Objective:To investigate the effects of obesity before pregnancy and excessive weight gain during pregnancy on the characteristics of offspring metabolism and the underlying mechanism.Methods:Pregnant women who delivered from April 2016 to December 2018 in Jiaxing Xiuzhou District Maternal and Child Health Hospital after providing written informed consent and their singleton newborns were considered for recruitment for this study. Finally, 2000 pregnant women and their newborns were included in this study. These pregnant women were divided into study control ( n = 1 576, normal body weight) and ( n = 424, overweight) groups according to their body mass before and during pregnancy. The levels of leptin, blood lipid, fasting blood glucose, fasting insulin, long form of leptin receptor (OB-Rb), suppressor of cytokine signaling 3 (SOCS3) gene expression, insulin resistance index, and insulin sensitivity index were compared between the control and study groups. Results:The body mass index before pregnancy and body mass during pregnancy in the study group were (30.91 ± 1.86) kg/m 2 and (21.25 ± 2.61) kg, respectively, which were significantly higher than those in the control group [(26.87 ± 1.05) kg/m 2, (14.57 ± 1.36) kg, t = 7.972, P = 0.013; t = 9.786, P = 0.001]. The levels of leptin, triglyceride, total cholesterol and low-density lipoprotein cholesterol in the study group were (1.23 ± 0.29) ng/mL, (0.65 ± 0.16) mmol/L, (1.40 ± 0.24) mmol/L, (0.76 ± 0.13) mmol/L, respectively, which were significantly higher than those in the control group [(0.63 ± 0.11) ng/mL, (0.38 ± 0.16) mmol/L, (1.13 ± 0.32) mmol/L, (0.56 ± 0.09) mmol/L, t = 7.701, P = 0.010; t = 7.329, P = 0.019; t = 5.734, P = 0.030; t = 9.387, P = 0.001]. The level of high-density lipoprotein cholesterol in the study group was significantly lower than that in the control group [(1.26 ± 0.17) mmol/L vs. (1.75 ± 0.26) mmol/L, t = 8.072, P = 0.008]. The expression of SOCS3 mRNA and OB-Rb mRNA in newborns from the study group was (1.44 ± 0.29) and (1.33 ± 0.39), respectively, which was significantly greater than that in the control group [(0.33 ± 0.19), (0.50 ± 0.21), t = 9.987, P < 0.001; t = 11.037, P < 0.001]. Fasting blood glucose and fasting insulin levels as well as insulin resistance index in the study group were (22.06 ± 3.94) mmol/L, (20.02 ± 4.61) mU/L, (19.79 ± 6.29) respectively, which were significantly higher than those in the control group [(11.73 ± 2.92) mmol/L, (13.31 ± 3.43) mU/L, (6.96 ± 2.52), t = 8.133, P = 0.001; t = 4.498, P = 0.027; t = 7.352, P = 0.002]. Insulin sensitivity index in the study group was significantly lower than that in the control group [(-6.07 ± 0.32) vs. (-4.98 ± 0.37), t = 8.244, P < 0.001]. Conclusion:Obesity before pregnancy and excessive weight gain during pregnancy will increase the expression of SOCS3 mRNA and further affect the expression of STAT3-SOCS3-leptin/insulin signaling pathway in offspring.

Objective:To investigate the clinical curative effect of closed reduction and internal fixation of Jakob type II lateral humeral condyle fractures in children under ultrasound guidance.Methods:A retrospective case series analysis was made on clinical data of 59 patients with Jakob type II lateral humeral condyle fractures treated at Children's Hospital of Chongqing Medical University from August 2016 to August 2017. There were 30 males and 29 females, with the age of 1.5-8.1 years [(4.0±1.8)years]. There were 34 patients treated by open reduction and internal fixation and monitored by the X-ray (control group), and 25 patients treated by closed reduction and internal fixation and monitored by ultrasound (study group). The operation time, bleeding volume, fracture healing time, and incidence of complications were compared between the two groups. The elbow joint function was evaluated by Broberg and Morrey standard at the latest follow-up.Results:All patients were followed up for 17-31 months[(23.2±4.2)months]. The operation time and bleeding volume in control group were (50.7±22.2)minutes and (6.1±3.8)ml, obviously higher than those in study group [(21.4±3.3)minutes, (1.1±0.3)ml] ( P<0.05). The fracture healing time was (8.0±0.8)weeks in control group and (7.8±0.7)weeks in study group ( P>0.05). According to the Broberg and Morrey standard, the good and excellent rate of elbow joint function in control group was 97%, with excellent results in 31 patients, good in 2, fair in 1, and poor in 0; the good and excellent rate of elbow joint function in study group was 100%, with excellent results in 22 patients, good in 3, fair in 0 and poor in 0 ( P>0.05). In study group, wound infection or malunion was not seen, and only two patients showed postoperative wire tail irritability and recovered after the removal of wires. While in control group, wound infection was seen in 3 patients and malunion was observed in 2 patients, but all patients were with distal humerus lateral bone formations. The incidence of complications was 15% in control group, higher than 0% in study group ( P<0.05). Conclusion:Compared to open reduction internal fixation, ultrasound-guided closed reduction and internal fixation of Jakob type Ⅱ lateral humeral condyle fractures in children has similar therapeutic effect, but it can shorten operation time and reduce bleeding and complications.

