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.

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.

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.

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.

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 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 investigate the efficacy and safety of oxycodone hydrochloride prolonged-release tablets and tramadol hydrochloride sustained-release tablets in the treatment of moderate cancer pain. Methods:Totally 290 cases of the patients with mod-erate pain were divided into the observation group with 148 cases and the control group with 142 cases. The observation group received oxycodone hydrochloride prolonged-release tablets, while the control group was given tramadol hydrochloride sustained-release tablets. The treatment course was 2 weeks, and the total efficiency and the incidence of adverse drug reactions( ADR) in the two groups were calculated and compared. Results:The total efficiency in the observation group and the control group was 92. 6% and 81. 7%, respec-tively, and the difference was statistically significant (P<0. 01). The incidence of ADR was 60. 1% and 57%, respectively with no significant difference (P>0.05). Conclusion: The effect of oxycodone hydrochloride prolonged-release tablets in the treatment of moderate cancer pain is better than that of tramadol hydrochloride sustained-release tablets.

[ ABSTRACT] AIM: To study the autophagy of prostate cancer PC-3 cells induced by CD147 in vitro.ME-THODS:Themethod of amino acid starvation to induce autophagy was used.The expression of CD147 was detected by Western blotting.To study the functional effects of CD147 on autophagy in prostate cancer PC-3 cells, the down-regulation of CD147 expression was induced by the technique of RNAi.The conversion of autophagic marker protein LC3-I to LC3-II was determined by Western blotting.The cell death after starvation-induced autophagy was analyzed by trypan blue exclu-sion assay.RESULTS:The CD147 expression gradually increased in starvation-induced autophagy.The down-regulation of CD147 significantly increased the expression of autophagy-related protein LC3-II compared with control group.Mean-while, the cell death rates increased from (19.3 ±3.1)%and (22.3 ±3.5)%in control groups to (38.4 ±3.1)%in si-lencing the expression of CD147 in the PC-3 cells (P<0.05).CONCLUSION:CD147 inhibits starvation-induced auto-phgy and autophagy death in the prostate cancer PC-3 cells.

Objective To investigate the clinical efficacy of treatment for chronic pancreatitis and mass in the head of the pancreas.Methods The clinical data of 19 patients with chronic pancreatitis with mass in the head of the pancreas who were admitted to the China-Japan Union Hospital of Jilin University from May 2008 to May 2013 were retrospectively analyzed,including 2 patients with gallstone.Methods of treatment were selected by in traoperative pathological results.All the patients were followed up by outpatient examination and telephone interview till January 2014.Results The operations of the 19 patients were successfully done,including 11 with pancreaticoduodenectomy,5 with exploratory laparotomy and 3 with the laparoscopic cholecystectomy and choledochojejunostomy.The operation time and intraoperative blood loss were (249± 140)minutes (50-390 minutes) and (320 ± 260)mL (50-900 mL).The postoperative mean time of recovery of gastrointestinal function and duration of postoperative hospital stay were 3.0 days (2.0-6.0 days) and 22.6 days (8.0-30.0 days) after the operation.The mean casein-IgG4 of 12 patients was higher (2.64 g/L) after operation.Five patients with operation-related complication were cured after symptomatic treatment,among 2 patients with leakage of the pancreatic fluid,2 with operative incision fat necrosis and liquefaction and 1 with bile leakage.No patients died perioperatively.Nineteen patients were followed up for 11.0 months to 36.0 months with the median time of 28.2 months.The pancreatic head mass of 8 patients with non-pancreaticoduodenectomy were reduced or disappeared by a computed tomography (CT) or magnetic resonance imaging (MRI) rescan,who were treated by the oral prednisone.No complications were detected in the other 11 patients with pancreaticoduodenectomy.Conclusion Method of surgery or medicine treatment for atypical mass in the head of the pancreas is selected according to the pathology results by effective communication with patients and family members,exploratory laparotomy and interpretative aspiration biopsy.

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.