Aim To compare the advantage of different methods of terminating early pregnancy. Methods 684 women in early pregnancy(≤49 d) were allocated into three groups according to their request: Group A (medical abortion,n=241), taking (po) mifepristone 25 mg every 12 h for three days and then taking misopostol 600 ?g at 8:00 on the forth day; Group B (induced abortion, n=220), taking the routine intrauterine operation by vacuum aspirator; and Group C (medical with induced abortion, n=223), inserting a Gongshuan suppository into rectum 0.5～2 h before induced abortion operation. Some indices were compared, including the efficacy, vaginal bleeding volume and time, side effects and acceptability of the three abortion methods. Results The abortion effects of Group C and B are better than that of Group A (P

Objective To report the development of clinical symptoms in a Chinese family with autosomal dominant progressive external ophthalmoplegia(adPEO).Methods Electromyologram and muscle biopsy were performed in the proband and 4 family members with the disease.Results The proband was a 57 year-old woman,who developed bilateral ptosis after the age of 30,external ophthalmoplegia after the age of 35 years old,weakness of extremities at the age of 37 years old and bulb palsy with palmus at the age of 47 years old.In the family there were 20 male and female members from five generations.All of them complained about bilateral ptosis between 26—33 years old,external ophthalmoplegia(12/15)and weakness of all extremities(14/15)between 35—45,facial and masticatory weakness(9/9)as well as dysphagia(8/9)between 44—60,accompanied with heart lesions(4/7)after 50 years old.Some patients died due to cardiac impairment.Electromyologram showed myopathic abnormalities in the examined patients. The main myopathological changes were ragged red fibers,cytochrome c oxidase negative fibers and ragged blue fibers in succinate dehydrogenase staining.Conclusions The adPEO started from extra-ocular muscles to limbs,finally facial and bulbar muscles.Heart lesions were presented in late stage and lead to death in some members.The developing process of symptoms suggested that we should pay more attention to cardiac manifestations in this disease.

Objective To investigate the axonal lesion in chronic inflammatory demyelinating polyneuropathy(CIDP).Methods Eighteen patients had undergone sural nerve biopsy.The clinical and electrophysiological distinction based on the different pathological changes were analyzed.Results Five patients with demyelination predominance which presented myelinated fiber with thin myelin.Three of them showed also mild axonal degeneration.Eight patients with axonal lesion predominance which presented Wallerian degeneration and regeneration of myelinated fibers.Three patients with mixed myelin and axon lesion of myelinated fibers and two with mild lesion.There was no significant difference between CIDP predominantly with axonal lesion and demyelination.Electrophysiological examination shows both axonal lesion and demyelination feature in some of the 2 types patients at the same time.Conclusions Axonal lesion is a common pathological change in CIDP and should not be considered as an exclusive criterion in diagnosis of the disease.Infiltration of macrophages is a common change.

Objective To investigate the predictive value of neutrophil to lymphocyte ratio (NLR) at admission for mortality risk during hospitalization in patients with acute ischemic stroke (AIS). Methods Patients with AIS admitted to the Department of Neurology, the First Affiliated Hospital of China Medical University from January 2017 to December 2018 were enrolled retrospectively. The demographic data and all baseline clinical data were collected, and compared between the in-hospital death group and survival group. Multivariate logistic regression analysis was used to determine independent influencing factors for in-hospital death in patients with AIS. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of NLR for death during hospitalization. Results A total of 266 patients with AIS were enrolled, with an average age of 65 years, 168 were males (63.2% ), 98 were females (36.8% ), 52 died in hospital (19.5% ), and 214 (80.5% ) survived. The NLR of the death group was significantly higher than that of the survival group (median [ interquartile range]: 7.6 [4.6-14.0] vs. 2.4 [1.8-4.0]; Z=7.727, P<0.001). Multivariate logistic regression analysis showed that advanced age (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.01-1.14; P=0.009), previous history of stroke or transient ischemic attack (OR 9.06, 95% CI 2.06-39.88; P=0.004), high NIHSS score (OR 1.13, 95% CI 1.04-1.24; P=0.004), and high NLR (OR 1.23, 95% CI 1.02-1.48; P=0.024) were the independent risk factors for death during hospitalization in patients with AIS. ROC curve analysis showed that the area under the curve of NLR predicting death during hospitalization for patients with AIS was 0.846 (95% CI 0.786-0.905; P<0.001). When the cut-off value of NLR was 4.52, the sensitivity and specificity were 76.9% and 80.8% respectively. The positive predictive value was 49.4% , and the negative predictive value was 93.5% . Conclusions The increased NLR level at admission had certain predictive value for the death of patients with AIS during hospitalization.

