Table of Content

20 June 2022, Volume 25 Issue 18

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Editorial

Evidence-based Medical Evidence and Clinical Recommendations for Dietary Modification and Dietary Fiber Supplementation in the Treatment of Chronic Constipation

Songpeng SUN, Junhong LONG, Hong NI, Longyu LIANG, Xingxiao HUO

2022, 25(18):  2179-2187.  DOI: 10.12114/j.issn.1007-9572.2022.0112

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The incidence of chronic constipation is high, and it will seriously affect people's quality of life. There are many treatment methods for chronic constipation, including dietary modification, drug therapy, acupuncture and massage, exercise, surgery, etc. Dietary modification or dietary fiber supplementation therapy is often recommended before or in combination with drug therapy, but its application in clinical practice lacks specific norms. Based on evidence-based medical evidence, this paper analyzed the importance of dietary modification in the prevention and treatment of chronic constipation and the clinical efficacy of dietary fiber supplements, natural fruits or food raw materials in the treatment of chronic constipation, and put forward the application principles and specific methods of dietary modification and dietary fiber supplementation in clinical practice, in order to provide useful assistance to specialists, general practitioners and patients with chronic constipation.

Article·Osteoporosis Study

Associated Factors of Osteoporosis and Physical Fitness in Elderly Chinese Men

Shufang WANG, Xiuyan WANG, Yuwei YAN, Risu NA, Yuyu HENG, Ruhong WU, Ling JIN, Juan AN, Yan MEI, Xiaochun WU, Zhenqing LIU

2022, 25(18):  2188-2193.  DOI: 10.12114/j.issn.1007-9572.2022.02.002

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Background

As life expectancy increases, the number of elderly patients with osteoporosis rises as well. Many factors affect the development of osteoporosis, and good physical fitness may contribute to having better social adaptability in older people. So it is very important to pay attention to osteoporosis and ensure physical fitness in this group.

Objective

To explore the factors associated with osteoporosis, and analyze physical fitness in elderly men, providing a theoretical basis for preventing osteoporosis, improving physical fitness and developing health management programs for this group.

Methods

This study was conducted from January 2018 to December 2020. A total of 250 elderly men who underwent bone mineral density (BMD) examination were selected from Health Management Center, Inner Mongolia People's Hospital, and divided into normal BMD, osteopenia and osteoporosis groups by BMD examination results. Data were collected, including baseline information, laboratory results, physical fitness test results〔 including muscular strength (number of elbow bending within 30 seconds, 30-second sit-to-stand test results) , flexibility (shoulder and arm stretches, sitting flexion test) , balance (stand on one foot with eyes closed) , aerobic capacity (2-minute step test) , agility/mobility (timed up go test with a minimal space of 2.5 meters) 〕.

Results

Of the 250 subjects, 76 (30.4%) had normal BMD, 123 (49.2%) had osteopenia, and 51 (20.4%) had osteoporosis. Multivariate Logistic regression analysis demonstrated that abdomen circumference〔OR=0.710, 95%CI (0.566, 0.891) 〕, body mass index 〔OR=0.685, 95%CI (0.474, 0.990) 〕, high-density lipoprotein cholesterol〔OR=74.182, 95%CI (3.738, 1 472.125) 〕, 25 (OH) D₃〔OR=0.745, 95%CI (0.619, 0.897) 〕, and estradiol〔OR=0.784, 95%CI (0.665, 0.924) 〕were associated with osteoporosis in elderly men (P<0.05) . All the subjects successfully completed physical fitness tests, without adverse events. The number of repetitions of sit-to-stands within 30 seconds, results of shoulder and arm stretches, sitting flexion test, and 2-minute step test, duration for stand on one foot with eyes closed, as well as time used for timed up go test with a minimal space of 2.5 meters differed significantly across normal BMD, osteopenia and osteoporosis groups (P<0.05) . The number of elbow bending within 30 seconds showed no significant differences across the three groups (P>0.05) .

Conclusion

In elderly men, abdomen circumference, body mass index, high-density lipoprotein cholesterol, 25 (OH) D₃, and estradiol may independently associated with osteoporosis. Physical fitness indices varied significantly by BMD, especially flexibility, balance, aerobic capacity and agility/mobility.

Associated Factors of Osteoporosis in Elderly Patients with Stable Chronic Conditions

Jingrong DAI, Jie LI, Xu HE, Yang LI, Yan LI

2022, 25(18):  2194-2200.  DOI: 10.12114/j.issn.1007-9572.2022.02.009

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Background

China is seeing increasingly osteoporosis prevalence as ageing marches on. However, the specific etiology and pathogenesis of osteoporosis are still unclear, and there are still limitations in its prevention and treatment.

Objective

To investigate osteoporosis prevalence and associated factors in older Chinese patients with stable chronic conditions.

Methods

Three hundred and two elderly inpatients with stable chronic conditions who underwent a reexamination in Department of Geriatrics, Yunnan First People's Hospital from November 2020 to September 2021 were recruited. Dual-energy X-ray absorptiometry (DXA) was used to measure lumbar spine and hip bone mineral density (BMD) . T value ≤-2.5 was defined as osteoporosis. Demographic data were collected. Comprehensive geriatric assessment was conducted via a self-developed online platform named Comprehensive Geriatric Assessment. Fasting venous blood samples were collected and measured for serum biomarkers.

Results

Among the patients, 126 (41.7%) were found with osteoporosis, and other 176 (58.3%) without. Binary Logistic regression analysis indicated that insomnia〔OR=2.180, 95%CI (1.080, 4.443) 〕, multiple chronic conditions〔OR=1.223, 95%CI (1.101, 1.358) 〕, elevated homocysteine〔OR=1.043, 95%CI (1.000, 1.088) 〕 were associated with increased risk of osteoporosis (P<0.05) , while elevated serum uric acid level〔OR=0.996, 95%CI (0.993, 0.999) 〕 was associated with decreased risk of osteoporosis (P<0.05) .

Conclusion

The prevalence of osteoporosis in these older patients with stable chronic conditions was 41.7%. The probability of osteoporosis may be decreased with elevated serum uric acid level, and increased with elevated homocysteine, insomnia and multiple chronic conditions.

