Objective To analyze the association between pre-pregnancy body mass index,pregnancy weight gain and gestational diabetes(GDM).Methods The pre-pregnancy body mass index,pregnancy weight gain and the incidence data of 345 gestational diabetes with full-term primiparae were analyzed.Results The GDM ratio of low-weight,ideal weight group,over-weight was 2.78％,2.96％,16.04％,respectively over-weight GDM pregnancy was significantly higher than the ideal weight group( x2 =4.269,P ＜0.05),and GDM over-weight before pregnancy was significantly higher than the low weight group the incidence of GDM,the difference was statistically significant( x2 =17.299,P ＜0.01 ) ;Pregnant women in different pregnancy weight gain A( ＜ 11.0kg),B( 11.0 ～ 17.9kg),C( 18.0～24.9kg),D(≥25.0kg) range,the GDM were 0％,1.75％,6.60％,11.02％,that GDM of A,B,C,D group were statistically different( P ＜ 0.05 ).Rate of weight gain during pregnancy on pregnancy size was proportional to the impact of diabetes.Conclusion Pre-pregnancy body mass index,pregnancy weight gain had clinical significance in evaluation of gestational diabetes.

Objective To explore the best opportunity of termination of pregnancy and conservative therapy in the treatment of lata trimester of pregnancy combining hypertension or preeclampsia.Methods The clinical data of 198 patients with pregnancy combining hypertension or preeclampsia were studied retrospectively.Among the total patients,107 patients performed conservative therapy (conservative therapy group),91 patients performed termination of pregnancy (termination of pregnancy group).The prognosis of two groups was compared,including maternal and neonatal complications and morbidity and mortality.ResultsThe cesarean section rate of conservative therapy group was 54.2％ (58/107),termination of pregnancy group was 51.6％(47/91 ),there was no significant difference between two groups(P＞0.05 ).The perinatal complication rate of conservative therapy group and termination of pregnancy group was 15.9％(17/107) and 17.6％( 16/91 ),there was no significant difference between two groups(P＞0.05).The rate of placental abruption,low platelet disease,hypoproteinemia,postpartum hemorrhage between two groups had no significant difference (P＞0.05).Conservative therapy group had 3 cases neonatal asphyxia,1 case neonatal death.Termination of pregnancy group had 7 cases neonatal asphyxia,1 case neonatal death.The rate of adverse events of conservative therapy group had no significant difference compared with termination of pregnancy group (P＞0.05 ).The perinatal average weight of conservative therapy group was (2.635 ± 0.446)kg,termination of pregnancy group was (2.014 ±0.721) kg,there was significant difference (P＜0.05).Conclusion Under the premise of control blood pressure,spasmolysis,ensure maternal and neonatal safety,expectant monitoring can give more chances for fetuses to get more mature so decrease the complications.

Objective To compare the alaryngeal speakers'voice acoustic parameters and intra-tracheal pressure when they spoke different vowels.Methods 24 patients after tracheo-esophageal shunt phonation by the anastomosis of the membranous portion of the tracheal section with the anterior wall of esophagus after total laryngectomy and 16 esophageal speakers enrolled in this study. The voice acoustic parameters were measured when they spoke soft /a/ and soft /i/. The intra-tracheal pressure of 20 TE speakers was measured when spoke /a/ and /i/.Results There were no significant differences between vowel /a/ and /i/ in the two alaryngeal speaker group. The pressure of TE speakers after Shang's procedrue for comfortable /i/ was higher than that for /a/, and there was significant difference.Conclusion There were the same clinical meanings in evaluating alaryngeal voice acoustic aspect. when using vowel /a/ and /i/. However when using different vowel, the intrtracheal pressure was different in TE speakers.

Objective To study the inclusion conditions for volatile oil from Danfu Tongmai Granules.Methods With the utilization rate of volatile oil and yield rate of inclusion as indexes,the optimum inclusion conditions were selected by orthogonal design,and the inclusion compound was identified by TLC.Results The optimal inclusion conditions for volatile oil were as follows:a proportion of 1 ∶7(mL ∶g) for oil to ?-cyclodextrin,stirring for 4 hours at 40 ℃.TLC results showed that inclusion process was successful and the main components of volatile oil were similar before and after inclusion.Conclusion This methods can be used for producing ?-cyclodextrin inclusion compound on a large scale.

