Objective To investigate the iron status in the newborns of maternal gestational diabetes mellitus(GDM) women,and explore the mechanism of iron deficiency in these newborns.Methods From June 2008 to October 2011,64 GDM women (GDM group) and 71 healthy pregnant women (control group)who delivered in the Second Affiliated Hospital of Wenzhou Medical College and their newborns were studied prospectively.Serum ferritin (SF),serum transferrin receptor (sTfR),erythropoietin (Epo),haemoglobin (Hb),serum level of insulin and plasma glucose in cord blood was measured.The neonatal birth weight (BW) and birth weight Z Score(WAZ) was recorded.The concentrations of serum fasting insulin (FINS),fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c)were tested for all the women before delivery.Results In the GDM group,the cord blood sTfR,Epo and serum level of insulin was (42 ± 10)nmol/L,(56 ±41) U/L and(18 ± 5) U/L,respectively.While in the control group,these were(35 ± 8)nmol/L,(41 ± 43) U/L and (10 ± 5) U/L,respectively.The cord blood sTfR,Epo and serum level of insulin in the GDM group were significantly higher than those in the control group (P ＜ 0.05).The cord blood SF in the GDM group[(60 ±36) μg/L] was significantly lower than that of the control group[(146 ±38) μg/L,P ＜ 0.01].The neonatal BW and WAZ in the GDM group [(3615 ± 538) g and 0.558] were significantly higher than those in the control group [(3449 ± 423) g and 0.224,P ＜ 0.05].No significant difference was found in the cord blood plasma glucose and Hb between the GDM group[(3.3 ± 1.0) mmol/L and (181 ± 18) g/L] and the control group [(3.0 ± 0.8) mmol/L and (176 ± 16) g/L,P ＞ 0.05].The FINS and HbA1c of the GDM group[(12.5 ±5.0) U/L and (6.5 ±0.7)％] were significantly higher than those in the control group [(10.9 ± 4.3) U/L and (5.3 ± 0.7) ％,P ＜ 0.05].The FPG of the GDM group and the control group were (5.3 ± 1.2) and (5.0 ± 1.0) mmol/L,respectively,with no statistically significant difference (P ＞ 0.05).Conclusion Maternal GDM may related to the iron deficiency of the newborns.

Objective To investigate the clinical effects of arthroscopic patelloplasty combined with lateral patellar retinaculum release and circumpatellar denervation for treatment of moderate and severe patellofemoral osteoarthritis.Methods A retrospective case-control study was done on 80 patients with moderate to severe patellofemoral osteoarthritis who were treated in our hospital between March 2013 and March 2015.According to treatment methods,the patients were divided into two groups:Group A including 40 cases (22 cases of Outerbridge grade Ⅲ degree and 18 cases of Outerbridge grade Ⅳ) undergone arthroscopic debridement,and Group B including 40 cases (22 cases of Outerbridge grade Ⅲ degree and 18 cases of Outerbridge grade Ⅳ) undergone arthroscopic patelloplasty combined with lateral patellar retinaculum release and circumpatellar denervation.The Kujula scores and Lysholm scores of the patellofemoral joint were compared between the two groups before and after operation.The lateral patellofemoral angle was measured according to patellar axial X-ray performed 3 months after operation to evaluate patellofemoral joint function.Results All patients were followed up for 13-36 months (average 19.8 months).The patellofemoral joint scores of the two groups was increased at different degrees after operation.In moderate patellofemoral osteoarthritis patients,at 3 months after operation and the last follow-up of Group B,Kujula scores [(85.1 ± 6.8)points,(86.8 ± 4.6)points] and Lysholm scores [(88.1 ± 1.8) points,(88.4 ± 2.3) points] were higher than that of Group A [(78.1 ± 5.7) points,(78.3±5.3)points,(82.4 ±2.9)points,and (82.5 ±2.5)points] (P＜0.05).In each group,the Kujula scores and Lysholm scores at 3 months after operation and the last follow-up were improved to be higher than preoperation (P ＜ 0.05),with insignificant statistical difference between the two groups (P ＞ 0.05).According to the Lysholm scores,the excellent rate after operation in Group B (86％) was higher than that of Group A (55％) (P ＜ 0.05).For patients with severe patellofemoral osteoarthritis,Kujula scores [(72.3 ± 5.3) points,(72.7 ± 3.6) points] and Lysholm scores [(75.1 ± 1.9) points,(75.3 ± 2.3) points] at 3 months postoperatively and at the last follow-up in Group B were higher than that of Group A [(70.8 ± 5.2) points,(71.1 ± 4.2) points,(73.4 ± 2.8) points,and (73.6 ± 2.5) points],but the difference was not statistically significant (P ＞ 0.05).Within each group,although the Kujula scores and Lysholm scores at 3 months postoperatively and at the last follow-up were improved compared with before operation,but the difference was not statistically significant (P ＞ 0.05).According to the Lysholm scores,although the excellent rate after operation of Group B (33％) was higher than that of Group A (28％),with insignificant statistical difference (P ＞ 0.05).No matter Outerbridge Ⅲ or Ⅳ patellofemoral osteoarthritis a patient was,the lateral patellofemoral angle of Group A after operation had no significant improvement (P ＞ 0.05),while Group B showed significant improvement after operation (P ＜0.01).Group B had better improvements than that of Group A (P ＜0.01).Conclusions Compared with simple arthroscopic debridement,patelloplasty combined with lateral patellar retinaculum release and circumpatellar denervation can better relieve the symptoms of moderate patellofemoral osteoarthritis and improve knee function.But for patients with severe patellofemoral osteoarthritis,this method is not effective.

