Objective To evaluate the effect of household-based health management model on community patients with gestational diabetes.Methods Eighty-four singleton pregnant women with diabetes who visited New City Community Healthcare Center of Zaozhuang Municipal Hospital from January 2009 to December 2012 were randomly assigned to the management group (n =42) and the control group (n =42).The pregnant women in the management group accepted household-based health management,and the pregnant women in the control group accepted conventional health education,intervention,and followup.Blood glucose,lipid profiles,blood pressure,body mass index (BMI) and pregnancy outcomes were compared between the two groups.Results There were no significant different of clinical characteristics between the two groups at baseline.Right before delivery,fasting plasma glucose,2 h postprandial blood glucose,blood pressure,childbirth BMI,pregnancy weight gain,total cholesterol,triglyceride and low-density lipoprotein cholesterol of the management group were significantly lower than those of the control group (t values were 5.81,2.28,3.14,2.41,5.17,4.97,7.81,2.39 and 3.39,respectively; all P ＜0.05),however high-density lipoprotein cholesterol was relatively higher (t =2.02,P ＜ 0.05).Polyhydramnios,premature rupture of membranes,hypertensive disorders in pregnancy,natural labour,cesarean section,fetal macrosomia and neonatal hypoglycemia were found significantly different between the two groups (x2 values were 4.61,4.48,4.48,4.94,4.27,4.48 and 4.76,respectively; all P ＜ 0.05).Health behavior of the management group was significantly improved following the intervention (for balanced diet,regular exercise,proper medication,standardized monitoring,timely referral,high and low blood sugar treatment and emotional management,x2 values were 5.61,4.76,5.27,5.73,4.48,5.19 and 4.20,respectively; all P ＜ 0.05).Conclusion Household-based health management could improve health behavior,metabolic status and maternal or neonatal outcomes of community patients with gestational diabetes.

The tobacco epidemic is a problem with serious consequence for public health in the whole world. Reducing the tobacco harm and protecting public health have become a crucial topic for ethics. This paper, firstly, presents some facts related to the tobacco epidemic. Based on these facts, then, it analyzes the issue from ethical perspectives. And finally, it discusses the moral responsibilities for reducing the tobacco epidemic.

Objective:To assess the efficacy and safety of oncoplastic breast-conserving surgery (OBCS) in the treatment of early breast cancer. Methods:The clinicopathological data of breast cancer patients who were treated with OBCS (67 cases) and standard breast-conserving surgery (SBCS;117 cases) in Affiliated Cancer Hospital of Guangxi Medical University were retrospectively analyzed. Postop-erative complication, specimen weight, margins, and surgery re-excision rate between the two groups were compared. Results:Sero-ma (14.9%versus 48.7%, P<0.001), hematoma (4.5%versus 14.5%, P=0.035), and poor wound healing (3.0%versus 11.9%, P=0.036) were more common in the SBCS group than in the OBCS group. The patient satisfaction in the OBCS group was statistically higher than in the SBCS group (P<0.05). Compared with standard surgery, oncoplastic techniques can be employed for significantly larger tumors (25.04 mm versus 21.14 mm, P<0.001). OBCS resulted in higher mean specimen weights (92.24 g versus 57.44 g, P<0.001), wider clear nearest margins (12.04 mm versus 9.58 mm, P<0.001), and wider furthest margins (24.16 mm versus 15.24 mm, P<0.001). No statisti-cal increase was observed in further surgery re-excision of margins. Conclusion:OBCS is more successful than standard wide local exci-sion in treating larger tumors and obtaining wider radial margins. Oncoplastic approach showed no increase in postoperative complica-tion rate. The postoperative complication was excellent. OBCS is a safe and effective procedure for early breast cancer.

Objective: To investigate the effects of FGFR1OP and p57/Kip2 proteins on the genesis and progression of gliomas and their clinical significance. Methods: The expression of FGFR1OP and p57/Kip2 in 54 glioma specimens was detected by SP immunohistochemical technique. The relationship between the ex-pression levels of those proteins and various clinical pathologic factors was evaluated. Results: The expres-sion of FGFR1OP and p57/Kip2 was found in 66.7% and 44.4% gliomas, respectively. The OD value of FG-FR1OP was 0.131±0.010 in high grade gliomas, and 0.118±0.010 in low grade ones, with a statistical signifi-cance (t=-5.497, P=0.000), showing that higher expression of FGFR1OP was significantly associated with glo-ma cell differentiation. The OD value of p57/Kip2 was 0.156±0.008 in high grade gliomas, and 0.165±0.006 in low grade ones, with a statistical significance (t=0.296, P=0.014), showing that lower p57/Kip2 expression was correlated with high grade gliomas. FGFR1OP was negatively correlated with p57/Kip2 in gliomas (r=-0.732, P<0.01). Conclusion: Increased expression of FGFR1OP and/or decreased expression of p57/Kip2 may play an important role in the genesis and progression of gliomas and may indicate a poor prognosis.

