Objective To estimate the influence of abnormal glucose metabolism during pregnancy and family history of cardio-cerebrovascular disease and/or diabetes on umbilical C-peptide concentrations. Methods Chesed 85 pregnant women who had prenatal examination and their newborns as the subjects. Thirty-six newborns of mothers with gestational diabetes mellitus, impaired glucose tolerance or diabetes mellitus with pregnancy and 49 newborns of mothers with normal glucose tolerance were randomly chosed as the control group. All newborns were also classified according to whether their maternal grandparents had history of diabetes and/or cardio-cerebrovaacular disease. Therefore, there were four groups in this study: 25 newborns in group A were of diabetic mothers and positive family history, 11 newborns in group B were of diabetic mothers but negative family history, 9 newborns in group C were of mothers with normal glucose tolerance but positive family history, 40 newborns in group D were of mothers with normal glucose tolerance and negative family history. The blood samples of umbilical veins were collected at the time of delivery. Umbilical C-peptide levels of the four groups were measured by radioimmunonssay. Results The umbilical C-peptide concentrations of newborns in group A, B, C, D were (2.22±1.52), (1.44±0.63), (1.13± 0.34), (1.31±0.69) μg/L respectively, the umbilical C-peptide concentrations of newborns in group A were elevated compared to those of other three groups (F=5.11, P=0.003), and there were no significant differences in C-peptide levels of newborns between the three groups (group B vs C P=0.499, group B vs D P=0.694, group C vs D P=0.642). Conclusion Special attention should be given to newborns of diabetic mothers and whose maternal grandparents have history of diabetes and/or cardio-cerebrovascular disease.

A rapid thin flat gel isoelectric focusing method followed by ultrasensitive silver staining was developed for the determination of apo E phenotypes. Using this method, apo E phenotypes and allele frequencies in 63 normal individuals, 70 patients with hyperlipidemia and 11 patients with familial hypereholesterolemia (FH) in Nanjing were examined. TC, TG, HDL-C, LDL-C, VLDL-C, VLDL-TG in these cases were also measured. The relative frequency of the ?4 allele is significantly lower while the relative frequency of the ?3 allele is higher in this group than in the Caucasian group. Plasma TG, VLDL-TG, VLDL-C and VLDL-C/VLDL-TG are higher in the apo E3/2 phenotype, and lower in the apo E4/3 phenotype, wherea splasma TC, LDL-C levels are lower in the apo-E3/2 and higher in the apo E4/3 phenotype. It implies that the ?2 allele has the action of increasing TG-rich lipoprotein particles and reducing ch-rich lipoproteins in plasma, while the ?4 allele has an effect opposite to that of the ?2 allele. The highest prevalence of the ?4 allele was associated with type Ⅱb hyperlipoproteinemia (HLP), while that of the ?2 allele was associated with type Ⅲ-HLP. The frequency of ?2, ?4 are higher in FH patients as compared with normal subjects.

Objective To observe the cyclooxygenase-2(COX-2) expression of gastric tumor tissue ,and to study the relationship between cagA + Helicobacter pylori(Hp cagA+ ) infection and COX-2 .Methods 42 specimens of gastric cancer tissue (including gastric carcinoma ,paracancerous hyperplastic tissue and paracancerous normal gastric mucosa ) in our hospitals from January 2010 to August 2011 were collected and detected the Hp cagA expression by PCR .Results The COX-2 protein positive rate in the gas-tric tcancer tissue was significantly higher than that in the paracancerous hyperplastic tissue and normal gastric mucosa (P<0 .01) . Among 42 cases of gastric cancer specimens ,Hp cagA+ was in 25 cases ,Hp cagA - was in 17 cases .The COX-2 protein positive rate was 88 .0% (22/25) in the Hp cagA+ group and 35 .3% (6/17) in the Hp cagA - group .The COX-2 protein positive rate in the Hp cagA+ gastric tissue was significantly higher than that in the Hp cagA - gastric tissue(P<0 .01) .Conclusion Abnormal ex-pression of COX-2 exists in gastric tcancer tissue ,cagA+ Helicobacter pylori infection may promote the occurrence and development of gastric cancer by regulating the expression level of COX-2 .

