Objective To investigate the changes of serum levels of sex hormone binding globulin (SHBG),free testosterone index (FTI) and insulin resistance; and to investigate the relationship among them and prevalence of gestational diabetes mellitus (GDM) and hypertensive disorder complicating pregnancy (HDP) in polycystic ovarian syndrome (PCOS) women during pregnancy. Methods Serum samples of 32 PCOS women and 32 non-PCOS women were collected during their gestational age from 12 to16 weeks.Serum levels of total testosterone,SHBG and insulin were detected.Free testosterone index (FTI) and homeostasis model assessment for insulin resistance (HOMA-IR) were calculated.Risk factors of GDM and HDP were analyzed by stepwise logistic regression.Data of two groups were compared with t test or Chi square test. Results Serum fasting insulin [(8.0±1.5) mU/L vs (7.1±1.5) mU/L,t=2.32,P＜0.05],FTI [0.96 (0.52-1.41) vs 0.61 (0.40-0.79),t=3.02,P＜0.05],HOMA-IR levels [1.53±0.32 vs 1.36±0.36,t=2.04,P＜0.05] and total testosterone [2.95 (1.61-4.40) nmol/L vs 2.15 (1.50-2.80) nmol/L,t=2.55,P＜0.05] were higher in PCOS group than in control group; and SHBG level [325 (312-355) nmol/L vs 360 (347-373) nmol/L,t=4.13,P＜0.05] was lower in PCOS group than in control group.Cesarean section rate (84％ vs 50％,x2 =8.58,P＜0.01) and HDP incidence (25％ vs 3％,x2=4.65,P＜0.05) were higher in PCOS group than in control group. SHBG level [(293 ±42) nmol/L] of PCOS women who complicated with GDM (n=6) was significantly lower than that [(333±40) nmol/L] of those who did not (n=26),t=2.22,P＜0.05.Serum total testosterone [(4.34±1.29)vs (2.49±1.44) nmol/L,t=3.23,P＜0.05] and FTI [1.42±0.52 vs 0.81±0.59,t=2.61,P＜0.05] were significantly higher in PCOS women complicated with HDP (n=8) than those of the PCOS women who did not (n=24).Stepwise logistic regression analysis showed that SHBG was the risk factor of GDM (OR=0.98,95％CI:0.96～1.00,P＜0.05); FTI was the risk factor of HDP in PCOS women (OR=5.53,95％CI:1.20～25.61,P＜0.05). Conclusions FTI and SHBG levels could be predictors for GDM and HDP in PCOS women during their pregnancies.

Objective To explore the imaging characteristics of pigmented villonodular synovitis(PVNS) of knee joint.Methods X-ray,CT and MR imaging features of PVNS of knee confirmed by operation,arthroscope and pathology were retrospectively analysed with literatures review.Results X-ray could only show the swelling of the joint cpasules,the destruction,defect and sclerosis of the bone under the articular surface.CT could show the soft tissue nodules in joint cavity projected from joint capsule.MRI was sensitive in showing the thickened synovium of joint and joint effusion,the soft tissue nodules and thickened synovium of joint were iso-or low signal intensity on T1WI,isointensity in one and low or slight hyperintensity in 4 on T2WI.Multiple haemosiderin deposit nodules were seen in the thickened synovium,which were low signal intensity on T1WI and T2WI in 4 cases,and the nodules were enhanced obviously on contrast-enhanced MR images.Conclusion MRI possesses obviously in diagnosis of PVNS of knee joint than X-ray and CT,which is helpful in diagnosis and differential diagnosis of PVNS of knee joint.

OBJECTIVE To explore uticozation of nursing care in the operating room disinfection and isolation management. METHODS The nurses and doctors operating room were selected as the observers. Obsening in the operating room for 30-60 min, and recorded the results. After the guidance of the staff discussed to address the problem. RESULTS From June 2006 to June 2008, observed in disinfection and isolation problems of operating room management. The measures include 45 long-term plan, measures need to improve the implementation. To continue to reduce the existing problems, the increasing outstanding operation; Operating room working environment, surgical sterilization materials, sterile technique quality control inspection pass rate in 2006 from the third quarter of 94.2%, 97.1%, 95.1% to 2008 second quarter of 100.0%, 100.0%, 99.8%. CONCLUSIONS The meause can improve the initiative to participate in the management increase the communication between the department and surgery, disinfection and isolation technology improve the quality of management effectiveness. Disinfection and isolation of the operating room are needed to ensure the effectiveness of management to prevent nosocomial infection.

