Objective To study the clinical features and the clustering of risk factors in gestational diabetes mellitus (GDM),and analyze the risk factors.Methods Two hundred and three gravida were selected.According to the result of 75 g oral glucose tolerance test,they were divided into 2 groups:GDM group(134 cases) and normal glucose tolerance (NGT) group (69 cases).Blood sugar,blood fat and insulin were measured,and the homeostasis model of assessment for insulin resistance index (HOMA-IR),pancreatic islet beta cell function index (HOMA-β) and insulin sensitivity index (ISI) were calculated.The relation was analyzed between the risk factors and GDM.Results The age,progestation body mass index (BMI),fasting blood glucose,fasting insulin,total cholesterol,triglyeride,low density lipoprotein-eholesterol (LDL-C),HOMA-IR and the positive rate of diabetes mellitus family history in GDM group were significantly higher than those in NGT group [(30.8 ±4.1) years vs.(28.7 ±3.9) years,(24.29 ±3.65) kg/m2 vs.(21.35 ±2.39) kg/m2,(5.22 ±1.26) mmol/L vs.(4.33 ±0.53) mmol/L,(9.27 ±3.55) mU/L vs.(4.75 ±2.73) mU/L,(5.54 ± 1.26) mmol/L vs.(3.74 ± 1.07) mmol/L,(2.63 ± 1.43) mmol/L vs.(1.73 ± 0.76) mmol/L,(3.02 ± 0.97) mmol/L vs.(2.10 ± 0.75) mtmol/L,0.67 ± 0.47 vs.0.43 ± 0.34,40.3％ (54/134) vs.26.1％(18/69)],there were statistical differences (P＜ 0.01 or ＜ 0.05).The HOMA-β and ISI in GDM group were significantly lower than those in NGT group (4.62 ± 0.72 vs.5.57 ± 1.30 and-3.79 ± 0.47 vs.-2.91 ± 0.48),there were statistical differences (P ＜ 0.01).Logistic regression analysis result showed that fasting blood glucose (OR =6.016,95％ CI:1.603-22.585,P =0.008),total cholesterol (OR =2.823,95％ CI:1.568-5.083,P=0.001),diabetes mellitus family history (OR =2.780,95％ CI:1.168-6.617,P=0.021),fasting insulin(OR =1.954,95％ CI:1.371-2.785,P=0.001),progestation BMI(OR =1.787,95％ CI:1.124-2.839,P =0.014),age (OR =1.374,95％ CI:1.087-1.737,P =0.008) and diastolic pressure (OR =1.184,95％ CI:1.045-1.342,P =0.008) were the risk factors of GDM.Conclusions GDM has the clinical features of the clustering of risk factors and genetic susceptibility.The disorder of lipid metabolism and glycometabolism,genetic susceptibility and age are the main risk factors in the development of GDM.

Objective To explore the risk factors of pregnancy complications in patients with gestationaldiabetesmellitus(GDM).Methods 134patientswithGDMweredividedintocontrolgroup without complication (n= 38) and complication group(n= 96).Serum fasting levels of glucose (FPG) , insulin ,lipid and C‐reactive protein (C‐RP) were measured. Both maternal and fetal complications of pregnancy were recorded. Results The levels of C‐RP ,FPG ,progestation BMI and lategestation BMI were significantly increased in complication group than in control group [(5.46 ± 4.20) vs (2.60 ± 2.76) mg/L ,(5.68 ± 1.36) vs (5.25 ± 0.77)mmol/L ,(24.79 ± 3.92) vs (23.03 ± 2.51)kg/m2 ,(29.05 ± 3.79) vs (27.25 ± 2.58)kg/m2 respectively ,P< 0.05].The C‐RP level is significantly associated with FPG.Logistic analysis showed that maternal complications were significantly related to lategestation BMI ,C‐RP , TC and HDL‐C.Infant complications were significantly related to C‐RP. Conclusion C‐RP ,lipid and late gestation BMI play important roles in the development of maternal‐neonatal complications during pregnancy. Keeping rational levels of glucose ,lipid and weight gain are helpful for improving pregnancy outcomes.

