Objective To investigate the effect of bilateral uterine artery embolization in the prevention of postpartum hemorrhage.Methods Twenty-seven patients with risk factors of postpartum hemorrhage (prevention group) and 36 patients with postpartum hemorrhage refractory tendency(treatment group) were underwent bilateral uterine artery embolization.The clinical efficacy and side effects were observed.Results The patients in prevention group were given bilateral uterine artery embolization and conventional induction by ethacridine.All of them finished vaginal delivery,postpartum hemorrhage was 200-480 ml,average 385 ml,no case of postpartum hemorrhage.The patients in treatment group occurred intractable postpartum hemorrhage before bilateral uterine artery embolization,the amount of hemorrhage was 1 000-4 200 ml,average 2 050 ml.Among them,9 patients were given carbasus to stuff cavitary uteri,2 patients were given striped-back saturation.Effective in 35 patients,the successful rate was 97.2％ (35/36).One patient was performed with hysterectomy because of inefficient treatment.None occurred maternal deaths,inefficient and necrosis of lower limbs.All of patients had entire involution of uterus.Reviewed at clinic service after delivery,none occurred postpartum hemorrhage,puerperal infection,Sheehan's syndrome.The menstrual recovery time was 3-13 months for 53 patients who were followed up.Conclusions Bilateral uterine artery embolization have advantage such as safe,effective,less side effects,and is an effective method for the treatment of various causes of intractable postpartum hemorrhage.It is worthy of clinical application on the prevention of postpartum hemorrhage.

Objective To characterize rpoB gene mutations in rifampin-resistant Mycobacterium tuberculosis (M.tuberculosis) in Zhejiang Province.Methods A total of 188 clinical isolates of M.tuberculosis from 188 patients with pulmonary tuberculosis in Tongde Hospital of Zhejiang Province and Integrated Chinese and Western Medicine Hospital of Zhejiang Province were collected.Conventional drug resistance analysis was performed and the mutation of rpoB gene was detected by PCR-based DNA sequencing.The association between gene mutations in rifampin-resistance determining region of M.tuberculosis and clinical resistance was analyzed.Results Fifty-seven out of 188 isolates (30.3％) were drug-resistant strains,including 18 isolates (9.6％) with single-resistance to rifampin,28 isolates (14.9％) with single-resistance to other anti-tuberculosis drugs (10 to isoniazid,12 to streptomycin and 6 to ethambutol),and 11 isolates (5.9％) with multi-drug-resistance (rifampin plus one or more drugs of isoniazid,streptomycin and ethambutol).Among 29 rifampin-resistant strains,rpoB gene mutation existed in 27 strains (93.1％),and the most frequently mutated sites were codons 526 (55.6％,16/27),513 (22.2％,5/27),531 (14.8 ％,4/27)) and 529 (7.4％,2/27).Among 28 strains which were resistant to other anti-tuberculosis drugs,rpoB mutations existed in 4 strains (14.3％),and the mutated sites were codons 526 (2 strains) and 513 (2 strains).All 13 sensitive isolates had no mutation in rpoB gene.Conclusion Rifampin resistance in M.tuberculosis is closely correlated with rpoB gene mutations in Zhejiang province,and the most frequent sites of mutation are at codons 526 and 513.

Objective To evaluate the significance of combined detection of leptin (LEP),tumor necrosis factor-α (TNF-α),carcino-embryonic antigen (CEA),C-reactive protein (CRP) and interleukin-6 (IL-6) in both serum and pleural effusion in differential diagnosis of tuberculosis and malignant tumor.Methods LEP,TNF-α,CEA,CRP and IL-6 levels in both pleural fluid and serum samples from 95 cases of pleural effusion (including 54 cases of malignant pleural effusion and 41 cases of tuberculous pleural effusion) were detected by immunoturbidimetry and enzyme linked immunosorbent assay (ELISA),respectively.The data with normal distribution and skewed distribution were analyzed by t test and rank sum test,respectively.Results In patients with tuberculosis and malignant tumor,significant difference was observed in serum LEP [(0.42±0.47) ng/ mL vs (1.80±0.91) ng/mL,t=9.666,P=0.0001],TNF-α [(30.88±24.72) pg/mL vs (59.83±30.93) pg/mL,t=4.917,P=0.0001],CEA [(0.22±0.30) ng/mL vs (5.67±3.60) ng/mL,t=ll.074,P=0.0001] and IL-6 [(146.48±54.90) pg/mL vs (20.51±11.62) pg mL,t=-14.449,P 0.0001] levels.Serum CRP levels of patients with tuberculosis and malignant tumor were comparable [(32.78±22.43) mg/mL vs (37.80±16.74) mg/mL,t =1.249,P=0.215].In pleural effusion of the two groups (tuberculous pleural effusion vs malignant pleural effusion),LEP [(0.69±0.65) ng mL vs (4.33±2.16) ng mL,t 11.711,P 0.0001],TNFα [(20.60±17.80) pg/ mL vs (40.40±20.60) pg/mL,t=4.926,P=0.0001],CEA [(0.10±0.17) ng/mL vs (4.02±2.49) ng/ mL,t=11.537,P=0.0001] and IL-6 [(87.80±48.40) pg/mL vs (9.30±5.50) pg/mL,t =-10.333,P=0.0001] levels were significantly different,while CRP levels [(27.34±17.93) mg mL vs (29.60± 13.40) mg mL,t =0.709,P =0.102] were comparable.Conclusion LEP,TNF-α,and CEA levels in both pleural effusion and serum samples from patients with malignant tumor are higher than those with tuberculosis,while IL 6 levels are quite opposite.Combined detection of these parameters can help the differential diagnosis of tuberculous and malignant pleural effusion.

