Objective We observed the effect of topical application of mucopolyccharide polysulfate cream (hirudoid) on phlebitis prevention initiated by continuous infusion of 5-Fu with Baxter infusor. Methods 60 untreated patients with nasopharyngeal carcinoma were selected and randomly divided into the control group (28 patients) and the experimental group (32 patients). The patients of the experimental group were gently massaged with hirudoid along the infusion vein since the beginning of 5-Fu infusion, while the control group received no intervention. The incidence of phlebitis was observed in the two groups. Results The incidence of phlebitis in the experimental group was lower and the degree was lighter compared with the control group. Conclusions Hirudoid can decrease the incidence and released the symptoms of phlebitis initiated by continuous infusion of 5-Fu with Baxter infusor, and is effective to prevent and treat phlebitis.

Objective To evaluate the expression and distribution of Toll-like receptor 4 (TLR4) in term placentas of women with gestational diabetes mellitus (GDM). Methods Placental samples were collected from 36 normal full-term singleton pregnant women (control group) and 33 full-term singleton pregnant women with GDM who had elective cesarean section in Peking University First Hospital between November 2014 and June 2015. Immunohistochemical assay was used to detect the expression and distribution of TLR4 in placental tissues. T test was used to compare the expression of TLR4 in various cell types of placenta by semi-quantitative analysis. Results (1) TLR4 was expressed in the cell membrane, cytoplasm or nuclei of trophoblast, decidual cells, vascular endothelial cells and amniotic epithelial cells of term placentas. (2) Compared with the control group, the expression of TLR4 was significantly enhanced in trophoblast and decidual cells of GDM women (0.38±0.01 vs 0.31±0.01, 0.39±0.01 vs 0.34±0.01, t=5.218 and 4.525, all P<0.01). Moreover, the change of TLR4 average optical density was most significant in trophoblast. (3) There was no difference in the expression of TLR4 in vascular endothelial cells and amniotic epithelial cells in term placentas of GDM women compared with the control group (all P>0.05). Conclusions The expression of TLR4 is different in various cell types of GDM term placentas.

Objective To investigate the adverse reactions by stereotactic body radiation therapy(SBRT)for advanced hepatocellular carcinoma and summarize nursing experience.Methods Forty-one patients with advanced hepatocellular carcinoma from the radiation department of Sun Yat-sen University Cancer Center from July 2010 to May 2012 were enrolled in this retrospective study.The adverse reactions were closely observed and the patients were given pertinent nursing.Results The effectiveness rate was 56.2%.During the therapy,36 patients developed nausea/vomiting of grade 1-2,taking up 87.8%,18 had grade 1-3 elevation of liver enzymes,taking up 43.9%,16 had grade 1-2 decrease of white blood cells,taking up 39.0%,8 had grade 1 anemia,taking up 19.5%and 21 had grade 1-2 decrease of blood platelet,taking up 51.2%.The adverse reactions were contained satisfactorily through careful observations and pertinent nursing.Conclusions The toxic reactions by SBRT are nausea,vomiting,enzymes elevation and decrease of whole blood cell.Therefore,nurses need to observe these toxic reactions carefully and give pertinent care to the patients so as to prevent the complications,especially radiation-induced liver injury.

Objective To compare SPECT/CT fusion imaging and MRI in the diagnosis of benign hip lesions. Methods Twenty-two patients suspected avascular necrosis of femoral head with hip discomfort, pain or action limited were analyzed retrospectively. All patients underwent radionuclide bone scan and MR examination within 5 days, and the diagnosis was proved with clinical follow-up. Results Eighteen necrosis of the femoral head and 4 hip arthritis including 1 patient with ankylosing spondylitis were found in 44 hip joints of 22 patients. MRI detected 17 femoral head necrosis and 4 hip arthritis, while SPECT/CT fusion image found out 18 femoral head necrosis and 4 hip arthritis. There was corresponding relationship in signs of hip lesions between MRI and SPECT/CT fusion imaging. Conclusion SPECT/CT fusion imaging and MRI has no markedly difference in the diagnosis of hip benign lesions, and is complementary to each other. SPECT/CT fusion image can distinguish the hip lesions from the femoral head lesions, and has a higher accuracy of diagnosing hip lesions than whole body bone scanning.

