Association between fasting blood glucose combined with gene polymorphisms of adiponectin, interleukin 6 and tumor necrosis factor-alpha in early pregnancy and insulin resistance in peri-pregnancy / 中国医师进修杂志

Objective:To study the relationship between fasting glucose (FPG) and gene polymorphisms of adiponectin (ADIPOQ), interleukin 6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in early pregnancy and insulin resistance in patients with gestational diabetes mellitus (GDM).Methods:Sixty patients diagnosed with GDM within 24 -28 weeks from January 2022 to August 2022 in the Affiliated Hospital of Jining Medical University were selected as the GDM group, and another 60 healthy pregnant women were taken as the normal control group. The fasting insulin (FINS), FPG levels and the homeostatic model assessment insulin resistance index (HOMA-IR) and other clinical data were detected at 8 -12 weeks of pregnancy. Meanwhile, polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the polymorphisms of ADIPOQ gene at S0100622 locus, IL-6 gene at S01006318 locus, TNF- α gene at S01009718. Receiver operating characteristics(ROC) curve was used to evaluate the diagnostic performance of FPG combined with polymorphisms of ADIPOQ, IL6 and TNF-α in predicting GDM in early pregnancy.Results:The body mass index (BMI), early pregnancy FPG, mid pregnancy FPG, 75 g oral glucose tolerance test (OGTT) 1 h blood glucose, OGTT 2 h blood glucose, glycosylated hemoglobin (HbA 1c), FINS and HOMA-IR in the GDM group were higher than those in the normal control group: (27.1 ± 2.6) kg/m 2 vs. (25.6 ± 2.5) kg/m 2, (4.7 ± 1.3) mmol/L vs. (4.1 ± 1.5) mmol/L, (5.5 ± 1.3) mmol/L vs. (4.2 ± 1.2) mmol/L, (6.3 ± 1.5) mmol/L vs. (5.5 ± 1.7) mmol/L, (6.0 ± 1.5) mmol/L vs. (5.2 ± 1.4) mmol/L, (5.8 ± 0.7)% vs. (5.2 ± 0.6)%, (6.4 ± 1.1) mU/L vs. (5.2 ± 1.2) mU/L, 1.5 ± 0.6 vs. 1.0 ± 0.7, there were statistical differences ( P<0.05). According to the risk assessment of genotype, the high-risk rate in the GDM group was 88.33% (53/60), while the normal control group was 56.67% (34/60), there was statistical difference ( χ2 = 17.67, P<0.05). In GDM group, the HOMA-IR with ADIPOQ gene S0100622 locus TG genotype was higher than that with TT genotype: 6.58 ± 0.89 vs. 4.98 ± 0.58; the HOMA-IR with IL-6 gene S01006318 locus CG genotype was higher than CC and GG genotype: 8.13 ± 1.31 vs. 6.53 ± 0.81, 4.85 ± 0.54, the HOMA-IR with TNF-αgene S01009718 locus AG genotype was higher than GG genotype: 6.31 ± 1.04 vs. 5.16 ± 0.82, there were statistical differences ( P<0.05). Logistic regression analysis showed that age>35 years, previous diabetes history, BMI, TG genotype at S0100622 locus of ADIPOQ gene, CG genotype at S01006318 locus of IL-6 gene, AG genotype at S01009718 locus TNF- α gene were risk factors for the onset of GDM ( P<0.05). The results of ROC curve analysis showed that the area under the curve (AUC) of FPG for predicting GDM onset was 0.737, with a specificity of 83.50%; FPG combined with ADIPOQ, IL-6, TNF- α genetic risk assessment predicted with AUC of 0.921 and a specificity of 86.80%. Conclusions:ADIPOQ gene TG genotype at S0100622 locus, IL-6 gene CG genotype at S01006318 locus, TNF- α gene AG genotype at the S01009718 locus has a certain correlation with the onset of GDM, which can predict the onset of GDM and is associated with perioperative insulin resistance in patients. Early FPG testing combined with genetic screening has practical clinical guiding significance in reducing adverse pregnancy outcomes for mothers and infants.