Objective To establish an ELISA for detecting antibody against Aspergillus fumigatus pectate lyase A(anti-PlyA),and evaluate its diagnostic value for invasive aspergillosis (IA).Methods An indirect ELISA for IgG antibody a-gainst PlyA was established using PlyA as coating antigen.The serum from 97 IA patients,80 non-IA patients and 200 healthy donors were tested,the results were compared with anti-DPPV (antibody against Aspergillus fumigatus dipeptidyl peptidase V fragment)and anti-TR (antibody against Aspergillus fumigatus thioredoxin reductase).Results The intra-as-say coefficients of variation of the ELISA method for detecting anti-PlyA was 5.3%,and inter-assay coefficients of variation was 10.9%.The sensitivity and specificity of diagnosis of IA were 62.9% and 90.4%,respectively.The positive rates of an-ti-PlyA in non-neutropenic and neutropenic IA patients were 43.8% and 72.3%,respectively (χ2 =7.493,P <0.05).There was no significant difference between the positive rates of anti-PlyA (62.9%),anti-TR (60.8%),and anti-DPPV (67.0%) (χ2 =0.562,P > 0.05).When combined anti-PlyA,anti-TR,and anti-DPPV,the diagnostic sensitivity for IA patients in-creased to 92.8%.Conclusion An ELISA for detecting anti-PlyA was successfully established.The diagnostic value of these three kinds of antibody was superior in non-neutropenic IA patientsto that in neutropenic IA patients.The combined detec-tion of three antibodies could provide higher sensitivity.

Objective To study the gene mutations and clinical features of mandibuloacral dysplasia with type A lipodystrophy (MADA) in a Chinese family. Methods The information of 5 family members including 2 siblings suspected atyp-ical progeria was assembled. Genomic DNA was extracted from peripheral blood of 5 family members, the 12 exons of LMNA gene were ampliifed by PCR and then the PCR products were directly sequenced and analyzed by using Blast software online. The SIFT and PolyPhen-2 software were used to predict the harmfulness of mutations. Results The 2 siblings were clinically diagnosed as MADA. Heterozygous c.1579C>T (p.Arg527Cys) and c.1583C>T (p.Thr528Met) mutations were detected in this family. The father carried c.1583C>T (p.Thr528Met) mutation, the mother carried c.1579C>T (p.Arg527Cys) mutation, and their normal daughter were all heterozygous carriers with c.1583C>T (p.Thr528Met) mutation. Compound heterozygous c.1579C>T (p.Arg527Cys) and c.1583C>T (p.Thr528Met) mutations in 2 siblings led to MADA. The MADA showed an autosomal re-cessive inheritance pattern in this family. Conclusions The 2 siblings with MADA in this family were caused by compound heterozygous mutations in LMNA gene.

BackgroundHigh myopia is one of leading causes of blindness,so far the pathogenesis remains unclear.Two single-nucleotide polymorphisms (SNPs) of rs6885224 and rs12716080 in CTNND2 gene were recently found to be associated with high myopia in Singaporean Chinese.But whether these SNPs are related with the pathogenesis of high myopia in Han Chinese is worth studying,Objective This study was to investigate the relationship between the genetic variations of the CTNND2 gene and high myopia in Han Chinese.MethodsA case-controlled association study was designed.Nine hundred and thirty-three individuals with high myopia and 1227age- and gender-matched normal subjects were included in this study.The 5 ml of periphery blood was obtained from all subjects for the extraction of genomic DNA.The target DNA was amplified using PCR and purified by the SNaPshot method.Four SNPs rs12716080,rs917012,rs6885224 and rs16901340 in the CTNND2 gene were genotyped.This study was approved by the Ethic Committee of Sichuan Provincial People Hospital.Written informed consent was obtained from each subject before his/her enrollment.Results The frequencies of the genotypes rs6885224,rs12716080,rs917012,rs16901340 SNPs were in Hardy-Weinberg equilibrium (HWE) ( P=0.181,0.085,0.732,0.313,0.264,0.663,0.084,0.196).There were no significant differences in genotypes frequency distribution ( in turn P =0.654,0.406,0.828,0.403 ) and allele frequency distribution of the CTNND2 gene ( in turn P =0.377,0.209,0.743,0.198) between the high myopia group and normal control group.The haplotypes (TA and GA)frequencies of rs12716080 and rs917012 in the high myopia group were significantly different from those of the normal control group(TA:0.784 vs.0.719;GA:0.087 vs.0.136) (x2 =6.115,P=0.013 ;x2 =6.634,P=0.010),but those of GG were similar between the high myopia group and normal control group ( 0.123 vs.0.143,x2 =0.889,P =0.346). ConclusionsThe SNPs rs12716080,rs917012,rs6885224 and rs16901340 in CTNND2 gene were not responsible for high myopia,however,the haplotypes of rs12716080 and rs917012 are susceptible for high myopia in Han Chinese.

