Objective To investigate the effects of gestational diabetes mellitus (GDM) on the growth rate of fetuses.Methods This was a retrospective study.Women who had deliveries in Peking University First Hospital between January 2012 and June 2013 were enrolled.Matched by maternal age,they were divided into four groups with 100 cases in each group:macrosomic fetuses of mothers with GDM (GDM-macrosomia group),normal birth weight infants of mothers with GDM (GDM-non-macrosomia group),macrosomic fetuses of mothers with normal pregnancy (normal-macrosomia group),and normal birth weight infants of mothers with normal pregnancy (normal-non-macrosomia group).The fetal abdominal circumference was measured at 20+1-24,28+1-32,32+1-37 weeks and 37+1 weeks to delivery under prenatal ultrasound.The growth rate of fetal abdominal circumference was calculated (abdominal circumference/gestational weeks).The analysis of variance,the least significant difference-t test and Student's t test were used for statistical analysis.Results At early pregnancy [(9.2±2.6) weeks of gestation] and 20+1-24,28+1-32,32+1-37 weeks and 37+1 weeks to delivery,the weight and body mass index (BMI) of the mothers in GDM-macrosomia group were higher than those in the other three groups (all P＜0.05).The body weight of the mothers increased by (15.5±5.4),(13.5±3.6),(16.4±4.1) and (16.2±4.3) kg,respectively,compared with early pregnancy.At 20+1-24,28+1-32,32+1-37 weeks and 37+1 weeks to delivery,the fetal abdominal circumference of GDM-macrosomia group was (182.0± 13.9),(270.7± 17.7),(335.2±21.3) and (362.3± 18.7) mm,respectively,being higher than that in GDM-non-macrosomia group [(176.8± 13.0),(256.6± 13.5),(313.2± 17.5) and (335.8± 15.5) mm] and normal-nonmacrosomia group [(176.9± 11.8),(260.0± 14.2),(310.6± 21.4) and (334.5 ± 16.1) mm] (all P＜0.05).The fetal abdominal circumference of GDM-macrosomia group was even higher than normal-macrosomia group at 32+1-37 weeks [(335.2±21.3) vs (326.1 ± 19.1) mm,t=4.01,P＜0.05].The changes of the growth rate of fetal abdominal circumference were consistent with the fetal abdominal circumference.Conclusions GDM accelerates fetal growth.

OBJECTIVE: To evaluate the preemptive analgesia effects of both the parecoxib sodium and the pentazocine in patients undergoing nasal endoscopic surgery. METHOD: In the randomized, double blind, controlled study, 120 patients undergoing septoplasty were divided into 3 groups (n = 40): group A received parecoxib 40 mg by muscle injection 30 min before the operation; group B received pentazocine 30 mg; group C received an equal volume of saline. The preemptive analgesia effect was evaluated with VAS scores which recorded at different time points. The proportion of participants using rescue analgesia after the operation were recorded as additional measures of preemptive analgesia. RESULT: Intra-operative as well as the postoperative pain scores were less in the group A and group B than in the control group. Fewer participants required rescue medication after operation with parecoxib as well as pentazocine than placebo. However there were no difference in the preemptive effects between the group A and group B. CONCLUSION Administration of both the parecoxib and pentazocine before the nasal endoscopic surgery can provide preemptive analgesia without serious adverse side effects that deserves popularization in the clinic.
Analgesia ; methods ; Analgesics ; therapeutic use ; Double-Blind Method ; Endoscopy ; adverse effects ; Humans ; Isoxazoles ; therapeutic use ; Nasal Surgical Procedures ; adverse effects ; Nose ; Pain ; prevention & control ; Pain, Postoperative ; prevention & control ; Pentazocine ; therapeutic use

