OBJECTIVE:To observe the protective effect of homocysteine(Hcy)on rats’cerebral microvascular endothe?lial cells(RCMEC)injury.METHODS:RCMEC were divided into injury group and normal control group,the effect of Hcy on which was observed;Besides,RCMEC were divided into normal control group,injury group and probucol groups of different dosage,the lactate dehydrogenase(LDH)release rate and the cells growth curve in each group were observed.RESULTS:As compared with the normal control group,the growth of RCMEC in the injury group was inhibited and the release rate of LDH increased remarkably;The release rate of LDH decreased in turn when probucol was in a concentration range of10～50?mol/L.CONCLUSION:Hcy can cause toxic injury to RCMEC,probucol assumes dose dependent counteraction on Hcy-induced in?jury.

Clinical data of 277 pregnant women attended to nutrition clinic at Haidian District Maternity and Children's Hospital,Beijing were analyzed retrospectively,including 64 cases of gestational diabetes mellitus(GDM),85 cases of gestational impaired glucose tolerance(GIGT)and 128 normal women(84 normal fasting blood glucose and 44 abnormal fasting blood glucose but normal glucose challenge test,GCT).There was a higher proportion of pregnant women with family history of diabetes among those with abnormal GCT.as compared to those with normal GCT(P＜0.05).Mean age was significantly higher in women with GDM than that in normal ones(P＜0.05),but no statistically significant difference in it was found between women with GIGT and normal GCT(P＞0.05).Body weight in women with GIGT was higher both before pregnancy and at GCT than that in normal ones(P＜0.05).Serum levels of total cholesterol and triglyceride presented an increasing trend in pregnant women of varied groups since their first prenatal care visits(P＜0.05),higher in those with GDM and/or GIGT than those in normal ones(P＜0.01).

Objective To investigate the safety,feasibility and effectivity of laparoscopic left hemihepatectomy for left hepatolithiasis.Methods From Jan.2005 to Dec.2013,36 patients with left hepatolithiasis underwent laparoscopic left hemihepatectomy (group LH),in comparison with 39 other patients who underwent conventional open left hemihepatectomy (group OH).The blood supply to left liver was dissected and cut off first.The liver parenchyma was transected and the left hepatic vein was dissected and clamped.Intraoperative choledochoscopy was carried out through the stump of left bile duct,laparoscopic choledocholithotomy and T-tube drainage were carried out when stones were found in the common or right bile duct.Blood loss,rate of residual stone,complication rate between the two groups were compared.Results The success rate of operation was 100％.Compared with group OH,group LH had shorter postoperative hospitalization,less incision infection and fewer analgesia needed(t =3.75,x2 =4.11,x2 =22.12,P ＜0.05).There was no statistical difference for blood loss,rate of transfusion,and postoperative complications such as bile leakage,pleural effusion,ascites,residual stones (t =0.66,x2 =0.70,x2 =0.01,x2 =0.52,x2 =0.01,x2 =0.28,x2 =0.01,P ＞ 0.05).Conclusions Laparoscopic left hemihepatectomy is safe,feasible,and effective for hepatolithiasis of the left liver lobe.

Objective To evaluate the feasibility,safety,post-operative short and long-term outcomes of laparoscopic-assisted D2 radical distal gastrectomy in treating advanced gastric carcinoma without serosal invasion.Method From May 2007 to May 2013,54 cases of advanced gastric antral cancer without serosal invasion underwent laparoscopic-assisted D2 radical distal gastrectomy (laparoscopic group),54 demographically and pathologically-matched cases undergoing open surgery served as control.The surgical risk,post-operative recovery and follow-up results were compared.Result Surgery was successful in all patients.The mean operation time in laparoscopic group and open group was (168 ± 31) mins and (157 ±20) min respectively,the difference was significant (t =2.237,P =0.027) ; Intra-operative blood loss was (151 ± 56) ml and (213 ± 86) ml (t =4.45,P =0) ; Post-operative intestinal function recovery time was (2.7 ± 0.7) d and (3.4 ± 0.5) d (t =5.4,P =0) ; Lymph node dissection number was (26.4 ± 4.2) and (24.8 ±5.2) (t =1.769,P=0.08).Post-operative complication rate was 4％ and 11％ (P =0.142).There was no perioperative mortality in either group.Post-operative pathological stage of Ⅰ B,Ⅱ A,Ⅱ B,ⅢA was 8,17,24,5 cases in laparoscopic group and 9,14,23,8 cases in open surgery group.108 cases were followed up from 7 to 79 months.In laparoscopic group,8 cases had local recurrence or distal mestastasis,and 4 cases died from tumor; In open group,9 cases had local recurrence or distal mestastasis,and 6 cases died from tumor.Conclusions Laparoscopic-assisted D2 radical distal gastrectomy in treating advanced gastric cancer without serosal invasion is feasible,safe and advantageous in minimal invasion and rapid recovery,with good short and long-term outcomes.