Objective:To evaluate whether Salviae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection has posi-tive effects on the prevention and treatment of radiation-induced lung injury. The basic function and mechanism of Salviae Miltiorrhi-zae Liguspyragine Hydrochloride and Glucose Injection were also investigated. Methods:A total of 70 adult male rats weighing about 200 g were selected and divided into seven groups. These groups were as follows:1) normal control group (N):rats were injected with 1 ml of normal saline per day;2) single medicine treatment group (D):rats were administered with 1 ml of Salviae Miltiorrhizae Ligus-pyragine Hydrochloride and Glucose Injection per day;3) single irradiation group (Z):rats were exposed to 20 Gy single whole-chest ir-radiation and injected with 1 ml of normal saline per day;4) irradiation with 10 Gy and medicine treatment group (Z10):rats were ex-posed to 10 Gy single whole-chest irradiation and administered with 1 ml of Salviae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection per day; 5) irradiation with 15 Gy and medicine treatment group (Z15): rats were exposed to 15 Gy single whole-chest irradiation and administered with 1 ml of Salviae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection per day;6) irradiation with 20 Gy and medicine treatment group (Z20a):rats were exposed to 20 Gy single whole-chest irradiation for four weeks, and administered with 1 ml of Salviae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection per day;and 7) irradia-tion with 20 Gy and medicine treatment group (Z20b):rats were exposed to 20 Gy single whole-chest irradiation and administered with 1 ml of Salviae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection per day. Two rats were selected and sacrificed at the end of two, four, six, eight, and ten weeks of irradiation. Samples of blood and lung tissues in rats were obtained. Results:In the group with single irradiation, the tumor necrosis factor-α (TNF-α) and transforming growth factor-β (TGF-β) levels in plasma of rats were higher than those in the other groups. In the group with irradiation and medicine treatment, the TNF-αand TGF-βlevels in plasma were higher than those in the normal control group and single medicine treatment group. In the group with single irradiation for four weeks,some petechial hemorrhages on the surface of the lung were visible to the naked eye. In the groups with medicine treatment, the petechi-al hemorrhages on the surface of the lung visibly reduced. According to the pathological mechanism of lung tissues, the groups with Sal-viae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection exhibited less inflammation than the single irradiation group. Ir-radiation at 20 Gy for four weeks followed by a daily abdominal injection was slightly better than single irradiation, but the effects were not obvious. Conclusion: Salviae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection could prevent the occurrence of lung injury by reducing the TNF-αand TGF-βlevels in plasma. After the occurrence of radiation-induced pneumonitis, the application of medicine could not decrease the symptoms.

Objective To evaluate the effect of detailed disease management model in community management of hyperuricemic patients.Methods One hundred and fifty patients with primary hyperuricemia were randomly divided into detailed management group and conventional group from April to June 2012,patients in two groups were managed by different models for 1 year.The weight,height,biochemical indexes including blood uric acid and serum lipids were measured and a questionnaire survey was conducted with the items of disease awareness score,smoking,drinking,diet,standard treatment,satisfaction of treatment etc.before and after management.Results One hundred and thirty six patients completed the study including 68 in detailed management group and 68 in conventional group.After one year management,the blood uric acid,triglyceride,low density lipoprotein (all P ＜ 0.01) were statistically lower than baseline in detailed management group,while there were no statistical differences of these indexes in conventional group (P ＞ 0.05).The disease awareness score increased from (65.4 ±5.4) to (82.7±4.2) (Z=-10.2,P＜ 0.01),high purine diet rate fell from 47.1％ to 7.4％ (x2 =33.6,P ＜ 0.01),the standard treatment rates increased from 10.3％ to 85.3％ (x2 =76.6,P ＜0.01),treatment satisfaction rate increased from 51.5％ to 88.2％ (x2 =21.8,P ＜0.01) in detailed management group.In detailed management group,the blood uric acid (Z =-7.4,P ＜ 0.01),total cholesterol (Z =-0.01,P ＜ 0.01),triglyceride (Z =-2.4,P ＜ 0.01) and low density lipoprotein (Z =-3.2,P =0.03) and high purine diet rate were lower (x2 =27.1,P ＜ 0.01),the standard treatment rate (x2 =70.6,P ＜ 0.01) and treatment satisfaction rate were higher (x2 =5.6,P =0.02) than those in conventional group after 1 year management.Conclusion Detailed disease management is an applicable and effective model for community management of hyperuricemic patients.

