Objective To investigate the association between third-trimester gestational weight gain rate (GWGR) and both maternal and neonatal health outcomes in a normal glucose tolerance obstetric population.Methods This was a retrospective cohort study of full-term singleton live births (n=1 967) in women with a normal oral glucose tolerance test (OGTT) tested at 24-28 gestational weeks,who gave birth at Beijing Obstetrics and Gynecology Hospital,Capital Medical University,between January and December in 2013.The subjects were divided into three groups based on third-trimester GWGR category of the 2009 Institute of Medicine (IOM) guidelines.Each group was divided into three subgroups by pre-pregnancy body mass index (BMI):low (＜18.5),normal (≥ 18.5-＜25.0),and high (≥ 25.0).One-way analysis of variance,Chi-square or Fisher's exact test,Logistic regression and corrected analysis were performed for statistical analysis.Results (1) Of the 1 967 women analyzed,third-trimester weight gain distribution was normal in 575(29.2％),excessive in 982(49.9％),and insufficient in 410(20.8％).No significant differences were found in terms of age,parity,education level,family history of diabetes or hypertension among the GWGR groups (all P＞0.05).(2) The mean third-trimester weight gain in the 1 967 normal OGTT women was (0.56±0.23) kg/week and the mean neonatal birth weight was (3 442±396) g.The above two parameters were linearly correlated (Y=103.839X+3383.752,r=0.621,P＜0.01).The excessive GWGR group had higher birth weight infants than the normal GWGR group [(3 463.1±417.3) vs (3 427.4±376.1) g,F=4.901,P=0.014].Women in the insufficient GWGR group had lower birth weight infants (3 375.1 ±370.1) g than those in the normal GWGR group (F=4.408,P=0.021).Compared to the normal GWGR group,the excessive GWGR group was associated with an increased risk of fetal macrosomia (OR=1.59,95％CI:1.10-2.30) and low birth weight infants (OR=2.25,95％CI:1.03-4.94),and decreased odds of normal birth weight deliveries (OR=0.81,95％CI:0.77-0.95).The insufficient GWGR group was associated with an elevated risk of low birth weight infants (OR=3.21,95％CI:2.56-7.51,P＜0.01),but not related to the risk of fetal macrosomia on normal birth weight deliveries (all P＞0.05).(3) Compared to the normal GWGR group,the excessive GWGR group had an increased incidence of cesarean section [30.2％ (297/982)vs 22.2％ (128/575)] and hypertensive disorders of pregnancy [4.0％ (39/982) vs 1.9％ (11/575)] (all P＜0.01).No significant differences in the risk of surgical delivery and pregnancy-related hypertension were observed in the insufficient GWGR group compared to the normal GWGR group.No significant differences in the odds of neonatal intensive care unit admission were noted among the three GWGR groups (P＞0.05).(4) In the normal and insufficient GWGR groups,no differences in neonatal birth weight or risk of small-for-gestational age (SGA)or large-for-gestational age (LGA) were seen in any of the BMI subgroups (all P＞0.05).In the excessive GWGR group,the high pre-pregnant BMI subgroup showed higher neonatal birth weight than the normal pre-pregnant BMI subgroup [(3 552.3±445.0) vs (3 481.8±416.1) g,P＜0.01],and the low pre-pregnant BMI subgroup showed lower neonatal birth weight (3 352.7 ± 371.2) g than the normal pre-pregnant BMI subgroup (P＜0.01).Moreover,the high pre-pregnant BMI subgroup in the excessive GWGR group had an increased risk of fetal macrosomia (OR=1.60,95％CI:1.11-2.81).Conversely,the low pre-pregnant BMI subgroup in the excessive GWGR group had a decreased risk of fetal macrosomia (OR=0.52,95％CI:0.29-0.97) (all P＜0.05).The high BMI subgroup had a greater risk of hypertensive disorders of pregnancy than the normal BMI subgroup in all GWGR groups (allP＜0.05).The incidence of surgical delivery or NICU admission was not significantly different among the three GWGR subgroups.Conclusions Excessive weight gain in third-trimester is common in normal OGTT women.Excessive gestational weight gain is associated with adverse maternal and neonatal outcomes.Thus,gestational weight gain in the third-trimester should be adequately monitored and a balance in weight gain within the range recommended by the 2009 IOM guidelines should be established in normal OGTT pregnant women.

