Objective To explore the metabolic phenotype of the adult offspring rats with maternal severe hyperglycemia during pregnancy and overfeeding in early life. Methods The adult Wistar rats were administered intraperitoneally with 20% Streptozotocin (STZ, 50 mg/kg) on day 5 of pregnancy to induce severely gestational diabetes mellitus (SDM) model (blood glucose ≥20 mmol/L). Early postnatal overfeeding models were established through reduction of the number of newborn rats fed by one mother rat. Offsprings were divided into 3 groups according to maternal blood glucose level during the pregnancy and feeding patterns during the lactation period (1) control pups (CP) :maternal euglycemia was achieved during pregnancy and eight pups fed by one mother rat; (2)SDM-normal feeding group: SDM mothers and 8 pups fed by one mother rat;(3)SDM-overfeeding group:SDM mother and 4 pups fed by one mother rat. All pups were fed by standard laboratory chow adlibitum after weaning at 3 weeks of age. The body weight of all pups were measured weekly after weaning. At the age of 26 weeks, the systolic blood pressure (SBP), diastolic blood pressure (DBP) ,heart rate (HR) and metabolic markers, including fasting plasma glucose (FPG), fasting insulin (FINS), total triglyceride (TG), total cholesterol (TC), low density lipoprotein-cholestrol (LDL-C)and high density lipoprotein-cholestrol (HDL-C) were measured in all 3 groups. ANOVA and LSD test were applied in statistical analysis. Results The average plasma glucose level was significantly higher in the SDM mothers than in the controls [(28.34±5.14) mmol/L va (6.25±1.41) mmol/L,P＜0.05]. After weaning at 3 weeks, the weight of SDM-overfeeding group and SDM-normal feeding group was lighter than that of CP group [(43.63±4.83) g, (31.45±10.21) g vs (55.75±8.41) g,P＜0. 05], meanwhile, that of the SDM-overfeeding group were heavier than that of the SDM-normal feeding group (P＜0. 05). Pups in SDM-overfeeding group exhibited catch-up growth during the lactation period, and those in SDM-normal group showed catch-up growth at both lactation period and childhood. At 26 weeks of age, the systolic blood pressure and TG level of pups in SDM-normal feeding and overfeeding group were (153.31 ± 13.91) mm Hg and (147.21 ± 12.29) mm Hg, and (0. 73±0. 22) mmol/L and (0. 71±0.49) mmol/L, respectively, which were higher than those of the CP group [( 132.21 ± 11.26) mm Hg, and (0. 37 ± 0. 08) mmol/L, P＜0.05], but no significant difference was found between the two SDM groups (P＞0.05). There was no difference in FPG levels among the three groups, but the FINS level and HOMA-IR in the SDM-overfeeding group were higher than in the SDM normal feeding and CP group [( 12. 552 ± 3.260) mU/L vs (9.067 ± 1.782) mU/L and (8.590± 0.806) mU/L, 2.400± 0.624 vs 1.797 ± 0.508 and 1.729 ± 0.246; P＜0.05].Conclusions Fetal exposure to maternal severe hyperglycemia during pregnancy may lead to low birth weight infant who will exhibit postnatal catch-up growth. This may lead to the increased risk of metabolic syndrome in the offspings when they grow up, and this process would be accelerated by early overfeeding.

