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

OBJECTIVETo explore the reasonable therapeutic strategy for different types of epicanthus.

METHODSPatients with epicanthus were classificated according to the shape, extent and inner canthal distance and treated with different methods appropriately. Modified asymmetric Z plasty with two curve method was used in lower eyelid type epicanthus, inner canthus type epicanthus and severe upper eyelid type epicanthus. Moderate upper epicanthus underwent '-' shape method. Mild Upper epicanthus in two conditions which underwent nasal augumentation and double eyelid formation with normal inner canthal distance need no correction surgery. The other mild epicanthus underwent '-' shape method.

RESULTSA total of 66 cases underwent the classification and the appropriate treatment. All wounds healed well. During 3 to 12 months follow-up period, all epicanthus were corrected completely with natural contour and unconspicuous scars. All patients were satisfied with the results.

CONCLUSIONSClassification of epicanthus hosed on the shape, extent and inner canthal distance and correction with appropriate methods is a reasonable therapeutic strategy.

Objective To compare radiation-induced lung injury (RILI) between concurrent and sequential combination of postoperative radiotherapy and endocrine therapy. Methods A total of 118 patients subjected by radical or modified radical operation of breast cancer were enrolled in this study and received radiotherapy and endocrine therapy between Jan 2003 and December 2007. All the patients were categorized into four groups: radiotherapy (RT) plus concurrent aromatase inhibitor(AI): RT+AI; RT plus sequential AI:RT-AI; RT plus tamoxifen (TAM): RT+TAM; RT plus sequential TAM: RT-TAM. Radiotherapy was delivered by using various energy of electron (6, 9, 12 Mev β-ray) or 6 M.V X-ray for different target with a dose of 50 Gy (2 Gy/Fx, 5 fractions per week). RILI grades were classified according to RTOG/EORTC and Aoki evaluation criteria from one month to at least one year after radiotherapy. Results 30/118(25.4 %) patients was observed with RILI, RT+AI 22.7 % vs. RT-AI 20.0 %(P =0.806), RT+TAM 35.7 % vs. RT-TAM 24.2 %(P =0.328). The incident rate of RILI was higher in elder patients(>60 yr) than in other patients (33.9 % vs.16.9 %, P =0.05). Patients with positive chemotherapy history had a higher risk of RILI than those with chemotherapy-negtive history (P =0.039). Conclusion These findings suggest that RILI are associated with age and chemotherapy history, but not correlated with the sequence of radiotherapy and endocrine therapy.

Objective To study the characteristic of inhibition on platelet P2Y12 and short-term change after clopidogrel intake in patients with cardiovascular disease. Methods Thirty-two patients with cardiovascular disease were enrolled. Samples at baseline, 10 h and 36 h after 300 mg loading dose and 75 mg/d maintenance dose of clopidogrel with 100 mg/d Aspirin intake were measured respectively. Platelet aggregation (PAgT) was measured on thromboelastograph(TEG) induced by ADP/AA. INH was detected and calculated activated by Kaolin, AA, ADP and Activator((R)) in the TEG reagent. CD62p and VASP phosphorylation (PRI), platelet activation markers were tested with FACSCalibur Flow Cytometry, and platelet secretion activity and suppression of P2Y12 receptor were detected respectively. The changes of indicators were compared before and after clopidogrel intake, and evaluate their function in platelet receptor activation. Results INHADP at baseline was (11.5 ±9.3)%, and increased to (42.5 ±29.1)% statistically (t =3.155, P<0.05) after taking the P2Y12 at 10 h, but decreased to (20.4±13.1)% at 36 h, non-statistical to baseline (t = 2.078, P > 0. 05) , INHAA increases from baseline level (56. 6 ± 36. 6) % to (83.0 ±27. 3)% at 10h(t=2.086,P>0.05) and (85. 4 ±20. 8)% at 36 h (t= 1. 888, P>0.05), no statistical defferences were found. Inhibition on platelet activativation induced by ADP function well till 36 h after 300 mg loading dose. PAgTADP decrease from (53. 7 ± 14. 1)% at baseline to (49. 2 ±22. 8)% at 10 h non-statistically (t=0.656, P>0.05), and (40.7±12.8)% at 36 h statistically (t=2.418, P<0.05), however PAgTAA decrease at both 10 h and 36 h statiscally, from (34. 3 ± 18. 1) % to (17.4 ± 13. 1) % , (t=3.134, P<0.05) and (14.6±5.1)%, (t=2.532, P<0.05), respectively. Data of PAgT was not corresponding to that from TEG for the difference in sample type partly. PRI in VASP assay was (78. 6 ± 22.3)% before loading dose, and decreased to (70.7 ±9.4)% at 10 h without significance (t = l. 194, P>0.05) and (59.6 ±28.0)% at 36 h (t=1.930,P<0.05) statistically, similarly to INHADP,indicating that within 36 h clopidogrel did not have strong inhibitory effect on the ADP receptor. On the contrary, CD62p changed from (7. 5 ± 1. 4) % at baseline to (4. 2 ± 1. 1) % statistically (10 h, t = 18. 027, P < 0. 05) and ( 4. 3 ± 0. 2 ) % non-statistically (36 h, t = 2. 908, P > 0. 05 ). Inhibition of secretion activity reflected by CD62p was significant. In contrast, it was more obvious inhibition in COX-1 passway, while the inhibition of P2Y12 receptor varied due to assay difference. Conclusions AA-induced platelet activation is significantly decreased in the inhibition of clopidogrel and aspirin, while ADP receptor is significantly inhibited until 36 h after the loading dose of clopidogrel. Platelet function in whole blood reflects total activity of platelet interaction with other components, in which no significant inhibition could be witnessed within 10 h.

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