Objective To explore the influence of gestational diabetes mellitus(GDM)on pregnancy and delivery outcomes.Methods 278 pregnant women with GDM were chosen as experimental group who underwent their antenatal care and delivery in Liuhe People's Hospital in Nanjing,according to the 75g oral glucose tolerance test(OGTT)performed in pregnant women at 24-28 pregnancy weeks from January 2014 to October 2015.Meanwhile,the other 278 healthy women were chosen as control group.The pregnancy and delivery outcomes of the two groups were compared.Results The 24-28 weeks' 3 time-point OGTT blood glucose (FPG,1 h PG and 2 h PG) (mmol/L) values of experimental group were 5.08±0.56,9.22±1.71 and 7.62±1.48 respectively,which were significant higher than that of control group:4.45 ± 0.43,7.76 ± 1.35,6.34±4 0.96 (P＜0.05).The incidences of pregnancy-induced hypertension syndrome,premature rupture of membranes,premature birth,fetal distress,postpartum hemorrhage,macrosomia and cesarean delivery of experimental group were significantly higher than that in control group (P ＜ 0.05).Conclusion GDM has a relatively large effect on pregnancy outcomes,causing serious complications of maternal and infant.Therefore,glucose metabolism during pregnancy should be surprised closely and education should be conducted to improve maternal and neonatal outcomes.

Objective To investigate the correlation between the connective tissue growth factor(CTGF)in serum and the stages of liver fibrosis of patients with chronic liver disease,and explore new marker for evaluation of liver fibrosis.Methods The serum levels of CTGF in 313 patients with liver disease was detected by ELISA.Hyaluronic acid,type III procollagen,type IV collagen and laminin in serum were determined by RIA.Liver biopsy was performed in 45 patients with chronic liver disease.The quantitative relationship between the levels of CTGF and the stages of liver fibrosis was statistically analyzed by SPSS 11.5 software.Results A positive correlation between the serum levels of CTGF and the severity degree of chronic liver disease was found and the correlation coefficient was strong(r=0.634,P

Objective To purify ?-glutamyltranspeptidase (GGT) strongly combined to datura stramonim (DSA) lectin from human liver cancer tissue,which will be used as the antigen to produce antibodies for early diagnosis of liver cancer.Methods The GGT strongly combined to DSA lectin in human liver cancer tissue was purified by lectin affinity chromatography from human liver cancer tissue, including rough extraction,dialysis,ion-exchange chromatography and lectin affinity chromatography.Results The catalysis units per milligram protein of GGT increased about 84.9 times.The yield of the GGT was 1.60%.Conclusion The protocol in this study is efficient to purity GGT from human liver cancer tissue.

Purpose To explore the relationship between connective growth tissue factor(CTGF) in serum and the severity of liver fibrosis,and to determine the clinical value of CTGF in the assessment of liver fibrosis.Methods Serums CTGF were tested utilizing enzyme linked immunosorbent assay(ELISA).The correlation between serum CTGF concentration and fibrosis stage was assessed.Results The diagnostic performance of CTGF was assessed by comparing the area under receiver characteristic curves(AUC) with a panel of fibrosis markers.Correlation coefficient was 0.689(P＜0.001) between the levels of serum CTGF and fibrosis stages and AUC of CTGF was 0.841(95% confidence interval,0.762-0.920) in distinguishing mild fibrosis from significant fibrosis.Conclusion The present data revealed that serum CTGF was significantly correlated with the stage of liver fibrosis,suggesting that serum CTGF was an indicator for the stage of liver fibrosis,and serum CTGF could be used as a valuable marker assessing liver fibrosis.

