Objective:To determine the relationship between trimester-specific gestational weight gain and pregnancy outcome among women with twin pregnancies.Methods:A retrospective cohort study was conducted among Chinese women with twin pregnancies delivered from January 2013 to October 2015 in the International Peace Maternity & Child Health Hospital of China Welfare Institute.Gestational weight gain was compared between women with different progestational BMI.After the adjustment for age and progestational BMI,binary Logistic regression analysis was conducted to explore the relationship between gestational weight gain rate and gestational complications,premature birth,premature rupture of membrane and neonatal birth weight.Results:①A total of 472 subjects met the inclusion criteria.Rate of gestational weight gain were(0.41 ±0.15),(0.64 ±0.30) and (0.49 ±0.15) kg/week in Early,Mid-and Late-,and Whole of pregnancy respectively.②With regards to trimester-specific gestational weight gain,statistically significant associations were found between rate of weight gain and gestational hypertension and preterm birth (P ＜ 0.05).Those with faster gestational weight gain had higher rate of premature rupture of fetal membrane(P ＜ 0.05).And those with lower gestational weight gain had lower neonatal birth weight(P＜0.05).③After adjusting maternal age,progestational BMI and gestational age at delivery,the sum of twins' birth weight increased 25.21g,30.89g and 21.46g respectively when the maternal body weight increased 1kg during the whole pregnancy,in Early and Mid-pregnancy (P ＜ 0.001),and during in Late-pregnancy(P =0.001).Conclusions:Gestational weight gain among women with twin pregnancy are closely related with adverse pregnancy outcomes.The gestational weight gain rate in different gestation are of some predictive value for pregnancy outcomes.More research with long follow-up are needed to determine proper gestational weight gain for twin pregnancy suitable for Chinese women.

Objective:To observe the application effect of continuous blood purification(CBP) machine in treatment of multiple organs dysfunction syndromes(MODS) in children.Methods: 26 cases of children with MODS implemented CBP therapy were choosed as the research objects. All the patient’s treatment time, replacement liquid dosage, the quantity of liquid ultrafiltration were recorded. All the patient’s blood pressure and heart rate were monitored before and after CBP therapy. The changes in the renal function indices such as BUN and SCr, the blood gas indexes such as pH, PaO2, PaCO2, HCO3-and BE, the electrolyte indicators such as Na+, K+, Cl- and osmotic pressure were observed and compared before and after CBP therapy.Results: (1)The average period of treatment of 26 cases in children with MODS was (77±53)h. The average amount of fluid replacement was (18.4±15.8)L/d, and the average quantity of liquid of ultrafiltration was (2630±1760)ml/d. The vital signs of all the children were stable in the process of CBP therapy, and the blood pressure and heart rate had no obvious changes before and after treatment. (2)The renal function indices such as BUN and SCr decreased obviously after treatment. The differences were statistically significant (t=50.392,t=96.115;P<0.05). The blood gas indexes such as PH, PaO2/FiO2, HCO3- and BE were improved significantly after treatment (t=4.450,t=20.105,t=11.209,t=54.840;P<0.05). The electrolyte indicators such as Na+, K+, Cl- and osmotic pressure had no obvious change after treatment (P>0.05).Conclusion: CBP therapy can effectively reduce various inflammatory mediators and toxin, improve renal function, help to stabilize the environment in the body and it is an effective, safe and reliable therapeutic method in the treatment of children with MODS.

Objective To explore the effect of swimming training on the microcirculations of cochlea in guinea pigs with tertram ethylpyrazine(TMP) treatment after chronic hypoxia.Methods 28 guinea pigs were divided into normal control group outside of cabin (A) and chronic hypoxia model group (B). After four weeks the model group were divided into the model control group (B 1),TMP treatment group (B 2),swimming training group(B 3) and swimming training with TMP treatment group (B 4).Until the given time,LDF was used to investigate the blood flow of every guinea pig's cochlea.The spiral ligament spreaded-slice optical lens was used to observe guinea pig's vascular veins, capillary appearance and RBC counts.Results There was significant difference in cochlear blood flow(CBF) and RBC counts between B 2,B 4 groups and B 1 group.CBF and RBC counts of B 3 group was improved comparing with B 1 gorup,so did that of B 4 group comparing with B 2.But no significant difference was found.Conclusion Swimming training can relieve the swelling on the thin blood vessel and improve the effect of TMP on the microcirculation in cochlea of guinea pigs under chronic hypoxia environment.

