Objective To explore the impacts of intensive nutritional intervention on maternal and infant outcomes in women with gestational diabetes mellitus(GDM). Methods From January 2014 to ecember 2014, a total of 518 women with GDM were stratified by age, height, body mass index (BMI), and were divided into treatment group (n=258) and control group (n=260) according to the random number generated by the computer software. Women in control group underwent conservative treatment while those in treatment group were given intensive nutritional intervention including keeping records of eating habits, measurement of blood glucose and regular follow-up. The incidence of pregnancy-related complications and newborn outcomes in both groups were compared. Results Women of the two groups were similar in basic clinical data. The range of gestational weight gain (GWG) [(12.2 ± 4.7) vs. (13.9 ± 5.0)kg] and birth weight of infants [(3 406.4±495.4) vs. (3 494.9±484.7)g] in the intervention group was significantly lower than those in the control group (P<0.01). The rate of reaching recommended target of GWG was significantly higher in the intervention group (60.9%) than in the control group (51.9%, χ2=4.2, P<0.05). There was a significant reduction in glucose-related parameters in both groups (P<0.01). In the intervention group, fasting blood glucose and postprandial blood glucose were reduced from (5.21 ± 0.71) mmol/L, (6.68 ± 0.90) mmol/L to (4.71 ± 0.73) mmol/L,(6.21 ± 0.71) mmol/L (P<0.01), respectively in comparison with the control group, the intervention group had lower incidence of cesarean section (44.6% vs. 53.8%), postpartum hemorrhage (2.3%vs. 6.2%), polyhydramnios (7.8%vs. 13.5%), neonatal hypoglycemia (3.1%vs. 6.5%) and macrosomia (8.1%vs. 13.8%, P<0.05). Conclusions Strengthening nutritional intervention in women with GDM could increase the rate of reaching recommended target of GWG, improve the glucose-related parameters and reduce the incidence rate of pregnancy complications.

Background:Intestinal metaplasia(IM)and dysplasia in Barrett’s esophagus(BE)can be detected by endoscopic biopsy combined with pathological examination. Aims:To evaluate the efficacy of acetic acid stain-guided biopsies in detection of IM and dysplasia in BE under standard endoscopy. Methods:One hundred patients found to have columnar-lined esophagus by endoscopy from January 2012 to November 2014 at Shanghai Jing’an District Central Hospital were enrolled. Under standard endoscopy,acetic acid was sprayed and multi-point biopsies were performed in visible abnormal regions. This was followed by four-quadrant biopsies at every 1 to 2 cm of the remaining BE segments. Detection rates of columnar epithelium,IM and dysplasia were compared between acetic acid stain-guided biopsies and four-quadrant biopsies. Results:A total of 96 patients were diagnosed as BE. Detection rates of columnar epithelium by acetic acid stain-guided biopsies and four-quadrant biopsies were 96. 9%(93 / 96)and 90. 6% (87 / 96),respectively,no significant difference was found between the two methods(McNemar test,P = 0. 146),however,consistency of the two methods was poor(κ = 0. 340). A total of 32 patients were diagnosed as BE with IM. Detection rates of IM by acetic acid stain-guided biopsies and four-quadrant biopsies were 84. 4%(27 / 32)and 40. 6%(13 / 32),respectively,difference in detection rate between the two methods was significant(McNemar test,P = 0. 007),and consistency of the two methods was poor(κ =0. 266). Five cases of low-grade dysplasia were detected by acetic acid stain-guided biopsies only. Conclusions:Acetic acid stain-guided biopsies can detect BE with IM and dysplasia better than four-quadrant biopsies.

Objective: To assess the renal cortical perfusion parameters by the imaging of computed tomography (CT) in patients of essential hypertension (EH) with target organ damage.
Methods: A total of 90 subjects with the entire information including 59 EH patients were studied. The EH patients were divided into 2 groups: EH + target organ damage group,n=30 and EH without target organ damage group,n=29. In addition, there was a Control group,n=31 healthy volunteers. All subjects received 128-slice dual-source CT renal perfusion scanning, the quantitative perfusion of renal cortex blood lfow (BF), blood volume (BV), time to peak (TTP) and the mean transit time (MTT) were examined and compared among different groups.
Results: There were 90/97 (92.8%) participants eligible for perfusion analysis. Compared to Control group, EH without target organ damage group had the similar parameters of BF, BV, MTT and TTP,P>0.05. While EH + target organ damage group had decreased BF (214.6 ± 36.1) ml/(min?100 ml ) than Control group (262.1 ± 26.6) ml/(min?100 ml ),P<0.01, and BV, TTP, MTT were similar to Control group,P>0.05. Compared to EH without target organ damage group, the EH + target organ damage group presented decreased BF (214.6 ±3 6.1) ml/(min?100 ml ) vs (268.9 ± 33.1) ml/(min?100 ml ), P<0.01 and prolonged MTT, TTP,P< 0.05.
Conclusion: CT imaging may evaluate the renal cortical perfusion changes, and especially BF which can relfect the renal perfusion more sensitively than other parameters in EH + target organ damage patients.

