Objective　To explore the association between th e heparan sulfate proteoglycan gene (HSPG) polymorphism and diabetic nephropathy in Chinese.Methods　A case control study of 326 Chinese s ubjects including 136 type 2 diabetics with or without nephropathy and 190 non- diabetic control was performed.Genotype frequencies of HSPG2 polymorphism were s tudied by PCR-RFLP analysis with BamHI digestion.Results　There was no difference in genotype frequencies or allele frequencies between normal albuminuria and abnormal albuminuria patients.Moreover,there was no assoc iation between diabetic patients and non-diabetic control in allele frequencies as well,but obvious difference in genotype frequencies(0.05＞P＞0.025) was found.Conclusion　Our study showed the lack of association between HSPG polymorphism and diabetic nephropathy in Chinese type 2 diabetics. There may be association between genotype frequencies of HSPG polymorphism and d iabetes in statistics.

0.025) was found.Conclusion Our study showed the lack of association between HSPG polymorphism and diabetic nephropathy in Chinese type 2 diabetics.There may be association between genotype frequencies of HSPG polymorphism and diabetes in statistics.

Objective To investigate the effect of clinical risk factors including maternal underlying medical conditions on the development of preeclampsia (PE) in order to improve and strengthen the early assessment of high clinical risk population of PE.Methods Clinical.observational data of patients with PE in Peking University Third Hospital from November 2008 to January 2011 were analyzed.Comparative analysis was made among medical conditions with PE (M-PE) sub-group and isolated PE (I-PE) sub-group and non-PE pregnancy with or without medical conditions (control group).Results Totally 159 cases,43.09％ (159/369) of total cases of PE had high clinical risk factors (multiple pregnancy and medical conditions) and 32.3％ (97/300) of singleton PE accompanied with medical conditions.The incidence of PE in singleton pregnancies with medical conditions was significantly higher than those without medical conditions [ 15.0％ (97/646) versus 4.45％ (210/4719),P ＜ 0.05 ].In M-PE sub-group,the average age [ ( 31.7 ± 4.5 ) versus ( 29.3 ± 5.2) year-old] and body mass index (BMI) in first trimester [ (26.0 ±5.6) versus (23.3 ± 3.7) kg/m2],the proportion with previous preeclampsia [ 11％ (11/97) versus 4.9％ (10/203) ] and pregnancy loss in third trimester [ 11％ ( 11/97 ) versus 3.0％ ( 6/203 ) ],were higher than those of I-PE sub-group ( all P ＜ 0.05 ).The onset of preeclampsia in M-PE sub-group was earlier than I-PE ( 32.9 versus 34.4 gestation weeks,P ＜ 0.05 ).The proportion serious cases of PE occurring before 32 gestational weeks were higher in M-PE than that of I-PE sub-group [ 45％ (44/97)versus 34.0％ (69/203),P ＜0.05].Multivariate regression analysis showed that previous history of late pregnancy loss and irregular prenatal care were clinical risk factors for early-onset PE whether early-onset was defined as ＜ 34 or ＜ 32 gestational weeks respectively (all P ＜ 0.05) ; medical conditions were risk factors for PE if early-onset was defined as ＜ 32 gestational weeks ( OR =1.718,95％ CI:1.005 - 2.937,P =0.048).Conclusions Multiple pregnancies and pregnancies with medical conditions exceed one-third of total subjects of PE.The onset of PE in subjects with maternal underlying medical conditions was earlier which is the subgroup should not be ignored.The difference of early pregnancy BMI may show the maternal heterogeneity in early onset and late onset of preeclampsia.Assessment of clinical risk factors including the underlying medical disorders for preeclampsia in early trimester should be strengthened.

Objective To investigate the insulin resistance and the changes of pancreaticβ-cell function in order to improve the clinical diagnosis and therapy .Methods 99 cases of pregnant women in the late ministers were randomly selected for the study and divided into three groups(normal glucose tolerance group ,impaired glucose tolerance group ,and gestational diabetes group) .The in-sulin resistance and isletβ-cell function of the three groups were evaluated by HOMA model and its related indicators .Results The blood pressure and blood lipid level was not significant different among the three groups(P>0 .05) .Pairwise comparisons of glu-cose infusion rate ,the first phase insulin secretion ,the second phase insulin secretion ,fasting glucose ,fasting insulin ,HOM A-IR , and HOMA-βwere made among the three groups ,and there were difference with statistical significance(P<0 .05) .Conclusion The situation of insulin resistance and the dysfunction of pancreaticβ-cell in trimester pregnant women would become bad associated with the abnormal glucose tolerance .

