Objective To identify the arteriographic manifestations of emergency uterine artery angiography and the efficacy of embolization treatment of postcesarean massive hemorrhage caused by placenta previa.Methods Emergency uterine artery angiogra-phy was performed in 35 patients with massive hemorrhage after cesarean section due to placenta previa.Emergency uterine arterial embolization (EUAE)was conducted using embolic agents such as tricacryl gelatin microsphere (TAGM)and gelatin sponge.Arte-riographic manifestations and effect of the emolotherapy were analyzed retrospectively.Results Contrast extravasations were con-firmed in 27 patients,and uterine artery pseudoaneurysms were in 8.The hemorrhage completely stopped after embolotherapy in all patients.A 12 month follow-up showed no recurrence hemorrhage and any severe complications were observed in all patients,such as necrosis of the uterus and ovary.Conclusion EUAE can be used as a safe,effective and minimally invasive therapeutic option for postcesarean massive hemorrhage caused by placenta previa.It is the key for the success of embolotherapy to choice and use reasona-ble embolic agents.

Objeetive To detect ERG11 gene mutations in clinical isolares of Candida albicans resistant to fluconazole.and discuss their relationship with formation of drug resistance.Methods Clinical specimens were collected.CHROMagar mediuln and amplification of the fragment spanning the conserved sequence of 25S rDNA including some transposable introns.were used to identify subtype Candida albicans isolates.FIuconazole sensitivity was detected in vitro through microdilution and Rosco tablets.The other three fragment of ERG11 gene were amplified and followed by sequencing with resistant type strain ATCC 76615-19 and Candida albicans Darlington strain with two sensitive isolates as controh.Results Fifteen resistant isolates of Candida albicans were found,all of which were type A.Sixteen silent mutations and 11 missense mutations were detected.Mutations in ATCC 76615-19 and Darlington strain were same with what had been reported.In the 2 sensitive strains.G640A(E165K),A945C(E266D)and G1609A/G(V488I)occurred,as well as the other 9 silent mutations.Only G487T(A114S)and T916C(Y257H)existed in each of 14 resistant isolates.In the other one resistant isolate,T541C(Y132H),T495A(D116E),A530C (K128T)and T1493A(F449Y)occurred Mong with 8 silent mutations.Conclusions The occurrence of G487T(A114S)and 1916C(Y257H)in 14 isolates from different sources suggested they may involve in fluconazole resistance.The novel mutation T1493A(F449Y)can appear in resistant isolves of Candida albicans.

BACKGROUND:Compared with conservative treatment, percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) can rapidly relieve the pain caused by the compression of osteoporotic vertebral body. However, the perfusion of bone cement can not only restore the rigidity of fractured vertebrae, but also theoretical y alter the stress distribution of fractured vertebrae and increase the stress load of adjacent vertebrae, thus causing adjacent intervertebral disc degeneration. ＜br> OBJECTIVE:To observe the effects of PVP and PKP on the adjacent intervertebral disc degeneration and explore the possible mechanism. ＜br> METHODS:A total of 85 patients with osteoporotic vertebral compression fracture were divided into three groups:conservative treatment group (n=23), PVP group (n=42) and PKP group (n=23). ODI scores, DHI, MRII, and peripheral interleukin-1β, interleukin-6, tumor necrosis factor-αlevels were col ected and analyzed at different time points. ＜br> RESULTS AND CONCLUSION:The results showed that, PVP group and PKP group relieved pain effectively, reduced the time in bed, and had a better treatment satisfaction, but there were no significant differences in the scores of ODI scores between PVP group and PKP group at 24 months after discharge (P>0.05). At 24 months after discharge, MRII in the PVP group and PKP group were lower than that in conservative treatment group and before treatment (P＜0.05), while peripheral interleukin-1, interleukin-6, tumor necrosis factor-αlevels were higher (P＜0.05), there were significant differences between PVP group and PKP group (P＜0.05). The disc degeneration adjacent to the fractured vertebral body can be accelerated by PVP and PKP procedures, and the latter is more serious. Interleukin-1, interleukin-6, tumor necrosis factor-αlevels are closely related to the degree of intervertebral disc degeneration.

