Objective To investigate the timing for delivery in twin pregnancies to improve the perinatal outcome. Methods A multicentered and retrospective study was conducted on 655 women with twin pregnancies in 6 hospitals of Shanghai from Jan 1993 to Oct 2003. The average birthweight(BW) for both twins in different gestation, the incidence of small for gestational age (SGA) and severe neonatal asphyxia were analyzed. Results For the smaller babies in all twins, the 50 percentile of the birth weight was far behind the singletons throughout the pregnancy. But for the larger babies, it was similar to the singletons if delivered before 33 weeks, lighter than the singletons if after 33 weeks and remarkable difference was shown beyond 39 weeks. The largest BW of the larger babies was 3073 g presented at 39 weeks, while 2670 g for the smaller babies at 40 weeks after which the average BW was decreased. It reached 2555 g and 2303 g at 41 weeks for the larger and smaller babies, respectively (P

Objective:To study the role of rennin and angiotension Ⅱ in the developement of acute pancreatitis in rats.Methods:Forth-two Sprague-Dawley rats were divided into two groups randomly-control group,and acute pancreatitis group.Acute pancreatitis model was reproduced by closed duodenal loop technique.Plasma amylase.Plasma renin activity and angiotesion Ⅱ level were measured,pancreatic histopathology was examined with light microscopy. Results:In acute pancreatitis group,pancreatitis histopathology developed from edematous to bleeding and necrotizing pancreatitis,plasma amylase,plasma renin activity,and angiotesion Ⅱ level were increased as acute pancreatitis developed,but after 10h,the angiotesion Ⅱ level was increased sequentially and plasma renin activity was increased unsignificantly.Conclusion:Renin and angiotension Ⅱ played the important role in the developement of experimental acute pancreatitis.

BACKGROUND:Studies on high glucose exposure in human periodontal ligament cel s usual y focus on the biological behaviors, pathways and secretory factors, but whether the metabolic memory is involved is little known. OBJECTIVE:To investigate the metabolic memory of high glucose exposure in human periodontal ligament cel s. METHODS:Human periodontal ligament cel s were primarily cultured and identified. Cel s at 5-8 passages were selected and randomized into four groups. Group A (controls):DMEM containing 5.5 mmol/L glucose for 8 days;group B (5-day memory group):DMEM containing 35 mmol/L glucose for 3 days and DMEM containing 5.5 mmol/L glucose for 5 days;group C (3-day memory group):DMEM containing 35 mmol/L glucose for 5 days and DMEM containing 5.5 mmol/L glucose for 3 days;group D (8-day high glucose group):DMEM containing 35 mmol/L glucose for 8 days. The cel proliferation was detected by cel counting kit-8, the cel apoptosis was determined by flow cytometry, and the levels of total proteins and alkaline phosphatase were investigated using ELISA. RESULTS AND CONCLUSION:Compared with the control group, the cel proliferation in the other three groups was significantly reduced (P<0.05), the number of apoptotic cel s was significantly increased, while the levels of total proteins and alkaline phosphatase were significantly decreased (P<0.05). These results suggest that high glucose causes persistent changes in human periodontal ligament cel s by inhibiting cel viability, increasing the apoptosis and downregulating the levels of the total proteins and alkaline phosphatase

Objective To detect the expression and potential correlation of ERK1 and P16 in gastrointestinal stromal tumor group and in control group.Methods Tissue chip and immunohistochemistry Elivison were used to detect the expression of ERK1 and P16 in 40 cases of gastrointestinal stromal tumor and 40 cases of control tissues.Quantitative analysis of mean absorbent density of the expression of ERK1 and P16 was conducted with image analytic software.Results The expressions of ERK was higher in GIST group than that in control group(P

This study examined whether exposure to nitrate in drinking water is associated with increased risk for bladder cancer by conducting a comprehensive literature research. A meta-analysis was performed with and without adjustment for confounding factors. Three groups (reference, intermediate and high groups) were established in terms of different nitrate concentrations in each included study. Separate relative risk measures were calculated for intermediate and high groups. Heterogeneity was assessed by using the Q statistics. Publication bias was evaluated by Egger's and Begg's test. Quality assessment for studies was performed by using the Newcastle-Ottawa scale. Two cohorts, two case-controls, and one ecological study were included in this study. The adjusted data showed that the combined risk ratios (RRs) were 1.13 (95% CI: 0.81 to 1.57) and 1.27 (95% CI: 0.75 to 2.15) for intermediate and high groups respectively. For unadjusted data, the corresponding RRs were 1.18 (95% CI: 0.89 to 1.57) and 1.29 (95% CI: 0.81 to 2.07). Sensitivity test indicated that results were significantly underestimated when Ward's study was included. No significant publication bias was found. There was heterogeneity among studies. The results suggested that there was no sufficient evidence that nitrate in drinking water is associated with increased risks for bladder cancer.

