Objective To observe the clinical application of extraperitoneal cesarean section(ECS) plus forceps vs transperitoneal cesarean sections(TCS) in repeated cesarean section.Methods 98 multiparous women with scar uterus for elective repeated cesarean sections were recruited retrospectively,47 cases for ECS plus forceps(group A),and 51 cases for TCS(group B).The multiparous women with hyperglycemia not controlled,severe preeclampsia,heart disease,placenta previa,premature rupture of membrane,a history of ＞ 1 cesarean section,myoma and/or ovarian neoplasm were excluded.Results Skin incision to baby delivery time and total operation time of group A were (7.7 ± 2.8) min and (42.8 ± 9.7) min,respectively,which were significantly shorter than (9.3 ± 3.2) min and (47.6 ± 9.4) min of group B,(t =2.700,2.497,P =0.008,0.014).There was significant difference in blood loss volume during the operation and postoperative 2 hours,which was (310.4 ± 106.3) mL,(365.3 ± 142.8) mL respectively(t =2.142,P =0.035).The Visual Analog Scale for pain (VAS pain) was (2.8 ± 1.8) in group A and (4.1 ± 1.9) in group B,respectively (t =3.252,P =0.002).The gastrointestinal function recovery mean time of group A was significantly shorter than that of group B (12.5 h versus 16.0h,t =2.771,P =0.007).And the postoperative febrile morbidity was significantly lower in group A than in group B(8.5％ versus 25.5％ ;x2 =4.918,P =0.033).The patients with chronic pelvic pain followed up after operation was 3 versus 12,and the difference was significant (x2 =5.143,P =0.026).There were no differences in neonatal Apgar score at 1 minute,birth asphyxia and wound healing rates.Conclusion ECS plus forceps can be safely used for repeated cesarean section,with the advantages of less operation time,less bleeding volume,lower postoperative morbidity,and fewer complications than TCS.

OBJECTIVE: To investigate whether the allergic factors impact the severity of chronic rhinosinusitis or not, further more, to explore the relationship between allergic rhinitis and chronic rhinosinusitis. METHOD: A retrospective review was done on 103 patients. All of these patients were under functional intranasal endoscopic sinus surgery after expectant treatment is ineffective. We devided the patients into different groups according to the result of skin prick and specific IgE and if there is difference in VAS score, Lund and Kennedy endoscopic score, Lund-Mackay CT score between the groups. We also analysed the symptoms in different chronic rhinosinusitis patients allerged to variant kinds of allergen. The SPSS 17.0 software was used to analyze the data. Statistical analysis was performed by t-test, rank order test or χ2 test. RESULT: The duration of the disease, VAS score of nasal blockage, score of Lund-Mackay CT and Lund and Kennedy endoscopic before the operation were in no statistical sense after when compared with the two groups of patients with chronic rhiriosinusitis who grouped according the result of skin prick and specific IgE. The VAS score of facial pressure and loss of smell was higher in patients with chronic rhinosinusitis which the skin prick and specific IgE were positive. The VAS score of nasal discharge was higher in patients with chronic rhinosinusitis who got negative skin prick and specific IgE result. The symptoms of chronic rhinosinusitis improved with operation no matter the group of skin prick and specific IgE positive or negative and VAS score of nasal blockage improved significantly in negative group. The symptoms of sneezing, rhinorrhoea and rhinocnesmus improved after operation among the chronic rhinosinusitis patients with skin prick and specific IgE. The number of cockroach allergy is larger among the patients with chronic rhinosinusitis without polyps than the one among the patients with chronic rhinosinusitis with polyps. CONCLUSION Allergic factor didn't impact much the severity of chronic rhinosinusitis patients who were failed in expectant treatment, besidesthe postoperative outcomes showed that only influence the severity of nasal discharge, facial pressure and loss of smell. Different kinds of allergen were found between the patients of chronic rhinosinusitis with or without polyps. No significantly functional endoscopic sinusitis sugrery outcome were related to the allergic factor. But the allergic factor may interfere the remission of nasal discharge after surgery.
Administration, Intranasal ; Allergens ; Chronic Disease ; Endoscopy ; Humans ; Nasal Obstruction ; Nasal Polyps ; surgery ; Polyps ; Postoperative Period ; Retrospective Studies ; Rhinitis ; immunology ; surgery ; Rhinitis, Allergic ; surgery ; Sinusitis

