China ; Diabetes, Gestational ; diagnosis ; diet therapy ; Female ; Humans ; Pregnancy

Objective To summarize the effect and experience of nursing of patients with rheumatic valvular heart disease with atrial fibrillation treated with Cox Ⅲ labyrinth and simultaneous valve replace-ment operation. Methods A retrospective analysis was carried out in the nursing of 58 patients with rheumatic valvular heart disease with atrial fibrillation treated with Cox Ⅲ labyrinth and simultaneous valve replacement operation in our hospital from April 2006 to July 2008. Results One patient died of periop-erative renal failure,one died of low cardiac output,one died of infectious endoearditis.Tbe mortality rate reached 5.2%.Other patients were discharged from hospital after completely cured.The survived patients maintained sinus rate during hospitalization days after operation and short-term follow-up after being dis-charged.Among 43 patients who completed follow-up of 6 months after operation,3 patients (7.0%) damon-strated atrial fibrillation,while others still kept sinus rate. Conclusions Attention should be paid to psy-chological nursing,respiratory tract preparation,cardiac function monitoring and nursing of anticoagulation treatment for patients treated with Cox Ⅲ labyrinth and simultaneous valve replacement operation.

Objective To establish a method for determination of chrysophanol,emodin and rhein in Huangzhi capsules.Method Chrysophanol,emodin and rhein in Huangzhi capsules was determined by TLC-scanning with a mixture of n-hexane-ethylacetate-formic acid(30∶10∶0.5) as the developing system.The detection wavelength was 435 nm and 610 nm.Results The calibraction curve of chrysophanol,emodin and rhein was linear in the range of 0.014 65～0.073 25,0.013 35～0.066 75,0.012～0.072 ?g respectively.Conclusion The method was simple,accurate with good repeatability,and suitable for the content determination of chrysophanol,emodin and rhein in Huangzhi capsules.

Objective To investigate the effects of ulinastatin on pulmonary and hepatorenal function of elderly patients undergoing resection of esophageal cancer. Methods The clinical data of 40 elderly patients with esophageal cancer who had been admitted to Southwest Hospital from January 2005 to January 2008 were retrospectively analyzed. All the patients were randomly divided into control group (n = 20) and ulinastatin group (n = 20) according to random number table. Patients were administered with total parenteral nutrition, and patients in ulinaslatin group were additionally instilled with 4×10~5 U/d of ulinastatin. The levels of PaO_2, PaCO_2, PaO_2/FiO_2, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (Tbil), blood urea nitrogen, creatinine and uric acid were detected preoperatively and at postoperative day 2 and day 6. All the data were analyzed by t-test and chi-square test. Results The levels of PaO_2 and PaO_2/FiO_2 were (87.3±4.2) mm Hg (1 mm Hg =0.133 kPa) and (416±20)mm Hg in ulinastatin group, which were significantly higher than (79.0±4.3)mm Hg and (376±20)mm Hg in control group (t =6.2, 6.2, P <0.05). The levels of ALT, AST and Tbil were (23±7)U/L, (38±8)U/L and (13.4±3.0) μmol/L in ulinastatin group, and (39±8) U/L, (50±9) U/L and (24.5±6.0) μmol/L in control group, with significant difference between the 2 groups (t = 7.0, 4.4, 7.6, P < 0.05). The levels of uric acid, blood urea nitrogen and creatinine were (279±84) μmol/L, (4.1±1.7) mmol/L and (66±12) μmol/L in ulinastatin group, and (386±67)μmol/L, ( 8.9±2.7) mmol/L and (95±38) μmol/L in control group, with significant difference between the 2 groups (t = 4.4, 6.4, 3.3, P < 0.05). The recurrence of complications in ulinastatin group was significantly lower than that in control group (χ~2 = 4.8, P <0.05). Conclusion Postoperative supplementation of ulinastatin and total parenteral nutrition is helpful in improving the pulmonary and hepatorenal function of elderly patients undergoing resection of esophageal cancer.

Objective In order to explore practical values of the revised Duck criteria for diagnosis and treatment of pediatric infective endocarditis(IE).Methods Seventy-three children′s cases diagnosed and treatmented as IE complicated with congenital heart defects in the past 22 years were collected to make retrospective analysis according to the Duck criteria.Results In 73 patients,a definite diagnosis of IE was made in 37 patients(51%),16(43%) of which proved by the pathologic lesions during the operations.Eight patients(22%) met two major criteria,13 patients(35%) met one major and more than 3 minor criteria.36 patients(49%) were diagnosed as possible IE.Forty-five patients(62%) were cured using antibiotic therapy.Sixteen cases(21%) were failure in antibiotic treatment,of whom 16 patients were operated by cutting off the detection of vegetation and repairing the heart malformation.Tweleve cases(17%) were died,one of which was died after the operation.Conclusions IE is still a significant complication of congenital heart disease.Duck criteria is relative rigid in sensitivity,but it is high in specificity.When the vegetation isn′t large enough in shape,revised Duck criteria is difficult to(diagnose) early.The surgery treatment is optimistic.To combine the medicine with surgery can contributed to decrease mortality rate.

Objective To establish a newborn animal model of renal injury caused by intrauterine asphyxia and explore the mechanism of renal injury in neonate after asphyxia.Methods After two-horn uterus and vessels supplying uterus and ovary were exposed in 21-day-pregnant Wistar rats,arterial clamp occluded one side of vessels.The occluding time were 10 and 30 minutes.Then arterial clamp was taken off,and reperfusion for 30 minutes,2,6,12 and 24 hours respectively.Reaching prescribed time uterus horn was opened rapidly and pups were removed.The pups sacrificed by decapitation.Kidneys were taken out and studied by HE staining and electron microscope.Results Kidney of fetal rats in 21 gestational age was developmental and mature degree of tubules dropped behind that of glomerule.Changes of proximal tubules were early and serious compared with distal tubules during ischemia and reperfusion stages.Conclusion Ischemia and reperfusion to graded pregnant rat can supply an ideal model to study injury of kidney and other organs(intraute)-rously.

