Objective:To analyze the application value of autophagy related molecular markers in placenta tissue in predicting fetal growth restriction in pregnant women with preeclampsia.Methods:A total of 46 pregnant women admitted to Changsha Hospital for Maternal and Child Health Care from January 2021 to August 2023 were collected. A cross-sectional study was conducted, and they were divided into a normal delivery group (control group, 23 cases) and an observation group with preeclampsia combined with fetal growth restriction (observation group, 23 cases) based on pregnancy outcomes. Transmission electron microscopy was used to observe the occurrence of autophagic vesicles in trophoblast cells in the placental tissue of both groups; The expression of Beclin-1, LC3, and P62 in placental tissues of two groups was detected by immunohistochemistry, real-time fluorescence quantitative polymerase chain reaction (qRT-PCR), and Western blot.Results:The transmission electron microscopy results showed that the presence of autophagic vesicles could be observed in the placental trophoblast cells of both the control group and the observation group, but the number of autophagic vesicles in the trophoblast cells of the observation group was higher than that in the control group ( P<0.05). The immunohistochemical results showed that the colorimetric values of Beclin-1 and LC3 in the placental tissue sections of the observation group were higher than those of the control group (all P<0.001), while the colorimetric values of p62 were lower than those of the control group ( P<0.001). The qRT-PCR and Western blot results showed that the mRNA and protein expression levels of Beclin-1 and LC3 in the observation group were significantly higher than those in the control group (all P<0.001), while the expression levels of p62 mRNA and protein were lower than those in the control group (all P<0.001). Conclusions:The autophagy activity of placental tissue trophoblasts in patients with preeclampsia combined with fetal growth restriction is enhanced, indicating a close correlation between elevated autophagy levels and the occurrence of preeclampsia combined with fetal growth restriction. Excessive autophagy may be involved in the occurrence of preeclampsia combined with fetal growth restriction.

Objective:We aimed to develop a novel visualized model based on nomogram to predict postoperative overall survival.Methods:This was a multicenter, retrospective, observational cohort study, including participants with histologically confirmed gastric and colorectal cancer who underwent radical surgery from 11 medical centers in China from August 1, 2015 to June 30, 2018. Baseline characteristics, histopathological data and nutritional status, as assessed using Nutrition Risk Screening 2002 (NRS 2002) score and the scored Patient-Generated Subjective Global Assessment, were collected. The least absolute shrinkage and selection operator regression and Cox regression were used to identify variables to be included in the predictive model. Internal and external validations were performed.Results:There were 681 and 127 patients in the training and validation cohorts, respectively. A total of 188 deaths were observed over a median follow-up period of 59 (range: 58 to 60) months. Two independent predictors of NRS 2002 and Tumor-Node-Metastasis (TNM) stage were identified and incorporated into the prediction nomogram model together with the factor of age. The model's concordance index for 1-, 3- and 5-year overall survival was 0.696, 0.724, and 0.738 in the training cohort and 0.801, 0.812, and 0.793 in the validation cohort, respectively.Conclusions:In this study, a new nomogram prediction model based on NRS 2002 score was developed and validated for predicting the overall postoperative survival of patients with gastric colorectal cancer. This model has good differentiation, calibration and clinical practicability in predicting the long-term survival rate of patients with gastrointestinal cancer after radical surgery.

Objective:To identify the transmission relationship between HIV infection cases the non-marital non-commercial heterosexual contact in Zhejiang Province.Methods:When HIV positive was informed during January 2020 to January 2022, the staff conducted an epidemiological investigation to collect cases information on sociodemographic characteristics, mobility information, past HIV testing history, high-risk sexual behaviors, sexual partners, and etcetera. At the same time, 6-8 ml of blood from the new diagnosis of people infected with HIV before antiviral treatment was collected to separate the bleeding plasma. pol gene was amplified by nucleic acid extraction and PCR, sequenced by Sequencer 5.0 software, and Cytoscape 3.6.0 software was used to draw HIV molecular transmission network. Results:From January 2020 to January 2022, 88 HIV infected individuals were found in Pujiang County, of which 74 were transmitted through heterosexual transmission, of which 31 were infected through non-marital non-commercial heterosexual contact. Preliminary case studies have found that three female cases have engaged in unprotected non-marital non-commercial heterosexual contact with one male case. Among the 4 infected individuals, 2 of their spouses tested positive for HIV antibodies. Molecular transmission network monitoring was carried out on 65 newly diagnosed cases of heterosexual transmission with acquired sequences, forming 9 transmission clusters. The largest cluster contained 10 cases. A total of 11 HIV-infected individuals were involved in this HIV cluster epidemic. They were 3 males and 8 females, all over 50 years old and were farmers or rural housewives. They were traced to 7 sexual partners (6 negatives of HIV, 1 undetected). Among the 18 respondents' sexual social network relationships, there were 6 couples, 8 permanent partners, and 3 temporary partners. Among 11 HIV infected individuals, there were 9 cases of non-marital non-commercial heterosexual transmission and 2 cases of intramarital transmission. The epidemiological association between 7 non-married non-commercial heterosexual partners and case 2 (56-year-old male farmer), 3 cases confirmed by epidemiological investigation and molecular transmission cluster results, 3 cases confirmed by molecular transmission cluster and epidemiological investigation results, and 1 case confirmed by epidemiological investigation results.Conclusions:The transmission mode of this cluster epidemic was to spread HIV through heterosexual sex with a male case as the core, then cause the transmission within marriage and between fixed sexual partners. The combination of epidemiological investigation and molecular transmission network traceability survey supports the conclusion of this study.