Objective To evaluate the clinical efficacy of thyroxine replacement therapy in the treatment of pregnancy patients with subclinical hypothyroidism.Methods 80 cases of patients with subclinical hypothyroidism who were admitted to our hospital from May 2011 to May 2016 were selected, they were divided into thyroxine replacement therapy treatment group ( replacement treatment group ) and conventional treatment group two groups according to the treatment methods, 40 cases in each group.The serum TSH, FT4, TG, CHO levels, childbirth, pregnancy outcomes and complications, neonatal status of the two groups were statistically analyzed.Results The serum TSH, TG, CHO levels of the replacement treatment group were significantly lower, the FT4 level was significantly higher, the difference was statistically significant (P<0.05), the trans vaginal yield rate 70.0%(28/40) was significantly higher than the conventional treatment group 35.0%(14/40), the cesarean section rate 30.0%(12/40) was significantly lower than the conventional treatment group 65.0%( 26/40 ) , the difference was statistically significant ( P<0.05 ) , the incidences of preterm delivery, postpartum hemorrhage, preeclampsia, hypoproteinemia, fetal development restriction 2.5%(1/40), 2.5%(1/40), 5.0%(2/40), 7.5%(2/40), 0 were significantly lower than the conventional treatment group 17.5%(7/40), 15.0%(6/40), 20.0%(8/40), 17.5%(7/40), 15.0%(6/40), the difference was statistically significant (P<0.05), the neonates body weight was significantly higher than the conventional treatment group, the difference was statistically significant (P<0.05), the proportions of low birth weight infants, giant infants, premature infants, asphyxia, death 0, 2.5%(1/40), 5.0%(2/40), 7.5%(2/40), 0 were significantly lower than the conventional treatment group 15.0%(6/40), 20%(8/40), 22.5%(9/40), 27.5%(11/25), 20.0%(8/40), the difference was statistically significant (P<0.05).Conclusion The clinical efficacy of thyroxine replacement therapy in the treatment of pregnancy patients with subclinical hypothyroidism is more significant than conventional treatment .

OBJECTIVE:To optimize the purification process of the extract from Yiqi guben granules. METHODS:The purifi-cation effect of the process was investigated with transfer rate of polysaccharide,calycosin glucoside and dry paste as evaluation in-dexes,using ZTC1+1 type Ⅱ,and shell poly sugar and 95% ethanol as clarifying agents. The purification process of the extract from Yiqi guben granules was optimized by orthogonal test using the ratio of material to liquid,the amount of clarifying agent and standing time as factor. The validation test was conducted. RESULTS:Selecting ZTC1+1 type Ⅱ as a clarifying agent,the best trans-fer rate of effective component had been obtained;optimal purification process was as follows as the ratio of material to liquid 1:2, the ratio of ZTC1+1 type Ⅱ A liquid 5%,the ratio of B liquid 10%,standing time of 5 h. The results of verification test showed transfer rates of dry paste in 3 tests were 71.54%,70.98%,69.21%,respectively;those of polysaccharide were 82.55%, 81.78%,82.15%,respectively;those of calycosin glucoside were 91.92%,92.34%,91.58%,respectively (all RSD≤1.72%, n=3). CONCLUSIONS:The optimized purification process is effective,stable and practical,and can be used for the purification of the extract from Yiqi guben granules.

High-fat diet-induced insulin resistance rat model was assessed by euglycemic-hyperinsulinemic clamp technique.Compared with the control group,the vaspin mRNA expression in adipose tissue was significantly decreased in insulin resistant rats induced by high-fat diet( P＜0.05 ),which was increased by metformin( P＜0.05 ).These data indicate that metformin may ameliorate insulin resistance in rats via upregulating vaspin mRNA expression.

