Objective To follow up the changes of postnatal cardiac sizes and function in infants of mothers with gestational diabetes mellitus (GDM). Methods Eighteen GDM mothers with euglycemia (GDM group) and 24 gestational age-matched normal pregnant women (control group),having prenatal examination and delivered in Women's Hospital of Fudan University from January to August in 2007, received fetal echocardiographic examination in late pregnancy. Infants of these GDM mothers and 24 age-matched healthy infants of normal pregnancy (control group) received sonographic follow up. Cardiac sizes and function were evaluated and compared. Results At birth, there were six (33.3%) infants of large for gestational age (LGA) and 12(66.7%) appropriate for gestational age(AGA) in GDM group, while in the control group, there were two LGA (8. 3%) and 22(91.7%)AGA infants (x2 =3. 840, P= 0. 05). Both the interventricular septum and left ventricular walls in GDM fetuses were thicker than in control fetuses (P ＜ 0.05). No increase in the thickness of ventricular walls was observed till infantile period. However, the end-systolic thickness of left ventricular walls in LGA infants was still larger than in control infants [(4.55 ± 0.37) mm vs (4. 13±0.39)mm, P＜0. 05], and end-diastolic left ventricular long-diameters were also larger [(37. 3±2.3) mm vs (34.6±2.6) mm] (P＜0. 05). In GDM fetuses, the peak velocities of aorta and pulmonary artery and left cardiac output were higher than in the controls (P＜ 0. 01 ), and right/left cardiac outputs ratios were lower (1.198±0.206 vs 1. 430±0. 321, t= -2.668,P=0. 011). Till infantile period, only right/left cardiac outputs ratios in AGA infants of GDM group were larger than in controls (P＜0. 05). GDM fetuses' left atrial shortening fraction and tricuspid E/A ratios were smaller (P＜0. 05). In infantile period, only left atrial shortening fraction in GDM infants was still smaller than in controls (0. 356 ± 0. 040 vs 0. 386 ± 0. 041, t = - 2. 332, P = 0. 025). Left and right ventricular Tei index in GDM fetuses were 0. 482±0. 129 and 0. 414±0. 094, both larger than those of control fetuses (0. 309 ± 0. 074 and 0. 283 ± 0. 072) (t = 5. 075 and 5. 129, P = 0. 000 ). Till infantile period they both became significantly lower and no differences were found among LGA, AGA and control infants. Conclusions The cardiac sizes and function at 2-3 months of age, in infants of GDM mothers with good glucose control, became better than that in uterus.

Objective To explore the bacterial drug resistance in blood culture in 2015 from the members of Antimicrobial Re-sistant Investigation Net of Shaanxi province,and to guide the clinicians touse antimicrobial drugs rationally.Methods All the objective bacterial isolates were collected and identifiedsusceptibility date by software WHONET 5.6.Results 6 871 bacterial isolates and their antibacterial susceptibilitydata were collected which included 3 199 (46.56%)Gram-negative bac-terial isolates and 3 672 (53.44%)Gram-positivebacterial isolates.The top five populationsof Gram-positive bacterial iso-lates were Staphylococcus epidermidis (30.94%),Staphylococcus hominis (17.84%),Staphylococcus haemolyticus (11.74%),Staphylococcusaureus (9.69%)and Enterococcus feacium (6.29%).The top five populationsof Gram-negative bacterial isolates were E.coli (43.67%),Stenotrophomonas maltophilia (14.63%),K.pneumoniae (13.47%), P.aeruginosa (4.13%)and Acinetobacter baumannii (3.63%).Theisolating rates of methicillin-resistant Staphylococcus aureus (MRSA)and methicillin-resistant coagulase negative Staphylococcus (MRCNS)were 31.2% and 76.1%,respec-tively.No vancomycin resistant Staphylococcusisolates were found.There were 0.9% E.faecium vancomycin-resistant iso-lates.The isolates of Enterobacteriaceae were still highly susceptible to carbapenem,whosetotal resistance rate was below 4.0%.The resistance rates of A.baumannii to most surveillance drugs in cludingimipenem were above 50.0% and the iso-lates of P.aeruginosa were still highly susceptible to most surveillancedrugs.Conclusion It is severe that the situation of bacterial drug resistance in blood culture in Shaanxi province.Should fullyuse bacterial drug resistance surveillance results for supervision and administration,and take effective measures forcontrolling the spread of resistant isolates.

Adolescent ; Child ; Child, Preschool ; Combined Modality Therapy ; External Fixators ; Female ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Radiography ; Radius Fractures ; diagnostic imaging ; therapy ; Splints ; Ulna Fractures ; diagnostic imaging ; therapy

Tumor immune checkpoint therapy is a clinical treatment strategy developed based on the new principle of the inhibition of negative immune regulation. In this article, the tumor immune checkpoint therapy and the drug delivery strategies were reviewed, mainly including immunity and tumor therapy, tumor immune checkpoint therapy and its mechanism of action, clinical application of tumor immune checkpoint therapy and therapeutic drugs, immune resistance of programmed cell death protein 1 (PD1)/programmed cell death ligand 1 (PDL1) treatment and countermeasures, drug delivery strategies for tumor immune checkpoint therapeutic agents, etc. As a revolutionary new immunotherapy strategy, tumor immune checkpoint therapy has shown obvious superior therapeutic efficacy in a variety types of tumor. However, tumor immune checkpoint therapy is also faced with a big challenge, namely, immunotherapy resistance. With the discovery of new mechanism, the continuous development of new therapeutic drugs and delivery strategies, tumor immune checkpoint therapy is expected to further improve the clinical efficacy of tumor.