Objective To understand the mutation characteristics of drug resistance-associated genes rpoB, katG and inhA in Mycobacterium tuberculosis (MTB) strains using gene chip method, and evaluate its clinical application value. Methods A total of 76 MTB strains were collected from Shijiazhuang area in 2013 to 2014. Gene chip was used to detect the mutations of rpoB, katG and inhA, and the L-J proportion drug susceptibility test was used as the gold standard to evaluate the overall concordance, sensitivity and specificity of gene chip. The consistency of microarray and phenotypic resistance was evaluated by Kappa test. Results Of all the 76 strains detected, 69 harbored mutations in katG/inhA. The predominant mutation site of katG was 315 codon with the mutation rate of 89.9%(62/69), and 5.8%(4/69) carried mutations at inhA-15(C→T), and 4.3%(3/69)carried combined mutations of katG 315 and inhA-15. The rpoB mutations were detected in 73 strains, of which 64.4%(47/73)carried mutations at codon 531, 15.1%(11/73)at codon 526, 12.3%(9/73)at 516 codon, 1.4%(1/73)at 513 codon, 1.4%(1/73)at 533 codon and 5.5%(4/73)had combined mutations. Compared with results from the L-J proportion method, the sensitivity, specificity and concordance rates of gene chip for RFP were 96.1%(73/76), 100%(50/50)and 97.6%(123/126). The sensitivity, specificity and concordance rates of gene chip for INH were 90.8%(69/76), 100%(50/50)and 94.4%(119/126). The sensitivity, specificity and concordance rates of gene chip for MDR-TB were 86.8%(66/76), 100%(50/50) and 92.1%(116/126). Conclusion The predominant mutation loci of MDR strains in Shijiazhuang area are katG315 and rpoB531. Gene chip is a fast and useful tool for clinical diagnosis of MDR strains.

Objective:To study the curative efficacy of budesonide combined with huaiqihuang granules in the treatment of children with asthma and its effects on the serum leukotriene D4(LTD4),nerve growth factor (NGF),tissue inhibitor of metalloproteinase-1 (TIMP-1) levels.Methods:90 cases of children with asthma who were treated from March 2014 to March 2015 in our hospital were selected and divided into the observation group (n=45) and the control group (n=45) according to the random number table.Both groups of children were given bronchial antispasmodic agent,oxygen,antibiotics,glucocorticoid and other conventional treatment after admission,the control group was given budesonide atomization inhalation treatment on the basis of conventional treatment,0.5 mg budesonide were add in 3ml saline for continuous inhalation,twice a day,while the observation group was treated with Huaiqihuang Granules on the basis of the control group,twice a day.After 12 weeks of treatment,the curative effect,disappearance time of wheezing,cough relief,pulmonary rales,wheezing and other symptoms,forced vital capacity (FVC),serum LTD4,NGF,TIMP-1 levels,CD3+,CD4+,CD8+ of both groups were compared.Results:After treatment,the total effective rate of observation group was significantly higher than that of the control group [93.33％(42/45) vs 77.77％(35/45)](P＜0.05);disappearance time of breath,cough,moist rales and wheezes were significantly shorter than those of the control group[(4.32± 1.03)d vs (6.08± 1.24)d,(5.60± 1.12)d vs (7.21± 1.30)d,(3.19± 0.98)d vs (4.98± 1.02)d,(3.25± 1.03)d vs (5.89± 1.35)d](P＜0.05);the FEV1,FEV1/FVC were significantly higher than those of the control group [(92.63± 10.01)L/s vs (78.36± 9.19)L/s,(95.37± 11.72)％ vs (80.19± 10.23)％](P＜0.05);the serum LTD4,NGF,TIMP-1 levels were significantly lower than those of the control group [(7.24± 0.86)ng/mL vs (12.68± 1.01vng/mL,(68.18± 9.01)pg/mL vs (80.78± 10.24)pg/mL,(34.16 ± 5.06)ng/mL vs (49.76 ± 5.47)ng/mL] (P ＜0.05);the CD3+,CD4+ were significantly higher than those of the control group [(66.15± 7.20)％ vs (62.03± 6.85)％,(45.13± 7.90)％ vs (37.42± 7.06)％],CD8+ was significantly lower than that of the control group[(34.16± 5.06)％ vs (49.76± 5.47)％] (P＜0.05).Conclusion:Budesonide combined with Huaiqihuang granules was effective for children with asthma,which could enhance the immune function,improve the lung function,reduce the serum levels of LTD4,NGF,TIMP-1.

