The changes of cerebral hemodynamics, morphology and hemodynamics of carotid artery in carotid endarterectomy were monitored using transcranial Doppler in combination with color duplex ultrasound. It is helpful to reduce the occurrence of intraoperative cerebral ischaemia and timely guides surgeons to perform the second repair. This article reviews the application values of ultrasonic technology in carotid endarterectomy.

Objective To investigate the relationship between gestational hyperglycemia and adverse pregnancy outcomes and find out the optimum diagnostic criteria of gestational diabetes mellitus in China. Methods A retrospective population-based study of 14 593 pregnant women, who delivered between Jan. 2005 and Dec. 2009 and accepted the gestational diabetes mellitus ( GDM ) screening and diagnosis was performed. The prevalence of gestational hyperglycemia according to different criteria was calculated, and the incidence of adverse pregnant outcomes relation to gestational hyperglycemia according to different criteria was analyzed. Results ( 1 ) According to National Diabetes Data Group (NDDG) criteria and International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria, the prevalence of gestational hyperglycemia that intervention required was 8.9% (1293/14 593 ) and 14.7% (2138/14 593 )respectively; the prevalence of gestational hyperglycemia differed significantly between NDDG and IADPSG criteria ( P ＜ 0. 05 ). ( 2 ) The prevalence of macrosomia, large for gestational ages ( LGA), cesarean section,preterm birth and neonatal hypoglycemia etc would increase in gestational glucose metabolic disorders according to any criteria. The prevalence of the complications in gestational hyperglycemia according to NDDG criteria, IADPSG criteria and the patients with normal glucose metabolism is as follows, macrosomia:8.4% ( 108/1293), 11.3% (241/2138) and 6. 7% ( 835/12 403 ); LGA: 9. 7% ( 125/1293 ), 11.7% (250/2138) and 5.5% (687/12 403); cesarean section: 59. 0% (763/1293), 60. 4% ( 1291/2138 ) and 51.6%(6397/12403); preterm birth: 11.4% (147/1293), 9.5% (203/2138) and 6.3% (777/12 403); neonatal hypoglycemia: 2. 6% ( 33/1293 ), 2. 2% (46/2138) and 0. 7% ( 89/12 403 ). ( 3 )About 71.3% (922/1293) of the gestational hyperglycemia according to NDDG criteria could be well control only by diet control. Conclusion The prevalence of perinatal complications would increase in gestational hyperglycemia that achieved IADPSG criteria without intervention, so IADPSG criteria is reasonable in China.

OBJECTIVE:To investigate the improvement effect of Eucalyptol enteric soft capsule on mice with lipopolysaccha-ride(LPS)-induced acute lung injury(ALI). METHODS:60 mice were randomly divided into blank control group,model control group,Eucalyptol enteric soft capsule low-dose,medium-dose,high-dose groups(100,300,900 mg/kg),12 in each group. Mice in administration groups were intragastrically given relevant medicines,mice in blank control group and model control group were intragastrically given equal volume of normal saline(0.1 mL/10 g). After 2 h of administration,except for the blank control group, ALI was induced in other groups by atomized LPS. After 6 h of modeling,the mice were sacrificed,alveolar lavage fluid(BALF) and lung tissue were taken. Morphological changes of lung tissue were observed under microscope;number of total cells,neutro-phils in BALF were calculated by blood cell count plate and staining by wright-giemsa respectively. Total protein concentration in BALF supernatant was detected by BCA method;TNF-α,IL-6 contents in BALF supernatant were determined by enzyme-linked immunosorbent assay. RESULTS:Compared with blank control group,lung tissue of mice in model control group showed obvious pathological damage and severe pulmonary edema;number of total cells,neutrophils in BALF,total protein concentration and TNF-α,IL-6 contents in BALF supernatant were significantly increased(P<0.01). Compared with model control group,pathologi-cal damage in lung tissue of mice was obviously improved in Eucalyptol enteric soft capsule high-dose group,number of total cells,neutrophils in BALF,total protein concentration and TNF-α,IL-6 contents in BALF supernatant were significantly decreased (P<0.05);and there were no significant differences in other groups (P>0.05). CONCLUSIONS:High-dose Eucalyptol enteric soft capsule can obviously improve LPS-induced ALI of mice.

