Gestational diabetes refers to the first occurrence or discovery of different degrees of abnormal glucose tolerance during pregnancy, which is one of the most common complications during pregnancy. As the incidence rate increased year by year, the complications of mother and child increased significantly. In recent years, gestational diabetes mellitus has been paid more and more attention. Most of the current researches are about the diagnosis and treatment of gestational diabetes 24 weeks and later, and the theoretical basis for the screening method and treatment of early gestational diabetes is still lacking. With the further understanding of early gestational diabetes mellitus and its adverse maternal and infant pregnancy outcomes, it is imperative to actively carry out the research on the screening and treatment of early gestational diabetes mellitus.

Objective To observe the effect of Danzhi Jiangtang Capsules(DJC) on serum interleukin-18 (IL-18),cystatin C (CysC) and relative biochemical indexes in patients with early diabetic kidney disease(DKD),and to explore its protective action on the kidney.Methods Sixty-two hospitalized patients with early diabetic nephropathy (period 11-Ⅲ) in Endocrinology Department of the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine were divided into western medicine group and DJC group,31 cases in each group.The patients in western medicine group received conventional hypoglycemic drugs,and DJC group received DJC based on the treatment for the western medicine group.Before and after treatment,we observed the levels of serum IL-18,CysC,fasting plasma glucose (FPG),2-hour postprandial glucose (2hPG),glycosylated hemoglobin (HbA1c),serum creatinine (SCr),blood urea nitrogen (BUN),microalbumin (mAlb),urinary albumin /creatinine ratio (UACR),and estimated glomerular filtration rate (eGFR).Results The total effective rate was 90.0％ in DJC group and 76.7％ in the western medicine group,there being significant difference between the two groups(P ＜ 0.05).After treatment,the main traditional Chinese medical syndrome scores of DJC group were significantly lower than those before treatment,and the improvement was better than that of the western medicine group (P ＜ 0.05 or P ＜ 0.01).After treatment,the serum levels of IL-18,CysC,2hPG,SCr,BUN,mAlb,UACR in the two groups were significantly lower than those before treatment (P ＜ 0.05 or P ＜ 0.01),while eGFR level was higher than that before treatment (P ＜ 0.05 or P ＜ 0.01),and the improvement effect (except for BUN) in the DJC group was superior to that in the western medicine group(P ＜ 0.01).DJC had an effect on lowering the FPG and HbA1c (P ＜ 0.05 or P ＜ 0.01 compared with those before treatment),and the western medicine had no obvious effect on the two indexes (P ＞ 0.05).The results of Spearman correlation analysis showed that IL-18 was correlated with CysC,IL-18 and CysC were correlated with HbA1c,mALB and uACR.Conclusion DJC can protect renal function of patients with early diabetic nephropathy.

Objective To investigate the effects of suramin application in acute angle closure glaucoma surgery patients.Methods A prospective study method was used.From February 2012 to January 2016,178 acute angle closure glaucoma surgeries in our hospital for treatment were selected,and were equally divided into observation and control groups (89 cases in each group) according to the order of admission,and two groups were given filtration surgery.The observation group was treated with suramin adjuvant therapy after surgery.The duration were 1 ～ 14 d after operation.The prognosis of two groups was observed.Results All patients were successfully completed surgery.The intraoperative and postoperative complications were no seriously occurred;the postoperative intraocular pressure in the observation group and the control group were (11.52 ± 3.24) mmHg and (16.98 ± 5.33) mmHg that compared preoperative [(31.98 ± 5.22) mmHg,(31.87 ± 5.11) mmHg] with significantly different (P ＜ 0.05),while the observation group was significantly lower than that of the control group (P ＜ 0.05).The postoperative peak systolic velocity (PSV) and end diastolic velocity (EDV) values of the central retinal artery of the observation group and the control group were significantly higher than that of preoperation (P ＜ 0.05),and the postoperative PSV and EDV values of the central retinal artery of the observation group were significantly higher than that in the control group (P ＜ 0.05).The postoperative ratios of functional filtering bleb in the observation group and control group were 80.9％ and 60.7％,respectively.The observation group was significantly higher than that of the control group (P ＜ 0.05).Conclusions The application of suramin in acute close angle glaucoma filtration surgery can promote the function of filtering bleb and intraocular pressure reduction,and improve the ocular blood flow speed that has good application effects.

