Objective To compare the clinical characteristics of pregnant women with gestational diabetes mellitus (GDM) and normal gestational glucose metabolism at the 25th weeks of pregnant. Methods Sixty-eighty patients with GDM (GDM group) and 68 patients with normal blood glucose(control group) were enrolled in this study. During 25 weeks of pregnancy, oral glucose tolerance test (OGTT), blood pressure, fasting insulin, glycosylated hemoglobin, uric acid, triglyceride, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol were measured and body mass index (BMI), homeostasis model of assessment for insulin resistence index (HOMA-IR), insulin sensitivity index (ISI) were computed. The results were compared between two groups. Results The age in GDM group was significantly higher than that in control group: (31.38 ± 0.54) years vs. (29.50 ± 0.56) years, P<0.05. The systolic pressure in two groups had no significant difference (P>0.05), but diastolic blood pressure in GDM group was significantly higher than that in control group:(73.2 ± 0.8) mmHg vs. (70.9 ± 0.8) mmHg, 1 mmHg=0.133 kPa, P<0.05. The body weight and BMI in GDM group were significantly higher than that in control group:(65.67 ± 1.76) kg vs. (57.76 ± 1.11) kg, (24.77 ± 0.61) kg/m2 vs. (22.11 ± 0.42) kg/m2, P<0.01. The levels of glycosylated hemoglobin, fasting insulin and HOMA- IR in GDM group were significantly higher than those in control group (5.546 ± 0.746)% vs. (5.085 ± 0.034)% , (17.870 ± 1.015) mU/L vs. (14.400 ± 0.634) mU/L, 4.192 ± 0.271 vs. 2.645 ± 0.128, but the level of ISI in GDM group was significantly lower than that in control group:0.014 ± 0.001 vs. 0.020 ± 0.001, and there were significantly differences (P<0.01). The levels of uric acid, triglyceride, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol in two groups had no significant differences (P>0.05). Conclusions Compared to those with normal blood glucose, the patients with GDM have the characteristics of higher age, higher body weight, higher BMI, higher diastolic blood pressure , higher level of insulin, insulin resistance and decreased insulin sensitivity.

Objective To evaluate the precision of the ACCU-CHEK Performa glucose monitor,the Optium Xceed glucose monitor,the Breeze glucose monitor and the Contour glucose monitor.Methods A total of 102 patients (diabetic patients or un-diabetic patients) who visited our endocrinology outpatient department were randomly selected.The venous blood samples were collected using the laboratory auto-analyzer,and the synchronous finger tip capillary blood were collected using the ACCU-CHEK Performa glucose monitor and the Optium Xceed glucose monitor,or using the Breeze glucose monitor and the Contour glucose monitor.Results The correlation coefficients between VPG by the laboratory auto-analyzer and CBG by the four kinds of glucose monitors was good,and R values were 0.990,0.985,0.963,0.952,and there was no significant difference between the CBG of Breeze glucose monitor and the same VPG(P ＞ 0.05).When the blood glucose concentration was higher than 4.2mmol/L,and compared with the VPG detected by synchronous measurement laboratory,95％ of the CBG test results detected by four kinds of blood glucose meters were in the range of ± 20％.Conclusion The four kinds of glucose monitors can provide high accurate.