Relationships of Inflammatory Factors and Risk Factors with Different Target Organ Damage in Essential Hypertension Patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Atherosclerosis (AS) is an inflammatory disease. Inflammation was considered to play a role in the whole process of AS. This study aimed to analyze the relationships of inflammatory factors and risk factors with different target organ damages (TOD) in essential hypertension (EH) patients and to explore its clinical significance.</p><p><b>METHODS</b>A total of 294 EH patients were selected and divided into four groups according to their conditions of TOD. Forty-eight healthy subjects were selected as control. The clinical biochemical parameters, serum amyloid A, serum tryptase, and lipoprotein-associated phospholipase A2 (Lp-PLA2) in each group were detected, and the related risk factors were also statistically analyzed.</p><p><b>RESULTS</b>Fibrinogen (Fbg) was the most significant independent risk factor in acute coronary syndrome (ACS) group (odds ratio [OR]: 22.242, 95% confidence interval [CI]: 6.458-76.609, P< 0.001) with the largest absolute value of the standardized partial regression coefficient B' (b': 1.079). Lp-PLA2 was the most significant independent risk factor in stroke group (OR: 13.699, 95% CI: 5.236-35.837, P< 0.001) with b' = 0.708. Uric acid (UA) was the most significant independent risk factor in renal damage group (OR: 15.307, 95% CI: 4.022-58.250, P< 0.001) with b' = 1.026.</p><p><b>CONCLUSIONS</b>Fbg, Lp-PLA2, and UA are the strongest independent risk factors toward the occurrence of ACS, ischemic stroke, and renal damage in EH patients, thus exhibiting the greatest impacts on the occurrence of ACS, ischemic stroke, and renal damage in EH patients, respectively.</p>

Clinical features and prognosis of conjunctival lymphoid hyperplasia / 中华实验眼科杂志

Background Primary conjunctival lymphoid hyperplasia exhibit atypical clinical symptoms and easy to cause misdiagnosis and mistreatment.Understanding the clinical characteristics of primary conjunctival lymphoid hyperplasia is of an important clinical significance.Objective This study was to analyze the clinical characteristics and therapeutic outcome of patients with primary conjunctival lymphoid hyperplasia.Methods The medical records of 20 patients with primary conjunctival lymphoid hyperplasia who was treated in Beijing Tongren Hospital from January 2012 to December 2014 were retrospectively analyed.The age,symptoms,therapy,prognosis,histopathological features and immonochemistry results were reviewed,and the treating approach targeting to different types of conjunctival lymphoid hyperplasia was evaluated.The fellow-up duration was 1-2 years.Results Age of the patients ranged from 27 to 83 years old.The lesions were classified as benign lymphocytic hyperplasia,atypical lymphoid hyperplasia and lymphoma.Majority of lesions located in fornix conjunctiva tissue (90％).Follicle-like appearance was seen in the benign lymphocytic hyperplasia,and pink elavation was exhibited at the bulbar conjunctiva in the atypical lymphoid hyperplasia.A diffuse salmon fish like appearance in conjunctiva was the primary feature of conjunctival lymphoma.Histopathological examination showed that conjunctival benign lymphocytic hyperplasia had follicle-like tissue in lesions,atypical lymphoid hyperplasia exhibited diffuse lymphocyte filtration,and conjunctival lymphoma appeared monocyte filtration.The 3 tpyes of lesions also could be differentiated by immunochemistry.The medicine was applied in the eyes with benign lymphocytic hyperplasia,and the combination of resection of lesions with conjunctival tissue or amniotic membrane transplantation was used for the atypical lymphoid hyperplasia or lymphoma eyes.No recurrence of the lesions was found during fellow-up duration.Conclusions The clinical manifestations of conjunctival lymphoid hyperplasia lesions are varied,and it is easy to be confused with chronic ocular surface diseases.Pathology and immunochemistry are helpful for the differential diagnosis.The treating regimen is dependent on the lesion type.Most patients have a favorable prognosis with treatment.

Investigation on undergraduates′cognition,attitude and behavior about low-carbon life / 重庆医学

Objective To investigate the undergraduates′cognition ,attitude and behavior about low‐carbon life and then to provide a relatively scientifically strategy .and provide scientific basis to formulate countermeasures about undergraduates′low‐car‐bon lifestyle .Methods By multistage sampling ,382 students′knowledge ,attitude and practice about low‐carbon life in Wuhan Uni‐versity of science and technology were analyzed .Results The students′cognition about low‐carbon life was good ,the awareness rate of girl was higher than that of boy ;Their attitude was positive ,grade and knowledge awareness were the two influence factors ;the behavior situation was unsatisfactory ,the origin of students and attitude enthusiasm were the elements affect rationality of be‐havior .Conclusion Undergraduates should strengthen the cognition of low‐carbon life ,improve attitude enthusiasm ,and form a good behavioral habit of low‐carbon life .