Distribution of Traditional Chinese Medicine Constitution and Associated Factors of Yang-deficiency in Patients with Postmenopausal Osteoporosis in the Community

Chuanrui SUN, Yili ZHANG, Baoyu QI, Shengjie FANG, Tao HAN, Yanming XIE, Xu WEI, Liguo ZHU

2022, 25(18):  2201-2206.  DOI: 10.12114/j.issn.1007-9572.2022.0106

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Background

Postmenopausal osteoporosis (PMOP) has an increasing incidence as aging advances. As the traditional Chinese medicine (TCM) constitution theory is of great significance in guiding PMOP prevention and treatment, studying the associated factors of yang-deficiency constitution, a common imbalanced constitution in PMOP patients, will contribute to the development of personalized treatment of PMOP.

Objective

To perform an analysis of the distribution of TCM constitution and associated factors of yang-deficiency constitution in PMOP patients in the community.

Methods

From November 2017 to July 2018, an interviewer-administered questionnaire survey for screening PMOP was conducted with a random sample of residents (45-80 years old) from 10 communities of Beijing's Chaoyang and Fengtai Districts. The general data collected include age, age at menopause, retirement status, types of job (mental, physical, or both) , educational level, monthly household income, height, weight, body mass index (BMI) , grip strength-weight index, history of fractures, history of falls, family history of osteoporosis, nighttime sleep duration, habits of eating leftovers, diet type (meat-based, plant-based, or meat-plant based) . TCM constitution was analyzed using the TCM Constitution Questionnaire. The associated factors of yang-deficiency constitution in PMOP cases were analyzed by multivariate Logistic regression.

Results

Four hundred and thirty-two cases were found with PMOP, four of them were excluded due to missing data of TCM constitution, and the other 428 cases were finally included. The residents with gentleness constitution numbered the most (n=175) . Among residents with biased constitution, those with yang-deficiency constitution numbered the most (n=107) . Through multivariate Logistic regression analysis, it was found that BMI<18.5 kg/m², frequently eating leftovers, and meat-based diet were associated with increased risk of PMOP in yang-deficiency residents (P<0.05) .

Conclusion

This cross-sectional survey indicates that yang-deficiency constitution may be highly prevalent in PMOP residents, and was associated with BMI<18.5 kg/m² often eating leftovers, and meat-based diet.

Predictive Value of Neutrophil-to-lymphocyte Ratio and Monocyte-to-high-density Lipoprotein Cholesterol Ratio for Osteoporosis in Postmenopausal Patients with Type 2 Diabetes Mellitus

Huifang NI, Jun LI, Yuan DING, Qun FU, Wenxun WU

2022, 25(18):  2207-2214.  DOI: 10.12114/j.issn.1007-9572.2022.02.021

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Background

People with diabetes mellitus are at increased risk of developing osteoporosis (OP) , especially those with postmenopausal type 2 diabetes mellitus (T2DM) . Chronic inflammation plays an important role in the development of OP.

Objective

To explore the predictive value of neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-high-density lipoprotein cholesterol ratio (MHR) for OP in postmenopausal patients with T2DM.

Methods

Two hundred and sixteen postmenopausal T2DM patients who were hospitalized in the Department of Endocrinology and Metabolism, the First Affiliated Hospital of Zhengzhou University from January 2018 to January 2020 were chosen. Clinical data were obtained, including blood routine and biochemical parameters (such as blood lipids and so on) in fasting venous blood, calculated NLR and MHR, and bone mineral density (BMD) of lumbar spine L_1-4, left femoral neck and left hip measured by dual-energy X-ray absorptiometry (DXA) . According to the BMD, the patients were divided into normal bone mass group (n=51) , osteopenia group (n=78) and OP group (n=87) . In addition, they were divided into 4 groups according to NLR quartiles (A1 to A4 group) and MHR quartiles (B1 to B4 group) , with 54 cases in each. Spearman correlation was used to analyze the association of NLR and MHR with BMD at lumbar spine L_1-4, left femoral neck and left hip. Multivariate Logistic regression analysis was applied to explore the influencing factors of OP. Receiver operating curve (ROC) analysis was performed to evaluate the value of NLR, MHR and their combination in predicting OP.

Results

NLR and MHR were increased in the osteopenia group than the normal bone mass group (P<0.05) . Compared with the normal bone mass group and the osteopenia group, NLR and MHR in the OP group were statistically significant increased (P<0.05) . Compared with A1 group, A3 group had decreased BMD at lumbar spine L_1-4, left femoral neck and left hip, so did A4 group (P<0.05) . A4 group had decreased BMD at lumbar spine L_1-4, and left hip than A2 group (P<0.05) . B1 group had higher BMD at lumbar spine L_1-4, left femoral neck and left hip than did B2, B3, and B4 groups (P<0.05) . B4 group had decreased BMD at lumbar spine L_1-4, left femoral neck and left hip than did B2 group (P<0.05) . B4 group also had decreased BMD at lumbar spine L_1-4 did B3 group (P<0.05) . Spearman correlation analysis showed that both NLR and MHR were negatively correlated with BMD at lumbar spine L_1-4, left femoral neck and left hip (P<0.001) . Multivariate Logistic regression analysis showed that long menopausal duration〔OR=1.092, 95%CI (1.005, 1.186) 〕, increased NLR〔OR=2.341, 95%CI (1.453, 3.770) 〕and increased MHR〔OR=329.250, 95%CI (21.421, 5 060.810) 〕were independently associated with elevated risk of OP, while high BMI〔OR=0.806, 95%CI (0.718, 0.903) 〕was associated with decreased risk of OP (P<0.05) . ROC analysis demonstrated that in predicting OP, the area under the curve (AUC) of NLR was 0.722, with 65.5% sensitivity and 72.1% specificity, and that of MHR was 0.709 with 52.9% sensitivity and 79.8% specificity, and that of NLR with MHR was 0.787, with 81.6% sensitivity and 67.4% specificity. The AUC of NLR with MHR was greater than that of NLR or MHR alone (Z=2.418, P<0.05; Z=2.893, P<0.05) .

Conclusion

Either NLR or MHR could be used as a predictor of OP in postmenopausal T2DM patients, and the predictive efficiency and sensitivity of the combination of them would be higher.

Article·Cervical Cancer Study

Progress and Challenge of Artificial Intelligence in Diagnosis and Treatment of Cervical Lesions

Aiyuan WU, ·Rezhake REMILA, Youlin QIAO

2022, 25(18):  2215-2222.  DOI: 10.12114/j.issn.1007-9572.2022.0095

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China has the considerable disease burden of cervical cancer, with the mortality and morbidity of cervical cancer showing an increasing and younger trend. Facing to the critical situation of cervical cancer control, it is urgent to explore the new methods that suitable for different resource areas for the early detection and treatment of cervical cancer. Recently, great progress has been made in the field of AI image classification, and scientists have developed many algorithms to identify cervical lesions and conducted corresponding studies on their accuracy. Here, by reviewing the papers published at home and aboard, which studied the applications value of AI in cervical cytology screening, colposcopy examination, diagnosis and treatment of cervical cancer, we summarized and discussed the current progress and challenges for AI's application in the area of cervical cancer control, in order to provide solid evidence for the future use of AI in improving human health.

