OBJECTIVE:To probe into the occurrence characteristics of the adverse drug reactions(ADR) in Lanzhou area and to intensify the reporting,monitoring and management of ADR.METHODS:A retrospective analysis was performed on 345 valid ADR cases.RESULTS:The ADR reports were mainly submitted by medical institutions,account for 88.70%.The clinicians and hospital pharmacists were the chief reporting personnel.16 drug categories totaled 143 varieties were involved in the ADR,leading the list were traditional Chinese medicine preparation that account for 48.70%and antibacterial drugs that account for 29.86%.CONCLUSION:The reporting and monitoring of ADR should be intensified so as to decrease the rate of missing report and incidence of ADR to a large extent.

Objective To explore the effects of high insulin and high glucose concentrations on glucose transport activity,the expression of insulin signaling peptides and glucose transporter 4(GLUT4) translocation in primary cultured rat adipocytes.Methods Isolated rat adipocytes were cultured for 24h at insulin(10 4?U/ml) and different concentration glucose(5,10,15 and 25mmol).Then the glucose uptake,cellular contents of insulin receptor substrate(IRS) 1/2,phosphatidylinositol 3-kinase 85 subunit(p85),protein kinase B(PKB) and GLUT4 were measured by Western blotting method.Results These adipocytes treated with insulin and different high concentration glucose had shown to impair glucose uptake in a dose-dependent manner,inhibited cellular IRS1 expression,impaired IRS2 protein expression independent on glucose concentration in the medium,it did not influence the contents of p85,PKB and GLUT4,but decreased GLUT4 translocation.Conclusions Chronic high insulin induced insulin resistance may be caused by the increasing glucose concentration surrounding the cells.The mechanism may be involved in affecting IRSs protein expression and GLUT4 translocation.

Objective To explore the clinical efficacy of captopril combined with nifedipine in the treatment of type 2 diabetes mellitus complicated with hypertension.Methods 100 patients with type 2 diabetes mellitus complicated with hypertension were divided into two groups by randomized single blind method.The two groups were given conventional hypoglycemic therapy,50 cases in the control group were treated with captopril,while 50 cases in observation group received captopril combined with nifedipine sustained -release tablets.The clinical therapeutic effect was compared between the two groups.Results The effective rate of the observation group was 94%,which of the control group was 80%,the difference was statistically significant (χ2 =9.65,P<0.05).After treatment,the diastolic blood pressure[(80.45 ±3.65)mmHg],systolic blood pressure[(128.67 ±5.66)mmHg],fasting blood glucose[(6.65 ±0.37)μmol/L],2h postprandial blood glucose[(9.76 ±1.22)μmol/L]of the observation group were significantly reduced than before treatment (t =8.06,8.18,8.00,7.94,all P <0.05),and diastolic blood pressure and systolic blood pressure were significantly different with the control group(t=8.66,7.90,all P<0.05). After treatment,the serum creatinine (97.44 ±6.32)μmol/L,urea nitrogen (4.20 ±0.30) mmol/L and 24h urinary albumin (17.99 ±4.10) mg/L of the observation group were significantly reduced compared with before treatment (t=7.67,8.27,8.32,all P<0.05),and the indicators had significant differences with the control group(t=7.23, 7.65,7.67,all P<0.05).Conclusion Captopril and nifedipine sustained-release tablets in the treatment of type 2 diabetic patients with hypertension can effectively reduce the blood pressure,improve renal function,and it has good clinical application and promotion value.