Objective Study the effects of early overfeeding in the adult offspring of mother with severely hyperglycaemia in pregnancy to islet development and insulin resistance. Methods Thirty healthy female Wistar rats were mated with 10 male Wistar rats and the morning on which sperm were found in three different visual fields of the vaginal smear was designated pregnancy day 1. The pregnant rats were intraperitoneally administered with Streptozotocin (STZ, 50 mg/L) on 5th day of pregnancy, and blood glucose exceeded 20 mmol/L to induce severely gestational diabetes mellitus (SDM) model. The pregnant Wistar rats were assigned to two experimental groups: SDM (n = 16) and control (n = 8). Litter size reduction in the lactation period induced early postnatal overfeeding model. Offspring were divided into three groups according to the level of blood glucose in pregnancy and feeding patterns in lactation: ( 1 ) control group (CG):euglycemia in pregnancy, eight pups in lactation;(2) severely gestational diabetes mellitusnormal feeding (SDM-N):severely gestational diabetes mellitus, eight pups in lactation; (3) severely gestational diabetes mellitus-overfeeding (SDM-O): severely gestational diabetes mellitus, four pups lactation. At the end of the lactation period, all pups were fed standard laboratory chow adlibitum until the date of the experiments. Offspring body weight was measured weekly after ablactation. Serum insulin was measured by enzyme-linked immunosorbent assay (ELISA) and pancreatic islet morphology was analyzed by immunohistochemistry (IHC) in all three groups at 26 weeks of age. Results (1) Blood glucose of pregnant Wistar rats: SDM (28.3 ±5.1 ) mmol/L was statistically higher than control (6.3 ± 1.4) mmol/L ( P ＜ 0.05 ). (2) Growth rates of body weight in 3 - 7 weeks and 3 - 9 weeks: SDM-N: (4. 6 ± 1.3) % and (6.8±2.5)%, SDM-O:(3.2±0.7)% and(4.6±1.2)%,CG:(2.9 ±0.6)% and(4.1 ±0.8)%.The growth rates of body weight in SDM-N and SDM-O were both significantly higher than those in CG ( P ＜0.05 ). (3) Body weight at 26 weeks: CG: (486 ± 132) g, SDM-N: ( 387 ± 115 ) g, SDM-O: ( 382 ± 122) g.There was no statistical difference among the three groups (P ＞0.05). (4) Fasting plasma glucose ( FPG),fasting insulin (FINS), homeostasis model of insulin resistance (HOMA-IR) and insulin sensitivity index (ISI): at 26 weeks, the SDM-offspring has nomal FPG, but more insulin was needed to keep it normal. The insulin level of SDM-O[ ( 12.6 ± 3.3) mU/L ] was statistically higher than those of SDM-N [ ( 10.9 ± 3.3 )mU/L] and CG [ ( 8.6 ± 0.8 ) mU/L ] ( P ＜ 0.05 ). The ISI of SDM-O ( 0.020 ± 0.006 ) was significantly smaller than its HOMA-IR(2.40 ±0.62,P ＜0.05). (5)The morphological change of pancreatic islet: The islets of CG and SDM-N were round or ellipse and have clear boundary between endocrine and exocrine parts and the β cells distributed equally. However, SDM-O islets were not of uniform size and most of islets were hyperplasia and hypertrophy. (6) Relative β cell area of pancreas, β-cell area and islet size: SDM-O:(1.81 ±0.31)%, (57.1 ±3.2)% and(39 067 ±3308)μm2; SDM-N:(1.34 ±0.43)%,(60.9 ±0.6)% and ( 30 570 ± 4824 ) μm2; CG: ( 1.11 ± 0.26 )%, ( 63.7 ± 2.7 )% and ( 26 443 ± 4431 ) μm2.SDM-O has significantly increasing β-cell mass, hypertrophic islet size and slightly decreasing β-cell percentage compared with other two groups (P ＜ 0.05 ). Conclusions The exposure of severely hyperglycemia in pregnancy induces low weight infant and postnatal catch-up growth leading to the possibility of insulin resislance (IR) in adult and early postnatal overfeeding will accelerate such course. Islet morphology of SDM-N has no significant change, indicating that maternal diabetes mainly affected β-cell function but not islet morphological features. SDM overfeeding results in early impairment of islet morphology and function, indicating that the compensation ability of islets has already been impaired and the risk of further development of impaired glucose tolerance (IGT) and diabetes. In conclusion, the nutritonal environment in early life ( duration of pregnancy and lactation) participate in the metabolic programming in adulthood.

Objective:To meet the multitier needs of medical students′ health and health career development through the establishment of relevant mechanisms for medical charity and strengthening the social responsibility theme education among medical students. Methods:The present study was conducted in a stratified sample using the method of investigation mainly. The questionnaire was self -conducted; in the end 967 valid questionnaires were collected and combined with 48 relevant interviews. The data was analyzed using SPSS l6. 0. Results: The current positive trends of social responsibility among medical students are gratifying. The students had correct atti-tude to study but the initiative needed to be improved. The professional cognition was optimistic but the morality emphasis needed to be strengthened. The capacity cognitive was clearly but the awareness of accountability needs to be improved. The social consciousness was intense but responsibility needed to be strengthened. The life value was positive but the physical and mental health needed concerns. And it was needed to further strengthen social respon-sibility education. Conclusion: We should make full use of the excellent resources of the Affiliated Hospital of Medical College. With the medical charity starting point, the social responsibility should be strengthened through the Five in One promotion mechanism that including the culture education leading, clinical practice inspiring, social practice annealing, campus culture edifying, and powers of role model effecting.

