Objective To investigate the relationship between expressions of alpha 2-HS-glycoprotein (AHSG) gene mRNA and protein in placenta and insulin resistance in patients with gestational diabetes mellitus (GDM).Methods The expressions of AHSG gene mRNA and protein in placenta were detected by reverse transcriptase-polymerase chain reaction (RT-PC R) and Western blot technique in normal uterogestation uterine-incision delivery patients (control group,43 cases) and patients with GDM (GDM group,45 cases).Fasting plasma glucose (FPG) and fasting insuhn (FINS) were detected before uterine-incision delivery,and the homeostasis model of assessment for insulin resistance index (HOMA-IR) was computed.Results The FPG,FINS and HOMA-IR in GDM group were significantly higher than those in control group [(5.28 ± 0.63)mmol/L vs.(4.24 ±0.21) mmol/L,(11.75 ±4.85) mU/L vs.(9.73 ±2.18) mU/L,2.79 ±1.02 vs.1.87 ± 0.66],there were statistical differences (P ＜ 0.01 or ＜ 0.05).The expressions of AHSG gene mRNA and protein in GDM group were significantly higher than those in control group (0.761 6 ± 0.069 1 vs.0.329 4 ± 0.025 1 and 0.824 5 ± 0.137 5 vs.0.420 3 ± 0.075 0),there were statistical differences (P＜ 0.01or ＜ 0.05).HOMA-IR level in GDM group was positively correlated with AHSG gene mRNA and protein (r =0.633,0.587,P ＜0.05).Conclusions The expressions of AHSG gene mRNA and protein are significantly higher in patients with GDM.Insulin resistance may play an important role in the pathogenesis and development of GDM.

Aim To study the protective effect and mechanism of geniposide on human umbilical vein endothelial cell(HUVEC) injury induced by H2O2.Methods The injured model was established by HUVEC treated with H2O2.HUVECs were cultured in vitro and divided into five groups:control group,H2O2 group and geniposide with different concentrations plus H2O2 group respectively.HUVECs were incubated with 400 ?mol?L-1 H2O2 for 12 hours in the absence or presence of various concentrations of geniposide pre-incubation.Survival rate of HUVECs was determined by tetrazolium assay.The intracellular activities of superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),total nitric oxide synthase(NOS) and extracellular nitric oxide(NO) level were detected.The intracellular reactive oxygen species(ROS) level and the apoptotic index and cell cycle alteration were detected by flow cytometry.Results Geniposide concentration-dependently increased the viability of injured endotheial cells,while increased the activity of SOD,GSH-Px,NOS and NO production.The intracellular ROS level and the apoptotic index were reduced by geniposide.The cell proliferation was increased with geniposide incubation.Conclusion Geniposid may be a potential anti-oxidation agent which has a protective effect against HUVEC injuries induced by H2O2.

Objective To evaluate factors associated with mechanical ventilation in infants and young children undergoing cardiac surgery with pulmonary hypertension.Methods 161 Children who were ≤36 months of age, had congenital heart disease with pulmonary hypertension, and had been treated at our hospital between October 2011 and April 2013 were included in this retrospective study.Stepwise linear regression analysis was used to analyse the independent risk factors associated with mechanical ventilation (MV).Results The average of MV time was 40.9 h, the independent risk factors for MV were cardiopulmonary bypass(CPB) time (P =0.020), risk adjustment for surgery for congenital heart disease (RACHS-1) (P =0.014) ,low cardiac output syndrome(LCOS) (P ＜0.001), ventilator-associated pneumonia(VAP) (P =0.001) and postoperative pulmonary artery systolic pressure (sPAP) (P ＜ 0.001).Conclusion The present results suggest that CPB time,RACHS-1 score, LCOS, VAP and postoperative sPAP can significantly affect the MV time in infants and young children with pulmonary hypertension after cardiac surgery.

Objective To investigate the incidence and risk factors of optic atrophy in cerebral palsy(CP).MethodsThe clinical dates of 872 children with CP were analyzed retrospectively.ResultsThe incidence of optic atrophy was 17.1% in CP.There was no significant difference among sexes,age and clinical types.Asphyxiation (OR=1.787,95%CI:1.225～2.608) and premature delivery (OR=2.074;95%CI:1.332～3.230) were significantly related to optic atrophy.ConclusionIn children with CP,the incidence of optic atrophy is high.Asphyxiation and premature delivery are risk factors of optic atrophy.Examination of ocular fundus should be considered as one of the routine examinations.

