Objective To explore the ultrasonic imaging features of fetal craniocerebrum, and improve the recognizition on the normal structure and deformity of fetal craniocerebrum. Methods Fetal cranium was measured during 12～40 weeks of gestation, including biaparietal diameter(BPD),lateral ventricular width(LVW),cerebellomedullary cistern(CM), and nuchal translucency(NT) or nuchal fold thickness(NF). Results 18 cases of abnormal craniocerebrum were identified,nine cases of which were accompanied with other abnormalities, and fourteen of which were found during 16～28 weeks of gestation. All cases were proved by subsequent labor or induced labor. Conclusion Second-trimester is the best period of prenatal ultrasound diagnosis of fetal craniocerebrum.

Objective To compare the clinical application of phloroglucinol combined with oxybuprocaine hydrochloride gel and propofol in artificial abortion .MethodFouhundredcaseundergoing artificial abortion in ouhospital from January 2011 to Decembe2012 were randomly divided into the phloroglucinol group and the propofol group ,200 casein each group .The phloro-glucinol group waintramuscularly injected by phloroglucinol 80 .00 mg a30 .00 min before abortion ,and oxybuprocaine hydro-chloride gel 30 .00 mg by cervical injection a4 .00 min before operation .The propofol group waperformed the operation undethe general anesthesiof propofol combined with fentanyl .The cervical relaxation ,operative time ,pain degree ,intraoperative vaginal bleeding ,vaginal bleeding apostoperative 30 .00 min and occurrence rate of abortion syndrome were observed and recorded in the 2 group.ResultThe operative time ,analgesieffec,occurrence rate of abortion syndrome and operation coshad no statistically significandifferencebetween the two groups(P＞0 .05);buthe cervical relaxation ,dug,monitoring cosand occurrence of respi-ration suppression had statistically significandifferencebetween the two group(P＜0 .01) .Conclusion Phloroglucinol combined with oxybuprocaine can achieve the analgesieffecclose to thaof proprofol in artificial abortion ,ieconomiand practical withouneeding anesthesimonitoring ,and can be used in the primary hospital especially the hospitalwith lack of monitoring devices.

Objective To investigate the clinicopathological diagnosis and differential diagnosis of leiomyoadenomatoid tumor of the uterus,to avoid clinical misdiagnosis and mistherapy.Methods The clinical histopathological and immunohistochemical features of 3 cases with leiomyo-adenomatoid tumor of the uterus were retrospectively evaluated,and the literatures were also reviewed.Results After hospitalization,before surgery,uterine smooth muscle tumor was diagnosed in 3 cases,adenomyomas were accompanied diagnosis in 2 cases.Through microscopic patterns of tumor and immunohistochemical staining showed,positive for MC and Calretinin,but negative for CD34,leiomyo-adenomatoid tumor of uterus was diagnosed,so gestrinone was stopped to use.Conclusion Pathological features and immunohistochemistry techniques are useful in establishing a correct diagnosis of leiomyo-adenomatoid tumor of the uterus,and avoiding misdiagnosis and mistherapy.

Objective: To establish the quality standard for Ganmaoling Tablets (Radix Ilex asprella, Flos Chrysanthem Indici, Ramulus et Radix Evodia leptae, acetaminophe, etc.). Methods:The acetaminophen, chlorphenamini maleas, caffeine, Radix Ilex asprella, Flos Chrysanthem Indici, Ramulus et Radix Evodia leptae were identified by TLC. The acetaminophen and chlorogenic acid were determined by HPLC. Results:The average recovery of acetaminophe was 101.36%, and RSD was 0.93%, respectively. The average recovery of chlorogenic acid was 100.8%, and RSD was 0.9%, respectively. Conclusion:The method developed is accurate and the reproducibility is good. The method can be used for quality control of the Ganmaoling Tablets.

