Objective To explore the clinical effect of uterine artery embolization on cesarean scar pregnancy (CSP) and curettage opportunity.Methods Sixty-three patients with CSP received curettage after uterine artery embolization with gelfoam were selected.Among of them,21 cases received curettage within 24 h after uterine artery embolization (group A); 20 cases within 1-3 d (group B);22 cases within 4-7 d (group C).The intraoperative haemorrhage,serum β-human chorionic gonadotropin (β-hCG)level resolution time,duration of hospital stay,hospitalization cost,postoperative complications were observed after the termination of the pregnancy.Results The duration of hospital stay and hospitalization cost in group A and group B were (10.5 ± 3.9),(10.2 ± 5.2) d and (7353 ± 962),(7594 ± 1032) yuan,respectively,and there was no significant difference (P ＞ 0.05).Which was lower than that in group C [(13.9 ± 5.4) d,(10 980 ± 1534) yuan],and there was significant difference(P ＜ 0.01).The intraoperative haemorrhage,serum β-hCG level resolution time and postoperative complications in group B and group C were(20.2 ± 8.8),(20.7 ± 9.3) ml and (25.9 ± 9.3),(25.7 ± 8.1) d and 40.0％(8/20),40.9％(9/22),and there was no significant difference(P＞ 0.05).But which was better than those in group A[(35.0 ± 10.7) ml,(20.5 ± 7.7) d,66.7％ (14/21)],and there was significant difference (P ＜0.01).Conclusions The treatment of curettage after the uterine artery embolization is a safe and effective method for CSP.There are fewer complications,shorter hospital stays and fewer hospitalization costs if receiving curettage within 1-3 d after uterine artery embolization.

Objective To establish chronic sleep deprivation mouse model,evaluate the learning and memory ability of mice and observe autophagy and apoptosis levels in mouse brain.Methods C57BL/6 mice (n =20) were randomly separated into sleep deprivation group and control group.After 2-month sleep deprivation by using an adapted multiple platform method,the behavioral performance of mice was measured by IntelliCage system.The expression of microtubule associated protein 1 light chain 3-Ⅱ (LC3-Ⅱ) and Beclin-1 was detected by Western blotting.Confocol microscopy was used to observe autophagosome.In addition,terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) staining was performed to detect neuronal apoptosis level in mouse brain.Results The results of behavioral test showed that the incorrect visit ratio was much higher in sleep deprivation group than that in control group.Moreover,the expression of LC3-Ⅱ (sleep deprivation group 1.681 ± 0.186,control group 1.125 ±0.048,t =2.892,P =0.027 6) and Beclin-1 (sleep deprivation group 1.144 ±0.048,control group 1.006 ± 0.017,t =2.721,P =0.018 6) in mouse hippocampus and cortex was significantly elevated in sleep deprivation group than those in control group.Accordingly,the confocal microscopy observation also revealed an increased nuclear LC3-positive puncta in hippocampus and cortex of sleep deprived mice (hippocampus in sleep deprivation group 1.665 ± 0.153,in control group 0.819 ± 0.072,t =5.024,P =0.002 4;cortex in sleep deprivation group 1.925 ± 0.175,in control group 1.195 ± 0.111,t =3.521,P =0.012 5).In addition,TUNEL staining showed a much higher percentage of TUNEL-positive nuclei in these brain regions (hippocampus in sleep deprivation group 47.24 ± 4.15,in control group 19.26 ± 3.72,t =5.025,P =0.007 4;cortex in sleep deprivation group 42.25 ± 1.25,in control group 27.50 ± 3.23,t =4.262,P =0.005 3).Conclusions Chronic sleep deprivation can impair the learning and memory,increase the expression of LC3-Ⅱ and Beclin-1,elevate the formation of autophagosome,and promote apoptosis in mouse brain.These findings suggest that autophagy and apoptosis might be involved in the cognitive impairment induced by chronic sleep deprivation.