Objective To study the efficacy and psychological intervention of budesonide combined with terbutaline inhalation in the treatment of children with asthma. Methods 100 children with asthma in our hospital from March 2015 to October 2016 were selected as the subjects. They were randomly divided into two groups: the control group and the experimental group, with 50 cases in each group. The control group received routine treatment of bronchial asthma, and the experimental group received budesonide combined terbutaline aerosol inhalation treatment, and psychological intervention, pay attention to the patient's psychological state. The clinical efficacy, relative clinical symptoms, improvement time and length of hospital stay were compared between the 2 groups. Results The effective rate of the treatment group was 94%, which was significantly higher than that of the control group (72%), and the difference was statistically significant (P<0.05). The improvement time of dyspnea, wheezing and cough in control group was significantly higher than that in experimental group, while the control group was significantly longer than the experimental group, the difference was statistically significant (P<0.05). Conclusion Compared with conventional treatment,budesonide combined with terbutaline aerosol inhalation and psychological intervention in the treatment of children with asthma has better clinical efficacy and shorter clinical symptoms. It has the significance of further popularization and application.

Detection of mycoplasma pneumoniae infections is essential to diagnosis and initiate appropriate antibiotic therapy.Laboratory detection of mycoplasma pneumoniae includes culture, nonamplified antigen detection, molecular-based methods(detection of DNA and RNA), serology and other new diagnostic methods.These relative methods, advantages, limitations and clinical utility are summarized in this review.

Objective To investigate the varaiation of the incidence of macrosomia and its influencing factors. Methods A population-based study of 25 944 pregnant women,who delivered in Peking University First Hospital in term birth,with singleton,between Jan. 1,2006 and Dec. 31,2013 and accepted the gestational diabetes mellitus(GDM)screening and diagnosis,was performed. The women are grouped according to the different clinical interventions at different period. Women delivered between Jan. 1, 2006 and Dec. 31,2006 was defined as Group 2006,and they were diagnosed with glucose metabolism disorder [gestational impaired glucose tolerance(GIGT)and GDM] and intervened only when meeting National diabetes data group(NDDG)criteria. Women delivered between Jan.1,2007 and Apr. 30,2011 were defined as Group post 2007,and NDDG criteria was also applied in this period. Women delivered between May. 1,2011 and Dec. 31,2013 were defined as Group post 2011,and Ministry of Health(MOH)of China was used for GDM diagnosis in this group. All pregnant women in Group post 2007 accepted the preliminary pregnancy nutrition advice and weight management. All participants met MOH criteria were diagnosed as glucose metabolism disorder in this study,in which women diagnosed and intervened in pregnancy were defined as Group diagnosis and those not being identified during pregnancy were defined as Group missed diagnosis. It was analyzed retrospectively for the incidence of macrosomia and the influencing factor. Results (1)The prevalence of macrosomia and cesarean section was decreased every year from Jan. 2006 to Dec. 2013. The incidence of macrosomia was 9.14%in 2006,reduced to 8.02%in 2007-2011 and 6.79%in 2011-2013. The incidence of cesarean section was 55.22%,reduced to 51.04%in 2007-2011 and 44.15%in 2011-2013. However,there was not remarkable change in the prevalence of small for gestational age(P>0.05).(2)Compared with Group 2006,the incidence of cesarean section was lower in Group post 2007 [51.04%(6 504/12 744)vs 55.22%(1 371/2 483)],and the difference is significantly(P<0.05). Meanwhile,the incidence of cesarean section(44.15%,4 732/10 717)and macrosomia(6.79%,728/10 717) in Group post 2011 was lower significantly than Group 2006 and Group post 2007(P<0.05).(3)The incidence of macrosomia was 7.41%(1 129/15 227)and 6.61%(1 006/15 227)respectively in Group diagnosis and Group missed diagnosis before May 2011,combined 14.02%(2 135/15 227)in total. It was increased significantly in the incidence of GDM 21.41%(2 294/10 717)after May 2011 compared with that before (P<0.05). The incidence of macrosomia was decreased significantly using MOH criteria in GDM women since 2011. It was the downtrend in the incidence of macrosomia since 2007 in non GDM women. However,there was no difference in SGA in different period.(4)In glucose metabolism disorder women, compared with Group 2006 and Group post 2007,the incidence of macrosomia and cesarean section was lower in Group post 2011,and the difference is significantly(P<0.05). However,there was no significant difference in the incidence of macrosomia and cesarean section between Group 2006 and Group post 2007, and there was no difference in SGA in the 3 groups(P>0.05). In non GDM women,the incidence of macrosomia and cesarean section was lower in Group post 2011 than Group 2006(P<0.05);meanwhile,it was the downtrend in the incidence of macrosomia in Group post 2007 compared to Group 2006,and the difference of the incidence of cesarean section was significant(P<0.05). Conclusion The prevalence of macrosomia and cesarean section might be reduced by application of suitable criteria for diagnosis of GDM and education on nutrition during pregnancy.

