Objective:To investigate the changes of blood glucose and blood lipid in gestational diabetes mellitus (GDM) patients with different insulin sensitivity during pregnancy and the effect of non-drug intervention.Methods:Data of 240 pregnant women with GDM and 240 healthy pregnant women were collected from July 1 to September 1, 2023 in Shijing People′s Hospital in Baiyun District and other five hospital. The insulin sensitivity index (ISI) was calculated by homeostasis model assessment 2(HOMA2) model, according to the 25th percentile of ISI of normal pregnant women, GDM patients were divided into insulin sensitive group (group A) and insulin sensitive deficiency group (group B), and group A and group B were divided into two groups according to 36-week blood glucose control: group A1 with good blood glucose control (group A1 and group B1) and group A2 with bad blood glucose control (group A2 and group B2). The age, body mass index (BMI) before pregnancy, fasting plasma glucose (FPG), blood lipids and blood glycated hemoglobin (HbA 1c ) in the first trimester, blood glucose and blood lipids in the second trimester were compared at the 28th, 32nd and 36th weeks of gestation, the number of cases, blood glucose, blood lipids and non-drug intervention were measured. Results:There were 166 cases in group A and 74 cases in group B. Blood glucose and blood lipid were normal in early pregnancy. There was no significant difference in blood glucose between group A and group B during the second trimester. The levels of blood lipids were significantly higher than those during the first trimester, and the levels of triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) were significantly higher than those during the first trimester. The number of pregnant women in group A1 was significantly more than that in group A2 in the third trimester ( P = 0.01), and the number of pregnant women in group B1 was more than that in group B2 at 28 weeks ( P = 0.01). At 32 weeks, the number of pregnant women in group B1 and group B2 was similar ( P = 0.31). At 36 weeks, the number of pregnant women in group B1 was significantly lower than that in group B2 ( P = 0.01). In the third trimester of pregnancy, the levels of blood glucose in group B2 were higher than those in group A2 ( P<0.05). The levels of TG and LDL-C in group A2 and group B2 were higher than those in group A1 and group B1 respectively, high-density lipoprotein cholesterol (HDL-C) was lower than that in group A1 and group B1( P<0.05), and there was no significant difference in TC between group A2 and group A1 at 28 and 32 weeks ( P>0.05), but it was significantly higher at 36 weeks ( P = 0.01). In the third trimester of pregnancy, diet control was the most common (91.7%, 87.7%, 81.6%, respectively) in group A ( P>0.05). The proportions of diet-only and diet-plus exercise interventions were similar in group B1 at 28 weeks and 32 weeks (52.9% vs. 47.1%, 45.7% vs. 54.3%)( P = 0.072, 0.113). At the 36 weeks, the main intervention was diet combined with exercise (73.3%). In group B2, dietary intervention (69.6%, 71.8%, 69.5%) was the main cause of poor control of blood glucose. Conclusions:In GDM patients with insulin sensitivity deficiency, the blood glucose and blood lipids in the second trimester are obviously increased, and the abnormality in the third trimester is even greater.

Objective:To describe the current situation of mental health service utilization of community pa-tients with five mental disorders in Inner Mongolia Autonomous Region and provide reference for health education and formulating relevant policies.Methods:The multistage stratified sampling method with unequal probability was used to select a total of 12 315 community residents aged 18 and over in Inner Mongolia Autonomous Region.Using Composite International Diagnostic Interview,mood disorders,anxiety disorders,substance use disorders,intermit-tent explosive disorders,and eating disorders,and health service utilization were investigated.Descriptive statistics was completed by single factor analysis method.Results:The lifetime rates of consultation and treatment of any mental disorder were 18.7％and 10.2％,respectively.The highest proportion of patients received treatment by non-medical professionals was 31.4％,followed by psychiatrists in psychiatric hospital or psychologists in general hospitals.Among the patients,1.1％of them received medication,and 2.5％received psychotherapy.Conclusion:The utilization rate of mental health services in community patients with five mental disorders is relatively low.It is necessary to conduct health education for medical help seeking properly.

