Objective To report the effect of hormone replacement plus orthopedic surgery for 4 patients with female pseudohermaphroditism caused by congenital adrenal hyperplasia. Methods Four patients with female pseudohermaphroditism caused by congenital adrenal hyperplasia were included.On admission their ages were 11,15,14 and 20 years,respectively.The diagnoses were confirmed by medical histories,ultrasonography,serum levels of hormones and chromosome analysis.They all underwent clitoroplasty and vaginoplasty with perineal skin flap. Results After operation the patients received estrogen and progestogen for a short time to adjust the menstrual cycle and hydrocortisone replacement(10 to 20 mg,twice a day) for their lifetime.Normal menstruation and well-developed breasts were observed in all the patients.No constriction occurred in the reconstructed vaginas. Conclusions This disease can be easily misdiagnosed as hypospadias with bilateral cryptorchidism.Therefore,in addition to careful physical examination,the measurement of serum hormones,ultrasonography of the abdomen,and chromosome analysis are necessary.Proper utilization of the perineal skin flap for reconstruction of the clitoris and vagina as well as careful perioperative managements in combination with hormone replacement therapy can greatly contribute to satisfactory results.

Abstract Objective: To study the relationshiop between the HBV pre-c mutant and the clinical the, the host immunity. Methods: Mu-tation specific PCR(msPCR) was employed for detecting pre-c mutant in 92 cases with HBV-DNA positive;T subpopulations were determinedby APAAP immune-bridge assay; the cytokines (TNF?、 sIL-2R ) levels by ELISA. Results: 57 cases had Pre-c mutant, the rate was ahaut 62 %;pre-c mutant existed popularly in different e systems status, mainly in anti-HBe(+) serum. The reat increased with the deterioration of liverfunction, and was highest in fulminant hepatitis, the percentage of CD4 T lymphocyte and the ratio of CD4/CD8 were aignificantly lower in mu-tational group than in wild group,but CD8 T lymphocyte was obviously higher, the quantity of sera TNF? and sIL-2R in mutational group wereobviously higher than in wild group, both groups were obviously higher than control group. Conclusion:PreC 1896 mutant existed popularly inpatients with HBV infection. There were more serious disturbance in host immunity in mutant group. The mutant may be associated with the pre-ssare of host immune system.The mutant type virus could provoke host immunity resulting in severe liver damage.

ObjectiveTo investigate the effect of Genistein (GST) on cell cycle and apoptosis in PC12 cells transfected App695MT gene.MethodsPC12 cells were transfected with pIRES2-EGFP plasmid or pIRES2-EGFP/APP695MT expression plasmid,and then were divided into control vectortransfected group,APP695 transfected group and GST treatment group.Flow cytometry was applied to detect cell cycle and apoptosis,laser confocal microscope was used to observe morphological changes of cell apoptosis.ResultsCompared with control vectortransfected group,PC12 cells in APP695 transfected group increased significantly in G0 and G1 phase,and less into S phase,cell proliferation index was decreased significantly( (55.6 ±0.57)％,P＜0.0l ),apoptosis rate was increased significantly( (77.10 ± 12.53)％,P＜0.01 ).Emitted red fluorescence increased significantly when cell death,cell body swelling,organelle disintegration,nuclear condensation or fragmentation.Compared with APP695 transfected group,PC12 cells in GST( 15μ mol/L) treatment group,decreased significantly in G0 and G1 phase,and more into S phase,cell proliferation index was increased significantly ( ( 61.57 ± 0.47 ) ％,P ＜ 0.01 ),apoptosis rate was decreased significantly ( (46.00 ± 8.43 ) ％,P ＜ 0.01 ).Cell death was significantly reduced red fluorescence,emitted green fluorescence was significantly enhanced,compared with APP695 transfected group cell morphology improved.ConclusionGST can improve APP695MT gene caused cell cycle arrest,promote cell to S phase transition,reduce apoptosis rate in PC12 cells,and have a protective effect on transfected cells.

Objective:To study the effects of 17-? estradiol on capillary ultrastructure of medulla oblongata in ovariectomized rats. Methods: The 30 adult femal rats were randomly divided into ovariectomy group(A group), estradiol group(B group) and sham- ovariectomy group(C group).The rats of A group and B group were bilaterally ovariectomized ,Which were injected with normalsaline 0.1 ml/d), 17-? estradiol(20 ?g/kg?d -1) ,The rats of D group were sham- ovariectomy ,animals were injected with normalsaline(0.1 ml/d), for 6 weeks. Results:(1)The level of serum estradiol of A group was significantly decreased compared with C group(P

Objective:To observe the protective effects of genistein(GST) on the medulla oblongata neurons in ovariectomized rats. Methods:Rats with bilaterally ovariectomized were injected genistein 200 ?g/(kg?d) for 6 weeks. The madlondialdehyde(MDA)and superoxide dismutase(SOD)activity of medulla oblongata were measured, and the ultrastructure of medulla oblongata neurons were observed. Results:In the GST group,the MDA activity was reduced and SOD activity was increased compared with the OVX group. The ultrastructure of medulla oblongata neurons showed pathological changes in OVX group. These ultrastructure was not find in GST group. Conclusion:GST could protect neurons of medulla oblongata, which might be related to eliminate oxygen free radical.