Objective To assess the behavior of children with tic disorder (TD),and to analyze the behavioral characteristics among children with TD at different clinic conditions.Methods Sixty-three children with TD were evaluated with Child behavior checklist (CBCL).ANOVA and t-test were used to analyze the difference in the total and individual scores of CBCL in the children classified according to the different clinical types,the severity of TD,and comorbid attention-deficit hyperactivity disorder(ADHD).Results There were no significant differences among the total and individual scores of CBCL in the patients of the different clinic types( P ＜ 0.05 ) ;the scores of body complain in the patients in moderate to severe conditions (4.15 ± 2.34) were higher than that of those in mild condition ( 2.68 ± 2.22 ) ( t =- 2.540,P =0.014) ; the scores of attention problem (9.94 ± 3.57 ),disciplinary offence ( 3.94 ± 3.06 ),aggressive behavior ( 15.39 ± 5.12 ),exportoriented behavior problems ( 13.98 ± 7.34)and behavior problem (47.89 ± 17.51 )in TD comorbid ADHD were higher than in simple TD group ( 7.31 ± 3.34,2.44 ± 2.22,7.24 ± 4.93,9.78 ± 6.55,37.07 ± 17.98 ) ( t =- 2.774,- 2.166,- 1.930,- 1.956,- 2.174,P =0.007,0.034,0.048,0.04 1,0.034 ).Conclusion Children with TD at different clinical conditions have varied behavioral problems and behavioral characteristics,while comorbid ADHD is the most significant factor to affect TD patient's behaviors.

significantly increased (all P < 0.01). Following SREBP-1 was down-regulated by siRNA, high glucose-stimulated TGF-β1 and FN protein expressions were decreased by 17.9% and 24.6% ,respectively(all P<0.01).

Objective: To study the value of speckle tracking echocardiography (STE) for assessing left ventricular remodeling (LVR) in patients of acute ST-elevation myocardial infarction (STEMI) with late percutaneous coronary intervention (PCI). Methods: A total of 127 STEMI patients with elective PCI were enrolled. Echocardiography was conducted within 48 hours of admission and the patients were followed-up for 6-9 (median 7.8) months after discharge. LVR was deifned by left ventricular end-systolic volume (LVESV) elevation >15% than the ifrst echocardiography. The patients were divided into 2 groups: LVR group,n=41 and Non-LVR group,n=84. Results: There were significant differences between 2 groups in left ventricular global longitudinal strain (GLS), longitudinal Ts-SD, radial strain (RS) and longitudinal postsystolic index. Further Logistic regression analysis indicated that GLS (OR=0.39, 95% CI 0.26-0.57,P<0.01) and RS (OR=1.07, 95% CI 1.02-1.13,P=0.01) were the independent predictors for LVR occurrence; ROC presented that the optimal cut-off value for GLS was -10.85% (sensitivity 89.7%, specificity 91.7%) and for RS was 28.46% (sensitivity 82.1%, speciifcity 66.7%). Conclusion: STE measured GLS and RS were the independent predictors for LVR occurrence in STEMI patients with late PCI.

Objective: To evaluate left atrial (LA) function and synchrony in lone atrial fibrillation (LAF) patients by two-dimensional speckle tracking echocardiography (2D-STE) and to explore the predictive value of 2D-STE parameters for AF recurrence after ablation procedure. Methods: Our research included in 2 groups: LAF group,n=50 patients diagnosed in our hospital from 2013-06 to 2015-05; it was further divided into 2 subgroups as Non-LA enlargement subgroup,n=34 and LA enlargement subgroup,n=16 and Control group,n=35 healthy subjects. With sinus rhythm, 2D-STE was conducted to obtain LA peak ventricular systolic longitudinal strain (PALS), strain rate (SRs) and atrial contraction longitudinal strain (ACLS), strain rate (SRa). Standard deviation for the time to peak (TPSD) of regional strain was calculated. TPSD during ventricular systole was named as SDs and TPSD during ventriculardiastole was named asSDa. Results: Compared with Control group, LAF group had reduced PALS (28.34±8.57) vs (38.73±6.13), SRs (1.17±0.31) vs (1.57±0.25), ACLS (14.11±4.91) vs (18.86±3.57 ) and SRa (-1.41±0.58) vs (-1.90±0.30), allP<0.05; while elevated SDs (8.11±3.00) % vs (4.67±1.48) % and SDa (5.57±2.26) % vs (3.11±1.13) %, bothP<0.05. Furthermore, Compared with Control group, Non-LA enlargement subgroup had decreased PALS, SRs, ACLS and SRa, allP<0.05; while increased SDs and SDa, bothP<0.05. Logistic regression analysis indicated that compared with traditional parameters, SDs and SDa could more effectively distinguish LAF patients from normal subjects (SDs with the sensitivity 83%, speciifcity 72% and SDa with the sensitivity 81%, speciifcity 76%). Elevated SDa and SDs were the best predictors for post-operative AF recurrence (SDs with the sensitivity 80%, speciifcity 71% and SDa with the sensitivity 86%, speciifcity 79%). Conclusion: 2D-STE may detect LA dysfunction and dyssynchrony in LAF patients, abnormal parameters could be found in LAF patients without LA enlargement. SDs and SDa were the best predictors for post-operative AF recurrence.

