Objective To investigate clinical predictors in early pregnancy for adverse pregnancy outcomes in women complicated with chronic nephropathy. Methods One hundred and eighty-four pregnancies complicated with chronic nephropathy who delivered between January, 2005 and January, 2014 in Peking University First Hospital were retrospectively analyzed. Two hundred pregnant women without chronic nephropathy were selected as the control group. Pregnancy outcomes were compared between the two groups. Relationships between clinical predictors in early pregnancy [age, history of kidney disease, drugs used before pregnancy (in three months), results of renal biopsy, blood pressure, serum creatinine, urea nitrogen, 24 h urinary protein, estimated glomerular filtration rate, stage of chronic nephropathy] and adverse pregnancy outcomes [maternal mortality;pregnancy complicated by severe preeclampsia;renal function decline, early preterm birth, very low birth weight infants, fetal loss after 20 weeks of pregnancy] were assessed by logistic regression analysis. T-test, Chi-square test and multivariate regressions were used for statistical analysis. Results There were 174 and 197 livebirths in the study and the control groups, respectively. The most popular type of chronic nephropathy in pregnant women was IgA nephropathy (38.6%, 71/184). Compared with the control group, the risk of premature labor [9.8%(17/174) vs 3.0%(6/197), χ2=7.184], low birth weight infants[18.4%(32/174) vs 7.1%(14/197),χ2=9.813], very low birth weight infants [5.7%(10/174) vs 1.5%(3/197),χ2=4.536], fetal loss after 20 weeks of pregnancy [5.7%(10/184) vs 1.5%(3/200), χ2=4.536] and severe preeclampsia [17.9%(33/184) vs 1.5%(3/200), χ2=33.544] increased significantly in the study group (all P < 0.05). Twenty-four-hour urinary protein content (OR=1.84, 95%CI: 1.36-2.50, P=0.001) and mean arterial pressure (OR=1.04, 95%CI: 1.00-1.07, P=0.027) in early pregnancy were risk factors for adverse pregnancy outcomes. The risk of renal function decline increased significantly in patients with higher stages of chronic nephropathy in early pregnancy (OR=6.50, 95%CI: 3.34-8.21, P<0.01). Mother complicated by preeclampsia during pregnancy was an independent risk factor (OR=11.10, 95%CI: 4.48-27.20, P<0.01). Compared with women whose 24 h urinary protein content less than 1g in early pregnancy (122 livebirths within 126 cases), the risk of premature labor [17.3%(9/52) vs 6.6%(8/122), χ2=4.780], increased significantly in women whose 24 h urinary protein content were more than or equal to 1 g in early pregnancy (52 livebirths within 58 cases) (P<0.05). Conclusions Elevated urinary protein level and mean arterial pressure in early pregnancy were risk factors of adverse pregnancy outcomes. The risk of renal function decline increased in patients with higher stages of chronic nephropathy in early pregnancy. Mother complicated by preeclampsia during pregnancy was an independent risk factor for poor prognosis of the fetus.

Purpose:To observe the curative effect and the clinical-benefit-response of patients with advanced pancreatic cancer who used a combine of Gemcitabine,5-FU and PDD.Methods:The treatment with Gemcitabine (800 mg/m 2) was followed by 5-FU(600 mg/m 2) and DDP (30 mg/m 2),administered on days 1,8 and 15 of 28-day schedule. The curative effect was estimated according to the standard of WHO and the clinical benefit response was evaluated at the same time. The standard of CBR included pain,physical states and body weight. Results:Twenty-five (25/29) patients received over two cycles chemotherapy. 6(24%) partial response (PR), 12 (48%) stable disease and 7(28%) progressive disease were observed. According to the standard of CBR, 18(62.1%) patients achieved the clinical-benefit-response level. Therapy was well tolerated. The main toxicities included that the alimentary tract reactions and the marrow depression. Grade 3-4 thrombocytopenia was reported in 8 (27.6%) patients. Conclusions:The combination of GEM, 5-FU and DDP is a moderatedly active treatment with tolerable side-effects. It has definite response rate and high CBR rate in pancreatic cancer.

