Decision on mode of delivery (MOD) is a process involved by both clients and health care providers, based on specific clinical situations and women′s values. To help each woman obtain the best MOD is crucial for obstetric health professionals to provide women-centered high quality of care. There is a steep upward trend in cesarean sections in China due to the introduced advanced technologies, overused antenatal monitoring methods, flexible indications for cesarean sections, delayed childbearing ages and people′s misconceptions, etc.. Recently the conditional and comprehensive two-child policy have been implemented in China, which might initiate changes in fertility and birth intentions of many families, and in subsequent decisions on MOD. This review illustrates the pros and cons of MOD, decision process on MOD, influencing factors and strategies to promote decision on MOD, in order for the obstetric professionals to provide evidence-based best care for women and their families in the process of decision-making.

The immune effect of two recombinant protein fragments of spike protein in severe acute respiratory syndrome coronavirus (SARS CoV) was investigated in Balb/c mice. Two partial spike gene fragments S1 (322 1464 bp) and S2 (2170 2814 bp) of SARS coronavirus were amplified by RT-PCR, and cloned into pET-23a prokaryotic expression vector, then transformed into competent Escherichia E. coli BL21 (DE3)(pLysS) respectively. Recombinant proteins were expressed and purified by Ni2+ immobilized metal ion affinity chromatography. The purified proteins mixed with complete Freund adjuvant were injected into Balb/c mice three times at a two-week interval. High titer antibody was detected in the serum of immunized Balb/c mice, and mice immunized with S1 protein produced high titer IgG1, IgG2a, IgG2b and IgG3, while those immunized with S2 protein produced high titer IgG1, IgG2a, but lower titer IgG2b and IgG3. Serum IFN-concentration was increased significantly but the concentrations of Il-2, IL-4 and IL-10 had no significant change. And a marked increase was observed in the number of spleen CD8+ T cells. The results showed that recombinant proteins of SARS coronavirus spike protein induced hormonal and cellular immune response in Balb/c mice.

To establish vascular endothelial growth factor (VEGF) and interleukin-8 (IL-8) as secretary biomarkers for cell growth on topographic substrates, we have evaluated the secretion and expression of these 2 factors by SH-SY5Y human neuroblastoma cells on poly-L-lactide (PLLA) micropillar arrayed topographic substrates. We fabricated topographic substrates with UV lithography, silicon etching and polydimethylsiloxane-based replica molding, and interfaced SH-SY5Y human neuroblastoma cells with both the topographic substrates and PLLA flat substrates. Cell morphology and spreading were examined with scanning electron microscopy. The secretion and mRNA expression of VEGF and IL-8 were evaluated with enzyme linked immunosorbent assay (ELISA) and real time qPCR, respectively, 24 hours after cell plating. We successfully achieved 4 topographic substrates with a nominal pillar diameter of 2 microm and 4 microm, and a nominal pillar spacing of 2 microm and 7 microm. We found that the secretion and mRNA expression of VEGF and/or IL-8 by SH-SY5Y cells on 2-2 microm (pillar diameter-spacing), 4-2 microm and 4-7 microm topographic substrates were upregulated in comparison to those by cells on PLLA flat substrate, 24 hours after cell plating. Furthermore, both cytokines were even more substantially upregulated on the 2-7 microm substrate than on the other 3 topographic substrates. Compared to those on PLLA flat substrate, cells on topographic substrates showed significant changes in morphology (spreading area, perimeter and roundness), and the increase in the secretion and mRNA expression of VEGF and IL-8 was accompanied with a decrease in cell spreading areas. These results provided evidence that pillar arrayed topography was an important microenvironmental factor in affecting VEGF and IL-8 expression or secretion, and VEGF and IL-8 might serve as important secretary biomarkers for growth on topographic substrates by SH-SY5Y cells.
Biomarkers ; Cell Line ; Cell Proliferation ; Cellular Microenvironment ; Humans ; Interleukin-8 ; genetics ; secretion ; Neuroblastoma ; secretion ; Polyesters ; chemistry ; RNA, Messenger ; genetics ; Vascular Endothelial Growth Factor A ; genetics ; secretion

Objective To explore emergency treatment methods for acute renal failure caused by negative imaging ureterolith. Methods There were 36 cases of acute renal failure caused by negative imaging ureterolith, which were finally diagnosed by ureteroscope examination. The negative imaging ureterolith were broken by air pressure ballistic curve shock wave,and taken out of ureter by ureteroscope. All cases were put double-J in ureter. Results Thirty-six cases were got success relieves of ureter obstruction in 24 hours. The urine volume of them were increased, symptoms of urinemia were disappeared, BUN and creatinine were normal after operations. Conclusions The treatment and diagnosis methods by ureteroscope for acute renal failure caused by negative imaging ureterolith are quick and safety, which can treat both side ureterolith at the same time and get reliable and safe effect with less trauma. It should be the first choice to treat acute renal failure caused by negative imaging ureterolith.

