OBJECTIVE To evaluate the standard of non-invasive diagnosis of Down′s syndrome between the different PCR machines. METHODS Two kinds of PCR machines were used respectively to amplify the homologous genes-the human liver-like phosphofructokinase gene (PFKL) and the human muscle-like phosphofructokinase gene (PFKM). RESULTS The best annealing temperature of the two PCR machines were 64 ℃ and 60 ℃,and only in this reaction conditions PFKL′s and PFKM′s electrophoresis strips had the same optical density value. CONCLUSIONS This approach has proven that the conditions of amplified the PFKL and PFKM are different between the two kinds of PCR machines.

Objective To investigate the methylation status of promoter CpG islands of the estrogen receptors (ERs) in leukemia cell lines,including 3 promoters of ER? (ER?-A,-B and -C) and one promoter of ER?,and explore the possible relationship between the mRNA expressions of the promoters and the CpG methylation. Methods With RT-PCR and methylation specific PCR (MSP),the mRNA expressions of above promoters and their status of methylation in leukemia cell lines HL-60,K562,Jurkat,THP-1,U937 and MOLT-410,and health controls with or without treatment of 5-AzA-2′-Deoxycitidine (5-Aza-DC). Results Promoters of ER were all methylated or semi-methylated in the 6 strains of leukemia cells. Only the ER?-A was inactivated in these leukemia cell lines and was unmethylated in all 10 health controls,and the expression was recovered after the treatment of 5′-Aza-DC. Conclusion The CpG islands of ER promoter are hypermethylated in 6 strains of leukemia cells,and this inactivate the expression of ER?-A,which can be activated by the treatment of 5′-Aza-DC.

ObjectiveTo compare the therapeutic effects of a new surgical endoscopic technique, the transilluminated powered phlebectomy (TriVex System, Smith+Nephew) and pointed phlebectomy in the treatment of varicosis of the great saphenous vein of the lower limbs. Methods Thirty-nine patients (46 limbs) received TriVex operations under spinal, or epidural anesthesia. The powered vein resector and an irrigated illuminator device-a minimally invasive system was used for varicose vein surgery. During the same period, 41 patients (46 limbs) underwent pointed phlebectomy. Results The average postoperative hospital stay was 4.6 days in patients receiving TriVex, and 8.1 days for pointed phlebectomy. Compared with the pointed phlebectomy, the incision of TriVex procedure was shorter and the number less. Conclusion This new surgical device is easy to operate, minimally invasive, efficacious and time saving with satisfactory results.

Objective To compare operative risks of the infrarenal aortic artery reconstruction between abdominal aortic aneurysm (AAA) and aortoiliac occlusive disease (AIOD), and to analyze the causes of the difference. Method Clinical data of 340 cases undergoing aortic artery reconstructions including 222 AAA cases and 118 AIOD cases , were analyzed retrospectively. Results The perioperative mortality was 7.6% and the mortality in AAA group (5.4%) was lower than that in AIOD group (11.9%)(P

OBJECTIVE To examine the feasibility of PCR amplification of 16S-23S rDNA intergenic spacer regions of bacteria in trauma infection by a pair of universal primers for gene diagnosis.METHODS The universal primers were designed at conserved regions of the 3' end of 16S rDNA and the 5' end of 23S rDNA.Bacterial genomic DNA from selected five commom bacteria in trauma infection were amplified by PCR.PCR products were examined using electrophoresis in agarose gel,and futher analyzed by sequencing.RESULTS The PCR products were similar to that we expected on the gel,which were confirmed by the results of sequencing and alignment.CONCLUSIONS Using the universal primers,16S-23S rDNA intergenic spacer regions of bacteria in trauma infection could be amplified by PCR,which lays a solid foundation for gene diagnosis in farther studies.

Objective:To evaluate the pregnancy outcomes of fetal tethered cord (TC) prenatally diagnosed by MRI.Methods:Clinical data of 38 fetuses diagnosed as having TC by MRI, including 36 singletons and two fetuses who were both one of dichorionic diamniotic twins, were retrospectively collected and analyzed in the Obstetrics and Gynecology Hospital of Fudan University from January 2015 to August 2019. According to whether conus medullaris was located above the bladder or reached the lower edge of the bladder, all cases were divided into high or low groups. Pregnancy outcomes were compared between the two groups using Fisher's exact test and Student's t-test. Results:(1) The gestational age at MRI was (25.5±4.7) weeks. Among the 38 cases, 14 (36.8%) were isolated TC, 24 (63.2%) were complicated by other anomalies. The meningocele was responsible for the most (39.5%, n=15). The results of the ultrasound were consistent with those of MRI in 24 cases (63.2%). While in the other 14 cases (36.8%), the ultrasound only showed vertebral body's abnormal morphology, after which further MRI examination revealed a tethered cord. (2) Twenty-nine women (76.3%) chose to terminate the pregnancy. One patient (2.6%) underwent fetal reduction at 23 gestational weeks (one normal twin was delivered prematurely), and one (2.6%) was lost to follow-up. Seven (18.4%) cases continued the pregnancies to delivery. The postnatal follow-up period was 8.1 months (4.0 to 54.9 months). Two infants without comorbidities showed normal growth and development. Another three cases underwent surgeries after birth, and two cases died in the neonatal period. (3) The average width of the medullary cone was (2.5±0.8) cm. There was no significant difference in the spinal cord width between the high [(2.5±0.8) cm, n=34] and low group [(2.7±1.1) cm, n=4]. Six pregnancies (17.6%) in the high group was continued to delivery, and one of the neonates died of severe hydrocephalus. One patient in the low group (1/4) was delivered, while the baby died of neonatal asphyxia. Conclusions:Fetuses with isolated TC are prone to have a good prognosis. Further study should focus on the relation between the high or low position of the conus medullaris and pregnancy outcomes.

