Objective To investigate the relationship among the leptin receptor(lepr) gene exon 20,nucleotide 3057 G→A transition and lipid metabolism,insulin sensitivity index,high blood coagulation in type2 diabetes mellitus.Methods Polymerase chain reaction(PCR) and restriction fragment length polymorphism(RFLP) were used to detect the variation of leptin receptor gene nucleotide 3057 G→A transition;Simultaneusly,we detected some parameters,including blood lipids,height,weight,blood glucose,waistline to hipline ratio(WHR).The body mass index(BMI),fat percent,insulin sensitivity index(ISI) were calculated out in all subjects.Results The variation frequency at 3057 nucleotide G→A transiton was 80% in type 2 diabetic group,though it was 68% in control group(P

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Objective: To identify the related psychosocial risk factors of emotional disorders in children. Methods:To use case-control approach in which. Diagnosis was made by clinical interview according to ICD-10 criteria. Eighty eight cases and controls separately filled out general condition inventory. The results were put into Logistic regression model for analysis. Results: The children with timid personality, without kindergarten education, or with parents who were administrative or technical personnel, were apt to have emotional disorders. The children who were usually counseled by their mothers had less emotional disorders than those were beaten. Conclusion: The emotional disorders were the results of multiple factors. Prevention of children's emotional disorders should be focused on the children's personality and family education.

Objective To evaluate operative methods and the clinical effect for comminuted calcaneal fractures.Methods 21 cases(24 feet)of comminuted calcaneal fractures were treated by one stage bone grafting plus open reduction and internal fixation with plastic calcaneus titanium plate.The fractures were classified according to the Sanders system into Sanders Ⅱ,Ⅲ and Ⅳ subgroups.Results All cases were followed up for 9～20 months(14months in average).All cases recovered with good healing of fracture.According to Maryland score,the results were excellent in 14 feet,good in 7 feet,fair in 2 feet,and poor in 1 foot.The excellent and good rate was 87.5％.Conclusions By using the method of internal fixation with plastic calcaneus titanium plate,fracture site can be well exposed,which is helpful to recover calcaneus to its normal length,width,height,Gissane angle and Bohler angle.A reliable internal fixation is helpful for early stage functional excise after surgery,which can maximize the recovery of the ankle function.

Objective To investigate the influence of synergistic effect of estradiol and testosterone on the level of lipids and coagulation function in mice with hyperlipidemia .Methods We established a maouse model in hyperlipidmia , giving estradiol (1 μg/d), testosterone (7 μg/d) or estradiol combined testosterone (1 μg/d E2 +7Tμg/d), respectively.After 14 weeks, we collected the blood from the mice , separated the serum to detect the lipids level , separated the plasma to test the coagulation function .Result Compared with controls , after high-fat diet , the serum level of total cholesterol ( TC) , triglyceride ( TG) , high density lipoprotein ( HDL) were significantly increased , PT and APTT were shorter ( P<0.05 ).However, after treating with estradiol combined testosterone , compared with cases, the serum level of C, TG and HDL were lower and PT , APTT were longer ( P <0.05 ), had no significance with controls . Conclusion The synergistic effect of estradiol and testosterone can mediate the lipids , reduce the level of LDL , regulate the coagulation function , reduce the risk of coronary heart disease , and also provide a new strategy for hormone therapy in coronary heart disease .

Objective To analyze the effect of clinical pathway management for capillary bronchitis in Department of Pediatrics.Methods 75 children with capillary bronchitis after the implementation of clinical pathway management were selected as the observation group,and 68 children with capillary bronchitis before the implementa-tion of clinical pathway management were selected as the control group.The hospitalization cost,average hospital stay, antibiotic use rate,cure rate,nonsocomial infection rate,rehospitalization rate within two weeks,service satisfaction and other comprehensive indices were compared.Result The total cost of drug of the observation group[(1 198.49 ± 397.48)yuan]was lower than (1 324.05 ±376.57)yuan of the control group(Z =2.00,P <0.05).The average hospital stay of the observation group[(6.99 ±2.39)d]was shorter than (8.01 ±2.22)d of the control group(Z =2.62,P <0.05).The service satisfaction rate of the observation group(95%)was higher than 82% of the control group(χ2 =5.44,P <0.05).The antimicrobial use rate of the observation group(49%)was apparently lower than 95% of the control group (χ2 =27.59,P <0.01).There were no statistically significant differences between the two groups in cure rate(hospital discharge rate),nosocomial infection rate and rehospitalization rate within two weeks(all P >0.05).Conclusion Clinical pathway management for capillary bronchitis in Department of Pediatrics of primary hospital can play a role in standardizing medical practice,reducing average hospitalization days,controlling medical cost,and improving service satisfaction under the precondition of ensuring medical quality.

