Objective To explore the relationship between excessive gestational weight gain and the risk of macrosomia. Methods Three databases were systematically reviewed and reference lists of relevant articles from January 2001 to December 2014 were checked. Meta-analysis of published epidemiological studies (cohort and case-control studies) was done. The odds ratio (OR) was used to evaluate the relationship of excessive gestational weight gain and macrosomia delivery. Results Twelve relevant articles were included to analyze, including 4 cohort studies and 8 case-control ones. The values of OR and 95%CI of macrosomia in pregnant women with excessive and non-excessiveweight gain were 1.66 (1.49, 1.83). Conclusion The risk of macrosomia in pregnant women with excessive gestational weight gain is much higher than those with normal gestational weight gain.

Background Primary open angle glaucoma (POAG) is one of the frequent glaucomatous types,and genetic factor participates in pathogenesis and development of the disease.Recently,MYOC mutation was found to be associated with POAG.Objective This study was to describe the clinical and genetic findings in a POAG family from Luoyang,China.Methods This study protocol was approved by Ethic Committee of Affiliated First Hospital of Henan University of Science and Technology.The study adhered to Declaration of Helsinki.A POAG family with 29 members of 5 generations was surveyed and followed-up for 5-year duration.The mode of inheritance was determined by the pedigree analysis.The periphery blood sample was collected form 12 families and 100 health controls for the extraction of genomic DNA under the informed consent.The third exon and its flanking introns of MYOC were amplified,and quantitative real time PCR products were sequenced,and the structure and function of mutated gene were examined by restriction fragment length polymorphism analysis.The predicted effects of the detected variants on the secondary structure of MYOC protein were evaluated using Garnier-Osguthorpe-Robson (GOR) method,and homology analysis of protein was carried out by Blast software provided by National Center for Biotechnology Information (NCBI).Results This POAG family included 29 members of 5 generations,and the clinical data were not clear in 11 family members.Three individuals from 3 generations were determined POAG,another one was ocular hypertension,and 2 were carriers.Pedigree analysis appeared an autosomal dominant inheritance.In 12 subjects included 6 members genetically affected and 6 members with normal phenotype,the heterozygous mutation was found in the third exon of MYOC gene in 6 genetically affected members,which revealed a T→C transition at position 1021 (p.S341P),resulting in a switch of serine (Ser) to proline (Pro).It was a missense mutation abolished a CviKI-1 restriction site that segregated with the affected members.Secondary structure prediction of p.S341P suggested that myocilin protein was misfolded.Analysis of protein homology and switched Ser was conservative amine acid at position 1021 (p.S341P).No similar change was found in the 6 normal families and the normal controls.Conclusions Ser341Pro MYOC mutation is disease-causing factor in the POAG family of Luoyang.The clinical and genetic features of this mutation warrant further investigation.The mutation spectrum of MYOC is expanded to offer a better diagnosis and treatment for POAG patients.

To investigate the mechanism of macrophages apoptosis induced by stressed Salmonella typhi,macrophages were co-cultivate with inhibitors caspase 3,8,9 and anti-TNF-α antibody and then S.typhi was added to construct the infection model..The rate of macrophage apoptosis was assayed by flow cytometry and the contens of caspase 3.8 ,9 and anti-TNF-α antibody as well as NO were then determined respectively.It was found that the apoptotic rates of macrophages were significantly inhibited by caspase 3 and caspase 8 inhibitors and antibody against TNF-α respectively (P<0.01).A significantly enhanced generation of caspase 3 and caspase 8 activities during macrophage apoptosis induced by S.typhi correlated with the increased generation of TNF-αand NO (P<0.01).These results indicate that the inactive NO and TNF-α mediated inhibitors caspase 3 and caspase 8 participate the exogenous apoptotitic pathway of macrophages induced by S.typhi.

Formative evaluation is a medical education evaluation form used to correct its own track in the course of activities so as to get better effect. In the medical education, it can significantly improve the medical students' ability such as active learning ability, relearning ability, ability to master and apply know l edge, ability of scientific thinking and debating, ability of innovation and analysis, ability of association and communication, and so on.

Intellectual property in medical institutions has been getting more attention in research activity.Large general hospitals have made significant achievements in intellectual property,and the management of intellectual property right has also gradually become the norm.This article discussed the possibility to carry out the intellectual property management in the primary health care sector,based on their current status and characteristics,proposed an evaluation system which suitable for the primary health care sector.We described the structure and method of this system,explored a standardized intellectual property management process used in primary health care institutions.

