Objective To investigate clinical presentation, diagnosis,gestational outcome and treatment of Eisenmenger’s syndrome during pregnancy. Methods Two patients with Eisenmenger’s syndrome during pregnancy were reported retrospectively. Results The first case was admitted in labor at 34 weeks and 4 days in pregnancy,She had dysphoria,tachypnea and dyspnea right after vaginal delivery and died immediately The diagnosis of pulmonary embolism was highly suspected clinically. The second case was admitted because of fetal growth restriction Cesarean section was performed after cyanosis worsened at 35 weeks and 4 days She was discharged from the hospital two weeks after delivery. Conclusion Eisenmenger’s syndrome during pregnancy was associated with extremely poor maternal and fetal outcome Pregnancy is contraindicated in such patients Contraception is necessary after marriage Pregnancy should be terminated as early as possible in such women. In cases who intends to continue the pregnancy,closely observation must be provided to ensure the safety for both mother and the fetus.

The main commercial production of fructooligosaccharides (FOS) comes from enzymatic transformation using sucrose as substrate by microbial enzyme fructosyltransferase. A fructosyltransferase genomic DNA was isolated from Aspergillus niger QU10 by PCR. The nucleotide sequence showed a 1 941 bp size, and has been submitted to GenBank (KF699529). The cDNA of the fructosyltransferase, containing an open reading frame of 1 887 bp, was further cloned by RT-PCR. The fructosyltransferase gene from Aspergillus niger was functionally expressed both in Escherichia coli and Pichia pastoris GS 115. The highest activity value for the construction with the α-factor signal peptide reached 431 U/mL after 3 days of incubation. The recombinant enzyme is extensively glycosylated, and the active form is probably represented by a homodimer with an apparent molecular mass of 200 kDa as judged from mobility in seminative PAGE gels. The extracellular recombinant enzyme converted sucrose mostly to FOS, mainly 1-kestose and nystose, liberating glucose. FOS reached a maximal value and represented about 58% of total sugars present in the reaction mixture after 4 h reaction. The results suggest that the availability of recombinant Pichia pastoris as a new source of a FOS-producing enzyme might result of biotechnology interest for industrial application.
Aspergillus niger ; enzymology ; genetics ; Base Sequence ; Cloning, Molecular ; DNA, Complementary ; Escherichia coli ; Fungal Proteins ; genetics ; metabolism ; Glycosylation ; Hexosyltransferases ; genetics ; metabolism ; Molecular Sequence Data ; Molecular Weight ; Pichia ; Sucrose ; metabolism ; Trisaccharides ; metabolism

BACKGROUND:With the development of minimal y invasive technique, more and more forearm fracture, especial y in children, was treated by elastic stable intramedul ary nailing. Recently, elastic stable intramedul ary nailing was also used in elder children, even adults. In particular, this technique has obtained good curative effects for open fracture and unstable fracture. OBJECTIVE:To evaluate the clinical effectiveness and safety of elastic intramedul ary nail and plate fixation for double fracture of forearm using evidence-based medicine. METHODS:We retrieved PubMed, Embase, Cochrane Library, China Biology Medicine, VIP, China National Knowledge Infrastructure, WanFang, and other electronic databases. The quality of the included studies was assessed using Cochrane Systematic Review. The analysis was performed using RevMan 5.2 software. RESULTS AND CONCLUSION:A total of 7 randomized control ed trials involving 468 cases were included. The results of meta-analyses showed that compared with plate fixation group, effective rate was higher in the titanium elastic nail group (P<0.000 1), the time of fracture healing was shorter (P<0.000 01), and the hospitalization time was shorter (P<0.000 01). In the aspect of adverse reactions, incidence of refracture (P=0.03) and breakage of internal fixation (P=0.03) was significantly lower. These indicated that compared with plate fixation, titanium elastic nail can improve the total effective rate, shorten the time of fracture healing on X-ray and the hospitalization time, at the same time, can effectively reduce the complications of refracture and breakage of internal fixation.