Objective To investigate the relationship between potential maternal risk factors between potential maternal risk factors in different level hospitals as well as different prenatal care patterns and characteristics of preeclampsia. Methods A retrospective study of 300 preeclamptic singleton patients delivered in Peking University Third Hospital was performed.Patients were divided into three groups:regular prenatal care in tertiary hospitals (n =100),regular prenatal care in primary hospitals (n=81) and without prenatal care (n=119). The onset of preeclampsia and incidence of severe preeclampsia of different groups were analyzed. Non-parametric and Chi-square test were adopted for continuous and categorical variables respectively. Results (1) In total cases of preeclampsia subgroup (I-PE subgroup) and with chronic hypertension (CH subgroup),the diagnosis of preeclampsia was later in patient with regular prenatal care in tertiary hospital (patient-TH)[100,64 and 14 cases,37.1 (4.1),37.3 (1.7) and 36.3 (2.5) weeks respectively] than those with regular prenatal care in primary hospital (patient-PH) [81,54 and 9 cases,32.9 (6.7),33.8 (6.1)and 27.9(6.3) weeks respectively] (Z=72.29,51.30 and 14.58 respectively,P＜0.05) or the patient without regular prenatal care (patient-NP) [119,85 and 19 cases,31.6(6.6),31.9(6.7) and 30.3(4.7) weeks respectively] (Z=86.69,58.83 and 11.33 respectively,P＜0.05).The proportion of severe preeclampsia occurred earlier than 32 weeks [13.0％ (13/100) vs 55.5％ (66/119),9.4％(6/64) vs 50.6％(43/85),and 35.7％(5/14) vs 89.5％(17/19); x2=43.95,29.42 and 10.17respectively,P＜0.05] or earlier than 34 weeks [17.0％ (17/100) vs 65.5％ (78/119),14.1％(9/64) vs 61.2％(52/85) and 42.9％(6/14) vs 94.7％(18/19); x2 =47.71,31.18 and 10.61 respectively,P＜0.05] were lower in patient-TH than in patient-NP.(2) In patient-NP and patientPH,onset of preeclampsia was earlier in CH subgroup compared with I-PE subgroup (Z=26.61 and 22.82,P＜ 0.05). In patient-NP,the proportion of severe preeclampsia occurred earlier than 32 weeks (x2 =9.11,P＜0.05) or earlier than 34 weeks (x2 =7.95,P＜0.05) was higher in CH subgroup than in I-PE subgroup. Conclusions Regular prenatal care in tertiary hospital might effectively delay the onset of preeclampsia or severe preeclampsia,especially in patients with risk factors for preeclampsia. Assessment of risk factors for preeclampsia in early trimester should be strengthened and individualized prenatal care plan should be established.

OBJECTIVE: To investigate the clinical effects of the combined modality therapy for the patients with difficult-to-treat rhinosinusitis (DTRS). METHOD: The clinical data involving 42 patients with DTRS were analyzed retrospectively. All patients received revision endoscopic sinus surgery (ESS) and combined modality therapy systematically and individually. The clinical effects of all patients were observed 6- and 12-month following revision ESS. RESULT: Forty-two patients were followed up for 6 months, whereas 35 patients were followed for 12 months post operation. VAS scores of the patients significantly improved (P < 0.01) 6- and 12-month after revision ESS, but there was no statistic difference (P > 0.05) between 6- and 12-month post operation. Moreover, Lund-Kennedy scores by endoscopy significantly improved (P < 0.01) 6- and 12-month following ESS. Similarly, there was no statistic difference (P > 0.05) between 6- and 12-month postoperatively. Additionally, within 6 months follow-up, 16 of 42 patients (38.1%) were cured, 19 of 42 patients (45.2%) were improved, and 7 of 42 patients (16.7%) were ineffective. The total effective rate in all patients was 83.3% 6 months postoperatively. While within 12 months follow-up, 11 of 35 patients (31.4%) were cured, 15 of 35 patients (42.9%) were improved, and 9 of 35 patients (25.7%) were ineffective. Hence, the total effective rate in 35 patients was 74.3% after 12-month follow-up. There was no statistic difference (χ² = 1.019, P > 0.05) between 6- and 12-month postoperatively. CONCLUSION Appropriate revision ESS plus the combined modality therapy has been proven to be an effective method for the treatment of DTRS. The clinical effects in this study are significant and stable, and thus it is worthy of further clinical applications.
Combined Modality Therapy ; Endoscopy ; Humans ; Nasal Surgical Procedures ; Paranasal Sinuses ; surgery ; Postoperative Period ; Reoperation ; Retrospective Studies ; Rhinitis ; surgery ; therapy ; Sinusitis ; surgery ; therapy ; Treatment Outcome

