<strong>Background</strong><span><strong>:</strong></span><span> With the rising prevalence in recent years, gestational diabetes mellitus has become one of the leading causes...<strong>Background</strong><span><strong>:</strong></span><span> With the rising prevalence in recent years, gestational diabetes mellitus has become one of the leading causes of maternal and child mortality and morbidity worldwide and has raised health concern. It is seriously detrimental to both the women and fetuses. However, there are limited evidences of two types of gestational diabetes mellitus on clinical characteristics and outcomes.</span><span> </span><span>Therefore, this study was aimed to explore the clinical characteristics and outcomes of patients with overt diabetes mellitus</span><span> </span><span>(ODM) and gestational diabetes mellitus</span><span> </span><span><span>(GDM) at the late pregnancy. </span><b><span>Methods</span></b></span><b><span>:</span></b><span> From January 2015 to August 2016, totally 63 gestational diabetes mellitus from the Department of Clinical Nutrition in Beijing Anzhen Hospital were enrolled in the study.</span><span> </span><span>Patients were classified into two groups.</span><span> </span><span>31 patients with gestational overt diabetes mellitus were grouped into ODM group and 32 patients with gestational diabetes mellitus were grouped into GDM group.</span><span> </span><span>Clinical characteristics and outcomes were compared between ODM and GDM.</span><span> </span><span>We collected records of the age, gestational week, family history, past history, pregnancy complications, insulin use,</span><span> </span><span>blood pressure, clinical nutrition indexes, blood pressure.</span><span> </span><span>Glycosylated hemoglobin</span><span> </span><span>(HbA1c), fasting blood glucose</span><span> </span><span>(FBG), total protein</span><span> </span><span>(TP),</span><span> </span><span>albumin</span><span> </span><span>(ALB), prealbumin</span><span> </span><span>(PALB), hemoglobin</span><span> </span><span>(HGB),</span><span> </span><span>urea nitrogen</span><span> </span><span>(BUN), serum creatinine</span><span> </span><span>(CREA), and dynamic blood glucose monitoring were measured.</span><span> </span><span><span>And we recorded the changes of blood glucose and the test data. We statistically analyzed the data of two groups. </span><b><span>Results</span></b></span><b><span>:</span></b><b><span> </span></b><span>In the ODM group,</span><span> </span><span>HbA1c, FBG, average blood glucose,</span><span> </span><span>two-hour postprandial blood glucose</span><span> </span><span>(2hPBG) after breakfast, 2hPBG after dinner, the number of hyperglycemic events and high blood glucose time ratio are significantly higher than th</span><span>ose</span><span> of GDM and two groups compared with statistical significance</span><span> </span><span>(P</span><span> </span><span><</span><span> </span><span>0.05)</span><span>. </span><span>The number of patients treated with insulin</span><span> </span><span>(10/31) in ODM is significantly more than that in GDM</span><span> </span><span>(1/32) (P</span><span> </span><span><</span><span> </span><span>0.05).</span><span> </span><span>45%</span><span> </span><span>(14/31) of ODM have a family history of diabetes patients.</span><span> </span><span>The ratio is significantly higher than 13%</span><span> </span><span>(4/32) of GDM</span><span> </span><span>(P</span><span> </span><span><</span><span> </span><span>0.05).</span><span> </span><span>There was significant difference in urinary ketone positive rate between the two groups</span><span> </span><span>(P</span><span> </span><span><</span><span> </span><span>0.05), but there was no significant difference in urinary microalbumin abnormal rate between them</span><span> </span><span>(P</span><span> </span><span>></span><span> </span><span>0.05).</span><span> </span><span>The number of preeclampsia in ODM</span><span> </span><span>(8/31) is significantly higher than that of GDM (P</span><span> </span><span><</span><span> </span><span>0.05).</span><span> </span><span>The level of HGB in ODM is lower than that of GDM</span><span> </span><span>(P</span><span> </span><span><</span><span> </span><span>0.05). There was no difference in the pregnancy outcomes between the two groups.</span><span> </span><b><span>Conclusion</span></b><b><span>:</span></b><span> Late pregnancy women with ODM have obvious family history, higher HbA1c, higher FBG, higher glucose levels of two-hours after breakfast and dinner,</span><span> </span><span>higher average blood glucose, longer hypoglycemia time, higher probability of hyperglycemic events and greater opportunity to use insulin in the treatment of symptomatic patients,</span><span> </span><span>higher risk of preeclampsia,</span><span> </span><span>lower HGB level than GDM,</span><span> </span><span>while GDM ha</span><span>s</span><span> higher positive rate of urine ketone than ODM.</span>展开更多
