Medicine
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Observational Study
Influencing factors of glycemic control in singleton pregnancies complicated by gestational diabetes mellitus in western China: A retrospective study.
To investigate the factors influencing glycemic control in gestational diabetes mellitus (GDM) patients and their impacts on pregnancy outcomes, providing insights for GDM management. Pregnant women diagnosed with GDM at a tertiary hospital in western China in 2019. Participants were categorized based on varying levels of glycemic control during pregnancy. ⋯ Compared with the satisfactory group, the unsatisfactory group has lower gestational age, lower rates of cesarean section and placenta previa, and higher rates of postpartum hemorrhage for mothers; lower length and weight, and higher rates of premature birth, jaundice, hypoglycemia, pneumonia, respiratory distress syndrome, anemia, hospitalization, and hospitalization for more than 15 days in both pediatric unit and neonatal intensive care unit for newborns (P < .05). Elevated prepregnancy body mass index, FPG in early pregnancy, 1-h and 2-h PG during OGTT, and with a history with GDM are independent factors influencing insulin utilization, while elevated 0-h PG is an independent influencing factor of unsatisfactory glycemic control. Poor glycemic control has negative impacts on both maternal and fetal outcomes under 2 classifications.
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This study aims to explore the utility of ColorViz mapping from dual data sources for assessing arterial collateral circulation and predicting cerebral tissue-level collateral (TLC) in patients with acute ischemic cerebrovascular diseases. A retrospective study was conducted at a single center on a cohort of 79 patients diagnosed with acute ischemic cerebrovascular diseases between November 2021 and April 2022, who had undergone both multi-phase CT angiography (mCTA) and computed tomography perfusion (CTP). The quality of images and arterial collateral status depicted on ColorViz maps from dual data-sets (mCTA and CTP) were assessed using a "5-point scale" and a "10-point scale," respectively. ⋯ Patients with robust arterial collateral circulation, as determined by dual data sources, were more likely to exhibit favorable TLC status, as evidenced by reductions in hypoperfusion volume (Tmax > 4 seconds, Tmax > 6 seconds, Tmax > 8 seconds, and Tmax > 10 seconds, P < .05) and HIR (Tmax > 6 seconds/4 seconds, Tmax > 8 seconds/4 seconds, Tmax > 10 seconds/4 seconds, and Tmax > 8 seconds/6 seconds, P < .05). The sensitivity and specificity in detecting LVO-AIS was 60.00% and 97.73% for mCTA source maps, while 74.29% and 72.73% for CTP source maps (P > .05 based on De-Long test). In conclusion, this study indicates that ColorViz maps derived from both data sources are equally important in evaluating arterial collateral circulation and enhancing diagnostic efficiency in patients with LVO-AIS, as well as offering insights into the TLC status based on hypoperfusion volume and HIR.
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Observational Study
Clinical observation of low temperature plasma ablation combined with collagenase injection in lumbar disc herniation.
To observe the effect of low temperature plasma ablation combined with collagenase injection on lumbar disc herniation. 90 patients with lumbar disc herniation admitted to the pain department of our hospital and receiving surgical treatment from April 2021 to April 2023 were included in this retrospective study, and were divided into 2 groups according to different treatment plans. One group was treated with low-temperature plasma ablation combined with collagenase injection, and the other group was treated with low-temperature plasma ablation alone. The sample size of both groups was 80 cases. ⋯ The Lehmann score of cryo-plasma ablation combined with collagenase injection group was significantly higher than that of cryo-plasma ablation group at 1 day and 3 months after treatment, and the difference was statistically significant (P < .05). The overall efficacy of low-temperature plasma ablation combined with collagenase injection is better than that of low-temperature plasma ablation alone. Low temperature plasma ablation combined with collagenase injection in the treatment of patients with lumbar disc herniation has less pain, faster recovery.
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Observational Study
Discussion on the relationship between the distribution characteristics of TCM syndrome types and related objective indicators in hepatolenticular degeneration.
Hepatolenticular degeneration is a rare treatable autosomal recessive inherited copper metabolism disorder with a diverse clinical phenotype and an exceptionally complex pathogenesis. Early definitive phenotypic diagnosis and targeted treatment are major challenges worldwide. In this study, we strictly followed the "National Standards of the People's Republic of China - Terminology of Traditional Chinese Medicine Clinical Diagnosis and Treatment (Syndrome Part)," "Chinese Medicine Nomenclature," and the clinical investigation-determined traditional Chinese medicine syndrome differentiation standards at Anhui University of Chinese Medicine to select 6 of the most common traditional Chinese medicine syndrome differentiations. ⋯ There were significant differences in the factors CP and SCO among patients with different traditional Chinese medicine syndromes. Significant differences were observed in the copper blue protein factor between damp-heat syndrome and liver and kidney deficiency syndrome, liver and kidney deficiency syndrome and liver and kidney yin deficiency syndrome, liver and kidney deficiency syndrome and phlegm heat and wind syndrome, as well as liver and kidney deficiency syndrome and syndrome of phlegm and blood stasis (P < .05). Significant differences were also found in the SCO factor between damp-heat syndrome and liver and kidney deficiency syndrome, liver and kidney deficiency syndrome and liver and kidney yin deficiency syndrome, liver and kidney deficiency syndrome and phlegm heat and wind syndrome, and liver and kidney deficiency syndrome and syndrome of phlegm and blood stasis (P < .05).
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Pediatric diseases possess unique characteristics, requiring pediatricians to have strong critical thinking skills and sound ethical decision-making abilities. This study aims to investigate and analyze the critical thinking dispositions of pediatric medical students and their impact on ethical decision-making levels, and to propose suggestions for improving teaching methods. A cross-sectional study design was adopted, using the Chinese version of the California Critical Thinking Disposition Inventory (CCTDI-CV) and an ethical decision-making questionnaire. ⋯ Critical thinking plays a crucial role in medical ethical decision-making, with family background and high school performance being important influencing factors. Educators should focus more on developing multidimensional critical thinking skills to enhance students' ethical decision-making abilities, thereby improving overall healthcare service quality. The study results also provide new perspectives for international pediatric medical educators.