Objective To investigate the expression of microRNA (miRNA) in placenta tissue, explore the function of miRNA in pathogenesis of gestational diabetes mellitus (GDM). Methods Placenta tissue from pregnant women with GDM and normal controls were selected from January 2013 to January 2014. Expression of miRNAs were detected by sequencing technique and quantity real time PCR(qRT-PCR). Target genes of miRNA were analyzed by KEGG. Results 52 insulin signaling pathway related miRNAs including 47 up-regulated and 5 down-regulated were differentially expressed in GDM compared with normal control. Expression of placental hsa-miR-548am-5p and hsa-miR-95-5p were significantly increased , but hsa-miR-1246 was significantly lower (P <0.05) in GDM group than normal control; all the results were consistent with sequencing results. Key points of insulin signaling pathway could regulate expression of targets such as PI3K. Conclusion miRNA expression in GDM placenta was abnormal.A variety of exp ressions of miRNAs were involved in the pathogenesis of GDM by regulating insulin signaling pathway.

OBJECTIVE Study the role of mycoplasma infection and expression of Ki67 protein in the pathogenesis, development and prognosis of laryngeal carcinoma. METHODS Immunohistochemistry method was used to study 145 specimens of laryngeal carcinoma tissues, 25 specimens of precarcinoma tissues, 31 specimens of vocal cord polyps and 15 specimens of normal tissues adjacent to laryngeal carcinoma. RESULTS ①The positive rates of PD4 and Ki67 were 45.52%(66/145) and 82.76 % (120/145) in laryngeal carcinoma tissue, 16.00 % (4/25) and 32.00 % (8/25) in precarcinoma tissue, 12.90 % (4/31) and 22.58 % (7/31) in vocal cords polyps, 6.67 % (1/15) and 0 (0/15) in normal tissues adjacent to laryngeal carcinoma. ②The positive rates of PD4 and Ki67 were higher in the advanced laryngeal carcinoma cases than that in the early laryngeal carcinoma cases. The positive rates of PD4 and Ki67 were higher in laryngeal carcinoma cases with cervical metastasis than that laryngeal carcinoma cases without cervical metastasis(P

Objective To explore the best mode of diabetic dietary education in the nursing specialist outpatient service,which is suit for China's national situation.Methods A total of 100 diabetic patients consulting diabetes diet in the nursing specialist outpatient service were divided into observation group and control group with 50 cases each by random digits table method.The routine sermonic education mode was used in control group,while the error-correction education mode was used in observation group.The question-real-time evaluation was performed at the end of the education and a follow-up evaluation after 6 months of intervention was evaluated.Results Grasp of the knowledge of diabetes diet in observation group immediately after education and 6 months after education were better than those in control group,t=3.07,3.06,P＜0.01.In the follow-up evaluation after 6 months of intervention,fasting blood glucose and glycosylated hemoglobin were (6.84±0.79) mmol/L,(6.83±0.36) ％ in observation group and (7.56±0.93) mmol/L,(7.67±0.87) ％ in control group.The indices in observation group were significantly better than those in control group,t=-4.17,-6.32,P＜0.01.Conclusions Using the error-correction education mode can correct the false dietary behavior of patients and improve the effect of the diabetic dietary education more effectively.

Objective To evaluate the effects of therapeutic hypothermia on both neurological status and survival rate in patients after cardiac arrest.Methods The data were searched from MEDLINE,PubMed,EMBASE,Cochrane Library,Wanfang database,CNKI and CBM.The randomized and controlled trials were selected for evaluating the main outcomes of neurological status and survival rate in patients after cardiac arrest.Meta-analysis was carried out by using Review Manger 5.0 software.The results were expressed in risk ratio (RR) for dichotomous outcomes data with 95％ confidence intervals (CI),and P ＜ 0.05 was considered to be significant.Results Eight randomized controlled clinical trials with a total of 1 512 patients met our inclusion criteria.The overall risk ratio of favorable neurological status was 1.34 (95％ CI:1.01-1.78,P ＜0.05) and of survival rate was 1.09 (95％ CI:0.98-1.20,P ＞0.05) with therapeutic hypothermia compared with controls,however,when the applications of conventional cooling trials were analyzed,the risk ratio was 1.51 (95％ CI:1.22-1.87,P ＜0.01) and 1.36 (95％CI:1.13 -1.63,P ＜ 0.01),respectively.Conclusions Patients treated with therapeutic hypothermia after cardiac arrest had more favorable neurological status compared with the controls.There was no benefit of therapeutic hypothermia to survival rate identified.Compare with conventional cooling methods,the therapeutic hypothermia could improve neurological status and survival rate in patients after cardiac arrest.

