Objective To explore the interactions between human leukocyte antigen ( HLA)-DRB1 gene polymorphism and environmental risk factors in gestational diabetes mellitus ( GDM ) pathogenesis.Methods Pregnant women who had prenatal cares in Obstetric Department , West China Second Hospital of Sichuan University were recruited from January 1st to December 31st in 2011.A prospective cohort study was conducted in the women who had a glucose challenge test ( GCT) or 75 g oral glucose tolerance test ( OGTT) during 24-28 gestational weeks.A total of 104 women diagnosed with GDM were randomly included in GDM group while another 103 normal women fell into the control group.The HLA-DRB1 polymorphism was detected by Polymerase Chain Reaction -Sequence Specific Primers ( PCR-SSP) method in both groups.The interactions between HLA-DRB1 polymorphism and environmental risk factors were analyzed based on the simple-case-study method.Results ( 1 ) There were 712 pregnant women with complete perinatal information during January 1st to December 31st, 2011, among whom 175 (24.6%) women were diagnosed with GDM.A logistic regression analysis showed that advanced maternal age (OR=1.081, 95%CI:1.027-1.138), imbalanced diet (OR=3.329, 95%CI:2.167 -5.116), high body mass index (BMI≥24.0 kg/m2) before pregnancy (OR=1.095, 95%CI:1.008 -1.190), HBsAg carrier status (OR=3.173, 95%CI:1.387-7.260) and family history of diabetes mellitus (DM) (OR=1.798, 95%CI:1.063 -3.041) were risk factors of GDM.(2) There were 49 HLA-DRB1 genotypes and 51 HLA-DRB1 genotypes in GDM group and the control group , respectively.We further compared the genotypes that occurred in over 3 cases in either group and found that HLA-DRB1*12,16 was only detected in 5 cases (5/103, 4.9%) in control group,and the difference was significant between the two groups (P=0.029).HLA-DRB1*11,16 and HLA-DRB1*09,09 were only detected in 4 cases (3.8%,4/104) and 5 cases (4.8%, 5/104) in GDM group respectively , but without significant differences between the two groups ( P >0.05 ).No significant difference was found in other genotype frequencies between the two groups ( P>0.05 ).( 3 ) Thirteen types of HLA-DRB1 allele were detected but no significant differences were observed in their frequencies between two groups ( P>0.05).(4) A positive interaction was detected between HLA-DRB1*07 polymorphism and advanced maternal ages (OR=5.952, 95%CI:1.314-26.970, P=0.022), while no interaction was found between HLA-DRB polymorphisms to other risk factors such as imbalanced diet , high body mass index ( BMI≥24.0 kg/m2 ) , HBsAg carrier status or DM family history.Conclusions Advanced maternal age, unbalanced diet, high body mass index (BMI≥24.0 kg/m2), HBsAg carrier status and DM family history are environmental risk factors of GDM in Chengdu.While HLA-DRB1*12,16 genotype may be a protective genotype for GDM.There is a positive interaction between HLA-DRB1*07 polymorphism and advanced maternal age which may play a critic role in GDM development.

Objective To investigate the risk factors of peripartum hysterectomy in placenta previa through retrospective study of 3 840 placenta previa cases. Methods The clinical data of 3 840 patients with placenta previa who delivered in West China Second University Hospital between Jan 2005 and June 2014 were analyzed retrospectively. The relationship of certain factors and peripartum hysterectomy was analyzed, including maternal age, residence place, parity, prior curettage, prior cesarean section, twin or multiple pregnancy, antenatal vaginal bleeding, type of placenta previa, suspected placenta accreta, antenatal level of hemoglobin and gestational age at delivery. Results The prevalence of placenta previa was 4.84% (3 840/79 304) in West China Second University Hospital during the study period, and the incidence of preipartum hysterectomy in patients with placenta previa was 2.76% (106/3 840). One-factor analysis demonstrated that residence place, parity, times of prior curettage, prior cesarean section, prenatal vaginal bleeding, anterior placenta, type of placenta previa, placenta accreta, antenatal anemia and gestational age at delivery were potential risk factors for peripartum hysterectomy (P<0.01). Variables with P<0.1 in one-factor analysis were introduced to multi-factor logistic regression analysis, which suggested that one prior cesarean section (OR=12.9,95%CI:6.3-26.3), two or more prior cesarean sections (OR=14.4, 95%CI:3.9-53.2), anterior placenta (OR=4.8, 95%CI:2.1-10.7), complete placenta previa (OR=5.9, 95%CI:1.8-42.5), placenta accreta (OR=11.2, 95%CI:6.8-18.6), antenatal hemoglobin<100 g/L (OR=1.7, 95%CI:1.0-2.8) and delivery before 34 gestational weeks (OR=3.2, 95%CI:1.6-6.3) were independent risk factors of peripartum hysterectomy in patients with placenta previa (P<0.05). Conclusions Prior cesarean section, anterior placenta, complete placenta previa, placenta accreta, antenatal anemia and delivery before 34 gestational weeks are high risk factors of peripartum hysterectomy in placenta previa patients. Perinatal care and risk evaluation before cesarean section are important to improve perinatal outcomes and reduce peripartum hysterectomy.