Objective To summarize our experience in the diagnosis and treatment of malignant peritoneal mesothelioma(MPM). Methods Clinical data of 10 patients admitted with MPM were analyzed retrospectively. Results The main symptoms of MPM were intraabdominal mass and abdominal pain in these patients; Seven patients were of localized type, 3 cases were of diffused type; Preoperatively 7 cases were misdiagnosed as other intraperitoneal tumor, 9 patients underwent laparotomy and tumor resection for a total 16 times, including once in 4 cases, two times in 3 cases, and three times in 2 cases. Seven patients received curative resection in initial operation. Five patients died within one year, 6 cases within two years, Tumors recurred postoperatively in 4 cases. 1 case is still survival 9 years after. Conclusion Being comparatively rare, MPM is often misdiagnosed, the prognosis is very poor, curative resection sometimes provides a long survival for localized type of MPM, when combined with perioperative comprehensive therapy.

Objective To detect levels of IL - 4 and INF - ? in induced sputum dynamically in children with mycnplasma pneamo-niae pneumonia( MPP), and to analyze the function of Th1 /Th2 cell factor immune response in the genesis and development of MPP, so as to evaluate the clinical value of induced sputum method in MPP research. Methods There were 38 cases who were diagnoses as MPP using 3% high osmotic pressure of saline water to ultrasonic atomizing inhalation for inducing sputum. ELISA was used to detect IL-4 and INF-?. Results The content of IL-4 in acute stage was higher than that in convalescence stage in induced sputum of MPP children. Severe stage was higher than mild stage. However, the comparison between acute and convalescence stage didn't have statistics difference in the content of INF-?, neither did the comparison between severe and mild stage. IL- 4/INF- ? in acute stage was higher than that in convalescence stage. Severe stage was higher than mild stage. In convalescence stage, the comparison of INF - ?, IL - 4, IL - 4/INF - ? between the severe and the mild didn' t have statistic significance. Conclusions IL-4 and INF - ? have participated in the monogenesis of MPP. The disequilibria of Th1 /Fh2 is existed in MPP and Th2 reaction predominates. So induced sputum analysis can be a better way to judge the light or heavy press degree of MPP practically, conveniently and sensitively.

Objective To examine the expression and analyze the significance of autophagy-related gene microtubule-associated protein 1 light chain 3 (MAP1-LC3,LC3),p62 and lysosorne-associated membrane protein 2 (LAMP-2) in pancreatic tissues of mice with acute pancreatitis (AP).Methods Twenty mice were randomized into AP group and control group,and the number of mice was equal between two groups.AP group was intra-peritoneally injected by 20％ L-arginine solution (two injections of 4 g/kg body weight,every 1 h) in the dosage of 4 g/l kg twice every 1 hour to establish AP model,while control group was administered with equal volume of normal saline by intra-peritoneal injection.All the mice were euthanized at 24 hour after the last injection.Pancreatic histopathological changes were measured.In addition,the protein expressions of LC3,p62 and LAMP-2 were detected by Western blot.Results No obvious pathological changes were observed in control group.Pancreatic acinar edema,structure destruction,missing,the obvious widening of interlobular septum,small interlobular septum and acinar septum,and the necrosis of acinar cells at different degrees were observed in AP group.The pathological score for tissue edema,hemorrhage,necrosis and inflammation in AP group was 3.13 ± 0.50,2.83 ± 0.32,3.25 ± 0.46 and 3.16 ± 0.47,respectively,which was all 0 in control group.The differences were statistically significant between AP group and control group (P ＜ 0.01).In AP group,the ratio of LC3-Ⅱ/LC3-Ⅰ,p62 and LAMP-2 protein in pancreatic tissue were 1.16 ± 0.08,0.94 ± 0.04 and 0.35 ± 0.04,respectively,which were 0.24 ± 0.02,0.34 ± 0.03 and 0.95 ± 0.03 in control group.The ratio of LC3-Ⅱ/LC3-Ⅰ and p62 protein in pancreatic tissue in AP group were much higher than those in control group,while LAMP-2 in AP group was lower than that in control group,and there was statistically significant difference between two groups (all P ＜0.01).Conclusions Intraperitoneal injection of L-arginine could induce acute pancreatitis,and autophagy is impaired,which was associated with decreased LAMP-2 protein expression.