Placenta-mediated pregnancy complication (PMPC), including preeclampsia, fetal growth restriction and recurrent pregnancy loss, is caused by inadequate trophoblast invasion and abnormal remodeling of maternal spiral arteries in early pregnancy, resulting in adverse perinatal outcomes and affecting the long-term maternal and child health. However, the molecular mechanisms of PMPC remain unclear. Endocrine gland-derived vascular endothelial growth factor (EG-VEGF) is highly expressed in human placenta and plays an important role in the development of a normal placenta through promoting placental angiogenesis and inhibiting trophoblast migration and invasion. EG-VEGF dysregulation is closely related to the pathogenesis of PMPC. This review described recent advances in EG-VEGF for better understanding of the underlying mechanism of PMPC and providing a potential biomarker for early diagnosis of PMPC.

Objective: To assess the diagnostic performance of contrast-enhanced spectral mammography (CESM) in suspected breast lesions. Methods: A total of 97 patients with suspected breast cancer identified by clinical examination or screening underwent two-views CESM examination on the basis of digital breast tomosynthesis (DBT) combined with full-field digital mammography (FFDM), and they were finally confirmed by biopsy or pathology. Three senior radiologists analyzed images, including lesion visibility, lesion characteristics, enhancement type, degree of enhancement, BIRDS classification, etc. Finally, based on the pathology, we compared the CESM+DBT+FFDM and DBT+FFDM two models according to sensitivity, specificity and ROC for diagnostic performance. Results: There were a total of 120 lesions. Eighty-nine lesions were malignant, 31 benign; CESM was not enhanced in 2 cases, mild enhancement was performed in 22 cases, moderately intensive in 15 cases, highly intensive in 81 cases, and 2 cases were not enhanced; mass-enhanced in 96 cases, including ring-enhanced in 12 cases, 22 cases of non-mass type. The sensitivities of the combination of CESM and not combination of CESM were 91.0% and 80.9%, respectively, and the specificities were 93.5% and 87.1%, respectively. The area under the ROC curve of combination of CESM was higher than the without combination of CESM (0.923 and 0.900, P<0.05), The difference was statistically significant. Conclusion For suspicious lesions, CESM examination can improve the diagnosis accuracy of breast cancer.

Objective To evaluate the diagnostic performance of digital breast tomosynthesis (DBT) breast X-ray photography image texture characteristics based deep learning classification model on differentiating malignant masses. Methods Retrospectively collected 132 cases with simplex breast lesions (89 benign lesions and 43 malignant lesions) which were confirmed by pathology and DBT during January 2016 to December 2016 in Nanfang Hospital. DBT was performed before biopsy and surgery. Image of cranio-caudal view (CC) and medio-lateral oblique (MLO) were captured. The lesion area was segmented to acquire ROI by ITK-SNAP software. Then the processed images were input into MATLAB R2015b to establish a feature model for extracting texture features. The characteristics with high correlation was analyzed from Fisher score and one sample t test. We built up support vector machine (SVM) classification model based on extracted texture and added neural network model (CNN) for deep learning classification model. We randomly assigned collected cases into training group and validation group. The diagnosis of benign and malignant lesions were served as the reference. The efficiency was evaluated by ROC classification model. Result We extracted 82 texture characteristics from 132 images of leisure (132 images of CC and 132 images of MLO) by establishing deep learning classification model of breast lesions. We randomly chose and combined characteristics from 15 texture characteristics with statistical significance, then differentiated benign and malignant by SVM classification model. After 50 iterations on each combination of characteristics, the average diagnostic efficacy was compared to obtained the one with higher efficacy. Nine of CC and 8 of MLO was selected. The result showed that the sensitivity, specificity, accuracy and area under curve (AUC) of the model to differentiate simplex breast lesions for CC were 0.68, 0.77, 0.74 and 0.74, for MLO were 0.71, 0.71, 0.71 and 0.76. Conclusions MLO has better diagnostic performance for the diagnosis than CC. The deep learning classification model on breast lesions which was built upon DBT image texture characteristics on MLO could differentiate malignant masses effectively.