Objective: To create a model for early prediction of essential hypertension (EH) based on the TreeNet algorithm, so as to provide a tool for early monitoring of EH. Methods: The health examination data were collected from individuals receiving health examinations in Hangzhou Haiqin Health Examination Center or Shanghai Yibao Health Management Co., Ltd from 2014 to 2016, and a predictive model for EH was created based on the TreeNet algorithm. The effectiveness of the model for early prediction of EH was evaluated using root mean square error (RMSE), mean absolute deviation (MAD), coefficient of determination (R2) and receiver operating characteristic (ROC) curve. Results: A total of 12 variables were included in the model, and the highest contributing variable was body mass index (BMI), followed by BMI difference, two-year BMI difference, two-year triglyceride (TG) difference, two-year total cholesterol (TC) difference, high-density lipoprotein cholesterol (HDL-C) in 2014, TG in 2014, low-density lipoprotein cholesterol (LDL-C) in 2014, body weight in 2015, fasting blood glucose in 2015, TG in 2015, urea nitrogen difference and platelet in 2015. The highest predictive accuracy was 100.00%, and the lowest was 56.89%. The risk of EH significantly increased among individuals with BMI in 2015 of >25 kg/m2, two-year BMI difference of >0.5 kg/m2, two-year TG difference ranging from 1.3 to 3.3 mmol/L, TC in 2015 of 2.0 to 2.4 mmol/L and HDL-C in 2014 of <0.52 mmol/L. The model presented RMSE of 0.082, MAD of 0.064, R2 of 0.811, area under the ROC curve of 0.788 (95%CI: 0.741-0.815), sensitivity of 69.05% and specificity of 66.21% for prediction of EH Conclusion The TreeNet algorithm-based model is effective for early monitoring of high-risk individuals for EH.

The general data, blood routine, liver and kidney function, glucose metabolism and lipid metabolism of 11 922 participants who underwent physical examination at the Health Management Center of the Second Xiangya Hospital of Central South University from January 2019 to December 2019 were collected. Clinical characteristics and independent factors of patients with discordance between HbA1c and FPG were evaluated and analyzed. The prevalence of HbA1c-defined diabetes and prediabetes (respectively 8.13%, 34.79%) were significantly higher than that in FPG-defined diabetes and prediabetes (respectively 4.70%, 8.97%) (χ2=2 635.940; P<0.001). The prevalence of inconsistence between HbA1c and FPG was 35.65% and increased with increasing age. This inconsistence mainly occurred in population with HbA1c:5.7%-6.0% and FPG<5.6 mmol/L, followed by population with HbA1c:6.1%-6.4% and FPG<5.6 mmol/L. The risk factors of inconsistency included advanced age, overweight or obesity, hypoalbuminemia, dyslipidemia and hyperuricemia. Among these special participants, compared with participants under 45 years old, participants with over 45 years of age ( OR=3.525, 95% CI: 3.216-3.863, P<0.001) were more likely to have inconsistence between HbA1c and FPG; and overweight participants ( OR=1.474, 95% CI: 1.341-1.620, P<0.001) or obese participants ( OR=1.856, 95% CI: 1.633-2.110, P<0.001) are prone to have the inconsistence than those with normal weight.