Objective To explore the safety and feasibility of controlled hypotension with urapidil and nitroglycerin esmolol-three drugs combination in endoscopic surgery. Methods Forty patients who were received endoscopic surgeries were randomly divided into two groups, 20 cases in each group, urapidil-esmolol-nitroglycerin controlled hypotension group (A group) and non controlled hypotension group (B group). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) were recorded at the following points: before anesthesia (basal, T1), immediate before surgery (T2), 30 minutes after the start of surgery (T3), end of the operation (T4), 10 minutes after the end of surgery (T5). We recorded blood loss, operative time, transfusion volume, urine. At last the parameters were compared between the two groups. Results The difference of SBP, DBP, MAP at the points of T2, T3, T4 in the two groups was statistically significant (P < 0.05) comparing with the control group (group B). The vital signs of patients during anesthesia in A group had more stable than that of the B group , and the operation time of the A group was significantly shorter than that of the B group. Meanwhile, the blood loss in A group was significantly decreased(P < 0.05). Conclusion It has synergistic antihypertensive effect, and can reduce both side effects and the risk of anesthesia and surgery for us to use urapidil-esmolol-nitroglycerin three antihypertensive drugs in combination. It is a safe and reliable method for clinical application.

Objective To investigate and compare the effects of etomidate or propofol on spatial cognitive,exploring,learning and memory abilities and hippocampus tissue in rapid development period of rats.Methods Thirty-nine SD rats with anage from 17 to 18 days were randomly divided into group C(10 ml/kg of normal saline),group E(5 mg/kg of etomidate),group P(50 mg/kg of propofol)(n=13).They were all single injected intraperitoneally.The tests of cognitive function were performed in Open Field Test(OFT),Hole Board Test and Ymaze Test at 3 hours postanesthesia awake.HE staining method was uesed to observe the morphology of hippocampus neuron tissue and immunohistochemistry(IHC) method was uesed to detect the expression of aspartic acid specificity cysteine protease (caspase-3) in hippocampal neurons.Results In the OFT,there was no significant difference between group C((3.70 ± 1.06)s,(39.10 ± 11.89)s)and group E,P((4.40 ±2.01)s and (4.60 ± 1.96) s,(37.90 ± 11.88) s and (36.30 ± 15.68) s) about the retention time in central check and the locomotion (P ＞ 0.05).In the Hole Board Test,the rats of groups E and P(12.00 ± 3.13,10.00 ± 2.79) about the times of rats stretch into the hole were significant different comparing with group C(16.30 ±4.62) (P＜0.05).In the Ymaze Test,compared with group C,the group E in the right number and total reaction time were no significant differences (P ＞ 0.05).The right number of group P (9.80 ± 2.39) were obviously decreased as compared with group C(13.30 ±2.00)(P ＜ 0.01),and there also had significant difference between group E and group C (P ＜0.05).In addition,the total reation time between group P ((82.30 ± 10.20) s) and group C ((67.70 ± 12.18) s) was significant difference(P ＜ 0.05).In HE staining,there were obvious changes in group E and P.In IHC,the expression of caspase-3 between groups C,E and P,there were no significant differences (P ＞ 0.05).Conclusion Single intraperitoneal injection of etomidate can make a transient effects for the rapid development period of rats ' ability of exploration,but have no obvious influence of the spatial cognition and learning and memory abilities.And etomidate lead less influence on newborn rat behavior and hippocampal tissue than propofol.

BACKGROUND:Recent studies have demonstrated that Niacinamide is capable of promoting the proliferation of intervertebral cells and improving intervertebral disc degeneration.Overloading is thought to the main cause of intervertebral disc degeneration.However,the protective effects of Niacinamide in loading induced intervertebral disc degeneration remains uncertain,OBJECTIVE:To investigate the protective effects of Niacinamide against axial loading induced degeneration of rabbit lumbar disc.DESIGN,TIME AND SETTING:A randomized controlled experiment was carded out in the Central Laboratory and the Laboratory of Department of Orthopaedics,Union Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology from November 2008 to April 2009.MATERIALS:Twenty-four Japanese white rabbits (4 months old,weighing 2.0 kg).Niacinamide was supplied by Tianjin Damao Chemical Reagent Factory.METHODS:Twenty-four Japanese white rabbits were randomly divided into 6 groups.The controllable axial loading induced rabbit lumbar disc degeneration model was adopted to impose 98N pressure on the rabbit discs to induce degeneration.Various doses of Niacinamide were given intragastrically to the rabbits in different groups:2 rabbits in group 1,the loading device was installed without pressing,and no Niacinamide was given;2 rabbits in group 2,given 50 mg/kg Niacinamide for 1 week;5 rabbits in group 3,loaded with 98N for 1 week;5 rabbits in group 4,loaded with 98N for 1 week,then the pressure was released for another week's recovery;5 rabbits in group 5,loaded with 98N and given 50 mg/kg Niacinamide for 1 week;5 rabbits in group 6,loaded with 98N for 1 week and then the pressure was released for another week's recovery,50 mg/kg Niacinamide was continually given during the 2 weeks.MAIN OUTCOME MEASURES:Magnetic resonance image and Thompson's grading system were used to assess degeneration degree of the discs;hematoxylin and eosin staining,immunohistochemical staining for type Ⅱ collagen,and Safranin O staining were used to evaluate histological changes;immunohistochemical staining for P161NK4A was used to evaluate cell proliferation and senescence.RESULTS：①According to the Thompson's grading system，there was no disc exhibited degeneration in group 2；5 rabbits graded Ⅱ in group 3；4 rabbits graded Ⅱ and 1 rabbit graded Ⅲ in group 4；2 rabbits graded Ⅰ and 3 rabbits graded Ⅱ in group 5；3 rabbits graded Ⅰ and 2 rabbits graded Ⅱ in group 6.MRI results revealed the alleviated degeneration in Niacinamide given groups.②The content of type Ⅱ collagen of annulus fibrosus of group 6 was 53.2% higher than that of group 4 (P＜0.01).③Safranin O-Fast Green staining density of group 2 was higher than that of group 1；The staining density of nucleus pulposus and annulus fibrosus of groups 5 and 6 was higher than the corresponding parts of group 4，especially that of nucleus pulposus (P＜0.01，P＜0.01)，and group 6 exhibited slightly increased levels than group 5.④P16INK4A positive staining rates decreased with the extension of Niacinamide administration time.CONCLUSION：Niacinamide can help to alleviate overloading-caused damage to intervertebral disc，and can benefit the recovery of damaged intervertebral disc.

