Metabolic Disease Management Guideline for National Metabolic Management Center(2nd edition) / 中华内分泌代谢杂志

The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.

Effects of 21-hydroxylase deficiency on male fertility / 中华内分泌代谢杂志

Congenital adrenal hyperplasia(CAH) is a group of autosomal recessive disorders caused by deficiency of specific enzymes in the adrenocortical hormone synthesis pathway, resulting in impaired corticosteroid synthesis. 21-hydroxylase deficiency is the most common type of CAH, and the disorder can lead to impaired fertility in patients. Most current studies have focused on fertility problems in female CAH patients. The most common causes of impaired fertility in men with 21-OHD include testicular adrenal rest tumors(TART), low gonadotropin secretion, and inappropriate glucocorticoid therapy. This article reviews the causes of impaired fertility and its treatment in male patients with 21-OHD, with the aim of providing guidance for improving the fertility of male patients with 21-OHD.

Analysis on the industry characteristics of newly diagnosed occupational pneumoconiosis in Foshan City， 2007-2021 / 中国职业医学

@#Abstract: Objective To analyze the industry characteristics of new occupational pneumoconiosis in Foshan from 2007 to Methods 2021. The data of new cases of occupational pneumoconiosis in Foshan City from 2007 to 2021 were obtained from “ ” ， “ the China Disease Prevention and Control Information System subsystem the Occupational Disease and Health Hazardous ”， Results Factors Monitoring Information System and the industry characteristics of the cases were analyzed. From 2007 to ， ， （ ） 2021 there were 886 new cases of occupational pneumoconiosis in Foshan mainly include silicosis 68.3% in males （ ）， （ ） 94.2% and stage Ⅰ pneumoconiosis cases 75.9% . The median age of cases at the time of diagnosed disease was 47 years ， old and the median working age of dust exposure was 11.2 years. The enterprises where all cases are located involve eight top ， ； ， - industry categories of which manufacturing industry accounted for 97.6% and 30 major industry categories of which non （ ） ， metallic mineral products industry was the highest 60.5% . There were 554 sporadic cases and 332 cluster cases and the ， ， Conclusion industries were mainly non-metallic mineral products accounting for 55.0% and 69.6% respectively. ， - Occupational pneumoconiosis in Foshan is dominated by silicosis and the key industries are non metallic mineral products.

Controlled clinical trial with the combination therapy with metformin, thiazolidinediones, glucagon-like peptide 1 analog in patients with type 2 diabetes and metabolic syndrome / 中华内分泌代谢杂志

Objective@#The aim of this study was to compare the efficacy and safety of metformin/thiazolidinediones (TZDs) / glucagon-like peptide 1 (GLP-1) analogs (triple therapy) with conventional glucose-lowering therapy(conventional therapy) for patients with type 2 diabetes and metabolic syndrome.@*Methods@#A prospective randomized-controlled 26-week study was carried out. A total of 82 patients with type 2 diabetes and metabolic syndrome were randomized to receive either triple therapy protocal or just conventional therapy, altogether with 41 cases in each group.@*Results@#HbA1C value was significantly reduced in triple therapy group versus the conventional therapy group [(2.23±1.75)% vs (1.48±1.59)%, P<0.05]. Values of body mass index, waist circumference, and visceral fat area were significantly reduced in triple therapy group as compared to those of conventional therapy group [(2.50±1.81 vs 0.92±1.82)kg/m2, (6.75±4.92 vs 1.66±3.25)cm, (24.10±19.10 vs 10.02±20.10)cm2, all P<0.01, respectively]. Control rates of HbA1C and fasting plasma glucose for triple therapy were higher than those for conventional therapy (both P<0.05). No hypoglycemia occurred in triple therapy group. Subjects receiving triple therapy experienced more frequent gastrointestinal side effects than those in conventional therapy group (18.87% vs 3.92%, P<0.05). The most common side event was mild nausea (90%).@*Conclusion@#Combination therapy with metformin/TZDs/GLP-1 analogs had statistically significant advantages in the control of body weight, waist circumference, and visceral fat area in addition to the control of blood glucose over conventional glucose-lowering therapy in our patient cohort, it seems to be an optimized therapeutic regimen for patients with type 2 diabete and metabolic syndrome.

