Tohoku Journal of Experimental Medicine最新文献

This study evaluated the effectiveness of implementing an Enhanced Recovery after Surgery (ERAS) protocol in enhancing recovery outcomes following cesarean section (CS) in 200 women with gestational diabetes mellitus (GDM). The patients were randomized into an ERAS group or a Control group. The ERAS protocol differed from routine care by reducing preoperative fasting times, using targeted medications, employing neuraxial anesthesia and warming measures, initiating early feeding and mobilization, goal-directed fluid management, and earlier catheter removal to enhance recovery and minimize complications. Various outcome measures, including postoperative length of hospital stay (LOS) and time to achieve postoperative milestones, were assessed. Postoperative pain relief was evaluated using the visual analogue scale (VAS), while quality of life was assessed through the EuroQoL (EQ-5D-5L) survey. Patient satisfaction with nursing care was determined using the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ). The ERAS group demonstrated significantly shorter postoperative LOS and achieved recovery milestones faster than the Control group. Postoperative pain relief outcomes were significantly improved in the ERAS group, with lower VAS scores for pain during rest and breastfeeding compared to the Control group. The ERAS protocol also effectively improved specific health dimensions and overall QOL following CS in patients with GDM. Furthermore, the ERAS group exhibited higher levels of patient satisfaction with postpartum nursing care quality compared to the Control group. Implementation of an ERAS protocol in CS for women with GDM significantly enhances postoperative recovery outcomes, including shorter hospital stay, improved pain relief, enhanced QOL, and increased patient satisfaction.

MiR-204-5p is involved in a variety of diseases related to thyroid dysfunction and pregnancy. However, the effect on subclinical hypothyroidism (SCH) during pregnancy remained unclear. We focused on the expression difference of serum miR-204-5p in pregnant women with subclinical hypothyroidism in the second trimester and evaluated the correlation between them in this study. One hundred normal pregnant women and 175 individuals diagnosed with SCH were enrolled. The miR-204-5p level was calculated by qRT-PCR and its relevance to serum thyroid stimulating hormone (TSH) was assessed by Pearson analysis. The predictive value was evaluated by receiver operator characteristic (ROC) curve. The risk factor of SCH was identified by multivariate logistic regression analysis. The miR-204-5p was obviously depressed in SCH group compared to control (P < 0.001) and was significantly negatively correlated to the serum TSH levels (r = -0.6082, P < 0.0001). ROC curve showed the potential predictive value while the area under the curve was 0.9153 with sensitivity of 90.29% and specificity of 86.00%. TSH (OR: 1.793, 95% CI: 1.072-2.998, P = 0.026) and miR-204-5p (OR: 0.528, 95% CI: 0.317-0.878, P = 0.014) were related to SCH risk in pregnant women. In both SCH group and low miR-204-5p group, individuals with respiratory distress syndrome (RDS) or depression possessed a higher proportion of adverse events during 32-38 gestational weeks. Depressed miR-204-5p was observed in SCH patients and was significantly negatively correlated to TSH level. MiR-204-5p was a risk factor for SCH in pregnant women. Additionally, depressed miR-204-5p might be related to the incidence of adverse pregnancy outcomes.