【Objective】 To study the effects of gestational diabetes (GDM) on morphological structure of brain tissue and microribonucleotide (miRNA) expression profile in neonatal mice, and to provide a new research target for the prevention and treatment of abnormal neurodevelopment in GDM progeny. 【Methods】 The pregnant mice were divided into model group and control group,each group consisted of 10 mice. The model group mice established a GDM model by injecting streptozotocin to measure fasting blood glucose (FPG) and random blood glucose (GLU) at different times. Successful molded mice were randomly divided into model group A and model group C, and control mice were divided into control group B and control group D, with 5 mice in each group. The newborn mice in groups A and B were used for hippocampal tissue GeneChip detection and brain morphology structure observation, and group C and D newborn mice were used for qRT-PCR detection of hippocampus tissue expression differences to verify the differentially expressed genes of miRANs obtained by GeneChip screening. After giving birth, the neonatal mice were sacrificed by decapitation, and the brain tissue was dissected to observe the overall morphological structure. The structural changes of hippocampus were observed under HE chromogenic microscope. The Agilent mouse miRNA oligonucleotide gene chip was used to detect the miRNA expression profile of mouse hippocampus, screen differential miRNAs and predict their target genes, and conduct GO analysis and signal transduction pathway analysis of target genes. The relative expression levels of the screened miRNAs were verified by qRT-PCR. 【Results】 Compared with the control group, the GLU increased significantly from the 3rd day after drug administration in the model group (P<0.01). Macroscopic observation of control group B mice had normal brain morphology and structure, smooth appearance, clear gyrus, close arrangement of hippocampus cell structure, uniform staining and complete structure; in model group A, the number of hippocampus cells decreased, loose arrangement and deep staining. In the initial screen of miRNA microarray, there were 11 differentially expressed miRNAs between control and model groups, all of which were downregulated miRNAs, including let-7b-5p、miR-130b-3p、miR-181c-5p、miR-181d-5p、miR-3099-3p、miR-3470a、miR-3473a、miR-3473b、miR-500-3p、miR-532-5p、miR-7047-5p(P<0.05). Two miRNAs (miR-3473b, miR-7047-75p) and 5 target genes (MAPK3, MAPK11, MAPK14, CALM3, AKT3). The relative expression of miR-3473b and miR-7047-5p in model group C were lower than that in control group D (t=19.13 and 6.24, P<0.05), and the validation results were consistent with the microarray test results. 【Conclusion】 Compared with the offspring of normal pregnant mice, GDM offspring mice have abnormal development of brain structure and damage of hippocampal nerve cells, and there are a large number of abnormal expression of miRNAs in hippocampal tissue. Differentially expressed miRNAs can be used as research targets for prevention and treatment of GDM offspring neurodevelopmental abnormalities.

Objective: To investigate the biocompatibility of copper-gadolinium nanomaterials and their antibacterial efficacy againstEscherichia coli(E.coli). Methods: Copper-gadolinium nanomaterials were prepared using a hydrothermal method, and the samples were characterized and analyzed using instruments such as transmission electron microscopy. The biocompatibility of copper-gadolinium nanomaterials was evaluated through CCK-8 experiments with mouse fibroblast cells(L929). Copper-gadolinium nanomaterials were co-cultured withE.coli, and their antibacterial performance was observed and assessed. Results: Transmission electron microscopy and Fourier transform infrared spectroscopy analysis confirmed the synthesis of the copper-gadolinium nanomaterials. The CCK-8 experiment results showed that the material had reliable biocompatibility within a concentration range of 0-2 μg/ml. The antibacterial experiments verified the excellent anti-E.coliactivity of copper-gadolinium, with the antibacterial effect positively correlating with concentration and co-cultivation time. When copper-gadolinium nanomaterials at a concentration of 2 μg/ml were co-cultured withE.colifor 4 hours, the antibacterial rate reached 99.99%. Conclusion The 2 μg/ml copper-gadolinium nanomaterials exhibit reliable biocompatibility and excellent anti-E.colicapabilities.