Background Accurate measurement of corneal refractive parameters plays an important role in the diagnosis of eye diseases,design of refractive surgery and calculation of intraocular lens (IOL) power.Ophtha TOP is a new IOL calculator,so it is necessary to evaluate the repeatability and accuracy of Ophtha TOP in measuring corneal refractive parameters.Objective This study was to evaluate the repeatability of Ophtha TOP in measuring corneal refractive status in normal eyes and determine the agreement of the measuring outcomes between Ophtha TOP and Pentacam in pre-surgery cataract eyes.Methods A reliability evaluation method of diagnosis test was performed from September 2013 to October 2014.Sixty eyes of healthy volunteers aged (30.83 ±8.66) years old were examined in Tianjin Eye Hospital with Ophtha TOP for more than 5 times to evaluate the stability in measuring corneal refractive parameters.Corneal refractive parameters were measured by both Ophtha TOP and Pentacam for more than twice in 30 pre-surgery cataract eyes to assess the agreement with Pentacam.Keratometry and astigmatism parameters were recorded,including the flattest meridian (Kf),steepest meridian (Ks),mean keratometry (Km) and the astigmatism at J0 and J45.Intra-class correlation coefficients (ICC),repeatability (2.77Sw) and coefficient of variation (CoVs) were used to assess the stability of Ophtha TOP,and Bland-Altman graphs were adopted to value the consistency of measuring outcomes between Ophtha TOP and Pentacam.This study complied with Helsinki declaration,and written informed consent was obtained from each patient prior to any medical examination.Results The ICC of Ks,Kf,Km,J0 and J45 by Ophtha TOP were all ≥0.90,and 2.77Sw were all ≤0.36,The CoVs of Kf,Ks,Km by Ophtha TOP were all ≤0.30.The measuring values of Kf,Ks and Km were significantly higher in the Ophtha TOP than those in the Pentacam,with the mean differences (0.18±0.28) D,(0.24±0.29) D and (0.21± 0.26) D,respectively(t =3.48,4.50,4.49,all at P=0.00).The mean difference of the J0 was (0.07±0.21) D and that of the J45 was (-0.02±0.18)D between Ophtha TOP and Pentacam,showing insignificant differences between them (both at P＞0.05).Bland-Altman graphs revealed that the 95％ limit of agreement (LoA) of Kf,Ks and Km between the two methods was-0.37 D to 0.73 D,-0.33 D to 0.81 D and-0.30 D to 0.72 D,respectively,and that of J0 and J45 was-0.34 D to 0.48 D and-0.37 D to 0.33 D,respectively.Conclusions Ophtha TOP shows an excellent repeatability.Compared with Pentacam,Ophtha TOP presents a good consistence for measurement of the corneal astigmatism and moderate consistence for corneal curvature.

Objective To analyze the cases of malignant tumors found in health examination in our hospital, and to determine the prevalence and characteristics of malignant tumor, and to provide evidence for the development of effective early screening program. Methods A total of 468673 subjects were included from those who had health checkup from July 2009 to December 2014 at the physical examination center. The subjects were between 4 to 96 years of age, with average age of (56.0±12.5) years. Of them, there were 278484 men, 190189 women. All cases found in the examination were confirmed with pathological testing. Prevalence comparison was done withχ2 test, statistic significance level was set at P<0.05. Results Totally 753 cases of malignant tumors were found in 6 consecutive years, with an overall prevalence rate at 160.7/100000. The prevalence rate increased yearly from 50.0/100000 for the first year, and 100.6/100000, 146.1/100000, 149.1/100000, 188.9/100000, 221.6/100000 thereafter. The difference between each 2 years was statistically significant (P<0.01). The top ten malignant tumors were liver cancer, cervical cancer, lung cancer, renal cell carcinoma, esophageal cancer, gastric cancer, colon cancer, breast cancer, leukemia and thyroid cancer. The prevalence rates of malignant tumors in the top three were liver cancer, lung cancer and kidney cancer for man and cervical cancer, lung cancer and breast cancer for women respectively. With the increase of age, the incidence of malignant tumor showed a rising trend, especially for the group of over 80 years old. But women with cervical cancer in the 50-years age group was the highest. Conclusion The number of cases of malignant tumors found in the health checkup population was rising. It is important to include early screening for malignant tumor in physical examination. We should also pay attention to the relevant departments, in order to improve the early cancer detection rate and decrease the morbidity and mortality of malignant tumors.

