Objective To investigate the changes of Bcl-2 and Bax expression in white matter of fetal rats after maternal endotoxin administration. Methods Pregnant rats were randomly divided into two groups: infection group and control group. The infection group was established by intraperitoneal injection of endotoxin in pregnant rats when gestation was 70% complete (15 days). The control group was treated with normal saline. The fetal rats were killed at 2, 4, 12, 24 and 72 hours after maternal endotoxin administration. The pathological changes in placenta and in fetal rat brain were determined by HE staining. Immunohistochemical method was used to detect the expression of Bcl-2 and Bax proteins in fetal rat brains. Results The major pathological changes in fetal rats niter maternal endotoxin administration included neutrophil infiltration in the placenta, weak staining of white matter and focal infarction. After maternal endotoxin administration, the expression of Bcl-2 gradually decreased from 2 h and arrived at the valley at 12 h, while that of Bax gradually increased 2 h and reached a peak at 12 h. Between the endotoxin-gronp and the control group, the number of positive cells of Bcl-2 and Bax in brain of the fetal rat had significant difference at 4, 12, 24 and 72 hours (P< 0.01 ), and there was no significant difference at 2 h (P > 0.05). The ratio of Bax to Bcl-2 in the endotoxingroup was significantly higher than that in the control group at each time point (P<0.01).Conclusion Endotoxin can be used to eatablish intrauterine irfection models and the infection may cause damage to the white matter. Overexpression of Bcl-2 protects cell from apoptosis, but Bax may function as a cell death effector pro-tein. The ratio of Bax to Bcl-2 may play an important role for apoptosis in the lesion of the white matter.

BACKGROUND: Ischemic reperfusion syndrome occurs in early donor liver reperfusion after orthotopic liver transplantation. It is the most important cause for liver function failure and patient death. Ischemic reperfusion severity is closely related to blocking of inferior vena cava period. Some studies demonstrate that inferior vena retrograde perfusion can shorten the blocking time during liver transplantation. OBJECTIVE: To observe the effect of retrograde perfusion on the hemodynamics in orthotopic liver transplantation without venovenous bypass during neohepatic reperfusion phase. DESIGN, TIME AND SETTING: Case comparison was performed at Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from December 2006 to June 2007. PARTICIPANTS: Thirty-nine patients underwent orthotopic liver transplantation without venovenous bypass under general anesthesia. METHODS: According to perfusion methods, the patients were divided into two groups: retrograde perfusion through inferior vena cave (n=19), and perfusion through portal vein (n=20). MAIN OUTCOME MEASURES: The systolic blood pressure, diastolic blood pressure, heart rate, central venous pressure and other hemodynamic parameters were measured before operation, and at anhepatic phase and primary neohepatic phase. The rewarming ischemia time of grafted liver was also recorded. RESULTS: The rewarming ischemia time of grafted liver in the retrograde perfusion through inferior vena cave group was significantly less than that in the perfusion through portal vein group (P

Objective To investigate the effect of Astragalus injection combined with low molecular weight heparin and nifedipine on levels of related indexes and pregnancy outcomes in patients with preeclampsia.Methods A total of 60 patients with preeclampsia from March 2013 to December 2016 in Cixi Municipal Maternal and Child Care Hospital were selected and randomly divided into the study group and control group, with 30 cases in each group.All patients were given spasmolysis, diuretic and other conventional treatment.The control group were treated with low molecular weight heparin and nifedipine while the study group were additionally treated with Astragalus injection.The blood pressure, blood coagulation and other laboratory indicators in the two groups were monitored before and after treatment , and the incidence of pregnancy complications and pregnancy outcomes in the two groups were statistically analyzed.Results There was no significant difference in blood pressure, human chorionic gonadotropin (β-hCG), alpha fetoprotein (AFP) and blood coagulation function indexes in the two groups before treatment .After treatment, the blood pressure,β-hCG, AFP, platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen (FIB) and D-dimer (D-D) were significantly improved, the difference was statistically significant ( P<0.05).After treatment, the diastolic and systolic blood pressure, β-hCG, AFP, PLT, FIB and D-D levels in the study group were significantly lower than those in the control group, the difference was statistically significant ( P<0.05), PT and APTT were significantly longer than those in the control group, the difference was statistically significant (P<0.05).The incidence rates of pregnancy complications ( uterine inertia, premature rupture of membrane, fetal distress, placental abruption) and adverse pregnancy outcomes (cesarean section, neonatal asphyxia) in the study group were significantly lower than those in the control group, the difference was statistically significant (P<0.05).Conclusion The application of Astragalus injection combined with low molecular weight heparin and nifedipine in the clinical treatment of patients with preeclampsia can effectively control the blood pressure level and other parameters , reduce pregnancy complications and improve pregnancy outcomes.

