Objective To study the clinical features and the clustering of risk factors in gestational diabetes mellitus (GDM),and analyze the risk factors.Methods Two hundred and three gravida were selected.According to the result of 75 g oral glucose tolerance test,they were divided into 2 groups:GDM group(134 cases) and normal glucose tolerance (NGT) group (69 cases).Blood sugar,blood fat and insulin were measured,and the homeostasis model of assessment for insulin resistance index (HOMA-IR),pancreatic islet beta cell function index (HOMA-β) and insulin sensitivity index (ISI) were calculated.The relation was analyzed between the risk factors and GDM.Results The age,progestation body mass index (BMI),fasting blood glucose,fasting insulin,total cholesterol,triglyeride,low density lipoprotein-eholesterol (LDL-C),HOMA-IR and the positive rate of diabetes mellitus family history in GDM group were significantly higher than those in NGT group [(30.8 ±4.1) years vs.(28.7 ±3.9) years,(24.29 ±3.65) kg/m2 vs.(21.35 ±2.39) kg/m2,(5.22 ±1.26) mmol/L vs.(4.33 ±0.53) mmol/L,(9.27 ±3.55) mU/L vs.(4.75 ±2.73) mU/L,(5.54 ± 1.26) mmol/L vs.(3.74 ± 1.07) mmol/L,(2.63 ± 1.43) mmol/L vs.(1.73 ± 0.76) mmol/L,(3.02 ± 0.97) mmol/L vs.(2.10 ± 0.75) mtmol/L,0.67 ± 0.47 vs.0.43 ± 0.34,40.3％ (54/134) vs.26.1％(18/69)],there were statistical differences (P＜ 0.01 or ＜ 0.05).The HOMA-β and ISI in GDM group were significantly lower than those in NGT group (4.62 ± 0.72 vs.5.57 ± 1.30 and-3.79 ± 0.47 vs.-2.91 ± 0.48),there were statistical differences (P ＜ 0.01).Logistic regression analysis result showed that fasting blood glucose (OR =6.016,95％ CI:1.603-22.585,P =0.008),total cholesterol (OR =2.823,95％ CI:1.568-5.083,P=0.001),diabetes mellitus family history (OR =2.780,95％ CI:1.168-6.617,P=0.021),fasting insulin(OR =1.954,95％ CI:1.371-2.785,P=0.001),progestation BMI(OR =1.787,95％ CI:1.124-2.839,P =0.014),age (OR =1.374,95％ CI:1.087-1.737,P =0.008) and diastolic pressure (OR =1.184,95％ CI:1.045-1.342,P =0.008) were the risk factors of GDM.Conclusions GDM has the clinical features of the clustering of risk factors and genetic susceptibility.The disorder of lipid metabolism and glycometabolism,genetic susceptibility and age are the main risk factors in the development of GDM.

Echocardiography plays an important role in diagnosing cardiac tumors and is helpful for subsequent treatment decision making.However,conventional echocardiography can hardly meet the clinical requirements of sufficient diagnosis,mostly due to the fact that it usually does little on identification of benign and malignant characters of tumors.Contrast echocardiography is a new technology using microbubbles as a contrast agent to trace the blood flow,which promotes the definition of endocardium lines and helps to reveal spaceoccupying abnormities in heart.Moreover,myocardial contrast echocardiography can be used to evaluate perfusions of intracardiac masses,and thus improves the accuracy of differential diagnosis enormously.

Objective To explore the risk factors of pregnancy complications in patients with gestationaldiabetesmellitus(GDM).Methods 134patientswithGDMweredividedintocontrolgroup without complication (n= 38) and complication group(n= 96).Serum fasting levels of glucose (FPG) , insulin ,lipid and C‐reactive protein (C‐RP) were measured. Both maternal and fetal complications of pregnancy were recorded. Results The levels of C‐RP ,FPG ,progestation BMI and lategestation BMI were significantly increased in complication group than in control group [(5.46 ± 4.20) vs (2.60 ± 2.76) mg/L ,(5.68 ± 1.36) vs (5.25 ± 0.77)mmol/L ,(24.79 ± 3.92) vs (23.03 ± 2.51)kg/m2 ,(29.05 ± 3.79) vs (27.25 ± 2.58)kg/m2 respectively ,P< 0.05].The C‐RP level is significantly associated with FPG.Logistic analysis showed that maternal complications were significantly related to lategestation BMI ,C‐RP , TC and HDL‐C.Infant complications were significantly related to C‐RP. Conclusion C‐RP ,lipid and late gestation BMI play important roles in the development of maternal‐neonatal complications during pregnancy. Keeping rational levels of glucose ,lipid and weight gain are helpful for improving pregnancy outcomes.

