Objective To study the different selections of delivery mode of pregnant women, and compare their outcomes. Methods Data of 7 509 pregnant women hospitalized in the General Hospital of Tianjin Medical University between January 2013 and December 2014 were retrospectively analyzed. Of them, there were 6 229 cases of primipara and 1 280 cases of multipara. The numbers of vaginal delivery and cesarean delivery were statistical analyzed between primipara and multipara. The cesarean delivery indications of multipara was also studied. The vaginal delivery rates and cesarean delivery rates, and their outcomes were compared between primipara and scar uterus maternal pregnancy. Results The cesarean delivery rate was higher in multipara than that of primipara (69.06%vs. 57.54%,χ2=59.19, P<0.05). Among them, 631 cases were uterine scar pregnancy, 39 cases (6.18%) were vaginal delivery and 592 cases (93.82%) were cesarean delivery. The uterine scar was the main indicator for cesarean delivery in multipara. Compared the outcomes of cesarean delivery, the weight of neonatal body mass was relatively light, the hospital stay was shorter, the amount of 24 h postpartum bleeding and postpartum fever were less in vaginal delivery in primipara and pregnant women with uterine scar ( P<0.05). There were no significant differences in scores of newborn. There were no significant differences in outcomes of vaginal delivery between primipara and pregnant women with uterine scar. Compared outcomes of cesarean delivery between multipara with scar uterus and primipara, there were increased maternal blood loss and postpartum fever in multipara with scar uterus (P<0.05). Conclusion The cesarean delivery is still the mainly mode for multipara. The vaginal delivery is the best mode for pregnant women with scar uterus compared with that of primipara. The vaginal delivery is the safer way of delivery for pregnant women.

Objective To explore the feasibility and safety of Mckeown-type minimally invasive esophagectomy in para-recurrent laryngeal nerve lymphadenectomy. Methods A total of 163 cases underwent minimally invasive McKeown resection for esophageal carcinoma in the Affiliated Tumor Hospital of Xinjiang Medical University were retrospectively analyzed. Patients were divided into routine treatment group (n=63), right recurrent nerve lymph node dissection group (right group, n=53) and bilateral recurrent laryngeal nerve lymph node dissection group (bilateral group, n=47) according to the operation modes. The postoperative pathology, operation time, intraoperative bleeding volume, postoperative hospitalization time, number of lymph nodes and pneumonia, anastomotic fistula, laryngeal nerve injury and other complications were compared between three groups of patients. Pathological conditions were consisted of the location of tumor, the degree of differentiation, T stage and pathological stage. Postoperative complications were followed up for 6 months. Results There were no significant differences in tumor location, pathological differentiation degree, T stage and pathologic stage between three groups. The amount of bleeding was more in the routine group than that of the right group and the bilateral group (P<0.05). There was no significant difference in the amount of bleeding between the right group and the bilateral group. The total lymph nodes and thoracic lymph nodes were increased in order in routine group, the right group and the bilateral group, and there was significant difference between three groups(P<0.05). There were no significant differences in other operation data and complications between three groups. Conclusion McKeown-type minimally invasive esophagectomy shows good feasibility and safety for para-recurrent laryngeal nerve lymphadenectomy .

Objective To observe the antibacterial effects of amikacin sulfate combined with the ingredient of coptis chinensis:the extract of coptis chinensis, berberine hydrochloride and palmatine hydrochloride on multiple drug resistance (MDR) of Escherichia coli (E.coli) in vitro. Methods One hundred strains of E.coli checked out from 2013 to 2014 that showed resistence to cefotaxime were selected, and in which MDR to bacteria were determined. The extended-spectrum β-lactamases (ESBLs)-producing by Kirby-Bauer test. The minimum inhibitory concentrations (MIC) of the extract of coptis chinensis, berberine hydrochloride, palmatine hydrochloride and amikacin sulfate on ESBLs-producing E.coli were determined firstly, and then the sterilization effects of amikacin sulfate combined with the other three medicines were observed by broth microdilution checkerboard method together with their fractional inhibitory concentrations (FIC), with ATCC 25922 for quality control strains. Results Ten MDR E.coli were screened and proved to be ESBLs-producing. The inhibitory effects were enhanced in a synergistic or additive pattern when amikacin sulfate combined with the extract of coptis chinensis, berberine hydrochloride on nine of the ten MDR E.coli in vitro, where the inhibitory effects were a synergistic or additive pattern when amikacin sulfate combined with palmatine hydrochloride on all of the MDR E.coli in vitro. Conclusion Palmatine hydrochloride or berberine hydrochloride or the extract of coptis chinensis combined with the amikacin sulfate has significant value in treatment of MDR E.coli, which is worthy of further study.

