The exact pathophysiological mechanisms of diabetic retinopathy (DR) remain elusive.The inflammatory reaction,retinal vascular leakage and retinal neovascularization are main features of DR.Adiponectin (APN) is an endogenous biological active protein secreted by adipocytes.It can increase insulin sensitivity,regulate blood glucose and lipid metabolism,and has anti-inflammation and anti-neovascularization functions.It may be involved in the development of DR.This review summarized the studies on the association between APN and DR in recent years.

Post-stroke fatigue is one of the most common and painful symptoms of stroke patients, and may persist for a long time, which has a negative impact on the rehabilitation and daily life and work of stroke patients. This article reviews the research progress of epidemiology, pathogenesis related factors, clinical evaluation methods and treatment of post-stroke fatigue.

Objective To investigate the association of fluctuation of anticardiolipin antibody (ACA) levels and clinical manifestations in patients with systemic lupus erythematosus (SLE). Methods Anticar-diolipin antibodies were measured sequentially by commercial enzyme-linked immunosorbent assay (ELISA) in 85 SLE patients. Patients were classified into two groups: group A was persistently positive for ACA, group B was transiently positive for ACA, and the clinical features of the two groups were compared. Results There were 37 patients (44%) in group A, and 48 (57%) patients in group B. 41% patients had occurred thromboeytopenia in group A, 19% patients in group B, the difference was significant (P<0.05); platelet accounts were (24±6)×109/L in group A,and (46±10)×109/L in group B, the difference was significant (P< 0.05), too. 11% patients experienced thrombosis in group A, and none in group B, the difference was significant (P<0.05). 19% in group A and 4% in group B had occurred valvular diseases, the difference was significant (P<0.05.). The prevalence of lupus anticoagulant was 32% in group A, 13% in group B and the difference was significant (P<0.05). There was no significant difference between the two groups in Raynaud's phenomenon, pulmonary hypertension, and lupus nephritis (P0.05). Conclusion Fluctuations of anticardio-lipin antibodies are asso-ciated with thrombosis, thrombocytopenia vascular disease and lupus anticoagulant however, there is no lack of association with other clinical manifestations in SLE patients.

OBJECTIVE:To provide reference for chemical composition analysis in Angiopteris fokiensis. METHODS:The fat-soluble components in A. fokiensis were extracted and separated. The separated fat-soluble compounds were analyzed and identi-fied by GC-MS after methyl esterification. RESULTS & CONCLUSIONS:Totally 52 compounds were detected and 43 of those were identified. They were mainly organic acids and sterols compounds. The 43 components are first identified in A. fokiensis.

Objective To compare magnetization transfer and diffusion characteristics of multiple sclerosis(MS)lesions,normal-appearing white matter(NAWM)from patients,and normal white matter from control subjects,and to investigate the correlation between the magnetization transfer ratio(MTR)and mean diffusivity(MD)in MS patients.Methods Conventional MRI,magnetization transfer imaging(MTI)and diffusion tensor imaging(DTI)were performed in 24 relapsing remitting MS patients and 24 healthy volunteers.Based on these images,the MTR,MD and fractional anisotropy(FA)maps were obtained.Then the MTR,MD and FA values were measured in lesions and NAWM from patients,and in the relevant white matter regions from volunteers.Results Average MTR in lesions(23.49%?5.16%)from MS patients was lower than those both in NAWM(29.49%?3.38%)and in the counterparts of the controls(32.78%?3.42%,F=101.44,P

Objective To evaluate the clinical efficacy of berberine for the treatment of insulin resistance (IR) in women with polycystic ovary syndrome (PCOS).Methods Sixty PCOS-IR women were randomized into treatment group and control group,30 cases in each group.At the end of the trial,26 cases in the treatment group (4 cases dropped out) and 29 cases in the control group (one case dropped out) completed the trial.The treatment group was treated with berberine orally,and the control group was treated with metformin orally,the treatment for the two groups lasting 3 months.Before and after treatment,we observed the parameters of body mass index (BMI),homeostasis model of assessment for insulin resistance index (HOMA-IR),fasting plasma glucose (FPG),fasting insulin (FINS),2-hour postprandial glucose after oral glucose tolerance test (OGTT2hPG) and 2-hour postprandial insulin after OGTT (OGTT2hINS),blood lipid levels of total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C),and sexual hormones of follicle-stimulating hormone (FSH),luteotropic hormone (LH),testosterone (T) and LH/FSH ratio.Results BMI,HOMA-IR,TC,TG and LDL-C of the two groups were decreased after treatment (P ＜ 0.05 or P ＜ 0.01 compared with those before treatment),but the differences between the two groups were insignificant(P ＞ 0.05).Serum levels of T and LH as well as LH/FSH ratio in the treatment group were also decreased (P ＜ 0.05 or P ＜ 0.01 compared with those before treatment and those in the control group after treatment).Conclusion Berberine can improve HOMA-IR,decrease serum sexual hormones levels,and regulate the blood metabolism in PCOS-IR women,and its effect is similar to that of metformin.

