Sex determination and differentiation mean the process that the bipotential gonads develop into ovaries or testes.There are many genes involved in male(s) sex determination and differentiation.The changes of the regulating genes may lead to disorders of sex development.Sex-determining region Y (SRY) gene was the first discovered gene related to abnormal sexual development.Serval studies have found that SRY-related HMG box 9 (SOX9) and fibroblast growth factor 9 (FGF9) are associated with disorders of sex development in recent years.This article aims to provide an review of recent study of the role of SRY,SOX9 and FGF9 in sex determination and differentiation.It will provide a foundation for diagnosis and treatment of genetic disease related with male(s) sex determination and differentiation.

Objective To compare the effect relapse rate and outconles between pulse intravenous cyclophosphamide(CTX)and mycophenolate mofeti(MMF)in the induction therapy of crescentic lupus nephritis(CLN)in children.Methods A retrspective comparative analysis in the general situation,clinical performance,patholoped features,ease of treatment,recurrence rate,the indicence of side effects and prognosis was done between the treatment group(n=10)and the control group(n=10).Results The results in the general situation,and clinical manifestations of lupus activity index,the pathological damage had no significant difference between the treatment group and the control group for 12 months,remission rates were 60% and 70% in the treatment group complete remission rate (50%)was significantly higher(30%),the recurrence rate(10%)was significantly lower than the control group (30%).2 cases of the control group(20%)died;without treatment group died.The side effect of infection was more significant in the CTX group.Conclusion Higher complete remission rates and less infection complications were observed in crescentic lupus nephritis patients who received MMF induction regime than in patients who received intravenous pulse(CTX)regime.

Objective:To explore the clinical significance of labelling MM C-CH 40 in the radical operation of gastric cancer.Methods:Fifty seven patients with gastric cancer were randomly divided into two groups-labelling group and control group.In the labelling group,MM C-CH 40 was injected into the periphery of tumor through gastroscope before operation,then performed radical gastrectomy,the dyed lymph nodes were regarded as marker of the operation.Results:(1)In the labelling group,the average number of eliminated lymph nodes(41.5) was far higher than that of control group (24.4).(2)In the labelling group,of the total eliminated lymph nodes,dyed lymph nodes were 67.1%.(3)In the case of lymph node metastasis,the average number eliminated in the labelling group was 10.05,and that of the control group was 6.74.(4) Inject MM C-CH 40 into the periphery of tumor through gastroscope one week before operation could get a satisfactory result.Conclusion:MM C-CH 40 labelled lymph nodes can guide the radical gastrectomy.

Objective To study significance of anicteric biliary tract dilatation in early diagnosis and treatment of patients with periampullary carcinoma.Method Review the resection rate and survival rate of 16 periampullary carcinoma patients with anicteric biliary tract obstruction found out by B-ultrasound,CT or PTC during 13 years(1986-1999).Result The operative resection rate was 87.50%(14/16) ,5-year survival rate was 43.75%(7/16),3-year survival rate was 62.50%(10/16).Conclusions Biliary tract dilatation existed before icterus occurred,while syndromes such as upset of upper abdomen,reclusion, epigastralgia distention and anorexia, may occur 1-3 months ahead of icterus occurred in patients with periampullary carcinoma. If the patient has syndromes mentioned above, more than 40 years of age and biliary tract dilatation found by B-ultrasound, CT,PTC or ERCP, periampullary carcinoma should be considered. The patients should be checked by operation,so as to raise the operative resection rate and survival rate.