Controlled clinical trial with the combination therapy with metformin, thiazolidinediones, glucagon-like peptide 1 analog in patients with type 2 diabetes and metabolic syndrome / 中华内分泌代谢杂志

Objective The aim of this study was to compare the efficacy and safety of metformin/thiazolidinediones (TZDs) / glucagon-like peptide 1 (GLP-1) analogs (triple therapy) with conventional glucose-lowering therapy ( conventional therapy ) for patients with type 2 diabetes and metabolic syndrome. Methods A prospective randomized-controlled 26-week study was carried out. A total of 82 patients with type 2 diabetes and metabolic syndrome were randomized to receive either triple therapy protocal or just conventional therapy, altogether with 41 cases in each group. Results HbA1C value was significantly reduced in triple therapy group versus the conventional therapy group [(2.23 ± 1.75)％ vs (1.48 ± 1.59)％, P<0.05]. Values of body mass index, waist circumference, and visceral fat area were significantly reduced in triple therapy group as compared to those of conventionaltherapygroup[(2.50±1.81vs0.92±1.82)kg/m2,(6.75±4.92vs1.66±3.25)cm,(24.10±19.10vs 10.02±20.10)cm2, all P<0.01, respectively]. Control rates of HbA1C and fasting plasma glucose for triple therapy were higher than those for conventional therapy ( both P<0. 05 ) . No hypoglycemia occurred in triple therapy group. Subjects receiving triple therapy experienced more frequent gastrointestinal side effects than those in conventional therapy group ( 18. 87％ vs 3. 92％, P<0. 05 ) . The most common side event was mild nausea ( 90％) . Conclusion Combination therapy with metformin/TZDs/GLP-1 analogs had statistically significant advantages in the control of body weight, waist circumference, and visceral fat area in addition to the control of blood glucose over conventional glucose-lowering therapy in our patient cohort, it seems to be an optimized therapeutic regimen for patients with type 2 diabete and metabolic syndrome.

A multicenter study on the clinical features and risk factors of poor prognosis in neonatal necrotizing enterocolitis / 中华实用儿科临床杂志

Objective To explore the clinical features and risk factors of poor prognosis in neonatal necrotizing enterocolitis(NEC).Methods A retrospective study was carried out in the infants with NEC admitted to 6 cooperative hospitals in Guangdong Province between January 2005 and December 2014.The clinical features and risk factors of poor prognosis in preterm and full-term infants diagnosed NEC,early onset and late onset NEC were analyzed.Results A total of 449 cases who met the criteria were admitted during the study time.The mortality was 23.6％ (106/449 cases),of which the preterm group was 24.6％ (58/238 cases) while the full-term group was 22.7％ (48/211 cases),the early onset group was 22.1％ (45/204 cases) while the late onset group was 24.3％ (57/235 cases).The median number of NEC onset in preterm group was 11 d after birth while the number of the full-term group was 6 d.Full-term infants who diagnosed NEC were more likely to manifest themselves as abdominal distension (52.1％ vs.42.0％,x2 =4.597,P =0.032),vomiting(36.5％ vs.17.2％,x2 =21.428,P =0.000) and bloody stool(30.3％ vs.21.4％,x2 =4.653,P =0.031);but in the onset of NEC,preterm infants more likely to have feeding intolerance (21.0％ vs.12.8％,x2=5.309,P =0.021).The early onset group of full-term NEC was much common in twins or multiplets(9.4％ vs.1.1％,x2 =6.226,P =0.013),which rate of surgical therapy was much higher (41.0％ vs.27.0％,P =0.036) and the breast-feeding rate before NEC was lower than the late onset group(14.5％ vs.32.6％,x2 =9.500,P =0.002),the differences were statistically significant.The gestational age and birth weight were bigger in the early onset group of preterm NEC[(33.8 ±2.5) weeks vs.(32.2 ±2.8) weeks,t =4.261,P =0.000;(2.1 ±0.5) kg vs.(1.7 ± 0.5) kg,t =4.735,P =0.000)],but length of stay was shorter than the late onset group (18.0 d vs.26.5 d,P =0.000).Logistic regression analysis showed that the risk factors of poor prognosis of full-term NEC were shock,peritonitis and sepsis;while risk factors of poor prognosis of preterm NEC were small for gestational age infant,pulmonary hemorrhage,shock,intestinal perforation and sepsis;the risk factors of poor prognosis of the early onset group of full-term NEC was shock;while those of the late onset group were shock and peritonitis;the risk factors of poor prognosis in the early onset group of preterm NEC were shock and sepsis,while those in the late onset group were pulmonary hemorrhage,shock,intestinal perforation and sepsis.Conclusions Compared to the preterm NEC,the onset time of full-term NEC was earlier and the clinical manifestations were more typical.Early identification and management of shock,peritonitis,intestinal perforation,sepsis and pulmonary hemorrhage can reduce the risk of poor prognosis of neonate NEC.

