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Objective:To investigate the relationship between serum fibrous gel protein-3 (ficolin-3) and serum alanine (ALA) levels and gestational diabetes (GDM) .Methods:A total of 98 pregnant women with GDM admitted to our hospital from Jan. 2020 to Aug. 2020 were selected as the observation group, and 98 healthy pregnant women undergoing physical examination during the same period were taken as the control group. The level of serum ficolin-3 was measured by enzyme-linked immunosorbent assay (ELISA) , and the level of serum ALA was measured by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) . The two groups were compared in terms of serum ficolin-3, ALA levels and biochemical indicators (hemoglobin (HbA1c) , total cholesterol (TC) , high-density lipoprotein cholesterol (HDL-C) , low-density lipoprotein cholesterol (LDL-C) , serum total protein (TP) , serum urea (SU) levels) , and pregnancy outcomes. Pearson method was used to analyze the correlation between serum ficolin-3 and ALA levels and various biochemical indexes. Univariate analysis and binary logistic regression analysis were used to investigate the risk factors of GDM.Results:Serum ficolin-3, HbA1c, and SU levels in the observation group were all higher than that in the control group. Serum ALA level was lower than that in the control group, and the difference was statistically significant ( P<0.05) . TC, HDL-C, LDL-C, TPT showed no significant difference between the two groups ( P>0.05) . In the observation group, serum ficolin-3 was positively correlated with HbA1c and Su, and serum ALA was negatively correlated with HbA1c and SU ( P < 0.05) . The incidence of adverse outcomes including gestational neonatal asphyxia, neonatal jaundice, giant size, and amniotic fluid contamination in the observation group (26.53%) was higher than that in the control group (12.24%) , The difference was statistical significant ( P<0.05) . The univariate analysis showed that GDM was associated with age, weight gain during pregnancy, serum ficolin-3, ALA, HbA1c, SU, family history of diabetes ( P<0.05) ; Binary logistics regression analysis found that age ≥28 years, weight gain≥ 14 kg, serum ficolin-3≥24ng/ml, HbA1c 6.0%, and a family history of diabetes were risk factors for GDM, while serum ALA≥1.9 μg/ml was a protective factor of GDM, ( P<0.05) . Conclusion:The increase of serum ficolin-3 and the decrease of ALA level in pregnant women are risk factors of GDM, and have an adverse impact on the final delivery outcome
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Objective@#To assess the current evidence regarding the efficacy, safety, and potential advantages of endoscopic compared with open salvage surgery for patients with local recurrent nasopharyngeal carcinoma.@*Methods@#A systematic search of Pubmed/Medline, Embase, and Cochrane databases ranged between 2000 and 2017 was conducted. Included studies reported specific residual or local recurrent nasopharyngeal cancer survival data. Proportional Meta-analysis was performed on both outcomes with a random-effects model and the 95% confidential intervals were calculated by Stata 12.0 software.@*Results@#A total of 24 case series studies were included in the Meta-analysis.The pooled 2-year overall survival rates of endoscopic and open group were 84% (95%CI:72%-93%), 68%(95%CI:59%-77%),respectively.The pooled 2-year disease-free survival rates of endoscopic and open group were 68%(95%CI:53%-81%), 65%(95%CI:54%-75%),respectively. The pooled 5-year overall survival rates of endoscopic and open group were 72%(95%CI:37%-97%), 48% (95%CI:40%-56%),respectively.The pooled 5-year disease-free survival rates of endoscopic and open group were 65%(95%CI:29%-93%), 50%(95%CI:43%-57%),respectively.The combined outcome of endoscopic was higher than open procedure. In addition, less severe complications, lower local recurrence rates(27%vs32%).The 2-year overall survival rates of endoscopic was higher than open procedure in the staging of rT1, rT2, and rT3 (93%vs87%; 77%vs63%; 67%vs53%) , but was equal to open in the staging for rT4 (35%vs35%) .Meta-regression showed that the heterogeneity was correlated with advanced tumor ratio.@*Conclusions@#The present Meta-analysis reveals that endoscopic approach offers a safe and efficient alternative to open approach with better short-term outcome and fewer postoperative complications in selecting patients strictly.
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Objective To discuss the correlation of Wiskott-Aldrich syndrome (WAS) with autoimmune disease of the central nervous system and its possible pathogenesis by reporting one case of the disease and reviewing related literature.Methods One case of WAS complicated with demyelinating disease of the central nervous system was reported.The patient' s clinical symptoms,laboratory examinations (such as blood tests,immune function tests,etc) and imaging features were analyzed.The patient's blood DNA was extracted and performed gene testing.And related literature was reviewed.Results The patient showed typical clinical symptoms of WAS,including eczema,thrombocytopenia and immune deficiency,complicated with demyelinating disease of the central nervous system.The DNA testing showed C400G ＞ C p.(ALa134Pro) mutation,which is a missense mutation.The 134th amino acid in protein was changed from alanine to proline.The patient also showed the symptoms of demyelinating disease of the central nervous system,which drew our attention.This was the first report on WAS complicated with demyelinating disease of the central nervous system,which was perhaps caused by a gene mutation.Conclusions WAS complicated with demyelinating disease of the central nervous system is possibly resulted from the gene mutation,which leads to the expression disorder of WAS protein.And then non-red hematopoietic cells lead to signal transduction and cytoskeleton recombination disorders in response to environment stimulus,which produces lymphocytes immigration,signal transduction and immune synaps formation disorders.