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.

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 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

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 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 investigate the level of self-perceived burden(SPB) and analyze the influencing factors in continuous ambulatory peritoneal dialysis(CAPD) patients.Methods One hundred and ten CAPD patients were investigated by a self-designed demographic questionnaire and Self-Perceived Burden Scale (SPBS).Results The total score of SPBS was (30.27±7.88) points,being in a middle level,and 85.45％ of the patients showed different levels of burden.Single factor analysis showed the influencing factors of self-perceived burden were marital status,family per capita income,the main caregivers and selfcare ability.Conclusions Most CAPD patients have obvious self-perceived burden,nursing staff should use the relevant nursing measures to reduce the SPB with CAPD patients and improve their quality of life.

Objective:To investigate the relationship between college freshman adaptation and adverse childhood events,and to explore the mediating role of personality characteristics.Methods:A sample of 523 college freshmen from a key university in Sichuan Province was assessed with the China College Student Adjustment Scale (CCSAS),Adverse Childhood Events Questionnaire (ACEQ) and Eysenck Personality Questionnaire-Revised,Short Scale for Chinese(EPQ-RSC).Results:The rate of adverse childhood events of college freshmen was 87％ in current study.The total scores of adaptation were negatively correlated with the scores of adverse childhood events influence and neuroticism (r ＝-0.13,-0.51,Ps ＜ 0.01),while positively correlated with introversion-extroversion and lie (r ＝ 0.47,0.25,Ps ＜ 0.01).The scores of adverse childhood events influence were negatively correlated with scores of introversion-extroversion (r ＝-0.08,P ＜0.05) and lie (r ＝-0.12,P ＜0.01),while positively correlated with scores of neuroticism (r ＝ 0.17,P ＜ 0.01).Introversion-extroversion and neuroticism mediated the relationship between adverse childhood events influence and college freshman adaptation,the mediating effects were 51.65％ and 58.10％.Conclusion:College freshman adaptation may be closely associated with adverse childhood events influence and personality characteristics.Personality characteristics may play a mediating role between adverse childhood events influence and adaptation in college freshman.

Objective To analyze the results in neonatal hearing screening,and then to make diagnosis and intervention for neonates with hearing problems as soon as possible.Methods From January 2004 to December 2008,7 064 newborns at Shanghai East Hospital received hearing screening by distortion product oto-acoustic emissions (DPOAE) 2～4 days after birth.Re-screening tests were performed for infants who failed the initial screening 42 days after birth.Those newborns who failed again received further audiologic diagnostic evaluations 3 months afterwards.Results Among 7 064 cases screened,out of 6 412 normal newborns,579 (9.03%)failed the initial screening,and 38 (7.41%)failed re-screening.129 cases of the other 652 (19.79%) newborns in NICU failed the initial screening,and 20 cases (18.69%) failed re-screening.There were statistical differences between the passing rates of the two groups (P