The enrollment of international medical students has been expanding.How to improve the quality of medical education is a key point.To explore a better way and method to improve the quality of the medical teaching for foreign students in China,the preliminary experi-ences of teaching of Clinical Diagnostics for foreign students are reviewed.

Animals ; Estrogens ; metabolism ; Gene Expression Regulation ; Humans ; Osteoarthritis ; complications ; genetics ; metabolism ; Pain ; etiology ; Pain Measurement ; Temporomandibular Joint ; pathology ; Temporomandibular Joint Disorders ; complications ; genetics ; metabolism ; Wnt Signaling Pathway

Objective To explore the effects of anxiety-like behaviors on the levels of sex hormones and severity of erectile dysfunction(ED) in young men.Methods A total of 120 young men with ED,between the ages of 23 and 35 years,were prospectively studied,and all of them were the outpatients from the Affiliated Hospital of Jining Medical University from January 2012 to October 2013.Self-Rating Anxiety Scale (SAS) was used.According to the scores of SAS,the patients were divided into four groups.26 were rated by SAS as in the normal,36 in the mild,32 in the moderate and 26 in the severe state of anxiety.The levels of serum sex hormone (FSH,LH,PRL,T,E2) were detected by immunochemiluminometric assays.ED was assessed using the IIEF-5.Further,the responses were divided into three diagnosing groups on the basis of cutoff scores for IIEF-5.The relationship between the SAS scores of measuring anxiety,serum sex hormone levels,and the indicators for ED,Spearman rank correlations were carried out.Results Comparing with the normal control group,the levels of serum sex hormones (FSH,LH,PRL,E2) increased in other groups,but there were no significant differences (F=0.28,P=0.08 ; F=2.91,P=0.06; F=0.90,P=0.44; F=0.80,P=0.15).The levels of serum testosterone and the scores of IIEF-5 in the moderate and severe anxiety group decreased.The more severe symptoms of anxiety,the more likely that the ED would occur(x2=72.423,P=0.00),and ED was significantly positively correlated with anxiety(r=0.637,P=0.00).Testosterone played the partial intermediary role on the relationship between anxiety score and the IIEF-5 score.Conclusion Anxiety may contribute to ED through disturbing the sex hormone and lowering the level of serum testosterone.

Objective To observe the effect of hydrogen on ultraviolet B (UVB)-induced oxidative damage to skin fibroblasts.Methods Primary human skin fibroblasts from foreskin tissues were divided into five groups:normal control group receiving no treatment,hydrogen control group treated with hydrogen-rich saline,UVB group receiving irradiation only,post-treatment group irradiated with UVB followed by hydrogen-rich saline treatment,and pre-treatment group treated with hydrogen-rich saline followed by UVB irradiation.The dose of UVB was 30,60 and 90 mJ/cm2 in the cell proliferation assay and 90 mJ/cm2 in the other experiments.Methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the proliferative activity of fibroblasts,a chemiluminescence method to estimate the activity of superoxide dismutase (SOD) and catalase as well as to determine the level of malondialdehyde in the culture supernatant of fibroblasts,enzyme linked immunosorbent assay (ELISA) to determine the supernatant level of 8-isoprostane-prostaglandin F2α (8-iso-PGF2α),Western blot to detect the expression of heme oxygenase-1 (HO-1) in fibroblasts.One-factor analysis of variance was conducted to assess differences in these parameters among these groups.Results UVB irradiation decreased the proliferative activity (absorbence value at 490 nm) of fibroblasts in a dose-dependent manner.Both the pre-treatment group and post-treatment group showed a statistical increase in proliferative activity of cells compared with the corresponding UVB control groups (all P ＜ 0.05).The activity of SOD and catalase as well as the protein expression of HO-1 were significantly higher (all P ＜ 0.05),whereas the supernatant levels of malondialdehyde and 8-iso-PGF2α were statistically lower (both P ＜ 0.05) in the pre-treatment group and post-treatment group than in the UVB control group.Conclusion Hydrogen may mitigate UVB-induced oxidative damage to skin fibroblasts.