OBJECTIVE:To observe the effect of metformin on related indicators of obese patients with type 2 diabetes. METHODS:136 obese patients with type 2 diabetes were randomly divided into control group and observation group. All patients were given conventional examination,conventional education about diabetes,diet control and stressed physical exercise. Based on it,control group was given 80 mg Metformin tablet(Ⅱ),once a day,and monitored blood glucose levels,the dosage was adjusted based on fasting blood glucose levels to ensure blood glucose in 3.9-6.1 mmol/L;observation group was given 0.5 g Metformin en-teric-coated tablet,twice a day. The 2 groups were compared after 12 weeks treatment. The glycated hemoglobin (HbA1c),body mass index (BMI),resistin,insulin-like growth factor-1(IGF-1),inflammatory cytokines [interleukin-1β(IL-1β),interleukin-6 (IL-6),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP)] levels in 2 groups before and after tveat-ment were observed,and the incidence of adverse reactions in 2 groups was recorded. RESULTS:After treatment,resistin,IGF-1, IL-6 and hs-CRP levels in 2 groups were significantly lower than before,and observation group was lower than control group;the differences were statistically significant(P<0.05);BMI,IL-1β and TNF-α levels in obser vation group were significantly higher than before and control group,the differences were statistically significant(P<0.05);HbA1c level in 2 groups was significiantly lower than before,the difference was statistically significant(P<0.05),but there was no significant difference between 2 groups(P>0.05);BMI level in observation group was lower than before and control group,and there was no significant difference in the inci-dence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:Metformin can effectively improve insulin resistance in obese patients with type 2 diabetes and inhibit the inflammatory reaction.

Effective medical practice in the bio-psycho-social medical model calls for the doctor's narrative and communicative skills.The gradual application of narratives in medical practice and research facilitates the combination of narrative methods with medical science.The narrative medicine movement greatly promotes the narrative turn in the research of doctor-patient communication and provides a new perspective in medical humanities education.In the process of doctor-patient communication,the appropriate use of doctors' high narrative competence contributes to effective doctorpatient communication and helps to build a harmonious doctor-patient relationship.In medical education,the teaching strategy of combining classroom teaching with clinical probation teaching should be adopted to cultivate and enhance medical students' medical narrative competence.

Nanometer material have been widely used in a number of fields because of their diversified physical and chemical effects.Owing to their good biocompatibility,well targeting property and high bioavailability,they are considered as a good support for vaccine adjuvant.In short,it has a targeting function to specific parts,can improve the immunogenicity of new vaccine,avoid first-pass metabolism in the liver and then has less side effect.With these advantages,it has shown a proved potential application for disease control and treatment.So some unique properties of nano-materials are reviewed,with a look forward to the future of their application technology in the areas of and medicine.

The circulation process of Chinese materia medica involves a series of links from planting to marketing. Unqualified problems of Chinese materia medica are common in each link of the process of circulation, which seriously harm public health and the further development of Chinese materia medica market. Therefore, the relevant government departments have paid high attention to quality safety of Chinese materia medica and issued many policies. This article sorted out the policies of quality safety control of Chinese materia medica in circulation, analysed the existing problems, and proposed the corresponding suggestions, with a purpose to provide valuable references for government departments to further improve the quality of Chinese materia medica.

Objective:To develop an appearance-management behavior scale for college female students.Methods:Based on literature analysis and open questionnaire,the preliminary scale was formed.A total of 822 college female students completed the scale.Exploratory and confirmatory factor analytic approaches were used to develop and evaluate the intra-structure of the scale.Results:Exploratory principle factor analysis of the items indicated that the scale had three factors.Internal consistency analysis showed that the Cronbach' ? coefficient,split-half and test-retest correlation coefficients were 0.88,0.86,0.77 respectively.Confirmatory factor analysis showed that the fit indexes for ?2/df,GFI,AGFI,NFI,NNFI,RMSEA,CFI,IFI were 3.20,0.87,0.83,0.82,0.85,0.085,0.87,0.87.Total scale had no significant correlation with SAAS,but with APS,PSS,IMS,SES (r=0.23,0.21,0.38,0.28,P

