Objective To investigate the clinical values of multiple ultrasound soft markers in screening for fetal chromosomal abnormality during first-trimester.Methods Two thousand seven hundred and eighty-nine nulliparas in Department of Obstetrics,the First Affiliated Hospital of Jinan University during early pregnancy (11-13+6 gestational weeks) were selected for this study.Fetalnuchal translucency (NT),facial angle (FA),ductus venosus (DV),fetal heart rate (FHR),tricuspid reverse (TR),nasal bone (NB) and fetal structures were scanned and measured.Risk calculation software (Astraia) was used to calculate the chromosomal abnormal risk (cut-off line:＞1/300) based on ultrasound records.The chorionic villi or amniotic fluid of high risk patients was collected with informed consent for karyotype analysis (prenatal diagnosis).All patients were followed up until six months after delivery.Chi-square test or Fisher exact test was used to compare the difference.Results One hundred and seven cases were high-risk of trisomy 21 among which 96 cases accepted invasive prenatal diagnosis.Sixteen chromosomal anomaly and six trisomy 21 cases were diagnosed out the 96 fetuses.Among 2789 cases,four were high-risk of trisomy 21 according to ultrasound screening.Six cases were diagnosed as trisomy 21.The false positive rate of ultrasound screening was 3.6％(101/2783).There were 196 cases whose NT ≥2.5 mm,in which 66 cases were high risk of chromosomal abnormality,and 16 fetal chromosomal abnormalities were diagnosed after chorionic villus sampling.The invasive procedure rate was 2.3％ (66/2789).Totally,186 pregnant women were older than 35 years,among which 32 cases were high risk.There was no significantly difference on the of rate fetal chromosomal abnormality between the groups of age≥ 35 pregnant women and the general population (P=0.055).But 29.9％ (32/107) high risk cases were detected in the group of age≥35.Five of thirteen fetal malformations cases were associated with abnormal karyotype.Conclusions Multiple ultrasound soft markers screening during early pregnancy could increase the diagnosis rate of chromosomal abnormality and decrease the false positive rate,false negative rate and invasive procedure rate.Early ultrasound screening might be effective in not only identifying chromosomal abnormality,but also diagnosing severe structure deformity of fetus.

Objective To investigate the effect of resistance nodulation division (RND) efflux pumps on reduced susceptibility to tigecycline in carbapenem-resistant Acinetobacter baumanii.Methods Totally 631 isolates of Acinetobacter baumanii were collected from 16 hospitals in 7 provinces in 2010.Genes oxa-51 and oxa-23 were detected by PCR method,and the ST profiles were determined by multilocus sequence typing (MLST).The disk susceptibility assay was used to determine the inhibition zone diameters of β-lactams,aminoglycosides,macrolides,tetracyclines,carbapenems,tigecycline and polymyxin.The minimum inhibitory concentration (MIC) of tigecycline was determined by E-test in strains with inhibition zone diameters ≤ 12 mm on tigecycline.The expression of operon genes adeB,adeG and adeJ was determined with efflux pump inhibitor NMP (N-methyl-2-pyrrolidone) for detection of efflux pump inhibitor phenotype.The isolates of Acinetobacter baumanii which were resistant both to tigecycline and carbapenems and with the inhibited phenotype of efflux pump inhibitor were collected as the experiment group,the isolates which were susceptible to tigecycline but resistant to carbapenems were collected as the control group,and ATCC 19606 was used as the reference strain.The expressions of adeABC,adeFGH and adeIJK were quantified by q-PCR at the transcriptional level.Genes adeR,adeS and adeL were amplified and sequenced using PCR method to find polymorphic locus and insertion sequences.Results There were 32 isolates of Acinetobacter baumanii with reduced susceptibility to tigecycline and carbapenem-resistant.Eight isolates were with the inhibited phenotype by efflux pump inhibitor.And 4 strains which were susceptible to tigecycline but resistant to carbapenems were selected as the control.The expressions of adeABC in A518,Z1219 and A527 of experiment group were 13-fold,5-fold and 7-fold higher than reference strain ATCC19606,respectively.The expressions of adeFGH and adeIJK were up-regulated slightly in some isolates.Transcript of adeABC was not found in control group strains A207 and A1731,and the expressions of adeABC,adeFGH and adeIJK were not up-regulated in other isolates.The single nucleotide polymorphism (SNP) was detected in adeR (E220K) and adeS (A130D),respectively.ISAab1 insertion sequence was identified in adeS of adeABC-over expressed isolates.No mutation was found in adeL.Conclusion High expression of adeABC pump may play an important role in tigecycline resistance in carbapenem-resistant Acinetobacter baumannii,mainly due to the insertion of ISAba1 sequence in its regulator gene adeS,but other mechanism of tigecycline resistance may not be excluded.

