Objective To explore the effect of insulin injection and protamine biosynthetic human insulin injection on basal insulin level in pregnant women with diabetes mellitus.Methods Retrospective analysis of 89 cases of pregnant women with diabetes mellitus from January 2013 to May 2016 in department of obstetrics and gynecology,tianjin red bridge hospital,the patients were divided into group A (n=38 cases) and group B (n=51 cases),the group A treatment with insulin injection,the group B treatment with protamine biosynthetic human insulin injection,compare the two groups of patients before and after treatment of three meals a day rate of blood glucose compliance, treatment compliance and satisfaction.Results Before treatment, there was no significant difference in the blood glucose compliance rate between the two groups before and after treatment;After treatment,the blood glucose compliance rate of two groups was significantly higher than before treatment ( P<0.05 ) , there was no significant difference in the compliance rate of fasting blood glucose between two groups,the compliance rate of blood glucose before dinner in group A was 81.58%,significantly higher than that in group B 60.78%(P<0.05).Conclusion Both insulin injection and protamine biosynthetic human insulin injection can maintain the basic insulin levels of pregnant women with diabetes mellitus,insulin injection can better control the blood glucose levels before dinner,with higher compliance and satisfaction.The compliance rate and satisfaction rate of pregnant women in group A were 97.37% and 97.37%,which were significantly higher than those in group B 82.35% and 80.39%(P<0.05).

【Objective】 To observe the promoting action of spleen-strengthening and Qi-promoting herbs on enteral nutrition(EN) for patients after abdominal surgery.【Methods】 Sixty patients after abdominal surgery were equally randomized into groups A and B.The two groups received oral use or tube feeding of enteral nutrition(Fresubin).Group A received oral use or tube feeding of the decoction with spleen-strengthening and Qi-promoting actions(composed of Radix Pseudostellariae,Rhizoma Dioscoreae,Fructus Hordei Germinatus,Pericarpium Citrus Reticulata,Radix Notoginseng) additionally.The treatment lasted one week.Before and after EN treatment,the contents of hemoglobin(Hb),total lymphocyte count(TLC),albumin(Alb),serum total protein(TP) and the ratio of albumin and globumin(A/G) were observed.【Results】After EN treatment,the above laboratory parameters were increased in the two groups as compared with those before treatment(P

Objective To study the expression and significance of Th17 and Tc17 cells in the peripheral blood,skin and lung in a murine model of bleomycin (BLM)-induced systemic sclerosis (SSc).Methods Thirty female BALB/c mouse were randomly divided into 3 groups,including a control group ( A group),a injected with BLM 4 week without pulmonary fibrosis(PF) group( B group) and with obviously PF group(C group).Pathological changes of skin and lung were detected.The proportion of CD4+,CD8+,CD4+IL-17+(Th17),CD8+IL-17+(Tc17) cells in the peripheral blood,skin and lung of mouse was determined by flow cytometry.The mRNA expressions of RORγt,IL-17A in skin and lung of mouse were evaluated by real-time PCR.Enzyme linked immunosorbent assay(ELISA) was used to measure the levels of IL-17 in serum.Results Dermal hydroxyproline(HYP) contents and the score of PF were significantly increased in C group [ (3.07±1.26) μg/mg,4.0±1.41 ]and B group [ (2.43±0.61) μμg/mg,1.50±0.76]as compared with A group [ (1.45±0.40) μg/mg,0.60±0.70 ],and pulmonary HYP contents was obviously increased in C group than in A and B groups,all P＜0.05.Compared with the A group,the percentage of CD4+ and Th17 cells in the peripheral blood,skin and lung of B and C groups,Tc17 cells of C group was significantly increased,and CD8+ cells was significantly decreased(all P＜0.05).The ratio of Th17/CD4+CD8+ in the peripheral blood,skin and lung of B and C groups [ ( 1.41 ±0.36)％,( 1.79±0.77)％ ],[ (2.58±1.07)％,(5.23±2.34)％ ]and [ (3.50±1.20)％,(4.02±1.32) ％ ]was significantly increased compared with A group (0.71±0.25)％,(1.15±0.59)％,(0.99±0.46)％.The ratio of Tc17/CD4+CD8+ in the lung of C groups( 1.62±0.53) ％ and in the skin of B and C groups [ (1.70±0.70) ％,( 1.63±0.63 ) ％ ]was significantly increased compared with A group [ ( 1.00±0.47 ) ％,( 1.1 1 ±0.34 ) ％ ],all P＜0.05.Compared with the A group,the mRNA levels of IL-17A,RORγt in skin of B and C groups,and in lung of C group were higher and the levels of IL-17 in serum was significantly increased,all P＜0.05.Th17 cells and the levels of IL-17 in blood were positive correlation with dermal and pulmonary inflammation,fibrosis and H YP contents,all P＜0.01.The frequency of Th17 and Tc17 cells in skin and lung respectively had a positive correlation with dermal and pulmonary inflammation,the score of fibrosis,and HYP contents of skin and lung,all P＜0.01.Conclusion Th17 and Tc17 cells were significantly increased in the peripheral blood,skin and lung of a murine model of SSc,and Th17 cells is dominated.They correlated with the inflammation and fibrosis of skin and lung,and may participate in the pathogenesis of SSc through secrete IL-17.