Influence of community health education on quality of life and compliance in patients with coronary heart disease / 心血管康复医学杂志

Objective:To explore influence of health education on quality of life and compliance in community pa‐tients with coronary heart disease (CHD) .Methods :A total of 83 community CHD patients were selected and ran‐domly divided into routine treatment group (n=38 ,received routine treatment of CHD ) and health education group (n=45 ,received CHD health education based on routine treatment ) .Score of Seattle angina questionnaire (SAQ) after intervention ,therapeutic compliance and incidence rate of major adverse cardiovascular events (MACE) with‐in six months were compared between two groups .Results:Compared with routine treatment group after interven‐tion ,there were significant rise in each item score and total score of SAQ [total score ,(54.3 ± 7.2) scores vs .(65.4 ± 7.5) scores] ,P<0.05 all;and therapeutic compliance also significantly rose (good rate ,52.6% vs .77.8% ) in health education group , P< 0.05. After six‐month follow‐up ,total incidence rate of MACE in health education group was significantly lower than that of routine treatment group (8.9% vs .26.3% ) , P< 0.05. Conclusion:Health education can significantly improve quality of life ,compliance and prognosis in community patients with cor‐onary heart disease ,which is worth clinical extending and use .

Combined therapy with methylprednisolone and ulinastatin in experimental autoimmune encephalomyelitis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Our previous study had demonstrated that ulinastatin (UTI) had a neuroprotective effect in experimental autoimmune encephalomyelitis (EAE). Methylprednisolone has been recommended to be a standard drug in multiple sclerosis (MS) therapies. The present study was to investigate the protective effects of UTI combined methylprednisolone in EAE.</p><p><b>METHODS</b>Mice were divided into a UTI treatment group, a methylprednisolone treatment group, a combined treatment group with UTI and methylprednisolone, a normal saline treatment group, and a normal control group. EAE mice were induced in groups receiving different combined treatments, or respective monotherapies. Demyelination was evaluated by Solochrome cyanin staining. 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNP)/ myelin basic protein (MBP)/ the precursor form of nerve growth factor (proNGF)/p75/ inducible nitric oxide synthase (iNOS) proteins in cerebral cortex of EAE were detected by Western blotting.</p><p><b>RESULTS</b>The combined treatment group had a lower clinical score (0.61 ± 0.06) and demyelinating score (1.33 ± 0.33) than the groups with normal saline (clinical score: 1.39 ± 0.08, P < 0.001; demyelinating score: 2.75 ± 0.49, P < 0.05) or monotheraphies. Compared with the saline treated EAE group, UTI combined methylprednisolone significantly increased expressions of CNP (1.14 ± 0.06 vs. 0.65 ± 0.04, P < 0.001), MBP (1.28 ± 0.14 vs. 0.44 ± 0.17, P < 0.001), and decreased expressions of proNGF (1.08 ± 0.10 vs. 2.32 ± 0.12, P < 0.001), p75 (1.13 ± 0.13 vs. 2.33 ± 0.17, P < 0.001), and iNOS (1.05 ± 0.31 vs. 2.17 ± 0.13, P < 0.001) proteins in EAE. Furthermore, UTI combined methylprednisolone could significantly upregulate MBP (1.28 ± 0.14 vs. 1.01 ± 0.15, P < 0.05) expression and downregulate iNOS (1.05 ± 0.31 vs. 1.35 ± 0.14, P < 0.05) expression compared to methylprednisolone treatment EAE group. And proNGF expression was significantly lower in combined treatment (1.08 ± 0.10) than that in UTI (1.51 ± 0.24, P < 0.05) or methylprednisolone (1.31 ± 0.04, P < 0.05) treatment group.</p><p><b>CONCLUSION</b>Combination treatment of UTI with methylprednisolone was shown to protect EAE, suggesting that combination therapy is a potential novel treatment in MS.</p>