Objective To establish the quality standard of Yuling Tea for its quality control. Methods Astragalus, Fructus cnidii L, Schisandra chinensis and Lycii Fructus in Yuling Tea were identified by TLC. The content of Schisandrin was determined by HPLC. Welch Materials C18 column (250 mm×4.6 mm, 5 μm) with mobile phase of methanol-water (70∶30) was used. The detective wavelength was 250 nm. Results The TLC for identification was simple and special. Schisandrin showed a good linear relationship in 0.222-0.222 0 μg, r=0.999 9. The average recovery was 98.96%, and RSD was 0.74%. Conclusion The method can accurately determine the content of Schisandrin in Yuling Tea. It can be used for quality control of the preparation.

Objective To identify and characterize uveal melanoma associated protein variants with two-dimensional electrophore- sis and mass spectrometry.Design Experiment study.Participants 4 cases of specimens of uveal melanoma and 4 cases of normal con- tributed uveal tissue.Methods Proteins from uveal melanoma and normal urea were separated with two-dimensional eleetrophoresis (2-DE)and visualized with Coomassie G-250.Gels were analyzed by Image Master 5.0 software.The mass spectra were measured by matrix-assisted laser desorption/ionizatian time-of-flight mass spectrometry(MALDI-TOF MS)and searched against NCBI database using Mascot software.Main Outcome Measures Differential proteins.Results A set of 30 proteins were differentially expressed in uveal melanoma compared to nomal urea.Twenty-four types of protein only expressed in uveal melanoma.Five types of protein were up-regu- lated and 1 type of one down-regulated.These proteins can be subdivided into groups according to cellular function,such as enzyme, signal transduction,signal regulation,cytoskehton,immune,etc.Conclusions There is significant difference in protein profilings be- tween uveal melanoma and normal uvea.The differentially expressed proteins may be associated with the development of uveal melanoma.

Background The underlying mechanism of choroidal neovascularization(CNV) is multifactorial and complex.Focal adhesion kinase(FAK) plays a crucial role in controlling essential cellular processes and influencing distinct steps of the angiogenic response.But to our knowledge,seldom study on the effect of FAK on CNV formation has been reported previously.Objective In this study,the effect of several CNV risk factors on the expression of FAK in cultured retinal pigment epithelium(RPE) cells was investigated to illuminate effect of FAK on CNV.Methods Human RPE cells were isolated from donor eyes and exposed to H2O2,swallow of outer segment of photoreceptors(POS) and extracellular matrix(ECM) separately with the treating as follows:RPE cells were co-cultured with 10,20,50 and 100μmol/L H2O2 for 20 days;POS(1×106/ml) were co-cultivated with RPE cells for 20 days(setting control group,POS group,hypoxia group with 200μmol/L CoCl2,and POS+hyoxia group);RPE cells were cultured on the plates coated with 100mg/L fibronectin(FN),laminin(LN) or collagen typeⅠfor 30minutes or 1 hour.The expression of FAK and pFAK in RPE cells were examined by Western blot analysis.Results FAK was highly expressed in the 20μmol/L and 50μmol/L H2O2 groups compared with control group(P＜0.01);while he expression level of pFAK was reduced after treated with H2O2 in comparison with the control group(P＜0.01).After cultured with POS for 20 days,the undigested lysosome could be observed in RPE cells.The expressions of FAK and pFAK in RPE cells were not significantly changed between control group and POS groups(P＞0.05),but those in hypoxia group were significantly up-regulated in comparison with control group(P＜0.01).Compared with the hypoxia group,the expression amount of pFAK was elevated in POS+hyoxia group(P＜0.01).In comparison with control group,the increased pFAK expression was seen in FN,LN and collagen typeⅠtreating for 1-hour groups(P＜0.05,P＜0.01).Conclusion FAK pathway participates in several CNV-initiated signaling,such as H2O2,POS and ECM,in cultured RPE cells.It is reasonable to believe that FAK potentially plays an important role in CNV-dependent disorder.

Objective To investigate the pathogen distribution and susceptibility profile of fungal isolates from bloodstream infections,and valuate the clinical utility of G test in diagnosis of fungal infections for the purpose to improve antifungal therapy.Methods A retrospective analysis was carried out to analyze the fungal pathogens isolated from bloodstream infections in the First Affiliated Hospital of Nanjing Medical University during the period from January 2013 through December 2015 and their antimicrobial susceptibility.Results A total of 114 fungal strains were isolated from bloodstream infections during the 3-year period,most of which were Candida (99/114,86.8％),especially Candida albicans (30.7％).About 41.2％ (47/114) of the fungal strains were isolated from Department of Thoracic Surgery (10,5 and 4 strains in 2013,2014 and 2015),Hematology (11 strains in 2014),and ICU (7 strains in 2014).Antimicrobial susceptibility testing showed that all the fungal strains (100％) were susceptible to amphotericin B,but 83.5％ susceptible to itraconazole (the lowest).G test was positive before the result of blood culture in 13 of the 54 patients who received G test.Conclusions Candida was the most common fungus in fungal bloodstream infection.Amphotericin B is the most active antifungal agent in vitro.Blood culture combined with serological test can provide clinicians an earlier and reliable diagnosis.