Objective To evaluate the clinical value and efficacy of prophylactic pancreatic duct stenting for biliary-type stenosis of Oddi sphincter with difficulty cannulation.Methods The present study was a retrospective study of 63 patients with biliary-type stenosis of Oddi sphincter and difficult cannulation.The stent group consisted 30 patients who underwent prophylactic pancreatic duct stenting from February 2010 to February 2011 and the control group included 33 patients who underwent only ERCP without prophylactic pancreatic duct stenting from January 2009 to January 2010.The incidence of postoperative pancreatitis were compared between the two groups.Results The incidence of postoperative pancreatitis of the control group was significantly higher than that of the stent group (P ＜ 0.05).Conclusion For patients with definite diagnosis of biliary-type stenosis of Oddi sphincter and difficult cannulation,prophylactic pancreatic duct stent placement is safe and effective.

Objective To investigate the gender differences of glucose metabolic network in brains of healthy adults at resting state by 18F-FDG PET.Methods A total of 204 dextromanual,healthy individuals (104 males,average age:(53.45±11.51) years;100 females,average age:(54.11±12.09) years) were enrolled from June 2011 to June 2016 to construct brain metabolic networks.The nodal and global parameters,including clustering coefficient (Cp),characteristic path length (Lp) and betweenness centrality (Cb),were analyzed by graph theory.Permutation test with 1 000 repetitions was used.Results The brain metabolic networks derived from 18F-FDG PET data were with small-world properties in both male group and female group.Compared with Cb in females,Cb in males was significantly reduced in left postcentral gyrus,right angular gyrus and left temporal pole/middle temporal gyrus (permutation test,all P<0.05);and it was increased in left amygdala,left precuneus,right temporal pole/middle temporal gyrus and left inferior temporal gyrus (permutation test,all P<0.05).Comparing with the females,the male group had higher Cp and longer absolute Lp but without significant difference (permutation test,all P>0.05).Conclusions There are gender-related differences of topological structure in whole-brain metabolic networks.Gender should be considered as a covariate while designing experiments,accounting for cerebral metabolic data from normal control and experimental patients as well as making clinical decisions.

Objective To study multimodal analgesia in patients who underwent transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).Methods 60 patients who underwent TACE for HCC from Aug.2016 to Nov.2016 were randomized into two groups:the multimodal analgesia group and the control group.The pain scores of these two groups of patient during the procedure and at different posttreatment time points,and the rates of adverse effect and pharmacoeconomic differences were recorded.Results When compared to the control group,the pain scores at 0 h,2 h,4 h,6 h,12 h after treatment in the multimodal analgesia group were significantly lower (P ＜ 0.05),and the satisfactory scores for the patients were significantly improved (96.6％ vs.66.7％).The multimodal group of patients also had significandy lower adverse effect rates of nausea and vomiting,and it was more cost-effective.Conclusions Patients who required multimodal analgesia had better pain relieve,patient satisfaction and less adverse reactions after TACE than patients in the control group.Multimodal analgesia was a safe,effective and economic way to control TACE pain and it was worth recommended in clinical practice.

Objective Analyze current clinical practice guidelines related to pre-anesthesia as-sessment to provide a resource for healthcare providers (or institutions)seeking protocols of their own.Methods National and international guideline databases were searched along with healthcare or-ganizations and associations.Content analysis method was used to analyze clinical practice guidelines searched from internet and obtained in the database search.Results Five clinical practice guidelines were included.A total of 39 items related to pre-anesthesia assessment were identified and when divid-ed into 3 essential areas:1)past history and present medical,2)physical examination,and 3)labora-tory examination.There is no guidance to general anesthesia currently in China.Pre-anesthesia testing in the presence of specific clinical characteristics was recommended.Conclusion We should develop local clinical practice guidelines of preanesthesia assessment with consideration of the actual medical situations in China.

