Objective To investigate the suitable mode of induced termination of pregnancy at second and third trimester for women with scarred uterus. Methods A retrospective study was performed in 90 cases of second and third trimester pregnant women with scarred uterus, who requested termination of pregnancy due to medical indications in Beijing Obstetrics and Gynecology Hospital from September 2002 to June 2009. The indications of termination of pregnancy were fetal anomaly, serious pregnant complication and intrauterine fetal deaths. 72 second trimester pregnant women and 18 third trimester pregnant women were included in this study. The interval time of previous operation to this pregnancy were recorded. And it was <2 years in 20 cases and ≥2 years in 70 cases. The patients with normal Hepatic function began to take mifepristone and had an allergic test of Ethacridine Lactate. The method of mifepristone combined with Ethacridine Lactate were adopted when the allergic test was negative (group A, 54 cases). The method of mifepristone combined with earbeprost methylate suppositories were used in the patients who had a positive reaction to the allergic test of Ethacridine Lactate, or who failed to amniotomy to inject Ethacridine Lactate because of oligohydramnios or small gestational age(group B, 36 cases). Record the detail information of every patient. (1) Age, gestational weeks, gravidity and parity. (2) The mode of previous operation (inducing the scar of uterus), previous operation time and indication. (3) The mode of induced labor in this pregnancy, the interval time from administration to uterine contraction, delivery or not and the interval time from induction to delivery. (4) Postpartum hemorrhage, the successful rate of induce labor, placental retention ratio and rupture of uterus or not. Results (1) It had no significant difference between group A and group B in age, gravidity, parity and the interval time of previous operation to this pregnancy (P> 0.05). But there was significant difference between two groups in gestational weeks of induction(16 weeks vs. 25 weeks,P<0.01). (2) It had no significant difference between two groups in successful rate of induction and postpartum hemorrhage(P>0.05), but the time from induction to regular uterine contraction and delivery in group B was significant shorter than that of group A(P<0.01). The rate of delivery with 24 hours in group B was 94%. It was significant higher than that of group A(13%, P<0.01). (3) The rate of retained placenta in group B (31%, 11/35) was significant higher than group A (10%, 5/52), but the ratio of residual of placenta and membranes in group A was significant higher than that of group B(54% vs. 34% ). It was no significant difference in total rate of postpartum complication between two groups. Further analysis was done in relationship of complication and the time of previous operation. It was no significant difference between the over 2 years group and the less 2 years group in the incidence rate of complications including placental retention, residual of placenta and membranes, rupture of uterus, placental abruption and postpartum hemorrhage. (4) There was 1 case of uterine rupture in group B and 1 case of placental abruption in group A. Conclusions Both of methods of mifepristone combined with carboprost methylate suppositories and the mifepristone combined with Ethacridine lactate are feasible to induced second trimester and late trimester termination of pregnancy for women with scarred uterus. But sufficient preoperation preparation and the course of induction and labor careful monitoring must be done to prevent the uterine rupture.

AIM: It has been proved that transforming growth factor-?1 (TGF-?1) has a close correlation with kidney fibrosis. This study investigated the effects of TGF-?1 on stromal cell-derived factor 1 (SDF-1) in rat renal tubular epithelial cells (NRK52E). METHODS: The experiment was carried out in the Division of Molecular Neurobiology, State Key Laboratory of Biotherapy, Sichuan University from March 2006 to May 2007. ①Rat renal tubular epithelial cells (NRK-52E, Monash Medical Center, Australia) were divided into normal control group, which were not treated with TGF-?1 (Cytola), and experimental group, which were subdivided into time-dependent groups: NRK-52E cells were incubated with TGF-?1 at the same concentration (2 ?g/L) for 6, 12, and 24 hours, and dose-dependent groups: NRK-52E cells were treated with TGF-?1 at different concentrations (2, 5, and 10 ?g/L) for 24 hours. ②The semi-quantitative calculation of SDF-1 protein expression in the cells treated with TGF-?1 at the concentration of 2 ?g/L for different time was accessed by immunocytochemistry to find the best time point. Then the variances of the mRNA and protein expression level in cells treated with TGF-?1 at different concentrations for 24 hours were detected by RT-PCR and Western-Blotting. RESULTS: ①The protein expression level of SDF-1 in NRK-52E cells treated with TGF-?1 for 12 and 24 hours was higher than for 0 hour (P 0.05). This indicated the SDF-1 expression reached a flat stage, and 24 hour was the bets time to study the dose dependence. ②Both the mRNA and protein expression level analyses demonstrated that the expression of SDF-1 in NRK-52E cells treated with 2 ?g/L TGF-?1 for 24 hours was significantly higher than that in normal control group (P