ObjectiveTo study whether the current Institute of Medicine (IOM) pregnancy weight gain recommendationsvarybypre-pregnancybodymassindex(BMI)wassuitabletoChinese people.MethodsA study was conducted on 4736 term singleton live birth gravidas,who were diagnosed normal glucose metabolism and delivered in Peking University First Hospital in 2005 and 2009,by reviewing the medical records.Based on the pre-pregnant BMI,the selected cases were divided into 3 groups:low body mass group ( BMI ＜ 18.5 kg/m2,n =465 ),normal body mass group ( BMI 18.5 - 24.9 kg/m2,n =3549),over body mass group ( BMI ≥ 25 kg/m2,n =722).All the cases were divided into 3 subgroups based on pregnancy weight gain as below,within,and above the IOM recommendations in each pre-pregnant BMI group.Totally 4736 newborns were divided by birth weight into 3 groups:normal birth weight group ( weight 2500 - 4000 g,n =4339 ),macrosomia group ( weight ≥ 4000 g,n =359 ) and low birth weight group (weight ＜ 2500 g,n =38).The difference of age,gestational age,pre-pregnant weight,pre-pregnant BMI and history of delivery of cases between 2005 and 2009 were analyzed.The difference of pregnancy outcome of women whose gestational weight gain was below,within,and above the IOM recommendations was analyzed.Results (1) Compared to mothers with pregnancy weight gain within IOM recommendations in low body mass group,risk of low birth weight in offspring was elevated tendency with pregnancy weight gain below IOM recommendations ( OR =3.71,95％ CI:0.97 - 14.12,P =0.055 ).(2) In normal body mass group, compared to women with pregnancy weight gain within IOM recommendations, risk of macrosomia in offspring was elevated with pregnancy weight gain above IOM recommendations ( OR =2.14,95％ CI:1.62 - 2.83,P ＜ 0.01 ).( 3 ) In over body mass group,compared to women with pregnancy weight gain within IOM recommendations,risk of macrosomia in offspring was elevated ( OR =3.25,95％ CI:1.65 -6.39,P =0.001 ) and risk of hypertensive disorders complicating pregnancy was high ( OR =1.79,95％ CI:1.04 -3.09,P =0.037 ) in women with pregnancy weight gain above IOM recommendations.ConclusionThe current IOM pregnancy weight gain recommendations vary by pre-pregnancy BMI may be suitable to Chinese people.

Objective To observe the changes of serum bilirubin(BIL) and high-sensitivity C-reactive protein(hs-CRP) after percutaneous coronary intervention(PCI) in acute myocardial infarction(AMI) patients.Methods The TBiI,IBil,DBil and hs-CRP levels in serum were detected in 60 AMI patients within 6 hours after attack with immunoturbidimetry before PCI,at the point of operation,6h,12h,24h,72h and 7d afer PCI.30 healthy persons were chosen as normal control.The two groups were compared.Results The hs-CRP level was increased gradually with time in AMI patients after PCI.The peak value was at 72h after PCI and it was significantly higher than those in the normal group( P ＜ 0.05 ).The TBil,IBil,DBil levels at pre-PCI point were significantly lower than the normal group (P ＜ 0.05).These index were gradually recovered to the normal group and no significancet differences between them (P ＞ 0.05 ).The coefficient correlation of hs-CRP and TBil,IBil,DBil were 0.44 ( P ＞ 0.05 ).Conclusion The TBil,IBil,DBil and hs-CRP levels in short time after attack of AMI with PCI presented a dynamic changing and recovered to the normal level.No associativity was observed between them,but as the follow-up index,it was significant for the disease turnover.