Inducing the degradation of KRAS represents a novel strategy to combat cancers with KRAS mutation. In this study, we identify ubiquitin-specific protease 2 (USP2) as a novel deubiquitinating enzyme of KRAS in multiple myeloma (MM). Specifically, we demonstrate that gambogic acid (GA) forms a covalent bond with the cysteine 284 residue of USP2 through an allosteric pocket, inhibiting its deubiquitinating activity. Inactivation or knockdown of USP2 leads to the degradation of KRAS, resulting in the suppression of MM cell proliferation in vitro and in vivo. Conversely, overexpressing USP2 stabilizes KRAS and partially abrogates GA-induced apoptosis in MM cells. Furthermore, elevated USP2 levels may be associated with poorer prognoses in MM patients. These findings highlight the potential of the USP2/KRAS axis as a therapeutic target in MM, suggesting that strategically inducing KRAS degradation via USP2 inhibition could be a promising approach for treating cancers with KRAS mutations.

Objective:To evaluate the relationship between sleep arousal, ambulatory blood pressure and new-onset heart failure(NOHF)in elderly patients with obstructive sleep apnea(OSA).Methods:A total of 584 elderly patients with OSA who were diagnosed and treated in our hospital between March 2015 and March 2019 were prospectively and consecutively selected, with a mean age of(70.1±7.2)years.Polysomnography(PSG)results were obtained at baseline, and the arousal index(AI)was calculated.Based on the quartiles of AI, patients were divided into 4 groups: a low-level group(AI<18.4/h, 186 cases), a low-medium level group(18.4-29.1/h, 177 cases), a medium-high level group(29.2-41.2/h, 137 cases)and a high-level group(>41.2 /h, 84 cases). Participants were followed up for 18 months, the results of ambulatory blood pressure were recorded and compared, and the relationship between AI and the risk of NOHF was analyzed.Results:Compared with the low-level group, patients in the low-medium, medium-high, and high-level groups were older(70.1, 70.3, 73.3 vs.68.7 years, F=2.726, P=0.043)and had more smokers(43.8%, 49.6%, 54.8% vs.38.2%, χ2=8.809, P=0.032), a larger body mass index(26.3, 26.7, 27.6 vs.25.4 kg/m 2, F=2.731, P=0.042), a higher Epworth sleepiness scale score(7.83, 8.50, 9.91 vs.7.64, F=5.124, P=0.018), a higher apnea hypopnea index(23.5, 34.8, 52.7 vs.17.6, F=5.632, P=0.007), lower nocturnal oxygen saturation(80.2, 75.3, 72.1 vs.83.7 mmHg, F=4.811, P=0.024), and higher N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels(317.5, 337.5, 359.2 vs.267.5 pg/L, F=4.307, P=0.033). At the median follow-up(18 months, 14-24 months), the results of ambulatory blood pressure monitoring showed that 24-hour systolic blood pressure(24 h SBP)(147.3, 148.6, 156.2 vs.143.8 mmHg, F=5.4311, P=0.013), 24-hour diastolic blood pressure(24 h DBP)(80.1, 79.5, 83.7 vs.76.5 mmHg, F=5.679, P=0.011)in the low-medium, medium-high and high-level groups were higher than those in the low-level group.The results of survival analysis showed that there were 75(12.8%)cases of NOHF, mostly with preserved ejection fraction(47 cases)or mid-range ejection fraction heart failure(20 cases). The incidences of NOHF were 6.5%, 12.4%, 16.1% and 22.4%, respectively for the low level, low-medium, medium-high and high-level groups, and the risk of NOHF in the low-medium, medium-high and high-level groups was significantly higher than in the low level group(log-rank χ2=11.624, P=0.007). Variables with P<0.2 in the univariate analysis, age and sex were included in the multivariate Cox regression analysis.The results showed that age( HR=1.724, 95% CI: 1.216-3.135), diabetes( HR=1.514, 95% CI: 1.127-3.058), NT proBNP( HR=1.517, 95% CI: 1.232-2.366), nocturnal diastolic blood pressure( HR=2.004, 95% CI: 1.332-4.638), and middle-high AI level( HR=1.611, 95% CI: 1.204-2.967)and high AI level( HR=1.863, 95% CI: 1.272-3.538)were independent factors of NOHF in elderly OSA patients. Conclusions:Sleep arousal in elderly patients with OSA increases blood pressure levels and the risk of NOHF.

