Objective To discuss the maternal and neonatal outcomes in gestational diabetes patients given insulin therapy at different periods.Methods Clinical data of 52 cases of gestational diabetes patients admitted from May 2011 to June 2013 in The Central Hospital of Ningbo Development Zone were analyzed,among whom 28 cases accepted insulin therapy before 32 weeks of pregnancy(early diagnosis treatment group)and the rest 24 cases accepted insulin therapy after 32 weeks of pregnancy(late diagnosis treatment group).The pregnancy outcome,hemodynamic parameters,incidence of hypertension,and the outcome of neonates were compared.Results The blood glucose of the 52 patients was controlled in the normal range after insulin therapy.However,incidence of preterm and cesarean section was significantly higher in the early diagnosis treatment group than that in the late diagnosis treatment group (P ＜ 0.05).The incidence of neonatal ketosis,fetal distress,and the incidence of macrosomia was significantly lower in the early treatment group than that in late diagnosis treatment group (P ＜ 0.05).The incidence of pregnancy-induced hypertension had not statistical difference between the two groups of pregnant women(P ＞ 0.05).S/D value of the two groups of pregnant women had no statistical significance(P ＞ 0.05).RI and PI value was significantly higher in the late diagnosis treatment group than those in early diagnosis treatment group(P ＜0.05).Conclusions The blood glucose of patients was controlled in the normal range after insulin therapy.Insulin therapy before 32 weeks of pregnancy can improve pregnancy outcomes.However,further research is needed for specific treatment programs.

Objective To study the application effectiveness of standard operating procedure (SOP) video in management of minimally invasive device cleaning.Methods Standard management began to be implemented in a hospital since January 2015, training was mainly conducted with video-based SOP lecture, defect rate of devices, qualified rate of sterilization package, and satisfaction of surgical staff before (in 2014) and after (in 2015) implementing SOP were compared, management efficacy was evaluated.Results After the implementation of SOP, device defect rate reduced from 6.19％ before the implementation to 0.99％, qualified rate of sterilization package increased from 90.03％ to 98.34％, satisfaction of surgical staff increased from 80.00％ to 97.78％, differences were all statistically significant(all P<0.05).Conclusion The implementation of SOP management can effectively improve the cleaning quality of surgical devices, reduce defect rate of devices, and improve the learning effect of staff, which is worth to be popularized and applied in clinical practice.

Objective To investigate the effects of right or left transaction of cervical sympathetic trunk (TCST) on left ventricalar remodeling (LVRM) after acute myocardial infarction in rats and the mechanism. Methods Sixty-four adult mule pathogen-free SD rats (230-250 g) were randomly divided into 4 groups (n=16 each): group Ⅰsham operation (group S) ; group Ⅱ LVRM; group Ⅲ left TCST and group Ⅳ right TCST. Myocardial infarct was induced by ligation of left anterior descending branch (LAD) of coronary artery in group Ⅱ, Ⅲ and Ⅳ. Left and right TCST were performed immediately after myocardial infarct was successfully induced in group Ⅲ and Ⅳ respectively. In group S LAD and cervical sympathetic trunk were exposed but not ligated and transected. The animals were killed at 4 weeks after ligation of LAD and TCST. The weight of left ventricle was measured and left ventricle weight index calculated, Left veatricular myocardial tissue volume (V_t), the volume density of myocardial cells (V_v) and myocardial cell volmne (V_c) were quantitatively analyzed by stereological method. The c-fos mRNA expression in myocardium was determined by RT-PCR. Results The left ventricle weight index, V_t, V_c and c-fos mRNA expression were significantly increased in group LVRM (Ⅱ), left and right TCST (Ⅲ, Ⅳ) as compared with group S. Left ventricle weight index, V_v, V_t, V_c and c-fos mRNA expression were all significantly decreased in fight TCST group (Ⅳ), while left ventricle weight index, V_t, V_c and c-fos mRNA expression were significantly increased in left TCST group (Ⅲ) as compared with LVRM group (Ⅱ). Conclusion Right TCST down-regulates the increase in c-fos mRNA expression after acute myocardial infarction and inhibits the left ventricular remodeling while left TCST up-regulates the c-fos mRNA expression and promotes the development of left ventricular remodeling.

