Objective To understand the incidence of abnormal glucose metabolism during pregnancy and the maternal and neonatal outcomes after standard management.Methods A retrospective study of maternal and neonatal outcomes was conducted in 1490 pregnant women who were diagnosed and treated for abnormal glucose metabolism and delivered in the Department of Obstetrics and Gynecology of First Hospital of Peking University from Jan 1995 to Dec 2004 by reviewing the medical records.The selected cases consisted of 79 women with diabetes mellitus(DM group),777 with gestational diabetes mellitus(GDM group),including 355 cases of A1,316 with A2 and 106 cases unclassified,and 634 with gestational impaired glucose test(GIGT group).Maternal and fetal outcomes were analysed in comparison with the controls of 19 013 pregnant women with normal glucose metabolism who delivered during the same period.Results(1)The total incidence of gestational abnormal glucose metabolism was 7.3% and increased gradually from 1995 to 2004.The first stage,from Jan 1995 to Dec 1999,saw a slow increase in the incidence [4.3%(376/8739)];the second stage,from Jan 2000 to Dec 2001,showed a fast increasing trend.The average incidence was 10.8%(445/4133).The incidence in the third stage kept stable at 8.9% (678/7640)from Jan 2002 to Dec 2004.(2)The incidence of macrosomia,preeclampsia and preterm birth were 12.1%(180/1490),9.5%(141/1490)and 9.4%(140/1490),which were significantly higher than those women with normal glucose metabolism(P0.05).(3)The perinatal mortality rate(PMR)of abnormal glucose metabolism group was 1.19%(18/1513)which was significantly higher in the DM group (4.93%)than GDM(1.14%)and GIGT groups(0.78%,P

OBJECTIVETo evaluate the clinical effects of arthroscopic reconstruction of anterior cruciate ligament (ACL) and minimally invasive reconstruction of posteromedial corner (PMC).

METHODSThere were 22 cases of ACL and PMC tear were performed with reconstruction from March 2012 to February 2014. The patients were 29.4 years old on average, including 8 males and 14 females. ACL reconstruction was performed under arthroscopy and PMC reconstruction was performed minimally invasively through the ACL incision. The stability of knee was assessed by anterior drawer test,Lachman test,vulgus stress test and Slocum test. The function of knee was assessed by Lysholm score and Tegner activity rating. MRI of knee was checked 12 months after operation.

RESULTSThe stability tests of all patients were negative at 2 and 6 months after operation, and there was one positive case in anterior drawer test and another positive case in vulgus stress test at 12 months after operation. Lysholm score of all patients 12 months after operation was 96.8 +/- 6.8, which was significantly better than 32.0 +/- 11.2 before operation. Tegner activity rating of all patients at 12 months postoperatively was 6.1 +/- 0.9, which was significantly better than 0.9 +/- 0.5 before operation. It showed the grafts were very well in the MRI 12 months postoperatively.

CONCLUSIONArthroscopic ACL reconstruction and minimally invasive PMC reconstruction can restore the stability of knee.

Adult ; Anterior Cruciate Ligament ; physiopathology ; surgery ; Anterior Cruciate Ligament Injuries ; Anterior Cruciate Ligament Reconstruction ; Female ; Humans ; Knee Injuries ; physiopathology ; surgery ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Treatment Outcome ; Young Adult

Objective:To observe the effect of acupuncture plus medium-frequency electric stimulation on bladder function after radical hysterectomy for cervical cancer. Methods:A total of 170 patients confirmed by biopsy and surgical pathology and treated with radical hysterectomy for cervical cancer were randomly divided into an acupuncture group, an observation group and a control group by random digital table. Fifty-six cases in the acupuncture group were treated with acupuncture after surgery, one session each day, till the extubation day; 58 cases in the observation group were treated with acupuncture plus medium-frequency electric stimulation after surgery, one session each day, till the extubation day; and 56 cases in the control group didn't receive any intervention, and the catheter was retained till the extubation day. On the postoperative day 14, all groups were dealt with catheterization to determine the residual urine volume, in order to observe the occurrence rate of urinary retention and the recovery of bladder function and to compare the differences of the therapeutic effects among the groups. Results:The occurrence rates of urinary retention were respectively 16.1%, 20.7% and 46.4% in the acupuncture group, observation group and control group, with significant differences (P<0.05). When comparing the acupuncture group and the observation group with the control group, there were significant differences (bothP<0.05). In comparison between the acupuncture group and the observation group, there was no significant difference (P>0.05). The recovery rates of bladder function in the three group were respectively 42.9%, 60.3% and 41.1% without significant differences (P>0.05). Moreover, there were no significant between-group differences (P>0.05), but acupuncture plus medium-frequency electric stimulation showed a better tendency. Conclusion: The single application of acupuncture therapy is effective and able to prevent urinary retention after radical hysterectomy for cervical cancer. Acupuncture plus medium-frequency electric stimulation can effectively enhance the recovery of bladder function and reduce the residual urine volume in the bladder to the maximum.

