiveness in the diagnosis of thoracic disease. Methods    We reviewed the clinical data of consecutive 40 patients (25 males and 15 females with an average age of 54.6 years) who received video-assisted mediastinoscopic surgery in our department of thoracic surgery from December 2011 to November 2016, including mediastinal lymph node biopsy in 27 patients, mediastinal primary lesions biopsy in 8, bronchial cystectomy in 3 and esophageal dissection in 2. Results    The histological results were positive in 20 patients (73.1%) in mediastinal lymph node biopsy, including granulomatous mediastinitis in 14 and metastasis in 6 (non-small cell lung cancer in 4, Ewing sacoma in 1 and small cell lung cancer in 1) and reactive proliferation in 7 (26.9%). In mediastinal primary lesions biopsy, the accuracy rate of diagnosis was 100.0%. The pathologic results were malignant in all patients, including small cell lung cancer in 5, adenoid cystic carcinoma in 1, squamous carcinoma in 1 and adenocarcinoma in 1. In patients who received the bronchial cystectomy, no recurrence was found during at least 2 years follow-up. There was one patient with severe complication (innominate artery injury). Two patients suffered transient laryngeal recurrent nerve palsy with hoarseness and two patients incision secretion. Conclusion    Video-assisted mediastinoscopic surgery is effective and safe and dissection should be careful in granulomatous mediastinitis to avoid the great vessel injures.