Objective:To explore the effect of different pregnancy termination timings on the delivery safety of maternal women with pernicious placenta previa after 34 weeks.Methods:A total of 84 patients with pernicious placenta previa in Laoshan Campus of the Affiliated Hospital of Qingdao University from March 2018 to March 2019 were selected. The time of admission for delivery was more than 34 weeks. Forty women who pregnant from 34 weeks to 36 weeks of pregnancy was in the study group, 44 women who pregnant over 36 weeks was in the control group, and the pregnancy outcomes of the maternal fetuses of the two groups were compared.Results:The postpartum hemorrhage and the incidence of interventional surgery in the study group were less than those in the control group: (754.58 ± 20.35) ml vs. (1 449.26 ± 512.32) ml, 17.5%(7/40) vs. 52.27%(23/44), the differences were statistically significant ( P<0.05). The changes in hematocrit after delivery and before delivery, the amount of hemoglobin after delivery and before delivery, the rate of uterine gauze packing, the rate of Xinmupei, the rate of hysterectomy, the incidence of blood transfusion, the rate of postoperative ICU transfer between two groups hand no significant differences ( P>0.05). The incidence of neonatal birth weight less than 2 500 g and the proportion of transfer to neonatology in the study group were higher than those in the control group: 75.0%(30/40) vs. 11.36%(5/44), 80.0%(32/40) vs. 11.36%(5/44), the differences were statistically significant ( P<0.05). There was no significant differences in Apgar scores and mortality rate of newborns after birth between the two groups ( P>0.05). Conclusions:When the pernicious placenta previa is delivered after 34 weeks, the termination of pregnancy before 36 weeks of gestation is more secure for maternal and fetal health. If the fetal development rate is slow, it is necessary to appropriately extend the delivery time, but don′t exceed 36 weeks.

Objective To investigate the diagnostic value of computer image analysis assisted aroundness measurement of gastric gland lumens in well-differentiated gastric adenocarcinoma.Methods From January 2016 to July 2016,10 hematoxylin-eosin (H-E) stained slides of pathologically diagnosed well-differentiated gastric adenocarcinoma were collected.At the same period,H-E stained slides of gastric epithelial hyperplasia and normal gastric mucosa,six slides of each,were collected as controls.All of them were scanned into high resolution.Digital data roundness,long diameter and short diameter were measured and compared.Kruskal-Wallis rank sum test was used for statistical analysis.Results The median values of lumen roundness of normal gastric mucosa,gastric epithelial hyperplasia and welldifferentiated gastric adenocarcinoma were 79.7°(10.6°),73.0°(12.3°) and 58.6°(15.2°),respectively,and the difference among three groups was statistically significant (H=494.827,P＜0.01).The values of gland roundness of normal gastric mucosa were higher than those of gastric mucosal hyperplasia and welldifferentiated gastric adenocarcinoma,and the differences were statistically significant (T=156.007 and -508.579,both P＜0.01).The value of gland roundness of gastric mucosal hyperplasia was higher than that of well-differentiated gastric adenocarcinoma,and the difference was statistically significant (T=-352.572,P＜0.01).The values of long diameter of gland lumens in normal gastric mucosa,gastric mucosal hyperplasia and well-differentiated gastric adenocarcinoma were 24.1 μm(11.8 μm),43.1 μm (28.8 μm),and 96.0 μm(79.3 μm),respectively,and the difference among three groups was statistically significant (H=744.987,P＜0.01).The values of short diameter of gland lumens in normal gastric mucosa,gastric mucosal hyperplasia and well-differentiated gastric adenocarcinoma were 16.0 μm (8.7 μm),22.7 μm (13.1 μm) and 33.5 μm (38.0 μm),respectively,and the difference among three groups was statistically significant(H=248.170,P＜0.01).Conclusion The roundness of gastric gland lumens can be used as an effective parameter for the differential diagnosis of normal gastric mucosa,gastric mucosal hyperplasia and well-differentiated gastric adenocarcinoma.

OBJECTIVE:To optimize the water extraction technology of Yangxue Jiegu capsule. METHODS:Using adding amount of water,decoction time and decoction times as investigation factors,ferulic acid content,icariin content and yield rate as investigation indexes,orthogonal test was used to optimize the optimal water extraction technology of Yangxue Jiegu capsule;and verification test was conducted. RESULTS:The optimized extraction technology was 10-fold water,extracting 3 times,1 h once. Contents of ferulic acid and icariin were 0.38,1.23 mg/g(n=3),yield rate was 28.2%(n=3),average comprehensive score was 97.11 (RSD=2.77%,n=3). CONCLUSIONS:Optimized extraction technology is feasible,accurate,reliable,and can be used for the extraction and preparation of Yangxue Jiegu capsule.

