Objective To investigate the effect of fasting blood glucose control and its influencing factors in patients with type 2 diabetes mellitus (T2DM) in community.Methods 905 cases of patients with T2DM were collected in Rencheng District of Jining city according to the stratified cluster random sampling method.The general demographic characteristics and lifestyle of the subjects were collected by questionnaire survey,and the height,body weight,blood glucose,blood pressure and blood lipids were measured by physical examination.Multivariate Logistic regression analysis was used to analyze the influencing factors of blood glucose control.Results A total of 905 subjects were recruited in the analysis.74.70％ of the subjects were aged 35 years above.The proportion reaching the control criteria of the blood glucose,blood pressure and cholesterol was 71.27％ (645),29.83％ (270) and 26.74％(242) of the subjects respectively.The influencing factors for blood glucose control in the subjects were age,duration of disease,blood pressure,weight,diet condition and psychological states and treatment compliance,and the differences were statistically significant(x2 =7.58,23.18,7.08,5.22,5.46,5.16,5.65,all P＜0.05).Multivariate Logistic regression analysis showed that age and duration of disease were the risk factors of blood glucose control in patients with T2DM.Standard blood pressure control was the protective factor that affects the effect of blood glucose control (OR=1.430,95％ CI=1.015-2.015,P＜0.05).Conclusion The blood glucose control of T2DM patients need to be improved comprehensively in community.By strengthening the control of blood glucose and blood pressure,establishing good habits of life behavior and improving the ability of self management,patients with T2DM can improve their quality of life.

Folic acid supplementation is one of the most important measures to prevent neural tube defects(NTDs)among child-bearing age women.This article reviews the NTDs prevention efficacy of the studies including field intervention trials,population folic acid supplementation and fortification in different countries,and analyzes the efficacy variation and their influencing factors of the related studies.The results of the article may provide references for folic acid supplementation,fortification and its efficacy evaluation in the population.

Objective To investigate the X-ray and MRI manifestations of osteochondritis dissecans (OCD) and to compare the sensitivity of detection among different sequences. Methods Thirty-six OCD cases (thirty-eight knees) with complete data were selected and analyzed. The sagittal and coronal images were acquired on T 1WI, T 2WI, PDWI, and FLASH T * 2WI. MRI manifestations were analyzed retrospectively with double blind contrast method. The radiographies were obtained on the same day. The sensitivity of detection among different sequences was also compared. Results (1) The medial femoral condyle was the most commonly affected location in the knee (63.2%). The proportion of classical type, expanded type, and inferocentral type was 55.3%, 15.8%, and 28.9%, respectively. (2) On radiographs, the lesions typically appeared as a well circumscribed area of sclerotic subchondral bone separated from the remainder of the epiphysis by a radiolucent line. (3) Subchondral bone lesion was displayed as small and crescent-shaped ( n =38) on the sagittal image and as wedge (14) or short bar (24) shape on coronal image. The signal of the lesion was hypointense or isointense on T 1WI,surrounded by a hypointense or hyperintense (FLASH T * 2WI, T 2WI) line. The subchondral plate disappeared or became thinner. Interruption or disappearance of the hyaline cartilage could be seen sometimes. (4) The detection rate on T 1WI was higher than that of PDWI, T 2WI, and FLASH T * 2WI. Conclusion (1) Osteochondritis dissecans has specific X-ray and MRI manifestations. The abnormality of the hyaline cartilage and the subchondral bone can be displayed by MRI. Thus a proper diagnosis can be made. (2) The detection rate on T 1WI is higher than that of PDWI, T 2WI, and FLASH T  2WI.

Objective To investigate the effect of nitric oxide synthase(NOS) inhibitors and L-arginine(L-Arg) on the prognosis of traumatic shock in rats. Methods Traumatic shock models of Sprague-Daulay rats were made and randomly devided into control group (n=24),L-NAME treatment group (n=24),AG treatment group (n=24) and L-Arg treatment group (n=24). Serum nitric oxide(NO) levels and oxygen partial pressure in tissues include skeletal muscles,liver and small intestine were detected at 1h,3h,5h after resuscitation. Meanwhile, hemodynamic data of the rats and their survival rates of 12h and 24h were monitored and recorded. Results Serum NO concentration was statistically lower after resuscitation in L-NAME group than that in control group, while there were no statistical significance of tissues oxygen partial pressure and survival rate in 12、24h between the two groups. AG could decrease serum NO levels only at late stage of traumatic shock,but no effect on the synthesis and relase of NO at early stage of traumati shock.AG could improve tissues oxygen partial pressure of the liver and small intestine, and prolonged the mean survival time. L-Arg could increase serum NO levels, and improve oxygen partial pressure of intestine and significantly increase the survival rate at 12h and 24h in rats with traumatic shock. Conclusions Treatment with AG and L-Arg can improve the prognosis of traumatic shock rats much better than that with L-NAME.