Objective To evaluate the clinical result of system rehabilitation training on joint rehabilitation after operation in cruciate ligament injury of the knee joint patients.Methods All patients were followed up for 6～18 months(average 12.8 months).The clinical results were evaluated according to Lysholm and Lachman clinical rating scales.Results At the end of follow-up,there was no knee extension limitation and the knee flexion was between 110°and 150°,with an average of 130°.The Lysholm score of the 110 cases was (69.3±4.8) before operation, and (88.3±11.6) at the end of follow-up.The difference between the Lysholm scores was significant (P < 0.01), the difference of Lachman score below 4mm in 82 cases and 19 cases were below 5mm.Conclusion Early system rehabilitation training can relieve the postoperative pain and swelling of pain,and improve the function of knee joint in cruciate ligament injury of the knee joint patients.

Objective To observe the clinical efficacy of Honggui capsule combined with chemotherapy in the treatment of lung cancer. Methods 61 cases of lung cancer patients were randomly divided into group A of 30 cases, treated with Honggui Capsule and chemotherapy, and group B of 31 cases treated with chemotherapy only by the envelope method. After both groups were treated for 21 days, the clinical effect, life quality improvement, improvement of TCM symptoms and the incidence of toxic and side effects in 2 groups were compared. Results After treatment, there was significant difference between group A and B in the tumor response rate (26.7% vs. 3.2%; χ2=4.927, P=0.026), Karnofsky (23.3% vs. 3.3%; χ2=5.410, P=0.020), and improvement of TCM symptoms (13.3% vs. 0.0%; χ2=4.423, P=0.035). During treatment, there was significant difference between group A and B in bone marrow suppression (33.3% vs. 58.1%; χ2=4.778, P=0.029), and gastrointestinal disturbance (16.7% vs. 58.1%; χ2=11.124, P=0.001). Conclusion Honggui capsule combined with chemotherapy has an enhanced efficacy and a detoxicating effect, besides it improves clinical symptoms and reduces the side effects of chemotherapy.

Objective To develop a reversed phase high performance liquid chromatography ( RP￣HPLC) method determining the related substances and levidipine. Methods The Welchrom C18 column (250 mm×4.6 mm,5 μm) was used with Octadecylsilane bonded silica as a filler.The mobile phase consisted of methanol￣ethanol￣water (40:20:40),at the flow rate of 1 mL.min-1 in an isocratic elution,the temperature was at 45 ℃ , and the detective wavelength was 240 nm. Results Levidipine could be separated from all impurities and intermediates within the concentration range from151 to 604 ng.mL-1 , which had a satisfied linear relationship (r= 0.999 9) with a regression equation of Y= 0.049 9X+0.597 9.The LOQ of detection was 31.9 ng.mL-1 . Conclusion The developed method is specific,sensitive,easy and fast to operate,which is suitable for detecting levidipine and its related impurities.

Objective To observe the effects of Taohechengqitang combined with danazol on CA125 and gonadal hormone in the treatment of patients with endometriosis.Methods 77 cases from July 2014 to January 2015 in department of obstetrics and gynecology of Daqing Longnan hospital were selected and divided into observation group of 40 cases and control group of 37 cases according to double-blind randomized.The observation group were treated with Taohechengqitang joint danazol treatment, and the control group were treated with danazol alone.The estradiol ( E2 ) , progestogen (P), cancer antigen 125 (CA125), thromboxane B2 (TXB2), endometrial cysts size and dysmenorrheal score pre-and post-treatment between two groups were compared.Results The contents of E2 and P post-treatment in observation group were lower than those in control group (P<0.05).The serum TXB2 and CA125 levels post-treatment in observation group were lower than those in control group (P<0.05).The endometrial cysts size and dysmenorrheal score post-treatment in observation group were lower than those in control group (P<0.05).The total efficacy in observation group was higher than that in control group (P<0.05).Conclusion Taohechengqitang combined with Danazol could reduce the CA125, E2 and P levels, relieve symptoms of dysmenorrhea and reduce the cyst volume, whose efficacy is exact.

Objective To investigate the present situation and to analyze related factors of nursing practice environment among 22 public hospitals in Shanghai area.Methods We investigated 1 600 nurses from the 22 hospitals with general information questionnaire and the Chinese version of Practice Environment Scale,and also analyzed related factors by single and multiple factor analysis.Results 1 582questionnaires were taken back.49％ were dissatisfied with their working environment,and 28.1％ were evaluated to have nice practice conditions.Nurse concerned with workforce management and adequate resources were widespread.Logistic analysis indicated that hospital's level,the nurse's age,educational background and seniority were main factors influencing nurses' satisfaction.Nurse work in tertiary hospitals reported lower satisfaction.Conclusions More attention should be paid on improving nursing practice environment.