Objective To investigate the relationships between fasting plasma glucose (FPG) level in early pregnancy and gestational diabetes mellitus (GDM).Methods Data of 11 477 pregnant women who accepted prenatal care in Beijing Obstetrics and Gynecology Hospital from October 2011 to September 2012 were collected.FPG was tested during 8 to 12 weeks of pregnancy in all women and those with FPG＜7.00 mmol/L were recruited.Women accepted 75 g oral glucose tolerance test (OGTT) during 24 to 28 weeks of pregnancy.The GDM diagnostic criteria was with reference to the criteria of International Association of Diabetes and Pregnancy Study Group.Mann-Whitney U test was used to analyze the difference of early pregnancy FPG between normal pregnant women and GDM women.Receiver operating characteristic (ROC) curve was used to analyze the validity and applicability of using early pregnancy FPG in GDM diagnosis.Chi-square test was used to analyze the relationship between the FPG levels and GDM diagnosis.Results There were 1 535 (13.4％) women diagnosed as GDM in 24 to 28 weeks of pregnancy (the rest 9 942 normal cases were taken as the controls).The median FPG level of the GDM group was 4.89 mmol/L (4.62-5.15 mmol/L),which was higher than that of the controls [4.75 mmol/L(4.53-4.98 mmol/L)] (Z=-13.994,P=0.000).The maximum area under curve (AUC),which was used to predict GDM with early pregnancy FPG,was 0.599 (95％ CI:0.582-0.617).Taking FPG 4.88 mmol/L as the cutoff value,the sensitivity was 0.523 and the specificity was 0.645.While taking FPG 5.10 and 5.60 mmol/L as the cutoff value,the sensitivity was 0.334 and 0.068,and the specificity was 0.811 and 0.983,respectively.When the FPG level ≤ 4.09,-4.60,-5.10,-5.60,-6.10 and ≥ 6.10 mmol/L,the GDM diagnostic rate gradually increased [8.5％(23/212),9.9％(335/3 379),12.3％(719/5 858),20.7％(359/1 734),40.2％ (78/194) and 52.5％ (21/40)] (x2=300.523,P=0.000).GDM diagnostic rate in FPG ≤ 4.09,-4.60,-5.10 and-5.60 mmol/L group were lower than that in FPG ≥ 5.60 but ＜6.10 mmol/L group and ≥ 6.10 mmol/L group (x2 were 67.242,164.680,128.125,37.860,55.843,76.856,58.589 and 23.484,all P=0.000) ; GDM diagnostic rate in FPG ≤ 4.09,-4.60,-5.10 mmol/L group were lower than that in FPG ≥ 5.10 but ＜5.60 mmol/L group (x2 were 22.877,113.717 and 78.040,all P=0.000); GDM diagnostic rate in FPG ≥ 4.09 but ＜4.60 mmol/L group was lower than that in FPG ≥ 4.60 but ＜5.10 mmol/L group (x2=11.803,P=0.001).When using abnormal fasting and postprandial OGTT level as GDM diagnostic criteria,the ratio of GDM in early pregnancy FPG level ≥ 5.60 but ＜6.10 mmol/L group and FPG ≥ 6.10 mmol/L group were higher than that of the FPG level ＜5.60 mmol/L group [50.0％ (39/78) and 71.4％ (15/21) vs24.1％ (346/1 436),x2 were 12.456 and 21.443,all P＜0.003].Conclusions Early pregnancy FPG level is not proper to be used as an early diagnostic tool of GDM.However,when early pregnancy FPG level is equal to or greater than 5.60 mmol/L,the incidence of GDM in late pregnancy will increase significantly.

Objective To investigate the types of commonly used anti-hypertensive drugs and hypoglycemic drugs and treatment schemes to provide a basis for rationally treating hypertension complicating type 2 diabetes mellitus(T2DM).Methods The medication situation in 191 patients with hypertension complicating T2DM in our hospital were analyzed and investigated.The use of anti-hypertensive drugs and hypoglycemic drugs and treatment scheme were statistically analyzed.Results In 191 patients with hypertension complicating T2DM,the single drug use in the anti-hypertensive scheme accounted for 9.42 ％,two-drug combined use accounted for 64.91％,three-drug combined use for 17.8 ％ and four-drug combined use for 7.85 ％.The medication of ARB+CCB had the highest use frequency;the anti-hypertensive total effective rate was 96.86 ％.In the hypoglycemic schemes,the insulin use accounted for 30.37％,and the use frequency of metformin+ gliclazide was highest,the hypoglycemic total effective rate was 98.43％.Conclusion The medication for the patients suffering from hypertension complicating T2DM is relatively reasonable,and worth of being popularized and applied in clinical practice.