Objective To explore the changes of Clara cell secretory protein(CCSP) in asthmatic children and the effects of inhaling glucocorticoid (ICS) on CCSP.Methods Sixty children with asthma were selected as asthma group(in which 39 cases were male and 21 cases were female,aged 3-12 years old) and 30 healthy children were selected as healthy control group(in which 20 cases were male and 10 cases were female,aged 3-12 years old).Venous blood samples were collected in asthma group and healthy control group in morning before breakfast,and then sera were obtained by centrifuge in speed of 1 500 r?min-1 in 10 min.The dynamic levels of CCSP were measured in sera by enzyme-linked immunosorbent assay.Results 1.In asthmatic children,the CCSP levels in acute episode,3 months after ICS,6 months after ICS, and 12 months after ICS[(5.140?2.331)?g?L-1,(8.730?3.392)?g?L-1,(10.510?2.813)?g?L-1]were all lower than that in healthy control group[(13.230?4.010)?g?L-1](Pa0.05).2.Compared with acute episode,the patients who ICS for 3 months,6 months and 12 months had significantly higher levels of CCSP (Pa0.05).Conclusions CCSP may play a protective role in the airway inflammation of asthma.Glucocorticoid may increase CCSP level in asthmatic children.Glucocorticoid and CCSP may cooperate in anti-inflammation in airway of asthmatic children.

· AIM: This study was designed to evaluate the effectiveness of anterior lens capsule inclusion in combined trabeculectomy and cataract surgery in preventing scar formation of the filtering bleb in rabbit model.· METHODS: Twerty-Four eyes (12 rabbits) with glaucoma model were studied, anterior lens capsule inclusion in trabeculectomy with the small-incision cataract surgery were performed on all right eyes (experimental group) and no implants were applicator in trabeculectomy with the small-incision cataract surgery on all left eyes (control group). These operated eyes were followed up from day 1 to 6 months postoperatively. Intraocular pressure (IOP) was measured and filtering blebs were observed after surgery. Other main outcome measures: cornea、conjunctiva、formation of the anterior chamber, anterior chamber depth、inflammatory reaction、achievement ratio of operation and complications were analyzed. On week 1, 2, 4, 12 and 24 after surgery the animal were killed in batch. Tissue was harvested from the bleb area and was made pathological section. HE staining、light microscope and micro photo analysis technique were applied to observe the cytological and histopathologic characteristics of the filtering tunnels.· RESULTS: There were significant differences between the two groups on IOP (1, 2, 4 weeks)、filtration bleb, achievement ratio of operation and complications. In experimental group, at the first month postoperatively, anterior lens capsule absorption started with inflammatory characteristics. The peak of inflammatory reaction occurred 1 week after operation and all the cells in the filtrating tunnel disappeared 6month after surgery. The fibroblast proliferation in control group occurred at I week and the filtrating tunnel closed with angiogenesis at 1 month after surgery. Fibroblast proliferation started 1week after surgery with no statistical difference during the time course (P ＞0.05). Significant statistical differences were observed by comparing the fibro blasts numbers per unit area in the filtrating tunnel in experimental group and those in control groups (P＜0.05).· CONCLUSION: Anterior lens capsule was totally absorbed at 6 months postoperatively. Anterior lens capsule inclusion in trabeculectomy with cataract surgery can possibly control intraocular pressure effectively, long-term sustainability of functional filtration bleb, inhibition of the proliferation of fibroblasts and opening of the filtrating pathway in the experimental animal models were satisfied. Compared to the control group, anterior lens capsule application has less complication.