Objective To discuss the diagnosis and surgical treatment of Takayasu arteritis accompanied with aneurysms. Methods The clinical features and the effect of operation types in 14 patients were reviewed.Results All the 14 patients had history of Takayasu arteritis and had steroid therapy before the formation of aneurysms.Among the 14 patients,aortic aneurysms were found in 13(including 9 thoracoabdominal aneurysms),carotid aneurysm with subclavian aneurysm in 1 and multiple aneurysms in 5.All the 14 patients underwent operations ,including replacement of aorta in 11 cases,bypass of aorta in 3 cases,reconstruction of visceral vessels in 8, renal autotransplatation in 1 and replacement of carotid in 1.1case had heart failure and cured ;1 died postoperatively. Eight cases were followed up for 4 months - 18 years,of which, 1 died of heart failure,2 were excellent, 3 of 5 cases with hypertension preoperatively showed normal blood pressure,and the other 2 were controlled by medicines.Conclusions Operation should be performed as early as possible if the aneurysm is found in patients with Takayasu arteritis.The stenosis of renal artery should be resolved during the operation.

Objective To study the defects of bone marrow-derived endothelial progenitor cells (EPCs) in number ratio and biological abilities (proliferation, adhesion and migration) in diabetic rats. Methods (1) Establishment of diabetic rat model:1%STZ solution was quickly injected into the abdominal cavity of the male SD rats with the dose of 60 mg/kg. (2). Isolation, culture and identification of bone marrow-derived EPCs in diabetic and normal rats. Bone marrow mononuclear cells were isolated from diabetic and normal rats by density gradient centrifugation methods and cultured by EGM-2 MV medium. The cells were identified by morphological observation, FITC-UEA-1 binding and Dil-Ac-LDL uptake assay, and fluorescent immunocytochemistry was used for detection of CD34 , CD133 and VEGFR-2 expression. CCK-8 method and Transwell kit method were used to determine biological activities of EPCs. Results (1) When cultured in vitro, both bone marrow-derived EPCs in diabetic and normal rats were fusiform in shape, the cells snuggled up to the wall. The expression of CD34, CDl33, VEGFR-2 could be detected in these cells, and the cells could uptake Dil-Ac-LDL and bind FITC-UEA-1, which proved that these cells were EPCs. (2) No significant difference in the number of EPCs derived from bone marrow existed between diabetic rats and normal rats, but the proliferation ability, migration ability and adhesion ability of bone marrow-derived EPCs in diabetic rats were obviously lower than those in normal rats. Conclusion The number of bone marrow-derived EPCs in diabetic rats is not obviously different from that in normal rats, but the biologic activity of EPCs derived from bone marrow in diabetic rats is degraded, which is manifested as weakened abilities of the proliferation, adhesion and migration.

Objective To evaluate the effect of preoperative localization of Adamkiewicz artery (AKA)by CT for patients undergoing endovascular descending thoracic aortic repair. Methods From May 2003 to April 2005, 12 patients received CT examination for the detection of the AKA before undergoing endovascular descending thoracic aortic repair. Eight patients were of Stanford type B dissecting aortic aneurysm, 2 of Crawford typeⅠthoracoabdominal aortic aneurysm (TAAA) , 1 of descending thoracic aortic pseudoaneurysm and 1 of descending thoracic aortic aneurysm combined with abdominal aortic aneurysm. The inclusion criterion was that the segment from T8 to L1 needed to be partially excluded. The CT assessment accentuated the identification of the level at which the aorta gave rise to the AKA-originating intercostal/lumbar artery and approval of the continuity from the origin of the intercostal/lumbar artery at the aorta to the anterior spinal artery (ASA). Results Thirteen AKAs were identified in 9 patients (75%). A single AKA was visualized in 5 cases and double in 4. Two AKAs arose from the T8 intercostal artery, 2 from T9, 3 from T10, 3 from T11 and 3 from T12. The continuity from the origin of the intercostal artery at the aorta to the ASA was identified in 8 patients. Ultimately, 10 AKAs were preserved while 3 sacrificed. More than 15-mm both proximal and distal landing distance of the stent-graft was achieved in all patients, and no paraplegia occurred perioperatively or during the follow-up raging from 3 to 19 months ( mean 12 months). Complete false lumen thrombosis of the thoracic aorta or aneurysmal thrombosis was evidenced on CT at 3 month in 11 patients while 1 patient with dissecting aneurysm caused by Marian's syndrome died for unknown cause 2 days after being discharged. Conclusion Localization of AKA by CT before stent-grafting in the descending thoracic aorta may enable us to avoid covering the origin of the AKA-originating intercostal/lumbar artery at the aorta, hence, the remaining segment from T8 to L1 could be saved for reliable landing the sten-graft.

Objective To evaluate the efficacy of endovascular repair (EVR) for aneurysms or dissection aneurysms of the aortic arch. Methods Twelve aortic dissection aneurysm (ADA) patients with the primary entry located within 15 mm beyond the origin of the left subclavian artery (LSA) and two aortic arch aneurysm patients underwent EVR from June 2003 to August 2004. EVR with intentional coverage of the LSA without any supportive bypass was employed in 8 ADA patients, and the preliminary cervical reconstruction combined with EVR in the remaining 6 cases. Results Technical success was achieved in all cases. One case died of postoperative cerebral infarction. No neurological deficits or limb ischemia developed perioperatively or during the follow up period raging from 1 to 14 months and complete thrombosis of the thoracic aortic false lumen and remarkable anenrysmal thrombosis were revealed by CT in all 12 ADA cases and the remaining aneurysm case respectively. Conclusions EVR is effective in the management of aneurysms or dissection aneurysms of the aortic arch.