Objective To investigate the relationship between early pregnancy fasting plasma glucose (FPG) and gestational glucose metabolism disorders. Methods Six hundred and fifty-six pregnant women who were singleton, non-diabetes before pregnancy and had FPG examined during 5-13 weeks of pregnancy were admitted into this study from January 1, 2009 to May 31, 2009. All these subjects had routine prenatal examination and finally delivered in the Department of Obstetrics of Peking University First Hospital. The FPG, 50 g glucose challenge test (GCT) after 24 weeks of pregnancy, 75 g oral glucose tolerance test (OGTT), gestational diabetes mellitus (GDM),gestational impaired glucose tolerance (GIGT) were analyzed with receiver operating characteristic (ROC) curve. Results (1) Relationship between FPG and GCT were analyzed with ROC curve.The maximum area under curve was 0. 539 (95% CI: 0. 493-0. 586) and there was no correlation between the FPG and GCT results(P=0. 057). (2) Relationship between early pregnancy FPG and abnormal FPG examined after 24 gestational weeks were also analyzed . The maximum area under curve was 0. 796(95% CI: 0. 672-0. 920). If 5. 05 mmol/L was taken as the cutoff value, the sensitivity and specificity was 54. 5% and 83. 2%, respectively. There was significant relationship between the two values (r=0. 432, P=0. 000). (3) There were no relationship between early pregnancy FPG and the blood glucose value of 1, 2 and 3 h in 75 g OGTT (r=0. 093, 0. 036 and 0. 107, P=0.122, 0. 549 and 0. 074 respectively). OGTT 0 h value was positively related to OGTT 1, 2 and3 h glucose level (r=0.493, 0.421 and 0.368, P=0.000, respectively). (4) All early pregnant FPG values in this study were under 6.1 mmol/L. Twenty-two GDM and 27 GIGT patients were diagnosed in this study. Early pregnancy FPG did not relate to the GDM and GIGT diagnosis.Conclusions Early pregnancy FPG could not replace 50 g GCT as an early screening for glucose metabolic abnormality in pregnancy, but FPG during early pregnancy is necessary.

Objective To study three single nucleotide polymorphisms (SNP), SNP-43, -19 and - 63 of calpain-10 (CAPN10) gene in pregnant women with glucose metabolism disorders and their relationship with the risk of these disorders. Methods Totally, 270 pregnant women including 156 with an abnormal oral glucose tolerance test (study group) and 114 healthy controls were selected among those delivered at the Department of Obstetrics and Gynecology, Peking University First Hospital from Jan. 2005 to Dec. 2006. The SNP of CAPN10 gene at posifons 43, 19, and 63 were analyzed by primer-introduced restriction analysis-polymerase chain reaction (PIRA-PCR). Results (1) The frequencies CAPN10 SNP-19 2R/2R genotype (26.9% ,42/156) and 2R allele (48.9%, 152/312 ) were higher than those in controls (12.3% ,14/114 and 36.8% ,84/228, respectively; P=0.012, 0.006). (2) Stratified analysis according to family history of diabetes mellitus showed the proportion of the CAPN10 SNP-19 2R/2R+2R/3R genotypes (83% ,47/57) in the study group were significantly higher than that of control group (52%,11/21 ; P=0.009), and the proportion of SNP-63 T/T + T/C genotypes(47% ,27/57) in study group were significantly higher than that of control group (14%, 3/21 ; P=0.026) among those with positive family history. (3) The combined effect of CAPN10 SNP-43, -19 and -63 on glucose metabolism disorders was analyzed by comparing with the other haplotypes and showed that the haplotype 121 distribution in study group was significantly higher than those in controls(P=0.036), and 221 haplotype was significantly lower than controls (P=0.042). Conclusions (1) CAPN10 SNP-19 is associated with glucose metabolism disorders in pregnant women. And 2R allele might be the risk factor. CAPN10 SNP-19 2R/2R +2R/3R and SNP-63 T/T + T/C genotypes might increase the risk of glucose metabolism disorders in women with positive family history. Haplotype 121 might increase the risk of glucose metabolism disorders in pregnant women and 221 be a protective factor.

Objective To study the change of reproductive endocrine function after improved hysterectomy.Methods 60 cases of patients who received improved hysterectomy for hysteromyoma were studied as study group, and 60 cases of patients who received traditional hysterectomy during the same period were set up as control group. Serum reproductive hormones in both groups were measured before the operation, in 1/2 year and in 1 year after the operation.Results In 1/2 year and in 1 year after operation, the serum levels of FSH and E 2 in study group had no significant difference as compared with those in preoperation, and the serum levels of FSH, LH in control group were significant higher, E 2 was significant lower than those in preoperation and those in study group.Conclusions Compared with traditional hysterectomy, improved hysterectomy can preserve the function of ovary. Therefore, improved hysterectomy is a good operation for treatment of benign uterine diseases.

