Objective To explore the ways to strengthen the mode and effect of the standard community management of the diabetes,and the management model of diabetic mellitus that adopt to current situation of China.Methods 80 diabetics patients were divided into intensive group and common group,and the period of the treatment is three consecutive months.We observed the levels of FBG,2hPG,HbA1c and the cost of drugs.Results The levels of FBG(6.82 ± 1.23),2hPG[(9.51 ± 2.18)mmol/L]and HbA1c(7.52 ± 1.31)％ in intensive group were significantly lower than common group[(8.65 ± 2.31)mmol/L、(12.22 ± 3.11)mtmol/L,(10.32 ± 3.51)％](t =3.12,3.25,3.56,3.69,all P ＜ 0.05).The cost of drugs in intensive group[(621.5 ± 204.5)yuan]was significantly lower than common group[(796.5 ± 240.6)yuan](t =3.69,P ＜ 0.05).Conclusion The ways to strengthen the mode could spend less but control disease well,and improving the existing community diabetes management should be truly effective in reducing medical costs.

Objective To investigate the expression of the ternary complex factor Net in human pancreatic carcinoma cell line BxPC3 and its effect on cell proliferation and the expression of c-fos.Methods pEGFP-Net prokaryotic expression plasmid and empty vector pEGFP were transfed into BxPC3 cens by using lipofectamine 2000,then monoclonal cell which stably expressing Net was established.Human pancreatic carcinoma cells proliferation was detected by MTT and flow cytometry.The tuRNA and protein expression of Net and c-fos in BxPC3 cells were detected by real.time PCR and Western blot.Results Net was low expressed in BxPC3 cells.After pEGFP-Net transfection,Net wag stably expressed and the expression of c-fos was inhibited,cell proliferation was also inhibited after pEGFP-Net transfection,the inhibitory rates at the 3rd, 5th,7th day was 38.81%,55.34%and 56.92%respectively,which were significantly higher than those in the empty vector group(5.09%,12.42%,8.6%,P<0.05).G_0/G_1 phase cell was(61.79±5.67)%,which were significantly higher than(45.14±3.37)%in the empty vector group(P<0.05).Conclusions The ternary complex factor Net could inhibit pancreatic carcinoma cell line BxPC3 proliferation.Its mechanism was possibly repressing expression of oncogene c-fos.

OBJECTIVETo investigate the effect of one kind of regulating-qi and Nourishing-yin Chinese herbs Zuoguiyin on the expression of rats ovarian vascular endothelial growth factor (VEGF) and secreted protein acidic rich in cysteine (SPARC) during the period of peri-menopause.

METHODThe animal models of perimenopause rats were established by natural aging. Perimenopause rats were treated by intragastric administration (ig) with low (13.78 g x kg(-1)), middle (20.67 g x kg(-1)) and high (31 g x kg(-1)) dose of Zuoguiyin for 8 weeks. Expression of VEGF and SPARC mRNA were detected by RT-PCR. Immunohistochemistry was used to evaluate expression levels of VEGF protein.

RESULTCompared with that in the control group, ovarian expression levels of VEGF mRNA and its protein in rats during peri-menopause increased significantly (P < 0.01). Middle and high dose of Zuoguiyin could both down-regulate the expression of VEGF in ovaries of praesenilis rats, and the difference has statistical significance (P < 0.01). Expression levels of SPARC mRNA in rat ovaries during peri-menopausal period decreased obviously compared to that in the control group (P < 0.01). Middle and high dose of Zuoguiyin could greatly promote ovarian SPARC mRNA expression of praesenilis rats (P < 0.01).

CONCLUSIONThe abnormal changes of VEGF and SPARC may play an important role in the aging process of ovary. Zuoguiyin, one kind of regulating-qi and Nourishing-yin Chinese herbs, can improve ovarian vascular formation through down-regulating the expression of VEGF meanwhile up-regulating the expression of SPARC. And it may delay aging by this way.