Electives,as an important component of medical education,are useful for students in expanding knowledge scope,improving knowledge structure and increasing overall capacity.Adjusting course resources,strengthening education administration and conducting course evaluation can achieve the establishment of electives system in medical colleges and universities.As a result,the electives system will contribute to the formation of inter-disciplinary medical talents.

BACKGROUND:Pasteurization is a perfect method for albumin virus inactivation, which may not be required for virus inactivation validation. However, there are no systematical reports concerning virus inactivation of hemoglobin blood substitutes. OBJECTIVE:To explore the effects of pasteurization on the physicochemical properties and biological function of hemoglobin blood substitutes. METHODS:Appropriate cord blood samples were taken fol owed by centrifugation, washing blood, rupture of membranes, stabilizer treatment. In the control group, the samples were placed in 55℃water bath, and when the temperature of hemoglobin solution reached (55±1)℃, a heat treatment began and lasted for 2 hours. In the pasteurization group, the samples were placed in 60℃water bath, and when the temperature of hemoglobin solution reached (60±1)℃, a heat treatment began and lasted for 10 hours. The heating process was under continues nitrogen protection. Then, the hemoglobin solution was placed in ice bath and cooled to below 4℃fol owed by low-speed centrifugation and filtration via microporous membrane, purification and viral inactivation thereby to obtain cord blood hemoglobin. RESULTS AND CONCLUSION:The products in the pasteurization group were al red clear liquid. There was no significant difference between the two groups in the yield, methemoglobin concentration, and oxygen-carrying capacity. The purification of the two groups was more than 98%. Two kinds of purification methods had no effects on the oxygen-carrying capacity of hemoglobin. Therefore, pasteurization method can replace thermosensitive purification method of 55℃, 2 hours. The pasteurization method wil not only ensure the physicochemical and biological properties of hemoglobin, but also achieve the purpose of virus inactivation.

Objective To evaluate the choices and surgical skills for tension-free femoral hernia repair under local anesthesia. Methods The clinical data of 109 nonincarcerated femoral hernia patients were summarized from December 2002 to December 2009. Patients were divided into 3 groups according the time period at which the surgery was performed. 85 patients from 2002 to 2008 were divided into 2 groups,45 cases treated with preperitoneal repair ( preperitoneal group), and the other 40 cases with mesh-plug repair (plug group). The 24 cases admitted from January 2009 to December 2009 received modified preperitoneal repair. Operation time, VAS, length of hospitalization, incidence of recurrence, foreign body feelings and seroma were compared among the three groups. Results All the 109 patients were repaired under local anesthesia, and there was no perioperative death. The statistical indicator value of incidence of recurrence, foreign body sensation and seroma in preperitoneal group was lower than plug group (P ＜0.05). The modified preperitoneal repair was better in operation time, VAS, length of hospitalization than preperitoneal group (P ＜ 0.05). Conclusions Modified preperitoneal repair under local anesthesia is the choice for treating femoral hernia without incarceration. Modified preperitoneal repair is faster, more minimally invasive and faster recovery.

Objective To study effect of the health resources on overall quality of medical students.Methods In three vacations,697 medical students investigated the basic conditions of medical institutions in accordance with the level from low to high and three self-designed questionnaire.Researchers educated the students in accordance with the findings.Results Medical students got to know the basic health resources of China better.They deeply realized the character of medical work,social position,occupational importance,value of professional course,and so on.Conclusion Comprehensive quality of medical students was improved by early clinical practice.