Objective To investigate the current status of workplace violence among Nursing Staff. Methods The Modified Version of Hospital Workplace Violence Questionnaire was used to investigate 792 nursing staff about their experiences of workplace violence over the past one year in a third-grade Class-A comprehensive hospital in Xi′an city. Results The prevalence of workplace violence among 792 participants was 58.08%(460/792), Outpatient department, Emergency department, Obstetrics and Gynecology department, Pediatrics department were the high-risk areas of workplace violence. Day-shift was the main period of workplace violence occurred. The families of patients, middle-aged, male were the main perpetrators. 72.60%(575/792) of the respondents thought the workplace violence were unavoidable. Correct media orientation (89.33%, 707/792) was considered as the primary measure for preventing workplace violence. Patience explanation (74.13%, 341/460), forbearance (53.04%, 244/460) were the main methods for coping with hospital workplace violence. Grievances (75.38%, 347/460), anger (65.65%, 302/460), part of them even wanted to resign (21.84%, 100/460) after experiencing workplace violence were their feelings. Security patrols (81.63%, 647/792), wards installed cameras (77.43%, 613/792) and bright lights (53.42%, 423/792) in the night work areas were the main measures to prevent workplace violence that the hospital had taken to prevent workplace violence. Conclusions Workplace violence among nursing staff is common. It is suggested that hospitals and the relevant government departments should conduct further intervention research, to formulate feasible administrative riot guiding for reducing the incidence of workplace violence.

Objective To explore the the interaction analysis of genetic and behavioral factors on the occurrence of acute coronary syndrome. Methods This study consisted of 134 subjects between June 2009 and Dec.2009 from affiliated hospital of Jining Medical University, All subjects underwented selective coronary angiography or coronary artery CT. Coronary artery disease based on the results of coronary angiography or coronary artery CT that at least one coronary artery diameter reduction of more than 50% and fulfilled the diagnostic criteria of ACC/AHA. 84 patients with acute coronary syndrome and 50 controls, and general informations, current disease history,past medical history, related be havioral factors were collected. DNA was extracted from acute coronary syndromepatients and healthy control subjects, stored in -20 ℃. The genotype of CFH Y402H was detected by polymerase chain reaction and restriction fragment length polymorphism(PCR-RFLP) methods in acute coronary syndrome patients and controls. PCR amplification products was verificated by electrophoresis on agarose gel. Deviation of genotype distribution form Hardy-Weinberg equilibrium was assessed using x2 test in each group. Univariate and multivariate conditional logistic analyses were conducted in the end. Results The results showed that smoking history (P=0.000, OR =4.894,OR 95% CI:2.537 ～9.441 ), alcohol drinking history(P= 0.008,OR =2.879,OR 95% CI: 1.499 ～ 5.528 ), hypertension (P = 0.000, OR = 4.222, OR 95% CI: 2.195 ～ 8.123), sports activities (P =0.002,OR =0.333, OR 95% CI:0.188 ～ 0.589 ), salt intake (P= 0.006, OR = 0.457, OR 95% CI:0.287 ～0.727 ), character(P = 0.000, OR = 0.385, OR 95% CI :0.247 ～ 0.600 ) stress of occupations (P = 0.015, OR =2.118, OR 95% CI: 1.278 ～ 3.511 ) were associated with acute coronary syndrome of Northern Chinese Han population. Smoking history(P = 0.010, OR = 6.084, OR 95% CI: 1.543 ～ 23.988), hypertension (P= 0.024, OR =2.821, OR 95% CI: 1.143 ～ 6.595 ), sports activities (P= 0.004, OR = 0.297, OR 95% CI:0.130 ～ 0.678 ), personality(P= 0.011, OR = 0.435, OR 95% CI:0.229 ～ 0.829 ) were significantly associated with acute coronary syndrome in multivariate conditional logistic analyses after adjusting other factors. Conclusions Smoking history,hypertension, personality are risk factors of acute coronary syndrome of Northern Chinese Han population. Butsports activities is protective factors.

This research analyzed the current situation of English learning anxiety of TCM majors by means of conducting a questionnaire based on the English learning anxiety scale (ELAS).The questionnaire results showed that communication apprehension was most prominent in terms of extent and amount while test anxiety also accounted for an important part of anxiety.The research further analyzed the influences of English learning anxiety and proposed some measures to ease students' anxiety and to enhance learning efficiency from teachers' perspectives.