Animals ; Drugs, Chinese Herbal ; pharmacology ; Female ; Gene Expression ; drug effects ; Humans ; Models, Animal ; Osteonectin ; genetics ; metabolism ; Ovary ; drug effects ; metabolism ; Perimenopause ; drug effects ; metabolism ; Rats ; Rats, Wistar ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

Obj ective To observe the detection rate of pathogens in hospitalized children with acute respiratory infection (ARI)from the year 2011 to 2013 in Changzhou region.Methods Hospitalized children with ARI (a total of 6 366 cases)in Changzhou First People′s Hospital from January 2011 to December 2013 were enrolled.Clinical materials of children were collected.Serum legionella pneumophila,mycoplasma pneumoniae,Q fever rickettsia,chlamydia pneumoniae,aden-ovirus,respiratory syncytial virus,influenza A virus,influenza B virus,para-influenza virus types 1/2 and IgM-3 antibody were detected by using indirect immuno-fluorescence assay (IFA).The detection of pathogens was analyzed,and detection rate of each pathogen in children with different ages,seasonal distribution and causative condition of each pathogen were analyzed as well.Results At least one kind of pathogen was detected positively in 1 ,850 cases with the total detection rate of 29.06% (1850/6366 ).Mycoplasma pneumoniae was the most common pathogen with the detection rate of 2 5 .3%(1 4 2 3 /6 3 6 6 ).The median age of children infected by respiratory syncytial virus and adenovirus was less than the median age of overall children (P<0 .0 1 ).The respiratory syncytial virus was detected highest in the group with the age of 1 to 6 months (3.58%,14/391);mycoplasma pneumoniae was detected the most in the rest groups with other ages.In addition to Q fever pathogen rickettsia,chlamydia pneumoniae,the rest of the pathogens were significantly seasonal.Mycoplasma pneumoniae infections were the most common in acute respiratory infection,laryngitis,bronchitis,bronchiolitis,bronchial pneumonia and bronchial asthma with infection.Conclusion Respiratory syncytial virus is the common cause of respirato-ry tract infection in hospitalized children with ARI in Changzhou.Different pathogens have dif-ferent age distributions with distinguished seasonal and disease distribution characteristics.

Obj ective To observe the detection rate of pathogens in hospitalized children with acute respiratory infection (ARI)from the year 2011 to 2013 in Changzhou region.Methods Hospitalized children with ARI (a total of 6 366 cases)in Changzhou First People′s Hospital from January 2011 to December 2013 were enrolled.Clinical materials of children were collected.Serum legionella pneumophila,mycoplasma pneumoniae,Q fever rickettsia,chlamydia pneumoniae,aden-ovirus,respiratory syncytial virus,influenza A virus,influenza B virus,para-influenza virus types 1/2 and IgM-3 antibody were detected by using indirect immuno-fluorescence assay (IFA).The detection of pathogens was analyzed,and detection rate of each pathogen in children with different ages,seasonal distribution and causative condition of each pathogen were analyzed as well.Results At least one kind of pathogen was detected positively in 1 ,850 cases with the total detection rate of 29.06% (1850/6366 ).Mycoplasma pneumoniae was the most common pathogen with the detection rate of 2 5 .3%(1 4 2 3 /6 3 6 6 ).The median age of children infected by respiratory syncytial virus and adenovirus was less than the median age of overall children (P<0 .0 1 ).The respiratory syncytial virus was detected highest in the group with the age of 1 to 6 months (3.58%,14/391);mycoplasma pneumoniae was detected the most in the rest groups with other ages.In addition to Q fever pathogen rickettsia,chlamydia pneumoniae,the rest of the pathogens were significantly seasonal.Mycoplasma pneumoniae infections were the most common in acute respiratory infection,laryngitis,bronchitis,bronchiolitis,bronchial pneumonia and bronchial asthma with infection.Conclusion Respiratory syncytial virus is the common cause of respirato-ry tract infection in hospitalized children with ARI in Changzhou.Different pathogens have dif-ferent age distributions with distinguished seasonal and disease distribution characteristics.