Change in expression of vascular endothelial growth factor in serum and wound tissue of rats with electrical burns / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe the change in expression of vascular endothelial growth factor (VEGF) in serum and wound tissue of rats with electrical burn (EB), and to explore its regulation mechanism in the pathological changes of EB.</p><p><b>METHODS</b>Sixty-four SD rats were divided into normal control group (n = 8) and EB group (n = 56) according to the random number table. Eight rats in EB group were sacrificed at post injury hour (PIH) 6 and on post injury day (PID) 1, 3, 7, 14, 21, and 28, to collect wound muscle tissue and serum samples. Histopathological changes in wound tissue were observed with HE staining. The serum content of VEGF was determined with double-antibody sandwich enzyme-linked immunosorbent assay. The expression level of VEGF in wound tissue was determined with Western blotting. VEGF expression intensity in wound tissue was observed with immunohistochemical staining. The microvessel density (MVD) was calculated. The correlation between VEGF expression intensity and MVD was analyzed. Muscle tissue of calf and serum of the rats in normal control group without any treatment were collected for above-mentioned observations and determinations. Data were processed with one-way analysis of variance and Spearman hierarchy correlation analysis, and LSD-t test was applied for paired comparison.</p><p><b>RESULTS</b>(1) In EB group, breakage of muscle fiber, heavy infiltration of inflammatory cells, and obvious tissue edema were observed at PIH 6 and on PID 1; new vessels were observed on PID 3; amount of granulation tissue and number of new vessels were found to be increased on PID 7. (2) In EB group, the serum level of VEGF was (43 ± 11) pg/mL at PIH 6, (44 ± 11) pg/mL on PID 1, and (74 ± 27) pg/mL on PID 14, which were all significantly higher than that in normal control group [(15 ± 9) pg/mL, with t values from 4.001 to 5.724, P values all below 0.01]. (3) The protein expression level of VEGF of wound tissue in EB group was higher than that in normal control group (0.21 ± 0.09) at each time point. The protein expression level of VEGF in EB group peaked on PID 7 (0.63 ± 0.13, t = 4.965, P < 0.05). (4) In EB group, strongly positive expression of VEGF was observed in inflammatory cells at early stage and in new vascular endothelial cells at late stage. (5) The expression intensity of VEGF was positively correlated with MVD in wound tissue on PID 3, 7, 14, 21, and 28 in EB group (r(s) = 0.834, P < 0.01).</p><p><b>CONCLUSIONS</b>Different expression levels of VEGF were observed in serum and wound tissue of rats at various stages after EB, and they were closely correlated with different stages of fluid exudation and wound healing process after EB.</p>

Evaluation of different methods for detection of Treponema pallidum antibody-positive samples / 临床检验杂志

Objective To analyze the false-positive results of Treponema pallidum antibody caused by 3 different assay in comparison with Treponema pallidum hemagglutination assay (TPHA).Methods Research group included 3957 clinically asymptomatic syphilis patients,and control group was 344 outpatients with sex-transmitted diseases (STD).The serum samples from the patients who were TPHA-positive were tested in parallel by enzymeimmunoassay (EIA) and syphilis toluidine red untreated serum test (TRUST).Western blot (WB) was performed as confirmatory test.Results In the clinically asymptomatic patients,60 were TPHA-positive.Among them 57 were confirmed by western blot assay,and 1 was false-positive and 2 were borderline in WB.Of the 60 TPHA-positive patients,53 were positive in EIA and 23 were positive in TRUST.In STD patients 40 were TPHA,WB and EIA-positive but 32 were TRUST-positive.Conclusions The results of TPHA and EIA were consistent for diagnosis of syphilis patients who may suffer from previous or latent infection.

Teaching reform of preventive medicine course for clinical medicine speciality / 中华医学教育探索杂志

Objective To meet the needs of the development of modern medicine and train health technical talent for basic level. Methods Using heuristic approach,and multi-form discussions,case teaching method,reform teaching methods,optimizing teaching content. Result Survey results showed that the satisfaction degree was high and it effectively enhanced the concept of preventive medicine and the actual working capacity. Conclusion Through teaching reform,the students’ ability to prevente and cure diseases,to analyze and solve problem has been markedly enhanced,and this approach can be widely used.

The discussion on the crisis management of hospital public relations in China / 中国医学伦理学

Public relation of hospital is important to the survival and development of hospital.It is essential to study on the crisis management of the hospital public relations in the current competitive market with uncertainties.From a public relations and crisis management point of view,this paper explores the actuality of public relation crisis in hospitals of china,and advances some strategies to strength public relation crisis management to promote more harmonious hospital development.