Objective To investigate changes of metabolism of glucose and lipoids in diabetes before and after Ramadan. Methods A total of 65 Muslim fasting diabetic patients, with complete data, were investigated about their diet and administrated medicines before and after the fasting and occurrence of hypoglycemia during the fasting. Indexes of WEIGHT, WAISTLINE, BMI, FPG, 2h-PG, HbA1c, TG, TC, HDL-C, and LDL-C were evaluated by questionnaire, physical examination and laboratory tests. Results During Ramadan, fasting time was prolonged (P＜0.01), intake of lipoids and protein were increased obviously (P＜0.01) and a significant increase of 2 h-PG, HbA1c (P=0.0149, 0.0175) was detected after Ramadan in s fasting group. No significant difference was found in WEIGHT, WAISTLINE, BMI, TG, TC, HDL-C, and LDL-C. Blood glucose was improved significantly in the control group than the fasting group. Conclusion Life style was changed obviously leading to unsatisfactory controlling of blood glucose in Muslim diabetic patients during Ramadan.

Objective To translate Parents' Perception of Uncertainty Scale (PPUS) into Chinese,analyze and selected items,and then test the reliability and validity of the Chinese version of PPUS initially.Methods 210 parents of hospitalized children were recruited for the investigation.Frequency analysis,dispersion degree analysis,correlation analysis and so on were applied to analyze and select items.Internal consistency test,Pearson correlation analysis and exploratory factor analysis etc.were applied to test reliability and validity of the scale.Results The final Chinese version of PPUS contained 28 items.The Cronbach α and parity split-half reliability coefficients were 0.844 and 0.835; The Cronbach α coefficient of 4 dimensions ranged from 0.537 to 0.770.The item-total scale correlation coefficient ranged from 0.300 to 0.737.Item-dimension correlation coefficients ranged from 0.376 to 0.762.Item-other dimension correlation coefficients ranged from 0.028 to 0.514.Dimension-total scale correlation coefficients ranged from 0.480 to 0.863 and those between dimensions ranged from 0.226 to 0.536.In the content validity assessed by experts,I-CVI ranged from 0.75 to 1.00,S-CVI/Ave was 0.928.Four-factor model was performed in the principal component analysis and they explained for 41.401％ variances.The maximum factor loading of all items were higher than 0.3,and most of items had adequate loadings in related dimensions.Conclusions Chinese version of PPUS had appropriate reliability and validity as an assessment tool for parental uncertainty in illness of hospitalized children' parents.

OBJECTIVE To comprehend the changes in the spectrum of clinically isolated pathogenic bacteria and their drug resistance,and to analyze their tendency.METHODS Totally 5746 pathogenic bacteria isolated from clinical samples of the inpatients in our hospital during 1997-2004 and their drug resistance was statistically(analyzed).RESULTS Most of clinically isolated pathogenic bacteria were Gram-negative.The detected rate of Gram-positive bacteria tended to rise,while the detected rate of fungi obviously increased year after year.Gram-positive cocci and Gram-negative bacilli were resistant to commonly used antibacterials in different degrees,(especially) to ampicillin.The sensitive rate of Gram-positive bacteria was high to vancomycin,while the sensitive rates of Escherichia coli and Klebsiella pneumoniae to imipenem were high.CONCLUSIONS The structure of(nosocomial) infection(pathogens) and their drug resistance patterns are changing continuously.It should be(emphasized) to inspect(bacterial) tolerance in order to select antibacterial reasonably.

Objective To investigate the effect of the artificial cycle on the prognosis after transcervical resection of adhesion (TCRA) and its mechanism .Methods 80 patients with intrauterine adhesion were randomly divided into the observation group and the control group .The observation group were performed TRCA and postoperative artificial cycle for successive 3 months :oral es-tradiol valerate(9 mg once daily) for 21 d ,adding oral medroxyprofgesterone acetate(10 mg once dialy) on 15 d ,then the medication discontinuation for 7 d ,which was taken as 1 cycle;the control group received only TCRA .The re-examination was performed after 3 months .The levels of follicle stimulating hormone(FSH) ,luteinizing hormone(LH) ,estradiol(E2 ) ,prolactin(PRL) ,progesterone (P) and testosterone(T) were examined by ELISA after TCRA three months .The expression of MMP-9 and TGF-β1 in adhesive endometrium were detected by real-time PCR and Western blot .Results Compared with the control group ,the artificial cycle thera-py combined with the operation could significantly increase the effective rate of TCRA for treating mild and moderate intrauterine adhesion(P<0 .05);the seum levels of FSH ,LH ,E2 ,PRL ,P and T had no statistical differences between the observation group and the control group(P>0 .05);the artificial cycle significantly improved the adhesive degree of intrauterine adhesion ,increased the MMP-9 expression and decreased the TGF-β1 expression .Conclusion Artificial cycle could improve the degree of uterine cavity ad-hesion after TCRA ,which the mechanism might be related to the increase of MMP-9 expression and decrease of TGF-β1 expres-sion .

