Objective To perform fetal karyotyping by percutaneous umbilical blood sampling guided by color Doppler ultrasonography in fetuses with congenital cardiac anomalies. Methods Fetal blood samples obtained by color Doppler ultrasound-guided cordocentesis in 56 fetuses with cardiac abnormalities detected by fetal echocardiography were taken for karyotyping.Fetuses were monitored post operation. Results The procedures were successfully performed in all cases and no procedure-related complications occurred.Six cases with abnormal karyotypes, 1 trisomy 21,2 trisomy 18,1 trisomy 13,1 trisomy AO and 1 cases 47XYY were identified and pre-operation ultrasonography detected multiple system anomalies besides cardiac anomalies in them. Conclusions Color Doppler ultrasonography facilitated percutaneous umbilical blood sampling by clear umbilical vein imaging and shortening the operation time.Abnormal karyotypes in fetuses with cardiac anomalies seemed to be related with multiple system anomalies.

0.05). Conclusion Brachytherapy ,when used to increase the dose effect,may enhance the local effect without any change in the overall survival.

Background and purpose:It has been confirmed that homozygous deletion of p16/p15 gene and its co-deletion of p16/p15 genes were related to the occurrence, progress and prognosis of epithelial ovarian cancer. However, the mono-deletion and co-deletion of the genes has been detected with tissue but not in serum DNA of the epithelial ovarian cancer. In this article, we studied the relationship between homozygous deletion of p16/p15 gene and its co-deletion of p16/p15 genes in serum DNA of the epithelial ovarian cancer.Methods:Primers were used to amplify exon 2 of p16 and exon 2 of p15 gene by polymerase chain reaction. Homozygous deletions of the p16, p15 and co-deletion of p16/p15 genes were studied in either serum DNA of 165 patients with epithelial ovarian cancer, their counterpart lymphocytes DNA, serum DNA of 25 benign ovarian cyst or of 15 health donors.Results:The homozygous deletion rates of either p15 or p16 gene were 27.9%(46/165)and 27.3%(45/165)serum DNA in the patients with epithelial ovarian cancer respectively, while the co-deletion rate of p16/p15 genes was 24.2% (40/165). However, the deletions of p15/p16 genes and its co-deletion were not found in serum DNA of the counterpart lymphocytes,25 benign ovarian cyst and 15 health donors (The P values were 0.000、0.000 and 0.000 respectively). The deletions of either p15 or p16 gene for the patients with stage Ⅰ~Ⅱ were 14.3%(5/35) and 11.4%(4/35), 33.3%(25/75) and 32.0%(24/75) for the patients with stage Ⅲ, 29.1%(16/55) and 30.9% (17/55) for stage Ⅳ, respectively. Although there was no significant differences among the groups, the deletion of p15 and p16 genes in the patients with advanced stage were higher than that with early stage. The deletion was not found to be associated with histopathology of epithelial ovarian cancer.Conclusions:Homozygous deletions of the p16, p15 genes and its co-deletion of p15/p16 genes were commonly found in the serum DNA of epithelial ovarian cancer and might be associated with clinical stage of the disease. It was suggested that detection with serum DNA may be used as a micro-invasive approach and the deletion of genes might served as biological markers for the development and prognosis of the patients with epithelial ovarian cancer.

Objective To study radiographic features of atypical adenomatous hyperplasia(AAH) of lung and correlate them with their pathologic findings,so as to improve the imaging diagnose.Methods The imaging features of 8 patients with pathology-proved AAH were reviewed.All patients were women with age ranging from 35 to 74 years.All cases had chest radiography and HRCT.The radiographic findings were studied retrospectively and correlated with those of pat hology.Results On chest X-ray,the foci in five patients presented as nodule-like area of a bit high attenuation,while the chest radiograph in the other three patients were negative.On HRCT,all 8 patients presented as non-solid nodules.All lesions were round or oval shaped with well-defined margin(n=4)or poor-defined margin(n=3).The greatest dimension of the lesions ranged from 5.0 mm to 20.0 mm.Their CT value ranged from-362.7 HU to-485.6 HU,the mean CT value was(-423.0?47.0)HU.Air bronchograms and/or bubbles were seen in 5 lesions.Coarse spiculation and pleural tag was not seen in any lesion.Before operation,all the nodules did not change in size over a follow-up period from one month to six months.Pathologic findings showed atypical epithelial cell proliferation along thickened alveolar septa without alveolar collapse.Conclusion AAH should be considered in cases with the following features:(1)nodules are found in lung cancer screening or incidentally detected;(2)the diameter of the nodule is usually less than 10 mm;(3)the lesion presented as non-solid nodule on HRCT,air bronchogram and/or bubble sign can be seen;(4)no coarse spiculation and plural tag was seen.

