Objective To investigate the relationship of fetal total bile acid (TBA) concentration with the change of fetal pancreas endocrine secretion and its impact on fetal growth and development in intrahepatic cholestasis of pregnancy(ICP). Methods The concentrations of TBA, insulin, glucagon and glucose in the cord blood were measured in 30 fetuses with maternal ICP (case group) and 30 fetuses of normogravidas(control group) after elective cesarean section during the same period in the Department of Obstetrics of Xiangya Second Hospital of Central South University from March 2007 to February 2008. The cord blood TBA concentration was investigated by enzyme method and the concentrations of insulin and glucagon were investigated by radioimmunoassay. The glucose was measured by oxidase-superoxide method. The neonatal weight, length and the ponderal index (PI) were measured after parturition. Results (1) The cord blood insulin concentration (9.0±3.3) mU/L and the ratio of insulin over glucagon 0. 048±0. 028 in the case group was significantly lower than that of controls(10.1±3.7) mU/L,0.050±0. 020 (P<0.05). The concentrations of TBA(10.3±3. 8)μmol/L and glucagon(235±57) ng/L in case group were obviously higher than that in controls (4.1±1.3)μol/L, (205±34) ng/L(P<0.05). But no difference was shown in the glucose concentration in cord blood between the ease and control groups [(3.4±1.1) mmol/L vs (3.6± 1.2 )mmol/L, P > 0.05]. (2)The neonatal weight and length in case group were significantly lower than that of control [(3163±478) g vs (3498±393)g, (46.5±2.3) cm vs (49.3±1.9)cm, P<0.01]; while the Ponderal index in ease group was significantly higher than that of control group (3.13±0. 23 vs 2. 92±0. 29,P <0.01). (3) The cord blood TBA concentration respectively showed a linear relationship with the cord blood insulin concentration, the cord blood glucagon concentration and the ratio of insulin over glucagon in the case group. With the increase in cord blood TBA concentration, the cord insulin concentration and the ratio of insulin over glucagon decreased; meanwhile the cord blood glucagon concentration rose(P<0.01). The cord blood insulin concentration and the ratio of insulin over glucagon in case group were respectively positively correlated with the neonatal weight and length, and were negatively correlated with the PI (P<0.01); while the cord glucagon concentration was respectively negatively correlated with the neonatal weight and length, and positively correlated with the P1 (P < 0.01 ).Conclusions In 1CP fetus pancreas, there are hypoinsulinism, glucagon oversecretion, and decrease of the ratio of insulin over glucagon, which is closely correlated with fetal TBA concentration. The endocrine function of fetal pancreas affects the fetal growth and development.

Objective To observe the level of autophagy induced by TRAIL in TT cell line and identify the role of autophagy in TRAIL-inducing apoptosis of TT cell line.Methods The growth inhibition of TT cells was measured by MTT assay.MDC staining was used to identify the happening of autophagy.Annexin V/PI double staining was used to analyze the apoptosis rate of TT cells by flowcytometry.The protein expression of caspase-8 and Beclin1 was detected by Western blot.Results ① The growth inhibition ratio of TT cells induced by TRAIL at the concentration of 250,500,1000 and 2000 ng/ml was (3.02 ± 1.82)％,(4.87 ± 1.45)％,(7.51 ± 1.57) ％,(12.76 ± 3.23) ％ respectively,which suggested significant resistance of TT cells to TRAIL.② MDC-labeled green light vesicles was significantly increased after the treatment of TRAIL for 48 h.③ The apoptosis rate of TT cells induced by TRAIL at the concentration of 500 ng/ml and 1000 ng/ml after the pretreat ment of 3-MA for 4 h was(17.83 ± 1.54) ％ and(27.81 ± 1.79) ％ respectively,which was significantly higher than the apoptosis rate induced by TRAIL(3.70 ± 0.34) ％,(6.55 ± 0.59) ％ alone and that induced by 3-MA(7.71 ± 0.64) ％ (t =3.282,P ＜ 0.05 ; t =7.830,P ＜ 0.01).④ The combination treatment of TRAIL and 3-MA increased the cleavage of caspase-8 and down-regulated the expression of Beclin 1.Conclusion Autophagy induced by TRAIL may contributes to the resistance of TT cells to TRAIL,which can be reversed by the inhibition of autophagy.

[Summary] Interleukin-2 receptor antagonist (IL-2Ra,ie,basiliximab and daclizumab),a new antibody agent,is widely employed in lowering the risk of acute rejection after organ transplantation,but it meanwhile causes increasing concerns on the effect it exerts on glucose metabolism in transplant recipients,and so far the exact effect still remains controversial.New onset diabetes after transplantation (NODAT) is one of the most influential metabolic complications affecting graft survival and patients' long-term outcomes.Some of the current researches indicate that IL2Ra may improve glucose metabolism in the transplant recipients,some show just the opposite,yet others show no effects.Hence further investigations focusing this aspect are needed.