Objective To compare the effects of different doses of amino acids and fat emulsions in parenteral nutrition on the incidence of complications and prognosis in very low birth weight infants (VLBWI). Methods The clinical data of 328 VLBWI who received nutrition support therapy for at least 5 days starting in 72 h after birth during January 2005 to December 2014 , were retrospectively analyzed. According to the dosage in parenteral nutrition, patients were divided into low-dose group and high-dose group. The incidence of complications and prognosis between two groups were compared. Results There were 204 cases in low-dose group and 124 cases in high-dose group. Compared with the low-dose group, the incidence of complications was lower in high-dose group during hospitalization and the incidence of intracranial hemorrhage was reduced most;the incidence of developmental retardation was lower at discharge;the overall incidence of metabolic complications of parenteral nutrition was higher, among which the incidence of high blood glucose, electrolyte disturbance and cholestasis were increased and the incidence of hypoglycemia was lower, and the differences were all statistically signiifcant (P??0 . 05 ). Conclutsions VLBWI can tolerate early aggressive parenteral nutrition which can reduce the incidence of extrauterine growth retardation and premature complications.

Adult ; Cerebrospinal Fluid Rhinorrhea ; surgery ; Endoscopy ; adverse effects ; Humans ; Male ; Pneumocephalus ; etiology

During growth and progression, the microenvironment of tumors suffers a series of abnormal characteristics, which include hypoxia, acid pH, increased oxidative stress, excess glutathione (GSH), as well as certain overexpressed enzymes. Although affect or limit the cancer therapeutic outcomes, these factors provide possible approaches to strategies for cancer detection and novel therapy at the same time. Recently, based on these properties of the tumor microenvironment (TME), various kinds of responsive nano-platforms have been continuously developed and applied in cancer theranostics preliminarily. Thus, this review would introduce the typical features of TME firstly, then detailly summarize the design principles and research progress of corresponding hypoxia-responsive, pH-responsive, redox-responsive, enzyme-responsive, dual-responsive and multi-responsive nano-platforms. Finally, the challenges and the perspectives of the TME-responsive nano-platforms are briefly discussed.

?AIM: To evaluate the effects on recovering of corneal wound and postoperative discomfort of different methods for primary pterygium.?METHODS: Forty-seven cases ( 60 eyes ) of primary pterygium were excised under microscope with limbal epithelial transplantation, with sharp dissection ( 24 cases, 30 eyes, Group A) and blunt dissection (23 cases, 30 eyes, Group B).All cases were followed up for 1d to 1mo.?RESULTS: The recovering of corneal wound was better in Group B on 1st day and 3rd day after surgery.Pain, photophobia and tears, foreign body sensation were more serious in group A on 1st day after surgery with a statistically significant difference (P=0.005,0.015,0.012). Pain, photophobia and tears, foreign body sensation were more serious in Group A on 3rd day after surgery with a statistically significant difference ( P=0.019,0.018, 0.015).There was no statistically significant difference on 1wk and 1mo after surgery (P>0.05).? CONCLUSION: Compared with sharp dissection, primary pterygium excised with blunt dissection can significantly improve recovering of corneal wound and postoperative discomfort.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Tremor ; therapy