Objective To summarize the clinical experience of one stage hybrid operation for aortic arch replacement and explore the indication. Methods From July,2009 to March,2010, 22 consecutive patients received one stage hybrid operation in our hybrid suite for aortic dissection or aortic aneurysm involving aortic arch. Two operative methods are used. (1)Bypass from ascending aorta to brachiocephalic arteries using midstemotomy and normothermia with antegrade aortic arch endovascular stented graft implantation. (2) Ascending aorta replacement and/or aortic valve replacement and/or coronary artery bypass grafting using midstemotomy and cardiopulmonary bypass with antegrade aortic arch endovascular stented graft implantation. Results All patients were technically successful. Angiography during the operation showed 100% patency of all the bypass grafts and no obvious translocation or endoleak of the stents. One patient in the first group died on sixth day after operation due to distal dissection rupture. There was one case of mediastinal lymph effusion in the second group and one case of death due to renal failure and respiratory failure 12 days after operation in the second group. The ICU stay and hospital stay were obviously shorter in hybrid open chest group than that in traditional open chest operation group(P ＜0.05). The blood product consumption and expenditure were also obviously less in hybrid open chest group than that in traditional open chest operation group (P ＜0.05). All the patients were followed up with a mean period of (14.45 ±2.33) months (range: 12 -20 months). All other patients were recovered with normal social life. CT showed neither endoleak nor translocation of the stented grafts. Faulse lumen closure rate at stented-graft segment is 100%. There was no obvious change of distal part of the dissection three months after operation except some thrombosis formation in some of the false lumen. Conclusion One stage hybrid operation for aortic arch replacement is safe and effective in shortening the duration of the operation and reducing the surgical trauma and risk of interval between procedures, shortening the hospital stay and reducing the blood product consumption compared with conventional operation with satisfactory early results. The midterm and long term results are still needed to be followed up.

Course teaching for international students in many domestic universities is in English.Some practice and experience of the department of nuclear medicine in Tianjin medical university are introduced from the aspects of teaching course,concerning preparations before class,teaching process and teaching techniques,which will give references to nuclear medicine teaching for international students.

Objective:To investigate the effects and underlying mechanisms of XRCC3 on esophageal squamous-cell carcinoma (ESCC) radiotherapy response. Methods:Expression levels of XRCC3 were detected by reverse transcription PCR, Western blot, and immunohistochemistry. We knocked down XRCC3 with lentiviral infection in ESCC cells. Cell apoptosis was examined by flow cytom-etry. DNA damage and telomere dysfunction-induced foci were determined by immunofluorescence. Results:The expression levels of XRCC3 in ESCC cells and tissues were higher than those in normal esophageal epithelial cells and corresponding adjacent noncancer-ous esophageal tissues. Knockdown of XRCC3 in ESCC cells substantially increased the therapeutic efficacy of radiation. We demon-strated that the radiation resistance of XRCC3 was attributed to the XRCC3-maintaining telomere stability, which reduced ESCC cell death through radiation-induced apoptosis. Conclusion: Our data suggested that XRCC3 protects ESCC cells from ionizing radia-tion-induced DNA damage and death by enhancing telomere stability. Thus, XRCC3 can be used as a promising therapeutic target for ESCCs.

Objective To investigate the impacts of pyruvate kinase M2 isoform (PKM2) silencing on the radiosensitivity of lung adenocarcinoma cell line (A549 cells) and the radiation synergy of xenografts, and to explore their mechanisms. Methods Plasmid pshRNA?PKM2 for interference with PKM2 expression was transfected into A549 cells, and empty vector?transfected cells and untransfected cells were set as con?trols. The silencing efficiency of pshRNA?PKM2 and the expression level of microtubule?associated protein 1 light chain 3(LC3) were measured by Western blot assay. The radiosensitizing effects in A549 cells and xen?ografts after PKM2 silencing were determined by colony?forming assay and xenografts growth curves. Autoph?agy formation in A549 cells and xenografts was analyzed by transmission electron microscopy, and the ex?pression level of PKM2 in xenografts was measured by immunohistochemistry. Comparison between groups was made by Student′s t?test, and the body weights of nude mice and xenograft volumes were subjected to a?nalysis of variance for continuous variables. Results Stable A549 cell lines transfected with pshRNA?PKM2 were successfully produced. Transfection with pshRNA?PKM2 significantly down?regulated PKM2 expression in A549 cells and xenografts (P= 0?? 001;P= 0?? 000). The sensitizer enhancement ratios for A549 cells and xenografts were 1?? 47 and 2?? 00, respectively. Interference with PKM2 expression enhanced radiation?in duced autophagy formation and significantly increased the ratio of LC 3 ? II / I ( P= 0.000 1 ) . Conclusions Silencing of PKM2 expression may enhance the radiosensitivity of A549 cells and xenografts by regulation of autophagy, which holds promise for becoming an effective radiosensitizing target for non?small cell lung canc?er, but still needs to be confirmed by further studies.

