Objective To evaluate the values of maternal serum levels of lipid and uric acid at second trimester in predicting preeclampsia,gestational diabetes mellitus and macrosomia. Methods Concentrations of selected metabolic markers including total cholesterol,triglyceride,low density lipoprotein-cholesterol,high density lipoprotein-cholesterol,apolipoprotein AI,apolipoprotein B and uric acid were examined in 1000 healthy singleton primiparous who accepted regular prenatal healthcare in Naniing Drum Tower Hospital,at 20 weeks of gestation from June 2009 to January 2010.All the pregnant women were followed up to their deliveries.Pregnancy complications,such as preeclampsia and gestational diabetes mellitus (GDM),the data of maternal and neonatal outcomes such as gestational age at delivery,neonatal birthweight were recorded.Relationship between adverse outcome and blood lipid,uric acid levels was analyzed by Logistic regression,and the risk factors were confirmed; predictive values of those sensitivity and specificity were calculated by receiver operating characteristic curve. Results Among the 1000 pregnant women, 61 (6.1％) developed preeclampsia and 100 (10.0％) developed GDM.The mean gestational age of delivery was (39.3±1.2) weeks,and the incidence of preterm delivery was 1.5％ (15/1000).The mean birthweight was (3389.6±4 422.8) g,and the prevalence of macrosomia was 8.9％ (89/1000).Women who had elevated triglyceride levels had a 3.42-fold increased risk of preeclampsia (95 ％ CI:1.88-6.22,P =0.000) and 2.12-fold increased risk of GDM (95％ CI:1.38-3.35,P =0.001).Hyperuricemic women experienced a 2.09-fold increased risk of preeclampsia (95％CI:1.24-3.53,P=0.005) and 2.22-fold increased risk of GDM (95％CI:1.32-3.43,P=0.002).Women who had decreased high density lipoprotein-cholesterol level experienced a 2.34-fold increased risk of preeclampsia (95 ％ CI:1.20-4.55,P =0.011),2.03-fold increased risk of GDM (95 ％ CIr:1.33-3.11,P =0.001 ) and 1.67-fold increased risk of macrosomia (95％CI:1.06-2.64,P=0.026).The area under receiver operating characteristic curve of these metabolic markers was 0.56-0.65, the sensitivity was 28％-82％ and the specificity was 34％-85％. Conclusions Hypertriglycemia,hyperuricemia,and hypo high density lipoprotein-cholesterolcmia at 20 weeks of gestation might relate to preeclampsia,GDM and macrosomia,but the predictive values of them are limited.

Objective To study the expression levels of inducible costimulator (ICOS) on CD4+ T cells in peripheral blood in patients with chronic hepatitis B and its change after treated with interferon.Methods All 56 patients were divided into two groups (interferon group has 28 cases,lamivudine group has 28 cases),and interferon group treated by PEG-IFN-α 2a,lamivudine group treated by lamivudine,respectively.There were 20 healthy individuals as control group.The levels of ICOS on CD4+ T cells of patients with chronic hepatitis B were kinetically detected by flow cytometry.The copies of HBV DNA in sera were dynamically detected by real-time PCR.Results The levels of ICOS on CD4+ T cells in patients with chronic hepatitis B was higher than that of normal controls(P＜0.001 ).However,the expressions of ICOS on CD4+ T cells in patients could be deduced by PEG-IFN-α 2a and obviously decreased after treatment.There was significant difference between interferon group and lamivudine group (P＜0.05 in 24 weeks,and P＜0.01 in 48 weeks).After treatment,the change values of ICOS in interferon group was positively correlated with the change copies of HBV DNA (r =0.972,P＜0.001 ).However,the change values mentioned above that did not find correlation in lamivudine group(r=-0.101,P=0.608).Conclusion The study shows the patients with chronic hepatitis B have disordered in cellular immunity and increased with the expression of ICOS on CD4+ T cells.PEG-IFN-α 2a could decrease the expression of ICOS on CD4+ T cells in patients,and correct the Th2 type immune polarization to some extent,and that plays a positive role in antiHBV.

AIM: To investigate the effect of mfn2 on mitochondrial function in steatosis hepatocytes. METHODS: Plasmid pEGFP-mfn2 was transfected into hepatocyte strain L02 by Lipofectamine 2000 in vitro, then the steatosis model of hepatocytes was establish by oleic acid induction. RT-PCR was used to evaluate mRNA expression and Western blotting was use to detect the protein expression. ATP level was determined by firefly luciferase bioluminescent. ROS production was measured by fluorescence probe DCFH-DA. Chondrosome transmembrane potential of L02 was observed by labeling of JC-1 and FCM. RESULTS: The stable expression of ectogenesis mitofusin2 in L02 cells was confirmed by RT-PCR and Western blotting. In the model of oleic acids induced lipid formation, Mfn2 obviously inhibited the descent of chondrosome transmembrane potential and ATP level, and increased ROS production in L02 cells. CONCLUSION: Up-regulated expression of mfn2 attenuates mitochondria dysfunction caused by oleic acids induced lipid formation.

