Objective To evaluate the effect and safety of glibenclamide for gestational diabetes mellitus (GDM).Methods Cochrane Central Register of Controlled Trials (CENTRAL),Medline,EMBASE,Science Citation Index,CNKI,VIP,Wanfang Data,and CBM were searched for the randomized controlled trials (RCTs) of glibenclamide for gestational diabetes from the date of establishment of the databases to March 2013.The bibliographies of the included studies were searched,too.The included studies were evaluated by GRADE.The extracted data were analyzed by Rev-Man 5.1 and GRADEprofiler 3.2.2.Results Five RCTs were included.Effectiveness (such as maternal postprandial glucose,HbA1C) and adverse perinatal outcomes (such as the change of the pregnant women body weight,cesarean section rate,maternal hypoglycemia incidence,birth body length,incidence of hypoglycemia,jaundice,newborn being in the care unit,congenital malformations,stillbirth,and mortality neonatal) showed no differences between glibenclamide (alone or complemented with insulin) group and insulin group (P＞0.05).However,compared with insulin group,higher maternal fasting blood glucose,higher birth weight of newborn infants,and incidence of macrosomia were shown in glibenclamide group.Conclusion Glibenclamide can effectively control maternal blood sugar,and would be a promising alternative therapy for GDM,without adverse effect on fetal growth and development,but with the higher incidence of neonatal macrosomia.Due to the limitations of the included studies,more large-sample,high-quality RCTs are required.

Congresses as Topic ; Medical Staff, Hospital ; organization & administration ; Otorhinolaryngologic Surgical Procedures

Background Retinal ischemia/reperfusion injury is a common pathological process in ophthalmology.It can cause permanent visual impairment.The prevention and treatment of retinal ischemia/reperfusion injury is one of the focus topics at home and abroad up to now.Objective Present study was to evaluate the protective effects of geranylgeranylacetone(GGA)on retinal ischemia/reperfusion injury.Methods The retinal ischemia/reperfusion models were established in 40 SD rats by the infusion of normal saline solution into the anterior ehamber to elevate the intraoeular pressure for 1 hour and then remove the process.GGA of 2 ml (800 ms/kg)was intragastrieally administered in 20 model rats as GGA group,and the equal volume of normal saline solution was used at the same way in other 20 models as model group.Four normal matched SD rats were served as normal control group.The histological changes of retina in 6,24,48,72 hours after modeling was examined by hematoxylin-eosin staining under the light microscope.and the expression of heat shock protein 70(HSP70)and caspase-3 in retina at the time points mentioned above was detected by immunohistochemistry.Results The edema of cornea and retina of rats appeared in 1 hour and peaked in 24 hours after modeling.In 72 hours after modeling,the edema was alleviated but the disorder of retina structure was found in model group.However,although the pathological change process was similar to that of model group,the damage of retina tissue was milder in the rats of GGA group under the light microscope.HSP70 and caspase-3 were absent in the retina of normal rats.But。The expression of HSP70 in retinal ganglion cells(RGCs)was found in 6 hours after modeling,reached peak in 24 hours and declined after that in model group.The numbers of positive cells for HSP70 in retina was significantly increased in various time points in GGA group,showing statistically significant differences between model group and GGA group(P<0.05).In model group,a few of caspase-3 positive cells were found 6 hours after reperfusion and increased gradually until reaching the peak 24 hours and then decreased gradually 48 hours later.Few caspase-3 positive cells were found 72 hour8 after reperfusion.The numbers of positive cells for caspase-3 decreased in GGA group compared with model group during the experimental duration with the considerable difference between these two groups(P<0.05).Conclusion GGA could protect RGCs against isehemia/reperfusion injury by upregulating the expression of HSP70 and downregulating the expression of caspase-3 in retina.

lntraocular lens ( lOL) often has different degrees of tilt, decentration and rotation in the eye. The deflection of lOL is an important factor to impact on the visual quality of the patients with cataract surgeries. Vision was commonly used to evaluate visual quality before. ln recent years, some new methods are also introduced to evaluate visual quality, such as optical aberration, modulation transfer function ( MTF ) and subjective visual perception. They show that the lOL deflection will cause decreases in eyesight and MTF, cause increase in aberration, lead to ametropia and so on. Therefore, a better evaluation of the effects of lOL deflection on visual quality, has significance for lOL selection, positioning and cataract individualized treatment.

