Objective To explore the interactions between human leukocyte antigen ( HLA)-DRB1 gene polymorphism and environmental risk factors in gestational diabetes mellitus ( GDM ) pathogenesis.Methods Pregnant women who had prenatal cares in Obstetric Department , West China Second Hospital of Sichuan University were recruited from January 1st to December 31st in 2011.A prospective cohort study was conducted in the women who had a glucose challenge test ( GCT) or 75 g oral glucose tolerance test ( OGTT) during 24-28 gestational weeks.A total of 104 women diagnosed with GDM were randomly included in GDM group while another 103 normal women fell into the control group.The HLA-DRB1 polymorphism was detected by Polymerase Chain Reaction -Sequence Specific Primers ( PCR-SSP) method in both groups.The interactions between HLA-DRB1 polymorphism and environmental risk factors were analyzed based on the simple-case-study method.Results ( 1 ) There were 712 pregnant women with complete perinatal information during January 1st to December 31st, 2011, among whom 175 (24.6%) women were diagnosed with GDM.A logistic regression analysis showed that advanced maternal age (OR=1.081, 95%CI:1.027-1.138), imbalanced diet (OR=3.329, 95%CI:2.167 -5.116), high body mass index (BMI≥24.0 kg/m2) before pregnancy (OR=1.095, 95%CI:1.008 -1.190), HBsAg carrier status (OR=3.173, 95%CI:1.387-7.260) and family history of diabetes mellitus (DM) (OR=1.798, 95%CI:1.063 -3.041) were risk factors of GDM.(2) There were 49 HLA-DRB1 genotypes and 51 HLA-DRB1 genotypes in GDM group and the control group , respectively.We further compared the genotypes that occurred in over 3 cases in either group and found that HLA-DRB1*12,16 was only detected in 5 cases (5/103, 4.9%) in control group,and the difference was significant between the two groups (P=0.029).HLA-DRB1*11,16 and HLA-DRB1*09,09 were only detected in 4 cases (3.8%,4/104) and 5 cases (4.8%, 5/104) in GDM group respectively , but without significant differences between the two groups ( P >0.05 ).No significant difference was found in other genotype frequencies between the two groups ( P>0.05 ).( 3 ) Thirteen types of HLA-DRB1 allele were detected but no significant differences were observed in their frequencies between two groups ( P>0.05).(4) A positive interaction was detected between HLA-DRB1*07 polymorphism and advanced maternal ages (OR=5.952, 95%CI:1.314-26.970, P=0.022), while no interaction was found between HLA-DRB polymorphisms to other risk factors such as imbalanced diet , high body mass index ( BMI≥24.0 kg/m2 ) , HBsAg carrier status or DM family history.Conclusions Advanced maternal age, unbalanced diet, high body mass index (BMI≥24.0 kg/m2), HBsAg carrier status and DM family history are environmental risk factors of GDM in Chengdu.While HLA-DRB1*12,16 genotype may be a protective genotype for GDM.There is a positive interaction between HLA-DRB1*07 polymorphism and advanced maternal age which may play a critic role in GDM development.

Monocyte chemotactic peptide 1(MCP 1) is a specific chemotactic and activating factor for monocytes in acute renal transplant rejection. The present study was to diagnose aimed at diagnosing acute renal transplant rejection by determination of MCP 1 concentration in urine of kidney recipients by avidin biotin complex enzyme linked immunosorbent assay(ABC ELISA).Among the 65 recipients, the urinary MCP 1 concentration was (1278?64)pg/ml in 17 with acute rejection, which was higher than that in 40 clinically stable ones(511?16 pg/ml, P