Objective:To investigate the clinical efficacy of microscopic myringoplasty versus endoscopic myringoplasty in the treatment of tympanic membrane perforation caused by chronic suppurative otitis media. Methods:The clinical data of 91 patients with tympanic membrane perforation caused by chronic suppurative otitis media who received treatment in Jiaxing Second Hospital, China between February 2017 and March 2019 were retrospectively analyzed. These patients were divided into a control group ( n = 45) and an observation group ( n = 46) according to different surgery methods. The control group was given microscopic tympanoplasty, while the observation group was given endoscopic tympanoplasty under the otoendoscope. Results:Blood loss in the observation group was significantly lower than that in the control group [(7.2 ± 2.0) mL vs. (13.7 ± 3.1) mL, t = 11.912, P < 0.001]. Operation time in the observation group was significantly shorter than that in the control group [(59.4 ± 5.4) min vs. (91.5 ± 11.2) min, t = 17.474, P < 0.001]. Postoperative pain score in the observation group was significantly lower than that in the control group [(2.9 ± 0.7) points vs. (4.8 ± 1.3) points, t = 8.707, P < 0.001]. Hospital stay in the observation group was significantly shorter than that in the control group [(4.3 ± 1.0) d vs. (6.5 ± 1.5) d, t = 8.249, P < 0.001]. Pure tone hearing thresholds at 1, 2 and 4 kHz frequencies in the observation group were significantly higher than those in the control group (all P < 0.05). Patient satisfaction regarding the aesthetic effect of the surgical incision in the observation group was significantly higher than that in the control group [97.8% (45/46) vs. 77.8% (35/45), χ2 = 8.604, P = 0.003]. Conclusion:Endoscopic myringoplasty has the advantages including shorter operation time, less blood loss, lower degree of pain, better hearing improvement and higher patient satisfaction over microscopic myringoplasty in the treatment of tympanic membrane perforation caused by chronic suppurative otitis media.

In order to understand the porcine epidemic diarrhea virus (PEDV) origin and variant characteristics in Liaoning province,diagnosed by PCR,separated by Vero cell,and identified by cell pathological observation,RT-PCR and S gene sequence analysis,1 PEDV strains (LN-2015-1) was successfully isolated from a pig farm of Liaoning province.Analysis of S gene sequence showed that compared withCV777 strain,there were the longest 9 bp insertion,6 bp deletion and 13 bp continuous mutation in addition to point mutation.There also were the longest 3 AA insert,2 AA deletion,and 3 AA or more continuous mutation.The epitope analysis showed that there were 16AA mutations in the 5 epitope regions.Homology analysis show that it had the highest sequence similarity of 99.2％ with HB-HA2015 strain,higher sequence similarity of 98.5％-98.8％ with the domestic and foreign representative strains isolated since 2010,and lower sequence similarity of 93.2％-95.6％ with the traditional strain isolated before 2010;the phylogenetic analysis showed that LN-2015-1 was clustered into the same group with home and abroad variation strain in recent years,and formed a small subgroup with HB-HA2015 at the same time.The evolutionary distance was far from the traditional strains.

To analyze the clinical, molecular genetic and biochemical characteristics of a family diagnosed with creatine deficiency syndrome (CDS) due to SLC6A8 gene mutation diagnosed in Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University in September 2018.The boy was referred at the age of 13 for intermittent vomiting and symptoms were relieved after symptomatic treatment, 7 months later, the patient was diagnosed again.He ate less and constipated as an infant, and had intermittent vomiting and severe constipation from 12 years old.He could walk at the age of 1 year and 6 months, could speak his first word at 2 years old, and only spoke simple sentences at the diagnosis.He rarely communicated with his parents.His brother has severe intellectual deficiency and seizures.His mother has cognitive impairment and had repeated stillbirths and miscarriages.When visiting the doctor, his weight was 22 kg (< P3), height was 131 cm (< P3), and head circumference was 52 cm.Besides, he had severe mental retardation and sluggish expression, poor communication, broad forehead, musculoskeletal atrophy and arched foots.His brain magnetic resonance imaging showed mild enlargement of the lateral ventricles.Magnetic resonance spectroscopy showed normal signals in the bilateral hippocampuses.The boy′s exon sequencing related to intellectual deficiency revealed the hemizygous mutation of SLC6A8 gene c. 626(exon3)-c.627(exon3)delCT.His mother and brother were carriers of the variant gene, but his father and grandmother had no such mutation.The urinary creatine to creatinine ratio was elevated but guanidinoacetate was normal, it was further confirmed that CDS can be caused by the novel mutation c. 626(exon3)-c.627(exon3) delCT in SLC6A8.In clinical practice, boy with mental retardation of unknown origin and often have gastrointestinal symptoms, especially when feeding difficulties and growth retardation occur in infancy, the early diagnosis of CDS can be achieved by examination of urinary creatine to creatinine ratio and gene detection.