Objective To evaluate the changes of platelet-derived growth factor(PDGF) and vascular endo-thelial growth factor(VEGF) in infectious and autoimmunity diseaases. Methods The growth factors were measured by ELISA in 149 patients for seven times in different periods,and the levels and duration were compared. Results PDGF was (6.32±2.54) μg/ml and (2.57±1.65) μg/ml (P<0.05), and VEGF was (179.5±53.30) ng/ml and (221.4±70.04) ng/ml(P<0.05) in the two groups before treatment;There was statistical significance in dif-ferent time points between groups and within groups for PDGF(P<0.05) and significant difference for time chan-ging to the peak and changed duration between two groups for VEGF(P<0.05). For the two groups,the peak time of PDGF were (2.6±1.1) and (5.4±3.3) days;The peak time of VEGF were (2.4±0.7) and (7.2±3.3) days respectively(P<0.05 for each). However in the two groups, the change duration were (6.7±3.1) and (15.4±6.1) days for PDGF and (8.1±3.4) and (16.7±7.2) days for VEGF (P<0.05 for each). Conclu-sions There is significant difference for serum levels of PDGF and VEGF and the level change duration as well in the two groups, which maybe correlated with inflammatory nature and outcome.

Objective To investigate the effect of stress-related hyperglycemia on myocardial function of patients with cardiac disorder after non-cardiac surgery.Methods The clinical data of 211 patients having undergone thoracic or abdominal operations in Department of Critical Care Medicine of Sun Yat-sen University Cancer Center were retrospectively analyzed. According to the postoperative average blood glucose level in the following 3 days after surgery and the patients' history of cardiac disorder, they were divided into four groups: without hyperglycemia (blood glucose ≤ 10 mmol/L) and cardiac disorder group (HG0CV0 group), without hyperglycemia but with cardiac disorder group (HG0CV1 group), with hyperglycemia (blood glucose > 10 mmol/L) but without cardiac disorder group (HG1CV0 group) and with hyperglycemia and cardiac disorder group (HG1CV1 group). The correlations between the blood glucose and each level of the following items: high-sensitivity cardiac troponin I (hs-cTnI), brain natriuretic peptide (BNP), myocardial zymogram aspartate aminotransferase (AST), creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB), lactic dehydrogenase (LDH), lactic dehydrogenase isoenzyme (LDH-1), myoglobin (MYO), α- hydroxybutyrate dehydrogenase (HBDH) in each group were analyzed.Results The postoperative blood glucose levels of all 211 patients were significantly higher than those before operation (mmol/L: 8.7±0.2 vs. 5.7±0.2,P < 0.05), and the blood glucose level more than 6.1 mmol/L in postoperative 179 patients accounted for 84.8% of the total. In HG0CV0 group, the postoperative blood glucose level was positively correlated with MYO and AST [r values were 0.193, 0.307; 95% confidence intervals (95%CI) were 0.010 - 0.362, 0.096 - 0.479;P values were 0.038, 0.003]. There were no correlations between postoperative blood glucose level and hs-cTnI, BNP, LDH, LDH-1, HBDH, CK and CK-MB (allP > 0.05). In HG0CV1 group, the postoperative blood glucose level was negatively correlated with hs-cTnI level (r = -0.609, 95%CI = -0.810 to -0.264,P = 0.001). There were no correlations between postoperative blood glucose level and the levels of BNP, MYO, AST, LDH, LDH-1, HBDH, CK and CK-MB (allP > 0.05). In HG1CV0 group, there were no correlations between postoperative blood glucoselevel and hs-cTnI, BNP, MYO, AST, LDH, LDH-1, HBDH, CK and CK-MB (allP > 0.05). In HG1CV1 group, the postoperative blood glucose level was positively correlated with hs-TnI level (r = 0.837, 95%CI = 0.476 - 0.984,P = 0.001). There were no correlations between postoperative blood glucose level and the levels of BNP, MYO, AST, LDH, LDH-1, HBDH, CK and CK-MB (allP > 0.05).Conclusion The early stress-related hyperglycemia after non-cardiac surgery may have a protective effect on myocardial function of patients with cardiac disorder.

