Objective To evaluate the consistency of fetal brain ultrasound screening and neurosonogram (NSG) with magnetic resonance imaging (MRI),and the clinical values of ultrasound and NSG in the diagnosis of fetal nervous system abnormalities,and the values of NSG in the diagnosis of fetal brain malformations.Methods A retrospective study was conducted on 221 gravidas who were diagnosed with fetal brain development abnormality by ultrasound screening or NSG in Peking University First Hospital between January 2012 and July 2015 and received fetal brain MRI within one week after ultrasound examination.According to the saved images,the 221 cases were divided into two groups:fetal brain ultrasound basic screening group (111 cases) which had three basic transverse planes and NSG group (110 cases) which had ten basic transverse planes.There were four conditions according to the diagnostic results of ultrasonography and MRI:ultrasonography and MRI suggesting the same diseases (A);ultrasonography and MRI suggesting the same diseases,but MRI providing more information for diagnosis (B);ultrasonography and MRI suggesting different diseases (C);ultrasonography suggesting abnormal,but MRI suggesting normal (D).Diagnostic results of ultrasonography and MRI were respectively comparatively analyzed in the two groups.T-test and Chi-test were used for statistical analysis.Results The diagnostic results for NSG group and fetal brain ultrasound basic screening group were listed as follows:A:70.9％(78/110) and 44.1％(49/111);B:7.3％ (8/110) and 8.1％ (9/111);C:3.6％ (4/110) and 21.6％ (24/111);D:18.2％ (20/110) and 26.1％ (29/111).The consistency with MRI results was higher in NSG group than that of fetal brain ultrasound basic screening group (x2=18.985,P＜0.001).Conclusions Compared with fetal brain ultrasound basic screening,NSG provides more consistent results with MRI,suggesting its great clinical value in the diagnosis of fetal nervous system malformations.

Background The clinical efficacy and safety of mouse nerve growth factor(NGF) for injection have been evaluated by Ⅰ,Ⅱ,Ⅲ stage of clinical trials.But as a clinical drug,its adverse effects for special population should been further studied.Objective This clinical trial was to observe and assess the safety and tolerability of mouse NGF for injection during the application in juvenile and elder patients with optic nerve damage.Methods A multicenter non-randomized controlled trial for the safety evaluation of mouse NGF injection solution was performed in 100 eye centers in China.This study protocol was approved by the Ethic Committee of each drug research center,and written informed consent was obtained from the subject,legal mandatary and guardian prior to this study.Total 2046 patients who met the included criteria of optical nerve damage were enrolled.The patients were divided into the juvenile group(90 cases,＜ 18 years),youth-middle-age group (1868 cases,1 8-75 years) and older group(88 cases,＞75 years).Mouse NGF(30 μg)was intranuscularly injected once per day for 21 days in all the patients.Systolic and diastolic blood pressure,heart rate,intraocular pressure (lOP),laboratory examinations of blood and urine,blood biochemical indexes were recorded before and after injection.All adverse events were evaluated after administration of drug.Results There were 189 (189/2046,9.23％)dropped out cases,including 184 lost cases after 3 weeks of treatment and 5 withdrew cases from adverse responses of drug,with a shedding rate ＜10％ in each group.Total 1857 individuals finished this trial.No significant differences were found in the IOP,heart rate and blood pressure between before and after admninistration of grug in the juvenile group,youth-middle-age group and older group (P＞0.05).The incidence rate of the adverse response in the juvenile group,youth-middle-age group and older group was 57.78％,68.18％,60.01％ respectively,and the primary local adverse events were pain(48.89％),redness and swelling(59.09％),duration(54.49％),without significant difference in the rate of local adverse events among the three groups(X2 =2.302,P =0.324).The abnormal rates of laboratory results of blood and urine were not significantly different among the three groups(all at P＞0.05).The percentage of impaired fasting glucose was 7.46％,23.73％and 7.79％ in the juvenile group,youth-middle-age group and older group,respectively,and the percentage in the older group was higher than that in the juvenile group and the youth-middle-age group (x2 =8.685,P =0.005 ;x2 =27.720,P =0.000).Conclusions Injection of mouse NGF is well tolerated in juvenile and elder patients over the age of 75 years.

Objective To protect patients and employees from being polluted and the inferiors,and to build a prototype to enhance the supply chain security of medical consumables according to JCI.Method According to the supply chain security model,adopting corresponding measures of the design of the supply chain management of medical consumables.Result The supply chain security capabilities are enhanced and the risk is reduced in accordance with the quality requirements of JCI.Conclusion The security model applied in the supply chain management of medical consumables can effectively strengthen the security of the supply chain.