Objective: To understand the current situation of toilet facilities among rural primary schools and toilet-using behavior among primary students,and to provide a reference for improving school environment. Methods: Totally 149 students in 2 rural non-boarding primary schools in northern China were selected. and on-site observation and questionnaire survey were used to obtain the current situation of toilet hygiene, toilet time and toilet behavior, as well as feelings towards school toilet. The results of the survey were statistically analyzed by using SAS 9.4. Methods: Both two schools were deep pit latrine, the number of pit in female toilets is lower than the requirements of the “Code for design of school”, and the urinal trough and the number of pit in male toilet meet the standard requirements. The average total time of toilet-using was (28.46±11.72)s for boys and (42.48±15.52)s for girls, the difference was of significant difference (t=-7.96, P<0.01). The average actual time of toilet-using is (24.27±9.13)s for boys and (24.69±9.40)s for girls, with no statistical difference. The result showed that school 2 was better than school 1 in the behavior of urinating frequency in toilet, queuing when using toilet, and the way to express needs of toilet-using in class(χ2=11.70,27.19,17.74,P<0.05); senior students use less toilets than lower grade students. The main complains for students in school toilet hygiene is its bad smell(χ2=5.28，13.18，P<0.05). Conclusion Primary school students in northern China always take bathroom breaks in the morning, and the average time of toilet-using is different from that of adults. Senior students are more willing to express their toilet needs than lower grade students. Students are not satisfied with the hygiene of school toilets, and the toilet experience is poor.

OBJECTIVETo study pharmacokinetic of puerarin in rats following different methods of administration of Tongqiao Sanyu prescription.

METHODTongqiao Sanyu prescription was administered to rats by caudal vein injection, nasal administration and oral administration. Plasma samples were extracted with methanol and the plasma concentration of puerarin was analyzed by RP-HPLC. The pharmacokinetic parameters and bioavailability were calculated with Kinetica software.

RESULTThe main pharmacokinetic parameters were as follows: AUC(0-infinity) of caudal vein injection was (787.99 +/- 70.44) mg x min x L(-1); AUC(0-infinity) of nasal administration was (376.56 +/- 93.93) mg x min x L(-1); AUC(0-infinity) and oral administration (The dose was decuple higher than that of caudal vein injection and nasal administration) was (491.18 +/- 110.64) mg x min x L(-1). The absolute bioavailability of puerarin was 47.78% by nasal administration and 6.23% by oral administration.

CONCLUSIONThe bioavailability of nasal administration is higher than oral administration significantly, this result can provide some scientific foundantion for the method of administration and the reform of dosage form of Tongqiao Sanyu prescription.

Animals ; Biological Availability ; Drug Administration Routes ; Drugs, Chinese Herbal ; administration & dosage ; pharmacokinetics ; Isoflavones ; administration & dosage ; pharmacokinetics ; Male ; Rats ; Rats, Sprague-Dawley

Objective To understand the clinical features of hepatic tuberculosis. Methods The clinical manifestations, laboratory findings, treatment, and prognosis of a case of hepatic tuberculosis were analyzed. Similar cases were identified from PubMed database during the period from 2013 to 2017 using search terms "Liver/Hepatology/Hepatic Tuberculosis". The clinical data of the identified patients with hepatic tuberculosis were reviewed and analyzed. Results The 16-year-old male patient presented with cough and abdominal distension. His sputum was positive for acid-fast bacillus. CT showed low-density spaceoccupying lesions. After anti-tuberculosis treatment, the lesion disappeared. Hepatic tuberculosis was finally considered, which was caused by disseminated tuberculosis. Literature search identified 63 similar cases. In summary, the 64 cases(containing this one)included 38 males and 26 females with age from 11 months to 77 years. Tuberculosis in other site or underlying disease was found in 39 cases. The main clinical manifestations were fever(51.6％), abdominal pain(50.0％), weight loss(31.2％), loss of appetite(25.0％), tiredness/weakness(21.9％), and nausea/vomiting(20.3％). Low-density space-occupying lesions were the main features on CT image. The diagnosis was confirmed by histopathological and/or bacteriological testing in 59 patients. Five patients were diagnosed after diagnostic anti-tuberculosis treatment was effective. Overall, 36 patients were cured, 19 improved, and 3 died.Conclusions The clinical symptoms of hepatic tuberculosis are atypical. Imaging combined with histopathological examination of the liver is the preferred method for diagnosis of hepatic tuberculosis. Anti-tuberculosis treatment and timely surgical treatment is usually effective with good outcomes.