Serum proteins differentially expressed in gestational diabetes mellitus assessed using isobaric tag for relative and absolute quantitation proteomics

BACKGROUND As a well-known fact to the public,gestational diabetes mellitus(GDM)could bring serious risks for both pregnant women and infants.During this important investigation into the linkage between GDM patients and their altered expression in the serum,proteomics techniques were deployed to detect the differentially expressed proteins(DEPs)of in the serum of GDM patients to further explore its pathogenesis,and find out possible biomarkers to forecast GDM occurrence.METHODS Subjects were divided into GDM and normal control groups according to the IADPSG diagnostic criteria.Serum samples were randomly selected from four cases in each group at 24-28 wk of gestation,and the blood samples were identified by applying iTRAQ technology combined with liquid chromatography-tandem mass spectrometry.Key proteins and signaling pathways associated with GDM were identified by bioinformatics analysis,and the expression of key proteins in serum from 12 wk to 16 wk of gestation was further verified using enzyme-linked immunosorbent assay (ELISA).RESULTS Forty-seven proteins were significantly differentially expressed by analyzing the serum samples between the GDMgravidas as well as the healthy ones. Among them, 31 proteins were found to be upregulated notably and the rest16 proteins were downregulated remarkably. Bioinformatic data report revealed abnormal expression of proteinsassociated with lipid metabolism, coagulation cascade activation, complement system and inflammatory responsein the GDM group. ELISA results showed that the contents of RBP4, as well as ANGPTL8, increased in the serumof GDM gravidas compared with the healthy ones, and this change was found to initiate from 12 wk to 16 wk ofgestation.CONCLUSION GDM symptoms may involve abnormalities in lipid metabolism, coagulation cascade activation, complementsystem and inflammatory response. RBP4 and ANGPTL8 are expected to be early predictors of GDM.

Clinical value of precise rehabilitation nursing in management of cerebral infarction

BACKGROUND Cerebral infarction,previously referred to as cerebral infarction or ischemic stroke,refers to the localized brain tissue experiencing ischemic necrosis or softening due to disorders in brain blood supply,ischemia,and hypoxia.The precision rehabilitation nursing model for chronic disease management is a continuous,fixed,orderly,and efficient nursing model aimed at standardizing the clinical nursing process,reducing the wastage of medical resources,and improving the quality of medical services.AIM To analyze the value of a precise rehabilitation nursing model for chronic disease management in patients with cerebral infarction.METHODS Patients(n=124)admitted to our hospital with cerebral infarction between November 2019 and November 2021 were enrolled as the study subjects.The random number table method was used to divide them into a conventional nursing intervention group(n=61)and a model nursing intervention group(n=63).Changes in the nursing index for the two groups were compared after conventional nursing intervention and precise rehabilitation intervention nursing for chronic disease management.RESULTS Compared with the conventional intervention group,the model intervention group had a shorter time to clinical symptom relief(P<0.05),lower Hamilton Anxiety Scale and Hamilton Depression Scale scores,a lower incidence of total complications(P<0.05),a higher disease knowledge mastery rate,higher safety and quality,and a higher overall nursing satisfaction rate(P<0.05).CONCLUSION The precision rehabilitation nursing model for chronic disease management improves the clinical symptoms of patients with cerebral infarction,reducing the incidence of total complications and improving the clinical outcome of patients,and is worthy of application in clinical practice.

Effect of nursing on postoperative respiratory function and mental health of lung cancer patients

