Objective To explore the relationship between the red cell volume distribution width (RDW)in patients with ges-tational diabetes and insulin resistance(IR).Methods A total number of 160 pregnancies performed in Guangzhou Women and Children’s Medical Center from January to October 2016.Matching 80 patients with gestational diabetes (the GDM Group)with 80 healthy pregnancies according to their age,gestational weeks and times.Their inflammatory parameters (hs-CRP,neutrophil-to-lymphocyte ratio,RDW)were respectively examined.HOMA-IR was calculated by testing the level of FBG and FIns.The association of the red cell volume distribution width with insulin resistance was analyzed.Results The level of four inflammatory parameters (hs-CRP,WBC,neutrophil-to-lymphocyte ratio,RDW)were significantly higher than that the control group (t=5.695,5.232,3.337,7.814,all P<0.01).Pearson correlated analysis suggested that RDW had positive correlation with HOMA-IR (r=0.58,P<0.01).Conclusion The RDW level were elevated in the GDM patients and had positive correlation with HOMA-IR,which indicated that IR was associated with inflammation and provided proof to research mechanism of GDM.

Objective To explore the change of red cell volume distribution width (RDW) and neutrophil-to-lymphocyte ratio (NLR) in the patients with gestational diabetes mellitus (GDM ) .Methods A total number of 160 pregnant women in our center from January to October 2016 were selected as the research subjects .Eighty patients with GDM served as the GDM group and 80 normal pregnant women as the control group .The clinical data at the second trimester (24 to 28 gestational weeks) ,and changes of RDW and NLR were analyzed .Results The age ,gestational weeks ,gestational times and pre-pregnant BMI had no statistical differences between the GDM group and control group (P>0 .05) .There was no statistically significant differences in the hyperten-sion family history and fetal macrosomia incidence between the GDM group and control group .However ,the family history of diabe-tes ,premature rupture of membranes and incidence of premature birth had statistical difference between the two groups (P<0 .05) . The RDW and NLR levels of the GDM group were higher than those of the control group (P<0 .01) .Conclusion GDM has a cer-tain association with inflammation .

OBJECTIVEThis study aimed to observe the postoperative pain rate and degree of pain in preschool children with cleft lip and palate, and investigate the effect of nursing intervention on pain relief.

METHODSA total of 120 hospitalized cases of three- to seven-year-old preschool children with cleft lip and palate were selected from May to October 2011. The subjects were randomly divided into the control group and experimental groups 1, 2, and 3. The control group used conventional nursing methods, experimental group 1 used analgesic drug treatment, experimental group 2 used psychological nursing interventions, and experimental group 3 used both psychological nursing intervention and analgesic drug treatment. After 6, 12, 24, and 48 h, pain self-assessment, pain parent-assessment, and pain nurse-assessment were calculated for the four groups using the pain assessment forms, and their ratings were compared.

RESULTSThe postoperative pain rates of the four groups ranged from 50.0% to 73.3%. The difference among the four groups was statistically significant (P < 0.001). The differences among the control group and experimental groups 1 and 2 were not statistically significant (P = 0.871), whereas the differences among experimental group 3 and the other groups were statistically significant (P < 0.001).

CONCLUSIONPostoperative pain in preschool children with cleft lip and palate is common. Psychological nursing intervention with analgesic treatment is effective in relieving postoperative pain.

Child, Preschool ; Cleft Lip ; surgery ; Cleft Palate ; surgery ; Humans ; Pain, Postoperative

OBJECTIVETo probe into an effective therapy for chronic pain of cervical intervertebral disc.

METHODSSixty-six cases of chronic pain of cervical intervertebral disc were randomly divided into an acupoint sticking group and an acu puncture group, 33 cases in each group. The acupoint sticking group was treated with acupoint sticking therapy, and the acupuncture group with acupuncture. Tianding (LI 17), Futu (LI 18), Dazhui (GV 14), Tianzong (S 11), etc. were selected in the two groups. After treatment for 3 therapeutic courses, their therapeutic effects were observed.

RESULTSThe effective rate was 93.5% in the acupoint sticking group and 72.4% in the acupuncture group, the former being better than the latter (P<0.05); in a 3-month following-up survey, the effective rate was 90.3% in the acupoint sticking group and 65.5% in the acupuncture group, the former being better than the latter (P<0.05).

CONCLUSIONThe acupoint sticking therapy has an satisfactory therapeutic effect on chronic pain of cervical intervertebral disc.

