Objective To investigate the impact of an integrated online and offline(O+O)co-care model on blood glucose management and pregnancy outcomes in pregnant patients with hyperglycemia.Methods A total of 200 pregnant patients with hyperglycemia(HIP)admitted to the Department of Endocrinology,Second Hospital of Jilin University were enrolled in this study from January 2021 to March 2023.All the participants were divided into two groups according to their diagnosis and treatment approach:routine group(n=102)and nursing group(n=98).General data were collected from the initial visit until delivery for comparative analysis between the two groups,including FPG,2 hPG,HbA1c,body weight,BMI,and daily insulin doses.Logistic regression analysis was used to evaluate the influencing factors for adverse pregnancy outcome in patients with gestational hyperglycemia.Results The care group exhibited higher rates of family history of DM,polycystic ovary syndrome,primipara,gestational diabetes mellitus,and diabetes combined with pregnancy compared to the routine group(P<0.01).The first visit of FPG,2 hPG,HbA1c,△FPG,△2 hPG,△HbA1c,2 hPG compliance rate,HbA1c compliance rate were higher(P<0.01),while the excess rates of △weight,2 hPG at delivery,△BMI and overweight weight gain were lower incare group than in routine group(P<0.05 or P<0.01).FPG,2 hPG and HbA1c were lower at delivery than at first visit in both groups(P<0.01).The nursing group had a lower incidence of adverse pregnancy outcomes including macrosomia and NICU admissions compared to the conventional group(P<0.05 or P<0.01).Logistic regression analysis revealed that the co-care mode was an influential factor for adverse pregnancy outcomes.Conclusions The O+O co-care mode is beneficial for managing blood glucose levels during pregnancy as well as controlling weight gain and reducing the risk of adverse pregnancy outcomes in HIP patients.

Objective To explore the general rules of complications of hemophilia based on the disease network and predict the possible complications of hemophilia patients. Methods The PubMed database was searched for literature related to hemophilia. Disease entities were extracted from the titles and abstracts of the literature using the MetaMap tool. A disease network was constructed based on the co-occurrence relationship of disease pairs, and the overall characteristics, node characteristics, and structural characteristics of the disease network were analyzed. The disease entity network was analyzed for association rules to explore the general patterns of hemophilia complications. The link prediction algorithm was used to predict potential complications of hemophilia. Results The association network composed of hemophilia and its complications satisfied the characteristics of small-world networks and evenly distributed cohesive subgroups in terms of network structure. Cohesive subgroup analysis showed that hemophilia complications can be divided into four categories: inherited diseases, blood system diseases, infectious diseases, and chronic diseases. Association rule analysis identified 133 rules with a confidence level ≥0.8, and link prediction further identified many well-documented disease pairs. Conclusion Based on the disease network, hemophilia complication association analysis and link prediction can effectively predict potential hemophilia complications, providing decision support for clinical diagnosis and treatment of hemophilia.

Objective To analyze the phenotypic characteristics of albinism and their correlations. Methods Literatures related to albinism in PubMed database before June 10, 2023 were obtained, and phenotypic entities were extracted from their abstract texts to construct a phenotypic co-occurrence network. GePhi and VOSviewer software were used to analyze the overall characteristics and phenotypic clustering of the network. The Apriori algorithm was used to mine the association rules between phenotypes. The AA index was used for link prediction, predicting possible combinations of albino phenotypes. Results The phenotypic co-occurrence network of albinism had a small-world characteristic, and nystagmus, hypopigmentation of skin and foveal dysplasia of retina were the main phenotypes. Phenotypic abnormalities of albinism were mainly divided into five categories, including visual system abnormalities, immune system abnormalities, skin and hair system abnormalities, nervous system abnormalities, and respiratory as well as digestive system abnormalities. A variety of ocular abnormalities were associated with nystagmus. The combination of abnormal phenotypes that may occur in albinism included pneumonia with hypopigmentation of the skin, foveal dysplasia of the retina and atrophy of the optic nerve. Conclusion Predicting and analyzing the phenotypic characteristics of albinism and the associative patterns among phenotypes, as well as the potential co-occurrence of phenotypes in albinism patients can provide valuable references for identifying research directions for albinism and for the recognition, diagnosis, and prediction of albinism development.

