Anti-D immunoglobulin effectively prevents RhD alloimmunity and has a low incidence of adverse reactions, which are generally mild. A consensus is yet to be reached regarding the clinical norms in China. We provide an overview of anti-D immunoglobulin in preventing RhD alloimmunity, including its mechanism of action, dose-effect, and safety, the timing and rationality of prenatal antibody screening, the timing and dosage of routine prenatal administration of anti-D immunoglobulin, as well as the prenatal indications for an additional dosage of anti-D immunoglobulin and postpartum prevention based on evidence from both domestic and abroad.

BACKGROUND: A few mesenchymal stem cells (MSCs) can be found in peripheral blood.OBJECTIVE: To isolate rabbit peripheral blood MSCs and induce its differentiation into osteoblasts.DESIGN, TIME AND SE'I-I'ING: The cytological in vitro study was performed at the Central Laboratory of Shangdong Provincial Hospital from June to December 2008.MATERIALS: A total of 6 New Zealand rabbits were purchased from Shandong Academy of Agricultural Sciences. α-MEM and L-DiEM were bought from Hyclone.METHODS: Full-thickness skin (3 cm×3 cm) (dorsal muscular layer was left) was incised at various sites of rabbit back, every 3days. Incised skin was dressed following orthotopic transplantation. Each rabbit received four consecutive wounds. Peripheral blood was collected from femoral vein before injury and 1 week after injury. MSCs were harvested from peripheral blood by density gradient cantrifugation. MSCs were divided into 2 groups, which were respectively incubated in α-MEM supplemented with 10% fetal bovine serum and L-DiEM. Cells at passage 2 and 1 ×105/cm2 were incubated in a 12-well plate and induced with H-DiEM containing osteogenic inductor.MAIN OUTCOME MEASURES: The following parameters were measured: cell morphology before and after injury; colony forming efficiency of MSCs; outcome of osteogenic induction.RESULTS: Following primary medium change and before injury, obtained cells were normal. Twenty-four hours following incubation and after injury, MSCs were spindle or polygonal, and adhered to the wall. 5-6 days later, cell colonies appeared.Compared with the L-DiEM group, the number of primary culture colony formation in α-MEM group was significantly greater (P < 0.05). Peripheral blood MSCs were spindle, tdangle or polygonal, with the presence of processes, 2-3 nuclei and cell division phase, and slowly proliferated following osteogenic induction. At day 7 after differentiation of MSCs into osteoblasts, positive rate of alkaline phosphates was above 80%. At day 21, calcium deposition was detected by Alizarin Red S (positive staining).CONCLUSION: MSCs could be harvested from peripheral blood of wounded rabbits, with characteristics of osteogenic differentiation, α -MEM was more suitable than L-DiEM for peripheral blood MSCs to growin vitro.

Objectives To analyze the clinical features, diagnosis and treatment of Lemierre syndrome. Methods The clinical data of one case of Lemierre syndrome were retrospectively analyzed. The relevant literatures were reviewed. Results The primary infection of the patient was oral infection, and jugular vein thrombosis and metastatic lung abscess were followed. The blood culture showed that Staphylococcus aureus was positive. Lemierre syndrome was diagnosed. After anticoagulation and anti-infection treatment, the symptoms were improved. Conclusion Lemierre syndrome should be considered in present of jugular vein thrombosis and pulmonary abscess caused by infection.

Objective To explore the effect of lentiviral delivery green fluorescent protein in different brain regions on the transfection of dentate gyrus neurons.Methods Lenti-pSyn-EGFP was stereotaxic injected into dentate gyrus (DG),Cornu Ammonis 1 (CAl) of hippocampus and medial entorhinal cortex (EC) of rats.All animals were perfused with 4％ paraformaldehyde.Their brains were cut into 30 μm sections which were performed with Nissl fluorescent staining.Results The resuts showed that the GFP positive cells in DG area of DG,CA1,EC,DG-EC groups were (18.0± 1.0),(17.0±0.6),(17.3±0.6),(18.3±0.6) respectively,and there was no statistical difference among each group(P＞0.05).Conclusion Lentivirus delivery in EC and CA1 both can transfect DG neurons.This is a useful method to transfect dentate gyrus neurons instead of injecting lentivirus into DG directly and avoid the lesion of DG.

Objective:To investigate the immediate bond strength and surface structure of resin and the tooth enamel which treated by cold plasma.Methods:In the study,40 bovine incisors were divided into two equal parts.In this sense,all enamel adhesive samples were prepared and then randomly divided into 4 groups(n =20).group 1:acid +single bond 2 +resin composite(control group);group 2:beyond bleaching+acid+single bond 2+resin composite;group 3:treated by cold plasma for 5 minutes+acid+single bond 2+resin composite;group 4:treated by cold plasma for 5 minutes+single bond 2+resin composite.Single bond 2 bonding system and Filtek Z250 resin were used in this experiment.The shear bond strength was tested by universal testing machine.The surface of the enamel in different processes was observed by scanning electron microscope (SEM).Statistical analyses by the single factor analysis of variance and multiple pairwise comparisons were performed with SPSS 1 7 .0 .Results:The shear bond strength of group 4 (8.60 MPa)was significantly lower than that of the other three groups (P<0.05). The shear bond strength of group 2 (1 7.89 MPa)was higher than that of group 4,but lower than group 1 and group 3 (P<0.05).There was no significant difference between group 1 (34.82 MPa)and group 3 (34.69 MPa).Scanning electron microscope indicated that the enamel treated by cold plasma had slight molten form,which was different from etched enamel surface.The fractured surface of group 3 was mix fracture,which was similar to the control group (group 1 ).Conclusion:Compared with the conven-tional clinic bleaching,immediate bond strength of resin-enamel that treated by cold plasma has not been affected.