Comparative Analysis of Cervical Cancer Screening Results in 2019 and 2020 in Shihezi Urban Areas, Xinjiang

Yu LIU, Yan WEI, Ping YANG

2022, 25(18):  2223-2230.  DOI: 10.12114/j.issn.1007-9572.2022.02.007

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Background

The results of cervical cancer containment have demonstrated regional differences in China, which may be due to various socioeconomic and cultural developments across regions. Understanding cervical cancer screening results in various regions is of a great significance for developing effective cervical cancer prevention strategies.

Objective

To perform a comparative analysis of the results of two yearly cervical cancer screening (2019 and 2020) in urban areas of Shihezi, Xinjiang, to estimate the changes in high-risk human papillomavirus (hrHPV) infection and cervical lesion detection rate in women.

Methods

A retrospective design was used. Participants were 46 994 women from Shihezi urban areas who underwent initial cervical cancer screening with an HPV test〔underwent once either between December 2018 and December 2019 (the 2019 yearly screening) or between January and June 2020 (the 2020 yearly screening) 〕 in Shihezi Maternal and Child Health Hospital, Shihezi People's Hospital, and First Affiliated Hospital, School of Medicine, Shihezi University during December 2018 to June 2020. Data of the screening results, including HPV infection rate and subtypes, Thinprep cytologic test results, and pathological diagnosis of cervical biopsy samples taken during a colposcopy were collected, and those of the 2019 yearly screening were compared with those of 2020 yearly screening.

Results

There were 18 378, and 28 616 attendees for 2019, and 2020 yearly screenings, respectively, and 44 746 of them finally completed the screening. The completion rate of cervical cancer screening in 2020 was higher than that in 2019 〔97.07% (27 779/28 616) vs (16 967/18 378) 〕 (P<0.05) . A total of 5 992 cases (12.75%) were detected with HPV infection, among them, the prevalence of HPV 16 and HPV 18 was 18.55% (1 112/5 992) , and that of other HPV subtypes was 81.45% (4 880/5 992) . The prevalence of HPV infections in participants of 2020 yearly screening〔11.09% (3 176/28 616) 〕was lower than that in participants of 2019 yearly screening〔15.32% (2 816/18 378) 〕 (P<0.05) . The prevalence of single-type HPV infections in participants of 2019 yearly screening was higher than that in participants of 2020 yearly screening 〔11.38% (2 092/18 378) vs 7.45% (2 674/28 616) 〕 (P<0.05) . The prevalence of multi-type HPV infections in participants of 2019 yearly screening was higher than that in participants of 2020 yearly screening〔3.94% (724/18 378) vs 1.75% (502/28 616) 〕 (P<0.05) . The prevalence of HPV was 10.37% (909/8 767) , 12.22% (1 916/15 677) , 13.71% (2 500/18 234) and 15.45% (667/4 316) , respectively, in four age groups of participants (30-39, 40-49, 50-59, and 60-65) in these two yearly screenings totally, showing an increase with age (P<0.05) . The prevalence of HPV showed a decrease in 30-39-year-old participants, so did it in 40-49-year-old, 50-59-year-old, and 60-65-year-old participants of 2020 yearly screening (P<0.05) . The top 5 prevalent single HPV subtypes found in 2019 yearly screening were HPV 52 (20.84%) , HPV 16 (14.48%) , HPV 53 (8.56%) , HPV 51 (7.93%) , and HPV 39/68 (7.60%) , while those found in 2020 yearly screening were HPV 52 (15.07%) , HPV 16 (12.64%) , HPV 58 (12.30%) , HPV 53 (10.25%) and HPV 66 (4.75%) . HPV 18 ranked as the 11th most prevalent single HPV subtype in both two screenings. The proportion of patients with pathological diagnosis of inflammation/condyloma and LSIL in cervical cancer screening in 2020 was lower than that in 2019 (P<0.05) . The 30-39-year-old participants of the 2020 yearly screening had lower prevalence of inflammation/condyloma detected by colposcopy than did those of the 2019 yearly screening (47.83% vs 74.36%) (P<0.05) . The 50-59-year-old participants of the 2020 yearly screening had lower prevalence of inflammation / condyloma detected by colposcopy than did those of the 2019 yearly screening (65.50% vs 77.22%) (P<0.05) . The 30-39-year-old participants of 2020 yearly screening had higher prevalence of colposcopy-detected low-grade squamous intraepithelial lesion (LSIL) than did those of 2019 yearly screening (31.30% vs 5.13%) (P<0.05) . The 40-49-year-old participants of 2020 yearly screening had higher prevalence of colposcopy-detected LSIL than did those of 2019 yearly screening (27.06% vs 16.07%) (P<0.05) . The 50-59-year-old participants of 2020 yearly screening had higher prevalence of colposcopy-detected LSIL than did those of 2019 yearly screening (23.64% vs 8.89%) (P<0.05) .

Conclusion

The completion rate of cervical cancer screening in 2020 was obviously better than that in 2019, but it still needs to be further improved. Compared with 2019, HPV infection rate decreased, the major prevalent HPV subtypes changed, and LISL prevalence increased in 30-39 and 50-59 age groups in 2020. Follow-up management is suggested to be strengthened in 30-39 and 50-59 age groups.

Appropriate Choice and Implementation of Radical Surgical Procedures for Cervical Cancer

Shuanghuan LIU, Bin LI

2022, 25(18):  2231-2234.  DOI: 10.12114/j.issn.1007-9572.2022.0006

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Cervical cancer is one of the most prevalent malignancies in women, which ranks fourth among malignancies in terms of incidence and mortality worldwide. Radical surgical procedure is the main treatment for early cervical cancer. With the development of healthcare and innovation of treatment concepts, multiple new medical ideas and technologies led by the Querleu-Morrow classification have continuously emerged and have been applied to clinical practice, facilitating the development of surgical procedures towards precision, individualization and humanization. We detailed the appropriate choice and implementation of radical surgical procedures for cervical cancer, aiming at increasing clinicians' understanding of relevant standards for such procedures, and thereby improving the precision and personalization levels of such procedures or treatments.

