Objective To investigate the relationship between fasting plasma glucose (FPG) in early pregnancy and diagnosis of gestational diabetes mellitus (GDM) and to confirm the rationality of the new standard for GDM diagnosis in early pregnancy set by the International Association of Diabetes and Pregnancy Study Groups (IADPSG).Methods Clinical materials of 2761 pregnant women without diabetes mellitus,who accepted prenatal cares in Peking University First Hospital from April 1,2011 to December 31,2011,were collected and analyzed.The difference between FPG levels of GDM and non-GDM women was compared.According to the early pregnancy FPG level,the subjects were divided into group A (FPG＜5.1 mmol/L,n=2431) and B (FPG≥5.1 mmol/L,n=330).The incidence of GDM and pregnant outcomes of the two groups were compared with t or Chi-square test.Relationship between FPG and GDM was analyzed by Logistic regression and receiver operating characteristic curve.Results (1) Among the 2761 subjects,515 were diagnosed as GDM (18.7％) and the early pregnancy FPG level in GDM group was significantly higher than that in non-GDM group [(4.84±0.46) mmol/L vs (4.57 ± 0.35) mmol/L,t =11.924,P =0.000].In early pregnancy,the risk of GDM increased by 7.984-fold (OR=8.984,95％CI:6.605-12.220) with every 1 mmol/L increase of the FPG level.(2) The diagnostic rate of GDM during mid-and last-trimester in group A (15.2％,370/2431) was lower than that of group B (43.9％,145/330),x2 =123.976,P =0.000.(3) Receiver operating characteristic curve analysis of FPG in early pregnancy and diagnosis of GDM:The largest area under the curve was 0.718 (95％ CI:0.690-0.747).The sensitivity and specificity were 0.600 and 0.612,or 0.735 and 0.726 respectively,when 4.795 mmol/L or 4.785 mmol/L were set as the cut-off value.(4) Among the 1208 cases delivered,GDM was diagnosed in 227 cases.The cesarean section rate (54.2％,123/227) of GDM women was higher than that (39.2％,385/981) of non-GDM women (x2 =16.884,P=0.000).There were no differences in the incidences of macrosomia,neonatal hyperbilirubinemia,low birthweight infant,premature delivery,fetal growth restriction and preeclampsia between GDM and non-GDM group (all P＞0.05).The incidence of premature birth in GDM women with FPG＜ 5.1 mmol/L was lower (5.8％,10/173) than that (14.8％,8/54) of women with FPG≥5.1 mmol/L (x2=4.601,P＜0.05).The incidence of cesarean section,insulin administration,macrosomia and preeclampsia increased from low FPG group to high FPG group,however there was no statistical significances.Conclusions Diagnosing GDM with FPG≥5.1 mmol/L in early pregnancy is not recommended as over diagnosis might happen.But this cut-off value might indicate that the patient are at risk of GDM,and this population should not be ignored.

A total of 120 medical students were surveyed to investigate the current status of communication between medical students and old patients and the awareness of medical laws. The questionnaire shows many students don't have enough knowledge of communication skills and medical laws. Furthermore, the most important reason of the medical disputes is the lack of communication between doctors and patients so the cultivation of communication skills and legal knowledge should be strengthened.

Aged ; Female ; Hemangioma ; Humans ; Nose Neoplasms ; Turbinates

Ten to twenty ?l of 20-50% horseradish peroxidase (HRP) in normal saline solution was injected into the myocardium of the anterior wall of left and right ventricles in 11 rabbits. The areas containing sino-atria as well as atrio-ventricular nodes and the dorsal wall of the atria were removed separately. Frozen or cryostate sections of these tissues 25-40?m thick, were incubated according to the HRP (tetramethylbenzidine "TMB" method)-AChE combined method. The blue granules produced by the HRP with TMB were observed in the perikarya of a few AChE intensely positive ganglion cells which were located in the epicardium of the dorsal wall of the atria. This indicated the processes of the HRP-AChE double labeled cells distributed to the myocardium of the anterior wall of the ventriculum. It is generally believed that the nerve cells of strong AChE activity can be referred as cholinergic neurons. For this reason, the present study may give further identification to assert the parasympathetic innervation of the ventricular myocardium. The parasympathetic postganglionic neurons innervated the anterior wall of left and right ventriculi are situated primarily in the epicardium of the posterior wall of the atria.

