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Purpose: To investigate the knowledge, attitude, and practice (KAP) on insulin pump among non-endocrinology nurses in Southern China. Methods: This multicenter cross-sectional study enrolled non-endocrinology nurses in Southern China between November 2020 and December 2020. A structured questionnaire about insulin pumps was designed and used to collect data. Results: A total of 1118 nurses from 29 hospitals participated in the study. The majority of them were female (98.48%), and 513 worked in the department of internal medicine (45.89%), followed by surgery (235, 21.00%), pediatrics (147, 13.14%), gynecology (127, 11.35%), and oncology (96, 8.71%). None of the nurses answered all questions correctly in the knowledge section. The score of knowledge was 50.12 ± 3.42 (total score range, 0 to 85). The attitude score of nurses in the department of gynecology was 47.76 ± 5.11 (total score range, 10 to 50), followed by nurses in the department of internal medicine (47.43 ± 4.65), pediatrics (46.71 ± 4.96), surgery (46.77 ± 5.78) and oncology (46.25 ± 5.87). The practice score of nurses in the internal medicine department was 79.16 ± 9.03 (total score range, 17 to 85), followed by nurses in the department of gynecology (78.76 ± 10.76), surgery (78.14 ± 10.09), oncology (76.89 ± 12.70) and pediatrics (73.35 ± 19.04). Conclusion: There was limited knowledge regarding insulin pumps among nurses, although they had a positive attitude and attached importance to the management of insulin pumps. In clinical practice, their implementation of insulin pump management norms was acceptable.

RESUMEN

This study aimed to confirm that atherosclerosis (AS) is a systemic immune-mediated chronic inflammatory disease and to investigate the anti-atherosclerotic effect of demethylzeylasteral by testing the immunocompetent cells and inflammatory mediators in the blood and atherosclerotic plaques of the rabbit model of AS. For this purpose, 60 male New Zealand white rabbits were given 150 g high-fat diet (1% cholesterol, 5% lard, and 15% egg yolk powder) daily for a total of 90 days. On day 61, the rabbits were randomly divided into the saline group (n=15), the rosuvastatin group (n=15), the low-dose demethylzeylasteral group (n=15), and the high-dose demethylzeylasteral group (n=15). The CD3+ T lymphocytes and the subsets CD4+, CD8+, and CD4+/CD8+, as well as the soluble interleukin-2 receptor (sIL-2R) were measured before and after the treatment. The contents of immunoglobulins IgG, IgA and IgM and the levels of complements C3 and C4 were also monitored. In addition, the level of anti-oxidized low-density lipoprotein (ox-LDL) antibody, the inflammatory cytokines tumor necrosis factor-α (TNF-α), IL-6 and metalloproteinase-9 (MMP-9), the blood lipids triglyceride (TG), total cholesterol (TC), LDL cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured, and the severity of plaque lesions was also evaluated. Our results showed that the saline group, the rosuvastatin group and the low-dose demethylzeylasteral group had significantly lower activated T lymphocyte parameters CD3+, CD4+, CD8+ and CD4+/CD8+ (P<0.05), and significantly higher levels of sIL-2R, immunoglobulins IgG, IgA and IgM, complements C3 and C4, anti-ox-LDL antibody, TNF-α, IL-6 and MMP-9 (P<0.01) when compared with the high-dose demethylzeylasteral group. Moreover, TG, TC, LDL-C contents were found significantly lower and their HDL-C contents were significantly higher in high-dose demethylzeylasteral group (P<0.01) as compared to the other three groups. Furthermore, Sudan staining and haematoxylin and eosin staining of the thoracic aorta showed that, after 30-day treatment, the high-dose demethylzeylasteral group had the smoothest intima and the lightest plaque lesions among the four groups. Based on these results, we concluded that AS is a systemic immune-mediated chronic inflammatory disease and the relatively high dose of demethylzeylasteral used in the treatment of atherosclerotic rabbits could significantly alleviate AS. This implies that demethylzeylasteral may be considered as a suitable drug for anti-immunization therapy.

RESUMEN

OBJECTIVE: To assess maternal and neonatal outcomes associated with increasing body mass index (BMI) and interpregnancy BMI changes in an Australian obstetric population. METHODS: A retrospective cohort study from 2008 to 2013 was undertaken. BMI for 14 875 women was categorised as follows: underweight (≤18 kg/m(2)); normal weight (19-24 kg/m(2)); overweight (25-29 kg/m(2)); obese class I (30-34 kg/m(2)); obese class II (35-39 kg/m(2)) and obese class III (40+ kg/m(2)). BMI categories and maternal, neonatal and birthing outcomes were examined using logistic regression. Interpregnancy change in BMI and the risk of adverse outcomes in the subsequent pregnancy were also examined. RESULTS: Within this cohort, 751 (5.1%) women were underweight, 7431 (50.0%) had normal BMI, 3748 (25.1%) were overweight, 1598 (10.8%) were obese class I, 737 (5.0%) were obese class II and 592 (4.0%) were obese class III. In bivariate adjusted models, obese women were at an increased risk of caesarean section, gestational diabetes, hypertensive disorders of pregnancy and neonatal morbidities including macrosomia, large for gestational age (LGA), hypoglycaemia, low 5 min Apgar score and respiratory distress. Multiparous women who experienced an interpregnancy increase of ≥3 BMI units had a higher adjusted OR (AOR) (CI) of the following adverse outcomes in their subsequent pregnancy: low 5-min Apgar score 3.242 (1.557 to 7.118); gestational diabetes mellitus (GDM) 3.258 (1.129 to 10.665) and hypertensive disorders of pregnancy 3.922 (1.243 to 14.760). These women were more likely to give birth vaginally 2.030 (1.417 to 2.913). Conversely, women whose parity changed from 0 to 1 and who experienced an interpregnancy increase of ≥3 BMI units had a higher AOR (CI) of caesarean section in their second pregnancy 1.806 (1.139 to 2.862). CONCLUSIONS: Women who are overweight or obese have a significantly increased risk of various adverse outcomes. Interpregnancy weight gain, regardless of parity and baseline BMI, also increases various adverse outcomes. Effective weight management strategies are needed.

Asunto(s)

Índice de Masa Corporal , Obesidad/complicaciones , Complicaciones del Embarazo/etiología , Delgadez/epidemiología , Adulto , Australia , Peso al Nacer , Peso Corporal , Cesárea/estadística & datos numéricos , Femenino , Macrosomía Fetal/epidemiología , Humanos , Modelos Logísticos , Obesidad/epidemiología , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Embarazo , Complicaciones del Embarazo/epidemiología , Resultado del Embarazo , Estudios Retrospectivos , Adulto Joven