Objective To investigate the changes of plasma insulin and C peptide level in women with gestational diabetes mellitus(GDM), gestational impaired glucose tolerance(GIGT) and normal pregnant and to find out the patterns of glucose metabolism in pregnancy and the function of islet ? cell in patients with gestational impaired glucose metabolism Methods Thrity one normal pregnant women (group Ⅰ), 36 GIGT (group Ⅱ)and 31 GDM (group Ⅲ) were selected. Insulin and C peptide levels were measured by radioimmunoassay. Results Insulin and C peptide levels of groups Ⅰand Ⅲ increased with the gestational age and decreased at postpartum. At 31 weeks of gestation, insulin and C peptide levels of group Ⅱ and group Ⅲ were significantly higher than that of group I [insulin: (13.95?3.15) mIU/L and (15.10?2.96)mIU/L vs (11.40?3.27) mIU/L; C peptide: (0.60 ?0.21) pmol/ml and (0.80?0.31) pmol/ml vs (0.44?0.26) pmol/ml, P 0.05). The peak value of insulin and C peptide was found at the first hour postprandially in group I, while at the second hour in group Ⅱ and Ⅲ. Conclusions Insulin resistance during pregnancy becomes stronger gradually with pregnant progress. Women with abnormal glucose metabolism during pregnancy would have more insulin resistance which leads to the damage of insulin secretion. These women should have long term followed up.

OBJECTIVE To investigate the protective effect of interleukin-35(IL-35)mRNA-lipid nanoparticles(LNP)against lipopolysaccharide(LPS)-induced acute lung injury(ALI)in mice.METHODS Fifity-six mice were randomly divided into 7 groups with 8 mice in each,including the normal control group,IL-35 mRNA-LNP(250 μg·kg-1)group,LPS group,LPS+IL-35 mRNA-LNP(50,125 and 250 μg·kg-1)group and LPS+Dexamethasone(DXM)group.Except for the normal control group and IL-35 mRNA-LNP(250 μg·kg-1)group and ALI model was established by tracheal infusion of LPS in each of the other groups.IL-35 mRNA-LNP(250 μg·kg-1)group and LPS+IL-35 mRNA-LNP(50,125 and 250 μg·kg-1)group were injected with a corresponding dose of LNP encapsulated mRNA complex via the tail vein while the LPS+DXM group was injected with DXM via the tail vein.Lung coefficient and the wet to dry weight ratio(W/D)of lung tissue were recorded.The mRNA levels of inflammatory cytokines tumor necrosis factor-α(TNF-α),Interleukin-6(IL-6)and IL-1βof lung homogenates were detected by real-time fluorescence quantitative PCR(RT-qPCR).LDH activity of lung homogenates and the protein levels of IL-35,TNF-α,IL-6 and IL-1β in lung homogenate were detected by corresponding kits.Hematoxylin-eosin(HE)staining was used to observe and analyze the pathological injury to lung tissue.The expres-sion of Lymphocyte antigen 6G(Ly6G)was detected by Immunofluorescence to reflect the infiltration of neutrophils.RESULTS Compared with the normal control group,LPS group and LPS+DXM group,IL-35 protein expression levels in lung homogenates of the other groups were more significant(P<0.01).Compared with the normal control group,lung coefficient,W/D ratio of lung tissue,LDH activity,mRNA levels and the protein levels of TNF-α,IL-6 and IL-1β in lung homogenates were significantly increased in the LPS group(P<0.01),accompanied by alveolar hemorrhage,alveolar wall thickening and neutro-phils infiltration.After IL-35 mRNA-LNP administration,lung coefficient,W/D ratio of lung tissue,LDH activity,mRNA levels and the protein levels of TNF-α,IL-6 and IL-1β in lung homogenates were signifi-cantly decreased(P<0.01),and alveolar hemorrhage,alveolar wall thickening and neutrophil infiltration were obviously improved.CONCLUSION IL-35 mRNA-LNP can express IL-35 protein in lung tissue of mice,and effectively improve LPS-induced ALI in mice by inhibiting the expression of proinflammatory factors.

