Objective To investigate the maternal nutritional status and its influences on pregnancy outcomes in order to provide evidence for possible prenatal interventions.Methods A survey was conducted in 800 pregnant women,who presented at Xiamen Maternal and Child Healthcare Hospital between January 2006 to April 2008.The information of knowledge,attitude and behavior towards maternal nutrition were collected in 734 women and 571 women were followed up before 20 weeks of gestation,at 26-27 weeks,and 35-36 weeks to analyze the relationship between different nutrients and the pregnant outcomes.Results The questionnaire survey showed that women who had received higher education presented with better knowledge,attitude and behavior on maternal nutrition (P<0.05).Among the 734 women,39.2%(288) had poor knowledge,44.5%(326) were lack of knowledge,and 44.8%(358) with poor behavior.Prenatal diet analysis found that the percentage of these women with milk,fish and beans intake daily was 52.2%,34.3%,and 29.5%,respectively.Before 20 weeks of gestation,significant difference was identified only in the level of triglyceride among different BMI groups,and the higher the BMI,the higher the level of triglyeeride (P<0.01).With the progress of pregnancy,the level of serum ferritin and folic acid was decreasing (P<0.05),while the level of triglyceride and cholesterol was increasing (P<0.01).The newborn's birth weight was positively correlated to maternal BMI before 20 weeks (r=0.23,P<0.05),and higher BMI was a risk factor for abnormal birth weight (OR=4.051,95%CI:1.085～15.117,P<0.05) and also complicated with higher cesarean section rate than those women with lower or normal BMI (60.3%vs 29.4%and 34.7%,P<0.05).The rate of postpartum hemorrhage was increased with the reduced ferritin level (P<0.05).Conclusions The pregnancy outcomes can be improved through the following measures:appropriate control of the maternal weight before and during the pregnancy,increased intake of milk,fish,beans and so on,reduced intake of food containing abundant fat and sugar,more intake of red animal foodstuff,supplementation of folie acid,iron and calcium throughout the pregnancy,and prevention against high level of triglyceride and cholesterol.

China donation after Citizen's death (CDCD) has been organized since 2010,and now has been synchronized with the international organ transplantation.At present,liver transplantation has become the only safe and curative treatment for the end-stage liver diseases.Nevertheless,there is much restriction over further exploration of this technique.This article will mainly focus on donation after brain death (DBD),and summarize the four dominating injuries of donor liver,including the donor's primary injury,cut and perfusion injury,graft preservation injury,and ischemia-reperfusion injury.

To assess the effectiveness and safety ofinside-out (TVT-O) vs. outside-in transobturator-tape procedures (TOT) in the surgical management of female stress urinary incontinence (SUI).A total of 8 randomized controlled trials were retrieved from the literature and analyzed by metaanalysis with RevMan 5.0 software.Meta-analysis showed that no statistical differences existed in objective cure rate,objective failure,postoperative voiding dysfunction,groin/thigh pain and sling exposure in both procedures (P ＞ 0.05).These preliminary results suggest there is no evidence of significant differences in the efficacy and safety between TVT-O and TOT.

Objective To investigate the repair function of extracorporeal membrane oxygenation (ECMO) in vivo for the liver after cardiac death with warm ischemia injury for 30 min from cardiac death swinc.Method Ten landraces,30 to 40 kg,randomized to experimental group and control group,were used to make 30-min cardiac death models through clamping trachea after deep anesthesia.An intravenous cannula was placed through right iliac arteries and veins,and connected to ECMO extracorporeal circulation pipes in experimental group.The balloon catheter was placed to diaphragm plane through left femoral artery.The ECMO was performed to infuse abdominal organs,and pH and electrolyte were adjusted.The circulation flow rate,intraperitoneal organ perfusion pressure,venous blood gas,electrolyte,transaminase,and bile product,etc.were monitored and recorded.The livers of control group were retrieved after 30-min cardiac arrest and stored in cold UW for 4 h.Pathological tissue was sliced and stained by HE.Result After 30-min cardiac arrest,the liver showed obvious congestion appearance; pathologically,there were hepatic sinus expansion,blood cells clog,and erythrocyte aggregation.Circulating blood gas analysis revealed severe acidosis.After the ECMO recirculation started,circulation flow rate maintained to 1 L/min,the liver gradually restored bright red,pathological biopsy showed that hepatic sinus expansion disappeared,and clogged blood cells dispelled.AST was markedly increased to (226.0 ± 28.0) U/L after 30-min cardiac arrest and reduced to (150.0 ± 30.0) U/L 4 h after the ECMO recirculation.Average bile production was 7.75 ml/h.Conclusion ECMO recirculation in vivo can repair the injured livers from cardiac death donor with 30-min cardiac arrest.