Objective To establish a biotin-streptavidin ELISA method to measure CTGF,and evaluate the clinical value of CTGF for the diagnosis of liver fibrosis in chronic hepatitis B (CHB) patients.Methods Biotinylated anti-CTGF polyclonal antibody and monoclonal antibodies were prepared for the establishment of this biotin-streptavidin ELISA method.Two hundreds and sixty-four CHB patients were subjected into non-or mild liver fibrosis group (S0-S1,108 cases) and severe liver fibrosis group (S2-S4,156 cases),according to the liver biopsy pathological diagnosis.The CTGF assay's diagnostic capacity for CHB was assessed by comparing the area under ROC (AUC) with that of a panel of hepatic fibrosis markers ( HA,PC Ⅲ,C Ⅳ,LN and APRI).Analysis of variance and rank sum test were performed to carry out comparisons between multiple groups.Student's t-test and Mann-Whitney U test were performed for the pairwise comparison between multiple samples.Spearman rank correlation test was performed to analyze the correlation between different hepatic fibrosis stages.Results The minimum detectable dose and detection rang of the ELISA was 0.2 μg/L and 0-64 μg/L respectively.The intra-assay and inter-assay CV at high and low level were 4.5％,9.8％ and 10.1％,12.8％ respectively.Serum CTGF concentrations in S0-S1 group and S2-S4 group were 6.7(3.1 - 10.1 ) μg/L and 16.1 ( 11.8 -27.2) μg/L,with a statistically significant difference (U =1 217,P ＜0.001 ).There was a significant correlation between the levels of serum CTGF and fibrosis stages ( r =0.689,P ＜ 0.001 ),AUC of CTGF was 0.841 (95％ CI:0.762 - 0.920) in distinguishing mild fibrosis from significant fibrosis.When the cut-off value of CTGF was 10.3 μg/L,the sensitivity and specification was 70.5％ and 82.4％ respectively.The sensitivity of parallel combination test of CTGF and APRI was 96.1％,which was higher than that of HA (75.6％),PC Ⅲ (70.5％ ),C Ⅳ(63.6％),LN(79.5％ ),APRI(86.3％ ).The specificity of the combination test was 65.5％,which was lower than of above liver fibrosis markers [HA ( 72.5％ ),PC Ⅲ ( 76.5％ ),C Ⅳ ( 78.4％ )].The specificity of serial combination test of CTGF and PC Ⅲ was 95.9％,which was higher than that of HA,PC Ⅲ,CⅣ,LN(64.7％ ),APRI(66.1％ ),however,the sensitivity of the combination test was 67.7％,which was lower than that of above HA,PC Ⅲ,and APRI.Conclusions The biotin-streptavidin ELISA method measuring serum CTGF has a high minimu detectable dose sensitivity,and specificity.Serum CTGF level is significantly correlated with fibrosis stage,and CTGF maybe a valuable marker for liver fibrosis assessment.The paralledl combination of CTGF and APRI could be used as screening for significant liver fibrosis markers.The serial combination of CTGF and PC Ⅲ may be considered as a confirmatory diagnostic marker for liver fibrosis.

Objective To prepare monoclonal antibody (McAb) against γ-glutamyhransferase(GGT) firmly bound to datura stramonim (DSA) leetin from primary hepatic carcinoma (PHC) tissue and establish an avidin-biotin enzyme-linked immunosorbent assay (ELISA) for evaluating the diagnostic value of serum DSA-GGT for PHC. Methods Anti-DSA-GGT monoclonal antibodies were obtained by McAb technology and purified by protein G-sepharose affinity chromatography. The McAb was labeled with biotin and avidin-biotin ELISA for measurement of serum DSA-GGT was established. Using the avidin-biotin ELISA, serum DSA-GGT levels was detected in 39 patients with PHC, and 122 patients with non-PHC diseases. The distribution of serum DSA-GGT values of 119 healthy subjects were determined by P-P plots. Optimal cut-off value for the diagnosis of PHC was determined by receiver operating characterstic (ROC) curve. Results The protein levels of McAb in the ascites derived from 5 McAb hybridoma cell strains ranged from 2. 12 to 6. 70 mg, The biotin-labeled rate varied from 48. 6% to 72. 2% respectively. The minimum detection limit of serum DSA-GGT in avidin-biotin ELISA was 2 μg/L. Intra-assay and inter-assay coefficients of variation were 8.9% and 11.5% respectively. The distribution of DSA-GGT values of 119 healthy subjects showed Gaussian distribution and its Mean ± SD was ( 1.50±0. 51 ) μg/L. Optimal cut-off value (3.25 μg/L) in the diagnosis of PHC was determined by ROC curve. DSA-GGT was positive in 26 out of 39 patients with PHC and 10 out of 122 patients with non-PHC diseases were positive. The sensitivity and specificity of this assay for the diagnosis of PHC were 66. 7% and 91.8% respectively. Conclusions The convenient avidin-biotin ELISA method was successfully established in our laboratory and it showed a good reproducibility and reliability. It may be a potential tool in the diagnosis of PHC to achieve higher sensitivity and specificity.