Objective To study the effect of intedeukin 6 (IL-6) on the expression of androgen receptor (AR) in porcine ovarian granulosa cells(GC) and to explore its role of in the polycystic ovary syndrome(PCOS) pathogenesis.Methods Different concentrations of IL-6 (10,100 and 1 000 ng/L) were treated with GC.Expression of androgen receptor (AR) mRNA and protein in GC were detected by real-time quantitative RT-PCR and Western blot.Results The mRNA and protein expressions of AR in GC were upregulated in groups with 100 and 1 000 ng/L IL-6 at 72 h.Conclusion IL-6 can improve androgen activity.This process may explain the function of chronic subclinical inflammation in PCOS pathogenesis.

Objective To estimate the maternal.neonatal morbidity associated with induction deliveries compared with spontaneous deliveries in 41 gestational weeks uncomplicated primiparae.Methods Three hundred and seventy.four uncomplicated primiparous deliveries at 41 gestational weeks at Peking Union Medical College Hospital from Sept 2002 to Apr 2007 were reviewed.including 225 women undergoing induced labor and 149 women undergoing spontaneous labor.The induction methods included drug induction (173),rupture of membrane induction(5)and combined drug with rupture of membrane induction(47).The maternal morbidity,delivery method,matemal cost on hospital stay and neonatal asphyxia associated with induction deliveries or spantaneous deliveries were retrospectively analyzed.Results (1)There was no maternal death.The caesarean section rate in the induction group(44.0%,99/225)was significantly higher than that of spontaneous group(18.1%,27/149;P<0.05).(2)No statistically significantdifference(P>0.05)was observed between induction group and spontaneous group in the following puerperal complications:postpartum hemorrhage(2.7%,6/225 and 1. 3%,2/149 respectively),puerperal morbidity(0.9%,2/225 and 0.7%,1/149 respectively),severe amniotie fluid contamination (11.6%,26/225 and 13.4%,20/149 respectively),wound infection(0.9%,2/225 and 0.7%.1/149 respectively),urinary retention(4.4%,10/225 and 3.4%,5/149 respectively),traumata(0.4%,1/225and 0 respectively)and neonatal asphyxia(1.3%,3/225 and 2.0%,3/149 respectively).(3)The average duration of first stage of labor in the induction group(413 min)Was not significantly different from tllat of spontaneous group(461 min;P>0.05).In the induction group,more women had precipitate lahore(P

Objective:To investigate the knowledge level of hospice care and the related influencing factors among health providers in Shanghai.Methods:From November to December 2019,a questionnaire survey on the hospice care knowledge was conducted among 7 074 health providers from 223 registered hospice care clinics or institutions in 16 districts of Shanghai.Results:A total of 7 027 valid questionnaires were recovered, with an effective recovery rate of 99.3%. Among the 7 027 responders, there were 1 460 males (20.8%) and 5 567 females (79.2%) with an mean age of (36.9±9.3) years; 2 682 nurses (38.2%) and 2 442 doctors (34.8%); 5 065 (72.1%) from community health service centers; 2 982 (42.4%) involving in hospice care services and 4 039 (57.5%) willing to work in hospice care. The average score of hospice care knowledge was (8.9±2.6), and the average accuracy for questions was 59.0%. Health providers had the highest awareness rate for the composition of hospice care professional team (93.9%, 6 597/7 027) and the lowest awareness rate for the emotional commitment in hospice care service (16.6%, 1 165/7 027). Health providers with junior colleges degree ( B=-0.429), vocational college degree and below ( B=-0.544), nurses ( B=-0.652), working in suburban areas ( B=-0.278), social office ( B=-0.891), without witness of dying process of end-of-life patients ( B=-0.329), not involving in hospice care services ( B=-0.283), and not willing to participating in hospice care ( B=-0.820) had low knowledge scores ( P<0.05). Conclusions:The overall level of hospice care knowledge of health providers in Shanghai is generally at a medium level, and the training of hospice care knowledge should be strengthened for the better development of hospice care.

Objective:To investigate the attitude of health providers towards hospice care in Shanghai,and analyze the related influencing factors.Methods:From November to December 2019,a questionnaire survey on the attitude towards hospice care was conducted among 7 074 health providers from 223 medical institutions in 16 districts of Shanghai.Results:A total of 7 027 valid questionnaires were recovered, with an effective recovery rate of 99.3%. The total score of attitude to hospice care was (91.9±11.6),the average score of items was (3.7±0.5). The highest score rate was "perception of the benefits for the quality of life promotion" (87.08%),and the lowest score rate was "perception of the threats from the worsening conditions of advanced patients" (60.88%).Health providers who were doctors ( B=-1.207), nurses ( B=-0.912), those without witness of dying or end-of-life patients ( B=-1.417), those without involving in hospice care services ( B=-1.203), and not willing to participating in hospice care ( B=-7.849) had lower attitude scores (all P<0.05). Conclusions:The survey indicates that health providers in Shanghai have a positive attitude towards hospice care,but the initiative to engage in hospice care service is not high. It is necessary to conduct targeted training of relevant professional knowledge to enhance the attitude and enthusiasm to hospice care among health providers.

