Our country has been using maturity grading method, which was proposed by Grammum in 1979, to evaluate the placental function. However, this method is subjective to consequence because it totally depends on the observation and experiences of clinicians. With the development of ultrasound technology, therefore, we reviewed more novel applications in other aspects of placenta (such as blood flow, vascularization, etc). Over the past years, scholars in the world have done a lot of research around these topics. In this review we introduce placental maturity grading with B-mode ultrasound, placental vascularization qualitative and quantitative analysis with three-dimensional Doppler ultrasound and placental volume measurement, respectively.
Female ; Humans ; Imaging, Three-Dimensional ; Neovascularization, Pathologic ; Placenta ; diagnostic imaging ; Pregnancy ; Ultrasonography, Prenatal

Objective To investigate the role of hydroxyapatite nanoparticle (nHAP) in the gene transfection of human colorectal cancer cell line SW480/M5 and the possible mechanisms.Methods The combination and protection of nHAP-Mg2+ to DNA were analyzed by gelose gelatin electrophoresis.Liposome and nHAP modified by magnesium chloride was combined,and the PEGFP-N1 plasmids were transfected into SW480/M5 cells.The gene transfection rate and the mean fluorescence intensity were observed by flow cytometry.The effect of nHAP-Mg2+ on the growth of the cells were studied by MTT.Results At appropriate proportion,nHAP-Mg2+ could combine the plasmids compeletly and protected the DNA.The gene could not be transferred by nHAP-Mg2+ alone.Combining the nanoparticles and liposome,the gene could be transferred very efficiently and the transfection rates were significantly higher than the liposome (P ＜ 0.05).The inhibition of cell growth was increased along with the concentration of nHAP-Mg2+ wether it was used alone or with the combination of liposome (P ＜ 0.05).Conclusions nHAP-Mg2+ has the ability to combining and protecting DNA and can be used to transfer gene as the adjunct carrier of liposome for the gene therapy of tumor cells to elevate the gene tansfection and expression rate and also enhance the anti-tumor effection.

Objective To summarize and learn the biological properties and clinical features of interdigitating dendritic cell sarcomas (IDCS).Methods The first IDCS patient concurrent with acute myelomonocytic leukemia (AML-M4) described herein,to our knowledge,was studied and 62 IDCS cases reported previously in the literature were reviewed.Results The patient had a history of breast cancer as well as radiotherapy and chemotherapy of it,and the patient showed poor response to 4 cycles of sequential chemocherapy regimens.Based on the laboratory results,IDCS and AML-M4 in this patient were both of myelogenous origination.Furthermore,review of the 62 IDCS patients reported previously showed that as high as 17 ％ of the patients had malignant disease and received radiotherapy or chemotherapy before they got IDCS,and patients of this group had worse prognosis compared with counterpart.Conclusion IDCS has poor prognosis,and therapy-related type worse.Prophylactic measures and stringent screening of the second cancer in those who received chemoterapy or radiotherapy are appropriated and necessary.

Objective To study the potential role of tumor necrosis factor-α (TNF-α) induction in the development of mucosal barrier dysfunction in rats caused by acute intestinal ischemia-reperfusion injury, and to examine whether pretreatment with monoclonal antibody against TNF-α (TNF-α MoAb) would affect the release of D(-)-lactate after local gut ischemia followed by reperfusion. Methods Anesthetized Sprague-Dawley rats underwent superior mesenteric artery occlusion for 75 min followed by reperfusion for 6 hr. The rats were treated intravenously with either TNF-α MoAb (20 mg/kg) or albumin (20 mg/kg) 30 min prior to the onset of ischemia. Plasma D(-)-lactate levels were measured in both the portal and systemic blood by an enzymatic spectrophotometric assay. Intestinal TNF-αmRNA expression as well as protein levels were also measured at various intervals. In addition, a postmortem examination was performed together with a macropathological evaluation based on a four-grade scoring system.Results Intestinal ischemia resulted in a significant elevation in D(-)-lactate levels in the portal vein blood in both the control and treatment groups ( P ＜0.05). However, animals pretreated with TNF-α MoAb at 6 hr after reperfusion showed significant attenuation of an increase in both portal and systemic D(-)-lactate levels when compared with those only receiving albumin (P ＜ 0.05). In the control animals, a remarkable rise in intestinal TNF-α level was measured at 0.5 hr after clamp release ( P ＜ 0.01); however, prophylactic treatment with TNF-α MoAb completely annulled the increase of local TNF-α levels seen in the control animals. Similarly, after anti-TNF-α MoAb administration, intestinal TNF-α mRNA expression was markedly inhibited, which showed significant differences when compared with the control group at 0.5 hr, 2 hr and 6 hr after the release of occlusion ( P ＜ 0.05-0.01 ). In addition, the pathological examination showed marked intestinal lesions that formed during ischemia, which were much worse upon reperfusion,particularly at the 6 hr time point. These acute injuries were obviously attenuated in animals receiving TNF-α MoAb.Conclusions It appeared that acute intestinal ischemia was associated with failure of the mucosal barrier, resulting in increased plasma D(-)-lactate levels in both portal and systemic blood. These results suggest that TNF-α appears to be involved in the development of local damage associated with intestinal ischemic injury. Moreover, prophylactic treatment with TNF-α MoAb exerts preventive effects on ischemia/ reperfusion-induced circulating D (-)-lactate elevation and gut injury. ( J Geriatr Cardiol 2004;1(2):119-124. )

