Objective To investigate the application of real-time quantitative PCR in quantification of cell-free fetal DNA maternal plasma in patients bearing fetuses affected with DOWN syndrome. Methods Cell-free fetal DNA in maternal serum was isolated from 30 samples(7 male DOWN syndrome fetal ,3 female DOWN syndrome fe-tal,14 male euploid fetal,6 female euploid fetal). Cell-free fetal DNA levels in maternal serum were measured using real-time quantitative PCR using SRY as marker. Results The median cell-free fetal DNA levels in pregnant carry-ing male fetuses(n=7) and the controls (pregnant carrying male euploid fetuses,n=14)were 318.03±96.74 ge-nome-equivalents/ml and 154.40±39.43 genome-equivalents/ml of maternal serum,respectively (t=3.33,P=0.004 ),which was o in women with female fetuses. Conclusion The cell-free fetal DNA levels in pregnant women with DOWN syndrome fetuses are higher than that in pregnant women with normal fetuses.

Objective To investigate the relevance between relapse and course of treatment in genotype 1 chronic hepatitis C (CHC)pa-tients with slow virologic response.Methods Totally 157 genotype 1 CHC inpatients or outpatients were selected from the Third People′s Hospital of Jiaozuo and the People′s Hospital of Jiaozuo from April 2010 to March 2013.The patients were treated with interferon α-1b in conjunction with ribavirin.At 6 months of the initial treatment,5 1 patients with slow virologic response were randomly divided into groups A (24 cases)and B (27 cases),which received continued treatment for another 6 and 12 months,respectively.A 1 -year follow-up of pa-tients was performed after withdrawal of treatment.Adverse reactions in patients receiving the antiviral therapy were assessed.Furthermore, group comparisons were performed on the clearance rate of hepatitis C virus (HCV)RNA and normalization rate of alanine aminotransferase (ALT)at withdrawal of treatment,as well as the CHC relapse rate and ALT normalization rate at 6 months and 1 year after withdrawal of treatment.Continuous data were compared using t test,and categorical data were compared usingχ2 test.Results The rate of adverse reac-tions in patients receiving antiviral therapy had no significant difference between groups A and B (P>0.05 ).At withdrawal of treatment, there were no significant differences between groups in terms of HCV RNA clearance rate (95.65%vs 92.59%)and ALT normalization rate (95.65% vs 88.89%)(χ2 =0.02 and 0.13,respectively,both P>0.05).At 6 months and 1 year after withdrawal of treatment,the CHC relapse rate in group B was significantly lower than that in group A (20.00% vs 50.00%,χ2 =4.69,P <0.05;36.00% vs 68.18%,χ2 =4.85,P<0.05);the ALT normalization rate in group B was nonsignificantly higher than that in group A (84.00% vs 59.09%,χ2 =3.63,P>0.05;72.00% vs 50.00%,χ2 =2.40,P>0.05).Conclusion To extend the 6 -month course of treatment can significantly reduce the relapse following slow virologic response in patients with genotype 1 CHC.

[Objective] To evaluate the value of Fulcrum-bending radiograph and new treatment strategy to the scoliosis with Chiari malformation and/or syringomyelia,and to analyze the effect of operation.[Methods]Eighteen cases suffering from scoliosis with Chiari malformation and/or syringomyelia were divided into 2 groups for surgical treatment.(1)Group 1:six cases had scoliosis with Chiari malformation and/or syringomyelia without obvious neurological impairment.Their scoliosis was corrected with anteroposterior instrumentation afer one week of Halo's traction.(2)Group 2:another 12 patients having similar scoliosis underwent posterior orthopedic operation according to the result of preoperative suboccipital Fulcrum-bending radiograph.[Results]In 6 patients who underwent opration after traction,the average frontal correction rate was 61%.In another 6 cases having soft scoliosis with only posterior operation,the average frontal correction rate was 60%,and the result of opration came close to the Fulcrum-bending radiograph's.But in 6 cases having rigid scoliosis with only posterior operation,the average frontal correction rate was 52%.One patient had nervous lesion and gradually recovered.There existed excessive rectification.[Conclusion]Patients with soft scoliosis with Chiari malformation and/or syringomyelia without obvious neurological impairment can be operated on according to Fulcrum-bending radiograph without preoperative traction,and the therapeutic effect is similar to classic operative result.