ObjectiveTo investigate the effects of ziprasidone on the behavior and the expression of pERK1/2 in posttraumatic stress disorder(PTSD) model rats.Methods 24 adult male SD rats weighing (200 ±20) g were randomly divided into four groups (n =6):control group,single prolonged stress and foot shock (SPS&S) group,ziprasidone group and ziprasidone + U0126 group.The fear response to environment,high alertness,and anxiety & depression behavior of rats were tested by the open field,elevated plus-maze,and the expression of pERK1/2 was measured by Western blot.ResultsIn open field test(OFT),the SPS&S group( (76.23 ± 54.76) cm for horizontal motion distance,(4.60 ± 1.14) for the number of entering central region) showed significant difference compared with control group ( (343.77 ± 74.22 ) cm,( 12.40 ± 3.36 ) ) or ziprasidone group ( ( 274.98± 83.56) cm,( 12.00 ± 2.92) ) (P ＜ 0.01 ),but showed no significant difference with ziprasidone + U0126 group ( ( 138.14 ± 41.98) cm,(5.00 ± 1.58) ) (P ＞ 0.05 ).The results of elevated plus maze (EPM) were in accordance with the results of OFT.The expression of pERK1/2 in SPS&S group and ziprasidone + U0126 group showed significant decrease when compared with control group or ziprasidone group (P ＜ 0.01 ).ConclusionZiprasidone can obviously improve fear response to environment,high alterness and anxiety & depression behavior of rats,and these effects of ziprasidone may be carried out by up-regulation the expression of pERK1/2.

Objective To investigate the clinical features, diagnosis and treatments of pelvic abscess with endometriosis. Methods A retrospective analysis was performed on 129 cases of pelvic abscess in Peking Union Medical College Hospital from January 2000 to January 2016. Among them, 34 women with endometriosis were divided into the study group and the others were in the control group. The clinical characteristics, therapeutic regimens and outcomes were compared. Results (1) General conditions:there were no statistic differences between the two groups in age, WBC, serum CA125, intrauterine device in use, pelvic inflammatory disease history;while incidence rates of dysmenorrhea (65%, 22/34) and infertility (21%, 7/34) in the study group were higher than those in the control group (all P<0.05). (2) Clinical manifestations:fever, abdominal pain and pelvic mass were the main symptoms in two groups. The incidence rates of septic shock were 12%(4/34) in the study group and 2%(2/95) in the control group (P<0.05). (3) Treatment:treatment with puncture all failed in the study group (7/7) and surgeries were required. In contrast, there was only 1/19 treatment failure with puncture in the control group. The puncture failure rates were statistically significant (P<0.05). Compared with the study group and the control group, there were significant differences (P<0.05) in the operation time of laparoscopic surgery [(76±41) versus (53±21) minutes] and of laparotomy [(168±58) versus (116±35) minutes], intra-operative blood loss of laparoscopic surgery [(216±296) versus (43±36) ml] and of laparotomy [(448 ± 431) versus (145 ± 24) ml]. Conclusions Pelvic abscess in women with endometriosis is more severe and refractory to antibiotics and puncture treatment. Active surgical intervention is required. Although surgical procedures are often difficult, prognosis is comparatively satisfied.