Objective To investigate the level of illness uncertainty and coping styles of parents of children with diabetes mellitus and their relationship, and provide theoretical basis of clinical intervention. Methods Totally 155 patients of children with diabetes mellitus were investigated with General Information Questionnaire, Parents′ Perception of Uncertainty Scale (PPUS) and Coping Health Inventory for Parents (CHIP) to analyze the correlation between illness uncertainty of parents and its influencing factors and coping styles. Results The total score of illness uncertainty was 80.15±10.38 in parents of children with diabetes mellitus. There was significant difference in total uncertainty score in parents with different number of children, parent′s age, education degree, profession, economic conditions and locations (P < 0.05). Coping style, education and Parent′s age entered into the multiple linear regression equation of illness uncertainty, predicting 23.2% of total variation in illness uncertainty. The level of illness uncertainty was negatively associated with coping styles (P < 0.01). Conclusions The illness uncertainty was at higher levels in parents of children with diabetes mellitus. Clinical nurses should measure illness uncertainty of parents of children with diabetes mellitus and improve their coping capacity to reduce illness uncertainty, so as to provide better services of family and promote the quality of life for children .

Objective To detect brain structural difference between children with unexplained mental retardation and children with typically normal development. Methods The high-resolution magnetic MR imaging were obtained from 21 children with unexplained mental retardation and 30 age-matched control children without intellectual disabilities. Voxel-based morphometry analysis with an optimization of spatial segmentation and normalization procedures were applied to compare differences of gray matter volume between the two groups. The total and regional gray matter volume were compared between the two groups with independent t test. Meanwhile, correlation was conducted to analyze the relationship between the total gray matter volume and intelligence quotient (IQ) with partial correlation test. Results The total gray matter volume was significantly increased in the mental retardation children [(1. 012 ±0. 079) × 106 mm3]in relative to the controls [(0. 956 ± 0. 059) × 106 mm3, t = - 2. 80, P ＜ 0. 05]. Compared to controls,children with unexplained mental retardation showed significantly increased gray matter volume in different regions, including the bilateral thalami, the bilateral superior frontal gyri, the bilateral gyri rectus, the bilateral temporal poles, the right inferior frontal gyrus, right parahippocampal gyrus and the right cerebellum. No correlation was detected between the total gray matter volume and IQ in children with mental retardation (r = 0. 078 ,P ＞ 0. 05). Conclusions VBM would detect the gray matter abnormalities that were not founded in routine MR scanning. The increase of gray matter volume in the frontal-thalamus network might indicate the delayed maturation of the brain development. This might be one of the causations of mental retardation in children.

ObjectiveTo investigate the relationship between testosterone level and related index and metabolic syndrome(MS) of women in perimenopause or postmenopause period.MethodsFrom May 2009 to August 2010,911 women aged 40 - 65 years underwent physical examination in the Memorial Hospital,Sun Yat-sen University were enrolled in this study,which were divided into 175 women with early perimenopause period in group A,112 women late perimenopause period in group B,161 women with early postmenopause period in group C,132 women with moderate postmenopause period in group D,88 women with late postmenopause period in group E,243 women with regular menstruation as control group (group F).MS was defined according to the International Diabetes Federation (IDF) criteria.The relationship of free testosterone level and MS of women in different stage of menopause was analyzed.Results (1) Compared with 1.13 nmol/L in group F,median testosterone level of 1.03 nmol/L in group A,0.91 nmol/L in group B,0.91 nmol/L in group C,0.87 nmol/L in group D,0.83 nmol/L in group E decreased significantly at early peri-menopause period(P ＜0.01 ).Median free androgen index(FAI) was 1.33 in group A,1.56 in group B,1.69 in group F.When compared median FAI in group A with those in group F or B,it all showed significantly difference ( P ＜ 0.01 ) ; Testosterone ( T)/estradiol ( E2 ) were 0.042 in group C,0.040 in group D,0.042 in group E,0.010 in group A.When compared T/E2 in group C with group F,D and E,it all reached statistical difference (P ＜ 0.01 ).(2)There were negative correlation among waist circumference (WC,r =- 0.287 ),fasting blood glucose ( FBG,r =- 0.281 ),triglyceride ( TG,r =-0.224) and sex hormone-binding globulin (SHBG) and positive correlation with high density lipoprotein cholesterone (HDL-C,r =0.314).The logistic regression analysis for MS showed that the MS was associated with SHBG significantly ( OR =0.993,95％ CI:0.986 - 0.999,P =0.035 ).( 3 ) When cut-off value of SHBG was defined at 56.14 nmol/L,SHBG was used to predict MS with sensitivity of 63.13％ and specificity of 69.45％.Conclusions Serum testosterone was associated with MS in women at perimenopausal and postmenopausal period,so window period of preventing MS was set at perimenopausal period.A serum testosterone level was elevated from premenopause to postmenopause period.Because there was an association between SHBG and MS,SHBG was a selectable parameter to predict MS.