Objective To investigate the change of MMP-9,TIMP-1,ICAM-1 and VCAM-1 expression in serum from patients with COPD,as well as the correlation between the expressions of these factors and lung function.Methods Enzyme-linked Immunosorbent Assay(ELISA)was used to determine the levels of MMP-9,TIMP-1,ICAM-1 and VCAM-1 in serum from 58 patients with COPD and 30 samples from healthy donors in order to better understand the correlation between the expression of these factors and airflow obstruction.Results The serum levels of MMP-9,TIMP-1,ICAM-1 and VCAM-1[(128.89?115.84),(228.28?107.13),(203.98?70.37) and (352.98?117.73)?g/L]from patients with COPD were statistically and significantly higher than the control group[(30.65?18.43),(133.69?41.41),(148.35?23.77) and (233.57?36.65)?g/L],P

Objective To investigate the feasibility of sentinel lymph node (SLN) detection in patients with cervical cancer undergoing radical hysterectomy Methods Twenty patients with cervical cancer at stage Ⅰb ( n =3), stage Ⅱa ( n =12) and stage Ⅱb ( n =5) underwent SLNs detection by using blue dye Four ml of methlene blue or lymphazurin was injected into the cervix at 4 points around the tumor at the time of radical hysterectomy and bilateral pelvic lymphadenectomy Tumor characteristics, surgical findings, and specific locations of lymphatic dye uptake were recorded and correlated with final pathology results Results Among 20 patients underwent this detection, dye uptake was seen in 18 patients Total number of SLNs were 33 Eighteen SLNs identified located in right pelvic and 15 SLNs located in left The SLNs were successfully detected in 78% patients (14/18) Six patients (33%) were diagnosed with lymph node metastases and there were 5 patients with positive nodes in the group of SLN Two patients had both positive SLNs and pelvic lymph nodes Three patients had positive SLNs only The predictive rate was 100% and the false negative rate was zero Conclusion SLN detection undergoing radical hysterectomy is feasible and safe, however, the detection rate of SLN needs improvement

[Objective] To retrospectively analyze the treatment of tailor's bunion with minimal incision osteotomy,and to investigate the indications and effects of this procedure.[Method]Thirty-seven patients(69 feet)underwent the procedure from July 2002 to August 2007.The axial and lateral films of all feet with loading were taken before and after operation.AOFAS were recorded and analyzed preoperatively and postoperatively.[Result]The forth intermetatarsal angle was 14.36??7.32? before operation and 9.36??2.92?after operation.The unguis aduncus angle of digitus quintus pedis was 20.44??7.36? before operation and 4.36??1.35?after operation.The forth reforming intermetatarsal angle was 10.36??.2.81? before operation and 7.83??2.37?after operation.The exstrophy angle of the fifth metatarsal was 5.46??1.70? before operation and 2.13??0.38?after operation.The score of AOFAS was 45.7?5.6 before operation and 85.3?5.1 after operation.[Conclusion]The treatment of tailor's bunion with minimal incision osteotomy is easy to operate and its therapeutic effect is convincing.

Purpose:To explore the clinical feature,and treatment of primary cervical lymphoma. Methods:Clinical data and follow-up survey data of 26 cases were retrospectively analyzed with SSPS software. Results:Primary cervical lymphoma could occur in any age group of women. The misdiagnosis rate was as high as 57.69% (15/26 case).Three of 26 patients died,the five years survival rate was 88.46%.Conclusions:Primary cervical lymphoma is rare,which was very often misdiagnosised. The treatment consisted of an combination of chemotherapy,operation and radiotherapy,which could improve curative results and reduce relapse.

