Objective To investigate the relationship between serum 25-hydroxyvitamin D level and gestational diabetes mellitus (GDM).Methods The fasting plasma glucose,fasting insulin,25-hydroxyvitamin D,and high sensitive C-reactive protein (hs-CRP) levels in the normal glucose tolerance group and gestational diabetes mellitus (GDM) group were measured.The homostasis model assessment insulin resistant (HOMA-IR) and homostasis model assessment β cell (HOMA-B) were calculated for assessing the insulin resistance and β-cell function.The relationship between 25-hydmxyvitamin D and hs-CRP,HOMA-IR,and HOMA-B were analyzed.Results The level of 25-hydroxyvitamin D in the GDM group [(2.16 ± 0.38) nmol/L] was significantly lower than that in the normal glucose tolerance group [(4.13 ±0.79) nmol/L](P =0.001).Serum 25-hydroxyvitamin D level was negatively correlated with hs-CRP (r =-0.448,P =0.002) and HOMA-IR (r =0.396,P =0.004),but was positively related with HOMA-B (r =0.495,P =0.001).Conclusions The serum 25-hydmxyvitamin D level remarkably decreases in GDM patients.Vitamin D deficiency may cause the functional damage of beta cell of islet,increase insulin resistance,and thus contribute to the development of GDM.

To compare the clinical efficacy and safety of atomization inhalation of epinephrine combined with budes-onide and dexamethasone in the treatment of children with acute laryngitis. Methods:Totally 68 cases of children with acute laryngitis were randomly divided into two groups. The two groups were given the conventional therapy, and 30 cases in the control group were giv-en dexamethasone inhalation additionally, and the treatment group was given epinephrine combined with budesonide inhalation addition-ally. The clinical effect in 12, 24 and 72h, clinical symptom disappearance time and adverse reactions in the two groups were ob-served. Results:The clinical effect of the treatment group in 12, 24 and 72h was better than that in the control group. 72h after the treatment, 17 cases in the control group were cured, and the curative rate was 56. 67%, while 27 cases in the treatment group were cured with the curative rate of 71. 05%. The disappearance time of dyspnea and stridor, barking cough, hoarseness and the other clini-cal symptoms in the treatment group was significantly shorter than that in the control group, and the difference was statistically signifi-cant (P<0. 05). The two groups had no obvious adverse reaction. Conclusion:The clinical effect of the combination of epinephrine and budesonide inhalation in the treatment of children with acute laryngitis is better than that of dexamethasone inhalation, and the combination is safe and effective, which is worthy of clinical application.

Objective To investigate the efficacy of procaterol and montelukast on lung function in children with moderate persistent asthma.Methods 86 children with moderate persistent asthma from January 2014 to December 2014 in our hospital were studied,and according to the random number table method,they were divided into the control group and the observation group,43 cases in each group.The observation group was treated with procaterol combined with montelukast,the control group was treated with procaterol.The cough relief and disappearance time,the improvement of pulmonary function after treatment,the clinical effect and the control of asthma after one month of the two groups were compared.Results After treatment,children cough relief and disappeared time of the observation group was significantly shorter than the control group (t =4.418 5,3.784 4,P =0.000 0,0.000 3).After treatment, the pulmonary function was found to improve the situation of the observation group being good than the control group, PEF,FVC,FEV1 ,FEV1 /FVC predicted values were significantly higher than the control group (all P <0.05).The total effective rate of the observation group (93.00%)was significantly higher than 74.40% of the control group (u =2.223 2,P =0.026 2).After one month of treatment,the basic control rate of the observation group(88.37%) was significantly higher than 67.40% of the control group(u =2.386 6,P =0.017 0).The incidence rate of adverse reactions of the observation group (6.98%)was significantly lower than 51.16% of the control group(P <0.05). Conclusion Procaterol combined with montelukast in the treatment of children with moderate persistent bronchial asthma can improve clinical efficacy,safety,and improve symptom control rate,it is worthy of promotion.

Objective To investigate the the curative effect of pidotimod combined with Yanhuning for children with refractory mycoplasma pneumonia(RMPP).Methods90 patients with RMPP from January 2013 to January 2015in shengzhou maternal and child health care hospital were divided into 3 groups, including Yanhuning group(A group), azithromycin combined with Yanhuning group(B group)and pidotimod combined with Yanhuning group(C group).And the total effective rate, the clinical symptoms, immune function parameters were analyzed.ResultsThe regulation of immune function in C group was more significant than that in A group and B group, the prognosis was better, and the repeated times and continuous time were decreased (P<0.05).ConclusionPidotimod combined with Yanhuning treatment of RMPP can regulate the immune function of children, improve clinical symptoms, it is worthy of popularization.

Objective To observe the effects of the third-stage community-based rehabilitation program on functional recovery of stroke patients with hemiplegia. Methods 158 stroke patients with hemiplegia were divided into rehabilitation group and control group. Besides normal medicine and first-stage institution-based rehabilitation similar with that of control, rehabilitation group received a standardized third-stage community-based rehabilitation. They were assessed with the National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), Modified Barthel Index (MBI) and Modified Rankin Scale (MRS) before, 1 month and 6 months after treatment. Results The scores of the FMA and the MBI of the rehabilitation group were higher than that of the control group (P<0.01), while were lower of the NIHSS and MRS in the rehabilitation group than in the control group at the end of the sixth month (P<0.01). Conclusion The third-stage community-based rehabilitation may improve the recovery of the stroke patients with hemiplegia.