Aim:To study the clinical effect and safety of iron supplementation in the treatment of mild thalassemia complicated by iron deficiency in late pregnancy.Methods:376 patients with mild thalassemia complicated by iron ...Aim:To study the clinical effect and safety of iron supplementation in the treatment of mild thalassemia complicated by iron deficiency in late pregnancy.Methods:376 patients with mild thalassemia complicated by iron deficiency in late pregnancy treated in our hospital from July 2019 to June 2021 were selected and recruited in the research group,and 200 normal pregnant women treated in the same period were selected and recruited in the control group.Hemoglobin(Hb),reticulocyte blood,red blood protein(RET he)level,ferritin(SF)level,soluble transferrin receptor(sTfR)level,adverse maternal and infant outcomes,etc.were analyzed.Results:There was no significant difference in the levels of SF,Hb,RET he and sTfR between the two groups before treatment.After treatment,the levels of SF,Hb,RET he and sTfR in the research group were significantly improved,which was statistically significant compared with the control group.The frequencies of intrapartum hemorrhage,premature delivery,stillbirth,hemorrhagic shock,and neonatal asphyxia in the research group were 289±47.88,36(9.57%),0(0.00%),25(6.65%),and 6(1.26%),respectively.The frequencies of intrapartum hemorrhage,premature delivery,stillbirth,hemorrhagic shock,and neonatal asphyxia in the control group were 284±46.99,7(3.50%),0(0.00%),6(3.00%),and 0(0.00%),respectively.There were significant differences in preterm delivery and hemorrhagic shock,and there was no significant difference in other delivery outcomes.Conclusions:Under the premise of strictly controlling the iron reserve in pregnant women,continuous medication until the end of delivery may be conducive to the control of maternal thalassemia complicated by iron deficiency and the improvement of pregnancy outcome.展开更多
Background:Large-for-gestational age(LGA)newborns can increase the risk of metabolic syndrome.Previous studies have shown that the levels of maternal blood lipids,connecting peptide(C-peptide),insulin and glycosylated...Background:Large-for-gestational age(LGA)newborns can increase the risk of metabolic syndrome.Previous studies have shown that the levels of maternal blood lipids,connecting peptide(C-peptide),insulin and glycosylated hemoglobin(HbA_(1c))were significantly different between LGA and appropriate-for-gestational age(AGA)newborns.This study aimed to determine the effect of the levels of maternal lipids,C-peptide,insulin,and HbA_(1c) during late pregnancy on LGA newborns.Methods:This study comprised 2790 non-diabetic women in late pregnancy.Among their newborns,2236(80.1%)newborns were AGA,and 554(19.9%)newborns were LGA.Maternal and neonatal characteristics were obtained from questionnaires and their case records.The levels of maternal fasting serum apolipoprotein A1(ApoA1),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),C-peptide,insulin and blood HbA_(1c) were measured.The chi-square and Mann-Whitney U test were used to analyze categorical variables and continuous variables between the AGA and LGA groups,respectively.Binary logistic regression analysis was made to determine the independent risk factors for LGA newborns.Results:Maternal TG,C-peptide,insulin and HbA_(1c) levels were signifi cantly higher in the LGA group than in the AGA group(P<0.05).The LGA group had signifi cantly lower levels of maternal TC,HDL-C and LDL-C than the AGA group(P<0.05).After adjustment for confounding variables,including maternal age,pre-pregnancy body mass index,education,smoking,annual household income,amniotic fluid volume,gestational hypertension,newborn gender and gestational age at blood collection,high maternal TG levels remained signifi cantly associated with LGA newborns(P<0.05).Conclusion:High maternal TG level during late pregnancy is signifi cantly associated with LGA newborns.展开更多
To summarize a case of late pregnancy complicated with acute Stanford type A aortic dissection who underwent multidisciplinary treatment perioperative nursing experience in emergency surgery. The patient was 37weeks o...To summarize a case of late pregnancy complicated with acute Stanford type A aortic dissection who underwent multidisciplinary treatment perioperative nursing experience in emergency surgery. The patient was 37weeks of intrauterine pregnancy and suffered from sudden chest pain. The emergency admission was diagnosed with aortic dissection(Stanford A type), and the condition was dangerous and life-threatening. After preoperative multidisciplinary combined systematic comprehensive disease assessment and comprehensive surgical emergency plan was formulated, do a good job of effective psychological counseling and operation cooperation education,nursing cooperation during intraoperative anesthesia and nursing focus of multidisciplinary combined surgical treatment, postoperative prevention of massive bleeding, puerperium infection and a series of effective nursing measures, no perioperative period occurred nursing complications. The newborn survived, the patient recovered and was discharged from the hospital, and returned to the hospital for re-examination with normal indicators and good physical condition.展开更多
