Objective To investigate the relationship between serum 25-hydroxyvitamin D level and gestational diabetes mellitus (GDM).Methods The fasting plasma glucose,fasting insulin,25-hydroxyvitamin D,and high sensitive C-reactive protein (hs-CRP) levels in the normal glucose tolerance group and gestational diabetes mellitus (GDM) group were measured.The homostasis model assessment insulin resistant (HOMA-IR) and homostasis model assessment β cell (HOMA-B) were calculated for assessing the insulin resistance and β-cell function.The relationship between 25-hydmxyvitamin D and hs-CRP,HOMA-IR,and HOMA-B were analyzed.Results The level of 25-hydroxyvitamin D in the GDM group [(2.16 ± 0.38) nmol/L] was significantly lower than that in the normal glucose tolerance group [(4.13 ±0.79) nmol/L](P =0.001).Serum 25-hydroxyvitamin D level was negatively correlated with hs-CRP (r =-0.448,P =0.002) and HOMA-IR (r =0.396,P =0.004),but was positively related with HOMA-B (r =0.495,P =0.001).Conclusions The serum 25-hydmxyvitamin D level remarkably decreases in GDM patients.Vitamin D deficiency may cause the functional damage of beta cell of islet,increase insulin resistance,and thus contribute to the development of GDM.

Objective To explore the efficacy of tentorium cerebelli hiatus incision for treatment of severe brain injury complicated with tentorial herniation. Methods Tentorium cerebelli hiatus incision was performed in 38 patients of severe brain injury with secondary brain stem damage resulted from tentorial herniation after intracranial hematoma evacuation and bone flap craniotomy decompression. The changes of four sides cistern, ambient cistern and interpeduncular cistern before and after operation were observed. Results There was a siginificant difference in the appearance ratio of four sides cistern, ambient cistern and interpeduncular cistern between the preoperation and postoperation(P

It is a trend that clinical researchers overemphasize on hypothesis testing and the P value. However, P value has some limitations in the presentation of study results. Power is a tool for study design and results explanation, especially for negative results. Confidence interval contains more information for clinical results than P value. P value, power, and 95% confidence interval should be provided in the clinical reports to facilitate the interpretation of the results.

Objective To observe the expression of oxidized purine nueleoside triphosphatase MTH2 in the hippocampi of senescence-accelerated mouse P8(SAMP8). Methods Randomly selected SAMP8 and its control strain SAMRl aged 1-,4-,8-and 12-month and performed immunohistochemisry and Western blot analysis to explore the expression changes of MTH2 in the 2 groups of mice. Results The MTH2 protein was detected in cytoplasm and nuclei of neurons throughout the whole hippocampus of SAMRl at all ages.There were no obvious changes of SAMR1 in both CA1 and CA3 subregions,but an age-related decline of MTH2 protein in both regions of SAMP8 was found.The optieal density(OD)value of Cal hippoeampus(0.0473),CA3 hippoeampus (0.0510)were significantly less in 8-month old mice than in the 4-month old[CA1:0.0619,CA3:0.06803(all P＜0.05).By immunoblot analysis,the grey values of MTH2 expression were 0.529,0.313,0.032 in hippoeampus of 4-12 months-old SAMP8 mice,and significantly Iower than in the age-matched SAMR1 mice(all P＜0.05). Conclusions MTH2 deficiency may be a new factor involved in the accelerated aging and in deficits of learning and memory ability in SAMP8.

Objective To compare dosimetrie difference of treatment planning of three-dimensional conformal radiotherapy (3D-CRT) and simplified intensity-modulated radiotherapy (slMRT) for non-small cell lung cancer (NSCLC). Methods Ten NSCLC patients treaded by radiotherapy were investigated. 3D-CRT and slMRT plannings were designed for each patient. The prescribed dose was 60 Gy(2 Gy/f), the 95 % of the planning target volume was received with this dose for each patient. The dose was computed with treatment planning system of ADAC Pinnacle3 using convolution/superpasition algorithm. Two plans were compared according to the homogeneity index (HI) and conformity index (CI) of dosimetry in the planning target volume and the parameters of dose-volume histogram (DVH) in normal tissue. Results In the terms of HI and CI, sIMRT had slight vantages over 3D-CRT. In the terms of DVH, compared with 3D-CRT, mean lung dose, V5, V10 and V20 of slMRT reduced by 14.81 %, 17.88 %, 19.15 % and 27.78 %, respectively. The dosimetric differences were not statistically significant between 3D-CRT and sIMRT in terms of esophagus, heart and spinal cord. Conclusions For NSCLC, sIMRT has some irreplaceable advantages over 3D-CRT and is worth spreading in clinical work.

