Doctors ought to belong to a social stratum with fairly high incomes. The high input and long cycle that is essential to becoming a high-caliber doctor constitute the high costs of the medical profession; high technology, high responsibility and high sacrifices constitute the high risks of the medical profession; the contrast between the input of high intelligence, high academic degree, and high expertise and the output of low economic income tends to warp the minds of doctors. The inversion of the burden of proof in medical lawsuits has practically put doctors on the weak side. Their rights and interests as well as their practice circumstances have been disregarded. For the sake of the development of the health cause, it is imperative to respect the labor of doctors and to provide them with sound survival circumstances.

Objectives To detect the expression of human leukocyte antigen-G (HLA-G) in tissues from pregnant women with preeclampsia and discuss the relationship between HLA-G and preeclampsia.Methods Pregnant women with preeclampsia in Maternal and Child Health Hospital of Shaanxi Province from March 2009 to December 2009 were included.Eight were included into mild preeclampsia groups and 22 were included into severe preeclampsia group.And 30 age-matched normal pregnancies were referred as the control group.All women in the three groups received cesarean section.The soluble HLA-G (sHLA-G)levels in peripheral blood,umbilical blood and amniotic fluid were examined by ELISA ; the expressions of HLA-G protein in placenta,fetal membrane and umbilical cord were examined by western blot.Results ( 1 ) The sHLA-G levels in peripheral blood,umbilical blood and amniotic fluid in each group.The sHLA-G levels in peripheral blood in mild and severe preeclampsia group were (50 + 14) and (30+6) μg/L respectively,and the sHLA-G levels in umbilical blood were (34 ± 10) and (26 ±8)μg/L respectively.All were significantly lower than those in the control group ( P ＜ 0.01 ),which were (100 ± 16) and (70±9) μg/L respectively.There was also statistical difference between mild and severe preeclampsia group (P ＜0.01 ).Although the sHLA-G level in umbilical blood of severe preeclampsia group was lower than that in mild preeclampsia group,there was no statistical difference ( P＞0.05 ).The sHLA-G levels in amniotic fluid in mild and severe preeclampsia groups were (26±7 ) and (25 ± 5 ) μg/L respectively,which were lower than that in the control group (27±6) μg/L,but the differences were not significant ( P＞0.05 ).There was no statistical difference between mild and severe preeclampsia groups ( P＞0.05 ).(2) The expression levels of HLA-G protein in placenta,fetal membrane and umbilical cord in each group.The expression levels of HLA-G in placenta and fetal membrane in the control group were 1.59 ± 0.36 and 0.42 ± 0.09 respectively.The expression of HLA-G in placenta was significantly higher than that in fetal membrane ( P＜0.05 ).The expression level of HLA-G in umbilical cord in the control group was 0.24±0.17,statistically different from those in placenta and fetal membrane,respectively (P＜0.01 ).The expression levels of HLA-G in placenta in mild and severe preeclampsia groups were 0.78 + 0.21 and 0.29 ± 0.17 respectively,significantly different from the control group ( P ＜ 0.01 ).There was no expression of HLA-G in fetal membrane and umbilical cord in mild and severe preeclampsia groups.Conclusions The expressions of HLA-G in the peripheral blood,umbilical blood and placenta in women with preeclampsia are significantly lower than those in normal pregnant women.The abnormal expression of HLA-G might be associated with the pathogenesis of preeclampsia.

Objective:To evaluate the objective imaging markers of cognitive impairment in patients with end-stage renal disease by MRI intravoxel incoherent motion.Methods:A total of 40 patients with ESRD were enrolled in the Department of Nephrology, Changzhou Second Hospital Affiliated to Nanjing Medical University from January 2019 to August 2020, and 24 healthy controls were prospectively enrolled at the same time.All subjects performed with MRI scan were collected, and the slow apparent diffusion coefficient (ADC slow) of the corresponding brain regions were obtained .The cognitive function was evaluated by the Montreal cognitive assessment scale (MoCA). Two-sample t test was used to analyze the difference of ADC slow and cognitive score between the two groups.Pearson correlation analysis was performed among the cognitive function score of end-stage renal disease and ADC slow value. Results:(1) The score of the intelligence test scale in the ESRD group (23.30±1.76) was significantly lower than that of the healthy control group (27.92±1.00) ( P<0.01). The ADC slow values of bilateral frontal lobe, hippocampus, and insula brain areas (respectively(0.648±0.035), (0.633±0.043), (0.762±0.043), (0.756±0.042), (0.792±0.048), (0.776±0.054))in the ESRD group were significantly higher than those in the healthy control group ((0.600±0.039), 0.610±0.037, (0.725±0.059), (0.711±0.054), (0.740±0.063), (0.716±0.051)) ( P<0.01). (2) Pearson correlation analysis showed that the ADC slow values of bilateral insula and right hippocampus in the ESRD group were negatively correlated with MoCA scales ( r=-0.38, -0.38, -0.66, all P<0.05). Conclusion:ADC slow value in IVIM can better reflect the changes of cognitive function impairment in ESRD patients.

