Objective To investigate the expression and significance of Toll-like receptors-4 in peripheral blood and placental tissue in gestational diabetes mellitus (GDM) patients.Methods From February 2013 to February 2015.a total of 30 cases of gestational diabetes mellitus patients(GDM group) and 30 cases of normal pregnant people(health group)were selected as research objects.Peripheral blood and placental tissue of two groups were collected.The expression of TLR4 mRNA in peripheral blood mononuclear cells was detected by RT-PCR,the expression of TLR4 protein in placenta tissue was detected by immunohistochemistry.Results The expression of TLR4 mRNA in peripheral blood mononuclear cells of the observation group was significantly higher than that of the health group[(0.63±0.12) vs.(0.32±0.07)],the difference was statistically significant(t=12.223,P<0.05).The expression of TLR4 in villous trophoblast cells,decidual cells and amniotic epithelial cells in GDM group was significantly higher than that in the health group(Z=2.325,2.374,2.162,P<0.05).Conclusion The expression of TLR4 in peripheral blood mononuclear cells,villous trophoblast cells and decidual cells in gestational diabetes mellitus patients significantly enhanced,suggesting that TLR4 might be related to the e gestational diabetes mellitus.

BACKGROUND:Pressure sensitive instrumented shoes are fast and easily used tools to measure ground reaction forces. Currently researches about the utilities of these systems in assessment of gait in children with neurological diseases have been started to run.OBJECTIVE: To find the gait characteristics of dynamic plantar pressure in children with spastic cerebral palsy. DESIGN: A cross-sectional study.SETTINGS: Department of Rehabilitation, Songgang People's Hospital; Department of Rehabilitation, Shenzhen Children's Hospital; Department of Rehabilitation Medicine, the First Affiliated Hospital of Sun Yat-sen University. PARTICIPANTS: ① Patient group: Twenty children with spastic cerebral palsy were selected from Shenzhen Children's Hospital from May 2004 to April 2005, including 9 boys and 11 girls, aged 26-66 months old, and they all could walk for more than 10 m independently. ② Normal control group: 52 healthy children with normal walking ability were enrolled, including 28 boys.and 24 girls, aged 35-76 months old.METHODS: Ultraflex gait analysis system was used to perform continuous plantar pressure tests of both groups of children. Diagram and data of dynamic plantar pressures in gait were recorded and analyzed with a computer. MAIN OUTCOME MEASURES: ① 10 sequential gait cycles were chosen from the continuous stable steps to calculate the average data with the software; ② Differences of the characteristic parameters of plantar pressure curve between the two groups.RESULTS: ① The curves of plantar pressure to time of testees in the normal control group were of the wave shapes with two peaks and one valley. Half of the CP children could not perform the two-peak shape pressure curve in the gait analysis. One kind of abnormal plantar pressure curve style was a wave shape with only one peak. Another kind of abnormal plantar pressure curve style was a shape showing asymmetry between sides and variation in different steps even in the same side. Two-peak shapes of dynamic plantar pressure were recorded in 10 CP children. ② Characteristic parameters picked up from the curves of plantar pressure had been compared between the two groups. Significant difference have been found in ts of both sides and tz1,tz2,tz3 on the right side between the two groups. It was shown that the single-limb support time of both sides in the CP children was longer than that in healthy children [left: (0.879± 0.658), (0.472±0.051) s; right: (0.818±0.682), (0.478±0.050) s; P ＜ 0.01]. The tz1 and tz3 on the right side in the CP children were longer and while the tz2 was shorter than those in the healthy children. CONCLUSION: ① Using dynamic plantar pressure gait analysis system, plantar pressure curves can be observed directly, and information about kinetic characters can be drawn straightly. ② Part of patients with spastic CP could not perform the two-peak shape pressure curves in gait analysis. In patient can be recorded of two-peak shape dynamic plantar pressure curves, ts of both sides are shorter than those in healthy children, tz1 and tz3 on the right side is longer and tz2 is shorter than those in healthy children.

Objective To explore the relationship between dopaminergic axon terminal and GABAergic neurons and explore the neuroanatomic mechanism of their effects in schizophrenia. Methods The co-location and the association of dopaminergic axon terminal and GABAergic neurons in the basolateral nucleus (BL) of rat amygdala were examined by using double labeling immunoelectron microscopic techniques. Dopaminergic axon terminal and GABAergic neurons were labeled with the antidopamine (anti-DA) and the anti-glutamic acid decarboxylase (anti-GAD) antibodies respectively. Results 43% of the DA-input synapses was observed to relate directly or indirectly to GAD-immunoreactive(IR) dendritic structures(DA/GAD), which includes single (38%), convergent (30%), serial (20%), and axoaxonic (12%) contact types.And 57% of the DA-input synapses was found to associate with unlabeled elements (DA/UE), which includes unlabeled perikarya (10%), dendrites (82%) and axons (8%). All of the synapses that show DA-IR terminals profiles were found to be symmetric (inhibitory) synapses.Conclusion These results suggest that the dopaminergic system in the BL of rat amygdala controls the mediations of the GABAergic interneurons via symmetric synapses. In addition, the dopaminergic axon terminal associates with the glutamatergic projection neurons and exerts influence on its activity.