Acute Disease ; Adult ; Autopsy ; Bridged-Ring Compounds ; poisoning ; Child ; Humans ; Male ; Poisoning ; pathology ; Rodenticides ; poisoning

Objective To compare the development of gastric insufflation related to different peak inspiratory pressures (PIPs) during facemask ventilation in the pediatric patients.Methods Ninety male pediatric patients,aged 2-4 yr,of American Society of Anesthesiologists physical status Ⅰ,scheduled for elective surgery under general anesthesia,were randomly divided into 5 groups (n =18 each) using a random number table:PIP 8 cmH2O group (group P8),PIP 10 cmH2O group (group P10),PIP 12 cm H2O group (groupP12),PIP 14cmH2O group (group P14) and PIP 16 cmH2O group (group P16).Anesthesia was induced with fentanil,propofol and rocuronium in sequence.After loss of eyelash reflex,positive pressure facemask ventilation was performed for a 120 s period in pressure-controlled mode.Gastric insufflation was detected by real-time ultrasonography of the antrum,and cross-sectional antral area was measured using ultrasonography before facemask ventilation and at 120 s of facemask ventilation.The pulse oximetry (SpO2),tidal volume (VT),end-tidal pressure of carbon dioxide (PETCO2) and end-tidal oxygen concentration (ETO2) were recorded at 30,60,90,and 120 s of facemask ventilation.The development of gastric insufflation and hypoventilation was recorded.Results Compared with group P8,the incidence of gastric insufflation was significantly increased in group P16 (P＜0.01),and no significant change was found in the incidence of gastric insufflation in the other groups (P＞0.05),the incidence of hypoventilation was significantly decreased,VT and ETO2 were increased,and PET CO2 was decreased in P12,P14 and P16 groups,and PETCO2 was significantly decreased at 120 s of facemask ventilation (P＜ 0.05 or 0.01),and no significant change was found in the other parameters in group P10 (P＞0.05).Compared with P12 and P14 groups,VT was significantly increased,PEHTCO2 was decreased at 120 s of facemask ventilation (P＜0.05),and no significant change was found in the incidence of hypoventilation and ETO2 in group P16 (P＞0.05).There was no significant difference between group P12 and group P14 in the incidence of hypoventilation,VT,PETCO2 and ETO2 (P＞0.05).The pediatric patients showed a certain CO2 accumulation [PETCO2 (40.6±4.0) mmHg] at 120 s of facemask ventilation in group P8,and the pediatric patients showed excessive ventilation [PETCO2 (23.6± 1.4) mmHg],and cross-sectional antral area was not measured using ultrasonography in three cases because of excessive gastric insufflation in group P16.Conclusion PIP at 12-14 mmHg in pressure-controlled ventilation mode can not only ensure adequate preoxygenation and but also avoid excessive gastric insufflation during facemask ventilation in the pediatric patients.

Objective To observe the treatment of ~(99)Te-MDP on typeⅡcollagen induced arthritis (CIA)in rat,and the effect on the expression of synovial MMP-3 and TIMP-1 mRNA.To explore the mech anisms of the ~(99)Te-MDP in the treatment of rheumatoid arthritis.Methods The rats in which C1A(n=24)were divided into three group:the control group(n=8),~(99)Tc-MDP group(n=8)and Methotrexate group(n=8). Arthritis were evaluated by arthritis index and histopathological index and the expressions of MMP-3 and TIMP-1 mRNA in synovium were detected by RT-PCR.Results①The arthritis indexs of the control group, the methotrexate group,the ~(99)Tc-MDP group were increased with time.②The histopathological scnres of the control group were significantly higher than those of methotrexate group and ~(99)Tc-MDP group(P＜0.01).The histopathological scores of cartilage destruction and bone erosion of ~(99)Tc-MDP group were lower than those of methotrexate group(P＜0.05).③The levels of MMP-3 mRNA of the control group,~(99)Tc-MDP group, methotrexate group were notably higher than those of the control group(P＜0.01).The levels of control group was notably higher than that of the ~(99)Tc-MDP group(P＜0.05).There was not significant difference in all groups on the levels of TIMP-1 mRNA(P＞0.05).Conclusions ~(99)Tc-MDP can notably relieve the arthritis symdrome and retard the catilage damage and bone erosion of CIA in rats,and could significantly decrease the MMP-3 mRNA in the synovium.Which may be one of the therapeutic mechanism.~(99)Tc-MDP is better than methotrexate in retarding catilage and bone erosion and decreasing MMP-3 mRNA in CIA rats in a 3-week therapeutic intervention.