Objective To investigate the influences of polyethylene glycol on the solubility and in vitro dissolution of m-nisoldipine,which could provide guidance for chosing formulations of m-nisoldipine. Methods Solid dispersions of m-nisoldipine were prepared by solvent-melting method with polyethylene glycol6000 matrix. DSC and XRD spectroscopy were applied to identify the solid dispersions. The solubility and in vitro dissolution were detected by UV spectroscopy. Results The DSC and XRD map were different from the crude drug and their physical mixtures. The dissolution rates(13,15,17) were faster(35. 31%,38. 71%,41. 48%) than that of the crude drug(26. 80%),and the dissolution rates of the solid dispersions in the same ratio were higher than the physical mixtures. Conclusion DSC analysis indicated that eutectic compounds were produced by the m-nisoldipine and polyethylene glycol,in which polyethylene glycol6000 acts as a carrier. The solubility and in vitro dissolution of m-nisoldipine can be increased.

The brain-gut axis is an important pathway for the interaction between the central nervous system and the gastrointestinal tract. Ischemic stroke can promote the imbalance and displacement of intestinal flora, and the intestinal flora and its metabolites in turn can affect the occurrence, development and outcome of ischemic stroke. This article reviews the related literature on ischemic stroke and intestinal flora, in order to review the relationship between the two and related mechanisms, and to prospect the stroke treatment of targeting intestinal flora.

Purpose To investigate the diagnosis and differentail diagnosis of metastatic small cell carcinoma of bone in needle biopsy, especially for the differentail diagnosis with Ewing sarcoma of bone. Methods Clinicopathological informations of 11 cases of metastat-ic small cell carcinoma and 20 cases of Ewing sarcoma were collected, and markers for differentail diagnosis were detected in two groups by immunohistochemistry of EnVision. Results The positive rates of CD99 and FLI-1 were 27. 3% and 54. 5% in metastatic small cell carcinoma group, while the positive rate of CK was 15. 0% in Ewing sarcoma group. Patient′s age, single lesion, expression of CK, vimentin, CD99, FLI-1, CD56 were significantly different in two groups. Conclusions Metastatic small cell carcinoma and E-wing sarcoma share similar histopathologic features in needle biopsy, no single immunohistochemical marker can specifically distinguish small cell carcinoma from Ewing sarcouma. The correct diagnosis should comprehensive analyze clinicopathologic characters and a se-ries of immunohistochemical markers.

Objective To observe the mode of RET proto-oncogene mutation in a pedigree with multiple endocrine neoplasia type 2A (MEN2A).Methods Six members from a MEN2A family,including the proband,were enrolled.Genomic DNAs of these members were extracted from peripheral blood lymphocytes for polymerase chain reaction(PCR),PCR products of 21 exons of the RET proto-oncogene were purified and a direct gene sequence analysis was performed.DNA sequencing was performed on the related exon of the other family members after verifying the mutation site.Results The female proband sufferd from pheochromocytoma and medullary thyroid carcinoma since the age of 45,two missense mutations of TGC(Cys) to TCC(Ser) at codon 634 and CTG(Leu) to TTT(Phe) at codon 633 in exon 11 of the RET proto-oncogene were detected in the proband,while the other members remain unchanged.Conclusions Analysis of the RET proto-oncogene identifies a united mutation of TGC (Cys) to TCC (Ser) at codon 634 and CTG(Leu) to TTT(Phe) at codon 633 in the proband.The former is a proven mutation related to MEN2A,while the latter has never been reported before.

OBJECTIVE:To investigate the application effect of PDCA circulation method in clinical pharmaceutical care. METHODS:According to the method of PDCA cycle,clinical pharmaceutical care quality and satisfaction degree of physicians, nurses and patients in 2013 were investigated to find out the problems;the reasons were analyzed and countermeasures were made out,checked and implemented. Finally,the quality of clinical pharmaceutical care,the medical staff and patient's satisfaction with clinical pharmaceutical care were compared before and after the implementation of PDCA circulation. RESULTS:Due to the poor quality of clinical pharmaceutical care and low satisfactory degree of our hospital,we formulated related countermeasures,such as enhancing the medication service skill of clinical pharmacists in obstetrics and gynecology department,extending the coverage of pharmaceutical ward round,developing the pharmaceutical care for patients with high risk pregnancy or underwent assisted repro-duction,strengthening communication and propaganda of medical staff and patients. After the implementation of countermeasures, the quality indicators of clinical pharmaceutical care were improved in 2014,compared to 2013,such as the number of patients in-cluded in pharmaceutical ward round increased from 445 to 1 780;total number of reasonable medication intervention suggestion in-creased from 14 to 29;that of pharmaceutical consultation increased from 8 to 23;the satisfaction degree of medical staff and pa-tients improved from 55.93% and 45.95% to 100% and 92.10%,respectively. CONCLUSIONS:PDCA circulation can significant-ly improve the quality of clinical pharmaceutical care and satisfactory degree of our hospital,and promote pharmaceutical care of our hospital.