Objective To study the effect of endouterine and extra-aterine exposure to lead on iron concentrations in the blood and hippocampus,hemogiobin level and the learning memory in young rats and the protective effect of zinc in this event.Methods Sixteen pregnant Wistar rats were randomized into 4 groups,group A fed with diet containing Zn 17.5 mg/kg and normal water,group B with Zn 17.5 mg/kg and water with PbAC? 3H2O 500 mg/L,group C with Zn 168.7 mg/kg and PbAC? 3H2O 500 mg/L,and group D with Zn

Objective To observe the clinical efficacy of treatment of chronic pelvic inflammatory disease with Kangfu Xiaoyan suppository combined ceftriaxone.Methods84 cases of chronic pelvic inflammatory disease in our hospital from June 2015 to August 2016 were randomly divided into observation group and control group, with 42 cases in each group.The control group were treated with ceftriaxone sodium alone,on the basis of the control group, the observation group was treated with Kangfu Xiaoyan suppository.After treatment, the changes tumor necrosis factor-α (TNF-α), transforming growth factor β1 (TGF-β1), interleukin 8,1β (IL-8, IL-1β) and clinical symptom score in the two groups were recorded and analyzed.Results①After two weeks of treatment, the total effective rate of observation group was 92.86%, significantly higher than that of the control group(76.19%), and the difference was statistically significant (P<0.05).②After treatment,the levels of TNF-α, TGF-β1 in the observation group[(0.80±0.23)μg/L, (12.43±1.98)μg/mL) were better than the control group[(1.81±0.35)μg/L,(19.01±2.24)μg/mL], and the differences were statistically significant (P<0.05);③After treatment,the abdominal pain, vaginal symptom score of observation group[(1.57±0.11),(1.45±0.15) points] were lower than the control group[(2.05±0.17),(2.16±0.20) points], and the differences were statistically significant (P<0.05).ConclusionKangfute Xiaoyan Suppository combined with ceftriaxone sodium in the treatment of chronic pelvic inflammatory disease, curative effect is exact, compared with the single application of ceftriaxone sodium in the treatment without obvious adverse reactions, can effectively improve the symptoms of patients with chronic pelvic inflammatory disease, it is worthy of further research and application.

It is complicated to decide the treatment plan of hopeless anterior teeth in esthetic zone due to severe periodontitis, periodontal-endodontic combined lesion or teeth trauma.The optional treatment plan for this kind of teeth includes retention after periodontal treatment, extraction and implant treatment, extraction and prosthodontic treatment and so on.To make an appropriate treatment plan, patients'' periodontal conditions, periodontal biotype, local anatomy, esthetic demand, economic condition and social psychological status should be comprehensively considered.A combine of periodontal, endodontic and orthodontic therapy may achieve a good treatment effect in hopeless anterior teeth with severe periodontal destruction, tooth extrusion and occlusal trauma.In this case, a 20-year-old female who presented with symptoms of bleeding on brushing and upper incisors loosening for 1 month came to the Department of Periodontology, Peking University School and Hospital of Stomatology.The clinical examinations revealed that the patient''s right upper incisor had signs of mobility (Ⅲ°), intrusion of 1-2 mm, and probing depth (PD) of 9-10 mm.The periapical radiograph showed that the alveolar bone of right upper incisor absorbed horizontally to the apex.And the patients showed Angle Ⅱ° malocclusion with Ⅱ° overbite in anterior teeth and maxillary protrusion.A diagnosis of aggressive periodontitis and Angle Ⅱ° malocclusion was made.The treatment of this patient lasts for 5 years which include periodontal initial therapy, orthodontic therapy, guided tissue regeneration (GTR) of right upper incisor and supportive periodontal therapy and the clinical result is fine.A hopeless upper incisor was successfully retained and the longtime clinical condition was stable.The strategy of retention of hopeless upper anterior teeth, the relationship of periodontal treatment and orthodontic treatment, and the indications of periodontal and orthodontic combined therapy were also discussed on the basis of this case.Generally, the positive factors in retention of hopeless teeth includes young age, absence of systemic conditions, strong motivation for maintaining the tooth, single root anatomy, integrated dentition, good response to cause-related therapy, intrabony alveolar bone defect, thick periodontal biotype, and regular supportive periodontal therapy.And in the progress of orthodontic therapy, regular supportive periodontal therapy and good plaque control is extremely important.