Composition of gut microbiome in neonates with severe hyperbilirubinemia and its effect on bilirubin brain injury / 中华实用儿科临床杂志

Objective To study the composition of gut microbiome in neonates with severe bilinebinemia (serum total bilirubin ＞ 342 μmol/L),and to explore the relationship between gut microbiome and bilirubin brain injury.Methods A prospective study was conducted.The neonates with serum total bilirubin ＞ 342 μmol/L from September 2016 to March 2017 in Guangzhou Women and Children's Medical Center,Guangzhou Medical University,were enrolled in the study and 16S rDNA sequence analysis technology was used to detect the composition of gut microbiome in all subjects.According to the results of brain magnetic resonance imaging (MRI),brain stem auditory evoked potential (BAEP) and clinical manifestations,the subjects were divided into the brain injury group (26 cases) and no brain injury group (28 cases).The differences of the composition of gut microbiome between the 2 groups were compared,and the levels of unconjugated bilirubin in serum and cerebrospinal fluid were also compared.Results The level of unconjugated bilirubin in serum of the brain injury group was (463.51 ± 110.62) μmol/L,but in no brain injury group was(364.18 ±63.13) μmol/L,and there was significant difference between the 2 groups(t =4.090,P =0.000 1).The level of unconjugated bilirubin in the cerebrospinal fluid of the brain injury group was (9.53 ± 2.68) μmol/L,but in no brain injury group was (6.94 ± 2.31) μmol/L,and there was significant difference between the 2 groups (t =3.812,P =0.000 3).There was no correlation between the level of unconjugated bilirubin in the cerebrospinal fluid and serum between the 2 groups(r =0.137,0.081,all P ＞0.05).The abundance of gut microbiome in the brain injury group was lower than that in no brain injury group in genus level,among which Fusobacterium,Catabacter,Succinivibrio,Clostridium and Bacteroides were significantly different (all P ＜ 0.05).Conclusions The occurrence of bilirubin brain injury depends on the level of unconjugated bilirubin in serum cerebrospinal fluid,but it may be more directly dependent on the level of bilirubin in the cerebrospinal fluid.The diversity of gut microbiome in neonates with bilirubin brain injury was significantly lower than that in no brain injury group.The level of unconjugated bilirubin in cerebrospinal fluid may be related to the different blood-brain barrier permeability caused by different composition of gut microbiome.

Clinical Observation of Milrinone Injection in the Treatment of Hypertensive Heart Disease Complicated with Heart Failure / 中国药房

OBJECTIVE:To observe therapeutic efficacy and safety of Milrinone injection in the treatment of hypertensive heart disease complicated with heart failure. METHODS:A total of 120 patients with hypertensive heart disease complicated with chronic heart failure were randomized into control group and observation group according to random number table,with 60 cases in each group. Control group received routine therapy,including blood pressure controlling,anti-heart failure and other symptomatic treatment;observation group was additionally given Milrinone injection 0.3 mg/kg,continuous pump,qd. A treatment course lasted for 5 d. Both groups received one course of treatment each month for consecutive 6 months. Both groups were followed up for one year. 6 min walking distance(6MWD),BNP,LVEF,CI,LVEDD,heart rate,sitting systolic blood pressure(SiSBP)and sitting diastolic blood pressure(SiDBP),re-hospitalization rate and cardiovascular mortality were observed in 2 groups before treatment, after 3,6 months and 1 year of treatment;therapeutic efficacy of heart function and the incidence of ADR were compared between 2 groups. RESULTS:Before treatment,there was no statistical significance in 6MWD,BNP,LVEF,CI,heart rate,SiSBP and SiDBP between 2 groups;after 3 months,6 months and 1 year of treatment,6MWD,LVEF and CI of 2 groups were increased significantly,while BNP,LVEDD,resting heart rate,SiSBP and SiDBP were decreased significantly;the observation group was significantly better than the control group,with statistical significance(P0.05). There were no statistical signifi-cance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Milrinone injection shows good efficacy in the treatment of hypertensive heart disease complicated with heart failure,can significantly reduce BNP and re-hospitalization rate as well as improve prognosis with good safety.