Objective To identify and evaluate the important risk factors for preeclampsia.Methods Databases of PubMed,Web of Science,Ovid CBM,China Knowledge Resource Integrated Database,Wanfang and VIP Database were searched from January 1,1990 to December 31,2012 to collect the cohort and case control studies involving the risk factors for preeclampsia.According to the inclusion and exclusion criteria,data of the included studies were extracted.Meta-analysis was performed using Stata 12.0 software with DerSimonian Laird model to calculate OR and its 95％CI of each risk factor.Results A total of 20 studies involving 53 393 patients in the research group and 1 197 773 cases in the control group were included.Fifteen risk factors for preeclampsia were investigated,including:history of preeclampsia (OR=10.27,95％CI:7.67-13.75),complication with chronic kidney diseases(OR=4.69,95％CI:1.94-11.33),history of chronic hypertension (OR-3.47,95％CI:2.39 5.04),multiple pregnancy (OR-2.98,95％CI:2.43-3.66),pre pregnancy body mass index (BMI) ≥ 25(OR=2.47,95％CI:1.97 3.09),maternal hyperglycemia(gestational diabetes and pre existing diabetes)(OR=2.84,95％CI:2.28-3.55),primiparity (OR=2.47,95％CI:2.12-2.82),physical work during pregnancy (OR=1.62,95％CI:1.30-2.02) ; family history of hypertension (OR=2.14,95％CI:1.84-2.50),basic diastolic blood pressure ≥ 70 mmHg (OR=2.17,95％CI:1.44-3.27),low education levels less than junior school (OR=1.69,95％CI:1.34 2.15),basic systolic blood pressure ≥ 120 mmHg (OR=2.31,95％CI:1.86-2.86),urinary tract infection (OR=1.96,95％CI:1.54-2.48),maternal age ≥ 35 or ≤ 20 years (OR=1.43,95％CI:1.29 1.57) and mental ademosyne (OR=1.35,95％CI:1.24-1.47).In addition,smoking before or during pregnancy was found to decrease the incidence of preeclampsia (OR-0.66,95％CI:0.56 0.79).Conclusions The main risk factors for preeclampsia are:history ofpreeclampsia,complication with chronic kidney diseases,history of chronic hypertension,multiple pregnancy,pre-pregnancy BMI ≥ 25,maternal hyperglycemia,primiparity,work during pregnancy and family history of hypertension.Smoking may decrease the incidence of preeclampsia.Nevertheless,more emphasis should be laid the adverse perinatal outcomes of smoking.

Objective To investigate the effects of different glucose concentration on EGR2 protein expression in Schwann cells . Methods Schwann cells were cultured in different glucose concentrations ,and they were divided into two groups ,normal glucose concentration (5 .5 mmol/L ,N group) and high glucose concentration(25 mmol/L ,H group) .Immunocytochemistry and Western blot were used to study EGR2 expression .Results The expression of EGR2 protein was higher in H group than that in N group the difference was statistically significont (P<0 .05) .Conclusion High glucose can lead to EGR2 protein upregulate in Schwann cells ,and EGR2 maybe one of the reasons of diabetic neuropathy .

