Objective To study the expression of the imprinted gene H19 and IGF-Ⅱ in newborn placenta,and to discuss its influence on the birth body mass of the neonate. Methods The fresh placental tissues from full-term newborn (without trimester of pregnancy complica-tion and placenta and funic abnormality) with normal,high and low birth body mass (12,10 and 8 samples respectively)were collected. The expression of imprinted gene H19 and IGF-Ⅱ mRNA in the placenta were estimated by reakime fluorescence quantitative PCR Results The ex-pression of H19 mRNA in the placenta was negative correlation to the birth body mass (r =-0.403,P = 0.027).The expression of of IGF-H mRNA was positive correlated to the birth body mass (r = 0.444,P = 0.014). The H19 mRNA expression level in the high birth weight neonates (0.21 0.31) was significantly lower than that in the low birth body mass neonates (1.51 2.04)(P= 0.013). But the expression level of IGF-Ⅱ mRNA in the high birth body mass neonates (2.67±3.41) was significantly higher than that in the low birth body mass neonates (0.39±0.33)(P =0.013). Conclusion The expression of H19 and IGF-Ⅱ mRNA was significantly different in the placenta of normal,high and low birth body mass newboms. These two genes may be related to the birth body mass,and there may be some realation-ship between these two genes.

Objective We compared the difference of diagnosing macrosomia using the body mass index (BMI)and body mass,so as to investigate whether BMI play an important role in the diagnosis and management of macrosomia in our clinical work.Methods We analysed 5522 newborns (without any maternal complication)delivered in Shengjing Hospital of China Medical University from Jan.2004 to Apr.2009,all of them were full term,singleton and with the birth body mass larger than 2500 g,among them 4989 were in the group with body mass <4000 g,that was 2510-4000 g.533 cases were in the group of body mass ≥4000 g.By both body mass and length,we got the BMI.According to statistical receiver operating characteristic curve(ROC),we determined the cutoff of BMI for diagnosing macrosomia,in addition the sensitivity and specificity of it. Using this newly gotten BMI cutoff as a method to diagnose macrosomia and analyse the results.Results (1)When the newborns with birth length 40-43 cm.the mean birth body mass was(3010 ±351)g,BMI was(17.0 ±2.7)kg/m2;the newborns with birth length 48-51 cm,the mean birth body mass was(3450 ±313)g,BMI was(13.2±1.4)kg/m2;newborns with birth length 56-60 cm,the mean birth body mass was(4332 ±456)g,BMI was(12.5 ±1.3)kg/m2,The longer the birth length,the larger the birth body mass,while the less BMI.(2)Determined by ROC curve,the BMI value could be used to diagnose macrosomia was 14.2 kg/m2.with sensitivity of 78.4% and specificity of 85.0%, the area of under curve was 0. 892. (3) By the BMI cutoff ( 14. 2 kg/m2 ), 111 macorsomia with birth body mass ≥4000 g were not macrosomia any more (20. 8%, 111/533 ),422 still were macrosomia (79.2% ,422/533) ; while for those birth body mass <4000 g, 728 were macrosomia determined by this BMI cutoff ( 14. 59%, 728/4989 ), 4261 were still not macrosomia ( 85.41%, 4261/4989 ). Using BMI cutoff 14. 2 kg/m2 to diagnose macrosomia, within the group of birth body mass ≥4000 g, their birth length in macrosomia and non macrosomia was (52. 2 ± 1.8) cm and ( 55.6 ± 1.3 ) cm respectively, the difference was significant (P <0. 01 ) ;while within the group with body mass <4000 g, the birth length of macrosomia and non-macrosomia was (49.0 ±2. 2) cm and (50. 8 ±2. 2) cm respectively,the difference was significant as well (P <0. 01 ). The whole incidence of macrosomia was 20. 83% (1150/5522) determined by this BMI cutoff. Conclusions Birth body mass and BMI in determining macrosomia show some bias, and birth length relates with this difference, which suggests birth length maybe play an important role in determine the macrosomia. We suggest it is very necessary to use BMI≥ 14. 2 kg/m2 in the diagnosis and management of macrosomia.

AIM: To establish a HPLC method for determing naringin,rhein,emodin,chrysophanol,honokiol and magnolol in Da,Xiao-Chengqi Decoction bought from Taiwan. METHODS: The seperation was performed on Licrospher C_(18) column(150 mm?4.6 mm,5 ?m) with acetonitrile-0.5% HAc(gradient elution) as mobile phase and the detection wavelength was set at 270 nm. RESULTS: In the eight samples measured the content of naringin was from 0.54 to 44.20 mg/g;rhein from 0.51 and 2.10 mg/g;honokiol from 0.44 to 6.65 mg/g;emodin from 0.02 to 0.23 mg/g;magnolol from 1.09 to 2.29 mg/g,chrysophanol from 0.09 to 2.70 mg/g.However,honokiol and magnolol were not detected in some samples. CONCLUSION: This established method is fully validated with respect to linearity,precision,reproducibility and accuracy and successfully applied to quantifying the six constituents in eight commercial samples.The overall results demonstrate that this proposed method is simple,reliable,and suitable for the quality control of Da,Xiao-Chengqi Decoction.

Objective To explore the influence of preferred contract-altering system on contracted nurses to provide reference for stabilizing a team of high quality nursing.Method A scale on effort-reward unfairness(ERI)was used to investigate the ERI conditions among 348 contracted nurses before and after the enforcement of preferred contract-altering system.Results The scores on satisfaction with nursing work and the security in nursing work after the enforcement of the system were higher than before the enforcement(P<0.01).The ratio between effort and reward after the enforcement was lower than before the enforcement(P<0.01). Conclusions The preferred contract-altering system may enhance the job security and sense of belonging.It may decrease the ERI condition among contracted nurses,which are beneficial for stabilizing the nurses team,retaining talents and increasing the group’s competitiveness and vigour.