Objective:To examine the clinical effect of early administration of Shakubatracvalsartan following early percutaneous coronary intervention(PCI)in patients diagnosed with acute myocardial infarction and acute heart failure.Methods:This study prospectively included 65 patients with acute myocardial infarction and acute heart failure who were admitted to the First People's Hospital of Shangqiu from June 2018 to October 2022.The patients were randomly divided into two groups: the control group(35 cases)and the observation group(30 cases).Both groups received early PCI treatment.After the operation, the control group received oral administration of Benazepril hydrochloride, while the observation group received oral administration of Shakubatracvalsartan for a duration of 8 weeks.The study compared the total treatment efficiency and cardiac function parameters, such as left ventricular ejection fraction(LVEF), left ventricular end-diastolic diameter(LVEDD), and clear brain natriuretic peptide precursor(NT-proBNP)as well as myocardial injury markers(creatine kinase isoenzyme MB(CK-MB)and myoglobin(Myo))before and at 8 weeks of treatment between the two groups.Additionally, any adverse effects that occurred during the treatment period were also compared.Results:The total effective rate was 93.33%(28 cases)in the observation group and 71.43%(25 cases)in the control group.The observation group had a higher rate compared to the control group, and this difference was statistically significant( χ2=5.149, P<0.05).Both groups showed an increase in left ventricular ejection fraction, a decrease in left ventricular end-diastolic diameter, and a decrease in N-terminal pro-brain natriuretic peptide.In the observation group, the left ventricular ejection fraction was(48.52±3.28)%, which was higher than the control group's(43.86±2.52)%, and the left ventricular end-diastolic diameter was(46.70±2.88)mm and the N-terminal pro-brain natriuretic peptide was(680.44±87.04)pg/L, which were lower than the control group's(50.46±3.47)mm and(1 715.94±115.41)pg/L, respectively.These differences were statistically significant( t=13.434, 5.287, 5.330, P<0.05 for all).The levels of creatine kinase-MB and myoglobin in both groups were significantly lower after treatment.Specifically, the observation group had levels of(31.42±5.76)U/L and(34.42±5.36)mg/L, which were lower than the levels in the control group of(38.44±4.94)U/L and(43.15±7.46)mg/L.These differences were statistically significant( t=5.287, 5.330, P<0.05 for all).The readmission rate was 10.00%(3 cases)in the observation group and 14.29%(5 cases)in the control group.The readmission rate of the observation group was lower than that of the control group, and the difference was not statistically significant( χ2=0.021, P>0.05). Conclusions:The early administration of Shakubatracvalsartan following early PCI has been shown to effectively enhance cardiac function in patients with acute myocardial infarction and acute heart failure.It also facilitates the repair of myocardial cells and improves the therapeutic outcomes after surgery.

Background: Tigecycline, eravacycline, and omadacycline are recently developed tetracyclines. Susceptibility of microbes to these tetracyclines and their molecular mechanisms have not been well elucidated. We investigated the susceptibility of Moraxella catarrhalis to tigecycline, eravacycline, and omadacycline and its resistance mechanisms against these tetracyclines. Methods: A total of 207 non-duplicate M. catarrhalis isolates were collected from different inpatients. The minimum inhibitory concentrations (MICs) of the tetracyclines were determined by broth microdilution. Tigecycline-, eravacycline-, or omadacycline-resistant isolates were induced under In Vitro pressure. The tet genes and mutations in the 16S rRNA was detected by PCR and sequencing. Results: Eravacycline had a lower MIC50 (0.06 mg/L) than tigecycline (0.125 mg/L) or omadacycline (0.125 mg/L) against M. catarrhalis isolates. We found that 136 isolates (65.7%) had the tetB gene, and 15 (7.2%) isolates were positive for tetL; however, their presence was not correlated with high tigecycline, eravacycline, or omadacycline ( ≥ 1 mg/L) MICs.Compared with the initial MIC after 160 days of induction, the MICs of tigecycline or eravacycline against three M. catarrhalis isolates increased ≥ eight-fold, while those of omadacycline against two M. catarrhalis isolates increased 64-fold. Mutations in the 16S rRNA genes (C1036T and/or G460A) were observed in omadacycline-induced resistant isolates, and increased RR (the genes encoding 16SrRNA (four copies, RR1-RR4) copy number of 16S rRNA genes with mutations was associated with increased resistance to omadacycline. Conclusions Tigecycline, eravacycline, and omadacycline exhibited robust antimicrobial effects against M. catarrhalis. Mutations in the 16S rRNA genes contributed to omadacycline resistance in M. catarrhalis.