Acupuncture Points ; Acupuncture Therapy ; Administration, Cutaneous ; Adult ; Aged ; Back Pain ; drug therapy ; therapy ; Cervical Vertebrae ; drug effects ; Chronic Disease ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Intervertebral Disc ; drug effects ; Male ; Middle Aged ; Young Adult

BACKGROUND:Sepsis has become the greatest threat to in-patients, with a mortality of over 25％.The dysfunction of gut barrier, especially the immunological barrier, plays an important role in the development of sepsis. This dysfunction occurs after surgery, but the magnitude of change does not differentiate patients with sepsis from those without sepsis. Increased intestinal permeability before surgery is of no value in predicating sepsis. The present study aimed to observe the changes of intestinal mucosal immunologic barrier in rat models of sepsis induced by cecal ligation and puncture. METHODS:Sixty Sprague-Dawley rats were randomly divided into a sepsis group (n=45) and a control group (n=15). The rats in the sepsis group were subjected to cecal ligation and puncture (CLP), whereas the rats in the control group underwent a sham operation. The ileac mucosa and segments were harvested 3, 6 and 12 hours after CLP, and blood samples were collected. Pathological changes, protein levels of defensin-5 (RD-5) and trefoil factor-3 (TFF3) mRNA, and lymphocytes apoptosis in the intestinal mucosa were determined. In an additional experiment, the gut-origin bacterial DNA in blood was detected. RESULTS:The intestinal mucosa showed marked injury with loss of ileal villi, desquamation of epithelium, detachment of lamina propria, hemorrhage and ulceration in the sepsis group. The expression of TFF3 mRNA and level of RD-5 protein were decreased and the apoptosis of mucosal lymphocyte increased (P<0.05) in the sepsis group compared with the control group. Significant differences were observed in RD-5 and TFF3 mRNA 3 hours after CLP and they were progressively increased 6 and 12 hours after CLP in the sepsis group compared with the control group (P<0.05, RD-5 F=11.76, TFF3 F=16.86 and apoptosis F=122.52). In addition, the gut-origin bacterial DNA detected in plasma was positive in the sepsis group. CONCLUSION:The immunological function of the intestinal mucosa was impaired in septic rats and further deteriorated in the course of sepsis.

OBJECTIVETo explore the prediction of the site for microsurgical vasoepididymostomy (VE) in the treatment of epididymal obstructive azoospermia (OA).

METHODSThis study involved 56 infertile men with confirmed OA whose obstruction was suspected to be in the epididymis. Based on their medical history and results of preoperative physical examination and ultrasonography, we predicted the sites for VE. We performed surgical scrotal exploration for the status of epididymal obstruction, conducted palpation and microscopic observation for the epididymal tubules to be anastomosed, and finally decided on the sites for VE by making sure of the presence of motile sperm in the epididymal fluid of the patients. After surgery, we followed up the patients for the rate of pregnancy.

RESULTSAll the patients received bilateral scrotal ultrasonography and surgical scrotal exploration, totaling 112 procedures, including 98 VE procedures. The accuracy rate of the predicted sites for VE was 80.5% (153/190) by medical history and physical examination, 80.3% (90/112) based on the results of ultrasonography, and 87.4% (90/103) according to the first selected epididymal tubules. Of the 28 patients followed up for more than 12 months, motile sperm were found in 19 (67.9% ) at 2 to 12 months and spontaneous pregnancies were achieved in 10 (35.7%), all with the anastomotic sites in the corpus or cauda.

CONCLUSIONMedical history and physical examination contribute to the selection of anastomotic sites and non-invasive scrotal ultrasonography is effective and practical for positioning epididymal obstruction. The epididymal tubules with motile sperm for anastomosis could be easily obtained from the most dilated ones in indurated epididymides.

Azoospermia ; surgery ; Body Fluids ; Epididymis ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Microsurgery ; methods ; Pregnancy ; Pregnancy Rate ; Scrotum ; diagnostic imaging ; Ultrasonography ; Vas Deferens ; diagnostic imaging ; surgery

Through the analysis on research status of Western medicine for treating hypertentionand the relationship between hypertension and "wind", and by combining with the characteristics of wind, this article believed that the multiple risk factors, pathogenesis and target organ damage of hypertension are related to the "wind". It pointed out that pathogenic wind is the major risk factor for hypertensionas, and linked the characteristics of carminatives to explore pathogenesis of treatment of hypertension from "wind".

BACKGROUNDThe relationship between monosymptomatic resting tremor (mRT) and Parkinson's disease (PD) remains controversial. In this study, we aimed to assess the function of presynaptic dopaminergic neurons in patients with mRT by dopamine transporter positron emission tomography (DAT-PET) and to evaluate the utility of clinical features or electrophysiological studies in differential diagnosis.

