Objective To study the iodine nutritional status and the thyroid function of pregnant women during different periods,and provide scientific basis for iodine supplementation.Methods Totally 728 pregnant women who visited the obstetric outpatient of Nanjing Drum Tower Hospital for routine prenatal care from December 2014 to August 2016 were recruited in this study,and at the same time 182 non-pregnant women were recruited as control group.The thyroid stimulating hormone (TSH) and free thyroxine (FT4) were measured by Roche 601.The urinary iodine level was measured by SR-I-100 kit.Results The median urinary iodine of 728 pregnant women was 168.24 g/L,and the median urinary iodine of those women in the T1,T2 and T3 period were 186.31,162.65 and 148.76 g/L,respectively.The TSH at T1 period was lower than T2 and T3 period (t=3.429,3.135,P＜0.05).The FT4 at T1 period was higher than T2 and T3 period (t=5.251,5.965,P＜ 0.05).The prevalence rate of thyroid disease in normal urinary iodine group was lower than that in low urinary iodine group and high urinary iodine group (x2 =4.139,4.131,P＜0.05).Conclusion There was no iodine deficiency among those pregnant women groups,but only 34.75 ％ individuals reached the appropriate iodine nutritional level,and the ratio of iodine insufficient increased with the extension of pregnancy.The whole prevalence rate of thyroid disease in abnormal urinary iodine pregnant women was obviously higher than that in normal.It is necessary to improve the pregnant women's knowledge of iodine nutrition,moreover it is suggested that urinary iodine monitoring and thyroid function should be conducted in pregnant women.

Objective To explore the molecular mechanisms of carbapenem-resistant Klebsiella pneumoniae.Methods Carba NP confirmatory test were used to detect carbapenemases.Carbapenemase genes,ESBL genes and plasmid-mediated AmpC genes were amplified by polymerase chain reaction (PCR).The genetic correlation analysis was carried out by using multiple sequence type (MLST).Results 42 out of the 50 carbapenem-resistant Klebsiella pneumoniae strains were KPC-2-positive strains,1 strain was positive for NDM-1,the other 7 strains were not detected for any carbapenemase genes.The percentages of KPC-2-positive Klebsiella pneumoniae with the bla CTX-M,bla SHV,bla TEM,bla DHA were 21.5 ％,42.9 ％,69.1％ and 4.8％ respectively.The results of MLST showed that 37 out of 42 KPC-2 positive strains were ST11.Conclusion The production of KPC-2 is the main mechanism of Klebsiella pneumoniae resistance to carbapenem and there is an outbreak of ST11 KPC-2 Klebsiella pneumoniae in this hospital.

Objective To investigate the clinical value of urinaryα1-acid glycoprotein (AAG)in the early diagnosis of diabetic nephropathy(DN).Methods 266 cases of diabetic patients in Drum Tower Hospital Affiliated to Medical School of Nanjing University from May 2013 to October 2014 were recruited,and patients were divided into four groups based on the urine al-bumin/creatinine (ACR)levels,as follows:non-diabetic nephropathy group (Non-DN)152 cases,low urinary albumin/cre-atinine group (LUA)49 cases,high urinary albumin/creatinine group (HUA)32 cases,and very high urinary albumin/cre-atinine group (VHUA)33 cases.63 cases of healthy subjects (NC group)and 66 cases of fracture patients (stress group) were recruited as control group.The urinary AAG and other biochemical indicators were measured for all subjects.Results The level of urinary AAG in DN group was significantly higher than that in stress group,Non-DN group and NC group (t=7.951,7.985,8.021,P <0.05),and gradually increased from LUA,HUA to VHUA group (P <0.05).The urinary AAG level was positively correlated with UA,Cr,CRP and ACR (r=0.169,0.286,0.373,0.606,P <0.01).Stepwise logistic re-gression analysis showed that the urinary AAG was the independent risk factor of DN (P <0.05).Conclusion The level of urinary AAG has good application value in the early diagnosis and monitoring progression of DN.

OBJECTIVE: To evaluate the cardiac function of fetuses with intrauterine growth retardation (IUGR) by using tissue Doppler imaging (TDI). METHODS: Peak velocity in early (E) and late (A) diastole were measured by pulsed-wave Doppler, and the peak annular velocities in systole (S'), early (E') and late (A') diastole were measured by TDI. Isovolumetric contraction time (ICT), ejection time (ET), isovolumetric relaxation time (IRT) were recorded. The ratios E/A, E'/A', E/E', E/(E'× S') and myocardial performance index (MPI) were calculated. RESULTS: Compared with the control group, E', A', S' and E'/A' were obviously lower (P<0.05) while E/E', E/(E'× S') and MPI were obviously higher (P<0.05) in the IUGR group; although E, A and E/A were slight lower in the IUGR group, the change was not significant (P>0.05). CONCLUSION Both diastolic and systolic heart function were jeopardized in IUGR fetuses.
Diastole ; Echocardiography, Doppler ; Fetal Growth Retardation ; Fetus ; Heart ; physiopathology ; Humans ; Systole ; Ultrasonography, Prenatal