OBJECTIVETo evaluate the fetal cardiac function in gestational diabetes mellitus (GDM) pregnancies under different maternal glycemic controls.

METHODSForty four GDM mothers received 78 fetal echocardiographic evaluations at three gestational periods (<28, 28-34 and >34 weeks) and were divided into poorly-(DM1) and well-(DM2) controlled groups according to their glycemic control at examination. Seventy uncomplicated mothers were selected as controls. Parameters of fetal cardiac anatomy and function were measured and analyzed.

RESULTSGDM fetuses' cardiac ventricular walls were thicker than controls', and the differences between DM1 and DM2 were not significant except for end-diastolic left ventricular walls. In both GDM groups, the aortic flow velocities increased earlier than pulmonary artery and DM1 fetuses changed earlier than DM2 ones. GDM fetuses' left atrial shortening fraction was smaller than the controls' in the period of ⩾34 weeks and negatively correlated with thicknesses of left ventricular walls and interventricular septum in DM1 fetuses (r=-0.438 and -0.506). The right ventricular diastolic function in DM1 and DM2 fetuses decreased after the period of 28-34 weeks and in the period of >34 weeks respectively. Tei index of both left and right ventricles increased in DM1 group after the period of <28 weeks and in DM2 group only in the period of ⩾34 weeks, with no significant differences between DM1 and DM2 groups in this period.

CONCLUSIONFetuses of GDM mothers showed cardiac function impairments. Good maternal glycemic control may delay the impairments, but cannot reduce the degree. Some cardiac changes in GDM fetuses were similar to those in pregestational diabetic pregnancies except for several parameters and their changing time.

Case-Control Studies ; Diabetes, Gestational ; diagnostic imaging ; pathology ; physiopathology ; Diastole ; Echocardiography ; Female ; Fetal Heart ; diagnostic imaging ; pathology ; physiopathology ; Humans ; Pregnancy ; Systole ; Ventricular Function

OBJECTIVETo investigate osthole effect on femoral tissue resorption activity of rat in vitro.

METHODSSix SD rats weighted (80 ± 5) g were used to isolate and culture femoral tissue (diaphyses and metaphysis) in vitro. The cultured tissue were devided into control group, estradiol group and osthole group. The femoral tissue was treated with final concentration of 1 x 10(-5) mol/L osthole and 1 x 10(-8) mol/L estradiol culture in vitro at 48 hours after cultured. Tartrate-resistant acid phosphatase (StrACP) activity, glucose and Lactic acid content, StrACP, MCSF (Macrophage colony stimulating factor) and CTSK (Cathepsin K) mRNA was detected by Real-Time RT-PCR were detected.

RESULTSConcetration of Alkaline phosphatase activity were 2226 and 2498 in 1 x 10(-5) mol/L osthole and 1 x 10(-8) mol/L estradiol respectively. As compared with control group, the activity of StrACP of 1 x 10(-5) mol/L osthole and 1 x 10(-8) mol/L estradiol were inhibited at 6, 9, 12 days (P < 0.05); under treatment of in l x 10(-5) mol/L osthole, the content of Lactic acid were increased and the content of glucose were decreased at 3, 6, 9 days (P < 0.05); StrACP, MCSF and CTSK mRNA expression level were inhibited at 6, 9 days (P < 0.05).

CONCLUSIONOsthole can inhibit bone resorption and raise the level of nutrition metabolism of femurs tissue.

Acid Phosphatase ; metabolism ; Animals ; Bone Resorption ; prevention & control ; Coumarins ; pharmacology ; Estradiol ; pharmacology ; Femur ; drug effects ; Glucose ; analysis ; Lactic Acid ; analysis ; Male ; Rats ; Rats, Sprague-Dawley

Aged ; Drug-Related Side Effects and Adverse Reactions ; blood ; therapy ; Emergency Treatment ; Female ; Hemoperfusion ; Humans ; Hypnotics and Sedatives ; poisoning ; Male ; Middle Aged ; Serum ; chemistry

OBJECTIVETo investigate the clinicopathologic features, immunophenotypes and differential diagnosis of Kimura's disease (KD) and epithelioid hemangioma (EH).

METHODSNine cases of KD and three cases of EH were evaluated by light microscopy and immunohistochemistry.