BACKGROUND:Destroying posterior stable structure of cervical vertebra may facilitate the ligamentum flavum regeneration. Whether anterior cervical instability can induce the regeneration in posterior and adjacent ligamentum flavum remains unclear.
OBJECTIVE:To observe the changes of transforming growth factor-β1 expression and histopathology in the ligamentum flavum of cervical instability animal models.
METHODS:Thirty-six New Zealand white rabbits were randomly divided into control group and experimental group, with 18 rabbits in each group. In the experimental group, cervical instability animal models were established made through destroying annulus fibrosus by anterior puncture and absorbing nucleus pulposus in C4/5 . And no intervention was given to the control group.
RESULTS AND CONCLUSION:Compared with the control group, fibers in the C 3/4, 4/5, 5/6 ligamentum flavum arranged disorderly and the glass like degeneration was found in the experimental group. The expression of transforming growth factor-β1 in ligamentum flavum was increased, especial y in C 4/5 , in the experimental group. At 4, 8, 12 weeks, transforming growth factor-β1 expression in the C 3/4, 4/5, 5/6 ligamentum flavum segments was similar between the two groups. Experimental findings indicate that, anterior cervical instability can induce the regeneration in posterior ligamentum flavum, especial y in the injured segment.

The vast majority of vertebral compression fractures are caused by osteoporosis and vertebral tumor,which lead to the pain of a fracture and intervertebral height lost.In recent 20 years,the use of percutaneous vertebroplasty and percutaneous kyphoplasty,a kind of minimally invasive surgery method intended for the vertebral compression fractures,are rising up for patients with vertebral compression fractures,which can quickly relieve patients' pain and restore injured vertebral deformities.Percutaneous vertebroplasty injects bone cement into fractures through a small incision.However,percutaneous kyphoplasty injects a balloon into a fracture to make a cavity by expending and shrinking,which is filled with filler material,and then removes the balloon,and injects bone cement.This article mainly reviews development,curative effect and safety,clinical application and future aspects.of the percutaneous vertebroplasty and percutaneous kyphoplasty.

Objective To investigate the influence factors of serum CA125 level in patients with ovarian chocolate cysts,and to study the effect on serum CA125 level of interventional therapy.Methods A total of 103 patients with single unilateral chocolate cyst of ovary underwent interventional treatment.According the serum CA125 level before interventional therapy,the patients were divided into normal group (CA125≤35 U/ml) and abnormal group (35 U/ml＜CA125≤200 U/ml).The clinical indexes of patients and ultrasound characteristics of cyst were compared between the two groups.The changes of serum CA125 levels before and after interventional therapy were analyzed.Results The difference of the course of diseases,dysmenorrhea history,diameter of cysts had statistical difference between the two groups (all P＜0.05).There were no statistical differences of age,history of dilivery,abortion history,history of pelvic surgery,cyst location between the two groups (all P＞0.05).In abnormal group,the mean serum level of CA125 reduced at 3 months (P＜0.000 1) and 6 months (P ＜0.000 1) after interventional therapy.In the normal group,there was no significant difference of the mean serum level of CA125 before and after interventional therapy (all P＞0.05).Conclusion Serum CA125 level is influenced by dysmenorrhea history,course of disease,diameter of cysts.Ultrasound-guided interventional therapy has intervention effect on patients with abnormal serum CA125 level before interventional therapy.

Objective To analyze the internal fixator remove time in different age patients after non-fusion cross injured vertebral screw of thoracolumbar vertebral fracture. Methods Sixty-eight patients who had underwent non-fusion cross injured vertebral screw were divided into 2 group according to the age:young group (20-44 years, 36 cases) and middle aged group (45-59 years, 32 cases). The numeric rating score (NRS), Oswestry disablility index (ODI), discoideum index (DI) and kyphotic Cobb angle 6, 9, 12 and 15 months after surgery were compared between 2 groups. Results The kyphotic Cobb angle, ODI and NRS 9, 12 and 15 months after surgery in 2 groups were significantly lower than those 6 months after surgery, which was in young group: (37.34 ± 6.86)° , (36.81 ± 6.78)° and (36.90 ± 6.97)° vs. (56.31 ± 3.56)° , (2.45 ± 0.55)%, (2.24 ± 0.53)% and (2.09 ± 0.41)% vs. (3.02 ± 0.89)%, (18.46 ± 2.73), (18.44 ± 3.05) and (18.28 ± 2.98) scores vs. (19.79 ± 2.85) scores, and in middle aged group: (37.11 ± 6.80)° , (35.58 ± 5.48)° and (35.40 ± 5.44)° vs. (56.03 ± 3.68)° , (2.21 ± 0.41)%, (2.08 ± 0.43)%and (1.97 ± 0.39)%vs. (3.04 ± 0.93)%, (19.17 ± 2.99), (18.57 ± 2.98) and (18. 43 ± 2.92) scores vs. (20.95 ± 2.49) scores. There were statistical differences (P<0.05). The DI 12 and 15 months after surgery in young group were significantly lower than that 6 and 9 months after surgery:(50.59 ± 4.60)%and (47.57 ± 4.30)%vs. (56.60 ± 3.98)%and (56.32 ± 3.87)%, and there were statistical differences (P<0.05). The DI 15 months after surgery in middle aged group was significantly lower than that 6, 9 and 12 months after surgery:(47.95 ± 4.87)%vs. (56.34 ± 3.97)%, (56.13 ± 3.88)%and (55.63 ± 3.94)%, and there were statistical differences (P<0.05). Conclusions The internal fixator remove time in the young patients after non-fusion of cross injured vertebral screw of thoracolumbar vertebral fracture is 9 months after surgery, and in the middle aged patients is 12 months after surgery. Intervertebral disc degeneration is one of the risk factors for delayed removal.