Objective To improve the clinical efficacy of angina pectoris with dyslipidemia patients, analysis of the combined use of trimetazidine, atorvastatin calcium, the clinical value of psychological intervention.Methods 86 cases of patients with coronary heart disease and angina pectoris with dyslipidemia were selected, according to the random number table method is divided into control group and study group, each group of 43 cases. The control group were given routine symptomatic angina pectoris of coronary heart disease with abnormal blood lipid therapy plus trimetazidine hydrochloride oral Sibutramine, study group on the basis of the control group given oral atorvastatin calcium plus psychological intervention of statin treatment. Results After treatment, the clinical efficiency of the study group and the control group was 95.34％ and 81.4％, the difference between the two groups was statistically significant (P<0.05); patients in the study group SDS, SAS score than the control group, the difference between the two groups was statistically significant (P<0.05); patients in the study group, TC, TG, LDL and C levels were significantly lower than the control group, the HDL level of C higher than that of control group, the difference between the two groups was statistically significant (P<0.05); study on patients with angina pectoris attack times less than the control group, the seizure duration shorter than the control group, the difference between the two groups was statistically significant (P<0.05). Conclusion Psychological intervention combined with the treatment of angina pectoris of coronary heart disease with abnormal blood lipid, clinical efficiency increased from 81.4％ to 95.34％, reduced in patients with depression, anxiety and other negative emotions, so that the blood has been effectively controlled, improve clinical symptoms, reduce the pain of patients, with high clinical value.

Objective To study the expression of CD163 in macrophages and sCD163 level in the serum of neonatal rat model of Escherichia coli (E. coli) sepsis. Methods A total of 72 specific-pathogen-free (SPF) neonatal rats (P7) were randomly and equally assigned into experiment group and control group. E. coli was injected peritoneally and the sepsis model was established in the experiential group while normal saline (NS) was injected in the control group. Samples were collected at 2, 4, 6, 12, 24 h and 48 h after the treatment. CD163 expression in macrophages of lung and liver tissues were tested using immunohistochemical(IHC) method, and the dynamic changes of sCD163 concentration in the serum were monitored usingenzyme-linked immunosorbent assay (ELISA) method. Results In the experiment group, CD163 expression in macrophages of lung and liver were gradually decreased at eachtime point (P <0. 001). At 2 h, CD163 expression in macrophages showed no significant differences between the two groups (P >0. 05). At 4 h and later timepoints, the differences were statistically significant (P <0. 001) . Meanwhile, sCD163 in the serum increased gradually (P <0. 01). At 2 h, sCD163 in the serum showed no significant differences between the two groups (P >0. 05). At 4 h and later timepoints, the differences were statistically significant (P <0. 001). Conclusions CD163 plays an important role in sepsis.

Objective To investigate the production of hydrogen sulfide (H2S) in rats with monocrotaline (MCT)-induced pulmonary hypertension(PAH).Methods Fourteen male Wistar rats were randomly divided into 2 groups (7 cases for each group):control group and MCT group.Rats in the MCT group were intraperitoneally injected with MCT (60 mg/kg) on day 1 while rats in the control group received only the same volume of 9 g/L saline.And then the conventional breeding was given for 21 days.Mean pulmonary artery pressure (mPAP) was evaluated via right cardiac catheterization procedure.The ratio of right ventricular mass (RV) and left ventricular plus septal mass (LV + SP) [RV/(LV + SP)] was calculated.The morphological change of pulmonary artery was observed by applying hematoxylin-eosin (HE) staining on the lung tissue paraffin section by measuring relative media thickness (RMT) and relative media area (RMA) of pulmonary aetery.H2S contents in serum and lung tissue rat were detected by using free radicals detector.The expression of cystathionine-γ-lyase (CSE),a key enzyme catalyzing endogenous H2S generaion,in lung tissue was detected by using Western blot method.CSE mRNA level in lung was detected by adopting the real-time polymerase chain reaction (RT-PCR) method.Results Compared with control group,mPAP of rats in MCT group was increased significantly [(49.31 ±3.67) mmHg vs (14.31 ±2.07) mmHg(1 mm Hg =0.133 kPa),P ＜ 0.01] and the ratio of RV/(LV + SP) was increased (0.43 ± 0.03 vs 0.21 ± 0.03,P ＜ 0.01),while RMT and RMA of pulmonary artery were enlarged [(43.46 ± 1.94) μm vs (13.16 ± 1.48) μm,P ＜ 0.01;(3 321.10 ± 318.20) μm2 vs (963.40 ± 127.26) μm2,P ＜0.01].The evaluation of microstructure of pulmonary artery showed that the vessel wall of pulmonary artery in control rats was thin and no inflammatory cell was observed around artery.However,the vessel wall of pulmonary artery in rats of MCT group was thickened and there was evident infiltration of inflammatory cells in perivascular area.Compared with control group,H2S contents in serum and lung tissue of rats in MCT group were markedly decreased [(9.28 ± 0.94) μmol/L vs (14.20 ± 1.21) μmol/L,P ＜ 0.01;(0.43 ± 0.08) μmol/g protein vs (0.87 ±0.17) μmol/g protein,P ＜0.01],while CSE protein and mRNA expression in lung tissue of rats in MCT group were downregulated (0.14 ± 0.02 vs 0.28 ± 0.09,P ＜ 0.01;0.84 ± 0.06 vs 1.12 ± 0.04,P ＜ 0.01).Condusion Endogenous H2S pathway is significantly downregulated in rats with monocrotaline-induced pulmonary hypertension.