Objective To explore the influencing factors during long-distance transportation and medical rescue of trauma patients in Wenchuan earthquake. Methods After Wenchuan earthquake, based on prehospital care scheme, we organized medical coordinators and psychologically trained medical staff in emergency medicine, cardiovascular medicine and logistics to transport trauma patients and pro-vide early psychological intervention during whole course of transportation. Results A total of 162 trauma patients were safely transported from Sichuan province to Chongqing relying on prehospital care scheme, equipment supplies, integrated rescue mode and psychological intervention during the transporta-tion. Conclusions Medical rescue mode and psychological intervention indicate that it is necessary to conduct psychological intervention for better transportation of patients for further medical treatments. In the meantime, we should establish medical rescue system for coping with psychological stress, improve rescue preparation scheme and professional medical care team for long-distance transportation and guaran-tee sufficient medical supplies in station hospitals.

Objective To observe the effect of metformin and exercise therapy for IGT. Methods 86 patients with IGT were given metformin and exercise therapy,the range of glucose,BMI and symptoms improvement were observed before and after the therapy. Results After 6 months therapy,the fasting blood glucose and 2 h after oral administration of 75 g glucose levels were significantly reduced(P＜0.01＝,BMI reduced(P＜0.05＝.72 cases (83.7%)were back to normal glucose tolerance,14 cases maintained IGT(those unable to adhere to exercise and no diet controlled),0 case became DM. Conclusion Metformin and exercise therapy had good efficacy in curing IGT.

Objective To collect the hot spots, development trends, high yield authors and their affiliated institutions by analyzing the papers on pancreatic cancer chemotherapy in recent 5 years. Methods The papers on pancreatic cancer chemotherapy were downloaded from PubMed. Their high frequency subject headings extracted by BICOMB were analyzed by bibliometric double clustering analysis and strategic coordinate analysis. The high yield authors were analyzed by co-authorship group analysis. Results The current studies on pancreatic cancer chemotherapy in foreign countries were focused on the pathological features of pancreatic duct adenocarcinoma before and after chemotherapy, drug therapy of pancreatic cancer according to its genetics, metabolism and pharmacology of antitumor drugs, surgical treatment combined with radiotherapy and chemotherapy for pancreatic cancer. The high yield authors could be divided into two large groups from Japan and USA and a number of small groups. Conclusion New breakthrough points should be found from the matured topics, the topics with a further developmental space should be greatly concerned, and cooperation should be strengthened between study groups or teams.

Objective To investigate the differences in the structures,numbers and phenotypes of the dendritic cells (DCs)at different stages in colorectal cancer (CRC)tissue,and to explore the effect of DCs in the occurrence and development of CRC.Methods 20 cases of CRC tissue were chosen as CRC group,other 20 cases of corresponding para-cancer tissue were chosen as control group.Immunohistochemical staining was used to detect the distribution, the structures,the number of positive cells at different stages;Western blotting was used to detect the expressions of CD1a and CD83.Results The results of immunohistochemical staining showed that DCs scattered among glands or vessels in both groups;the CD1a+imature DCs (imDCs)were round and oval,dendritic processes were faintly visible in both groups,and the number of CD1a+imDCs in experimental group was significantly higher than that in control group (P<0.01).The CD83+ mature DCs (mDCs)were irregular,branched in both groups,and the number of CD83+mDCs in CRC group was significantly lower than that in control group (P<0.01).The results of Western blotting method showed that the expression of CD1a protein was higher and the expression of CD83 protein was lower in CRC group than control group (P<0.01).Conclusion CD1a+imDCs may play important roles in promoting the occurrence and development of CRC;CD83+mDCs may inhibit the occurrence and development of CRC.

Objective To analyze of the relationship between level of anxiety and depression before surgery and anus exhausting time for patients after gynecological abdominal surgery.Methods A descriptive study was conducted with a survey of 100 cases of patients with gynecological abdominal surgery where the level of anxiety and depression before surgery and post-anus exhausting time were analyzed to explore the correlation between them.Results In the 88 valid questionnaires,the incidences of stress and anxiety before surgery were respectively 38.64％(34/84) and 19.32％(17/88) and the average anus exhausting time after surgery was (44.55 ± 13.90) hours;the anus exhausting time of anxious patients was significantly longer than that of non-anxious patients [(48.35±12.84) hours vs.(42.50±14.13) hours,t=-2.12,P＜0.05] and bivariate Logistic regression analysis suggested that preoperative level of anxiety had a significant effect on anus exhausting time after surgery.Conclusions Stress,anxiety and other negative emotions can affect anus exhausting time after surgery and level of anxiety could be used as one predictor of the delay of anus exhausting time after surgery.