Purpose To investigate the expression of Axin, β-catenin and p53 in the pleural fluid and to discuss their relationships and significances. Methods The expression of Axin, β-catenin and p53 was detected using immunocytochemistry in adenocarinoma cells of the pleural fluid from 40 patients with primary lung adenocarcinomas or reactive mesothelial cells of the pleural fluid from 40 pa-tients with benign lung diseases. Results Axin positive expression rate was 30% (12/40) in cases with primary lung adenocarcino-mas. The positive expression rate of β-catenin was 15% (6/40) on cell membrane and 60%(24/40) in cytoplasm. The expression rate of p53 was 57. 5% (23/40) in cases of primary lung adenocarcinomas. The expression of Axin was positively correlated with the membranous expression of β-catenin, and negatively correlated with p53 in cancer cells of the pleural fluids. The positive expression rate of Axin was 77. 5% (31/40), but the expression rate of p53 was 1. 25% (5/40). There was no expression ofβ-catenin in reac-tive mesothelial cells from benign lung diseases. Conclusions The expression of Axin is significantly reduced in adenocarcinoma cells. The expression rate ofβ-catenin in cytoplasm is higher than that in membrane of cancer cells. It has a certain value to detect the expression of Axin,β-catenin and p53 for diagnosis and differential diagnosis of lung adenocaicinomas from benign lung diseases.

A 16-year-old male presented with a 11-year history of progressively enlarging erythema and crusting on the right cheek.Physical examination revealed an irregularly shaped,sharply marginated,dark erythematous patch sized 6 cm x 10 cm and plaques with mild verrucous proliferation.There were strip-like scar at the margin of lesions and multiple ulcers measuring 0.5 to 1 cm in diameter with firm crusts.No small jellycolored nodules were observed.Direct microscopy of multiple scrapings under the crusts showed many light brown,septate,branching and irregular hyphae.Olivaceous-black woolly colonies grew at 25 C and 35 C on Sabouraud's dextrose agar and potato dextrose agar; flask-shaped conidiogenous cells with funnel-shaped collarettes and ellipsoidal conidia arranged in flower-like shape were observed microscopically.PAS staining showed numerous septate and branching hyphae,pseudohyphae and yeast-like cells.There was a 99.73％ similarity in the species-specific rDNA sequence between the isolate and phialophora verrucosa standard strain CDC-B2152.The patient was diagnosed with cutaneous phaeohyphomycosis caused by Phialophora verrucosa.The lesion subsided after treatment with amphotericin B and itraconazole,but recurred after drug withdrawal.Itraconazole and terbinafine were administered for the retreatment of this patient.

ObjectiveTo observe the effect of alcohol exposure during pregnancy on learning and memory and content of hydrogen sulfide(H2S) in the hippocampus of infant rats.MethodsThe animal models of alcohol exposure during pregnancy were made,and the learning and memory were evaluated by Y-maze in adult offspring.Content of H2S and activity of cystathionine-beta-synthase(GBS) in the hippocampus of the brain were evaluated with spectrophotometry;and CBS protein expression in the hippocampus was detected by immunohistochemistry.ResultsThe learning and memory ( (43.00 ± 15.33 ) times) of alcohol exposure during pregnancy group was significantly decreased compared with that of control and drinking groups (( 25.13 ± 12.35 )times and (26.12 ±11.95 ) times,P ＜ 0.05 ) ; spectrophotometry results showed that the content of H2S ( ( 30.32 ± 5.84 ) nmoL/g) of alcohol exposure during pregnancy group was significantly increased compared with that of control ( ( 52.51 ±7.85 ) nmol/g) and drinking groups( (49.93 ± 4.29 ) nmol/g),and the activity of CBS( ( 55.13 ± 4.45 ) nmol/g)of alcohol exposure during pregnancy group was significantly increased (P ＜ 0.01 ) compared with that of control ( (71.06 ± 5.58 ) nmol/g) and drinking groups( (69.96 ± 6.13 ) nmol/g) ; immunohistochemistry showed that the expressionof CBSproteinofalcoholexposureduringpregnancygroupwassignificantlyincreased.ConclusionThe damage effect of alcohol exposure during pregnancy on nerve system of infant rats may interrelate with down-regulation of H2S/CBS in the hippocampus.