Vascular construction is an important content in tissue engineering domain,in vitro implanting seed cells on absorbable scaffold materials to form multi-layered cellular layer and establish autoblood vessels along the scaffold absorption. The tissue-engineered vessels are characterized by high biocompatibility and plasticity,less foreign body reaction,and no thrombus production and infection; in addition,the vessels may finally become autoblood vessels in the complete significance. In this article,artificial vascular materials,scaffold processing methods,and vascular culture of seed cells were compared to explore an ideal method to make artificial vessels.

A male patient, 49 years old with drug use, swallowed a toothbrush and a tube of 20 centimeters long which lead to the upper abdomen pain for six years. The gastroscopy examination showed the head of the toothbrush in the gastric antrum and the tail inserting in the pylorus. The intragastric toothbrush was removed by the gastroscopy combining with esophagoscopy.
Esophagoscopy ; Foreign Bodies ; surgery ; Gastroscopy ; Humans ; Male ; Middle Aged ; Stomach

Regulatory T cell (Treg) infiltration is an important mechanism for inhibition of tumor immune microenvironment. Treg is highly expressed in peripheral blood and tumor tissue of various cancer patients. A high expression of Treg may inhibit the antitumor effect of CD4 + CD8 + T lymphocytes or induce immunological resistance to tumor antigens among cytotoxic T lymphocytes(CTL) without producing acute or memory CTL responses, resulting in tumor escape from immuneattack and immune suppressionin in the tumor microenvironment.

Objective To investigate the value of fasting plasma glucose (FPG) in 75 g oral glucose tolerance test (OGTT) on the diagnosis of gestational diabetes mellitus (GDM).Methods Data of 6516 pregnant women who accepted prenatal cares from Beijing Obstetrics and Gynecology Hospital,Capital Medical University between Jan.2010 and Dec.2010 were collected.All patients had normal FPG at first trimester,and accepted 75 g OGTT after abnormal 50 g glucose challenge test (≥7.8 mmol/L).According to the result of OGTT,they were divided into 12 groups,and Chisquare test was used to analyze the role of FPG of OGTT in GDM diagnosis.Results According to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria,15.0％ (980/ 6516) of this group of pregnant women was diagnosed with GDM by FPG (≥5.1 mmol/L) of OGTT in this study.Then,the rest 5536 pregnant women with normal FPG of OGTT were divided into 12 groups according to FPG level (FPG level interval 0.1 mmol/L).As FPG level rose,the incidence of GDM also rose (X2 =282.175,P =0.000).Similar results also appeared when the interval was 0.2 mmol/L and the FPG level was between 4.0 and 4.8 mmol/L (X2 =274.364,P=0.000).When FPG level was lower than 4.2 mmol/L(22.1％,1226/5536),the incidence of GDM diagnosed by OGTT was 3.6％ (44/1226).And when FPG level of OGTT was higher than 4.8 mmol/L,the incidence of GDM was 26.2％ (298/1138).Conclusions FPG screening is recommended between 24 and 28 gestational weeks before OGTT,and GDM low-risk women whose FPG ≤4.2 mmol/L do not need OGTT.

