Objective To investigate the association of single nuchotide polymorphism (SNP) + 45 T/G and + 276 G/T in the adiponectin gene with type 2 diabetes in Guangxi Zhuang pregnant women.Methods Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to determine the distributions of allele and genotype frequencies of SNP + 45T/G polymorphism and SNP + 276 G/T polymorphism in adiponect in gene in 98 type 2 diabetic patients and 135 normal control subjects.Results The TG,GG genotype frequencies of the SNP +45T/G were higher in gestational diabetes mellitus (GDM) than those in controls (P ＜ 0.05).The G-allele frequency was significantly higher than those in controls (P ＜ 0.05).The distribution of genotype and allele frequencies of the SNP + 276 G/T polymorphism was not different in diabetes and control groups (P ＞ 0.05).Women carrying the TG and GG allele of SNP +45T/G showed higher TG (P ＜0.05),and lower APN levels than those with TT genotype (P ＜0.05).Conclusions G allele of SNP +45T/G was related to GDM possibly.T→G variation might involve in the occurrence of GDM by reducing serum diponectin levels.Monitoring this site in pregnant women could predict the risk of GDM.

Objective To know the blood lead level of children aged 3-14 years in some areas of Guangdong province. Methods Stratified-clustered-random sampling and simple random sampling were used. 1905 children aged 3-14 years were chosen from Guangzhou,Shenzhen,Shaoguan,Zhaoqing and Lianping and the blood lead level was tested by ICP-MS. Results The mean lead level of children aged 3-14 years was 69.55 ?g/L. The rate of exceed standard limit of blood lead was 16.4% (≥100 ?g/L). The differences of the blood lead level and the rate of lead poisoning of children among different areas were significant. The blood lead level and the rate of lead poisoning of children in Shaoguan were highest in the investigated areas. The blood lead level and the rate of lead poisoning of children aged 3 years were higher than those in the other age groups. The blood lead level of boys was higher than that of girls. Conclusion The blood lead level and the rate of children lead poisoning in the underdeveloped cities and rural areas are higher.

To determine fluoride in toothpaste samples by ion chromatography,the solution of NaHCO3 and the solution of Na2B4O7-NaOH were selected as eluents respectively to optimize chromatographic detection conditions. Either the 0. 45～1.0 mmol/L NaHCO3 solution or the 5.0～20. 0 mmol/L NaB4O7-1. 0～2.0 mmol/L NaOH solution as eluents could effectively separate the chromatographic peak of fluoride in toothpaste samples from acetate and formate and accurately quantify the contents of fluoride in toothpaste samples. The recovery rates,precision(relative standard deviation) and detection limit were 92.5％～100. 2％ ,＜0. 6％ and 0. 208 mg/kg respectively. The data obtained by ion chromatography using NaHCO3 solution as eluent more approached to that by selective-fluoride-ion-electrode.

Objective To investigate the patients with postoperative skin damage around the stoma after Miles operation,take measures according to the influencing factors,and explore an effective way to reduce the incidence of skin damage around the stoma patients.Methods There were 62 cases of skin damage around the stoma in 110 cases of patients with permanent colostomy in out-patient follow-up.Each patient with skin damage occurring around the stoma were retrospectively analyzed the reasons,and the related factors that might affect Miles postoperative stoma skin damage were analyzed.Results The incidence rate of Miles postoperative skin damage around the stoma was 56.36％,through the multi-factor Logistic regression analysis,there were six related factors with the Miles postoperative skin damage around the stoma,patients' excrement stimulation,ostomy bag allergies,improper operation of the replacement of the ostomy bag,the potential skin disease,excessive scrub / rub the skin,unfamiliar with ostomy care knowledge were the influencing factors of patients with skin damage around the stoma.Conclusions Appropriate stoma care products and paste methods,detailed guiding of patients and their families about ostomy care knowledge and skills can significantly reduce the incidence rate of Miles postoperative skin damage around the stoma.