Objective To investigate the dynamic change of serum Hcy level in patients with non-small lung cancer when under-going chemotherapy,and to study the value of monitoring serum Hcy for chemotherapy efficieney in non-small-cell carcinoma.Meth-ods In our study,we enrolled 62 patients with non-small-cell carcinoma when undergoing chemotherapy.The concentrations of ho-mocysteine,carcino-embryonic antigen and cytokeratin 1 9 fragments were detected,and then these results were analyzed by statisti-cal methods.Results Compared with before treatment,the serum homocysteine,carcino-embryonic antigen and cytokeratin 1 9 frag-ments levels in patients who had effective response decreased.After 2 courses of chemotherapy,the levels of the three markers were significantly lower than those detected before chemotherapy (P <0.05).But at the end of the first course,the serum hcy level was significantly lower than that detected before chemotherapy.There was no significant difference in the levels of the serum three markers in non-responders between before and after chemotherapy (P >0.05).The positive rates of the three markers were statisti-cally significant between single lung squamous cell carcinoma and adenocarcinoma of the non-small-cell carcinoma.Conclusion The detection of the dynamic changes of serum Hcy in patients with non-small-cell carcinoma when undergoing chemotherapy is useful in evaluating the effect of chemotherapy and tumor activity.

Objective To evaluate the impact of different anatomical landmarks on registration in imaging-guided radiation (IGRT) for lung cancer. Methods For 20 patients with non-small cell lung cancer receiving stereotactic body radiotherapy (SBRT) in Fudan University Cancer Hospital, 100 frames of kilo-voltage cone-beam computed tomography scanning were evaluated in this study. The spine, carina and tumor were selected as landmarks for registration, respectively. Results of registration using different landmarks were documented and compared. Results The average set-up errors in the left-right, superiorinferior and anterior-posterior directions were -0. 08 cm ±0. 32 cm, -0. 16 cm ±0. 45 cm and 0. 06 cm ±0. 23 cm with the spine for registration;0. 06 cm ±0. 34 cm, -0. 13 cm ±0. 45 cm and -0. 02 cm±0.23 cm with the carina;and -0. 17 cm ±0.25 cm, 0.03 cm ±0.47 cm and 0. 15 cm ±0.38 cm with tumor. The registration results between using the carina and tumor as landmarks were statistically significant different (q=4.61, P=0. 002 ;q = 2. 23 , P=0. 118;q=3.44, P=0. 017). The registration results were equal when using the spine and tumor as landmarks ( q = 1.85, P = 0. 195; q = 2. 54, P = 0. 075; q = 1.89,P=0. 185), as well as using the carina and tumor as landmarks (q=2.76, P=0. 054;q=0.31, P=0. 826 ;q = 1.55, P = 0. 276). Conclusions For early stage lung cancer, the spine and tumor can be used equally as registration landmarks in imaging-guided SBRT. The carina is not suggested for its poor reproducible position.

BACKGROUND:It is a great potential study that calcium sulfate product loaded with antibiotics is developed, but this product is not systematicaly studied and its biocompatibility and security need to be further studied.
OBJECTIVE:To evaluate the biocompatibility and safety of vancomycin- or gentamicin-loaded calcium sulfate bone.
METHODS: (1) Hemolysis test: vancomycin-loaded, gentamicin-loaded calcium sulfate extracts, double distiled water and saline were added into rabbit anticoagulant blood samples. (2) Micronucleus test: vancomycin-loaded and gentamicin-loaded calcium sulfate extracts, cyclophosphamide and normal saline solution were intraperitonealy injected to mice, respectively. (3) Acute toxicity test: vancomycin-loaded and gentamicin-loaded calcium sulfate extracts, and normal saline solution were intraperitonealy injected to mice, respectively. (4) Pyrogen test: the mice were injected vancomycin-loaded and gentamicin-loaded calcium sulfate extractsvia the ear vein. (5) Intradermal stimulation test: vancomycin-loaded and gentamicin-loaded calcium sulfate extracts were respectively injected into the unilateral spine of rabbits, respectively. (6) Intramuscular implantation test: vancomycin-loaded and gentamicin-loaded calcium sulfate extracts were respectively injected to the dorsal muscle of rabbits. (7) Intraosseous implantation test: vancomycin-loaded and gentamicin-loaded calcium sulfate were implanted into the necrotic femoral bone of rabbits.
RESULTS AND CONCLUSION:Both vancomycin-loaded and gentamicin-loaded calcium sulfate products, which have no hemolytic reaction, genetic toxicity, acute toxicity, pyrogen reaction and skin irritation, are considered to have good biocompatibility and safety.

