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Objective:To analyze the effect of insulin aspart on the islet cell secretion function, ultrasound imaging indicators and maternal and infant outcome in patients with gestational diabetes mellitus (GDM).Methods:The clinical data of 120 patients with GDM in Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University from February 2017 to July 2019 were retrospectively analyzed. Among them, 60 cases were treated with insulin aspart (observation group) and 60 cases were treated with biosynthetic human insulin (control group). The efficacy indexes, ultrasound imaging indexes and maternal and infant outcome were compared.Results:The 2 h postprandial blood glucose (2 h PBG) after breakfast on the third and fifth day of treatment in observation group was significantly lower than that in control group: (6.85 ± 0.87) mmol/L vs. (7.47 ± 1.35) mmol/L and (6.24 ± 0.59) mmol/L vs. (6.60 ± 0.87) mmol/L, and there was statistical difference ( P<0.01); there was no statistical difference in 2 h PBG after breakfast on the first day of treatment and after lunch and dinner on the first, third and fifth day of treatment between 2 groups ( P>0.05). The homeostasis model assessment-insulin resistance index (HOMA-IR) after treatment in observation group was significantly lower than that in control group (2.57 ± 0.25 vs. 3.00 ± 0.35), the homeostasis model assessment- β cell function index (HOMA-β) was significantly higher than that in control group (72.45 ± 12.33 vs. 63.66 ± 10.72), and there were statistical differences ( P<0.01). There were no statistical differences in pre-lunch blood glucose, pre-lunch initial insulin amount, pre-lunch final insulin amount and blood glucose target time between 2 groups ( P>0.05); the incidence of pre-meal hypoglycemia in observation group was significantly lower than that in control group: 8.33% (5/60) vs. 23.33% (14/60), and there was statistical difference ( P<0.05). The umbilical artery and renal artery resistance index (RI), maximum systolic blood flow velocity and end-diastolic blood flow velocity ratio (S/D) after treatment in observation group were significantly lower than those in control group (RI: 0.49 ± 0.16 vs. 0.59 ± 0.15 and 0.69 ± 0.17 vs. 0.76 ± 0.12; S/D: 2.09 ± 0.22 vs. 2.38 ± 0.26 and 5.17 ± 0.45 vs. 5.77 ± 0.63), and there were statistical differences ( P<0.01 or <0.05). There were no statistical differences in gestational age, delivery mode, neonatal body weight and the incidences of macrosomia, neonatal hypoglycemia and neonatal referral between 2 groups ( P>0.05). Conclusions:Insulin aspart can significantly improve the islet cell secretion function and ultrasound imaging indexes in the treatment of GDM, and can reduce the risk of pre-meal hypoglycemia, but the effect on maternal and infant outcome remains to be explored.
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AIM: To explore the inhibitory effect of Ras-association domain family 1A ( RASSF1A) on the small-cell lung cancer cell growth .METHODS:The lentiviral expression vector containing RASSF1A gene was constructed and used to infect the small-cell lung cell line H446.The growth curve and cell cycle were detected by MTT assay and flow cytometry.The mRNA and protein levels of cell cycle-associated proteins were determined by real-time PCR and Western blotting.RESULTS:We obtained the H446 cells in which RASSF1A was stably expressed (named RASSF1A-H446). Compared with normal cell group and negative cell group , RASSF1A inhibited the proliferation of H446 cells, and arrested H446 cells in G1 phase.The expression of p21 and p27 was significantly increased , and E2F1 was significantly decreased in RASSF1A-H446 cells.CONCLUSION:RASSF1A inhibits the H446 cell growth by increasing the expressions of p 21 and p27, and decreasing the expression of E 2F1.
