Objective To investigate the significance of thyroid function screening in high-risk pregnant women with gestational diabetes (GDM) in early pregnancy.Methods A total of 194 cases with GDM were selected as our subjects.The patients were divided into group A(three normal items,a total of 109 cases),group B (one abnormal item,a total of 57 cases) and group C (two abnormal items,a total of 28 cases).The levels of serum anti-thyroglobulin antibody (TGAb),anti-thyroid peroxidase antibody (TPOAb),serum three triiodothyronine(TT3),thyroxine (TT4),free three triiodothyronine (FT3),free thyroxine (FT4) and thyroidstimulating hormone (TSH) were screened.Results TSH levels in group A was (1.45 ± 0.43) mU/L,significantly lower than in group B and group C((1.77±0.53),(1.89±0.74) mU/L).FT4 levels in group A was (11.62±0.98) nmol/L,significantly higher in group B and group C((10.23±0.75),(9.87±0.88) nmol/L)).Proportion of TPOAb,TGAb positive in group A were 9.17％(10/109) and 21.05％(12/57),significantly lower than that of group B and group C((28.57％(8/28) and 3.67％(4/109),7.02％(5/57) and 17.86％(5/28)).And the differences were significant (P＜ 0.05).And TPOAb + TGAb in group A was 0.92％(1/109),significantly lower than that of group B and group C(7.02％ (4/57),17.86％ (5/28);P ＜0.05).Conclusion The importance of screening thyroid function in early pregnancy in women at high risk for gestational diabetes is worthy of clinical promotion.

Objective To investigate clinical features,drug resistance,risk factors and prognosis of extended-spectrum beta-lactamases (ESBLs)-producing Escherichia coli infection in hospitalized newborns.Methods Sixty eight newborns infected with ESBLs-producing Escherichia coli admitted in Neonatal Ward of Ningbo Women and Children's Hospital during.January 2010 and January 2013 were enrolled in the study; 81 newborns infected with multiple resistant non-ESBLs-producing Escherichia coli served as controls.The drug sensitivity of the isolated ESBLs-producing Escherichia coli was tested using K-B method.Clinical data including birth weight,gestational age,mode of delivery,site of infection and disease outcome were analyzed.Logistic regression analysis was performed to study the risk factors for ESBLs-producing Escherichia coli infection.Results The highest positive rate of ESBLs-producing Escherichia coli was detected in sputum samples (49/68,72.1％),followed by blood (7/68,10.3％) and urine (6/68,8.8％) samples.Strains were highly resistant to ampicillin,cefotaxime,ceftazidime and cefepime (61.8％-100.0％),but the resistant rates to cefoxitin,cefoperazone/sulbactam and amikacin were low (2.9％-10.3％),and were completely sensitive to carbapenems.Lower respiratory tract infections were most popular in both groups,but in ESBLs-producing Escherichia coli infected group,lower respiratory tract infection rate in late newborns was higher than that in early newborns (x2 =12.879,P ＜ 0.05).Multivariate logistic regression analysis showed that gestational age ＜ 37 weeks (Exp (B) =0.352,95％ CI:0.134-0.929),cesarean section (Exp (B) =0.488,95 ％ CI:0.243-0.984),invasive procedures (Exp (B) =0.363,95 ％ CI:0.142-0.927),use of hormones and/or antibiotics one week before birth (Exp (B)=0.325,95％ CI:0.127-0.833) were independent risk factors for ESBLs-producing Escherichia coli infection.Conclusions Respiratory tract infection is popular in ESBLs-producing Escherichia coli infection in hospitalized newborns.The strains are highly resistant to most antibiotics.Reducing invasive procedures,strict control of cesarean section and prenatal use of hormones and antibiotics may reduce the infection of ESBLs-producing Escherichia coli in newborns.

Objective To investigate the accuracy of serum neuron-specific enolase (NSE)predicting malignant middle cerebral artery infarction(mMCAI).Methods A total of 40 patients with acute massive cerebral infarction within 24 hours after symptom onset were recruited.Blood samples were collected at 24,36 and 48 hours after symptom onset.Serum NSE concentration was determined by automatic electrochemiluminescence analyzer.mMCAI was defined as hernia signs in clinical practice,and CT/ MRI showed mass effect.The receiver operating characteristic curve was used to analyze the accuracy of serum NSE concentration in predicting mMCAI at 3 time points.Results Sixteen patients(40%)developed mMCAI.The serum NSE concentration for predicting the accuracy of mMCAI was poor at 24 hours after symptom onset;the serum NSE concentration for predicting the specificity of mMCAI was high (96%)at 36 hours after symptom onset,but the sensitivity was lower(69%);the serum NSE concentration for predicting the specificity(92%)and sensitivity(88%)of mMCAI were high at 48 hours.Conclusions The serum NSE conoentration and its dynamic changes may predict the occurrence of mMCAI,and the predicting time points are appropriate from 36-48 hours after symptom onset.