Objective To compare the real time diagnosis and treatment values of magnifying endoscopy and electronic colonoscopy Methods A total of 105 colorectal polyps for colonoscopic examination were included in this study A magnifying videoscope with zoom ranges from ?1 to ?100 magnification and a common electronic endoscopy combined with indigocarmine dye were employed to observe the pit patterns of colorectal polyps Pit patterns were analyzed according to Kudo's modified classification as follows: ①type Ⅰ: round pit; ②type Ⅱ: asteroid pit; ③type Ⅲs: tubular or round pit, which is smaller than a normal pit (type Ⅰ); ④type ⅢL: tubular or round pit, which is larger than a normal pit (type Ⅰ); ⑤type Ⅳ: dendritic or gyrus like pit; ⑥type Ⅴ: irregular or amorphous pit; and ⑦ mixed type Results Magnifying colonoscopy revealed that phenotypes of non neoplastic and neoplastic lesions were 78 57% and 21 43% in inflammatory and hyperplastic polyps, 3 33% and 96 67% in neoplastic polyps, and 100% non neoplastic phenotype in juvenile polyps, respectively Pit pattern analysis according to Kudo's modified classification showed that the diagnostic sensitivity of neoplastic and non neoplastic lesions was 96 67% and 80%, and specificity was 86 57% and 94 73%, respectively The overall diagnostic accuracy in differentiating neoplastic from non neoplastic lesions was 89 52% Pit pattern by common electronic colonoscopy showed that the diagnostic sensitivity of neoplastic and non neoplastic lesions was 88 3% and 73 3%, and specificity was 81 5% and 82 5%, respectively The overall diagnostic accuracy in differentiating neoplastic from non neoplastic lesions was 82% Conclusion The pit pattern analysis of colorectal lesions by magnifying colonoscopy or electronic endoscopy combined with indigocarmine dye is a useful method for the identification of non neoplastic polyps, adenomas and invasive carcinomas in the large bowel Therefore, it may be possible to determine, at the time of colonoscopy, which lesions should be removed endoscopically and surgically

Objective To summarize the cytological features of breast carcinoma by fine needle aspiration and differential diagonsis of breast hyperplasia and breast flbroadenoma. Methods Cytological features about 175 cases of breast cancer were analyzed,contrasted with 76 cases of breast hyperplasia and 93 eases of fibroadenoma. And 20 cases of low-diagnosis breast cancer were analyzed, compared with 13 cases of excessive diagnosis. Results The followings were found:disorderly arranged cells in 169 cases of breast cancer, about 96.9% in 175 cases,loose distance between the nucleus in 125 cases of all cases (about 71.4%). The percentage of small groups or scattered cells, medium size cells, round nucleus and irregular border nucleus was 34.3% (60/175) ,81.1% (142/175), 88.6% (155/175) and 28.6% (50/175) respectively. The nucleus/cytoplasm ratio was increased in 105 cases of all (about 60%). The nucleus/cytoplasm ratio was obviously reduced in 15 cases of all (about 8.6%). Big nucleolis were observed in 49 cases of all (about 28%). There was significant difference between nucleus size in 136 cases of all (about 77.7%). There was not myoepithelial cell in 168 cases of all (about 96%). The percentage of visible necrosis, scsttered round nucleus and integrity of cytoplasmic was 13.7% (24/175) ,89.7% (157/175), 66.9% (117/175) respectively. The cases of all above features were significantly more than those of breast hyperplasia and breast fibroadenoma (P <0.05). The percentage of large number of cells was 52.6% in 175 breast cancer cases,higher than 5.3% in 76 breast hyperplasia cases. There was a significant difference(P <0.05) between two groups. In 20 cases of low-diagnosis breast cancer the percentage of round nucleus with integrity of cytoplasmic, special arrangement cells was 70% (14 cases) ,35% (7 cases) ,higher than the cases in 13 excessive diagnosis cases. There was a significant difference(P < 0.05) between two groups. Conclusion The cell morphological characteristics of breast caner by fine needle aspiration are large number of cells, loose distance between the nucleus, disorderly arranged cells, small guoups or scattered cells, integrity of cytoplasmic, increased nuclear, round nuclear, irregular border nucleus,increased or decreased nucleus/cytoplasm ratio, big nucleoli, significant difference in nuclear size, no myoepithelial cell, visible necrosis. Most of breast cancer can be distinguished from breast hyperplasia and breast fibroadenoma by above characteristics. All those cytological characteristics are helpful to identify difficult case.