Objective To investigate expression and promoter methylation status of BRCA1 in sporadic breast cancer .Meth-ods The expression of BRCA1 mRNA and protein were detected in 60 cases of sporadic breast cancer ,the adjacent breast tissues , and 30 cases of breast benign lesion tissue by RT-PCR and and immunohistochemical staining respectively .The methylation status of BRCA1 promoter in those tissues were detected using bisulfite genomic sequencing PCR (BSP) combined with TA clone for se-quencing .The relation between BRCA1 expression in sporadic breast cancer and promoter methylation status was analyzed .Results The expression level of BRCA1 mRNA and protein were down-regulated in sporadic breast cancer tissues compared to the corre-sponding adjacent breast tissues and breast benign lesion tissue(P<0 .001) .The positive rates of BRCA1 protein was 51 .7% (31/60)in sporadic breast tissue ,which were significantly lower than those of in the adjacent breast tissues 71 .7% (43/60)and breast benign lesion tissue 66 .7% (20/30)(P< 0 .001) .The methylation rate of BRCA1 promoter CpG was 31 .7% (19/60)in sporadic breast ,while it wasn′t found in adjacent breast tissues and breast benign lesion tissue(P=0 .000) .The statistical analysis showed the expression of BRCA1 had significant negative correlation with promoter methylation(r= -0 .345 ,P=0 .007) .Conclusion The hypermethylation of BRCA1 promoter could induce BRCA1 down-regulating ,which may be involved in the occurrence and develop-ment of sporadic breast cancer .

Animals ; Cell Line ; Ear, Inner ; cytology ; drug effects ; Female ; Hair Cells, Auditory ; drug effects ; ultrastructure ; Male ; Neomycin ; adverse effects ; Rats ; Rats, Sprague-Dawley

Objective To analyse the risk factors of medical complications after hip fracture surgery.Methods Clinical data of 327 hip fracture patients undergoing surgical treatment in Beijing Haidian Hospital from January 2009 to December 2013 were retrospectively studied.There were 114 males and 213 females with a mean age of (75.1 ±15.6) years, 129 patients(39.4%) had femoral neck fractures, and 198 patients ( 60.6%) had intertrochanteric fractures.Fifty four patients had medical complications during hospitalization ( complication group) and 273 patients did not have complications ( non-complications group ) . The clinical features, presurgical comorbidities and operative parameters were documented and compared between two groups.The risk factors of medical complications were assessed by regression analysis.Results Univariate analysis showed that age ( t =2.85, P=0.007), lying in bed before fracture(χ2 =12.86,P =0.000), the history of chronic obstructive pulmonary diseases(COPD) (χ2 =9.45, P=0.000), coronary heart disease(χ2 =10.67,P=0.000), heart failure(χ2 =15.85,P=0.000), diabetes (χ2 =3.22,P=0.024), cerebrovascular disease(χ2 =4.21,P=0.008), anesthesia method(χ2 =8.67,P=0.018), American Society of Anesthesiologists(ASA) score ≥3 level(χ2 =2.01, P=0.042) and the delay time of operation (t=4.24, P=0.037) were significantly different between two groups.Multivariate regression analysis revealed that age(β=0.030, OR=1.030), lying in bed before fracture (β=2.303, OR=10.716), the history of COPD (β=0.831, OR =1.995), coronary heart disease(β=0.858, OR=2.392), heart failure(β=1.971, OR=7.333)and ASA score ≥3 level(β=0.809,OR=2.583) were the independent risk factors of medical complications after hip fracture surgery. Conclusion Age, lying in bed before fracture, the history of COPD, coronary heart disease, heart failure and ASA score≥3 level would increase the risk of postoperative medical complications for patients with hip fracture.

