Objective To investigate the clinical features,critical laboratory parameters,and fetal monitoring methods in intrahepatic cholestasis of pregnancy(ICP).Methods A retrospective analysis of 21 cases of ICP suffered with fetal death in Women's hospital.School of Medicine.Zhejiang University from January 1999 to December 2010 were discussed.Results(1)The average age of ICP patients suffered with fetal death were(30.2±4.6)years old.Among them,4 cases were older than 35 years,six cases were multipara.oneo of them suffered stillbirth 2 year before.Twenty cases were singleton pregnancies and 1 cage was twin pregnancy.(2)All 21 cases of fetal death occurred in the third trimester,12 cases occurred before 37 weeks,9 cases after 37 weeks.Nine cases were diagnosed by ultrasound in outpatient clinics,fetal heart beat disappeared in 9 patients after admission because of ICP, two disappeared after labor, one during anesthesia before emergent surgery. Perinatal mortality rate of ICP was 0. 148% (21/14 184), and fetal death occurred from 29 to 41 weeks with an average gestational age of ( 33.8 ± 4. 2 ) weeks, ( 3 ) Puritus occurred in all 21 cases while 11 of them had pruritus all over the body. Ten pregnant women felt the fetal movement decreased or disappeared before diagnosis of fetal death. The glycocholic acid levels increased in all of the 21 cases. Among them, glycocholic acid levels in 11 cases were (21.49 -64. 48) μmol/L, while in 10 cases were ≥64. 48 μmol/L Serum bile acid levels elevated in 16 cases which had been analyzed ( the other 5 cases had not been checked ), and the highest level reached 270 μmol/L Serum alanine aminotransferase and aspartate aminotransferase were increased in 14 cases. Seven cases had their total bilirubin ＞21 μmoL/L, and 12 cases had their direct bilirubin levels significantly elevated. Among the 21 cases of ICP, 15 cases were in severe status, while the other 6 cases were mild. (4) Nine patients had no antepartum surveillance since fetal death were diagnosed before admission. The results of antepartum surveillance were as follows: 2 cases had nonreassuring nonstress test (NST), one had mild "V" type deceleration. Absence of diastolic flow in umbilical artery were found in 3 cases, and low fetal biophysical score was got in one case. ( 5 ) All 21 patients had vaginal delivery. Six of them delivered after natural contraction, and the remaining 14 cases delivered after oral intake of mifepristone and amniotic injection of ethacridine, or oxytocin induced labor within 48 hours, only one case delivered after additional dinoprostone suppositories. The appearance of fetus, placentas and membranes were normal, the lengths of umbilical cord were average. Four cases were found with cords binding the necks or the bodies. Eighteen cases had grade Ⅲ amniotic fluid with meconium-stained, and 2 cases complicated by oligohydramnios. Ten cases had their fetuses and placentas examined by pathologist. Among them, one case had multiple malformations, no more obvious pathological abnormalities were found in other fetuses. Pathologic examination showed that fibrin deposited around chorion and deciduas basalis, large vessels accompanied by calcification, degeneration,hemorrhagic infarction, and increased focal syncytial nodules could be seen in all of the ten placentas. Conclusions Fetal death in pregnant women with ICP of ten occurs after the contractions, Severe ICP may be a key factor that involved in the occurrence of fetal death. Up to now, there is no valid indicators in fetal monitoring, which can predict fetal death. Extensive assessment of the severity and careful antepartum surveillance should be achieved before timely termination of pregnancy.

Objective To study the effect of nutrition supports in aged mechanically ventilated patients fol-lowing thracic trauma. Methods 48 aged mechanically ventilated patients following thracic trauma were randomly divided into two groups,patients in treatment group( n = 24) received EEN and PN,control group( n = 24) only re-ceived TPN. Compared the nutritional index, time of mechanical ventilation and compared the complications such as windy,intestine paralysis, alimentary tract heorrhage, second heavy infection, hypohepatia and high blood glucose.Results The nutritional index between treatment group and control group had no statistical difference,but the time of mechanical ventilation and the ratio of the complications in control group were higher than that in-treatment group (P < 0.01). Conclusion EEN and PN can improve nutritional condition, have less complieations, promoting the pa-tient recovers form illness.