Objective To investigate the dosage and safety of insulin aspart in continuous subcutaneous insulin infusion plus oral antidiabetic drugs for the treatment of hyperglycemia in elderly hip fracture.Methods Patients with hip fracture and hyperglycemia who required insulin pump therapy were divided into 2 groups according to age:elderly group (patients aged over 65 years,n=42) and non-elderly group (patients aged under 65 years,n=43).All patients were treated with insulin aspart in continuous subcutaneous insulin infusion plus oral antidiabetic drugs combined with diet therapy.Dosages of aspart insulin and adverse effects were compared between the two groups.Results There were no significant differences in basic aspart dosage and additional premeal dosage between elderly and non-elderly groups [(0.29±0.09) IU/kg vs.(0.30±0.07) IU /kg,(0.27±0.09) IU/kg vs.(0.27±0.07) IU/kg,both P＞0.05].The incidences of hypoglycemia with and without symptoms in elderly versus non-elderly groups were 4.8％ vs.4.7％ and 14.3％ vs.18.6％,which had no significant differences between the two groups (P＞0.05).Hypoglycemia accompanied by consciousness disorders,allergy,nonhealing and slow healing wounds were not found in the two groups.The ratio of oral antidiabetic drugs including metformin,glimepiride,and glycosidase inhibitor had no differences between the two groups.Conclusions Aspart insulin in continuous subcutaneous insulin infusion is effective and safe in the treatment of acute severe hyperglycemia in elderly patients with hip fractures when combined with diet therapy and oral antidiabetic drugs.

Objective To investigate the specific measures and effect of the nursing care for elderly lung cancer patients who were receiving the treatment of CT-guided permanent interstitial co-implantation of 125I seeds and slow-released fluorouracil.Methods Active care,including adequate preoperative preparation,proper support during operation and postoperative nursing,was carried out for fifty-three elderly patients with lung cancer during their treatment course of CT-guided permanent interstitial brachytherapy with co-implantation of 125I seeds and slow-released fluorouracil.Results In order to ensure accurate puncture and the smooth particle implantation,the possible conditions which might happen after the procedure were informed to the patients before the surgery and useful advice was given to patients to guide their daily activities.All 53 patients showed no obvious fear before surgery and made good cooperation during the procedure,moreover,they well responded to the therapy and recovered pretty soon.Conclusion CT-guided permanent interstitial co-implantation of 125I seeds and slow-released fluorouracil is a safe,minimally-invasive and newly-developed technique with reliable effect,which is especially suitable for aged patients.Active and adequate nursing care is essential during the whole therapeutic course.