Objective To investigate the application effect of nasojejunal feeding tube nutrition in patients with severe traumatic brain injury. Methods The clinical data of 54 patients with severe traumatic brain injury admitted to the Department of Surgical Critical Care Medicine,the Third Affiliated Hospital,Sun Yatsen University between June 2012 and December 2014 were analyzed retrospectively. They were divided into either a nasojejunal feeding tube nutrition support group (nasojejunal group,n = 26)or an asogastric feeding tube nutrition support group (asogastric group,n = 28)according to the different ways of enteral nutrition. All patients began to receive nasal feeding whole protein preparations (enteral nutritional emulsion,TPF-D)from the second day after admission to intensive care unit (ICU). The time to reach the enteral nutrition support target,the time of parenteral nutritional support,nutritional index (albumin and hemoglobin),the time admission to ICU,and the incidences of infection and gastrointestinal complications in both groups were observed. Results (1)According to the body weight to calculate calorie demand, the nasojejunal group reaching the time of enteral nutrition support target was faster than that of the asogastric group (3. 0 ± 0. 8 d vs. 7. 7 ± 2. 5 d). There was significant difference between the 2 groups (P < 0. 01). The time of the combined parenteral nutrition support in the nasojejunal group was reduced significantly compared with the asogastric group (2. 0 ±0. 8 d vs. 6. 7 ±2. 5 d). There was significant difference between the 2 groups (P <0. 01). (2)At day 30after treatment,the levels of total serum protein and hemoglobin in the nasojejunal group were higher than those of the asogastric group (64 ± 6 g/ L vs. 61 ± 6 g/ L and 120 ± 17 g/ L vs. 106 ± 16 g/ L,respectively. There were significant differences (P < 0. 05). (3)The mean length of stay in the ICU was obviously shorter in nasojejunal group compared with the asogastric group (11 ± 5 d vs. 14 ± 6 d). There was significant difference between the 2 groups (P < 0. 05). (4)There were no significant differences in complications of the patients,such as the incidences of pulmonary infection,hyperglycemia,and diarrhea between the 2 groups (P > 0. 05). Conclusion Nasojejunal feeding tube nutrition support may be faster to achieve the target of enteral nutrition supports and shorten the time in ICU.

To investigate the inhibitory effects of Ginsenoside Rb1 (GRb1) on apoptosis caused by Herpes Simplex Virus-1 (HSV-1) in Human Glioma Cells (U251),U251 cells were infected by HSV-1 at a multiplicity of infection of 5 and GRb1,GRb1+HSV-1,HSV-1 and control groups.MTT and cell apoptosis assays were used to detect the inhibitory effects of GRbl on the apoptosis of U251 cells that caused by HSV-1 infection for various concentrations of drug and virus treatments by MTT assay.We found that in the 400 μg/mL GRbl and 400 μg/mL GRbl+HSV-1 groups,MTT values were higher than control group at all times (P＜0.05).Moreover,the apoptosis rate in the 400 μg/mL GRb1+HSV-1 group was lower than the HSV-1 group (P＜0.05).These results confirmed that,at appropriate concentrations,GRb 1 could inhibit nerve cell apoptosis in HSV-1 infections.

Objective To investigate the cause,prevention and treatment of intra-abdominal hemorrhage after liver transplantation. Methods Clinical data of 82 patients undergoing liver transplantation were retrospectively analyzed. All participants were divided into the intra-abdominal hemorrhage (n =12)and control groups (n =70). Preoperative parameters including age,model for end-stage liver disease (MELD)score,prothrombin time (PT),prothrombin time international normalized ratio (PT-INR),fibrinogen (FIB),activated partial thromboplastin time (APTT),platelet (Plt) were statistically compared between two groups. Intraoperative hemorrhage volume,cold ischemia time of donor liver, anhepatic phase time and operation time were also compared between two groups. Postoperatively,the mortality rate was compared between two groups. Results Among 82 patients,1 2 (1 5%)presented with intra-abdominal hemorrhage and required twice surgical hemostasis. In the intra-abdominal hemorrhage group,4 cases (33%)died,and 8 (1 1%)died in the control group. No statistical significance was documented between two groups (P>0. 05 ). Age,MELD score,PT-INR, FIB,APTT and PLT did not significantly differ between two groups (all P>0. 05 ). Compared with patients in the control group,those in the intra-abdominal hemorrhage group yielded significantly more blood loss intraoperatively,longer operation time and longer cold ischemia time of donor liver (all P<0. 05 ). Anhepatic phase time did not significantly differ between two groups (P>0. 05 ). Conclusions After liver transplantation,intra-abdominal hemorrhage is associated with longer cold ischemia time of donor liver,more intraoperative blood loss and longer operation time. In order to decrease the incidence of postoperative intra-abdominal hemorrhage,coagulation function should be completely corrected prior to surgery and the surgical skills should also be enhanced.

Objective To summarize the treatment experience of sepsis after liver transplantation.Methods The clinical features and treatment methods of 1 patient developing sepsis after liver transplantation, who was admitted and treated in the Surgical Intensive Care Unit of the Third Affiliated Hospital of Sun Yat-sen University in September 201 4,were retrospectively studied.The interpretation of International Guidelines for Management of Severe Sepsis and Septic Shock (SSC Guidelines)and relevant literature were reviewed.Results One male patient at the age of 50 years old developed high fever and decrease of blood pressure at 1 d after liver transplantation,and was diagnosed as septic shock.The symptoms were relieved after the appropriate treatment like goal-directed fluid resuscitation,anti-infection and blood purification,etc.And the patient was discharged in stable conditions.Conclusions It is easy to develop infection after liver transplantation and the fatality rate of sepsis caused by infection is high.Once the sepsis occurs,clinicians must perform early goal-directed therapy and bundle therapy according to the SSC Guidelines positively,and select the appropriate drugs according to the pathogen culture results in order to reduce the fatality rate.