Objective: To compare the long term prognosis between revascularization (REV) and medical therapy (MP) in patients with three-vessel disease (3VD) with or without left main (LM) lesion.
Methods: A total of 4,875 consecutive patients with elective coronary angiography (CAG) diagnosed 3VD with or without LM lesion treated in our hospital from 2007-01 to 2008-12 were retrospectively studied. The patients were divided into 2 groups: MT group,n=705 (14.5%) and REV group,n=4170 (85.5%). The all cause mortality and the rate of revascularization during follow-up period were compared between 2 groups by inverse-probability-weighting approach with propensity score.
Results: There were 3962/4875 (81.3%) patients with simple 3VD (right, left anterior descending and left circumlfex coronary arteries) and 913 (18.7%) with 3VD+LM lesion. The in-hospital mortality was similar between 2 groups (OR=0.7, 95% CI 0.3-1.4,P=0.30). With the longest 2-year follow-up study, the adjusted all cause mortality and the rate of revascularization in MT group were both higher than those in REV group (HR=8.3, 95% CI 6.7-11.1,P<0.001) and (HR=1.4, 95% CI 1.1-1.6,P<0.001). No matter the patients with simple 3VD or 3VD+LM lesion, compared with REV group, MT group had the higher all cause mortality, for 3VD+LM lesion (HR=10.4, 95% CI 7.1-15.4,P<0.001) and for simple 3VD (HR=7.1, 95% CI 5.3-10.0,P<0.001).
Conclusion: In real world, the long term prognosis by revascularization treatment was superior to medical treatment in patients with either simple 3 vessel coronary disease or 3 vessel combining LM disease.

BACKGROUND: Inhibiting the degradation of extracellular matrix in the intervertebral disc can delay the degenerative process of intervertebral disc. Matrix metalloproteinases-3 (MMP3) is considered as a key enzyme for degradation of extracelular matrix components such as type II collagen and aggrecan.
OBJECTIVE:To construct the short hairpin RNA lentiviral vector targeting human MMP3 gene and to detect its efficiency of gene silence by infecting human degenerative nucleus pulposus cells.
METHODS:According to the human MMP3 mRNA (NM_002422.4) sequence, four groups of the short hairpin RNA gene sequences targeting MMP3 were designed, synthesized and annealed to form double stranded DNA fragments, which were connected with the LV3 vectors digested by BamHI andEcoRI enzymes, and then transfected into the competent cels. The positive clones were identified by PCR, and analyzed by sequencing. The packaging and titer of lentivirus were determined after transfecting 293T cells. Human degenerative nucleus pulposus cels were infected with lentivirus vector, and the transfection efficiency of each group was observed under inverted fluorescence microscope. The interfering efficiency was detected by real time-PCR and western blot at 72 and 96 hours.
RESULTS AND CONCLUSION:The ds-oligo DNA was successfully inserted into the lentiviral vector as confirmed by electrophoresis and sequence analysis. The recombinant lentivirus was harvested from 293T cels with a viral titer of 1-5 ×108 TU/mL. RNA interference targeting the GCC AGG CTT TCC CAA GCA AAT sequences with the highest interfering efficiency in MMP3 gene at 72 and 96 hours resulted in suppression of MMP3 mRNA expression by 98% and 72%, respectively; and at 96 hours, the interfering efficiency of protein expression was 57.2%. The recombinant lentivirus vector containing RNA interference targeting MMP3 gene is successfuly constructed, which lays a foundation for further studies on the MMP3 function and gene therapy.

Objective To summarize and explore the clinical effect of auricular reconstruction with autologous costal cartilage grafts and delaying postauricular skin flap.Methods The procedure involved three stages.The first stage was the delay procedure of postauricular skin flap.The second stage was the auricular reconstruction with autologous costal cartilage grafts and delaying postauricular skin flap about 3 weeks after the delay procedure.The third stage involved construction of tragus and conchal cavity and other local correction 6 months or longer after the second stage surgery.The clinical effect,patients' satisfaction and complication were observed.Results This method was used in 28 patients,31 ears of congenital microtia.23 cases completed auricular reconstruction with three stages,the other 8 cases completed only two stages.All auricular reconstruction were successful.The location,size and shape of reconstructive ears were good.The complications were few.The patients or their relatives were basically satisfactory.Conclusions Auricular reconstruction with autologous costal cartilage grafts and delaying postauricular skin flap is a safe and effective method.