Objective To analysis the relationship between gestational age and perinatal outcomes in patients complicated with early onset severe preeclampsia.Methods Retrospective study was conducted on clinical documents of 221 patients with early onset severe preeclampsia( ＜ 34 weeks) who delivered after 28 gestational weeks in Peking University First Hospital from July 1999 to June 2009.Patients were divided into three groups based on gestational weeks at delivery: group Ⅰ (n = 81 ) delivered at 28 -31 weeks+6,group Ⅱ (n = 78) at 32 -33 weeks+6 and group Ⅲ (n = 62) after 34 weeks.The clinical characteristics and perinatal outcomes were compared among those three groups.Results ( 1 ) Outcome of neonates:Among 221 neonates, 13 neonates lost follow-up, including 9 in group Ⅰ , 3 in group Ⅱ, 1 in group Ⅲ.The incidence of neonatal respiratory distress syndrome ( RDS ) of 26% ( 19/72 ) in group Ⅰ were significantly higher than 7% (5/75) in group Ⅱ and 10% (6/61) in group Ⅲ (P ＜ 0.05 ).The neonatal mortality rate of (43% ,31/72) in group Ⅰ were significantly higher than 3% (2/61) in group Ⅲ and 28%(21/75) in group Ⅱ (P ＜0.05 ).The incidence of maternal complications showed no statistical difference among three groups.(2) Neonatal death analysis: all neonatal death were due to parents' give up, including 26%(8/31) in group Ⅰ, 67% (14/21)in group Ⅱ and 1/2 in group Ⅲ, which reached statistical difference(P＜0.05).Conclusions The incidence of neonatal RDS in mother with early onset severe preeclampsia was decreased if delivered after 32 weeks, and the perinatal mortality was remarkably decreased if delivered after 34 weeks.Therefore, the perinatal survival rate in women with early onset severe preeclampsia can be improved by minimizing the impact of social factors.

CD56 Antigen ; metabolism ; Carcinoid Tumor ; diagnostic imaging ; metabolism ; pathology ; surgery ; ultrastructure ; Chromogranin A ; metabolism ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; ultrastructure ; Male ; Microscopy, Electron, Transmission ; Middle Aged ; Phosphopyruvate Hydratase ; metabolism ; Synaptophysin ; metabolism ; Tomography, X-Ray Computed ; Vimentin ; metabolism

Objective To observe the protective effect of acetylcysteine against radiation pneumonia.MethodsTotal of 80 patients who were inoperable were randomly allocated into treatment group and control group.Using conformal radiation technology and the total dose was 65 ～ 75Gy.The patients in treatment group were given acetylcysteine and radiotherapy;the patients in control group were given radiotherapy only.ResultsAll patients were treated radiotherapy.The effective rate( CR and PR) of treatment group was 90％,and that of control group was 85％(P ＞ 0.05);The incidence of acute radiation pneumonia and pulmonary fibrosis in treatment group were 15％ and 20％,respectively;and that of control group were 33％ and 45％ respectively.There was significant difference between the two groups ( P ＜ 0.05 ).ConclusionUsing acetylcysteine during radiotherapy could prevent radiation pneumonia in the non-small cell lung cancer patients.

Objective To establish a novel method to screen for anti-varicella-zoster virus (VZV) compounds with our previously generated reporter cell line for VZV, MV9G. MethodsMV9G cells were directly infected with cell-free virus of Oka vaccine strain (vOka) for 2 hours( CFV direct-infection) or cocultured with vOka-infected MeWo cells containing cell-associated virus for 48 hours (CAV co-culture) to promote expression of the reporter gene firefly luciferase. Antiviral compounds including heparin, mannose-6-phosphate( M-6-P), acyclovir( ACV ), resveratrol and roscovitine were added in the medium before or after the virus infection. Inhibitory effects( IC50 ) of the antiviral compounds were analyzed by comparing firefly luciferase activities of MV9G cells in the presence of antiviral compounds with those in the absence. Results Antiviral compounds inhibited luciferase activities of MV9G cells activated by CFV direct-infection and/or CAV co-culture in different levels. The reductions of luciferase activities statistically correlated with those of viral foci shown by immunostaining with a monoclonal antibody against VZV immediate early 62 antigens (IE62) in controls. Among these compounds, heparin, M-6-P, and 2.5 μmol/L of roscovitine inhibited CFV-activated more strongly than CAV-activated luciferase activities, whereas ACV and resveratrol inhibited CAV-activated more strongly than CFV-activated luciferase activities. Cell-associated ACV-resistant strains,Kanno and rOka YSR, activated luciferase activities of MV9G cells, too. However, the inhibitory concentrations (IC50) of ACV to the ACV-resistant strains were much higher than those to the ACV-sensitive strains,pOka and CaGu. ConclusionThe CFV direct-infection and CAV co-culture assays were useful to screen for antiviral compounds targeting the early and late phases of VZV infection, respectively. The VZV reporter cell-based assays may provide a simple, rapid, sensitive, and high-throughput method to screen for anti-VZV compounds.

