Objective To investigate the features of female sexual dysfunction (FSD) in type 2 diabetic patients (T2DM)and to analyze its risk factors. Methods According to FSFI indexes in the sexual function questionnaire,227 female T2DM patients were divided into DM group without FSD [n=144,FSFI≥25] and DM+FSD group[n=83,FSFI<25]. 80 healthy women served as normal controls. The risk factors for FSD were analyzed using logistic regression analysis. Results The occurrence of FSD was 36.6%(83/227) in female T2DM patients. The levels of FSH,TSTO and LH were higher,and E2 was lower in DM+FSD group and DM group than those in NC group(P<0.01),but there was no statistical significance between DM+FSD group and DM group(P>0.05). The score of sexual desire[(2.54±0.58) vs (3.76±0.90) vs (4.59±1.22) score],sexual arousal[(2.30±0.42) vs (3.57±0.85) vs (4.81±1.00) score],vaginal lubricate[(3.35±0.29) vs (4.46±1.32) vs (5.14±0.83) score],orgasm[(2.75±0.68) vs (3.40±1.86) vs (4.02±1.25)score] and total score [(17.94±4.15) vs (24.71±6.33) vs (28.13±5.78) score] were lower in DM+FSD group and DM group than those in NC group. The score of sexual satisfaction[(3.45±1.68) vs (4.94±0.93),(4.99±0.86)score] and pain[(3.55±0.50) vs (4.58±0.47),(4.58±0.62)score] were lower in DM+FSD group than those in DM group and NC group(P<0.05),but there was no statistical significance between DM group and NC group(P>0.05). Logistic regression analysis showed that age,BMI and HbA1c were risk factors for FSD in T2DM patients (P=0.029,0.001,0.022,respectively). Conclusion The occurrence of FSD is common in female type 2 diabetic patients. BMI and HbA1c are the main risk factors for FSD.

Objective The aim of our study is to differentiate left atrial from right atrial tachycardia on the basis of P wave configuration during focal atrial tachycardia (AT).Methods Thirty-three patients with focal atrial tachycardia who had undergone successful radiofrequency catheter ablation were considered for inclusion in the study . Site of origin was the left atrium in 10 patients, and right atrium in 23 patients . The surface 12-lead ECG recordings during atrial tachycardia were reviewed in all patients. We analyzed the correlativity between P wave configuration and left atrial tachycardia.Results The specificity of negative P wave in lead I and aVL that indentifed a left atrial focus was 100% and 95% respectively, but the sensitivity was only 30% and 50% respectively. The specificity and sensitivity of positive P wave in V 1 that predicted a left atrial focus was 87% and 80%,respectively.Conclusion It is possible to predict the site of origin of focal atrial tachycardia by analyzing its P wave configuration,,and may be helpful for preparation before ablation.

Objective To study the effect of hypoxia on EMT molecule E-cadherin, Vimentin and invasion of human breast cancer MCF-7 cells, reveal the mechanism of breast cancer invasion and metastasis and provide experimental and theoretical basis. Methods Western blot was used to observe the change of HIF-1α, E-cadherin and Vimeutin during hypoxia on MCF-7. MTT was used to study the effects of viability.Transwell chamber was used to detect the ability of invasion and metastasis. Results The expression of E-cadherin was significantly lower (0.09±0.02)(t=30.98,P=0.0007) and the expression of Vimentin was significantly higher (0.69±0.04) (t=915,P=0.0000) with the extension of hypoxia.The capability of adhesion (81.23±0.74) (t=82.05,P=0.000),invasion(120±6) (t=22.78,P=0.0009) and migration(190±6) (t=23.49,P=0.000)was significantly increased after 72 h hypoxia(P＜0.05).Conclusion Hypoxia can downregulate E-cadherin and upregulate Vimentin and enhance the adhesion,invasion and migration of MCF-7.