Objective To investigate the therapeutic effect and safety of plasma exchange in the treatment of patients with severe liver disease in pregnancy. Methods Clinical data of 28 patients with severe liver disease in pregnancy in Surgical Intensive Care Unit (SICU), the Third Afifliated Hospital of Sun Yat-sen University from March 2009 to October 2013 were analyzed retrospectively. According to the therapeutic schedule, the patients were divided into treatment group (n=12, age range:21 to 28 years old, median age:25 years old) and control group (n=16, age range:18 to 29 years old, median age:24 years old). The informed consents of all patients were obtained and the ethical committee approval was received. All patients were transferred to SICU after childbirth and received treatments of anti-infection, anti-virus, liver protection, reducing jaundice, supplying human albumin and gamma globulin, infusing blood coagulation and so on. And patients in treatment group received the treatment of exchange of homotype fresh plasma on the basic of the above treatments. The differences between 2 groups in clinical examination indicators and therapeutic effect were compared. The adverse reactions after plasma exchange in treatment group were observed. The examination indicators of 2 groups were compared using t test and the ratios were compared using Chi-square test. Results The blood total bilirubin (TB), albumin (ALB) , serum creatinine (Scr), fasting blood glucose (FPG) , prothrombin time activity (PTA) and arterial lactic acid (Lac) were (197±69)μmol/L, (30±7)g/L, (111±42)μmol/L, (5.7±2.4)mmol/L, (55±24)%, (2.3±0.6)mmol/L respectively in treatment group and were (299±113)μmol/L, (24±6)g/L, (165±82)μmol/L, (3.7±1.7)mmol/L, (33±11)%, (4.4±1.5)mmol/L respectively in control group. The indicators in treatment group were signiifcantly improved compared with those in control group (t=-3.453, 2.389,-4.892, 2.798, 6.079, -3.339; P<0.05). The effective rate in treatment group (92%,11/12) was signiifcantly higher than that in control group (56%,9/16) ( χ2=4.215, P<0.05). One case in treatment group suffered transitional hypotension after plasma infusion and the blood pressure returned to normal 1 h later after giving a small dose of vasoactive drugs. Conclusions Plasma exchange can improve the clinical examination indicators and therapeutic effect of patients with severe liver disease in pregnancy. It is a safe and effective treatment.

ObjectiveTo investigate the effects of early enteral nutrition on the recovery of patients with severe hepatitis after liver transplantation (LT).MethodsThirty-two patients with severe hepatitis undergoing allogeneic orthotopic LT in the Third Affiliated Hospital of Sun Yat-sen University between June 2012 and April 2014 were included in this prospective study. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients were randomized into the enteral nutrition group and the parenteral nutrition group according to the random number table method. Among the 14 patients in the enteral nutrition group, all patients were males with the average age of (42±9) years old. Among the 16 patients in the parenteral nutrition group, 14 were males and 2 were females with the average age of (44±10) years old. Patients in the enteral nutrition group were given warm water and lactulose through gastro-jejunal tube 1 d after LT. Enteral nutritional suspension was offered 2 d after LT and gradually increased to 1 000 ml/d, meanwhile, parenteral nutrition was reduced gradually. Patients in the parenteral nutrition group were given parenteral nutrition. Patients in both groups started normal diet after full recovery of the intestinal function. Venous blood was collected before LT and 1, 10 d after LT to examine hepatic and renal function. The recovery of gastroenteric function, hepatic and renal function and incidence of infection were observed 2 weeks after LT. The comparison of the observed indexes of two groups was conducted usingt test or rank-sum test and the rate comparison was conducted using Fisher's exact test.Results The postoperative recovery time of gastroenteric function of the enteral nutrition group was (6.1±1.4) d, which was significantly shorter than (10.6±3.8) of the parenteral nutrition group (t=-4.21,P<0.05). The median ALT, AST, TB, prealbumin and blood urea-nitrogen (BUN) in the enteral nutrition group 10 d after LT were respectively 106 (50-163) U/L, 62 (27-135) U/L, 67 (35-116) μmol/L, 201 (105-389) mg/L and 12.5 (6.4-18.8) mmol/L, and those in the parenteral nutrition group were respectively 276 (46-716) U/L, 119 (33-447) U/L, 131 (89-391) μmol/L, 162 (103-238) mg/L and 26.1(12.9-37.6) mmol/L. Signiifcant difference was observed (Z=-3.76,-3.15,-4.01, 2.93,-3.79;P<0.05). The incidence of infection of the enteral nutrition group 2 weeks after LT was 43% (6/14), which was signiifcantly lower than 69% (11/16) of the parenteral nutrition group (P<0.05). ConclusionCompared with parenteral nutrition, early enteral nutrition after LT may promote the recovery of gastroenteric function, improve the hepatic and renal function and nutritional situation and reduce the incidence of postoperative infection, which is beneficial to postoperative recovery.