OBJECTIVE To explore the association between the use of oral progesterone drugs in early pregnancy and gestational diabetes mellitus （GDM）. METHODS Through real-world retrospective cohort research method， pregnant women who underwent the oral glucose tolerance test （OGTT） at the Affiliated Maternal and Child Health Hospital of Nantong University between January 2022 and January 2023 were enrolled. Based on whether oral progesterone drugs were used in early pregnancy， they were divided into treatment group and control group； propensity score matching （PSM） with a 1∶1 ratio was employed to control for confounding factors； Logistic regression and linear regression were employed to analyze the association between drug factors （whether use of oral progesterone drug， duration of medication， dosage， and drug type） and outcome indicators （occurrence of GDM， fasting blood glucose levels， and OGTT 1 and 2 h blood glucose levels in late pregnancy）. RESULTS A total of 709 pregnant women were enrolled in the two groups before PSM； after PSM， 256 cases were included in both the treatment group and the control group. The results of association analysis indicated that there was no significant association between the use of oral progesterone drugs and GDM （P＞0.05）； but a significant correlation was found with OGTT 1 h blood glucose levels [β＝0.965， 95%CI （0.007，1.922）， P＜0.05]， specifically with Dydrogesterone tablets [β＝0.977， 95%CI （0.009， 1.944）， P＜0.05] and Progesterone soft capsules [β ＝1.089， 95%CI （0.077， 2.102）， P＜0.05]. There was no significant correlation between other drug factors and outcome indicators （P＞0.05）. CONCLUSIONS The use of oral progestogen drugs in early pregnancy is not significantly associated with GDM. The blood glucose levels in late pregnancy， especially OGTT 1 h blood glucose levels， have a certain correlation with Progesterone soft capsules and Dydrogesterone tablets.

Objective To explore the effect of head CT blend signs on short-term outcomes in patients with spontaneous supraten-torial intracerebral hemorrhage(ICH)after craniotomy.Methods A total of 435 patients with spontaneous supratentorial ICH who un-derwent craniotomy in the Department of Neurosurgery,Jinyang Hospital Affiliated to Guizhou Medical University from January 2019 to December 2022 were enrolled retrospectively.The patients were divided into the blend sign group(n=105)and control group(n=330)based on the CT features at admission.The general clinical data,imaging data,surgical data,complications and prognosis were collected and compared between the two groups.The outcome was assessed by the mRS(modified Rankin scale)at discharge.Multivariate Logistic regression model was used to analyze the independent correlation between CT blend sign and poor outcomes.Results During the follow-up period,there was no significant differences in the proportion of patients with poor outcomes between the two groups.The poor outcomes after craniotomy was independently correlated with age,smoking history,diabetes history and Glasgow coma scale(GCS)at admission,but not with blend signs.Conclusion Head CT blend signs on admission is not associated with the poor outcomes in patients with sponta-neous supratentorial ICH after craniotomy.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

Background Electroplating technology is widely used in the mechanical manufacturing industry. Electroplating workers may be exposed to occupational hazards such as chromium, zinc, cyanides, and sulfuric acid. With the continuous improvement of protective conditions, occupational hazards have been effectively controlled, but there is less focus on the potential acute occupational poisoning that may occur during the electroplating process. Objective To identify causes of an acute chromium poisoning accident occurred during the cleaning process of electroplating tank in a hardware processing plant, and to formulate relevant prevention and control measures to avoid similar poisoning accidents. Methods Occupational history, medical history, and treatment process of the poisoned worker were inquired in detail, his inpatient medical records were consulted , and his blood samples were tested. Occupational health investigation and testing were carried out at the scene of the poisoning accident. Results The air concentration of peak exposure (CPE) and permissible concentration-time weighted average (CTWA) of chromium and its compounds in the workplace were 0.49 mg·m⁻³ and 0.31 mg·m⁻³ respectively. The results of auxiliary test were Serum chromium 4175.85 μg·L⁻¹, serum creatinine 1370.2 μmol·L⁻¹, urea 42.28 mmol·L⁻¹, and urine osmotic pressure 248 mosm·L⁻¹. The final diagnosis was occupational acute severe toxic nephropathy (chromium and its compounds) and occupational chemical skin moderate burn (chromic acid, sulfuric acid). The prescribed treatment included right lower limb expansion skin grafting, hemodialysis and symptomatic support. The patient’s condition was stable and gradually improved after the treatment. Conclusion The main causes of the poisoning accident include weak awareness of the employer of occupational disease prevention and control; failures in fulfilling legal obligations of occupational disease prevention and control, implementing effective occupational disease prevention measures, and providing proper occupational health and safety training and effective personal protective equipment. In order to protect the health of workers, the relevant government departments and employers should attach great importance to the prevention and control of occupational diseases, such as strengthening training and education, increasing the intensity of occupational health supervision, and urging employers to implement occupational disease prevention measures in accordance with the law.