Objective To analyze the risk factors of aggressive posterior retinopathy of prematurity (AP-ROP). Methods A retrospective case-control study was applied. Questionnaire was designed through literature research to collect data of AP-ROP and ordinary ROP(except for AP-ROP)from March,2012 to September, 2014 in the department of neonatology in Guangdong Women and Children′s Hospital. Based on the ratio of 1:2 , the two groups were selected with the matching conditions:the closest date of admission in hospital,ordinary ROP children,collection and analysis of the data. Results Univariate analysis:gestational age(P<0.05),birth weight(P<0.05),oxygen therapy days(P<0.05),days of mechanical ventilation(P<0.05),gestational age<32 w(P<0.05),birth weight<1250 g(P<0.05),oxygen(P<0.05),oxygen≥14 d(P<0.05),mechanical ven-tilation(P < 0.05),mechanical ventilation ≥ 14 d(P < 0.05),PS(P < 0.05),neonatal anemia(P < 0.05), blood transfusion≥2 times(P<0.05),RDS(P<0.05),neonatal pneumonia(P<0.05),apnea(P<0.05), BPD(P < 0.05),intracranial hemorrhage(P < 0.05),metabolic acidosis(P < 0.05),and retinal hemorrhage (P < 0.05) were related to AP-ROP. Multivariate analysis with conditional logistic regression analysis indicated that blood transfusion ≥2 times(OR:14.956,95%CI:4.328~51.684)and apnea(OR:7.590,95%CI:2.507~22.978)were regarded as the independent risk factors for AP-ROP. Conclusions AP-ROP is associated with low gestational age,low birth weight,oxygen therapy and related complications including RDS and retinal hemorrhage. Blood transfusion and apnea are important independent risk factors of AP-ROP.

Objective To explore the moderating or mediating effects of life-meaning between optimism and suicide risk in undergraduates.Methods A total of 1310 college students from one Chinese university completed a survey that included Suicidal Behaviors Questionnaire-Revised (SBQ-R),the Life Orientation Test-Revised (LOT-R) and the Chinese meaning in life questionnaire (C-MLQ).Results The total scores of SBQ-R,LOT-R and C-MLQ of undergraduate were (5.04 ± 2.28),(11.22 ± 2.07) and (37.22 ± 5.22),respectively.Optimism had significant negative correlation with suicide risk (r =-0.22,P ＜ 0.01),and positive correlation with life-meaning (r=0.28,P＜0.01).Life-meaning had significant negative correlation with suicide risk (r=-0.18,P＜0.01).The life-meaning's moderating effects between optimism and suicide risk were not significant(P ＞ 0.05),while the relationship between optimism and suicide risk was mediated by life-meaning,and the mediating effect was 0.07,which accounted for 17％ of the total effects.Conclusion Life-meaning doesnt morderating effect,but partially mediates the relationship between optimism and suicide risk.

Objective To explore the initial therapy indications of acute immune thrombocytopenia (ITP) in children based on the classification treatment.Methods Three hundred and eighty newly diagnosed ITP cases were enrolled in this study from Jan.1st 2012 to Apr.30th 2013 in Children's Hospital Affiliated to Shanghai Jiaotong University.In total 380 patients,there were 214 male cases (56.31％) and 166 female cases (43.68％).The cases were divided into observation group and therapy group according to the initial platelet count which was ≤ 30 × 109/L or the bleeding over moderate volume or with active bleeding.Platelet values were observed in the observation group weekly,adrenal cortical hormone and immunoglobulin treatment were adopted in the therapy group,cases were followed up to Aug.30th 2013,9 months on the average.Results Three hundred and five cases showed overall response (80.26％) and 75 cases showed no response(19.74％).One hundred and seventy-eight cases were divided into observation group (46.84％),in which 133 cases (74.72％) showed complete response or response.Two hundred and two cases were included in therapy group (53.16％),in which 167 cases (82.67％) were with complete response or response.There was no statistical difference between the 2 groups in curative effect (Z =-0.54,P =0.59).Forty-five cases in observation group were no response and accepted therapy,35 of them (77.78％) had response.There were equal efficiency in the initial therapy group and the subsequent therapy group (x2 =3.60,P =0.06).There was no difference between the age of onset,sex and season in 2 groups.Cases aged from 1 month to 1 year seemed to have a high incidence because of vaccination,and in the cases aged from 3 to 14 years the onset was related to infection.The children over 3 years old had higher risk factors in self-healing and the curative effect.There was no severe bleeding or adverse effect or dead cases in this study.Conclusions It is feasible to take platelet count ≤30 × 109/L as the threshold for initial therapy indications.Almost half of the cases could avoid overtreatment and pretherapy observation will not reduce the initial cure effect; no severe internal bleeding was observed in all the cases.