Objective To investigate the value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)and multi-phasic enhanced MRI in the classification of clear cell renal cell carcinoma(ccRCC).Methods The data of 91 patients with pathologically confirmed ccRCC who all underwent multi-phasic enhanced MRI and IVIM-DWI examination were analyzed retrospectively. According to Fuhrman classification criteria,grade Ⅰ - Ⅱ were defined as low-grade group(n=73),grade Ⅲ - Ⅳ were defined as high-grade group(n=18).Mann-Whitney U test,independent sample t test and receiver operating characteristic(ROC)analysis were used for statistical analysis.Results The maximal diameter and pathological stage of ccRCC in the low-grade group were lower than those in the high-grade group,and the differences between the two groups were statistically significant(P<0.001 and P=0.003). The signal intensity and enhancement rate of ccRCC in the high-grade group in corticomedullary phase and parenchyma phase were lower than those in the low-grade group,but there was no significant difference between the two groups(all P>0.05).The ADC and D values of ccRCC in the high-grade group were lower than those in the low-grade group,and the differences between the two groups were statistically significant(P=0.007 and P=0.009).However,there was no significant difference of D *and f between the two groups(P=0.604 and P=0.695).Conclusion Multi-phasic enhanced MRI scanning has a limited value in the classification of ccRCC.IVIM-DWI derived diffusion-related parameters(ADC and D)is of great significance for differentiating between high-grade and low-grade ccRCC.

Objective To investigate the correlation between serum levels of antiphospholipid antibody(aPL)(ACA-IgG,ACA-IgM,β2-GPI-IgG,β2-GPI-IgM),LAC,ds-DNA,and ANA and preterm labor with pre-maturity,and to analyze the prediction of preterm labor with the combination of age,week of gestation,history of delivery,and history of miscarriage,so as to provide references for the prevention and treatment of preterm la-bor and to promote eugenics.Methods Through a retrospective study design,43 pregnant women with preterm la-bor with preeclampsia diagnosed and treated at Guangdong Provincial People's Hospital from June 2018 to Decem-ber 2020 were collected as a case group,and 47 healthy pregnant women of the same period and similar gestational age were randomly selected as a control group.aPL(ACA-IgG,ACA-IgM,β2-GPI-IgG,β2-GPI-IgM)and ds-DNA were detected by enzyme immunoassay(ELISA)using an enzyme immunoassay instrument,lupus anticoagulant(LAC)in plasma was detected by coagulometer,and ANA was detected by indirect immunofluorescence using an immunofluorescence analyzer,and the application of SPSS 24.0 software was used to statistically analyze the gen-eral information and laboratory test data.the age of the patients was combined,gestational week,birth history,miscarriage history and other general information,logistic regression analysis was performed to find the indepen-dent influencing factors related to preterm labor;the analysis was performed by using the subjects'work charac-teristic curve(ROC curve)to determine the area under the ROC curve(AUC),the best predictive value,sensi-tivity and specificity,and to analyze the predictive value of preterm labor with preterm labor.Results In this study,the pregnant women in the group of pregnant women with preterm labor with preeclampsia were aged 27～40 years,with a mean age of(29.93±3.91)years,and the gestational weeks at the time of blood collection were 27-36 weeks,with a mean gestational week of(31.96±2.35)weeks,while the pregnant women in the healthy control group during the same time period were aged 25～40 years,with a mean age of(30.74±3.44)years,and the gestational weeks at the time of blood collection were 28～36 weeks,with a mean gestational week of(32.84±2.13)weeks.In the same period,healthy control group pregnant women were aged 25～40 years,with a mean age of(30.74±3.44)years,and were 28～36 weeks pregnant at the time of blood collection.The β2-GPI-IgM level of pregnant women in the case group with preterm labor was significantly higher than that of pregnant women in the healthy control group at the same time,with statistically significant differences(P<0.05),while the differences in the levels of β2-GPI-IgG,ds-DNA,and LAC between the two groups were not statistically significant(P>0.05).The analysis of the ROC curves showed that the AUC of β2-GPI-IgM was 0.642(P<0.05),which was the highest in the preterm group,and the AUC was 0.642(P<0.05).0.05),which was an independent influencing factor of preterm labor;age,gestational week,labor history,and miscarriage history could not be used as independent in-fluencing factors of preterm labor.Conclusion β2-GPI-IgM is associated with threatened preterm labor,it can be used as a predictor of threatened preterm labor,and has clinical utility in the monitoring of threatened preterm labor in pregnant women.