Objective To explore the neuropsychological development in twin premature infants,and to analyze the risk factors for the retardation of development.Methods The premature infants hospitalized in the Neonatal Ward First Affiliated Hospital of Kunming Medical University from Jun.2010 to Jun.2012 were divided into study groups of twin premature infants and a control group of singleton premature infants.The neuropsychological development of 88 premature infants was evaluated at corrected gestational age of 1 year old by Bayley scales of infant development.According to normal lab findings of the Bayley scales of infant development,the premature infants were then divided into abnormal neuropsychological development group [mental development index(MDI) ≤79 scores] and normal neuropsychological development group (MDI ＞ 79 scores),and the data of 2 groups were statistically analyzed.Results The frequency distribution of MDI score in study group showed a skewed distribution,of which 59％ (27/46 cases) had abnormal neuropsychological development (MDI ≤ 79 scores); However,the frequency distribution of MDI score in control group showed an approximate normal distribution,of which only 12％ (5/42 cases) for abnormal neuropsychological development.Head circumference,body length,body weight,MDI,psycho-motor development index of twin premature infants of one-year old were lower than those of the singleton premature infants of the same age,and the differences were statistically significant (all P ＜0.05).The single factor analysis demonstrated that the risk factors for abnormal neuropsychological development (MDI ≤ 79 scores) of twin premature infants were gestational age,birth weight,mother' s gcstational age,the cultural degree of parents,mode of feeding,neonatal hyperbilirubinemia,neonatal hypoglycemia and neonatal sepsis.Multiple regression analysis showed that neonatal hyperbilirubinemia was the independent risk factor for abnormal neuropsychological development of twin premature infants.Conclusions At same gestational age,neuropsychological development of twin premature infants lagged behind singleton premature infants.Neonatal hyperbilirubinemia may be the risk factors for neuropsychological development of twin premature infants,so the earlier management of neonatal hyperbilirubinemia may be beneficial for the neuropsychological development of twin premature infants.

Objective To investigate the relationship of homocysteine and blood glucose wavy coefficient with type 2 diabetic nephropathy.Methods Glycosylated hemoglobin A1c (HbA1c),fasting blood glucose(FBG),fasting C-peptide,homocysteine(Hcy),blood-fat and 24h urinary albumin quantitative (UAlb) of 154 patients with type 2 diabetes were determined,and the blood glucose wavy coefficient were calculated after blood glucose monitored by a continuous glucose monitoring system (CGMS).The patients were divided into two groups according to the quantity of UAlb:high UAlb group (n =81 ) and normal UAlb group( n =73 ).Then the difference were compared between two groups and multiple regression analysis was done between UAlb and a variety factors.Results The course of disease in high UAlb group were significantly longer than that in normal UAlb group ( (9.68 ± 7.31 ) years vs ( 5.44 ± 3.65 ) years,t =3.427,P ＜ 0.05 ).There were significant difference on HbA1c [ ( 9.61 ± 2.44 ) ％ vs ( 8.69 ± 2.35 ) ％,t =2.162 ],blood glucose wavy coefficient [ ( 3.06 ± 0.85 ) vs (2.58 ± 0.91 ),t =2.437],low density lipoprotein-cholesterol (LDL-C) [ (3.46 ± 0.83 )mmol/L vs ( 3.01 ± 0.84 ) mmol/L,t =2.596 ],UAlb [ ( 129.64 ± 118.5 ) mg/24 h vs ( 18.14 ± 3.54 )mg/24 h,t =6.421 ),UA ( ( 335.02 ± 90.39 ) mmol/L vs ( 287.00 ± 92.03 ) mmol/L,t =2.541 ) and Hcy [ ( 15.55 ± 4.53 ) mmol/L vs ( 13.12 ± 4.44 ) mmol/L,t =2.603 ] between the two groups ( P ＜ 0.05 or P ＜0.01 ).Pearson analysis showed that the courses of disease,LDL-C,UA,Hcy and blood glucose wavy coefficient were positively correlated with UAlb ( r =0.363,0.270,0.220,0.252,0.236 respectively ; P =0.000,0.008,0.033,0.014,0.022,respectively).And the multiple regression analysis indicated that UAlb was related with courses of disease(β =0.344,P =0.000),Hcy(β =0.244,P =0.011 ) and blood glucose wavy coefficient(β =0.229,P =0.012).Conclusion The elevation of serum Hcy and blood glucose wavy coefficient are risk factors to type 2 diabetic nephropathy.Lowering Hcy concentration and reducing the glucose variability may be a new way to prevent the occurrence of type 2 diabetic nephropathy.