Objective To survey birth defects of neonates conceived by using various types of in vitro fertilization and embryo transfer (IVF-ET) between 1998 and 2007 in Shanghai. Methods From 1998 to 2007, 8507 neonates from 6551 pregnancies conceived through assistant reproductive technology (ART) from 7 reproductive medicine center in Shanghai were enrolled in this retrospective study, including Shanghai Ji-Ai Genetics and IVF Institute, Shanghai Jiaotong University School of Medicine affiliated Renji Hospital,Buijin Hospital, China Welfare Institute International Maternal and Infant Health Hospital, Shanghai First Maternity and Infant Health Hospital, Shanghai the Ninth People's Hospital and the Second Military Medical University affiliated Changhal Hospital. The clinical data about the type and incidence of birth defect were analyzed. Meanwhile, the factors associated with birth defect were investigated, such as various ART,gender, mother age, numbers of gestational sac, the source and quality of sperm. Results The birth defect rate was 1.08% (92/8507) and the most remarkable malformation occurred in circulation system [34% (31/92)]. The rates of major congenital malformations were 1.21% (34/2799) in fresh conventional IVF-ET, 1.07% (20/1871) in IVF-frozen-thawed embryo transfer(IVF-FET), 1.04% (23/2212) in fresh intracyto plasmic sperm injection (ICSI)-ET and 0.92% (15/1625) in ICSI-FET, which did not show statistical difference (P>0.05). There was also no significantly different incidence of malformations between 1.12% (49/4371) in male neonates and 1.02% (42/4136) in female neonates (P >0.05).However, the occurrence of congenital malformation is positively related with maternal age, the rates were 0.84% (41/4884) in mother's age less than 30 years and 1.77% (16/902) in mother' age more than 35 years, which reached statistical difference (P < 0.05). It also showed remarkable different incidence among 0.53% (25/4679) in singletons, 1.59% (57/3576) in twins and 3.97% (10/252) in triplets (P< 0.05). No remarkable difference of malformation rate among sperm sources used in fertilization were observed, including 1.09% (81/7419)in ejaculated sperm, 1.21% (7/579)in percutaneous epididymal aspiration (PESA) and 0. 79% (4/509) in donor sperm (P>0.05). Conclusions The overall incidence of birth defect in neonates from ART is similar to those conceived naturally and is not associated with different types of IVF-ET, embryo cryopreservation, sperm sources. However, maternal age and multiple pregnancies coder the higher possibility of birth defect.

Objective:To explore multidisciplinary team (MDT) for the treatment of hip fracture in the elderly.Methods:A retrospective analysis was done of the 196 elderly patients who had been admitted to Department of Joint Surgery, Beijing Shijitan Hospital from September 2017 to December 2018 for hip fractures. They were divided into 2 groups depending on whether MDT had been applied or not. In the MDT group of 102 patients, there were 43 males and 59 females with an age of 81.9±8.4 years, and 63 femoral neck fractures and 39 intertrochanteric fractures. In the traditional treatment group of 94 patients, there were 37 males and 57 females with an age of 81.3±8.6 years, and 55 femoral neck fractures and 39 intertrochanteric fractures. The 2 groups were compared in terms of complications and mortality during hospitalization, interval from admission to surgery, total hospital stay, and Harris hip scores at 6 months after surgery.Results:There were no statistically significant differences in general data before surgery between the 2 groups, indicating comparability ( P>0.05). Eighty-four patients (89.4%) in the traditional treatment group and 98 patients (96.1%) in the MDT group underwent surgery, showing no significant difference between the groups ( χ2=3.327, P=0.068). In the patients undergoing surgery in the MDT group, the incidences of postoperative delirium [12.2% (12/98)], pulmonary infection [11.2% (11/98)], cardiogenic disease [13.3%(13/98)], electrolyte disturbance[12.2%(12/98)] and deep venous thrombosis of lower extremity [6.1% (6/98)] were significantly lower, the interval from admission to surgery (1.9 d±0.9 d) and total hospital stay (10.2 d±0.9 d) significantly shorter, and Harris hip scores (81.3±6.2) at 6 months after surgery significantly higher than those in the patients undergoing surgery in the traditional treatment group [31.0%(26/84), 22.6% (19/84), 25.0% (21/84), 28.6% (24/84), 16.7%(14/84); 3.1 d±1.6 d and 14.1 d±6.2 d; 75.4±7.8; respectively] (all P<0.05). Conclusion:In the treatment of hip fracture in the elderly, multidisciplinary team is effective in reducing complications during hospitalization, shortening the interval from admission to surgery and total hospital stay, and promoting functional recovery of the hip.