Objective To explore the diagnostic value of combined bedside detection of aminoterminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) in the diagnosis of cardiac dyspnea. Methods A total of 120 patients with dyspnea admitted in our department from June 2014 to February 2016 were included in this study. At the time of admission, NT-proBNP and cTnI levels were measured by bedside test. Values of NT-proBNP>300 ng/L or cTnI>0.16 mg/L were defined as positive for cardiac dyspnea. According to the final diagnosis, patients were divided into two groups:cardiac dyspnea group (n=68) and pulmonary dyspnea group (n=52). At the same time, 30 healthy people were selected as control group. Values of NT-proBNP and cTnI were used for statistical analysis between the three groups. The sensitivity and specificity of NT-proBNP, cTnI and cTnI+NT-proBNP were compared between three groups. Results The levels of NT-proBNP and cTnI were significantly higher in pulmonary dyspnea group and cardiac dyspnea group than those in the control group, and the levels were significantly higher in cardiac dyspnea group than those of pulmonary dyspnea group (P<0.01). The detection sensitivity of NT-proBNP and cTnI alone was 67.65% and 52.94%, combined detection of both was up to 94.12%. The specificity of NT-proBNP and cTnI detection alone was 70.00% and 53.33%, respectively, and combined detection of both was up to 86.67%. The sensitivity of NT-proBNP+cTnI was significantly higher than that of NT-proBNP and cTnI alone (P<0.05), but there was no significant difference in the specificity between combined detection andindividual detection of NT-proBNP. The positive predictive value of the combined detection in the diagnosis of cardiac dyspnea was 94.12%(64/68), and the negative predictive value was 86.67%(26/30). Conclusion Bedside detection with combination of cTnI and NT-proBNP has important clinical application value in the rapid diagnosis of cardiac dyspnea, which is a rapid clinical testing method.

Objective To evaluate the effects of geraniol(GOH) on neointima hyperplasia in rat carotid artery balloon injury model, and explore the potential molecular mechanisms associated with this effect. Methods Totally 20 male Sprague-Dawley (SD) rats were randomly divided into sham operation group (without balloon injury), control group (with balloon injury), low concentration group (with 50 mg/kg GOH intervention after balloon injury) and high concentration group (with 200 mg/kg GOH intervention after balloon injury). The intima to media (I/M) area ratio of neointima was measured by hematoxylin- eosin (HE) staining. The expression of proliferating cell nuclear antigen (PCNA) was measured by immunohistochemical staining at 14th day after operation. As the marker of oxidative stress, the levels of 8-hydroxy-2’-deoxyguanosine (8-OHdG) and malondialdehyde (MDA) were measured by enzyme linked inmmnosorbent assay (ELISA). Results The I/M ratio, IOD, 8-OHdG and MDA values were increased in control group compared with those of sham group. The I/M ratio, IOD and 8-OHdG values were reduced in low concentration group compared with those of control group. But there was no significant difference in MDA level between low concentration group and control group. The I/M ratio, IOD, 8-OHdG and MDA values were significantly reduced in high concentration group compared with those of control group, which showed a more significant inhibitory effect than that of low concentration group (P<0.05). Conclusion GOH could attenuate balloon iniury induced neointima hyperplasia, which might be related to its effect on inhibiting expression of PCNA and decreasing oxidative stress.