Objective To investigate the expression level of cyclooxygenase-2 (COX-2) and its effects on cell proliferation activity and apoptosis in colorectal carcinoma. Methods The expression of COX-2, proliferating cell nuclear antigen (PCNA) and apoptosis in 60 cases of colorectal carcinoma, 20 cases of colorectal adenoma and 20 cases of normal mucous were studied by the immunohistochemical and TUNEL methods, the apoptosis index(AI)and proliferation index(PI) were defined respectively. Results The positive expression rate of COX-2 in colorectal carcinoma was significantly higher than that in the other groups. Overexpression of COX-2 in colorectal carcinoma was related to its lymph node metastasis and the size of tumor and clinical stages. In the group with COX-2 positive expression, PI was higher than that in the group with COX-2 negative expression; whereas AI was higher in the latter group than in the former group. Conclusions The expression level of COX-2 may have a close correlation with cell proliferation and apoptosis, they may participate in oncogenesis and progression of colorectal carcinoma.

The rodipicolinate synthase gene was cloned from Nicotiana tabacum L.cv,which encodes the key enzyme in the synthesis of lysine,and then a vitro molecular reform reliefing feedback suppression was made. Some resistant seedlings were acquired using the mutated gene as selectable marker and analog of lysine as selectable reagent,and the detection results were positive by means of PCR and Real-Time PCR,however the phenotype is somewhat abnormal.

Adult ; Device Removal ; Equipment Failure ; Female ; Foreign-Body Migration ; surgery ; Heart Septal Defects, Atrial ; surgery ; Humans ; Myocardial Revascularization ; adverse effects ; instrumentation ; Postoperative Complications ; etiology

Objective To research and evaluate measuring Toric intraocular lens (Toric IOL) alignment by iTrace aberration without mydriasis.Methods Forty-five eyes of 35 patients underwent phacoemulsification in Tianjin Medical University Eye Hospital from June 2015 to February 2016 were enrolled.Follow-up and iTrace aberration examination were performed at postoperative 1 week.The internal optics aberration astigmatism axis was transformed into postoperative Toric IOL alignment.The result and the Toric IOL alignment measured by tradition slitlamp method were compared by linear correlation and difference.Results At postoperative 1 week,the uncorrected distant visual acuity and corrected distant visual acuity were (0.19 ± 0.12)LogMAR and (0.10 ±0.09) LogMAR.The UCVA was 20/40 or better in 42 eyes (93.3％).The mean IOL misalignment measured by slitlamp was (3.13 ± 2.86) degrees (ranged 0-9 degrees) and by the iTrace aberration was (4.44 ± 3.42) degrees(ranged 0-13 degrees),there was statistical significant difference (t =-2.321,P =0.025).The mean difference in the error of the Toric intraocular lens alignment measured by iTrace aberration and the slitlamp was (3.67 ± 3.59) degrees (ranged 0-14 degrees).The results showed that there was less than 5 degrees of difference between the two methods in 32 eyes (71.1％),locate 5 to 10 degrees in 9 eyes (20％),more than 10 degrees in 4 eyes (8.9％).The correlation between the 2 methods showed significant linear relationship (r =0.926,P ＜ 0.01).Conclusion Using iTrace aberration can accurately measure Toric intraocular lens alignment without mydriasis,the result has some reference value.

