Objective To investigate the risk factors of adverse pregnancy outcome of women in China by Meta analysis.Methods Meta analysis was used to analyze the influencing factors of adverse pregnancy outcomes from January 2010 to January 2015.According to the inclusion and exclusion criteria,124 articles were retrieved,and 38 articles were excluded.14 papers were included in this study.Results There was strong correlation between fetal abnormalities and adverse pregnancy outcomes.And the maternal history of abortion and adverse pregnancy outcomes were not related.There was strong association between multiple pregnancy,syphilis infection and adverse pregnancy outcome,and there was moderate correlation between the high blood pressure in pregnancy and adverse pregnancy outcome.Abnormal fetal position,the OR value was 3.48 (2.70 -4.43),history of abortion OR value was 1.14 (0.90 -91.44),gestational hypertension OR value was 2.88 (1.69 -4.92),multiple births OR value was 6.40 (2.05 -20.01),syphilis OR value was 5.54 (1.64 -18.64).Conclusion The risk factors of adverse pregnancy outcomes from strong to weak are as follows:multifetal pregnancy,syphilis infection,abnormal fetal position and hyper-tensive disorder complicating pregnancy.

Objective To evaluate the diagnostic value of multi-slice spiral CT for non-angle caused nutcracker syndrome(NCS). Methods A total of 177 cases of clinical suspected nutcracker syndrome patients recevied multi-slice spiral CT examination,,inclu-ding 33 patients with negative results,144 cases patients with positive results.The analysis was performed by measuring the angle between superior mesenteric artery(SMA)and the abdominal aorta(AA),and the ratio of the diameter of the narrowest and expan-sion in the left renal vein.Results Within 33 cases of nutcracker-negative patients,the angle of SMA and AA was (46.06 ± 24.46)°;the ratio was (2.11±0.76).144 cases was diagnosed as nutcracker-positive patients,the angle of SMA and AA was (23. 10±9.63)°;the ratio was (3.83±1.24).There was positive correlation between angle and ratio in NCS (P<0.0001).Among9 ca-ses of nutcracker syndrome caused by non-angle factors three were oppressed by the uncinate process pancreas,two cases were caused by the malformations of the left renal vein,one case was posterior nutcracker syndrome,one case was oppressed by portal veinOne case of pressured renal vein due to tortuosity renal vein coiled renal artery.One case of the left renal vein compression lumen narrowing,causing significant downward pressure on the left renal vein.Conclusion Spiral CT angiography reconstruction can clear-ly show the cause and the location of the left renal vein compression,which may provide helpful information in diagnosing nutcracker syndrome caused by non-angle factors.

Objective To summarize and evaluate the clinical features,therapeutic methods and prognosis of 197 cases with eating crayfish caused rhabdomyolysis in our hospital within July,2016 to August,2016.Methods Using retrospective method,197 rhabdomyolysis cases induced by eating crayfish were admitted into study.Data of epidemiological character,clinical features,therapy protocol and prognosis were collected and analyzed.Results All the patients had the experience of eating crayfish within 12h before the onset.Patients in this cohort had the common symptoms but varying degrees of myalgia,fatigue of the whole body muscles,and urine color change.Laboratory tests revealed:On day 1 of onset,serum myoglobin level had raised up to the peak with average level at (2 135 ± 1 547) μg/L (0-46 μg/L).Creatine kinase with average level at (4 657 ± 2 178) U/L (25-190 U/L);Aspartate transaminase with average level at 264 ± 83 U/L (10-45 U/L);Lactate dehydrogenase with average level at (1 457 ± 673) U/L (313-618 U/L),all these three markers reached peak on day 2,then gradually declined.All the patients recovered and discharged after relaxation,fluid infusion,alkalization of urine and dealing with the complications.Conclusion Timely diagnosis and treatment of the rhabdomyolysis syndrome induced by eating crayfish could indicate favorable prognosis in these patients from July,2016 to August,2016.