Objective To explore the clinical significance of serum concentrations of Cystatin C (CysC) in children with kidney disease in different disease courses. Methods The serum concentrations of CysC, creatinine(Cr) and endogenous creatinine clearance rate(Ccr) were determined in 182 children with kidney disease. They were divided into five study groups:normal renal function group (73 cases), compensatory renal disfunction group (44 cases), non-compensatory renal disfunction group (35 cases), renal failure group(22 cases) and end stage of renal failure group(8 cases). Meanwhile 70 healthy children were involved in control group. Relationships among CysC, Cr and Ccr were calculated and the diagnostic efficiency was assessed by comparing the areas under the ROC curves. Results The serum concentrations of CysC increased in different courses of renal function impairment in children and were significantly related to the severity of impairment. CysC was positively correlated to Cr and negatively correlated to Ccr. The areas under the ROC curves of Cr and CysC were 0.764 and 0.725. Conclusions The serum concentrations of CysC can accurately identify different impairment grades of renal function and the function of glomerular filtration. As an indicator of early reduction of renal function, its sensitivities and specificities are superior to Cr and Ccr. CysC can be a sensitive endogenous marker for glomerular filtration rate determination. With simple, convenient and applicable assays methods, CysC is essential for early diagnosis of children kidney diseases.

Objective To evaluate the accuracy of continuous noninvasive hemoglobin ( Hb ) monitoring in the patients undergoing cesarean section. Methods A total of 200 patients, at 36-42 weeks of gestation, aged 19-40 yr, with body mass index of 20.5-35.1 kg∕m2 , of ASA physical statusⅠorⅡ, undergoing elective cesarean section from June 2014 to October 2014 in our hospital, were enrolled. A sensor was positioned at patient′s finger and connected to the Masimo Radical?7 Pulse CO?Oximeter, a continuous noninvasive Hb measurement device. Noninvasive Hb obtained with Pulse CO?oximeter ( SpHb) was recorded. Before skin incision ( T0 ) , after delivery of the placenta ( T1 ) , after suturing the uterus ( T2 ) and at the end of operation ( T3 ) , blood samples from the radical artery were collected for determination of total Hb ( tHb) , and SpHb was also recorded. The agreement between two methods was assessed using Bland?Altman analysis. Results At T0-T3, tHb was 111±9, 103±8, 94±8 and (89±7) g∕L, respectively, and SpHb was 124 ± 9, 120 ± 12, 108 ± 9 and ( 103 ± 8 ) g∕L, respectively. Bland?Altman analysis showed that at T0-T3 , the mean difference between SpHb and tHb was 13.5, 17.1, 14.1 and 13.9 g∕L, respectively, and 95% confidence interval was 13.1-13.9, 16.5-17.7, 13.6-14.6 and 13.4-14.4 g∕L, respectively. The limit of agreement was 8.4-18.6, 9.1-25.1, 7.8-20.4 and 7.4-20.4 g∕L at T0-T3 , respectively, and the interchangeable limits of the two methods ranged between 3.5-23.5, 7.1-27.1, 4.1-24.1 and 3.9-23.9 g∕L at T0-T3 , respectively. The repeatability coefficient of tHb and SpHb was 16.5 and 15.8 g∕L, respectively. The relative error of SpHb was (4.6±1.0)%, (5.3±1.4)%, (4.9±1.2)% and (4.8±1.2)% at T0-T3, respectively. Conclusion Continuous noninvasive Hb monitoring provides good accuracy in the patients undergoing cesarean section.

Objective To analyze the clinical manifestations and electroencephalogram (EEG)characteristics of agyria-pachygyria for its early diagnosis,treatment and prognosis judgment in clinical practice.Methods The clinical manifestations and EEG features of twenty-four patients with agyria-pachygyria who were diagnosed by CT or magnetic resonance imaging(MRI) at Pediatric Neurology of Children's Hospital of Chongqing Medical University from July 2004 to July 2013 were retrospectively analyzed.Results Of twenty-four patients,eighteen cases were diagnosed as diffuse agyria-pachygyria and six cases were diagnosed as partial agyria-pachygyria.The clinical features were mainly manifested as mental retardation (twenty-four patients),and motor retardation (twenty-four patients),and epilepsy (eighteen patients).All of the twenty-four patients had abnormal EEG pattern which were mainly three tapes.Type Ⅰ had diffused high amplitude alpha and beta activity in all cortical regions,frontal-central,or parietal-occipital region (fourteen patients).Type Ⅱ showed alternating high amplitude bursts with sharp and slow waves (seven patients).Type Ⅲ was characterized by high amplitude spike or sharp wave activity generalized or multifocal distribution and δ,θ wave mixing graphics (twelve patients).Nine of twenty-four patients showed two or three EEG characteristic patterns in an awake-asleep EEG recording.During the follow-up of 1-8 years old,twelve of the thirteen patients who were diagnosed as epilepsy in diffuse agyria-pachygyria had refractory epilepsy,mainly with infantile spasms or Lennox-Gastaut syndrome.One of the five patients who was diagnosed as epilepsy in focal agyria-pachygyria had refractory epilepsy,mainly for partial epilepsy secondary generalized seizures.There was a significant difference between them (P =0.008).Eighteen of twenty patients who had moderate-severe mental retardation or dyskinesia were diagnosed as diffuse a gyria-pachygyria,while two were focal agyria-pachygyria.Both of them had a significant difference (P =0.005).Conclusions Agyria-pachygyria is a brain malformation caused by neuronal migration abnormality.Diffuse agyria-pachygyria is presented with serious clinical manifestations and poor outcome while the clinical manifestation of focal agyria-pachygyria is relatively mild and epilepsy could be controlled by antiepileptic drugs or epilepsy surgery.These characteristics of EEG patterns along with clinical findings could provide important evidence for early diagnosis,timely treatment and prognosis judgment of agyria-pachygyria.