OBJECTIVE To mine the focus and emotional attitude of the public on rare diseases， and to provide decision- making reference for relevant departments to formulate and implement relevant policies， systems and strategies for medical security of rare diseases. METHODS Latent Dirichlet allocation （LDA） topic model and sentiment analysis method were used to analyze the comment text of short videos related to the “nosinasine” medical insurance admission event on the Bilibili video website， mine the theme and sentiment tendency of the text， and put forward relevant strategy suggestions. RESULTS A total of 8 videos with tens of thousands of playback and 7 109 text data were obtained. According to the LDA analysis， online public paid attention to 9 topics related to rare diseases （the price of rare disease drugs， the inclusion of rare disease drugs in medical insurance， the status quo of research and development of rare disease drugs， the scope of medical insurance and the medical security system， the plight of rare disease patients， the prevention and screening of rare diseases， the value of rare disease drugs in medical insurance， the Chinese and western medical methods of rare diseases， and the supply and demand status of rare disease drugs）， which could be summarized into 4 categories according to the objects of concern （rare disease drugs， rare disease medical insurance， rare disease medical and health services and rare disease patient groups）. On the whole， the emotional tendency of the Internet public towards each topic showed a low positive and high negative tendency. CONCLUSIONS The public paid more attention to the price， research and development， supply and demand of rare disease drugs， and was deeply worried about the current medical status of rare diseases in China. To strengthen and improve the medical security for patients with rare diseases， such as actively carrying out public health services for rare diseases， strengthening cooperation in the diagnosis and treatment of rare diseases， and researching rare disease drugs， etc. Chinese medical and health departments can make concerted efforts in medical and health services， drug supply security， medical security and other social security.

ObjectiveTo analyze the online public Q&A texts on HPV vaccine， focus on the important issues related to HPV vaccination and cervical cancer prevention in China， and propose strategies and suggestions. MethodsThe latent Dirichlet allocation （LDA） topic model was employed to extract key topics of 15 565 Q&A texts related to HPV vaccines from the social Q&A platform "Zhihu". The Baidu AI sentiment analysis tool was used to analyze the emotional tendencies of the texts corresponding to each topic， and the topics were classified based on the strategic coordinate method. ResultsOnline users focused on eight topics about HPV vaccine information. Among them， vaccination knowledge， HPV vaccination hesitation， and HPV vaccine development and marketing belonged to the low positivity-high negativity emotional topics， HPV infection and high-risk factors belonged to the low positivity-low negativity emotional topics， and HPV vaccine appointment channels， comparison between domestic and imported vaccines， HPV vaccines and cervical cancer prevention， and HPV vaccine types and selection were grouped under high positivity-low negativity emotional topics. ConclusionPublic concerns regarding HPV vaccines can be classified into three major dimensions： health knowledge， health beliefs， and health behaviors. Overall， the public's views and attitudes towards vaccine-related issues are not optimistic. Strengthening science publicity and education， enhancing vaccine supervision， and encouraging enterprises’ innovative research and development capability are effective strategies to improve public awareness of cervical cancer prevention and accelerate the full HPV vaccination coverage.

Objective:To investigate the risk factors of respiratory distress syndrome (RDS) complicated by pulmonary hemorrhage (PH) in premature infants.Methods:A total of 102 infant patients with RDS whose gestational age was < 37 weeks received treatment in the Department of Neonatology, Kunming Children's Hospital (Children's Hospital Affiliated to Kunming Medical University) from January 2015 to July 2021 and were included in this study. According to the diagnostic criteria of PH, these infant patients were divided into a PH group and a non-PH group. The clinical data of the two groups were compared using a t-test, non-parametric test, or χ2 test. The risk factors of PH were analyzed. The independent risk factors of RDS complicated by PH in premature infants were determined using multivariate logistic regression analysis. Results:A total of 102 premature infants with RDS were collected, including 51 in the PH group and 51 in the non-PH group. The gestational ages at birth were (32.3 ± 3.0) weeks and (31.6 ± 3.0) weeks in the PH and non-PH groups, respectively. There were 36 males (70.6%) and 33 males (64.7%) in the PH and non-PH groups, respectively. There were no significant differences in proportion of males and gestational ages at birth between the two groups (both P > 0.05). The incidence of gestational age < 32 weeks [52.9% (27/51) vs. 31.3% (16/51)], PH and RDS complicated by patent ductus arteriosus [90.5% (38/42) vs. 70.0% (35/50)], and RDS grade 3-4 [80.4% (41/51) vs. 23.5% (12/51)] in the PH group were significantly higher than those in the non-PH group ( χ2 = 5.29, 4.66, 33.03, all P < 0.05). Multivariate logistic regression analysis showed that RDS grade 3-4 was an independent risk factor of RDS complicated by PH ( OR = 9.83, 95% CI: 3.545-27.265, P < 0.05). The proportion of infants with mechanical ventilation time ≥ 7 days in the PH group was significantly higher than that in the non-PH group [56.9% (29/51) vs. 31.4% (16/51), χ2 = 6.72, P < 0.05]. Conclusion:Gestational age < 32 weeks, PH and RDS complicated by patent ductus arteriosus, and RDS grade 3-4 are the risk factors of PH in premature infants with RDS. RDS grade 3-4 is an independent risk factor.

