s Objective To explore the value of B mode ultrasound in the detection of amniotic fluid(AF) for fetus of 41～ 46 +6 gestation weeks.Methods B mode ultrasound was performed to monitor AF in 232 fetus of 41～46 +6 gestation weeks compared with that in 296 fetus of 37～40 +6 gestation weeks. Results There were significant differences in amniotic fluid index(AFI), amniotic fluid muddy(AFM) and cavity fetal distress(CFD) between the two groups (P

Objective:To survey the level of hospice care and the influencing factors in Shaanxi province. Methods:Interview and return visit method was used to investigate. Results:In total 235 patients, 37. 02% patients received hos-pice care. There is not significant difference between hospice users and no hospice users in sex and geographic differ-ences. There was significant difference between hospice users and no hospice users in personal ages, and in gap between urban and rural areas. and in medical payment, and in basic lesions. Malignant tumor patients receive hospice care most-ly. No patient received hospice care patients with acute trauma. The effect of ages on hospice is maximum ( OR =2. 877). Basic lesions is an important cause of influence whether patients receiving hospice care services(OR=1. 569). Conclusion:The level of hospice care is low in Shaanxi. The age and basic lesions is influencing factors of hospice care. The geographic differences has no effect on hospice care.

Perinatal glucocorticoid therapy has been proved to be effective on promoting fetal/neonatal lung maturity and has contributed to a dramatic improvement in the mortality and morbidity associated with neonatal respiratory distress syndrome.The underlying mechanisms studies are aimed primarily at accelerating the development of alveoli and pulmonary surfactant system.Meanwhile,a growing number of investigations focus on the side effects of perinatal glucocorticoid therapy on fetal/neonatal.Whether the repeat antenatal glucocorticoid and early postnatal glucocorticoid by intravenous injection is safe remains unclear.More studies are needed on the different route of giving glucocorticoid,the effect of different doses and their machanisms.This review presents the relevant information surrounding perinatal glucocorticoid therapy to enhance fetal/neonatal lung maturity,including clinical and animal studies over the last decades.

Objective To investigate the protective effect of glutamine(Gln) pretreatment on intestinal ischemia-reperfusion (I/R) injury and endothelial nitric oxide synthase (eNOS)/nitric oxide (NO) signaling pathway in rat model. Methods Thirty male Wistar rats were randomly divided into three groups(n=10 for each group):sham group, I/R group and Gln group. Animals were pretreated with 1 g/(kg·d)Gln by orogastric route for 7 days in Gln group, and normal saline was given to the other two groups in the same dose. Intestinal I/R was induced by 30 min occlusion of the superior mesenteric artery followed by 24 h of reperfusion. After the operation, the intestinal histopathological changes, the plasma endotoxin level, serum D-lactic acid, eNOS, inducible NOS(iNOS)activity and NO levels were detected by ultraviolet spectrophotometer. The mRNA expressions of myocardial eNOS and iNOS were detected by real-time fluorescence quantitative PCR (RT-PCR). Results After reperfusion, in IR group, extensive epithelial sloughing and mucosal ulceration of villous tips were observed, whereas these findings did not occur in Gln group and sham group. Compared with IR group, the serum NO, eNOS levels and eNOS mRNA expression of intestinal tissue were elevated in Gln group (P<0.01), but the plasma endotoxin level, serum D-lactic acid, serum iNOS and intestinal iNOS mRNA expression decreased in IR group(P<0.05). Conclusion Glutamine pretreatment has protective effects on intestinal ischemia-reperfusion injury in vivo. The mechanism may be related to the inhibition of iNOS expression and the increased expression of eNOS, thereby increasing NO activity.