AIM: To investigate the relationship between levels of blood viscosity and ocular hemodynamic changes in patients of primary glaucoma (PG).METHODS: The blood rheology indices (including whole blood, plasma, packed cell, relative blood visco-sities and yield stress) were determined in primary open angle glaucoma (POAG) patients, primary acute angle closure glaucoma (PAACG) patients, primary chronic angle closure glaucoma (PCACG) patients and normal control group (patients with senile cataract), 20 cases each group. The peak systolic velocity (PSV), end diastolic velocity (EDV), resistant index (RI), shape of spectra and frequency of monitor of ophthalmic artery (OA) and central artery of retina (CRA) were detected with color Doppler imaging (CDI) simultaneously. Comparing to the differences of each group with t test and giving a linear relational analysis to targets between the blood viscosity and hemodynamic of primary glaucoma patients.RESULTS: The blood rheology targets in PG groups were significantly higher than those in control group except fibrinogen. Comparing to control group, PSV and EDV in PG groups were significantly decreased but RI was remarkably increased. All targets of blood viscosity in PG patients were significantly negatively correlated with the PSV, EDV of both OA and CRA, but were significantly positively correlated with RI of OA and CRA. There were no significant correlations between the blood viscosity and ocular hemodynamics in the normal control.CONCLUSION: There are ocular blood circulation obstacles in and high level of blood viscosity PG patients, CDI has an important reference value in early diagnosis and prognosis of glaucoma.

OBJECTIVEIn this study, the clinical data of 240 cases of data acquisition on ovulation in patients with anovulatory infertility.

METHODUsing the method of factor analysis, summed up the distribution situation of various syndromes and the relationship of disease-syndrome-symptom.

RESULTFrom the study we found that polycystic ocary syndrome > premature ovarian failure > corpus luteum insufficiency > luteinized unruptured follicle syndrome > hyperprolactinemia > anovulatory dysfunctional uterine bleeding. Using the factor analysis method, the syndromes of anovulatory infertility were divided into six types and the distribution proportion of them is: kidney Yang deficiency and blood stasis > kidney Yang deficiency > kidney Yin deficiency and blood stasis > kidney Yin deficiency and liver Qi stagnation syndrome > kidney Yang deficiency and phlegm dampness stagnation > kidney Yin deficiency. By means of statistics, the traditional Chinese medicine (TCM) symptoms as abdomen pain before menstrual onset, obfuscation colour, cold lower abdomen, insomnia, fatigue, eyes dark, face dark or ring lip dark, before and after menstruation breast swelling, chest tightness, irritable insomnia, depression and lower abdomen pain during menstruation etc contribute high degree in the process.

CONCLUSIONPolycystic ovary syndrome and premature are the main causes of ovulatory disorder infertility and the disease incidence rate assumed the tendency which rose year by year. The treatment of the disease of kidney yang deficiency syndrome scales biggest the disease degree of contribution. Blood stasis is the important factor in the process of pathogenesis evolution. In the study of disease distribution, we found that symptom distribution trend roughly the same and the same symptom severity in different diseases with different, which provides experience for the theory-different diseases with the same therapeutic method. These conclusions provide guidance and reference evidences for clinic practice.