Objective:To explore the clinical characteristics of pediatric glucose transporter type 1 deficiency syndrome (GLUT1 DS), evaluate the efficacy and safety of ketogenic diet therapy (KDT).Methods:Clinical data of 19 children with GLUT1 DS admitted to Children′s Hospital of Fudan University, Tianjin Children′s Hospital, Shenzhen Children′s Hospital, Children′s Hospital of Nanjing Medical University and Jiangxi Provincial Children′s Hospital between 2015 and 2019 were collected retrospectively. The first onset symptom, main clinical manifestations, cerebrospinal fluid features and genetic testing results of patients were summarized, the efficacy and safety of ketogenic diet treatment were analyzed. Results:Among the 19 cases, 13 were males and 6 females. The age of onset was 11.0 (1.5-45.0) months,the age of diagnosis was 54.0 (2.8-132.0) months. Epilepsy was the first onset symptom of 13 cases. Different forms of tonic-clonic seizures were the most common types of epilepsy (7 cases with generalized tonic-clonic seizures, 5 cases with focal tonic or clonic seizures, 4 cases with generalized tonic seizures). Antiepileptic drugs were effective in 4 cases. Paroxysmal motor dysfunction was present in 12 cases and ataxia was the most common one. All patients had different degrees of psychomotor retardation. Among 17 patients received cerebrospinal fluid examination, cerebrospinal fluid (CSF) glucose level was lower than 2.2 mmol/L and CSF glucose/glycemic index was<0.45 in 16 cases, only 1 case presented normal CSF glucose level (2.3 mmol/L) and normal CSF glucose/glycemic index(0.47). SLC2A1 gene mutations were found in 16 patients, missense, frameshift and nonsense mutations were the common types with 5 cases, 5 cases and 3 cases respectively. All 19 patients were treated with ketogenic diet, which was effective in 18 cases in seizure control, 11 cases in dyskinesia improvement and 18 cases in cognitive function improvement. No serious side effects were reported in any stage of KDT.Conclusions:The diagnosis of GLUT1 DS is often late. It is necessary to improve the early recognition of the disease and perform CSF glucose detection and genetic testing as early as possible. The KDT is an effective and safe treatment for GLUT1 DS, but a small number of patients have not response to diet therapy.

OBJECTIVETo survey the acceptance and willingness-to-pay for colorectal cancer colonoscopy screening among high risk populations in urban China.

METHODSFrom 2012 to 2013, a Cancer Screening Program in Urban China (CanSPUC) was initiated in 9 provinces, the current survey was conducted among those participants who were evaluated as "high risk for colorectal cancer" by a risk-factor-evaluation-model (community-based) and then went through a colonoscopy screening procedure (hospital-based). All the data were obtained through a questionnaire-based interview (face-to-face or self-completed), mainly focusing on the acceptance and willingness-to-pay of the participants for colorectal colonoscopy screening.