Objective To study the influence of precision medicine-based health education on cognitive level of disease knowledge,anxiety and depression in patients with gestational diabetes.Methods Toally 84 cases of gestational diabetes patients in our hospital from September 2014 to December 2015 were divided into a study group and a control group according to the random number table,42 cases in each group.While the routine nursing intervention was done in the control group,the precision medicinebased health education program was carried out in the study group.The two groups were assessed using the cognitive questionnaire designed by our hospital.The self rating anxiety scale (SAS) and self rating depression scale (SDS) prepared by Zung were used to assess the levels of anxiety and depression in the two groups before the intervention and two weeks after the intervention.Results The cognitive level of disease knowledge in the study group after the intervention was statistically significantly higher than that of the control group (P＜0.05).Before the intervention,there were statistically insignificant differences in anxiety and depression between the two groups (P＞0.05),but after the intervention,the levels of anxiety and depression in the study group were significantly lower than those of the control group (P＜0.05).Conclusion The precision medicine-based health education is helpful for the patients with gestational diabetes to improve their diabetes-related knowledge and meanwhile it can relieve their anxiety and depression.

Objective To follow up the changes of postnatal cardiac sizes and function in infants of mothers with gestational diabetes mellitus (GDM). Methods Eighteen GDM mothers with euglycemia (GDM group) and 24 gestational age-matched normal pregnant women (control group),having prenatal examination and delivered in Women's Hospital of Fudan University from January to August in 2007, received fetal echocardiographic examination in late pregnancy. Infants of these GDM mothers and 24 age-matched healthy infants of normal pregnancy (control group) received sonographic follow up. Cardiac sizes and function were evaluated and compared. Results At birth, there were six (33.3%) infants of large for gestational age (LGA) and 12(66.7%) appropriate for gestational age(AGA) in GDM group, while in the control group, there were two LGA (8. 3%) and 22(91.7%)AGA infants (x2 =3. 840, P= 0. 05). Both the interventricular septum and left ventricular walls in GDM fetuses were thicker than in control fetuses (P ＜ 0.05). No increase in the thickness of ventricular walls was observed till infantile period. However, the end-systolic thickness of left ventricular walls in LGA infants was still larger than in control infants [(4.55 ± 0.37) mm vs (4. 13±0.39)mm, P＜0. 05], and end-diastolic left ventricular long-diameters were also larger [(37. 3±2.3) mm vs (34.6±2.6) mm] (P＜0. 05). In GDM fetuses, the peak velocities of aorta and pulmonary artery and left cardiac output were higher than in the controls (P＜ 0. 01 ), and right/left cardiac outputs ratios were lower (1.198±0.206 vs 1. 430±0. 321, t= -2.668,P=0. 011). Till infantile period, only right/left cardiac outputs ratios in AGA infants of GDM group were larger than in controls (P＜0. 05). GDM fetuses' left atrial shortening fraction and tricuspid E/A ratios were smaller (P＜0. 05). In infantile period, only left atrial shortening fraction in GDM infants was still smaller than in controls (0. 356 ± 0. 040 vs 0. 386 ± 0. 041, t = - 2. 332, P = 0. 025). Left and right ventricular Tei index in GDM fetuses were 0. 482±0. 129 and 0. 414±0. 094, both larger than those of control fetuses (0. 309 ± 0. 074 and 0. 283 ± 0. 072) (t = 5. 075 and 5. 129, P = 0. 000 ). Till infantile period they both became significantly lower and no differences were found among LGA, AGA and control infants. Conclusions The cardiac sizes and function at 2-3 months of age, in infants of GDM mothers with good glucose control, became better than that in uterus.

Objective To explore the association between HbA1c and acute myocardial infarction(AMI) in youth. Methods Seventy-two AMI patients (≤44y) diagnosed during the period from January in 2009 to August in 2012 were enrolled and 79 young age-matched adults without coronary artery disease at the same period were enrolled to be control group. The relationship between HbA1c, fasting blood-glucose(FBG) and AMI was explored. Results (1)Compared with the control group,the plasma FBG and HbA1C value were significantly higher(P<0.05) in AMI group. (2)Logistic regression analysis showed that HbA1c is the independent risk factor for AMI in youth. (3)In AMI group, the HbA1c level in single vessel disease had remarkable difference with that in double vessel disease and triple vessel disease(P<0.05). Conclusions Increasing HbA1c level is the independent risk factor for AMI in youth,and positively correlated with the degree of coronary artery lesions. Primary intervention of glycometabolism abnormality possibly becomes the new opinion for prevention and cure of AMI.

Objective To investigate the experience of family caregivers in nursing perioperative patients undergoing permanent cardiac pacemaker. Methods Twenty-five family caregivers taking care of the patients undergoing permanent cardiac pacemaker participated in the non-structural study. Data were analyzed by phenomenological procedure. Result The factors by category analysis includes fear, anxiety and uneasiness due to preoperative lack of relevant knowledge and postoperative lack of caring experience, lowered health level of the caregivers, strong demand for health education and lack of confidence in home care. Conclusions The family caregivers′ experience varies with different phases in perioperative period. Nurses should provide personalized services to enhance the continuity of home care so as to enhance the care quality.