Objective To investigate the feasibility of implementing the 24 hours treatment and management model of children with cerebral palsy in Shanghai,in order to provide a set of effective and saving manpower,material and financial rehabilitation and management model for children with cerebral palsy.Methods Firstly,the 10 exports engaged in cerebral palsy rehabilitation were selected as the in depth interviewees by the sampling method of grounded theory.Secondly,applying in depth interviews,the 10 exports were interviewed by designing interview outline and subjects.Last,the interview data were collected and analyzed.Results By analyzing the interview data in three-stage coding mode,three factors affecting the feasibility of 24 hours treatment and management model of children with cerebral palsy in Shanghai were obtained,including the favorable factors,obstacles and necessary factors.Conclusions The 24-hour treatment and management model of children with cerebral palsy in Shanghai is feasible,but it will encounter some obstacles in the implementation process.Through the policy support for health care and education sectors,the feasibility of the pattern will be greatly enhanced.

Objectives:To construct rGA antisense eukaryotic expression vector. Methods:Using molecular cloning technology, we subcloned rGA cDNA in its antisense orientations of the pcDNA 3.0 vector. Results:Cutting with Eco RⅠ and Hin D Ⅲ,antisense recombinant plasmid produce 2 bands. One was 0.28 kb fragment, the other was 5.5 kb fragment which corresponded to theoretical calculation. Conclusions:We succeeded in constructing rGA antisense eukaryotic expression vector.

Objective To investigate the biological effect of wild p16 gene on senescence of human keloid fibroblasts (HKFb) and discuss the feasibility of gene therapy on keloid. Methods Firstly, the HKFb was transfected with pcDNA3-p16 and the positive clones selected by G418. Then, the fibroblast changes were investigated by determining growth curve, cycle profile and ultrastructure of the transfected HKFb. Meanwhile, morphological changes of the transfected HKFb were identified by senescence associated-?-galactosidase staining. Results After HKFb was transfected by p16, the morphology of HKFb changed obviously from the third passage on. The cell proliferation was inhibited markedly and the cell cycle profile analysis showed that about 96.7% cells were trapped in stage G1. The electroscopic analysis of HKFb also showed that the lysosomes were overloaded. Senescence associated-?-galactosidase staining identified the senescence of HKFb. Conclusions The wild p16 gene can induce the HKFb into senescence in advance, as may provide experimental basis for gene therapy on human keloid.

Objective To discuss appropriate management of postpartum hemorrhage(PPH). Material and Methods By means of hospital based data over 10 years, 15 cases of severe PPH were retrospectively analyzed about the clinical parameters and management. Results Among the 15 patients, 9 had hysterectomy, selective arterial embolization was carried out in 7 and 1 had focus clearance. The main causes of postpartum hemorrhage requiring operative management were: DIC, uterine arteriovenous fistula and malformation, placental abnormality, uterine myoma and laceration. Conclusion Upon recognition of postpartum hemorrhage, the most effective management should be initiated. Every effort should be made to stable patient, save life and maintain the reproductive capability.

Objective The purpose of this study was to compare the differences of job satisfaction degree between contract nurses and formal nurses. Methods 350 incumbency clinical nurses were ob-tained from 3 provincial and grade three A hospitals(including nurses in internal medicine, surgical,gyne-cologic,pediatric,emergency departments and ICU). Research instruments used in this study included the self-designed demographic questionnaire and the nurses' job satisfaction scale. Results The level of the overall job satisfaction degree among contract nurses was lower than that of the formal nurses. Of all job satisfaction subscales, the scores of professional opportunities, performance and responsibility,salary and welfare, administration and hospital policy, interpersonal relationships among contract nurses were lower than those of formal nurses. But the scores of scheduling and work conditions, professional traits were higher than those of formal nurses. Conclusions It is advocated to adopt different management and incentive mechanisms to improve the job satisfaction degree for contract nurses according to the differ- ences between contract nurses and formal nurses, so that the nursing staff can be stabilized.