Objective To compare the clinical effects and safety of treating newly diagnosed type 2 diabetes patients by combining Glargine insulin with Metformin or/and Acarbose. Methods 84 patients with newly diagnosed type 2 diabetes ,who have a history of weight loss, body mass index( BMI )23 ～ 28kg/m2 and poorly controlled blood glucose in Metformin at least a month ,were randomly divided into three groups. Glargine insulin plus Mefformin were used in group A. Glargine insulin plus Acarbose(without mefformin)were used in group B, Glargine insulin, Acarbos and metformin were used in Group C. All three groups were given a 12-week follow-up. Results FBG,2hBG and HbA1c levels were lower in the patients after treatment( P ＜0. 05 ). HbA1c of patients was partly up to the standard in group A and group B,but HbA1c of patients was all up to the standard in group C. The effects in group C were better than those in group A and group B. It had the shortest time to achieve the target and the smallest dose of insulin in group C. BMI in group A and B did not change but decreased in group C(P＞0.05).The incidence of low blood sugar in all three groups was low and no significant difference observed among three groups (P＞0.05). And in all three groups no severe hypoglycemia occurred. Conclusion The method of combining Glargine insulin with Mefformin or/and Acarbose could effectively control blood sugar had little impact on body weight of the newly diagnosed type 2 diabetes patients, and moreover, the incidence of low blood sugar in the newly diagnosed type 2 diabetes patients was lower. It would be the ideal method to treat newly diagnosed type 2 diabetes patients considering the general safety and effectiveness and convenience.

Objective To investigate the diagnostic value of gluocose-6-phosphate isomerase (G6PI) detected by an enzy-me linked immunosorbent assay (ELISA) in patients with rheumatoid arthritis (RA). Methods The G6PI was detected by ELISA in serum samples from 106 patients with RA, 53 non-RA controls with various rheumatic diseases, and healthy individuals. The level of rheumatoid factor (RF), anti-CCP antibodies and AKA were also assessed in RA patients. The correlation analysis beween G6PI and anti-CCP, IgM-RF. G6PI, anti-CCP, IgM-RF and AKA were carried out between patients with erosion and with non-erosion diseases . Results ① G6PI serum level of patients with RA was (1.61 ±1.20) μg/ml, and was (0.11 ±0.17) in patients with other rheumatic diseases, and (0.06±0.07) μg/ml in healthy individuals. There was statistical significant difference between RA patients and patients with other rheumatic diseases (P<0.05). Receiver operator curve analysis (ROC) showed an opitium cut off level for C6PI at 0.225 μl/ml. The sensitivity of G6PI was 0.868, the specificity was 0.853 in RA. C6PI was associated with RF, but was not associated with anti -CCP. C6PI ws not associated with disease activity index by Spearman' s correlation analysis. The association between above parameters with bone erosion was not detected, however. Conclusion C6PI is abnormally increased in some RA so it may be a new diagnostic marker for RA. G6PI has a reasonable sensitivity (86.8%) and with high specificity(85.3%) to RA and it is valuable for RA diagnosis. C6PI is associated with RF, but not completely overlaps. C6PI is not associated with diseases activity. No association is found between G6PI and bone erosions.

Objective To investigate the prevalence of depression among the patients with diabetic foot and analyze the influence factors. Methods One hundred and ten patients with diabetic foot were inquired and assessed with patient health questionnaire for self-administered measurement (PHQ-9), meanwhile, the demo-graphic data, metabolic data and diabetes behaviors were also investigated. Results Prevalence of depression was 47.3%. Logistic regression analysis showed that alternation of diarrhea and astriction (OR = 6.901, P =0.017) and formication (OR = 23.401, P = 0.009) were risk factors, and medical insurance (OR = 0.217, P =0.007) was a protective factor. Conclusions Depression is a frequent mental disorder in patients with diabet-ic foot and its influence factors include alternation of diarrhea and astriction , formication and medical insur-ance .

Objective To explore the clinical characteristics and risk factors in patients with peripartum cardiomyopathy (PPCM).Methods A total of 35 patients admitted in Peking Union Medical College Hospital and diagnosed with PPCM between January 1995 and December 2014 was included and analyzed in this study.The subjects were divided into two groups:the early recovery and delayed recovery.Early recovery was defined as normalization of left ventricle ejection fraction (LVEF) ≥ 50％ before 6 months post-diagnosis.Delayed recovery was defined if the length of time required for recovery of LVEF was longer than 6 months or death was reported during follow-up.Risk factors for delayed recovery were assessed.Results The incidence of PPCM was 1 per 1 067 deliveries between the study periods.The age of the 35 patients was (28.9±5.6) years old.Among them,20 (57.1％) patients were not in the first pregnancy,13 (37.1％) had delivered before,and 5 (14.3％) patients had twin pregnancies.The LVEF at diagnosis was (34.1 ±8.0) ％.62.9％ (22 cases) of the subjects were in the early recovery,while 37.1％ (13 cases) of the subjects were in the delayed recovery group,2 of whom suffered death.Multivariate logistic regression indicated that LVEF (OR =1.339,95％ CI 1.063-1.688,P =0.013) and left ventricle end-dilated diameter(OR 0.763,95％CI 0.607-0.960,P =0.021)were independent risk factors for delayed recovery.Conclusions PPCM is a rare but life-threatening complication of pregnancy.LVEF and left ventricle end-dilated diameter at diagnosis were two independent factors associated with the prognosis of PPCM.