Objective To observe the clinical efficacy and safety of immediate-effect moxibustion combined with massage for the treatment of knee stiffness after knee ligament reconstruction surgery.Methods A total of 138 patients after knee ligament reconstruction surgery were randomly divided into control group and observation group,69 cases in each group.The control group received joint rehabilitation therapy,which included TDP light radiation,joint exercise by continuous passive motion apparatus,contraction and relaxation of quadriceps femoris muscle and ankle pump.The treatment group was given immediate-effect moxibustion combined with massage based on the treatment for the control group.The treatment lasted from postoperative day 3 to 14.Before and after treatment,Lysholm knee joint scores,joint activity scores and activities of daily living(ADL) scores of the two groups were observed.Results After treatment,the Lysholm knee joint scores,joint activity scores and ADL scores of the two group were obviously increased (P ＜ 0.05 or P ＜ 0.01 compared with those before treatment),and the increase in the observation groups was superior to that in the control group,the differences of the alove indexes except for joint activity scores being statistically significant between the two groups (P ＜ 0.05 or P ＜ 0.01).Conclusion Immediate-effect moxibustion combined with massage is effective on preventing knee from postoperative ankylosis after knee ligament reconstruction surgery.

Background Retinal hypoxia is one of primary causes of retinal neovascularization,and its mechanism is research hot topic.Studies showed that hypoxia stimulates the activation of many trancripation factors and vascular endothelial cells,which leads to angiogenesis.Besides to the vascular endothelial growth factor,the effect of adenosine on angiogenesis is increasingly concerned.Objective This study was to invastigate the relationship of biological behaviour of human microvascular endothelial cells (HMEC-1) under the hypoxia and adenosine,and to explore the effect of adenosine on angiogenesis under hypoxia.Methods HMEC-1 cell line was cultured in vitro,and the cells were divided into normoxia group and hypoxia group.The cells in the normoxia group were cultured under the 5％ CO2 environment,and those in the hypoxia group were cultured under the 1％ O2,94％ N2 and 5％ CO2 environment.The proliferation ability and percentage of the cells were assayed by cell counting kit-8 (CCK8) and EDU.The migration number and invasive number of the cells were detected by transwell chamber.The expressions of CD39 and CD73 proteins in the cells were tested by Western blot and immunofluorescence technique,and the level of adenosine was measured by high performance liquid chromatography (HPLC).Results The proliferation values (absobancy) were 0.715-±0.067 and 0.821 ±0.056 in the normoxia group and the hypoxia group in 12 hours after culture,and those in 24 hours were 0.946±0.028 and 0.998±0.028,showing significant increase in the hypoxia group compared with the normoxia group (t12h =3.805,t24h =3.222,all at P ＜ 0.01).The precentage of the proliferation in the hypoxia group was evidently higher than that in the normoxia group (t =-6.868,P＜0.01).The number of the cell migration and invasion in 24 hours after culture was 185.3 ± 10.594 and 74.2± 10.741 respectively in the normoxia group,and that in the hypoxia group was 300.7±22.853 and 107.5±7.007,with significant differences between the two groups (t=-12.124,-6.367,both at P＜0.01).The expression levels of CD39 and CD73 proteins in the hypoxia group were significantly higher than those in the normoxia group in bothl2 hours and 24 hours after culture(all at P＜0.05),and the adenosine content in the cells is gradually increased in 2,6,12,24 and 36 hours after culture,with the highest content in 36 hours.The adenosine content was significantly higher in the hypoxia group than in the normoxia group at various time points (t2h =2.469,P =0.017;t6h =5.442,P＜0.001;t12h =3.841,P＜0.001;t24h =4.458,P＜0.001;t36h =2.757,P =0.008;t48h =3.319,P =0.002).Conclusions Compared with the normoxia group,the proliferation,migration and invasion abilities of HMEC-1 are stronger,meanwhile,the expression of CD39 and CD73 as well as the adenosine level in the cells are all increased under the hypoxic condition.It is suggested that the activation of human microvascular endothelial cells might be significantly related to the level of adenosine and its key enzymes.

Objective To investigate the relation between anormalities of fetal abdominal great vessels and heterotaxy, the clinical significance of screening fetal heterotaxy by the abnormalities of fetal abdominal great vessels. Methods 6532 fetuses from our hospital were scanned and the fetuses with abdominal great vessels abnormalities were included. Parameters of fetal growth, abdominal great vessels and anatomical survey were detected. Results Forty-five cases (0.7%) of fetal abdominal great vessels abnormalities were detected prenatally. Forty-two cases were confirmed postnatally, including 35 cases of heterotaxy syndrome and 7 cases of situs inversus totalis and 3 cases missed. The incidences of the abnormal fetus,heterotaxy syndrome and situs inversus totalis of the fetuses with abnormal abdominal great vessels were higher than that of the fetuses with normal abdominal great vessels, the differences were statistically significant( P＜ 0.001). The incidence of both type Ⅰ and type Ⅱ of the heterotaxy syndrome were significantly higher than that of type Ⅳ (P＜0.001). There was a high incidence of left isomerism in abnormal type Ⅰ and of right isomerism in abnormal type Ⅱ , the differences were statistically significant (P＜ 0.001). Conclusions Abnormal great vessels abnormalities have strong relations to heterotaxy and situs inversus which can be used as effective and simple indicator in screening heterotaxy syndrome.

