D and the differences between groups were statistically significant(P0.05).Proliferation index increased in the early phase and reached the peak at the 4th post-operative week.Level of proliferation index in four groups was gradiently decreased from group A to group D.At the 4th post-operative week,differences of proliferation index were statistically significant between groups(P0.05).The changing trend of ratio of CD4+/CD8+ was similar to that of proliferation index.Histological observations showed inflammatory cells infiltrated in early phase gradiently decreased from group A to group D.At the 4th post-operative week,histological observations showed neovascularization in group D.At the 8 weeks post-operatively,more new bone formation was observed in group D. The correlation analysis showed significant positive correlation between proliferation index,CD4+/CD8+ ratio at the 4th post-operative week and the content of total lipid (P

[Objective]To explore the influence of defatting procedure on osteogenicity of cancellous bone allograft.[Method]Thirty inbred Lewis rats were killed.Distal femoral metaphyses were resected as cancellous bone grafts.Grafts were randomly divided into four groups which were treated by four different procedures,respectively.Content of total lipid and total protein in grafts were measured.Twelve inbred Fisher344 rats were randomly divided into four groups according to different grouped grafts which were transplanted into femoral metaphysis bone defects of the recipients.Two different fluorochrome dyes were given subcutaneously to the recipients at 14th and 4th days before sacrifice respectively.All rats were killed at the 8th postoperative week.The experimental distal femoral metaphyses were harvested and nondecalcified sections were prepared.Sections were observed with a fluorescent microscope and bone histomorphometries were studied.The correlation analysis was performed between mineral apposition rate(MAR) and the content of total lipid.[Result]Results of measurement showed content of total lipid in four grouped grafts were different and the difference between groups were statistically significant(P

[Objective] To investigate the establishment of the Allograft Menisci Bank so as to provide suitable allograft meniscus for clinical study of allograft meniscus transplantation.[Method]The allograft menisci from the plentiful donors of the tissue bank were achieved and preserved with the deep-frozen technique.Clinical use of allograft menisci should be based on practical requirement of patients and the data recorded in the Menisci Bank.[Result]From 2005 to the end of 2006,an Allograft Menisci Bank was established which consisted with about 300 different-sized menisci and 14 allograft menisci were provided for clinical study.[Conclusion]Establishment of the Allograft Menisci Bank can provide a base for clinical meniscus transplantation.The short-term effects of the allograft menisci transplantation are satisfactory,but the long-term outcomes need more cases and further observation.

Purpose To investigate the clinicopathological features, histogenesis, morphological characteristics, immunophenotypes and differential diagnosis of primary extragonadal yolk sac tumor ( eYST) . Methods Clinicopathological data, morphological charac-teristics and immunophenotypes results of 40 cases of eYST were retrospectively studied and the relevant literatures were reviewed. Re-sults All 40 patients, which included 24 male and 16 female, aged from 6 months to 42 years with a 12 years average age and 17 (42.5%) cases were over 12 years old. Mediastinum, sacrococcygeal, retroperitoneal, pineal gland and vagina were involved in 16 (40.0%), 12(30.0%), 5(12.5%), 4(10.0%) and 3(7.5%), respectively. All 40 cases included 32(80.0%) cases pure YSTs, while other 8(20.0%) cases contained other one or two types of germ cell tumor (GCT) components. Conclusions Primary eYST is rare, mediastinum and sacrococcygeal are the most common anatomic sites for eYST, and these mediastinal tumor patients are overwhelmingly confined to adult males, whose average age are significantly older than that in sacrococcygeal, retroperitoneal, pineal gland and vaginal tumor patients (P<0.05), while other sites eYST are restricted to prepubertal children. Adult eYST contain other types of GCT components in some cases, and children's counterparts are always pure YST. Extragonadal eYST manifestate pleomorphic histological features, which combine with immunohistochemical markers is definite value for diagnosis, differential diagnosis.