Objective To investigate the therapeutic effect of the meso-cavo-atrial shunt (MCAS) in the treatment of combined Budd-Chiari syndrome (BCS). Methods The clinical data of 17 cases of combined BCS with all or bilateral hepatic vein occlusion and long range occlusion or obstruction of inferior vena cava (IVC) were admitted to the Qilu Hospital from February 2000 to May 2004. All patients were treated by MCAS with artificial blood vessels. The pre- and postoperative clinical symptoms, the IVC and portal venous (PV) pressures, the incidence of postoperative complications and the patency rate of the artificial vessels were analyzed. The survival of patients was analyzed using the Kaplan-Meier analysis, and the data were analyzed using the chi-square test and t test. Results No patient died during the perioperative period, and the symptoms of 15 patients disappeared or were relieved after operation, with a significant difference compared with those before operation (χ2 =9.78, P <0. 05 ). Three patients had complications after the operation. The postoperative PV and IVC pressures were decreased by 1.2 cm H2O (1 cm H2O =0.098 kPa) and 18.5 cm H2O, respectively. There were significant differences in the decrease of IVC and PV pressures ( t = 2.38, 3.06, P < 0.05 ). The 1-, 3-, 5-year survival rates were 16/17, 15/17 and 14/17, respectively, and the 5-year patency rate of the artificial vessels was 14/17.Conclusions MCAS can simultaneously relieve IVC and PV hypertension for patients with combined BCS. The postoperative complication rate was decreased, the 5-year survival rate and the patency rate of the artificial vessels were improved after the treatment, so MCAS is an optional surgical method for treating combined BCS.

Bile Duct Neoplasms ; diagnosis ; Bile Ducts, Intrahepatic ; pathology ; Cholangiocarcinoma ; diagnosis ; Humans ; In Situ Hybridization, Fluorescence

Objective To evaluate the outcomes of mature B-cell acute lymphoblastic leukemia(mature B-ALL) and to assess the safety and efficacy of the treatment protocol.Methods From February of 2003 to December of 2012,15 children were diagnosed as mature B-cell acute lymphoblastic leukemia/lymphoma possible (mature B-ALL/NHLp) in Shanghai Children's Medical Center(SCMC) were enrolled,and they were treated with SCMC-mature B-ALL/NHLp-2003 protocol.All of the clinical characteristics,therapeutic effects and long-term outcomes were analyzed.The statistical data were processed by SPSS 21.0.Results The median age on diagnosis was 8.7 years (1 year and 5 months to 14 years and 4 months).Among them,4 cases presented with local mass including maxillofacial tumors,neck and abdominal mass.The others had systemic manifestations such as fever and pale face.These neoplastic cells retained the expressions of surface membrane immunoglobulin M,terminal deoxynucleotidyl transferase,Cμ,CD10,CD19,cCD79 a differently.Follow-up was updated to November 30,2013.The median follow-up period was 80 months (39-128 months).Theestimated 5-year event free survival rate was (80.0 ± 10.3) ％.According to univariate analysis,increased lactate dehydrogenase level (＞ 4-times the normal value),increased serum ferritin level (＞ 2-times the normal value),no small residual disease markers were indepen-dent poor prognostic factors(x2 =5.49,4.89,5.49,all P ＜ 0.05).Conclusions SCMC-mature B-NHL/ALLp-2003 protocol is feasible and safe for children with mature B-ALL/NHLp,but more sample cases need to be investigated.

Objective To explore the clinical application value of virtual touch tissue quantification (VTQ) technique in Hashimoto's thyroiditis(HT).Methods Fifty-three patients with HT and 46 health subjects were examed by conventional ultrasonography and VTQ, their shear were velocity (Vs) was measured.A receiver-operating characteristie(ROC) curve was drew according to Vs which can obtain the value of optimal operating point for diagnosing HT.Results The 2D ultrasonic appearance of 53 cases HT were classified into five species, but there was no significant difference in the Vs (F = 0.424, P = 0.790).The area under the ROC curve was 0.976,which showed a high statistical significances(P = 0.000).ROC curve displayed that Vs of 2.53 m/s could be used to diagnose HT,the sensitivity and specificity were 87％and 100％ ,respectively.Fifty-three patients with HT were classified into three groups according to thyroid function, 10 patients with hyperthyroidism, 25 patients with hypothyroidism and 18 patients with euthyroidism.The Vs of HT among the three groups were no significant difference(P = 0.884), but their Vs were all obviously higher than that of normal thyroid Vs(P = 0.000).Conclusions VTQ technique can evaluate the hardness of thyroid and has some help for differential diagnosis of HT.