Objective To investigate the incidence of glucose metabolism disorder during pregnancy and establish the diagnosis criteria for gestational diabetes mellitus (GDM) among Chinese patients.Method A prospective popolation-bused study of 16 286 pregnant women,who received 50 g glucose challenge test (GCT) for the first time between Apr 1,2006 and Sept 30,2006,was performed throughout 18 cities in China. Results According to national diabetes data group (NDDG)criteria,the overall incidence of GDM and glucose impaired glucose tolerance (GIGT) was 2.763% (450/16 286) and 3.862% (629/16 286),respectively; it changed to 5.078% (827/16 286)and 5.268% (858/16 286) when using American diabetes association (ADA) criteria.If the women who had 2 or more abnormal oral glucose tolerance test (OGTT) values meeting or exceeding ADA criteria was classified as group 1,and the women who had one or more meeting or exceeding NDDG criteria was group 2,the ratio of women who met both the criteria of ADA and NDDG in group 1 was 94.2%.The 95% CI of normal glucose when using ADA criteria were fasting glucose 5.3 mmol/L,1 hour 10.4 mmol/L,2 hour 8.7 mmol/L,3 hour 7.7 mmol/L,which is close to ADA criteria.Conclusions ADA criterion is more suitable for Chinese patients.According to NDDG criteria,it is reasonable to treat the patient with 1 or more abnormal OGTT values,and if choosing ADA criteria,2 or more abnormal OGrIT values is more reasonable.

Objective To investigate the effect of malignant tumor on neuromuscular block of cisatracurium. Methods Sixty ASA Ⅰ or Ⅱ patients with head and neck neoplasms (15 cases with benign tumor, 45 with malignant tumor), aged 18-64 yr, were randomly divided into 4 groups ( n = 15 each): Ⅰ benign tumor group (group B,3 × ED95 ); Ⅱ -Ⅳ different dose cisatracurium group (group C1 (2 × ED95 ), C2 (3 × ED95 ) and C3 (4 ×ED95)). Neuromuscular block was assessed with accelerograph F (TOF-watch SX). Single stimulation of ulnar nerve was used. Anesthesia was induced with TCI of propofol (target plasma concentration 3 μg/ml) and remifentanil (target effect-site concentration 3 ng/ml). Tracheal intubation was facilitated with cisatracurium 0.15 mg/kg in group B, and with cisatracurium 0.10, 0.15 and 0.20 mg/kg in group C1, C2 and C3 respectively. The onset time, clinical duration, time for recovery of T/Tc to 75 % and recovery index were recorded. Results The clinical duration, time for recovery of T/Tc to 75 % and recovery index were significantly longer in group C2 than in group B (P ＜ 0.05). The onset time was significantly shorter, while the clinical duration and time for recovery of T/Tc to 75% were significantly longer in group C2 and C3 than in group C1 , and in group C3 than in group C2 ( P ＜0.05) .Conclusion The duration of action and recovery times of cisatracurium were prolonged in patients with malignant tumor.

Objective To collect the basic information on publications in Chinese Journal of Perinatal Medicine,and understand the current situation and set the goals for the future. Methods Information on all publications in this journal from 1998 to 2007 was collected.The distribution of all publications,Price Index and relative data were analyzed. Results There were 1368 publications altogether during the past 10 years.The first six kinds of papers were original articles(508,31.7%),short articles(258,18.9%),case reports(194,14.2%),reviews(122,8.9%),experimental studies(90,6.6%)and brief communications(83,14.2%).47.9% of all publications were from Beijing,Guangdong and Shanghai.The first three areas who had the most submissions were Beijing,Shandong and Guangdong in 2007.The citation frequency analysis showed that 708 publications were cited at 1east once and only two were cited over 80 times.53.4% of all cited publications were original articles and experimental studies. Conclusions Original articles and short articles are the two main types of publications in this journal,however original articles and experimental studies contributed to half of the publications being cited.Publications in this journal are focused in few areas and this might be related to the number of submissions.