Objective:To investigate the neuroendocrine properties of adrenalcortical tumors.Methods: We retrospectively reviewed the clinical data of 99 adrenalcortical tumor patients,who were treated in Changzheng Hospital form June 1999 to June 2005.Expression of neuron specific enolase(NSE),chromogranin A(CgA) and synaptophysin(Syn) proteins were examined by immunohistochemistry(S-P method) using monoclonal antibodies.The general data of patients,including the age,symptoms,laboratory findings,and pathological types,were collected and subjected to statistical analysis with SAS v6.12 software.Results: The expression of all the above 3 proteins was found in adrenalcortical adenoma tissues,with the positive rate of NSE being 80%,the positive rate of CgA being 48.9%,and the positive rate of Syn being 75.6%;the positive rates in the adrenalcortical carcinoma tissues were 77.8%,22.2%,and 77.8%,respectively;and those in the normal adrenal tissues was 20%,0%,and 10%,respectively.The positive rates of 3 proteins in adrenalcortical tumors was significantly higher than those in the normal adrenal tissues(P

Objective To assess the application of rosuvastatin control contrast induced acute kidney injury (CIAKI) risk on diabetes mellitus (DM) patients with mild to moderate chronic kidney disease (CKD) and diuretics at high risk.Methods One hundred T2DM patients with mild to moderate CKD scheduled for coronary or peripheral vascular interventional diagnosis selected from May 2013 to June 2015 in endocrinology department of Zhejiang Huzhou Central Hospital and perioperative routine use of diuretics were randomly divided into observation group (51 cases) and control group (49 cases).The observation group received rosuvastatin at draught of night, 10mg per time and needed to take at least 2 times and then performed medical surgery, after surgery, continued to receive rosuvastatin for 3 d, and the total number of days taking rosuvastatin were not less than 5 d;control group not received any statins pre-and post-operation.Results The angiographic site, angiography showed lesions, the proportion of patients with coronary interventional therapy, iodixanol dosage during and preoperative and postoperative levels of SCr and eGFR and other project data between two groups were compared with no significant difference.The CIAKI incidence in observation group was 1.96% (1/51), which was significantly lower than that in control group of 16.33% (8/49) (P<0.05).The clinical follow-up after interventional treatment 30d results showed that secondary end points between two groups groups related to the project data surgery was not statistically significant.There were 2 cases with transaminases elevating, 1 case with rash and 1 case with gastrointestinal reactions, the adverse reactions rate was 7.84% (4/51) and 1 case with gastrointestinal reactions, 1 case with myalgia in control group, the adverse reactions rate was 4.08% (2/49), there was no significant difference between two groups.Conclusion This preliminary study demonstrates that rosuvastatin has the good efficacy on the DM patients with mild to moderate CKD received diuretics at high risk with security, which has the certain significance to control CIAKI.

Objective:To compare bone marrow-sparing intensity-modulated radiotherapy(BMS-IMRT)with conventional (four-field box[3DCRT]and anteroposterior-posteroanterior[CRT])techniques in the treatment of cervical cancer.Methods:For a cohort of 10 patients,BMS-IMRT,3DCRT and CRT planning were designed.The prescribed dose was 45Gy/1.8Gy/25f,95%of the planning target volume received this dose.Doses were computed with a commercially available TPS.Plans were compared according to dose-volume histogram (DVH)analysis in terms of PTV homogeneity and conformity indices(HI and CI)as well as OARs dose and volume parameters.Results:BMS-IMRT had an advantages over 3DCRT and CRT in terms of CI,but inferior to the latter two for HI.BMS-IMRT was superior to 3DCRT in reducing the dose to PBM,small bowel,bladder and rectum.Compared with CRT,BMS-IMRT reduced the volume irradiated to the doses from 30Gy to 40Gy,but increased the volume irradiated to the low doses from 5Gy to 20Gy.In addition,BMS-IMRT reduced the volume of small bowel,bladder,rectum at nearly all dose levels.Conclusion:BMS-IMRT reduced irradiation of PBM compared with 3DCRT technique.Compared with CRT technique,BMS-IMRT reduced the volume of PBM irradiated to high doses.Therefore,for patients with cervical cancer after hysterectomy,BMS-IMRT might reduce acute hematologic toxicity(HT)compared with conventional techniques.

Objective To explore the effect of predictively nursing care for children with congenital large-sized nevus.Methods 142 cases of children with congenital large-sized nevus were treated by surgical resection,based on the principle of voluntary and informed patients,and order of children admitted to hospital were randomly divided into control group and observation group,and the two groups of children were 71 cases.Children in the control group received routine care;children in the observation group received nursing care support.Comparison of the two groups of children with treatment compliance and the satisfaction of paediatric patients' family,postoperative recovery and complicatians were observed.Results Observation group of patients treatment compliance was significantly higher;the difference was significant (P＜0.05).Observation group of children family satisfaction was significantly higher [97.2 ％ (63/71) vs 88.7 ％ (63/71)],the difference was significant (P ＜ 0.05).1,3,6,and 9-month postoperative follow-up was observed in children with recovery of the observation group were better than the control group;the difference was significant (P＜0.05).After nine months the two groups of children were cured.Group of children were observed without serious complications;redness developed in 1 patient in the control group and skin graft necrosis developed in 2 patients.Conclusions Pediatric patients with congenital large-sized nevus with predictively nursing care measures have better clinical efficacy,worthy of promoting.