OBJECTIVETo investigate the effect of alendronate on the expressions of osteoprotegerin (OPG) and receptor activator of nuclear factor-κB ligand (RANKL) in mouse osteoblasts.

METHODSMouse calvarial osteoblasts cultured in vitro were identified by alkaline phosphatase (ALP) staining and immunofluorescence assay of OPG and RANKL expressions. The second passage of the osteoblasts were treated with different concentrations of alendronate (10(-4) to 10(-7) mol/L) for 48 h, and the changes in OPG and RANKL mRNA and protein expressions were examined using real-time PCR and Western blotting, respectively.

RESULTSThe isolated osteoblasts were positive for ALP and expressed OPG and RANKL. Real-time PCR and Western blotting showed that at the concentration of 1×10(-4) mol/L, alendronate caused an obvious down-regulation of OPG and RANKL expressions in the cells, whereas at lower concentrations, alendronate increased the expressions of both genes with the highest expressions occurring after treatment with 1×10(-5) mol/L.

CONCLUSIONHigh concentrations of alendronate (>1×10(-4) mol/L) decrease the expressions of OPG and RANKL, whereas low concentrations (1×10(-5) to 1×10(-7) mol/L) increase their expressions in mouse osteoblasts cultured in vitro.

Alendronate ; pharmacology ; Animals ; Cells, Cultured ; Mice ; Mice, Inbred BALB C ; Osteoblasts ; drug effects ; metabolism ; Osteoprotegerin ; metabolism ; RANK Ligand ; metabolism

Objective To study the expression of visfatin and related mRNAs in myocardium of acute myocardial ischemia in rats,and to explore the role of both in acute myocardial ischemia model and to propose new ideas for clinical cardiovascular diseases.Methods Wistar rats (n=20) were randomly divided into sham operation control group and acute myocardial ischemia groups.Left anterior descending (LAD) of coronary artery was ligated to establish the model of acute myocardial ischemia.The total myocardium proteins were collected 12 h after operation.Western blot was used to observe the expression changes of visfatin in myocardium.The expressions of miR-124 and miR-327 in myocardium were detected by real-time PCR.Results The levels of serum CK and LDH in the model group of myocardial ischemia rats were elevated [(46.20±7.12) vs (72.19±9.38)kU/L;(2542.23±173.54) vs (6428.76±237.81)U/L,P＜0.05)].The visfatin expression levels in the rats of acute myocardial ischemia groups were higher than those in controls [(0.804±0.042) vs (1.046±0.031),P＜0.05].MiR-124 was up regulated and miR-327 was down regulated in acute ischemia myocardium.Cndusion The up-regulation of miR-124,the down-regulation of miR-327 and the increase of visfatin expression may be related to acute myocardial ischemia.The changes of visfatin expression may be regulated by miR-124 and miR-327 posttranscriptional levels.

Objective To analyze the clinical features and risk factors for an emerging infection during the first induction chemotherapy in elderly patients with acute leukemia.Methods A retrospective analysis of clinical data of 79 elderly patients with newly diagnosed acute leukemia was performed in Second Hospital of Shanxi Medical University from January 2014 to May 2016.Results The 70 cases among 79 elderly patients with acute leukemia were suffered from infection with infection incidence rate of 88.6％ (70/79)during first induction chemotherapy.The infection-related fatality rate was 8.6 ％ (6/70).Being clear about sites of infection accounted for 90.0 ％ (63/70),and the top three infection sites were the lungs,gastrointestinal tract and the bloodstream.113 pathogenic strains were detected,including gram-negative bacilli accounting for 42.5 ％ (48/113),Gram-positive cocci for 30.1％ (34/113),fungi for 24.8％ (28/113),the virus for 2.7％ (3/113).Based on clinically and confirmatively diagnosis,the invasive fungal diseases mostly as Candida accounted for 30.4 ％ (24/79),mixed infections accounted for 34.3％ (24/70).Univariate analysis showed agranulocytosis and AML were risk factors for infection.Logistic multivariate regression analysis showed that agranulocytosis was a risk factor for infection (OR=12.010,95％CI:2.346-107.973,P=0.000).The infection does not affect a complete remission rate of acute leukemia (x2 =0.001,P=0.983).Conclusions For newly diagnosed elderly acute leukemia patients,an emerging infection during the first induction chemotherapy is characterized by a high incidence,high fungal infection rate,most common site in lung,Gram-negative bacteria as most common pathogen,and an increased infection rate by agranulocytosis.The infection does not affect the remission rate of acute leukemia.