Objective To present a self-designed self-guided driver for clinical removal of cannulated screws. Methods The diameter of the selfguided rod is 2.8 mm and its length is 50 mm.The hexagonal driver head is 4 mm in height,2 mm in width and 5 mm in length.The other parts are similar to those of a solid driver.We then tested the stabilization of the selfdesigned driver by measuring the lateral load and displacement in 5 different experimental groups.Next we put it into use in the 26 patients who had been treated in our department from July 2008 to July 2009.They had been divided into 2 groups randomly.In the self-guided group,there were 9 males and 4 females,with an average age of 36 years and an interval of 30 months after the first operation.In the solid driver group.there were 7 males and 6 females.with an average age of 43 years and an interval of 21 months after the first operation. Results The mechanical tests revealed that the instrument designed by us was stable and could prevent lateral displacement.In clinic.the 39 screws were removed saccessfully in the self-guide driver group.The mean surgical time and incision in the self-guided driver group were significantly less and smaller than in the solid driver group.Conclnsions The self-guided driver is as stiff as a common solid driver and as stable as a cannulated driver.It can reduce the likelihood of screw invalidation which may make the operation very difficult and timeconsuming.It is a simple,timesaving,and less traumatic instrument,especially fit for removal of cannulated screws of the femoral neck.

Apoptosis ; Apoptosis Regulatory Proteins ; genetics ; Genetic Vectors ; Humans ; K562 Cells ; Transfection

Objective To investigate incidence and onset of deep vein thrombosis (DVT) in elderly patients with hip fracture, and to evaluate the laboratory tests of plasma levels of D-Dimer, fibrinogen(FIB)and platelet(PLT) in diagnosing DVT. Methods From January, 2005 to December, 2006, 112 patients, 47 men and 65 women, aged 65 and over, were recruited into this study. Their mean age was 75.5 (range, 65 to 90) years. D-Dimer, FIB and PLT, as high specific fibrin degradation products, were detected via laboratory testing. The incidence, onset and distribution of DVT in these cases were observed. Univariate analysis was used to determine the associations between laboratory values and DVT. Influences of sex and type of hip fracture on the concentration of D-Dimer were studied as well. Results DVT was detected in 18 patients by means of B-mode ultrasonography and venography. The incidence rate of DVT in the elderly was 16. 1%. The onset of DVT took place between the second day and sixth day of hospitalization (average, 5.4 days), apparently earlier than the time of surgery (11. 6 days). Serum D-Dimer level was found significantly higher in the DVT group (P ＜ 0. 05) whereas levels of plasma FIB and PLT showed no significant influence on DVT(P ＞ 0. 05) . The D-Dirmer level was strongly influenced by type of fracture but not by sex.Conclusions Elderly patients with hip fracture have a high incidence of DVT. Since the onset of DVT usually happens before surgery, emergent operation is strongly indicated. A normal level of serum D-Dimer may be clinically significant in excluding the onset of DWT, but a simple rise in plasma D-Dimer level may not indicate DWT. The plasma levels of FIB and PLT may have no clinical significance in diagnosing DVT.D-Dimer level is not associated with sex of patients but with type of fracture.

Objective To study the relationship between balance function and attention in children with attention deficit hyperactivity disorder(ADHD),and guide the clinical intervention and training of ADHD.Methods The Tetrax balance system and the CPT were conducted among 124 ADHD children (age 6.0-14 years) and the normal controls.Results (1) The balance function was different between ADHD and normal controls.In junior grade of elementary school,the Fourier score of ADHD children was significantly higher than that of the normal control group in F1,F2-F4 and F5-F6 (P＜0.05).In senior grade of elementary school,the Fourier score of ADHD children was significantly higher than normal controls in F2-F4 and F5-F6 (P＜ 0.05).There was no significant difference between ADHD and normal controls in junior high school.(2) There was correlation between balance function and attention in children with ADHD.In junior grade of elementary school,the full scale attention quotient was negatively correlated with F2-4,F5-6,F7-8 (P=0.018,0.009,0.010; rs =-0.146,-0.203,-0.189),and the visual attention quotient were negatively correlated with F1,F2-4,F7-8 (P =0.043,0.039,0.046 ; r s =-0.062,-0.071,-0.112).In senior grade of elementary school,the full scale attention quotient was negatively correlated with F5-6,F7-8 (P=0.015,0.033; rs =-0.217,-0.172),and the visual attention quotient were negatively correlated with F1,F7-8(P=0.037,0.045; rs =-0.051,-0.101).In junior high school,the negative correlation was existed between the visual attention quotient with F7-8 (P=0.038,r s =-0.114).Conclusion ADHD children have deficit balance.The balance function of ADHD children matures gradually.There is internal connection between balance and attention,especially for visual attention.

Objective The purpose of this study was to research the expression of Twist in cervical cancer tissues and the relationship between its expression and clinicopathologic characteristic, and to investigate the role of twist in cervical cancer invasion, metastasis and progress. Methods Immunohistochemistry was used to detect the expression of the Twist in 78 cases of middle and advanced stages cervical cancer tissue microarray chip. The relationship between its expression and clinicopathological characteristic was analyzed. Results (1) The positive expression of twist in cervical cancer was 56/78 (71.8%);(2) The expression of Twist in cervical cancer was significantly related to tumor histology type, FIGO stage, lymph node metastasis and differentiation degree. With the increase of FIGO stage, the emergence of lymph node metastasis and the decrease of differentiation degree, the expression of Twist increased gradually ( <0.05) . Conclusion The expression of Twist may be closely related to the invasion, metastasis and progress of cervial cancer.