Objective To investigate the fluctuations in the population density of Aedes albopictus and changes in the population density of Ae. albopictus in different geographical areas and different breeding habitats in Guangdong Province from 2018 to 2023, so as to provide insights into prevention and control of mosquito-borne infectious diseases in the province. Methods Ae. albopictus surveillance sites were assigned in 1 609 townships (streets) from 121 districts (counties) of 21 cities in Guangdong Province during the period between March and November from 2018 to 2023. The surveillance of the population density of Ae. albopictus was performed once a month in each surveillance site, and once a month in specific settings in cities where dengue were highly prevalent in Guangdong Province from December to February of the next year during the period from 2018 through 2023. Four streets (villages) were selected in each surveillance site according to the geographic orientation, and mosquito ovitraps were assigned in gardens, rooftops or public green belts at residential areas, parks, hospitals and construction sites. All mosquito ovitraps were collected, and the mosquito ovitrap index (MOI) was calculated. The population density of Ae. albopictus was classified into four grades in each surveillance site according to MOI, including no risk, low risk, medium risk and high risk. The risk classification of the Ae. albopictus density was analyzed in each surveillance site each year from 2018 to 2023, and the population density of Ae. albopictus was analyzed at different months and in different geographical areas and breeding habitats. Results A total of 118 241 Ae. albopictus surveillance sites were assigned in 21 cities of Guangdong Province from 2018 to 2023, and there were 68.26% of the surveillance sites with the population density of Ae. albopictus that met the requirements for dengue prevention and control, among which low, medium and high risk surveillance sites accounted for 23.61%, 6.67% and 1.47%. The risk classification of the Ae. albopictus density increased rapidly in Guangdong Province since April to May each year from 2018 to 2023, and then gradually reduced since September to October, with the peak during the period between May and July. The mean MOI was 4.21 at each surveillance site in Guangdong Province during the period from 2018 to 2023, with 4.69, 4.80, 4.38, 3.82, 3.38, and 4.33 from 2018 to 2023, respectively. The MOI was 4.35, 4.43, 3.53 and 3.58 in the Pearl River Delta region, and eastern, western, and northern Guangdong Province, respectively, and was 4.18, 5.44, 4.75, 3.24, 4.27 and 3.70 in residential areas, parks, construction sites, hospitals, waste collection stations, and other breeding habitats, respectively. Conclusions The population density of adult Ae. albopictus peaked in Guangdong Province during the period between May and July from 2018 to 2023, with a high density of Ae. albopictus in the Pearl River Delta region and eastern Guangdong Province. Targeted Ae. albopictus control measures are recommended to be implemented prior to the peak of the Ae. albopictus population density to reduce the development of mosquito-borne infectious diseases.

Purpose/Significance To construct a Chinese medical knowledge Q&A corpus dataset as a standardized evaluation bench-mark for large language models(LLMs)in the medical domain,so as to improve the accuracy and efficiency of LLMs in handling Chinese medical questions.Method/Process Chinese medical paper knowledge,medical terminology explanations and supplementary questions are acquired from the Chinese medical licensing examination,and open-source Chinese medical Q&A datasets are encompassed in the developed Q&A datasets.Result/Conclusion The Chinese medical knowledge Q&A corpus datasets enrich the sources of existing datasets and promote the objective and comprehensive quantitative evaluation of large models in the medical field.In the near future,additional data such as electronic medical records and those from online health communities will be used to strengthen the support of artificial intelli-gence for the Healthy China strategy.