Objective:To investigate the vascular protective mechanism of different levels of herbs through detecting activity of HO-1/CO system in arterial tissues of rats with stagnancy of collateral-Qi in deficiency condition.Methods:Healthy male Wistar rats of cleanness level were randomly divided into control group,stagnancy of collateral-Qi in a deficiency condition group(SCQDC group),Renshen group,Shuangshen group,and Tongxinluo group.The ultrastructure of endothelium cells in the artery was observed.RT-PCR,Western blot,and immunohistochemical approaches were used to detect JNK,c-Jun mRNA and albumen expression in the arterial tissues.Meanwhile,the content of CO in the arterial tissue was also detected.Results:In SCQDC group,the counts of pinocytotic cells and microvili on the free surface of vascular endothelial cells were significantly decreased;most crests of mitochondria fused with membrane,some even disappeared;serious degranulation was observed in the rough surfaced endoplasmic reticulum.Immunohistochemistry showed that the HO-1 positive signals in the arterial histiocyte weakened significantly compared with the control group.The HO-1 expression was increased in the 3 treatment groups.Compared with control group,SCQDC group had decreased HO-1 mRNA and albumen expression(P

Objective To use CT and 3D reconstruction technique to locating mark of sustentaculum tali ,and measure the an‐gle & length of the specified point of the lateral wall of the calcaneus to sustentaculum tali for providing .To basis for the operation of calcaneus .Methods Thirty adult ankle wet specimens were chosen and scanned with CT ,and the dicom data were converted into the software to 3D‐reconstruction ,the observation and measurement to find new methods of locating mark of sustentaculum tali ;Forty adult calcaneus dried specimens were chosen and scanned with CT .The dicom data were converted into the software to 3D‐re‐construction ,using a workstation software measure the angle and length of the line which from the center of the sustentaculum tail to each point on the calcaneal lateral wall .Results First ,in the function of ankle joint position ,with the foot medial surface as “sag‐ittal reference plane” measurement ,the vertical line passing through the leading edge of medial malleols and the coronal line passing through the leading edge of sustentaculum tali intersect at a point .The vertical distance of the point to leading edge of medial malle‐ols was (34 .95 ± 2 .60) mm ,the length of sustentaculum tali was (21 .44 ± 1 .89) mm ,the height of sustentaculum tali was (10 .17 ± 1 .16) mm ,the anteversion of sustentaculum tali was (35 .31 ± 3 .73)° .Second ,in front of calcaneus ,upward angel of points G ,E were (28 .78 ± 3 .90 )° ,(29 .47 ± 2 .96 )° respectively .Frontward angle of points G ,E were ( - 19 .83 ± 4 .60 )° , ( - 11 .02 ± 4 .74)° respectively .Under the posterior articular surface ,upward angel of points C ,K ,I ,J were(2 .52 ± 2 .46)° ,(2 .92 ± 2 .28)° ,(14 .98 ± 2 .49)° ,(14 .38 ± 1 .90)° respectively .Frontward angle of points C ,K ,I ,J were(7 .32 ± 1 .66)° ,(19 .25 ± 1 .98)° , (10 .30 ± 2 .63)° ,(19 .33 ± 1 .97)° respectively .The length of screw was about 40 - 44 mm .The length of C point to the sustentacu‐lum tail was minimum ,and the length of G was maximum .Conclusion In the function of ankle joint position ,the sustentaculum tail can be located with the leading edge of medial malleols as a surface landmarks .The measurement of the angle and length of which from each point on the calcaneal lateral wall to sustentaculum tail by using CT .

Objective To study the dose distribution in tumor target of radioactive esophageal stent covered with 125I seeds which are arranged at different distance. Methods According to the longitudinal and horizontal distance between the 125I seeds, the experiment was divided into group A (0.5 cm), group B (1.0 cm) and group C (1.5 cm). A sheet of white paper, on which a 2cm diameter circle was drawn and was marked with a 5 cm scale, was scanned with a laser scanner, and the scanning data were saved in JPEG format on the computer desktop. By using image conversion program, pictures of 17 layers with the layer space of 5 mm were created. The picture was transmitted to the computer treatment planning system (TPS) to simulate a 2 cm diameter and 8 cm length esophageal stent. Using TPS to delineate the tumor target area (gross tumor volume, GTV), which was used as the simulation of the inner boundary of the tumor target area, outward expansion of 0.5 cm being regarded as the outside border. An annular and 6cm length tube was delineated and it was used as the target area, and the same prescription dose was set, and in each group 125I seeds of 0.3, 0.4, 0.5, 0.6, 0.7, 0.8 and 0.9 mCi were successively loaded on the simulation of esophageal stent. With the help of TPS the DVH graph was obtained, and the D90 (the dose received by 90% of the target) and V90 (the percentage of the GTV receiving 90% the prescription dose) of the three groups were determined. The results were statistically analyzed. Results The arithmetic mean values of D90 of group A, B and C were (217.15± 19.92), (89.16±32.44) and (31.68±11.52) Gy respectively (F=159.18, P<0.05); and the arithmetic mean values of V90 of group A, B and C were (100.00±0.00)%, (86.47±21.36)%and (29.33±21.54)%respectively (F=32.11, P<0.05). Conclusion The 2 cm-diameter radioactive esophageal stent covered with 125I seeds, which have o.6mci activity and are arranged at 1.0cm distance in both longitudinal and horizontal directions, should be recommended in clinical practice.