Objective To evaluate the patient-controlled paravertebral block (PCPB) in optimizing the cellular immune function when used after radical resection of pulmonary carcinoma performed via video-assisted thoracoscope in patients.Methods Forty-one ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 50-64 yr,with body mass index of 20-25 kg/m2,of TNM staging Ⅰ or Ⅱ,undergoing radical resection of pulmonary carcinoma performed via video-assisted thoracoscope,were randomly divided into 2 groups using a random number table:PCIA group (n =21) and PCPB group (n =20).PCIA solution contained sufentanil 2 μg/kg in 100 ml of normal saline.The PCIA pump was set up to deliver a 2 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h.In PCPB group,the patients received paravertebral injection of 0.2％ ropivocaine 5 ml at T5 level on the affected side under ultrasound guidance at the end of operation,and then received PCPB.PCPB solution contained 0.75％ ropivacaine 67 ml in 250 ml of normal saline,and the pump was set up to deliver a 5 ml bolus dose,with a 15-min lockout interval and background infusion at 5 ml/h.VAS score was maintained ≤ 3,and analgesia lasted until 50 h after operation.Before induction of anesthesia (baseline),at end of operation,and at 1,3 and 5 days after operation,peripheral venous blood samples were collected to determine the levels of regulatory T cells,natural killer cells and natural killer T cells (by flow cytometry) and plasma concentrations of interleukin-10 and transforming growth factor-β (by ELISA).Results Compared with group PCIA,the level of regulatory T cells was significantly decreased,the levels of natural killer cells and natural killer T cells were increased,and the plasma concentrations of interleukin-10 and transforming growth factor-β were decreased at 1 and 3 days after operation,and no significant change was found in the rate of cellular immune function decline after operation in group PCPB.Conclusion PCPB provides no significant difference clinically in optimizing the cellular immune function when used after radical resection of pulmonary carcinoma performed via video-assisted thoracoscope in the patients.

Objective To study the effects of light on body weight,learning and memory of mice.Methods Fifty mice aged 20 days were randomly assigned to one of the five groups: 200 W light group,100 W light group,60 W light group,40 W light group and normal control group,with 10 in each.They were exposed to different intensities of light 8 hours per day for 1 week.Then we monitored their body weight,examined the mean latency and inaccuracy number in step-down test,and examined the mean latency using a Morris' water maze to observe the effect of light pollution on the mice's learning and memory.Results Compared with the other four groups,there were significant decelerations of body weight increase in 200 W light group.No significant difference in body weight gain was found among the other four groups.The four light-treatment groups had no significant differences from control group in the mean latency,inaccuracy number in step-down test or the mean latency,or the mean crosses to the target in the Morris' water maze.Conclusion Short time high-intensity light can inhibit body weight increase in mice,but short-time light has no effect on the learning and memory of mice.