To explore the major risk factors for hepatitis B (HBV) in Shanghai Jinshan district.A one-to-two matched case control study was performed among the residents of Shanghai Jinshan district in 2010.The data were analyzed by single factor and multivariate analysis performed with SAS 9.13.Single factor analysis showed that the risk factors for hepatitis B were family member with hepatitis B,no vaccination history of hepatitis B virus vaccine and oral treatment.Muhivariable analysis showed that family member with hepatitis B (OR =1.91),no vaccination history of HBV vaccine (OR =0.49) and oral treatment (OR =2.06) were independent risk factors for HBV infection in Shanghai Jinshan district.Strengthening health education for HBV prevention,modifying unhealthy living habits and standardizing the treatment of oral diseases are important measures for lowering infectious rate of HBV.

Objective:To analyze and compare the clinical outcomes of total knee arthroplasty with patella arthroplasty and patella replacement. Methods: From May 1999 to January 2004, 251 knees in 203 patients (45 males and 158 females; age range: 25 to 91 years, average 62.8 years) with osteoarthritis (206 knees) and rheumatoid arthritis (45 knees) were evaluated using a questionnaire during physical examination. Totally 137 knees underwent patella arthroplasty and 114 underwent patella replacement, with a mean follow-up of 28.1 months. The patients were scored using KSS Score, Feller Score and British Orthopedics Association Patient-satisfaction Score. Results: Patella arthroplasty and replacement showed no obvious difference in post-operative improvement of the knee score, knee function score, patella function score and range of flexion and extent of knee. Compared with patella replacement group, patella arthroplasty group had a higher patient satisfaction rate (P

BACKGROUND: Hypoxic training in combined with exercise training can increase the hypoxia levels of the body to mobilize the potentials of the body, resist to and actively adapt physiological responses resulted from hypoxia, so as to improve athletic performance.OBJECTIVE: To summarize the influence of hypoxic training on skeletal muscle structure and function, to provide a theoretical basis and guidance for hypoxic training.METHODS: Using "hypoxic training, skeletal muscle, function, structure" in English as the search terms, PubMed database was ratrieved from 1990 to March 2009; Using "hypoxic training, skeletal muscle, function and structure" in Chinese as the search terms,CNKI database was searched from 2000 to May 2009. Literatures are limited to English and Chinese languages. The content related to the effect of hypoxic training on skeletal muscle structure and function was selected, and repetitive researches were eliminated.RESULTS AND CONCLUSION: Totally 144 literatures were obtained from computer screening, and then analyzed according to the inclusion and exclusion criteria. Hypoxic training could avoid the disadvantages caused by conventional altitude training, the hypoxia environment is regulated according to the body's ability to adapt hypoxia, the normal training is ensured, so that skeletal muscle obtains beneficial physiological adaptation. Compared with pure hypoxia stimulation, different forms of hypoxia and different training methods may integrate into different modes of hypoxic training, which makes skeletal muscle function and structure more complex. The combination form of hypoxia and training is the main factor of the effect of hypoxia training on skeletal muscle function and structure. Different objects of experiments and test methods are likely to interfere with the conclusions, which also affect the mechanism of the role of hypoxic training on skeletal muscle.

Objective To explore the scientific development direction in medical institutions under the new health care reform,and provide a reference for promotion of scientific innovation and development of medical institutions in Beijing.Methods Through analyzing the fund of Natural Science Foundation of China (NSFC) in 2016,scientific competitive power of medical institutions in Beijing was explored from the aspect of project type,subject classification and talent training.Results The NSFC by medical institutions in Beijing mainly focused on medical science department (92.68％),of which corresponding subjects were mainly oncology,neural and mental disease and traditional Chinese medicine.The project approved rates of tertiary hospitals subordinate to country and Beijing were 43.46％ and 29.22％,respectively.Only a few dispersing talent projects were obtained.Conclusions Funds and approved rate of NSFC increased.Medical institutions in Beijing had relatively strong scientific competitive power in the fundamental researches of major and difficult diseases,and traditional Chinese medicine.Fundamental researches,talent training,research team building and international cooperation should be improved in the further.