Objective To investigate and discuss the limb salvage strategies of malignant bone tumors in region S2 of shoulder girdle.Methods The data of 17 patients(13 males and 4 females)were retrospectivelv analyzed.All of them had malignant scapular tumor at least in region S2,and underwent limb salvage between January 2005 and January 2009.They aged from 14 to 55 years old(mean,32.6 years).The histologic types of them were chondrosarcoma in 6 patients,osteosarcoma in 4,fibrosareoma in 1,myeloma in 1,Ewing's sarcoma in 1,rhabdomyosarcoma in 1,non-Hodgkin lymphoma in 1,malignant giant cell tumor of bone in 1 and recurrent chondrosarcoma in 1.The tumors were staged according to Enneking surgical staging system:IB in 4 and IIB in 13.According to the MSTS classification system,the region S2 and lateral 1/3 of region S1 were effected in 11 cases,the region S2 and large part of region S1 were effected in 6 cases.The rotator cuff was involved to some extent in all patients,and the articular capsule were involved in 8 cases.Neo-adjuvant chemotherapy was given to 14 patients.The surgical strategies were depended on the range of tumor and preservation of articular capsule.The scapular prosthetic replacement was done in 8 cases with a relatively large range of tumor or resection of articular capsule,otherwise the scapular allograft replacement was done.Among the 11 cases with region S2 and lateral 1/3 of region S1 effected,the scapular allograft replacement was done in 9 cases with articular capsule preserved and the prosthetic replacement was done in 2 cases with articular capsule resected.And the prosthetic replacement was done in the other 6 cases.The articular capsule and partial rotator cuff were preserved and reconstructed preferentially.Results All patients were followed up 16-62 months (mean,35.1 months).Postoperative complications were noted in 9 patients, including mild allograft rejection and mild allograft resorption in 1 patient,allograft rejection in 1,prosthetic acromion exposure in 3,allograft resorption in 4.Local recurrence were noted in 1 patients.Three patients were dead because of extensive metastasis.The average function scores were 74.1%(range,53.3%-93.3%).Conclusion During the limb salvage surgery.it's very important to guarantee the en bloc resection of the tumor.In the meanwhile,the en bloc resection and functional reconstruction should be well balanced.

Objective To establish a time resolved fluoroimmunoassay (TRFIA) method for detecting Glypican 3 (GPC3) and to explore the diagnostic value of serum GPC3 for hepatic carcinoma (HCC). Methods Microplate coated with anti-GPC3 monoclonal antibody 7C8 and GP9 labeled with Eu3+ were used to establish TRFIA kit. The serum concentrations of GPC3 in 41 HCC patients and 44 chronic hepatitis (CH) patients were quantitatively analyzed. AFP was detected by with lowest limit of 2.06 μg/L. The CV of inter and intra assay were 12.25% and 12.91%, respectively. The average serum concentration of GPC3 in HCC patients was (86.68±110.39) μg/L (median: 56.98 μg/L). But in CH patients it was only (14.77±29.48) μg/L, which was significantly lower than that in HCC (Wilcoxon W=1335.00, Z=-4.99, P<0.001). With diagnostic cut-off value set at 42.94 μg/L, the diagnostic sensitivity and specificity of TRFIA GPC3 for HCC were 58.5% (24/41) and 95.5%(42/44) respectively. The diagnostic sensitivity of AFP was 46.3% (19/41) in 41 HCC patients, and was raised to 78.0% (32/41) when combined with GPC3. Conclusions Serum GPC3 assay by TRFIA is established and it could increase the diagnostic sensitivity for HCC when combined with AFP.

Aim To investigate the influence of echi-nacoside ( ECH ) on monoaminergic neurotransmitter extracellular of the hippocampus and cerebral cortex in rat model of Alzheimer′s disease ( AD) , and ultimately to provide a theoretical basis for ECH′s improving the ability of learning and memory. Methods 60 male SD rats were randomly divided into 6 groups with 10 rats in each group : sham operation group, model, ECH groups of low, medium and high doses (10, 20, 40μg ·g-1 ·d-1 ) , and Hup A ( Huperzine A, 0. 02 μg· g-1·d-1) group. The AD rat model was established by abdominal cavity injection with D-galactose and uni-laterally injected with amyloid beta-protein fragment 25-35 ( Aβ25-35 ) into the right hippocampus. Morris wa-ter maze test was used to study the animals′ ability of spatial learning and memory. The synchronous dual-probe dual-channel brain microdialysis sampling tech-nology was applied to collect dialysates from different encephalic areas continuously, and combined with HPLC electrochemical detection were used to measure the extracellular levels of norepinephrine ( NE) , dopa-mine (DA), 5-serotonin (5-HT). Results 1. Com-pared with the sham operation group, the mean escape latency of the model group was significantly prolonged ( P<0. 05 ) , and the time that rats were in the plat-form quadrant was significantly shortened ( P<0. 05 );on the contrary, compared with the model group, the mean escape latency of ECH groups were significantly shortened ( P<0. 05 ) , and the time that rats were in the platform quadrant was significantly extended ( P<0. 05). 2. Compared with the sham operation group, the contents of NE,DA and 5-HT were significantly de-creased in the model group ( P <0. 05 ) . However, compared with the model group , ECH could improve the concentrations of NE, DA, 5-HT in the hippocam-pus and cerebral cortex, and these monoamine levels of the brain regions were restored to near control. Con-clusion ECH can effectively improve the ability of learning and memory of rats with AD, giving a rise to the monoamine neurotransmitter both in hippocampus and cortex, exerting a positive effect on treatment of cognitive dysfunction . The ECH low dose group is sig-nificantly lower than the ECH groups of medium and high doses and Hup A group in improving the ability of learning and memory.