Objective To evaluate the effect of electroconvulsive therapy (ECT) on the expression of phosphorylated glutamate receptor 1 (p-GluR1) and Ca2+/calmodulin-dependent protein kinase Ⅱ α (p-CaMK Ⅱ α) under small dose ketamine combined with propofol anesthesia in the depressed rats.Methods Forty healthy adult male Sprague-Dawley rats,weighing 200-250 g,aged 2-3 months,were used in this study.Mental depression was induced by exposing the animals to chronic unpredictable mild stress (CUMS).Forty mentally depressed rats were divided randomly into 5 groups (n =8 each) using a random number table:M0-4 groups.Propofol 80 mg/kg and ketamine 10 mg/kg were injected intraperitoneally in M0-4 groups.After disappearance of righting reflex,M1-4 groups received ECT of 60,120,180 and 240 mC once a day for 7 consecutive days,respectively,by means of a current (frequency 50 Hz,sine-wave,pulse width 0.7 ms,1-s duration) delivered via ear-clip electrodes,while group M0 received ECT of no quantity of electric charge via ear-clip electrodes.Before CUMS,at 1 day after CUMS and at 1 day after ECT,sucrose preference test was applied to evaluate the depressive behavior.The sucrose preference percentage (SPP) was calculated.At 4 days after CUMS and 4 days after ECT,the learning and memory function was assessed using Morris water maze test.The rats were then sacrificed,and hippocampi were isolated to detect the expression of GluR1,p-GluRl,CaMK Ⅱ α and p-CaMK Ⅱ α by Western blot.Results The SPP was significantly lower after CUMS than before CUMS in M0-4 groups (P＜0.05).Compared with that after CUMS,the SPP was significantly increased,the escape latency was shortened,and the space exploration time was prolonged after ECT in M1-4 groups (P＜0.05).There was no significant difference in SPP after ECT between M1-4 groups (P＞0.05).Compared with group M0,the SPP was significantly increased,and the expression of pGluR1 and p-CaMK Ⅱ α was up-regulated in M1-4groups (P＜0.05).Compared with group M2,the escape latency was significantly prolonged,the space exploration time was shortened,and the expression of pGluR1 and p-CaMK Ⅱ α was down-regulated after ECT in the other groups (P＜0.05).There was no significant difference in GluR1 and CaMK Ⅱ α expression after ECT between the five groups (P＞ 0.05).Conclusion ECT can induce cognitive decline when applied for anti-depression under small dose ketamine combined with propofol anesthesia,and the mechanism is related to increased phosphorylation of GluR1 and CaMK Ⅱ α expression in rats.

Objective To explore the effect of low-dose ketamine combined with propofol anesthesia on expres?sion of glutamine receptor subunit 1 (GluR1) and 2 (GluR2) in the hippocampus of depressed rats after electroconvulsive therapy. Methods Healthy adult male Sprague-Dawley rats, weighing 200~250 g, were used in this study. Mental depres?sion was induced by chronic unpredictable mild stress. Thirty-two depressed rats were randomly divided into 4 groups (n=8): metal depression group (group A), ECT group (group B), ECT+propofol group (group C) and ECT+propofol+ket?amine group (group D). Eight normal rats served as control group. Control group received no treatment. Group A received intraperitoneal injection of normal saline 8 mL/kg plus sham ECT. Group B, C and D received ECT once a day for 7 con?secutive days following intraperitoneal injection of normal saline 8 mL/kg, propofol 80 mg/kg and propofol 80 mg/kg +ketamine 10mg/kg, respectively. Sucrose preference test and Morris water maze were performed to assess depressed be?havior and learning and memory function, respectively. RT-PCR and Western-blot assay were used to detect the expres?sion of GluR1 , GluR2 and their mRNA expression. Results After ECT, compared with control group and group A, changes of SPP in group B, C and D were obvious. The change of SPP in group D was much higher than all other groups (P<0.05). Rats in group B showed prolonged escape latency and shortened space exploration time, which were significantly different from all other groups (P<0.05). Rats in group D showed the most shortened escape latency and prolonged space exploration time (P<0.05). The expression of GluR1 was significantly increased in group B, C and D compared with group A (P<0.05). The expression of GluR2 and mRNA was significantly decreased in group B and C (P<0.05). The difference in GluR2 and mRNA expression was not significant among group A, D and control group (P>0.05). Conclusion Low-dose ketamine combined with propofol anesthesia exert effective antidepressive action and improve learning and memory function of depressed rats after electroconvulsive therapy. The beneficial effects of the ketamine combined with propofol anesthesia may be related to up-regulation expression of GluR1 and GluR2 in hippocampus.