RESULTSIn this series, KD occurred predominantly in males, whereas EH had a female predilection. Both KD and EH arose most frequently in the head and neck region. However, KD usually presented as multiple subcutaneous nodules or swellings and was accompanied by lymphadenopathy in some cases. On the other hand, EH appeared only as a small skin nodule or red plaque. Histologically, both lesions may involve the dermis or subcutis. All the 9 KD cases displayed florid hyperplasia of lymphoid tissue, of which, 7 cases exhibited formation of lymphoid follicles and active germinal centers. Proliferation of post-capillary venules were seen between follicles. They were lined by plump or attenuated endothelial cells. Large number of eosinophils aggregated around the vessels or adjacent to the follicles, formation of microabscesses were observed in 3 cases. All the 3 EH cases showed prominent proliferation of vessels (capillary-sized in 2 cases and small to medium-sized in 1 case). The vessels were lined by epithelioid endothelial cells with abundant eosinophilic cytoplasm. The endothelial cells also proliferated within the lumen in 1 case and grew in sheets or cords adjacent to the vessel walls in 2 cases. Some endothelial cells contained intracytoplasmic vacuoles, suggesting formation of primitive vessels. Associated inflammatory component was noted in 2 cases. Lymphoid follicles however were not present and eosinophil infiltration was not as prominent as in KD. Immunohistochemical study in KD revealed B cells in the lymphoid follicles and mostly T cells in the interfollicular regions. In EH, the epithelioid endothelial cells showed strong reactivity to CD31 and factor VIII-related antigen.

CONCLUSIONSKD and EH are two distinctive entities. The former represents a lymphoid hyperplasia and the latter represents a benign vascular tumor. Recognition of the clinical characteristics and morphologic features of KD and EH is very important in making this distinction.

Adult ; Aged ; Angiolymphoid Hyperplasia with Eosinophilia ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Head and Neck Neoplasms ; metabolism ; pathology ; Hemangioma ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; metabolism ; Leukocyte Common Antigens ; metabolism ; Male ; Middle Aged ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Sex Factors ; Skin Neoplasms ; metabolism ; pathology ; von Willebrand Factor ; metabolism

Objective To evaluate the advantages of TB-IGRA and protein chip to detect the Mycobacterium tuberculosis. Methods From October 2013 to March 2014,collected 78 cases of clinical diagnosis of tuberculosis and normal control’s pe-ripheral blood specimens,used TB-IGRA kits and Mycobacteriumtuberculosis IgG kit(protein chip)to detected respectively. The results were analyzed and compared.Results The sensitivity of protein chip and TB-IGRA in the detection of Mycobac-teriumtuberculosis were 34.5% and 89.7% respectively,which was statistically significant (χ2=26.95,P<0.05).The spe-cificity of protein chip and TB-IGRA were 90.0%,95.0% respectively,which were not statistically significant (χ2=1.64,P> 0.05).The positive rate of TB-IGRA and Protein chip in tuberculosis were 90.5% and 42.9%.The positive rate of TB-IGRA and Protein chipin extrapulmonary tuberculosis were 89.20% and 29.7% respectively.Conclusion Compared TB-IGRA and protein chip,either diagnose tuberculosis or extrapulmonary tuberculosis has highly positive rate and sensitivity, TB-IGRA can be widely used in the early screening of tuberculosis.

OBJECTIVETo study the feasibility of umbilical cord brain natriuretic peptide (BNP) level measurement for the evaluation of perinatal cardiac function in fetuses from pregnant women with abnormal blood glucose levels and the influence of abnormal blood glucose on fetal cardiac function.

METHODSTwenty-four mothers with gestational diabetes mellitus (n=18) or gestational impaired glucose tolerance (n=6) (diabetic group) were classified into two subgroups according to blood glucose level before delivery: good (n=17) and poor (n=7) glucose control. They underwent fetal echocardiography in their late pregnant periods and fetal cardiac sizes and function were measured. Twenty-five normal pregnant mothers served as the control group. Umbilical cord blood BNP concentrations were measured at delivery.

RESULTSThe umbilical cord blood BNP concentrations in the diabetic group were significantly higher than in the control group(114.0+/-39.0 pg/mL vs 80.6+/-13.7 pg/mL; p<0.01). The poor glucose control subgroup demonstrated higher umbilical cord blood BNP concentrations than the good glucose control subgroup (142.1+/-44.1 pg/mL vs 102.4+/-31.2 pg/mL; p<0.01). No difference was found between the gestational diabetes mellitus and the impaired glucose tolerance groups. The BNP concentration was positively correlated to the thicknesses of fetal left ventricular walls and the peak velocities of mitral A wave (r=0.715, 0.491 respectively, p<0.05), and negatively correlated to the mitral E/A ratio (r=-0.507, p<0.05).

CONCLUSIONSThe fetuses of pregnant women with abnormal blood glucose levels have an increased BNP level in umbilical cord blood. Umbilical cord BNP level is related to maternal blood glucose control and the changes in fetal cardiac function. It may reflex the latent impairments of fetal cardiac function. A good glucose control may decrease the impact of abnormal maternal blood glucose on fetal hearts.

Biomarkers ; Diabetes, Gestational ; physiopathology ; Female ; Fetal Blood ; chemistry ; Fetal Heart ; physiology ; Humans ; Infant, Newborn ; Natriuretic Peptide, Brain ; blood ; Pregnancy