RESULTSThe current analysis included a total of 1 624 participants, with an median age of 55.0 years (P25 = 49.0, P75 = 61.0 years) and an annual income per capita of 17 thousand (range: 10-25 thousand) Chinese Yuan (CNY), 42.8% (695/1 624) of whom were males. Of all the participants, 87.0% (1 414/1 624) could totally or substantially accept the colonoscopy screening, particularly in those at higher education level (junior high school: OR = 0.34, 95% CI: 0.22-0.52; high school OR = 0.41, 95% CI: 0.26-0.66; college or over OR = 0.35, 95% CI: 0.20-0.59). Of all the participants, 13.0% (210/1 624) could not or hardly accept it, particularly in those with older age (60-69 years) (OR = 1.48, 95% CI: 1.06-2.07), not in marriage (OR = 2.15, 95% CI: 1.25-3.70) or with family member(s) to raise (OR = 1.60, 95% CI: 1.17-2.20). 1 388 (85.5%) of all the participants had willingness-to-pay for a long-term colonoscopy screening service, particularly in those working in public (OR = 0.61, 95% CI: 0.44-0.84) or enterprise sectors (OR = 0.60, 95% CI: 0.38-0.94), but 82.3% (1 141/1 386) of whom would only pay less than 100 CNY; 14.5% (236/1 624) of total had no willingness-to-pay, particularly in those living in areas with moderate (OR = 4.08, 95% CI: 2.75-6.33) or high GDP per capita (OR = 3.26, 95% CI: 2.11-4.92), or with an absence of willingness-to-pay for colonoscopy screening (OR = 3.98, 95% CI: 2.81-5.65).

CONCLUSIONSAlthough a larger community-based colorectal cancer screening program was warranted to examine the extrapolation of these findings, it suggested that the acceptance for colorectal cancer colonoscopy screening among the selected high-risk populations was considerable. The willing-to-pay was relatively high but the amount of payment was limited, the indicated subgroups with potentially less acceptance or willingness need to be more focused in the future to reach a higher participation rate. The data will also be informative in integrating the screening service into the local health insurance system.

China ; Colonoscopy ; Colorectal Neoplasms ; Data Collection ; Demography ; Early Detection of Cancer ; Family ; Fees and Charges ; Female ; Humans ; Income ; Insurance, Health ; Male ; Mass Screening ; Middle Aged ; Patient Acceptance of Health Care ; Risk Factors ; Surveys and Questionnaires ; Urban Population

Objective To survey the acceptance and willingness-to-pay for colorectal cancer colonoscopy screening among high risk populations in urban China. Methods From 2012 to 2013, a Cancer Screening Program in Urban China (CanSPUC) was initiated in 9 provinces, the current survey was conducted among those participants who were evaluated as“high risk for colorectal cancer”by a risk-factor-evaluation-model (community-based) and then went through a colonoscopy screening procedure (hospital-based). All the data were obtained through a questionnaire-based interview (face-to-face or self-completed), mainly focusing on the acceptance and willingness-to-pay of the participants for colorectal colonoscopy screening. Results The current analysis included a total of 1 624 participants, with an median age of 55.0 years (P25=49.0, P75=61.0 years) and an annual income per capita of 17 thousand (range:10-25 thousand) Chinese Yuan (CNY), 42.8% (695/1 624) of whom were males. Of all the participants, 87.0%(1 414/1 624) could totally or substantially accept the colonoscopy screening, particularly in those at higher education level (junior high school:OR=0.34, 95%CI:0.22-0.52;high school OR=0.41, 95%CI:0.26-0.66;college or over OR=0.35, 95%CI:0.20-0.59). Of all the participants, 13.0%(210/1 624) could not or hardly accept it, particularly in those with older age (60-69 years) (OR=1.48, 95%CI:1.06-2.07), not in marriage (OR=2.15, 95%CI: 1.25-3.70) or with family member(s) to raise (OR=1.60, 95%CI: 1.17-2.20). 1 388 (85.5%) of all the participants had willingness-to-pay for a long-term colonoscopy screening service, particularly in those working in public (OR=0.61, 95%CI:0.44-0.84) or enterprise sectors (OR=0.60, 95%CI:0.38-0.94), but 82.3%(1 141/1 386) of whom would only pay less than 100 CNY;14.5%(236/1 624) of total had no willingness-to-pay, particularly in those living in areas with moderate (OR=4.08, 95%CI:2.75-6.33)or high GDP per capita (OR=3.26, 95%CI:2.11-4.92), or with an absence of willingness-to-pay for colonoscopy screening (OR=3.98, 95% CI: 2.81-5.65). Conclusions Although a larger community-based colorectal cancer screening program was warranted to examine the extrapolation of these findings, it suggested that the acceptance for colorectal cancer colonoscopy screening among the selected high-risk populations was considerable. The willing-to-pay was relatively high but the amount of payment was limited, the indicated subgroups with potentially less acceptance or willingness need to be more focused in the future to reach a higher participation rate. The data will also be informative in integrating the screening service into the local health insurance system.