Objective To detect the levels and study the clinical significance of serum procollagen type Ⅰ amino-terminal propeptide (PINP) and β-C-telopeptides of type Ⅰ collagen (β-CTX) as bone turnover markers in recombinant human growth hormone (rhGH) treatment of prepuberty idiopathic short stature (ISS) children.Methods Forty patients of ISS (18 boys and 22 girls) had been collected and treated with GH 0.15 IU/(kg · d) injection every night.Serum levels of PINP,β-CTX,insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP3) were measured by electrochemiluminescence immunoassay in ISS before treatment and after 3,6 months,and they were also measured in 50 healthy children of the healthy control group,and the height,weight,body mass index,height standard difference score (HtSDS),bone age and growth rate were recorded.Results (1) In ISS group,the serum level of PINP[(479.51 ± 134.61) μg/L] was lower than that of the healthy control group [(651.31 ± 212.41) μg/L],the level of β-CTX[(0.84 ± 0.33) μg/L] was higher than that of the healthy control group [(0.50 ± 0.15) μg/L].The differences were statistically significant (t =2.276,-2.709,all P ＜ 0.05).(2) The serum levels of PINP and β-CTX had no significant difference in 18 boys and 22 girls before and after GH treatment (P＞0.05) of ISS.After 3 months of GH treatment,the serum levels of PINP[(736.15 ± 156.59) μg/L] and β-CTX [(1.08 ± 0.27) μg/L] were higher than those before treatment in 40 cases,and the difference was statistically significant (t =4.736,2.497,all P ＜ 0.05),as the increase of PINP was particularly significant.HtSDS (-2.95 ±0.43),compared with before treatment (-2.69 ± 0.58),was significantly different (t =2.714,P ＜ 0.05).However,after 6 months of GH treatment,the levels of PINP[(860.90 ±254.59) μg/L] and β-CTX[(0.94 ±0.32) μg/L] increased slowly (t =1.366,-0.831,all P ＞ 0.05).HtSDS (-2.51 ± 0.54) showed no significant difference (t =1.609,P ＞ 0.05) compared with 3 months of treatment.(3) The serum level of PINP was positively correlated with IGF-1 and IGFBP3 (r =0.636,0.673,all P ＜ 0.05),and there was no correlation with β-CTX (r =0.336,P ＞0.05).PINP and β-CTX had significant correlation with HtSDS (r =0.655,0.782,all P ＜ 0.05).Conclusions The serum PINP and β-CTX as bone turnover markers in serum can be used as one of the early supplementary indicators to predict GH response of ISS.

Objective To explore the effect of intracavitary therapy on acute pulmonary embohsm.Methods Fifteen patients were selected as our subjects,who suffered acute pulmonary embolism and received percutaneous catheter thrombus crashing and catheter directed thrombolysis in Beijing Military.Region General Hospital from January 2009 to June 2011.Local injection of Urokinase was performed with a total amount of 500 000 U in catheter directed thrombolysis.After thrombolysis,low molecular Heparin was administered to patients for 7-10 days and oral administration of Warfarin was performed for 3-6 months.Clinical symptoms,improvement of physical signs,complications,changes of mean pulmonary arterial pressure(mPAP) and arterial partial pressure of oxygen(PO2),and the opening of pulmonary artery were recorded.Results The pulmonary arteries of the 12 patients were completely opened,and partially opened in 3 patients.The effective rate was 100％ (15/15).mPAP was reduced from (40.07 ±5.97) mmHg to (20.00 ±4.66) mmHg (t =-1.128,P ＜ 0.05),PO2 was increased from (50.26 ± 9.30) mmHg to (80.49 ± 9.04) mmHg (t =1.246,P ＜ 0.05).Patients were followed-up for 3-6 months and no recurrence case was seen.Conclusion The interventional therapy is effective,safe and practicable in the treatment of acute pulmonary embolism.

Objective To evaluate the efficacy of color Doppler sonography combined with digital mammography for micro breast cancer screening.Methods Both of color Doppler sonography and digital mammography were performed in 66 patients with micro breast cancer less than 1.5 cm in diameter and 20 patients with benign lesion less than 1.5 cm in diameter.The images of sonography and mammography were analyzed respectively.A comparative study on the results of sonography,mammography and pathological finding of specimen in breast lesions was made.Results Fifty-five of 66 Cases with micro breast cancer were detected by digital mammography.52 of 66 cases by color Doppler sonography and 65 of 66 cases by sonography combined with mammography.The color Doppler sonography combined with digital mammography provided higher sensitivity,specificity and accuracy[98.5%(65/66),100.0%(20/20)and 98.8%(85/86)respectively]than color Doppler sonography[78.8%(52/66),75.0%(15/20),77.9% (67/86)respectively]and digital mammography alone[83.3%(55/66),90.0%(18/20)and 84.9%(73/86)respectively](P＜0.05).The peak flow velocities and the mean resistant index were higher in malignant lesion than those in benign lesion(P＜0.05).Conclusions The color Doppler sonography combined with digital mammography can increase the sensitivity and accuracy of diagnosing micro breast cancer.Digital mammography is recommended to identify micro breast cancer.It is helpful of color Doppler sonography in differentiation of benign and malignant breast lesion.