Objective To discuss the impact of nursing intervention on self- care ability and health behavior of cancer patients with indwelling PICC in order to improve their life. Methods 218 cases of cancer patients with PICC catheter were randomly divided into the intervention group (107 patients)and the control group (111 patients),the control group were treated with conventional care, the intervention group was treated with targeted cognitive intervention by the PICC nurse specialists on the basis of conventional care. Interventions included improving health knowledge, self-concept, self-care responsibility and self-care skills in four areas, the intervention lasted 3 months. A questionnaire survey was conducted before and after intervention. Self-care skills and health behavior levels were compared between the two groups. Results Self-care skills and health behavior levels of the intervention group were significantly higher thanthose of the control group after intervention. Conclusions Targeted interventions can effectively improve the self-care capacity of outpatient oncology patients with PICC catheter and improve their health behaviors.

Objective To analyze the reasons of abnormal extubation for the chemotherapy patients with PICC,and put forward preventive measures. Methods A retrospective investigation was carried out about the reasons for abnormal extubation in 583 chemotherapy patients with PICC in our hospital from December 2007 to September 2009. Results There were 63 cases of abnormal extubation in 583 patients, accounted for 10.8% of the total number. The reasons of abnormal extubation included: catheter-related infection, misplacement,prolapse, dilapidation and fracture, catheter occlusion,thrombosis and abandoning treatment. Conclusions Complications caused by PICC are the main reasons for abnormal extubation. Important care measures to prevent and deal with kinds of complications timely can reduce the incidence of abnormal extubation.

BACKGROUND: The initial stability of implantable distractor depends on the stress distribution of bone-distractor interface. The understanding of the biomechanical change in initial stage can improve the clinical success ratio of implantable distractor used in alveolar crest.OBJECTIVE: To evaluate the influence of bone quality on stress distribution and deformation in initial distraction stage.METHODS: Four three-dimensional models with 10 079-11 456 cells and 17 299-20 101 nodes were prepared by finite element methods (11 mm in length and 3.7-4.1 mm diameter). Implantable distractor was embedded in a segment of mandible. The elastic modulus of cancellous bone and the thickness of cortical bone, stress and deformation of bones and distractor were calculated.RESULTS AND CONCLUSION: The highest stress in the bone was concentrated in transportable section and the maximum deformation of transportable section was observed at the edge of the cortical bone, both of which were increased with bone quality decreased. The subsidence of distractor was observed with bone quality decreased. Bone quality influenced the initial stability and the result of the implantal distraction. The decrease of bone elastic modulus would increase the failure risk of distraction osteogenisis.

Objective To apply a hand function laserimager to evaluate the effect of acupuncture on hand dysfunction after stroke. Meth-ods From January to June, 2016, 18 stroke patients with upper limb dysfunction were divided into control group (n=9) and acupuncture group (n=9). The control group received routine medication and rehabilitation, while the acupuncture group received acupuncture in addi-tion. They were assessed with modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FMA) of upper limb motor function and modified Bathel Index (MBI) before and after three-week treatment, while the region of interest (ROI) of their hands was tested with the hand func-tion laserimager. Results The scores of MAS and FMA improved after treatment in both groups (t>4.44, P<0.01), and improved in the score of MBI in the acupuncture group (t=3.95, P<0.01). The scores of MAS, FMA, and MBI improved more in the acupuncture group than in the control group (t>3.17, P<0.01). Meanwhile, the scores of ROI decreased in the affected hands after treatment (t>7.78, P<0.001), and de-creased more in the acupuncture group than in the control group (t=-2.23, P<0.05). No significant difference was observed in the scores of ROI of the unaffected hands (t=-0.11, P>0.05) between groups. Conclusion The hand function laserimager, which responds to the blood perfusion of the hand, can be used as a tool to evaluate the hand function.

Antigens, Neoplasm ; immunology ; Cancer Vaccines ; immunology ; Carcinoma, Hepatocellular ; immunology ; therapy ; Humans ; Immunotherapy ; Liver Neoplasms ; immunology ; therapy

OBJECTIVETo compare the dissolution characteristics of colloidal silica and porous silica as the solid dispersion carrier, with baicalin as the model drug.

METHODThe baicalin solid dispersion was prepared by the solvent method, with colloidal silica and porous silica as the carriers. In the in vitro dissolution experiment, the solid dispersion was identified by scanning electron microscopy, differential scanning and X-ray diffraction.

RESULTThe solid dispersion carriers prepared with both colloidal silica and porous silica could achieve the purpose of rapid release. Along with the increase in the proportion of the carriers, the dissolution rate is accelerated to more than 80% within 60 min. Baicalin existed in the solid dispersion carriers in the non-crystalline form.

CONCLUSIONThe release behaviors of the baicalin solid dispersion prepared with two types of carrier were different. Among the two solid dispersion carriers, porous silica dissolved slowly than colloidal silica within 60 min, and they showed similar dissolutions after 60 min.

Calorimetry, Differential Scanning ; Colloids ; chemistry ; Drug Carriers ; chemistry ; Drug Delivery Systems ; instrumentation ; Flavonoids ; chemistry ; pharmacology ; Porosity ; Silicon Dioxide ; chemistry ; Solubility