Objective To explore the diagnostic value of color Doppler ultrasonography and ultrasonography in the differential diagnosis of ectopic pregnancy.Methods 142 patients with ectopic pregnancy were given ultrasonic examination,to observe whether intrauterine gestational sac,carefully looking for recognition of ovarian masses and distinguish the relationship and structure,and were compared with pathologic diagnosis.Results Ultrasound could clearly display the uterus,ovary,failed to break the gestational sac and blood(block) mass image structure,with pathological diagnosis coincidence rate was 95.1％ (135/142),the misdiagnosis rate was 1.4％ (2/142),the missed diagnosis rate of 3.5％ (5/142).Conclusion Ultrasound was rapid,simple,noninvasive,high-accuracy,it was the preferred method for early diagnosis of the ectopic pregnancy.

Objective To compare the effects of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) on classifications and locations of choroidal neovascularization (CNV) located under subretinal hemorrhage in age-related macular degeneration, and on the area-measuring of subretinal hemorrhage. Methods The medical record of 177 patients with subretinal hemorrhage associated with AMD confirmed by photochrome of ocular fundus, FFA and ICGA examinations were retrospectively reviewed. The locations and classifications of CNV on the images of FFA and ICGA in the 177 patients and the area of subretinal hemorrhage of 30 patients randomly selected from the 177 patients were analyzed and measured. Results On the images of FFA, the locations and classifications of CNV could be defined in 160 patients (90.4%), and CNV was considered eligible for laser therapy in 24 patients (13.6%). On the images of ICGA, the locations and classifications of CNV could be defined in 175 patients (98.9%),and CNV was considered eligible for laser therapy in 51 patients (28.8%). There was no statistical difference of the locations (Z=-0.383,P=0.701) and classifications (?2=2.993,P=0.810) of CNV on the images of FFA and ICGA. The areas of blocked fluorescence measured on the images of FFA (=26.610 mm2 and M= 13.548 mm2) were larger than those of ICGA (=24.714 mm2, M=12.875 mm2) with statistical differences (Z=-3.000,P=0.003) between FFA and ICGA. Conclusions ICGA is beneficial for imaging CNV located under subretinal hemorrhage, and may increase the number of the patients who are considered eligible for laser treatment. The effect of measurement of the area of subretinal hemorrhage in AMD evaluated by FFA is better.

The etiology of reversible posterior leukoencephalopathy syndrome(RPLS)is more complex.Its pathogenesis has a lot of controversies,and its clinical manifestations are headache, nausea,vomiting,epileptic seizure,consciousness disturbance and visual abnormality.Neuroim- aging examinations have shown that diffuse symmetrical white matter edema is predominantly in the bilateral posterior brain regions.Clinical symptoms and neuroimaging changes can be recov- ered completely after timely and effective treatment.If the treatment is delayed,it may compli- cate with cerebral infarction or hemorrhage,and lead to irreversible damage.

In this study,we isolated and characterized chlorobenzene degrading bacteria from the effluent and sludge samples of one chemical plant.Minimal medium supplemented with chlorobenzene as sole car-bon source was used during the enrichment and domestication process.Seven major bacterial isolates were obtained and purified.Their 16S rRNA genes were amplified by PCR for sequencing and their identities were determined with homology comparisons.Five of the seven isolates belong to Actinomycetales in-cluding Kocuria KD139,Rhodococcus KD140,Rhodococcus KD142,Arthrobacter KD230,and Ar-throbacter KD232;one is classified as Bacillus d KD178;and another one as Stenotrophomonas KD237.The phylogenetic tree was also constructed based on the analysis of 16S rRNA gene sequences.Chloro-benzene concentrations were quantified with gas chromatography to investigate the bio-degradation rates of the isolated strains.Stenotrophomonas KD237 degraded 60.78% chlorobenzene in the minimal medium within 24 h.

Brain Concussion ; complications ; Hearing ; Hearing Disorders ; prevention & control ; Humans ; Thioctic Acid ; therapeutic use

Adult ; Female ; Humans ; Maxillary Sinus Neoplasms ; Middle Aged ; Neoplasms, Muscle Tissue

High fidelity human patient simulator has become more and more important in clinical medical practice education.Medical circle has more and more realized that non-technical skill (NTS) is closely associated with the improvement of medical quality.This paper attempted to carry out a preliminary discussion on theory and practice of applying NTS in simulation training of critical care medicine based on their own teaching experiences.