Abstract: Objective　To investigate the clinical manifestations, diagnosis, treatment and prognosis of COVID-19-associated multisystem inflammatory syndrome in children (MIS-C) with multisystem organ failure, and to analyze the differences between the syndrome resembling Kawasaki disease and Kawasaki disease. Methods We report a case of child diagnosed with SARS-CoV-2 infection who developed MIS-C with multi-organ failure. Literature was reviewed to further discuss clinical symptoms, diagnosis, treatment, and prognosis of MIS-C. Results The patient 's condition progressed rapidly and was severe, with acute kidney injury at admission, presenting with urine output of 0 mL in 8 hours, serum creatinine of 675.1 μmol/L, urea nitrogen of 38.2 mmol/L, creatine kinase 4 932 U/L, along with continuously elevated serum amylase, peaking at 5 809.7 U/L, aspartate aminotransferase of 995 U/L, alanine aminotransferase of 240 U/L, and frequent vomiting. The patient was categorized as critically ill. The confirmed patient with MIS-C was managed in pediatric intensive care units (PICU), received early continuous blood purification, jejunal tube feeding, and combined treatment with intravenous methylprednisolone pulse and human immunoglobulin for intravenous injection (IVIG), resulting in complete recovery and discharge. Through literature review, it can be analyzed that MIS-C is systemic inflammatory response characterized by multi-organ dysfunction from a cytokine storm, which differentiates it from Kawasaki disease characterized by acute systemic vasculitis triggered by infectious factors, ultimately leading to cardiovascular accidents as the main cause of death.Conclusions When fever (≥38 ℃) persists for at least 24 hours, accompanied by high inflammatory symptoms and dysfunction in two or more systems, requiring intensive care treatment, and there is evidence of SARS-CoV-2 infection, MIS-C should be diagnosed early, and intervention and treatment should be initiated promptly to achieve favorable outcomes.

OBJECTIVETo apply single nucleotide polymorphism (SNP) microarray for delineation of small supernumerary marker chromosome (sSMC) in two newborns.

METHODChromosome karyotyping was performed on newborns who were born in Jan. 2013 and Jan. 2014 in Haidian Maternal and Child Health Hospital because of the abnormalities found in pregnancy checkups. SNP microarray analysis was carried out on 2 newborns with de novo sSMCs (one was mos 47,XY, + mar[45]/46,XY[5] and the other was mos 47, XY, + mar [30]/46, XY [20]), which could not be determined by conventional banding techniques. Genomic DNA was extracted from cord blood samples, amplified, tagged and hybridized following the manufacturer' s protocol. Data were collected and analyzed.

RESULTThere was a 78. 6 Mb duplication in chromosome 8 for Newborn A, which was associated with 8p22 duplication syndrome; and a 32. 7 Mb duplication in chromosome 13 for Newborn B, which was not yet reported definitely as pathogenic. The newborn A was identified with agenesis of the corpus callosum, obvious right eyelid drooping, the onset of low muscle tone and mental developmental lag behind their peers, while the newborn B had normal findings on physical and mental evaluation.

CONCLUSIONSNP-array can identify sSMCs of newborns at the DNA level, and can be used as an important supplement to the conventional karyotype analysis, but the pathogenicity of positive outputs need further verification.

Objective To investigate the value of copy number variation analysis based on next-generation sequencing (NGS-CNVA) in the genetic analysis of missed abortion chorionic villi. Methods From August 2012 to May 2014, chorionic villi from 74 cases of missed abortion at 6-13 gestational weeks in Haidian Maternal and Child Health Hospital were collected and analyzed by karyotype analysis and NGS-CNVA. The results of the two methods were compared. Results (1) Karyotype analysis was carried out for the villi from the 74 missed abortion patients. Thirty cases were euploid, 26 cases were aneuploid, while 18 cases had structural abnormalities. The resolution of the karyotyping was 320 bands and the average report time was 22 days. (2) All of the 74 samples obtained NGS-CNVA results and the report time was 7-10 days. (3) The NGS-CNVA results of 56 cases were consistent with karyotype. Among them, 28 cases (28/56, 50%) had no copy number variants (CNV), and 19 cases (19/56, 34%)had CNV between 1 Mb and 10 Mb. 9 cases (9/56,16%) had CNV≥10 Mb found by NGS-CNVA, but not found by karyotyping. (4) According to the results of NGS-CNVA, karyotype were reviewed. The reviewed results found 7 cases with CNV<10 Mb and 3 cases with CNV≥10 Mb in 30 cases which got normal karyotype results at the first analysis. (5) Among the 18 cases of structural abnormalities, 6 cases were Robertsonian translocation. Sequencing technology could confirm the specific area of chromosome deletion/duplication in 8 cases, but could not locate them. Conclusions NGS-CNVA has lower failure rate, higher resolution, lower specimen requirement and shorter report time than karyotype analysis when used for the genetic analysis of missed chorionic villi . NGS-CNVA could be a useful genetic analysis method for the missed abortion villi.