Objective To establish a model of pancreatic cancer(PC)in SD rats,and to study the changs of serum levels of AMS and TNF-? and the significances.Methods Dimethylbenzanthracene(DMBA)was directly implanted into pancreatic parenchyma of SD rats(experimental group,group A),and in the process of establishing PC,weekly TSA by 1P was done in intervention group(group B).The tumor development of rats executed within 3～5 months in Group A and Group B were observed by HE staining and gross examination.Meanwhile,the rats in the sham operation group(Group C)were executed at 5 months.The levels of serum AMS were detected by autobiochemical assay apparatus,and the levels of serurn TNF-? were determined by ELISA.Results(1)The incidence of pancreatic cancer in Group A within 3～5 months was 48.7%(18/37),including 17 cases of pancreatic ductal adenocarcinoma and 1 case of fibrosarcoma.The incidence of pancreatic cancer in Group B was 33.3%(12/36),including 11 pancreatic ductal adenocarcinoma and 1 case of fibrosarcoma.The maximal diameter of tumor mass in Group A was higher than that in Group B((P

Objective: To investigate β2 adrenergic receptor (β2-AR) gene polymorphism, Arg16Gly, Gln27Glu and essential hypertension (EH) occurrence in Tibetan population living at high altitude area. Methods: Our research included in 2 groups: EH group, n=385 patients and Control group,n=297 normal healthy subjects. β2-AR polymorphisms of Arg16Gly and Gln27Glu were detected by Snapshot mini-sequencing technique and their frequencies were compared between 2 groups and male, female genders. Results: The genotype and allele frequency distributions of Arg16Gly and Gln27G1u were similar between 2 groups, P>0.05; there were no signiifcant differences between male and female genders,P>0.05. Conclusion: No obvious relationship was found between β2-AR gene polymorphism (Arg16Gly, Gln27Glu) and EH occurrence in Tibetan population living at high altitude area.

ObjectiveTo study the different clinical effects of using 5 kinds of hemostatic surgeries to manage the intractable postpartum hemorrhage and analyse the risk factors of failed hemostasis.Methods From Jan.2007 to Jul.2011,96 patients with intractable postpartum hemorrhage were studied retrospectively and grouped by the first step surgical treatment.The hemostatic surgeries included uterine tamponade (tamponadegroup ), pelvicbloodvessels ligation(ligationgroup), pelvical arterial embolization (embolization group), uterine compression sutures (sutures group)and uterine compression sutures combining tamponade (combined group).The intraoperative and postoperation datum were compared among groups,so dose the treatment outcomes.Multivariate analysis were used for failed hemostasis.Results( 1 ) The blood loss of 96 patients ranged from 1200 to 9100 ml,and 71 patients had a succeed hemoatasis after employing these surgeries and 25 failed.(2) The blood loss before hemostasis surgeries in tamponade group and embolization group was statisically greater than in sutures group ( P ＜ 0.05 ).Blood loss during the hemostasis surgeries in ligation group was statistically greater than in embolization and sutures groups ( P ＜0.05).The operating time of embolization group was statistically shorter than ligation group,sutures group and the combined group (P ＜ 0.05 ).(3) Fine of 96 patients had uterine atony and 43 had a successful hemostasis with the success rate about 78％.Forty-six had placenta previa and 39 success with success rate 85％.Thirty-three had placenta accrete and 13 of which succeed in hemostasis with success rate about 39％.In patients with uterine atony and placenta previa,the difference of hemostasis rate in groups had no statistically significant ( P ＞ 0.05 ).In patients with placenta accrete,the hemostasis rate in embolization group was higher than in others groups (P ＜ 0.01 ). (4) The multivariate analysis found that scar uterus,placenta accrete and coagulation defects were the risk factors of failed hemotasis.The OR value respectively was 2.9 (95 ％ CI:1.1 - 7.6 ),17.9 ( 95 ％ CI:5.6 - 56.3 ) and 16.2 ( 95 ％ CI:3.2 - 83.5 ).Embolization had some extent of protective effection ( OR =0.9,95 ％ CI:0.8 - 0.9 ).Conclusions ( 1 ) Five kinds of hemostatic surgeries were all effective.Though the success rate among groups did show statistical difference,pelvical arterial embolization has the comparative advantage of shorter operating time,less operating blood loss and higher success rate in placenta accrete.(2) Since scar uterus,placenta accrete and coagulation defects were the risk factors of failed hemostasis,sufficient preparation should be made for patients with these risk factors and the hemostatic surgeries should be choosed individually.