Assessment and Surgical Strategies for Lymphatic Metastasis in Cervical Cancer

Qingquan ZHANG, Shijun WANG

2022, 25(18):  2235-2238.  DOI: 10.12114/j.issn.1007-9572.2021.02.111

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Cervical cancer is a common gynecologic malignant tumor. Surgical treatment is an important treatment for early stage cervical cancer. Whether having lymph node metastasis is of great significance to the assessment of the prognosis of cervical cancer and the choice of treatment options. Preoperative assessment of lymph node metastasis based on identified related risk factors and imaging findings is helpful to the formulation of surgical strategies. In recent years, sentinel lymph node biopsy has been recommended for surgical treatment of patients with early stage cervical cancer due to its safety and feasibility. Patients with cervical cancer can selectively undergo sentinel lymph node biopsy, systematic lymph node resection, or para-aortic lymph node resection based on their preoperative lymph node assessment. According to intraoperative diagnosis of the degree of lymph node involvement, the extent of surgical resection can be determined. So the assessment of lymphatic metastasis, especially the formulation of surgical strategieswere of great significance in the treatment of cervical cancer.

Application and Update of Radiotherapy in the Treatment of Cervical Cancer

Yuxuan LIN, Weimin KONG, Yuanjing WANG, Fengshuang LI

2022, 25(18):  2239-2243.  DOI: 10.12114/j.issn.1007-9572.2022.0058

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As one of the three major treatments for cervical cancer, radiotherapy plays an important role in treating cervical cancer. In recent years, new technologies such as three-dimensional external beam radiotherapy and image-based brachytherapy have been widely used in the treatment of cervical cancer, which can increase the dose of tumor radiation while reducing the dose radiating surrounding normal tissues. In addition, the researches on the use of individualized radiotherapy guided by imaging indicators and proton therapy are also in progress. This paper presents the basic knowledge of radiotherapy for cervical cancer and the application of radiotherapy in the treatment of cervical cancer, summarizes the application of new technologies, and proposes issues that need to be emphasized in the use of new technologies, in order to guide clinical application.

Original Research

Recurrence Status and Combined Risk Factors of Surviving Stroke Patients Aged Over 40 in Urban Areas

Yike JIAO, Li JING, Yuanmeng TIAN, Xinbin HAO, Weizhong WANG, Chengguang SONG, Qun SUN, Lei SHI, Jixu SUN, Xiaoxia AN, Liying XING, Zuosen YANG

2022, 25(18):  2244-2248.  DOI: 10.12114/j.issn.1007-9572.2022.0025

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Background

Stroke has become the 3rd leading cause of death among urban residents in China, and the combined rate ofrisk factorssuch as hypertension, diabetes, and dyslipidemia is high among urban high-risk groups. Liaoning Province is a high incidence area of stroke in China, however, there are a few studies on the recurrence of stroke and its combined risk factors in the northern urban areas.

Objective

To explore the recurrence status of surviving stroke patients aged over 40 and its combined risk factors in urban areas of Liaoning Province, in orderto provide a theoretical basis for formulating effective secondary prevention strategies.

Methods

From September 2018 to December 2020, 6 349 permanent urban residents aged over 40 in Liaoyang, Dandong, Benxi, and Chaoyang Cities of Liaoning Province were selected according to the economic and regional distribution using stratified cluster random samplingand investigated. A total of 488 surviving stroke patients were included and their recurrence rate and associated risk factors were analyzed in this study.

Results

There were 244 males and 244 females among the 488 surviving stroke patients, the average age was (65.8±7.5) years old and the proportion of patients aged 60-69 was the largest (43.7%) ; There were 352 (72.1%) first-onset stroke patients, 136 (27.9%) recurrent stroke patients, and a recurrence rate of 27.9% among surviving stroke patients; The recurrence rates of male and female surviving stroke patients were 29.5% (72 cases) and 26.2% (64 cases) , respectively, and the difference was not statistically significant (χ²=0.652, P=0.419) . The recurrence rate of stroke among people aged 40-49, 50-59, 60-69, 70-79 and ≥80 years old was 4/11, 23.4% (22/94) , 25.4% (54/213) , 35.9% (47/131) and 23.1% (9/39) , respectively, there was no significant difference in recurrence rate between male and female surviving stroke patients in different age groups (P>0.05) .The current drinking rate of the relapsed patients was lower than that of the first-onset stroke patients, and the awareness rate of hypertension, dyslipidemia, the treatment rate of dyslipidemia, and the control rate of dyslipidemia were higher than those of the first-onset stroke patients, and the difference was statistically significant (P<0.05) .

Conclusion

The recurrence rate of surviving stroke patients aged over 40 in urban areas of Liaoning Province is high, and patients with recurrence have higher rates of smoking, physical inactivity, overweight or obesity, and poor control of combined risk factors such as hypertension and diabetes mellitus, which require comprehensive and effective secondary prevention measures to reduce the risk of recurrence, disability and death in stroke patients.

Association and Predictive Value of Maternal Serum C1q/Tumor Necrosis Factor-related Protein-3 Ratio with Gestational Diabetes Mellitus in Early Pregnancy: a Prospective Study

Liqian ZHANG, Yanwei GUO, Qian XU, Ting YANG, Shufang MAO

2022, 25(18):  2249-2254.  DOI: 10.12114/j.issn.1007-9572.2021.02.130

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Background

Gestational diabetes mellitus (GDM) is characterized by increased insulin resistance. As serum complement C1q/tumor necrosis factor-related protein 3 (CTRP3) ratio is closely related to insulin resistance, which may be involved in the development of GDM. However, the association and predictive value of serum CTRP3 ratio with GDM in early pregnancy have been rarely reported.

Objective

To explore the association and predictive value of serum CTRP3 ratio with GDM in early pregnancy, providing new ideas for the prevention and treatment of GDM.

Methods

Women in early pregnancy who underwent regular obstetric examinations in Obstetric Clinic, Affiliated Hospital of Chengde Medical University, were prospectively and consecutively enrolled from June 2018 to March 2019. Demographics, fasting plasma glucose (FPG) , fasting insulin (FINS) , glycosylated hemoglobin (HbA_1c) , triglyceride (TG) , total cholesterol (TC) , high-density lipoprotein cholesterol (HDL-C) , low-density lipoprotein cholesterol (LDL-C) and serum CTRP3 ratio measured at 6-14 weeks of gestation were collected. The 75 g oral glucose tolerance test (OGTT) was performed to screen GDM at 24-28 weeks of gestation. The patients were divided into GDM group and normal glucose tolerance (NGT) group.