Objective To explore the clinical effect of transvaginal repair of cesarean scar diverticulum (CSD). Methods Totally 64 patients of CSD in the First Maternity and Infant Hospital, Tongji University between Mar. 2013 and Sept. 2014 underwent transvaginal repair of CSD were reviewed retrospectively and followed. Result All the patients had a prolonged period, and the duration was (14.8± 3.5) days; all the patients were received the transvaginal repair of CSD, there was no intra-operative complications, the procedures were successfully performed in all patients. The mean operation time was (67± 12) minutes, the mean blood loss was (53±32) ml, and the mean length of hospital stay was (4.0±1.1) days. All patients were followed after the operation, the duration of menstruation was (8.1 ± 3.5) days shorter in average, which was statistically significant (P<0.01);the operation effective rate was 94%(60/64) to assess the clinic syptoms, the operation effective rate was 95%(61/64) for anatomic assessment. The distance of the CSD from the serosa became thicker after surgery significantly, the distance was thicker (3.4 ± 0.4) mm compared with preoperation (P<0.01). Conclusions Transvaginal repair of CSD offers minimal invasiveness, good exposure and accurate resection. It is worth to be popularized in the treatment of patients with CSD.

Objective To carry out a molecular screening of Chinese common deafness gene mutations in Chinese pregnant women group,so as to expatiate on the content,provide molecular epidemiological data,reduce the birth rate and provide a theoretical basis to the deaf children. Methods The molecular detection was done to the pregnant women underwent normal antenatal care in our hospital,using gene chips to screen the four com?mon deaf genes(GJB2,GJB3,SLC26A4 and mitochondrial 12S rRNA)in China;then,the newborn infants carrying mutations were treated with the hearing screening,using the methods of Otoacoustic Emissions(OAE)and Brainstem Auditory Evoked Potentials(BAEP),and the husbands of mutation carrying pregnant women were adopted molecular testing of the deaf susceptibility genes in order to investigate the correlation of the rate of pregnant women carrying the mutant genes and newborn infants deafness. Results Totally 2 067 cases of pregnant women were accepted to do the molecular screening,there were 110 cases of deafness mutations detected(5.320%),in which GJB2 gene(67 cases),GJB3 gene(6 cases), SLC26A4gene(33 cases),mitochondrial 12SrRNAgene(4 cases)mutation detection rates were 3.240%,0.290%,1.600%and 0.190%,respec?tively;especially:GJB2gene 235 del C,GJB2gene 299 del AT double mutant 1 case;GJB2gene 299 del AT,GJB3gene 538 C>T double mutant 1 case;GJB2 gene 235 del C,SLC26A4 gene IVS7?2 A>G double mutant 1 case. About 108 cases children newborn accepted to do the hearing screening,in which 3 cases had problems with the left ear,3 cases with the right ear,and 4 cases with the double ears. Conclusion The use of ge?netic deafness gene chip to do the molecular diagnostics in pregnant women can be convenient,fast and efficient for prenatal diagnosis of deafness, which provides a theoretical basis and good method for reducing the birth rate of deaf children and should be popularized more widely.

OBJECTIVE:To improve the level of sampling test management of national essential medicine in China.METHODS:The sampling test system of national essential medicine was analyzed in terms of background,difficulty,experience and effect,so as to make suggestions for the work in the future.RESULTS & CONCLUSIONS:In view of the difficulties,such as personnel,equipment,funds and mechanism,sampling test of national essential medicine can be finished successfully by "establishing management principle,information system and focusing on evaluation".The basic database of national essential medicine quality has establisaed successfully so as to establish the quality database of national essential medicine,strengthen the supervision of national essential medicine,form the resultant force to prevent the risk of quality safety.It is suggested to consider about both "full coverage" and "randomness",play the role of "information database" and "risk warning" and objectively treat its "versatility" and "scientificity" of sampling test management of national essential medicine in the future.