Objective To investigate the clinical distribution situation and drug resistance change of Klebsiella pneumoniae in the Navy General Hospital during 2011‐2015 in order to provide reference for rational use of antibacterial agents in clinic .Methods The clinically isolated Klebsiella pneumoniae in this hospital during 2011‐2015 were selected and performed the analysis on the de‐tection rate ,department distribution ,specimens source ,resistance of antibacterial drugs and change trend of resistance to carbapen‐em antibacterial drugs .Results The number the detected Klebsiella pneumoniae strains and isolation rate during 2011 -2015 showed an increasing trend year by year ,the specimens sources were mainly from 10 departments of intensive care units(ICU) ,hy‐perbaric oxygen department ,respiratory department ,radiation oncology department ,kidney disease department ,etc .;the submitted specimens were dominated by sputum and urine ,accounting for 59 .7% and 21 .4% of submitted specimens ;the drug resistance of Klebsiella pneumoniae during 2011‐2015 showed the increasing trend year by year .Klebsiella pneumoniae had higher resistance rates to piperacillin ,ampicillin ,ampicillin/sulbactam and cefuroxime and had lower resistance rate to amikacin ,imipenem ,meropen‐em and tobramycin ;the resistance rates to imipenem and meropenem were increased year by year ,and pan‐drug resistant Klebsiella pneumoniae showed a rapidly rising trend .Conclusion The drug resistance of Klebsiella pneumonia is serious ,especially carbapene‐ms‐resistant Klebsiella pneumoniae is significantly increased in the recent years ,therefore its drug resistance monitoring should be strengthened for guiding rational drug use in clinic .

Objective: To understand the working categories of primary percutaneous coronary intervention (PCI) nursing and its existing problems, and to provide a realistic basis for the construction of primary PCI in clinical nursing. Methods: Qualitative interviews were used to carry out semi-structured and personal in-depth interviews among 5 doctors and 27 nurses in 5 hospitals. 7 step analysis of Colaizzi was used to analyze the data. Results: The working categories of primary PCI nursing involves professional team management, early identification, preoperative preparation, evaluation and predictive nursing, disease observation, safe transfer, psychological nursing and health guidance. Conclusion Primary PCI nursing is still in the stage of continuous optimization, but some parts of the process are not standardized and the nursing behavior is inconsistent. Primary PCI nursing needs to form nursing behavior norms under the guidelines of evidence-based medicine.

Objective To investigate the value of Chlamydia trachomatis antigen in patients with tubal infertility and its effect on the prevention of infection. Methods 80 patients with tubal infertility who were admitted in our hospital from January 2016 to October 2017 were selected as the study group and 80 patients with tubal patency by hysterosalpingography in our hospital were selected as the control group. The study group underwent Chlamydia trachomatis antigen detection. The relevant indicators were observed and clinical diagnostic effect and the effect of infection prevention of patients was recorded in detail. Results The diagnostic results showed that there were 77 cases diagnosed in the study group, and the diagnostic coincidence rate was 96. 2％, of which the diagnostic coincidence rates of tubal blockage, genital tract infection, tubal effusion, acute salpingitis were 100. 0％, 96. 1％, 96. 6％, 93. 8％. The positive rate of Chlamydia trachomatis antigen in the study group was 82. 5％ (66/80). The positive rate of Chlamydia trachomatis antigen in the control group was 15. 0％ (12/80). The positive rate of the study group was significantly higher than that of the control group (P＜0. 05). The test results showed that the incidence of abortion, preterm birth, dead fetus, stillbirth, ectopic pregnancy and other symptoms was significantly higher in the positive patients' study group. In the aspect of infection prevention, the number of patients infected at each time period in the study group gradually reduced with the growth of time and the increase of number of infected people. Conclusion The detection of Chlamydia trachomatis antigen in patients with tubal infertility can achieve high coincidence rate of clinical diagnosis, earlier detection of tubal disease in patients and timely treatment measures, reduce the incidence of postoperative infection in patients, which should be further applied in clinical.