Objective To study the value of magnetic resonance diffusion tensor imaging(MR-DTI) in evaluating the severity of liver cirrhosis.Methods Seventeen patients with Child A liver fibrosis (age=35.0+11.8 years,14 males and 3 females),12 with Child B(age=44.7+14.0 years,5 males and 7 females) and 8 with Child C(age=48.7+7.6 years,3 males and 5 females) were recruited.All patients had clinical data and serum makers in full.Fifty normal controls (age=35.2+14.2,28 males and 22 females) were also recruited.Diffusion tensor imaging(DTI) was performed in all subjects using a GE Propeller HD 1.5T MR scanner by employing a spin echo single-shot EPI(echo planar imaging) sequence.Average diffusion coefficient(DCave) and fractional anisotropy(FA) maps were generated from each P articipants DTI scan using AW 4.2 functool software.All the statistic analysis was performed in SPSS 13.0 , and P value of less than 0.05 was deemed to be significant . Results DCave values were 1.54±0.25 ,1.33±0.18 ,1.02±0.12 ,0.66±0.27 in control group and Child A , B , C respectively , the FA values were 0.46±0.10, 0.42±0.08, 0.56±0.05,0.71±0.41 in control group and Child A, B, C respectively. Significantly low DCave and changed FA in liver fibrosis group were found(P< 0. 05). Among the four groups, significant differences were found in DCave values and FA values(P<0.05) except control group VS Child A group in FA values(P=0.54).Conclusion MR-DTI is relevant to the severity of liver cirrhosis, and may be a useful tool for evaluating the severity of liver cirrhosis.

Objectives To compare the safety and efficacy of radial artery access versus femoral artery access for percutaneous coronary intervention in acute myocardial infarction population. Methods From June 2004 to December 2006, 446 patients with acute myocardial infarction treated with percutaneous stenting were reviewed retrospectively. The radial artery approach was used in 242 patients, and the femoral artery approach in 204 patients. The success of the procedure, procedure duration, X-ray exposition, volume of contrast, incidence of major adverse cardiac events and complications were compared between the radial artery and femoral artery approach. Results Total procedure duration, X-ray exposition, the immediate success of the procedure and the proportion of patients with reperfusion time above 60min are higher in patients with radial artery acess than that with femoral artery access [(62. 1 ± 23. 4) min vs(56. 8 ± 16. 7)min,(2829. 4 ± 1365.2) mGY vs (2352. 3 ± 903.1) mGY, 4% vs 0.9% and 7.44% vs 2.94%respectively, all P ＜ 0. 05]. Conclusions In non-selected patients with acute myocardial infarction treated with primary stent implantation, the success rate of the radial artery approach is lower than the femoral artery approach and could prolong the reperfusion time. It is suitable to change artery access immediately if abnormality is found via radial artery access.

In this article,from the view of the cognitive structure,we talk about the role of transfer of learning in medical innovative education,and propose the strategies on how to increase the positive transfer of learning through the rational organization of teaching contents,improved teaching methods,highlighting the dominant status of student to raise innovative talents.

Objective To minimize unfavorable factors and elevate accuracy of coronary angiography, nursing must be paid more attention. Methods Siemens 64-slice dual source CT , double tube high pressure syringe of MeoRao company, electrocardiogating, non-ion constrast medium are applied. 100 patients, including 65 males and 35 females are involved. Their age ranges 35-81 years old,and average age is 58. Results 96 cases are successful, 4 cases are failed. Conclusion Nursing work is an important factor of coronary angiography. Good nursing may gurantee coronary angiography.

Objective To probe the advantages and characteristics of imaging on dual-energy CT boneless and digital sub- traction brain angiography through comparative analysis. Methods Siemens 64-slice dual-source spiral CT and double high pressure syringe; The 200 patients were randomly divided into dual-energy group(n=100) and DSACT group(n=100); Every patient was injected 50 ml contrast medium and 50ml normal saline, injection rate was 4ml/s. Results The groups of cere- bra-vascular imaging without interference, and completely boneless; but experimental group has more boneless defects and vascular surface definition less. The cerebral arteries were interfered by the venous shadow in dual-energy group, and the dual-energy group received low-dose radiation. Conclusion The DSACT imaging quality is superior to dual-energy CT boneless imaging. The radiation dose of the dual -energy CT is lower than DSACT.

OBJECTIVE To investigate the productive rate of AmpC ?-lactamases and ESBLs produced by the Gram-negative bacilli from the nosocomial infection in our hospital. METHODS AmpC ?-lactamases and ESBLs were detected by the improved cefotaxime and ceftriaxone three-dimensional test. RESULTS The productive rate of AmpC ?-lactamases was 16.00%.Among them,the productive rate of AmpC ?-lactamases was only 8.84%.The Enterobacter cloacae,Serratia marcescens and Enterobacter aerogenes were easy to produce the enzymes(36.00%,31.25% and 28.00%).The productive rate of AmpC ?-lactamases and ESBLs at the same time was 7.16%. CONCLUSIONS The productive rate of the enzymes by the Gram-negative bacilli from the nosocomial infection is rather high.

Objective Establish premature ovarian failure ( POF ) model in female Sprague Dawley by tripterygium wilfordii , and investigate the effect of bushenyangxue prescription on the levels of anti -mullerian hormone ( AMH) .Methods After POF model was established , rats were gave by gavage of different dosage of Bushenyangxue prescription for 30 days.The changes of histomorphology on rat ovarian tissue were observed by hematoxylin -eosin staining. Serum AMH concentraction , protein and mRNA expression of AMH were measure with ELISA , immunohistochemical staining and qRT-PCR, respectively .Results The follicle and corpus luteum were atrophied after tripterygium wilfordii challenge, which was improved after treatment with Bushenyangxue prescription .Serum AMH, protein and mRNA expression of AMH were decreased tripterygium wilfordii-treated rats; this decrease was inhibited after treatment with Bushenyangxue prescription .Conclusions Our study indicates that Bushenyangxue prescription could preserve the AMH levels of POF rats.These findings suggest that Bushenyangxue prescription may be a useful strategy to treat POF .