Objective:To explore the predictive value of amplitude integrated electroencephalography(aEEG)in the neurological prognosis of children with neonatal bacterial meningitis(NBM).Methods:The clinical data and aEEG results from 148 children diagnosed with NBM who completed aEEG examinations in the Department of Neonatology at Kunming Children′s Hospital from January 2018 to December 2019 were retrospectively analyzed.According to whether aEEG is abnormal, the children were divided into aEEG abnormal group and aEEG non-abnormal group.According to the degree of aEEG abnormality, children with aEEG abnormality were divided into aEEG mild abnormal group and aEEG severe abnormal group.The abnormal rate and abnormal characteristics of aEEG were analyzed; The clinical data of two groups were compared.Results:(1)Among the 148 children with NBM, 49 children had abnormal aEEG, 99 children had no abnormality, and the aEEG abnormal rate was 33.1%.The abnormal aEEG was manifested as delayed sleep-wake cycle maturation in 39 (26.3%) cases, abnormal discharge in eight (5.4%) cases, and abnormal background activity in one (0.6%) case.(2)The proportion of children with convulsive seizures and refractory NBM in aEEG abnormal group were significantly higher than those in aEEG non-abnormal group ( P<0.05). In the routine and biochemical abnormal indexes of cerebrospinal fluid, the proportion of protein >3 g/L, cerebrospinal fluid leukocyte>500×10 6/L, cerebrospinal fluid glucose<1.5 mmol/L, positive cerebrospinal fluid culture, positive blood and cerebrospinal fluid culture, abnormal head MRI in aEEG abnormal group significantly increased ( P<0.05); While there was no significant difference regarding blood routine leukocyte abnormality, CRP increase, and positive blood culture ratio between two groups ( P>0.05). (3) 148 cases of NBM children were followed up to 15 months old, 119 (80.4%) cases completed the follow-up, the loss rate was 19.6%, three cases died, and 11 cases had psychomotor retardation.Compared with the children with abnormal aEEG, the prognosis of children with NBM was significantly different, the Spearman rank correlation coefficient r was 0.315 ( P<0.05). COX regression was used to analyze the predictive value of each index for adverse outcomes. Abnormal aEEG was an independent risk factor for adverse outcomes in children with NBM ( OR=7.452, 95% CI 1.605-34.591, P<0.05). Conclusion:The aEEG monitoring of children with NBM, if abnormal, may indicate severe NBM, which is likely to be transformed into refractory NBM or has a poor prognosis.

Objective:To investigate the effect of withdrawal time on postpartum liver function in pregnant women receiving tenofovir disoproxil fumarate (TDF) therapy for blocking mother-to-child transmission of HBV.Methods:A prospective study was conducted in Hangzhou First People’s Hospital from June 2016 to August 2018. A total of 84 pregnant women with HBsAg and HBeAg positive were enrolled and divided into two groups according to simple randomized grouping method with 42 cases in each group. In group A TDF was withdrawn immediately after delivery and in group B TDF was withdrawn 12 weeks after delivery. Finally, 66 patients completed the follow-up for 24 weeks postpartum, 35 cases in group A and 31 cases in group B. All patients were administered TDF from week 24-28 of pregnancy. HBV DNA loads and ALT levels were regularly measured and compared. Multivariate logistic regression was used to explore the risk factors of postpartum ALT flare. SPSS 26.0 statistical software was used for statistical processing.Results:Compared with the baseline levels, the HBV DNA loads at 16 weeks postpartum had no significant changes in both groups( Z=-0.742 and -1.891, both P>0.05). Postpartum ALT flare was observed in 21 of the 66 patients, 9 cases (25.71%, 9/35) in group A, and 12 cases (38.71%, 12/31) in group B ( χ2=1.280, P>0.05); and there was no significant difference in the severity of postpartum ALT flare between the two groups ( χ2=0.527, P>0.05). Binary logistic regression analysis showed that increased ALT level during pregnancy was an independent risk factor of postpartum ALT flare ( OR=13.75, 95% CI 1.49-126.85, P<0.05). Conclusions:When TDF was used for preventing mother-to-child HBV transmission, withdrawal at different times after delivery had no effect on postpartum liver function. ALT flare during pregnancy is a risk factor for postpartum ALT flare, so TDF should be discontinued carefully and liver function should be closely monitored postpartum for such patients.