Vascular complications after liver transplantation can seriously threaten the survival of patients.In the preoperative assessment and postoperative monitoring of patients' vascular conditions,although the digital subtraction angiography (DSA) is the golden standard for vascular lesion diagnosis,but not the first choice due to traumatic lesions.In some clinical circumstances,DSA can only be used when Doppler ultrasound,spiral CT,and MRI are not applicable,and in most cases DSA is used for treatment rather than diagnosis.This article reviewed the current interventional treatment of vascular complications to stress the important role of DSA in diagnosis and treatment of related complications after liver transplantation.

With the increasing demand for liver transplantation,some previously abandoned donors,called marginal donor,started to be involved in clinical liver transplantation,which raises higher requirement on the organ preservation methods.Normothermic perfusion is regarded to be superior to the currently adopted hypothermic perfusion,and plays an important role in the organ preservation of marginal donors.This review will summarize the clinical applications of liver normothermic perfusion in transplantation and repair,as well as its roles in basic research.

Objective To explore the differential proteins between livers of control and brain dead grups,and to provide an experimental basis for the assessment of liver quality in brain dead rabbits.Methods 60 healthy male New Zealand rabbits were divided into two groups.The brain dead group (n=30) contained rabbits 2 hours (B1),6 hours (B2),and 8 hours(B3) after brain death.The sham group (n=30) contained groups of 2 hours (C1),6 hours (C2),and 8 hours (C3).At the end of the relevant experiments,blood samples and liver tissues were collected.The level of ALT and AST were determined by an automatic biochemistry analyzer and the morphologic changes of the livers were detected by HE staining.The differentially expressed proteins were screened and identified by two-dimensional gel electrophoresis,PDQuest software,matrix-assisted laser desorption ionization time of flight mass spectrometry,and the NCBI database.Results In 8 hour brain dead group,the level of ALT increased comparing with 6 h (P＜0.05),but there was no significant statistical difference in the other groups.Under real time observation with the light microscope,the livers of the brain dead groups had increased edema and infiltration of lymphocytes in the portal area,especially in the 8 hour group.However,infiltration of neutrophils also appeared in the 8 hour control group and all groups had no damage in the liver cell.There were 10 kinds of differentially expressed proteins through the two-dimensional gel electrophoresis,mass spectrometry analysis,and database query.One protein of interest was ALDH2,which showed a gradually decreasing expression in the liver when the braid dead time increased.Conclusion Brain death could lead to no damage of liver function and little damage to liver morphology.The identified protein ALDH2 may be related with liver injury after brain death and could be a new indicator in the assessment of liver quality in brain dead rabbits.

Objective To explore the way to establish the brain death model for rabbits and pathophysiological changes before and after brain death.Methods 80 healthy male New Zealand rabbits were divided into brain death group (n =60) and sham operation group (n =20),The 60 brain death rabbits were established by increasing intracranial pressure in a modified,slow,and intermittent way.The sham operation rabbits were only maintained with anesthesia.Results The 56 brain death rabbits were established successfully and maintained for 10 h with the respiration and circulation supports.2 rabbits died due to anesthetic accident,the other 2 died because of improper pressure.The surgical success rate is 93.3％ (56/60).The changes of mean artery pressure (MAP) and heart rate (HR) in brain death group were more significant than in sham operation group:MAP and HR fluctuated and showed the increased tendency.The mean MAP and HR during increasing intracranial pressure were (400.24±18.36) mm Hg (1 mm Hg=0.133 kPa) and (258.00 ± 25.70) beats/min respectively,which was significantly higher than before and after increasing intracranial pressure (P＜0.05).Conclusions The brain death model for rabbits could be established by increasing intracranial pressure in a modified,slow,and intermittent way successfully and maintained 10 h.the MAP and HR before and after brain death showed characteristic changes.The model is helpful to the further observation of organ changes in brain dead state.

