Objective To evaluate the influence of gestational diabetes mellitus (GDM) on maternal and perinatal outcomes in twin pregnancies. Methods We retrospectively analyzed the clinical features of both twin and singleton pregnancies, which delivered in Guangzhou Women and Children's Medical Center between January 1, 2012 and December 31, 2013. The twin pregnancies were divided into two groups:those with (GDM-T, n=51) and without GDM (non-GDM-T, n=130), which were matched by maternal age and delivery time (within one month) in a ratio of 1∶2 among singleton pregnancies with (GDM-S, n=102) and without GDM (non-GDM-S, n=102), respectively. The differences of adverse maternal and perinatal outcomes among these four groups were examined. The overall assessment of pregnancy outcomes was completed using Delphi method. Statistical analysis was performed with one-way analysis of variance, t test, Kruskal-Wallis test, rank test, Chi-square test or Fisher's exact test. Results (1) When compared to GDM-S and non-GDM-S group respectively, less women conceived with the help of assisted reproductive technology, higher proportion of women underwent and gestational age at delivery tend to be earlier in GDM-T and non-GDM-T group (all P<0.01). In oral glucose tolerance test,the fasting blood glucose level of GDM-T group was higher than the other three groups (F=21.716, P<0.01), the glucose levels at 1 and 2 h were higher than non-GDM-T and non-GDM-s respectively (both P<0.01), but no significant difference was found when compared with GDM-S group (P>0.01). Similarly, no significant difference was found in prenatal glycosylated hemoglobin value between GDM-T and GDM-S group (P>0.01). (2) There was no significant difference in the incidences of hypertensive disorders of pregnancy, anemia, premature rupture of membranes, oligohydramnios, placental abruption, postpartum hemorrhage, asphyxia neonatorum, small for gestational age, hypoglycemia of newborn, hyperbilirubinemia of newborn and perinatal death between GDM-T group and the other three groups(all P>0.01). Higher incidences of hypertensive disorders of pregnancy and postpartum hemorrhage were shown in the GDM-T group than in the GDM-S and non-GDM-S groups, respectively (both P<0.01). The incidences of preterm birth in GDM-T and non-GDM-T group were both higher than that in GDM-S and non-GDM-S, respectively [54.9%(66/102), 53.8%(140/260), 5.0%(10/102) and 3.0%(6/102), all P<0.01], while no significant difference was found between GDM-T and non-GDM-T group (P>0.01). (3) The overall assessment of pregnancy outcomes did not show any difference between GDM-T group and the other three groups (χ2=6.707, P>0.01). However, the score for fetal outcomes in the GDM-T group was higher than in the GDM-S and non-GDM-S group, but lower than in non-GDM-T group [M(Q)=1.0(2.3), 0.0(3.0), 0.0(0.0), 1.0(2.8) score, χ2=122.818, P<0.01]. Conclusions GDM does not increase the risk of adverse pregnant outcomes in twin pregnancies.

OBJECTIVETo study the relationship between fumonisin biosynthesis gene and toxicity of Fusarium moniliforme isolated in China.

METHODSThe toxigenic gene of 29 Fusarium moniliforme isolated from different provinces and varied food samples were determined. Eighteen fum5-positive strains were selected for biosyhesizing fumonisin and determined by high performance liquid chromatography (HPLC).

RESULTSTwenty-six isolates were identified as fum5 gene positive strains. And all of these strains produced FB(1), FB(2) and FB(3). The amount of FB(1), FB(2) and FB(3) was ranging from 0.41-140.20 mg/kg, 0.06-14.30 mg/kg to 0.30-58.00 mg/kg, except one strain produced a lower level of FB(1) only. It wight be the first report showing a high level fumonisin-producing strain isolated from the sesame sample and identified in the world. The amount of FB(1), FB(2) and FB(3) produced by the isolate was 128.84 mg/kg, 11.80 mg/kg and 14.88 mg/kg.

CONCLUSIONSIt should have a close relationship between fumonisins biosynthesis gene and toxicity of Fusarium moniliforme isolated in China. The study demonstrated that strain of Fusarium moniliforme might contaminate the sesame sample and produce a high level of fumonisins.