Background High myopia is seriously harmful to visual function.To explore the mechanism of high myopia is significant for the prevention and treatment.Complement proteins C1q and C3 have emerged as critical mediators of synaptic refinement and plasticity,however,their effects in retina on myopia remain elusive.Objective This study was to investigate the expressions of complement factors C1q and C3 in the retina with negative lensdefocused myopia in guinea pigs.Methods The use and care of animals complied with the application of Peking Union Medical College Hospital Iaboratory Animal Welfare Ethics Committee.Twelve 3-day-old pigmented guinea pigs were assigned randomly to the lens-defocused group and the normal control group.The left eyes were covered by -10 D PMMA lens for 4 weeks as the defocused eye group,and the right eyes were covered using 0 D PMMA lens in the same way as the fellow control eye group.The right eyes of the normal guinea pigs were used as the normal control eye group.The refractive diopter of guinea pigs was examined by retinoscopy.The animals were sacrificed at the fourth week and the expressions of complement C1q and C3 in the retinas of guinea pigs were detected by Western blot.Results The diptors were (-1.21±0.71)D,(+2.46±0.75)D and (+1.75±0.50)Din the defocused eye group,normal eye group and the fellow eye group at the fourth week,showing a significant difference among the groups (F=51.55,P=0.69),and diopters were insignificantly different between the normal eye group and fellow eye group (q =2.62,P=0.08).However,the diopters of the defocused eye group were significantly higher than those of the fellow eye group (q =10.92,P＜0.01).The expressions of C1q and C3 proteins in the retinas were significantly different among the defocused eye group,fellow eye group and normal eye group (C1 q:F=8.810,P =0.003;C3:F =14.490,P＜0.001),and expression levels of C1q and C3 proteins in the defocused eye group were significant higher than those of the fellow eye group (C1q:q=4.14,P=0.01 ;C3:q=4.71,P=0.005) ;while no significant differences were found between the fellow eye group and the normal eye group (C1q:q =1.61,P =0.27; C3:q =2.82,P =0.070).Conclusions The expression levels of C1q and C3 up-regulate in the retinas with lens-defocused myopic animal model.Excessive complement activation in retinas may be involved in the development of myopia.

Objective To study the expression of HIF-1αand and its correlation with gastric cancer recurrence, and to identify its prog-nosis evaluation in gastric cancer recurrence. Methods 80 patients with gastric cancer recurrence after radical surgery were selected as the observation group, and 50 patients without gastric cancer recurrence 5 or more than 5 years after surgery were selected as the control group. The immunohistochemical situation and expression of VEGF of the two groups were compared, and the correlation of HIF-1αand VEGF and gastric cancer recurrence were analyzed. Results The positive expression rate of HIF-1αand VEGF were 77. 50% and 73. 75% respectively in the observation group, which were significantly higher than 12. 00% and 10. 00% in the control group. Univariate analysis showed that the related indices such as degree of differentiation, depth of invasion, lymph node metastasis, vascular invasion, and TNM clinical stage were associated with VEGF expression and positive expression of HIF-1α. The Spearman correlation analysis showed that HIF-1α and VEGF was positively correlated (r=0. 458,P=0. 000). 1-year survival rate of HIF-1α-positive group was 45. 16%, and the average survival time was (8. 62 ± 2. 32) months, which was significantly lower than 77. 77% and (18. 96 ± 3. 14) months respectively in the negative group. Cox risk model analysis showed that HIF-1αand VEGF expression were high risk factors for gastric cancer recurrence. Conclusion HIF-1αand VEGF expression have a very colse correlation with gastric cancer recurrence, and it can be used as evaluation of gastric cancer recurrence and prognosis.

Objective To study the changes in protease and cytokines,and to evaluate the protective effect of ulinastatin on ischemia-reperfusion lung injury in rabbits.Methods Thirty New Zealand rabbits were randomly divided into three groups(n=10): control group,traumatic hemorrhagic shock group(shock group) and ulinastatin-treated group.Blood samples were taken at four time points: pre-shock,post-shock,as well as 2h and 4h after blood volume repleshment.The serum levels of TNF-? and IL-8 were measured.4h after blood volume repleshment,the rabbits were sacrificed.The activity of myeloperoxidase(MPO) in lung tissue and neutrophil elastase(NE) in bronchoalveolar lavage fluid(BALF) were determined.Results In control group,the serum concentrations of TNF-? and IL-8 showed no obvious changes during the experiment.While in shock group and ulinastatin-treated group,the serum concentrations of TNF-? and IL-8 increased significantly in the duration of experiment compared with the values before shock(P