Objective To evaluate the trend in prenatal diagnosis of single gene disorders (SGD) and role ofmultidisciplinary cooperative mode.Methods In January l,2012,amultidisciplinarycooperativemode for SGD diagnosis was established in the Peking University First Hospital,involving Departments of Obstetrics,Pediatrics,Neurology,Dermatology and Central Laboratory.For each pregnant woman with a family history of SGD for prenatal diagnosis,propositus should be diagnosed in the relevant departments,and then further diagnosed,managed and followed up by the Obstetrics Department.Up to December 31,2014,of 6 681 women for prenatal diagnosis,279 women had a family history of SGD:76 of them received chorionic villus sampling (CVS) at 11-14 gestational weeks,and 203 received amniocentesis (AC) at 16-22 gestational weeks.The trend in SGD diagnosis and the safety of CVS and AC were analyzed using Chi-square test.Results The proportion of SGD family history in AC group was 3.2％ (203/6 355),which stayed stable with 2.3％ (47/2 054) in 2012,3.9％ (78/2 023) in 2013 and 3.4％ (78/2 278) in 2014,and there was no significant difference between 2013 and 2014 (x2=0.571,P=0.463).In CVS group,the proportion of SGD family history was 23.3％ (76/326),showing an increasing trend with 18.2％ (8/44) in 2012,17.6％ (19/108) in 2013 and 28.2％ (49/174) in 2014,and there were significant differences between 2013 and 2014 (x2=4.067,P=0.046).The proportion of SGD family history in CVS group was higher than in AC group in year 2012,2013 and 2014 (x2＝42.626,44.531 and 201.400,all P=0.000).Among the 279 cases of SGD family history,no complications and adverse outcome were observed except an intra-uterine fetal death occurring 6 months after CVS in one woman,but 3 fetuses were found to have chromosome anomalies with one trisomy 18,one 45,X,and one mosaicism of 45,X/46,XY which was determined to be normal by AC.Conclusions SGD family history is one of the important indicators in prenatal diagnosis,and CVS is feasible for prenatal diagnosis of SGD family history as early as in the first trimester.Multidisciplinary cooperative mode is helpful in SGD family history diagnosis.

0.05).We did not find any difference of the expression of fibronectin,laminin and type IV collagen in them.Expression of ICAM and VCAM were(56.4?14.8)% and(55.6?12.2)%,respectively,obviously higher than those in control group(P

Objective To investigate the incidence of gestational diabetes mellitus (GDM) and perinatal outcome in Beijing in 2013. Methods Fifteen hospitals in Beijing were selected by systematic and cluster sampling method. Clinical data of 15 194 pregnant women who attended prenatal care and delivered in these hospitals between June 20 and November 30, 2013 were collected. And 2 987 pregnant women were diagnosed with GDM (GDM group), and 11 999 had no diabetes (non-GDM group). The incidence of GDM, perinatal outcome and complications in mother and infant were compared between the two groups. Two independent samples t-test and Chi-square test were used for statistical analysis. Results The incidence of GDM in Beijing was 19.7%(2 987/15 194). The average age was much higher in GDM group than in non-GDM group [(29.4±4.5) vs (28.0±4.2) years, t=285.705, P<0.05]. The pre-pregnancy weight was much higher in GDM group than in non-GDM group [(59.5±10.2) vs (56.1±8.6) kg, t=352.565, P<0.05]. The incidence of GDM in pre-pregnancy overweight and obese women [29.9%(664/2 230) and 38.8%(250/664)] was much higher than in normal pre-pregnancy weight and low pre-pregnancy weight women [18.0%(1 777/9 890) and 12.9%(273/2 118)] (χ2=296.843, P<0.05). The incidence of GDM in pluripara was higher than in primipara [21.2% (910/4 298) vs 19.4%(2 077/10 688),χ2=5.813, P<0.05]. The incidence of GDM in gradeⅢhospitals was higher than in grade Ⅱ hospitals [21.1% (1 654/7 849) vs 18.7% (1 333/7 173), χ2=13.440, P<0.05]; and the incidence in urban areas was higher than in rural areas [21.3%(2 028/9 521) vs 17.1%(896/5 249),χ2=39.137, P<0.05]. The rate of cesarean section was 47.1%(1 407/2 987) in GDM group, significantly higher than in non-GDM group [39.8% (4 782/11 999)] (χ2=72.204, P<0.05). The incidences of preterm labor [7.3%(217/2 987)], hypertensive disorders [6.3%(185/2 987)], large-for-gestational-age infants [9.2%(275/2 987)], macrosomia [9.5%(283/2 987)] and neonatal ward admission [8.6%(258/2 987)] were all significantly higher in GDM group than in non-GDM group [5.7%(686/11 999), 3.9%(454/11 999), 5.8%(694/11 999), 7.2%(861/11 999), and 6.5%(778/11 999), respectively] (χ2=10.117, 34.371, 79.378, 20.346 and 17.236, respectively, all P<0.05). Conclusions The incidence of GDM is still high in Beijing, and advanced maternal age and pre-pregnancy overweight or obesity are high risk factors for GDM. The rate of preterm labor, hypertensive disorders, and macrosomia in GDM group is higher than in normal fasting glucose group. Systematic obstetric care for GDM should be intensified in Beijing.

