Objective To evaluate therapeutic effect and safety of hysteroscope operation in treating hysteromyoma. Methods 146 patients were subjected to transcervical resection of myoma (TCRM), curative effects were evaluated as satisfaction or dis-satisfaction according to the degree of bleeding control, the rate of growth of myoma and the need of subsequent surgery. Results The total satisfactory rate is 95%. and satisfactory rate of type 0 and Ⅰ reached 100%. There was no complication in all patients. Conclusion TCRM is the best choice in treating submucous myoma. The results of surgery were satisfactory to intramural myoma if gasp the indictions. Selecting proper indications for operation, B ultrasonic monitoring severity are important for ensuring the operation effect and safety.

Objective To explore the clinical significance of the three indicators combined detection that plasma endotoxin,pro-calcitonin (PCT)and (1,3)-β-D-glucan(BG)in pulmonary tuberculosis patients complicated with bacterial,fungal infection.Methods Retrospective investigation was conducted in 240 pulmonary tuberculosis patients,who were divided into gram negative bacteria (G- )group(39cases),gram positive bacteria (G+ )group(45 cases)including fungal,germ-free group(156 cases).Other 45 healthy people were selected into control group.The levels of plasma endotoxin,PCT and BG in the four groups were compared.Results The levels of plasma endotoxin(0.682±0.418)EU/mL,PCT(2.93±0.87)μg/L in the G- group were significant higher than those of the G+ group (0.063±0.034)EU/mL,(0.85±0.52)μg/L,the difference was significant (P <0.05).The levels of the plasma endotoxin,PCT in the G- group were higher than those of the germ-free group.The levels of plasma endotoxin,PCT and BG in the control group had no significant difference with those of the germ-free group.Conclusion The combined detection of plasma endo-toxin,PCT and BG have some clinical value on the early diagnosis of the patients with pulmonary tuberculosis complicated with G-fungal infection for the advantages of fast and sensitiveness.

ObjectiveTo explore the relationship between the expression of Dishevelled2 and Vangl2 and the embryonic neural tube defects (NTDs) induced by all-trans retinoic acid (RA)in Kunming mouse. Methods Fifty pregnant mice were randomly divided into control and RA-treated groups.RA-treated mice were fed with 30mg/kg RA dissolved with peanut oil on embryo 7.75 days, while the mice of control group were administrated with an equal volume of peanut oil on the same time. Then all the embryos were sampled from pregnant mice at the 4th, 18th, 42nd, 66th and 90th hour after treatment. In situ hybridization and immunohistochemical staining technique were used to detect the expression of Dishevelled2 and Vangl2 in embryonic neural tube. Results The two proteins both existed in the epithelial tissue of the mouse embryonic neural tube and displayed different expression modes at various developmental stages.Compared with the control group, the RA treated group showed a significant decrease (P≤0.05) at the 18th and 42nd hour and a significant increase (P≤0.05) at the 66th hour in Dishevelled2 protein after maternal treatment, and no significant difference was found at the 90th hour. Compared with the control group, the Vangl2 mRNA expression in the RA treated group displayed a significant decrease (P≤0.05) at the 4th and 18th hour and a significant increase (P≤0.05) at the 66th hour after RA treatment, and no difference was found at the 42nd hour. Compared with the control group, the expression of Vangl2 protein in the RA treated group decreased (P≤0.05) at the 18th and 42nd hour, and increased (P≤0.05) at the 90th hour after RA treatment, no difference was found at the 66th hour. Conclusion Excessive RA may interfere with the normal embryonic neural tube closure by regulating the expression of Dishevelled2 and Vangl2.