Aim To investigate the effect of CD44 anti-body-A3 D8 on the expression of IL-3 Rα and down-stream PI3K/Akt in NB4 cells. Methods The ex-pression of IL-3 Rα mRNA was detected by real-time quantitative RT-PCR, the IL-3Rα protein expression and changes of PI3 K/Akt signal pathway in NB4 cells treated with A3D8 were analyzed by Western blot. An-nexin-V-FITC/PI double staining flow cytometry was u-tilized to detect the apoptotic cells. The inhibitor of PI3 K/Akt signaling LY294002 combined with A3 D8 was used to inhibit the PI3K/Akt in NB4 cells. Re-sults After treated with A3 D8 , both the transcription-al level and translational level of IL-3 Rα were remark-ably reduced, and the PI3K/Akt pathway was inhibi-ted. LY294002 improved the inhibitory and apoptotic effects of A3D8 on NB4 cells. Conclusion CD44 antibody A3 D8 can downregulate the expression of IL-3Rα and inhibit the downstream PI3K/Akt pathway.

Objective To explore the differences of patient comfort and nursing workload between ultrasound guidance on upper arm placement of PICC and traditional placement of PICC, and to provide a reference for correct selection of catheter way. Methods Using a nonrandomized controlled study, a total of 1 116 patients were divided into the control group and the observation group, patients with traditional placement of PICC were set as the control group, and the patients with upper arm placement of PICC were named as the observation group. The patient comfort and workload of use and maintenance of PICC by nurses were compared between two groups. Results The incidence of catheter sliding out of PICC in the observation group was 1.9%(7/365), obviously higher than that of the control group, which was 0.3%(2/751), the difference was significant (χ2=8.37,P=0.007). The patient comfort had no statistical significance between two groups (t=2.13,P=0.082). The workload of use and maintenance of PICC in the observation group were (1.87±0.31) min and (9.16±1.07) min ,which were obviously higher than that of the control group [(0.85±0.16) min and(7.22±2.13) min] in winter (t=4.39, P=0.022;t=3.44, P=0.041), but there was no statistical significance between two groups in summer (P>0.05). Conclusions The workload of use and maintenance of PICC on upper arm placement was higher than traditional placement of PICC in winter, but the obvious differences of patient comfort and nursing workload in summer between the two PICC groups were not been found.

Objective To compare the efficacy and safety between Chinese generic imatinib (Xinwei(R),Jiansu Hansoh Pharmaceutical Group Co.,Ltd.) versus branded imatinib (Glivec(R),Novartis) in patients with newly-diagnosed chronic myeloid leukemia in chronic phase (CML-CP).Methods Patients with newly diagnosed CML-CP were enrolled and assigned to receive either Xinwei or Glivec at an initial dose of 400 mg/d according to patients' financial capability.The efficacy and adverse effects were evaluated.Results From January 2014 to September 2015,145 eligible patients were assigned to Xinwei (n =89) or Glivec (n =56) group.All patients were treated and followed up at least 3 months.At 3 months,the complete response rates were 95.5％ (85/89) and 100％ (56/56),major cytogenetic response rates were 74.2％ (66/89) and 80.4％ (45/56),and the proportions of achieving BCR-ALBIS ≤ 10％ were 76.1％ (67/88) and 82.1％ (46/56) in Xinwei and Glivec groups respectively (all P ＞0.05).With a median follow-up of 12 months,2 patients in each group progressed to accelerate or blast phase.Hematologic and non-hematologic side effects were similar between the 2 groups.Conclusions Early hematological,cytogenetic and molecular responses between Xinwei and Glivec are comparable in newly-diagnosed CML-CP patients.The progression rate and side effects are also similar between the 2 groups.

Objective To investigate effects of neuromuscular electrical stimulation (NMES) on pulmonary arterial hypertension induced by chronic hypoxic hypercapnia in rats.Methods Eighteen male Sprague-Dawley rats were randomly divided into a normal control group (the control group),a hypoxic hypercapnia group (the model group),and a hypoxic hypercapnia + NMES group (the NMES group),each of 6.The rats in both the model and NMES groups were placed in an isobaric cabin with an O2 concentration of 9％ to 11％ and a CO2 concentration of 5％ to 6％ for 8 hours a day for 4 weeks.After leaving the cabin,NMES was performed on the NMES group's bilateral calf muscles for 30 minutes every day.The heart was removed,and the right ventricle (RV) and the left ventricle plus the septum (LV+S) were dissected.An index of right ventricular hypertrophy was calculated as RVHI=RV/(LV+S).Any changes in the pulmonary vasculature were observed using an optical microscope.WT％ and WA％ were calculated.The expression of hypoxia-inducible factor-1α (HIF-1α),PDH-E1α and PDK1 in the lung tissue were determined using western blotting.The LDH activity and the concentration of PDH in the lung tissue homogenate were measured was measured by spectrophotometric method using the LDH assay kit and ELISA,respectively.Results Compared with the control group,the average RVHI,WT％ and WA％,the protein expression of HIF-lα and PDK1,and LDH activity had all increased significantly in the NMES group,while the average expression of PDH-1Eα had decreased significantly.Compared with the model group,significant decrease was observed in the average RVHI,WT％,WA％,protein expression of HIF-1α and PDK1,and LDH activity in the NMES group,but the average expression of PDH-1Eα increased significantly.No significant differences in PDH concentration were detected among the 3 groups.Conclusions NMES may alleviate pulmonary artery hypertension induced by chronic hypoxic hypercapnia,at least in rats.The mechanism may be attributed to inhibiting the expression of HIF-1α protein,which may inhibit the activity of PDH-E1α and LDH,then the aerobic metabolism into glycolysis,finally improving the remodeling of the pulmonary vascular structure.