OBJECTIVETo explore the value of nutrition management in obese patients with type 2 diabetes mellitus(T2DM) after laparoscopic sleeve gastrectomy(LSG).

METHODSClinical data of 22 obese T2DM patients undergoing LSG from March 2013 to July 2015 in Fudan University Pudong Medical Center were collected. All the patients strictly followed the specialized instruction by nutritionists: diabetic and low calorie diet 3347.2 to 5020.8 kJ (800 to 1200 kcal) per day before the operation; low calorie liquid diet 2510.4 kJ(600 kcal) per day before operation for promoting gastric emptying; fasting diet before postoperative ventilation; clear liquid diet 1673.6 to 2510.4 kJ (400 to 600 kcal) per day after postoperative ventilation (liquid intake >2000 ml); low fat liquid diet 2928.8 to 3765.6 kJ (700 to 900 kcal) per day (protein 60 g per day at least, 2000 ml liquid) 2 weeks after the operation; semi-liquid diet 1 month after operation and gradually normal diet. All the 22 patients were followed up at 1 week, 1, 3, 6 months after operation on time. Changes of body weight, waist circumference, hip circumference, body mass index(BMI), blood glucose indexes induding fasting blood glucose(FBG), 2-hour postparandial blood glucose(PBG), fasting C-peptide, 2-hour postprandial C-peptide, fasting serum inculin(FINS), 2-hour postprandial inculin(INS), HbAlc, blood pressure and blood lipid indexes were observed and analyzed before and 1 week, 1, 3, 6 months after operation.

RESULTSThe average age of 22 patients (10 men and 12 women) was 38.6 years (18 to 66 years). The duration of diabetes varied from 1 month to 15 years. Comorbidity included 12 patients of high blood pressure, 14 of fatty liver, 1 of coronary heart disease, 1 of gout, 1 of chronic thyroiditis and 1 of menstrual disorder. LSG was performed successfully in all the patients and no severe complications and transference to laparotomy occurred. As compared to pre-operation, at 6 months after operation, the average body weight decreased from (103.9±20.2) kg to (80.9±12.6) kg (t=6.294, P=0.000), waist circumference from (118.6±13.8) cm to (96.4±8.0) cm (t=6.331, P=0.000), hip circumference from (116.9±12.6) cm to (104.0±7.7) cm (t=3.854, P=0.000), BMI from (36.2±5.9) kg/mto (27.9±3.5) kg/m(t=5.630, P=0.000), showing a decreasing trend over time. There was no underweight patient after 6 months follow-up. As compared to pre-operation, at 6 months after operation, the average FBG reduced from (7.4±1.4) mmol/L to (6.0±0.9) mmol/L (t=3.172, P=0.003), 2 h PBG from (14.1±4.9) mmol/L to (7.5±2.2) mmol/L (t=7.026, P=0.000), FINS from (160.0±71.9) mIU/L to (43.8±20.8) mIU/L (t=7.259, P=0.000), 2-hour postprandial INS from (437.6±261.4) mIU/L to (140.5±104.6) mIU/L (t=5.858, P=0.000), fasting C-peptide from (1.1±0.6) μg/L to (0.7±0.3) μg/L (t=3.560, P=0.000), 2-hour postprandial C-peptide from (2.5±0.9) μg/L to (1.5±0.7) μg/L (t=3.865, P=0.000), HbAlc from (8.0±1.6)% to (5.9±0.6)% (t=5.953, P=0.000), showing a decreasing trend over time except FBG, 2h postprandial C-peptide and HbAlc(all P<0.05). FBG and 2-hour PBG of 16 patients returned to normal 3 months after the operation. Blood pressure and trigly ceride decreased obviously 6 months after operation compared to pre-operation with significant difference(P<0.05). At 6 months after operation, blood pressure of 8 comorbidity patients with high blood pressure became normal (8/12, 66.7%) and of 4 patients improved(4/12, 33.3%); B ultrasound examination revealed normal in 11 comorbidity patients with fatty liver(11/14,78.6%) and improvement in 3 patients (3/14,15.4%). Blood uric acid of the gout patient and the menstruation of the menstrual disorder patient returned to normal 3 months and 1 month after the operation respectively.