Objective To observe the effects of Renshen Yimai Prescription on oxidative stress and vascular aging in ApoE-/-mice;To explore its mechanism of intervention in vascular aging.Methods Forty ApoE-/-mice were divided into model group,Western medicine group(rosuvastatin,2.6 mg/kg),TCM low-and high-dosage group(Renshen Yimai Prescription,4.29,8.58 g/kg),with 10 mice in each group.Another 10 C57BL/6J mice were set as normal group.A vascular aging model was established by ApoE-/-mice fed with a Western diet.Each medication group was given corresponding drugs by gavage for 12 consecutive weeks,the normal group and model group were given equivalent volume of pure water.HE staining and Masson staining were used to observe the morphological changes of aortic tissue,and ox-LDL content in serum was detected by ELISA,the contents of ROS,GSH,GPX and NAD+in serum were detected by colorimetric method,the expressions of SIRT1,p53,p21 and NOX4 protein in aortic tissue were detected by Western blot.Results Compared with the normal group,the model group mice showed significant fat deposition in the aorta,thickening of the intima and media,a significant decrease in elastic fibers,and an increase in collagen fibers;the serum contents of ox-LDL and ROS significantly increased(P<0.01),while the contents of GSH,GPX and NAD+significantly decreased(P<0.01);the expression of SIRT1 protein in the aortic tissue significantly decreased(P<0.05),the expressions of p21 and p53 protein significantly increased(P<0.01,P<0.05).Compared with the model group,a small amount of lipid deposition was observed in the intima of aorta in each medication group,with clearer membrane structures in each layer and reduced collagen fiber;the serum contents of ox-LDL and ROS in each medication group were significantly decreased(P<0.01),while the GSH content significantly increased(P<0.05,P<0.01),the NAD+content in TCM low-dosage group significantly increased(P<0.05);the expressions of p21 and NOX4 protein in aortic tissue of the TCM high-dosage group significantly increased(P<0.05,P<0.01).Compared with the Western medicine group,the TCM high-dosage group showed a significant decrease in ROS content(P<0.01)and a significant decrease in p53 protein expression(P<0.05).Compared with the TCM low-dosage group,the TCM high-dosage group showed a significant decrease in p21 protein expression(P<0.01)and a significant increase in NOX4 protein expression(P<0.01).Conclusion Renshen Yimai Prescription may reduce vascular endothelial damage by regulating oxidative stress levels and related protein expression,thereby playing a role in improving vascular aging.

Objective:To analysis the clinical characteristics of The clinical characteristics of using automated external defibrillation in the public place,To explore the feasibility and effectiveness of AED application in public places in China.Methods:From January 2014 to April 5, 2019, 54 cases of on-site emergency medical records of AED use in public places in China were analyzed retrospectively from three aspects: patient and AED user attributes, and AED clinical performance.Results:After field application of AED analysis, 54 patients did not have out of hospital cardiac arrest in 9 patients; cardiac arrest in 45 patients, cerebral resuscitation in 40 patients (88.9%), death in 5 patients (11.1%), one of them died in hospital. The accuracy of AED for defibrillation rhythm recognition and defibrillation recommendations was 100%. The success rate of shock to VF was 97.22%, and that of non pulse VT was 100%. The data shows that AEDs of different brands show clinical effectiveness in the core indicators of work. The operation level of the rescuer determines the critical time of AED shock, which is closely related to the prognosis of the patient ( P<0.05) . Conclusions:AED is reliable and effective in electric shock decision and performance.The overall efficiency of AED application can be improved by strengthening training, shortening the critical time of electric shock, rational configuration and effective management.

