Overweight or obese women have a significantly increased risk of gestational diabetes mellitus (GDM). With the increasing prevalence of obesity among women of reproductive age, the prevalence of GDM has also risen. The prevention of GDM during pregnancy is particularly important in reducing the adverse pregnancy outcomes for both mothers and their offspring and decreasing the economic burden of the society. Lifestyle interventions (exercises, dietary), dietary supplementation, and pharmacological approaches are the main preventive measures. Exercise intervention and myo-inositol supplementation are effective in preventing GDM; dietary intervention and combined lifestyle intervention have some benefits, but the results remain controversial; probiotic supplementation and prophylactic use of metformin seem to be ineffective; the effectiveness of vitamin D supplementation is unclear.

Objective To investigate the distribution of pathogenic of nosocomial infections in intensive care unit (ICU) and the tendencies of its drug-resistances.Methods All of 130 patients of nosocomial infection from March 2009 to March 2013.Results Of all the nosocomial infection pathogens,gram-negative(G-) bacteria was the main(53.76％).The first five pathogens were E.coli(13.9％),E.faecalis (11.3％),A.baumannii (10.3％),S.aureus (9.8％) and K.pneumoniae (8.3％).The lower resistant to pseudomonas aeruginosa were amikacin (5.3％).A.baumannii increases rapidly and its resistances was severe.Two trains of E.faecalis were resistant to vancomycin.Conclusion G-bacteria is the main pathogens in ICU,fungal has upward tendency.The multidrug resistances of A.baumannii and E.faecalis were severe; Target monitoring is an effective surveillance method to reduce the prevalence of the nosocomial infection in ICU.

As a low-and middle-income country, Cuba has successfully implementedUniversal Health Coverage ( UHC) in the true sense, of which the major health indicators and human development index are relatively high. Moreover, many aspects of Cuba's healthcare system are worth learning from, especially constructing family doctor system, integrating medicine policy into national economic and social development strategies, focusing on drug re-search and development, standardizing high-quality medical education, etc.

Autophagy is a catabolic process responsible for the degradation and recycling of misfolded proteins and damaged organelles for cellular homeostasis. This degradative pathway,closely related to many diseases including cancer,has become a focus of cancer research. lt can serve as a tumor suppressor,also functions as a protective cell-survival mechanism against chemotherapies. Of the autophagy-related proteins,vacuolar protein sorting 34(VPS34)has attracted major attention over the past decade because of its role in autophagic procedure. Recently,three specific inhibitors of VPS34,PlK-Ⅲ,VPSlN1 and SlR405,have been invented,showing unique implications for autophagy reduction and therapeutic benefit in tumor treatment. This paper summarizes the different roles of autophagy in clinical settings and the functional regulation of VPS34 upon post-translational modification and also discusses the application prospects of inhibitors targeting VPS34 or autophagy in cancer prevention and treatment.

Objective:To compare the differentiated endothelial cells from the embryonic stem cells in vitro with human umbilical vein endothelial cells (HUVECs).Methods:Induction of the stem cells HUES9 to endothelial cells follows 2 steps.Stem cells were treated with CHIR99021 (10 μmol/L) and bone morphogenetic protein 4 (25 ng/mL) for 3 days to keep mesoderm state,then subsequent exposure them to VEGF165 (200 ng/mL) and Forskolin (2 μmol/L) to differentiate into endothelial cells.The morphology of differentiated endothelial cells were compared with HUVECs.The surface marker CD144 on differentiated cells and HUVECs were detected.The capabilities of two types of endothelial ceils in migration and angiogenesis were examined.Results:The differentiated endothelial cells show the same morphology with HUVECs.After 6 days of differentiation,the efficiency reached 73.4％.The positive percentage of CD144 for the differentiated endothelial cells and HUVECs was 86.6％ and 94.4％,respectively.Both of them show capabilities of migration and angiogenesis,especially when they were treated with SB431542 to inhibit TGF-β signal pathway.Conclusion:The method for induction of stem cells to endothelial cells is productivity and it can be used for further study.

OBJECTIVE:To establish the method for the determination of particle size distribution of Budesonide nasal spray, and to analyze the consistency of particle size distribution of spray samples. METHODS:Water was used as dispersant for mixing and dispersing(1800 r/min). The particle sizes [d(0.1),d(0.5),d(0.9)] corresponded to accumulative particle size of 10%,50%and 90%were used as characteristic value. The distribution of granularity was determined by laser scattering method. The consisten-cy of particle size distribution of samples from 2 manufacturers (A,B) were analyzed among different batches or same batch of same manufacturer by SAS 9.3 statistical software. RESULTS:The mean values of d(0.1),d(0.5) and d(0.9) were 3.96 μm, 29.58 μm and 67.10 μm in manufacturer A. The mean values of d(0.1),d(0.5)and d(0.9)were 2.00 μm,7.53 μm and 28.51 μm in manufacturer B. By analysis,there was great difference in particle size of samples from 2 manufacturers. The particle size of the samples from manufacturer A were larger than that of manufacturer B. The consistency among different batches from manufacturer B was better,and the consistency among same batch were all good from 2 manufacturers. CONCLUSIONS:The established meth-od is suitable for particle size distribution of Budesonide nasal spray and the consistency analysis of particle size distribution.

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.

In order to improve the efficiency and quality of medical services,the authors applied the lean production and system simulation into optimizing the transfusion system of a hospital.By means of describing and analyzing the current situation and problems of a transfusion system of the hospital,the paper presented the cause-effect diagram for overlong patient waiting.5W1H and ECRS were adopted to analyze the infusion processes,while Simio was used to simulate the existing infusion system and simulation data so obtained were used to draw a value stream mapping for the system.In line with the ideas of Shojinka and one stream production,nurses deployment and conveyor speed were reconfigured.Based on these ideas,a reform plan is presented and the simulation method is used to verify the outcomes.The study proved that lean production and system simulation can effectively improve the hospital transfusion system,medical efficiency and medical service level.

0.05);the difference on d3 with that on d9 was significant(P0.05);the difference on d3 with that on d7 and d9 was significant(P

A quality control (QC) strategy for quantitative and qualitative analysis of “common peaks” in chemical fingerprint was proposed to analyze Yuanhu Zhitong tablet (YZT), using high performance liquid chromatography with diode array detector and tandem mass spectrometry (HPLC-DAD-MS/MS). The chromatographic separation was achieved on an Agilent Eclipse plus C18 column with a gradient elution using a mixture of 0.4‰ ammonium acetate aqueous (pH 6.0 adjusted with glacial acetic acid) and acetonitrile. In chemical fingerprint, 40 peaks were assigned as the “common peaks”. For quantification of “common peaks”, the detection wavelength was set at 254 nm, 270 nm, 280 nm and 345 nm, respectively. The method was validated and good results were obtained to simultaneously determine 10 analytes (protopine, jatrorrhizine, coptisine, palmatine, berberine, xanthotoxin, bergapten, tetrahydropalmatine, imperatorin and isoimperatorin). For qualification of “common peaks”, 33 compounds including 10 quantitative analytes were identified or tentatively characterized using LC-MS/MS. These results demonstrated that the present approach may be a powerful and useful tool to tackle the complex quality issue of YZT.