Objective To assess the clinical value of pentraxin-3 (PTX-3) in diagnosis and survey of therapeutic effect for lung cancer.Methods The serum level of PTX-3,carcinoembryonic antigen (CEA),cytokeratin 19 fragment (CYFRA 21-1) were measured in 802 patients with lung cancer,462 with benign lung diseases and 522 healthy controls from multiple research centers,using ELISA and electrochemiluminescent assays.The clinical value of PTX-3 was assessed by comparing the area under receiver characteristic curves (AUC) with CEA and CYFRA21-1.The optimum cutoff value for diagnosis of lung cancer was investigated by maximizing the sum of sensitivity and specificity.By following-up,the serum level of PTX-3 was measured at 3 day,7 day,and 14 day in 61 lung cancer patients after surgical resection of lung cancer.Results In test group and validation,the serum levels of PTX-3 (g/L) are significantly higher in lung cancer group [9.21 (6.13-12.80),10.4(5.54-13.11)] than in benign lung diseases [5.28 (3.42-8.53),6.52 (3.84-7.89)] and in healthy controls [2.18 (0.54-5.44),2.44 (0.67-5.87)],[Z =8.161,14.118,(test group,all P ＜ 0.05) ;Z =9.832,17.595 (validation group,all P ＜0.05)].ROC curve showed the optimal cut-off values for PTX-3 was 8.03 g/L [AUC of 0.831,with a sensitivity of 76.1％ and specificity of 75.2％ in the test cohort; 0.828,71.3％,89.2％ in the validation cohort].Similar results were noted for early-stage lung cancer [0.764,79.1％,and 62.2％ in the test cohort; 0.744,71.3％,and 69.6％ in the validation].In the diagnosis of early-stage lung,the AUC and sensitivity and specificity of PTX-3 were 79.1％,0.764,71.3％ (test group),and 75.2％,89.2％,0.824 (validation group) significantly higher in these patients than CEA and CYFRA21-1.In small cell lung cancer,PTX-3 and NSE shared similar AUC differentiating LC from benign lung diseases and health controls.In following-up 61 lung cancer patients,PTX-3 levels before surgical resection of tumours [11.12(9.12-12.59)] was significant high than following 3 day after surgery(Z =4.32,P ＜0.01),and 14 day (5.12 ±2.54) vs.7 day (7.13 ±3.42) (t =2.143,P =0.023).The correlation between PTX-3 and CRP in LC,benign lung diseases,health control was 0.364,0.592,0.512 (all P ＜ 0.05).Conclusion Serum PTX-3 is a valuable biomarker of lung cancer and early-stage lung cancer with high sensitivity and specificity and improved identification of patients with lung cancer from those with non-malignant chronic lung diseases.

It is necessary to use objective and accurate methods to assess the changes of the consciousness of patients emergencing from general anesthesia. In this way, adverse medications during the waking period can be avoided, and it can ensure the stable and safe recovery of consciousness of the patients, quickly remove the adverse factors affecting the patients, and strive to reduce the occurrence of complications during the waking period. This article briefly reviews the research progress of bispectral index and other common clinical anesthesia depth monitoring techniques used to assess the changes of consciousness of patients awakening from general anesthesia, and explores the regular pattern of recovery of consciousness in patients awakening from general anesthesia, in order to reduce complications in the recovery period .