Fifteen patients with chronic renal failure(CRF)underwent laparoscopic cholecystectomy(LC)at carbon dioxide(CO2)pneumoperitoneum pressure of 10-12 mm Hg(Group A,n=9)or 13-15 mm Hg(Group B,n=6).Renal function and urinary volume(UV)of Group A showed no remarkable change following the operation.But in Group B,the levels of blood urine nitrogen(BUN)and serum creatine(Scr)were increased significantly,and creatinine clearance rate(Ccr)and UV were remarkably decreased(P＜0.05).These variants gradually retumed tO the preoperative levels after 1 week.The analysis showed that laparoscopic choleeystectomy at CO2 pneumoperitoneum pressure of 10-12 mm Hg in CRF patients might be safe.Higher CO2 pneumoperitoneum pressure could result in reversible renal Email:yuanhuizhong2000@yahoo.com.cnfunction change.

Objective The aim of the experiment is to make an intracranial aneurysm model in canine.Methods A digital tube was made based on raw magnetic resonance images of the human intracraaial carotid artery.Then 6 tubes were made in the 3 D rapid prototyping machine and coated with silicone.Finally we isolated the common carotid arteries of 6 canines and made them go through the tubes and anastomosed them end-to-side to get the aneurysm model.Six stents were implanted after one week.Results Six aneurysm models were successfully made in canines.The parent artery had similar geometrv of the human carotid siphon.All the aneurysms and parent arteries were patent in one week's follow-up.One canine died of excessive anesthesia after stentingr Two vaseular models kept patent in one month without stenosis.The other 3 had some stenosis on the bends of the vessel.Conclusions The aneurysm model in tIle experiment has high flexibility and reliability.The model provides an effective tool for research and testing neurovascular devices.It's also a useful device to train the neuroradiologists and interventional physicians.

Objective To analyze the complications after procedure for prolapse and hemorrhoids (PPH) in treating severe mucocutaneous hemorrhoids.Methods The clinical data of 550 patients with severe mucocutaneous hemorrhoids who were admitted to the Hangzhou Hospital of Nanjing Medical University from January 2005 to December 2013 were retrospectively analyzed.All the patients were treated by PPH or PPH + external hemorrhoids resection.The postoperative complications were recorded and assessed.Patients were followed up via outpatient examination and telephone interview till June 2014.Results Operation was successfully carried out on all the 550 patients.The operation time and duration of hospital stay were (15 ± 10)minutes and (4.2 ± 1.8)days,respectively.A total of 445 patients were followed up for 6-60 months,with the median time of 28 months.The overall incidence of complications was 14.61％ (65/445).Forty-five patients were complicated with anal pain,12 with hemorrhoid recurrence,7 with bleeding,5 with dysporia,4 with anastomotic stenosis and 2 with rectal and perianal infection.Of the 12 patients with hemorrhoids recurrence,5 was alleviated by medication and 7 received PPH for the second time.Of the 4 patients with anastomotic stricture,the condition of 2 patients were alleviated by anus dilatation,and the condition of 1 patient was alleviated by balloon dilatation under enteroscope,1 patient received circular incision of the stricture because of severe stricture and failed of conservative treatment.Of the 2 patients with rectal and perianal infection,1 was alleviated by intravenous and local medication,and the other patient who was complicated with anal fistula was alleviated by surgery.The condition of other patients was improved after symptomatic treatment.Conclusions PPH is effective and safe for the treatment of severe mucocutaneous hemorrhoids.The main complication is anal pain,and it could be cured or alleviated by symptomatic treatment.