Objective:To identify the epitope of mAb15A11 which is specific against RA associated autoantigen cartilage oligomeric matrix protein ( COMP ).Methods: A filamentous phage library displaying random linear dodecapeptides was used to mapping the epitope of mAb15A11.After three rounds of screenings,40 phage clones were selected at random and sequenced.The specificity of phages was confirmed by enzyme immunoassays.Homology search by ClustalW2 and structure analysis by PyMol to identified the epitope amino acid sequence.Western blot analysis of COMP and ELISA analysis of COMP-derived peptides were used to confirm epitope′s characterization.Results: After repeated screenings using bio-panning method, 2 clones were identified, which interacted specifically with mAb 15A11.Homology search did not find succession consensus sequence within COMP molecular,which indicated that the epitope was not linear.PyMol Structure analysis identified the rationality of conformational epitope.Western blot analysis and ELISA of EDTA-treated COMP further prove an conformational structure of the epitope recognized by mAb 15A11.ELISA analysis of COMP-derived peptides demonstrated both disulfide bonds between 229 C-243 C and 237 C-253 C and every epitope amino acid of 232 G,238 H,240 H,241 A,244 V,247 R and 251 R were essential to the binding of mAb 15A11 with COMP.Conclusion: In this study, the potential B cell antigentic epitopes of mAb 15A11 was identified by phage display library.The epitope amino acids sequence and char-acterization were also recognized.It may have important theoretical value for the study of reaction mechanism of COMP antibody and antigen and may also show application significance in the detection of rheumatoid arthritis.

Objective To assess the application of Chinese children's intelligence equation (CCIE) and Bayley Scales of infant and toddler development-Ⅲ (BSID-Ⅲ) in screening of postoperative cognitive dysfunction (POCD) in children after general anesthesia.Methods The study group (Group A),including 50 ASA-Ⅰ participants of 1-3 years old who would undergo hernia repair laparoscopic surgery,was assessed on one day (1 d) before and three days (3d) after the surgery respectively by both of CCIE and BSID-Ⅲ according to their ages of month.The control group (Group C),including 50 healthy participants with the matched age,was assessed in the same period by the same method.Both of Group A and C were assessed by the Z score method to diagnose POCD and both scales were used to analyze the results of POCD screening and their agreement.Results (1) Compared with preoperative 1 d,the CCIE score of Group A on 3d after surgery was relatively decreased (21.22±4.96 vs 18.65±4.74,P＜0.05) and the POCD rate was 12.0％.While in Group C,the CCIE score and the POCD rate had no statistical significance (20.83±4.97 vs 21.22±5.21,P＞0.05).(2) Compared with preoperative 1d,the scores of cognition,language,motion,social-emotion and adaptive behaviors in BSID-Ⅲ of Group A decreased (100.00±4.58 vs 96.44± 4.20,103.22±4.99 vs 96.24± 5.75,102.06±4.01 vs 95.28±4.27,101.22±7.38 vs 91.06±7.10,98.52±9.11 vs 90.5±8.47,P＜0.05) and the POCD incidence was 20.0％.While in group C,the BSID-Ⅲ score and the POCD rate had no statistical significance (104.61±5.48 vs 103.79±5.38,107.68±5.60 vs 107.11 ±6.05,108.29±5.91 vs 108.29±4.21,101.11±7.61 vs 101.86±6.99,99.00±7.99 vs 100.82±7.36,P＞0.05).(3)Reasonable agreement of the CCIE and BSID-Ⅲ was observed (Kappa value was 0.70;P＜ 0.05).Conclusion There is considerable agreement between BSID-Ⅲ and CCIE.While BSID-Ⅲ is relatively more sensitive to the POCD and more efficient in the diagnosis of POCD than the CCIE.Thus,BSID-Ⅲ is more likely to provide better evaluation of the postoperative cognitive functions of children within 1-3 years old and should be recommended to the health professionals in China.