Objective To compare the effects of different modes of delivery on arterial oxygen saturation in the fetus.Methods One hundred and twenty ASA Ⅰ or Ⅱ parturients aged 22-32 yr with a single fetus at full term lying in normal headdown position were divided into 3 groups according to the modes of delivery (n =40 each):group cesarean section (group CS) ; group labor analgesia (group LA) and group spontaneous labor (group SL).In group CS cesarean section was performed under epidural anesthesia with 0.5％ ropivacaine.Epidural catheter was placed at L2,3 interspace in groups CS and LA.In group LA labor analgesia was started from the first stage and maintained until complete cervical dilatation.The patients received epidural PCA (PCEA) with O.125 ％ropivacaine plus fentanyl 2 μg/ml.PCEA setting was as follows:a loading dose of 8-10 ml; demand bolus 5 ml;20 min lockout; background infusion 6-10 ml/h.Blood samples were taken from umbilical artery at delivery for blood gas analysis and determination of serum concentrations of lactate,β-endorphin (β-EP) and neuropeptide Y (NP-Y).Apgar score and neurological and adaptive capacity score (NACS) were recorded.Results There was no significant difference in Apgar score,NACS and NP-Y and β-EP concentrations in umbilical arterial blood among the 3 groups.The lactate concentration and the absolute value of BE were significantly higher while pH was lower in group SL than in groups CS and LA.PO2 was significantly higher while PCO2 was lower in group LA than in groups SL and CS,and the lactate concentration and absolute value of BE were significantly lower while pH was higher in group LA than in group SL.Conclusion The 3 modes of delivery have significant effects on arterial oxygenation in fetus but have no clinical significance.

Objective:To investigate the relationship between serum retinol binding protein (RBP), stromal cell derived factor-1 (SDF-1) and renal function in patients with diabetic nephropathy (DKD).Methods:The patients with type 2 diabetes mellitus (T2DM) admitted to Yantai Affiliated Hospital of Binzhou Medical College from October 2017 to October 2020 were prospectively selected, 438 patients were divided into simple T2DM group ( n=276)and DKD group( n=162) according to the presence or absence of DKD, according to the ratio of urinary albinin/creatinine (UACR) were divided into normal( n=25), microalbuminuria ( n=75) and macroalbuminuria group ( n=62), according to the estimated glomerular filtration rate (eGFR) were divided into G1 stage ( n=28), G2 stage ( n=27), G3A + G3B stage ( n=35), G4 stage ( n=39)and G5 stages( n=33). The relationship between RBP, SDF-1 and renal function index UACR, serum uric acid (UA), blood urea nitrogen (BUN), β 2-microglobulin (β 2-MG) and serum creatinine (Scr) was analyzed. Measurement data of normal distribution were expressed as Mean± standard deviation ( Mean± SD). Independent sample t-test was used for comparison between two groups, and one-way analysis of variance was used for comparison between multiple groups.Chi-square test was used to compare the enumeration data between groups. Receiver operating characteristic curve (ROC) was used to analyze the discriminant value of RBP and SDF-1 for DKD. Pearson was used for correlation analysis among indicators. Multivariate linear regression analysis was used to analyze the influencing factors of RBP. Results:In the DKD group, the duration of diabetes was longer, the levels of RBP, UACR, UA, BUN, β 2-MG, Scr were high, SDF-1 and eGFR were lower, with statistically significant differences compared with the simple T2DM group( P<0.05).The areas under the curve of RBP and SDF-1 to distinguish DKD were 0.903 and 0.868, and the optimal cut-off values was 70.71 mg/L and 5.69 ng/mL. With the increase of urinary albumin and clinical stage, the levels of RBP, UACR, UA, BUN, β 2-MG, Scr increased gradually, while SDF-1 and eGFR decreased gradually, and the differences were statistically significant ( P<0.05).RBP was positively correlated with UACR, UA, BUN, β 2-MG and Scr in DKD patients ( r=0.764, 0.787, 0.693, 0.577, 0.801, P<0.000 1), and negatively correlated with EGFR ( r=-0.782, P<0.000 1). SDF-1 was negatively correlated with UACR, UA, BUN, β 2-MG and Scr ( r=-0.744, -0.794, -0.666, -0.605, -0.820, P<0.000 1), and positively correlated with EGFR ( r=0.767, P<0.000 1). The multiple linear regression equation was RBP=29.852+ 0.007UACR+ 0.101UA+ 0.497BUN+ 0.034Scr-0.083eGFR ( P<0.001). Conclusion:RBP and SDF-1 have certain discriminant value for DKD patients in T2DM population, and the degree of DKD renal function injury is positively correlated with RBP and negatively correlated with SDF-1, the increase of UACR, UA, BUN, Scr and the decrease of eGFR are risk factors for the increase of RBP.

