Objective To investigate the perinatal outcomes of twin-twin transfusion syndrome (TTTS)and the management.Methods During Nov 1, 2002 to Sep 30, 2005, 24 cases of TTTS in Beijing Obstetrics and Gynecology Hospital were analyzed.The outcomes of them were compared with the pregnancy without TTTS in all twins and in monozygotic twins.The outcomes of the blood-supplying fetus and the blood-recepter were compared.Results 6.8%cases had TTTS in all twins.The group of TTTS had more maternal,fetal and neonatal complications than twins pregnancy without TTTS :polyhydramnios [37.5%(9/24)vs 2.1%(7/328),P＜0.01],gestational hypertension[20.8%(5/24)vs 7.0%(23/328),P=0.043],premature labor[66.7%(16/24)vs 36.3%(119/328),P=0.003],perinatal dead fetus in uterus[18.8%(6/32)vs 1.1%(7/540),P＜0.01],neonatal asphyxia[73.1%(19/26)vs 3.0%(19/632),P＜0.01],the proportion of NICU[88.5%(23/26)vs 23.4%(148/632),P＜0.01],neonatal death [15.4%(4/26)vs 1.7%(11/632),P=0.002 ]and the rate of perinatal mortality [31.2%(0/32)vs 2.8%(18/632)].Compared with the monozygotic twins without TTTS,in TTTS group there were more complications of the mother,the fetus and the neonates:gestational hypertension[20.8%(5/24)vs 9.9%(14/142),P=0.224],premature labor[66.7%(16/24)vs 49.3%(70/142),P=0.115 ],perinatal dead fetus in uterus [ 18.8%(6/32)vs 0.7%(2/282),P＜0.01 ],neonatal asphyxia [73.1%(19/26)vs3.9%(11/280),P＜0.01 ],the proportion of NICU[88.5%(23/26)vs 29.3%(82/280),P＜0.01],neonatal death[15.4%(4/26) vs 2.1%(6/280),P:0.006]and the rate of perinatal mortality[31.3%(10/32) vs 3.2%(8/282)].The perinatal outcomes were better in those cases that the grades of TTTS were below 3 in the first diagnosis.Conclusions We should try to diagnose and treat TTTS as early as possible because the outcome is poor.

Objective To explore the relationship between vertebrobasilar insufficiencies caused by subclavian steal syndrome and degree or type of steal phenomena.Methods 80 patients who were diagnosed subclavian steal syndrome by transcranial doppler ultrasound were analyzed retrospectively,24 cases in them were received digital subtraction angiography.The degree of steal phenomena were determined by direction of blood flow in the ipsilateral vertebral artery,and the type of steal phenomena were determined by whether basilar artery involved in steal phenomena.Finally,we made the correlation analysis between vertebrobasilar insufficiency caused by subclavian steal syndrome and degree or type of steal phenomena.Results There was a significant relationship between the severity of subclavian artery stenosis and degree of VA steal in 24 patients performed with both TCD and DSA(t =15.59,P ＜0.05).There was no significant relationship between the vertebrobasilar insufficiency and severity of steal phenomena (P ＞0.05).There were 21cases(77.8％) exist vertebrobasilar insufficiency in the patients whose basilar artery were involved in steal phenomena,and there were 18 cases(33.9％) exist ertebrobasilar insufficiency in the patients whose basilar artery were not involved in steal phenomena.There was a significant differences between the two type of steal phenomena(P ＜ 0.05).Conclusion The vertebrobasilar insufficiency caused by subclavian steal syndrome doesn't associate with the degree of steal phenomena,and associates with the type of steal phenomena.Paying close attention to whether basilar arteries are involved in steal phenomena is useful for analyzing the patient 's condition and guide clinical treatment.

Dendritic cells (DCs)can capture HIV from the mucosal site and carry it to the draining lymph nodes to promote CD4 + T cell infection.DC-SIGN(CD209)plays a vital role during this process. Heroin,methamphetamine and cocaine are the most abused drugs used by drug abusers,which can increase the opportunities of HIV infection.Drugs acting on the corresponding receptors activate the downstream signaling pathway and regulate the expression of DC-SIGN on the surface of DCs,weakening the inhibited effects of immune cells on HIV and promoting HIV infection in many aspects.Given the multiplex effects of drugs on immune function,this article reviews the relationship between abused drugs,DCs and HIV infection,particularly in the signal pathway on immune modulation.

Objective To observe the head and neck CTA application value in the diagnosis of ischemic cerebrovascular disease.Methods 430 patients with suspected diagnosis of ischemic cerebrovascular disease were adopted with head and neck CTA examination.The carotid artery stenosis degree,grade and plaque formation were observed,and the sensitivity and specificity of CTA in the diagnosis of ischemic cerebrovascular disease were calculated.Results After CTA examination,a tctal of 293 cases (68.14％) with carotid artery stenosis symptoms,among them 87 cases of mild stenosis,moderate stenosis in 169 cases,35 cases of severe stenosis and occlusion in 2 cases.430 plaques were detected in 430 patients,in extracranial arteries,81 soft plaques were identified,as well as 134 calcified plaque and 107 cases of mixed plaque,totally 322 cases;in intracranial arteries 312 cases of the soft plaque were identified,as well as 115 cases of calcified plaque and 97 cases of mixed plaque,totally 524 cases.The sensitivity of CTA in the diagnosis of ischemic cerebrovascular disease was 97.09％ and the specificity was 83.33％.Conclusion In the diagnosis of ischemic cerebrovascular disease,head and neck CTA examination for head and neck vascular stenosis and plaques has visual assessment,and high sensitivity,specificity.