The aim of this study is to develop the recombinant adenovirus vaccine (rAdV) candidates containing neuraminidase (NA) gene of H5N1 influenza virus and test in BALB/c mice the effect of cell-mediated immunity. In this study, two kind of NA gene (WtNA gene, the wild type; Mod. NA gene, the codon-modified type) derived from H5N1 influenza virus (A/Anhui/1/2005) were cloned and inserted respectively into plasmid of adenovirus vector, then the rAdV vaccines candidates (rAdV-WtNA and rAdV-Mod. NA) were developed and purified, followed by immunization intramuscularly (10(9) TCID50 per dose, double injection at 0 and 4th week) in BALB/c mice, the effect of cell-mediated immunity were analysed at 5th week. Results indicated that: (i) NA protein expression was detected in two rAdV vaccines candidates by Western blotting; (ii) the rAdV-Mod. NA vaccine could elicit more robust NA specific cell-mediated immunity in mice than that of rAdV-WtNA vaccine (P = 0. 016) by IFN-gamma ELIspot assay. These findings suggested rAdV-Mod. NA vaccine was a potential vaccine candidate against H5N1 influenza and worthy of further investigation.
Animals ; Blotting, Western ; Female ; Humans ; Immunity, Cellular ; genetics ; immunology ; Influenza A Virus, H5N1 Subtype ; genetics ; immunology ; Influenza Vaccines ; genetics ; immunology ; Mice ; Mice, Inbred BALB C ; Neuraminidase ; genetics ; immunology ; Orthomyxoviridae Infections ; immunology ; virology ; Polymerase Chain Reaction ; Random Allocation ; Viral Proteins ; genetics ; immunology

OBJECTIVETo evaluate the therapeutic effect of combined CT-guided percutaneous radio-frequency ablation (RFA) plus percutaneous ethanol injection (PEI) on nonresectable priminary hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE).

METHODSOne hundred fifty patients diagnosed as HCC either by pathology or by AFP combined with typical CT and angiographic image findings were studied, 99 men and 51 women, with an average of 51 years. Each patient had at least 3 lesions, ranging from 3.1 to 7.9 cm in diameter, average 5.0 cm. All patients were randomly divided into group A (control group) and group B (combination group) according to their check-in date (odd or even). In group A, 74 patients were treated with RFA alone two weeks after TACE. In group B, 76 patients were treated with RFA plus PEI two weeks after TACE.

RESULTSThe complete necrosis rate was 75.8% in group A and 89.5% in group B (P < 0.05).

CONCLUSIONThe clinical therapeutic effect of radiofrequency ablation (RFA) combined with percutaneous ethanol injection (PEI) is better than that of RFA alone after TACE in HCC.

Carcinoma, Hepatocellular ; therapy ; Catheter Ablation ; methods ; Chemoembolization, Therapeutic ; Ethanol ; administration & dosage ; Female ; Humans ; Liver Neoplasms ; therapy ; Male ; Treatment Outcome

Objective To explore the differential expression of CD269 and CD317 in patients with multiple myeloma(MM). Methods Newly diagnosed samles from patients of MM(20 cases)and iron deficiency anemia(20 cases),40 cases in total (from 06/2015 to 08/2013,the Department of Hematology,Central Hospital of Zhuzhou City)were collected.Real-time quantitative PCR(RQ-PCR)tests were used to detect the relative expression of CD269 and CD317 in bone marrow sam-ples,and the results were statistically analyzed with clinical features.Results The relative expression levels of CD269 and CD317 in patients with multiple myeloma(4.418±4.568,4.327±2.876)were significantly higher than those in the control group(0.600±0.838,1.033±1.335),the difference was statistically significant(t=3.676,4.646,all P<0.05)respective-ly,while not related with the gender,age(P>0.05).There was no correlation between the expression of CD269 and CD317 (r=0.041,P=0.864),but positively correlated with the ratio of myeloma cells(r=0.495,P=0.026;r=0.533,P=0.016).Conclusion CD269 and CD317 were highly expressed in patients with multiple myeloma and may be involved in the pathogenesis of multiple myeloma.