Objective To evaluate the left ventricular function in patients with different extents of coronary stenosis by the left ventricular pressure volume loop Methods In 65 patients who were undergoing coronary angiography and left ventriculography examinations, materials of clinical and cardiac catheter examinations were collected In right anterior oblique 30 degrees the left ventriculography was progressed The pressure curves of the left ventricle and the aorta were recorded continuously and volumes of the left ventricles were measured with the dot tracing method Pressure volume loop was set up and ventricular energy indexes embodied by the pressure volume loop were measured and calculated Results In normal group, pressure volume loop was located in the left and lower portion of the coordinate system Along with the levels of the coronary stenosis becoming more severe, pressure volume loops moved to the right and upper portion of the coordinate system Little changes occurred in ejection fraction except that there was a decreasing in patients with lesions of three branches; Stroke work showed no obvious changes; Filling energy became larger; Total energy increased obviously in both groups with lesions of double branches and three branches; End systolic energy increased gradually while energy efficiency decreased gradually Conclusion The ventricular pressure volume loop can be obtained in routine ventriculography which can reflect many indexes of ventricular function quantitatively The ventricular energy indexes change correspondingly with coronary artery lesions and may be useful to assess ventricular function in patients with different levels of coronary stenosis

Object:Investigate the protective effect of chitosan (CTS) on rat fatty liver.Methods:Male Sprague Dawley rats were treated with a low dose of carbon tetrachloride (CCl 4) and fed a high fat diet to produce fatty liver model.At the same time,the protective groups were treated with chitosan in different concentration,then observe the steatosis degree and determined the contents of lipids in the rats liver.Results:Combine use of CCl 4 and high fat diet caused the contents of triglyceride(TG)、total cholesterol (TC) in liver increased significantly,pathological examinations showed the swelling hepaocytes full of lipid droplets inside of them while the treated groups displayed a moderated steatosis degree and lower TG、TC compared with model group,which effects in a dose dependent mode.Moreover,this study also demonstrated that the activity of superoxide dismutase (SOD) was depleted in fatty liver,and it recovered with the reduce of TG、TC by treated with the drugs.Conclusions:The results show that chitosan have protective effect,on fat liver injury,and the protection may be associated with interfere of lipids absorption in intestine,improve liver ability of antioxidation and then increase the lipolysis and remove of TG from the liver.

Objective To investigate the influencing factors of learning adaptability of nursing student in the emergency department and come up with relevant countermeasures. Methods Two hundred nursing student in the emergency department participated in the survey. A self-designed questionnaire on their learning adaptability and the results were analyzed. Result The job category, work environment, disease of the patients, internship time, teaching method and the professional identification were the top six factors influencing their learning adaptability situation. Conclusion Such measures as strengthening the orientation of student nurses, cultivating their observation ability and communication skills, enhancing the consciousness about law, increasing practice time appropriately, improving teaching methods and ability, and strengthening sense of identity can guarantee effective internship and adaptability of the nursing student in emergency department.

Objective:To develop a mental status scale in non psychiatric settings (MSSNS) and to test its reliability and validity.Methods:Based on the common negative emotions in non psychiatric settings confirmed by nursing specialists and international scales, the MSSNS was constructed with psychological testing and statistical techniques. The reliability and validity were examined with 1 010 patients in non psychiatric settings.Results: The MSSNS consisted of 38 items. The reliability coefficients were 0.932 9 for internal consistence(Cronbach ?) and 0.894 0 for split half. Using the principle component analysis with varimax rotation, we got 4 factors: anxiety, depression, anger and loneliness. The correlation between MSSNS and related factors of HAD were 0.652 and 0.533 respectively. Conclusion: With its good reliability and validity, MSSNS is an ideal rating scale for total and convenient rating of patients' mental status in non psychiatric settings.

Objective:To quantitively assess the mental status of patients with severe acute respiratory syndrome(SARS) for correct diagnosis of those have serious mental crisis,providing scientific basis for the psychological intervention. Methods:The mental status in 46 SARS patients were analyzed with the Mental Status Scale in Non psychiatric Settings(MSSNS, by Department of Psychology, Second Military Medical University )and compared with that of the common pneumonia patients and the norm of common inpatients. Results:The scores of SARS patients and those of the other pneumonia patients and the norm of common inpatients had no significant difference. The psychological reactions of SARS patients were related significantly with the patient's age, marital status, occupation and the duration of fever. Conclusion:The psychological reactions of SARS patients were accordant with those of the common patients. The results indicated that the patient's personality, such as the emotional stability, was the essential impact factor on the patient's mental status. The level of negative emotional reactions in SARS patients are influenced by whether the patients are young, single, lack of medical knowledge and fever duration. So the effective psychological intervention to the SARS patients should be based on the scientific assessment and influencing factors analysis.