Clinical data of 277 pregnant women attended to nutrition clinic at Haidian District Maternity and Children's Hospital,Beijing were analyzed retrospectively,including 64 cases of gestational diabetes mellitus(GDM),85 cases of gestational impaired glucose tolerance(GIGT)and 128 normal women(84 normal fasting blood glucose and 44 abnormal fasting blood glucose but normal glucose challenge test,GCT).There was a higher proportion of pregnant women with family history of diabetes among those with abnormal GCT.as compared to those with normal GCT(P＜0.05).Mean age was significantly higher in women with GDM than that in normal ones(P＜0.05),but no statistically significant difference in it was found between women with GIGT and normal GCT(P＞0.05).Body weight in women with GIGT was higher both before pregnancy and at GCT than that in normal ones(P＜0.05).Serum levels of total cholesterol and triglyceride presented an increasing trend in pregnant women of varied groups since their first prenatal care visits(P＜0.05),higher in those with GDM and/or GIGT than those in normal ones(P＜0.01).

Objective To discuss action of microelement Se in serum and milk of gestational diabetes melli-tus parturient.Methods The serum and milk samples were collected from 50 gestational diabetes mellitus parturient and 50 healthy parturient.The selenium contents were detected by radioimmunoassay.Results The serum Se content in gestational diabetes mellitus parturient was obviously lower than that in healthy parturient(t =2.128,P <0.05). The milk Se content in gestational diabetes mellitus parturient was lower than that in healthy parturient(t =1.014, P >0.05).Conclusion Selenium deficiency persisted in gestational diabetes mellitus parturient.But Selenium defi-ciency did not exist in milk of gestational diabetes mellitus parturient.So encouraging breastfeeding,elevating selenium containing food intake,and supplement the selenium preparation properly maybe prevent and delay type 2 diabetes in gestational diabetes mellitus parturient.

[Objective]To observe the degradation process of PDLLA in the intervertebral fusion.[Method]Twenty goats were divided into 4 groups as experimental group,and their L_(3~4)intervertebal spaces were implanted with PDLLA cage containing pieces of graft bone.Animals were sacrificed at 4,8,12,16 wks and specimens were taken for observation of the degradation process and bone fusion by gross observation and electronic microscope.Another 12 goats were used as normal fusion control group.Their L_(3~4)space were grafted with bone block for fusion.[Result]The degradation rate was non-lineal.In the early stage of fusion,the main degradation and decrease of molecular weight was shown at the superficial decomposition.With the proceeding of fusion and degradation,as the kydrolyzation speeding-up,internal decomposition by self-catalyse resulted into the collapse and total disassemble of the PDLLA.The PDLLA cage maintained its shape in the early stage and its biomechanical strength decrease in late stage but was still enough to keep the structure from collapse,till the fusion was achieved in the bone implant area.[Conclusion]The velocity of degradation of PDLLA is slower than the speed of bone regeneration of bone fusion,so the PDLLA cage could provide sufficient support during the process of intervertebal fusion and is a suitable choice of degradative material for cage in the intervertebal fusion.

Objective:To investigate and analyze the situation of professional identity of new undergraduates in medical image profession, and guide and arouse the learning initiative, provide education guidance with more pertinence for the professional plan of undergraduate, and enhance employment competence of graduates, and improve the social status of this profession.Methods:The questionnaire survey, comparison of results and trend analysis of relative question for new undergraduates of image specialty were collected and analyzed, and then the general situation of professional identity was obtained.Results: The professional identity of new undergraduates were below the average level, and their cognition for employment situation were not clear, and their evaluations for this profession were lower. Besides, the situations of male were lower than that of female.Conclusion: Face to the trend of fast development of image specialty and shortage of image professionals, the analysis of professional identity for new undergraduates is worthy because it can improve teaching quality, enhance quality for image talent and contribute to establish thorough employment guidance plan for colleges and universities.

To strengthen the medical ethics education in the clinical practice stage in the department ot obstetrics and gynecology meets the requirements of the modern medical education under new situation.Aiming at the status quo of medical ethics education in China and abroad,this paper put forward specific recommendations in terms of the setting of teaching contents,the design of teaching approaches,the construction of teaching staff,as well as the evaluation of teaching achievements,and thus to enhance the understanding of medical students and interns to medical ethics and cultivate their practical capacity of analyzing and solving problems in clinical ethical dilemmas.

