Objective To study the maternal and fetal outcome in pregnancy with overt diabetes. Methods Retrospective study was made on 88 pregnancies with overt diabetes from 1981 to 2001 in department of Obstetrics & Gynaecology, first teaching hospital, Beijing university to study the maternal and fetal outcome in pregnancy with overt diabetes and its relationship with the level of blood glucose. One case with artificial abortion and 2 cases with metaphase induced labor were rejeceted from the 88 cases, we devided the other 85 cases into two groups. Group A with well controlled glucose had 42 cases; group B without well controlled glucose had 43 cases. Results In this study, we found 5 cases of fetal death in group B, 3 of them were perinatal death. Nine cases of newborn malformation were all found in those people without well controlled glucose in early pregnancy, the incidence of newborn malformation was 10.2%. The rate of asphyxia of newborn in group B (24.4%) is significant higher than in group A (4.8%) ( P =0.011). The rate of pregnancy induced hypertension in group B (44.2%) is significantly higher than that in group A (21.4%) ( P = 0.026). The rate of premature labor in group B (30.2%) is significantly higher than that in group A (9.2%) ( P =0.017). Conclusions Maternal blood glucose with ideal control throughout pregnancy may reduce the maternal complications and perinatal morbidity and mortality in pregnancy with overt diabetes.

To investigate the effect of ESWL on the distal ureteral stone in contralateral prone po sition. Methods:Patients were kept in contralateral prone position and shock wave was focused on distal ureteral stone by contralctaral lower abdomen during the fragmenting of the stone. Results :All stones had been fragment ed during the first time of ESWL. The stone-free rate was 100％. Conclusion :It was suggested that ESWL in con tralateral prone position should be the treatment of choise for patients with distal ureteral stone,if the function of lithotripster was achicved.

Objective To investigate the respective effects of highly concentrated amino acids, highly concentrated glucose and mixture of the above two on the proliferation and extracellular matrix synthesis of glomerular mesangial cells. Methods Mesangial cells were cultured with mannitol (13.3 mmol/L ), highly concentrated amino acids (13.3 mmol/L), highly concentrated glucose (30.5 retool/L) and the mixture of highly concentrated amino acids and highly concentrated glucose repectively. Mesangial cell proliferation was examined by MTT and flow cytometry. The mRNA expression of TGF-β1,ColⅣ and fibronectin (FN) was detected by semi- quantitative RT-PCR, and the protein expression was detected by ELISA, Western blot and radioimmunoassay. Results (1) Cellular proliferation was increased in response to amino acids and was further enhanced by increased levels of both amino acids and glucose in a time-depentent manner. And the most prominent action occured at 48 hours. (2) Among the three group, mesangial cell cycle was affected, and the number of G0/G1 mesangial cells was reduced, but the number of cycle S cells was improved. (3) In the three group, the mRNA and protein expression of TGF-β1 was improved [protein unit: ng·ml-1·(105 cells)-1, 3023±85, 3163±80, 3321+85 vs 1506±63, P< 0.05]. (4)In the three group, the mRNA and protein expression of Col Ⅳ and FN was enhanced [protein unit: ng'ml-1(105 cells)-1, Col Ⅳ:16.78±2.56, 18.65±2.56, 22.83±2.45 vs 10.22±2.54, P<0.01; FN:18.47±2.34, 13.58±3.13, 17.98±2.56 vs 8.22±2.54, P<0.05]. The expression of Col Ⅳ mRNA and protein was stronger when the cells were cultured with the mixture of highly concentrated amino acids and highly concentrated glucose. Conclusions Highly concentrated amino acid can promote cell proliferation similarly to highly concentrated glucose, which may be through increasing the activity of mesangial cells and the synthesis of extracellular matrix via TGF- β1 signaling way. Highly concentrated amino acid has the synergism with highly concentrated glucose.

Objective To identify the accurate measurement of glomerular filtration rate (GFR) in chronic glomerulonephritis (CGN)patients. Methods Forty-two patients were enrolled in the study, including 15 females with age from 18 to 73 years old (mean 46 years old) and 27 males with age from 20 to 77 years old (mean 48 years old). The methods used for measuring GFR were classical dual plasma sample clearance method (tGFR), considered to be the gold standard,renal dynamic imaging method (dGFR), 24-hour creatinine clearance method (24hCcr). The difference and correlation amony them were analyzed. When the difference was significant, Pearson correlation and linear regression analysis were further performed. The difference of GFR detected by dGFR between left and right kidney of patients was compared simultaneously. A two-sided P value＜0.05 was considered as statistically significant. Results Either dGFR or 24hCcr was statistically different from tGFR, but had excellent correlation with tGFR, and the coefficient was 0.916 (P=0.000) and 0.957 (P=0.000) respectively. The linear regressions correlation existed and the regression equations were tGFR=0.936 dGFR-4.648 (F=208.941, P=0.000), tGFR =0.887 24hCcr+2.919 (F=376.513, P=0.000) respectively. Difference had not statistically significance between left and right kidney of patients (P=0.591). Conclusions Neither dGFR nor 24hCcr can substitute tGFR, but both can reflect the GFR of the CGN patients safely and effectively. The decrease of GFR is homochronous for left and right kidney of CGN patients. Therefore, the 24hCcr can be chosen to evaluate the GFR in the hospitals without SPECT.

Social network analysis has been a study hot spot in academic circle in recent years and is applied in several fields.After a brief description of its basic theories and study methods, its application in domestic medical and health field were analyzed with its key study hot spots summarized and its problems pointed out, in order to provide the methods that can learned in domestic medical and health studies.