BACKGROUND: The number of roots and morphology of the root canal system of permanent mandibular first molars vary greatly among different populations; therefore, it is important to be familiar with the variations in the root and root canal for the location and negotiation of the canals. OBJECTIVE: To investigate the variations in the roots and root canal of permanent mandibular first molars in the Han population of southwest Shandong Province by cone-beam CT. METHODS: 656 patients undegoing cone-beam CT examination at the Department of Stomatology, Affiliated Hospital of Jining Medical University, from September 2012 to October 2015 were recruited, and all patients had healthy, well-developed, and untreated bilateral permanent mandibular first molars with normal appearance. Subsequently, the three-dimensional reconstruction based on cone-beam CT data was performed using Planmeca Romexis software to observe the variations in the root and root canal system of permanent mandibular first molars in the Han population of southwest Shandong Province. RESULTS AND CONCLUSION: Among 1312 permanent mandibular first molars, the incidence of permanent mandibular first molars with three roots was 70.66% (927/1312); the majority of root canal variations involved two roots and three root canals, accounting for 48.09% (631/1312). The incidence of distal root was 35.37% (232/656), the incidence of distal root was 29.34% (385/1312) in total teeth, and the incidence of distal root bilaterally was 68.95% (153/232). There was a significantly increased incidence of distal root on the right side than on the left side (P < 0.05), and the incidence in the male was significantly higher than that in the female (P < 0.05). These results suggest that most of Han populations in southwest Shandong Province have permanent mandibular first molars with two roots, and the root canal variations mainly involve two roots and three root canals, with the high incidence of distal root. Moreover, cone-beam CT is available for detecting the variation in roots and root canal system, which can provide references for root canal treatment.

Objective To evaluate the value of digital subtraction computed tomography angiography(DSCTA)in the diagnosis of intracranial small aneurysms.Methods 92 patients with intracranial aneurysms confirmed by digital subtraction angiography(DSA) or surgery were selected as the subjects of this study.Their clinical and CT imaging data were analyzed retrospectively.The diagnos-tic accuracy of DSCTA and conventional CTA for intracranial aneurysms was compared.Results A total of 102 aneurysms were con-firmed in the 92 patients,100 of them were detected by DSCTA and 89 by conventional CTA (χ2 =8.707,P =0.003).Two small aneurysms of less than 5.0 mm located respectively at the cavernous sinus and beneath the clinoid segments were missed by DSCTA, while 13 by conventional CTA.When aneurysms of less than 3.0 mm and 3.0-5.0 mm were combined with calculation,the sensi-tivity of DSCTA in detecting aneurysms of less than 5.0 mm was significantly higher than that of conventional CTA (χ2 =8.393,P =0.004).Conclusion DSCTA has more advantages than conventional CTA in the diagnosis of intracranial aneurysms,especially for the small aneurysms adjacent to the skull base.DSCTA can be used as a preferred technique in the screening and diagnosis of in-tracranial aneurysms.

AIM To study if cholecystokinin octapeptide (CCK-8) alter cardiovascular functions by its direct inhibitory effect on carotid sinus baroreceptor (CSB) activity. METHODS The functional curve of carotid baroreceptor (FCCB) was constructed and the functional parameters of carotid baroreceptor were measured by recording sinus nerve afferent discharge in anesthetized male rats with perfused isolated carotid sinus. RESULTS ① CCK-8 0.1, 0.5 and 1.0 μmol·L-1 shifted FCCB to the right and downward, with a marked decrease in peak slope and peak integral value of carotid sinus nerve discharge in a concentration-dependent manner, indicating the inhibitory effect of CCK-8 on CSB activity. ② Pretreatment with proglumide (100 μmol·L-1), a nonselective CCK receptor antagonist, or Bay K8644 (0.5 μmol·L-1), an agonist of calcium channel, partially attenuated the inhibitory effect of CCK-8 (0.5 μmol·L-1) on CSB activity. Pretreatment with L-NAME (100 μmol·L-1), an inhibitor of NO synthase, did not affect the inhibitory action of CCK-8. CONCLUSION CCK-8 inhibits CSB activity, which may be mediated by activating CCK receptors in the carotid sinus area and thereby resulting in an inhibition of stretch-sensitive channels and decrease in Ca2+ influx.