Nonalcoholic fatty liver disease (NAFLD) is a common liver disease with multiple factors involved,and its incidence is gradually increasing around the world.Recent studies have found that gut microbiota is involved in the development and progression of NAFLD.This article summarizes the association between gut microbiota and NAFLD from the aspects of influencing factors for gut microbiota and the roles of gut microbiota and its metabolites in the development and progression of NAFLD and points out that the intervention of gut microbiota and its metabolites may be a new target for the prevention and treatment of NAFLD.

Adolescent ; Adult ; Busulfan ; therapeutic use ; Female ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Male ; Middle Aged ; Transplantation Conditioning ; methods ; Young Adult

4-Hydroxycoumarins ; poisoning ; Adolescent ; Adult ; Female ; Humans ; Male ; Rodenticides ; poisoning ; Young Adult

Objective To investigate the role played by fibroblast growth factor-21 (FGF-21) in glucoselipid metabolism in mice adipocyte and hepatocyte. Methods FGF-21 over-expressive vector and FGF-21-shRNA vector were transfected to Hepa1-6 hepatocyte and 3T3-L1 adipocyte, respectively. FGF-21 protein levels were evaluated by Western blotting, glucose uptake rate (GUR) was evaluated by radioimmunoassay. The mRNA expression of transcription factors was detected by real-time quantitative PCR. Results Transfection of pcDNAFGF21 significantly increased FGF-21 expression in both liver and fat cells (4.8 fold and 4.2 fold, both P<0.05). Moreover, FGF-21 expressions were down-regulated by 86. 3% and 77. 8% with pGenesil-FGF21,respectively (both P<0.05 ). The FGF-21 up-regulation markedly increased GUR and decreased intracellular triglycerides content in the 3T3-L1 adipocyte. Meanwhile, the up-regulation of glucose transporter-1, insulin receptor substrate-1 (IRS-1), PPARγ, adipose triglyceride lipase (ATGL), hormone-sensitive lipase (HSL),and adipocyte fatty acid binding protein 2 ( ap2 ) mRNA expressions were also observed ( all P<0. 05 ). The reverse changes happened in FGF-21 deficient adipocyte except IRS-1. In hepatocyte, FGF-21 has no effect on GUR.FGF-21 over-expression reduced PPARγ, 3-hydroxy-3-methylglutaryl-CoA reductase (HMGR), and phosphoenolpyruvate carboxykinase (PEPCK) mRNA expressions, and increased low-density lipoprotein receptor expression (P<0.05). Conclusions FGF-21 regulates glucose homeostasis and accommodates intracellular fat content in adipocyte. In hepatocyte, FGF-21 plays an important role in gluconeogenesis and cholesterol metabolism.

OBJECTIVETo observe the clinical efficacy on fibromyalgia syndrome treated with acupuncture at the acupoints selected from the affected meridians based on the location differentiation and the heavy moxibustion at painful points by the randomized controlled trial with medication.

METHODSThirty-two patients of fibromyalgia were randomized into an acupuncture-moxihustion group and a medication group, 16 cases in each one. In the acupuncture-moxibustion group, acupuncture at the acupoints selected from the affected meridians based on the location differentiation and the heavy moxibustion at painful points were applied, once every two days, three times a week, for 4 weeks totally. In the medication group, tramadol sustained release tablets and amitriptyline were prescribed for oral administration, once a day, for 4 weeks. The follow-up visit was conducted for 4 weeks in the two groups. Before and after treatment and in follow-up visit, the revised version of the fibromyalgia impact questionnaire (FIQR) and visual analogue scale (VAS) were adopted for assessment and comparison of the efficacy between the two groups.

RESULTSAfter treatment and in follow-up visit, FIQR score and VAS score were improved apparently as compared with those before treatment in the two groups (all P<0. 05). At the end of treatment, the differences were not significant statistically between the two groups (all P>0. 05). But the differences were significant in follow-up visit (all P<0. 05). The scores in the acupuncture-moxibustion group were improved persistently, but those in the medication group were rebound.