Objective To analyzed the expression and clinical characteristics of CD 20 marker in children with B-lineage acute lymphoblastic leukemia ( B-ALL) and evaluated its medical significance in assessing the prognosis of disease.Methods From November 2008 to July 2012,125 cases of children with B-lineage acute lymphoblastic leukemia were collected from Shanghai Children ′s Hospital,including 79 males and 46 females, aged between 2 months to 14 years old.Flow cytometry based immunophenotyping and Minimal Residual Disease ( MRD) screening were applied to these children when newly diagnosed ,and MRD monitoring was again carried out after 35 days of induction remission therapy to those bears the MRD markers.These 125 patients were divided into CD20-positive group and CD20-negative group, and the corresponding clinical characteristics ,stage of immunophenotype ,MRD,risk stratification,and overall survival rates were recorded and compared.Data were statistically analyzed by using SPSS 16.0 software including χ2 test,t-test,standard deviation test and survival test.Results A total of 125 children with ALL-B,the group of CD20-positive were 48 while CD20-negative groups were 77,with a median age of 6 years old,and the median follow-up time of 30 months.Multivariate Cox regression Analysis showed that there was no clear correlation between CD20 expression level with age ,sex,white blood cell count at diagnosis ,fusion-gene,the stage of immunophenotype as well as risk stratification.The MRD-positive incidence at 35 days in the CD20 positive group was 35.4%,much higher than that of the CD20-negative group (16.9%),which is statistical significance (χ2 =5.236,P<0.05),while the overall survival rate (OS) for the CD20 positive group is 75.0%,much lower than that of the CD20 negative group (84.4%,χ2 =4.160,P<0.05).Conclusions CD20 positive expression level in children with B-lineage acute lymphoblastic leukemia at diagnosis demonstrates negative correlation with the overall survival rate of the patient ,indicating its usefulness as an additional joint marker for the current regimens to incorporate CD 20-targeted monoclonal therapy.

Objective To evaluate the practicability of using flow cytometry analysis for diagnosis of non-hodgkin′s lymphoma ( NHL) among children with serous effusion.Methods Twelve children who were diagnosed with malignant lymphoma from February 2011 to November 2013 at Shanghai Children′s hos-pital were recruited in this study.Pleural effusion and ascites samples were collected from those children who showed serous effusion as initial symptoms and analyzed by using flow cytometry based immunophenotyping. The antibodies used for immunophenotyping included CD45, CD10, CD33, CD7, CD1a, MPO, cCD3, CD79a, CD22, CD19, CD20, CD5, CD3,κ,λ,αβ,γδ,CD56 and other common markers for T, B and NK cells.Anti-CD30 antibody was used when necessary.Results All of the twelve cases with serous effusion were diagnosed with aggressive NHL.Six out of the twelve children including five cases with ascites and one case with pleural effusion showed high expression of CD20 and were classified as NHL-B type by flow cytom-etry.Three children with pleural effusion and one child with both pleural effusion and ascites were typed as NHL-T as characterized by monoclonal expression of αβorγδ.The other two children with pleural effusion were diagnosed with anaplastic large cell lymphoma with positive expression of CD30 and morphological het-erogeneity.Conclusion Flow cytometry analysis based immunophenotyping could be used as an auxiliary method for rapid and accurate diagnosis of lymphoma in children with serous effusions.

The role of PACAP (pituitary adenylate cyclase activating polypeptide), a peptidergic transmitter, in the pathogenesis of acute pancreatitis is not yet clear. This experiment was conducted to examine the action of exogenous PACAP on rat pancreas and on the course of experimental acute pancreatitis. The results showed that 5-30 microg/kg of PACAP slightly raised the serum amylase level, induced pancreatic edema (23.88% +/- 2.532%-25.86% +/- 1.974% of experiment groups versus 29.21% +/- 5.657% of control group), inflammatory cell infiltration, vacuolization of acinar cells, and occasionally fatty and parenchymal necroses. 15-30 microg/kg of PACAP aggravated cerulein-induced acute pancreatitis; the pancreatic edema became more marked (13.45% +/- 2.045%-17.66% +/- 4.652% of expreiment groups versus 21.83% +/- 3.013% of cerulein group, P<0.05), the serum amylase level became higher; and ascites, pancreatic bleeding, fatty and parenchymal necroses, and extensive vacuolization of acinar cells appeared. For sodium taurocholate-induced pancreatitis, 5-10 microg/kg of PACAP mildly attenuated the pancreatic edema, reduced the serum amylase level (1986.91 +/- 710.97-2944.33 +/- 1182.47 IU/L vs 3690.87 +/- 2277.99 IU/L, P<0.05), whereas it caused multifocal hemorrhage and prominent necrosis in pancreas. Except the cerulein-induced pancreatitis groups, other groups were found to have reduced pancreatic functional capillary density (FCD); when pancreatic edema was taken into consideration and calibrated FCD was introduced (FCD weighted against pancreatic wet/dry ratio), all groups revealed increases in pancreatic functional capillaries when compared with normal control. In conclusion, PACAP is proinflammatory in the pathogenesis of acute pancreatitis, PACAP plus cerulein can induce acute hemorrhagic/necrotizing pancreatitis, and the action of PACAP on cerulein-induced panceatitis may differ from that on sodium taurocholate-induced one. In this experiment, pancreatic FCD was underestimated due to pancreatic edema.
Amylases ; blood ; Animals ; Capillaries ; pathology ; Ceruletide ; Disease Models, Animal ; Male ; Pancreas ; blood supply ; Pancreatitis, Acute Necrotizing ; chemically induced ; enzymology ; pathology ; Rats ; Rats, Wistar