Objective:To analyze the knowledge, skills and self-efficacy of cardiopulmonary resuscitation among the public in mountainous areas of southern Ningxia, and provide scientific support for the popularization of cardiopulmonary resuscitation.Methods:According to inclusion and exclusion criteria, a total of 1 503 inhabitants in Ningxia district (Jan. 2018 to Jan. 2019) were chosen as research samples. The general data was analyzed; the self-made questionnaire was applied to evaluate the inhabitants ′ theory knowledge, skill mastery and self-efficacy by professional nurses. Multiple linear regression was used to analyze the influence factors of theory knowledge and skill mastery degree. Results:A total of 1 503 valid questionnaires were collected, the assessment scores of theory knowledge, skill mastery and overall self-efficacy were (53.11±12.34), (62.64±18.35) and (6.09±2.18) points; According to demographic characteristics, multiple linear regression indicated that the influence factors of theory knowledge and skill mastery assessment scores included age, occupational distribution, education backgrounds, training conditions, time of taking training to survey, "onlooker" experience and self-efficacy indicators ( t/ F values were 5.723, 4.393, 5.817, 6.435, 5.990, 6.438, 6.631, P<0.01). The positive correlations were assumed ( r values were 0.012, 0.016, P<0.05) . Conclusion:In Ningxia, the inhabitants generally have low theory knowledge, skill mastery and self-efficacy levels. Therefore, the relevant medical institutions shall enhance the inhabitants ′ cardio-pulmonary resuscitation training through multiple methods and approaches.

Objective:To investigate the association between levator hiatus area, pelvic organ prolapse quantification (POP-Q) examination and prolapse symptoms.Methods:The prospective multicenter study enrolled 996 female patients between January 2017 and January 2019. All enrolled patients underwent a standard clinical interview, POP-Q examination and transperineal ultrasound examination. Volume data of pelvic floor ultrasound examinations were obtained at rest, during contraction and during maximal Valsalva maneuver. The association between levator hiatus area, POP-Q examination and prolapse symptoms was analyzed. The performance of levator hiatus area on maximal Valsalva for assessing significant POP(POP-Q stage≥2) and prolapse symptoms were also evaluated.Results:There were significant differences of levator hiatus area at rest, during contraction and during maximal Valsalva among patients with different POP-Q stages (all P<0.001). Levator hiatus area during maximal Valsalva showed the highest correlation with abdominal dragging sensation ( r=0.277, P<0.001). The area under the ROC curve (AUC) of levator hiatus area during maximal Valsalva for significant POP (POP-Q stage≥2) was significantly higher than that for prolapse symptoms (AUC: 0.77 vs 0.69, P<0.001). Conclusions:Levator hiatus area on transperineal has moderate correlation with POP-Q examination and their association is stronger than the correlation between ultrasound findings and prolapse symptoms.

Objective:To investigate the feasibility of transperineal ultrasound in quantitative assessment of posterior compartment prolapse among Chinese women.Methods:The prospective multicenter study enrolled 485 women between January 2017 and January 2019. All patients underwent a standard clinical interview, pelvic organ prolapse quantification (POP-Q) examination and transperineal ultrasound examination. Volume data of transperineal ultrasound examinations were obtained at rest and in maximal Valsalva maneuver.Results:The higher POP-Q stage of posterior compartment, the lower rectal ampulla position in maximal Valsalva maneuver (POP-Q stage=0 vs POP-Q stage=1, P<0.001; POP-Q stage=1 vs POP-Q stage≥2, P<0.001), and the greater rectal ampulla hypermobility (POP-Q stage=0 vs POP-Q stage=1, P<0.001; POP-Q stage=1 vs POP-Q stage≥ 2, P=0.007). The rectal ampulla position at rest and in maximal Valsalva maneuver and rectocele depth were correlated with prolapse symptoms ( r=-0.200, P<0.001; r=-0.252, P<0.001; r=0.086, P=0.045). The corresponding cut-off values of rectal ampulla position in maximal Valsalva in diagnosing posterior compartment prolapse (POP-Q stage ≥1) and clinical significant posterior compartment prolapse (POP-Q stage ≥2) were 7.32 mm below the symphysis pubis and 12 mm below the symphysis pubis, respectively, with the area under the ROC curve as 0.75 and 0.85, respectively. Conclusions:The ultrasonic measurements by transperineal ultrasound is significantly associated with POP-Q examination in posterior compartment, and it is demonstrated as a useful tool in quantitative assessment of the severity of posterior compartment prolapse.