CONCLUSIONThe acupuncture at the acupoints selected from the affected meridians based on the location differentiation and the heavy moxibustion at painful points are safe and effective in the treatment of fibromyalgia syndrome and present the better persistent effect as compared with the combined medication of tramadol sustained release tablets and amitriptyline.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Fibromyalgia ; therapy ; Humans ; Male ; Meridians ; Middle Aged ; Moxibustion ; Pain Measurement ; Young Adult

Objective To analyze the changes of cesarean section rate (CSR) and indications of cesarean section (CS) after implementation of responsible system of attending physician (RSAP) and new partogram.Methods Totally,11 814 women,who delivered in the Department of Obstetrics,Beijing Obstetrics and Gynecology Hospital,Capital Medical University in the fourth quarter of 2012,2013 and 2014,were chosen.The mode of delivery,CSR,CS indications and matemal and fetal outcomes of these women were analyzed with Chi-square test.The RSAP was started in 2013,and both RSAP and the new partogram were applied in 2014 in our hospital.Results The CSRs in the fourth quarter of 2012,2013 and 2014 were 46.4％(1 502/3 235),40.4％(1 524/3 770) and 33.5％(1 612/4 809) (x2=138.312,P＜0.05),and the converting CSR in the delivery room were 10.9％(212/1 945),7.8％(189/2 435) and 6.1％(208/3 414),respectively (x2=39.765,P＜0.05).The proportion of assisted vaginal delivery in the fourth quarter of 2014 was higher than those of the former two years [4.9％(237/4 809) vs 3.4％ (108/3 235) and 3.5％(131/3 770),x2=17.041,P＜0.05].More and more CS deliveries emerged due to scarred uterus,multiple pregnancy,comorbidities and complications during pregnancy year by year,while those CS deliveries because of macrosomia,narrow pelvis,social factors,elderly primipara,umbilical cord entanglement,precious fetus and high myopia gradually decreased (all P＜0.05).In the fourth quarter of 2014,the proportions of CS with fetal distress,abnormal labor,cephalopelvic disproportion and intrauterine infection were lower than those in 2013 (all P＜0.05).No significant difference was shown in the proportion of postpartum hemorrhage and neonatal asphyxia among the three years (both P＞0.05).In 2014,smaller percentage of neonates were transferred to the Pediatrics Department after birth than in 2012 and 2013 [10.2％(491/4 809) vs 12.0％(388/3 235) and 13.7％(516/3 770),x2=24.681,P＜0.05].Conclusions The implementation of RSAP and the application of new partogram effectively reduce the CSR through strict control on indications of CS.

Objective To investigate the telephone information-memory-concentration test (TIMCT) in evaluating the cognitive function of patients with nasopharyngeal carcinoma(NPC)after radiotherapy. Methods The cognitive function were evaluated by TIMCT and mini mental state examination (MMSE) in 2 weeks for 30 normal persons and 90 NPC patients. And the 90 NPC patients were divided into the 3 months, 2 years and 5 years after radiotherapy groups. All patients were carried out firstly face to face interview and telephone interview 1 time after 2 weeks. Results The correlation coefficient of all groups between TIMCT(telephone) and TIMCT (face to face) were bigger (R = 0.850) when MMSE wasn't control variable. And the correlation coefficients between TIMCT (telephone) and TIMCT (face to face) were lower (R = 0.366) when MMSE was control variable. As for examining time was classification factor, TIMCT (telephone) and TIMCT (face to face) were analyzed by partial correlation analysis. Only normal group was correlated with group of 3 months after radiotherapy and group of 2 years after radiotherapy wasn't correlated with group of 5 years after radiotherapy (R = 0.447,0.970,0.200 and 0.062). In addition, the difference plot of TIMCT(telephone) and TIMCT (face to face) indicated that telephone was consistent with face to face interview (MMSE≥28). Both telephone and face to face interview reflected the cognitive function downtrend of rescareh objects. Conclusions TIMCT (telephone), TIMCT(face to face) and MMSE (face to face) can reflect cognitive function downterend of patients with NPC after radiotherapy. But TIMCT(telephone) used in clinical screening cognitive function impairment of patients with NPC after radiotherapy should be improved further.