China ; Chromatography, High Pressure Liquid ; Food Contamination ; analysis ; prevention & control ; Fumonisins ; analysis ; metabolism ; Fungal Proteins ; genetics ; metabolism ; Fusarium ; genetics ; isolation & purification ; metabolism ; Sesamum ; microbiology

Objective To investigate and evaluate the effect of continued nursing intervention on anxiety and other negative emotions and quality of life in postoperative patients with lumbar spinal tuberculosis.Methods A total of 187 postoperative patients with lumbar spinal tuberculosis were selected and randomly divided into two groups:94 patients in the experimental group with continued nursing intervention and 93 patients in the control group with conventional standard nursing.After the treatment,all of patients received the anxiety level test by using the Self-Rating Anxiety Scale,and three months after operation,all of patients were investigated with questionnaire to compare their quality of life.Results The results showed that,there were 26 (27.66％) patients without anxiety,43 (45.74％) patients with mild anxiety,18 (19.15％) patients with moderate anxiety,7 (7.45％) patients with severe anxiety in the experimental group,and there were 18 (19.35％),25 (26.88％),39 (41.94％),11 (11.83 ％) in the control group,respectively.The degree of anxiety was statistically significant difference between the two groups (Z =-2.948,P ＜ 0.05).The total scores of life quality of patients in the experimental group and in the control group were (67.52 ± 18.61) and (43.68 ± 12.46),respectively.There were higher scores of physical,psychological,social in the experimental group than in the control group,and the difference was statistically significant (P ＜ 0.05).The patient satisfaction rate in the experimental group was 86.17％ (81/94),only 69.89％ (65/93) in the control group,and the difference was statistically significant (x2 =7.227,P ＜ 0.05).Conclusions Continued nursing can help to improve the anxiety emotion and quality of life in postoperative patients with lumbar spinal tuberculosis.

OBJECTIVETo evaluate the cost-effectiveness and economic efficiency of integrated prevention of mother-to-child transmission (PMTCT) of HIV in four high-incidence counties.

METHODSData of local resource investment and total cost for PMTCT in 4 counties in China from 2003 to 2006 were collected. Cost analysis and cost-effectiveness analysis were conducted. Average costs of a confirmed HIV case, a prevented case and a disability-adjusted life-year (DALY) saving were calculated.

RESULTSAverage cost of identifying one HIV-infected mother was yen5512. Costs of a pediatric HIV case prevention and per DALY saving were yen46 747 and yen1870 ($231), respectively, based on the total cost perspective.

CONCLUSIONThe cost of integrated prevention of mother-to-child transmission of HIV was low. The PMTCT program was economical efficiency.

Acquired Immunodeficiency Syndrome ; prevention & control ; transmission ; Cost-Benefit Analysis ; Female ; Humans ; Infectious Disease Transmission, Vertical ; prevention & control ; Pregnancy ; Pregnancy Complications, Infectious ; prevention & control ; Universal Precautions ; economics

Objetive: To investigate whether apoptosis of SGC7901 cells can be induced by the expression of the recombinant gene of anti-HER2 ScFv/tBid. Methods: The recombinant anti-HER2 ScFv/tBid gene was cloned into vector pCMV and the recombinant plasmid was transfected into SGC7901 cells. The gene expression was detected by RT-PCR and immunofluorescent staining. Cell counting was carried out to show the effect of the gene transfection on cell growth. At the same time, significant apoptotic peak was detected by flow cytometry in recombinant anti-HER2 ScFv/tBid gene transfected cells. Results: The fusion protein of anti-HER2 ScFv/tBid was observed in the cytoplasm of transfected SGC7901 cells. The transfected cells displayed typical cell growth inhibition and apoptosis. Conclusion: Fusion protein of anti-HER2 ScFv/tBid can induce apoptosis of SGC7901.

Objective To investigate the distribution characteristics of methicillin-resistant Staphylococcus aureus (MRSA)in a children's hospital,and provide basis for the prevention and control of MRSA infection in children. Methods Children who admitted to a children's hospital from 2011 to 2015 were analyzed retrospectively,clinical data of children,isolation of pathogens,types of specimens,and healthcare-associated infection(HAI)status were analyzed.Results From 2011 to 2015,a total of 911 children isolated Staphylococcus aureus (SA,1108 positive specimens),494 of whom isolated MRSA (599 positive specimens),54.23% of children isolated MRSA(isolation rate of specimens was 54.06%);there was no significant difference in the isolation rate of MRSA between children of different genders(P > 0.05);isolation rate of MRSA in different age groups was statistically significant(P <0.05).Isolation rates of MRSA from blood,puncture fluid,secretion,and pus were 68.97%,66.00%,55.81%, and 54.47% respectively.Isolation rate of SA and MRSA increased from 0.61% and 21.74% in 2011 to 1.40%and 75.59% in 2015 respectively,difference were both significant(both P <0.05).Incidence of SA and MRSA in-creased from 0.198% in 2011 to 2.697% and 2.119% in 2015 respectively,both showed an upward trend year by year(both P <0.05).Conclusion Isolation rate of MRSA and incidence of HAI in this children's hospital increased year by year,it is necessary to intensify management,use antimicrobial agents scientifically and rationally,timelyperform disinfection and isolation,so as to curb the emergence and spread of MRSA in hospital settings.