Objective To establish a method for the determination of complanatuside in Semen Astragali Complanati, and study the content change of complanatuside processed. Method HPLC was used with Apollo-C18 column (4.6 mm?250 mm, 5 ?m), acetonitrile-0.1%phosphoric acid (21∶79) as mobile phase, the flow rate at 1.0 mL/min, and detected wavelength was set at 266 nm. Result Complanatuside showed a good linearity relationship in the range of 0.041 6～0.665 6 ?g, r =0.999 9. The average recovery was 100.6%, RSD was 0.73%. Conclusion The method is simple, accurate, reproducibility and strong specificity. It can be used for the quality control of Semen Astragali Complanati. Processing with salt can lead to content decrease of complanatuside in Semen Astragali Complanati.

Objective To explore the effect of psychological intervention on the mental conditions and the quality of life of patients with radiation encephalopathy(REP).Methods thirty-five patients with REP from radiotherapy for nasopharyngeal carcinoma were divided into the control group(n=17)and the experiment group(n=18)according to their registration sequence. The control group was managed with conventional nursing,and the experiment group with individualized psychological intervention in addition to routine nursing for 12 weeks.The two groups were compared in terms of depression and quality of life by Hamilton Depression rating Scale(HAMD)and The short-form health survey questionnaire(SF-36).Results The two groups before treatment showed no statistical difference in scores by HAMD and SF-36(P>0.05).The experiment group was superior to the control group after intervention in depression and quality of life(P<0.01).Conclusion Psychological intervention may alleviate REP in the patients at poor psychological status and improve their quality of life.

In order to study the expression and the feasibility of scaled production of neuropeptide in the routine expression system such as E.coli with the pituitary adenylate cyclase activating polypep tide(PACAP) as an example, the following experiments were carried out. First, on the basis of the reported amino acid sequence of PACAP, DNA sequence of PACAP w as deduced and six partially complementary oligonucleotide fragments were design ed. The coding region of PACAP was obtained by renaturing the DNA fragments and ligation and identified by DNA sequencing. The coding region of PACAP was cloned into plasmid pGEX-4T-3 and transformed into E.coli BL21(DE3 ). An expression strain BLPACAP was selected. SDS-PAGE analysis revealed that t he GST-PACAP fusion protein was highly expressed and accumulated to about 30% o f the total bacterial proteins. By affinity chromatography, up to 90% GST-PACAP was purified by one step from bacterial lysate. The purified protein could prom ote neurite outgrowth of PC12 cells and the survival of spinal cord neurons.

Objectives:To compare the effect of glial cell line-derived neurotrophic factor(GDNF) and methylprednisolone(MP) on intracellular free calcium(［Ca2+］i) and capacity of containing water(CCW) after spinal cord injury(SCI).　Methods:Forty-two SD rats were divided into four groups： control, GDNF,MP and GDNF+MP.GDNF and MP were supplied through subarachnoid cavity, tail vein and both of the above after T12 segments spinal cord injury by modified Allen crush method. Animals were executed and specimens were collected at 24 h, 72 h and 168 h after SCI.［Ca2+］i and CCW were measured using Fura-2 method.　Results:Both ［Ca2+］i and CCW of injured spinal cord in GDNF,MP, and GDNF+MP groups were lower than that of the control group at 24 h and 72 h after SCI(P<0.01).Levels of ［Ca2+］i and CCW in GDNF group was much higher than that of MP and MP+GDNF groups(P<0.01),but there was no difference between MP group and MP+GDNF group(P>0.05) 24 hours after SCI. Seventy-two hours after SCI,［Ca2+］i in GDNF group was higher than that in MP group, MP group was higher than MP+GDNF group(P<0.05).CCW of GDNF group exceeded that of MP and MP+GDNF group(P<0.01).［Ca2+］i in GDNF group was higher than that in MP group, and MP group was higher than MP+GDNF group(P<0.01) 7 days postoperatively, but for CCW, there were no differences among GDNF,MP and MP+GDNF groups(P>0.05).　Conclusions: Both GDNF,MP and GDNF + MP groups might reduce ［Ca2+］i and CCW of injured spinal cord. The curative effect of MP for SCI preponderate over that of GDNF, the effect of MP could be enhanced by adding GDNF.