Objective To investigate the trends in and characteristics of syphilis epidemiology in China,and to provide a scientific basis for the development of control strategies.Methods An epidemiological study was performed on syphilis cases reported from 31 provinces,autonomous regions and municipalities between 2000 and 2013.Results The reported syphilis incidence increased yearly from 6.43 per 100 000 person-years in 2000 to 32.86 per 100 000 person-years in 2013,with an average annual growth rate of 13.37％.Syphilis was reported in most (99％) counties/districts in China mainland except for a few remote mountain areas,with a significant difference in the incidence of syphilis between different regions.The regions with a high incidence of syphilis included minority areas in Northwest China (Xinjiang,Qinghai and Ningxia),Minjiang River area,Yangtze River Delta (Zhejiang,Shanghai),Zhujiang River Delta (Guangxi,Guangdong),etc.There had been a rapid increase in the incidence of syphilis in some regions previously reported to have a low incidence (such as Guizhou,Shaanxi,Henan,etc).Among the reported cases,female patients predominated with an average male/female ratio of 0.92 ∶ 1.The incidence of syphilis was highest in the age group of 20-39 years,but increased yearly by more than 30％ in the population aged ＞ 60 years.Of 20 occupations,peasant workers accounted for the highest proportion (31.56％) of syphilis cases,and retired population showed the most rapid increase by about 27.35％ per year.The constituent ratio of primary and secondary syphilis in all the syphilis cases had declined yearly,while that of latent syphilis increased by more than 50％ after 2010.Conclusions Syphilis remains a major public health issue in China,and measures based on the epidemiological features are urgently needed to effectively control epidemic syphilis.

Objective To study the local recurrence,distant recurrence and survival rate of anastomotic leak after surgery in patients with colorectal cancer.Methods Chinese and English related studies published from January 1970 to June 2011 were searched in PubMed/Medline,Excerpta medica database (EMBASE),Springger,Google scholar,China national knowledge infrastructure (CNKI),China biomedical literature database (CBM),Wanfang data.All controlled trials related to anastomotic leak after surgery in patients with colorectal cancer were retrieved.Outcomes were evaluated including local recurrence,distant recurrence and survival rate,then Mate-analysis was performed using RevMan 5.0 software provided by the Cochrane network.Results Fifteen studies were included,including a total of 18 225 patients.There were 1 425 patients with anastomotic leak and 16 800 patients without anastomotic leak.The patients with anastomotic leak were compared with patients without anastomotic leak.The OR value of local recurrence was 2.47 (95％ CI 1.72-3.55,P ＜ 0.01),the OR value of distant recurrence was 1.18 (95％ CI 0.98-1.43,P =0.08),and the OR value of 5-year survival rate was 1.68 (95％ CI 1.36-2.07,P ＜ 0.01).Conclusions Anastomotic leak after surgery is a bad prognosis factor in patients with colorectal cancer.It can increase the local recurrence rate,and decrease survival rate.

Objective To investigate the clinical and pathological characteristics, diagnosis and treatment of gastric cancer with ovarian metastasis. Methods The clinical data of 17 cases of gastric cancer with ovarian metastasis, confirmed by surgery and pathology, were analyzed retrospectively. Results The average age of the patients was 48.41 years, and the first appearance of symptoms and signs often were of metastatic ovarian cancer. The main ultrasonographic findings were either a complex type of mass with both solid and cystic characteristics or only solid, and most of them were accompanied by intraperitoneal fluid accumulation. Bilateral metastatic ovarian cancer was more common(13 cases). The preoperative accurate diagnosis of this disease was difficult, so that the misdiagnostic rate was 64.7% in this series. Operation was done in all the patients, but prognosis was poor. The median survival time was only 11.6 months. Conclusions The prognosis of gastric cancer with ovarian metastasis is poor. It is of importance to inspect the stomach in cases of bilateral ovarian cancer. Radical resection of the primary disease focus together with hysterectomy and bilateral adnexectomy should be performed. Postoperative comprehensive therapy is conducive to improve the prognosis of gastric cancer with ovarian metastasis.

Objective To study the effects of unilateral graded facetectomy on lumbar spinal stability in biomechanics and to investigate the biomechanical characteristics of articular process and the safety of decompression produre for lumbar disc herniation.Methods The vertebral column L4/5 function spinal unit(FSU) of 5 adult cadavers was used and graded facetectomy was performed on left articular process of L4/5 resulting in 0,1/4,1/2,3/4,4/4 facetectomy of lateral small vertebral joints.The stability of each model was determined using three-dimension movement test machine of vertebral column.Results When more than 1/2 facetectomy of lateral small vertebral joints was carried out,the circuitation stability of left,right lateral flexion and the left,right axial direction of vertebral column and that of normal vertebral column had significant difference(P

Objective Analyze the causes of ambiguous medical records to provide evidence for the DRGs.Methods 268 Ambiguous medical records were selected from 17 751 surgery medical records between 2010 and 2014 based on major diagnosis and major surgery.The single factor Chi-square test was used to study the influence of various inpatient characteristics on the occurrence of ambiguous medical records, and those significant variables were given assignment to find influencing factors of ambiguous medical records by using logistic regression analysis.Results Ambiguous medical records account for 1.51％ of all surgical medical records.Logistic regression analysis results show that such risk factors as discharging from internal medicine, death of patient, transfer between departments, elderly, long time of hospitalization, and tumor patients, as contributing to ambiguous medical records.All the results are statistically significant (P＜0.05), including discharging from which departments (OR=6.595, 95％CI..5.043 ～ 8.625), death of patient (OR=3.787, 95％ CI: 2.611 ～ 5.492) and transfer between departments (OR =2.746, 95％ CI: 2.061 ～ 3.659), which rank important risk factors for ambiguous medical records.Conclusion Analysis of the causes of ambiguous medical records provides important evidences for the hospital to improve its medical record quality management.