CONCLUSIONAs for obese patients with T2DM undergoing LSG, reasonable nutrition management is helpful to decrease body weight, and to obtain an ideal improvement of blood glucose and blood lipid levels.

Adolescent ; Adult ; Aged ; Bariatric Surgery ; Blood Glucose ; physiology ; Body Weights and Measures ; C-Peptide ; blood ; physiology ; Caloric Restriction ; Combined Modality Therapy ; Comorbidity ; Coronary Disease ; complications ; Diabetes Mellitus, Type 2 ; complications ; therapy ; Diet Therapy ; methods ; Diet, Diabetic ; Endoscopy ; Fatty Liver ; complications ; surgery ; Female ; Food, Formulated ; Gastrectomy ; Glycated Hemoglobin A ; physiology ; Gout ; complications ; surgery ; Hashimoto Disease ; complications ; Humans ; Hypertension ; complications ; surgery ; Insulin ; blood ; physiology ; Lipids ; blood ; physiology ; Male ; Menstruation Disturbances ; complications ; surgery ; Middle Aged ; Obesity ; complications ; therapy ; Perioperative Care ; methods ; Thyroiditis ; complications ; Treatment Outcome ; Triglycerides ; blood ; physiology

cleaning and disinfection.Results All 28 surveyed medical institutions had separate endoscope disinfection rooms, 89.29% of which had integrated endoscopic cleaning station,17.86% had automatic endoscope washer/disinfector;100% used multi-enzymatic detergent,chose the right disinfectant,monitored disinfectant concentration every day, and implemented standard disinfection time.But only 39.29% changed multi-enzymatic detergent for each endo-scope,cleaning and disinfection personnel in 78.57% of medical institutions wore personal protective equipment correctly.77 digestive endoscopes were detected,the qualified rate was 88.31%.Conclusion Cleaning and disin-fection management of digestive endoscope in secondary and above medical institutions in Suzhou City is generally standardized,there are still some problems in the manipulation procedures,relevant national regulations should be strictly complied with,efficacy of cleaning and disinfection of digestive endoscope should be further improved.

Objective: To investigate the feasibility of multiplex real-time RT-PCR with fluorescent probes in early screening of Ph-like acute lymphoblastic leukemia (ALL) and analyze the clinical feature and prognos. Method: A total of 118 adult B-ALL patients diagnosed between October 2010 and March 2016 were enrolled in this study. Multiplex RT-PCR was used to detect the Ph-like ALL related fusion gene and CRLF2 expression in 58 BCR-ABL and MLL rearrangement negative patients. The clinical features, treatment response and prognosis were analyzed in Ph-like fusion gene positive and/or CRLF2 over-expression patients. Result: Among 58 patients, 9 patients (9/58, 15.5%) showed Ph-like ALL related fusion genes positive and 10 patients (10/58, 17.2%) showed CRLF2 over-expression. There were statistical differences in age, WBC count, immunophenotypes, cytogenetics and risk stratification among Ph-like fusion gene positive or CRLF2 over-expression patients, Ph⁺ patients, MLL⁺ patients and B-other patients. The 2-year overall survival rates were 65%, 47%, 64% and 74% respectively among these four groups (P=0.043) . The 2-year relapse free survival rates were 51%, 39%, 62% and 70% respectively among these four groups (P=0.010) . Conclusion Routine screening of Ph-like ALL by multiplex RTPCR is feasible.

Objective To explore the efficacy of comprehensive community-based rehabilitation on chronic schizophrenia and assess in the view of health economy. Methods 80 chronic schizophrenic patients accepted comprehensive community-based rehabilitation for 1 year and were followed up for 1 year. Other 80 chronic schizophrenics were as the controls. They were observed with outcome and the cost. Resultsn The social function, compliance, stability rate, burden on family caregiver, satisfaction of living, psychiatric symptoms, hospitalization were all better in the rehabilitation group than in the control group (P<0.01), and the total cost in the 2 years was less, especially that on hospitalization,maintenance treatment, work loss of caregivers, public prevention (P<0.01). Conclusion Comprehensive community-based rehabilitation can improve the outcome of chronic schizophrenics with less cost.