Objective To clone the gene encoding protein of EspA and Stx2B from EHEC OI57:H7 by DNA recombinant technology, construct prokaryotic expression vector pET-28a ( + )-espAstx2B, express fusion protein of EspA-Stx2B and to analyze the biological and immunological characteristics of the fusion protein. Methods the sequence encoding the protein of EspA and Stx2B was amplified by PCR from the enterohemorrhagic Escherichia coli strain. The amplified products were connected with linker by recombinant technology and cloned into pET-28a( + ) vector. The vector was then transferred to the host cells E. Coli BL21 strain (DE3). Following, the protein expression was induced by IPTG. The expression quantities and style of fusion protein was then determined by SDS-PAGE. Its immunoreactivity was analyzed by Western blot. Finally, BALB/c mice were injected with the preliminarily purified recombination protein EspA-Stx2B, then oral challenged these mice with EHEC O157-SMR2 and counteracted toxic substances with O157 ultrasonic supernatant. Results The determination of the sequence encoding of the espA-stx2B fusion gene has 100% of consistency with the sequence from GenBank Sakai strain and contrivable linker. This fusion protein EspA-Stx2B was expressed as inclusion body formation and the percentage is approximately 40%. Western blot suggested the fusion protein has excellent immunoreactivity. Titer of antiserum of the mice to EspA-Stx2B increased evidently. EspA-Stx2B could not decrease bacterial number attached to the intestinal tract of mice based on fecal shedding of Oi57 in mice. In the test of death of BAI,B/c causing by conteracting toxic substances with O157 ultrasonic supernatant, immunoprotection of EspA-Stx2B rate was 66.7%. Conclusion A recombinant plasmid that has high performance on expression of EspA-Stx2B prorein was successfully constructed in present study, and the fusion protein has excellent immunoreactivity and immunogenicity. EspA-Stx2B could not decrease bacteria] number attached to the intestinal tract of mice based on fecal shedding of O157 in mice, but evidently decrease the mortality rate of the mice. The antiEspA and anti-Stx2B had immunoprotection effect by different means. These results may provide the foundation for the further development on EHEC O157:H7 double subunit vaccine.

Objective To probe into the clinical value of the whole pelvis internal organs joint excision in locally advanced cervical carcinoma. Methods Four cases of local cervical carcinoma patients who have been implemented the peculiar operation from April 1997 to April 2001 were analyzed. Results The operation progressed well and the time of surviving was 4-41 months, 16.3 months in life cycle on average. 4 patients died of intestinal obstruction, vagina-small intestine atrophy and the pain of pelvis which resulted in a hunger strike and lung metastasis. Conclusion Implement the operation to those patients whose rectum and bladder were invaded simultaneously can lengthen a patient's life cycle and improve the quality of surviving. To grasp the operation target, standardize the step and improve the treatment method before and after operation were necessary.

Objective:To evaluate the risk and influencing factors of pulmonary embolism in patients with iliac vein compression syndrome (IVCS) and acute iliofemoral vein thrombosis by CT pulmonary angiography combined with CT venography of inferior vena cava.Methods:The data of 166 patients with acute left iliofemoral vein thrombosis diagnosed in the Affiliated Hospital of Jining Medical University from July 2016 to June 2020 were analyzed retrospectively. All patients underwent one-stop CT pulmonary angiography combined with inferior vena cava CT venography. The patients were divided into IVCS group (101 cases) and non-IVCS group (65 cases) according to the presence or absence of IVCS. The general data of the patients, the stenosis rate of left common iliac vein, the presence of inferior vena cava floating thrombosis, the presence of large pelvic collateral veins, the detection of pulmonary embolism and the pulmonary artery obstruction index of the two groups were compared, and multivariate logistic regression and multiple linear regression were used to analyze the influencing factors of the incidence and severity of pulmonary embolism in IVCS group.Results:There were significant differences in the stenosis rate of left common iliac vein [(68±8)% vs (25±14)%, t=-25.300, P<0.001], the incidence of inferior vena cava floating thrombosis [25/101, 31/65, χ2 =9.310, P=0.002], the length of inferior vena cava floating thrombosis [17.2 (10.9, 27.8)mm vs 27.4 (20.1, 55.9) mm, Z=-2.316, P=0.021], the incidence of pulmonary embolism (43/101 vs 41/65, χ2 =6.651, P=0.010) and the pulmonary artery obstruction index [(10.0% (5.0%, 17.5%) vs 22.5% (10.0%, 30.0%), Z=-3.490, P<0.001] between IVCS group and non-IVCS group. In the IVCS group, multiple logistic regression analysis revealed that the stenosis rate of left common iliac vein [β=-1.964, OR(95%CI) 0.140(0.031-0.638), P=0.011] and inferior vena cava floating thrombosis [β=1.212, OR(95%CI) 3.360(1.566-7.209), P=0.002] was independent factors for the occurrence of pulmonary embolism. Multiple linear regression showed that the influence of inferior vena cava floating thrombosis on the pulmonary artery obstruction index was statistically significant (b=0.352, t=2.410, P=0.021). Conclusion:The incidence and severity of pulmonary embolism in patients with IVCS and acute left iliofemoral vein thrombosis are lower than those without IVCS, and the presence or absence of inferior vena cava floating thrombosis is an important factor affecting the severity of pulmonary embolism.