The Relationship between Thyroid Hormone and Purine Metabolism and Body Weight in Patients with Type Ⅱ Diabetes and Normal Thyroid Function / 昆明医科大学学报

Objective To investigate the relationship between thyroid hormone and uric acid (UA) and body mass index (BMI) in patients with type Ⅱ diabetes and normal thyroid function.Methods Total of 313 patients with type Ⅱ diabetes and normal thyroid function were selected.BMI,fasting blood glucose (FBG),the metabolism of blood lipid,thyroid hormones and UA indicators were examined and the correlations of thyroid hormone,BMI and UA were analyzed.Results (1) The patients were divided into two groups according to gender,and FT3,FT4,and UA of male were found to be significantly higher than those in female (P＜0.01).TSH,SBP,HDL-C in female were significantly higher than those in male (P＜0.01);(2) The patients were divided into three groups according to BMI Level.Thyroid-stimulating hormone (TSH),three iodine armour gland original glycine (TT3),free three iodine thyroid glycine (FT3),UA,and FBG in overweight and obesity groups were found to be higher than those in normal weight group (P ＜ 0.05);(3) The patients were divided into two groups according to the TSH level.Serum uric acid,TT3,FT3,fasting insulin in the group with TSH above 2.5 uIU/L were found to be higher than those in the group with TSH under 2.5 uIU/L (P ＜ 0.05);(4) Patients were divided into two groups according to the UA level.TSH,FT3 in male with high uric acid were found to be higher than those in male with normal uric acid (P ＜ 0.05);TSH was in female with high uric acid was found to be higher than that in female with normal uric acid (P ＜ 0.05).Conclusion Thyroid hormone in patients with type Ⅱ diabetes can be used to assess the body weight and uric acid,which is of great clinical importance.

Progress of management and standardization strategy research in diabetics with insulin pump therapy outside hospital / 中国实用护理杂志

The role of insulin pump in the treatment of diabetes is becoming more and more significant. Based on the systematic literature review, collation and analysis, this article introduces the management of insulin pump outside the hospital from the development trend of insulin pump, application and common problems. In order to enhance the therapeutic satisfaction of patients and improve their quality of life, our aims are to put forward the strategy of standardized management and provide a reference for establishing and improving the standardized management system of insulin pump therapy outside hospital.

¹H-NMR based metabonomic approach to evaluate anti-coagulant effect of Danggui Sini decoction / 中国中药杂志

To study the anti-coagulant effect and influence of danggui Sini decoction (DSD) on rat's plasma endogenous metabolites by animal experiment and ¹H-NMR based metabolomics method. After intragastric administration of Danggui Sini Decoction for 7 days, Plasma thrombin time (TT) was measured. Rat plasma metabolic fingerprint in two groups was analyzed using ¹H-NMR, based on which the principal component analysis( PCA) and orthogonal partial least-squares discriminant analysis(OPLS-DA) models for metabonomic analysis. Potential biomarkers were screened by using variable importance in the projection (VIP) and T test. DSD could prolong TT of the rat significantly (P < 0.05). Compared with control group, six kinds of endogenous metabolites in DSD group change significantly (P < 0.05), among which isobutyrate, carnitine and phenylalanine content had an upward trend (P < 0.01) and lysine, Histidine and cholesterol content had a downward trend (P < 0.05). It is likely that carnitine, phenylalanine, Histidine and cholesterol are the potential metabolic markers in the anti-coagulant process and DSD affects the platelet aggregation and the expression of tissue factor and fiber protease by regulating the energy, amino acid and lipid metabolism.

Protective Effects of Biifdobacterium on intestinal tissue of newborn rats with necrotizing enterocolitis and its regulation / 中华围产医学杂志