Objectives To investigate the relationship of methylenetetrahydrofolate reductase (MTHFR) and methioninesynthase reductase (MTRR) with unexplained recurrent spontaneous abortion (URSA). Methods Case control study was used to select 244 patients with URSA (miscarriage group) and 116 normal women (control group) who were admitted to Tianjin Medical University General Hospital and Tianjin Women’s and Children’s Health Center from January 2013 to March 2015. The oral mucosal epithelial cells were extracted using fluorescence quantitative PCR to detect MTHFR gene C677T, A1298C and MTRR gene loci of A66G single nucleotide polymorphisms (SNP). The relationship between folate metabolism related gene polymorphisms of MTHFR and MTRR and URSA was analysed. Results The frequency of C677T genotype MTHFR was significantly higher in URSA group than that in the control group, and the frequency of CT genotype was significantly lower than that of the control group (P<0.05). There was no significant difference in the frequencies of A1298C MTRR and A66G MTHFR between the two groups. The activity of MTHFR, red cell folate and plasma folate levels were significantly lower in URSA group than those of control group. Homocysteine levels were significantly higher in URSA group than those of control group (P<0.05). There were no significant differences in serum folic acid, red cell folate, homocysteine cysteine levels between patients <35 years old and ≥ 35 years old in URSA group. Conclusion C677TMTHFR gene polymorphism is associated with unexplained recurrent spontaneous abortion.

Objective To investigate the role of purinergic 2X7 receptor (P2X7R) and its downstream target-NLRP3 inflammasome activation in the process of pancreatic fibrosis in a mouse model of chronic pancreatitis (CP). Methods Forty C57BL/6 mice were randomly divided into normal control group, CP group, P2X7R antagonist oxidized ATP (OxATP) group and brilliant blue G (BBG) group. The chronic pancreatitis model was induced by repeated intraperitoneal injection of the cholecystokinin analogue caerulein with the dose of 50μg/kg for six weeks. Normal saline, OxATP (20μL, 300μmol/L) or BBG (20μL, 10μmol/L) were administered for CP group, OxATP group and BBG group for two weeks after the last caerulein injection. Then all mice were sacrificed and the histopathological changes of the pancreas, especially the fibrotic degrees were evaluated by HE stain, fibrosis score, Sirius red staining and α-SMA immunohistochemical stain. The pancreatic P2X7R, NLRP3 and Caspase-1 expressions were detected by immunohistochemistry respectively to compare the changes between the groups, and explore the role of P2X7R-NLRP3 signaling pathway in pancreatic fibrosis. Results Compared with the normal control group, the scores of pancreatic fibrosis and the expressions of P2X7R, NLRP3 and Caspase-1 in pancreas were significantly increased in CP model group (P<0.05). Compare to CP group, the pancreatic chronic inflammation and the fibrosis indices such as HE fibrosis score, Sirius red staining and α-SMA immunohistochemical stain were ameliorated obviously in OxATP and BBG groups (P<0.05). And expressions of P2X7R, NLRP3 and Caspase-1 in the pancreas were allreduced greatly in both OxATP and BBG groups (P<0.05). Conclusion P2X7R antagonist OxATP and BBG can significantly decrease pancreatic chronic inflammation and fibrosis in the mouse model of CP, which suggests that the blockade of P 2X7R-NLRP3 inflammasome signaling pathway may represent a novel therapeutic strategy for CP and its fibrotic process.