Objective To identify the scientific research status of Ershiwuwei-Shanhu pill among the literature review. Methods The literature were retrieved from CNKI, Wanfang and VIP databases (from databases built up to 2017), and quantitative analysis was carried out in the fields of time, journals and types of literature published. Results There were 58 literatures, including 33 clinical studies, 9 pharmacological studies, 14 pharmacological studies and 2 reviews. The literature published 39 kinds of journals, among which there were 81.0％ studies published in the journals holding the impact factors more and equal to 0.15 and 7 were core journals. Conclusions The results showed that the Ershiwuwei-Shanhu pill was in the developing period, mainly focused on clinical research, although there are some studies on pharmacology and pharmacy.The study of the ancient Tibetan medicine to the mature period there is still much space for development.

Objective:To explore the clinical characteristics and treatment regimens of adrenal incidentaloma (AI) in children.Methods:Clinical data of 38 children with AI treated in the Department of Urology, Children′s Hospital of Nanjing Medical University from December 2016 to October 2021 were retrospectively analyzed.A total of 38 children were divided into neonatal group and non-neonatal group according to their age at first diagnosis.The neonatal group had 7 males and 9 females patients, of whom 7 cases were detected with AI during prenatal examinations, 9 cases were diagnosed postnatally.Four children in neonatal group had AI in the left adrenal gland and 12 cases in the right, with the maximum diameter of tumor (MDT) ranging from 16-48 mm.In the non-neonatal group, there were 14 males and 8 females patients aged 7 months and 1 day to 12 years and 1 month, and the MDT was 29-131 mm.Paired t test was used to compare the age and MDT of benign and malignant tumors. Results:In the neonatal group, 3 patients were surgically treated, with 2 cases and 1 case of neuroblastoma and teratoma confirmed by postoperative histology, respectively.The remaining 13 patients in the neonatal group were followed up for 1-31 months, with 8 cases and 5 cases of complete remission and significantly decreased tumor volume, respectively.In the non-neonatal group, there were 3, 9 and 10 patients received open biopsy, laparoscopic adrenalectomy, and open adrenalectomy, respectively.Of these 22 surgically treated cases, 8 cases had a benign lesion, including ganglioneuroma ( n=4), adrenocortical adenoma ( n=1), adrenal cyst ( n=1), teratoma ( n=1), and pheochromocytoma ( n=1); while 14 cases had a malignant lesion, including neuroblastoma ( n=8), ganglioneuroblastoma ( n=5), and adrenocortical carcinoma ( n=1). The mean age of patients with malignant tumors was significantly younger than those with benign tumors[(38.94±35.44) months vs.(95.89±41.43) months, t=3.63, P=0.001]. The mean MDT in malignant tumors was significantly longer than that of benign tumors[(64.43±25.20) mm vs.(41.44±15.66) mm, t=2.45, P=0.023]. Conclusions:AI in children has a high risk of malignancy.Therefore, more detailed examinations are needed to detect tumor markers and endocrinological parameters, and imaging tests such as non-contrast and CT examination should be performed as early as possible.AI in children is predominantly neuroblastic tumors.For non-neonatal patients, surgery should be performed as early as possible.For AI found in the neonatal period and prenatal examination, expectant management is feasible if the tumor is relatively small and limited to the adrenal gland without distant metastases.