The zinc finger protein A20 exists in many kinds of ceils in the body and plays multiple roles in physiological and pathological processes such as regulation of immune response,inflammatory diseases and cancers by inhibiting cell apoptosis induced by tumor necrosis factor (TNF) and restricting NFKB signaling pathway.Recently,the role of A20 in generation and development of tumors draws wide attention,hence,we summarized recent research progress of the relation between A20 and cancer in this review.

Objective To summarize the experience of emergency treatment and cosmetic repair of facial trauma.Methods The clinical materials of 584 wounds from 291 cases of facial trauma,recruited in hospital from January 2010 to August 2012,were summed up retrospectively.The principles of medical aesthetics and plastic and cosmetic surgery were followed.A high pressure douching technique was employed to carry out thorough debridement,but occasion of the debridement did not emphasize with intensive attention.A wound without skin and soft tissue defect was sutured accurately according to tissue zonation with a new suture technique,and the needle distance or side distance was limited in 0.2 cm to 0.3 cm.Otherwise,the wound was repaired by full-thickness skin graft or various flaps according to the repair principle ofrather near than further,rather simple than complicated.Attention was paid to rehabilitation care.Results After debridement,328 wounds were sutured directly,147 wounds were repaired by full-thickness skin grafting and 109 wounds by various flaps.A total of 571 wounds healed on the first stage,and the healing rate reached 97.8％.The wounds were in satisfactory apposition and without obvious cicatrix.Five senses did not appear in malposition and deformity.The other 13 wounds did not heal because of bad taking of skin grafts and flaps or wound splitting.Among them,4 wounds were repaired by second operation,and 9 wounds healed by changing dressings.By means of rehabilitation care,scar hyperplasia and pigmentation appeared slightly in those 13 wounds.A total of 454 wounds from 217 cases were followed up.The results showed good appearance and slight cicatrix hyperplasia,a pigmentation in different degree appeared in 11 wounds covered by skin grafting.In addition,eyebrow excalation,auricle excalation or total lose appeared in 12 cases.Conclusion During treating emergency cases of facial injuries,if an idea cosmetic repair of traumais followed,the theory of aesthetics and the techniques of plastic and cosmetic surgery are fully used,a multiple-discipline cooperation is brought into full play,and a prompt and accurate treatment is put into practice,the aim of cosmetic repair would come true.

Objective To study the application of suture and ligature and swelling technique in the removal of giant skin benign tumor in none-extremity position.Methods The swelling technique was merely used in those whose lesions were located on face and neck before operation.If the lesions were located on scalp or truck,suture and ligature and swelling technique would be combined in the treatment.Firstly,the lesion was sutured and ligated one or two circles all around.Then swelling fluid was injected under lesion,and incision was done inside or between sutures.Results The area of lesion once excised was 154.00-2394.75 cm2,and the quantity of swelling fluid was 150 1950 ml.The longest time to suture and to ligate the lesion was one hour,and operative bleeding was obviously decreased.Conclusions Suture,ligature and swelling technique might be helpful to decrease operative bleeding during excision of giant skin benign tumor in none-extremity position,and therefore increase operative safety.

Objective To probe the definition of cicateicial cryptotia and its plastic and reconstructive surgery.Methods Local skin flaps combined with full-thickness skin graft by zonation grafting technique were used to treat twenty-six patients with thirty-three cicateicial cryptotia.A cicateicial adhesion between auricle and cranial wall and mastoidea was removed,cranioaural angle was reformed,and helix and auricular lobule were reconstructed.Results All skin flaps survived,and the survival rate of skin grafts reached over 95 ％.The appearance of auricle was very good,its major constructions might be noted,and cranioaural angle nearly returned to normal.The follow-up results from three months to one year post-operation showed that the appearance of auricle kept well,and the patients felt satisfactory.Conclusions In view of deformity characteristics of cicateicial cryptotia,it might be an effective approach to treat cicateicial cryptotia to take a seris of appropriate surgical procedures.