Objective:To explore the effect of remote ischemic post-conditioning (RIPoC) on oxidation/reduction response, energy metabolism and inlfammatory reaction of ischemic myocardial tissue in rats with ischemic reperfusion (IR) injury.
Methods:IR model was established by 30 min left anterior descending (LAD) artery occlusion followed by 120 min reperfusion, conditioning was defined as 3 cycles of 30 seconds ischemia followed by 30 seconds reperfusion in adult rats. The rats were divided into 5 groups:①ischemic pre-conditioning (IPC) group, the rats received the conditioning prior to IR treatment,②ischemic post-conditioning (IPoC) group, the rats received 30 min LAD occlusion followed by conditioning at the beginning of 120 min reperfusion, ③ remote ischemic post-conditioning(RIPoC) group, the rats received 30 min LAD occlusion, followed by femoral artery conditioning at the beginning of 120 min reperfusion, ④ IR group, ⑤ Sham group. n=8 in each group.Ischemic myocardial tissue was collected at the end of experiment, superoxide dismutase (SOD) activity was assayed by xanthine oxidase method,malondialdehyde (MDA) content was examined by thiobarbituric acid method, myeloperoxidase (MPO) activity was determined by chemistry colorimetric method, adenosine triphosphate(ATP)amount was measured by bioluminescence method;expressions of myocardial stromal cell derived factor-1 (SDF-1) and vascular endothelial growth factor (VEGF), mitochondrial function related genes Ndufa2, Ndufa4, Cox4il and Cox7a2 were evaluated by real time quantitative PCR.
Results:In IPC, IPoC and RIPoC groups, the ischemic myocardial tissue had increased SOD activity and ATP amount, decreased MDA content and MPO activity; induced expressions of SDF-1, VEGF, mitochondrial function related genes Ndufa2, Ndufa4, Cox4il and Cox7a2.
Conclusion:RIPoC may increase anti-oxidation/reduction response, protect energy metabolism and reduce inlfammatory reaction in ischemic myocardial tissue, the effect was similar to pre-conditioning and post-conditioningin rats with IR injury.

Objective To explore the influence of group B Streptococcus screening during pregnancy and the incidence of the ear‐ly‐onset GBS disease for newborns .Methods Totally 47 cases of pregnant women with premature rupture of membranes (PROM ) , which were GBS positive and accepted antibiotic treatment ,who were chosen as the experimental group .While 73 cases of pregnant women with premature rupture of membranes (PROM) ,which were not accept GBS screening and antibiotic treatment ,were chosen as control group .The neonatal clinical manifestations were observed .The swab specimens were collected from throat and detected of GBS by using PCR method .Results The experimental group showed no occurrence of neonatal group B streptococcal infection , dyspnea ,cyanosis and fever .Totally 7 cases of the control group had group B Streptococcus infection .Totally 2 cases had dyspnea and 2 cases had cyanosis .Totally 4 cases had fever .The neonatal research indicators of these two groups were statistically signifi‐cant differences (P<0 .05) .Conclusion The group B Streptococcus screening during pregnancy would effectively reduce the inci‐dence of neonatal infection of group B Streptococcus .

Objective To investigate the status quo of social support and effective disorder nurses perceived in the operating room and analyze the correlation between them. Methods A total of 200 nurses in the operating room of four general hospitals in Guangxi Zhuang Autonomous Region were enrolled to investigate the social support and the effective disorders using the perceived social support scale (PSSS) and Toronto Alexithymia Scale (TAS). Results The total scores by PSSS and TAS were (66.08 ± 10.64) and ( 53 . 85 ± 8 . 89 ) , respectively . The scores by PSSS and its dimensions were all negatively correlated with the score by TAS ( r=-0 . 492 , P < 0 . 05 ) . Conclusions The nurse-perceived social support is generally at the medium or above level and their affective disorder at a lower level. The nursing managers should pay attention to the nurses in the operating room, taking corresponding measures to improve their affective disorder and improve the quality of nursing.