Objective To compare the success rate and complication rate between real-time ultrasound-guided and technique modified methods of right subclavian vein puncture in tumor patients during implantation of totally implanted port, and to evaluate their effectiveness and safety. Methods We randomly divided 260 tumor patients into ultrasound-guided group and technique modified group, and compared the success rate, pneumothorax, arterial injury, ectopic catheter, local hematoma, puncture times, pinch-off syndrome, etc. Results The success rate of primary puncture in the ultrasound-guided group was better than that in the technique modified group (96.92% vs. 86.15%, P=0.002). The overall complication of the ultrasound-guided group was lower than that of the technique modified group (0 vs. 9.23%, P < 0.001). The incidence of pneumothorax (0 vs. 3.85%, P=0.024) and accidental arterial injury (0 vs. 3.08%, P=0.044) in the ultrasound-guided group were lower than those in the technique modified group. There was no arteriovenous fistula and pinch-off syndrome in any group. Conclusion Compared with the technique modified group, the ultrasound-guided group has more advantages in puncture. Patients with vascular variability can be detected in time.

Objective To explore the risk factors of gestational diabetes mellitus and its influence on pregnancy outcome,and to provide guidance for early intervention of gestational diabetes to improve pregnancy outcome in clinic.Methods Totally 159 patients with gestational diabetes mellitus in our hospital from January 2014 to January 2016 as observation group were collected,and at the same time,634 healthy pregnancy women as control group were collected.The risk factors of gestational diabetes mellitus were analyzed by the Logistic regression analysis and comparison of pregnancy outcome between two groups was conducted.Results The patients in the observation group with age ≥ 35 years,overweight or obesity before pregnancy,adverse pregnancy history,family history of diabetes,hypertension and vaginal candida and thyroid peroxidase antibody (TPOAb) compared with the control group,the difference was statistically significant (P ＜ 0.05).Multivariate logistic regression analysis showed that age ≥ 35 years,overweight or obesity before pregnancy,adverse pregnancy history,family history of diabetes,and positive TPOAb were the independent risk factors of gestational diabetes mellitus,OR was 2.441,2.889,1.486,4.879,and 1.323,respectively;the difference was statistically significant (P ＜ 0.05).The incidence of premature rupture of membrane,pregnancy hypertensive disorder,premature birth,polyhydramnios,uterine-incision and postpartum hemorrhage in observation group were higher than those in control group,the difference was statistically significant (P ＜ 0.05).The incidence of giant baby,fetal distress and mild neonatal asphyxia were higher than those in control group,and the difference was statistically significant (P ＜ 0.05).No statistical significance in fetal growth restriction,neonatal malformations between two groups was found (P ＞ 0.05).Conclusions Age ≥35 years,overweight or obesity before pregnancy,adverse pregnancy history,family history of diabetes,and thyroid dysfunction were the independent risk factors of gestational diabetes mellitus,and it has serious effect on pregnancy outcome,so that it should take measures to prevent the independent risk factors.

Objective:To observe the changes in bone mineral density and microstructure parameters in sclerostin (SOST) gene knockout (SOST -/-) mice after ovariectomy. Methods:Twelve 4-week-old SOST knockout mice were randomly divided into two groups ( n=6): ovariectomized group (SOV), sham operated group (SSO). Twelve wild-type mice were randomly divided into two groups ( n=6): wild-type ovariectomized group (WTO), wild-type sham operated group (WTS). Twelve weeks later, mice were sacrificed and one lumbar vertebra of each mouse was selected for micro-CT analysis. The bone mineral density, trabecular volume fraction, trabecular number and trabecular thickness were observed and compared in the 4 groups. Results:There was no difference in bone mineral density, trabecular volume fraction, trabecular number and trabecular thickness between SOV and SSO groups. Bone mineral density, trabecular volume fraction, trabecular number and trabecular thickness in SOV and SSO groups were significantly higher than those in WTO and WTS groups ( P<0.001). Bone mineral density, trabecular volume fraction and trabecular number in WTO group were significantly lower than those in WTS group ( P=0.017, 0.039, 0.021, respectively). There was no difference in trabecular thickness between WTO and WTS groups. Conclusions:Sclerostin knockout mice showed high bone mass, and ovariectomy did not lead to bone loss and bone microstructure degeneration, which indicates that slerostin is a potential therapeutic target for postmenopausal osteoporosis.