Objective To discuss the possible molecular mechanisms involved in the protective effects of Biifdobacterium on intestinal tissue of necrotizing enterocolitis (NEC) newborn rats. Methods Seventy-five newborn Sprague-Dawley rats (born within 2 h) were randomly divided into five groups, each group with 15 rats. Group A was the NEC model group, and the rats were fed lipopolysaccharide (LPS) and formula. Group B was the Biifdobacterium treatment group, and the rats were fed LPS and formula and Biifdobacterium micro-capsule. Group C was the artificial feeding control group, and the rats were fed formula. Group D was the Biifdobacterium control group, and the rats were fed formula and Biifdobacterium micro-capsule. Group E was the breastfeeding control group, and the rats were fed rat breast milk by mothers. LPS 30 mg/kg was administered by gavage once per day for 3 days. Bifidobacterium micro-capsules were given as 1×1010 colony forming units/ml by gavage with formula once per day. After fed for 72 h and fasted for 12 h, the five groups of rats were killed by decapitation. Morphological changes in the terminal ileum tissue were observed under a light microscope and intestinal injury was scored. The expression of Toll-like receptor (TLR) 2, TLR4, and nuclear transcription factor (NF)-κB p65 was detected by immunohistochemical methods. Kruskal-Wallis test, analysis of variance, corrected Chi-square test and Fisher's exact test were used for statistics. Results The morbidity of NEC in group A to E was 11/15, 4/15, 3/15, 2/15 and 0/15, respectively;the intestinal injury score in group A to E was 3.37±0.27, 1.53±0.44, 1.75±0.37, 0.92±0.39 and 0.30±0.18, respectively; the expression level of TLR2 in group A to E was 0.35±0.05, 0.30±0.03, 0.32±0.04, 0.30±0.02 and 0.29±0.03, respectively;the expression level of TLR4 in group A to E was 0.48±0.05, 0.34±0.03, 0.36±0.03, 0.37±0.04 and 0.35±0.02, respectively;the expression level of NF-κB p65 in group A to E was 0.43±0.03, 0.29±0.03, 0.35±0.02, 0.32±0.02 and 0.30±0.02, respectively. The differences in NEC morbidity, intestinal injury score, and the expression levels of TLR4, TLR2 and NF-κB p65 among the five groups were all statistically significant (χ2, H or F=23.863, 70.290, 8.803, 38.599 and 75.076, respectively, all P 0.05). The intestinal injury score in the Bifidobacterium treatment group was significantly higher than that in the Bifidobacterium control group and the breastfeeding control group (both P 0.05). The expression levels of TLR4 and NF-κB p65 in the Biifdobacterium treatment group were significantly lower than those in the artificial feeding control group and the Biifdobacterium control group (all P 0.05). The expression level of TLR2 in the Biifdobacterium treatment group compared with the three control groups was not significantly different (all P > 0.05). Conclusions Biifdobacterium may inhibit pathogenic bacteria or regulate the negative feedback of TLR2 to reduce the expression of TLR2 and TLR4 in intestinal mucosa cells, inhibit the NF-κB pathway, attenuate the inflammatory reaction, and play a role in the prevention and control of NEC.

Levothyroxine dosage and related factors in the treatment of pregnant women with subclinical hypothyroidism / 中华内分泌代谢杂志

Objective To study the levothyroxine doses and related factors in the treatment of pregnant women with subclinical hypothyroidism (SCH).Methods Fifty-six pregnant women with SCH (diagnosed before 12 weeks of gestation) were recruited and divided into 2 groups according to the baseline TSH levels,SCH group 1 (2.5 mIU/L ≤ TSH ≤ 5.0 mIU/L,n =24) and SCH group 2 (TSH＞5.0 mIU/L,n =32).Thyroid autoantibodies [thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody(TGAb)] were detected.All the subjects were treated with levothyroxine and the doses were adjusted according to the TSH level.The therapeutic target was to keep the TSH levels under control,0.3 to 2.5 mIU/L for the first trimester and 0.3 to 3.0 mIU/L for the second and third trimesters.Results There was a positive correlation between the levothyroxine doses and baseline TSH levels (r =0.533,P＜0.01) in pregnant women with SCH.A significant difference in the levothyroxine doses between SCH group 1 and SCH group 2 was found [(0.583 ± 0.341) vs (0.961 ± 0.405) μg/kg,t =-3.695,P＜ 0.01].The levothyroxine doses in SCH group 2 were 64.84％ higher than those in group 1.There was a significant difference in the levothyroxine doses between thyroid autoantibody negative and positive subjects [(0.680 ± 0.370) vs (0.918 ±0.440) μg/kg,t =-2.197,P =0.032].The levothyroxine doses in thyroid autoantibody positive subjects were 35 ％ higher than those in the negative subjects.In addition,there was a significant difference in the levothyroxine doses between subjects with negative and positive thyroid autoantibody [(0.421 ± 0.192) vs (0.720 ± 0.385)μg/kg,t =-2.331,P =0.029] in SCH group 1.While in SCH group 2,the difference did not reach statistical significance.Conclusion The baseline TSH levels and status of thyroid autoantibodies may affect the levothyroxine dosage in pregnant women with SCH.