Objective:To assess the value of CD4 + and CD8 + T-lymphocyte counts for the diagnostic classification and prognosis of coronavirus disease 2019 (COVID-19). Methods:A total of 95 COVID-19 adult patients admitted to Shanghai Public Health Clinical Center, Fudan University from January to March 2020 were recruited. The CD4 + and CD8 + T-lymphocyte counts among ordinary, severe and critical patients, as well among the cured, improved, unimproved and death patients were compared. The area under receiver operating characteristic curve (AUROC) was used to evaluate the value of CD4 + and CD8 + T-lymphocyte counts for the clinical diagnosis and prognosis of COVID-19. The comparison among groups was performed by Mann-Whitney U test. Results:A total of 95 COVID-19 cases including 68 common, 11 severe and 16 critical cases were enrolled. The counts of CD4 + and CD8 + T-lymphocyte of patients in common, severe and critical groups were 419 (309, 612), 267 (212, 540), 141 (77, 201)/μL, and 238 (153, 375), 128 (96, 172), 92 (51, 144)/μL, respectively, with significant differences ( Z=24.322 and 15.956, respectively, both P<0.01). The counts of CD4 + and CD8 + T-lymphocyte of the death, unimproved, improved, and cured patients were 149 (143, 349), 315 (116, 414), 344 (294, 426), 745 (611, 966)/μL, and 106 (43, 501), 176(67, 279), 194(188, 432), 429(276, 564)/μL, respectively, with significant differences ( Z=36.083 and 16.658, respectively, both P<0.01). The optimal cut-off point of CD4 + T-lymphocyte counts was 237/μL for critical COVID-19 with AUROC 0.911 (95% confidence interval ( CI) 0.833-0.989, P<0.01), with the sensitivity of 86.1% and specificity of 87.5%. For predicting severe and critical cases, the optimal cut-off point of CD4 + T-lymphocyte counts was 405/μL with AUROC 0.863 (95% CI 0.727-0.999, P=0.001), with the sensitivity of 78.6% and specificity of 74.6%. Conclusions:The conditions of patients with COVID-19 are aggravated with CD4 + and CD8 + T-lymphocyte counts decreasing. CD4 + T-lymphocyte counts may be an indicator for diagnostic classification of COVID-19 and prognostic indicator for severe and critical patients.

1000 IU/L,TBil 40～250 mg/L,and mild liver dysfunction at beginning of the disease,but acute severe hepatic lesion occurred due to the use of antibiotics,immunodepressant or NSAIDs.Three patients developed liver function failure and died,7 patients' liver function recovered to nor- mal by increasing dosage of glucocorticoid.Conclusion AOSD with mild liver dysfunction is frequently en- countered.During the treatment,acute severe hepatic lesion may occur due to certain drugs.Therefore,any drug used in AOSD with mild liver dysfunction should be cautious.Once acute severe hepatic lesion happens, increases the dosage of glucocorticoid promptly can improve prognosis.

This study is to offer a clinical pain-depression dyad therapy of ferulic acid, the pain-depression dyad induced by reserpine was established and the dose-effect relationship of ferulic acid on ameliorating pain-depression dyad was explored. Mice were randomly divided into control group, reserpine + vechile and reserpine + ferulic acid (5, 10, 20, 40 and 80 mg x kg(-1)) groups. The reserpine treated mice were tested with thermal hyperalgesia, mechanicial allodynia and forced swimming tests, and the SOD and NO levels of hippocampus and frontal cortex were measured. Moreover, the HPLC-ECD was used to detect the changes of central monoamines concentrations. Compared with control group, reserpine can induce a significant decrease in the nociceptive threshold and increase in the immobility time of the forced swimming test. The results suggested that reserpine significantly increased the level of nitrite in hippocampus and frontal cortex and reduced the levels of SOD, 5-HT and NE in these two brain regions. However, these indexes can be a dose-dependently reversed by ferulic acid (5, 10, 20, 40 and 80 mg x kg(-1)). Ferulic acid can reverse pain-depression dyad, especially at the dose of 80 mg x kg(-1). In addition, it can influence oxidative stress and monoamine level.
Animals ; Antidepressive Agents ; administration & dosage ; pharmacology ; Coumaric Acids ; administration & dosage ; pharmacology ; Depression ; chemically induced ; complications ; metabolism ; physiopathology ; Dopamine ; metabolism ; Dose-Response Relationship, Drug ; Frontal Lobe ; metabolism ; Hippocampus ; metabolism ; Hyperalgesia ; physiopathology ; Male ; Mice ; Mice, Inbred ICR ; Nitric Oxide ; metabolism ; Norepinephrine ; metabolism ; Pain ; chemically induced ; complications ; metabolism ; physiopathology ; Pain Measurement ; Random Allocation ; Reserpine ; adverse effects ; Serotonin ; metabolism ; Superoxide Dismutase ; metabolism ; Swimming ; physiology

Human herpes simplex virus 1 (HSV-1) causes facial,ocular,and encephalitic disease and is associated with latent infection and cancer.Here,we developed a means of studying the pathogenesis of HSV-1 infection at the protein level by using the SELDI Protein Chip to detect changes of protein expression in Vero cells cultured in vitro.After infection with HSV-1 and culture for 12,24 or 48 h,cells were harvested and lysed.IMAC3 arrays were applied to SELDI-TOF-MS to detect proteomic differences before and after infection.The chip detected a series of differentially expressed protein peaks.Interestingly,both peaks at 16 912 Da and 17 581 Da corresponded precisely with the molecular mass of ISG 15,which may participate in antiviral activity during the process of infection.Thus,the results we obtained can serve as a basis to study the pathogenesis of HSV-1 and the interaction between the virus and its host.In addition,they can help in the discovery of new therapeutic targets for treatment of HSV-1 infection.