Objective:To study combined adjuvant transcatheter arterial chemoembolization (TACE) with anti-tumor drug treatment on early hepatocellular carcinoma (HCC) recurrence in patients with microvascular invasion (MVI) after partial hepatectomy with curative intent.Methods:The clinical and pathological data of 169 patients with HCC who underwent partial hepatectomy with curative intent from January 2015 to December 2018 at the Affiliated Hospital of Qingdao University were retrospectively analyzed. MVI was diagnosed by postoperative histopathology. There were 147 males and 22 females, with the median age 56 years(ranged 32-79 years). The patients were divided into surgery group ( n=62, patients who did not receive adjuvant therapy), TACE group ( n=42, patients who only received TACE) and combined group ( n=65, patients who received TACE with anti-tumor drug) according to the therapies after resection. Patients in each group were further divided into grade M1 (mild) and grade M2 (severe) subgroups according to the severity of MVI. All patients were followed-up for observing tumor recurrence. The relapse-free survival in the three groups were compared using the Kaplan-Meier method and the log-rank test was used to compare the tumor-free survival rates. Results:The tumor-free survival rates of 169 patients at 1 and 2 years after operation were 59.2% and 40.8%. The tumor-free survival rates at 1 and 2 years after operation were 45.2% and 25.8% in surgery group, 61.9% and 40.5% in TACE group, 70.8% and 52.3% in combined group respectively. The differences among the three groups were significant: TACE group was better than surgery group, and combined group was better than TACE group, combined group was better than surgery group (all P<0.05). In TACE group and combined group, tumor-free survival rates of M1patients better than M2 patients, and the difference was significant ( P<0.05). Among M1 patients and M2 patients, tumor-free survival rates of combined group patients were better than surgery group and TACE group, the difference was significant (all P<0.05). The cumulative tumor-free survival rate was not significantly affected by different antineoplastic agents. Conclusion:Adjuvant TACE reduced the early recurrence rate of HCC patients with MVI. Adjuvant TACE combined with anti-tumor drug further reduced early tumor recurrence.

ObjectiveTo investigate the clinical features of systemic lupus erythematosus (SLE) patients with fever and find out the related factors.MethodsData was collected by the same methods in the past ten years in fifteen hospitals in Jiangsu province and then the data wereretrospectively analyzed.The potentially possible risk factors of fever in SLE were selected and then analyzed by chi-square test,Wilcoxon rank sum test and Logistic regression analysis.ResultsAll 1762 patients were investigated.Seven hundred and twenty-nine had active fever.Age at hospitalization,initially treated patients,photosensitivity,serositis,nervous system involvement,generalized lymphadenopathy/hepatosplenomegaly,white blood cell count (WBC),haemoglobin (HB),erythrocyte sedimentation rate (ESR),C-reaction protein (CRP),alanine aminotransferase(ALT),albumin(ALB),serum creatinine (Scr),complement C3,anti-dsDNA antibodies positive rate,anti-Sm antibodies positive rate,SLEDAI score and past therapies were factors associatedwith SLE fever.Logistic regression analysis showed that abnormal WBC count (OR=1.396,95％CI 1.114-1.711,P=0.004),CRP(OR=1.005,95％CI 1.002-1.009,P=0.002),ALT(OR=1.003,95％CI 1.001-1.005,P=0.005),Scr (OR=0.997,95％CI0.995-0.999,P=0.007),HB (OR=0.986,95％CI 0.981-0.992,P=0.000),age (OR =0.984,95％ CI 0.974-0.993,P=0.001 ) and past usage of cyclophosphamide (CTX) (OR =0.557,95％CI 0.382-0.813,P=0.002) were correlated with SLE fever.ConclusionFever is one of the most common clinical manifestations of SLE patients.Leucopenia,elevated CRP levels,liver function abnormalities,anemia,younger age are risk factors for SLE fever,while renal impairment and past usage of CTX are protective factors.

OBJECTIVE: To systematically evaluate the clinical efficacy of acupuncture for dysarthria, and to explore the rules of acupoints selection for dysarthria. METHODS: The clinical randomized control trial literature regarding acupuncture for dysarthria published before January of 2018 were searched in databases, including CNKI, Wanfang, VIP, CBM, PubMed, Ebsco, Science Direct and Cochrane Library. The information of included studies was extract and the quality was assessed. The Meta analysis was performed by using RevMan 5.3 software. The frequency of acupoints was calculated by using Excel software to analyzed the rules of acupoints selection. RESULTS: Totally 21 papers were included, involving 1651 patients. The pooled effects of clinical efficacy: heterogeneity test =0.74, =0%, =6.36, 95% CI: 4.55, 8.88, =10.84 (<0.01), indicating the efficacy in the treatment group was significantly higher than that in the control group. The pooled effects of the symptom score in Frenchay scale: heterogeneity test =0.56, =0%, =3.20, 95% CI: 1.38, 5.02, =3.45 (<0.01), indicating the efficacy in the treatment group was significantly higher than that in the control group. The acupoints with frequency of more than 5 times were Fengchi (GB 20), Yuye (EX-HN 13), Jinjin (EX-HN 12), Lianquan (CV 23), Baihui (GV 20), tongue-three needles and Yamen (GV15). The meridians with frequency of more than 5 times were the extra channels, governor vessel, gallbladder channel, conception vessel and stomach channel. CONCLUSION The clinical efficacy of acupuncture combined with speech training/regular treatment is significantly superior to that of control group (speech training, medication, regular treatment); acupuncture is safe and effective for dysarthria; the majority of selected acupoint is local acupoints around tongue, throat and neck, as well as extra points and empirical points. However, high-quality randomized controlled trials with large sample sizes are still needed to provide further evidence.
Acupuncture Therapy ; Dysarthria ; therapy ; Humans ; Meridians ; Speech Therapy