To investigate the expression level of serum ZAG protein in patients with gestational diabetes mellitus and the predictive effect of ZAG protein and early Pregnancy index on GDM.

42 patients with gestational diabetes mellitus who were examined in the third affiliated Hospital of Zhengzhou University from July 2018 to April 2019 were included in the GDM group, and 42 healthy pregnant women were treated as control group in the same period, and 24-28 weeks of OGTT spatiotemporal abdominal serum were collected. The serum ZAG levels of the two groups were detected by enzyme-linked immunosorbent method (ELISA) and compared, and the baseline data and early biochemical indexes of pregnancy were collected and analyzed retrospectively. Using a paired T-test, Mann-Whitney U test group comparison, using logistic regression to analyze the link between indicators and disease.

The expression level of serum ZAG protein in the GDM group was lower than that in control group, pre-pregnancy BMI, early pregnancy fasting blood glucose(FPG) and triglycerides (TG) were higher in the GDM group than in the control group, and all the difference were statistically significant (P<0.05), and logistic regression analysis showed that FPG ,age ,were Increases the incidence of GDM; ZAG is an independent protective factor for GDM. ROC curve analysis indicators showed ZAG is the predictive abilities (P<0.05) for GDM.

The expression level of ZAG in the serum of the GDM group is significantly lower than that in the control group, and ZAG may be involved in the occurrence and development of GDM, which is expected to be used as a new high specificity index for the clinical diagnosis of GDM.

To evaluate the analgesic effect of transverse abdominal plane (TAP) block in obese women undergoing cesarean section.

A total of 50 obese women who underwent cesarean section at Yangjiang People’s Hospital from January 2019 to June 2020 were selected and randomly divided into treatment group and control group, 25 cases in each group. The treatment group was treated with ultrasound-guided lower transversus abdominis plane block before operation, and 0.375% ropivacaine 20 ml was injected on each side. The control group was given conventional treatment. Comparing the doses of sufentanil given by patient-controlled epidural analgesia at 24 h and 48 h after operation between the two groups of parturients, recording the time of initial supplementary analgesia, and comparing the pain scores, Ramsay sedation and BCS comfort of the two groups at different time points after surgery Score, record the adverse reactions of the two groups.

The amount of sufentanil in 24 h and 48 h in patient-controlled epidural analgesia in the treatment group was significantly less than that in the control group, and the difference was statistically significant (P<0.01); The first additional analgesia time in the treatment group was significantly longer than that in the control group (P<0.01), and 4 h, 8 h, 12 h, 24 h and 48h postoperative pain VAS scores of the treatment group were significantly lower than those of the control group (P<0.05). The BCS comfort scores of the treatment group at 12 h and 24 h after surgery were significantly higher than those of the control group, and the difference was statistically significant (P<0.001). There was no statistically significant difference in Ramsay sedation and PONV scores between the two groups (P>0.05).

TAP block has a good analgesic effect in obese women undergoing cesarean section, can significantly improve the postoperative comfort of the women, and has good safety.

To investigate the relationship between non-alcoholic fatty liver and Gensini score in obese patients with coronary heart disease.

A retrospective analysis of a total of 367 overweight or obese patients undergoing coronary angiography in our hospital from January 2016 to December 2019. The general information, biochemical parameters, GRACE (the global registry of acute coronary events) score at admission and the Gensini score of coronary angiography were recorded for all patients, and the ultrasound and CT evaluation results of NAFLD were recorded.

The levels of UA and TG in NAFLD group were significantly higher than those in non-NAFLD group, while HDL-C was significantly lower than that in non-NAFLD group (P< 0.001). The Gensini score of the NAFLD group was significantly higher than that of the non-NAFLD group (t= 6.504, P < 0.001), and the Gensini score of patients with severe NAFLD was significantly higher than that of the mild and moderate groups (P< 0.05). Obese coronary heart disease patients with NAFLD (OR: 1.64, 95% CI: 1.17-1.95, P= 0.002) is a risk factor for high Gensini score.

The severity of non-alcoholic fatty liver in obese patients with coronary heart disease is positively correlated with the Gensini score. Non-alcoholic fatty liver is an independent risk factor for severe coronary artery disease.