objective To evaluate the effect of intensive diabetes health education plus web-based follow-up program on metabolic control.Methods One hundred and fifteen patients with type 2 diabetes mellitus (DM) were assigned to receive intensive diabetes health education plus web-based follow-up (treatment group,n=57) or conventional education program (control group,n=58).Hemoglobin Alc(HbAlc),body mass index (BMI),lipid profile,and blood pressure were compared at 3 or 6 month with baseline.Results At 3 month.the patients with HbAlc<6.5% in the treatment group was increased from 26.32% to 80.79%.At 6 month.HbAlC was decreased by 2.10% and 1.13% in the treatment or control group.In contrast to the control group,in the treatment group,the patient with BMI<24 increased from 43.86% to 68.42%.Neither groups showed significant changes in blood pressure.Conclusion Intensive diabetes education may be more effective than conventional program in improving metabolic control.

Objective To know the influence of short-term hard health education combined with net-working fellow-up on diabetes related costs. Methods Divided 83 diabetes patients into the experimental group (41 cases) and the control group (42 cases) randomly. Short-term hard health education combined with networking fellow-up and traditional health education was used in the two groups respectively, and then evaluat-ed the diabetes related costs between the two groups on the time points of the third, the sixth and the dozenth month. Results The costs of health products in the control group was significant higher than that of in the experimental group from the first month to the third month after the intervention, while the inspection expenses in the experimental group was significant higher than that of in the control group from the fourth month to the sixth month after the intervention. Conclusions Short-term bard health education can not change the average level of diabetes related costs, but it can change the constituent ratio of costs.

Objective To explore the influence of high fat diet on learning and memory,as well as the alteration of the number of neurons and morphology of dendritic spines in rat hippocampi.Methods 24 male adult SD rats were randomly assigned to high fat diet group or control group.The rats were fed with high-fat diet or standaM laboratory rodent chow diet for 12 weeks.Learning and memory were tested by Morris water maze and object recognition tests, and mood and motor ability were tested by open field tests.Golgi staining detected dendritic spine density of hippocampal neurons, and Nissl staining was used to observe the number of hippocampal neurons and pathological changes.Results High-fat diet induced rat spatial learning deficits, which was demonstrated by the prolonged escape latency ((38.50±9.70) s, (20.08±7.35) s, (19.96± 10.56) s, (22.75± 12.51) s, (14.56±4.82) s) compared with the control ((33.61±12.41) s, (14.25±7.89) s, (15.06±7.59) s, (5.53±2.81) s, (4.7± 1.58) s).The spatial memory deficits demonstrated that the latency reaching platform ((30.46± 21.43) s) was prolonged compared with control ((5.18± 1.33)s).The working memory was impaired, which was demonstrated by the prolonged escape latency compared with control group (P＜ 0.05).Discrimination index lowered than control group ((0.67±0.12) vs (0.81±0.08)), and the difference was significant (P=0.038), but no anxiety behaviors were observed(P=0.461).The neuron number of hippocampal neurons and dendritic spine density were significantly lowered than those in the control group((209.73±24.29) vs (262.2±18.94), (17.9±2.84) vs (21.93±2.56) ,respectively) (P＜0.05).Conclusion Intake of high-fat diet can impair learning and memory in rats, as well as decrease the number of neurons and the density of dendritic spines in the hippocampus.