Objective To study the roles of advanced glycation end products and its receptor on fetal brain injury of gestational diabetes mellitus (GDM) rats.Methods Twenty one adult pregnant Wistar rats were administered streptozotocin (STZ) intraperitoneally to induce GDM rats model.The fourteen pregnant rats were divided into two groups according to the fasting glucose on the 3rd day of pregnancy:severe GDM group with the fasting glucose ＞ 16.7 mmol/L and mild GDM group with the fasting glucose between 6.7 - 16.7 mmol/L Another seven pregnant rats were chosen as the severe GDM and intervention with micronutrient group,receiving gavage with micronutrient during the whole pregnancy.Five control rats received the same volume of citric acid buffer.All the pregnant rats were tested fasting glucose from the tailvein and their weight on the pregnant day 3,13 and 19.Maternal serum levels of AGE were measured by ELISA and RAGE levels in the embryonic brain tissues were tested by immunohistochemistry.Results ( 1 ) There was no statistically significant difference of pre-pregnancy fasting glucose level among all groups (P ＞ 0.05 ).The fasting glucose levels on the 3rd day and the mean fasting glucouse level of pregnancy in the severe GDM group and the severe GDM and intervention with micronutrient group were higher than those of the control group ( P ＜0.05 ).And there was no significant difference between the severe GDM group and the severe GDM and intervention with micronutrient group (P ＞0.05 ).(2)The serum AGE levels in the severe GDM group and the mild GDM group were( 1037 + 38) ng/L and( 880 ± 34) ng/L respectively,with no significant difference ( P ＞ 0.05 ).The serum AGE levels in the control group and the severe GDM and intervention with micronutrient group were (857 ± 32 ) ng/L and (988 ± 37 ) ng/L,and the difference was statistically significant ( P ＜ 0.05 ).The serum AGE levels in the severe GDM and intervention with micronutrient group and in the mild GDM group had no significant difference ( P ＞ 0.05 ).( 3 ) The serum AGE levels in the severe GDM group,mild GDM group and the control group were positively associated with the mean glucose level of pregnancy ( r =0.603,P ＜ 0.05 ) and the grlucose on the 3rd day of pregnancy (r =0.704,P ＜ 0.05 ).(4)The fetal brain nerve cell number and morphology in the control group were normal.While in the mild GDM group fetal brain nerve cells decreased,the proliferation and swelling of glial cells were seen.In the severe GDM group and the severe GDM and intervention with micronutrient group,the fetal brain cells furtherly reduced,and large vacuole around the cells,deformation and debris of the cells were seen. Glial scar formation was visible in some fetal brain tissues.There was a few RAGE expression in the control fetal brain tissues.In the mild GDM group and the severe GDM group,RAGE expression increased significantly.And the RAGE expression intensity in the severe GDM and intervention with micronutrient group was between the severe and the mild GDM groups.Conclusions( 1 ) Abnormal fetal brain development of GDM rats was associated with the increase of maternal serum AGE and the enhancement of RAGE expression in fetal brain tissues,which suggested that AGE/RAGE pathway may play an important role in the fetal brain injury of GDM rats.(2) Micronutrients can reduce the brain damage of GDM fetuses.

Objective To assesment the effect of risk factors at gestational diabetes mellitus (GDM).Methods We collected 427 pregnant women who had done 75 g oral glucose tolerance test (OGTT) between September 1st,2012 and April 19th,2013 in Peking University First Hospital,including 74 pregnant women diagnosed as GDM (GDM group) and 353 pregnant women undiagnosed (non-GDM group).Then we conducted a multiple logistic regression to analyze the clinical datas collected from two groups,which included age,pre-pregnancy body weight and body mass index (BMI),body weight during 11-12 weeks pregnancy,body weight during 23-24 weeks pregnancy; and fasting plasma glucose(FPG),triglyceride (TG),total cholesterol (TCH),high density lipoprotein (H DL),low density lipoprotein (LDL),fasting insulin (FINS),homeostasis model assessment of insulin resistance (HOMA-IR) during early pregnancy; and family history of diabetes mellitus.Results (1)There were significant difference in age,pre-pregnancy BMI,and FPG,TG,FINS,HOMA-IR during early pregnancy,and family history of diabetes mellitus between two groups (P ＜ 0.05).(2) The risk factors of GDM that have statistical significance included FPG during early pregnancy (OR:4.03,95 ％ CI:1.62-10.02),family history of diabetes mellitus (OR:3.15,95 ％ CI:1.66-5.99),TG during early pregnancy (OR:2.13,95 ％ CI:1.17-3.87),BMI before pregnancy (OR:1.36,95 ％ CI:1.08-1.70),age ≥ 35 years (OR:1.15,95 ％ CI:1.05-1.26),early pregnancy weight gain (OR:1.20,95％ CI:1.06-1.35),mid pregnancy weight gain (OR:1.28,95％ CI:1.12-1.47),FINS during early pregancy (OR:1.09,95％ CI:1.01-1.17).Conclusions FPG,TG and FINS during early pregnancy,BMI before pregnancy,early and mid pregnancy weight gain,family history of diabetes mellitus and age≥35 years are the indepadent risk factors for GDM.We should pay more attention to FPG and TG during early pregnancy,and put weight management into practise since early pregnancy and try to control pregnancy weight gain within reasonable limits.