Objective To analyze the value of dynamic contrast-enhanced MRI(DCE-MRI) parameters of Extended Tofts and Exchange model in the differential diagnosis of hepatocellular carcinoma (HCC) and hepatic metastases of colorectal cancer. Methods A retrospective analysis of 40 pathologically confirmed cases was conducted , including 25 cases of HCC and 15 cases of hepatic metastases of colorectal
cancer,all patients underwent DCE-MRI. Applying liver double blood supplement model , and respectively using Extended Tofts two-compartment model and Exchange model liver microvascular permeability parameters [volume transfer constant of the contrast agent(Ktrans), efflux rate from extracellular extravascular space to plasma(Kep), extravascular extracellular volume fraction(Ve)and blood plasma space volume fraction (Vp)] and the perfusion parameter hepatic arterial perfusion index(HPI) in the lesion parenchyma of HCC and metastases were calculated. We used t test to compare the differences of the parameters measured from the two types of tumors , statistically significant parameters between HCC and metastases were screened which compared with the gold standard of pathological findings in order to draw the ROC curves to evaluate the diagnostic efficacy of different model parameters, using χ2 test compared the diagnostic accuracy of optimal parameters between the two models. Results By using Extended Tofts and Exchange model , Ktrans value of HCC were (0.661 ± 0.402)/min and (0.604 ± 0.316)/min respectively, Ktrans value of hepatic metastases were (0.196±0.175)/min and (0.179±0.135)/min respectively;Vp value of HCC were (0.334±0.217) and (0.294± 0.098), Vp value of hepatic metastases were (0.089 ± 0.015) and (0.089 ± 0.022),respectively; HPI value of HCC were (0.680±0.281) and (0.769±0.245) , HPI value of hepatic metastases were (0.326±0.216), (0.373± 0.298), respectively. There were significant differences between HCC and hepatic metastases in Ktrans, Vp and HPI values in both models(P<0.05). There was not statistically significant difference between HCC and hepatic metastases in Kep, Ve values(P>0.05).Drawn ROC curves of Ktrans, Vp, HPI , the Ktrans value (area under the curve of 0.869) among Extended Tofts model parameters was selected as optimal parameter to identify HCC and hepatic metastases; the HPI value (area under the curve of 0.845) among Exchange model parameters was selected as optimal parameter to differentiate these two types of tumors.The diagnostic accordance rate of Extended Tofts model and Exchange model were 80.0%(32/40), 82.5%(33/40), respectively ; There was no significant difference between them(χ2=0.082,P=0.775). Conclusions Parameters including Ktrans, Vp, HPI of the Extended Tofts model and Exchange model in DCE-MRI perfusion can be used to identify HCC and hepatic metastases of colorectal cancer. Among these parameters, Ktrans of Extended Tofts model and HPI of Exchange model have higher diagnostic value in differentiating HCC and hepatic metastases of colorectal cancer.