Objective To investigate the expression profile of mRNAs in brain samples collected from pronuclear transfer (PNT) mice. Methods Female CD-1 mice were superovulated, and zygotes were collected after mating with adult male mice. Zygotes with two pronuclei were selected for pronuclear transfer manipulation, and then the reconstructed zygotes were transferred into the oviduct of pseudopregnant female mice. The infant mice obtained from pronuclear transfer were called PNT group, while the embryoes that were not performed pronuclear transfer was regarded as control group. Total RNA were extracted from brain samples of both PNT and control mice, and cDNA were labeled with fluorescent dye. Genes that were differentially expressed were identified using the Agilent mouse mRNA array. Gene ontology analysis and pathway analysis were also completed. Results Compared with control group, 392 mRNAs were expressed differentially, which showed more than 2.0 times variation and statistical significance, accounting for 1.7% of all mRNAs. Among those 366 mRNAs were up-regulated and 26 mRNAs were down-regulated. Eleven mRNAs came to 4.0 times variation in total. Gene ontology analysis indicated that differentially expressed genes were significantly enriched in alternative mRNA splicing, small GTPase mediated signal transduction, regulation of insulin receptor signaling pathway, hydrolase activity, transmembrane transporter activity and pyrophosphatase activity. Significant enriched pathway terms contained ion channel transport, fatty acid metabolism, butanoate metabolism, triacylglycerol and ketone body metabolism. Conclusion Pronuclear transfer might influence some key metabolism process in mouse brain.

Objective To investigate the effects of D-tryptophan (D-Trp) on the formation of Streptococcus mutans (S. mutans) biofilm and the dispersal of 24 h-old biofilm, and the drug susceptibility of S. mutans against chlorhexidine (CHX) under the role of D-Trp. Methods Optical density assay was used to evaluate the growth curve of S. mutans exposed to 5.0 mmol/L D-Trp for 28 h. The non-treated group was not added with D-Trp. After treatment with 1.0, 2.5 and 5.0 mmol/L D-Trp, crystal violet staining was used to observe the changes of S. mutans biofilm formation in treatment group and non-treatment group. Crystal violet staining and confocal laser scanning microscopy (CLSM) were applied to illustrate the effects of 1.0, 2.5 and 5.0 mmol/L D-Trp on the dispersal of 24 h-old S. mutans biofilm. Resazurin sodium was used to indicate the effect of 5.0 mmol/L D- Trp on the minimum inhibitory concentration (MIC) and the minimum biofilm inhibitory concentration (MBIC) of treatment groups and negative control group. Results The growth curves of planktonic S. mutans within 28 h was consistent in treatment group and the non-treated group, both attained exponential phase after 4 h and reached stationary phase at 22 h. Notably, when compared with non-treated group, the biomass of S. mutans biofilm was increased with time from 0 to 72 h after treatment with 1.0, 2.5 and 5.0 mmol/L D-Trp. And at the same time point, the biomass was significantly less in each subgroup of treatment group than that of non-treated group (P<0.05). Crystal violet staining demonstrated that values of biomass(OD570)were less in treatment groups treated with 1.0, 2.5 and 5.0 mmol/L D-Trp than those of non-treated group (P<0.01). CLSM also showed that bacteria was adhered to the surface of media intreatment groups treated with 1.0, 2.5 and 5.0 mmol/L D-Trp. The values of biomass were lower in treatment groups than those of non-treated group (P<0.01). The MIC against S. mutans was 0.073 mg/L in both experimental group and negative control group. The values of MBIC were 0.293 mg/L and 2.344 mg/L in experimental group and negative control group, respectively. Under the action of 5.0 mmol/L D-Trp, the MBIC of S. mutans was reduced to 1/8. Conclusion Results indicate that D-Trp may inhibit the formation of S. mutans biofilm and promote the dispersal of biofilm already formed. D-Trp may further help CHX exert its bactericidal activity to S. mutans.

Objective To prepare specific mouse monoclonal antibodies against Homo sapiens dynein,axonemal, heavy chain 2 (DNAH2). Methods Firstly, recombinant plasmid encoding His tagged immunogen, targeting N-terminal sequence of DNAH2 protein (1-300 aa), in E. coli was constructed. IPTG was used to induce the expression of His-immunogen, which was then purified and immunized in BALB/c mice. Hybridoma cells were obtained through the fusion between myeloma cells and splenocytes isolated from BALB/c mice. Finally, ELISA and Western blot assays were performed to screen the positive hybridoma. Results IPTG was used efficiently to induce the expression of DNAH2 immunogen in E. coli. DNAH2 protein bands were detected in screened positive hybridoma. Conclusion Mouse monoclonal anti-DNAH2 antibody is prepared successfully.