Objective To investigate the effects of gestational diabetes mellitus (GDM) on the growth rate of fetuses.Methods This was a retrospective study.Women who had deliveries in Peking University First Hospital between January 2012 and June 2013 were enrolled.Matched by maternal age,they were divided into four groups with 100 cases in each group:macrosomic fetuses of mothers with GDM (GDM-macrosomia group),normal birth weight infants of mothers with GDM (GDM-non-macrosomia group),macrosomic fetuses of mothers with normal pregnancy (normal-macrosomia group),and normal birth weight infants of mothers with normal pregnancy (normal-non-macrosomia group).The fetal abdominal circumference was measured at 20+1-24,28+1-32,32+1-37 weeks and 37+1 weeks to delivery under prenatal ultrasound.The growth rate of fetal abdominal circumference was calculated (abdominal circumference/gestational weeks).The analysis of variance,the least significant difference-t test and Student's t test were used for statistical analysis.Results At early pregnancy [(9.2±2.6) weeks of gestation] and 20+1-24,28+1-32,32+1-37 weeks and 37+1 weeks to delivery,the weight and body mass index (BMI) of the mothers in GDM-macrosomia group were higher than those in the other three groups (all P＜0.05).The body weight of the mothers increased by (15.5±5.4),(13.5±3.6),(16.4±4.1) and (16.2±4.3) kg,respectively,compared with early pregnancy.At 20+1-24,28+1-32,32+1-37 weeks and 37+1 weeks to delivery,the fetal abdominal circumference of GDM-macrosomia group was (182.0± 13.9),(270.7± 17.7),(335.2±21.3) and (362.3± 18.7) mm,respectively,being higher than that in GDM-non-macrosomia group [(176.8± 13.0),(256.6± 13.5),(313.2± 17.5) and (335.8± 15.5) mm] and normal-nonmacrosomia group [(176.9± 11.8),(260.0± 14.2),(310.6± 21.4) and (334.5 ± 16.1) mm] (all P＜0.05).The fetal abdominal circumference of GDM-macrosomia group was even higher than normal-macrosomia group at 32+1-37 weeks [(335.2±21.3) vs (326.1 ± 19.1) mm,t=4.01,P＜0.05].The changes of the growth rate of fetal abdominal circumference were consistent with the fetal abdominal circumference.Conclusions GDM accelerates fetal growth.

Objective To investigate the relationship between gestational hyperglycemia and adverse pregnancy outcomes and find out the optimum diagnostic criteria of gestational diabetes mellitus in China. Methods A retrospective population-based study of 14 593 pregnant women, who delivered between Jan. 2005 and Dec. 2009 and accepted the gestational diabetes mellitus ( GDM ) screening and diagnosis was performed. The prevalence of gestational hyperglycemia according to different criteria was calculated, and the incidence of adverse pregnant outcomes relation to gestational hyperglycemia according to different criteria was analyzed. Results ( 1 ) According to National Diabetes Data Group (NDDG) criteria and International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria, the prevalence of gestational hyperglycemia that intervention required was 8.9% (1293/14 593 ) and 14.7% (2138/14 593 )respectively; the prevalence of gestational hyperglycemia differed significantly between NDDG and IADPSG criteria ( P ＜ 0. 05 ). ( 2 ) The prevalence of macrosomia, large for gestational ages ( LGA), cesarean section,preterm birth and neonatal hypoglycemia etc would increase in gestational glucose metabolic disorders according to any criteria. The prevalence of the complications in gestational hyperglycemia according to NDDG criteria, IADPSG criteria and the patients with normal glucose metabolism is as follows, macrosomia:8.4% ( 108/1293), 11.3% (241/2138) and 6. 7% ( 835/12 403 ); LGA: 9. 7% ( 125/1293 ), 11.7% (250/2138) and 5.5% (687/12 403); cesarean section: 59. 0% (763/1293), 60. 4% ( 1291/2138 ) and 51.6%(6397/12403); preterm birth: 11.4% (147/1293), 9.5% (203/2138) and 6.3% (777/12 403); neonatal hypoglycemia: 2. 6% ( 33/1293 ), 2. 2% (46/2138) and 0. 7% ( 89/12 403 ). ( 3 )About 71.3% (922/1293) of the gestational hyperglycemia according to NDDG criteria could be well control only by diet control. Conclusion The prevalence of perinatal complications would increase in gestational hyperglycemia that achieved IADPSG criteria without intervention, so IADPSG criteria is reasonable in China.