Background Despite many guidelines for the management of gestational diabetes available internationally, little work has been done to summarize and assess the content of existing guidelines. A paucity of analysis guidelines within in a unified system may be one explanatory factor. So this study aims to analyze and evaluate the contents of all available guidelines for the management of gestational diabetes. Method Relevant clinical guidelines were collected through a search of relevant guideline websites and databases (PubMed, Web of Science, Embase, etc.). Fourteen guidelines were identified, and each guideline was assessed for quality using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument. Two independent reviewers extracted guideline recommendations using a “recommendation matrix” through which basic guideline information and consistency between search strategy and selection of evidence, between selected evidence and interpretation, and between interpretation and resulting recommendations were analyzed. Results Fourteen documents were analyzed, and a total of 361 original recommendations for gestational diabetes mellitus (GDM) management were assessed. In all guidelines included, the recommendations were developed in five domains, namely, diagnosis of GDM, prenatal care, intrapartum care, neonatal care and postpartum care. Different guidelines appeared to have significant discrepancy in consistency of guideline content, but overall, there was consistency between search strategy and selection of evidence, between selected evidence and interpretation, and between interpretation and resulting recommendations (scilicet 49.31, 57.20 and 58.17%, respectively). Conclusion Although commonality in most recommendations existed, there were still some discrepancies between guidelines. Consistency of guidelines on the management of GDM in pregnancy is highly variable and needs to be improved. Electronic supplementary material The online version of this article (10.1186/s12884-019-2343-2) contains supplementary material, which is available to authorized users.

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Background It has been reported that long non-coding RNAs (lncRNAs) play vital roles in diabetic nephropathy (DN). Our study aims to research the function of lncRNA KCNQ1OT1 in DN cells and the molecular mechanism. Methods Human glomerular mesangial cells (HGMCs) and human renal glomerular endothelial cells (HRGECs) were cultured in high glucose (30 mM) condition as models of DN cells. KCNQ1 opposite strand/antisense transcript 1 (KCNQ1OT1) and miR-18b-5p levels were detected by quantitative real-time polymerase chain reaction (qRT-PCR). The mRNA and protein levels of Sorbin and SH3 domain-containing protein 2 (SORBS2), Type IV collagen (Col-4), fibronectin (FN), transcriptional regulatory factor-beta 1 (TGF-β1), Twist, NF-κB and STAT3 were measured by qRT-PCR and western blot. Cell viability was detected by cell counting kit-8 (CCK-8) assay for selecting the proper concentration of glucose treatment. Additionally, 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) and flow cytometry assay were employed to determine cell proliferation and apoptosis, respectively. The targets of KCNQ1OT1 was predicted by online software and confirmed by dual-luciferase reporter assay. Results KCNQ1OT1 and SORBS2 were elevated in DN. Both knockdown of KCNQ1OT1 and silencing of SORBS2 restrained proliferation and fibrosis and induced apoptosis in DN cells. Besides, Overexpression of SORBS2 restored the KCNQ1OT1 knockdown-mediate effects on proliferation, apoptosis and fibrosis in DN cells. In addition, miR-18b-5p served as a target of KCNQ1OT1 as well as targeted SORBS2. KCNQ1OT1 knockdown repressed NF-ĸB pathway. Conclusion KCNQ1OT1 regulated DN cells proliferation, apoptosis and fibrosis via KCNQ1OT1/miR-18b-5p/SORBS2 axis and NF-ĸB pathway.

Objective: With the widespread use of peripherally inserted central catheters, plenty of studies have compared peripherally inserted central catheters with other venous access devices to choose the most appropriate device in different clinical scenarios. Economic attributes are one of the important influencing factors in the selection of venous access devices. Several economic evaluation studies have been conducted in this area, but the evaluation methods, contents, outcomes, and quality of these economic studies have not been systematically evaluated. Therefore, we aimed to map the existing research on the economic evaluations of peripherally inserted central catheters and other venous access devices to provide economic evidence for decision-makers to choose a suitable venous access device. Second, we appraised the quality of economic evaluation studies in this area to highlight methodological weaknesses and provide an outline for the normative application of this methodology for future research. Methods: A literature search was undertaken through 11 databases from inception until 11 March 2019, to identify economic evaluation studies comparing peripherally inserted central catheters with other venous access devices. After screening articles and extracting data independently, we summarized methods, contents, and outcomes of the included studies and appraised their methodological quality using the Joanna Briggs Institute critical appraisal checklist for economic evaluations. Results: A total of 16 studies were included. Among the six studies comparing peripherally inserted central catheters with peripheral intravenous catheters, four studies performed a cost-effectiveness analysis and noted that peripherally inserted central catheters were more cost-effective than peripheral intravenous catheters. Two studies performed a cost analysis to compare peripherally inserted central catheters with peripheral intravenous catheters during the insertion and maintenance/removal periods but reached different conclusions. Seven of the included studies performed a cost analysis to compare peripherally inserted central catheters with central venous catheters. They pointed out that the catheter insertion costs of peripherally inserted central catheters were lower than those for central venous catheters in developed countries, whereas the opposite conclusion was reached in developing countries. Conversely, conclusions regarding the costs for catheter maintenance and catheter insertion and maintenance/removal were inconsistent. Six of the included studies performed a cost analysis to compare peripherally inserted central catheters with vascular access ports. They pointed out that the insertion costs of peripherally inserted central catheters were lower than those for vascular access ports, and the maintenance costs were higher than those for vascular access ports. Conversely, conclusions regarding the costs for catheter insertion and maintenance/removal were inconsistent. In addition, the methodological quality of the included studies had plenty of deficiencies, including no discounting, no sensitivity analysis, no incremental analysis, a lack of validity of costs and effectiveness, and so on. Conclusion: This scoping review highlighted the desperate paucity of economic evaluation studies of peripherally inserted central catheters and other venous access devices in amount, evaluation contents, and economic evaluation methods. The conclusions of the cost-effectiveness analysis of peripherally inserted central catheters with other venous access devices were consistent. Conversely, the conclusions of the cost analysis of peripherally inserted central catheters with other venous access devices were inconsistent mainly in the comparison of peripherally inserted central catheters with peripheral intravenous catheters, central venous catheters, and vascular access ports during the insertion and maintenance/removal periods. This review also highlighted many methodological issues of economic evaluations in this area. Therefore, it is necessary to conduct more high-quality economic evaluation studies on peripherally inserted central catheters and other venous access devices by performing cost-effectiveness analysis, cost–utility analysis, or cost–benefit analysis from catheter insertion to removal to provide evidence for clinical practitioners, patients, and decision-makers to choose a suitable venous access device in different clinical scenarios.