Objective To investigate the present situation of the combination of antimicrobial drugs and to improve the rationality of antimicrobial medication.Methods Choose 1734 prescription of antimicrobial from February 2015 to May 2016 in our hospital outpatient service and emergency departments, combined with pharmacology, clinical medication instructions and drug instruction,the prescriptions were analyzed statistically,and the name of antimicrobials, combination mode, type, period of treatment, rationality and other aspects of the situation were studied.Results The total prescription of antibiotics was 45.44%, and the combination of antimicrobial drugs was 76.65 %, with the combination form of the dosage form and the injection machine with a maximum of 41.72%.Oral dosage form and oral dosage form combined drug 21.19%.The proportion of combined penicillin was 43.54 percent, followed by the cephalospora 27.81%.The rational compatibility prescription 86.92%, the prescription compatibility is unreasonable 13.08%.In the unreasonable preparation of the prescription, the majority of the formulations for pharmacodynamics were 82.28%.Conclusion The current use of antibiotics in our hospital gradually become standardized, in the process of clinical treatment, to understanded and master the drug combination medication indications, can significantly improve the treatment effect, to avoid the occurrence of adverse reaction phenomenon, the use of drug safety is effectively guaranteed.

Objective To evaluate the effect of octreotide on the survival of patients with advanced hepatocellular carcinoma(HCC).Methods Electronic databases searches were conducted.Meta-analysis of all randomized controlled trials (RCTs) comparing octreotide versus placebo or no treatment was performed.Results Five RCTs including 579 patients with HCC wers assessed.Meta-analysis of the five studies showed that octreotide had no significant effect on the 6,12 and 24 months survival rates of the patients(6months:OR=1.69,95%CI 0.89-3.21,P=0.11;12 months:OR=2.41,95%CI 0.83-6.93,P=0.10;24months:OR=0.58,95%CI 0.28-1.17,P=0.13).To perform the sensitivity analysis,the blank study,the trial detecting somatostatin receptor expression,the study with short survival or the two trials with short follow-up intervals were excluded,and the results also showed that the octreotide treatment had no significant effect on the 6 and 12 months survival rates.A sensitivity analysis based on two trials indicated that the 24months survival rate of the octreotide group was even lower than that of the control group(OR=0.51,95% CI0.27-0.98,P=0.04).Conclusions This Meta-analysis demonstrates that octreotide could not improve the survival of patients with advanced HCC.The administration of octreotide should not be recommended for the treatment of advaneed HCC.

Reovirus,a kind of oncolytic viruses, is seldom pathogenic, but is selectively able to replicate in cancer cells through activation of Ras signaling. Pre-clinical studies have demonstrated that treatment with reovirus is associated with significant anticancer activity across a range of tumor types. Further clinical evaluation of reovirus therapy has shown that it is well tolerated when administered locally or systemically. Encouraging anticancer efficacy has been observed with single-agent treatment and in combination with chemotherapy and radiotherapy. High safety and promising efficacy of reovirus has raised hopes that it will become a new anticancqt agent.

Objective To explore the effects of siRNA on survivin gene expression in osteosarcoma cell line MG63 using siRNA eukaryotic expression vector,and on the cell cycle of osteosarcoma.Method The specific RNA interference(RNAi)fragments targeting survivin gene were synthesized,and they were cloned into pSilencer 3.0-H1 neo plasmid vector.After the vector was constructed,MG63 cells were transfected with negative control vector or RNAi vectors and selected by G418.Expression of protein of survivin in the stable transfected cells was determined by Western blot.These cells which were cultured on cover slips were observed with electron microscopy.Apoptosis analysis was performed with flow cytometry and Hoechst staining.Results Specific siRNA eukaryotic expression vector PsiS targeting survivin gene was constructed successfully.The stable transfectants containing negative control vector and PsiS were obtained.Protein expression of survivin was inhibited significantly in MG63/PsiS cells,whereas survivin gene expression levels were hardly changed in normal MG63 and negative control cells.There were much more pyknotic nuclei found in MG63/PsiS pool than those in MG63 and control.Analysis of DNA content in PsiS transfectants revealed a 7-fold increase in the fraction of sub-G1 peak(apoptotic peak)as compared with other transfectants under the same experimental conditions(P

Objective To investigate the effect of Honghua Injection on the activity of rat liver CYP2D6.Methods The metabolic rates of probe dextromethorphan(DM) in the blank and Honghua Injection groups(0.9,1.8,and 3.6 mL/kg) in vivo urine and in vitro liver microsome incubated system were determined by high performance liquid chromatography(HPLC).The variation of the metabolic rate of DM represented the effect of Honghua Injection on the activity of rat liver CYP2D6 in vivo and in vitro.Results In vivo and in vitro,the DM metabolic rates of treated groups(1.8 and 3.6 mL/kg) are lower than that in the blank group(P

The subjects examined were 398athletes. The method used included both questions and clinical examination. The differences of the data obtained all underwent Chi Square (X~2) test. Result of the investigation showed: the site of the highest incidence of injury was the ankle, 38.4%; the nextwas the knee, 26. 1%; the foot, 15. 3%; low back, 10. 3%; the thigh, 6. 8%; Tendo Achilles, 6. 5%; tibia, 4. 5%and fibula, 2. 3%. The incidence was relatively higher wbenever the injury had any relation with the shape ofthe knee (genu valgum, genu recurvatum), hallux Yalgus, c avus and callus and tarsal navicular. The differencesamong incidences of injury related with the shape of the lower limbs are of important statistical significance.As for the incidence of abnormal shape of limbs, genu valgum and recurvatum are outstanding in female wbilegenu varum occurs much more in male. This article is emphasized on the analysis of the mechanism of the influence of limb shape on injury;and it is thought that it is mainly due to changes in the line of force. In the authors' opinion, in the choiceof high level athletes, those who have such abnormal anatomy of their limbs should not be selected.