Pregestational diabetes mellitus may cause fetal heart defects,and it is considered to be an important non-genetic risk factors for congenital heart defects. However, the pathogenesis is unclear. Recent studies have shown that hyperglycemia, which acts as a primary teratogen in pregestational diabetes mellitus, may affect the endocardial cushion formation and neural crest cell development. Cardiac oxidative stress damage, increased myocardial cell apoptosis,increased synthesis of extracellular matrix, as well as the alteration of heart development-related genes expression are important pathogenic mechanism. In this paper, we review the progress in the effect and the pathogenesis of pregestational diabetes mellitus on heart development.

Objective: To evaluate the properties of PLA-PEG as a biodegradable scaffold material combined with rhBMP-2 for bone construction.Methods:PLA-PEG/rhBMP-2 multipore compound was prepared,then compression intensity and compression module were tested.The mandibular defect model was made in 20 rabbits,then PLA-PEG/rhBMP-2 was implanted into the defects on one side,and PLA-PEG without rhBMP-2 was implanted into the defect on another side as the control.The bone specimens were retrieved to make density analysis with X-ray photogram following sacrifice of the rabbits 2,4,8 and 16 weeks respectively after operation,then the specimens were decalcified to make histopathological observation by means of HE stain.Results:Compression intensity(MPa) of the PLA-PEG/(rhBMP)-2 compound was 30.05?3.12,and compression module(MPa) was 371.67?12.37.At 2,4,8 and 16 weeks,more new bone was observed,and higher intensity(P

Objective To investigate the effects of retrograde cardioplegia on serum soluble inter cellular adhesion molecule (sICAM)-1,soluble P-selectin (sPs) and cardiac troponin Ⅰ(cTnI) in the process of heart valve replacement operation.Methods Fifty-six cases undergoing heart valve replacement with cardiopulmonary bypass (CPB) were divided into antegrade cardioplegia (AC) group and retrograde cardioplegia (RC) group.Serum levels of sICAM-1,sPs and cTnI were measured using enzyme-linked immunosorbent assayd (ELISA) at six times.Results After the CPB,the levels of sICAM-1,sPs and cTnI ascended quickly,at the time of 8-hour after operation achieved the peak value.The peak value of RC group were lower than those of AC group[sICAM-1 (817.9±133.2)μg/L vs(901.1±132.0)μg/L,sPs(83.46±16.24)μg/L vs(107.82±19.68) μg/L,cTnI(10.50±2.03) μg/L vs (14.45±2.26)μg/L],and the dedined degree of RC group were faster than those of AC group.Conclusion Retroperfusion has a better myocardial protection to the patients suffering heart valve replacement operation through active suppressed expression of sICAM-1,sPs and cTnI palliated inflammatory reaction.

This article compares and analyzes the content and theoretical structure of the concept of pathogenesis from the national textbooks of Basic Theory of Chinese Medicine and Diagnostics in Chinese Medicine from the first to the ninth version.The authors consider the mechanism as the main content of pathogenesis concept in contemporary Chinese medicine.During the construction of this concept,the concept of pathology has a profound influence,wh ich differs a lot from the emphasis on key in ancient pathogenesis content,mainly reflected in clinical diagnosis and treatment ideas transferring from dealing with key issues to dealing with abstract concept.This change is associated with the impact of western medicine on modern Chinese medicine,emphasizing the mechanism and so on,so that the ancient Xiang (象) concept is marginalized.

Objective To retrospectively analyze the one-year outcomes of modified single-armed suture technique for microsurgical vasoepididymostomy in men with epididymal obstructive azoospermia (EOA).Methods From February,2012 to November,2013,microsurgical longitudinal intussusception vasoepididymostomies using a modified single-armed suture technique in 51 men with EOA was performed.The followed-up period was designed as 1 year.The correlations between the sperm motility in epididymal fluid,unilateral or bilateral procedure,anastomotic site,and the female partner age and the patency or pregnancy rate were analyzed.Results Followups were carried out for 39 (76.5％) men.The patency was noted in 24 (61.5％) men and pregnancy was reported in 15 (38.5％) female partners,including 1 received in vitro fertilization using fresh ejaculated sperm.Motile sperms in epididymal fluid were observed intraoperatively in 14 (58.3％) patent men and 3 (20.0％) nonpatent men,respectively (P ＜ 0.05).In patent cohort,the mean ages of the pregnant and non-pregnant female partners were 26.5 and 32.7 years(P ＜ 0.05),respectively.Conclusion The modified single-armed suture technique showed favourable patency and pregnancy rates in this study.It's a practical alternative in the areas without the specialized double armed suture.