Objective To study newborns weight in singleton term births and the associationbetween newborns birth weight and mode of delivery in 3 hospitals.Methods From Jan.2005 to Dec.2009,13 963 singleton term live neonates born in the Department of Obstetrics and Gynecology of Peking University First Hospital(PU group),6519 neonates in Affiliated Hospital of Binzhou Medical College (BMC group,)and 8725 neonates in Miyun Hospital Affiliated to Capital Medical University,Yanjing Medical College(MYC group)were enrolled in this retrospective study.The newborns weight and the rate of macrosomia was calculated and compared.Those newborns from PU group and MYC group were divided into 2288 neonates at macrosomia group and 20 400 neonates at non-macrosomia group,their mode of deliveries were analyzed.Results(1)The mean neonatal birth weight were(3386 ± 414)g at PU group,(3389 ± 446)g at BMC group and(3445 ± 449)g at MYC group.Neonates born weight in MYC was significantly higher than those from in PU group and BMC group(P =0.000).Neonates born weight in BMC showed higher than those in PU group,which did.not reached statistical difference(P =0.638).(2)The incidence of macrosomia were 7.935％(1108/13 963)in PU group,9.802％(639/6519)in BMU group and 13.524％(1180/8725)in MYU group.The incidence of macrosomia in MYC group was higher than those in PU and BMC group,the incidence of macrosomia in BMC group was higher than that in PU group,which reached statistically difference(P =0.000).(3)The proportion of cesarean delivery were 75.306％(1723/ 2288)at macrosomia group,50.765％(10 356/20 400)at non-macrosomia group,which showed statistical difference(P =0.000).Conclusions(1)The difference of newborns birth weight existed in different administrative level hospital.(2)The risk of cesarean delivery due to macrosomia is higher than that of nonmacrosomia.(3)Obstetricians should pay more attention to nutrition in gestation period to lessen the incidence of macrosomia and cesarean section.

Objective (1) To investigate the glucose and lipid metabolism 6-12 weeks after delivery in women with hyperglycemia during pregnancy. (2) To find out factors associated with the prognosis of women with hyperglycemia during pregnancy. (3) To investigate the feasibility of the diagnostic criteria set by the International Association of Diabetes and Pregnancy Study Group according to the follow-up data of women with hyperglycemia in pregnancy. Methods Clinical data of 262 women with hyperglycemia during pregnancy delivered in our hospital from January 1, 2007 to December 31, 2009 were collected. All patients underwent oral glucose tolerance test (OGTT) at 6-12weeks after delivery. They were divided into two groups according to the postnatal status of glucose and lipid metabolism. Multivariate Logistic regression model was used to analyze the factors affected glucose and lipid metabolism after 6-12 weeks of delivery. Results (1) Among the 262 women, 92(35.1%) were reported with abnormal glucose metabolism at 6-12 weeks of delivery, including one (0. 4 % ) woman with impaired fasting glucose, 81 (30. 9 % ) with impaired glucose tolerance, 4( 1.5 % )with impaired fasting glucose+impaired glucose tolerance and 6 (2. 3%) with diabetes mellitus.glucose levels in OGTT (OGTT 2hPG and the OGTT 3hPG) were risk factors for postpartum 0. 181-0. 918)]. (3) All markers of lipid metabolism were detected in 250 women with hyperglycemia during pregnancy at 6-12 weeks after delivery, the rate of abnormal postnatal lipid metabolism was 63.2%(158/250). In the abnormal group (n= 174), the most common abnormal marker was hypercholesterolemia (n = 126, 50. 4 % ), followed by high levels of low-density lipoprotein-cholesterol (n = 102, 40. 8 %), hypertriglyceridemia (n= 60, 24. 0 %) and low levels of high-density lipoproteincholesterol (n= 11, 4. 4 %). (4) Logistic regression model showed that elevated OGTT 2hPG was the risk factor for postpartum abnormal glucose metabolism [OR= 1. 364 (95%CI: 1. 063-1. 751)], while 0. 169-0. 851)]. Conclusions Women with hyperglycemia during pregnancy are more likely to present with abnormal glucose and lipid metabolism which commonly coexisted with insulin resistance.The risk factors for the postpartum abnormal glucose metabolism in mothers with hyperglycemia during pregnancy include early diagnosis, OGTT 2hPG and OGTT 3hPG, while the protective factor is breastfeeding. The risk factor for the postpartum dyslipidaemia in mothers with hyperglycemia during pregnancy is OGTT 2hPG, while the protective factor is high-density lipoprotein-cholesterol level in pregnancy.