Objective:To explore the quality of inventory samples of a biobank stored in a deep freezer from 0 to over 10 years in Shanghai Ruijin Hospital. Methods:We extracted 24 pairs of stocked gastric cancer samples between 2003 and 2014. We used 1%aga-rose gel electrophoresis to analyze DNA and RNA purity and integrity while adding the RNA integrity number (RIN) for precise analysis. Bicinchonininc acid (BCA) assay was used for protein concentration evaluation. Coomassie brilliant blue method was used for protein integrity assay. Results: The samples were divided into four groups according to cryopreservation period (<2 years, 3-5 years, 6-8 years, and>9 years). No significant difference in DNA integrity was found between the groups (P>0.05);however, DNA degradation in normal gastric mucosa was faster than that in gastric cancer tissue (P=0.023). The RIN significantly declined when the storage period was 6 years or longer (P=0.018). No significant difference in protein concentration was observed between different groups. Using Coo-massie brilliant blue method, we found significant differences in preserved proteins with different molecular weights. Proteins with varying molecular weights were detected in the groups with the following cryopreservation periods:>9 years, a small number of low-molecular-weight (average 36.5 KD) proteins;6-8 years, medium-molecular-weight (average 65.63KD) proteins;3-5 years, high-molecu-lar-weight (average 127.5 KD) proteins;<2 years, high-molecular-weight (average 160 KD) proteins. Conclusion:Cryopreservation does not exert an obvious effect on DNA. If the cryopreservation period is more than 5 years, serious degradation of RNA should occur;like-wise, degradation of proteins with higher molecular weight should occur.

Objective To assess the vaIue of speckle tracking imaging (STI) in quantifying the regional myocardial strain in systemic lupus erythematosus (SLE) group.Methods ① Sixty subjects were divided into SLE group and normal group.High frame rate two-dimensional images were recorded from the apical two-chamber view,long-axis view and four-chamber view of the left ventricle (LV).Peak systolic strain of each view of 18 segments were measured by automated functional imaging (AFI) software of 2-DSE.All parameters were compared between the two groups.② Twenty cases were randomly taken from the normal group.The same observer at different times and two observers measure the strain of left ventricular respectively.The results of the measurement between the two groups were compared with unpaired t test and its relevance was analyzed using Pearson's correlation analysis.ResultsLeft ventricular two-dimensional longitudinal strain gradually increased from the base to apex in the normal group.There were statistically differences between the apical segments and the basal,middle segments of every left ventricular wall (P＜0.05).The same wall segment time to peak myocardial systolic peak strain was consistent.Left ventricular two-dimensional longitudinal strain gradually increased from the base to apex in the SLE group,except for the anterio-septal and anterior wall [ (-18.7±4.2)％,(-16.3±9.4)％,(-18.1±10.5)％ vs (-19.0±9.0)％,(-18.6±7.9)％,(-17.7±1.4)％ ].There was no statistically significant difference between the apical segments and the basal,middle segments of every left ventricular wall(P＞0.05).All parameters of S were significantly higher in the normal group than those of the SLE group.The difference was statistically signoficant (P＜0.05).The time to peak systolic peak strain of every segments was not consistent.The results from the same observer at different times and peak systolic myocardial strain measurements by the two observers were correlated well(P＜0.01).Conclusion The myocardial function assessment by STI technology in the SLE patients is significantly different from that of the normal control:SLE patients with left ventricular myocardial damage can be manifested as reduced regional myocardial systolic peak strain.

Objective To investigate the role of loss of heterozygosity (LOH) of SMAD2 and its relationship with clinicopathological parameters of primary gastric carcinoma. Methods Fifty cases of primary gastric carcinoma were monitored by polymerase chain reaction -single strand conformation polymorphism (PCR- SSCP) and silver staining to detect SMAD2 LOH. Results The incidence of LOH was 40.0%(22/45) at D18S450 and 33.3%(16/48)at D18S460 . LOH occurred in SMAD2 was 55.1%(27/49).The rate of SMAD2 LOH was 72.0% (18/25) in primary gastric carcinoma with lymph node metastasis , which was significantly higher than that in without lymph node metastasis (P

After 4 weeks old male Sprague-Dawley rats were fed with normal diet and high-fat diet for 10 weeks,the rats were treated with metformin (200 mg/kg) for 6 weeks. Insulin sensitivity was determined by hyperinsulinemic-euglycemic clamp technique.Realtime PCR and western blot were used to measure mRNA and protein levels of chemerin in perirenal adipose tissue of rats.The results showed that the expressions of chemerin mRNA and protein were higher in high-fat diet-induced insulin resistant rats compared with rats fed with normal diet ( both P＜0.05 ),and these incremental findings were diminished by metformin treatment ( both P＜0.01 ).The levels of chemerin mRNA and protein were correlated well with the epididymis fat mass index.