Objective To study the association between paternal CD3, CD4 and CD8 antigenecity to their pregnant spouses and the development of pregnancy induced hypertension (PIH). Methods Maternal serum from 15 women with PIH in the third trimester and 82 in normal pregnancies (16 in the first, 32 in the second and 34 in the third trimester) were incubated with paternal T lymphocytes. Monoclonal CD3, CD4 and CD8 fluorescent conjugated antibodies were then added and the percentage of paternal T cell differentiation antigen CD3, CD4 and CD8 were measured by flow cytometry. Results During normal pregnancy, the levels of maternal serum blocking antibodies on paternal CD3, CD4 and CD8 were (4.14?1.02, 2.02 ?0.24, 2.37?1.05)% in first trimester, (-0.29?0.13, 1.03?0.27, 0.65?0.23)% in the second trimester and (-1.33?1.47,0.15?0.01, -1.04? 0.37)% in the third trimester. There were significant difference between them( P

Objective To study the epidemiological characteristics and influencing factors of hand-foot-mouth dis-ease(HFMD)outbreaks in kindergartens,so as to provide reference for control and prevention of HFMD. Methods Papers published between 2009 and 2015 about HFMD outbreaks in kindergartens were retrieved from Wanfang database and China National Knowledge Infrastructure (CNKI),then collected papers were analyzed. Results Data about 39 cases of HFMD outbreaks were obtained,35 cases occurred in 2008-2012,1 case occurred respectively in 2007,2013,2014,and 2015. 33.34% and 23.08% of outbreaks occurred in May and April. Out-breaks lasted 5-52 days,with a median of 11 days,30.77% of outbreaks lasted more than 2 weeks. The attack rates of the whole kindergartens were 1.90% -39.74% ,attack rates of whole kindergartens were 5% -15% a-mong 65.79% of outbreaks,attack rate of whole kindergartens was >20% among 13.16% of outbreaks. 85.71%of outbreaks involved more than 20% of classes,25.71% of which involved all classes. Both EV71 and CoxA16 caused HFMD outbreaks in kindergartens,two kinds of viruses were both detected in some outbreaks;there were no significant difference in attack rate of whole kindergartens,attack rate of classes with highest incidence,class in-volving rate,and duration of epidemic between EV71 and CoxA16 epidemic groups(all P>0.05).Conclusion Once an HFMD outbreak occurred in a kindergarten,epidemic intensity would be high,both EV71 and CoxA16 can cause HFMD outbreak. There is no obvious correlation between class size and attack rate.

BACKGROUND:The hip is a complicated structure and irregular in shape. It is hard to measure stress distribution and transmission. OBJECTIVE:To establish a three-dimensional finite element model of the hip joint and upper femur, and analyze the stress distribution and transmission characteristics of the acetabulum region under different loads, and explore mechanics mechanism of hip fracture based on CT data. METHODS:The three-dimensional finite element hip and femur model were reconstructed in Mimics 14.0 based on the CT data of a healthy adult man. After dividing mesh, assigning material and transforming into finite element model, the stress distributions of anterior wal , the top, and the posterior wal of the acetabulum, the stress of acetabulum areas and displacement of acetabular unit were calculated with finite element software Ansys 13.0 software under 300, 600, 900 and 1 200 N. RESULTS AND CONCLUSION:(1) A three-dimensional finite element model of the hip and the femur was successful y established, consisting of 284 183 nodes and 160 665 units. (2) The characteristics of the stress distribution of acetabulum region:the maximal stress was concentrated on the posterosuperior part of acetabular crest, fol owed by the posterior wal and the anterior wal in order in upright position under different loads. The stress transmitted by four ways:from acetabular crest to ilium, along linea terminalis of pelvis to sacroiliac joint, in the acetabular sockets, and along the pubic ramus. The stress and the propagation distance were increasing as the loads increased. Acetabular element stress variable was increased. (3) Above results indicated that three-dimensional finite element model of the human hip joint established by Mimics 14.0 based on CT data matches the anatomical structure in a great degree, could be used in the biomechanics analysis under different loads, and has a guiding significance for design of artificial hip prosthesis.