Objective:To explore the differences of leukocyte subtypes and thyroid function of the patients with different thyrotoxicosis diseases,and to clarify the practical significance of leukocyte subtypes and thyroid function tests in the differential diagnosis of Graves disease thyrotoxicosis and destructive thyrotoxicosis.Methods:A total of 33 patients with Graves disease thyrotoxicosis and 30 patients with destructive thyrotoxicosis confirmed by clinical and laboratory examination were selected; the levels of neutrophils (Ne),lymphocyte (Ly),basophils (Ba), eosinophil (Eo)and mononuclear cells (Mo),serum free thyroxine (FT4),three free iodine thyroid former glycine (FT3),and thyroid stimulating hormone (TSH)of the patients in two groups were analyzed and the receiver operator characteristic curve (ROC)was used to evaluate the values of the indicators with statastical significance in the differential diagnosis of Graves disease thyrotoxicosis and destructive thyrotoxicosis.Results:The levels of serum Eo,FT4 and FT3,and the modified data Eo/Mo,Eo × FT3 / Mo of the patients in Graves disease thyrotoxicosis group were significantly higher than those in destructive thyrotoxicosis group (P <0.05);the levels of TSH and Mo of the patients were lower than those in destructive thyrotoxicosis group (P < 0.05).The ROC curve analysis results showed that the sensitivities and specificities of Eo,Eo/Mo,Eo×FT3/Mo in the differential diagnosis of two diseases were good, and the best diagnostic boundaries were 1.54, 0.34, and 3.94. Conclusion:Eo,Mo,TSH,FT3,FT4,Eo/Mo,and EoxFT3/Mo could be regarded as the basis in the differential diagnosis of Graves disease thyrotoxicosis and destructive thyrotoxicosis ,and the practical significances of Eo,Eo/Mo,and Eo×FT3 /Mo in the differential diagnosis of Graves disease thyrotoxicosis and destructive thyotoxicosis are bigger.

OBJECTIVETo compare two equations for calculating glomerular filtration rate (GFR) in the evaluation of the prevalence of chronic kidney disease (CKD) and the risk factors of CKD in urban healthy population.

METHODSA total of 40377 subjects (24164 males and 16213 females) participated in this study. Body height, weight and blood pressure were measured, and morning urine and venous blood samples were collected for routine urine and blood tests with measurements of blood glucose, total cholesterol, high density lipoprotein (HDL), low-density lipoprotein (LDL), creatinine and uric acid.

RESULTS AND CONCLUSIONUsing Japanese CKD Epidemiology Collaboration (J-EPI) equation and Chinese modified Modification of Diet in Renal Disease (C-MDRD) equation, the prevalence of CKD calculated was 3.9% and 6.3% in this population, respectively. The independent risk factors of CKD included an age over 60 years, high uric acid, and high blood glucose.

Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Female ; Glomerular Filtration Rate ; Humans ; Male ; Middle Aged ; Physical Examination ; Prevalence ; Renal Insufficiency, Chronic ; epidemiology ; physiopathology ; Risk Factors ; Sex Distribution ; Young Adult