Objective To explore the development of the cross sign of olivepontocerebellar atrophy(OPCA) and its diagnostic value.Methods The clinical and imaging data of 8 patients with OPCA were analyzed retrospec-tively.MRI imaging used SE sequence,plain T1 WI,T2 WI,axial,coronal,sagittal imaging.Results All patients were hide onset.The major clinical presentation was cerebellar atsxia and autonomic nerve dysfunction.Positive radiographic findings were consistent with clinical presentation,mainly for the brain stem atrophy,8 patients of the group had this performance,followed by cerebellar atrophy,6 patients had symmetrical atrophy and 2 patients had asymmetric atro-phy.6 patients after onset of 1.5 -3 years showed a typical cross.Conclusion The cross sign gradually appears at a certain stage of development,and it has high specificity.So the combination of clinical and MRI is valuable for the diagnosis and differential diagnosis of OPCA.

Objective To construct S6K1 shRNA gene recombinant adenovirus(S6K1 Ax)and evaluate its gene silencing effects on mouse cell lines and C57 BL/6J mice level.Methods Three S6K1 shRNA gene sequences were designed and spliced from pcPUR plasmid,pcDNA3.1 plasmid to cosmid plasmid and transfected into adenovirus.S6K1 Ax which has best gene silencing effect was selected and proliferated in 293 cell.Silencing effect of S6K1Ax was checked on mice AML12,C2C12,3T3-L1 cell lines.C57BL/6J liver was obtained after S6K1 Ax was injected into mice tail vein six days later.S6K1 was evaluated by qRT-PCR and Western blot.Alanine transferanse(ALT)was examined before and after S6K1 Ax injected.Results S6K1Ax can silence S6K1 expression of mouse AML12,C2C12 and 3T3-L1 cell lines and liver of C57 BL/6J mice on Western blot.S6K1 mRNA expression of C57BL/6J liver were control group 1.39±0.21 vs S6K1Ax group 0.63±0.09,t=6.132.P<0.01.ALT of mice hepatic function did not change after S6K1Ax injected:before(15.15±4.43)U/L,after(17.32±4.22)U/L,t=1.451,P>0.05.Conclusion Construction of shS6K1 Ax can knockdown S6K1 gene on mice cell lines and C57BL/6J mice liver,it provides a good tool to study the function of S6K1.

OBJECTIVE To understand environmental factors which cause nosocomial infection in ICU. METHODS Air sampling adopted by plain board exposure and hand and object appearance by cotton wool method according to Disinfection Technique Regulation published by Ministry of Health. RESULTS From 289 samples, 182 were qualified and pass ratio was 62.98%. Staphylococcus aureus and mixed opportunistic pathogens were the main bacteria on the air and objects. CONCLUSIONS Through monitoring and analyzing environmental factors of ICU nosocomial infection, to control the prevalence and outbreak of ICU nosocomial infection as well as reduce the chance of infection.

Objective To assess the application of rosuvastatin control contrast induced acute kidney injury (CIAKI) risk on diabetes mellitus (DM) patients with mild to moderate chronic kidney disease (CKD) and diuretics at high risk.Methods One hundred T2DM patients with mild to moderate CKD scheduled for coronary or peripheral vascular interventional diagnosis selected from May 2013 to June 2015 in endocrinology department of Zhejiang Huzhou Central Hospital and perioperative routine use of diuretics were randomly divided into observation group (51 cases) and control group (49 cases).The observation group received rosuvastatin at draught of night, 10mg per time and needed to take at least 2 times and then performed medical surgery, after surgery, continued to receive rosuvastatin for 3 d, and the total number of days taking rosuvastatin were not less than 5 d;control group not received any statins pre-and post-operation.Results The angiographic site, angiography showed lesions, the proportion of patients with coronary interventional therapy, iodixanol dosage during and preoperative and postoperative levels of SCr and eGFR and other project data between two groups were compared with no significant difference.The CIAKI incidence in observation group was 1.96% (1/51), which was significantly lower than that in control group of 16.33% (8/49) (P<0.05).The clinical follow-up after interventional treatment 30d results showed that secondary end points between two groups groups related to the project data surgery was not statistically significant.There were 2 cases with transaminases elevating, 1 case with rash and 1 case with gastrointestinal reactions, the adverse reactions rate was 7.84% (4/51) and 1 case with gastrointestinal reactions, 1 case with myalgia in control group, the adverse reactions rate was 4.08% (2/49), there was no significant difference between two groups.Conclusion This preliminary study demonstrates that rosuvastatin has the good efficacy on the DM patients with mild to moderate CKD received diuretics at high risk with security, which has the certain significance to control CIAKI.

Objective To investigate treatment of meditation training for elderly patients with cogni-tive disorder recovering from operation for valvular heart disease( VHD) . Method 67 elderly patients who were up to the inclusion criteria were divided into experiment group( n=34)and control group( n=33),by dropping coins according to the admission time.Both of the two groups accepted regular health education and mental nursing.Besides,the experiment group accepted meditation training 5 times a week. Montreal Cogni-tive Assessment (MoCA) was used to evaluate cognitive function before and after the treatment. Results ( 1) Ridit analysis showed the intervention effect of the experimental group was better than that of the control group( R=2.12, t=-2.48, u=0.02),and the difference was statistically significant(P<0,05).The total effec-tive rate of experiment group is 90.32%,while the rate of control group is 62.89%. (2)The score of MoCA for the experiment group(25.79±1.23)was higher than that of the control group(23.85±1.82)after 6 weeks intervention,and the difference was statistically significant( t=5.14,P<0.01).(3) The score of MoCA of the experiment group before the intervention (23.91±2.22)was lower than after 6 weeks intervention(25.79±1. 23),and the difference was statistically significant( t=-4.30,P<0.01).Conclusion Meditation training can effectively improve cognitive function of elderly patients recovering from operation for VHD.