Objective To explore the utilization and effectiveness of ultrasound screening for neural tube defects (NTDs),so that to provide scientific evidences for the secondary prevention of NTDs.MethodsFour hundred and fifty-nine women who delivered or gestated NTDs babies or fetuses were randomly selected from Shandong Province and Shanxi Province,and the related information was collected with structured questionnaire by trained interviewers.Results Of the 459 cases,the ultrasonography utilization rate was 98.7%,and 6 cases (1.3%) never took examinations by ultrasonography during the whole pregnancy period.The total diagnosis rate of ultrasound screening for NTDs was 85.9%,and those of anencephalus,spina bifida and encephalocele were 96.4%,79.6% and 73.8% respectively (P<0.05).The average diagnosis week of NTDs was 24.0 and those of anencephalus,spina bifida and encephalocele were 21.2,27.1 and 24.7 respectively (P<0.05).The detection rates of NTDs before 16 weeks,16-20 weeks,20-24 weeks,24-28 weeks and after 28 weeks were 14.1%,49.4%,46.3%,49.2% and 52.1% respectively (P<0.05).The detection rates of NTDs in hospitals,maternal and child care service centers and family planning centers were 46.4%,52.0% and 28.1% respectively (P<0.05).The detection rate of NTDs by two-dimensional ultrasound equipment was 41.3% and 83.3% by three-dimensional ultrasound equipment (P>0.05).Conclusions The detection rates of NTDs and the subtypes by ultrasonography are low at different pregnant periods and in different medical institutions.It is important to increase the utilization rate of ultrasound screening by pregnant women and improve the NTDs diagnostic level of primary health care institutions,so that to improve the efficacy of secondary prevention strategy for NTDs in China.

Objective To determine the clinical value of cytological diagnosis of the impressed specimens in the radical gastrectomy for patients with gastric cancer. Methods During radical gastrectomies for 52 patients with gastric cancer, 232 impressed specimens were taken from the tumor tissues,paratumor tissues, proximal and distal incision margin,and partial lymph nodes respectively, to detect if there was tumor cells by cytological examination and compared with the pathology. Results In the tumor tissues,there were no pseudo positive specimen,and the pseudo negative specimen occurred in 1.In the incision margin,there was no pseudo negative specimen,while 12 pseudo positive specimens were found.In the paratumor tissues,there were 3 pseudo negative and 10 pseudo positive specimens.In all specimens,the sensibility was 92.8%; specificity was 85.8%; accuracy rate was 87.9%. Conclusions Cytological examination of the impressed specimens in radical gastrectomy is helpful in detecting residue tumor tissue in the incision margin, especially in hospitals without rapid pathologic examination.If cytological examination is combined with rapid pathological examination,the results will be better.

Objectives To explore the effect of holder pasteurization, frozen storage time and thawing methods on macronutrients and energy content of donor human milk, and to provide theoretical basis for the rational use of breast milk. Methods Thirty-three samples of donor human milk were collected and an aliquot of each sample was analyzed before and after pasteurization. The remaining milk after pasteurization was split into 9 aliquot , and frozen at -20 ℃. After 30, 60, and 90 days, the milk was thawed by three different methods of room tempe-rature, 4 ℃ refrigeration, and 37 ℃ water bath, respectively. The nutrient components of each aliquot were analyzed and compared. Results We observed a mild reduction in fat and energy content after pasteurization (P <0.05). A significant decrease of fat, protein and energy content with the prolonged storage time was observed (P <0.01), and during the whole process (pasteurization + frozen storage), the decrease of fat, protein and energy content was 36.6%, 32.6%and 22.6%, respectively. The protein was influenced mostly by different thawing methods and the content of protein reached highest while thawed at 4 ℃ refrigeration. Conclusions Holder pasteurization and frozen storage at-20℃significantly reduce fat, protein and energy content of donor human milk. The donor milk should be used as quickly as possible when applied for preterm infants and thawing at 4 ℃ refrigeration is recommended before delivery to newborn infants.