Objective To investigate the anti-inflammatory effect of penehyclidine hydrochloride on oleic acid-induced acute respiratory distress syndrome (ARDS) in rats.Methods According to randomize number table method, 30 adult male Sprague-Dawley (SD) rats were divided into control group, model group and treatment group. Catheters were placed in femoral vein in each group. The control group was injected with 1.1 mL/kg physiological saline; the model group was injected with 0.1 mL/kg oleic acid and then injected with 1.0 mL/kg normal saline to establish ARDS model; the treatment group was injected with 0.1 mL/kg oleic acid and then injected with 1.0 mL/kg penehyclidine hydrochloride. At 3 hours after the model was established, blood gas analysis was carried out in each group, oxygenation index (PaO2/FiO2) was calculated, and the levels of serum interleukins (IL-1, IL-6) were measured by enzyme linked immunosorbent assay (ELISA). Rats were sacrificed to harvest lung tissue, and the lung wet/dry ratio (W/D) was calculated; the morphological changes of lung tissue was observed under microscope; the superoxide dismutase (SOD) activity and malondialdehyde (MDA) levels were detected by colorimetry; the expression of tumor necrosis factor-α(TNF-α) in lung tissue was detected by immunohistochemical method. The correlations between lung W/D ratio and various indicators were analyzed using Pearson correlation test.Results Compared with the control group, PaO2/FiO2 in model group was significantly decreased, lung W/D ratio was significantly increased, serum IL-1, IL-6 levels and lung tissue MDA content were significantly increased, lung tissue SOD activity was significantly decreased; the alveolar space was filled with exudate, neutrophils and red blood cells, and there were obvious edema and broadening in pulmonary interstitial and alveolar under light microscope; the type Ⅱ alveolar epithelial cells were partly destroyed, accompanied by lamellar body degeneration and emptying phenomenon under electron microscope; and immunohistochemistry showed that the positive expression of TNF-α in lung tissue was significantly increased. Compared with the model group, PaO2/FiO2 in the treatment group was significantly improved [mmHg (1 mmHg = 0.133 kPa): 204.42±31.61 vs. 113.91±47.78,P < 0.05], the lung W/D ratio was significantly decreased (5.80±0.44 vs. 6.82±0.59,P < 0.01), serum IL-1, IL-6 levels and lung tissue MDA content were significantly decreased [IL-1 (μg/L): 18.38±0.28 vs. 20.04±0.39, IL-6 (μg/L): 12.64±0.67 vs. 14.28±1.33, MDA (nmol/mg): 3.95±0.28 vs. 5.17±0.29, allP < 0.05], the activity of SOD in lung tissue was significantly increased (U/mg: 48.75±2.41 vs. 45.09±1.69,P < 0.01), histological and pathological changes were significantly reduced, and the positive expression of TNF-α in lung tissue was significantly reduced [positive cell rate: (25.80±3.44)％ vs. (38.82±3.59)％,P < 0.01].Conclusion Penehyclidine hydrochloride can effectively improve the oxygenation, alleviate lung injury and reduce pulmonary edema in oleic acid induced ARDS rat by decreasing lung W/D ratio, inhibiting oxidative stress and inflammatory response.

Objective To compare two equations for calculating glomerular filtration rate (GFR) in the evaluation of the prevalence of chronic kidney disease (CKD) and the risk factors of CKD in urban healthy population. Methods A total of 40377 subjects (24164 males and 16213 females) participated in this study. Body height, weight and blood pressure were measured, and morning urine and venous blood samples were collected for routine urine and blood tests with measurements of blood glucose, total cholesterol, high density lipoprotein (HDL), low-density lipoprotein (LDL), creatinine and uric acid. Results and Conclusion Using Japanese CKD Epidemiology Collaboration (J-EPI) equation and Chinese modified Modification of Diet in Renal Disease (C-MDRD) equation, the prevalence of CKD calculated was 3.9%and 6.3%in this population, respectively. The independent risk factors of CKD included an age over 60 years, high uric acid, and high blood glucose.

Objective To compare two equations for calculating glomerular filtration rate (GFR) in the evaluation of the prevalence of chronic kidney disease (CKD) and the risk factors of CKD in urban healthy population. Methods A total of 40377 subjects (24164 males and 16213 females) participated in this study. Body height, weight and blood pressure were measured, and morning urine and venous blood samples were collected for routine urine and blood tests with measurements of blood glucose, total cholesterol, high density lipoprotein (HDL), low-density lipoprotein (LDL), creatinine and uric acid. Results and Conclusion Using Japanese CKD Epidemiology Collaboration (J-EPI) equation and Chinese modified Modification of Diet in Renal Disease (C-MDRD) equation, the prevalence of CKD calculated was 3.9%and 6.3%in this population, respectively. The independent risk factors of CKD included an age over 60 years, high uric acid, and high blood glucose.