Objective To explore the role of H19 imprinting in etiology of pre-eclampsia. Methods Placentas of 24 women with pre-eclampsia (3 with mild pre-eclampsia and 21 with severe pre-eclampsia) and 50 healthy pregnant women at full term (control) were collected during selected cesarean delivery between August 2007 and March 2008. The statuses of H19 imprinting with placental tissues from normal pregnancy and patients with pre-eclampsia were identified upon polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The systolic and diastolic pressure were analyzed in H19 heterozygotic women. Results (1) There were 20 (40%) heterozygotes in 50 cases placenta tissues of the third trimesters, 11 (45%) heterozygotes in 24 cases placenta tissues of pre-eclampsia, There were no significant difference between two groups ( P > 0.05 ). (2) All 20 heterozygotes in placenta tissues of the third trimesters are exclusively monoallelically expressed, while 5 cases (45%) in 11 heterozygotes of pre-eclampsia are biallelically expressed (loss of imprinting, LOI). There were significant difference between two groups (P < 0. 01 ). (3) The values of systolic and diastolic pressure of patients with monoallelic expression of H19 were (171 ±9) mm Hg (1 nun Hg =0.133 kPa) and ( 104±8) mm Hg, the values of systolic and diastolic pressure with biallelic expression were ( 194±21 ) mm Hg and ( 124±18) mm Hg. There were significant difference between two groups (P<0.05 ). Conclusion LOI of H19 can be identified in pre-eclamptic placentas and is associated with maternal blood pressures, which implies the involvement of H19 gene LOI in the pathogenesis of pre-eclampsia and its potential relationship with the severity of the disease.

Objective To obtain the expression pattern of imprint gene H19 in JEG-3 cell in order to explore the regulation mechanism of H19 on trophoblast cellular biological behavior .Methods After correct identification with sequencing for the recom-binant eukaryotic expression plasmid pRc/CMV which including the whole length of H19 cDNA ,the plasmid was transfected to the cell line JEG-3 .The expression of H19 mRNA was observed and the gene expression profile of three groups of JEG-3 cell were de-tected with Affymetri :U133 plus 2 .0 Array .Results After being transfected with target H 19 gene ,the expression of the mRNA level was significantly increased compared with control group .And the gene expression profile was changed significantly .19 genes were up-regulated ,77 genes were down-regulated .Expression levels of HES1 gene which being choosed as a different expression gene were detected by fluorescence quantitative PCR in severe preeclampsia placenta tissue and normal late pregnant placenta .The expression level of HES1 mRNA in severe preeclampsia placenta decreased significantly than normal late pregnant placenta tissues . Conclusion Many genes induced by H19 have been screened by high-throughput gene chip method .It provides the experimental ba-sis for advanced studying the regulation the cellular biological behavior with H 19 gene .

Objective:To analyze the clinical features of type 2 diabetic patients with insulin autoimmune syndrome after treatment with exogenous insulin.Methods:A total of 106 patients with type 2 diabetes diagnosed with exogenous insulin-related insulin autoimmune syndrome (EIAS) were included from September 2017 to March 2019 in the Department of Endocrinology, Zhongshan Hospital, Fudan University. The clinical data, physical examination, and laboratory examination results of patients were collected.Results:Of the 106 patients, 84 (79.24%) used premixed human insulin or premixed insulin analogs, and 18 patients (16.98%) presented recurrent hypoglycemia. The arginine stimulation test showed that the median value of the baseline insulin was 73.40 (23.07-146.75) μU/ml, and the median ratio of 4 minute insulin to 0 minute insulin was 1.27 (1.03-1.85), with the mean of the ratio 1.72±1.47. The ratio of baseline insulin (μU/ml) to C-peptide (ng/ml) was 44.60 (14.92-87.93), with an average of 81.92±130.93. Taking the two-fold upper limit of fasting insulin reference value (49.8 μU/ml) as the cut-off point, the subjects were divided into insulin accumulation group (baseline insulin≥49.8 μU/ml) and insulin non-accumulation group (baseline insulin <49.8 μU/ml). Among the 66 patients in the insulin accumulation group, 14 patients had hypoglycemia (21.21%) and 4 patients in the insulin non-accumulation group presented hypoglycemia (10%). The ratio of 4 minute insulin to baseline insulin, ratio of baseline insulin to C-peptide, blood glucose level standard deviation (SDBG) and maximum blood glucose fluctuation amplitude (LAGE) in the insulin accumulation group were significantly higher than those in the insulin non-accumulation group (all P<0.05). Among 66 patients in the insulin accumulation group, 36 patients changed the type of insulin preparafion (insulin treatment group), 30 patients were changed from insulin to oral hypoglycemic agents (oral medication group). After treatment, both SDBG and LAGE in the two groups were significantly lower than before treatment ( P<0.05). Conclusions:With the aggravation of exogenous insulin accumulation, the fluctuation of blood glucose and the proportion of hypoglycemia were significantly increased. There was a characteristic change in islet function in patients with insulin autoimmune syndrome. After arginine stimulation, there was no significant peak of insulin secretion, showing a " high-level" curve. The baseline insulin/C-peptide ratio was significantly increased. The prognosis of EIAS patients is good after timely diagnosis and adjustment of treatment.

Under the new situation of rapid development of medical science and technology, how to effectively cultivate medical students’ humanistic spirit and comprehensively improve medical quality is an important responsibility of medical college teachers. Blend-learning can guide students to immersive learning in multiple dimensions and forms. Obstetrics and Gynecology is one of the main compulsory courses for clinical medical students, which is faced more sensitive and vulnerable female patients, and required higher humanistic quality training for medical students. Through the construction of the blend-learning platform, medical humanities can be better integrated into the content and teaching design of medical education, and students can be more appropriately imperceptibly trained in medical humanities in obstetrics and gynecology teaching, so as to enhance medical students’ medical humanities quality in the process of obstetrics and gynecology diagnosis and treatment, and improve doctor-patient relationship.