Objective To investigate the immune protective effect of recombinant growth hormone on chronic obstructive pulmonary disease ( COPD) patients with typeⅡin respiratory failure during the application of ventilator.Methods 52 patients with COPD with respiratory failure in Taizhou City Hospital from July 2014 to November 2015 in this study who were treated with ventilator therapy were divided into two groups.The control group received routine treatment, and the treatment group received more with recombinant growth hormone 8 U/d subcutaneous injected.Before and after treatment 14 days,determination of nutritional indicators,immune function,inflammatory markers and indicators of oxidative stress.Results Compared with before treatment,levels of total protein,albumin,transferrin and fibronectin in 2 groups after treatment increased,levels of IgM,IgG,CD4 +,CD8 +and CD4 +/CD8 +increased,levels of TNF-α,IL-8 and CRP decreased,levels of MDA,GSH and TAO decreased,levels of SOD increased(P<0.05), compared with the control group,levels of total protein,albumin,transferrin and fibronectin in the treatment group were higher,levels of IgM,IgG,CD4 +, CD8 +and CD4 +/CD8 +were higher,levels of TNF-α,IL-8 and CRP were lower,levels of MDA,GSH and TAO were lower,levels of SOD were higher (P<0.05).Conclusion Recombinant growth hormone has immune function protective effect on the COPD patients with type II respiratory failure in the process of breathing machine, which can improve the nutritional index and reduce the inflammatory reaction.

Objective To investigate whether the aberrantly expressed HLA class Ⅱ molecules on the follicular epithelial cells of Graves' disease and Hashimoto's thyroiditis present autoantigens. Methods Expressions of HLA class Ⅱ, invariant (Ii) chain and B7 on follicular epithelial cells were detected by labeled streptavidin binding (LSAB) and expression of Ii chain at mRNA level was assayed by in situ hybridization (ISH). Results The expression pattern of HLA class Ⅱ, Ii chain and B7 on epithelial follicular cells from Graves' disease and Hashimoto's thyroiditis is highly heterogeneous. Conclusion Follicular epithelial cells possess the necessary molecular basis for presenting autoantigens and activating T cells, at least in a part of the patients.

Objective To investigate the differential diagnosis of Reye syndrome and the characteristics of primary carnitine deficiency,and to provide diagnostic strategy for similar cases.Methods There was a case presented with fever,poor response,convulsions and hepatomegaly hospitalized in Wuhan Children's Hospital,and the clinical manifestations were described,the physical examination was comprehensively conducted,the auxiliary examination results were recorded,some pediatric specialists from ICU,neurology department,genetic metabolic department,digestive system department were invited to discuss the case.The treatment was adjusted according to the suggested opinions;the treatment effects and the final diagnosis were tracked.Results The primary diagnosis of the case was central nervous system infection or toxic encephalopathy at the time of admission,but Reye syndrome could not be excluded.Although the cerebrospinal fluid test and brain MRI examination detected nothing abnormal,liver function suggested alanine aminotrans ferase ALT increase,blood sugar decrease,the liver volume increase,which was detected by liver ultrasound.Blood amino acids examination revealed the carnitine level decreased,and it was confirmed as primary carnitine deficiency in the end.L-carnitine was used to treat the disease,and its effect was good.Conclusions Great importance should be attached to children with onset age,physical check-up,and multidisciplinary cooperation.Use monism to explain the illness and the auxiliary inspection as far as possible,so that it can get early diagnosis and treatment,and the outcome is good.

Objective To prepare and characterize docetaxel incorporated phosphatidylcholine -sodium desoxycholate mixed micelles (DOX EPC/SDC MMs).Methods Docetaxel mixed micelles (DOX MMs) were prepared using the co-precipitation method .An optimized formulation was obtained by single factor method , which was used to study the effect of several factors on water solubility of DOX in MMs, including EPC/total(EPC+SDC)concentration, total(EPC+SDC) concentration, the pH and ionic strength of the hydrated solution .Then, the obtained DOX MMs were characterized by investigating particle size distribution and morphology , and by conducting dilute experiments to examin micelle stability . Results The EPC/total ( EPC+SDC) concentration ratio was 0.4.The total supplementary material concentration was 2.5%.Pure water was used to disperse the film .The drug loaded MMs had an average size of 18.56 nm and average zeta potential of -24.3 mV.A roundlike shape was observed under a transmission electron microscope ( TEM).Conclusion DOX EPC/SDC MMs, prepared by a simple and convenient method , can enhance water solubility , is physically compatible with injection solutions and is expected to become a new drug delivery system .