BACKGROUND Both pulmonary rehabilitation training and psychological care have been shown to have a positive effect on the postoperative recovery of patients with lung cancer.However,few studies have combined the two to explore their combined effect.Therefore,this study aimed to investigate the effects of pulmonary rehabil-itation training combined with psychological care on postoperative respiratory function and mental health in lung cancer patients.AIM To investigate effect of nursing on postoperative respiratory function and mental health of lung cancer patients.METHODS 122 cases of lung cancer patients who underwent surgical treatment in our hospital and were treated in our department from January 2022 to April 2023 were selected and randomly divided into the control group and observation group.The control group performed the routine care intervention.The obser-vation group was given pulmonary rehabilitation training and psychological care based on conventional nursing interventions.Forced expiratory volume,forced vital capacity.Maximum ventilatory volume(MVV)in one second was measured,and the patient's 6-min walking distance and dyspnoea index scale were used to assess the patient's respiratory condition.The Connor-Davidson resilience scale(CD-RISC),self-rating anxiety scale(SAS),and self-rating depression scale(SDS)were used to evaluate the mental health of the patients.RESULTS There was no difference between the two groups regarding age,gender,education level,surgical procedure,type of pathology,and treatment(P>0.05).After treatment,MVV,6-min walking distance,toughness,strength,optimism,and total CD-RISC scores were significantly higher in the observation group(P<0.05),dyspnoea scores,SAS,and SDS scores were substantially lower in the control group compared to the observation group(P<0.05).CONCLUSION Pulmonary rehabilitation training combined with psychological care for patients after lung cancer resection could improve lung function,enhance daily activities,effectively relieve negative emotions such as anxiety and depression,and reduce complications.

Effects of nursing team communication and collaboration on treatment outcomes in intensive care unit patients with severe pneumonia

BACKGROUND Severe pneumonia is a common severe respiratory infection worldwide,and its treatment is challenging,especially for patients in the intensive care unit(ICU).AIM To explore the effect of communication and collaboration between nursing teams on the treatment outcomes of patients with severe pneumonia in ICU.METHODS We retrospectively analyzed 60 patients with severe pneumonia who were treated at the ICU of the hospital between January 1,2021 and December 31,2023.We compared and analyzed the respiratory mechanical indexes[airway resistance(Raw),mean airway pressure(mPaw),peak pressure(PIP)],blood gas analysis indexes(arterial oxygen saturation,arterial oxygen partial pressure,and oxygenation index),and serum inflammatory factor levels[C-reactive protein(CRP),procalcitonin(PCT),cortisol(COR),and high mobility group protein B1(HMGB1)]of all patients before and after treatment.RESULTS Before treatment,there was no significant difference in respiratory mechanics index and blood gas analysis index between 2 groups(P>0.05).However,after treatment,the respiratory mechanical indexes of patients in both groups were significantly improved,and the improvement of Raw,mPaw,plateau pressure,PIP and other indexes in the combined group after communication and collaboration with the nursing team was significantly better than that in the single care group(P<0.05).The serum CRP and PCT levels of patients were significantly decreased,and the difference was statistically significant compared with that of nursing group alone(P<0.05).The levels of serum COR and HMGB1 before and after treatment were also significantly decreased between the two groups.CONCLUSION The communication and collaboration of the nursing team have a significant positive impact on respiratory mechanics indicators,blood gas analysis indicators and serum inflammatory factor levels in the treatment of severe pneumonia patients in ICU.

Relationship Between Gene-Phenotype and Clinical Manifestations of Chromosomal Copy Number Variations Indicated by Non-Invasive Prenatal Testing

Objective:To analyze the clinical value of non-invasive prenatal testing(NIPT)in detecting chromosomal copy number variations(CNVs)and to explore the relationship between gene expression and clinical manifestations of chromosomal copy number variations.Methods:3551 naturally conceived singleton pregnant women who underwent NIPT were included in this study.The NIPT revealed abnormalities other than sex chromosome abnormalities and trisomy 13,18,and 21.Pregnant women with chromosome copy number variations underwent genetic counseling and prenatal ultrasound examination.Interventional prenatal diagnosis and chromosome microarray analysis(CMA)were performed.The clinical phenotypes and pregnancy outcomes of different prenatal diagnoses were analyzed.Additionally,a follow-up was conducted by telephone to track fetal development after birth,at six months,and one year post-birth.Results:A total of 53 cases among 3551 cases showed chromosomal copy number variation.Interventional prenatal diagnosis was performed in 36 cases:27 cases were negative and 8 were consistent with the NIPT test results.This indicates that NIPT’s positive predictive value(PPV)in CNVs is 22.22%.Conclusion:NIPT has certain clinical significance in screening chromosome copy number variations and is expected to become a routine screening for chromosomal microdeletions and microduplications.However,further interventional prenatal diagnosis is still needed to identify fetal CNVs.