Objective To explore roles of total immunoglobulin E(IgE),interleukin-13(IL-13) in asthmatic children,and relation-ship between IgE,IL-13 levels in serum and those in induced sputum.Methods Twenty-six children with asthma who were in chronic persistent period and 20 healthy children were enrolled.Serum and hypertonic saline-induced sputum were obtained in asthmatic children,and serum alone were obtained in control subjects.The levels of IgE were deteced in serum and induced sputum by Pharmacia UniCAP system,and levels of IL-13 were measured by enzyme linked immunosorbent assay(ELISA).Results Asthmatic children had significantly higher serum of IgE and IL-13 levels than those of healthy control group(P0.05).There was positive correlation of IL-13 in serum and induced sputum(r=0.432 P

Objective To study the regulatory effect of interferons(IFNs) on retinoic acid-inducible gene-Ⅰ(RIG-Ⅰ) and the roles of RIG-Ⅰ in IFNs signaling pathway. Methods RIG-Ⅰ expression before and after IFNs treatment in mouse embryonic fibroblasts(MEFs) were analyzed with Northern blotting and semi-quantitative RT-PCR assay.MEFs isolated from wild-type and RIG-Ⅰ-/-mice were used to test growth inhibition and antiviral activity of IFNs with MTT assay and cytopathic effect inhibition assay. Results Both IFN-? and IFN-? could induce RIG-Ⅰ expression in MEFs.Treated with 100 U/mL IFN-?,growth inhibition and antiviral activity of MEFs from wild-type mice were more significant than those from RIG-Ⅰ-/-mice.With the absence of RIG-Ⅰ,the antiviral protective role IFN-? plays was significantly weaker than the wild type. Conclusion RIG-Ⅰ gene is a novel mediator of interferon effects on cells.It may participate in the inflammation responses mediated by IFNs through modulating cytokines production.

Objective: To analyze the prevalence and predictor for left ventricular reverse remodeling (LVRR) in patients of primary hypertension combining left ventricular systolic dysfunction (LVSD) with tailored medication.
Methods: A total of 118 consecutive patients admitted in our unit from 2010-08 to 2012-10 with the base line left ventricular ejection fraction (LVEF)≤40%were enrolled. The demographic and clinical information with the findings of echocardiography at admission were collected. The patients were followed-up until 2013-12 or until the all cause death/cardiac transplantation. According to echocardiography, LVRR was deifned by 2 criteria at the same time:①the absolute elevation of
LVEF≥10%than base line and the follow-up LVEF≥50%,②the relative reduction of left ventricular end-diastolic diameter (LVEDD) index≥10%than base line and the follow-up LVEDD index≤27 mm/m2. LVRR prevalence with its base line predictor was investigated.
Results: The overall mean follow-up time was (23 ± 15) months, and 39/118 (33.1%) patients acquired LVRR as LVEF from the base line level (30.6 ± 6.8)%increased to the follow-up level (57.0 ± 4.9)%;LVEDD index from the base line level (31.6 ± 3.9) mm/m2 decreased to the follow-up level (24.4 ± 1.9) mm/m2, all P<0.01. The average time length for reaching LVRR was (11 ± 9) months, and 27/39 (69.2%) patients reached LVRR within 12 months. There were 79 patients not reached to LVRR, while their LVEF also from the base line level (28.6 ± 6.1)%increased to the follow-up level (39.0 ± 13.2)%;LVEDD index from the base line level (38.1 ± 5.6) mm/m2 decreased to the follow-up level (36.1 ± 6.9) mm/m2. Multivariable logistic regression analysis indicated that the patients with the shorter duration of heart failure (HF) as>6 months vs≤6 months (OR=0.244, P<0.01), shorter QRS interval as≥120ms vs<120ms (OR=0.276, P<0.05) and the higher quartile of systolic blood pressure (SBP)/LVEDD index (OR=2.724, P<0.01) at admission were the independent predictors for LVRR.
Conclusion:With tailored medication, about 1/3 of patients with hypertension combining LVSD could acquire LVRR, the patients with shorter duration of HF, shorter QRS interval and higher ratio of SBP/LVEDD index had more possibilities.