文摘<strong>Background</strong><span><strong>:</strong></span><span> With the rising prevalence in recent years, gestational diabetes mellitus has become one of the leading causes of maternal and child mortality and morbidity worldwide and has raised health concern. It is seriously detrimental to both the women and fetuses. However, there are limited evidences of two types of gestational diabetes mellitus on clinical characteristics and outcomes.</span><span> </span><span>Therefore, this study was aimed to explore the clinical characteristics and outcomes of patients with overt diabetes mellitus</span><span> </span><span>(ODM) and gestational diabetes mellitus</span><span> </span><span><span>(GDM) at the late pregnancy. </span><b><span>Methods</span></b></span><b><span>:</span></b><span> From January 2015 to August 2016, totally 63 gestational diabetes mellitus from the Department of Clinical Nutrition in Beijing Anzhen Hospital were enrolled in the study.</span><span> </span><span>Patients were classified into two groups.</span><span> </span><span>31 patients with gestational overt diabetes mellitus were grouped into ODM group and 32 patients with gestational diabetes mellitus were grouped into GDM group.</span><span> </span><span>Clinical characteristics and outcomes were compared between ODM and GDM.</span><span> </span><span>We collected records of the age, gestational week, family history, past history, pregnancy complications, insulin use,</span><span> </span><span>blood pressure, clinical nutrition indexes, blood pressure.</span><span> </span><span>Glycosylated hemoglobin</span><span> </span><span>(HbA1c), fasting blood glucose</span><span> </span><span>(FBG), total protein</span><span> </span><span>(TP),</span><span> </span><span>albumin</span><span> </span><span>(ALB), prealbumin</span><span> </span><span>(PALB), hemoglobin</span><span> </span><span>(HGB),</span><span> </span><span>urea nitrogen</span><span> </span><span>(BUN), serum creatinine</span><span> </span><span>(CREA), and dynamic blood glucose monitoring were measured.</span><span> </span><span><span>And we recorded the changes of blood glucose and the test data. We statistically analyzed the data of two groups. </span><b><span>Results</span></b></span><b><span>:</span></b><b><span> </span></b><span>In the ODM group,</span><span> </span><span>HbA1c, FBG, average blood glucose,</span><span> </span><span>two-hour postprandial blood glucose</span><span> </span><span>(2hPBG) after breakfast, 2hPBG after dinner, the number of hyperglycemic events and high blood glucose time ratio are significantly higher than th</span><span>ose</span><span> of GDM and two groups compared with statistical significance</span><span> </span><span>(P</span><span> </span><span><</span><span> </span><span>0.05)</span><span>. </span><span>The number of patients treated with insulin</span><span> </span><span>(10/31) in ODM is significantly more than that in GDM</span><span> </span><span>(1/32) (P</span><span> </span><span><</span><span> </span><span>0.05).</span><span> </span><span>45%</span><span> </span><span>(14/31) of ODM have a family history of diabetes patients.</span><span> </span><span>The ratio is significantly higher than 13%</span><span> </span><span>(4/32) of GDM</span><span> </span><span>(P</span><span> </span><span><</span><span> </span><span>0.05).</span><span> </span><span>There was significant difference in urinary ketone positive rate between the two groups</span><span> </span><span>(P</span><span> </span><span><</span><span> </span><span>0.05), but there was no significant difference in urinary microalbumin abnormal rate between them</span><span> </span><span>(P</span><span> </span><span>></span><span> </span><span>0.05).</span><span> </span><span>The number of preeclampsia in ODM</span><span> </span><span>(8/31) is significantly higher than that of GDM (P</span><span> </span><span><</span><span> </span><span>0.05).</span><span> </span><span>The level of HGB in ODM is lower than that of GDM</span><span> </span><span>(P</span><span> </span><span><</span><span> </span><span>0.05). There was no difference in the pregnancy outcomes between the two groups.</span><span> </span><b><span>Conclusion</span></b><b><span>:</span></b><span> Late pregnancy women with ODM have obvious family history, higher HbA1c, higher FBG, higher glucose levels of two-hours after breakfast and dinner,</span><span> </span><span>higher average blood glucose, longer hypoglycemia time, higher probability of hyperglycemic events and greater opportunity to use insulin in the treatment of symptomatic patients,</span><span> </span><span>higher risk of preeclampsia,</span><span> </span><span>lower HGB level than GDM,</span><span> </span><span>while GDM ha</span><span>s</span><span> higher positive rate of urine ketone than ODM.</span>