Objective To investigate the roles of fiberoptic bronchoscopy in diagnosis and treatment for infants with refractory and persistent wheezing. Methods From Jun. 2012 to Dec. 2013, 52 hospitalized children with age between four 4 months and 1 year old were recruited for ifberoptic bronchoscopy, who had been wheezing for at least four weeks and treated ineffectively with conventional anti-inlfammatory agents:budesonide and compound ipratropium bromide solution. Then, the pathogenesis of refractory and persistent wheezing was summarized based on clinical features, detection of CT imaging of three-dimensional airway reconstruction and cardiac CT, results of bronchoscopy inspection, and bronchoalveolar lavage lfuid culture. Results Among the 52 cases, 40 were with ground glass-like changes (76.92%) in pulmonary spiral CT testing, 4 with mosaic perfusion syndrome (7.69%), 8 with segmental pulmonary consolidation (15.38%), 8 with obstructive pulmonary emphysema (15.38%), and 1 with left primary bronchial foreign body. In addition, through bronchofibroscopy, there were 52 cases with imlfammation (100%),3 with tracheal stenosis (5.77%), 3 with left and/or right main bronchus stenosis of the external pressure, 18 with bronchomalacia(34.62%), 2 cases with foreign body (3.84%), one in trachea (1.92%), the other in left main bronchus (1.92%), 10 with bronchial mucus plug (19.23%), and 8 (15.38%) with congenital airway malformations (including 3 at tracheal bronchus, 1 at left upper lobe bronchial stenosis and 1 at bronchial Bridge). The culture of bronchoalveolar lavage lfuid were conducted for all patients. The positive rate of bronchoalveolar lavage lfuid was 9.62%(5/52 cases), including 2 cases with tip Escherichia coli, 2 with Haemophilus inlfuenzae, and 1 with Acinetobacter baumannii. Conclusions First, infection is the primary cause of refractory and persistent wheezing, which is persistent in airway resulted from multi-drug resistant bacteriua. Second, refractory and persistent wheezing is often caused by multi-factors including infection, congenital airway malformations, the endogenous and exogenous foreign body, cardiovascular malformation, etc. These factors often lead to dififcult wheezing control. The last, the diagnosis rate of the refractory and persistent wheezing can be improved by combination of ifberoptic bronchoscopy and lung spiral CT.

Objective:To investigate the component changes in compound granatum berberine capsules after the radioactive ray ir-radiation sterilization. Methods: The chromatographic fingerprints were obtained on a Diamonsil C18 analytical column ( 250 mm × 4. 6 mm,0. 5 μm) with solvent system composed of acetonitrile-0. 033 mol·L-1 potassium dihydrogen phosphate, the flow rate was 1. 0 ml·min-1 and the detection wavelength was set at 265nm, the column temperature was maintained at 30℃, and the injection vol-ume was 10 μl. Results:Totally 10 co-possessing peaks were selected as the fingerprint peaks for compound granatum berberine cap-sules, and the fingerprints exhibited promising separation for each peak and revealed the fingerprint information according to the techni-cal requirements of fingerprints for Chinese traditional medicines. Most components were with different degrees of reduction, and some peaks even lost after the irradiation. Conclusion:The main ingredients show no statistically significant change after irradiation ( P>0. 05), suggesting the sterilization method is suitable for the preparation.

Objective To observe the clinical efficacy of electroacupuncture in treating peri-menopausal depression. Method Patients diagnosed with peri-menopausal depression were randomized into a Guanyuan (CV4) group (n=30) and a Neiguan (PC6) group (n=30). After 1-month treatment, Hamilton Depression Scale (HAMD), modified Kupperman index, plasm ACTH and serum CORT levels were observed and compared. Result After intervention, the observed indexes were decreased to different extents, and the between-group differences were statistically significant (P<0.05). Conclusion Electroacupuncture can effectively regulate the endocrine function of peri-menopausal depression patients, improve symptoms, and thus enhance the compensatory function and the quality of life, and the Guanyuan group shows a more significant effect.