Mild traumatic brain injury (MTBI) is defined as a mild brain trauma resulting in a short loss of consciousness and alteration of mental status. It may also occasionally develop persistent and pro-gressive symptoms. It has been confirmed that MTBI causes changes of anatomic structures in central nervous systemand biomarkers in the body fluid. How ever, there is no sufficient research on relevance among threshold for the brain injury, individual vulnerability and duration of disturbance of conscious-ness. Furthermore, there are no reliable diagnostic methods to establish w hether a blow to the head is sufficient to cause the brain injury. T his review provides references for biomarkers in cerebrospinal fluid and blood associated w ith T B I. It also provides application status and potential prospects for further as-sessment and diagnosis of MTBI.

Objective To investigate the relationship between human leptin receptor(LEPR)gene G3057A polymorphism and type 2 diabetes complicated with non-alcoholic fatty liver disease(NAFLD).Methods 216 cases of newly diagnosed type 2 diabetes(104 cases complicated with NAFLD)and 108 cases of normal glucose tolerances(NGT)were recruited.Hemi-nested PCR-RFLP and PCR direct sequence analysis were conducted to detect the polymorphisms of LEPR G3057A polymorphism.The plasma leptin and insulin levels were measured by ELISA kit.Plasma lipid and glucose metabolic parameters were measured routinely.Liver ultrasound scanning Was carried out among all subjects.Results Type 2 diabetic patients complicated with NAFLD had higher plasma alanine aminotransferase(ALT),triglycerides(TG),low density lipaprotein cholesterol(LDL-C),leptin levels and lower plasma insulin levels than those cages without NAFLD and NGT.The variant frequency at nucleotide 3057 G to A transversion Was 76.0% in type 2 diabetic patients complicated with NAFLD,which Was also significant higher than those cases without NAFLD(62.1%)or NGT cases(53.2%)(x2=14.63,P＜0.01).Conclusions The polymorphism of LEPR gene 3057 probably contributes to the onset of NAFLD in type 2 diabetes by regulating lipid metabolism and affecting insulin sensitivity.

ObjectiveTo explore the association between hepatic steatosis and the liver tissue expression of HBsAg and HBcAg in chronic hepatitis B (CHB) patients.MethodsFrom January 2005 to June 2008,a total of 147 CHB patients with hepatic steatosis diagnosed by liver biopsy and other 149 CHB patients without hepatic steatosis but with similar HBV DNA titer were enrolled.The differences of HBsAg and HBcAg immunostaining and liver injury in these two groups were compared.The data were analysed using t test and chi square test.ResultsCompared with non-steatosis group,the average age and body weight index of hepatic steatosis group were higher (t values were -3.31and -6.57,both P＜0.01).The percentage of moderate to severe hepatic inflammation in liver,obvious hepatic fibrosis and the strong positive HBsAg staining was lower (30.6％ vs 15.4％ ； 26.5％vs 12.8％； 23.1 ％ vs 6.7 ％； x2=9.63,8.92,15.76； all P＜0.01),and the percentage of strong positive HBcAg staining was also in downtrend.Compared with degree F1 and F2 of liver steatosis,the percentage of HBsAg and HBcAg strong positive staining in liver tissues of degree F3 and F4 was in downtrend.ConclusionsHepatic steatosis affected the expression of HBsAg and HBcAg in liver tissue of CHB patients.As hepatic steatosis appeared and became more severe,both expression of HBsAg and HBcAg and the degree of liver injury were in downtrend.

Objective Women with gestational diabetes mellitus (GDM) are at risk to develop Type 2 diabetes mellitus ( DM2).The aim of this study is to compare the effect of three diagnostic criteria on the prevalence of GDM.Methods 2864 pregnant women receiving obstetric care at 24 to 28 weeks of gestation at Peking University First Hospital,underwent the 75 g oral glucose tolerance test for routine GDM screening.The pregnancies were evaluated bythe American Diabetes Association (ADA 2004) Cuideline,the new criteria which was proposed by the International Association of Diabetes and Pregnancy Study Groups (IADPSG 2010) based on the HAPO study,not by the criteria of American College of Obstetricians and Chinese Obstetrics and Gynecology (6th edition 2005).Venous plasma glucose was measured by the IDMS-traceable glucose oxidase method.Results The mean age of the women was 30 years.590 women were diagnosed with GDM using the IADPSG criteria.According to the IADPSG standard,GDM diagnostic rate reached 20.6％.The diagnostic rate of new criteria was increased by 307％ and 199％ compared with the Chinese Obstetrics and Gynaecology (6th edition) and the old ADA standard,respectively.If increasing the number of abnormal glucose values in the IADPS standard to 2 or more,the number of positive cases dropped to 227 people.The diagnostic rate of GDM plummeted to 7.93％,similar with that of the old ADA diagnostic criteria (6.8％).Conclusions The diagnosis rate of GDM was significantly higher using the IADPSG criteria,due to more stringent glucose abnormality recommended by the IADPSG.