Investigation of thyroid function parameters in subclinical hypothyroid women treated with levothyroxine during pregnancy / 中华内分泌代谢杂志

Subclinical hypothyroidism during pregnancy is associated with some adverse outcomes during maternal pregnancy.The present study investigated thyroid function parameters measured by electroehemiluminescence (ECL) immunoassays in subclinical hypothyroid women treated with levothyroxine (L-T4) during pregnancy.The results showed that in evaluating thyroid function with ECL immunoassays during replacement with L-T4,determination of serum TT4 appears to have a closer correlation with TSH and may better reflect the effìcacy of treatment.

Inhibition of islet beta cell apoptosis and prevention diabetes by subcutaneous administration of insulin in NOD mice / 中南大学学报(医学版)

OBJECTIVE@#To investigate the effects of subcutaneous administration of insulin on insulitis,beta cell apoptosis and diabetes in non-obese diabetic (NOD) mice, and to explore the mechanism of immune tolerance induced by insulin.@*METHODS@#Sixty female NOD mice were randomly divided into insulin group (n=32) and phosphate buffered saline (PBS) group (PBS group, n=28). Insulin was subcutaneously injected with humulin N (60 microL, 6U)+IFA (60 microL) at 4, 12, 20, and 28 weeks respectively, while the PBS group received PBS (60 microL) + IFA (60 microL). Insulitis and beta cell apoptosis of islets were observed at 12 weeks. IL-4 and IFN-gamma in the sera were measured by enzyme linked immunosorbent assay (ELISA). The expression levels of I-Abeta(g7), IL-4, IFN-gamma, IL-1beta, and Fas mRNA of islets were measured by reverse transcription-polymerase chain reaction (RT-PCR) at 12 weeks.@*RESULTS@#The incidences in the insulin group were significantly lower than those in the PBS group (21.4% vs 71.4% at 30 weeks, 28.6% vs 85.7% at 52 weeks, P<0.05). The insulitis scores in the insulin group were lower than those in the PBS group, but there was no statistical significance. Fas expression on islets and apoptotic beta cell rates in the insulin group were lower than those in the PBS group (P<0.05). In the insulin group, serum IL-4 levels were higher, but IFN-gamma levels were lower than those in the PBS group (P<0.05). The levels of I-Abeta g7, IFN-gamma, IL-1beta and Fas mRNA transcription in islets were lower in insulin group, but IL-4 mRNA levels were higher than those in the PBS group (P<0.05).@*CONCLUSION@#The specific autoantigen insulin may induce immune tolerance and prevent diabetes in NOD mice, but it can't block the progression of insulitis. Subcutaneous administration of insulin can induce the regulatory T cells, and make Th1 to Th2 cytokine shifts in system and islets, thus preventing the Fas-mediated beta-cell apoptosis and diabetes.

Study on the time selection of pregnancy and delivery in women with systemic lupus erythematosus / 中华妇产科杂志

Objective To analyze the appropriate time selection of pregnancy and delivery in women with systemic lupus erythematosus (SLE ). Methods Twenty-nine pregnancies in women with SLE in our hospital from 1998 to 2003 were retrospectively analyzed regarding the selection of appropriate time of pregnancy and delivery. Results All patients did not take any cytotoxic medicine for at least 6 months before pregnancy. Twenty-three conceptions occurred when SLE was inactive for at least 1 year. Two conceptions occurred when SLE was active without doctors' agreement SLE was diagnosed during pregnancy in the remaining 4 cases. The condition of all patients fluctuated and the gestational time at delivery ranged from 30 to 38 weeks after we modified the doses of glucocorticoid (prednisone). Among totally 29 living neonates, eight were premature neonates, three were FGR and one had serious congenital heart disease. Two neonates died of complications in early stage of neonatal period. None of the 29 neonates from all patients had neonatal lupus. Conclusion Pregnancy safety will be improved obviously if the condition of SLE is controlled and the patients are given reasonable doses of glucocorticoid and intensive monitoring. If pharmacotherapy does not work well and the condition threatens the safety of mother and fetus, or the fetus has matured, termination of pregnancy should be done on time, which reduces maternal complications and improves the perinatal mortality rate. The gestational time should be 34 to 38 weeks.