ObjectiveTo investigate the influence of pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) on lipid variations of first and third trimester.MethodsA retrospective analysis was conducted on 2 593 singleton pregnant women without diabetes from 15 hospitals in Beijing from June 20 to November 30 in 2013. Serum lipid levels were determined in all of these women at the first trimester (<14 weeks) and the third trimester (≥28 weeks). Demographic data and medical information were collected individually through questionnaires. The recruited gravidas were divided into normal pre-pregnant BMI group (BMI<25) and pre-pregnant overweight and obese group (BMI≥25) according to recommendations of the Institute of Medicine (IOM). Based on the same recommendations on normal GWG, the pregnant women in the two groups were further assigned to two subgroups including normal GWG and over GWG group. The serum lipid levels in both first and third trimester and the increases from first to third trimester were compared between the normal and abnormal BMI groups with two independent samplet-test.Results(1) The levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C) in the third trimester were all significantly higher than those in the first trimester in the normal BMI group [(6.47±1.17) vs (4.63±0.80), (3.14±1.19) vs (1.22±0.70), (1.94±0.44) vs (1.85±0.49) and (3.56±1.00) vs (2.29±0.67) mmol/L,t=-61.250,-65.909,-6.448 and-49.952, allP<0.01]. And the same results were shown in the abnormal BMI group [(6.20±1.14) vs (4.75±0.88), (3.31±1.20) vs (1.44±0.70), (1.86±0.44) vs (1.65±0.37) and (3.30±0.89) vs (2.51±0.82) mmol/L, t=-18.756,-25.165,-6.905 and-12.191,allP<0.01]. Significant differences were identified between the normal and abnormal pre-pregnant BMI groups both in first and third trimester (allP<0.05). (2) The increases of TC from early to late pregnancy in the abnormal BMI group was lower than that in the normal BMI group [(1.45±1.01) vs (1.84±1.02) mmol/L,t=6.664,P<0.01], but the increase of HDL-C was higher [(0.21±0.39) vs (0.09±0.51) mmol/L,t=-4.301,P<0.01]. (3) In the normal BMI group, the increase of TC and HDL-C between the third and the first trimester was lower in the over GWG subgroups than in the normal GWG subgroups [(1.77±0.96) vs (1.89±1.05) mmo/L,t=-2.802,P=0.005; (0.06±0.41) vs (0.12±0.58) mmo/L,t=-2.588,P=0.010], but the increase of TG was higher [(2.00±1.07) vs (1.86± 1.18) mmo/L,t=3.015,P=0.003]. While in the abnormal BMI group, smaller increase of HDL-C was found in the over GWG subgroup than in the normal GWG subgroup [(0.17±0.35) vs (0.29±0.44) mmo/L,t=-2.664, P=0.008].ConclusionsThe lipid levels during pregnancy are significantly higher in late pregnancy than in early pregnancy. Pre-pregnancy BMI has much more effect on lipid variations during pregnancy than GWG, which primarily affect the lipid levels of women with normal pre-pregnancy BMI.