Objective To explore the best methods of catheterization in patients with neurogenic bladder using clean intermittent self-catheterization. Methods From December, 2014 to December, 2015, sixty patients with neurogenic bladder were equally divided into observation group who were taught the non-contact clean intermittent self-catheterization, and control group who were taught routine clean intermittent self-catheterization. Their materials, times to learn, and the incidence of catheter contamination and urinary tract infection were compared. Results The observation group mastered the catheterization in fewer times of learning than the control group (Z=-4.400, P<0.001). The incidence of catheter contamination (χ2=5.880, P=0.015) and urinary tract infection (χ2=4.043, P=0.044) were less in the observa-tion group than in the control group. Conclusion Non-contact clean intermittent catheterization is beneficial to manage neurogenic bladder.

Objective To compare the similarities and differences of the five detection methods used in the detection of fungi in vaginal secretions,and find the most sensitive、the most specific、the fastest、the most cost effective and the simplest method used in the detection of fungi in vaginal secretions.Methods A total of 442 patients were selected from the Department of Gynecology of Shenzhen OCT Hospital from May 2016 to August 2016.The vaginal secretion of 442 specimens was detected by using the methods of fungi culture、saline and KOH suspension method,Gram stain,Wright''s stain and Vaginitis Multi Test Kit.In these five methods,Fungi culture were using as gold standard to evaluate the specificity,sensitivity,negative predictive value,positive predictive value and accuracy of the other four methods.Results Using the fungus culture method to detect 442 cases of vaginal secretion,we found the positive rate of mycotic infection was 34.8%(154/442).Compared with the fungi culture method,the Specificity of saline and KOH suspension method was 97.9%,the sensitivity was 64.9%,the negative predictive value was 83.9%,the positive predictive value was 94.3% and the accuracy was 86.4%;the Specificity of Gram stain was 96.5%,the Sensitivity was 83.1%,the negative predictive value was 91.4%,the positive predictive value was 92.7% and the accuracy was 91.8%;the Specificity of Vaginitis Multi Test Kit was 84.7%,the Sensitivity was 46.8%,the negative predictive value was 74.8%,the positive predictive value was 62.0% and the accuracy was 71.5%;the Specificity of Wright''s stain was 96.9%,the Sensitivity was 78.6%,the negative predictive value was 89.4%,the positive predictive value was 93.1% and the accuracy was 90.5%.Conclusion Gram stain could be the most sensitive and specific method in the four methods,with highest accuracy,and the the fastest,the most cost effective and the simplest method for the detection of fungi in vaginal secretions.The accuracy of detecting fungi in vaginal secretions could be improved by the combination of Gram stain method in clinical work.

Objective To study the clinical effect of personalized intervention on elderly patients with colostomy after Miles operation for rectal carcinoma. Methods 114 cases elderly patients with colonic stoma after Miles operation for rectal cancer from June 2014 to January 2016 were divided into control group and observation group by random number method, 57 cases in each. The control group were treated with routine intervention, while patients in observation group was treated with personalized intervention. the self-care ability score before intervention, the incidence of complications, intervention satisfaction and life quality score were compared between the two groups at the same time. Results The total complication rate in the observation group was significantly lower than that in control group ( 5.25% vs 22.80%) (χ2 = 8.36, P = 0.000); the intervention satisfaction of the observation group was significantly higher than that in control group (91.23% vs 75.44%) (χ2 = 6.60, P = 0.010). After intervention, the self-care ability score and life quality score of observation group were significantly higher than that in control group (P < 0.01). Conclusion The personalized intervention can reduce the complications, significantly improve the patients' life quality score and self-care ability, and effectively alleviate the negative situation, improve the patients intervention satisfaction, with a higher development value, it is worth of clinical promoting.

Objective To explore the cerebrovascular reactivity of the patients with cerebral infarction by transcranial color Doppler ultrasound (TCCD) and breath holding test.Methods TCCD was used to record the color Doppler imaging and Doppler spectrum and to measure peak velocity,mean velocity of double side middle cerebral artery(MCA) in thirty two normal persons and thirty seven patients with cerebral infarction confirmed by CT or MRI.Breath holding test was performed to record the Doppler spectrum and breath holding time and to calculate breath holding index(BHI).Results ①The peak velocity of MCA of the damaged side was abnormally increased by 35.1% and decreased by 40.5% .②The BHI of the damaged side was significantly lower than that of undamaged side and that of control group (P