Objective To investigate the efficacy of Bifidobacterium triple live bacteria enteric-coated capsules in the adjuvant treatment of patientys with gestational diabetes mellitus(GDM)complicated with depression,and its effect on intestinal flora and inflammatory indicators.Methods A total of 168 patients with GDM complicated with depression were selected and randomly divided into the control group(81 cases,treated with psychological counseling,dietary control and appropriate exercise)and the observation group(87 cases,treated with Bifidobacterium trilactis enteric-coated capsules on the basis of the control group,2 capsules each time,twice a day).Both groups were treated for 1 month continuously.The therapeutic effects were evaluated after treatment.The depression degree of patients was evaluated by Self-Rating Depression Scale(SDS)before treatment and one month after treatment.The fasting blood glucose(FBG)and 2-hour postprandial blood glucose(2 hPG)of patients were detected.The intestinal flora was detected by fluorescence quantitative PCR.The inflammatory indicators serum tumor necrosis factor-α(TNF-α)and serum C-reactive protein(CRP)were detected by enzyme-linked immunosorbent assay and immunoturbidimetry.The neutrophil and lymphocyte counts in peripheral venous blood were detected by automatic blood analyzer,and the neutrophil-to-lymphocyte ratio(NLR)was calculated.The adverse drug reactions were recorded.Results The total effective rate was 96.55%in the observation group,which was higher than that of the control group(87.65%,P＜0.05).After 1 month of treatment,the SDS score,FBG,2 hPG,serum TNF-α,CRP and NLR were decreased in both groups,and those of the observation group were lower than the control group(P＜0.05).One month after treatment,there was no significant difference in the number of intestinal flora compared with that before treatment in the control group.The number of Lactobacillus and Bifidobacterium in the observation group was increased compared with that before treatment,while the number of Escherichia coli and Bacteroides fragilis decreased.After 1 month of treatment,the number of Lactobacillus and Bifidobacterium in the observation group was higher than that in the control group,while the number of Escherichia coli and Bacteroides fragilis was lower than that in the control group(P＜0.01).The adverse reaction rate of the observation group was 3.45%,and there was no significant difference compared with 1.23%of the control group.Conclusion Bifidobacterium triple live bacteria enteric-coated capsules has a good clinical effect in the adjuvant treatment of GDM with depression,which can effectively control blood glucose level,improve intestinal flora,reduce inflammatory reaction and has good safety.

Objective To investigate the efficacy of Bifidobacterium triple live bacteria enteric-coated capsules in the adjuvant treatment of patientys with gestational diabetes mellitus(GDM)complicated with depression,and its effect on intestinal flora and inflammatory indicators.Methods A total of 168 patients with GDM complicated with depression were selected and randomly divided into the control group(81 cases,treated with psychological counseling,dietary control and appropriate exercise)and the observation group(87 cases,treated with Bifidobacterium trilactis enteric-coated capsules on the basis of the control group,2 capsules each time,twice a day).Both groups were treated for 1 month continuously.The therapeutic effects were evaluated after treatment.The depression degree of patients was evaluated by Self-Rating Depression Scale(SDS)before treatment and one month after treatment.The fasting blood glucose(FBG)and 2-hour postprandial blood glucose(2 hPG)of patients were detected.The intestinal flora was detected by fluorescence quantitative PCR.The inflammatory indicators serum tumor necrosis factor-α(TNF-α)and serum C-reactive protein(CRP)were detected by enzyme-linked immunosorbent assay and immunoturbidimetry.The neutrophil and lymphocyte counts in peripheral venous blood were detected by automatic blood analyzer,and the neutrophil-to-lymphocyte ratio(NLR)was calculated.The adverse drug reactions were recorded.Results The total effective rate was 96.55%in the observation group,which was higher than that of the control group(87.65%,P＜0.05).After 1 month of treatment,the SDS score,FBG,2 hPG,serum TNF-α,CRP and NLR were decreased in both groups,and those of the observation group were lower than the control group(P＜0.05).One month after treatment,there was no significant difference in the number of intestinal flora compared with that before treatment in the control group.The number of Lactobacillus and Bifidobacterium in the observation group was increased compared with that before treatment,while the number of Escherichia coli and Bacteroides fragilis decreased.After 1 month of treatment,the number of Lactobacillus and Bifidobacterium in the observation group was higher than that in the control group,while the number of Escherichia coli and Bacteroides fragilis was lower than that in the control group(P＜0.01).The adverse reaction rate of the observation group was 3.45%,and there was no significant difference compared with 1.23%of the control group.Conclusion Bifidobacterium triple live bacteria enteric-coated capsules has a good clinical effect in the adjuvant treatment of GDM with depression,which can effectively control blood glucose level,improve intestinal flora,reduce inflammatory reaction and has good safety.

Objective To study the value of using endoscopy iodine staining combined detecting the expression of p53, survivin and telomerase in the diagnosis of early esophageal carcinoma and precancerous lesions. Methods Three hundred patients who received routine gastrescopy and had high risk of esophageal carcinoma were examined by the iodine dyeing on their esophageal mucosa with 2. 5% Lugol solu-tion. Multiple biopsies were taken from the unstained or light-stained areas when their diameters were over 5mm for pathology diagnosis. The expression of p53, survivin and telomerase were detected by immunohistochemical staining. Results With the Lugol staining method, the incidences of light, moderate and high grade dysplasia and early esophageal carcinoma were 16. 3% ,9. 7% ,3.7% and 4. 3% respectively. The expression of p53, survivin and telomerase were related and the unstained were related to the expression of p53, survivin and telomerase in dysplasia and early esophageal carcinoma. Using endoscopy iodine staining combined testing p53, survivin and telomerase showed sensitiv-ity of 100%, specificity of 92. 3% and accuracy of 91.8% to diagnose of early esophageal carcinoma and high grade dysplasia. Conclusion Lugol solution chromoendscopy combined assay of p53, survivin and telomersse might be useful in the diagnosing early esophageal carcino-ma and precancerous lesion.

The status of current clinical probation teaching is not satisfactory,so it is essential to establish and perfect clinical teaching mode based on laws and guide students to properly handle the relationship among the internship,employment and preparation for the examination for postgraduates,reform the clinical teaching system,strengthen the training and education of medical ethics and quality,integrate the clinical teaching resources and make full use of clinical cases,as well as strengthen the internship management so as to ensure the quality of teaching of clinical internship.

OBJECTIVE: To approach efficacy of Dianning tablet in the treatment of refractoriness epilepsy.METHODS: 180 patients with refractoriness epilepsy were randomized into treatment group,control group Ⅰand control group Ⅱ(n=60).Treatment group were given Dianning tablet produced by our hospital.Control group Ⅰwere treated with carbamazepine tablet and clonazepam tablet while control group Ⅱ were treated with valproate sodium tablet and clonazepam tablet.The efficacies of three groups were compared after 6 months.RESULTS: Treatment group was better than control groups in total effective rate,seizure frequency and improvement of EEG (P