Objective To evaluate the protective effects of ulinastatin on renal function in rabbits with traumatic hemorrhagic shock. Methods Thirty rabbits were randomly allocated to three groups: control group, traumatic hemorrhagic shock group and ulinastatin treatment group. Blood was sampled at two time points: pre-shock and 4h after blood volume replenishment, and the plasma levels of NE, BUN and Cr were measured. 4h after blood volume replenishment, the rabbits were sacrificed, and the activity of MPO in renal tissue and urine NAG were measured. Results In all the three groups, the plasma concentrations of BUN and Cr were somewhat elevated but showed no statistical significance in comparison with each other. The activity of NE in blood, MPO in renal tissue and NAG in urine were increased significantly in the traumatic hemorrhagic shock group compared with those of ulinastatin-treated group (P

Objective To investigate the effect of parecoxib on cardiac function after acute myocardial infarction (AMI) in rats. Methods Twenty-four adult male SD rats, weighing 230-250 g, were randomly divided into 3 groups ( n = 8 each): group Ⅰ sham operation (group S), group Ⅱ AMI and group Ⅲ parecoxib (group P). Myocardial infarction was induced by ligation of left anterior descending branch (LAD) of coronary artery in group Ⅱ and Ⅲ . In group S, LAD and cervical sympathetic trunk were exposed but not ligated and transected.Group P received intrperitoneal parecoxib 8 mg/kg once a day for 3 days 24 h after ligation of LAD, while group AMI received normal saline instead. At 4th day after ligation LAD, the left ventricular systolic pressure ( LVSP),left ventricular end-diastolic pressure (LVEDP) and ± dp/dtmax were measured and recorded. Blood samples were taken from common carotid artery to determine the plasma concentrations of TXA2 and PGI2 and PGI2/TXA2 was calculated. Then the animals were sacrificed and hearts removed. Myocardial infarct size of left venicle was calculated. Results Compared with group S, LVSP, ± dp/dtmax, plasma concentrations of PGI2 and PGI2/TXA2 were significantly decreased, while LVEDP and plasma concentrations of TXA2 increased in group AMI and P( P ＜0.05). Compared with group AMI, LVSP, ± dp/dtmax, plasma concentrations of PGI2 and PGI2/TXA2 were significantly decreased, while LVEDP and plasma concentrations of TXA2 increased in group P ( P ＜ 0.05). There was no significant difference in myocardial infarct size between group AMI and P (P ＞ 0.05). Conclusion Parecoxib can improve cardiac function after AMI in rats and the mechanism is related to regulation of the balance of PGI2/TXA2.

Objective To determine the effect of ulinastatin on perioperative inflammatory response to coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). Methods Forty patients undergoing CABG with CPB were randomly divided into 2 groups: a ulinastatin group (1.5×10~4 U/kg before CPB, n=20) and a control group (n=20). The inflammatory cytokines such as tumor necrosis factor-α (TNF-α), interleukin (IL)-6, IL-10 and neutrophil elastase (NE) were measured before the anesthesia (T1), 1 h after the start of CPB (T2), 1 h after weaning of CPB (T3), and 24 h after weaning of CPB (T4). The postoperative organ dysfunction in the 2 groups was noted.Results The concentration of TNF-α, IL-6, IL-10, and NE at T2,T3, and T4 and increased more significantly than that at T1 in the 2 groups(P<0.05). The concentration of TNF-α, IL-6 and NE at T2, T3, and T4 in the ulinastatin group decreased more significantly than that in the control group (P<0.05), and IL-10 in the ulinastatin group increased at the same time. The postoperative complications of pneumonia, kidney and central nervous system in the ulinastatin group decreased more significantly than that in the control group (P<0.05). There was no significant difference in the postoperative cardio or liver complications and hours in the ICU between the 2 groups.Conclusion Administration of ulinastatin before CPB can decrease the inflammatory response and complication during CABG.

Objective To analyze the application effect of disposable surgery retractor which made of high polymer medical plastic.Methods From January 2016 to October 2016,80 patients of HCC who were treated with hepatectomy under general anesthesia in our hospital were randomly divided into the control group and the observation group according to different retractor during surgery.The control group used the traditional abdominal retractor during the sugery.Meanwhile,the observation group used disposable surgery retractor.The application effect between the two groups were compared.Results The satisfaction rate of surgical exposure and effect in surgeon of the observation group were higher than those of the control group.The wound pain time of patients in perioperative period and 1 month after surgery and chronic pain incidence in postoperative 6 months between the two groups were evaluated.It turned out that the difference in average pain score was statistically significant (P<0.05).Conclusion The disposable surgical retractor can improve the satisfaction rate of surgeons with better surgical exposure,and it can significantly reduce the damage of wound tissue,which effectively relieves the postoperative pain,shortens the time of postoperative pain,and reduces the incidence of chronic pain.