Objective To establish a zebrafish IGFBP-2 gene knock-down model by morphilino modified antisense oligonucleotide injection, so as to investigate the abnormal phenotypes of heart and vessels in early stage of zebrafish development and the expression of zebrafish cardiogenesis related genes. Methods The spatiotemporal expression of IGFBP-2 gene in early stage of zebrafish development was testified by whole mount in situ hybridization with antisense RNA IGFBP-2 probe. The IGFBP-2 morpholino (IGFBP-2 MO) that especially inhibited the gene promoter and standard control morpholino (Con-MO) were designed and synthesized by Gene-tools Corporation. Four different concentration gradients (0.05, 0.10, 0.25 and 1.0 mmol/L) were set as IGFBP-MO injection groups with 0.25 mmol/L Con-MO injection group and wild type group as controls. Contribution to the incidence of heart abnormal phenotypes and mortality rate induced by 4 different IGFBP-2 concentrations injection group was recorded and compared with 2 control groups. Heart abnormal phenotypes at different developmental stages in 0.25 mmol/L IGFBP-2 injection group were observed in detail. To validate the effectiveness of IGFBP-2 MO, the expression of enhanced green fluorescence presented by wild type zebrafish embryos at 12hpf which received single injection of IGFBP-2 EGFP recombinant plasmid and those co-injected with Con-MO or IGFBP-2 MO were detected. To investigate the regulation relationship between IGFBP-2 gene and other cardiogenesis related genes, expression of atrium specific marker gene Amhc was detected in IGFBP-2 MO and wild type group by in situ hybridization. Ventricle specific green fluorescence of Vmhc-EGFP transgenic zebrafish embryos whose IGFBP-2 gene was knocked-down were compared with those untreated. Zebrafish peripheral vascular development in the IGFBP-2 MO group was also checked out by micro-angiography. Results Whole mount in situ hybridization revealed that IGFBP-2 gene expressed in turn at eyes, midbrain and then focused on liver in early stage of zebrafish development. The micro-injection of 0.25 mmol/L IGFBP-2 MO resulted in heart malformation in nearly 60% of all injected zebrafish embryos. Heart malformation phenotypes included slow heart beat, pericardial edema, weak ventricle systole contraction and heart tube looping disorder. Some of them represented atria dilation, blood regurgitation and ciculation obstruction. Wild type zebrafish embryos that received single injection of IGFBP-2 EGFP plasmid DNA or co-injected with Con-MO presented strong enhanced green fluorescence at 12hpf, meanwhile, the fluorescence was barely seen in the embryos co-injected with IGFBP-2 MO. This strongly validated the gene specific knock-down effect of IGFBP-2 MO. Amhc was down-regulated at 48hpf in IGFBP-2 MO group. Vmhc-EGFP transgenic zebrafish down-regulated by IGFBP-2 gene also resulted in attenuated expression of ventriclar-specific green fluorescence protein at 48hpf. Intersegmental blood vessels of IGFBP-2 MO group by micro-angiography at 60hpf demonstrated an sparsate and chaos image, which suggested that IGFBP-2 gene expression was involved in the regulation of normal vascular development. Conclusions Micro-injection of IGFBP-2 MO is an efficient way to knock-down IGFBP-2 gene in zebrafish embryos. IGFBP-2 gene expression down-regulation leads to heart and vessels maldevelopment and have an impact on the expression of cardiogenesis related genes of zebrafish embryos as well. In short, IGFBP-2 plays a critical role in the normal cardiovascular development of zebrafish embryos.

Objective To study effect of refined nursing management in the treatment of asthma in children with acute bronchitis and its effect on lung function,white blood cell count and Creactive protein.Methods A total of 128 children with bronchitis admitted in our hospital were randomly divided into study group and control group,with 64 cases in each group.The patients in the control group were treated with traditional care,and the patients in the study group implemented refined nursing management.The symptom disappearing time,oxygen saturation,pulmonary function indicators [forced expiratory volume in one second (FEV1),forced vital capacity (FVC),peak expiratory flow rate (PEFR)],white blood cell count,and C-reactive protein were observed and compared in two groups.Results The symptoms disappeared time such as cough and asthma in the study group was significantly shorter,and oxygen saturation was higher than that in the control group (P ＜ 0.05).Before nursing intervention,levels of FEV1,FVC and PEFR between the two groups had no significant differences (P ＞ 0.05),and were significantly improved after nursing in both groups,and the study group improved more than that in the control group (P ＜ 0.05).After nursing intervention,the C-reactive protein and white blood cell counts in both groups were lower than before nursing,and the study group was lower than the control group,the difference was statistically significant (P ＜0.05).Conclusion Refined nursing management in children with acute bronchitis can significantly reduce asthma,cough symptoms,shorten treatment and hospitalization time,improve treatment compliance and lung function,so it is worthy of further promotion.