Objective To discuss feasibility and clinical effect of minimally invasive percutaneous plate osteosynthesis (MIPPO) in treatment of unstable anterior pelvic ring fractures.Methods A retrospective study was carried out on data of eight patients with pelvic fractures,including five males and three females at age of 21-57 years (average 38 years).All fractures were identified as unstable type according to Tile classification.MIPPO was performed for all patients after closed reduction.Reduction effect was analyzed according to Matta radiological evaluation criterion.Results All patients were followed up for 3-5 months (average 4.1 months),which showed reduction of anterior pelvic ring in eight patients including satisfactory reduction in five patients and good reduction in three.Fractures in all patients obtained bony union without complications like vascular nerve injury,wound infection,intraoperative massive hemorrhage,deep venous thrombosis or postoperative long-term pain.Conclusion MIPPO has advantages of reduced bleeding,few soft tissue complications,low infection rate and easy removal in treatment of anterior pelvic ring fractures and thereby is a promising surgical method.

Objective To design a new cancer vaccine by using alpha-galactosylceramide (α-Galcer,α-GC) loaded tumor cells in combination with TLR 9 ligand and to evaluate its therapeutic effects on colon canc-er in mice.Methods MC38 cells were transfected with lentivirus (GFP-CD1d) to prepare CD1d-MC38 cells. The expression of CD1d molecules in CD1d-MC38 cells was detected by fluorescence microscopy , RT-PCR and flow cytometry.The sorted CD1d-MC38 cells were loaded with α-Galcer to prepare CD1d-MC38/α-GC complex. Flow cytometry was performed to evaluate the efficiency of combination .A mouse model of colon cancer was es-tablished to investigate the therapeutic effects of α-Galcer loaded tumor cells in combination with TLR 9 ligand ( CD1d-MC38/α-GC+CpG1826) on colon cancer in mice by analyzing tumor growth and mice survival time .Im-munohistochemical staining was used to detect CD 4+T and CD8+T infiltrating lymphocytes in tumor tissues .Re-sults The MC38 cancer cells that expressed CD 1d and GFP were successfully constructed , among which 98.10%±2.53%were positive for CD1d.Moreover, the CD1d-MC38 cells could combine with α-Galcer effec-tively in a dose and time dependent manner .Compared with PBS treated group ,α-GC treated group and TLR9 ligand treated group , the experimental vaccine strategy was sufficient to inhibit the growth of established tumors and prolong survival of tumor-bearing mice (P<0.01).Immunohistochemistry analysis revealed that levels of CD4+T cells and CD8+T cells in experiment group were significantly higher than those in groups treated with PBS,α-GC and TLR9 ligand (P<0.01).Conclusion CD1d-MC38/α-GC in combination with CpG1826 could efficiently inhibit the growth of established tumors and prolong survival of tumor-bearing mice .Immunohisto-chemistry analysis revealed that CD 4+T cells and CD8+T cells played important roles in anti-tumor immunity.

Objective To observe the clinical effect of arthrodesis in treating severe hallux rigidus. Methods Totally 30 patients (30 feet) with severe hallux rigidus treated by arthrodesis from January in 2010 to January in 2013 were retrospec?tively analyzed. AOFAS and VAS scoring system were employed to evaluate the clinical curative effect including acquiring the fusion rate, the time to fusion and the incidence rate of hallux valgus. Forefoot-plantar pressure values before and after operation were measured by Plantar pressure measurement system. Results The mean follow-up time was 18 months. AO?FAS score was raised from (48.2±7.6) to (72.8±6.2) after operation (P<0.01). VAS score was also increased from (1.7±0.7) to (8.3 ± 1.1) after operation (P<0.01). The average healing time of knitting was 12.1 weeks. None was non-union and devel?oped to hallux valgus. The forefoot-plantar pressure returned to normal postoperatively from abnormal laterally distribution.Conclusion The surgical strategy of arthrodesis is proved to be effective in treating severe hallux rigidus, in terms of capa?bility of relief from pain, recovery of forefoot-plantar pressure distribution, low incidence of complication.