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Objective To investigate the prevalence of macrosomia in China and the risk factors.Methods By stratified cluster random sampling,the medical records of 101 723 singleton term infants born in 37 hospitals nation wide (in 14 provinces) from January 1,2011 to December 31,2011 were reviewed.Adjusted odd ratio (aOR) and 95％ confidence interval (CI) were used to describe the risk factors.Population attribute risk (PAR) was used to quantitatively describe the associations between risk factors and the prevalence of macrosomia.Results The general prevalence of macrosomia was 7.3％ (7403/101 723).The prevalence varied among provinces (4.1％ to 13.4 ％).Logistic regression analysis showed that macrosomia were positively associated with living in northern China (aOR =1.4,95 ％ CI:1.2 ～ 1.6,PAR =19.9 ％),maternal age ≥ 35 (aOR =1.1,95％ CI:0.9～1.3,PAR=8.7％),pre-pregnant BMI≥28 (aOR=3.6,95％ CI:2.9～4.5,PAR=15.1％),gravidity＞1 (aOR=1.2,95％ CI:1.1～1.4,PAR=10.8％),parity＞1 (aOR=1.8,95％ CI:1.5～ 2.1,PAR=10.1％),maternal height≥160 cm (aOR =1.6,95％ CI:1.4～ 1.9,PAR=29.5％),gestational weight gain (GWG) ≥16 kg (aOR=2.2,95％ CI:1.9～2.4,PAR=25.2％),gestational diabetes mellitus (aOR=1.2,95％ CI:1.0～ 1.3,PAR =3.2％),gestational weeks≥40(aOR=2.4,95％ CI:2.1～ 2.7,PAR=34.4％)and baby boy (aOR=l.6,95％ CI:1.4～1.8,PAR=25.4％).Maternal BMI,gestational week and GWG were most strongly associated with macrosomia.Conclusions The prevalence of macrosomia varied dramatically between different areas in China.Pre-pregnancy BMI,gestational week and GWG,as the main modifiable risk factors for macrosomia,need more attention from health care providers.
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Objective To investigate the perinatal outcomes of twin-twin transfusion syndrome (TTTS)and the management.Methods During Nov 1, 2002 to Sep 30, 2005, 24 cases of TTTS in Beijing Obstetrics and Gynecology Hospital were analyzed.The outcomes of them were compared with the pregnancy without TTTS in all twins and in monozygotic twins.The outcomes of the blood-supplying fetus and the blood-recepter were compared.Results 6.8%cases had TTTS in all twins.The group of TTTS had more maternal,fetal and neonatal complications than twins pregnancy without TTTS :polyhydramnios [37.5%(9/24)vs 2.1%(7/328),P＜0.01],gestational hypertension[20.8%(5/24)vs 7.0%(23/328),P=0.043],premature labor[66.7%(16/24)vs 36.3%(119/328),P=0.003],perinatal dead fetus in uterus[18.8%(6/32)vs 1.1%(7/540),P＜0.01],neonatal asphyxia[73.1%(19/26)vs 3.0%(19/632),P＜0.01],the proportion of NICU[88.5%(23/26)vs 23.4%(148/632),P＜0.01],neonatal death [15.4%(4/26)vs 1.7%(11/632),P=0.002 ]and the rate of perinatal mortality [31.2%(0/32)vs 2.8%(18/632)].Compared with the monozygotic twins without TTTS,in TTTS group there were more complications of the mother,the fetus and the neonates:gestational hypertension[20.8%(5/24)vs 9.9%(14/142),P=0.224],premature labor[66.7%(16/24)vs 49.3%(70/142),P=0.115 ],perinatal dead fetus in uterus [ 18.8%(6/32)vs 0.7%(2/282),P＜0.01 ],neonatal asphyxia [73.1%(19/26)vs3.9%(11/280),P＜0.01 ],the proportion of NICU[88.5%(23/26)vs 29.3%(82/280),P＜0.01],neonatal death[15.4%(4/26) vs 2.1%(6/280),P:0.006]and the rate of perinatal mortality[31.3%(10/32) vs 3.2%(8/282)].The perinatal outcomes were better in those cases that the grades of TTTS were below 3 in the first diagnosis.Conclusions We should try to diagnose and treat TTTS as early as possible because the outcome is poor.