Objective To observe the adipose-derived cytokine changes and aggravate cognitive impairment in olanzapine-induced obese rats caused by glucose metabolic disorder.Methods 20 rats fed with ordinary fodder were used as normal control group,olanzapine group of 20 rats fed with olanzapine(1.2 mg · kg-1) and ordinary fodder for 4 weeks.Successfully established experimental model rats induced by olanzapine after 4 weeks.Serum tumor necrosis factor α(TNF-α),interleukins 6 (IL-6) and C-reactive protein (CRP) contents were measured by Elisa.Serum glucose contents were determined by biochemical colorimetric method and blood lipid contents determined with automatic biochemical analyzer.Learning,memory capacity and escape latency were detected with Maze test.Results After administration 4 weeks,the levels of body weight,blood glucose and blood lipid in olanzapine group were higher than those in control group.The serum TNF-α((1.57±0.04) ng/ml),IL-6((127.47±11.38) pg/ml) and CRP ((2.68±0.06) mg/ml) in olanzapine group rised,compared with control group ((0.59±0.03) ng/ml,(96.58± 8.77) pg/ml and (1.86±0.04) mg/ml respectively),the differences were statistically significant(P＜0.05).Electric shocks and escape latency in olanzapine group were higher than those in control group (P＜0.05).The FBS had positive correlation with hs-CRP,IL-6 and TNF-α respectively (r=0.385,0.260,1.280; all P＜0.05).Conclusion Olanzapine can induce metabolic disturbance of blood glucose,blood hpid,and the increase of serum TNF-α,IL-6 and CRP levels in rats.Positive correlation is showed between TNF-of and FBS.Hyperglycemia can promote cell toxicity and leads to cognitive dysfunction in rats.

Objective To investigate the status of tuberculosis (TB)infection among health care workers (HC-Ws)in an infectious diseases hospital,and explore the risk and influencing factors of TB infection.Methods All HCWs in an infectious diseases hospital were surveyed through questionnaire and purified protein derivative (PPD) testing.Results Incidence of TB infection among all HCWs in this hospital was 48.18%.There was no significant difference in TB infection among HCWs in different departments(P >0.05).TB infection among HCWs of different working seniority,different ages,and different job titles were all significantly different (all P <0.05).Risk factors for TB infection were education level,job title,living condition,and working time in TB clinics or wards,OR (95%CI )were 1 .70(1 .03-2.80),1 .95(1 .10-3.45),1 .84(1 .03-3.28),and 2.38(1 .40-4.04)respectively;personal protection was a protective factor for TB infection (OR,0.92 [95% CI ,0.85 - 0.99]).Conclusion HCWs in in-fectious diseases hospital are at high risk of TB infection,they should improve their self-protection consciousness, and take protective measures as early as possible.

Objective To select the optimal registration method for on-line kilovoltage cone-beam CT (KVCBCT) guided lung cancer radiation and evaluate the reproducibility of the selected method. MethodsSixteen patients with non-small cell lung cancer were enrolled into this study.A total of 96 pre treatment KVCBCT images from the 16 patients were available for the analysis.Image registration methods were bone-based automatic registration,gray-based automatic registration,manual registration and semi-auto matic registration.All registrations were accomplished by one physician.Another physician blindly evaluated the results of each registration,then selected the optimal registration method and evaluated its reproducibili ty.Results The average score of the bone-based automatic registration,gray-based automatic registration, manual registration and semi-automatic registration methods was 2.4,2.7,3.0 and 3.7,respectively.The score of the four different groups had statistics significant difference (F = 42.20,P < 0.001).Using the semi-automatic registration method,the probability of the difference between two registration results more than 3 ram in the left-right,superior-inferior,and anterior-posterior directions was 0,3% and 6% by the same physician,0,14% and 0 by different physicians,and 8%,14% and 8% by physician and radiation therapist.Conclusions Semi-automatic registration method,possessing the highest score and accepted re producibility,is appropriate for KVCBCT guided lung cancer radiation.

Objective To assess the rotational set-up errors in patients with thoracic neoplasms. Methods 224 kilovohage cone-beam computed tomography (KVCBCT) scans from 20 thoracic tumor pa-tients were evaluated retrospectively. All these patients were involved in the research of " Evaluation of the residual set-up error for online kilovohage cone-beam CT guided thoracic tumor radiation". Rotational set-up errors, including pitch, roll and yaw, were calculated by 'aligning the KVCBCT with the planning CT, using the semi-automatic alignment method. Results The average rotational set-up errors were -0.28°±1.52°, 0.21°± 0.91° and 0.27°± 0. 78° in the left-fight, superior-inferior and anterior-posterior axis, respective-ly. The maximal rotational errors of pitch, roll and yaw were 3.5°, 2.7° and 2.2°, respectively. After cor-rection for translational set-up errors, no statistically significant changes in rotational error were observed. Conclusions The rotational set-up errors in patients with thoracic neoplasms were all small in magnitude. Rotational errors may not change after the correction for translational set-up errors alone, which should be e-valuated in a larger sample future.