Objective To review the first case of paired-exchange kidney transplantation between two couples in China.Methods In April 2006,two cases of paired-exchange living kidney transplantations were successfully performed.Husband 1 in blood type O received a kidney donated from husband 2 in blood type O,while wife 2 in blood type A received a kidney from wife 1 in blood type A.Results The transplantation was performed smoothly.Renal graft in husband 1 functioned for 21 months,and the recipient died at 9th month due to infection.Graft survival and patient survival in wife 2 were 30 month and 31 month respectively.Conclusion Paired-exchange of living-related kidney donation and transplantation,as an effective pathway to resolve the shortage of organ,could be programmed with cautious medical guideline,ethical consideration and legal framework in China.

The functional framework of information management system for regional medical and health institutions was established according to the 5 application systems (public health, medical service, medical support, drug supply support and general management ) and the target to develop 2 databases ( a resident electronic health records data-base and a resident electronic medical records database ) and an operational network put forward in the overall framework of health information construction during The National Twelfth-5 Year Plan Period, based on the functional position of health institutions at different levels.The difficulties to realize the target of the national 3521 project and its prospects were pointed out.

Objective To investigate the survival of islet isograft in NOD mice treated with islet antigen-specific regulatory T cells.Methods GAD-65 antigen pulsed immature dendritic cells (imDC) were used to induce naive T cells into islet antigen-specific regulatory T cells.NOD mice which had progressed to type 1 diabetes (T1DM),as the recipients,received islet isografts (500 IEQ) under renal capsule from NOD mice without T1DM.In NOD mice in control group without transplantation,the changes in blood glucose (BG) were observed.NOD mice in simple islet transplantation group were given islet isograft without Treg infusion.In experiment group,NOD mice were infused with 1 × 106 islet antigen-specific regulatory T cells on the 1st day before transplantation,subsequently underwent islet isotransplantation.The survival of the islet isograft was evaluated by BG levels and the pathological changes were observed.Results BG levels were sustained above 11.1 mmol/L in control group.In simple islet transplantation group,BG level was decreased to the normal level in 1 ～2 days after transplantation,and began to rebound in 7～ 17 days posttransplantation and maintained at the preoperative level.The mean survival of the islet isograft in the NOD mice was (12.2 ± 2.6) day;In experiment group,BG level was decreased to the normal level in 1 ～2 days after transplantation,rebounded above 11.1 mmol/L in some mice on the 27th day after transplantation,and rebounded above 11.1 rnmol/L on the 43th day in all mice.The mean survival of the islet isograft in the NOD mice was (35.2 ± 4.3) days,which was significantly prolonged compared to simple islet transplantation group (P＜ 0.01).In simple islet transplantation group,the islet isograft was infiltrated by many lymph cells and damaged severely,and only few residual islet cells secreted insulin without complete islet existing in insulin staining.The islet isograft in experiment group was intact on the 15th day,with little lymph cell infiltration and a great number of islets secreting insulin.Conclusion Infusion of islet antigen-specific regulatory T cells induced by imDC and islet antigen GAD-65 in vitro could delay the destruction of autoimmune system and prolong the islet isograft survival in NOD mice.

Objective To investigate the relationship between single-nucleotide polymorphisms of IVS13-98G/T of human protection of telomeres 1 (hPOT1) genes and gastric cancer. Methods A total of 168 patients with gastric cancer (gastric cancer group) who had been admitted to Wuwei Cancer Hospital, Wuwei People's Hospital and Liangzhou District Hospital from December 2005 to July 2006 and 156 healthy people (control group) were genotyped by polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism (PCR-RFLP) method, and the relationship between the distribution of genotypes and the risk faetors of gastric cancer was analyzed. The distribution of genotypes and allele frequency between the 2 groups were compared by chi-square test. Hardy-weinberg equilibrium test was adopted to determine whether the distribution of genotypes and allele frequency were representative. Relative risk and 95% confidence interval were calculated by non-conditional Logistic regression model. Results The frequencies of genotypes GG, GT and TT of hPOT1IVS13-98 G/T were 21.4%, 41.7% and 36.9% in gastric cancer group, and 24.4%, 51.9% and 23.7% in control group. The allele frequencies of G- and T-allele were 42.3%, 57.7% in gastric cancer group, and 49.7%, 50.3% in control group. There was no significant difference in allele frequencies of G- and T-allele between the 2 groups (X~2=3.58, P>0.05). Compared with genotype TT, the relative risks for GT and GG were 0.439 (95% CI: 0.251-0.767, P < 0.05) and 0.514 (95 % CI: 0.264-0.999, P=0.05). There was no influence of different genotypes of hPOT1IVS13-98 G/T, sex, smoking history, family history of cancer on gastric cancer. Conclusion Single-nucleotide polymorphisms of IVS13-98G/T of hPOT1 may be a protective factor of gastric cancer.

Objective: To compare the clinical efficacy and safety between tocilizumab (TCZ) combined with methotrexate (MTX) and TCZ used alone in the patients with active rheumatoid arthritis (RA) by meta-analysis to provide reference for the treatment adjustment for the patients with poor response to MTX.Methods: Literature searches were conducted in sinoMed, VIP, PubMed, Cochrane Library and OVID, and then identified according to the inclusion and exclusion criteria.Meta-analysis was conducted using Rev Man 5.3.5 software.Results: Totally 7 randomized controlled trials (RCTs) were included in the analysis.A total number of patients were 1534 cases.The meta-analysis showed that in the treatment of RA, TCZ combined with MTX had significantly higher odds of DAS28≤2.6 remission and CDAI≤2.8 remission when compared with TCZ alone , and the incidence of adverse events (AE), serious adverse events (SAE) and serious inection had no statistical differences.Conclusion: The efficacy of TCZ combined with MTX is higher than that of TCZ alone in RA patients, and the safety is similar.The conclusion still needs further confirmation by RCTs with large samples and high quality.