Objective To analyze the characteristics of pre-gestational diabetes mellitus (PGDM) diagnosed during pregnancy (missed diagnosis before pregnancy), and to evaluate the effects of diagnostic time on pregnancy outcomes. Methods A retrospective study of 746 pregnant women who were diagnosed PGDM and delivered in Peking University First Hospital from January 1st, 2005 to December 31st, 2015 was conducted. The patients were divided into 2 group. Those diagnosed PGDM before pregnancy were defined as Group diagnosed before pregnancy, and those diagnosed during pregnancy were defined as Group diagnosed during pregnancy. In Group diagnosed during pregnancy, those diagnosed before 24 gestational weeks were defined as Group diagnosed during pregnancy A, and those diagnosed after 24 weeks were defined as Group diagnosed during pregnancy B. The prevalence of adverse pregnancy outcomes in each group were analyzed. Results (1) Rate of missed diagnosis for PGDM:the incidence of PGDM diagnosed before pregnancy was 32.2% (240/746), and those diagnosed during pregnancy (missed diagnosis before pregnancy) was 67.8% (506/746). (2) Blood glucose control during pregnancy: ①Group diagnosed before pregnancy and Group diagnosed during pregnancy: the highest glycosylated hemoglobin (HbA1c) in Group diagnosed before pregnancy was (6.6±1.1)%, higher than that in Group diagnosed during pregnancy [(6.3± 1.0)%, P=0.019]. However, there was no significant difference in the average HbA1c level between the 2 groups (P=0.616). The insulin needed percentage [90.8%(218/240) vs. 53.8%(272/506)] in Group diagnosed before pregnancy were higher than that in Group diagnosed during pregnancy (P<0.01).②Group diagnosed during pregnancy A and B:the highest HbA1c in Group diagnosed during pregnancy A was (6.9± 1.3)%, higher than that in Group diagnosed during pregnancy B [(6.1 ± 0.8)%, P<0.05]. And the average HbA1c in Group diagnosed during pregnancy A [(6.4±0.8)%] was also higher than that in Group diagnosed during pregnancy B [(6.0 ± 0.8)%, P<0.05]. In Group diagnosed during pregnancy B, 46.1%(187/406) used insulin, lower than the percentage in Group diagnosed during pregnancy A (85.0%, 85/100;P<0.01). ③There were no significant differences in the highest HbA1c and the average HbA1c between Group diagnosed during pregnancy A and Group diagnosed before pregnancy (P=0.020, P=0.037). There was neither no significant difference in the percentage used insulin during pregnancy between them (P=0.128). There were significant differences in the highest HbA1c and the average HbA1c between Group diagnosed during pregnancy B and Group diagnosed before pregnancy (P<0.01, P=0.014). There was also significant difference in the percentage used insulin during pregnancy between them (P<0.01). (3) Pregnancy outcome:①Group diagnosed before pregnancy and Group diagnosed during pregnancy: the cesarean section rate [72.5% (174/240) vs. 59.7% (302/506)] in Group diagnosed before pregnancy were higher than those in Group diagnosed during pregnancy (P<0.01). However, there were no significant differences in preterm birth rate, pre-eclampsia, macrosomia percentage, percentage of neonates being hospitalized between the 2 groups (P=0.546,P=1.000,P=0.671,P=0.804). ②There was no significant difference in preterm birth rate, cesarean delivery rate, macrosomia percentage, pre-eclampsia rate, percentage of neonates being hospitalized between Group diagnosed during pregnancy A and Group diagnosed during pregnancy B (P=0.887, P=0.495, P=0.841, P=1.000, P=1.000).③There was no significant difference in preterm birth rate, cesarean delivery rate, macrosomia percentage, pre-eclampsia rate, percentage of neonates being hospitalized between Group diagnosed during pregnancy A and Group diagnosed before pregnancy (P=0.875, P=0.093, P=0.662, P=1.000, P=0.837). The cesarean delivery rate was lower in Group diagnosed during pregnancy B than that in Group diagnosed before pregnancy (P=0.001). However, there were no significant differences in preterm birth rate, macrosomia percentage, pre-eclampsia rate, percentage of neonates being hospitalized between them (P=0.530, P=0.776, P=1.000, P=0.797). Conclusions The diagnosis of PGDM is commonly missed before pregnancy. Fasting plasma glucose should be used as screening test to identify PGDM at pre-pregnancy examination or first antenatal care. Using abnormal value of 2-hour glucose after 24 gestational weeks as the only way to diagnose PGDM is not suitable.

Objective:To explore effects of Ningshen Mixture on contents of sexual hormones,interleukin-2(IL-2)and the therapeutic effect in the patient of menopausal syndrome.Methods:Patients in the Ningshen Mixture group were treated with Ningshen Mixture and the control group with Gengnianan.Level of follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E_2)and IL-2 and the therapeutic effect were investigated.Results:After treatment E_2 level was increased in both groups with a significant difference as compared with that before treatment(P0.05).Conclusion:Ningshen Mixture can increase E_2 level,which is possibly one of the mechanisms.