The biological characterization, differentiation and regeneration of hepatic stem/progenitor cells are the one of very active and interested fields. In this report, intravenous injection of human umbilical cord blood (HUCB) cells into the BALB/c-nu and SCID mice, an animal model for transplantation and liver injury, was reported. Using of flow cytometry and tissue typing (HLA), it was found that the HUCB cells were survived in mouse liver for 9 weeks. After separation from perfused liver, HUCB cells were detected by hematopoietic colonies (CFU-GEM M) in hepatocyte culture. It was concluded that the transplanted HUCB hematopoietic stem/progenitor cells can be survived in the liver over a long period of time.
Animals ; Cell Division ; Fetal Blood ; cytology ; Flow Cytometry ; HLA-DR Antigens ; analysis ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; physiology ; Humans ; Infant, Newborn ; Liver ; cytology ; Male ; Mice ; Mice, Inbred BALB C ; Mice, SCID

OBJECTIVETo find out association mapping of loci related to schizophrenia on chromosome 1 with microsatellite markers in DNA pooling samples from schizophrenic cases and normal controls in Shandong peninsula.

METHODSA total of 31 microsatellite markers on chromosome 1 spaced at approximately 10 cM were scanned to two separated DNA pooling samples consisting of 119 schizophrenic cases and 119 normal controls respectively. Statistic analysis was performed by Chi-square test method to compare the difference between the ratio of each allele between the two pooling samples.

RESULTSSignificant statistic difference was found at D1S2878 between cases and controls, and P< 0.01 at this loci.

CONCLUSIOND1S2878 locus on chromosome 1 associates with schizophrenia in Shandong peninsula. Fine mapping and searching for candidate genes are warranted in this region.

Adult ; Case-Control Studies ; China ; Chromosome Mapping ; Chromosomes, Human, Pair 1 ; genetics ; DNA ; genetics ; Female ; Genomics ; Humans ; Male ; Microsatellite Repeats ; genetics ; Schizophrenia ; genetics ; pathology

OBJECTIVETo establish the rat model of estradiol valerate medication in early pregnancy, and to investigate the effects of estradiol valerate on the development of the reproductive system of the first filial generation (F1) male rats by evaluating the anogenital distance (AGD) and the development of the testis and epididymis.

METHODSPregnant SD rats were divided at random into a blank control group and a low dose, a medium dose and a high dose medication group to receive intragastric estradiol valerate at 0.2 mg/kg, 0.5 mg/kg and 0.8 mg/kg, respectively. The newborn F1 male rats were normally fed. Their anogenital distances were measured on postnatal day (PND) 3 and 21, the organ coefficients of the testis and epididymis (testicular and epididymal weight g/body weight 100 g) were obtained on PND 60, the morphological changes of spermatogenic cells were observed by testis biopsy, and the diameter of the seminiferous tubule and epithelial height were measured.

RESULTSThere was no significant difference between the control and medicated F1 male rats in AGD on PND 3 and 21 (P > 0.05), nor in the organ coefficients of the testis and epididymis on PND 60 (P > 0.05), nor in the diameter of the seminiferous tubule and epithelial height.

CONCLUSIONMedication of estradiol valerate (0.2 -0.8 mg/kg) to rats in early pregnancy neither significantly affects the reproductive system development, nor induces obvious histological changes of the testis in the sexual maturation period of their F1 males.

Animals ; Estradiol ; analogs & derivatives ; pharmacology ; Female ; Male ; Maternal Exposure ; Pregnancy ; Rats ; Rats, Sprague-Dawley ; Sexual Maturation ; drug effects ; Testis ; drug effects ; growth & development

OBJECTIVETo detect lymphangiogenesis by labeling the lymphatic endothelial marker, lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1), and study the prognostic relevance of lymphangiogenesis in laryngeal squamous carcinoma.

METHODSClinical files and specimens of 78 patients with histologically diagnosed laryngeal carcinoma were stained with LYVE-1 as a specific lymphatic endothelial marker. The lymphatic vessel density (LVD) was measured, and the correlation between LVD and clinicopathological features of the tumor cases was analyzed.

RESULTSThe mean LVD in laryngeal carcinoma (13.24 ± 5.09) was significantly higher than that in adult laryngeal papilloma (5.54 ± 3.15) and squamous dysplasia (6.76 ± 4.45, P < 0.05). The LVD of poorly differentiated tumors (15.74 ± 5.24) was significantly higher than that in the moderately differentiated tumors (13.84 ± 6.20), and the LVD in the moderately differentiated tumors was significantly higher than that in the well-differentiated tumors (11.68 ± 6.34). The LVD in stage 0 to stage II group (10.66 ± 5.70) was significantly lower than that in the stage III to IV group (17.01 ± 6.35). The lymph node metastasis group (17.25 ± 7.37) was significantly higher than non-lymph node metastasis group (8.60 ± 5.23, P < 0.05). There was no significant association between LVD and age, sex, primary site and distant metastasis. The overall survival in the patients with a LVD higher than the mean value was 33.5 month, and that of cases with a LVD lower than the mean value was 81.6 month (P < 0.05). The multivariate survival analysis showed that the clinical stage and LVD were independent prognostic factors of laryngeal cancer.