Background Sphingosine-l-phospate (S1P) is a bioactive lipid and important messenger molecule in cells.It participates in the regulation of many biological processes,such as cell proliferation,migration,survival,differentiation,apoptosis,etc.Hypoxia is a trigger factor of choriod neovascularization (CNV) and pathological basis of many diseases,and retinal pigment epithelial (RPE) cells are involved in formation of CNV.However,the effects of S1P on proliferation and apoptosis of RPE cells are below understood.Objective This study was to investigate the influence of S1P on proliferation and apoptosis of human RPE cells under hypoxic conditions.Methods Human RPE cells line-D407 cells were cultured and passaged and generation 3-5 cells were used and divided into 6 groups.The cells were regularly cultured in the blank control group using DMEM containing 10％ fetal bovine serum.CoCl2(200.00 μmol/L) was added into the colture medium for 2 hours in the hypooxic group.S1P of different concentrations (0.01,0.10,1.00,10.00 μmol/L) were added in culture medium 2 hours after the affection of 200.00 μmol/L CoCl2.The proliferative values of the cells were detected using WST-1 method as the absorbance (A value) and the proliferative rate of different groups were calculated.The apoptosis of the cells was assayed by Hoechst staining.The results were compared among different groups.Results Cultured cells showed the round-like in shape with clear nuclei and pigment.The proliferative values (A value) was 0.91 ±0.08,0.37±0.09,0.46±0.08,0.52±0.09,0.61 ±0.06,0.70±0.10 in the blank control group,hypoxic group and 0.01,0.10,1.00,10.00 μmol/L S1P groups,respectively,with a significant difference among the groups (F=21.104,P=0.000),and A values in various S1P groups were higher than those in the hypoxiac group (all at P＜0.05).The proliferative rate was gradually raised with the increase of dose of S1P.Hoechst staining exhibited a few apoptosis cells in the blank control group,but in the hypoxic group,a lots of apoptosis cells were seen with the light-blue nuclei and condensable chromatin.However,the number of apoptosis cells was significantly decreased in various concentrations of S 1 P groups.The apoptosis rates were (1.21 ±0.08) ％,(8.99 ±0.09) ％,(6.60 ±0.08) ％,(5.95 ±0.09) ％,(4.81 ± 0.06)％ and (3.96±0.10)％ in the blank control group,hypoxic group and the 0.01,0.10,1.00,10.00 μmol/L S1P groups,respectively,with a significant difference among the groups (F =25.070,P =0.000).Compared with the hypoxia group,the cellular apoptosis rates of various S1P groups were lower (all at P＜0.05).Conclusions Under the hypoxia condition,S1P can promote the proliferation of human RPE cells and inhibit apoptosis.

Objective To investigate T cell receptor(TCR)variable β(BV)chain usage at the maternal-fetal interface and explore the relationship between the skewed TCR BV usage and unexplained recurrent spontaneous abortion(BSA).Methods Eighteen cases with unexplained RSA,together with matched 41 women with normal pregnancies in first trimester from Renji Hospital,Shanghai Jiao Tong University were studied.A high-resolution spectrum typing analysis of complementarity-determining region 3 (CDR3)was used to detect and compare the degree and frequency of TCR BV family expression in deciduas between RSA patients and normal controls.Results(1)The expression degree of BV19(0.029±0.031 vs.0.013±0.010,P=0.038)in RSA group showed a higher usage,while BV5.2(0.040±0.035 vs.0.067±0.052,P=0.046)showed a significantly lower usage when compared with normal controls.No significant difference in the expression of the other TCR BV families between RSA and controls were observed(P>0.05).(2),TCR BV2,3,6,and 7 were the four most common BV families in deciduas of patients with RSA and normal controls,whose frequencies were all mors than 50%.In RSA group,higher frequencies of BV15 (33.3%vs.7.3%,P=0.018),BV19(38.9%vs.14.6%,P=0.049)and BV20(33.3%vs.7.3%,P=0.018)were observed;meanuhile lower frequencies of BV4(33.3%vs.65.9%,P=0.026)and BV7 (66.7%vs.92.7%.P=0.018)distributions were observed.The other TCR BV families did not display significantly different freqencies of distribution(P>0.05).Conclusions It is suggested that a significant skewed TCR BV family occurs at the maternal-fetal interface in patients who undergo abortion.The specific skewed usages of TCR BV might be associated with the susceptibility to unexplained pregnancy loss.

Objective To develop a prediction model for functional gain in the activities of daily living (ADL) after stroke rehabilitation. Methods Logistic regression was applied to 896 patient records from two hospitals. Functional gains in ADL were measured using a modified Barthel index (MBI). Results Five parameters were screened in the logistic regression model. The equation was: Logit( P/Y =1)=6.259+1.048 ( first onset to admission interval)+1.242(MBI score at admission)+0.300(number of comorbidities)+1.095(retired cadre dummy)+ 0.906(worker dummy) + 1.384 (professional dummy). This formulation accounted for about 78% of the variance in the data. Conclusions MBI score at admission, the interval between first onset and admission, comorbidities, job status and occupation are the main factors predicting functional ADL gains after stroke. The model can be used to predict outcomes for individual stroke patients at admission to rehabilitation.