METHODSThirty-three consecutive patients with mRT were enrolled prospectively. The Unified Parkinson's Disease Rating Scale and electromyography were tested before DAT-PET. Striatal asymmetry index (SAI) was calculated, and a normal DAT-PET was defined as a SAI of <15%. Scans without evidence of dopaminergic deficits (SWEDDs) were diagnosed in patients with a subsequent normal DAT-PET and structural magnetic resonance imaging.

RESULTSTwenty-eight mRT patients with a significant reduction in uptake of DAT binding in the striatum were diagnosed with PD, while the remained 5 with a normal DAT-PET scan were SWEDDs. As for UPRDS, the dressing and hygiene score, walking in motor experiences of daily living (Part II) and motor examination (Part III) were significant different between two groups (P < 0.05 and P < 0.01, respectively). Bilateral tremor was more frequent in the SWEDDs group (P < 0.05). The frequency of resting tremor and the amplitude of postural tremor tend to be higher in the SWEDDs group (P = 0.08 and P = 0.05, respectively).

CONCLUSIONSmRT is heterogeneous in presynaptic nigrostriatal dopaminergic degeneration, which can be determined by DAT-PET brain imaging. Clinical and electrophysiological features may provide clues to distinguish PD from SWEDDs.

Adult ; Aged ; Dopamine Plasma Membrane Transport Proteins ; Female ; Humans ; Male ; Middle Aged ; Parkinson Disease ; diagnosis ; Positron-Emission Tomography ; methods ; Prospective Studies ; Tremor ; diagnosis

OBJECTIVETo investigate the incidence, case fatality and risk factors of acute cerebral arterial thrombosis complicated by multiple organ dysfunction syndrome (MODS).

METHODSA retrospective study was conducted in 830 patients with acute cerebral arterial thrombosis, among whom 89 also developed MODS.

RESULTSThe incidence of MODS in these patients was 10.7% with case fatality of 58.4%. The presence of concurrent infection and increased number of organ involved both resulted in higher case fatality. The preceding health status, number of failing organs and score of neurologic impairment were the main fetal factors according to logistic regression analysis.

CONCLUSIONMODS usually occurs in two weeks after the onset of acute cerebral arterial thrombosis. Prevention of MODS involves rigorous treatment of the compromised organs and comprehensive systemic therapy in addition to the management of the primary diseases.

Cerebral Arterial Diseases ; complications ; diagnosis ; epidemiology ; mortality ; Female ; Humans ; Intracranial Thrombosis ; complications ; diagnosis ; epidemiology ; mortality ; Male ; Middle Aged ; Multiple Organ Failure ; complications ; diagnosis ; epidemiology ; mortality ; Prognosis ; Risk Factors

OBJECTIVETo investigate the effects of the Chinese herbal medicines Fructus Lycii and Radix Astragali on the function of the Sertoli cells in the rat testis and their mechanisms.

METHODSSertoli cells from the testes of the SD rats aged 18 - 22 days were isolated and cultured. The effects of Fructus Lycii, Radix Astragali and the combined administration of the two on the proliferation of Sertoli cells in vitro were detected by MTT assay, and their effects on the level of INHbetaB mRNA transcription in Sertoli cells in vitro were investigated in both normal environment and peroxide-damaging environment by RT-PCR.

RESULTSThe proliferation of Sertoli cells was promoted by either Fructus Lycii or Radix Astragali at high concentration (P < 0.05), and significantly promoted by the combined administration at high concentration (P <0.01). Sertoli cell INHbetaB transcription was significantly up-regulated by Fructus Lycii, Radix Astragali and their combined administration in vitro (P < 0.01). When the level of INHbetaB mRNA in Sertoli cells significantly dropped (P < 0.01) in the presence of injury induced by peroxide (H2O2), it could be elevated by Radix Astragali (P < 0.05) and significantly up-regulated by Fructus Lycii or the combined administration in vitro (P < 0.01).

CONCLUSIONFructus Lycii, Radix Astragali and the combined administration of the two could promote and protect INHbetaB mRNA in Sertoli cells in vitro.

Animals ; Astragalus membranaceus ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; pharmacology ; In Vitro Techniques ; Inhibin-beta Subunits ; biosynthesis ; genetics ; Lycium ; Male ; RNA, Messenger ; genetics ; Rats ; Rats, Sprague-Dawley ; Sertoli Cells ; drug effects