Objective To study effect of refined nursing management in the treatment of asthma in children with acute bronchitis and its effect on lung function,white blood cell count and Creactive protein.Methods A total of 128 children with bronchitis admitted in our hospital were randomly divided into study group and control group,with 64 cases in each group.The patients in the control group were treated with traditional care,and the patients in the study group implemented refined nursing management.The symptom disappearing time,oxygen saturation,pulmonary function indicators [forced expiratory volume in one second (FEV1),forced vital capacity (FVC),peak expiratory flow rate (PEFR)],white blood cell count,and C-reactive protein were observed and compared in two groups.Results The symptoms disappeared time such as cough and asthma in the study group was significantly shorter,and oxygen saturation was higher than that in the control group (P ＜ 0.05).Before nursing intervention,levels of FEV1,FVC and PEFR between the two groups had no significant differences (P ＞ 0.05),and were significantly improved after nursing in both groups,and the study group improved more than that in the control group (P ＜ 0.05).After nursing intervention,the C-reactive protein and white blood cell counts in both groups were lower than before nursing,and the study group was lower than the control group,the difference was statistically significant (P ＜0.05).Conclusion Refined nursing management in children with acute bronchitis can significantly reduce asthma,cough symptoms,shorten treatment and hospitalization time,improve treatment compliance and lung function,so it is worthy of further promotion.

Objective To study the effects of high concentrated quercetin on red blood cells in vitro of patients lacking G6PD. Methods A total of 50 cases whose G6PD activity were normal and 50 cases who lacked G6PD were selected. Peripheral blood was collected and incubated with quercetin to test the erythrocyte GSH and MetHb and the morpho-logical changes of red blood cells was observed. The effects of quercetin on erythrocyte of patients lacking G6PD activ-ity were investigated. Results Quercetin had obvious effect on the oxidation of erythrocytes of patients lacking in G6PD and the patients' GSH decreased but their MetHb increased significantly (P<0.05). The MetHb in the high concentra-tion group was (5.70±2.03)%, which was significantly higher than that in medium and low concentration groups (3.51± 1.67)%,(1.31±0.68)%. The difference was statistical significant(P<0.05). The effect of alpha naphtha on the patients in deficiency group and the normal group had obvious differences, but the performance of alpha naphthol in the 2 in-cubation system at the presence was different. Conclusion The effect of quercetin on red blood cells of erythrocyte of patients lacking G6PD have some adduction. So it could be cautious when the compounds preparation containing oxidiz-ing falconoid is used.

Objective: To evaluate the clinical effect of clear aligners in the anterior region in non-extraction cases by establishing a three-dimensional model of crown-root fusion to guide clinical application. Methods: Eleven patients visiting the orthodontic department of Xuzhou Stomatological Hospital from December 2020 to December 2021 were collected, and the orthodontic plan was designed using Maestro 3D Dental Studio scheduling software to obtain the expected three-dimensional model of the patient's orthodontic treatment result. CBCT, intraoral scan, and 3D reconstruction software were used to create a postoperative model of the patient. The crown and root data were aligned in Geomagic Studio 2014, and differences in torque and axial inclination between the actual model after treatment and the predicted model of the anterior teeth before treatment were compared in 3-matic. Results: The actual torque angles of the anterior teeth were all smaller than the predicted angles before treatment, with the highest realization rate of 77.55% for lateral incisors and the lowest of 60.70% for central incisors; the actual axial inclination angles of the anterior teeth were also smaller than the predicted angles before treatment, with the highest realization rate of 81.49% for central incisors and the lowest of 74.95% for cuspids. Conclusion A digital model of crown-root integration based on a combination of 3D reconstruction and intraoral scanning techniques is advantageous in assessing the efficacy of clear aligners. In non-extraction cases with clear aligner, the efficiency of movement is higher for small areas of the anterior region.