Objective To evaluate and analyse the effectiveness of surgical treatment for fibrous dysplasia in proximal femur with severe varus deformity.Methods A retrospective study was performed in 21 patients (24 femora)of fibrous dysplasia who were treated in our hospital between August 2000 and May 2009.All patients had severe femoral varus deformity.The four-step procedures were performed orderlv as valgus osteotomy,lesion curettage,impacting of massive bone allograft,and fixation by femoral intramedullary nail.There were 6 patients with monostotic disease,15 with polyostotic diseases,including 12 males and 9 females with a mean age of 22.7 years(range,14-39 years).The average neck-shaft angle and femoral varus angle was 75°(range 55°-105°)and 30°(range,18°-45°),respectively.The average length of thigh shortened 3.4 cm(range,2.0-4.5 cm)compared with the contralateral thigh.Results All of the 21 patients were followed up from 21 months to 7 years with an average period of 3 years and 4 months.There were 30 osteotomy sites in 24 femurs,28 osteotomy sites showed bone union after 3-6 months from surgery.Two distal location of the double-level osteotomy showed nonunion,which received bone grafting again and got bone union after 3 months finally.The femoral mechanical alignments of the 21 patients had been recriticd.The average neck-shaft angle was 118°(range,95°-135°)postoperatively,the femoral varus angle disappeared.The average extremity lengthening was 2.8 cm(range,1.8-3.6 cm)postoperatively.There were no infection,recurrent fracture and progression of deformity.The visual analogue scales(VAS)score of 17 patients decreased to zero postoperatively from 7-10 preoperatively,and that of the other 4 patients decreased to 3-4 postoperatively from 8-10 preoperatively.The result of Harris hip functional score was excellent in 12 cases,good in 6,and fair in 3.Conclusion The valgus osteotomy can rectify varus deformity effectively.The reconstract nail of the fumer can support the stability of femur.Impacting of massive bone allograft can improve the capacity of the femur.

BACKGROUND: Body mass index(BMI)is a commonly used phenotype for obesity,which is determined by multiple genetic factors.OBJECTIVE: To investigate whether osteocalcin(also known as bone Gla protein,BGP)Hind Ⅲ genetic polymorphism is associated with BMI variation.METHODS: A total of 390 premenopausal women from a local population of Nanchang City were selected.Body weight and height were measured.All participants were genotyped at the BGP Hind Ⅲ locus using polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).RESULTS AND CONCLUSION: The BGP genotype frequencies of HH,Hh and hh were 0.077,0.408 and 0.515,respectively.The distribution of BGP Hind Ⅲ genotypes was consistent with Hardy-Weinberg equilibrium(P > 0.05).The BGP Hind Ⅲ were significantly associated with BMI(P=0.002),which could explain about 5.47% of BMI variation.On average,BMI of individuals with HH genotype was the highest[(22.81±0.73)kg/m2],individuals with Hh genotype was intermediate[(21.50±0.53)kg/m2],while individuals with hh genotype was the lowest[(20.23±0.63)kg/m2].Therefore,carriers of HH and Hh genotypes had,respectively,approximately 12.75% and 6.28% higher BMI than carriers of the hh genotype.To our best knowledge,this is the first study reporting the association of BGP Hind Ⅲ genetic polymorphism and BMI in healthy premenopausal women.

Objective To explore the effects of traditional Chinese medicinal herbs (TCMHs) on the expression of tyrosinase gene, melanogenesis and proliferation of melanocytes and elucidate the mechanism of TCMHs in promoting melanogenesis. Methods Seven TCMHs including Herba Ecliptae, Spica Prunellae, Caulis Spatholob, etc, which were known to be effective in activating tyrosinase in vivo, were selected. Brownish guinea pigs were selected as the experimental model. The mRNA in situ hybridization (ISH), Schmorl-staining and dopa-oxygenase staining were performed to observe the effects of TCMHs on gene expression of tyrosinase, melanogenesis and melanocyte proliferation. Results The mRNA ISH showed that these seven drugs, especially Herba Ecliptae,Spica Prunellae and Tribulus terrestris could significantly increase the number of positive cells and the intensity of hybridization signal in the treated group as compared with that in the control group (P 0.1). Conclusions These results suggested that these 7 TCMHs including Herba Ecliptae can upregulate the gene expression of tyrosinase, enhance the melanogenesis and promote the proliferation of melanocytes.