Objective To investigate the exercise performance in maintenance dialysis patients,and analyze its correlative factors.Methods Maintenance dialysis patients admitted in Tongji Hospital of Shanghai from December 2014 to March 2015 were enrolled,with their baseline data and biochemical measurement being collected.The anthropometric indexes including arm circumference,triceps skinfold,waist circumference and hip circumference were detected.The exercise activity was assessed by hand grip test,timed up and go test (3mTUG) and five times sit-to-stand test (FTSST).Patients were divided into fast group (3mTUG≤12 s) and slow group (3mTUG ＞ 12 s).Univariate and multivariable analyses were used to evaluate the factors influencing exercise performance in maintenance dialysis.Results There were 121 patients enrolled:62 on peritoneal dialysis and 59 on hemodialysis,76 men and 45 women.Patients' average age was (61.6± 13.0) years and median dialysis age was 31.7(12.3,69.0) months.There was no statistical difference between fast group (n=80) and slow group (n=41) in gender,dialysis method,dialysis age,body mass index (BMI),arm muscle area (AMA),waist-hip ratio (WHR),hemoglobin (Hb) and total cholesterol (TC).Patients in fast group were younger,had higher serum albumin,prealbumin,serum phosphate and iPTH,and less prevalence of diabetes than those in slow group.In exercise activity,patients in fast group had better performance in handgrip,3mTUG and FTSST (all P ＜ 0.05).Univariate analysis showed that,handgrip was correlated with sex (male),AMA,BMI,age,diabetes,serum phosphorus and TC;scores in FTSST was correlated with age,BMI,diabetes,WHR,dialysis method,dialysis age,prealbumin and serum phosphorus;scores in 3mTUG was correlated with age,diabetes,WHR,dialysis method and dialysis age,prealbumin,serum phosphorus and iPTH (all P ＜ 0.05).Multiple stepwise regression analysis showed that sex (male),age,AMA and diabetes were independently correlated with handgrip in dialysis patients (all P ＜ 0.05);age,dialysis method,BMI and diabetes were independently correlated with scores in FTSST (all P ＜ 0.05);age,dialysis method,diabetes and WHR were independently correlated with scores in 3mTUG (all P ＜ 0.05).Conclusions The exercise performances of patients on maintenance dialysis are impaired.Age and diabetes are independent factor associated with the exercise performances of patients on maintenance dialysis.AMA is independently associated with upper limb movement,and dialysis method,BMI and WHR are independent factors associated with lower limb movement in dialysis patients.

OBJECTIVE:To investigate the current situation of anticoagulant therapy for patients with non-valvular atrial fibril-lation,and to provide reference for standardized anticoagulant therapy. METHODS:A total of 1056 patients with non-valvular atri-al fibrillation were collected from our hospital during Jul. 2015-Jun. 2016. According to 2012 European Society of Cardiology Guide-lines for the Management of Atrial Fibrillation,the risks of thrombosis and hemorrhage were evaluated,and the standardized anti-coagulant therapy was also evaluated. RESULTS:Among 1056 patients with non-valvular atrial fibrillation,the number of patients with thrombosis risk score ≥1 was 1028,accounting for 97.3%. 763 patients received antithrombosis therapy,and only 139 pa-tients were given warfarin anticoagulant therapy. The international normalized ratio(INR)of prothrombin time in just 30.9% of pa-tients receiving warfarin was in line with the standard before discharge. CONCLUSIONS:The anticoagulant therapy for patients with non-valvular atrial fibrillation is still not optimistic,and effective measure should be adopted to improve the standardization of anticoagulant therapy in the patients with atrial fibrillation.

Objective:To study the effect of shear stress on the expression of KLF2 and eNOS in venous endothelial cells under physiological and uremic conditions, and to explore the mechanism leading to dysfunction of venous endothelial cells.Methods:Under physiological conditions and uremia conditions, different shear stresses were simulated in the parallel plate flow cavity, and the shear stresses were applied to the venous endothelial cells of each group for 4, 12, and 24 hours. The expression of KLF2 and eNOS was detected by immunohistochemical fluorescent staining technique and real-time fluorescent quantitative PCR technique.Results:Under physiological conditions, KLF2 is obviously regulated by shear stresses. High-intensity shear stresses and physiological shear stresses will up-regulate the expression of KLF2, while low-intensity shear stresses and oscillating shear stresses will down-regulate the expression of KLF2. As the duration of action increases, the expression of KLF2 will also increase. In the state of uremia, the expression of KLF2 is significantly inhibited. Even if high shear stresses is applied, the level of KLF2 is not high-expressed as the physiological state. And under the action of low shear stresses and oscillating shear stresses, KLF2 expression is more significantly inhibited. KLF2 is mainly expressed in the nucleus. With the action of shear stresses, KLF2 is also expressed in the cytoplasm, while eNOS is mainly expressed in granular form in the cytoplasm and nucleus.Conclusions:After arteriovenous fistula operation, the expression of KLF2 and eNOS is inhibited under the action of multiple factors of uremia environment and oscillating shear stresses, which may be the main cause of the occurrence and development of venous endothelial cell dysfunction, intimal hyperplasia, and AVF failure.