ObjectiveTo discuss the feasibility of the method that can be used to induce the model of type 2 diabetic mellitus rat and explore the characteristic of the nephropathy.The rats were fed with the high sucrose,high fat and high energy feed for a long time and then it was injected with the low dose STZ.Methods30 SD rats were selected and then it was randomly divided them into 2 groups,the control group (10 rats) and the model group (20 rats).The model group was fed with the high calorie feed forl0 weeks to induce insulin resistance and then the rats were induced to type 2 diabetes mellitus by injection of streptozocin (30 mg/kg).The rats of the model group were continually fed with the high calorie feed for 2 months.Before the end of this study,the 24-hours microalbuminuria,serum creatinine and blood urea nitrogen were detected and the periodic acid Schiff staining on the kidney were also measured.ResultsAfter the rats of the model group were established,the levels of the bodyweight,the cholesterol,the triglyceride and the insulin were [ (468.7 ± 8.8 ) g,( 1.92 ± 0.27 ) mmol/L,( 1.32 ± 0.34) mmol/L,(38.81 ± 5.39 ) mU/L ] respectively,all of them were higher than the levels in the normal group,which were [ (436.9 ± 7.4) g,(1.16 ±0.17)mmol/L,(0.8 ±0.18)mmo1/L,(21.43 ±4.19)mU/L],respectively( t =9.755,8.077,4.437,8.902,P ＜ 0.01 ).After injection of STZ for 2 weeks,the levels of the blood glucose,the insulin and the insulin resistance of the diabetes mellitus rats were [ ( 19.31 ± 1.55 ) mmol/L,( 31.31 ± 8.60) mU/L,(26.55 ± 6.33) ] respectively,it was higher than levels inf the normal group,which was[ (5.45 ±0.69) mmol/L,( 19.97 ± 3.26) mU/L,(4.82 ± 0.84) ] ( t =26.383,3.951,10.719,P ＜ 0.01 ).Before the end of this study,the levels of the blood glucose,insulin resistance,24-hours microalbuminuria,serum creatinine,blood urea nitrogen of the diabetes mellitus rats were [ ( 19.27 ± 1.97 ) mmol/L,( 16.70 ±7.51 ),(72.49 ± 8.53 ) mg/24 h,( 74.76 ± 8.38 ) μmol/L,( 19.09 ± 4.21 ) mmol/L],it was higher than the levels in the normal group,which were [ (5.62 ±0.65) mmol/L,(5.45 ± 1、33),( 15.26 ±2.20) mg/24 h,(40.81 ± 1.97) μmol/L,(9.87 ±2.13) mmol/L,t =20.961,4.657,20.623,12.495,6.352,P ＜0.01 ].And the pathological changes of the diabetes mellitus rats kidney tissues were the most serious through themethod of periodic acid-Schiff's staining (PAS).ConclusionsThe model of type 2 diabetic mellitus rat was constructed through the way of feeding the SD rats with high sucrose,high fat and high energy feed for a long time and low dose STZ.The diabetic mellitus rats had the symptom of drinking more,eating more and diuresis,and the character of this model had high levels of albuminuria,serum creatinine,blood urea nitrogen.The incrassated glomerular mesangium,the crescent-shaped focus and the glomerulosclerosis were also observed through the PAS.

Objective To discuss about the relationship between the occurrence of the uterine cervix cancer and the risk factors.MethodsAmong the patients we collected,92 patients were diagnosed to have the cervical cancer,63 patients were diagnosed as CINⅢ (the cervical intraepithelial neoplasia,CIN),and 252 patients belonged to the control group.All patients had not been cured before.We used the questionnaire to investigate them about the dietary habit and other information.Through using different statistical Methods ,we explored the relationship between the cervical cancer and the potential factors.ResultsWe found out that many factors contributed to the happening of the cervical cancer,such as gynecopathy(χ2=19.31,P＜0.01),the first time of the menses(F＝11.62,P＜0.01),the first time of the sex life(F＝25.76,P＜0.01),the first time of the parturition (F＝28.02,P＜0.01),the times of the pregnancy and the parturition(F1＝13.98,P1＜0.01;F2＝4.78,P2＜0.01),the culture degree(χ2＝10.70,P＜0.05),the infection of HPV(χ2＝179.95,P＜0.01),the level of the folic acid (F＝3.39,P＜0.05) and so on.The result of the logistic regression analysis showed that keeping the habit of drinking tea(OR＝0.321,β＝-1.136,P＜0.05),paying attention to the sanitation of the sex life(OR＝0.387,β＝-0.950,P＜0.05),putting off the first time of the sex life(OR＝0.551,β＝-0.596,P＜0.05),and the higher level of the folic acid (OR＝0.502,β＝-0.688,P＜0.05) were the protective factors tothe occurrence of the uterine cervix cancer.Meanwhile,the infection of the HPV(OR＝27.215,β＝3.304,P＜0.01),many times of the parturition(OR＝1.846,β＝0.613,P＜0.05) and the passive smoking (OR＝1.673,β＝0.515,P＜0.05) were the risk factors.ConclusionsWith the higher level of the folic acid,the less possibility you will get the cervical cancer.There exists many measures to prevent the happening of the cervical cancer,like keeping the healthy sex life,keeping far away from the passive smoking,not to give birth too early or too many and preventing being infected the HPV.What's more,having the good habit of drinking tea and paying attention to the supplement of the folic acid and Vitamin B12 may be the effective method to prevent the occurrence of the cervical cancer.