Objective To monitor the indoor radon concentration of urban residents in Shiyan, China, and to analyze the related influencing factors. Methods From April to July, 2019, RSKS standard detectors were used to measure the indoor radon concentration of 125 households in Shiyan, and the results were analyzed. Results The indoor radon concentration of residents in Shiyan showed a skewed distribution, ranging from 13.8 to 145 Bq/m³, and M (P₂₅,P₇₅) was 38.3 (29.0,62.0) Bq/m³. The estimated annual effective dose of radon and radon daughters from inhalation was 0.52-5.50 mSv, and M (P₂₅,P₇₅) was 1.45 (1.10, 2.36) mSv, which was consistent with literature. Building structure (H = 14.10, P < 0.001), floor (H = 24.41, P < 0.001), and geographical region (H = 8.963, P < 0.05) were influencing factors of indoor radon concentration, and the differences were significant. Conclusion The indoor radon concentration of urban residents in Shiyan is lower than the national standard limit. However, in daily life, it is still necessary to take appropriate measures to reduce the concentration of indoor radon as much as possible.

Objective To investigate the residential radon concentration in typical areas of Hubei Province and assess the dose hazards of radon to human body. Methods According to geographical location, five cities including Wuhan, Enshi, Shiyan, Xianning and Daye were selected, and the stratified cluster sampling and monitoring were conducted in accordance with the residential building structure. From April to July, 2019, RSKS standard detectors were placed in the bedroom or living room of the tested families. After continuously sampling for three months, those detectors were returned back to the laboratory for test readings using Radosys system. Results A total of 651 detectors were deployed in 577 households of 70 communities, and 634 detectors were recovered. The recovery rate of detectors was 97.4%. The indoor residential radon concentration in Hubei Province showed a logarithmic normal distribution, with a median (25% quantile and 75% quantile) of 40.52 (29.13,64.74) Bq/m3 and an annual effective dose of 2.02 mSv. The indoor radon concentrations in Wuhan and Enshi were significantly higher than those in Shiyan, Xianning and Daye (P<0.05). The indoor radon concentrations in brick wood or civil structures were significantly higher than those in reinforced concrete structures (P<0.05), and indoor radon concentration in the first floor was significantly higher than those in other floors (P<0.05). The indoor radon concentrations after 2010 were significantly lower than those between 2001 and 2010 (P<0.05). Conclusion The number of households with indoor radon concentrations exceeding the national limit in newly-built buildings accounted for 10.1%; The indoor residential radon concentration levels of in Hubei Province were influenced by building structure, age and floor.

Background There is a lack of research evidence on the association between sugar-sweetened beverage (SSB) consumption and gestational diabetes mellitus (GDM) in China. Objective To explore the association between frequency of SSB consumption before pregnancy and risk of GDM in pregnant women in Shaanxi Province, and to provide a scientific basis for targeted interventions to control maternal blood glucose. Methods The recruitment to the China Birth Cohort study started in October 2020. Pregnant women at 6-16 weeks who had their first prenatal examination at five hospitals in Shaanxi Province were recruited. A maternal health questionnaire was used to collect basic information about pregnant women. A semi-quantitative food frequency questionnaire was used to collect the consumption of carbonated beverages, fruit and vegetable juice beverages, coffee beverages, and milk tea beverages in one year before pregnancy, which were summed to obtain the SSB consumption. Pregnant women were divided into three groups according to SSB consumption, namely <1 serving·week⁻¹, 1-4 servings·week⁻¹, and ≥5 servings·week⁻¹. GDM was confirmed by oral glucose tolerance test (OGTT) between 24-28 weeks of gestation. A binary logistic regression model was applied to explore the association between SSB consumption and risk of GDM. Multiple linear regression was applied to investigate the associations between SSB consumption (per 1-serving·d⁻¹ increase) and OGTT fasting plasma glucose, 1-hour glucose, and 2-hour glucose. Results A total of 3811 pregnant women were finally enrolled in this study, of which 752 developed GDM, with an incidence rate of 19.7%. The incidence rates of GDM in pregnant women with SSB consumption frequency of <1 serving·week⁻¹, 1-4 servings·week⁻¹, and ≥5 servings·week⁻¹ were 18.0%, 21.1%, and 26.8%, respectively. After adjusting for maternal age, pre-pregnancy body mass index (BMI), education, number of children born, family history of diabetes, smoking, alcohol consumption, physical activity level, and total energy intake, the risk of GDM increased by 26% (OR=1.26, 95%CI: 1.05, 1.50) in the 1-4 servings·week⁻¹ group and by 76% (OR=1.76, 95%CI: 1.31, 2.38) in the ≥5 servings·week⁻¹ group compared to the <1 serving·week⁻¹ SSB consumption group, respectively. Further stratified analysis revealed no interaction effect (P_interaction>0.05) between SSB consumption and maternal age, pre-pregnancy BMI, or first labor or not. For each additional SSB consumption per day, the risk of GDM increased by 94% (OR=1.94, 95%CI: 1.37, 2.75); and the maternal OGTT 1-hour glucose and 2-hour glucose increased by 0.33 mmol·L⁻¹ and 0.18 mmol·L⁻¹, respectively (P<0.05), and no significant increase in fasting plasma glucose was found (P>0.05). Conclusion Higher SSB consumption before pregnancy increases the risk of GDM in pregnant women.