Objective To explore the mechanism action of Shoutai Pill in the embryo from the molecular level. Methods The model of normal pregnancy was established with the model of recurrent abortion CBA/J ×DBA/2. The recurrent abortion model CBA/J×DBA/2 in pregnant mice were randomly divided into model group, high-, medium-, low-dose group of Shoutai Pill. From the first day of gestation, mice were given medicine by gavage for 14 d, and then sacrificed. Immunohistochemistry was used to detect differences in protein HSP27,α-enolase, transferrin, annexin A2 protein expression. Results Compared with normal group, decidual HSP27 and α-enolase expression of model group increased significantly, the expression of transferrin and annexin A2 was significantly decreased, with significant differences (P<0.01). Compared with model group, decidual HSP27 andα-enolase expression of Shoutai Pill high and low dose group decreased, annexin A2 expression was increased. Compared with model group, expression of decidual transferrin of Shoutai Pill high dose group increased, with significant differences (P<0.01), decidual transferrin expression of Shoutai Pill medium and low dose group had no significant difference (P>0.05). Conclusion Through the protein expression, Shoutai Pill achieves the maintenance of pregnancy, reducing the rate of embryo resorption, which may be one of the mechanisms of Shoutai Pill preventing miscarriage effect.

Objective To analyze the clinical characters,treatment and prognosis of primary malignant tumor in vagina.Methods A retrospective analysis of 42 patients diagnosed with primary malignant tumor in vagina in Peking Union Medical College Hospital(PUMCH)between Jan 1984 and Aug 2006 was performed.Results Primary malignant tumor accounted for 0.98%(42/4286)in the total gynecological malignant tumors during that period in PUMCH.According to the International Federation of Gynecology and Obstetrics(FIGO)staging system,19 cases were at stage Ⅰ,12 cases at stage Ⅱ,5 cases at stageⅢ,and 6 cases at stage Ⅵ.Thairteen cases were squamous carcinoma,13 cases were malignant melanoma,8 cases were adenocarcinoma.3 case8 were yolk sac tumor and 5 cases were other types.The majority of patients were treated with surgery combined with radiotherapy and chemotherapy.Up to August 2007,19 cases survived.18 cases were dead and 5 casefl were lost.The longest follow up was 10 years,with the median time of 2 years.The overall 2-year SUrvival rate was 60.6%.For stage Ⅰ,stage Ⅱ, and stage Ⅲ-Ⅵ,the 2-year survival rates were 71.3%.58.3%and 29.6%respectively.The 2-year survival rate of patients with squamous carcinoma Was 46.8%,malignant melanoma 72.9%,adenocarcinoma 20.0%and patients with yolk sac tumor were all alive tumor-free after 6-10 years'follow up.Conclusions The prognosis of primary malignant tumor in vagina is affected by clinical stage and histological type.A8 to malignant melanoma,radical surgery combined with chemotherapy and immunotherapy produce good effects.Patients with yolk sac tumor can be cured only with chemotherapy.As to other types,more treatment experiences are needed.

Objective To observe the effect of Shoutaiwan on the expression ofα-enolase in the decidua tissue of recurrent abortion mice. Methods The abortion-prone CBA/J × DBA/2 matings were established as the model of recurrent abortion and the nonabortion-prone CBA/J×BALB/C matings were used as the model of normal pregnancy. The model of recurrent abortion CBA/J × DBA/2 of pregnant mice were randomly divided into model group and Shoutaiwan high-, medium-, low-dose groups, pregnant mice of every group were orally administrated in different doses. On the 14th day of pregnancy, the mice were killed. The expression ofα-enolase was detected by using immunohistochemical method and Western Blot. Results α-enolase expression in the model group was significantly higher than the normal pregnancy group (P<0.01). Compared with the model group, Shoutaiwan low-, medium- and high-dose group significantly decreasedα-enolase expression of pregnant mice (P <0.01). Compared with high-dose group, Shoutaiwan medium-and low-dose group showed no significant difference (P>0.05). Conclusion Shoutaiwan could down-regulate the expression ofα-enolase in the decidua tissues of recurrent abortion mice, which may be one of its mechanisms of preventing miscarriage.