Management of the palato-radicular groove with a periodontal regenerative procedure and prosthodontic treatment:A case report

BACKGROUND Palato-radicular groove(PRG)is defined as an anomalous formation of teeth.The etiology of PRG remains unclear.The prognosis of a tooth with a PRG is unfavorable.The treatment of combined periodontal-endodontic lesions requires multidisciplinary management to control the progression of bone defects.Some researchers reported cases that had short-term observations.The management of teeth with PRGs is of great clinical significance.However,to date,no case reports have been documented on the use of bone regeneration and prosthodontic treatment for PRGs.CASE SUMMARY This case reported the management of a 40-year-old male patient with the chief complaint of slight mobility and abscess in the upper right anterior tooth for 15 d and was diagnosed with type II PRG of tooth 12 with combined endodonticperiodontal lesions.The accumulation of plaque and calculus caused primary periodontitis and a secondary endodontic infection.A multidisciplinary management approach was designed that included root canal therapy,groove sealing,a periodontal regenerative procedure,and prosthodontic treatment.During a 2-year follow-up period,a good prognosis was observed.CONCLUSION This report indicates that bone regeneration and prosthodontic treatment may contribute to the long-term favorable prognosis of teeth with PRGs.

Correlation of Sema3A/Nrp1 pathway in gingival crevicular fluid of chronic periodontitis with inflammatory response and bone destruction

Objective: To study the correlation of Sema3A/Nrp1 pathway in gingival crevicular fluid of chronic periodontitis with inflammatory response and bone destruction. Methods: A total of 49 patients who were diagnosed with chronic periodontitis in the First People's Hospital of Jiangxia District, Wuhan City between July 2014 and January 2017 were selected as CP group, and 55 volunteers who received physical examination during the same period and had complete dentition were selected as control group. Gingival crevicular fluid was collected to detect the protein levels of Sema3A/Nrp1, inflammatory response indexes, bone metabolites and bone metabolism molecules. Results: Sema3A, Nrp1, PICP, Wnt1, β-catenin, and OPG protein levels in gingival crevicular fluid of CP group were significantly lower than those of control group while YKL40, CXCL16, ICAM1, HMBG1, SDF1α, ICTP, NTX, CTX, RANKL, 5-LOX and LTB4 protein levels were significantly higher than those of control group;Sema3A and Nrp1 protein levels in gingival crevicular fluid of CP patients were negatively correlated with YKL40, CXCL16, ICAM1, HMBG1, SDF1α, ICTP, NTX, CTX, RANKL, 5-LOX and LTB4 protein levels, and positively correlated with PICP, Wnt1, β-catenin and OPG protein levels. Conclusion: The inhibition of Sema3A/Nrp1 pathway in gingival crevicular fluid of chronic periodontitis can aggravate inflammatory response and promote bone destruction.

Clinical observation of the effects of moxibustion with seed-sized moxa cone plus opioid drugs on cancer pain and immune function