Objective To observe the clinical efficacy and safety of citicoline sodium tablets combined with edaravone injection in the treatment of cerebral ischemic stroke. Methods A total of 100 patients with cerebral ischemic stroke were randomly divided into control group (n = 48 cases) and treatment group (n = 52 cases) . Control group was given edaravone injection 30 mg per time, bid, intravenous drip. Treatment group received citicoline sodium tablets 0. 2 g per time, tid, orally, on the basis of control group. Two groups were treated for 14 days. The clinical efficacy, the levels of serum calmodulin (CAM) , growth differentiation factor 15 (GDF-15) and pentraxin-3 (PTX-3) , the scores of national institutes of health stroke scale (NIHSS) and modified Barthel index (MBI) , and adverse drug reactions were compared between twogroups. Results After treatment, the total effective rates of treatment and control groups were 88. 46％ (46 cases/52 cases) and 70. 82％ (34 cases/48 cases) with significant difference (P < 0. 05) . After treatment, the main indexes of treatment and control groups were compared: CAM were (102. 45 ± 14. 59) and (136. 58 ± 14. 55) mg ·m L-1, GDF-15 were (443. 59 ± 49. 34) and (567. 36 ± 55. 20) pg·m L-1, PTX-3 were (0. 40 ± 0. 05) and (0. 56 ± 0. 08) ng·m L-1, NIHSS scores were (9. 19 ± 1. 67) and (11. 13 ± 1. 65) , MBI scores were (58. 37 ± 3. 17) and (49. 75 ± 3. 43) , the differences were statistically significant (all P < 0. 05) . The adverse drug reactions of treatment group were gastrointestinal discomfort and fever, which in control group were fever and elevated blood pressure. The total incidences of adverse drug reactions in treatment and control groups were 5. 77％ and 4. 17％ without significant difference (P> 0. 05) . Conclusion Citicoline sodium tablets combined with edaravone injection have a definitive clinical efficacy in the treatment of cerebral ischemic stroke, which can effectively reduce the levels of serum CAM, GDF-15 and PTX-3, improve the nerve function, without increasing the incidences of adverse drug reactions.

OBJECTIVETo investigate the association between a new polymorphism (IVS3-20 T>C GenBank accession number: AY463003) in intro 3 of the parkin gene and the risk for Parkinson's disease (PD) in Chinese, particularly the relation between this polymorphism and the age of onset of PD patients.

METHODSPD was diagnosed according to the criteria of Core Assessment Program for Intracerebral Transplantations(CAPIT). All patients and controls were examined by two neurologists and were of the Han ethnic background. Polymerase chain reaction (PCR), denaturing high performance liquid chromatography (DHPLC) and sequencing were used to determine the genotype of each subject.

RESULTSA total of 312 PD patients (including 99 early-onset PD patients and 213 late-onset PD patients) and 236 controls were studied. The C/C homozygote was not found in this study. Chi-square analysis revealed that the frequencies of the C allele and T/C genotype were higher in total PD group but were not statistically different from those of the control group (P=0.6350 and 0.6331, respectively). After being stratified by age of onset, the frequency of T/C genotype was significantly higher (OR=3.52, 95%CI 0.97-13.13) in PD group with an onset age at or below 45 years old (7.07%), compared with that in the control group (2.12%). Similarly, C allele was much higher (OR=3.42, 95%CI 0.96-12.57, P=0.0276) in the early-onset PD group (3.90%) than that in the control group (1.06%). The linear trend analysis showed that both the T/C genotype and C allele increased significantly in the PD group with the increase of the onset age [chi-square(trend of Genotypes)=4.414, P=0.036; chi-square(trend of Alleles)=4.344, P=0.037]. On the other hand, there was no difference in the frequencies of allele and genotype between the late-onset PD patients and controls.