Objective To compare the effect between problem-based learning and lecture-based learning for clinical teaching in the department of cardiovascular medicine. Methods Totally 110 five-year-program cardiovascular interns from June 2011 and June 2012 were selected. They were randomly divided into the PBL group(n=55) and LBL group(n=55). PBL and LBL teach-ing methods were applied in the two groups respectively. Teaching effects were evaluated by exam and questionnaire investigation. SPSS 15.0 was used to do data processing; t test was used to compare the average score of two groups;chi-square test was used to process the results of the questionnaire. P<0.05 signifies sta-tistically significant differences. Results There were statistical differences in examinational average score between PBL group and LBL group ((87.89 ±5.39) vs. (82.63 ±5.26), P<0.05). PBL group had significantly higher satisfaction rate in motivating study interests , deepening understanding of theoretical knowledge, cultivating self-learning ability, training verbal expression and developing clin-ical thinking, etc(P<0.05). Conclusions PBL teaching method demonstrates advantages in teaching of cardiovascular medicine and enhances the teaching effect. But the PBL teaching method should be improved in basic knowledge teaching, cultivation of teachers' ability and case selection.

Objective To investigate the expression of gastrin, cyclooxygenase-2(COX-2) and Ki-67 in dif-ferent gastric mucosal lesions and to assess the role of gastrin and COX-2 in the sequence of gastric carcinogenesis and its relationship. Methods 96 samples with different gastric mucosal lesions were obtained by gastroscope. The expression of gastrin,COX-2 and Ki-67 was examined with immunohistochemical staining technique(EnVision). Re-sults Positive rates of gastrin expression in chronic superficial gastritis (CSG), chronic atrophic gastritis (CAG), intestinal metaplasia(IM),dysplasia(Dy) and gastric cancer(GC) were 58.8 % ,30. 0% ,57.9 % ,68.2% and 77.8% ,respectively, and there were significant differences between GC and CAG(P<0.05). Positive rates of COX-2 expression in CSG,CAG,IM,Dy and GC were 41.2 % ,45.0% ,68.4 % ,72.7% and 88.9% respectively, and there were significant differences between GC and CAG(P<0.05). Ki-67 proliferation index (PI) from CSG, CAG, IM, Dy to GC also had an increasing tendency. From CAG to GC,the expression of gastrin and COX-2 was positively correlated with PI (P<0.05). The expression between gastrin and COX-2 was correlated significantly in gastric pre-cancerous lesions (P<0.01). PI was increased significantly in group with co-expression of gastrin and COX-2. Con-clusion Gastrin expression is decreased in CAG. From CAG to GC, gastrin expression is increased gradually. COX-2 expression has an increasing tendency in the sequence of gastric cancerization. From CSG to GC, PI is gradually in-creased. Gastrin and COX-2 co-promote proliferation of gastric epithelial cells,and gastrin may take part in up-regu-lation of COX-2 expression in gastric precancerous.

Objective This study was designed to understand the characteristics of colonic polyps in aged people, and the relationship between the colonic polyps and the malignant change. Methods A total of 158 patients with colonic polyps diagnosed by endoscopy were retrospectively analyzed during the recent years. Among them, 120 patients had been followed up by endoscopy for 1 to 6 years(average 4 5 years) and were compared with 437 young patients. Results The detective rate and the malignant change rate of colonic polyps in the aged people were 30% and 23 4%, respectively, being significantly higher than that of the young (10 2%) and the middle aged people(6 9%, P

Objective: To study the effect of notoginsenoside in various doses on local ischemic neurotic dysfunction and the ultrastructure. Methods: 35 Wistar rats were divided at random. The reversible middle cerebral artery occlusion (MCAO) model was made according to the assessment of the literature. The changes of SEP contents of cerebral cortex NO and SOD, and the changes of the ultrastrcture were recorded by evoked potential electrograph before and after MCAO. Results: notoginsenoside 200mg?kg -1 and 400mg?kg -1 could remarkably alter MCAO, shorten the latent period, improve the dysfuntion induced by MCAO, lower the concentration of NO and enhance the activity of SOD. The differential value in MCAO group was statistically remarkable ( P