Objective To understand the incidence of abnormal glucose metabolism during pregnancy and the maternal and neonatal outcomes after standard management.Methods A retrospective study of maternal and neonatal outcomes was conducted in 1490 pregnant women who were diagnosed and treated for abnormal glucose metabolism and delivered in the Department of Obstetrics and Gynecology of First Hospital of Peking University from Jan 1995 to Dec 2004 by reviewing the medical records.The selected cases consisted of 79 women with diabetes mellitus(DM group),777 with gestational diabetes mellitus(GDM group),including 355 cases of A1,316 with A2 and 106 cases unclassified,and 634 with gestational impaired glucose test(GIGT group).Maternal and fetal outcomes were analysed in comparison with the controls of 19 013 pregnant women with normal glucose metabolism who delivered during the same period.Results(1)The total incidence of gestational abnormal glucose metabolism was 7.3% and increased gradually from 1995 to 2004.The first stage,from Jan 1995 to Dec 1999,saw a slow increase in the incidence [4.3%(376/8739)];the second stage,from Jan 2000 to Dec 2001,showed a fast increasing trend.The average incidence was 10.8%(445/4133).The incidence in the third stage kept stable at 8.9% (678/7640)from Jan 2002 to Dec 2004.(2)The incidence of macrosomia,preeclampsia and preterm birth were 12.1%(180/1490),9.5%(141/1490)and 9.4%(140/1490),which were significantly higher than those women with normal glucose metabolism(P0.05).(3)The perinatal mortality rate(PMR)of abnormal glucose metabolism group was 1.19%(18/1513)which was significantly higher in the DM group (4.93%)than GDM(1.14%)and GIGT groups(0.78%,P

According to the limited class hours and requirements of medicinary major curriculum application,this paper attempts to make some choice of physical chemistry teaching contents and emphasize on the first class,and also to explore bilingual teaching of partial chapters and experimental teaching.

Objective To evaluate the diagnostic and predict value of procalcitonin (PCT) levels in patients diagnosis of sepsis with immune system defect in the intensive care unit (ICU).Methods This is a retrospective analysis.We enrolled 278 patients diagnosis of sepsis in Emergency ICU,general ICU and Respiratory ICU in Renmin Hospital of Wuhan University from October 2011 to September 2012.Among them,122 patients have normal immune function and 156 patients have auto-immune system diseases or/and requiring corticosteroids or chemotherapy.According to the APACHE Ⅱ score,patients were divided into low-risk group,middle-risk group and high-risk group,and their PCT levels were compared.Logistic regression analysis of the multiple factors was used to screen independent risk factors for predicting 7 days' mortality.The predictive ability was also evaluated and compared between the first time of PCT concentration after admission and dynamic change of PCT within the first week with area under receiver operator's characteristic curve (ROC curve,AUC).Result The results of Spearman correlation analysis showed that there was a significant positive correlation between the patients' PCT concentration and APACHE Ⅱ score (r =0.979,P ＜ 0.05).And there was a positive correlation between the first PCT concentration after admission and 7 days' mortality in-hospital (r =0.826,P ＜ 0.05).Multiple factors logistic regression analysis indicated that both the first time PCT concentration after admission and APACHE Ⅱ score of patients were independent risk factors for predicting 7 days' mortality (PCT OR =1.77,95％ CI =1.28-3.83,P =0.0023).The warning value of 7 days' mortality for patients with normal immune function was PCT≥7.18 ng/ml and for those with abnormal immune function was PCT ≥ 3.52 ng/ml.Compared to dynamic monitoring of PCT,there was no significant difference in sensitivity but specificity is less than the dynamic monitoring of PCT.Conclusions The diagnostic and predict value of procalcitonin (PCT) levels were not affected by the immuno-suppressive therapy.The first time PCT concentration after admission was an independent risk factor for predict of 7 days' mortality in ICU patients with sepsis.The PCT warning value of the sepsis patients with abnormal immune function was much lower compared to those with normal immune function.

Objective To investigate the diagnostic and predict vaIue of procalcitonin (PCT) in ICU patients with sepsis and the correlation between PCT concentration and positive results of bacterial culture.Methods A total of 278 patients with sepsis were admitted into emergency ICU,general ICU and respiratory ICU from October 2011 to September 2012.Of them,193 patients had definite microbial infection evidence.Serum PCT levels among groups of different pathogens were compared.The analysis of correlation between the PCT concentration of the first assay was got after admission and short-term prognosis was evaluated.The correlation between PCT level and positive results of bacterial culture was also evaluated.Results Spearman correlation analysis showed that serum PCT levels of bacterial infections in patients with sepsis were significantly higher than those of the non-bacterial infections in patients with sepsis (P =0.001).And there was a positive correlation between the PCT concentration of the first specimen after admission and 7-day in-hospital mortality in patients with sepsis due to bacterial infections (r =0.277,P =0.004).The patients with PCT levels greater than 2 ng/ml had high vulnerability to bacterial infection Conclusions The PCT concentration of the first assay after admission was positively correlated to 7-day mortality in ICU patients with sepsis due to bacterial infections.The serum PCT concentration indicated the severity of host response to the bacterial infection.And etiological evidence directly showed pathogenic factors.Both of PCT and etiological evidence related to bacterial infection,reflected different aspects of bacterial infection.