Specific antibodies purified from sera of rabbit infected with Toxoplasma gondii were used to immun-oscreen the 12-mer and 7-mer phage random peptide libraries. By 3 rounds of screening, 70 clones were picked out ra-ndomly to test the specificity and 43 were found positive by ELISA. 23 of the 43 positive clones showing strong reaction in ELISA were picked out for sequencing. Clone A7 was selected as mimic antigen in ELISA test after analysis of the 23 short peptide sequences. 23 out of 47 sera from rabbits infected with Toxoplasma gondii were ELISA positive by A7 mimic antigen with a positive rate of 68.1%, and 10 of 155 sera from healthy persons showed false positive with a sp-ecificity of 93.5%. The primary result suggests that mimic antigen may have a potential use in diagnose of toxoplasmosis.

Objective:To investigate clinical features, risk factors and prognostic effects of paradoxical response(PR)in children with tuberculous meningitis(TBM)during anti-tuberculosis treatment.Methods:The clinical and follow-up data of TBM children admitted to the Department of Pediatrics, the Affiliated Hospital of Zunyi Medical University between January 2013 and December 2018 were retrospectively analyzed.The children were divided into the PR group and the non-PR group.Influencing factors of PR were selected by the univariate analysis, and independent risk factors were screened from these influencing factors by using the multivariate Logistic regression model.The effect of PR on long-term prognosis (≥9 months) of TBM was evaluated. Results:There were 31 cases(35.6%)with PR among the 87 TBM children enrolled, including 16 boys and 15 girls, with median age of 92(8-168)months.The median time for PR occurrence during the anti-tuberculosis treatment was 33(15-180)days.PR could present dete-rioration or recurrence of original symptoms, cerebrospinal fluid(CSF)deterioration and neuroimaging deterioration, accounting for 71.0%(22/31 cases), 80.6%(25/31 cases)and 51.6%(16/31 cases), respectively.Univariate analysis showed that stage Ⅱ, limb paralysis, cranial nerve palsy, positive tests of tuberculosis infection(T-SPOT), an increased lactate dehydrogenase(LDH)level in CSF, basilar meningeal enhancement, and tuberculosis infection outside the central nervous system were the influencing factors of the PR(all P<0.05). Multivariate analysis showed that limb paralysis, cranial nerve palsy, an increased CSF-LDH level, and positive T-SPOT were independent risk factors of PR(all P<0.05). PR was not associated with prognosis( P=0.165). Conclusions:PR occurs in 35.6% of children with TBM.Limb paralysis, cranial nerve palsy, an increased CSF-LDH level and positive T-SPOT are independent risk factors of PR.PR does not adversely affect the outcome.Identifying PR is extremely important for the prevention of some clinical misunderstandings.

α1-Antitrypsin (α1-AT) belongs to serine protease inhibitor (Serpin) superfamily and is the main protease inhibitor in human circulation. It can inhibit many proteases to protect tissues from digradation. The mutant Z (Glu342Lys) of α1-AT predisposes to the early onset of emphysema due to decreased functional α1-AT in the lung and to neonatal hepatitis due to accumulation of α1-AT polymers in the endoplasmic reticulum of hepatocytes, which disrupts the balance between protease and protease inhibitors. This paper reviews recent research progress on the pathogenic mechanism and the prognosis of α1-antitrypsin deficiency.

Objective To investigate the effect of extracellular signal-regulated kinases(ERK) signal transduction in the process of NSCs differentiating into neurons in the fimbria-transected hippocampi's extracts. Methods Twelve Sprague-Dawley rats'right fimbrias were transected. The extracts were gained from the fimbria-transected hippocampi at the 14th day normal rat, and the extracts supernatant fluid was collected after centrifugal process, then the protein concentration in the extracts was determined. In the serum-free medium,NSCs from the fetal hippocampus were planted on 24 well culture plate, then were divided into three group and eight wells for each group as follows: the transected group contained the extracts of the fimbria-transected hippocampi;the normal group contained the extracts of the normal hippocampi;the pure control group have no extracts. After cultured for 14 days,the cells were detected by using MAP-2 and p-ERK immunofluorescence. Result The number, area, perimeter of MAP-2 positive neurons were all declined in transected group, the normal group and the control group orderly. Statistic results showed significant difference between every two groups. The number of MAP-2/p-ERK double-positive neurons were decreased in transected group, the normal group and the control group orderly, but the percentage of double-labeled neurons in total MAP-2 positive neurons were increased in turn. In these two aspect, there were also significant difference between every two group. And most of the MAP-2/p-ERK double-positive neurons were immature. Conclusion The extracts of the fimbria-transected hippocampi had obvious effects on promoting NSCs differentiating into neurons and speeding up the maturation of neurons than those of the normal hippocampi. The morphological results showed that ERK signal transduction might be related to the differentiation of NSCs into neurons.