Objective: To determine the effects of active constituent of Radix Ranunculi Ternati on immune function of experimental animal.Methods: Immune suppression mouse models were made by cyclophosphamide method.After intragastric administration,the effects of polysaccharide and saponin of Radix Ranunculi Ternati on phagocytosis of peritoneal macrophage,formation of hemolysin and T-lymphocyte population of peripheral blood were observed and compared.Results: These two active constituent can highten the percent and the index of phagocytosis,enhancement the formation of the hemolysin obviously and increase the number of T-lymphocytes in peripheral blood.Conclusion: The active part of Radix Ranunculi Ternati can stimulate the immunologic function of immune suppression mouse models.

Objective To investigate the outcomes of increased gestational diabetes mellitus (GDM) and the influencing factors after the implementation of the new GDM diagnostic criteria.Methods A total of 1 439 GDM women who delivered in the Peking University First Hospital between May 1,2011 and December 31,2012 were studied and divided into two groups.Group Ⅰ included the women who met the new GDM diagnostic criteria (fasting plasma glucose and 1 or 2 h plasma glucose levels for 75-g oral glucose tolerance test performed between 24 and 28 weeks of gestation were no less than 5.1,10.0 and 8.5 mmol/L),but did not meet the National Diabetes Data Group (NDDG) criteria;and Group Ⅱ included the women who met the NDDG criteria only.Women in Group Ⅰ were further divided into two subgroups according to whether attending the one-day GDM outpatient visit.Follow-up rate and detecting rate of abnormal glucose metabolism at 6-12 weeks after delivery were analyzed.Chi-square test,t test and multivariate Logistic analysis were used for statistical analysis.Results There were 849 GDM women in Group Ⅰ (59.0％,849/1 439) and 590 (41.0％,590/1 439) in Group Ⅱ.The follow-up rate in group Ⅰ was lower than in group Ⅱ [25.9％(220/849) vs 32.0％(189/590),x2=6.112,P=0.013].There were five cases of impaired fasting glucose and 34 impaired glucose tolerance in Group Ⅰ;and four cases of impaired fasting glucose,56 impaired glucose tolerance,eight impaired fasting glucose tolerance with impaired glucose tolerance and five diabetes mellitus in Group Ⅱ;there were significant differences [17.7％(39/220) vs 38.6％(73/189),x2=33.810,P=0.000].(2) In Group Ⅰ,the increased glucose level at 2 h in oral glucose tolerance test during pregnancy (OR=1.547,95％CI:1.038-2.306,P=0.032) and family history of diabetes mellitus (OR=1.879,95％CI:1.066-3.313,P=0.020) were risk factors for postpartum abnormal glucose metabolism,while breast-feeding was a protective factor (OR=0.290,95％CI:0.092-0.914,P=0.035).(3) In group Ⅰ,the follow-up rate in those who attended the one-day GDM outpatient visit was higher than those who did not [30.7％(185/603) vs 14.2％(35/246),x2=23.780,P=0.000],but the detecting rate of postpartum abnormal glucose metabolism were similar in women attending the one-day GDM outpatient visit and those not attending [17.8％(33/185) vs 17.1％(6/35),x2=0.020,P=0.887].Conclusions Increased GDM women still have glucose metabolism abnormality after delivery,especially those who have higher glucose level at 2 h after glucose intake in 75 g oral glucose tolerance test during pregnancy and who have a family history of diabetes mellitus.The one day GDM outpatient visit may improve the follow-up rate for these women.