Objective To study the imaging features and possible aetiology of osteonecrosis in adults with acute leukemia.Methods Ten adult patients with acute leukemia for osteonecrosis were reviewed retrospectively.All the lesions were confirmed with MRI.Results Four patients with ALL had accepted chemotherapy contained corticosteroids,two of them were performed HSCT,and one patient suffered GVHD.Six patients with AML had accepted chemotherapy without steroids,five of them were performed HSCT,and four patients suffered GVHD.One patient with AML-M3 had accepted chemotherapy including four courses of ATRA.The mean time between diagnosis of osteonecrosis and leukemia was 25.1 months.Nine cases had multiple lesions,one case had single lesion.The lesions involved femurs,tibias,patellas,iliums,and lumbars.Plain radiographs in six patients can not detect any lesion.Circinal reaction ossification could be detected in CT images of four cases.All the cases had typical feature in MRI.Conclusions In adult leukemia patients,osteonecrosis is a complication after chemotherapy or HSCT.Steroids in chemotherapy protocols or treatment for GVHD,ATRA for APML,chemotherapy-induced direct cytotoxic effect or leukemia itself can be the possible risk factor.For the diagnosis,MRI is the most effective way,and CT features of osteonecrosis in leukemia patients are different from those in non-leukemia patients.

Objective To explore the possibility and safety of the simultaneous esophagectomy and off-pump coronary artery bypass grafting(OPCABG) in patients suffering from esophageal cancer combined with coronary artery and summarize the clinical experiences.Methods We retrospectively analyzed the clinical dates of 5 patients performed at the Henan province Chest Hospital from May 2009 to December 2014.The related literature was reviewed.Results All patients were performed the simultaneous esophagectomy and OPCABG through the single left posterolateral thoracotomy 4cases and through median sternotomy and left thoracotomy 1 case.Instrument anastomosis under aortic arch 2 cases and above aortic arch 1 case , left neck anastomosis by hand 2 cases.Coronary artery three ressel disease 3cases, double-vessel 1 case, left main single vessel 1 case.There was no hospital death in this series.Postoperative complications included arrhythmia,anastomotic fistula and pneumonia.Only one patient was still alive, the other patients died of tumor recurrence or metastasis and median survival time was 20.6 months.Conclusion Simultaneous esophagectomy and OPCABG is a safe and feasible treatment modality in patients with severe CAD and esophageal cancer and it may be more beneficial for the patient with early esophageal cancer.

Objective To study the bowel-cleansing efficacy, patient security and mucosal injury of low-volume PEG plus ascorbic acid regimen. Methods Five hundred patients referred for colonoscopy were enrolled and randomly divided into two groups. Group A received low-volume PEG regimen, Group B received sodium phosphate (NaP) regimen for bowel preparation. Patients of the two groups drank solution 5 h before colonoscopies, serum creatinine and electrolyte were monitored at 5 h and 3 h before colonoscopies. The bowel-cleansing efficacy was rated during colonoscopy. All mucosal injuries observed during colonoscopy were biopsied and histopathologically reviewed. Results The patients of group A completed bowel preparation of 233 cases, completed colonoscopy 226 Cases, group B completed bowel preparation 238 cases, completed colonoscopy 210 cases. There was no significant difference in bowel cleansing between the groups (P > 0.05). Group A reported less incidence rate of the mucosal injuries than Group B. Group A reported better patient security than Group B at the same time. Conclusion Compared with sodium phosphate (NaP) regimen low-volume Polyethylene Glycol (PEG) plus ascorbic acid regimen exhibited equivalent bowel-cleansing efficacy and less incidence rate of the mucosal injuries and better patient security.