Objective To analyze the reproducibility of keratometry and astigmatism measured by the VERION Digital Guidance System and the comparability of VERION with iTrace,Lenstar LS900 and manual keratometer.Methods The keratometry of 62 cataract patients were measured using four different devices.The steep keratometry (Ks),flat keratometry (Kf),astigmatic magnitude,astigmatic axis,cylinder at 0-degree meridian (vector component,J0) and cylinder at 45-degree meridian (vector component,J45) from each machine were recorded and analyzed.The three repeated measurements and the results of VERION system with other three devices were compared to analyze the reproducibility and comparability of VERION system.Results Reproducibility:Intraclass correlation coefficients and Cronbach's alpha values were higher than 0.9 for Ks,Kf,astigmatic magnitude,astigmatic axis,J0 and J45 measured by the VERION system (all P ＜ 0.001).Comparability:The results of Ks and magnitude of astigmatism of VERION were larger than the iTrace (all P ＜ 0.05) in the paired-samples t test.There was no statistical difference for the rest of parameters (all P ＞ 0.05).The Bland-Altman graphs revealed the 95％ limits of agreement (LOA) of J0,J45 and the astigmatic axis between VERION and iTrace were (-0.31-0.35) D,(-0.25-0.31) D and-13.5 °-12.3 °,respectively;There was no statistical differences for all parameters except for J45 in the paired-samples t test between the VERION and Lenstar LS900 (all P ＞ 0.05).The Bland-Altman graphs revealed the 95％ LOA of J0,J45 and the astigmatic axis were (-0.25-0.31)D,(-0.27-0.36) D and-13.5°-11.0°,respectively;There were statistical differences for the results of Kf and magnitude of astigmatism between the VERION and manual keratometer (all P ＜ 0.05).The Bland-Altman graphs revealed the 95％ LOA of J0,J45 and the astigmatic axis between VERION and manual keratometer were (-0.38-0.35) D,(-0.41-0.42) D,-12.6°-16.4°,respectively.Conclusion The VERION system is a reliable system for the measurement of keratometry and astigmatism.The keratometry and astigmatic magnitude of the VERION system have a good agreement with the iTrace,Lenstar LS900 and manual keratometer.However,the astigmatic axis measurements are significantly different among the four devices.

Objective To study blood type B antigen elimination with α-galactosidase in human liver tissue,and discuss the feasibility of blood type conversion in human liver.Methods The liver specimens from patients with blood type B in liver transplantation were collected,and an in vitro liver perfusion model was established.The in vitro livers were perfused with UW solution +/-α-galactosidase.The effect of enzyme in B antigen of human liver were analyzed by immunofluorescence.Results With UW solution containing α-galactosidase to perfuse the in vitro livers,immunohistochemistry showed the level of blood type B antigen in liver was significantly reduced after hypothermic perfusion and preservation.The B antigen level in 1 h perfusion was reduced to approximate 58％ of this figure prior to perfusion,in 2 h was 10％,and in 4 h was 4％.Among the different intervals,the blood group antigen levels showed significant differences (P ＜ 0.05).In the control group,the blood group antigen levels showed no obvious change on statistical analysis.Conclusions α-galactosidase was effective to clear blood type B antigen in isolated liver tissue.In the experimental group,Although the B antigen did not fall to a undetectable level,liver blood type conversion from B→O remains a promising potential which has been meaningful for related researches on blood type conversion of human organs.

Objective To evaluate the significance of the mannose-binding lection (MBL) gene polymorphism at code 54 of exon 1 and MBL serum level and C-reactive protein (CRP) in the severity of community acquired pneumonia (CAP) in adults.Methods A prospective observation was conducted.104 adults Han patients with CAP hospitalized in Tianjin People's Hospital were enrolled.Frequencies of MBL54 alleles and genotypes were measured.The patients were evaluated by pneumonia severity index (PSI) score and were graded.Serum MBL was determined by enzyme linked immunosorbent assay (ELISA),and serum CRP was detected by immunoturbidimetry before and 4 days and 7 days after the treatment.100 healthy control subjects with the same region,age,gender,nationality were enrolled as control group.Serum MBL and CRP levels were compared between CAP group and the control group or among different grades of PSI,and the correlation was analyzed.Results The variation of GGC→GGC in MBL54 was found in CAP patients and controls.Similar frequencies of genotypes (x2=0.018,P=0.893) and alleles (x2=0.019,P=0.903) of MBL54 with wild type and mutant type were found between two groups.The serum MBL level (mg/L) before and 4 days and 7 days after the treatment in CAP group was increased followed by the reduction and they were 3.75 ± 1.78,4.53 ± 1.99 and 4.04 ± 1.91,respectivelv,which were significantly higher than those in control group (2.84 ± 1.41,all P＜0.01).The serum CRP levels (mg/L) in CAP group were gradually declined,and they were 66.88 ± 40.47,51.21 ± 37.54,36.91 ± 36.02,respectively,which were significantly higher than those in control group (6.96 ± 2.19,all P＜0.01).There were 12 cases with PSI grade Ⅰ,32 cases with grade Ⅱ,20 cases with grade Ⅲ,22 cases with grade Ⅳ and 18 cases with grade V in CAP patients.There was no significant difference in frequencies of MBL54 genotypes among different grades of PSI (x2=1.210,P=0.876) and between general ward and intensive care unit (x2=0.569,P=0.451).No differences in the serum MBL level before (F=1.313,P=0.279) and 4 days (F=1.705,P=0.165) and 7 days (F=1.684,P=0.170) after the treatment were found among different PSI grades.The serum MBL level 4 days after the treatment was significantly higher than that before treatment,then decreased to the level before treatment on the 7th day after treatment in CAP patients with grade Ⅱ-Ⅳ.There was significant difference in serum CRP level before (F=23.179,P=0.000) and 4 days (F=26.601,P=0.000) and 7 days (F=10.358,P=0.000) after the treatment among different PSI grades in CAP patients.The serum levels of CRP in patients with different PSI grades were gradually decreased with time prolonged,the higher the PSI grade,the more obscure the serum CRP decrease.No correlation was found between PSI grade and serum MBL before and 4 days and 7 days after the treatment (before treatment:r=-0.205,P=0.145; 4 days after treatment:r=-0.062,P=0.662; 7 days after treatment:r=-0.063,P=0.656),and positive correlation between PSI grade and serum CRP was found (before treatment:r=0.809,P=0.000; 4 days after treatment:r=0.842,P=0.000; 7 days after treatment:r=0.702,P=0.000).Conclusions The MBL54 codon genotypes had no effect on the susceptibility of CAP.The serum MBL was elevated and dynamic changes with increasing treatment time in CAP patients were shown.MBL can be used as a reaction of CAP in acute stage.But it cannot be used as an inflammatory marker for the severity of CAP.