Objective To analysis the influence factors of standardization in the hierarchical chain management of type 2 diabetes and to enhance the hierarchical chain management of type 2 diabetes.Methods ( 1 ) Six hundred and ninty patients with type 2 diabetes completed 1 years management were divided into well-controlled glycosylated hemoglobin ( HbAlc ) group (＜7.0％ ) and bad-controlled glycosylated hemoglobin (HbAlc) group ( ≥ 7.0％ ).The conditions of diet,physical activity,medication,self-blood sugar monitoring and participation in health seminars were investigated and analyzed.(2) The patients were divided into standardized management group and not standardized management group.Their age,sex,educational background,occupation,monthly income per person,medical security,the course,cognition for glycuresis,two-way transfer,and chronic complications were investigated and statistically analyzed.Results ( 1 ) The proportions of physical activity (70.1％ vs 54.2％,x2=6.163,P=0.018),self-blood sugar monitoring(60.4％ vs 43.8％,x2=6.268,P=0.016) and participation in health seminars (56.0％ vs 41.7％,x2=4.577,P=0.045) in the well-controlled HbAlc group were significantly higher than those in the bad-controlled HbAlc group.(2) Their age [(61.08 ±10.04) years old vs ( 57.75 ± 9.89 ) years old,t=2.539,P=0.012],educational background ( ratio of low educational attainment:8.3 ％ vs 17.2％,x2=6.426,P=0.041 ),medical security (own expense ratios:4.6％ vs 11.5％,x2=3.543,P=0.048 ),awareness of diabetes ( ratio of poor awareness of diabetes:19.4％ vs 41.0％,x2=17.518,P=0.000 ),two-way transfer ( ratio of not transfer treatment:4.6％ vs 14.8％,x2=7.662,P=0.022) and chronic complications ( ratio of chronic complication:41.7 ％ vs 26.2％,x2=6.130,P=0.017) were significantly different between the standardized management group and not standardized management group.(3) Logistic regression analyses indicated that the age ( OR=0.954,P=0.006),monthly income per person ( OR=4.101,P=0.018 ),medical security ( OR=7.617,P=0.003 ),cognition for glycuresis ( OR=0.030,P=0.000),two-way transfer ( OR=9.079,P=0.000) and chronic complications ( OR=0.456,P=0.031 ) were the risk factors of standardized management.Conclusion We should focus on the impact factors affecting the standardized management of patients including age,monthly income per person,medical security,awareness of diabetes,ratio of not transfer treatment,positive strategies for chronic complications,improve the hierarchical chain management of type 2 diabetes,and then make the diabetic patients to early participate in standardization management of diabetes mellitus and delay the appearance of complications.

Objective To investigate the relationship and mechanism of the heme oxygenase-1 expression in peripheral blood mononuclear cells (PBMC) and the oxidative stress in diabetic nephropathy. Methods Two groups of diabetic patients with or without diabetic nephropathy and a normal control group were enrolled in this study. Fasting blood glucose (FBG), HbA1c, serum MDA level, ROS level, HO-1 mRNA level and HO-1 protein expression in PBMC were determined. Results In control group, diabetic group and diabetic nephropathy group , the MDA levels significantly increased[(14.23±5.07)nmol/ml vs (24.90±7.12)nmol/ml vs (43.83±16.97)nmol/ml](F＝37.022,P＜0.01), the ROS levels significantly increased (113.18±58.59 vs 364.54±88.67 vs 524.35±162.51)(F＝68.369,P＜0.01) and the HO-1 protein expression also increased significantly (22.84±9.98 vs 36.72±15.85 vs 58.1±15.93)(F＝31.302,P＜0.01). There was a positive correlation among the HO-1 mRNA, protein expression and MDA level(r＝0.407,0.429,P＜0.05). Conclusions There existed a severer oxidative stress condition in patients with diabetic nephropathy compared with the patients without diabetic nephropathy. HO-1 could be a potential pathway to ameliorate oxidative stress in diabetic kidney disease patients.