Objective To explore the related factors of diabetes insipidus and disorders of sodium and water after surgery of sellar region tumor,and to find nursing strategy and improve the prognosis of sellar region tumors.Methods In this study,we retrospectively reviewed 150 cases of sellar region tumor from January 2005 to January 2011 in our department,including 67 cases of pituitary adenoma,53 cases of meningioma,30 cases of craniopharyngiona.Approaches were depended on the size and growing pattern of the tumors.Related factors of postoperative diabetes insipidus and disorders of sodium and water were analyzed.Results Large tumor size,the pathology of tumor,preoperative endocrine dysfunction,preoperative visual field and vision disorders and surgery approach were related to such complications.Conclusions Finding the related factors of these complications in patients and adopting care measures play an important role in improving the prognosis of sellar region tumors.

Objective To analyze clinical and pathological data of IgA nephrology patients with microalbuminuria and investigate risk factors of its prognosis.Methods Clinical and pathological data of IgA nephrology patients with microalbuminuria were confirmed with renal biopsy and follow-up time with ＞ 6 months of trace was reviewed retrospectively;24-hour urine protein quantification ＞ 1 g, normal serum creatinine level when renal biopsy turned into abnormal level, or doubled serum creatinine level was defined as end point of follow-up.Renal survival was calculated with Kaplan-Meier survival analysis, and risk factors of progression were analyzed with univariate and multivariate Cox regression models.Results A total of 96 patients was followed up successfully, with an average follow-up time of (35.6 ± 22.7) months, and 34 cases (35.42％) entered the endpoint.The 12-, 24-, 36-, 48-, 60-, and 72-month renal survival rate was 97.92％, 92.71％, 86.45％ , 81.25％ , 71.88％, and 64.58％, respectively.Urine proteins, abnormal serum creatinine, Lee's Ⅲ～ V, renal interstitial fibrosis, glomerular sclerosis, and crescentic body were independent risk factors to affect prognosis of IgA nephropathy with microalbuminuria.Conclusions Early and active control of urinary microalbumin, and acute kidney injury caused by treatment of crescentic formation could slow the progress of IgA nephropathy.

Objectives To investigate the clinical features of clomiphene citrate (CC) resisitant in patients with the polycystic ovary syndrome(PCOS). Methods A total of 145 women with PCOS were analyzed in the center for reproductive medicine of our hospital. According to the responses to CC ,patients were divided into two groups:(1)the CC resistant group(n = 32),(2)the CC response group(n = 113). The clinical features were compared between these two groups. Results (1)Body weight,body mass index(BMI),blood pressure and F?G scores were significantly higher in the CC resistant group than those in the CC response group (P < 0.05, respectively).(2)Basic antral follicle counts(AFC),C reaction protein(CRP),fasting insulin(FI)and HOMA?IR in the CC resistant group were significantly higher than those in the CC response group (P < 0.05, respectively),however,no significant difference was observed in sex hormones between these two groups. Conclusion PCOS patients with CC resistant are more likely to have higher body weight,BMI,blood pressure, insulin resistant?indexes and basic AFC ,the clinical doctors should consider these features before the treatment of ovulation induction.

Objective To evaluate the effects of dexmedetomidine on dreaming during general anesthesia in pediatric patients.Methods A total of 400 pediatric patients of both sexes,aged 5-12 yr,with body mass index of 15.2-18.1 kg/m2,of American Society of Anesthesiologists physical status Ⅰ,undergoing elective orthopedic surgery under general anesthesia,were randomly divided into control group (group C,n=200) and dexmedetomidine group (group D,n =200) according to the computer-generated random numeral order and numeral parity.Dexmedetomidine was infused intravenously in a loading dose of 0.5 μg/kg over 10 min before induction of anesthesia followed by infusion of 0.5 μg · kg-1 · h-1 until 30 min before the end of surgery in group D,while the equal volume of normal saline was given instead of dexmedetomidine in group C.The pediatric patients who regained consciousness and recovered orientation in post-anesthesia care unit were interviewed for dreaming using a modified Brice questionnaire,and the dream (emotion,hearing and behaviours in dreams,memories for dreams) was evaluated using a 5-point Likert scale.Results Compared with group C,the incidence of dreaming was significantly decreased,the memory score was decreased (P＜0.05),and no significant change was found in emotion,hearing and behaviour scores in dreams in group D (P＞0.05).Conclusion Dexmedetomidine can decrease the development of dreaming during general anesthesia and produces no effect on the content of dreams (most are pleasant) in pediatric patients.