Objective: To investigate the effects of XIAOJI Decoction combined with FOLFOX chemotherapy on serum cytokine expression profile in patients with advanced colorectal carcinoma by liquid chip technology. Methods: Fourteen patients with advanced colorectal carcinoma, who met the inclusion criteria and were treated in the Department of Oncology, Higher Education Mega Center Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine during January 1, 2018 and December 31, 2018 were retrospectively analyzed in this study. The patients were divided into chemotherapy group (n=7, treated with 5-Fluorouracil + Calcium Folic Acid+Oxaliplatin (FOLFOX)) and combined treatment group (n=7, treated with XIAOJI Decoction + FOLFOX) according to therapeutic scheme. The curative efficacy was evaluated after 6 treatment courses. The expression profile of cytokines in blood serum of patients was examined by liquid chip technology after every 2 courses. Results: Fourteen patients received a total of 84 cycles of therapy. Survival analyses showed that the progress-free survival time (PFS) and overall survival time (OS) of two groups couldn't be compared due to insufficient samples, although the combined treatment group had longer PFS (10 months vs 6 months) and OS (17 months vs 12 months) than the chemotherapy group.As to adverse reactions, the rates of leucopenia, diarrhea, nausea, peripheral neuritis and alopecia in two groups were comparable, while the severity in combined treatment group were lighter than that in chemotherapy group. In comparison with the combined treatment group, concentrations of serum BDNF and IL-2 were statistically higher in the chemotherapy group (P<0.05). By comparing the cytokine concentrations at different collection time points before and after the treatment, it showed that the concentration of serum IL-2 in chemotherapy group was higher than that in combined treatment group after 2 courses of treatment (P<0.05). In total, there were 19 cytokines showed a tendency to be higher in combined treatment group than chemotherapy group during different treatment periods. Conclusion: Combined treatment of XIAOJI Decoction with FOLFOX for advanced colorectal carcinoma is a treatment option worth exploring, and liquid chip analysis showed that the mechanism may be related to the reduction of serum LI-2 and BDNF levels in patients.

This research conducted retrospective multi-center study on medical records of Uyghur Medicine diagnosis and treatment program of shingles, and collected information about demography, diagnostics, and therapeutics, efficacy evaluation and nursing to conclude and analyze the main syndromes and sub-disease performance. Shingles was divided into 3 types in Uyghur Medicine field: abnormal blood type shingles, abnormal bile liquid type shingles, and abnormal black choledochal typeshingles. Uighur Medicine syndrome type standards of shingles were established. Rash suspended time, rash dry scab time, the pain start to ease time interval, time completely pain, pain bounce rate, the incidence of postherpetic neuralgia, and PHN recovery time were evaluated. Disease and syndrome clinical criteria of shingles were established by evaluating Uygur Medical symptoms improvement, improvement of patients’ life quality and the changes in patients’ internal environment. On this basis, in accordance with the technical requirements of the national medicine review, the research developed clinical research guidelines for the treatment of shingles with new Uyghur Medicine (draft).

In this article, retrospective multi-center study on medical records of Uyghur Medicine diagnosis and treatment program of acne vulgaris was done and demographic, diagnostic, therapeutic, efficacy evaluation and nursing data and other information were collated and analyzed. The main and secondary disease manifestations of acne vulgaris were analyzed inductively and acne vulgaris was divided into 3 types in Uyghur Medicine field, which are blood-type acne vulgaris, yellow bile-type acne vulgaris, and astringent mucus-type acne vulgaris. Uyghur Medicine syndrome type standards of acne vulgaris were established. At the same time, through evaluating skin integrity and morphology of lesions as well as changes in patients’ symptoms and quality of life and observing changes in patients’ internal environment respectively before and after treatment, disease and syndrome clinical criteria of acne vulgaris were established. On this basis, in accordance with the technical requirements of the national medicine review, this study developed clinical research guidelines for the treatment of acne vulgaris with new Uyghur Medicine.

Based on medical ethics, retrospective multi-center study on medical records of Uyghur Medicine diagnosis and treatment program of hyperlipidemia was done and demographic, diagnostic, therapeutic, efficacy evaluation, nursing data and other information were collated. The main and secondary disease manifestations of hyperlipidemia were analyzed inductively and hyperlipidemia were divided into 4 types in Uyghur Medicine field, which were surplus and sticky Kan type, Chuchumal Balgham type, Gaisiman Balgham type, and Koygan Savda type. Therefore, Uighur Medicine syndrome type standards of hyperlipidemia were established. Treatment efficacy was evaluated with the combination of laboratory observation parameters and main and secondary disease manifestations. On this basis, in accordance with the technical requirements of the national medicine review, this study developed clinical research guidelines for the treatment of hyperlipidemia with new Uyghur Medicine (draft).