Purpose To prepare 68Ga-NOTA-SPIO as PET/MRI dual mode imaging probe with high sensitivity and resolution,and further evaluate its in vitro and partly in vivo biological properties.Materials and Methods The precursor SPIO-PEG2000-NOTA was prepared and characterized.The precursor was radiolabeled by using one step method to prepare 68Ga-NOTA-SPIO as dual mode imaging probe.The labeling rate of the probe was determined by rapid thin-layer chromatography.Besides,the in vitro stability and lipid water partition coefficient of the probe were evaluated,and its biodistribution in normal mice was also observed.Results The precursor SPIO-PEG2000-NOTA with uniform dispersion and uniform particle size was prepared,and the dual mode probe 68Ga-NOTA-SPIO was synthesized.The labeling rate reached 99％,and the lipid water partition coefficient (Log P) was (-2.60±0.13).The radiochemical purity of the probe was higher than 95％,as it was incubated in the phosphate buffer and fetal bovine serum within 2 hours.The probe was mainly distributed in the liver and spleen of mice,and its clearance velocity in blood was fast.Conclusion The double mode probe 68Ga-NOTA-SPIO synthesized by one step method has high labeling rate with no need of purification,which has good physic-chemical properties and biocompatibility.The probe can be used in the further research of PET/MRI dual modality imaging.

This investigation was aimed to detect the carotid elasticity in normal adults by use of echo-tracking (ET) technique. The stiffness parameter (beta), pressure-strain elasticity modulus (Ep), arterial compliance (AC), argumentation index (AI) and one-point pulse wave velocity (PWV beta) of carotid in 145 normal adults with the average age of 47.0 were calculated. The population were divided into five groups according to age: 20-29 y, 30-39 y,40-49 y, 50-59 y and > or = 60 y. The elasticity parameters between left and right side, between male female and between different age groups were compared using SAS 6.12 statistic software. There was no difference in carotid elasticity regarding the side and gender. The carotid beta, Ep, AI and PWV beta were noted to increase with age while AC was noted to decrease with age. The carotid elasticity was found to correlate with age significantly, but not with side and gender. This change can be detected by ET technique.
Adult ; Age Factors ; Biomechanical Phenomena ; Blood Flow Velocity ; Carotid Arteries ; diagnostic imaging ; physiology ; Compliance ; Echocardiography, Doppler, Color ; methods ; Elasticity ; physiology ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Web-based medical education has permeated into almost every corner of traditional med-ical teaching, persistently upgrading the medical teaching models and qualities, and network teaching has become the hot spot of modern education mode.Although the medical network education industry is in good shape, due to many factors, the development of pediatric imaging network education goes slowly. By com-paring current situation of our and other countries' pediatric imaging websites, this study aims to reveal the deficiencies of domestic online teaching in pediatric imaging, and further, to probe the practical meaning and strategy in construction of pediatric imaging teaching website stations, so constructing our own website stations is beneficial for the development of pediatric imaging education of our country.