Abstract Childhood overweight and obesity has become a serious public health problem. Family, as the primary environment in which children grow up, is closely related to their overweight and obesity. With the continuous development of social economy, grandparents gradually participate in family feeding, and play an imortant role in family feeding. The oresent paper systematically reviews grandparents feeding awareness, feeding behaviors, feeding styles and feeding environment choices, in order to provide a reference for improving intergenerational feeding and reducing the incidence of overweight and obesity in children.

Objective:To explore the methods and effect of applying specialized training and multimedia education in key infection-related departments of a hospital to intervene standard precautions for clinical practice interns.Methods:Based on the cases of nosocomial infection at home and abroad, the Science and Education Section and Infection Management Section designed and produced videos about standard precautions and occupational protection. The content of these videos covered two fields including knowledge training and skill training, with emphasis on enhancing awareness of profession risks and skills of hospital infection control and occupational protection of 196 medical students through specialized training in key infection-related departments. The training effect of standard precautions education for the two groups of students was evaluated from the theoretical test scores, questionnaire survey on their attitude and compliance to standard precautions, and the incidence of their occupational exposure to needle stab wound. SPSS 18.0 was performed for t test and chi-square test. Results:Apart from the knowledge of the unfavorable factors of implementing standard precautions, there were significant differences between the experimental group and the control group in six aspects: theoretical test scores, hospital infection risk cognition, significance cognition of standard precautions, favorable factors of implementing standard precautions, self-efficacy evaluation and self-evaluation of compliance to standard precautions ( P<0.05). And there was significant difference in the incidence of occupational exposure to needle stab wound between the experiment group and control group (1.02% vs. 7.14%; χ2=4.69, P<0.05). Conclusion:Various teaching interventions of standard precautions during the entire internship period have expanded and deepened the contents of school education, enabling the students to form good occupational risk awareness and coping skills to protect the patients and themselves.

Objective:To investigate the relationship between angiopoietin-like protein 4(ANGPTL4) and vascular endothelial growth factor(VEGF) in serum and lower limb arterial lesions in Type 2 diabetes mellitus.Methods:Using the method of retrospective cohort study, 164 inpatients with type 2 diabetes admitted to the Department of Endocrinology, Dahua hospital, Xuhui District, Shanghai from October 2017 to December 2018 were selected as the type 2 diabetes group, and 69 healthy people in the same period were collected as the normal control group.According to the ankle brachial index<0.9, diabetic patients were divided into two groups: the group without lower extremity artery disease and the group with lower extremity artery disease.The levels of ANGPTL4 and VEGF in serum were measured by enzyme-linked immunosorbent assay.Results:(1)Compared with the normal control group: the concentration of ANGPTL4 in serum of lower extremity arterial disease group and no lower extremity arterial disease group((44.78±15.15), (47.46±10.43) μg/L) were lower than that of normal control group((52.87±12.74) μg/L), the difference was statistically significant (all P<0.05). The serum VEGF concentration in lower extremity arterial disease group and no lower extremity arterial disease group((340.98±76.18), (314.83±75.30) ng/L) were higher than that in normal control group((282.58±81.4) ng/L), the difference was statistically significant(all P<0.05). (2)Compared with no lower extremity arterial disease group: the concentration of ANGPTL4 in serum of lower extremity arterial disease group was lower than that of no lower extremity arterial disease group, but the difference was not statistically significant( P>0.05). The serum VEGF concentration in lower extremity arterial disease group was higher than that in no lower extremity arterial disease group, the difference was statistically significant( P<0.05). (3)Correlation analysis: Diabetes mellitus and diabetic course>10 years( OR 4.594, 95% CI2.540-8.311, P<0.001), fasting blood glucose>8 mmol/L( OR 2.353, 95% CI1.023-5.416, P=0.044), glycosylated hemoglobin>8%( OR 6.442, 95% CI 2.874-14.441, P<0.001) and the increase of VEGF( OR 3.745, 95% CI1.566-8.953, P=0.003) are risk factors for lower limb arterial disease in type 2 diabetes, while the increase of ANGPTL( OR 0.154, 95% CI0.064-0.372, P<0.001) can reduce the occurrence of lower limb arterial disease in type 2 diabetes. Conclusion:ANGPTL4 is a protective factor and VEGF is a risk factor of type 2 diabetes mellitus.Both of them influence each other and participate in its occurrence and development.