Objective To assess the safety and the curative effect of the combination of minipercutaneous nephrolithotomy (mini-PCNL) and ureteroscopic lithotripsy (URL) in the treatment of nonhydronephrotic staghorn calculi. Methods The clinical data of 53 eases with non-hydronephrotic staghom calculi treated by mini-PCNL combined with URL were retrospectively analyzed. Results Fifty-three cases (64 renal units) were performed first-stsge operation, 9 renal units were stone free in first-stage operation, 33 renal units were stone free in second-stage operation, other 13 renal units were stone free in third-stage operation. A complete stone clearance rate of 85.9%(55/64) was achieved, and after one to three sessions of mini-PCNL and extracorpereal shock wave lithotripsy afterwards that increased to 95.3% (61/64). Blood transfusion was performed in 3 cases, no major complication was noted in the patients. Conclusions The combination of mini-PCNL and URL has more advantages, less invasions, easier recovery and less complications. It provides a new minimally invasive way for non-hydronephrotic staghorn calculi.

ObjectiveTo investigate the cost-effectiveness ratio of Gd-EOB-DTPA contrast-enhanced magnetic resonance imaging (EMRI) versus ultrasound in liver cancer screening for the high-risk population. MethodsThe TreeAge Pro 2011 software was used to establish a decision-tree model. A mathematical model was used to simulate the costs and benefits of EMRI or ultrasound screening every 6 months in patients with liver cirrhosis, and the cost-effectiveness ratios under different screening models were calculated. ResultsThe EMRI group had a mean cost of liver cancer screening of 2050.2 RMB each person each time and mean benefits of 0.11 YLG, while the ultrasound group had a mean cost of 262.6 RMB and mean benefits of 0.02 YLG. When the incidence rate of liver cancer was 17.8%, the EMRI group had a similar cost-effectiveness ratio as the ultrasound group, and the cost of 1 YLG was 11445 RMB; EMRI tended to have a lower cost and a better effect in screening with the increase in the incidence rate of liver cancer. The cost-effectiveness ratio of EMRI gradually decreased with the reduction in its price, and its effect in screening gradually increased with the reduction in price. ConclusionThe cost-effectiveness of liver cancer screening is closely related to the incidence rate of liver cancer and the price of screening. EMRI has a good cost-effectiveness ratio in screening when the risk of liver cancer is higher than 17.8%.

The immune effect of two recombinant protein fragments of spike protein in severe acute respiratory syndrome coronavirus (SARS CoV) was investigated in Balb/c mice. Two partial spike gene fragments S1 (322-1464 bp) and S2 (2170-2814 bp) of SARS coronavirus were amplified by RT-PCR, and cloned into pET-23a prokaryotic expression vector, then transformed into competent Escherichia E.coli BL21 (DE3)(pLysS) respectively. Recombinant proteins were expressed and purified by Ni2+ immobilized metal ion affinity chromatography. The purified proteins mixed with complete Freund adjuvant were injected into Balb/c mice three times at a two-week interval. High titer antibody was detected in the serum of immunized Balb/c mice, and mice immunized with S1 protein produced high titer IgG1, IgG2a, IgG2b and IgG3, while those immunized with S2 protein produced high titer IgG1, IgG2a, but lower titer IgG2b and IgG3. Serum IFN-γ concentration was increased significantly but the concentrations of IL-2, IL-4 and IL-10 had no significant change. And a marked increase was observed in the number of spleen CD8+ T cells. The results showed that recombinant proteins of SARS coronavirns spike protein induced hormonal and cellular immune response in Balb/c mice.

Objective To construct a prokaryotic expression system containing the dense granule protein 4(GRA4) of Toxoplasma gondii,purify the expressed protein and detect its immunogenicity.Methods The specific fragment of GRA4 gene was amplified by PCR.After subcloning the prokaryotic expression recombinant pET,GRA4,the expressed product was purified with His?BindTM affinity chromatography and analyzed by Western blot.BALB/c mice were immunized with the GRA4 recombinant protein,and the antibody IgG titer was detected by ELISA.Results The pET,GRA4 prokaryotic expression system was obtained.The MW of the expressed protein was Mr 40 000 and formed in inclusion body.After purification,the recombinant protein could be specifically recognized by the T.gondii infected rabbit serum.Mice immunized with the purified recombinant protein elicited high titer of IgG antibody.Conclusion The pET,GRA4 recombinant protein was successfully expressed and purified,which shows the immunogenicity.