AIM: To investigate the effect of interleukin-2 (IL-2) on the intracellular calcium in electrically stimulated adult rat ventricular myocytes during anoxia and reoxygenation. METHODS: The isolated cardiac ventricular myocytes were exposed to 5 min anoxia followed by 10 min reoxygenation. Chemical anoxia was introduced by Krebs-Henseleit (K-H) solution containing 10 -3 mol/L sodium dithionite. The spectrofluorometric method was used to verify intracellular calcium transient with fura-2/AM as calcium fluorescence probe. RESULTS: It was shown that during anoxia, the amplitude of Ca 2+ transient was decreased, diastolic [Ca 2+ ] i, time to peak and time to relaxation of Ca 2+ transient were increased. All the parameters were got back but did not returned to the pre-anoxia level during reoxygenation. IL-2 at 2?10 5 U/L administrated during anoxia aggravated the effect of rexoxygenation on [Ca 2+ ] i transient. Pretreatment with a specific ? opioid antagonist, nor-BNI (10 -8 mol/L), abolished the effect induced by IL-2 during anoxia on the [Ca 2+ ] i transients, whereas specific ? opioid antagonist, naltrindole (10 -6 mol/L), did not cancel the effect. CONCLUSION: It is concluded that administration of IL-2 during anoxia aggravated the effect of reoxygenation on the [Ca 2+ ] i transients of isolated ventricular myocytes, which was mediated by cardiac ? opioid receptor pathway.

AIM: The objectives of the present study were to examine the effect of iron on relaxation of isolated rat aortic rings,and to elucidate the underlying mechanism. METHODS: The thoracic aortic rings of male Sprague-Dawley rats were mounted on bath system. Vasodilatation of aortic rings preconstricted with 10 -6 mol/L of phenylephrine (PE) was measured. RESULTS: (1) Exposure of endothelium-intact aortic rings to ferric ammonium citrate (FAC) for 30 min caused a significant reduction in the relaxation response to acetylcholine (ACh). Pretreatment with L-arginine (L-Arg) before incubation with FAC did not reverse the inhibition of relaxation response to ACh completely. (2) In endothelium-intact aortic rings,L-Arg relaxed the PE preconstricted vessels. Exposure to FAC for 30 min caused the decrease in the relaxation response to L-Arg. There was no difference in the relaxation response to nitric oxide donor,sodium nitroprusside, between endothelium-denuded arteries treated with or without FAC. (3) Dimethyl sulfoxide had no effect on the inhibition of relaxation to ACh by FAC in endothelium-intact rings. Pretreatment of arteries with glutathione and catalase prevented the decrease in relaxation responses to ACh induced by FAC. (4) The nitric oxide synthase activity was (56.49?2.49)?10 3U/g protein in normal aorta with endothelium,while after incubation with FAC for 30 min,it reduced to (25.15?5.75)?10 3U/g protein ( P

AIM: To test whether ischemic preconditioning (IPC) del ays ischemia-induced electrical uncoupling by activation of mitochondrial ATP-se nsitive potassium channels (mitoK ATP ). METHODS: Adult rat hearts perfused on a Langendorf f apparatus were subjected to 40 min ischemia followed by 30 min reperfusion. C han ges in coupling were monitored by measuring whole-tissue resistance. RES ULTS: IP C delayed the onset of uncoupling campared to ischemic control; Blocking mitoK ATP channels before the IPC protocol abolished the delay of uncoupling. The specif ic mitoK ATP channel opener diazoxide mimicked the protective effect of IPC . The delay induced by diazoxide was reduced by 5-HD, L-type Ca 2+ channel inhibitor verapamil and a free radical scavenger N-(2-mercaptopropionyl)glycine. CONCLUSIONS: IPC delays the onset of cellular electrical uncoup ling induced by acute ischemia, in which activation of the mitoK ATP channe ls may be involved.