Objective:To evaluate the therapeutic effect of 177Lu-prostate specific membrane antigen (PSMA)-I&T on prostate cancer. Methods:The culture medium of 1.85, 18.50, 185.00, 555.00 and 925.00 MBq/L 177Lu-PSMA-I&T was added into LNCaP cells (200 μl/well, 5 experimental groups and 1 control group, 3 replicates in each group) for 24 h, and the cell viability in each group was detected. The culture medium of 3.7 MBq 177Lu-PSMA-I&T was added into LNCaP cells (1 experimental group, 1 control group, 3 replicates in each group) for 48 h to detect the changes of cell cycle. LNCaP cells (3 experimental groups and 1 control group, 3 replicates in each group) were added into the culture medium of 3.7, 19.5 and 37.0 MBq 177Lu-PSMA-I&T for 48 h to detect cell apoptosis. Tumor-bearing mice models were established (BALB/c-nu/nu nude mice, n=32). The changes of tumor volume and body mass of tumor-bearing mice were observed within 20 d after treatment. On the 7th day after treatment, tumor tissues of tumor-bearing mice were stained with HE staining and fluorescently stained with Ki-67 protein, and apoptosis was detected by TdT-mediated dUTP nick end labeling (TUNEL) assay. On the 20th day after treatment, pathological analysis was performed on the main viscera of the tumor-bearing mice. One-way analysis of variance, the least significant difference t test and paired t test were used to analyze the data. Results:Compared with the control group ((100.00±12.35)%), the cell survival rates were significantly decreased after 177Lu-PSMA-I&T intervention in 185.00, 555.00, 925.00 MBq/L groups ((57.56±6.35)%, (38.65±3.39)%, (27.95±4.48)%; F=78.91, t values: 8.312-14.106, all P<0.01). Cell survival rates were significantly reduced in 185.00 MBq/L group at different time points (24, 48 and 72 h; F=78.28, t values: 6.628-14.384, all P<0.01). The proportion of LNCaP cells in G2/M phase was increased from (12.36±0.28)% to (19.92±0.48)% ( t=17.180, P<0.01). The apoptosis rates of cells were significantly increased in 18.5 and 37.0 MBq groups ( F=71.86, t values: -6.138, -13.050, both P<0.05). The difference of relative tumor volume (RTV%) was statistically significant among 3.7, 14.8 and 29.6 MBq groups and control group (136.7±7.4, 59.2±23.8, 47.3±13.8 vs 240.3±3.7; F=78.20, t values: 7.549-13.345, all P<0.01). But there was no significant difference in body mass of tumor-bearing mice among groups. Compared with the control group, the positive rates of Ki-67 staining cells ((37.23±3.04)% vs (14.89±3.80)%, (5.60±1.83)%, (3.46±0.71)%) and TUNEL-fluorescein isothiocyanate (TUNEL-FITC) staining ((0.74±0.18)% vs (1.61±0.30)%, (3.19±0.44)%, (3.54±0.47)%) in tumor tissues of 3.7, 14.8 and 29.6 MBq groups were statistically significant ( F=103.91, t values: 10.429-15.762; F=38.66, t values: from -9.312 to -2.881, all P<0.01). Conclusions:177Lu-PSMA-I&T has a good therapeutic effect on prostate cancer, with no obvious therapeutic side effects. Therefore, 177Lu-PSMA-I&T is expected to be an ideal drug for treating prostate cancer.

Objective To investigate the phenotype and genetic characteristics of a Chinese family with an autosomal-dominant inherited sensorineural hearing loss.Methods A Chinese pedigree associated with an autosomal-dominant inherited low-frequency sensorineural hearing loss (LFSNHL) was investigated.After obtaining informed consent from all study participants medical and audiological examination were used to rule out any syndromic hearing impairment.Five patients were tested with DPOAE and ABR,while two patients were tested with vestibular function and computed tomography scan of the temporal bone to exclude auditory neuropathy and other possible aural disorders.Twenty-one loci and twenty-three genes of DFNA screening had been done by using microsatellite markers and linkage analysis.Results Proband of the family had been diagnosed with low-frequency sensorineural hearing loss.A Chinese family BJ-L046 with non-syndromic autosomal dominant hearing loss was ascertained.Hearing impairment in the affected members in family BJ-L046 occured from 10 to 20 years of age and mainly affected the low frequencies,causing an upsloping audiogram.Higher frequencies were getting involved with increasing age,thus causing a flat-type audiogram.No positive result was found in twenty-one loci and twenty-three genes of DFNA screening.Conclusion A Chinese family with late-onset low-frequency sensorineural hearing loss was clinically studied.No positive result was found by linkage analysis,and twenty-one loci and twenty-three genes of DFNA were preliminary excluded.