BACKGROUND: For patients with myocardial infarction occupied most of the heart, the effect of coronary artery bridge is not obvious. Currently, myocardial and vascular regeneration by stem cells has become a focus of ischemic cardiovascular disease. Myocardial survival directly correlates with improvement of blood perfusion following stem cell transplantation.OBJECTIVE: To investigate the feasibility of ~(18)F-FDG and ~(99)Tc~m-MIBI single photon emission computed tomography imaging in assessing myocardial glucose metabolism and perfusion with old myocardial infarction after coronary artery bypass grafting (CABG) and CD34~+ stem cell transplanting. METHODS: Bone marrow was extracted from the anterior superior iliac spine 1 day before surgery. Mononuclear cells were isolated by Ficoll density gradient centrifugation. CD34~+ cells were isolated and purified by immunomagnetic bead system. Coronary artery pathological changes were examined under general anesthesia. The end-to-side anastomosis of graft vessel and coronary artery was performed. 1×10~(11)/L CD34~+ cell suspension was extracted, and injected into the surrounding and center of the infarct (blood flow/metabolism matching depletion) at 6 points, with 0.2 mL in each point. According to preoperative perfusion/metabolism imaging, myocardium segments were divided into two groups: match group: blood perfusion and metabolism images were sparse or normal, i.e. infarction or normal myocardium; mismatch group: blood perfusion image displayed depletion, but metabolism images were normal or radially distributed, i.e. surviving myocardium. ~(18)F-FDG and ~(99)Tc~m-MIBI dual-isotopic imaging were performed before and 4 months after CABG. Circumferential count profiles from ~(18)F-FDG and ~(99)Tc~m-MIBI short axis slices were generated to assess myocardial blood perfusion and glucose metabolism. RESULTS AND CONCLUSION: The 31 patients were divided into 279 segments, and 145 segments were in myocardial perfusion-metabolism mismatch (MM). ~(99)Tc~m-MIBI and ~(18)F-FDG uptake fraction was significantly increased 4 months before operation (P < 0.01); match group without transplanting had 81 segments, and the ~(99)Tc~m-MIBI and ~(18)F-FDG uptake fraction remained unchanged after operation (P > 0.05). Match group undergoing transplanting had 54 segments, and their ~(99)Tc~m-MIBI and ~(18)F-FDG uptake fraction increased remarkably 4 months after operation (P < 0.01). CABG can improve the function of survival myocardial segments, but it is helpless to infraction myocardium. The autologous CD34~+ stem cell transplantation can improve myocardial blood perfusion and glucose metabolism of the distributions of infract myocardium.

Objective To study the effect and related mechanism of celecoxib on tumor necrosis factorrelated apoptosis-inducing ligand(TRAIL) induced apoptosis of medullary thyroid cancer TT cell line.Methods MTT assay was used to measure the growth inhibition induced by TRAIL and celecoxib alone and their combination.TT cell cycle distribution was analyzed by flowcytometry.Hochest33258 staining and DNA ladder was used to detect the apoptosis of drug combination on TT cells.Western blot was used detect the protein change of cyclin A,Cdk2,caspase-8,c-FLIP,and RIP.Results ①MTT showed the growth inhibition ratio of TT cell intervened by the combination of TRAIL and celecoxib was 47.53％ ± 1.34％,which was much higher than that intervened by TRAIL(7.75 ％ ± 3.84％)and celecoxib alone.The differences had statistical significance (t test,F =5.234,P ＜0.01);②PI detection found the cells' number in G0/G1 phase in celecoxib group and combination group were increased compared to that in control group and TRAIL group(F =242.694,P ＜ 0.01);③Western blot indicated the expression of Cyclin A and Cdk2 were down regulated,there was no statistic significance;④ The apoptosis morph in nuclus was detected by Hochest33258 staining and showed the karyopycnosis and muclear fragmentation were increased in combination group with the apoptosis rate 24.23％ ± 2.91％,which was much higher than that in TRAIL(5.86％ ± 1.41％) and celecoxib(20％ ± 1.24％) (t test,F =1.824,P ＜0.01),the difference has statistic significance;⑤Western blot illustrated the active schizolysis of casplase-8 was higher and the expression of c-FLIP and RIP was down regulated in combination group.Conclusion celecoxib plays a positive effect on TRAIL-reduced apoptosis of medullary thyroid cancer TT cell line,which may due to the cell cycle arrest at G0/G1 phase,down-regulation of c-FLIP and RIP and subsequent activation of caspase-8.

Objective To assess the mental health status of the pregnant women with missed abor-tion, as well as related influencing factors, and to provide the basis for mental nursing. Methods 100 pregnant women with missed abortion were chosen as the observation group by convenience sampling, while other 100 normal pregnant women as the control group. The mental state of the pregnant women in both groups was evaluated by using symptom checklist-90 (SCL-90), the results of which were then studied in contrast using t test and variance analysis. Results The total scores and the average scores of pregnant women in the observation group were significantly higher than those in the control group. The mental health status of pregnant women with missed abortion was influenced by age, education degree, and the times of pregnancy. Conclusions There are significant mental health problems in pregnant women with missed abortion, to which should be paid much attention. And the psychological counseling should be carried out in time in case of detrimental influences in treatment, rehabilitation, and next pregnancy.