Objective: To investigate the clinical characteristics, treatment and prognosis of relapsed demyeli-nating disease (RDD) associated with myelin oligodendrocyte glycoprotein antibodies (MOG abs) children in southern China. Methods: Children with RDD associated with MOG abs at Department of Neurology in Guangzhou Women and Children′s Medical Center from January 2015 to December 2018 were retrospectively analyzed.The annualized relapse rates (ARRs) and expand disability status scale (EDSS) were used to assess the recurrence frequency and neurological dysfunction respectively. Results: Ten children were included with the age of (6.4±3.6) years old, and male to female ratio was 4∶6.(1)Clinical phenotype: all children had 24 episodes during follow-up, with acute disseminated encephalomyelitis (ADEM)(7/10 cases) and neuromyelitis optica spectrum disorders (NMOSD)(3/10 cases) on the first episode.Among 14 recurrent episodes, ADEM (9/14 times) was the most common, followed by optic neuritis(ON)(3/14 times)and brainstem encephalitis (2/14 times). By the final follow-up, the final diagnosis was multiphasic disseminated encephalomyelitis(MDEM)(6/10 cases), NMOSD(3/10 cases), ADEM-ON(1/10 case), respectively.(2)Laboratory examination: all the children had positive serum MOG abs in the acute stage.The serum MOG abs titer high group(≥1∶640)(6 cases)on the first episode complicated ON (3 cases) and long segment myelitis (3 cases) more common than those of low group(1∶320)(4 cases). (3)Imaging changes: 25 times of bain magnetic resonance imaging (MRI) were performed in the acute stage, MRI changes mostly involved the cortex and subcortical white matter.Four cases had abnormal spinal cord MRI.(4)Treatment and prognosis: intravenous methylprednone (IVMP) combined with intravenous immunoglobulin (IVIG) were administrated in acute stage.Rituximab (2/10 cases), mycophenolate mofetil (4/10 cases), IVIG (2/10 cases) monthly and low dose prednisone orally (2/10 cases) were given respectively in maintains stage.ARRs decreased from 1.4 to 0 and EDSS score improved significantly after these treatments above.Seven cases had residual neurological dysfunction with 3 cases of NMOSD, 3 cases of MDEM and 1 case of ADEM-ON, including motor dysfunction, learning disability and inattention, symptomatic epilepsy and visual impairment. Conclusions ADEM is the most common form of RDD associated with MOG abs in children.Those with high serum MOG abs titer on the first episode are prone to have ON or long segment myelitis.Immunomodification therapy is effective in the relapsed patients, residual neurological sequelae were related to the type of repeated demyelination.

Objective To observe the effect of Dexmedetomidine (DEX)on induction peri-od of hemodynamics in patients undergoing general anesthesia combined with epidural block.Meth-ods A total of 40 hysterectomy patients in optional period (ASA Ⅰ~Ⅱ)were randomly divided into Dexmedetomidine group(Group D)and Propofol group(P group).Group D received continuous epidural anesthesia with infusion of DEX 0.5 μg /(kg·h)and endotracheal intubation was applied after general anesthesia.Group P was given the same therapy with group D except dexmedetomi-dine.HR,SBP,DBP and MAP of the hemodynamic index were recorded at the time of entering the operation room(T1),after the determination of epidural plane(T2),pre-intubation(T3),intu-bation(T4),immediately after trachea intubation(T4),and the beginning of operation(T4).Results The difference was not statistically significant in the index between the two groups at T1 .HR of group D was lower than that in group P at all-time points(P <0.05).SBP,DBP and MAP of group D were higher than group P at T2,T3 and T4(P <0.05).SBP,DBP,MAP of group D were lower than group P at T5 and T6(P <0.05).SBP、DBP and MAP in group D at T2、T3 and T4 were higher than that in the group P (P <0.05).Conclusion Dexmedetomidine can offer a stable hemo-dynamics in the patients with general anesthesia combined with epidural block.

Objective To observe the effect of Dexmedetomidine (DEX)on induction peri-od of hemodynamics in patients undergoing general anesthesia combined with epidural block.Meth-ods A total of 40 hysterectomy patients in optional period (ASA Ⅰ~Ⅱ)were randomly divided into Dexmedetomidine group(Group D)and Propofol group(P group).Group D received continuous epidural anesthesia with infusion of DEX 0.5 μg /(kg·h)and endotracheal intubation was applied after general anesthesia.Group P was given the same therapy with group D except dexmedetomi-dine.HR,SBP,DBP and MAP of the hemodynamic index were recorded at the time of entering the operation room(T1),after the determination of epidural plane(T2),pre-intubation(T3),intu-bation(T4),immediately after trachea intubation(T4),and the beginning of operation(T4).Results The difference was not statistically significant in the index between the two groups at T1 .HR of group D was lower than that in group P at all-time points(P <0.05).SBP,DBP and MAP of group D were higher than group P at T2,T3 and T4(P <0.05).SBP,DBP,MAP of group D were lower than group P at T5 and T6(P <0.05).SBP、DBP and MAP in group D at T2、T3 and T4 were higher than that in the group P (P <0.05).Conclusion Dexmedetomidine can offer a stable hemo-dynamics in the patients with general anesthesia combined with epidural block.