Objective: To analyze the correlation of miR-625 expression with clinicopathological characteristics in esophageal squa-mous cell carcinoma (ESCC) and to explore the effect of miR-625 on the migration and proliferation of ESCC cells. Methods:The expres-sion level of miR-625 was determined through real-time PCR in 86 paired human ESCC tissue specimens and tumor-adjacent normal esophageal tissue specimens, ESCC cell lines, and esophageal epithelial cell line. The associations of miR-625 expression with clinico-pathological characteristics and survival in ESCC patients were analyzed. Transwell and CCK-8 assays were performed to examine the effect of miR-625 expression on migration and proliferation of ESCC cells. Results:Compared with tumor-adjacent normal specimens, miR-625 was significantly downregulated in ESCC tissue specimens (P<0.05). MiR-625 expression was decreased in ESCC cell lines com-pared with human esophageal epithelial cell lines (P<0.05). Lower miR-625 expression was associated with poorer prognosis and sur-vival. The migration and proliferation abilities of ESCC cells were inhibited by miR-625 overexpression (P<0.05). Conclusion:MiR-625 acts as a tumor suppressor gene in the development and progression of ESCC, suggesting that miR-625 may serve as an efficient prog-nosis biomarker and a potential therapeutic target for ESCC.

Objective To explore the relationship between periodontal disease and preeclampsia and the effects of periodontal treatment on preeclampsia.Methods China National Knowledge Infrastructure,Chinese Biomedical Literature Database,WANGFANG DATA,China Dissertation Full-Text Database,China Proceedings of Conference Full-Text Database,Cochrane Library,PubMed,EMbase,Elsevier,Springer,and Science Direct OnSite were extracted from inception till September 30,2014.The case-control,cohort and randomized controlled trials about the association of matemal periodontal disease and preeclampsia were searched according to the inclusion and exclusion criteria.RevMan5.1 and Stata12.0 were used to test the heterogeneity of the results among the different studies and amalgamate the effect size using fixed or random effect models.Results Twenty studies (15 case-control and 5 cohort) involving 8 775 women assessed the association between periodontal disease and preeclampsia.A positive association was found (OR=2.48,95％CI:1.76-3.48,P ＜ 0.01).Meta-analysis of the case-control studies showed more than twice in the odds of preeclampsia with the presence of periodontal disease (OR=2.75,95％CI:1.93-3.92,P ＜ 0.01).Meta-analysis of cohort studies did not reveal any significant differences (OR=1.84,95％CI:0.91-3.74,P ＞ 0.05).Four randomized controlled trials with 3 712 women evaluated the effect of periodontal treatment on preeclampsia,and meta-analysis showed no relative risk reduction in preeclampsia with periodontal treatment (RR=1.04,95％CI:0.84-1.30,P ＞ 0.05).Conclusions Periodontal disease appears to be a possible risk factor for preeclampsia,but treatment during pregnancy does not prevent preeclampsia.High-quality prospective studies are needed to confirm the relationship between periodontal disease and preeclampsia.

Objective To explore the possibility of three-dimensional orbit replications for clinic and teaching of orbital blowout fracture surgical operation.Methods The orbital CT DICOM format data from 10 patients with orbital floor fractures were selected between November 2016 and January 2017 from Wendeng Osteopath Hospital.Thresholding technique,region growing technique,edit mask technique and multiple slice edit technique were used in sequence by Mimics software.And 3D replications were printed by Object 500 3D printer.The sizes of the replications were measured.The model of orbital blowout fracture and surgical implant model were simulated by senior orbital surgeon.Results In the 10 cases,male was 5 cases,and female was 5 eyes.The 3 D replications of the orbits were successfully designed and printed.The sizes of the 3D replications were basically consistent with those of patients' orbits,and there was no statistical difference (all P ＞ O.05).Under operation room surgery simulation environment,the orbital fracture surgical repair operation was demonstrated to the resident by the senior surgeon,3D printing orbital blowout fracture model can be successfully used to simulate the operation and teaching demonstration.Conclusion 3D printing orbital blowout fracture model can restore the true orbital injury and orbital anatomic details,provides the design operation of stereoscopic model for the physician,which has positive significance to understand the scope and surgery teaching simulation of orbital blowout fracture.