To evaluate the effectiveness and safety of transvaginal cervical cerclage and to investigate the influencing factors in prognosis. Methods The medical records of 85 cases who underwent transvaginal cervical cerclage in Peking Union Medical College Hospital from January, 1985 to September, 2011 were reviewed. Patients with a typical history of recurrent preterm birth/second trimester miscarriage, or for whom the 8.0 mm Hegar uterine dilator could be pushed through the internal cervical os without resistance during the non-pregnancy period were included in the elective cerclage group (n=69) and those diagnosed as cervical insufficiency during pregnancy were included in the emergency cerclage group (n=16). The numbers of premature birth/second trimester miscarriage, gestational age at cerclage, gestational age at delivery and its influencing factors were compared between the two groups. T test, rank sum test and Fisher's exact test were used for statistical analysis. Results All patients underwent cerclage between 13+3 and 26+6 weeks of gestation without major complications, such as rupture of membrane, placental abruption or bladder injury. Patients in the elective cerclage group underwent the procedure significantly earlier than those in the emergency cerclage group [16.6(15.4, 18.3)vs 22.7(19.5, 24.6)weeks, Z=-5.140, P<0.05]. Nine cases had lost to follow-up. Among the remaining 76 cases, the rate of infection after surgery was 18.4%(14/76);the rate of abortion was 17.1%(13/76); and the rate of live birth was 82.9%(63/76). The live birth rate of the emergency group was lower than that of the elective cerclage group [9/15 vs 88.5%(54/61), Fisher's exact test, P<0.05]. Apparent infection after surgery was observed more frequently in the emergency group than that in the elective cerclage group [6/15 vs 13.1% (8/61), Fisher's exact test, P<0.05]. Uterine malformation, infection after surgery and latent infection befor surgery were unfavorable factors associated with miscarriage and early preterm labor. Conclusions Transvaginal cervical cerclage is a safe and effective treatment for cervical insufficiency. Elective cervical cerclage is superior to emergent cerclage. Emphasis should be placed on the monitoring and treatment of perioperative infection. Cervical cerclage should be undertaken with caution in patients with uterine malformation.

Objective To construct the recombinant plasmid carrying antisense GA cDNA, and evaluate the effect of antisense GA gene on the biological characteristics of colon cancer cells. Methods The recombinant plasmid pcDNA3.0/GA containing antisense GA gene was constructed by gene recombination technique. The recombinant plasmid was transfected into colon cancer cells by lipofectamine. The effect of antisene GA gene on the biological characteristics of colon cancer cell line DH52 was evaluated by MTT and electron microscopy. Results The recombinant plasmid pcDNA3.0/GA was successfully constructed. The growth rate of colon cancer cells decreased, and microstructure of the cells appeared typical apoptotic changes after transfection. Conclusion Antisense GA gene could inhibit the growth of colon cancer cells possibly by suppressing GA gene expression and decreasing GA activity in the colon cancer cells.

Objective To evaluate the predictors of maternal and fetal outcome of pregnancy for systemic lupus erythematosus(SLE)patients.MethodsNinety-four patients with 96 pregnancies which were evaluated retrospectively from Jan 1990 to Jan 2008 in Peking Union Medicai College Hospital were divided into two groups:disease stable during pregnancy(group A)and lupus flares during pregnancy (group B).Statistical analysis was performed by X2 or Fisher exact test and Student's t-test.A binary logistic regression model was used to evaluate the predictors of matemal and fetal outcome.Results There were 36 pregnancies with stable lupus disease(group A)and 60 pregnancies with lupus flares(group B).of the 96 pregnancies.18 resulted in therapeutic abortion and 7 in fetal loss,71 resulted in a live birth,3 in neonatal death.The rates of preterm delivery,small gestational age(SGA)and neonatal asphyxia in group B were higher than those in group A(P＜0.05).By binary logistic regression analysis,preeclampsia/eclampsia low serum platelet count and SLE flares were associated with poor fetal outcome(β=2.463,2.228.2.769 respectively.P＜0.05).,rhere were 56 pregnancies with stable lupus disease at the conception with 22(39.3%)occurred lupus flares during pregnancies.Twenty-four preeclampsia and 2 eclampsia were seen in all the pregnancies.Fifty-two pregnancies were complicated with lupus nephritis,and 25 pregnancies(48.1%,25/52)of which were disease stable at the conception,and among 22 pregnancies with disease stable over one year.twelve of which occurred lupus nephritis flares.Three pregnancies which have disease activity within one year before pregnancy all occurred lupus nephritis flares.There were four maternal death which all occurred at the postpartum.By binary logistic regression analysis,lupus nephritis flares were associated with preeclampsia/eclampsia(B=2.658,P＜0.05),and proteinuria at the conception before dilivery were significantly associated with SLE flares(13=3.263,P＜0.05).Conclusion An increase of fetal loss,preterm delivery,SGA and neonatal asphyxia was seen in patients with lupus flares during pregnancy compared with those with stable disease.About 1/3 lupus activity may increase after pregnancy.Preeclampsia and eclampsia were increased when there were lupus nephritis flares.