Objective To explore the effect of hepatitis B virus(HBV) on the expression of complement 3 (C3) and complement 4 (C4) and its regulatory mechanism.Methods Differentially expressed genes between HepG2 and HepG2.2.15 cells was screened by gene chip,serum complement component 3 (C3) and 4 (C4) levels in patients with HBV infection and in healthy individuals were measured by Immunoturbidimetry,HBV infectious clone pHBV1.3 was transfected into HepG2 cells,and expression of C3 and C4 was measured by RT-PCR and Western blot.Results Expression of C3 and C4 mRNA was lower in HepG2.2.15 cells than in HepG2 cells,serum C3 and C4 levels was much lower in patients with chronic hepatitis B and hepatic carcinoma as compared to healthy individuals (P＜0.05 ).HBV could downregulate the expression of C3 and C4 at mRNA and protein levels.Conclusion HBV may inhibit the expression both in vivo and in vitro.

Objective To study the effects of light on body weight,learning and memory of mice.Methods Fifty mice aged 20 days were randomly assigned to one of the five groups: 200 W light group,100 W light group,60 W light group,40 W light group and normal control group,with 10 in each.They were exposed to different intensities of light 8 hours per day for 1 week.Then we monitored their body weight,examined the mean latency and inaccuracy number in step-down test,and examined the mean latency using a Morris' water maze to observe the effect of light pollution on the mice's learning and memory.Results Compared with the other four groups,there were significant decelerations of body weight increase in 200 W light group.No significant difference in body weight gain was found among the other four groups.The four light-treatment groups had no significant differences from control group in the mean latency,inaccuracy number in step-down test or the mean latency,or the mean crosses to the target in the Morris' water maze.Conclusion Short time high-intensity light can inhibit body weight increase in mice,but short-time light has no effect on the learning and memory of mice.

Objective To investigate the incidence and pregnant outcome on vaginal birth after cesarean (VBAC). Methods From January 2005 to December 2015, clinical data of 507 cases with VBAC in West China Second Hospital were studied retrospectively. There were 370 cases of VBAC from January 2013 to December 2015 as study group (VBAC group), in contrast, 740 cases of elective repeat cesarean section (ERCS group) and 740 primiparas of vaginal delivery without history of cesarean section as control groups, the pregnancy outcome were analyzed between the study group and control groups respectively. Results (1) There were 76 547 total births from January 2005 to December 2015. Among these, 10 178 (13.296%, 10 178/76 547) patients had a single prior low transverse cesarean section, of which 4.981%(507/10 178) had VBAC. The incidence of VBAC was rising from 1.020%-3.704%during 2005-2012 to 6.028%-7.662% during 2013-2015. The rate of scared uterus during 2013-2015 was 18.269% (5 539/30 319), of which 9.26%(513/5 539) chose trial of labor after cesarean section (TOLAC). Successful VBAC occurred in 72.12%(370/513) of patients with TOLAC, and 27.88%(143/513) delivered by emergency cesarean. (2) The following parameters of the successful group and the unsuccessful VBAC group were compared, maternal age (29±4) versus (34±4) years, body mass index at prenatal visit (22.2±1.4) versus (22.6±1.4) kg/m2, gestational age (38.7±0.9) versus (39.6±1.3) weeks, birth weight (3 326±317) versus (3 404±285) g, and the rate of induction of labor 0 (0/370) and 6.29%(9/143), there were significant differences (all P<0.01). There was no statistical difference between two group for lower uterine segment (P=0.947). (3) The duration of labor of VBAC group and 740 primiparas of vaginal delivery without history of cesarean section was compared, (10.3± 1.8) versus (11.5 ± 2.0) hours, there was significant difference (P<0.01). There were no statistical difference between two groups for the following parameters, including postpartum hemorrhage, hospitalization duration, the ratio of 5-minute Apgar score≥8, neonatal admission rate (all P>0.05). (4) The postpartum hemorrhage and hospitalization duration in VBAC group incidence were respectively (194±34) ml and (2.32±0.49) days, and the indexes of the ERCS group were respectively (419 ± 57) ml and (4.14 ± 0.78) days, there were significant differences (all P<0.01). There were no statistical difference between two groups for the ratio of 5-minute Apgar score≥8 and neonatal admission rate (all P>0.05). Conclusions The majority of patients choose ERCS rather than TOLAC. It′s important to assess the indications and contraindications of patients for the successful VBAC, and to monitor maternal and fetal conditions during the delivery process. The premise of TOLAC is a comprehensive understanding of closely monitoring the progress of delivery. Compared with the ERCS, VBAC could reduce patients′ postpartum hemorrhage and hospitalization duration, improve the outcomes of pregnancy, and the cesarean section rate could be reduced.