Objective: To explore the gene lifestyle interaction of ATP2B1-eNOS pathway gene polymorphisms on blood pressure. Methods: Using the convenient cluster sampling method, a total of 872 junior middle school students from 3 school in July to August 2019, were included in the final analysis. The survey included questionnaire investigation, anthropometry measurement and blood sample collection. After DNA was extracted from peripheral blood samples, the gene polymorphisms ( ATP2B1 gene rs 17249754 and rs 2070759, eNOS gene rs 1799983 and rs 2070744) were genotyped. Logistic regression model was used to analyze the association between gene polymorphism and blood pressure phenotypes. Results: The prevalence of high blood pressure was 9.52 % in adolescents(9.15% in boys and 9.87% in girls),with no significant sex difference ( χ 2=0.13, P =0.72). There were statistically significant differences between boys and girls in age, systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI) classification, birth weight, daily school physical exercise time and daily playing video games time ( P <0.05). Logistic regression analysis showed that, eNOS gene rs 2070744 polymorphism was associated with high blood pressure (HBP) under the recessive model, and the risk of HBP in CC genotype carriers were higher than that TT/TC genotype carriers ( OR=3.88, 95%CI =1.00-15.02, P < 0.05 ). The results of gene lifestyle interaction showed that ATP2B1 gene rs 2070759 polymorphism gene had an interaction with the time of physical exercise in school ( P interaction =0.05). In the subgroup with daily physical exercise time at sch ool ＜1 hour , the TT/TG genotype carriers were associated with increased risk of HBP compared with GG genotype carriers( OR= 2.65 , 95%CI =1.11-6.30, P <0.05). But in the subgroup with daily physical exercise time in school ≥1 hour, rs 2070759 was not significantly associated with HBP. Conclusion eNOS/rs 2070744 polymorphisms are associated with risk of HBP among adolescents. There is significant interaction between ATP2B1 gene rs 2070759 polymorphism and physical exercise time in school on HBP. Adolescents should spend more time on physical activity in school, which will help to maintain normal blood pressure level.

Objective: To analyze the trends and influencing factors of endurance performance of 19-22 years old college students in Hunan Province from 1985 to 2019, so as to provide objective and scientific basis for sports and health work in colleges and universities. Methods: A retrospective analysis was conducted on the data of 14 490 college students aged 19-22 in Hunan Province from 8 consecutive National Student Physical Fitness and Health Surveys conducted from 1985 to 2019. The analysis indexes were 1 000 m running for boys and 800 m running for girls. Results: From 1985 to 2019, the endurance running time of 19-22 years old Han college students in Hunan Province showed an obvious trend of decline. The 1 000 m running time of urban and rural male students increased by 41.9 and 45.4 s on average, and the 800 m running time of urban and rural female students increased by 29.5 and 30.6 s on average, respectively. Multiple linear regression analysis showed that age ( β =0.17), urban students (rural students as reference; β =0.44), GDP ( β =0.94) and urbanization level ( β = 0.44 ) were positively correlated with the average endurance running time of males. Urban students ( β =0.92), GDP ( β = 1.38 ) and Engel coefficient ( β =0.93) were positively correlated with the average endurance running time of females. BMI ( β =-0.47) was negatively correlated with the females mean time of endurance running ( P ＜0.05). Conclusion The endurance performance of Han college students in Hunan Province showed a declining trend from 1985 to 2019,which is associated with age, urban and rural distribution, regional GDP, Engel s coefficient, urbanization level and BMI. Effective measures should be taken to improve the physical quality of college students.

Placental and maternal-fetal circulation Doppler ultrasound are the main noninvasive means for maternal-fetal monitoring. However, Doppler studies on placental abnormalities are not well studied yet. Doppler monitoring of the maternal-fetal circulation, involving uterine arteries, umbilical arteries, and fetal vessels, is still used to screen diseases related to placental dysfunction (such as preeclampsia and fetal growth restriction) and to guide clinical management. This article reviews the advances in the clinical application of placental and maternal-fetal circulation Doppler in obstetrics to optimize the clinical management of disorders associated with abnormal placental structure and function.

The widespread application of next generation sequencing (NGS) in clinical settings has enabled testing, diagnosis, treatment and prevention of genetic diseases. However, many issues have arisen in the meanwhile. One of the most pressing issues is the lack of standards for reporting genetic test results across different service providers. The First Forum on Standards and Specifications for Clinical Genetic Testing was held to address the issue in Shenzhen, China, on October 28, 2017. Participants, including geneticists, clinicians, and representatives of genetic testing service providers, discussed problems of clinical genetic testing services across in China and shared opinions on principles, challenges, and standards for reporting clinical genetic test results. Here we summarize expert opinions presented at the seminar and report the consensus, which will serve as a basis for the development of standards and guidelines for reporting of clinical genetic testing results, in order to promote the standardization and regulation of genetic testing services in China.