Objective To investigate the relationship between HLA DRB1 gene polymorphism and susceptibility to leukopenia in patients with Graves′ disease (GD). Methods The HLA DRB1 alleles were typed by the polymerase chain reaction based sequence specific primer (PCR SSP) method in 45 GD patients with leukopenia, 50 GD patients without leukopenia and 90 normal controls. The allele frequencies in the leukopenic GD group were compared with those in the GD patients without leukopenia and control group. Results (1)Gene frequencies of HLA DRB1*08 (P

Objective:To investigate the biomechanical effect of magn et ic expansion by a new electronic speckle pattern interferometry. Methods :One fresh human skull of 12 years old with intact suture tissues and pe riodontal membrane was adopted. Magnetic expansion was loaded on the maxilla for 1,5,15,30 and 60 min respectively by magnetic force (NdFeB).Relative informa tion on the maxillary complex was acquired by electronic speckle pattern interfe rometry(ESPI). The deforming fringes was processed by the microcomputer image s ystem and the corresponding out-of plane displacement of the maxillary complex was analyzed. Results:Fringes of the maxillary complex were obs erved on monitor screen when magnetic force was loaded. From 1 min to 30 min-lo ading the fringe density was increasing, but decreased 1 h after loading. There was no fringe in the suture of the skull. Greate deformity was found on the lowe r part of maxilla. Conclusion:Magnetic force of expansion is con centrated in the deep structure of the maxillary complex.

Objective To investigate the expression and significance of osteopontin (OPN) and monocyte chemoattractant protein-1 (MCP-1) in lipid -induced rat renal injury. Method Wistar rats were randomly divided into two groups: normal control rats (C group) and cholesterol fed rats (H group). Twelve weeks later, the 24h total urine protein amount, creatinine clearance rate and the levels of total serum cholesterol, LDL- cholesterol, HDL- cholesterol and triglycerides were measured. Kidney pathological changes were observed by HE and PAS statning. Immunohistochemitry were used to detect the expression of OPN, MCP-1 and ED1. Results Total serum cholesterol level, LDL-cholesterol level and 24h total urine protein amount in H group rats were higher than those in C group rats, and there were no significant difference between two groups in HDL-cholesterol and triglycerides level. Compared with C group rats, the expression of OPN and MCP-1 increased in cortical tubular epithelium of H group rats, and the number of ED1 + cells increased in tubulointerstitium as well. Either OPN or MCP-1 expression was positive correlation with the number of ED1 + cells. Conclusion The expression of OPN and MCP-1 in tubular epithelium increased in hypercholesterolemia rats, which might mediate M? infiltration into tubulointerstitium and lead to interstitial fibrosis.

ObjectiveThe purpose of this research was to investigate functional connectivity of 16-channel electroencephalograph(EEG) in δ frequency band based on Granger causality analysis.MethodsThe experimental data was recorded at a sampling rate of 200 Hz from temporal lobe epilepsy (TLE) patients(6 left and 3 right TLE,and 9 normals as control group.Ten of EEG segments of 20 s length for three different states:epileptiform discharges (ED) state in interictal durations,non-ED state for TLE patients,and control state for the normal.The δ band components (1～4 Hz) were filtered from EEGs.The functional connection values Iδ between two EEG δ components were calculated separately by Granger causality analysis.The two EEG components were from inferoposterior temporal lobe (left:T5,right:T6) to frontal lobe (Fp1,Fp2,F3,F4,and parietal lobe (C3,C4) for three states.ResultsThe Iδ values for ED state was 0.1323±0.0329～0.1670±0.028 9,which was significantly higher than that of non-ED state (0.0300±0.0130～0.0420±0.0072) (P＜0.05).The Iδ values for the control group (0.0153±0.0028～0.0193±0.0057) was much lower than that of ED state (P＜0.01),and no obvious distinctions were observed compared with non-ED state at P=0.05 level.ConclusionThere is a stronger connection of EEG' s δ bands from the inferoposterior temporal lobe to frontal and parietal lobe for the ED state,and the over-discharges transmission is from inferoposterior temporal lobe to other brain regions.There is a weaker connection from the top temporal lobe to frontal and parietal lobe for non-ED state and control group,and the onset zones is not inferoposterior temporal lobe.