Objective:To investigate the effects of moxibustion on the serum metabolism in healthy human body based on the 1H nuclear magnetic resonance (1H NMR) metabolomics technology, and to find the differences in metabolites, as well as to elucidate the effects of moxibustion on healthy human body from the viewpoint of global metabolism. Methods:Sixty subjects of healthy young men from the enrolled students were randomly divided into a moxibustion group and a control group using random number table, with 30 cases in each group. Subjects in the moxibustion group accepted mild moxibustion on the right Zusanli (ST 36), once a day, 15 min for each time, and continuous treatment for 10 d; those in the control group did not receive any intervention. There were 28 cases in the moxibustion group and 23 cases in the control group after interventions. On the 1st day, 5th day and 10th day of the intervention, serum samples were collected from subjects of the two groups, and metabolic spectra were obtained by the1H NMR technology. Results: Before and after the intervention, serum1H NMR of the moxibustion group was significantly different, while the difference was insignificant in the control group. Metabolite changes in the moxibustion group were mainly in low density lipoprotein (LDL)/very low density lipoprotein (VLDL), valine, isoleucine, leucine, lactic acid, glutamine, citric acid, polyunsaturated fatty acids, creatine, glycine, glycerol, glucose, tyrosine, histidine, formic acid, alanine, lysine, acetic acid, and glutamic acid. Conclusion:Moxibustion can cause changes of serum metabolic patterns in healthy human by influencing the concentrations of branched-chain amino acids, polyunsaturated fatty acids, and other metabolites to strengthen body's metabolisms of amino acids and fatty acid.

Under the background of technological assistance to prepare for the Beijing Winter Olympics in China, the biomechanical research highlights and the latest achievements related to competitive performance of alpine skiers in recent years were systematically analyzed in this paper, so as to determine biomechanical factors affecting competitive performance of alpine skiers, including aerodynamic drag, frictional forces, ground reaction force (GRF), energy dissipation, turn radius, trajectory of the skis and/or center of mass (COM). In addition, biomechanical differences in turn techniques, multiple turns connections and abilities of individuals were also considered as important factors affecting the alpine skiing performance. In the case of slalom and giant slalom events, the earlier initiation of turns, longer path length and trajectory, earlier and smoother application of GRF, and carbene technique carving to reduce the ski-snow friction and thereby dissipate energy should be used to improve sports performance. During speed skiing, minimizing the exposed frontal area and positioning the arms close to the body can reduce the energy loss caused by aerodynamic drag, thereby improving sports performance. Top-level alpine skiers will always perform well on different courses, terrains and snow conditions during the race. Excellent alpine ski performance from a biomechanical perspective includes the efficient use of potential energy, minimizing ski-snow friction and aerodynamic drag, choosing optimal trajectory and maintaining high-speed skiing. Individual tactics and techniques should be valued in training and competition. For better results, the same performance on multiple sections and on different terrains is more important than excellence in individual sections and specific conditions.

Objective:To analyze the vascular distribution of palmar digital arteries in syndactyly through color Doppler ultrasound angiography and make the classification according to the level of artery bifurcation points, discusse its clinical significance.Methods:A retrospective analysis was performed for the data of children with congenital and digital malformations admitted to Wuxi Ninth People’s Hospital from January 2017 to December 2022. Preoperative vascular ultrasonography of the hand was performed to locate the bifurcation point of the common palmar digital artery in the digital webbed area. The vascular conditions were classified according to the distance between the bifurcation point and the 1/3 point of the proximal phalangeal as the reference, such as normal type (<0 mm), mild reduction type (0-5 mm), moderate decrease type (6-10 mm), and severe reduction type (>10 mm), absent type (only 1 artery between the fingers). The total variation of the bifurcation point of the common palmar digital artery in the children, as well as the proportion of different vascular condition subtypes were recorded. According to the classification of blood vessels, the corresponding operation plan was made. The positioning accuracy of color Doppler ultrasound angiography was evaluated based on the gold standard of common palmar digital artery bifurcation points detected during operation. Complications such as postoperative infection, flap necrosis, finger vasospasm and the morphology of finger web at the last follow-up were observed. Descriptive statistical analysis was used.Results:A total of 123 children with 181 finger webs were enrolled, including 72 males and 51 females, aged 10-28 months. There were 55 cases of simple type, 36 cases of complex type (bone) and 32 cases of Poland syndrome. Color Doppler ultrasound angiography showed that the total variation rate of the common palmar digital arterial bifurcation point was 24.3% (44/181), of which 11.6% (21/181) were mildly reduced type, 8.3% (15/181) were moderately reduced type, 3.3% (6/181) were severe reduced type, and 1.1% (2/181) were absent type. The vascular variation rates of simple syndactyly, bony syndactyly, and Poland syndrome were 0 (0/55), 19.5% (7/36), and 41.1% (37/90), respectively. Compared with the actual situation during surgery, the positioning accuracy of color Doppler ultrasound angiography was 100%. All pediatric surgeries were successfully completed, and the flaps and skin grafts survived smoothly. There were no postoperative complications such as infection, vascular crisis, or finger necrosis. All patients were followed up for 6 to 27 months, with an average of 13.5 months. At the last follow-up, the depth, width, and slope of the fingerwebs were all close to normal.Conclusion:Congenital syndactyly has a high variation rate at the bifurcation point of the common palmar digital artery, and bony syndactyly and Poland syndrome refer to the need to improve preoperative vascular evaluation. Color Doppler ultrasound angiography has the advantages of no radiation, high sensitivity and low price, and the vascular typing based on color Doppler can improve the reliable basis for the formulation of clinical surgical plans.