Objective To discuss the effect of blood glucose monitoring during pregnancy and pregnancy outcome in patients with gestational diabetes mellitus (GDM). Methods One hundred and fifty-three GDM patients from July 2007 to July 2008 were analysed.The cases were divided into satisfactory group (74 cases)and unsatisfactory group (79 cases) based on the level of bleod glucose and compared the pregnancy outcome between the two groups. Results The incidences of pre-eclampsia, polyhydramnios, macrosomia, neonatal hypoglycemia, hyperbilirubinemia of satisfactory group were lower than those of unsatisfactory group(5.41% vs 17.72%,4.05% vs 20.25%, 12.16% vs 31.65% , 5.41% vs 20.25%,8.11% vs 30.38%). The difference is statistically significant (P <0.05). The incidence of premature rupture of membranes, premature birth, postpartum hemorrhage, fetal distress of satisfactory group were lower than those of unsatisfactory group, but there was no significant difference between the two groups. Conclusion GDM can cause great harm to maternal and child health, and satisfactory blood glucose control during pregnancy may reduce maternal and child complications.

Objective To assess the reflectance confocal microscopic features of childhood lichen planus (LP),and to evaluate the performance of reflectance confocal microscopy (RCM) in the diagnosis of childhood LP.Methods RCM was performed for imaging of lesions in 35 children with LP.Then,biopsies were carried out at the same sites followed by histopathological examination.A comparison was conducted between confocal microscopic and histopathological findings.All the 35 cases were diagnosed based on clinical manifestations and histopathological findings.Results RCM imaging of lesions in the 35 cases showed cellular edema forming lowly reflective areas in the epidermis,sharp transition between the granular and spinous layers,and infiltration of moderately reflective inflammatory cells,which corresponded to wedge-shaped thickening of the granular layer on pathological examination.The dermo-epidermal junction was unclear,and dermal papillary rings were obscure or absent with infiltration of inflammatory cells arranged in lamelliform structures around the dermo-epidermal junction,which corresponded to interface dermatitis on histopathological examination.A band-like infiltration of inflammatory cells,including big,highly reflective oval or stelliform pigmentophages and small,moderately reflective round lymphocytes,was observed in the dermis,and the thickness of infiltration was measurable.Dilated blood vessels were longitudinally distributed in the papillary dermis with perivascular infiltration of inflammatory cells and pigmentophages.RCM images were highly consistent with histopathological findings in these patients.Conclusion RCM,as a real-time non-invasive imaging technique,can serve as an auxiliary examination method for the diagnosis of childhood LP.

Objective To evaluate the clinical application value of reflectance confocal microscopy(RCM) in the diagnosis of several common diseases manifesting as papules in children, including lichen nitidus, verruca planae, lichen striatus, milium, molluscum contagiosum and lichen pilaris. Methods A total of 579 children clinically characterized by papules were recruited into this study. RCM was used to observe lesions and perilesional normal skin. The RCM features of 6 diseases manifesting as papules were analyzed and compared. Results Based on RCM images, 236 patients were diagnosed with lichen nitidus, 70 with verruca planae, 123 with lichen striatus, 40 with milium, 53 with molluscum contagiosum and 57 with lichen pilaris. All the 6 diseases had typical RCM features. Concretely speaking, RCM images of lichen nitidus lesions showed infiltration of dense inflammatory cells and melanophages in enlarged dermal papillae. In RCM images of verruca planae lesions, cells in the granular and spinous layers were arranged in concentric circles, giving a rose cluster?like appearance. RCM images of lichen striatus lesions revealed focal swelling of stratum spinosum, absent or local liquifaction degeneration of basal cells, and clustering of a moderate number of inflammatory cells in the superficial dermis. In RCM images of milium lesions, well?circumscribed round or oval structures containing highly but nonuniformly refractive materials could be seen in the dermis. RCM images of molluscum contagiosum lesions showed intact cystoid structures containing highly refractive molluscum bodies. Lowly to moderately refractive cutin ? like materials were observed along with the dilation of hair follicle infundibula in RCM images of lichen pilaris lesions. In RCM images, the 6 diseases were distinguished mainly based on structural features(patterns and refractivity)of skin lesions shown by continuous vertical scanning. Conclusion RCM is of great value to the diagnosis of diseases manifesting as papules in children.