Results

Finally, 368 of the 393 cases were enrolled for analysis, including 81 (22.0%) who were detected with GDM by the 75 g OGTT. Compared with those with normal glucose tolerance (NGT) diagnosed by the 75 g OGTT, GDM cases had much greater average age, pre-pregnancy BMI, FPG, FINS, HbA_1c, and TG (P<0.05) . Serum CTRP3 ratio in GDM group was lower than that in NGT group〔0.528 0 (0.461 3, 0.634 0) μg/L vs 0.604 8 (0.510 8, 0.666 0) μg/L, P=0.001〕. Multivariate Logistic regression analysis showed that serum CTRP3 ratio was an independently associated with GDM〔aOR=0.101, 95%CI (0.010, 0.997) , P≤0.05〕. The AUC of serum CTRP3 ratio in predicting GDM was 0.622〔95%CI (0.571, 0.672) 〕with 49.38% sensitivity, and 72.13% specificity when≤0.524 2 μg/L was chosen as the optimal cutoff value. The AUC of a combined prediction model (serum CTRP3 ratio in combination with age, pre-pregnancy BMI, FPG and HbA_1c) in predicting GDM was 0.841〔95%CI (0.799, 0.877) 〕, with 69.14% sensitivity and 89.20% specificity when 0.315 0 was chosen as the optimal cutoff value. The AUC of the combined prediction model was greater than that of serum CTRP3 ratio (Z=5.634, P<0.001) .

Conclusion

Increased serum CTRP3 ratio may be associated with lowered risk of GDM, so it could be used as an independent predictor for GDM in early pregnancy. Furthermore, its combined use with maternal demographic and metabolic indicators may produce a better predictive value for GDM in early pregnancy.

Characteristics of Metabolic Calorific Values Measured by Infrared Thermal Imaging in Female Adults with Hashimoto's Thyroiditis: an Exploratory Analysis

Qian YANG, Hua LU, Qianchen LIU

2022, 25(18):  2255-2261.  DOI: 10.12114/j.issn.1007-9572.2021.02.121

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Background

Hashimoto's thyroiditis (HT) is an autoimmune disease, and a major cause of hypothyroidism. Due to its insidious nature, non-presence of clear clinical symptoms, there is often a delay in getting a diagnosis for HT, which leads to irreversible damage. Therefore, early screening and improving diagnostic accuracy are essential to the treatment of HT. There are few studies on the application of infrared thermal imaging technology as an auxiliary diagnostic tool for HT.

Objective

To explore the features of metabolic calorific values measured by infrared thermal imaging in female adults with HT.

Methods

Participants were recruited from the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from April 2019 to June 2021, including 100 adult gynecological outpatients with HT, and 100 healthy, adult female physical examinees. Both groups completed the Classification and Determination of Constitution in TCM (ZYYXH/T157-2009) for assessing the constitution in TCM. Thyroid function test was performed to understand levels of thyroid function parameters〔thyroglobulin antibody (TGAb) , thyroid peroxidase antibody (TPOAb) , thyroid-stimulating hormone (TSH) , free triiodothyronine (FT₃) , free thyroxine (FT₄) 〕. Full body thermography using infrared thermal imaging was implemented to examine the calorific values of the left and right lobes of the thyroid gland, the uterus, the Shenque acupoint and the Governor vessel. The aforementioned parameters were compared between HT patients and physical examinees to identify intergroup differences. The calorific values of thyroid left and right lobes, the uterus, the Shenque acupoint and the Governor vessel were compared across HT patients with 9 types of constitution in TCM, and the associations of them with thyroid function parameters were explored, then their associations with infertility in HT were evaluated using binary logistic regression analysis.

Results

The top 4 types of constitution in TCM in HT patients were yang-deficiency, qi-stagnation, damp-heat, and phlegm-dampness. The calorific values of Shenque acupoint and the Governor vessel varied significantly across HT patients by types of constitution (n=9) in TCM (P<0.05) . Compared with the control group, the levels of TGAb, TPOAb and TSH in HT group increased (P<0.05) . There was no significant difference in FT₃ and FT₄ levels between the two groups (P>0.05) . HT patients had higher calorific values of thyroid left and right lobes and lower calorific values of the uterus, Shenque acupoint and the Governor vessel than physical examinees (P<0.05) . In the HT group, the calorific value of the left or right lobe of the thyroid gland was positively correlated with TGAb (r_s=0.260, 0.198, P<0.05) , and the calorific value of the uterus was negatively correlated with TSH (r_s=-0.313, P<0.05) . The calorific values of the uterus〔OR=0.413, 95%CI (0.180, 0.945) 〕, the Governor vessel〔OR=0.270, 95%CI (0.075, 0.971) 〕, and the Shenque acupoint〔OR=0.264, 95%CI (0.073, 0.954) 〕were associated with infertility in HT (P<0.05) .

Conclusion

In adult female HT patients, the most common four types of constitution in TCM were yang-deficiency, qi-stagnation, damp-heat, and phlegm-dampness. The metabolic calorific values measured by infrared thermal imaging were featured by higher values of thyroid left and right lobes, and lower values of the uterus, Shenque acupoint and the Governor vessel, which may be new theoretical evidence obtained from clinical practice explaining infertility in HT. Furthermore, the calorific values of thyroid left and right lobes could be used as parameters for early screening or identifying HT. So infrared thermal imaging could be used as an auxiliary diagnostic tool to improve the diagnostic efficiency of HT.

Expression of Programmed Death Ligand 1 and Density of CD₈⁺ Tumor-infiltrating T-lymphocytes in Gastric Cancer Tissues and Their Relationship with Clinicopathological Characteristics and Prognosis of Patients with Gastric Cancer

Like ZHANG, Lei MA, Fangyu SHI, Quanxiao XU

2022, 25(18):  2262-2267.  DOI: 10.12114/j.issn.1007-9572.2021.02.080

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Background

At present, whether the expression of programmed death ligand 1 (PD-L1) and the density of CD₈⁺ tumor-infiltrating T lymphocytes (TILs) in gastric cancer tissue can be used as prognostic indicators for gastric cancer patients has been still unclear.

Objective

To analyze the expression of PD-L1 and density of CD8+ TILs in gastric cancer tissues and their relations with clinicopathological characteristics and prognosis of patients with gastric cancer.