Objective To investigate the mechanisms modulating the functions of dendritic cells (DCs) and suppressing the activation and proliferation of T cells by transforming growth factor-β (TGF-β).Methods Mouse splenic DCs were purified with CD11c+ immunomagnetic beads and the purity of isolated DCs were detected by flow cytometry.Gene chip was used to detect gene expression in DCs after stimulation with TGF-β, and then real-time PCR was performed to analyze the differentially expressed genes in microarray at mRNA level.The activation and proliferation of CD4+ T cells which were co-cultured with DCs after stimulation with TGF-β were detected by flow cytometry.Results The purity of DCs reached over 95% after isolation.TGF-β down-regulated the expression of cell surface markers CD53, CD69, CD33, CD74 and CD93 on DCs;decreased the expression of chemokines Ccl3, Ccl5, Ccl9, Ccl6, Ccl17, Cxcl10, Ccl22, Ccl4, Ccr7, Ccl2, Cxcl9 and Ccl7;inhibited the expression of inflammatory cytokines IL-2ra, IL-12rb2, IL-15ra, IL-1b and IL-15.Moreover, the DCs-mediated activation and proliferation of CD4+ T cells were suppressed by TGF-β.Conclusion TGF-β inhibits the DCs-mediated activation and proliferation of CD4+ T cells by suppressing the expression of surface markers on DCs and down-regulating the expression of chemokines and inflammatory cytokines.

Objective To observe the therapeutic effect of Guizhi Decoction plus Yupingfeng Powder for chronic urticaria and its effect on serum total IgE level.Methods One hundred and twenty patients were randomly divided into treatment group,control group 1 and control group 2,40 cases in each group.The treatment group was treated with Guizhi Decoction,Yupingfeng Powder and Loratadine Tablets orally,the control group 1 was given intramuscular injection of Bacillus Calmette-Guerin polysaccharide nucleic acid and oral use of Loratadine Tablets,and the control group 2 was only given oral use of Loratadine Tablets.The course of treatment covered 5 weeks.The levels of serum total IgE in the three groups were determined before and after treatment,and the therapeutic effect was evaluated after treatment.Results (1) The total effective rate was 85.0％ in the treatment group,80.0％ in the control group 1,and 55.0％ in the control group 2.The effect of control group 1 and the treatment group was superior to that of the control group 2 (P＜ 0.05),but the difference was insignificant between the treatment group and control group 1 (P＞ 0.05).(2)Before treatment,the serum total IgE level of the three groups was higher than that of the normal control group (P ＜ 0.05).After treatment,the serum total IgE level of the three groups was obviously decreased (P ＜ 0.05 compared with that before treatment);the inter-group comparison results showed that the effect of the treatment group and control group 1 on decreasing the serum total IgE level was superior to that of the control group 2(P ＜ 0.05),while the effect of the treatment group was similar to that of the control group 1 (P ＞0.05).(3) During the treatment,blood routine examination indexes and hepato-renal function of the three groups showed no abnormal changes,neither adverse reaction was shown.Conclusion Guizhi Decoction plus Yupingfeng Powder exerts certain therapeutic effect for the treatment of chronic urticaria,and can decrease the serum total IgE level,thus to stabilize the curative effect and reduce the recurrence.

Objective To investigate the association of insulin resistance (IR),blood pressure variability (BPV) and the severity of acute coronary syndrome (ACS),and assess the effect of percutaneous coronary intervention (PCI) on recent prognosis.Methods A total of 260 patients diagnosed as ACS and hospitalized in our department of cardiology from December 2009 to December 2010 were enrolled in the study.There were 93 cases of unstable angina pectoris ( UAP),84 of non ST segment elevation myocardial infarction and 83 of unstable angina pectoris.The subjects were divided into two groups according to 24 hour systolic blood pressure coefficient of variability (24 h SBP-CV) levels:high-CV group (24 h SBP-CV ＞11.5,n =130) and low-CV group(24 h SBP-CV ＜ 11.5,n =130).The differences in HOMA-IR and the severity of coronary artery diseases between the two groups were compared.The association of major adverse cardiac events within 6 months after PCI treatment,and IR as well as BPV was analyzed.Results Compared with the low-CV group,ACS patients in the high-CV group had obviously higher HOMA-IR levels (5.7 ± 1.2 vs 4.0 ± 1.4,P ＜0.01 ),more multivessel diseases (49.2％ vs 33.3％,P ＜0.05) and B2/C type coronary diseases (48.5％ vs 27.7％,P ＜0.01 ),and higher coronary Gensini scores (59.7 ± 17.5vs 43.8 ± 18.6,P ＜ 0.01 ).Multi-factors logistic regression analysis indicated that both 24 h BPV-CV and IR were independent predictors for MACE incidence within 6 months after undergone PCI ( P ＜ 0.05 or P ＜0.01 ).Conclusions IR and BPV were obviously associated with the severity of coronary artery diseases in ACS patients.IR and 24 h BPV-CV were valuable in predicting recent prognosis of ACS patients.