CONCLUSIONThe above results suggest that the parkin IVS3-20 T>C polymorphism might be a genetic risk factor for early-onset PD in Chinese.

Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Base Sequence ; Female ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Parkinson Disease ; genetics ; Polymorphism, Genetic ; Sex Distribution ; Ubiquitin-Protein Ligases ; genetics

OBJECTIVE: We wanted to describe the computed tomography (CT) findings of gallbladder tuberculosis (TB) and to correlate them with pathologic findings. MATERIALS AND METHODS: There were seven patients (M:F = 3:4; mean age, 46.3 years; age range, 32 to 78 years) in whom gallbladder TB was eventually diagnosed. All of them underwent cross-sectional imaging with CT, a pathologic examination and a retrospective review. CT imaging evaluation was done in each case, including the findings of a mass versus nodule, wall thickening (uniform or irregular) and the enhancement patterns (homogeneous or heterogeneous). RESULTS: All the cases of gallbladder TB revealed the following three different CT findings: micronodular lesion of the gallbladder wall (n = 1), a thickened wall (n = 4) and a gallbladder mass (n = 2). There were three cases of homogeneous enhancement of the lesions, including homogeneous enhancement with nodular lesion, homogeneous uniform thickness enhancement and homogeneous thickness enhancement in one case each, and these cases pathology showed tuberculous granuloma with a little caseating necrosis in one case and tuberculous granuloma with rich fibrous tissue, but little or no evident caseating necrosis in two cases. Four cases of heterogeneous enhancement of the lesions, including heterogeneous uniform-thickness enhancement in two cases, heterogeneous enhancement with a local mass lesion in one case and heterogeneous enhancement with a mass that replaced the gallbladder in one case; in these cases, pathology showed tuberculous granuloma with marked caseation or liquefaction necrosis in three cases and tuberculous granuloma by fibrous and calcifications accompanied by caseating necrosis in one case. Among the seven cases of gallbladder TB, six cases were accompanied by abdominal extra-gallbladder TB, including abdominal lymph node TB in five cases and hepatic TB in four cases. CONCLUSION: Gallbladder TB has various CT manifestations, and the enhanced CT findings are well matched with pathological features. An irregularly thickened gallbladder wall or a gallbladder wall mass with multiple-focus necrosis or calcifications accompanied by the typical CT findings of abdominal extra-gallbladder TB should suggest the diagnosis of gallbladder TB.
Adult ; Aged ; Female ; Gallbladder Diseases/pathology/*radiography ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed/*methods ; Tuberculosis, Gastrointestinal/pathology/*radiography

OBJECTIVETo investigate the changes in brain injury after the induction chemotherapy in children with acute lymphoblastic leukemia (ALL) by cranial MRI.

METHODSThe clinical data and cranial MRI results of 62 children with ALL who were hospitalized from March 2014 to June 2015 were analyzed retrospectively.

RESULTSBefore chemotherapy, MRI showed bone marrow infiltration of the skull in 33 patients (53%); the children with WBC<20×10(9)/Lhad a significantly lower incidence rate of bone marrow infiltration of the skull than those with WBC≥20×10(9)/L (16 patients/42% vs 17 patients/71%; P<0.05), and the high-risk group had a significantly higher incidence rate of bone marrow infiltration of the skull than the non-high-risk group (71% vs 44%; P<0.05). Before chemotherapy, there were 4 cases (7%) of brain atrophy, and 2 cases (3%) of abnormal signals in the sensory conduction bundle. MRI reexamination in 28 patients after 3 months of chemotherapy showed 3 new cases (11%) of brain atrophy and 1 aggravated case of brain atrophy.

CONCLUSIONSThe children with ALL have bone marrow infiltration of the skull, brain atrophy, and abnormal signals in the sensory conduction bundle before chemotherapy, especially bone marrow infiltration of the skull, and some changes in brain injury disappear after treatment.

Adolescent ; Bone Marrow ; pathology ; Brain ; drug effects ; pathology ; Child ; Child, Preschool ; Female ; Humans ; Induction Chemotherapy ; adverse effects ; Infant ; Magnetic Resonance Imaging ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; pathology ; Retrospective Studies ; Skull ; pathology