Objective To investigate the efficacy and safety of enhanced external counter pulsation(EECP) in treatment of coronary heart disease in patients aged 80 years and older.Methods The 336 consecutive elderly patients with coronary heart disease were treated in our hospital from May 2016 to October 2017 in a prospective study.The 168 coronary heart disease patients aged 80 years and older were divide into a control group(n=84)receiving conventional therapy(anti-platelet drugs,angiotensin converting enzyme inhibitors,angiotensin-receptor blocker,β-blockers,calcium antagonists,nitrates,statins),and EECP group(n =84) receiving enhanced external counter pulsation 0.5 h/time,2 times per day,36 days as a course as add-on therapy to conventional therapy.And 168 patients aged 60～ 79 years received the same therapy as those in EECP group.After one course of EECP treatment,the therapeutic effects were evaluated by Seattle angina questionnaire (SAQ)and Pittsburgh sleep quality index(PSQI),and the incidence of major adverse cardiovascular events and readmission rate were compared between groups of the EECP vs.control group and group of patients aged 60-79 years.Results The scores of SAQ and PSQI were better in the EECP group than in the control group after one course of EECP treatment,as follows:physical limitation(35.7 ±10.7 vs.26.0 ± 12.1),anginal stability (53.3 ± 22.9 vs.33.9 ± 18.9),anginal frequency (39.6 ± 6.5 vs.30.4 ± 21.1),treatment satisfaction(38.0±6.0 vs.33.7±4.7),subjective sleep quality(1.0±0.7 vs.2.5± 0.7),sleep latency(1.3±0.6 vs.2.4±0.5),sleep duration(0.9±0.6 vs.2.3±0.6),habitual sleep efficiency(1.1 ± 0.6 vs.2.5 ± 0.6),sleep disturbances (1.2 ± 0.4 vs.2.2 ± 0.6),use of sleeping medication(1.2±0.6 vs.2.2±0.6),and daytime dysfunction score was 1.3 ±0.5 vs.2.3 ±0.6 (P ＜0.01).The incidence of major adverse cardiovascular events was lower in the EECP group(31.0％,26/84)than in the control group(66.7 ％,56/84)(P＜0.05).At 1,3,6,12 months after EECP treatment,there was no significant difference in the incidence of major adverse cardiovascular events and readmission rate between patients aged 60-79 years vs.80 years and over(P＞ 0.05).Conclusions EECP treatment is relatively safe and effective for coronary heart disease patients aged 80 years and older.

We Injecte(?) 12-16 ?l 20—40% HRP in normal sanne into the myocardium orthe anterior wall of the left ventricle in six rats and 10 ?l choleragenoid-horsera-dish peroxidase conjugate(CB-HRP)in three rats.The Th1-3 DRG and the nodoseganglia of both side were removed.The sections of these ganglia were proceeded bythe TMB chromogentic reaction for HRP and immunohistochemical reaction(the firstantibody is the substance P antiserum).There are three types of labeled cells——theHRP labeled cells.Sp-IR cells,and HRP-Sp-IR double labeled cells were observedin the Th1-3 DRG and nodose ganglia of both side.The parts of Sp-IR nerve fib-ers in the heart wall originate from the DRG and nodose ganglia and these neuronsprojecting the HRP-Sp-IR nerve fiber contained substanse P.Their functions may berelated to the pain(nociceptive)sensation of the heart.This study may also be aevidence of the main function of the cardiac sympathetic afferent fiber is the con-duction of the pain sensation.A few of HRP-Sp-IR double labeled cells in thenodose ganglion observed suggest that the cardiac parasympathetic afferent fibermay participate in conduction of the pain sensation.This question requires furtherstudy.