To obtain the functional fusion protein of rhoptry protein 2, compound rhoptry protein2 and surface antigen 1 of Toxoplasma gondii. the ROP2 and P30 genes from genomic DNA of T.gondii RH strain were amplified by PCR, and were inserted into pMD18-T cloning vector. Then the ROP2 fragment was subcloned to pET-30a(+) plasmid digested by EcoRⅠand Hind Ⅲ to construct plasmid pET-ROP2. Furthermore,the P30 fragment was subcloned into pET-ROP2 digested by BglⅡand EcoRⅠto create plasmid pET-ROP2-P30, the resulting recombinant plasmids , transformed into E.coli BL21 (DE3), were induced with IPTG. and the proteins identified by SDS-PAGE were further purified and refolded. The biological activity was analyzed by Western blot with specific antibody. It was found that the sizes of ROP2 and ROP2-P30 were 1212 and 1896bp with corresponding molecular weight 50- kDa and 75-kDa, respectively. The recombinant protein ROP2 (50-kDa) could specifically react with rabbit-polyclonal antiserum, and complex fusion protein ROP2-P30 (75- kDa) could react with P30 monoclonal antibody.

Objective To evaluate the efficacy of intermittent positive pressure ventilation (IPPV,1 ml/kg) of the operated lungs in preventing hypoxemia during one-lung ventilation (OLV) in elderly patients undergoing radical resection of esophageal cancer.Methods Sixty American Society of Anesthsiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 65-75 yr,with body mass index of 18.5-24.0 kg/m2,were divided into 2 groups (n =30 each) using a random number table method:convention group and IPPV group.In convention group,ventilator settings were adjusted with the tidal volume of 6-8 ml/kg,respiratory rate of 15 breaths/min,inspiratory/expiratory ratio of 1 ∶ 2,and fraction of inspired oxygen 70％ during OLV.In IPPV group,ventilator settings were adjusted with the tidal volume of 1 ml/kg,respiratory rate of 15 breaths/min,and fraction of inspired oxygen 70％ on the operated side during OLV,and the ventilator settings on the other side were consistent with those previously described in convention group.Before anesthesia induction (T0),at 10 min of two-lung ventilation (T1),at 15,30 and 45 min of OLV (T2,4) and at 10 min after the end of OLV (T5),blood samples were collected from the radial artery for blood gas analysis.The partial pressure of arterial oxygen (PaO2) and alveolar to arterial partial pressure of oxygen were recorded.Respiratory index (RI) and oxygenation index (OI) were calculated.The occurrence of PaO2 ＜ 60 mmHg,RI＞ 1.0 and OI＜ 200 mmHg was recorded during OLV.Results Compared with convention group,the RI was significantly decreased at T4,the PaO2 and OI were increased,and the incidence of PaO2＜60 mmHg,RI＞ 1.0 and OI ＜ 200 mmHg was decreased in IPPV group (P＜ 0.05).Conclusion IPPV (1 ml/kg) of the operated lungs can prevent the occurrence of hypoxemia during OLV in elderly patients undergoing radical resection of esophageal cancer.