ObjectiveTo investigate feasibility of use of glucose injection instead of glucose powder in oral glucose tolerance test (OGTT). MethodsSixty healthy adult volunteers without history of diabetes were recruited for a standard OGTT with 75 g anhydrous glucose powder first. One week later, they were randomly divided into two groups, each of the one group (30 volunteers) orally took seven ampoules (20 ml/ampoule) and each of the other group (30 volunteer) took 7.5 ampoules of 50％ glucose injection for OGTT again, as compared to those with standard OGTT.Plasma levels of glucose and insulin were examined to evaluate whether different forms and dosage of glucose had similar results in OGTT. ResultsIn 23 volunteers with normal glucose tolerance, their plasma levels of glucose were ( 4. 8 ± 0. 4 ), ( 6. 7 ±0. 6), (5.9 ±0. 8), (5.5 ±0. 9) and (4. 8 ±0. 9) mmol/L at 0, 30, 60, 120 and 180 min after oral load with 75 g anhydrous glucose powder, respectively. These values changed to (4. 8 ± 0. 3 ), (7.5 ± 1.1 ),(6.8±1.8), (6.3 ±1.0) and (4.6 ±1.2) mmol/Lor (4.7 ±0.3), (7.2±1.3), (6.1 ±1.1),(5.6 ± 0. 9 ) and (4. 3 ± 0. 9) mmol/L after oral load with seven ampoules ( 15 volunteers) or 7. 5 ampoules of (8 volunteers ) of 50％ glucose injection, respectively.With standard OGTT, 37 cases of impaired glucose tolerance were found from 60 volunteers tested, and their plasma levels of glucose were (5. 2 ±0.6), (9. 1 ±1.4), (8.9 ±2.6), (6.7±2.0) and (4.7 ±1.0) mmol/L at 0, 30, 60, 120 and 180 min after oral load with 75 g anhydrous glucose powder, respectively; (5. 1 ± 0. 7 ), ( 8. 8 ± 1. 7 ), (9. 0 ±3.0), (7.3±2.2) and (5.1 ±1.1) mmol/L (15 volunteers) or (5.3 ±0.6), (8.8 ±1.9), (8.5 ±2. 4), (6. 6 ± 1.4) and (4. 8 ± 1.6) mmol/L (22 volunteers) at 0, 30, 60, 120 and 180 min after oral load with seven or 7.5 ampoules of 50％ glucose injection, respectively, with no statistically significant difference between varied methods.Normal serum level of insulin was found in 38 of 60 volunteers, with their logarithmic transformation of serum insulin levels of 1.5 ± 0. 3, 3.9 ± 0. 3, 3.7 ± 0. 4, 3.2 ± 0. 6 and 2.2 ±0. 8 at 0, 30, 60, 120 and 180 min, respectively after glucose load in standard OGTT, and 20 of 38 volunteers with normal serum insulin of 1.7 ± 0. 4, 3.9 ± 0.4, 3.4 ± 0. 7, 3.3 ± 0. 8 and 2. 4 ± 0. 7 at 0,30, 60, 120 and 180 min after oral load with seven ampoules of 50％ glucose injection, respectively, or 18 of 38 with normal serum insulin of 1.7 ± 0. 4, 3.9 ± 0. 4, 3.8 ± 0. 5, 3. 3 ± 0. 7 and 2. 3 ± 1.0 at 0, 30,60, 120 and 180 min after oral load with 7. 5 ampoules of 50％ glucose injection, respectively, with no statistically significant difference between varied methods. Twenty-two cases of high serum level of insulin were found from 60 volunteers with standard OGTT, with their logarithmic transformation of serum insulin of 2.2±0.6, 4.7 ±0.5, 4.9±0.7, 4.2 t 1.0 and 2. 8 ±0.9 at0, 30, 60, 120 and 180 min after oral load with 75 g anhydrous glucose powder, respectively; 10 of 22 volunteers were found with high serum insulin level of its logarithmic transformation of 2. 4 ± 0. 6, 4. 7 ± 0. 5, 4. 7 ± 0. 3, 4. 1 ± 0. 8 and 2. 8 ± 1.1 at 0,30, 60, 120 and 180 min after oral load with seven ampoules of 50％ glucose injection, respectively ; and 12 of 22 volunteers were found with high serum insulin level of its logarithmic transformation of 1.9 ± 0. 5,4. 5 ± 0. 6, 4. 6 ± 0. 6, 3. 7 ± 1.0 and 2. 4 ± 0. 9 at 0, 30, 60, 120 and 180 min after oral load with 7. 5ampoules of 50％ glucose injection, respectively; with no significant difference between varied methods.There also was no statistically significant difference in occurrence of adverse effects between these three OGTT methods. ConclusionsEither seven or 7. 5 ampoules of 50％ glucose injection can substitute 75 g anhydrous glucose powder in OGTT, with similar test results and safety.