Methods

A total of 125 gastric cancer patients underwent surgical treatment in Nanyang First People's Hospital from January 2016 to March 2018 were selected, and the expression level of PD-L1 mRNA in gastric cancer tissue was detected by real-time fluorescence quantitative polymerase chain reaction, the density of CD₈⁺ TILs in gastric cancer tissue was detected by immunohistochemical methods. The relations of the relative expression quantity of PD-L1 mRNA and the density of CD₈⁺ TILs in gastric cancer tissue with the clinicopathological characteristics of patients with gastric cancer was analyzed; the correlation between the relative expression quantity of PD-L1 mRNA and the density of CD₈⁺ TILs in gastric cancer tissue was analyzed by Pearson correlation analysis; telephone follow-up was conduct till to 36 months after operation, taking death or loss to follow-up as outcome event, Kaplan-Meier survivorship curve was drawn to conduct survival analysis; univariate and multivariate Cox regression analysis was used to analyze the influencing factors of prognosis of gastric cancer patients.

Results

The average relative expression quantity of PD-L1 mRNA was 3.1 in gastric cancer tissue, the average number of CD₈⁺ TILs was 36 in cancer nests, thus the 125 patients were divided into low-level group (with relative expression quantity of PD-L1 mRNA less than 3.1, n=73) , high-level group (with relative expression quantity of PD-L1 mRNA equal or over 3.1, n=52) , low-density group (with number of CD₈⁺ TILs less than 31, n=55) and high-density group (with number of CD₈⁺ TILs equal or over 31, n=70) . There were significant differences in lymph node metastasis, vascular invasion and peritoneal metastasis between the the low-level group and high-level group (P<0.05) , so as in depth of infiltration, incidence of lymphatic metastasis, vascular invasion and peritoneal metastasis between the the low-density group and high-density group (P<0.05) . Pearson correlation analysis showed that the relative expression quantity of PD-L1 mRNA was negatively correlated with density of CD₈⁺ TILs in gastric cancer tissue (r=-0.412, P<0.001) . We found 88 cases with good prognosis and 37 cases with poor prognosis, with the medium time of follow-up of 36 months; there was significant difference in Kaplan-Meier curve between low-level and high-level groups, low-density and high-density groups, respectively (P<0.05) . Multivariate Cox regression analysis showed that high-level PD-L1 mRNA〔HR=3.021, 95%CI (1.632, 5.045) 〕and low-density CD₈⁺ TILs〔HR=2.158, 95%CI (1.854, 4.632) 〕were independent risk factors of poor prognosis of patients with gastric cancer (P<0.05) .

Conclusion

High level of PD-L1 mRNA and low density of CD₈⁺ TILs are independent risk factors of poor prognosis in gastric cancer patients, which are expected to be biomarkers for poor prognosis in gastric cancer patients.

Maternal Physical Activity in the Third Trimester and Delayed Onset of Lactogenesis

Jingjing ZHAO, Yuhong LI, Min YU, Fangfang YANG, Qiaozhi YU, Xiaoyue WANG, Sisi BU, Peipei LIAO

2022, 25(18):  2268-2274.  DOI: 10.12114/j.issn.1007-9572.2022.0070

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Background

Delayed onset of lactogenesis (DOL) is an important cause of failed lactation. Excessive gestational weight gain and postpartum depression will increase the risk of DOL, but appropriate physical activity (PA) during pregnancy may effectively prevent excessive gestational weight gain, improve postpartum negative mood, benefiting breastfeeding. However, the relationship between PA during pregnancy and DOL is still unclear.

Objective

To investigate the PA level in the third trimester and its association with DOL, providing a basis for early prevention of DOL and ensuring breastfeeding success.

Methods

A prospective study design was adopted. Participants were women in their third trimester who underwent prenatal examination and later delivery in the 901 Hospital, Joint Logistic Support Force of the Chinese People's Liberation Army, from December 2020 to August 2021. General information (including demographic and obstetric data) , PA and sedentary behaviour time (evaluated by the International Physical Activity Questionnaire-Short Form) , postpartum depression (evaluated by the Edinburgh Postnatal Depression Scale) , and DOL were investigated and collected. Unconditional Logistic regression analysis was used to explore the relationship between PA level in the third trimester and DOL.

Results

A total of 261 cases were selected, and 247 of them (94.7%) who returned responsive questionnaires were finally enrolled. The prevalence of DOL was 27.9% (69/247) . Respondents with and without DOL had significant differences in gestational weight gain, depression prevalence, and prevalence of infant formula feeding within 48 hours after delivery (P<0.1) . The prevalence of having appropriate and inappropriate PA in the third trimester was 73.3% (181/247) and 26.7% (66/247) , respectively. The prevalence of duration of sedentariness ≥6.5 h/d was 15.8% (39/247) . Respondents with DOL had lower prevalence of having appropriate PA, and higher prevalence of duration of sedentariness ≥6.5 h/d than did those without (P<0.05) . Unconditional Logistic regression analysis showed that inappropriate PA level 〔OR=0.421, 95%CI (0.223, 0.797) 〕 and longer duration of sedentariness ≥6.5 h/d〔OR=0.193, 95%CI (0.090, 0.414) 〕 in the third trimester were associated with increased risk of DOL (P<0.05) .

Conclusion

Inappropriately increasing the level of PA during pregnancy and reducing the duration of sedentariness per day could reduce the risk of DOL and effectively improve the rate of successful breastfeeding.

Risk Factors for Adverse Neurodevelopment Outcomes in Neonates with Necrotizing Enterocolitis

Zhenzhen JUE, Juan SONG, Xiangmin ZHANG, Han ZHANG, Huimin DONG, Wendong LI, Falin XU

2022, 25(18):  2275-2279.  DOI: 10.12114/j.issn.1007-9572.2022.0119

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Background

Neonatal necrotizing enterocolitis (NEC) adversely affects the long-term neurodevelopmental outcomes of preterm infants. However, few studies concerning the risk factors for neurodevelopmental outcomes in preterm infants with NEC have been conducted.

Objective

To investigate the risk factors for adverse neurodevelopmental outcomes of NEC in preterm infants.

Methods

Preterm infants diagnosed with stageⅡ toⅢ NEC in Department of Neonatology, the Third Affiliated Hospital of Zhengzhou University from January 2019 to June 2020 were included. General conditions and neonatal complications of the infants, as well as pregnancy-related complications of the mothers were obtained. All infants were followed up to a corrected age of 12 months, at which the neurodevelopmental outcome was evaluated by the Bayley Scales of Infant Development Ⅲ (BSID-Ⅲ) , and in accordance with the evaluation results, the infants were divided into a normal group and an adverse neurodevelopment outcome group. Multivariate Logistic regression analysis was performed to investigate the risk factors for adverse neurodevelopmental outcomes.