Objective:To observe the clinical efficacy of moxibustion with seed-sized moxa cone plus opioid drugs for moderate-to・severe cancer pain,and the effect on immune function in patients with cancer pain.Methods:A total of 80 patients with moderate-to-severe cancer pain were randomized into an observation group and a control group by the random number table method,with 40 cases in each group.Both groups were treated with opioid drugs for an algesia accordi ng to the stan dardized man agement prin ciples for cancer pain.In addition,the observati on group was given moxibustion with seed-sized moxa cone.The treatment was performed once a day,continuous 5-day treatment with a 2-day interval constituted a treatment course,and a total of 2 courses were performed.The score of numerical rating scale(NRS)and 24 h eq ui vale nt morphi ne consumpti on was compared betwee n the two groups before treatment,after 1 treatment course and after 2 courses of treatment.The immune functions were compared between the two groups before and after 2 courses of treatment.Results:During the treatment,there were 3 dropouts in the control group,and 2 dropouts in the observation group.Before the treatme nt,there were no sign ificant differe nces in the NRS score and 24 h equivale nt morphine consumpti on betwee n the two groups(both P>0.05).The NRS scores of both two groups were quite stable during the whole treatment period,and there was no significant differenee in the intra-group comparison after treatment(both P>0.05),and there was no significant difference between the two groups at the same time point(both P>0.05).In the control group,the 24 h equivale nt morphine con sumpti on showed an in creasi ng trend.The dosage after 1 treatme nt course and 2 courses of treatment was statistically different from that before treatment in the control group(both P<0.01).There was no significant cha nge in the mea n 24 h equivale nt morphi ne con sumpti on in the observati on group compared with that before treatme nt(both P>0.05).After 2 courses of treatme nt,the 24 h equivale nt morphine con sumpti on in the observati on group was significantly lower than that in the control group at the same time point(P<0.05).Before treatment,there was no significant difference in the levels of T lymphocyte subsets(CD3:CD4+and CD4+/CD8+)between the two groups(all P>0.05).After treatment the levels of T lymphocyte subsets(CD3+Z CD4+and CD4+/CD8+)in the control group were lower than those before treatment(all P<0.05),while the levels in the observation group were higher than those before treatment,and the levels of CD3+and CD4+were significantly different from those before treatment(both P<0.05).After treatment,the levels of T lymphocyte subsets(CD3+,CD4+and CD4+/CD8+)of the observation group were significantly higher than those of the control group at the same time point(all P<0.05).Conclusion:Moxibustion with seed-sized moxa cone can reduce the dosage of opioid drugs used in patients with moderate-to-severe cancer pain and improve their immune functions.

Therapeutic observation of grain-sized moxibustion for chemotherapy-induced myelosuppression for non-small cell lung cancer

Objective: To observe the clinical efficacy of grain-sized moxibustion in treating chemotherapy-induced myelosuppression for non-small cell lung cancer (NSCLC) and its effect on quality of life (QOL). Methods: Eighty NSCLC patients admitted to the Inpatient Department of Zhejiang Cancer Hospital between September 2016 and March 2018 were recruited and divided into an observation group and a control group by random number method, with 40 cases in each group. The two groups both received chemotherapy with paclitaxel plus cisplatin (TP regimen). The control group received oral administration of leucogen tablets starting from the first day of chemotherapy, 20 mg each time, three times a day, for consecutive 14 d;the observation group was additionally given grain-sized moxibustion, once a day, five days per week at a two-day interval, until the fourteenth day. The myelosuppression severity was observed and compared between the two groups prior to chemotherapy, at the 3rd, 7th and 14th days of chemotherapy;the QOL in the two groups was evaluated before chemotherapy, at the 14th and 21st days of chemotherapy. Results: Regarding myelosuppression, the peripheral blood indicators increased significantly at the 3rd day of chemotherapy in both groups (P<0.05 or P<0.01);at the 7th and 14th days of chemotherapy, the peripheral blood indicators presented a decreasing tendency in the two groups, but the level in the observation group was still significantly higher than that before chemotherapy (P<0.01);at the 3rd, 7th and 14th days of chemotherapy, the peripheral blood indicators in the observation group were higher than those in the control group (P<0.05 or P<0.01);the occurrence rate of myelosuppression in the observation group was significantly lower than that in the control group (P<0.01). The QOL score in the observation group was markedly higher than that in the control group at the 14th and 21st days of chemotherapy (both P<0.05). Conclusion: Grain-sized moxibustion can effectively improve myelosuppression after chemotherapy for NSCLC, reducing its occurrence and enhancing the patient's QOL.