Purpose:To investigate the feasibility of detecting intraoperatively blue sentinel lymph node (BSLN) in patients with cervical cancer and to evaluate the accuracy of predicting pelvic lymph node disease. Methods:Between May 2002 and Jun 2003,29 patients with cervical cancer FIGO stage Ⅰb ( n =3),stage Ⅱa ( n =21),stage Ⅱb ( n =5) underwent BSLNs detection. During operation 4ml of methlene blue or lymphazurin was injected into the cervical tissue around the tumor or 3′,6′,9′,12′ of normal appearance of cervix about 0.5cm deep. Blue lymph duct and BSLNs were observed and located carefully for 10 minutes. Tumor characteristics,surgical findings,and location and number of BSLNs were recorded and correlated with pathologic results to get the accuracy and false-negative rate.Results:Among 29 patients underwent this technique,BSLNs were seen in 24 patients. Total detection rate was 83%(24/29). Location of BSLNs was mainly in obturator and internal iliac group. BSLNs located in left internal iliac group in 11 patients and 13 patients in right internal iliac group,10 patients in left obturator group,and 14 patients in right obturator group. 3 patients had BSLNs in both iliac and internal iliac group. Among 24 patients with BSLNs,there were 6 patients with lymph node metastases. 5 patients had only SLN metastases and one patient had both SLN and other lymph node disease. 18 patients had neither SLNs nor other pelvic lymph nodes metastases. The false-negative rate was 0.Conclusions:Intraoperatively BSLN detection was feasible and safe. Sentinel lymph node was representative of the lymphatic basin.

Objective To study the relation between the pressure in forefoot and the second metatarsalgia in hallux valgus deformity, finally to quantitatively analyze the pressure under the second metatarsal head which is a dangerous factor leading to second metatarsalgia. Methods Three groups volunteered for this study by a self-devised foot pressure measurement system: fifty-eight normal subjects (116 feet) without pain and deformity in foot, thirty-two patients (45 feet) with hallux valgus and pain only under the second metatarsal head, fifty-six patients (102 feet) with hallux valgus without symptoms of metatarsalgia. The percentage of pressure to weight was the criteria for data analysis. First the pressures under second metatarsal head among three groups were compared with each other. Secondly we used case-control study to identify whether it was high pressure that was likely to result in metatarsalgia. Finally we compared the pressure interval under second metatarsal head among three groups to define the pressure interval which might be a dangerous factor to second metatarsalgia. Results 1)The pressure beneath the second meatatarsal head in patients with metatarsalgia was the highest in the three groups (P

BACKGROUND:Previous studies have shown that nerve function may achieve different degrees of recovery in most patients after transvertebral transposition of the spinal cord for repair of spinal cord nerve compression and kyphoscoliosis. However, the effective mechanism of the proposed method to improve postoperative nerve function is stil not clear. OBJECTIVE:To investigate the improvement in neurological outcomes after transvertebral transposition of the spinal cord and posterior correction in patients suffering from neurologic deficit secondary to angular kyphoscoliosis. METHODS:Eighteen patients suffering from neurologic deficit secondary to angular kyphoscoliosis underwent transvertebral transposition of the spinal cord and posterior correction. Preoperatively and 1 week postoperatively, al patients were subjected to somatosensory evoked potential detection. During operation, motor evoked potentials and somatosensory evoked potentials were monitored. Using MRI, the distance from the inner edge of the spinal canal to the outer edge of the convex side of the spinal cord at apical region was measured, and the distance of spinal cord transposition was calculated. RESULTS AND CONCLUSION:(1) There were no significant differences in terms of the latency and amplitude of posterior tibial nerve P40 (preoperatively versus intraoperatively:amplitude:(1.66±0.29)μV vs. (1.68±0.28)μV, P>0.05;latency:(39.25±3.02) ms vs. (38.68±2.67) ms, P>0.05). (2) After surgery, the major curve was improved with (51.1±21.2)%correction rate, and the mean kyphosis was improved with (38.9±18.1)%. The distance between spinal cord and canal on the convex side at the apex was decreased by (2.4±1.7) mm on average. (3) The amplitude and latency of posterior tibial nerve P40 at 1 week postoperatively were (2.21±0.40)μV and (34.98±2.83) ms, respectively (P<0.05). (4) These results suggest that posterior correction and internal fixation can remarkably improve neurophysiological index and nerve function in patients with neurologic deficit secondary to angular kyphoscoliosis.