Objective:To investigate the association between CITP/MMP-1 ratio and the severity of Myocardial fibrosis (MF) in patients with Chronic Heart failure (CHF) and its diagnostic and prognostic value in patients with MF.Methods:A retrospective study was conducted to select 110 cases [86 males, (56.60±11.15) years old;24 females, (60.06±12.02) years old] who were hospitalized in the Department of Cardiology, Teda International Cardiovascular Hospital from May 18, 2021 to February 30, 2022 and underwent magnetic magnetic examination. Serum CITP and MMP-1 were detected by enzyme-linked immunoassay and CITP/MMP-1 ratio was calculated. Plasma brain natriuretic peptide (BNP) was detected by automatic chemiluminescence analyzer. Anova and non-parametric test were used to compare the difference of indexes among all groups. Spearman analysis was used to analyze the correlation between serum collagen metabolites and the severity of myocardial fibrosis. Logistic regression analysis was performed for multivariate analysis, and ROC curve was used to evaluate the auxiliary diagnostic value of related indexes. Major adverse cardiac events within 1 year after discharge were recorded, including cardiogenic death, HF rehospitalization, malignant arrhythmia, and myocardial infarction. The risk factors of poor prognosis were analyzed by Cox regression. Patients were divided by the median value of CITP/MMP-1 ratio or the median value of CITP/MMP-1 ratio and BNP. Survival analysis was performed by Kaplan-Meier and Log Rank test was performed.Results:Serum MMP-1 and BNP in LGE (+) group were higher than those in LGE (-) group (1.79 ng/ml > 0.91 ng/ml, Z=-2.924; 503 pg/ml > 367 pg/ml, Z=-1.932; P<0.05); The CITP/MMP-1 ratio in the LGE (+) group was lower than that in the LGE (-) group (3.84 < 10.85, Z=-3.601, P<0.001). MMP-1 in CHF with arrhythmia group was higher than that in CHF group (1.98 ng/ml > 1.25 ng/ml, Z=-2.016), while CITP/MMP-1 ratio was lower than that in CHF group (3.25 < 5.73, Z=-2.751), all P<0.05. CITP/MMP-1 ratio in CHF patients was negatively correlated with the severity of MF ( r=-0.363, P<0.001), and BNP and MMP-1 were positively correlated with the severity of MF ( r=0.267, r=0.264, P<0.05). Serum BNP was positively correlated with collagen metabolite MMP-1 and negatively correlated with CITP/MMP-1 ratio (all P<0.05). Logistic multivariate regression analysis showed that only CITP/MMP-1 was a predictor of myocardial fibrosis, with an OR value of 0.624 ( P=0.005). ROC curve was used to evaluate serum BNP, MMP-1 and CITP/MMP-1 ratio in the diagnosis of myocardial fibrosis in HF patients, with AUC of 0.653, 0.696 and 0.754, respectively. The accuracy of CITP/MMP-1 ratio in diagnosing fibrosis was better than that of BNP by comparing their AUC, and the difference was statistically significant ( Z=-3.808, P<0.001). Cox regression analysis showed that CITP/MMP-1 ≤3.84 was a risk factor for poor prognosis, OR=2.647 ( P=0.009). Kaplan-Meier survival analysis at 1-year follow-up showed that the survival rate of the group with lower CITP/MMP-1 ratio was significantly lower than that of the group with higher CITP/MMP-1 ratio ( P=0.014). The survival rate of CITP/MMP-1 increased and BNP decreased group was higher than that of CITP/MMP-1 decreased and BNP increased group ( P=0.011). Conclusions:The ratio of CITP/MMP-1 can be used as a negative correlation indicator of the degree of cross-linking, which is better than BNP in the evaluation of MF, and has a good auxiliary diagnostic value for myocardial fibrosis in patients with chronic heart failure, and is expected to become a protective indicator for patients with chronic heart failure and be used in clinical evaluation of myocardial fibrosis. CITP/MMP-1 ratio is associated with the incidence of major adverse cardiac events, and CITP/MMP-1 ≤3.84 can be used as a predictor of prognostic adverse cardiovascular events in CHF patients.

Objectives To evaluate the effectiveness of cognitive behavior therapy for insomnia (CBT-i) in chronic insomnia patients in terms of the improvements of psychological and sleep diary parameters. Methods Patients who met the diagnostic criteria of chronic insomnia, were divided into primary group or comorbid group. Both groups received standard CBT-i interventions. Psychological scales and sleep diaries were used to evaluate participants' severity of insomnia and psychological conditions related to insomnia at four time points:before intervention (baseline), immediate after intervention, 4 weeks and 16 weeks after intervention. Results Both groups achieved significant improvements after intervention on psychological measurements and sleep diary parameters. Such improvements were maintained at 4-week and 16-week follow-ups. The sleep diary data indicated that by the end of the intervention, there were significant differences on sleep onset latency(51.72 min to 10.53 min in primary group, P<0.01;59.26 min to 15.67min in comorbid group, P<0.01)and sleep efficiency (71％to 95％in primary group, P<0.01;68％to 90％in comorbid group, P<0.01). There were differences on sleep onset latency (10.00 min vs. 13.93 min,P<0.05), total sleep time (355.71 min vs. 327.85 min, P<0.05) and sleep efficiency (95％vs. 91％, P<0.01) in primary group and comorbid group respectively. No differences were found on wake after sleep onset in the two groups. Conclusions Chronic insomnia patients with or without comorbidities both have improvements after CBT-i. Sleep diary parameters rather than psychological measurements are different in two groups. Thus, CBT-i is an effective non-pharmaceutical therapy inpatients with chronic insomnia.