Objective To observe the difference in the effect of chest compression quality between the traditional training (TT) and the standard video training (SVT). Methods A total of 197 graduate students were divided into two groups according to the different training methods: group A (traditional modality, n=98) and group B (video training modality, n=99). After training for 2 hours, all trainees were asked to practice CPR on a resuscitation manikin for 2 minutes under the monitoring of CPR quality by a feedback system with trainee's back towards compute monitor. The data of chest compression rate (times/min), average depth (cm) and chest compression release velocity (CCRV, mm/ s) were collected and analyzed. Results Compared with TT, the mean compression depth in SVT was (5.42 ± 0.07) cm vs. (5.33±0.08) cm; the effective rate of CPR in SVT was (115±1.034) /min vs. (113.6±1.152) times/min; the mean CCRV in SVT was (439.7±7.72) mm/s vs. (417.3±7.64) mm/s in the first minute (P＜0.05) and (403.9±7.22) vs. (384.5±8.48) mm/s in the second minute (P＞0.05). Conclusions There were no significant differences on improving the quality of CPR between the two groups. The video training showed no significant effectivity on improving the quality of CPR compared with the traditional way.

Objective To discuss the effect of Quality Control Circle activity optimize Traditional Chinese Medicine (TCM) nursing program in improving the recovery of gastrointestinal function after cesarean section. Methods In the management of applying QCC method to optimize TCM nursing program to promote the recovery of gastrointestinal function after cesarean section. The study was conducted on patients with cesarean section of the department of obstetrics and gynecology of shenzhen hospital of Guangzhou university of traditional chinese medicine (Futian). 36 cases of the control group were patients before the optimization of TCM nursing program by QCC on February 13-26, 2017, and 36 cases of the intervention group were patients after that on July 2 to 15, 2017. Before and after the QCC program, the time of postoperative of cesarean section patients' first anus exhaust, anal exhaust rate in 18 hours and lactation time were compared. The postoperative of cesarean section patients′first anus exhaust time, 18 hours anal exhaust rate and lactation time were investigated , and essential factors and really causes of the anal exhaust rate in 18 hours were analyzed, and a corresponding countermeasures were made. Results After TCM nursing program, the postoperative of cesarean section patients′ first anus exhaust time and lactation time were significant reduced (P<0.05);anal exhaust ratein 18 hours wasrise from 22.2％(8/36) to 86.1％(31/36). The patients after cesarean sectionwhose anal exhaust rate in 18 hours was increased significantly. The target success rate was as high as 116％, and the recovery rate was as high as 287.8％. Conclusions QCC activity optimize TCM nursing program can improve the recovery of gastrointestinal function after cesarean section. It enriched the connotation of TCM nursing programs, promote the implementation and standardizes the operation process of it. It also improved the clinical efficacy of TCM nursing program, and indeed promoted the patients′ gastrointestinal function after cesarean section, so that it is worthy of clinical application.

Objective:To study clinical characteristics and risk factors of young patients with coronary heart disease (CHD) complicated metabolic syndrome (MS).Methods: A total of 200 CHD young patients were selected from our hospital, including 100 patients with MS (CHD+MS group) and 100 patients without MS (CHD control group).Lesion severity was evaluated according to coronary lesion score.General data were compared between two groups,and risk factors were assessed CHD+MS group.Results: Compared with CHD control group, there were significant rise in body mass index (BMI), levels of total cholesterol (TC), 2h postprandial blood glucose (2hPG), fasting blood glucose (FBG), triglyceride (TG), blood pressure, serum uric acid (UA) and creatinine (Cr) and homeostasis model-insulin resistance index (HOMA-IR), and significant reduction in level of high density lipoprotein cholesterol (HDL-C) in CHD+MS group, P<0.01 all.Compared with CHD control group, there were significant rise in incidence rate of multi-vessel coronary disease (6% vs.32%) and Gensini score of coronary angiography [(5.1±2.0) scores vs.(8.4±5.3) scores] in CHD+MS group, P<0.01 both.Logistic regression analysis indicated that low HDL-C, HOMA-IR, hypertension and diabetes mellitus history were risk factors for CHD complicated MS in young patients(OR=1.097~2.246,P<0.01 all).Conclusion:There are much risk factors and abnormal metabolism,and coronary disease are more serious in young patients with CHD complicated MS.