Objective To explore the differential expression of the key microfilament cytoskeleton-binding proteins in immature dendritic cells(imDCs)during antigen phagocytosis.Methods Monocytes(MOs)were isolated from peripheral blood of healthy individuals and cultured with recombinant human granulocyte-macrophage colony stimulating factor(rhGM-CSF)and recombinant human interleukin-4(rhIL-4)for 6 days to obtain imDCs.ImDCs were co-cultured with low molecular weight(40 kDa)and high molecular weight(150 kDa)dextrans for 1,3 and 6 hours,respectively.Flow cytometry was used to detect the percentage of imDCs phagocytosing dextran and the expression of immunophenotype molecules.The localization of filamentous actin(F-actin),PFN1,WASP,and α-actinin in cells were observed by immunofluorescence imaging.The differential expression of MCBPs at the mRNA and protein levels were respectively detected by q-PCR and Western blotting.Finally,the MCBPs with the highest component coefficients were identified based on the stepwise regression and principal component analysis method in systems biology algorithms.Results During the process of antigen phagocytosis,imDCs phagocytized low molecular weight antigens at a faster rate,with a phagocytic duration of approximately three hours.Their cell phenotypes and morphology gradually differentiated into mDCs,and F-actin remodeling was occurred significantly.The expression of MCBPs such as PFN1,CDM,WASP,CAPZB,Filamin A,α-actinin were downregulated,while the expression of WAVE1,Arp2/3 complex,and Fascin were upregulated.The mRNA expression of signaling protein Rac1 was upregulated,while the mRNA expressions of CDC42 and RhoA were downregulated.The immunofluorescence results showed that PFN1,WASP,and α-actinin were transposed during the antigen phagocytosis process of imDCs.The results of stepwise regression and principal component analysis showed that PFN1 had the highest component coefficient.Conclusions PFN1 may be a key MCBPs involved in the process of antigen phagocytosis of imDCs,which is of great significance for further understanding the relationship between changes in the cytoskeleton structure of imDCs and their immunological functions.

Objective To systematically assess the interventional effects of aerobic combined resistance exercise on walking ability,cardiorespiratory endurance,dialysis adequacy and quality of life in the patients with hemodialysis(HD).Methods The published randomized controlled trials on the interventional effects of aerobic combined resistance exercise in HD patients were retrieved from the databases of PubMed,Cochrane Library,Embase,Ovid,Web of Science,CNKI,VIP,Wanfang and China Biomedical Literature Service System(SinoMed).The retrieval time was from the database establishment to May 28,2021;the included literatures were analyzed by using RevMan 5.4 software.Results A total of 24 studies with 1 086 research subjects were included.The results showed that compared with the control group(adopting the usual care or conducting no-resistance limb movement),the walking ability,cardiopulmonary endurance and the dimensions of partial quality of life in the HD patients of the intervention group(aerobic combined resistance exercise)were signifi-cantly improved.The dialysis adequacy during dialysis in the intervention group was significantly improved compared with that in the control group.Conclusion Aerobic combined resistance exercise could improve the physical function,quality of life and dialysis adequacy in HD patients,and it is recommended that the patients are encouraged to conduct the aerobic combined resistance exercise by combining with the specific situation.

Objective:To construct a core competency indicator system for oncology advanced practice nurses.Methods:This study is a cross-sectional study. A preliminary draft of the core competency indicator system for oncology advanced practice nurses was developed through literature review and expert group coordination from June to November 2022. The core competency indicator system for oncology advanced practice nurses was established using the Delphi method for expert consultation and the analytic hierarchy process.Results:A total of 54 experts from 11 hospitals and four medical schools in 10 provinces and municipalities directly under the central government across the country were included in two rounds of expert consultation. The effective response rates of the questionnaire were all 100%, with an expert authority coefficient of 0.90, Kendall coordination coefficients of 0.089 to 0.179 and 0.101 to 0.176 ( P<0.01). The final established core competency indicator system for oncology advanced practice nurses included seven primary indicators and 69 secondary indicators. Conclusions:The core competency indicator system for oncology advanced practice nurses is comprehensive and has the characteristics of specialized oncology nursing, and the construction process is scientific and reliable, laying the foundation for future training of oncology advanced practice nurses.

The purpose of this study was to reveal the resistance mechanism of Mycoplasma bovis from Xizang yaks to macrolide antibiotics and provide theoretical basis for clinical medication.In this study,10 strains of Mycoplasma bovis from Xizang yaks were tested for drug sensitivity to macrolide antibiotics using the micromethod,and sensitive strains were induced to be highly resist-ant in vitro.The results showed that all 10 strains of Mycoplasma bovis exhibited varying degrees of resistance to macrolide antibiotics.However,through methylation enzyme and inactivation en-zyme gene detection and analysis,it was found that there was no methylation enzyme encoded by the methylation enzyme gene and no resistance mechanism mediated by macrolide inactivation en-zymes,indicating that there were no mutations in the target gene loci of the sensitive and resistant strains.However,highly resistant strains in vitro have mutations at the domain Ⅱ,L22,and even L4 target gene loci,indicating that if two or more target gene amino acid loci undergo mutations,highly resistant strains can be produced.After testing with active efflux systems,it was found that there were no active efflux systems using macrolide antibiotics as substrates.It can be seen that the strain of Mycoplasma bovis from Xizang yaks is prone to mutation under the pressure of high con-centrations of macrolides,and there are mutations in two or more target gene amino acid sites,which is prone to produce highly resistant strains.