Fetal heart sound is nonlinear and non-stationary, which contains a lot of noise when it is colleced, so the denoising method is important. We proposed a new denoising method in our study. Firstly, we chose the preprocessing of low-pass filter with a cutoff frequency of 200 Hz and the resampling. Secondly, we decomposed the signal based on empirical mode decomposition method (EMD) of Hilbert-Huang transform, then denoised some selected target components with wavelet soft threshold adaptive noise cancellation algorithm. Finally we got the clean fetal heart sound by combining the target components. In the EMD, we used a mask signal to eliminate the mode mixing problem, used mirroring extension method to eliminate the end effect, and referenced the stopping rule from the research of Rilling. This method eliminated the baseline drift and noise at once. To compare with wavelet transform (WT), mathematical morphology (MM) and the Fourier transform (FT), the SNR was improved obviously, and the RMSE was the minimum, which could satisfy the need of the practical application.
Algorithms ; Fetal Heart ; physiology ; Heart Sounds ; Humans ; Signal Processing, Computer-Assisted ; Signal-To-Noise Ratio ; Wavelet Analysis

Objective : To investigate the status and influencing factors of self-management behaviors among pregnant women with gestational diabetes mellitus (GDM), so as to provide insights into health management of GDM. Methods: GDM patients admitted to Medical Community General Hospital of Shaoxing Second Hospital were sampled from January to June 2023, and basic characteristics were collected using questionnaire surveys, including age, parity, education level and gestational age. The self-management behaviors were evaluated among GDM patients using the self-management behavior scale, and the social support level was evaluated using the social support scale, while the modes of coping with diseases were identified using the medical coping modes questionnaire (MCMQ). Factors affecting the self-management behaviors were identified among GDM patients using a multiple linear regression model. Results: A total of 120 GDM patients were enrolled, with a mean age of (27.58±3.73) years and gestational age of (22.16±5.82) weeks. The score for self-management behaviors was (118.19±24.86) points among GDM patients, including 15 cases with good self-management behaviors (12.50%), 61 cases with moderate behaviors (50.83%) and 44 cases with poor behaviors (36.67%). Multiple linear regression analysis showed that educational level (high school: β'=0.168; junior college and above: β'=0.187), per capita monthly household income (≥5 000 Yuan, β'=0.305), health education for GDM (β'=0.087), coping mode (avoidance: β'=0.168; acceptance: β'=0.375) and social support level (general: β'=0.184; high: β'=0.429) were factors affecting self-management behaviors among GDM patients. Conclusion The self-management behaviors of GDM patients are associated with educational level, per capita monthly household income, health education for GDM, coping mode and social support level.

BACKGROUND:At present, there are few reports about the non-human primate models of type 2 diabetes mel itus in domestic and abroad, so it lacks of standardized production methods and evaluation criteria.
OBJECTIVE:To establish a safe and effective type 2 diabetes mel itus model of rhesus monkey and evaluation method.
METHODS:Twelve rhesus monkeys were randomly assigned to experimental group (n=9) and control group (n=3). Rhesus monkeys in the experimental group were fed with high-glucose and high-fat diet for 4 weeks, and intraperitoneal y injected with 30 mg/kg streptozotocin to establish models of type 2 diabetes mel itus. Rhesus monkeys in the control group were fed with an equal volume of physiological saline. At 12 weeks after injection, peripheral blood serum was col ected to measure fasting blood glucose, lipids, insulin, and C-peptide levels. Intravenous glucose tolerance test and C-peptide release test were used to detect pancreatic gland and pancreatic islet function. Histopathological examination was performed in pancreas, kidney and liver.
RESULTS AND CONCLUSION:(1) 12 weeks after injection, fasting blood glucose, triglycerides, and total cholesterol levels were significantly higher in the experimental group than in the control group (P<0.05). Insulin and C-peptide levels were significantly lower in the experimental group than in the control group (P<0.05). (2) The area under the curve for intravenous glucose tolerance test was increased in the experimental group than in the control group (P<0.05). The area under the curve for C-peptide response test was significantly reduced in the experimental group than in the control group (P<0.05). (3) The pathological sections of pancreas, kidney and liver showed typical pathological changes of diabetes in the experimental group. (4) It is confirmed that we got high achievement about rhesus monkey models of type 2 diabetes mel itus made by high-glucose and high-fat diet combined with low-dose streptozotocin. It is a feasible, safe and effective method.