ABSTRACT:Objective To prepare polymeric nanomicelles capable of simultaneously loading doxorubicin (DOX) and Bcl‐2 small interfering RNA (Bcl‐2 siRNA ) , and to explore their in vitro cytotoxicity and cellular uptake in MCF‐7 human breast cancer cells .Methods Copolymer poly (ethylene glycol )‐g‐polyethylenimine‐g‐poly(γ‐benzyl‐L‐glutamate) was synthesized by the combination of reductive amination and carbodiimide methods , and its chemical structure was verified by 1 H NMR .Empty and drug‐loaded copolymeric nanomicelles were prepared by dialysis method and characterized by transmission electron microscope and dynamic light scattering .The ability of the nanomicelles to compress Bcl‐2 siRNA was measured by by agarose gel electrophoresis method . The release profiles of DOX and Bcl‐2 siRNA from the nanomicelles were explored by means of fluorescence spectrometry and dialysis method .The in vitro cytotoxicity and cellular uptake of DOX and Bcl‐2 siRNA co‐loaded nanomicelles in MCF‐7 human breast cancer cells were characterized by MTT assay and confocal laser scanning microscopy , respectively .Results The critical micelle concentration of the copolymer was about 4 mg/L ,and the sizes of self‐assembled empty and drug‐loaded nanomicelles were smaller than 200 nm .The drug‐loading efficiency and drug‐loading content of DOX in the nanomicelles were 88 .7% and 15 .1% ,respectively .The DOX‐loaded nanomicelles could efficiently compress Bcl‐2 siRNA when an N/P ratio was ≥64 .The zeta potential of DOX and Bcl‐2 siRNA co‐loaded nanomicelles was +30 mV .The release behavior of the cargoes from the nanomicells was pH‐sensitive , and the release of Bcl‐2 siRNA was more sensitive to acidic pH than that of DOX . The nanomicelles could simultaneously deliver DOX and Bcl‐2 siRNA into MCF‐7 cells , and the co‐delivered DOX and Bcl‐2 siRNA significantly increased the cytotoxicity of DOX (P<0 .05) .Conclusion The polymeric nanomicelles can co‐load DOX and Bcl‐2 siRNA and deliver them into MCF‐7 cells , and DOX in combination with Bcl‐2 siRNA can synergistically inhibit the growth of MCF‐7 cells and promote cell apoptosis ,suggesting that the nanomicells may be a promising carrier for the co‐delivery for chemotherapeutics and genes .

OBJECTIVE To make the patients using the central venous catheter safely when given chemotherapy and intravenous nutritional therapy,and to decrease the catheter infection by establishing effective infection-preventing systems. METHODS Many infection-preventing actions were carried out,including a three-level management,improving the workers′ training in catheter operation and maintenance,and health education. RESULTS Comparing with the matched group,the infection rate of the experimental group was much lower after the actions.The actions prevented the increase of infection effectively. CONCLUSIONS Building and carrying out the systems are proved to be important measures to decrease the catheter infection and ensure the quality of life among patients during the therapy in hospital.

Objective To develop a PCR-SSP method for detection of HLA-DRB1 alleles in the patients who were hypersensitive to Platanus Acerifolia pollen allergen,and to probe into the association between the atopic subjects to Platanus Acerifolia pollen allergen and HLA-DRB1 alleles.Methods DNA in whole blood was extracted by phenol-chloroform method.Eight pairs of specific primers for alleles were synthesized,and HLA-DRB1*0401,*0402,*0403,*0404,*0405,*0406,*0407,*0408 alleles in 20 atopic patients and 36 healthy individuals of Jiangsu Province with Han nationality were detected by PCR-SSP(polymerase chain reaction-sequence specific primer).Results By optimizing the experimental conditions PCR-SSP methods for detection of the 8 alleles were established and the distributing data of above-mentioned HLA DRB1 were obtained.The frequency of HLA DRB1*0405 and *0406 in the patients group was higher than that of in healthy controls group,while the frequency of HLA DRB1*0402 in the patients group was lower than that in controls.No significant deference for the other 5 alleles was found between the 2 groups.Conclusion HLA-DRB1*0406和*0405 seems to be the likely suspected candidate alleles responsible for susceptibility to Platanus Acerifolia pollen allergen in the atopic patients,while DRB1*0402 might be contribute to the related resistance to the allergen.