CONCLUSIONSThe LYVE-1 staining histochemistry demonstrates that the lymphangiogenesis occurrs mainly at the edge of the tumors, and lymphangiogenesis plays an important role in the carcinogenesis, cancer progression and lymph node metastasis in laryngeal cancer. LVD may be an independent indicator of poor prognosis of laryngeal cancer.

Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymphangiogenesis ; Lymphatic Metastasis ; Lymphatic Vessels ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Papilloma ; metabolism ; pathology ; Precancerous Conditions ; metabolism ; pathology ; Survival Rate ; Vesicular Transport Proteins ; metabolism

OBJECTIVETo investigate the clinicopathologic features of the brain tissue diagnosed as ulegyria from modified anatomic hemispherectomy for refractory epilepsy.

METHODSThe clinical and pathologic findings were reviewed in 39 patients who underwent modified anatomic hemispherectomy and diagnosed as ulegyria in the Epilepsy Center of Tsinghua University Yuquan Hospital from 2007 to 2011.

RESULTSAll patients including 30 males and 9 females had medically intractable seizures, and the mean age of seizure onset and disease duration were 4.0 years and 7.3 years respectively. Significant history included febrile seizure in 14 patients (35.9%), cerebral hemorrhage in 8 patients (20.5%), fetal distress and surgical trauma each in 6 patients (15.4%), vascular malformation and cerebral hemorrhage in 1 patient (2.6%), and unclear history in 4 patients (10.2%). Histologically, all cases were characterized by cortical destruction, with neuronal loss and gliosis. All cases were accompanied by varying degree of cortical dysplasia, which were diagnosed as focal cortical dysplasia IIId. Hippocampus sclerosis was identified in 2 cases. Seizure outcome after surgery revealed 37 patients (94.9%) had an Engel grade I, two patients (5.1%) had an Engel grade II.

CONCLUSIONSFebrile seizure, cerebral hemorrhage, fetal distress and surgical trauma in childhood can lead to refractory epilepsy. Histopathological change in the brain is ulegyria accompanied by focal cortical dysplasia IIId. Modified anatomic hemispherectomy is an effective therapy to treat those patients with extensive changes of one hemisphere.

Adolescent ; Adult ; CD3 Complex ; metabolism ; Cerebral Cortex ; abnormalities ; pathology ; surgery ; Child ; Child, Preschool ; Epilepsy ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Hemispherectomy ; methods ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Malformations of Cortical Development ; metabolism ; pathology ; surgery ; Retrospective Studies ; Young Adult

Objective:To investigate the bacterial composition and antimicrobial resistance profile of clinical isolates from bloodstream infections in China.Methods:The clinical bacterial strains isolated from blood culture were collected during January 2020 to December 2020 in member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS). Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical Laboratory Standards Institute(CLSI, USA). WHONET 5.6 was used to analyze data.Results:During the study period, 10 043 bacterial strains were collected from 54 hospitals, of which 2 664 (26.5%) were Gram-positive bacteria and 7 379 (73.5%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (38.6%), Klebsiella pneumoniae (18.4%), Staphylococcus aureus (9.9%), coagulase-negative Staphylococci (7.5%), Pseudomonas aeruginosa (3.9%), Enterococcus faecium (3.3%), Enterobacter cloacae (2.8%), Enterococcus faecalis (2.6%), Acinetobacter baumannii (2.4%) and Klebsiella spp (1.8%). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus aureus were 27.6% and 74.4%, respectively. No glycopeptide- and daptomycin-resistant Staphylococci were detected. More than 95% of Staphylococcus aureus were sensitive to rifampicin and SMZco. No vancomycin-resistant Enterococci strains were detected. Extended spectrum β-lactamase (ESBL) producing Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were 48.4%, 23.6% and 36.1%, respectively. The prevalence rates of carbapenem-resistance in Escherichia coli and Klebsiella pneumoniae were 2.3% and 16.1%, respectively; 9.6% of carbapenem-resistant Klebsiella pneumoniae strains were resistant to ceftazidime/avibactam combination. The prevalence rate of carbapenem-resistance in Acinetobacter baumannii was 60.0%, while polymyxin and tigecycline showed good activity against Acinetobacter baumannii. The prevalence rate of carbapenem-resistance of Pseudomonas aeruginosa was 23.2%. Conclusions:The surveillance results in 2020 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while Escherichia coli was the most common pathogen, and ESBL-producing strains declined while carbapenem-resistant Klebsiella pneumoniae kept on high level. The proportion and the prevalence of carbapenem-resistant Pseudomonas aeruginosa were on the rise slowly. On the other side, the MRSA incidence got lower in China, while the overall prevalence of vancomycin-resistant Enterococci was low.