ObjectiveTo investigate the effect of focal ischemic preconditioning (IPC) on the expression of protein kinase-like endoplasmic reticulum kinase ( PERK ) and glucose-regulated protein 78 (GRP78) mRNA and protein after focal cerebral ischemia/reperfusion (I/R) in rats.MethodsAll 120 male SD rats were randomly divided into three groups: sham-operation group,middle cerebral artery occlusion (MCAO) group and brain ischemia preconditioning (BIP) group.Each group was further divided into 4 subgroups according to 12 h,1,2 and 3 d after I/R.The IPC models were made in order to measure the expression of PERK,GRP78 mRNA and protein by in situ hybridization and Western blot,and the apoptosis rate of neuron by flow cytometry. Results ①The expression of PERK mRNA increased and reached the peak at 12 h,then decreased continuously after 1 d.BIP could decrease its expression.The expression of PERK protein increased at 12 h and reached the peak at 24 h,then decreased continuously after 2 d.BIP could decrease its expression.②The expression both of GRP78 mRNA and its protein all increased and reached the peak at 12 h,then decreased continuously.BIP could increase their expression (mRNA:12 h: 136.70±9.53,F=32.265; 24 h:147.54 ±9.97,F=54.920; 2 d:158.16 ±9.44,F=45.374; 3d: 165.85±10.26,F=16.493,P＜0.05; protein:12 h: 1.319±0.116,F=5.619,P＜0.05; 24 h: 1.226±0.108,F=33.742,P＜0.01; 2 d:1.183 ±0.112,F =46.556,P ＜0.01; 3 d:1.115± 0.098,F =11.730,P＜0.05).③The rate of apoptosis neuron of rats in MCAO increased markedly at 12 h after reperfusion,and reached the peak at 1 d,then decreased continuously.BIP could decrease the rate of apoptosis neuron. Conclusion BIP can protect neurons through inhibiting the expression of PERK and inducing the expression of GRP78 after endoplasmic reticulum stress in rats.

Objective To study the antitumor effect and the mechanism of the polysaccharide from Gloipeltis furcata on H_(22),tumor bearing mice.Methods The polysaccharides from Gloipeltis furcata were administered by oral route in mice bearing H_(22) tumor.The treatments lasted for 7 days.The inhibition rate against H_(22) tumor and the indices of thymus, spleen and liver were measured.In addition,the levels of antibodies against H_(22) tumor and GPT in serum,and GPT,GOT,MDA and SOD in liver were measured using commercially available kits.Results The administration of the polysaccharides from Gloipeltis furcata(200 mg?kg~(-1)?d~(-1) and 400 mg?kg~(-1)?d~(-1) ) for 7 days,the inhibition rates of H_(22) tumor were 35.64%(P

AIM:To observe the effect of Jianwei Yuyang Granule(Radix Bupleuri,Radix Codonopsis,Rhizoma Atractylodis macrocephalae,Rhizoma Corydalis,etc.) on the expressions of PS_2 and platelet activating factor(PAF) of helicobacterpylori-associated gastritis and study the potential mechanisim. METHODS:80 cases were divided into two groups.Jianwei Yuyang Granule group(42 cases) was given Jianwei Yuyang Granule and the control group(38 cases) was given three kinds of western medicines combined.H.pylori was detected by urease test on biopsy specimen of gastric mucosa and Warthin-Starry method and the changes of expressions of PS_2 and platelet activating factor(PAF) were observed.The contents of aninohexose and phosphatide in gastric mucosa were determined at the same time.All patients were rechecked gastroscope in the 6th week. RESULTS:The total effect rate of Jian-wei Yuyang group was higher than that of the control group(P

AIM: To investigate the potencional mechanism of Sea Buckthorn Procyanidins(SBPC) against peptic ulcer. METHODS: 72 gastric ulcer patients(final diagnosis by gasroscope),were randomly divided into two groups,including Sea Buckthorn Procyanidins(SBPC) treatment group(36 cases),and Ranitidine control group(36 cases),among them,50 Hp-positive PU patients were confirmed by endoscopy,histological instection,urease test.Normal group was 12 cases.Detection on Biospy specimens of gastric mucosa was used to observe the change of ITF for Immunohischemical,PS_2 for western blotting and the contents of aninohexose and phosphatide in ulcerated gastric mucosa. RESULTS: The contents of aninohexose,phosphatide of PU patients increased in sea buckthorn procyanidins(SBPC) group.There was a linear correlation between the contents of phosphatide,aninohexose and the expression of ITF、PS_2 in PU patients(P