Chronic obstructive pulmonary (COPD) has significant extra pulmonary effects, which could induce atrophy of peripheral skeletal muscle and respiratory muscles, and significantly influence the respiratory function and quality of life. Muscle nuclear factor (NF)-κB activation plays a key role in the skeletal muscle atrophy. This article discussed the potential mechanisms on how NF-κB signaling pathway increasing protein breakdown and reducing muscle regeneration. On this basis, we explored the role of NF-κB in skeletal muscle at-rophy in patients with COPD during exercise.

Objective To investigate the relationship between abnormalities of maternal serum markers in Down syndrome screening in second trimester and adverse pregnancy outcome.Methods Totally,1935 pregnant women were screened for Down syndrome with maternal serum tri marker with time-resolved fluorescence assay,including alpha fetoprotein (AFP),free β-human chorionic gonadotropin (β-hCG) and unconjugated estriol (uE3),between 15 and 20+6 gestational weeks at Peking Union Hospital from January 1,2009 to January 31,2011,and were followed up till delivery.The relationship between incidence of adverse pregnancy outcomes and women with normal or abnormal levels of serum markers in Down syndrome screening was investigated.T-test or Chi-square test were applied for statistical comparison.Results (1) Among the 1935 pregnant women,normal levels of serum markers were found in 1255(normal group) and 680 were abnormal(abnormal group),in which 577 with only one abnormal serum marker,89 with two and 14 with three abnormal serum markers.According to the serum marker level,the 577 women with one abnormal serum marker were further divided into five groups,including high AFP group (n=17),low AFP group (n=114),high β-hCG group (n=242),low β-hCG group (n=139) and low uE3 group (n=65).The birth weight of infants in lower AFP group and the gestational age at delivery in low β-hCG group were greater than those in normal group [(61.3±9.1) kg vs (59.5±8.3) kg,(272.6±11.8) d vs (274.4±10.1) d,t=2.21 and 1.99,both P＜0.01].(2) The incidence of adverse pregnancy outcome in normal group was 42.8％(537/1255),while comparing with the abnormal group(43.7％,297/680),no statistical significance was shown (RR =1.02,P =0.71).While comparing with the normal group,the incidences of placenta previa [25.5％ (32/1255) vs 2/17,RR=4.61,P＜0.05] and abnormal placental morphology were higher in high AFP group [4.1％ (51/1255) vs 5/17,RR=7.24,P＜ 0.05],the incidence of gestational diabetes mellitus (GDM) was higher in low AFP group [8.1％ (101/1255) vs 14.4％(16/114),RR=1.74,P＜0.05],the incidence of placenta and membrane retention was higher in high β-hCG group [3.5％ (44/1255) vs 6.2％(15/242),RR=1.77,P＜0.05],the incidence of pre-eclampsia was higher in low β-hCG group [1.7％ (21/1255) vs 6.5％ (9/ 139),RR=3.87,P＜0.05].(3) There were 89 women with two abnormal serum markers.Comparing with the normal group,the incidences of small for gestional age (SGA) infants,oligohydramnios,abruptio placenta were higher in women with low AFP but high β-hCG [SGA infants:6.9％(2/29) vs 1.8％(22/1255),RR=3.94; oligohydramnios:20.7％(6/29) vs 6.4％(80/ 1255),RR=3.24; both P＜0.05],the incidences of oligohydramnios was higher in women with both low AFP and low uE3[3/14 vs 6.4％(80/1255),RR=3.36,P＜0.05],the incidence of premature birth and GDM were higher in women with both low β-hCG and low uE3 [premature birth:2/6 vs 4.3％(54/1255),RR=7.75; GDM:3/6 vs 8.0％ (101/1255),RR=6.21; both P＜0.05].(4) There were 14 women with three abnormal serum markers.The relationship between adverse outcome and abnormal serum markers did not show any statistical significance.Conclusions The abnormality of serum markers of Down syndrome screening is closely related to adverse pregnancy outcomes,and women with abnormal serum markers should be carefully monitored during pregnancy.