Objective To compare the effect of three β-thalassemia prenatal screening strategies in Guangdong province. Methods A total of 13 284 hospital-delivered couples and 13 369 newborns were recruited from 91 hospitals in 21 counties or districts of Guangdong province from June to December 2012. Mean cell volume (MCV), mean corpuscular hemoglobin (MCH) and hemoglobin A2 (Hb A2) were tested for all the couples, and all the couples and newborns were detected by 17 types ofβ-globin gene mutations. The effect of three β-thalassemia prenatal screening strategies were compared as following:(1) MCV/MCH with Hb A2 serial screening(SS):Hb A2 was tested if the woman′s MCV<82 fl and(or)MCH<27 pg. If the woman′s Hb A2>3.5, it meant positive. And if the woman wasβ-thalassemia carrier and her husband′s Hb A2>3.5, it meant couple positive. (2) MCV/MCH with Hb A2 parallel screening(PS):if the woman′s MCV<82 fl and (or) MCH<27 pg and(or) Hb A2>3.5 pg, it meant couple positive. And the husband would be tested forβ-globin gene mutations if the woman was β-thalassemia carrier. (3) MCV/MCH with Hb A2 serial screening for couples(SSC):if one of the couple or both of them had MCV<82 fl and(or) MCH<27 pg, the couple would be tested for Hb A2, and if one of the couple got Hb A2>3.5, it meant couple positive. Results (1) For the SS strategy, the sensitivity was 92.69%(583/629);the specificity was 99.87%(12 638/12 655); the positive predictive value was 97.17%(583/600);and the negative predictive value was 99.64%(12 638/12 684). The results ofβ-globin gene mutations tested showed that the rate ofβ-thalassemia carriers was 4.74%(629/13 284) in the 13 284 pregnant women, and it was 4.29%(570/13 284) in their husbands. (2) The SS strategy detected 27 (0.20%,27/13 284) β-thalassemia carrier couples. For the SS strategy detecting β-thalassemia carrier couples, the missed diagnosis rate was 11.11%(3/27);the sensitivity was 88.89%(24/27);the specificity was 100.00%(27/27); the positive predictive value was 100.00%(24/24); and the negative predictive value was 99.98%(13 257/13 260). (3) When using the SS strategy for 13 369 offsprings, there were 582β-thalassemia carriers (4.35%,582/13 369), including 578 (99.31%,578/582) minorβ-thalassemia, 3 (0.52%,3/582) intermediaβ-thalassemia and 1 (0.17%,1/582) major β-thalassemia. The SS strategy detected 25 fetuses who neededβ-thalassemia prenatal diagnosis. (4) For the PS strategy, the sensitivity was 98.09%(617/629); the specificity was 88.73%(11 229/12 655); the positive predictive value was 30.20%(617/2 043); and the negative predictive value was 99.89%(11 229/11 241). (5) When using the PS strategy for theβ-thalassemia carrier couples, the sensitivity was 100.00%(27/27);the specificity was 95.55%(12 667/13 257);the positive predictive value was 4.38%(27/617);and the negative predictive value was 100.0%(12 667/12 667). (6) The PS strategy detected 28 fetuses who needed β-thalassemia prenatal diagnosis in 13 369 offsprings. (7) For the SSC strategy, the sensitivity was 93.80%(590/629); the specificity was 95.75%(12 117/12 655); the positive predictive value was 52.30%(590/1 128); and the negative predictive value was 99.68%(12 117/12 156). When the SSC strategy was used for the husbands, the sensitivity was 92.28%(526/570); the specificity was 95.27%(12 112/12 714);the positive predictive value was 46.63%(526/1 128); and the negative predictive value was 99.64%(12 112/12 156). (8) When the SSC strategy was used inβ-thalassemia carrier couples, the sensitivity was 100.00%(27/27);the specificity was 91.69%(12 156/13 257);the positive predictive value was 2.39%(27/1 128);and the negative predictive value was 100.00%(12 156/12 156). (9) The SSC strategy detected 28 fetuses who neededβ-thalassemia prenatal diagnosis. Conclusions All the three β-thalassemia prenatal screening strategies had good effect in clinical practice and public health. While in the high-prone area of β-thalassemia, MCV/MCH with Hb A2 parallel screening and MCV/MCH with Hb A2 serial screening for couples stratigies were better.