Objective:To investigate the clinical efficacy of low-dose aspirin in the prevention of preeclampsia recurrence during pregnancy.Methods:Thirty-six women in the first trimester of pregnancy who received examination in Hangzhou Women's Hospital from January 2018 to June 2019 were included in this study. All included women had a history of preeclampsia or severe preeclampsia and met the indications of oral aspirin. They were randomly divided into A ( n = 14) and B ( n = 22) groups. An additional 51 pregnant women who had no history of preeclampsia or severe preeclampsia were included in the control group. The A group was given oral aspirin 50-100 mg/d starting from the second trimester of pregnancy. The other two groups were not given oral aspirin at the same time. Pregnancy outcomes (including delivery weeks, cesarean delivery, placental abruption, preeclampsia, postpartum hemorrhage and gestational hypertension) and urine protein were compared between groups. Neonatal outcomes in different groups were analyzed. Results:The incidence of eclampsia in B group was [40.91% (9/22)], which was significantly higher than [7.14% (1/14)] in A group and [0.00% (0/51)] in control group ( χ2 = 9.872, 12.031, both P < 0.05). The cesarean delivery rate in B group was [22.73% (5/22)], which was significantly higher than 7.14% (1/14) in A group and 5.88% (3/51) in control group ( χ2 = 8.072, 10.810, both P < 0.05). Delivery weeks in A and control groups were (42.78 ± 1.32) weeks and (43.14 ± 1.17) weeks, respectively, which were significantly longer than (35.08 ± 2.03) weeks in group B ( F = 13.765, P < 0.05). The amount of blood loss in A and control groups was (217.62 ± 19.85) mL and (211.37 ± 18.56) mL, respectively, which was significantly less than (233.05 ± 22.37) mL in B group ( F = 18.873, P < 0.05). The Apgar score of newborns in B group was (6.03 ± 0.54) points, which was significantly lower than (9.58 ± 0.86) points in A group and (9.73 ± 0.85) points in control group ( F = 9.037, P < 0.05). The incidence of intrauterine growth restriction [7.14% (1/14), 5.88% (3/51)] and the incidence of preterm birth [7.14% (1/14), 5.88% (3/51)] in A and control groups were significantly lower than those in B group [22.73% (1/22), 15.00% (3/22), χ2 = 10.651, 14.040, 11.715, 13.602, all P < 0.05]. There were no significant differences in the incidence of neonatal death and hemorrhagic diseases among the three groups ( χ2 = 2.020, 3.606, both P > 0.05). Conclusion:Aspirin enteric coated tablets 50-100 mg/d per day for management of pregnant women at a high risk for preeclampsia at 12 weeks of gestation can decrease the incidence of preeclampsia to a certain extent, which is worthy of clinical application.

Objective To comparO thO Officacy and safOty of concurrOnt chOmoradiothOrapy and sOquOntial chOmoradiothOrapy in thO trOatmOnt of locally advancOd non -small cOll lung cancOr ( NSCLC). Methods From SOptOmbOr 2016 to FObruary 2018, 88 patiOnts with locally advancOd NSCLC admittOd to Li Huili East Hospital wOrO randomly dividOd into synchronous group ( 45 casOs) and sOquOntial group ( 43 casOs). ThO synchronous group rOcOivOd concurrOnt radiothOrapy and chOmothOrapy, whilO thO sOquOntial group was givOn radiothOrapy aftOr 4 cyclOs of chOmothOrapy. Both two groups took thO samO radiothOrapy and chOmothOrapy prOscription. ThO clinical Officacy, advOrsO rOactions and quality of lifO of thO two groups wOrO comparOd.Results ThO total OffOctivO ratO in thO synchro-nous group was significantly highOr than that in thO sOquOntial group (6.22% vs. 39.53% , χ2 =4.530,P<0.05). ThO incidOncO ratO of Ⅰ ~Ⅱ gradO radiation lung injury and radiation Osophagitis in thO synchronous group wOrO significantly highOr than thosO in thO sOquOntial group (26.67% vs. 9.30% ;17.78% vs. 2.32% , χ2 =4.457, 4.159,all P<0.05).ThOrO was no statistically significant diffOrOncO in quality of lifO scorO bOtwOOn thO two groups bOforO trOatmOnt (P>0.05).ThO body hOalth and total hOalth status of thO synchronous group wOrO significantly lowOr than thosO of thO sOquOntial group at thO Ond of trOatmOnt [(66.48 ± 9.28) points vs.(70.95 ± 11.68) points;(51.48 ± 10.26)points vs.(55.42 ± 9.84)points, t=2.010,2.144,all P<0.05], but thO scorO of total hOalth status in thO synchronous group was significantly highOr than that in thO sOquOntial group at thO Ond of trOatmOnt [(61.28 ± 6.48)points vs.(57.83 ± 7.93)points, t=2.239,P<0.05].Conclusion ConcurrOnt chOmoradiothOrapy has bOttOr clinical Officacy than sOquOntial radiothOrapy and chOmothOrapy in thO trOatmOnt of locally advancOd NSCLC. Although it can incrOasO thO incidOncO of radiation pnOumonitis and Osophagitis, thO patiOnts arO wOll tolOratOd and thO quality of lifO is improvOd gradually at thO Ond of thO trOatmOnt. It is worthy of clinical promotion.