Background and purpose: Small bowel adenocarcinoma (SBA) is uncommon, and frequently diagnosed at late stage. Chemotherapy is the main treatment method for advanced SBA. Despite recent progress in SBA therapy, no standard regimen has been established up to now, and new active regimen is expected to improve the outcome of this disease. The purpose of this study was to evaluate the efifcacy and safety of S-1/oxaliplatin for the treatment of advanced SBA. Methods:In a retrospective study, clinical characteristics and outcomes of 29 patients with advanced SBA were collected and analyzed. Patients received oral S-1 40 mg/m2, twice daily, d1-14, oxaliplatin was administered intravenously 130 mg/m2 on the ifrst day of every cycle, repeated every 3 weeks. Efifcacy and toxicity were evaluated after at least two consecutive cycles. Results:All patients were evaluated for efifcacy and safety. The objective response and disease control rates were 37.9%and 65.5%, respectively. The median progression-free survival and overall survival were 5.4 months (95%CI:3.6-7.2) and 13.2 months (95%CI:6.7-19.7), respectively. In univariate analysis, the following factors were signiifcantly associated with poor outcome:not ifrst line chemotherapy setting, ECOG performance status>1 and sites of metastasis>2 (Log-rank, P<0.05). The treatment related adverse events were mild and manageable. Myelosuppression, gastrointestinal reaction, fatigue, sensory neuropathy and rash were the most common toxicities. Conclusion:This study was the ifrst to report the efifcacy of S-1 combined with oxaliplatin for advanced SBA. S-1/oxaliplatin may be effective and safe for advanced SBA and worthy of further study.

Objective To investigate CT findings of hepatic necrosis and regeneration after liver failure.Methods Five patients with liver failure underwent CT scan before orthotopic liver transplantation.These findings were retrospectively reviewed and correlated with gross specimen and pathologic findings obtained after transplantation.Results Among 5 cases,the CT appearances of liver failure can be divided into 3 types.(1)Massive confluent aggregate foci in 2 patients demonstrated low attenuation and high attenuation as geographical patlerns on CT scans before contrast enhancement.respectively.The histopathological liver changes showed massive necrosis and regencratinn. Regions of necrosis enhanced to attenuation greater than that of normal liver parenchyma in portal-venous phase,the regions of regeneration enhanced to attenuation greater than that of normal liver parenchyma in arterial phase on postcontrast CT images.(2)In 2 patients,diffuse nodules of liver demonstrated high attenuation on plain CT scans,which was nodular necrosis and nodular regeneration pathologically.All enhanced to attenuation greater than that of normal liver parenchyma in arterial phase.The former showed hypointensity in portal-venous phase and equilibrium phase.The latter enhanced to attenuation equal to that of normal liver parenchyma in portalvenous phase and equilibrium phase on postcontrast CT images.(3)Multiple small foci in 1 case demonstrated low attenuatiun on precontrast CT images and enhanced to hyperintensity in portal-venous phase and isointensity in arterial phase and equilibrium phase on postcontrast CT images.The histopathological liver changes showed multiple necrosis.Conclusion Liver failure may reveal characteristic imaging patterns at CT.

Objective To study the effects of X-ray radiation on CC-chemokine receptor 7(CCR7) expression in human non-small cell lung cancer (NSCLC) cells.Methods Humanadenocarcinoma cells of the line A549 were cultured and irradiated by X-ray at the absorbed doses of 2,4,6,and 8 Gy respectively by linear accelerator (with the source skin distance of 100 cm and dose rate of 442.89 cGy/min).The relative levels of CCR7 mRNA and protein expression in the A549 cells were respectively detected by real time-PCR and Western blotting 4,12,24,48,and 72 h after radiation.Untreated A549 cells were used as control group.Results The expression levels of CCR7 mRNA and protein in the A549 cells began to increase since 4 h after radiation and then decreased gradually after they reached the peak.The CCR7 mRNA expression levels 72 h after radiation of the 6 and 8 Gy groups were still significantly higher than those of the control group (t = 6.75-7.26,both P < 0.01),and the CCR7 protein expression levels of the 2 and 6 Gy group were still significantly higher than those of the control group(t=11.13-14.17,both P <0.01).Then the CCR7 protein expression levels of the 4 and 8 Gy groups decreased to the control group level 48 and 72 h after radiation respectively.Conclusions The CCR7 mRNA and protein expression levels in the NSCLC cells increase after X-ray irradiation,which may be correlated with the promotion of proliferation and metastasis of NSCLC cells by X-ray irradiation at a certain dose.