Prepulse inhibition ( PPI) is the suppression of the startle reflex when the startling stim-ulus is preceded by a non-startling stimulus ( the prepulse) . It is an operational measurement of sensorimotor gating mechanism to help the brain adapt to the complex environment,which could be top-down modulated by attention and other higher cognitive processes. Deficits of PPI and the top-down modulation of PPI are closely related to psychiatric diseases. Research papers published from January 2001 to October 2016 related to PPI in psychiatric disorders were searched in the Chinese and English databases. Results showed that schizo-phrenic patients and their relatives showed deficits in baseline PPI as well as the attentional modulation of PPI,and more importantly,the attentional modulation of PPI rather than the baseline PPI was more related to the symptom severity. Patients with Tourette'' s syndrome showed PPI impairment,while patients with obsess-ive compulsive disorder had lower levels of PPI. PPI deficits in bipolar disorder patients were gender-depend-ent. Studying PPI and the top-down modulation of PPI could provide a basis to study the interaction of senso-ry processing and attention,and facilitate the researches of neural mechanism underlying the deficits of senso-ry gating. To establish advanced paradigms of PPI,new cognitive components could be introduced,such as at-tention,emotion,motor control,compulsivity and so on,thus improving the specificity of PPI test and promo-ting the PPI test as new biomarker and endophenotype in various psychiatric disorders.

Objective To compare diagnostic performance of ultrasound and radionuclide imaging in diagnosis of Meckel's diverticulum.Methods Totally 46 children suspected with Meckel's diverticulum were enrolled.Ultrasound,radionuclide imaging data were analyzed and compared with pathology.Results In 46 children suspected with Meckel's diverticulum,38 cases were confirmed by operation.Thirty-three cases of 38 were diagnosed Meckel's diverticulum by ultrasound,5 cases of 38 were false negative,there was no false positive case.Radionuclide imaging was positive in 24 cases of 46,false positive in 4 eases and false negative in 18 cases.The ultrasound diagnostic accuracy rate was 89.13％ (41/46),sensitivity was 86.84％ (33/38),specificity was 100％ (8/8).Diagnostic accuracy rate of radionuclide imaging was 52.17％ (24/46),sensitivity was 52.63 ％ (20/38) and specificity was 50.00 ％ (4/8).The sensitivity of ultrasound and radionuclide imaging in diagnosis of Meckel's diverticulum had significant difference (P＜0.01).Conclusion Ultrasound in diagnosis of Meckel's diverticulum has advantages of non-invasive,no radiation,acceptable price and high sensitivity.