OBJECTIVE: To compare the hemodynamics and post-anesthetic recovery of total intravenous anesthesia (TIVA) with remifentanil or fentanyl combined with propofol administered by target controlled infusion (TCI) in neurosurgery. METHODS: A total of 80 patients undergoing selective neurosurgery were randomly divided into a remifentanil group (Group R, n=40) and a fentanyl group (Group F, n=40). In Group R,remifentanil and propofol was administered by TCI and the blood concentration were 3 approximately 5 microg/L and 3 approximately 5 mg/L each. In Group F, fentanyl was continuously infused at 2 approximately 3 microg/(kg.h) and propofol was administered by TCI with the same blood concentration as that in Group R.Vecuronium was injected at intervals to maintain muscle relaxant.Mean arterial pressure and heart rate during the anesthesia and post-anesthetic recovery were recorded. RESULTS: Mean arterial pressure of all the patients was decreased significantly from induction of anesthesia to termination of operation compared with that before the induction( P<0.01). The heart rate of Group R was increased obviously from recovery of respiration to extubation and heart rate of Group F was decreased obviously from fixed headframe to termination of operation compared with that before the induction (P<0.01). But there was no significant difference between the 2 groups (P>0.05). The eyes opened and extubed time of Group R were decurtated obviously and the scores of pain were increased significantly (P<0.01). CONCLUSION TIVA with remifentanil or fentanyl combined with propofol administered by TCI in neurosurgical operation can provided steadible hemodynamics. Resuscitation of remifentanil with propofol administered by target controlled infusion were more quickly but the scores of pain were more higher than that of fentanyl.
Adolescent ; Adult ; Aged ; Anesthesia Recovery Period ; Anesthesia, Intravenous ; methods ; Anesthetics, Intravenous ; administration & dosage ; Craniotomy ; Female ; Fentanyl ; Humans ; Infusion Pumps ; Male ; Middle Aged ; Neurosurgical Procedures ; Piperidines ; Propofol ; Remifentanil ; Vecuronium Bromide ; administration & dosage ; Young Adult

OBJECTIVE: To construct the recombinant lentivirus vector containing short hairpin RNA (shRNA) inhibited DREAM expression and to investigate the gene therapy of neuropathic pain by inhibiting the expression of DREAM gene by RNA interference. METHODS: An effective short hairpin RNA targeting to rat DREAM was cloned into the plasmids on the base of Lentivirous vectors, pKCSHR-Puro/GFP, and both of the pKCSHR-Puro/GFP-DREAM and Lentivector package plasmids mix were transferred into the 293T cells. The culture supernatant was harvested, and the virus titer was detected 48 hours after transferring. Thirty-six sheer breed pathogen free adult Sprague Dawley rats were randomly divided into 6 groups (6 in each group): normal control group (N); sham-operated group (S); CCI group (C0 group):CCI model without any intervention; Saline control group (C1 group); empty vector control group (C2 group); and LV-shRNADREAM lentiviral vector treatment group (C3 group). The rats in the last 3 groups respectively accepted injection of normal saline, blank vector, LV-shRNADREAM lentiviral vector in the subarachnoid on the 7th day after CCI, and the pain behavior was observed after 3, 7, 10, 14, 21 d after CCI. Green fluorescent protein (GFP) expression was detected by fluorescence microscope and the contents of DREAM mRNA and DREAM protein were detected by Realtime PCR and Western blot respectively in the rat lumbar spinal cord. RESULTS: The short hairpin RNA sequences targeting at rat DREAM were cloned into the vectors, and an entry clone and an expression clone were constructed successfully confirmed by sequence analysis. Lentiviral packaging was successful in 293 T cell line and the transfection titer of the lentivirus was 1 x 10(8) IFU/mL. LV-shRNADREAM lentivirus vector was transfected successfully in the rat spine with Intrathecal injection of LV-shRNADREAM. Compared with the other 3 groups, heat pain threshold and mechanical pain threshold in Group C3 improved significantly (P<0.01), and the expression of DREAM mRNA and DREAM protein in the lumbar spinal cord in Group C3 were lowered significantly (P<0.01). CONCLUSION Lentivirus vectors containing rat DREAM gene are constructed successfully, and lentivirus mediated shRNA can inhibit the DREAM expression in the rat spine, which may prove to be an effective method for neuropathic pain.
Analgesia ; methods ; Animals ; Base Sequence ; Genetic Therapy ; methods ; Genetic Vectors ; genetics ; Kv Channel-Interacting Proteins ; biosynthesis ; genetics ; Lentivirus ; genetics ; metabolism ; Male ; Molecular Sequence Data ; Pain ; etiology ; Pain Management ; RNA Interference ; RNA, Small Interfering ; genetics ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Repressor Proteins ; biosynthesis ; genetics ; Sciatic Nerve ; injuries ; Transfection