Objective To investigate the influence of different end shapes of esophageal stents on the mechanical behavior of the stent-esophagus system. Methods Through finite element simulation, the mechanical behavior of the coupling system between braided esophageal stents with different end shapes (straight-tube-shaped, cup-spherical-shaped, double-trumpet-shaped) and the esophageal cavity was analyzed. The influences of bare stents and covered stents with three different end shapes on stress distributions in the inner wall of the esophagus and on dilatation of the esophageal stenosis zone were compared. Results The reduction in stenosis rate caused by the bare stent was larger than that of the covered stent. Moreover, the equivalent stress and the contact stress caused by the bare stent were much larger than those of the covered stent. Different end shapes had a significant influence on the stress occurring in the healthy esophageal zone. Stress concentration occurred in the zones where the esophagus contacted the central part of the cup-shaped end and the edge of the double-trumpet-shaped end. The braided esophageal stents with three different end shapes all had good apposition.Conclusions Different end shapes of stents cause different stress states in the esophagus. A larger stress involves a higher probability of occurrence of esophageal tissue hyperplasia, but a smaller possibility of stent migration. Therefore, understanding the effect of the end shapes on stent performance can provide important theoretical references for optimization design of the braided stent and its clinical selection.

Background In recent years, ozone (O₃) has gradually become a key air pollutant affecting public health. Studies have been conducted to evaluate O₃ pollution-associated disease burden for general population, but there is a lack of research on O₃ pollution-associated disease burden of gestational complications. Objective To assess the disease burden of O₃ pollution on pregnancy complications in the Yangtze River Delta region and the changes in the disease burden resulting from the improvement of O₃ pollution levels. Methods Through Chinese databases such as China National Knowledge Infrastructure (CNKI) and Wanfang, as well as English databases including PubMed and Web of Science, a systematic search was conducted to retrieve epidemiological studies investigating the association between O₃ exposure and pregnancy complications from January 1, 2010 to February 28, 2023. Using predetermined inclusion and exclusion criteria, retrieved studies were screened and assessed for heterogeneity using the Higgins I² statistic. The exposure increment was standardized to 10 µg·m⁻³, and a meta-analysis was conducted to evaluate the exposure-response relationship. Spatial analysis and environmental health risk assessment were then employed, using O₃ monitoring data at national air monitoring stations, population data, and related disease burden parameters in the Yangtze River Delta region, to evaluate changes in the disease burden of pregnancy complications associated with improvements in O₃ pollution levels. Results The meta-analysis revealed a significant association between maternal O₃ exposure and increased risks of gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP), particularly in early pregnancy, and the related odds ratios (OR) and 95% confidence intervals (CI) were 1.028 (1.002, 1.055) and 1.031 (1.023, 1.040), respectively. The cities with higher attribution fractions (AF) of GDM and HDP related to O₃ exposure in 2017 and 2020 in the Yangtze River Delta region were Xuzhou, Huaibei, Suzhou (Anhui Province), Changzhou, and Wuxi, with most cities showing a significant decrease in AF in 2020. Except for Hefei, the cases of GDM and HDP attributable to O₃ exposure in the remaining cities of the Yangtze River Delta region decreased by 16.31% to 57.41% in 2020 compared to 2017. In addition, except for Hefei, Suqian, Anqing, and Wuxi, the direct medical costs attributed to O₃ exposure in the remaining cities decreased by 1.12% to 45.36% in 2020 compared to 2017. Conclusion Exposure to O₃ during pregnancy is associated with increased risks of GDM and HDP. There are differences in the disease burden of GDM and HDP related to O₃ pollution among cities in the Yangtze River Delta region in 2017 and 2020. In 2020, compared to 2017, the disease burden in most cities is decreased.