Objective:To investigate the changes of advanced glycosylation end product(AGEs)/sodium-glucose cotransporter-1(SGLT-1) in intestinal and renal tissues and intestinal flora of mice with diabetes kidney disease.Methods:Twenty KKay mice were divided into diabetic group(DM group, n=10) and diabetic kidney disease group(DKD group, n=10). The concentrations of serum AGEs, lipopolysaccharide(LPS), tumor necrosis factor-α(TNF-α), and intereukin-6(IL-6) were measured. Western blot technique was used to detect the protein expression of AGEs and SGLT-1 in kidney and intestinal tissue, and high-throughput sequencing was used to analyze the difference of intestinal flora. Results:The levels of inflammatory markers TNF-α, IL-6, and serum endotoxin in DKD group were significantly higher than those in DM group( P<0.05). The contents of AGEs in serum and intestine and kidney were increased, and the contents of SGLT-1 in intestine and kidney were increased( P<0.05). Metastats test showed that the abundance of Verrucomicrobia decreased and the abundance of Proteobacteria increased in DKD group( P<0.05). G - bacteria such as Aeromonas, Enterobacter, Morgan, Klebsiella, Serratia, and Burkholderia were relatively dominant, and the abundance of Akkermansia was significantly lower than that in DM group( P<0.05). Conclusion:The increase of AGEs in intestinal tract of DKD mice may induce intestinal dysbacteriosis, especially the increase of Proteobacteria, the decrease of Verrucosa and Wilhelm Ackermann, and the leakage of G-bacteria into the blood to produce intestinal endotoxemia and cause inflammatory reaction, this may be an important factor in the development of DKD. SGLT-1 is elevated in intestinal tissue, which may be involved in the development of DKD.

Objective To observe the clinical efficacy and related complications of modified suture method in treating perimembranous ventricular septal defect(VSD). Methods The clinical data of 110 children with perimembranous VSD were retrospectively analyzed. Among them, 51 cases were treated with conventional suture method (conventional suture group), and 59 cases were treated with modified suture method(modified suture group).The extracorporeal circulation time,intraoperative blood transfusion volume, postoperative drainage volume, total hospital stay and related complications were recorded. The transthoracic echocardiography was performed 1, 6 and 12 months after operation. Results The children successfully completed the operation,and no intraoperative death occurred.The extracorporeal circulation time, intraoperative blood transfusion volume, postoperative drainage volume, total hospital stay and rate of related complications in modified suture group were significantly lower than those in conventional suture group: (41.2 ± 9.6) min vs. (52.1 ± 10.6) min, (182.2 ± 42.9) ml vs. (255.3 ± 56.7) ml, (73.2 ± 18.7) ml vs. (102.3 ± 23.5) ml, (12.8 ± 2.5) d vs. (16.1 ± 3.6) d and 13.6% (8/59) vs. 29.4% (15/51), and there were statistical differences (P<0.01 or <0.05). The blood flow velocity of pulmonary valve and blood flow velocity of aortic valve 1,6 and 12 months after operation in modified suture group were significantly better than those in conventional suture group, blood flow velocity of pulmonary valve: (113.8 ± 21.4) cm/s vs. (126.5 ± 22.6) cm/s, (104.6 ± 18.2) cm/s vs. (112.3 ± 18.5) cm/s, (102.3 ± 15.8) cm/s vs. (113.8 ± 16.5) cm/s; blood flow velocity of aortic valve:(141.9 ± 24.6)cm/s vs.(136.0 ± 25.7)cm/s,(148.3 ± 18.7)cm/s vs.(142.3 ± 20.3)cm/s,(148.8 ± 18.1) cm/s vs. (141.6 ± 18.1) cm/s, and there were statistical differences (P<0.05). Conclusions The modified suture method has the characteristic of short operating time, less blood transfusion and postoperative drainage,and swift recovery.It also can reduce postoperative arrhythmia and residual reflux.

Objective: To examine the association of pre-pregnancy body mass and weight gain during pregnancy with macrosomia. Methods: From January 2015 to December 2015, a total of 20 477 pregnant women were recruited by probabilistic proportional scale sampling with simple randomization in Sichuan, Yunnan and Guizhou Provinces. Basic information of pregnant women, weight gain during pregnancy and weight of newborn were collected. A multiple logistic regression model was used to assess the association between the pre-pregnancy body mass and gestational weight gain indicators with macrosomia. Results: 20 321 mother-infant were included in the final analysis. 20 321 pregnant women were (30.09±4.10) years old and delivered at (39.20±1.29) weeks, among which 12 341 (60.73%) cases were cesarean delivery. The birth weight of 20 321 infants were (3 292.26±431.67) grams, and 970 (4.77%) were macrosomia. The multiple logistic regression model showed that after adjusting for the age of women, compared to the normal weight group in the pre-pregnancy, the overweight and obesity group elevated the risk of macrosomia, with OR (95%CI) about 1.99 (95%CI: 1.69−2.35) and 4.05 (95%CI: 3.05−5.39), respectively. After adjusting for the age, the pre-pregnancy BMI, delivery weeks, delivery mode and infant′s gender, compared to the weight-gain appropriate group, higher weight gain rate in the mid-pregnancy and excessive total gestational weight gain elevated the risk of macrosomia, with OR (95%CI) about 1.99 (95%CI: 1.66−2.39) and 1.80 (95%CI: 1.55−2.08), respectively. Conclusion The overweight before pregnancy, obesity before pregnancy, the rate of weight gain in the second trimester and the high total weight gain during pregnancy could increase the risk of macrosomia.