Objective To evaluate the patient-controlled paravertebral block (PCPB) in optimizing the cellular immune function when used after radical resection of pulmonary carcinoma performed via video-assisted thoracoscope in patients.Methods Forty-one ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 50-64 yr,with body mass index of 20-25 kg/m2,of TNM staging Ⅰ or Ⅱ,undergoing radical resection of pulmonary carcinoma performed via video-assisted thoracoscope,were randomly divided into 2 groups using a random number table:PCIA group (n =21) and PCPB group (n =20).PCIA solution contained sufentanil 2 μg/kg in 100 ml of normal saline.The PCIA pump was set up to deliver a 2 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h.In PCPB group,the patients received paravertebral injection of 0.2％ ropivocaine 5 ml at T5 level on the affected side under ultrasound guidance at the end of operation,and then received PCPB.PCPB solution contained 0.75％ ropivacaine 67 ml in 250 ml of normal saline,and the pump was set up to deliver a 5 ml bolus dose,with a 15-min lockout interval and background infusion at 5 ml/h.VAS score was maintained ≤ 3,and analgesia lasted until 50 h after operation.Before induction of anesthesia (baseline),at end of operation,and at 1,3 and 5 days after operation,peripheral venous blood samples were collected to determine the levels of regulatory T cells,natural killer cells and natural killer T cells (by flow cytometry) and plasma concentrations of interleukin-10 and transforming growth factor-β (by ELISA).Results Compared with group PCIA,the level of regulatory T cells was significantly decreased,the levels of natural killer cells and natural killer T cells were increased,and the plasma concentrations of interleukin-10 and transforming growth factor-β were decreased at 1 and 3 days after operation,and no significant change was found in the rate of cellular immune function decline after operation in group PCPB.Conclusion PCPB provides no significant difference clinically in optimizing the cellular immune function when used after radical resection of pulmonary carcinoma performed via video-assisted thoracoscope in the patients.

Objective To investigate the effect of influenza virus on the expression of collagen triple he-lix repeat containing 1 (CTHRC1). Methods A549 cells were infected with influenza virus. mRNA and protein levels of CTHRC1 were determined by RT-PCR and Western blot , CTHRC1 levels in the cell supernatants and sera of influenza virus infected patients were determined by enzyme-linked immunosorbent assay (ELISA). The difference of CTHRC1 levels between healthy controls and HCV patients was analyzed. Results Compared with controls, mRNA and protein levels of CTHRC1 were higher in A549 cells infected with H3N2. Serum CTHRC1 levels were higher in influenza virus infected patients than in healthy controls (P < 0.05). Conclusion Influenza virus can promote the synthesis and secretion of CTHRC1.

Objective To establish a model of pancreatic cancer(PC)in SD rats,and to study the changs of serum levels of AMS and TNF-? and the significances.Methods Dimethylbenzanthracene(DMBA)was directly implanted into pancreatic parenchyma of SD rats(experimental group,group A),and in the process of establishing PC,weekly TSA by 1P was done in intervention group(group B).The tumor development of rats executed within 3～5 months in Group A and Group B were observed by HE staining and gross examination.Meanwhile,the rats in the sham operation group(Group C)were executed at 5 months.The levels of serum AMS were detected by autobiochemical assay apparatus,and the levels of serurn TNF-? were determined by ELISA.Results(1)The incidence of pancreatic cancer in Group A within 3～5 months was 48.7%(18/37),including 17 cases of pancreatic ductal adenocarcinoma and 1 case of fibrosarcoma.The incidence of pancreatic cancer in Group B was 33.3%(12/36),including 11 pancreatic ductal adenocarcinoma and 1 case of fibrosarcoma.The maximal diameter of tumor mass in Group A was higher than that in Group B((P