Objective To observe the clinical effects of double support plate via posteromedial approach in the treat?ment of tibial plateau fracture of posterior column. Methods A total of 21 cases of tibial plateau fracture in closed posterior column with an average age of 34.6 (range, 21 to 56) years old were treated using double support plate through posteromedial approach from January in 2010 to January in 2013(16 males and 5 females). Among all, 4 cases were combined with lateral column fracture and 17 cases were three column fracture. Wound healings were observed after operation. X-ray examina?tions were performed at 2 weeks, 3 months, 4 months, 6 months and 12 months after operation as well as at last follow up. The averaged healing time was calculated. Changes of tibial plateau angle and posterior slope angle were compared between time points at 2 weeks after operation and at last follow up. Rasmussen knee score criteria was employed to assess knee joint recovery. Results The mean follow-up was (18.2 ± 1.8) months. No infection was reported. The average fracture healing time was 3.8(3.8±0.6)months. There was no significant difference between tibia plateau angle and posterior slope angle be?tween time points at 2 weeks after operation and at last follow-up (P<0.05). According to Rasmussen knee score criteria at last follow-up, 13 cases were graded as excellent, 6 cases as good, and 2 case as fair, with an excellent and good rate of 90.5%. Conclusion With posteromedial approach, the fractures of medial column, posteromedial and posterolateral of pos?terial column can be exposed well. Using double support plates to fix posteromedial and posterolateral of posterior column fracture can effectively prevent loss of reduction and the function of knee recovered well postoperatively.

Objective To study the thyroid hormone receptor β(TRβ)gene mutation types and characteristics in children with congenital hypothyroidism(CH)and thyroid dysgenesis(TD)from Shandong Province,and to provide theoretical basis for gene diagnosis and prenatal diagnosis. Methods Sixty cases of TD patients of which genomic DNA were isolated from peripheral blood leukocytes were selected by neonatal screening system in Shandong Province. The exon 6 to 12 of TRβ gene were amplified with 8 pairs of sequence specific primers using PCR and the first generation of sequencing method(Sanger method)to detect mutation. The sequencing results were compared with the TRβ gene reference sequence[National Center for Biotechnology Information(NCBI)Reference Sequence:NC 000003. 12]to see whether there was a mutation. Results Analysis of TRβ in 60 cases of CH patients with TD revealed no mutation was demonstrated in exons 6 - 12,but 2 single nucleotide polymorphism(SNP)( rs 3752874,c. 735C ﹥ T;rs79220627, c. 162G ﹥ A)were detected. Through the analysis,the 2 SNP were all synonymous mutations(Phe→Phe;Ser→Ser), without the change of the amino acids. Conclusions TRβ mutation rate is very low,which may not be the main mutation type in CH patients with TD in Shandong Province.

Objective Combination of nanoparticle with p53 and Rb gene therapy by gene targeting was applied to investigate its curative effect and safety evaluation on colorectal rabbit hepatic VX2 metastasis for tumor eradication and survival enhancement. Methods Recombinant expressing plasmids harboring wild type p53 and Rb were cotransferred or transferred separately to the rabbit hepatic VX2 metastasis by the emulsion of PLL-nHAP nanoplex and lipodiol through the hepatic artery in a tumor target manner. Subsequent co-expressions of p53 and Rb protein within the treated tumors were detected by Western blot and in situ analysis of confocal laser scanning microscope. The therapeutic effect was evaluated by the tumor growth velocity and the survival time of animals. Eventually, investigations of liver function were applied to evaluate the safety of the process. Results With safe procedure for the rabbits liver function, both p53 and Rb local nano-therapy showed favorable anti-tumor effects and increased animal survival time. p53+Rb local nano-therapy could significantly inhibit hepatic VX2 metastasis and enhance the animal survival time compared with p53 local nano-therapy or Rb local nano-therapy. Local nano-therapy showed no significant influence to animal liver function. Conclusions Rb can work synergistically with p53 in the combined therapy mediated by PLL-nHAP nanoplex to augment the anti-tumor effect. The local nano-therapy with p53 and Rb is likely to be an effective and safe anti-tumor therapy for hepatic colorectal metastasis.