Objective To investigate the clinical features , diagnosis and treatment of ectopic thyroid in order to avoid misdiagnosis and mismanagement .Methods Six cases of ectopic thyroid admitted to Fuzhou Gen-eral Hospital from Jan .2000 to Oct.2011 were retrospectively analyzed and the literatures were reviewed .Re-sults Three cases of ectopic thyroid were located in the anterior cervical area , 2 cases were at the base of the tongue and 1 case in the gall bladder .Two cases of aberrant thyroid were confirmed preoperatively in patients whose gland wasn't discovered by imaging examinations at the normal position of the thyroid gland .A symptomless individual of aberrant thyroid did not need other treatment but follow-up.One case with foreign body sensation in pharynx had a good response to thyroxine therapy .Four cases with accessory thyroid were operated because of misdiagnosis .Three cases were ectopic thyroid tissue and one was nodular goiter confirmed by pathology .None of these patients developed hypothyroidism after surgery .Conclusions Ectopic thyroid gland is a rare disease fre-quently misdiagnosed and mistreated .Goiters in the commonly location of ectopic thyroid gland such as the anteri-or cervical area and the base of the tongue should be paid special attention .Hormonal therapy or surgical inter-vention should be chosen according to clinical features , type of the goiter , thyroid function and whether it is be-nign or malignant .Long term follow-up and thyroid function tests are absolutely necessary .

Objective To evaluate the feasibility,security and efficiency of general anaesthesia compared with regional anaesthesia for minimally-invasive thyroid surgery(MITS)with short-stay discharge.Methods 103 cases undergoing MITS with short-stay discharge from Jan.2013 to Jun.2013 in Fuzhou General Hospital were collected.54 patients were operated under regional anaesthesia and 49 under general anaesthesia.All variables of patients including demographic characteristics,vital signs (blood pressure,heart rate,blood glucose) during the operation,duration and type of operation,postoperative complications,difficulty in airway management and anesthesia consumption were recorded and analyzed.Results There was no difference in respect to level of blood glucose,length of hospital stay,discharge time,patient or operator satisfaction rate,anesthesia or operation complications rate between the two groups.Blood pressure (T1:(90 ± 7.0) vs (79 ± 8.3) mmHg,T2:(88 ± 6.8) vs (80 ±7.6) mmHg,P ＜0.05) and heart rate(T1:(130 ± 18.2) vs(101 ± 12.0)/min,T2:(120 ± 19.7) vs(103 ± 13.3)/min,P ＜ 0.05)level were higher,while the recovery time of anesthesia((0.3 ± 0.14)vs(0.8 ± 0.35)h,P ＜ 0.05)) and anesthesia consumption ((1350 ± 78) vs (2580 ± 220) yuan,P ＜ 0.05)) were lower in the regional anaesthesia group compared with those in the general anaesthesia group.Conclusions Both general anaesthesia and regional anaesthesia for MITS with short-stay discharge are safe and effective.General anesthesia has less psychological trauma,while regional anaesthesia has shorter recovery time and lower anesthetic consumption.

Objective To evaluate the role of three vessels and trachea view (3VT) in diagnosis of fetal heart disease and great artery abnormality.Methods 39 pregnant women undergoing fetal ultrasound scan and diagnosed with great artery abnormality were enrolled in this study.Then the image characteristics and significance of 3VT in these 39 cases were analyzed and evaluated.Results In these 39 cases proved by autopsy,persistent truncus arteriosus(7 cases),transposition of the great arteries(7 cases),coarctation of the aorta(5 cases),tetralogy of Fallot (4 cases),pulmonary stenosis (3 cases),hypoplastic left ventricle syndrome(2 cases),persistent left superior vena cava (2 cases),pulmonary valve stenosis with single ventricle(2 cases),Ebstein anomaly with pulmonary stenosis (1 case),interruption of the aortic arch( 1 case),hypoplastic right ventricle(1 case),dextroaortic arch (1 case),and ductus arteriosus stenosis( 1 case) were detected.All of them had anomalies performance on 3VT.While in the 2 cases of double outlet right ventricle,only one eoncurrenting with pulmonary artery stenosis showed reduced inner diameter of pulmonary artery on 3VT.According to the performance of 3VT in great artery abnormality,it could be divided into 4 categories:abnormal location,abnormal ratio,abnormal amount and abnormal blood direction of great artery.Conclusions 3VT is a useful supplement to the 4-chamber view,and has significant value in diagnosis of fetal heart and great arteries abnormities.