Objective To investigate the relationship of different types of gestational diabetes mellitus (GDM) and pregnancy outcomes.Methods A total of 4090 cases,who received prenatal examination and delivered in Peking University First Hospital and performed a 75 g oral glucose tolerance test (75 g OGTT) at 24-28 gestational weeks,from January.1st,2011 to Jul 31st,2012,were divided into 2groups.Normal blood glucose group:the result of OGTT (fasting plasma glucose,1 hour glucose and 2 hour glucose) was normal; Gestational diabetes mellitus group (GDM group):the result of OGTT was abnormal at any time point.GDM group were separated into A,B and C.GDM A means fasting plasma glucose annormal but others were normal,GDM B:fasting plasma glucose,1 hour and/or 2 hour glucose abnormal,GDM C:fasting plasma glucose normal.To analyse the effect of different number of abnormal result of OGTT on pregnancy outcomes,GDM group were divided into Ⅰ,Ⅱ and Ⅲ.GDM Ⅰ means one abnormal blood glucose of OGTT result,GDM Ⅱ:two abnormal blood glucose and GDM Ⅲ:three abnormal blood glucose.We analyzed the pregnant outcomes of each group.Results (1) Among the 4090 cases,858 cases (21.98％) were diagnosed as GDM (GDM group),and 82 cases (9.6％,82/858) were treated with insulin,other 3232 cases with normal blood glucose (normal blood glucose group).In GDM group,the rate of cesarean section (51.9％,445/858),premature delivery (8.4％,72/858) and LGA (5.9％,51/858)were respectively significantly higher than those of normal blood glucose group [(43.5％,1406/3232),(5.8％,189/3232) and (4.2％,137/3232)] (P ＜ 0.05).But,there was no statistically significant differences for the rate of macrosomia (P ＞ 0.05) between the GDM group (6.8％,58/858) and normal blood glucose group (6.2％,199/3232).(2)In the GDM group,GDM A was 317 cases (36.9％),GDM B 239 cases (27.8％),GDM C 302 cases (35.2％).The incidence of Macrosomia and LGA in GDM B was significantly higher than that in GDM C and normal blood glucose group (P ＜ 0.05).Comparing with GDM A,there was no statistically significance in GDM B and GDM C (P ＞ 0.05).(3)In GDM group,GDM Ⅰ was 521 cases (60.7％),GDM Ⅱ203 cases (15.6％),GDM Ⅲ 134 cases (23.7％).Compared with the normal blood glucose group,GDM Ⅲ had a significantly higher incidence of macrosomia and LGA and cesarean section(P ＜ 0.01) ;and GDM Ⅱ had only a significantly higher incidence of cesarean section (P ＜ 0.01).(4) Among the 4090 cases,there were 1118 patients (27.3 ％) whose fasting blood glucose was below 4.4 mmol/L,of which 55 cases were diagnosed as GDM.There were 4 premature infants and 1 macrosomia.Conclusions The GDM group with more than FBG ≥5.1 mmol/L had a higher incidence of adverse pregnancy uutcomes,it suggested that we should pay more attention and take actively intervented;the pregnant woman is not recommended for 75g OGTT detection when fasting blood glucose was below 4.4 mmol/L because of the low rate of GDM and adverse pregnancy outcomes among them.

Objective To investigate the incidence of glucose metabolism disorder during pregnancy and establish the diagnosis criteria for gestational diabetes mellitus (GDM) among Chinese patients.Method A prospective popolation-bused study of 16 286 pregnant women,who received 50 g glucose challenge test (GCT) for the first time between Apr 1,2006 and Sept 30,2006,was performed throughout 18 cities in China. Results According to national diabetes data group (NDDG)criteria,the overall incidence of GDM and glucose impaired glucose tolerance (GIGT) was 2.763% (450/16 286) and 3.862% (629/16 286),respectively; it changed to 5.078% (827/16 286)and 5.268% (858/16 286) when using American diabetes association (ADA) criteria.If the women who had 2 or more abnormal oral glucose tolerance test (OGTT) values meeting or exceeding ADA criteria was classified as group 1,and the women who had one or more meeting or exceeding NDDG criteria was group 2,the ratio of women who met both the criteria of ADA and NDDG in group 1 was 94.2%.The 95% CI of normal glucose when using ADA criteria were fasting glucose 5.3 mmol/L,1 hour 10.4 mmol/L,2 hour 8.7 mmol/L,3 hour 7.7 mmol/L,which is close to ADA criteria.Conclusions ADA criterion is more suitable for Chinese patients.According to NDDG criteria,it is reasonable to treat the patient with 1 or more abnormal OGTT values,and if choosing ADA criteria,2 or more abnormal OGrIT values is more reasonable.