OBJECTIVETo provide guidance for the high-dose methotrexate (HD-MTX) treatment of pediatric acute lymphoblastic leukemia (ALL), and to understand the impact of SLCO1B1c.521T>C (rs4149056) variant on methotrexate (MTX) pharmacokinetics and clinical outcome in children with ALL.

METHODEighty-two children with ALL in Division of Hematology of Wuhan Children's Hospital from January 2008 to February 2013 were enrolled. All patients were genotyped for rs4149056 single nucleotide polymorphism (SNP) into wild-type group (TT genotype) and variant group (TC/CC genotype). According to the ALL-BFM 2000 protocol, all patients received intravenous infusion of MTX every ten days at 3 to 5 g/m(2). Leucovorin rescue was performed after 36 hours of the MTX administration and its dose was adjusted according to the MTX plasma concentration at 48 hours. The concentrations of MTX and its metabolite at 24, 48 and 72 h were determined by high performance liquid chromatography with solid phase extraction. Population pharmacokinetic parameters were estimated by the NLME software. The pharmacokinetics, toxicity and leucovorin rescue was compared. The relapse rate within 5 years and event-free survival were followed up.

RESULTEighty-two pediatric patients were classified into two groups: variant group including 20 TC genotype carriers and one CC genotype carrier, wild-type group included 61 patients with TT genotype. Compared with wild-type group, plasma concentration of MTX at 48 and 72 h increased significantly [48 h: (1.00±1.41) vs.(0.34±0.17) µmol/L, t=2.131, P=0.046; 72 h: (0.31±0.26) vs.(0.08±0.04) µmol/L; t=3.995, P=0.001]. Area under the concentration time curve (AUC48-∝) of MTX significantly increased in variant group [(23.18±19.91) vs.(5.66±2.01) h·µmol/L] (t=4.025, P=0.001). Time above the MTX safety threshold (TC>0.1 µmol/L) increased significantly in variant group [(95.3±22.0) vs.(67.1±7.5) h, t=5.880, P<0.001]. Rescue dosage of leucovorin in variant group was higher than that in wild-type group [(312.7±287.8) vs.(140.6±27.5) mg/m2, t=2.614, P=0.017]. The children carrying rs4149056 C allele suffered from a higher frequency of serious adverse effect [gastrointestinal toxicity: 33% (7/21) vs. 5% (3/61);hepatic toxicity: 24% (5/21) vs. 2% (1/61)]. The difference was statistically significant (χ2=9.275, 8.289, all P<0.05). Hospital stay of variant group was significantly longer than that of wild-type [(4.95±1.43) vs. (4.05±0.22) d, t=2.881, P=0.009]. The relapse rate within 5 years of variant group and wild-type group were 9% (2/21) and 13% (8/61), respectively. There were no significant differences in the event-free survival between the two groups (χ2=0.001, P=0.971).

CONCLUSIONThe SLCO1B1 c.521T>C variant was an important determinant of MTX pharmacokinetics. An appropriate leucovorin dose raise in variant group was beneficial to reducing the serious toxicity and did not affect the long-term clinical outcome.

Alleles ; Antineoplastic Combined Chemotherapy Protocols ; Asparaginase ; Child ; Daunorubicin ; Disease-Free Survival ; Genotype ; Humans ; Leucovorin ; administration & dosage ; Methotrexate ; administration & dosage ; pharmacokinetics ; Organic Anion Transporters ; genetics ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; genetics ; Prednisone ; Solute Carrier Organic Anion Transporter Family Member 1b1 ; Treatment Outcome ; Vincristine

OBJECTIVETo explore the clinical features and genomic abnormality of a patient with Coffin-Siris syndrome.

METHODSMicrodeletion and microduplication were detected with chromosomal microarray analysis (CMA) and verified with real-time quantitative PCR.

RESULTSThe patient, a 6-month-old boy, featured global development delay, thick eyebrows, low frontal hairline, long eyelash, flat nasal bridge, hypotonia, difficulty in turning over, over stretching of head, and hypoplatic nails. He could not stand stability or actively grasp. He also has characteristics of rickets. Chromosome karyotype of the patient was normal. Genomic analysis has detected a 1.3 Mb deletion in 6q25.3 region encompassing the ARID1B gene. Neither of his parents was found to harbor the same deletion.

CONCLUSIONThe 6q25.3 microdeletion probably underlies the Coffin-Siris syndrome in this patient, and rickets may be part of its clinical spectrum.