Objective To evaluate the effect of the collaboration care model on posttraumatic growth and resilience in patients with breast cancer.Methods 70 patients who were diagnosed with breast cancer in department of Breast Surgery of the First Affiliated Hospital of Dalian Medical University were assigned into two groups by random number table.32 patients who completed the research in the experimental group received collaboration care while 31 patients who completed the research in the control group received routine care both for there months.The patients were investigated with the Posttraumatic Growth Inventory (PTGI) and Connor-Davidson Resilience Scale (CD-RISC) before and after intervention.Results After the intervention,there were significant differences in scores of posttraumatic growth [(63.83±11.87) scores vs.(60.33±10.09) scores,t=2.384] and resilience [(66.52±15.23) scores vs.(61.33±10.09) scores,t=2.472] between the two groups (P＜0.05).And also there were significant differences of posttraumatic growth scores before and after intervention in the experimental group [(56.24±10.01) scores vs.(63.83±11.87) scores,t=-3.988,P＜ 0.01] and the control group [(56.68±10.32) scores vs.(60.33±10.09) scores,t=-2.426,P＜0.05].Differences of resilience also existed in the experimental group [(61.28±14.40) scores vs.(66.52±15.25) scores,t=-3.225,P＜0.01] and the control group [(63.97±17.66) scores vs.(61.33±10.09) scores,t=-2.370,P＜0.05].Conclusions Collaboration care model can significantly improve the level of patients' posttraumatic growth and resilience.

Objective To study the methods and value of emergency interventional therapy in digestive tract bleeding.Methods 61 cases with digestive tract bleeding accepted emergency angiography.According to find out positions and causes of bleeding during angiography,these patients accepted arterial embolization and /or perfusion of vasoconstrictor substance.Results In 29 cases accepted arterial embolization and 32 cases accepted perfusion of vasoconstrictor substance,the stoped bleeding immediately occured in 100% and 82.7% respectively.Bleeding recurrence was 3 cases in the patients with arterial embolization one week later and 25 cases of the patients with perfusion of vasoconstrictor substance forty-eight hours later.Conclusion To treat the digestive tract bleeding by arterial embolization or vasoconstrictor substance perfusion are safe and effective hemostatic ways during emergency angiography.Though the bleeding recurrent rate is high after vasoconstrictor substance perfusion,these ways can race against time for surgical operation.

Objective To observe the efficacy and safety of intravitreal injection of ranibizumab in the treatment of retinopathy of prematurity (ROP).Methods Data from 49 consecutive ROP patients (95 eyes) including type Ⅰ pre-threshold,threshold and aggressive posterior ROP who had received anti-VEGF treatment for the first time in our hospital from June 2014 to August 2015 were collected.60 eyes from the 95 eyes were confined as the zone Ⅰ disease group,while the remaining 35 eyes as zone Ⅱ disease group.The difference of birth weight,gestational age,corrected gestational age,treatment effects,recurrence and re-treatment time between two groups were compared.0.025 mL ranibizumab (10 mg · mL-1) was injected through 1.5 mm puncture after corneal limbus by using 30G 1 mL injection syringe.At the end of the injection,tobramycin and dexamethasone ophthalmic ointment eye bag was used.After the injection of 3 days,the portable slit lamp and tonometer were used to observe the intraocular pressure,intraocular hemorrhage and endophthalmitis.The indirect ophthalmoscope was used to observe the retinal vascular tortuosity and ridge regression of lesion expansion at 1 week after treatment.At the same time,the systemic adverse reactions related to treatment were observed.Results After receiving ranibizumab treatment for the first time,93 eyes (95.9％) exhibited ROP regression after single injection,including 58 eyes in zone Ⅰ disease group,35 eyes in zone Ⅱ disease group.There was no statistical difference between two groups (P ＞ 0.05).22 eyes required additional anti-VEGF injection or laser treatment for ROP recurrence,including 17 eyes in zone Ⅰ disease group,5 eyes in zone Ⅱ disease group.There was statistical difference between two groups (P ＜0.05).The time from recurrence to re-treatment was (6.50 ±2.54) weeks,which in zone Ⅰ disease group was (6.44 ± 2.74) weeks and in zone Ⅱ disease group was (6.67 ± 2.31)weeks,there was no statistical difference between two groups (P ＞ 0.05).No local or systemic adverse events associated with the treatment or drug was observed within the following period.Conclusion Intravitreal injection of ranibizumab is an effective and well tolerated method for zone Ⅰ and zone Ⅱ ROP,but the recurrence rate is high.There Is no local or systemic adverse events associated with the treatment or drug.