ObjectiveTo investigate the effect of anti-liver fibrosis Chinese patent drugs on renal hypofunction associated with alcoholic liver disease (ALD). MethodsA retrospective analysis was performed for 592 patients with ALD who were admitted to Beijing Ditan Hospital, Capital Medical University, from August 1, 2008 to March 1, 2016, and according to whether they were treated with Fuzheng Huayu capsules, Anluo Huaxian pills, or Fufang Biejia Ruangan tablets for ≥180 cumulative defined daily doses, they were divided into Chinese medicine group and control group. After propensity score matching at a ratio of 1∶1, two groups were obtained with 187 patients in each group. Related data were recorded, including medical history, drinking amount, routine blood test results, liver and renal function, coagulation, and abdominal imaging findings. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups; the Kaplan-Meier method was used to compare the cumulative incidence rate of renal hypofunction between two groups. ResultsThere were no significant differences between the two groups in age, drinking amount, proportion of patients with hypertension or diabetes, baseline aspartate aminotransferase, estimated glomerular filtration rate, uric acid, and prothrombin time, and the patients were followed up for 36 months (range 23-54 months). Uric acid (hazard ratio ［HR］=1.003, 95% confidence interval ［CI］: 1001-1.005, P=0.001), prothrombin time (HR=1.103, 95%CI: 1.034-1.177, P=0.003), and red cell volume distribution width (HR=1.024, 95%CI: 1.011-1.038, P＜0.001) were independent risk factors for renal hypofunction in patients with ALD, and anti-liver fibrosis Chinese patent drug was an independent protective factor against renal hypofunction (HR=0.170, 95%CI: 0.053-0552, P=0.003). The Chinese medicine group had a significantly lower incidence rate of renal hypofunction than the control group (166% vs 32.1%, χ2=10.263, P=0.001). The subgroup analysis of the patients in the Chinese medicine group showed that Chinese medicine treatment for ＞24 months had the best effect (HR=0.210, 95%CI: 0.084-0.525, P=0.001). Compared with the control group, the Chinese medicine group had a significantly longer time to the onset of renal hypofunction (36 months vs 24 months, Z=-2.652, P=0.008). ConclusionAnti-liver fibrosis Chinese patent drugs can reduce the incidence rate and delay the onset of renal hypofunction in patients with ALD.

OBJECTIVETo elucidate the role of let-7d in regulating the biological behavior of ovarian cancer cells and their expressions of HMGA2 and ras proteins.

METHODSThe pre-let-7d sequence was synthesized and inserted into pcDNA6.2GW/EmGFPmiR and transfected into ovarian cancer IGROV1 cells to cause pre-let-7d overexpression. Real-time quantitative RT-PCR was employed to examine the expression levels of let-7d miRNA and HMGA2 mRNA, and Western blotting was performed to detect the expressions of HMGA2 and ras protein in the transfected cells. The effect of pcDNA6.2GW-let-7d transfection on IGROV1 cell proliferation was determined using MTT assay and the cell apoptosis rate was measured using flow cytometry.

RESULTSThe eukaryotic expression vector containing the target gene let-7d was successfully constructed and transfected into IGROV1 cells. The transfected cells showed a marked reduction of HMGA2 expression but a less obvious down-regulation of ras expression. Transfection with pcDNA6.2GW-let-7d to suppress the expression of HMGA2 caused alterations of the phenotype of IGROV1 cells shown by a reduced proliferative activity and increased cell apoptosis.

CONCLUSIONLet-7d plays an important role in altering the malignant cell phenotype of ovarian cancer IGROV1 cells by regulating the expression of HMGA2.

Cell Line, Tumor ; Female ; Gene Expression Regulation, Neoplastic ; HMGA2 Protein ; genetics ; metabolism ; Humans ; MicroRNAs ; genetics ; Ovarian Neoplasms ; genetics ; metabolism ; pathology ; Plasmids ; ras Proteins ; genetics ; metabolism