Objective To explore the efficacy and safety of endovascular therapy in the treatment of symptomatic M1 stenosis of middle cerebral artery as well as the causes of perioperative complications.Methods Two hundred fifty-six patients with symptomatic M1 stenosis of middle cerebral artery (＞90％) confirmed by TCD,cerebral CT angiography and DSA was treated by endovascular intervention.The success rate,the changes of stenosis,longterm vascular patency rate,in-stent restenosis rate were analyzed.Results endovascular stent was successfully placed in 251 patients with the M1 part of symptomatic middle cerebral artery stenosis and the successful rate was 98.05％.Fifteen patients had complications (5.86％) which caused neurology deficits and deaths.The degree of vascular stenosis was significantly reduced after stenosis (Before vs After:92.26％±2.11％ vs 15.40％±2.60％).The mean mRS and NIHSS scores was decreased significantly.The average follow-up duration was (21.70±0.80) months,249 patients underwent a second DSA and the mean stenosis was (21.70％±0.80％).Twenty-three patients developed instent restenosis (ISR) and ISR rate was 9.24％.Recurrence ischemic stroke and transient ischemic attacks occurred in 5 patients and recurrence rate was 2.01％.Conclusion Endovascular therapy of symptomatic M1 stenosis of middle cerebral artery is safety and efficacy with low complications.The follow-up results reveal good patency rate and excellent prevention of anterior circulation ischemia.

Objective To survey the scientific research integrity situation of community health care organizations in Yangpu district in Shanghai,meanwhile,provide a reference for scientific research integrity management in any community health care organization.Methods Using the convenience sampling method,we sampled 200 health staff from 4 community health service centers.They were surveyed with uniform questionnaires.Results No dramatically relationship existed in health staff's knowledge about scientific research integrity breach and their age.However,education background,their academic titles,how many times they have learned relative information,publicity about science research integrity would impact their awareness on research integrity.Conclusions There is dramatically discrepancy on the scientific research integrity among these community health staff.

Objective To investigate the effect of trastuzumab for injection on apoptosis and the expression of related genes in locally advanced breast cancer and related indexes.Methods 166 patients with locally advanced breast cancer were selected and divided into two groups, 83 cases in the control group treated with neoadjuvant chemotherapy before operation, 83 cases in the experimental group received trastuzumab for injection on the basis of the control group, serum tumor marker levels, tumor cell apoptosis index and proliferation activity, Bcl-2, Bax gene expression levels, the clinical effect and incidence of adverse reactions were compared after the treatment.Results The effective rate in the control group(78.32%)was lower than the experimental group(90.36%), with significant difference (P<0.05).Compared with the control group, serum levels of CA153,CA125,CEA,TSGF were lower in the experimental group after chemotherapy, levels of apoptosis index(AI) in tumor tissue was higher, levels of S-phase fraction (SPF), proliferation index ( PI) were lower after treatment, Bcl-2 gene in tumor tissue expression level was lower, Bax gene expression level was higher after treatment, all with significant difference (P<0.05).There was no significant difference in the incidence of adverse reactions between two groups. Conclusion The trastuzumab for injection treatment can significantly improve the total remission rate of patients with locally advanced breast cancer , reduce the levels of serum tumor markers, can down-regulate the expression of apoptosis related gene Bcl-2, up-regulate the expression of Bax gene, promote the apoptosis of tumor cells.

Objective To observe the expression of cytotoxicity and receptors on NK cells in breast cancer,and investigate the impact of soluble MICA(sohble MHC class Ⅰ-related molecules A,sMICA) on NK cells receptors expression and cytotoxicity.Methods ELISA was used to examine the sMICA in peripheral blood.The expressions of activated receptor(NKG2D),killer inhibitory receptor (KIR)(CD158b) and NK cells were identified by flow cytometry(FCM).Cytotoxicity of NK cells to breast cancer were tested by MTT.Results sMICA was (205.36±71.27)ng/L in breast cancer patients and 81.6 % samples were detected.There were positive correlations between sMICA levels with breast cancer stages.There were no difference of NK cells percentage between breast cancer and healthy person.The cytotoxicity of NK cells and expressions of NKG2D were obviously lower in breast cancer with sMICA(+) than in healthy person,but CD158b was higher in healthy person.After cultured with sMICA,NK cells cytotoxicity decreased from(76.2±6.7)% to(48.4±4.1)% and the expression of NKG2D reduced from(92.5±7.1)% to (62.5±6.4)%,but the the expression of CD158b increased from(10.6±3.2)% to (43.6±3.4)%.IL-15 up regulated the expression of NKG2D and NK cells cytotoxicity,but decreased the expression of CD158b by co-culturation with IL-15 and sMICA in sMICA+ patients with breast cancer.Conclusion sMICA reduced the expression of NKG2D and increased the expression of Kill,which lead to the down regulation of NK cells cytotoxicity.IL-15 can reverse this effect.