Objective To survey the acceptance and willingness-to-pay for colorectal cancer colonoscopy screening among high risk populations in urban China. Methods From 2012 to 2013, a Cancer Screening Program in Urban China (CanSPUC) was initiated in 9 provinces, the current survey was conducted among those participants who were evaluated as“high risk for colorectal cancer”by a risk-factor-evaluation-model (community-based) and then went through a colonoscopy screening procedure (hospital-based). All the data were obtained through a questionnaire-based interview (face-to-face or self-completed), mainly focusing on the acceptance and willingness-to-pay of the participants for colorectal colonoscopy screening. Results The current analysis included a total of 1 624 participants, with an median age of 55.0 years (P25=49.0, P75=61.0 years) and an annual income per capita of 17 thousand (range:10-25 thousand) Chinese Yuan (CNY), 42.8% (695/1 624) of whom were males. Of all the participants, 87.0%(1 414/1 624) could totally or substantially accept the colonoscopy screening, particularly in those at higher education level (junior high school:OR=0.34, 95%CI:0.22-0.52;high school OR=0.41, 95%CI:0.26-0.66;college or over OR=0.35, 95%CI:0.20-0.59). Of all the participants, 13.0%(210/1 624) could not or hardly accept it, particularly in those with older age (60-69 years) (OR=1.48, 95%CI:1.06-2.07), not in marriage (OR=2.15, 95%CI: 1.25-3.70) or with family member(s) to raise (OR=1.60, 95%CI: 1.17-2.20). 1 388 (85.5%) of all the participants had willingness-to-pay for a long-term colonoscopy screening service, particularly in those working in public (OR=0.61, 95%CI:0.44-0.84) or enterprise sectors (OR=0.60, 95%CI:0.38-0.94), but 82.3%(1 141/1 386) of whom would only pay less than 100 CNY;14.5%(236/1 624) of total had no willingness-to-pay, particularly in those living in areas with moderate (OR=4.08, 95%CI:2.75-6.33)or high GDP per capita (OR=3.26, 95%CI:2.11-4.92), or with an absence of willingness-to-pay for colonoscopy screening (OR=3.98, 95% CI: 2.81-5.65). Conclusions Although a larger community-based colorectal cancer screening program was warranted to examine the extrapolation of these findings, it suggested that the acceptance for colorectal cancer colonoscopy screening among the selected high-risk populations was considerable. The willing-to-pay was relatively high but the amount of payment was limited, the indicated subgroups with potentially less acceptance or willingness need to be more focused in the future to reach a higher participation rate. The data will also be informative in integrating the screening service into the local health insurance system.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

Biliary atresia is a rare infant disease that predisposes patients to liver transplantation and death if not treated in time. However, early diagnosis is challenging because the clinical manifestations and laboratory tests of biliary atresia overlap with other cholestatic diseases. Therefore, it is very important to develop a simple, safe and reliable method for the early diagnosis of biliary atresia. Herein, a novel NIR-II fluorescence probe, HZL2, with high quantum yield, excellent biocompatibility, low cytotoxicity and rapid excretion through the liver and gallbladder was developed based on the oil/water partition coefficient and permeability. A simple fecal sample after injection of HZL2 can be used to efficiently identify the success of the mouse model of biliary atresia for the first time, allowing for an early diagnosis of the disease. This study not only developed a simple and safe method for the early diagnosis of biliary atresia with great potential in clinical translation but also provides a research tool for the development of pathogenesis and therapeutic medicines for biliary atresia.