Objective To investigate the effect of low molecular weight substance extracted from chick embryo on mitochondrial DNA(mtDNA)deletion in senile mice induced bv D-galactose.Methods Senile mice induced by D-galactose were treated with low molecular weight substance extracted from chick embryo.The deleted fragment of mtDNA was examined by using polymerase chain reaction technique and agarose gel electrophoresis.A relative quantitation of band densities was performed by using densitometry scanning techniques.The deletion was identified by using direct sequencing analysis. Results The 4239 bD mtDNA deletion were present in liver,cerebral cortex and hippocampus tissues in all of the mice.and it was significantly higher in senile model mice than in control mice(all P＜0.01).Low molecular weight substance extracted from chick embryo reduced the mtDNA deletion in various tissues in senile model mice(all P＜0.05).Deletion was more abundant in liver than in cerebral cortex and hippoeampus. Conclusions The 4239 bp mtDNA deletion is a common deletion,and low molecular weight substance extracted from chick embryo could decrease the incidence of 4239 bD mtDNA deletion.

Objective To observe the clinical effect of transforaminal endoscopic surgical system (TESSYS) technique for atypical lumbar disc herniation. Methods Eighteen patients with atypical lumbar disc herniation underwent TESSYS technique under local anesthesia. Numerical rating scale (NRS) was used to evaluate the sciatica and/or back pain. The outcomes were evaluated by Oswestry disability index (ODI) and the Macnab score. Results The postoperative NRS scales were significantly lower than preoperative one (P<0.01). The postoperative ODI was lower than preoperative one (P < 0.05). Good rate of modified Macnab criteria was 88.89%. One patient occurred right hip pain and disappeared after partial closure. one patient turned to open surgery at 1 week. Conclusion The TESSYS technique was an effective method for atypical lumbar disc herniation. It has satisfactory clinical effect which is worthy of spreading for clinical application.

OBJECTIVE:To study the effect of tanshinone on inflammatory response in air-pouch model mice with artificial joint aseptic loosening. METHODS:Mice were randomly divided into blank control group(normal saline),titanium particle group (normal saline),tanshinone low-dose,medium-dose,high-dose groups(50,100,200 mg/kg),10 in each group. Air-pouch mod-els were induced. Except that mice were injected 0.5 mL normal saline into air-pouch in blank control group,other groups were in-jected 0.5 mL Titanium particle suspension(10 mg/mL)into air-pouch,continuously administrated medicines by 0.1 mL/10 g after 24 h,ig,for 14 d. After 24 h of last administration,the air-pouch was collected,air-pouch inflammation was observed by eyes and by microscopy after hematoxylin-eosin staining,and inflammatory cell density was calculated. Real-time quantitative poly-merase chain reaction method was conducted to detect the tumor necrosis factor α(TNF-α),interleukin 1β(IL-1β)mRNA expres-sion;enzyme-linked immunosorbent method was used to detect the TNF-α,IL-1β protein expression. RESULTS:Compared with blank control group,air-pouch swelling was obvious in titanium particle group,much exudation and neovascular were observed,in-flammatory response was severe,inflammatory cell density was increased significantly(P<0.05);TNF-α,IL-1β mRNA and pro-tein expression were obviously enhanced(P<0.05). Compared with titanium particle group,air-pouch swelling was relieved in tan-shinone doses groups,exudation and neovascular were decreased,inflammatory response was relieved,inflammatory cell density was decreased significantly(P<0.05);TNF-α,IL-1β mRNA and protein expression were obviously decreased(P<0.05),with a dose-dependent manner. CONCLUSIONS:Tanshinone can effectively inhibit the aseptic inflammatory response in air-pouch model mice with artificial joint aseptic loosening.

Objective To investigate the feasibility of fine needle aspiration cytopathology in the diagosis of lymphoma.Methods To compare cytopathology with histopathology of 72 lymphoma cases and analyse immunochemistry stain of 3 cases.Results 61 of 72 cases were diagnosised as lymphoma in cytopathology,while 58 of 61 cases were diagnosised as lymphoma in histopathology.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value rates of cytopathology were 89.2 ％ (58/65),57.1％ (4/7),86.1％ (62/72),95.1％ (58/61),and 36.4 ％ (4/11) respectively.Conclusion Fine needle aspiration cytopathology is significant to the diagnosis of lymphoma.It should greatly improve the accuracy of lymphoma diagnosis and make it possible to subclassify lymphoma,combined cytopathology with other auxilary detection.