Objective To detect the antibodies of streptococcal C5a peptidase from group B streptococcus(SCPB)in neonates,demonstrate the existence of SCPB antibody in pregnant women after natural group B streptococcus(GBS)infection,and provide clinical evidence for prevention of GBS infection. Methods Sera were collected from 107 neonates(80 term infants and 27 premature infant)between February 2007 and December 2007. The antibodies of SCPB were detected using ELISA method,and cultures of GBS were done simultaneously. Results 21(19.6%)newborns were found to be SCPB antibody positive(including 20 term infants and 1 premature infant),the difference of positive ratio between term and premature infant was significant(25% and 3.7%,respectively). Conclusions This study indicated that pregnant women could produce SCPB antibody by immune response,and transmitted it to the infants through the placenta. Further study is needed to clarify the effect of SCPB antibody in expectant mother and newborn with GBS infection.

Objective To investigate the predominant genotypes of β-lactamase in Klebsiella pneu-moniae isolates and the mechanism of antibiotic and histidine kinase inhibitor in affecting β-lactamase gene expression .Methods Tube dilution method and E-test were used to detect the susceptibility of K.pneumon-iae isolates to β-lactam antibiotics .The major genotypes of β-lactamase in β-lactam antibiotic-resistant iso-lates were identified by PCR and sequencing method .Disk diffusion test was performed to analyze the activity ofβ-lactamase .The effects of cefotaxime and histidine kinase inhibitor closantel on the expression of β-lac-tamase gene were evaluated by real-time fluorescent quantitative RT-PCR.Results All of the 118 β-lactam antibiotic-resistant K.pneumoniae isolates expressed β-lactamase, 90.7%(107/118) of which were KPC-2, TEM-1, CTX-M-14, SHV-11 and/or OXA-1 gene positive.The positive rates of TEM-1 (71.0%) and SHV-11 (64.5%) were significantly higher than that of the other three genotypes ( P<0.05).68.2%(73/107) of the isolates possessed two or more than two β-lactamase genotypes, and 30.8%(33/107) iso-lates were identified as TEM-1+SHV-11 genotype.Except for KPC-2 mRNA, the levels of TEM-1, SHV-11, CTX-M-14 and OXA-1 mRNA were significantly up-regulated by cefotaxime at MIC/4 (P<0.05), but were inhibited by 100μmol/L closantel (P<0.05).Conclusion TEM-1 and SHV-11 are the majorβ-lactamase genotypes carried by K.pneumoniae strains isolated from Zhejiang area , and TEM-1 plus SHV-11 ( TEM-1+SHV-11) is the predominant carrying mode of the β-lactamase genotypes .Sublethal dose of cefotaxime can enhance the expression of β-lactamase genes in K.pneumoniae, while the histidine kinase inhibitor , closan-tel, can block the increased expression of β-lactamase genes induced by cefotaxime .

Objective There is a high occurrence rate of thalassaemia in Guangdong Province .Major and intermedia thalas-saemia bring severe burden for patients , families, and societies.This study aimed to reveal the economic burden of thalassaemia major and intermedia thalassaemia in Guangdong Province . Methods Eight areas of Guangdong Province were selected as the sampling ar-eas.Patients with major or intermedia thalassaemia were enrolled in the study .The patients′economic burden of this disease , inclu-ding direct economic burden , indirect economic burden and intangible economic burden was calcultated .The direct economic burden was estimated by outpatient fee , hospitalization expense , nutrition and transportation fees , indirect economic burden was evaluated u-sing disability adjusted life years ( DALY) combined with human capital , and intangible economic burden was calculated using method of willingness. Results Per average annual direct economic burden of 45 patients with major or intermedia thalassaemia was 43 058.66 yuan, per average annual indirect economic burden was 20 474.51 yuan, and per person intangible economic burden was 302 466.67 yuan. Conclusion Economic burden of major and intermedia thalassaemia is huge and most patients do not receive standardized treatment .More effective way should be taken to reduce the economic burden of thalassaemia and help the patients to re -ceive standardized treatment .