Objective To compare the clinical results of minimally invasive percutancous plate os-teosynthesis (MIPPO) and open reduction with internal fixation (ORIF) for treatment of distal tibial fractures. Methods From October 2006 to June 2007, 94 cases of closed distal tibial fracture with intact articular surface were treated by internal fixation with plates. Of them, 42 were treated with ORIF and 52 with MIPPO. We retrospectively analyzed their union time, malunion and complications. Results The average follow-up was 14.5 (8 to 24) months. In the ORIF group, 35 cases got union, 3 cases delayed union and 4 cases nonunion. The average time for union was 3.83 (3 to 8) months. There were no cases of malunion and 2 cases of superficial infection in this group. In the MIPPO group, 47 cases obtained union, 5 cases delayed union and none nonunion. The average time for union was 3.66(2 to 8) months. No significant differences were found between the 2 groups in total union time or in the union time for Type AI, Type A2 and Type B fractures respectively. The union time for Type A3 fracture was longer in the MIPPO group than in the ORIF group, but the union time for Type C fracture in the MIPPO group was shorter than in the ORIF group. In the MIPPO group, external rotation occurred in 2 cases and posterior angnlation displacement in 3, and 8 cases com-plained of discomfort around the ankle which was relieved after removal of the plate. Conclusions Gen-erally speaking, there is no significant difference between ORIF and MIPPO in union time for distal tibial fractures. ORIF may be superior to MIPPO in treatment of Type A3 fracture, but inferior to MIPPO in treatment of Type C fracture. A high rate of delayed union may be expected in patients who have been treated with MIPPO and have had anteroposterior angnlation.

The morbidity of pregnant related diseases and pregnant complications become higher and higher in China, such as pregnant obesity, pregnant hypertension, pregnant psychological disorder etc. which were common in western countries in the past. Dystocia and abnormal birth are increasing. The ration of operation in obstetrics to vaginal delivery is growing. These are partially due to the less exercise of mothers in pregnancy. Exercise during pregnancy is significant to the mothers as well as their children, which is an effective method to prevent or treat the diseases mentioned.

Background:Intrahepatic cholestasis is a commonly seen clinical manifestation, and often accompanied with jaundice.Study on clinical characteristics of patients with different degrees of jaundice is helpful for the acknowledge of intrahepatic cholestasis.Aims:To explore the clinical characteristics of intrahepatic cholestasis with jaundice.Methods:General data, biochemistry parameters, etiology and treatment of 703 patients with intrahepatic cholestasis were retrospectively analyzed.Results:Jaundice occurred in 168 patients (23.9%), including 149 mild jaundice, 15 moderate jaundice and 4 severe jaundice.Levels of ALT, AST, ALP, GGT, DBIL, TBIL, ratio of DBIL/TBIL, TBA were significantly increased in jaundice group than in non-jaundice group (P<0.05).Levels of ALT, AST, DBIL, TBIL, TBA were statistically different between groups with different degrees of jaundice (P<0.05), however, no significant differences in ALP, GGT, ratio of DBIL/TBIL were seen (P>0.05).The main etiology of intrahepatic cholestasis were digestive system tumors, cardiovascular diseases, shock, hematologic diseases and primary biliary cholangitis.Ursodeoxycholic acid and S-ademetionine were the main drugs for treatment of intrahepatic cholestasis.Conclusions:For patients with intrahepatic cholestasis, levels of ALT, AST, ALP, GGT are increased with the development of jaundice, and attention on damage of hepatocytes should be paid.The etiology of intrahepatic cholestasis with jaundice involves diseases of different organs and systems, most of them are malignant tumor, cardiovascular diseases, shock and primary biliary cholangitis.

Objective To study the anti-inflammation and analgesic action s of Guanjiekang Tablet and to observe its toxicity.Methods Rat pedal swelling experiment,rat capillary permeability experiment,mouse acetic-acid-induced twisting experiment and mouse acute toxicity experiment were carried out in this study.Results Guanjiekang Tablet could obviously reduce the twisting times in mice(P 0.05).The LD50 of oral dose in mice is 1.74(g/kg).Conclusi ons Guanjiekang Tablet has good anti-inflammation and analgesic actions,but also has some toxicity.