The general data, blood routine, liver and kidney function, glucose metabolism and lipid metabolism of 11 922 participants who underwent physical examination at the Health Management Center of the Second Xiangya Hospital of Central South University from January 2019 to December 2019 were collected. Clinical characteristics and independent factors of patients with discordance between HbA1c and FPG were evaluated and analyzed. The prevalence of HbA1c-defined diabetes and prediabetes (respectively 8.13%, 34.79%) were significantly higher than that in FPG-defined diabetes and prediabetes (respectively 4.70%, 8.97%) (χ2=2 635.940; P<0.001). The prevalence of inconsistence between HbA1c and FPG was 35.65% and increased with increasing age. This inconsistence mainly occurred in population with HbA1c:5.7%-6.0% and FPG<5.6 mmol/L, followed by population with HbA1c:6.1%-6.4% and FPG<5.6 mmol/L. The risk factors of inconsistency included advanced age, overweight or obesity, hypoalbuminemia, dyslipidemia and hyperuricemia. Among these special participants, compared with participants under 45 years old, participants with over 45 years of age ( OR=3.525, 95% CI: 3.216-3.863, P<0.001) were more likely to have inconsistence between HbA1c and FPG; and overweight participants ( OR=1.474, 95% CI: 1.341-1.620, P<0.001) or obese participants ( OR=1.856, 95% CI: 1.633-2.110, P<0.001) are prone to have the inconsistence than those with normal weight.

The technique of flap transplantation has been widely used in the field of wound repair, functional and surface feature reconstructions. After surgery vascular crisis directly affects the success rate of the flap transplantation, hence method of monitoring the after surgery microcirculation has been developed as a medical practice. However, clinical application of postoperative monitoring of microcirculation is still in debate. In particular, the invasive monitoring techniques are not systematically reported in China. The purpose of this review is to summarize the advantages and disadvantages of the postoperative monitoring of microcirculation and to provide reference for staffs in microsurgery.

Objective    To explore the current situation of the readiness for hospital discharge and the quality of discharge teaching in lung cancer patients based on enhanced recovery after surgery, and to analyze their correlation. Methods    We conducted a cross-sectional study and 141 postoperative patients with lung cancer in our hospital from July to August 2018 were investigated by general information questionnaire, readiness for hospital discharge scale and quality of discharge teaching scale. There were 65 males and 76 females at age of 18-85 (55.35±12.15) years. Results    Totally 88.65% of postoperative patients with lung cancer reported that they were ready for discharge, and the total score of readiness for hospital discharge was 78.36±16.48, and the total score of quality of discharge teaching was 90.94±18.62. There was a positive correlation between the readiness for hospital discharge and the quality of discharge teaching in postoperative patients with lung cancer (r=0.57, P<0.01). Conclusion    The readiness for hospital discharge of postoperative patients with lung cancer keeps in medium level, while the quality of discharge teaching is good, and the readiness for hospital discharge is positively correlated with the quality of discharge teaching. Medical staff should pay more attention to the cognitive level of lung cancer patients' disease-related information and their physical function recovery, and enrich the discharge guidance content, in order to improve the readiness of postoperative patients with lung cancer.

Objectives To analyze the changes of serum complement C1q level in patients with metabolic syndrome (MS) and investigate whether it is associated with lipid metabolism and glycometabolism. Methods In a cross-sectional study, the subjects were selected as the patients and healthy people who went to the second xiangya hospital of central south university from July 2017 to June 2018. A total of 152 MS patients were enrolled and another 90 healthy subjects were enrolled as control group. Anthropometry parameters such as body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP) were measured. Serum concentrations of C1q and other biochemical indexes including blood glucose (GLU), triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured in all groups. The correlations between C1q and these parameters were analyzed by spearman's rho test and the clinical value of C1q in predicting MS was further evaluated by stepwise multiple linear regression analysis. Results MS group had higher serum C1q levels (244.34±62.66) mg/L compared with the control group (202.37±35.92) mg/L (t=-6.250, P=0.000). C1q levels (244.34±62.66) mg/L were positively associated with TG levels [2.34(1.89, 3.62)] mmol/L (r=0.245, P=0.001), TC levels (4.91±1.26) mmol/L (r=0.398, P=0.000), LDL-C levels (3.23±1.03) mmol/L (r=0.325, P=0.000) in MS group, While C1q levels (258.92±69.59)mg/L were positively associated with SBP (144.76 ± 22.94) mmHg (r=0.388, P=0.018), TG levels [2.65(1.87, 3.82)] mmol / L (r=0.482, P=0.003), TC levels (5.18±1.31) mmol/L (r=0.529,P=0.001) in MS patients with obesity. The stepwise multiple regression analysis showed that TG levels were independently correlated with serum C1q levels both in MS patients (β=0.302, P=0.000) and in MS patients with obesity (β=0.653, P=0.000) after adjusting for age, gender and other biochemical markers. Conclusions MS patients had higher C1q levels than healthy subjects and serum C1q levels were closely positive related to harmful lipid profiles. Serum TG level was an independent influencing factor of serum C1q in MS patients.