Objective:To analyze the expression of E-cadherin in the epithelial-mesenchymal transition (EMT) induced by transforming growth factor-β1 (TGF-β1) in neuroblastoma.Methods:TGF-β1(1 μg/L, 5 μg/L, 10 μg/L), was applied to SK-N-SH cells in vitro compared with the blank control group.EMT-related genes mRNA and protein expression were detected by carrying out real-time PCR assays and Western blot.A scratch test and migration assay were performed to verify the alteration of SK-N-SH cell migration capacity.Data collected from 18 cases of neuroblastoma patients were selected from the Department of Hematology Oncology, Shanghai Children′s Hospital from January 2008 to December 2012.The expression of E-cadherin in the tumor tissue of the neuroblastoma patients after operation was detected by immunohistochemistry.The clinical features and survival prognosis of these patients were analyzed. Results:Compared with the control group, after SK-N-SH cells were treated with TGF-β1(1 μg/L, 5 μg/L, 10 μg/L), real-time PCR assays and Western blot revealed that the mRNA(0.603±0.081, 0.606±0.008, 0.716±0.166 vs.1.000) and protein expression levels(0.855±0.026, 0.600±0.017, 0.495±0.011 vs.1.000) of E-cadherin were significantly decreased ( F=8.144, P=0.040; F=74.810, P<0.001), while the mRNA(2.132±0.167, 3.494±0.017, 4.184±0.021 vs.1.000) and protein expression levels (1.175±0.053, 1.189±0.058, 1.225±0.106 vs.1.000)of α - smooth muscle actin were significantly increased ( F=547.300, P<0.001; F=68.810, P=0.007), suggesting that EMT changes occur in cells.Scratch test and Transwell migration assay revealed that the number of migrating cells increased obvious with the treatment of TGF-β1 (5 μg/L) ( t=16.070, P=0.040). The 10-year overall survival(OS) rates of neuroblastoma patients with E-cadherin strong positive expression, positive expression, weak positive expression and negative expression in the pathology were (77.78±13.86)%, (75.00±21.66)%, (25.00±21.65)% and 0, respectively ( F=8.160, P=0.040). Conclusions:TGF-β1 can induce the EMT in SK-N-SH cells and increase cell migration.The decrease expression of E-cadherin in neuroblastoma patients is closely associated with clinical progress and recurrence or metastasis of the disease.

Objective To analyze the clinical data of children with Langerhans cell histiocytosis (LCH),to discuss the therapeutic effect,and to analyze the factors related to prognosis.Methods A total of 45 children diagnosed as LCH were divided into group A (18 cases with bone lesion only),group B(6 cases with soft tissue lesion),and group C (21 cases with viscera lesion) according to Shanghai Children's Hospital-LCH-2007 scheme [SCH-LCH-2007 (modified DAL-HX83/90) scheme].(1) Initial treatment:group A was treated with Prednisone (Pred) + Vincristine (VCR) for 28 weeks,and group B was treated with Pred + VCR + Etoposide (VP16) + Mercaptopurine (6MP) for 43 weeks,and group C was treated with Pred + VCR + VP16 + Methotrexate (MTX) +6MP for 52 weeks.(2) Re-treatment scheme after relapse included:①upgrading treatment,group A to group B,group B to group C.②Individual treatment for group C included VP16 modification,and maintained Thymosin and/or Ciclosporin etc.Results The total survival rate was 93.3％ (42/45 cases) and recurrence rate was 26.7％ (12/45 cases).Children in group A and B were all effective,while 2 patients in group C died,and 1 case missed follow-up.Multi-factor analysis showed that the factors like age,sex,group,skeleton,soft tissue,erythra,lymph gland,lung,mouth,ears,hypophysis pituitary had no statistical significance,but liver,spleen and blood involvement had statistical significance in disease relapse:liver (P=0.007 1),spleen (P=0.016 9),and blood (P=0.011 1).Conclusion LCH can affect several organs of children and relapse,and modified DAL-HX83/90 scheme is very effective.The liver,spleen and hematopoiesis system involvement is correlates with the relapse.