文摘Aim:To study the clinical effect and safety of iron supplementation in the treatment of mild thalassemia complicated by iron deficiency in late pregnancy.Methods:376 patients with mild thalassemia complicated by iron deficiency in late pregnancy treated in our hospital from July 2019 to June 2021 were selected and recruited in the research group,and 200 normal pregnant women treated in the same period were selected and recruited in the control group.Hemoglobin(Hb),reticulocyte blood,red blood protein(RET he)level,ferritin(SF)level,soluble transferrin receptor(sTfR)level,adverse maternal and infant outcomes,etc.were analyzed.Results:There was no significant difference in the levels of SF,Hb,RET he and sTfR between the two groups before treatment.After treatment,the levels of SF,Hb,RET he and sTfR in the research group were significantly improved,which was statistically significant compared with the control group.The frequencies of intrapartum hemorrhage,premature delivery,stillbirth,hemorrhagic shock,and neonatal asphyxia in the research group were 289±47.88,36(9.57%),0(0.00%),25(6.65%),and 6(1.26%),respectively.The frequencies of intrapartum hemorrhage,premature delivery,stillbirth,hemorrhagic shock,and neonatal asphyxia in the control group were 284±46.99,7(3.50%),0(0.00%),6(3.00%),and 0(0.00%),respectively.There were significant differences in preterm delivery and hemorrhagic shock,and there was no significant difference in other delivery outcomes.Conclusions:Under the premise of strictly controlling the iron reserve in pregnant women,continuous medication until the end of delivery may be conducive to the control of maternal thalassemia complicated by iron deficiency and the improvement of pregnancy outcome.
基金supported by grants from the"11th Five-Year Plan"and the"12th Five-Year Plan"from the National Science and Technology Issues Research,China(2009BAI80B03,2012BAI02B03)the Innovation Program for Early Screening and Intervention of Birth Defects,Zhejiang Province(2010R50045)the National Key Scientifi c Research Projects of China(973 Program)(2012CB944900).
文摘Background:Large-for-gestational age(LGA)newborns can increase the risk of metabolic syndrome.Previous studies have shown that the levels of maternal blood lipids,connecting peptide(C-peptide),insulin and glycosylated hemoglobin(HbA_(1c))were significantly different between LGA and appropriate-for-gestational age(AGA)newborns.This study aimed to determine the effect of the levels of maternal lipids,C-peptide,insulin,and HbA_(1c) during late pregnancy on LGA newborns.Methods:This study comprised 2790 non-diabetic women in late pregnancy.Among their newborns,2236(80.1%)newborns were AGA,and 554(19.9%)newborns were LGA.Maternal and neonatal characteristics were obtained from questionnaires and their case records.The levels of maternal fasting serum apolipoprotein A1(ApoA1),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),C-peptide,insulin and blood HbA_(1c) were measured.The chi-square and Mann-Whitney U test were used to analyze categorical variables and continuous variables between the AGA and LGA groups,respectively.Binary logistic regression analysis was made to determine the independent risk factors for LGA newborns.Results:Maternal TG,C-peptide,insulin and HbA_(1c) levels were signifi cantly higher in the LGA group than in the AGA group(P<0.05).The LGA group had signifi cantly lower levels of maternal TC,HDL-C and LDL-C than the AGA group(P<0.05).After adjustment for confounding variables,including maternal age,pre-pregnancy body mass index,education,smoking,annual household income,amniotic fluid volume,gestational hypertension,newborn gender and gestational age at blood collection,high maternal TG levels remained signifi cantly associated with LGA newborns(P<0.05).Conclusion:High maternal TG level during late pregnancy is signifi cantly associated with LGA newborns.
基金supported by Science and Technology Program of Guangzhou,China (No. 202002020037)Science and Technology Program of Guangzhou,China (No.202206010049)。
文摘To summarize a case of late pregnancy complicated with acute Stanford type A aortic dissection who underwent multidisciplinary treatment perioperative nursing experience in emergency surgery. The patient was 37weeks of intrauterine pregnancy and suffered from sudden chest pain. The emergency admission was diagnosed with aortic dissection(Stanford A type), and the condition was dangerous and life-threatening. After preoperative multidisciplinary combined systematic comprehensive disease assessment and comprehensive surgical emergency plan was formulated, do a good job of effective psychological counseling and operation cooperation education,nursing cooperation during intraoperative anesthesia and nursing focus of multidisciplinary combined surgical treatment, postoperative prevention of massive bleeding, puerperium infection and a series of effective nursing measures, no perioperative period occurred nursing complications. The newborn survived, the patient recovered and was discharged from the hospital, and returned to the hospital for re-examination with normal indicators and good physical condition.