Objective To investigate the safety of vaginal delivery in gravidas with previous cesarean section and its influencing factors.Methods Four hundred and seventy-four full-term gravidas who received cesarean section at the Department of Obstetrics and Gynecology of Peking University First Hospital from January 1,2012 to August 31,2014 were enrolled in this study.Among those subjects,38 who underwent successful vaginal delivery were grouped into vaginal birth after cesarean (VBAC) group,and the other 436 accepting repeated cesarean section were grouped into cesarean group.Delivery outcomes and maternal/neonatal complications of the two groups were retrospectively analyzed with two-sample t-test and Chi-square test.Results Among the 45 patients (9.5％) who attempted VBAC,seven underwent cesarean section for suspected fetal distress and the other 38 (84.4％) succeeded in vaginal birth without uterine rupture.The amount of postpartum hemorrhage in patients of cesarean group was more than that of VBAC group [(330.8±94.8) vs (257.7± 199.7) ml,t=2.021,P＜0.01] after exclusion of three patients with dangerous placenta previa,and the postpartum hospital stay was shorter than that of cesarean group [(2.5± 1.4) vs (4.5± 1.3) d,t=7.952,P＜0.01].There were three newborns with neonatal asphyxia,twelve with neonatal infections and forty transferred to the Pediatrics Department following cesarean section.Besides,complications of headache and urinary retention occurred in 20 and 32 mothers after cesarean section,respectively.However,no complication occurred in VBAC group.Sixty-three cesarean sections were indicated as thin lower uterine segment and among them,fourteen (22.2％) had muscular rupture.Among the six patients who complained of tenderness in lower uterine segment,three were found having muscular rupture during cesarean section.Conclusion VBAC is an option for gravidas with history of cesarean section only if they meet the criteria for VBAC attempt.VBAC could lower the cesarean section rate without increase the incidence of complications.The rate of trial of labor after cesarean was low,patients education should be strengthened to increase it.

Objective To investigate the expression and significance of cellular inhibitor of protein phosphatase 2A (CIP2A), bcl-2 and p63 in papillary thyroid cancer (PTC). Methods Using immunohistochemistry to detect the expression of CIP2A, bcl-2 and p63 in 30 cases of nodular goiter (NG), 30 cases of thyroid adenoma (TA) and 57 cases of PTC [including classical PTC (cPTC) 20 cases, papillary microcarcinoma (PMC) 20 cases, follicular thyroid papillary carcinoma (FPTC) 7 cases]. Results In NG group, TA group and PTC group, positive rates of CIP2A were 0, 0 and 94.74 % (54/57), respectively. The differences were statistically significant. In NG group, TA group and PTC group, positive rates of bcl-2 were 16.67 % (5/30), 13.33 % (4/30) and 85.96 % (49/57), respectively. The differences were statistically significant. In each group, positive rates of p63 were 6.67% (2/30), 3.33% (1/30) and 5.26% (3/57), respectively, no significant difference among them. In PTC, expression of CIP2A and bcl-2 were significantly higher than in NG and TA (χ2 = 105.56, P= 0.00; χ2 = 58.95, P= 0.00). Furthermore, the expression of CIP2A and bcl-2 had correlation in PTC (r=0.94, P=0.00). The expression of CIP2A, bcl-2 and p63 had no significantly difference among all the PTC subtype (χ2 values were 2.02, 2.64, 1.85; all P> 0.05). The expression of CIP2A, bcl-2 and p63 was not associated with patients'age, sex, site, lymph node metastasis (all P>0.05). Conclusions High expression of CIP2A and bcl-2 is associated with PTC, and the expression of CIP2A and bcl-2 has correlation in PTC. The expression of p63 has no correlation with PTC.

Objective To detect the expression of hypoxia-inducible factor 1α (HIF-1α) and bcl-2 ovarian serous carcinoma and their clinical significances. Methods Paraffin specimens including 61 cases of ovarian serous carcinoma and 50 normal ovarian tissues were selected. The expressions of HIF-1α and bcl-2 proteins were detected by immunohistochemical EnVision method and their relationship between them was analyzed. Results The positive rate of HIF-1α and bcl-2 proteins expression in 61 ovarian serous carcinoma was 68.9%and 54.1%, respectively. There was a significant difference between the two groups (χ2=55.381, P< 0.05; χ2= 38.493, P< 0.05). The clinical pathological parameters showed that the positive expression of HIF-1αand bcl-2 proteins were not related with the age (P>0.05). HIF-1αpositive expression was correlated with tumor grades, the state of lymph node metastasis and FIGO stages (χ2=4.931, 25.008, 5.610, P<0.05). Bcl-2 was significantly associated with tumor grades and lymph node metastasis (χ2= 6.956, 33.869, P<0.05), but not with FIGO stages (χ2=3.391, P>0.05). The expression of bcl-2 was positively correlated with HIF-1α in ovarian serous carcinoma (r= 0.304, P= 0.017). Conclusions The expressions of HIF-1α and bcl-2 play a synergic role in the progression of ovarian serous carcinoma. The combined detection of HIF-1αand bcl-2 is effective for patients'prognosis judgment.