OBJECTIVE:To establish the method for determining the contents of protocatechuic acid,rutin,gallic acid and kaempferol in Uygur medicine Capparis spinosa. METHODS:HPLC was performed on the column of Agilent C18 with the mobile phase of acetonitrile-0.1% phosphoric acid solution(7∶93,V/V)at the flow rate of 1.0 ml/min,the detection wavelength was 327 nm,column temperature was 30 ℃ and volume was 10 μl. RESULTS:The linear range was 0.260 0-50.0 μg for protocatechuic ac-id(r=0.995 6),3.109 0-102.0 μg for rutin(r=0.999 9),1.018 0-40.0 μg for gallic acid (r=0.998 9) and 0.063 0-36.0 μg for kaempferol(r=0.998 8);RSDs of precision,stability and reproducibility tests were all no more than 1.20%;average recoveries were respectively 101.51%(RSD=1.85%,n=6),99.70%(RSD=1.23%,n=6),98.28%(RSD=1.86%,n=6) and 100.97%(RSD=1.74%,n=6). CONCLUSIONS:The method is specific,and can fast and accurately determine the contents of protocate-chuic acid,rutin,gallic acid and kaempferol in Uygur medicine C. spinosa.

Objective To study the effects of different dose 6 MV and 10 MV photons for classic conformal radiotherapy on cervical cancer patients with different height and weight,in order to provide guidance for clinical irradiation energy choosing for different patients.Methods Twenty-one recruited patients were divided into obese and non-obese group according to the body mass index (BMI).The 4-field classic conformal radiotherapy plans was designed and applied in both groups and the results were compared.Statistical analysis was carried out on the dosimetric parameters.Results The treatment plan of 10 MV photons could both reduce the maximum and minimum dose (Dmax and Dmin) of the target area PTV and increase the conformal and heterogeneity index (CI and HI),and change the median dose (D50) for non-obese patients,while it could not reduce the mean dose (Dmeen) for two groups.It was more effective in reducing Dmax and increasing HI for obese patients.The plan could also reduce the dose of organs at risk (OAR) near the PTV.Using 10 MV photons plan could more effectively reduce the low isodose volume of the patients and machine hops.Conclusions The 10 MV photons plan has many advantages in classic conformal radiotherapy for obese cervical cancer treatment.

Objective To assess the value of endoluminal convex array probe combined with high frequency linear array probe in diagnosis of internal carotid artery occlusion, and to improve the diagnostic accuracy rate of ultrasonography. Methods Patients suspected with ischemic cerebrovascular disease (n=490) were examined by carotid ultrasound. First, suspicious patients with carotid artery occlusion were selected using high-frequency linear array probe, then screen results were confirmed by endoluminal convex array probe and compared with previous results in those patients. Results Sixty eight patients,who were suspected of internal carotid artery occlusion,were screened out by high-frequency linear array probe. Results were re-examined by endoluminal convex array probe, 42 patients were diagnosed as internal carotid artery occlusion, 19 patients were diagnosed as severe stenosis as the internal carotid artery and 7 patients were diagnosed as ca?rotid artery tortuosity with no significant stenosis. Conclusion Endoluminal convex array probe is an effective complement for internal carotid arterial inspection when it combines with high-frequency linear probe. It can improve the diagnostic accu?racy rate of degree and the range in internal carotid artery occlusion and stenosis, therefore reduce chances of misdiagnosis.

Objective To study the changes of gastrin 17 (G17) and pepsinogen (PG) after gastric bypass surgery in gastric antrum resection, and the influences of different surgical methods on postoperative peptic ulcer. Methods Clinical data of 63 patients with gastric bypass surgery in our hospital from October 2013 to October 2015 were divided into resection of pyloric antrum group (n=33) and preserved pyloric antrum group (n=30). The values of G17, PGⅠ, PGⅡand PGⅠ/PGⅡwere detected by enzyme linked immunosorbent assay at 1 month, 6 months and 12 months after operation. The correlation between the different surgical methods and the incidence of peptic ulcer was analyzed between two groups. Results The G17 levels were significantly decreased in resection of pyloric antrum group 6 and 12 months after operation than those in preserved pyloric antrum group (P<0.05). Compared with preserved pyloric antrum group,PGⅠ and PGⅡ levels was significantly decreased 12 months after operation (P<0.05). There was no significant difference in the ratio PGⅠ/PGⅡat 1 month, 6 months and 12 months after operation between two groups (P>0.05). There was no significant difference in postoperative peptic ulcer between two groups (P>0.05). Conclusion Gastric bypass after resection of the pyloric antrum can reduce the postoperative secretion of G17, PGⅠ and PGⅡ, but which can not reduce the incidence of postoperative anastomotic ulcer.

Objective To investigate the influential factors of brachial-ankle artery pulse wave velocity (baPWV) in healthy individuals.Methods Total 716 healthy subjects including 503 males and 213 females,who underwent health check up in 2010,were enrolled in the study Bilateral baPWV was examined in all subjects and multiple factor linear regression was applied to evaluate the correlations of baPWV with sex,age,body mass index,arterial blood pressure,ankle-brachial index and biochemical variables.Results The mean baPWV of 716 healthy subjecs was ( 1224 ± 162) cm/s,and there was significant difference between men and women [ ( 1257 ± 159) cm/s vs.( 1144 ± 143) cm/s].There was a significant linear correlation of baPWV with sex,age,mean arterial blood pressure and plasma homocysteine concentration ; and the linear regression equation was:mean PWV =6.635 × age + 7.285 × mean arterial blood pressure + 2.682 × homocysteine concentration - 64.334 × sex + 347.500 ( sex:man =0,woman =1 ).Conclusion Age,sex,mean arterial blood pressure and plasma homocysteine concentration are independent influential factors of baPWV.