Objective To compare efficacy of female sterilization by modified Uchida technique and silver clips and to evaluate the influence on operation procedure and clinical effect with or without surgery training of service providers. Methods A comparative, multicenter clinical trial was performed in 18 county and township-level service centers. Totally 2198 women underwent sterilization from these 18 study center were divided into 1116 women sterilized by modified Uchida technique and 1082 women by silver clips.Those 18 centers were classified into 9 training groups which provide surgical skills of sterilization and other contents and 9 non training groups. Clinical documents of sterilization were recorded. All women were followup at 3, 6 and 12 months after surgery. Results There were no complications during surgery by both sterilization. The failure rate was 2.03% (22/1082) in silver clip method and the mean operative time were ( 12. 4 ± 6. 4 ) minutes in training group and ( 14. 4 ± 8. 1 ) minutes in non training group. In modified Uchida method, the failure rate was 0. 18% (2/1116) and the mean operative time were (16. 2 ± 4. 9)minutes in training group and (19.0 ±8.6) minutes in non training group. The mean operative time between two groups reached statistical difference ( all P ＜ 0. 05 ). Total ended rate in modified Uchida technique were 2. 2/hundred women year in training group and 2. 5/hundred women year in non training group, and the rate of silver slips were 3. 9/hundred women year and 4. 8/hundred women year, which did not show significant difference ( all P ＞ 0. 05 ). There was no significant difference in acceptability and side effects of all women between two methods (P ＞ 0. 05). The training of service providers could influence acceptability of women (P ＜ 0. 05). Conclusions Clinical efficacy was not influenced by those two methods. The operative time and acceptability were improved by training surgeons in silver clips method.

Objective To explore the value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in assessing severity and predicting prognosis in children with severe hand-foot-mouth disease (HFMD).Methods A total of 119 eligible children with severe HFMD admitted in the pediatric intensive care unit were enrolled in this retrospective study from March 2012 to March 2014.According to NT-proBNP level,children were divided into ≤ 500 pg/mL group (n =70) and ＞ 500 pg/mL group (n =49) ; whereas according to severity,children were divided into severe-type (n =74) and critical-type (n =45) ; and based on 28 days outcome in children with critical-type HFMD,children were divided into fatal group (n =27) and survival group (n =18).The chi-square test,two-sample t test,rank sum test Pearson or Spearman' s correlation,area under the receiver operating characteristic curve (AUC) were used to analyze 119 children with severe hand-foot-mouth disease (HFMD).Results Within 24 hours after admission,NT-proBNP ＞ 500 pg / mL group had higher rates of fever,abnormal breathing,abnormal heart rate,abnormal systolic blood pressure,capillary refill time ＞ 2 seconds and higher levels of laboratory biomarkers than NT-proBNP ≤ 500 pg/mL group (P ＜ 0.05) ; and during hospitalization,the rates of pulmonary edema,pulmonary hemorrhage and death also higher than NT-proBNP ≤ 500 pg/mL group (P ＜ 0.05).NT-proBNP,BS,WBC were higher in critical-type group than severe-type group (P =0.00),while the PCIS (pediatric critical illness score) was lower in critical-type group (x2 =14.70,P =0.00).NTproBNP was higher in fatal group than that in survival group (t =-2.60,P =0.01),PCIS was lower in fatal group (Z=2.70,P=0.01); and there were no statistically significant differences in BS and WBC between fatal and survival groups (BS:t =-0.60,P=0.55; WBC:t =-0.72,P=0.48).NT-proBNP,BS and WBC were negatively correlated with PCIS (r values were-0.58,-0.46,-0.56,P values were 0.00).The AUCs of NT-proBNP,BS,WBC and PCIS to determine the severity of severe HFMD children were 0.94,0.80,0.74,and 0.97,respectively; and to predict 28 days survival in criticaltype HFMD were 0.73,0.56,0.53,and 0.73,respectively.Conclusions Higher level of NT-proBNP could prompt cardiopulmonary involvement.NT-proBNP could reflect the severity of illness and served as a sensitive marker in predicting 28-day survival,being better than BS and WBC.

Objective: To observe the treatment effect of acupoint sticking at Shenque (CV 8) with ginger-preparedBan Xia (Rhizoma Pinelliae) on nausea and vomiting induced by Amifostine for myelodysplastic syndromes (MDS).
Methods: Totally 124 eligible subjects intervened by Amifostine were randomized into 2 groups by the visiting order,an observation group and a control group,62 in each group. The control group was intervened by conventional treatment, while the observation group was by acupoint sticking at Shenque (CV 8) with ginger-preparedBan Xia (Rhizoma Pinelliae) in addition to the same conventional treatment. The occurrence rate of nausea and vomiting in the two groups were observed.
Results: After intervention, the occurrence rate of nausea and vomiting in the observation group was significantly lower than that in the control group (P<0.01).
Conclusion: Acupoint sticking at Shenque (CV 8) with ginger-prepared Ban Xia (Rhizoma Pinelliae)can produce a content effect on nausea and vomiting induced by Amifostine for MDS.