Results

Of the 236 infants included, 23 died, and 13 were lost to follow up, the other 200 cases who completed the follow-up were finally included for analysis, including 21 (10.5%) with neurodevelopmental disorders (adverse neurodevelopmental outcome group) , and 179 (89.5%) with normal neurodevelopmental outcome (normal group) . Compared with infants with normal neurodevelopmental outcome, those with neurodevelopmental disorders had lower mean birth weight, and higher incidence of sepsis, intestinal perforation, and short bowel syndrome (P<0.05) . Univariate analysis revealed that, compared to infants with normal neurodevelopmental outcome, those with neurodevelopmental disorders had lower mean birth weight, and higher incidence of sepsis, bowel perforation and short bowel syndrome (P<0.05) . Multivariate Logistic regression analysis indicated that birth weight <1 000 g〔OR=4.603, 95%CI (1.220, 17.365) , P=0.024〕, sepsis〔OR=4.401, 95%CI (1.191, 16.262) , P=0.026〕and bowel perforation〔OR=5.239, 95%CI (1.522, 18.029) , P=0.009〕were independently associated with increased risk factor of adverse neurodevelopmental outcomes.

Conclusion

Birth weight less than 1 000 g, sepsis and bowel perforation may be risk factors for adverse neurodevelopmental outcomes in preterm infants with NEC, which should be significantly valued by newborn pediatricians for the prevention or early identification of NEC, thereby reducing the rate of NEC-caused disabilities.

Effect and Mechanism of Action of Acupoint Injection of Puerarin on Myocardial Mitochondria Energy Metabolism in Bupivacaine-poisoned Rats

Yan YU, Chunai WANG, Xiaoyu QIN, Yulan LI, Xi LIANG, Xiaohui WEN, Min LIU

2022, 25(18):  2280-2285.  DOI: 10.12114/j.issn.1007-9572.2021.02.143

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Background

There is no safe and effective antidote for cardiotoxicity induced by bupivacaine, an extensively used anaesthetic. Our previous research shows that acupoint treatment may partially improve bupivacaine-induced cardiotoxicity, but the mechanism of action needs to be further studied.

Objective

To observe the effect of acupoint injection of puerarin on mitochondrial energy metabolism in myocardia in bupivacaine-poisoned rats, and to explore its mechanism of action.

Methods

This experiment was conducted from January to December 2019. Forty 6-month-old male SPF Wistar rats were selected and equally randomized into a blank group (group C) , a model group (group B) , a treatment group (group T) , and a prevention group (group P) . Interventions were given to the groups as follows: Group P received: 0.1 ml puerarin injection injected into bilateral Neiguan acupoints. Then 5 minutes later, bupivacaine-poisoned model was established for three groups (except for group C) using intravenous infusion of 0.5% bupivacaine (10 mg/kg) via femoral vein within 2 minutes. Group C received 0.1 ml of 0.9% sodium chloride solution injected into bilateral Neiguan acpoints. : Immediately after successful modeling, 0.1 ml of 0.9% sodium chloride solution was injected into bilateral Neiguan acupoints for group B, and: 0.1 ml puerarin injection was injected into bilateral Neiguan points for C. The rats in group C were sacrificed at the 8th minute of intravenous infusion of 0.9% sodium chloride solution, and those in groups B, T, and P were sacrificed at the 8th minute of intravenous infusion of bupivacaine, then the left ventricular myocardium of all rats were taken out and cardiomyocyte mitochondria were isolated, the structure of which was observed under the transmission electron microscope. The semi-quantitative analysis of mitochondrial structure was evaluated by Flameng classification system. The activity of mitochondrial adenosine triphosphate synthase (ATPase) was measured by ELISA. The content of adenosine triphosphate (ATP) was measured by colorimetric assay. The mitochondrial membrane potential (MMP) was detected by JC-1 fluorescence staining and colorimetry. The protein levels of myocardial mitochondrial peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) , nuclear respiratory factor 1 (NRF1) , and mitochondrial transcription factor A (mtTFA) were measured by Western blotting.

Results

Group C had lower Flameng score than did other three groups (P<0.05) . The Flameng score in group P was lower than that of groups B and T (P<0.05) . Group C had lower activity of ATPase than did groups B and T (P<0.05) . The activity of ATPase in group P was higher than that in groups B and T (P<0.05) . Group C had higher ATP content and MMP, and protein levels of PGC-1α, NRF1 and mtTFA than did other three groups (P<0.05) . Group B had lower ATP content, MMP, and PGC-1α protein level than did groups T and P (P<0.05) . Group B had lower protein level of mtTFA than did groups T and P (P<0.05) . The protein level of mtTFA in group P was higher than that in group T (P<0.05) .

Conclusion

Acupoint injection of puerarin could reduce the damage of myocardial mitochondria caused by bupivacaine, and its mechanism of action may be related to puerarin's protection of mitochondrial energy metabolism by regulating the content of ATP synthesis-related proteins PGC-1α, NRF1 and mtTFA in mitochondria.

Clinical Efficacy of Compound Daxueteng Enema plus Dydrogesterone in Post-laparoscopic Adenomyosis Patients with Blood Stasis-heat Syndrome

Pian YING, Jiaxi WANG, Huadi YANG, Li XU, Shenyi LU, Yanping WU

2022, 25(18):  2286-2290.  DOI: 10.12114/j.issn.1007-9572.2021.02.122

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Background

Adenomyosis is a difficult-to-treat gynecological disease with unclear pathogenesis, individualized treatment for which is extensively valued, and the integrated traditional Chinese and western medicine treatment has been proven to have unique benefits merits.

Objective

To examine the clinical efficacy of compound Daxueteng enema plus dydrogesterone for post-laparoscopic adenomyosis patients with blood stasis-heat syndrome.

Methods

Participants (n=46) were selected from Zhejiang Provincial Hospital of Chinese Medicine during January 2019 to August 2020. All of them received laparoscopic surgery, and were diagnosed with adenomyosis by pathological examination of the surgical specimen, and with blood stasis-heat syndrome by TCM syndrome differentiation. For comparing the effects of two types of postsurgical treatments lasting for three months, they were randomized into a control group (n=22) and a treatment group (n=24) , receiving oral dydrogesterone, and oral dydrogesterone plus compound Daxueteng enema, respectively. TCM syndrome score, pain level (VAS score) , menstrual blood loss (PBAC score) , uterine volume, ovarian function parameters and serum CA125 were measured at baseline and the end of the three-month treatment. The overall efficacies of two groups were assessed at the end of treatment, and one year after the treatment, respectively.