Objective To investigate the relationship between the mutation of ERG11 gene,a target of azole antifungal drugs (fluconazole,itraconazole,voriconazole),and azole-resistance in Candida albicans isolates from patients with AIDS.Methods Ninety-three Candida albicans strains were isolated from patients with AIDS.DNA was extracted from these isolates,and ERG11 gene was amplified by PCR followed by bidirectional sequencing.DNAman software was used to compare the resultant sequence with the reference sequence of ERG11 gene (GenBank accession no.X13296).Then,different base sequences were translated into amino acid sequences to determine whether missense mutations occured.Results A total of 40 mutation sites were identified in these isolates,including 27 silent mutations and 13 missense mutations.One or no missense mutation was detected in Candida albicans strains resistant to 1 antifungal agent,while those resistant to 2 or 3 antifungal agents simultaneously harbored 2 or 3 missense mutations.Conclusion The missense mutations in ERG11 gene are probably connected with azole resistance in Candida albicans.

ObjectiveTo investigate the accuracy of automated breast volume scanning (ABVS) for the measurement of breast tumor size.MethodsSixty-two breast tumors in 59 patients were included in this study and were examined using conventional ultrasound and ABVS to measure the maximal diameters of the tumors. And the measurement results were compared with the pathological maximal diameters.Results There were 21 malignant and 41 benign tumors according to histopathological evaluation. There were no signifi cant differences between the maximal diameters on ABVS and on pathological measurements for both benign tumors and malignant tumors (Z=1.761, 0.262,P=0.078, 0.794). However, for malignant tumors, the maximal diameters on conventional ultrasound were significantly smaller than those on pathological measurements (Z=3.743,P=0.000). For benign tumors, the maximal diameters on conventional ultrasound were similar with those on pathological measurements (Z=1.935,P=0.053). The measurement values of conventional ultrasound and ABVS were both positively correlated with those on pathological values (r=0.935, 0.964,r=0.870, 0.964). And the correlation coeffi cients between ABVS and pathological measurement values were higher than those between conventional ultrasound and pathological measurement values for both benign and malignant tumors. ConclusionABVS can assess the size of breast tumor more accurately than conventional ultrasound, especially for the malignant tumors.

Objective To investigate molecular epidemiology and antimicrobial susceptibility of Salmonella spp. isolates recovered from the stool samples of children with diarrhea. Methods Seventy-two isolates of Salmonella spp. were collected from children with diarrhea. The serum type of Salmonella spp.was determined by serology agglutinating method. Antimicrobial susceptibility was determined by K-B disk diffusion method and MICs of cefotaxime and ceftazidime were measured by agar dilution method for Salmonella spp. isolates. PCR and DNA sequencing were used for detecting ESBL, ISEcpl and AmpC genes; The transfer of cefotaxime resistance was determined by conjugation experiments. PFGE was performed for determining the homogeneity of the S. typhimurium isolates. Results A total of 72 isolates of Salmonella spp. were collected, among which S. typhimurium accounted for 86 % (62/72) and was the main serum type. S. typhimurium isolates and S. thompson isolates were often resistant to most of clinically used antimicrobial agents. Resistance of S. thompson isolates to ampicillin was the highest (90%, 56/62),followed by tetracycline (81%, 50/62), trimethoprim/sulfamethoxazole (74%, 46/62) and chloramphenicol (66%, 41/62). Seventeen S. typhimurium isolates (27%, 17/62) and two S. thompson isolates were resistant to cefotaxime. Forty-nine S. typhimurium isolates and two S. thompson isolates were positive for blaTEB-1b and resistant to ampicillin. Thirteen ESBL-producing S. typhimurium isolates (21%, 13/62) were positive for blaCTX-M (eight for blaCTX-M-14, three for blaCTX-M-15, one for blaCTX-M-55, one for both blaCTX-M-14 and blaCTX-M-55). All isolates harboring blaCTX-M genes were positive for upstream insert sequence ISEcpl. blaDHA-1was detected in a cefoxitin-resistant S. thompson isolate. Two main clones (PFGE type A and D) accounting for 19% (12/62) and 50% (31/62) respectively were found among 62 S. typhimurium isolates. Seven CTXM-producing isolates belonged to PFGE type D. Conclusions The multi-resistance to antimicrobial agents and high prevalence of blaCTX-M genes are found among S. typhimurium and S. thompson clinical isolates. blaCTX-M-55 is first found in S. typhimurium isolates and blaDHA-1 is found in S. thompson isolates. Clonal spread is responsible for the dissemination of S. typhimurium isolates.