Objective To investigate the therapeutic effect of the fourth ventricle tumors through lateral wall type of the transcerebellomedullary fissure approach under endoscope.Methods Clinical data of 14 cases with the fourth ventricle lesions were analyzed retrospectively.All the patients were treated by lateral wall type of the transcerebellomedullary fissure approach surgery.The endoscope was used if the lesions develop to the aqueduct and hard to be exposed.Both neurophysiological monitoring and intraoperative ultrasound were used regularly.Results Tumors were totally removed in 12 cases,subtotally in 1,and partially in 1.All the patients were diagnosed in postoperative histopathology,including 4 medulloblastoma,three epidermoid cyst,two ependymoma,two hemangioblastoma,one meningioma,one cavernous hemangioma and 1 astrocytoma.Hypopnea occurred immediate after operation in 1 patient.Ventilatory support was performed by Ventilator,and the respiration was restored 1 day later.Normal cerebrospinal fluid circulation was return in all cases.Neither aggravation of preoperative symptoms nor nuclei injury related complication had been found.The follow-up interval between 3 months to 28 months,one patient was dead with unexplained,and 1 medulloblastoma patient was relapse.Conclusion Lateral wall type of the transeerebellomedullary fissure approach,under endoscope,combined with the usage of neurophysiological monitoring and intraoperative ultrasound,can degrade the surgical related complications such as facial palsy and amblyacousia.

Objective To compare the efficacy and safety of mesalazine oral plus enema or only oral admin-istration in the treatment of ulcerative colitis .Methods 114 patients with ulcerative colitis were selected , and they were randomly divided into the observation group and treatment group according to random number table , with 57 cases in each group .The observation group was given mesalazine oral treatment ,and the treatment group was given mesalazine oral plus enema .The changes of CRP ,Fid,MPV after treatment were compared between the two groups .The situation of mucosa under colonoscopy , effective rate and the incidence of adverse reactions were compared between the two groups.Results After treatment,the CRP,Fid levels in the treatment group were lower than those in the observation group [(3.17 ±1.48)mg/L vs.(6.14 ±2.53)mg/L,(2.14 ±0.17)g/L vs.(2.91 ±0.27)g/L],the MPV in the treatment group was higher than that in the observation group [(10.93 ±0.59) fL vs.(10.21 ± 1.21)fL],the differences were statistically significant (t=7.650,18.220,4.038,all P<0.05).The total remission rate of the treatment group was higher than that of the observation group (100.00%vs.78.95%) (χ2 =13.412,P<0.001).The total effective rate of treatment group was higher than that of the observation group (89.47% vs .75.44%) (χ2 =3.881,P=0.049).The incidence rate of adverse reactions in the treatment group was lower than that in the observation group (3.51%vs.26.32%) (χ2 =11.683,P=0.001).Conclusion Mesalazine oral plus enema in the treatment of ulcerative colitis has good effect ,minor adverse reactions,high safety,which is worthy of clinical application .

Objective To investigate the clinical efficacy and safety of mesalazine combined with Clostridium butyricum tablets in the treatment of colitis gravis.Methods From January 2016 to December 2016, a total of 120 patients with colitis gravis in the Second Hospital of Qinhuangdao were selected in the research .According to different treatment methods,the patients were divided into observation group and control group ,with 60 cases in each group.The control group was given mesalazine , and the observation group was given mesalazine combined with Clostridium butyricum tablets.All the patients were treated for 2 months.The changes of cytokine levels and C -reactive protein were observed.The therapeutic effects and adverse drug reactions were compared between the two groups . Results The total effective rate of the observation group was significantly higher than that in the control group (91.66%vs.78.33%),and there was statistically significant difference between the two groups ( χ2＝4.183,P＝0.041).The level of IL-10 in the observation group was significantly higher than that in the control group [(110.05 ± 2.61)pg/L vs.(98.35 ±2.42)pg/L,t＝25.462,P＜0.05].The IL-18 level in the observation group was significantly lower than that in the control group [(97.74 ±2.82) pg/L vs.(120.86 ±3.21) pg/L,t＝41.914,P＜0.05].The level of C-reactive protein in the observation group was lower than that in the control group [(8.02 ±1.97) mg/L vs.(6.33 ±3.82)mg/L,t＝14.976,P＜0.05].The incidence rate of adverse reactions of the observation group was significantly lower than that of the control group ( 5.00% vs.25.00%, χ2＝9.412, P ＝0.002 ).Conclusion Mesalazine combined with Clostridium butyricum tablets in the treatment of colitis gravis has obvious curative effect , and can effectively improve the levels of cytokines and C -reactive protein and with high safety.