Objective To identify the effect of arsenic trioxide (As2O3) on the differentiation and apoptosis of different types of neuroblastoma(NB) cell lines.Methods The cell lines [SK-N-SH,SK-N-BE2,SH-SY5 Y] were induced with different concentrations (0 μmol/L,1 μmol/L,3 μmol/L,5 μ mol/L and 7 μ mol/L) of arsenic trioxide for 24 h,48 h,72 h under the same conditions.The expression of MYCN gene was examined by fluorescence in situ hybridization assay in SK-N-BE2,cell proliferation,cell cycle and cell apoptosis were detected with cell counting kit-8 (CCK-8) assay and flow cytometry.Results 5 μmol/L of As2O3 inhibited the expression of MYCN gene in SK-N-BE2;CCK-8 assay indicated that As2O3 inhibited the proliferation of NB cell in a dose-and time-dependent manner,the cell proliferation was significantly suppressed compared with the low concentration (1 μ mol/L) after treated with As2O3 by 1 μmol/L,3 μmol/L,5 μmol/L and 7 μmol/L in 24 h,48 h and 72 h,SH-SY5Y:24 h(chisq =9.666 7,P ＜ 0.05),48 h (chisq =9.666 7,P ＜ O.05),72 h (chisq =9.512 8,P ＜ 0.05);SK-N-SH,24 h (chisq =10.38,P＜0.054 6),48 h(chisq=8.641 0,P＜0.05),72 h(chisq=9.461 5,P＜0.05);SK-N-BE2:24 h (chisq =8.435 9,P ＜0.05),48 h(chisq =8.641 O,P ＜0.05),72 h(chisq =9.545 5,P ＜0.05);compared with the control group,the As2O3-treated cells showed increased apoptosis percentage,with the percentage of 1.6％ (0 μmol/L),3.8％ (1 μmol/L),6.1％ (3 μmol/L),10.4％ (5 μmol/L),40.2％ (7 μ mol/L);the cell cycle was arrested at G2/M phase,which prevented cell division.Conclusions (1) As2O3 play an important role on the NB cells proliferation,apoptosis which were dose-and time-dependent manner.(2)As2O3 can inhibit the expression of MYCN gene.(3)As2O3 also could block NB cell cycle at S and G2/M,and inhibit the cell nucleus replication and the As2O3 had different induced effect between different types of NB cell.

Objective To investigate the effects of 13-cis retinoic acid (13-cis RA) in inducing differentiation of 3 types of human neuroblastoma (NB) cells in vitro.Methods The status of MYCN gene amplification of cultured SH-SY5Y,SK-N-SH and SK-N-BE2 cells was detected by fluorescence in situ hybridization.After treatment with different concentrations of 13-cis RA,morphological changes were observed by phase-contrast microscope,and neuron-specific enolase (NSE) concentrations were determined by enzyme linked immunosorbent assay.The cell viability was measured through cell counting kit-8 assay,and the cell apoptosis was assayed with flow cytometry (FCM).Results The morphological changes in differentiation were observed in all 3 types of NB cells after 13-cis RA treatment.MYCN amplification was detected in SK-N-BE2 cells even after 13-cis RA treatment,while the other 2 cell lines were amplification-null.After different concentrations of 13-cis RA treatment,NSE concentration increased with prolonged time,especially for SK-N-BE2 cell(F =27.00,P ＜ 0.000 1).13-cis RA stimulated cell proliferation within 48 hours of treatment,and then inhibited cell growth.FCM indicated that the degree of apoptosis in SH-SY5Y cell was significantly higher after 13-cis RA treatment of 10 μmol/L concentration for continuous 96 h and 120 h as compared to the control group (F =16.21,P =0.011;F =16.04,P =0.016).Cell apoptosis of SK-N-SH cell after 13-cis RA treatment of 1 μ mol/L and 10 μ mol/L concentration for 48 h,were significantly higher than those of the control group (F =15.05,P =0.012;F =31.18,P =0.005);while SK-N-BE2 cell with different concentrations of 13-cis RA(1 μmol/L,5 μmol/L,10 μ mol/L) for 120 h were significantly higher than those of the control group(F =9.05,P =0.030;F =11.38,P =0.028;F =7.88,P =0.041).Conclusions The present study showed that 13-cis RA could induce differentiation of human NB ceils in vitro.It induces cell proliferation within 48 hours of 13-cis RA,and thereafter suppresses cell growth.No improvement was found in MYCN amplification cells with the detection of DNA level after 13-cis RA treatment,which suggests that combined treatment is possibly needed.