Objective To analyze and set up the effective dose of different ionizing radiation for tunnel construction workers. Methods A total of five tunnels constructed using drilling and blasting methods were selected as the research subjects using the convenient sampling method. The workplace γ radiation effective dose, radon concentrations, and radioactive activity concentrations were detected, and on-site surveys were conducted to estimate the internal and external irradiation doses and total effective doses for workers in different work sites. Results Radiological hazards in tunnels constructed using drilling and blasting methods included radon and its progeny, γ radiation, radioactive dust (uranium-238, radium-226, thorium-232, and potassium-40) and others. The average total effective dose of ionizing radiation exposure for tunnel construction workers was (6.730 1±1.541 1) mSv. The average dose of radon and its progeny was (6.163 0±1.512 8) mSv, radioactive dust was (0.014 6±0.009 1) mSv, γ radiation was (0.552 6±0.138 7) mSv. The dose of radioactive dust of radon and its progeny was 0.24%. Radon and its progeny contributed more to the radioactive dose than radioactive dust and γ radiation (all P<0.05). Among all the radioactive dusts, the dose contribution ranked from highest to lowest was thorium-232, uranium-238, and radium-226. Conclusion For tunnel construction workers, the largest contribution to the effective dose of ionizing radiation exposure is from radon and its progeny for internal irradiation, followed by γ radiation for external irradiation. The contribution of radioactive dust to internal irradiation dose can be considered negligible.

Objective:To evaluate the effect of edaravone on long-term cognitive function in elderly patients undergoing hip replacement.Methods:A total of 160 patients, aged≥65 yr, undergoing elective hip replacement, were divided into 2 groups ( n=80 each) using the random sequence generated by the McLeod-modified Wichmann-Hill pseudo-random number generator: edaravone group (group E) and control group (group C). Spinal-epidural anesthesia was applied in two groups.Edaravone 60 mg (in 100 ml of normal saline, infusion rate 200 ml/h) was intravenously infused from the time point immediately after achieving the anesthesia plane until the following 30 min.Serum chemokine ligand 13 (CXCL13) and interleukin-6 (IL-6) concentrations were detected by enzyme-linked immunosorbent assay before anesthesia, during surgery (30 min after skin incision), and at postoperative days 1, 3 and 7.The Confusion Assessment Method Scale in Chinese was used to detect the postoperative delirium at postoperative days 1, 2, 3 and 7, and the Telephone Interview for Cognitive Status-Modified and ADL score were adopted to assess the cognitive function and quality of daily living, respectively, and the occurrence of cognitive impairment was recorded at 1 and 12 months after surgery. Results:Compared with group C, the total Telephone Interview for Cognitive Status-Modified score and ADL score were significantly increased, the incidence of postoperative delirium and cognitive impairment was decreased, and the serum CXCL13 and IL-6 concentrations were decreased during surgery and at each time point after surgery in group E ( P<0.05). Conclusion:Edaravone can reduce inflammatory responses and improve long-term cognitive function in elderly patients undergoing hip replacement.

Objective:To investigate the effect of long-term low dose ionizing radiation on the levels of interleukin (IL) and TGF-β1 in the population in high background radiation area(HBRA).Methods:Appropriate amount of peripheral blood was drawn from 41 and 44 healthy men aged 45-65 years who were randomly selected from Tangkou town of Yangjiang city (HBRA) and Hengpo town of Enping city (control area, CA), respectively. After centrifugation and stratification, the upper plasma of blood was separated to determine IL-2, sIL-2R, IL-4, IL-5 and TGF-β1 by using ELISA. The difference of plasma IL of the residents in those two regions was analyzed. The influence of region, age, smoking, drinking and income on the indexes of ILs and TGF-β1 was evaluated by Covariance analysis.Results:The concentration of IL-2 at HBRA area was slightly higher than those in the control area, but the other indexes were lower than those in CA residents. The differences of IL-5 ( t=7.124, P<0.001) and TGF-β1 ( t=4.900, P<0.001) between two areas were significant statistically. Covariance analysis showed that smoking had a significant effect on IL-2 level ( F=5.283, P<0.05). Conclusions:Under the influence of long-term low-dose ionizing radiation, all kinds of plasma interleukin levels of residents in HBRA were different with that in CA. The immune balance was biased towards Th1 type cytokines, and the immune function in HBRA was slightly stronger than that in CA, suggesting that long-term chronic low-dose ionizing radiation may induce adaptive changes in the immune function, which needs further study.