Objective To explore the pattern of cervical nodal metastasis and the clinical significance of total thyroidectomy plus functional neck lymphadenectomy in papillary thyroid carcinoma patients. Methods Clinical and pathological data of 172 patients with papillary thyroid cancer who underwent total thyroidectomy plus functional neck lymph node dissection at Jinan Military General Hospital were retrospectively reviewed, including patient demographics, extent of surgery, parathyroid hormone level,recurrence, tumor pathology, such as tumor size, multifocality, capsular invasion, vascular invasion,extrathyroidal extension, and lymph node status. Results Of the 172 functional neck dissection patients (47 ambilateral), the incidence of lymphonodus metastasis in regions Ⅵ, Ⅳ and Ⅲ was 96. 3% ,78. 5%and 62.1% respectively. Rate of nodal metastasis was higher in patients with extracapsular invasion than in patients with no invasion ( P ＜ 0. 05 ). Serum parathyroid hormone levels significantly decreased immediately postoperatively in total thyroidectomy plus functional neck dissection and remained low for several weeks thereafter ( P ＜ 0. 01 ). The 5-, 10- and 15-year survival rate was ( 98. 83 ± 0. 82) %, (98. 23 ± 1.02 ) % and (96. 42 ± 1.43 )%, respectively. Conclusions Therapeutic neck lymph node dissection for papillary thyroid cancer is recommended for cervical nodal metastasis patients. Total thyroidectomy plus functional neck dissection is important in the treatment of papillary thyroid cancer.

OBJECTIVETo examine the effect of post-discharge nutrition management on the growth speed of neonates after bowel surgery.

METHODSNutrition feeding guidance was carried out in 133 post-discharge infants after surgery through nutrition clinic. The growth speed was detected every month and compared with the normal standards, then the time to accelerate growth speed was evaluated.

RESULTSThe growth speed of neonates in the first postoperative month was lower than the normal standards, especially in males(weight P=0.000; length P=0.041; circumference P=0.010). While during two to three months, male infants showed acceleration in length growth speed [(4.53±1.22) cm vs. (3.1±0.4) cm, P=0.013], and female infants showed acceleration in weight [(1.51±0.76) kg vs. (0.83±0.39) kg, P=0.028] and circumference growth speed [(2.50±0.93) cm vs. (1.2±0.7) cm, P=0.021].

CONCLUSIONSScientific post-discharge nutrition management helps neonates grow faster after bowl surgery. The two to three months after operation is the key period of growth speed acceleration.

Objective:To observe the effect of isorhmnetin on the ER/TGF-β1/Smad3 signaling pathways in human dermal fibroblasts (HSF) damaged by UVA.Methods:HSF were divided into control group, model group, estradiol group, isorhmnetin groups with 100, 10, 1, 0.1, 0.01, 0.001 μmol/L by random number table method, and cell photoaging models were established in all groups excepting the control group. After the intervention with corresponding drugs, cell proliferation rates were detected with MTT method, and the effective concentration of isorhmnetin was screened. Then the cells were divided into control group, model group, estradiol group, isorhmnetin group, TGF-β1 blocker group, Samd3 blocker group, and COL1A1 blocker group. Cell photoaging models were established in all groups excepting the control group. After intervened with corresponding drugs, the TGF-β1, Smad3, Ⅰ collagen α1 (collagen, type Ⅰ, alpha 1, COL1A1) mRNA and protein expression in all groups were detected by the real-time quantitative PCR and the Wester blot method.Results:The proliferation rate of isor administration group were increased than those in the control group ( P<0.01). Compared to the UVA irradiation group, the expression of TGF-β1 mRNA (0.956 ± 0.020 vs. 0.718 ± 0.036), Smad3 mRNA (0.981 ± 0.044 vs. 0.753 ± 0.047), COL1A1 mRNA (0.998 ± 0.032 vs. 0.786 ± 0.031), TGF-β1 protion (0.761 ± 0.026 vs. 0.542 ± 0.023), Smad3 protion (0.776 ± 0.016 vs. 0.551 ± 0.025), COL1A1 protion (0.792 ± 0.025 vs. 0.584 ± 0.012) in isor administration group significantly increased ( P<0.01). Compared to the isor administration group, the TGF-β1 mRNA (0.762 ± 0.051, 0.802 ± 0.012, 0.828 ± 0.030 vs. 0.967 ± 0.026), Smad3 mRNA (0.784 ± 0.027, 0.816 ± 0.015, 0.830 ± 0.032 vs. 0.998 ± 0.021), COL1A1 mRNA (1.082 ± 0.025, 1.101 ± 0.012, 1.138 ± 0.011 vs. 1.263 ± 0.022), TGF-β1 protion (0.675 ± 0.028, 0.682 ± 0.026, 0.722 ± 0.015 vs. 0.862 ± 0.014), Smad3 protion (0.712 ± 0.013, 0.764 ± 0.012, 0.778 ± 0.011 vs. 0.901 ± 0.015), COL1A1 protion (0.738 ± 0.016, 0.770 ± 0.038, 0.792 ± 0.026 vs. 0.964 ± 0.017) in the TGF-β1 blocker group, Smad3 blocker group and COL1A1 blocker group significantly decreased ( P<0.01). Conclusions:Isorhmnetin can promote the collagen synthesis of photo aging HSF cells, and its mechanism is related to the regulation of ERβ/TGF-β1 signaling pathway.