Objective To explore factors affecting long-term compliance to weight management (WM) of patients with congestive heart failure (CHF)and to provide evidence for improving patients' compliance.Methods In-depth semi-structured interviews based on reinforcement theory were conducted among 18 CHF patients who received WM intervention over 6 months.The data were analyzed by Colaizzi analysis program.Results Three themes were found:precipitating factors such as the correct perception of disease and self-efficacy,the factors of positive reinforcement such as early gains from WM,readmission,follow-up,family and social support,as well as the factors of negative reinforcement such as gaining nothing during long period,physical and mental disorders.These above factors made long-term compliance to WM of 50％ of the participants dynamic and fluctuant.Conclusions Medical staff should identify patients'compliance at different stages in time during follow-up,analyze the factors that affect their compliance,and then grasp the optimal timing of intervention to perform targeted,multiform and multiple health education to improve compliance.

Objective To determine the characteristics of retinal vascularization in premature infants. Methods A prospective study was carried out which included all premature infants with birth weight<2 000 g, who were hospitalized in Guangdong Women and Children's Hospital from September 1, 2009 to August 31, 2010. Close retinal screening and follow-up were carried out in order to record retinal vascularization at different post-conceptional ages. Spearman correlation analysis was performed for statistical analysis. Results A total of 231 infants were enrolled, and follow-up was completed in 212 infants giving a follow-up rate of 91.8%. Twenty-eight infants developed retinopathy of prematurity (ROP) resulting in a ROP morbidity of 13.2%, and 184 cases had full retinal vascularization. The median birth weight was 1 600 g (1 000-1 900 g) and the median gestational age was 32.4 weeks (27.0-35.5 weeks). In the 32-week post-conceptional age group, the proportion with full vascularization in ZoneⅠ,ⅡandⅢwas 87.1%(81/93), 7.5%(7/93) and 0.0%(0/93), respectively. In the 36-week post-conceptional age group, full vascularization was observed in ZoneⅠ, and the proportion with full vascularization in ZoneⅡandⅢrose sharply at 38-week and 40-week post-conceptional age, respectively. The proportion with full vascularization in ZoneⅢwas 100.0%(24/24) at 43-week post-conceptional age. According to Spearman correlation analysis, there was a positive correlation between ZoneⅡand Zone Ⅲ retinal vascularization progression and post-conceptional age (r=0.690 and 0.720;P=0.000). In premature infants, full retinal vascularization in ZoneⅠoccurred at 36-week post-conceptional age. The median gestational age for ZoneⅡand ZoneⅢretinal vascularization was 38 weeks (32.2-40.4 weeks) and 41 weeks (36.0-42.6 weeks), respectively. Therefore, a further 2-3 weeks were required for full retinal vascularization in ZoneⅡand ZoneⅢ. The time differences for under-vascularization in ZoneⅡandⅢwere 8 to 10 weeks, and the time differences for full vascularization in ZoneⅡandⅢwere 8 weeks and 6 weeks, respectively. Conclusion Retinal vascularization varies in premature infants. Almost all premature infants complete vascularization by term gestational age and the majority of infants need to be followed up to 41 weeks. It is essential to focus on the different retinal regions during maturation.