Objective To explore the effect and mechanism of glucose regulated protein 78 (GRP78) on autophagy and apoptosis in ovarian carcinoma, and to investigate the influence on the growth and sensitivity to cisplatin on the ovarian cancer cells.Methods The human ovarian cancer cell line SKOV3 were treated by the GRP78 regulator BAPTA-AM and A23187, which were used to decrease or increase the expression levels of GRP78, respectively.The experiment were divided into three groups.Cells in the group of BAPTA-AM were treated by BAPTA-AM at the final concerntration of 40 μ mol/L for 1 hour.Cells in the group of A23187 were treated by A23187 at the final concerntration of 4 μmol/L for 24 hours.While, cells in the control group were treated by culture medium without any GRP78 regulator for 24 hours.The expressions of GRP78, beclin1, Bcl-2 and CHOP mRNA and protein were detected by reverse transcription (RT)-PCR and western blot.The autophagy levels was observed by green fluorescent protein-microtubule-associated protein 1 light chain 3-Ⅱ (GFP-LC3-Ⅱ) fluorescence staining.The flow cytometry was used to analyse the apoptosis rates of cells.The effect on cell growth and the sensitivity to cisplatin of SKOV3 were accessed by methyl thiazolyl tetrazolium (MTT).Results (1)The mRNA expressions of GRP78, beclin1, Bcl-2 and CHOP in the group of BAPTA-AM were 0.583±0.025, 0.860± 0.055, 0.714±0.032 and 0.811±0.004, respectively.The mRNA expressions of GRP78, beclin1, Bcl-2 and CHOP in the group of A23187 were 0.840± 0.044, 0.654 ± 0.065, 0.908 ± 0.047 and 0.620 ± 0.062, respectively.The mRNA expressions of GRP78, beclin1, Bcl-2 and CHOP in the control group were 0.687± 0.032, 0.772 ±0.029, 0.845 ±0.018, 0.712 ± 0.077, respectively.While the protein expressions of GRP78, beclin 1, Bcl-2 and CHOP in the group of BAPTA-AM were 0.423±0.035, 0.952±0.022, 0.385±0.032, 0.681± 0.095, respectively.The protein expressions of GRP78, beclin1, Bcl-2 and CHOP in the group of A23187 were 0.743 ±0.032, 0.638±0.025, 0.596±0.029, 0.431 ±0.095, respectively.The protein expressions of GRP78, beclin1, Bcl-2 and CHOP in the control group were 0.617±0.031, 0.789±0.083, 0.492±0.036, 0.531 ± 0.003, respectively.The mRNA and protein expressions of beclin and CHOP in the group of BAPTA-AM were both higher than those in the control group (P＜0.05).While, the mRNA and protein expressions of beclin and CHOP in the group of A23187 were both lower than those in the control group (P＜ 0.05).(2) The autophagy fluorescence of SKOV3 in the group of BAPTA-AM, A23187 and the control group were 706±117, 473±128, 595± 126, respectively, in which there were significant differences among three groups (P＜0.05).(3) The apoptosis rate of SKOV3 in the group of BAPTA-AM was (27.4±2.2)％, which was higher than that in the control group [(19.6± 1.4)％, P＜0.05].The apoptosis rate of SKOV3 in the group of A23187 was (12.2± 1.9)％, which was lower than that in the control group (P＜0.05).(4) The comparison of the sensitivity to cisplatin in 3 groups of SKOV3.The 50％ inhibition concentration (IC50) of SKOV3 to cisplatin was (3.02±0.62) mg/L.After treated by BAPTA-AM + cisplatin, the IC50 was (2.00±0.17) mg/L and the sensitivity of SKOV3 to cisplatin was increased by 33.8％, and there was significant difference (P＜0.05), compared with the control group.And after treated by A23187 + cisplatin, the IC50 was (4.91±2.52) mg/L and the sensitivity of SKOV3 to cisplatin was decreasd by 62.6％;and there was significant difference (P＜0.05), compared with the control group.Conclusion GRP78 could regulate autophagy and apoptosis of ovarian cancer cells by regulating the expressions of beclin1, Bcl-2 and CHOP, thereby affecting the sensitivity to cisplatin in ovarian carcinoma, which may be a new method for the treatment and improvement of the sensitivity to cisplatin in ovarian carcinoma.

AIM:To compare the difference between diopter of refration measured after cycloplegic mydriasis with retinoscopy and hand-held autorefractor so as to explore the feasibility of using hand - held autorefractor for refraction screening in cadet candidates.
METHODS:Respectively using hand-held autorefractor and streak retinoscope to do optometry examination in 317 cadet candidates students ( 634 eyes ) after mydriasis. Main index of refraction values ( spherical, cylindrical mirror degree and axial) were analyzed by difference test and correlation analysis. And the elimination rate was comparatively analyzed.
RESULTS: Diopters of sphere and cyclic refraction measured by hand-held autorefration were significantly higher than those by retinoscopy ( P< 0. 05 ), but the correction analysis showed that there was high correlation (r=0. 733, 0. 694), axial of refration measured by these two methods were non - significant ( P > 0. 05 ). The disqualifying rate using autorefraction was much higher than that using retinoscopy. It was easy to be wrongly eliminated.
CONCLUSION:Because of the high correlation between diopters of autorefraction measured by retinascopy and autorefractor, autorefraction has application value in refraction screening in cadet candidates with normal vision.

The"Experiencing teaching"is a students-centered and task-based teaching approach,from which students can apply what they learn to practice through their own experiences in classes.Using experiencing teaching in medical psychology,we get good teaching effects.

Objective To reveal the effects of cold-dryness and modified Zhisou Power on epidermal growth factor receptor (EGFR) and neutrophil elastase (NE) in rats with COPD. Methods COPD model was established with an elastase dose into the trachea combined with exposure to smoking for 90 d; cold-dryness COPD group was further developed by exposure to a cold, dry environment for 90 d. After 90 days, cold-dryness COPD rats was divided into cold-dryness group and Zhisou Power intervention group (treated with modified Zhisou Power for 7 days). On the 97th day, all rats were killed. Pathological changes in lungs were observed. mRNA and protein expression of EGFR were measured by RT-qPCR and Western blot, and the amount of NE in serum and BALF were examined by ELISA. Results EGFR mRNA and protein expression were significantly higher in COPD group, cold-dryness group and Zhisou Power intervention group than in control group. EGFR was significantly lower in Zhisou Power intervention group than in COPD group and cold-dryness group. NE was significantly higher in serum and BALF in COPD group, cold-dryness group and Zhisou Power intervention group than in control group. NE in BALF was significantly higher in cold-dryness group than in COPD group. NE in BALF was significantly lower in Zhisou Power intervention group than in cold-dryness group. Conclusion Modified Zhisou Power can down-regulate the expression of EGFR and the mount of NE in cold-dryness COPD rats to treat COPD.