Results

The treatment group had statistically higher overall three-month efficacy than the control group (u=2.140, P=0.032) . TCM syndrome score of the treatment group were lower than the control group (P<0.05) . After treatment, the VAS score, PBAC score uterine volume, LH, E2 and CA125 showed a statistical decrease in both groups (P<0.05) . And the VAS score, uterine volume, demonstrated decreases, LH and CA125 demonstrated better improvements in the treatment group than the control group (P<0.05) . One-year post-treatment follow-up revealed that treatment group and control group had no statistically significant differences in recurrence rate〔20.8% (5 cases) vs 45.5% (10 cases) 〕 (χ²=3.166, P>0.05) , and pregnancy rate〔8.3% (2 cases) vs 9.1% (2 cases) 〕 (χ²=0.008, P>0.05) .

Conclusion

Oral dydrogesterone plus compound Daxueteng enema may be superior to oral dydrogesterone alone for post-laparoscopic adenomyosis patients with blood stasis-heat syndrome.

Rosuvastatin Calcium with Metformin Improves Kidney Function in a Rat Model of Diabetes by Regulating the Expression of Glucose Transporter 4

Gechu SHANG, Xiaoyong WANG, Yan GAO

2022, 25(18):  2291-2296.  DOI: 10.12114/j.issn.1007-9572.2022.0039

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Background

Rosuvastatin calcium with metformin improves diabetic renal injury, but the mechanism is not yet fully understood.

Objective

To explore the mechanism of action of rosuvastatin calcium with metformin improving renal injury in a rat model of streptozotocin (STZ) -induced type 2 diabetes mellitus (T2DM) .

Methods

Forty clean grade Wistar rats were equally randomized into a control group (group C) , a metformin group (group M) , a metformin+low-dose rosuvastatin calcium group (group M+RL) , and a metformin+high-dose rosuvastatin calcium group (group M+RH) from July to October 2021. T2DM model was established for three groups (except for group C) using intraperitoneal injection of STZ. Then drug was administered by intragastric administration to the groups as follows: equal amount of 0.9% sodium chloride solution for group C, metformin (200 mg·kg^-1·d^-1) for group M, metformin (200 mg·kg^-1·d^-1) suspension+rosuvastatin calcium (0.42 mg·kg^-1·d^-1) for group M+RL, and metformin (200 mg·kg^-1·d^-1) suspension+rosuvastatin calcium (0.83 mg·kg^-1·d^-1) for group M+RH. Rats were sacrificed after 6 weeks of intervention, while their blood and kidney tissues were collected. The extent of injury of kidney tissues was observed under light microscope after being stained with H&E, and was analyzed using Image-Pro Plus 6.0 after being stained with periodic-acid schiff, and Masson's trichrome, respectively. The expression of glucose transporter 4 (GLUT4) mRNA in the renal tissue was measured by real-time polymerase chain reaction (PCR) , and the protein levels of GLUT4 were detected by Western-blotting.

Results

Compared with group C, the glomerulus of rats in other three groups showed significant structural damage, accompanied by inflammatory cell infiltration and interstitial fibrosis. Moreover, mRNA expression levels of GLUT4 in these groups were significantly lowered (P<0.05) . Furthermore, the protein levels of GLUT4 in groups M and M+RL were lowered notably (P<0.05) . The mRNA and protein expression levels of GLUT4 in group M+RL or M+RH were higher than those of group M (P<0.05) . In addition, the mRNA and protein expression levels of GLUT4 in M+RH group were higher than those in M+RL group (P<0.05) .

Conclusion

Rosuvastatin calcium with metformin could reduce inflammatory cell infiltration in glomerular and tubular, alleviate glomerular basement membrane thickening and tubular vacuolar degeneration, delay the interstitial fibrosis development, and increase GLUT4 mRNA and GLUT4 protein expression in STZ-induced T2DM rats. Moreover, higher dose of rosuvastatin calcium showed better effect. Our study indicated that rosuvastatin calcium combined with metformin may achieve a renoprotective effect by regulating the expression of GLUT4 mRNA and protein in T2DM rats, and this effect may be enhanced with the increase in the dose of rosuvastatin calcium.

Cutting Edge

New Research Progress of a New Auxiliary Antihypertensive Model Targeting Intestinal Flora

Xiaojun HUANG, Jin YANG, Yaqimei LEI, Zhijie ZENG, Zhaohui JIN

2022, 25(18):  2297-2302.  DOI: 10.12114/j.issn.1007-9572.2022.02.023

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As an important part of the internal environment of human, intestinal flora participates in and regulates the immune inflammatory response and metabolic process of the body. It is closely related to the occurrence and development of hypertension, and has become the focus of research on hypertension. The thesis summarizes the relationship between intestinal flora and hypertension, then clarifies their effects and possible mechanisms on hypertension in terms of inflammation and immune response, brain-intestine-bone marrow axis and metabolites, focusing on the new auxiliary antihypertensive pathways that dietary intervention affects intestinal flora to improve blood pressure from salt, probiotics and polyphenols. It is hoped that more in-depth research will come out on improving hypertension through dietary intervention and Chinese herbal medicine prevention and treatment with intestinal flora as the target.

Application Research Progress of Continuous Blood Glucose Monitoring System in Patients with Gestational Diabetes Mellitus

Yuan GAO, Min ZHOU

2022, 25(18):  2302-2306.  DOI: 10.12114/j.issn.1007-9572.2022.0040

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The "Decision of the Central Committee of the Communist Party of China and the State Council on Optimizing the Fertility Policy to Promote the Long-term Balanced Development of the Population" issued in June 2021made a major decision to implement the three-child policy, and the number of pregnant women will increase significantly. As one of the common complications during pregnancy, gestational diabetes seriously affects the health of pregnant women and fetuses. Continuous blood glucose monitoring has been called "the road map for effective self-management" and is critical in the management of blood glucose in people with gestational diabetes. This article reviews the development of continuous blood glucose monitoring and its application and impact in patients with gestational diabetes, in order to promote the clinical application of continuous blood glucose monitoring, encourage patients with gestational diabetes to participate in diabetes response and improve accurate blood glucose management.