To investigate the role of microRNA-375 (miR-375) in efficacy evaluation and prediction of laparoscopic Roux-en-Y gastric bypass (LRYGB) in treating type 2 diabetes mellitus (T2DM).

Clinical and laboratory data of 17 patients with T2DM undergoing LRYGB in the First Affiliated Hospital of Soochow University from May 2010 to March 2013 were retrospectively studied. Among the 17 patients, 7 were males and 10 were females with an average age of (46±13) years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. Body mass index (BMI), fasting plasma glucose (FPG), glycosylated hemoglobin A1c (HbA1c), homeostatic model assessment of insulin resistance (HOMA-IR), fasting insulin (FIns), fasting C peptide (FCP), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and miR-375 of all the patients were collected and compared before and 1, 3, 6 months after surgery. The comparisons of clinical and laboratory data before and after surgery were conducted using t test and Mann-Whitney U test, and the correlation analysis between miR-375 and each factor was conducted using Spearman rank correlation analysis.

All patients received LRYGB successfully. At 6 months after LRYGB, BMI was (26±5) kg/m², FPG was (6.3±1.7) mmol/L, HbA1c was (6.5±0.8)%, FIns was 6.1[3.5, 8.6] mU/L, HOMA-IR was 1.9[1.0, 2.6], TC was (4.1±1.1) mmol/L, TG was (0.9±0.4) mmol/L, LDL-C was (2.3±0.7) mmol/L and miR-375 was 0.06[0.00, 0.12], which were significantly lower than (33±7) kg/m², (11.1±3.6) mmol/L, (9.3±1.6)%, 12.7[3.6, 19.3] mU/L, 5.4[1.9, 13.7], (5.0±1.0) mmol/L, (3.6±4.0) mmol/L, (3.1±0.7) mmol/L and 1.20[0.60, 1.85] before operation respectively (P<0.05); and HDL-C of these patients was (1.23±0.19) mmol/L, which was significantly higher than (1.05±0.14) mmol/L before operation. The correlation analysis showed that miR-375 was positively correlated with BMI, TC, TG, LDL-C, HbA1c, FPG, FIns, FCP and HOMA-IR respectively (P<0.05).

MiR-375 is closely related to blood glucose control and improvement of lipid and insulin resistance. Owing to the convenience and feasibility of being tested in serum, miR-375 may become a new biomarker, which can be used to evaluate and predict the curative effect of LRYGB on T2DM.

To evaluate the correlation between overweight/obesity and osteoarthritis in Chinese population.

In both English and Chinese, the terms "overweight, obesity, osteoarthritis, case control study, cohort study" were used as search terms. The major Chinese biomedical databases (CBM, CNKI, VIP, Wanfang) , PubMed, Embase, Cochrane library and related clinical registry database were searched, and the references of included literatures were also screened. These literatures were selected and the related data were extracted by two authors according to the inclusion and exclusion criteria. The Newcastle-Ottawa Scale(NOS)was used to evaluate the quality of the included studies, and RevMan 5.3 software was used for meta-analysis.

Four case-control studies which included 12 295 patients were included. Among all the patients, 2 127 were included into the knee osteoarthritis group, and the other 10 168 patients were included into the non-osteoarthritis group. The NOS score indicated that there were one high-quality study, and three low-quality studies. The meta analysis showed that the number of obese people in the knee osteoarthritis group was 2.06 times as high as that of the non knee osteoarthritis group, and there was a statistical difference between the two groups (OR=2.06, 95% confidence interval[1.43, 2.95], P<0.0001). In Begg test, "Pr>|z|= 0.089" showed that there was an obvious published bias. In Egger test, the index of "P>|t|" equaled 0.291 which showed that there was no obvious bias in these studies. According to the two test results, it can not be defined whether published bias existed or not.

Overweight and obesity belong to the factors that can influence the development of knee osteoarthritis. Therefore, prevention of obesity may be a way to reduce knee osteoarthritis. But most of the current domestic research are not well designed, their quality are relatively low, outcomes are not complete and sample sizes are small; so it is necessary to design trials with high quality to improve the level and strength of evidences.