Objective To explore the perinatal risk factors and clinical characteristics of complications of early term neonates.Methods Data of 5 468 live term newborns and their mothers hospitalized in the Third Affiliated Hospital of Zhengzhou University from January 2013 to December 2013 were analyzed.Background information,morbidity and complications of the mothers were compared among early,full and late term groups (n=l 933,3 013,412,respectively).And background information and incidence of complications were also investigated among neonates of early,full and late term groups (n=2 033,3 023,412,respectively),and neonates born between 37-37+6 (n=695) and 38-38+6 weeks (n=1 338).One-way analysis of variance,LSD-t test,logistic regression analysis,Chi-square or Fisher exact test,Pearson Chi-square test,corrected Chi-square test were used for statistical analysis.Results 1.Comparison among the early,full and late term group showed that higher proportions of elder gravida [21.1％(407/1 933),10.5％(317/3 013),6.8％(28/412),x2=127.690],multipara [43.7％(844/1 933),23.1％(697/3 013),15.0％(62/412),x2=287.765],scarred uterus [27.9％(539/1 933),8.9％(267/3013),1.5％(6/412),x2=396.521],higher incidence of cesarean section [75.2％(1 453/1 933),56.2％(1 693/3 013),54.1％(223/412),x2=196.348],hypertensive disorder complicating pregnancy [9.2％(178/1 933),3.5％(105/3 013),2.9％(12/412),x2=79.915],multiple pregnancy[5.1％(99/1 933),0.3％(9/3 013),0.0％(0/412),x2=147.860],gravidity＞1[63.1％(1 220/1 933),47.3％(1 425/3 013),39.6％(163/412),x2=147.668],premature rupture of fetal membranes[20.6％(398/l 933),14.2％(428/3 013),10.2％(42/412),x2=47.217],abnormal amniotic fluid[17.8％(344/1 933),12.3％(370/3 013),11.2％(46/412),x2=32.777],gestational diabetes mellitus[11.5％(223/1 933),5.9％(178/3 013),5.1％(21/412),x2=56.169],abnormal presentation [9.5％(184/1 933),5.1％(155/3 013),2.9％(12/412),x2=43.511],abnormal placenta [7.6％(146/1 933),3.1％(92/3 013),2.7％(11/412),x2=57.739],hysteromyoma[4.9％(94/1 933),2.3％(68/3 013),0.7％(3/412),x2=35.062] in the early term group than in the full and late term group,respectively (all P＜0.016).Multivariate logistic analysis showed that multiple pregnancy (OR=21.736,95％CI:10.785-43.806),scarred uterus (OR=3.302,95％CI:2.679-4.071) and hypertensive disorder complicating pregnancy(OR=2.658,95％CI:2.040-3.465) were the leading three perinatal risk factors for early term delivery.2.The incidence of the following neonatal conditions were different among early,full and late term infants (all P＜0.05):hyperbilirubinemia [12.5％(255/2 033),3.9％(119/3 023),4.9％(20/412),x2=138.343],infectious diseases [4.3％(88/2 033),2.0％(59/3 023),1.7％(7/412),x2=27.122],asphyxia[3.0％(60/2 033,1.4％(42/3 023),1.0％(4/412),x2=17.795],brain damage [2.3％(46/2 033),0.5％(15/3,023),10.％(4/412)],respiratory distress syndrome [1.1％(23/2 033),0.2％(7/3 023),0.0％(0/412)],feeding problems [2.0％(41/2 033),0.3％(10/3 023),1.0％ (4/412)],surgical diseases[2.0％(41/2 033),0.9％(28/3 023),1.5％(6/412),x2=0.709],intracranial hemorrhage [1.9％(39/2 033),0.9％(26/3 023),0.5％(2/412),x2=13.263],wet lung [0.9％(19/2 033),0.4％(11/3 023),0.5％(2/412)].Incidences of the above complications in the early term infants were all higher than in the full term infants,but when compared with the later term infants,only that of hyperbilirubinemia and infectious diseases was higher (all P＜0.016).Incidence of admission ot NICU [24.5％(170/695) vs 11.5％(153/1 338),x2=57.729],hyperbilirubinemia [19.0％(132/695) vs 9.2％(123/1 338),x2=40.046],infectious diseases[6.2％(43/695) vs 3.4％(45/1 338),x2=8.807],brain damage[4.0％(28/695) vs 1.3％(18/1 338),x2=14.828],and NRDS[2.0％(14/695) vs 0.5％(9/1 338),x2=7.329],feeding problems [3.2％(22/695) vs 1.5％(20/1 338),x2=6.271],intracranial hemorrhage [3.2％(22/695) vs 1.3％(17/1 338),x2=8.684],wet lung [1.7％(12/695) vs 0.5％(7/1 338),x2=7.049] of the early term infants born at 37-37+6 weeks were all higher than those born at 38-38+6 weeks(all P＜0.05).Conclusions Multiple pregnancy,scarred uterus and hypertensive disorder of pregnancy are the three leading perinatal risk factors of early term delivery.The incidence of neonatal complications among early term infants are higher than those among full term infants,and early term infants are more likely to stay in NICU.We should take preventive measures to decrease the rate of early term delivery and improve the follow-up management of early term infants.

STMN1 is a microtubule-destabilizing protein that regulates cell cycle by phosphorylation and dephosphorylation. It plays an important role in the proliferation and differentiation of cells, in addition to the tumorigenesis. This protein is highly expressed in a wide variety of human cancers, including leukemia and multiple types of solid tumors. The relationship between STMN1 and gastric cancer has recently been investigated. Studying STMN1 in gastric cancer is important. A number of studies have suggested that overex-pression of STMN1 can affect the therapeutic response of docetaxel, an anti-microtubule drug. This review summarizes the role of ST-MN1 in gastric carcinogenesis, development, prognosis, and treatment. The relationship between STMN1 and clinical pathology and its regulation pathways is also investigated.

Objective To explore the effect of early intervention on patients with severe illness deterioration induced multiple organ dysfunction syndrome(MODS). Methods 184 severe patients were randomly divided into conventional treatment and intervention groups(each,92 cases). Active treatment of primary disease and symptomatic treatment were given to the patients in the control group,and based on the treatment of the above group, low dose heparin was additionally given to the observation group for anticoagulation to change hemorheology. Before and after treatment for 1 week,life signs,blood routine test,blood biochemistry,blood coagulation index,D-dimer, hemorheology,blood gas analysis and acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score were observed in two groups to judge the overall changes of disease situation. The length of stay in intensive care unit(ICU), the incidence of MODS and mortality after 1 week treatment were compared between the two groups. Results The levels of platelet count(PLT),fibrinogen(Fib),D-dimer,whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity,white blood cell count(WBC),arterial blood lactate(Lac),alanine aminotransferase (ALT),serum creatinine(SCr),APACHE Ⅱ score in two groups after the treatment were decreased significantly, while oxygenation index(PaO2/FiO2),mean arterial pressure(MAP)were increased significantly,and the observation group improvement was better than that of the control group〔PLT(×109/L):180.74±85.59 vs. 214.33±78.68,Fib (g/L):3.15±0.83 vs. 3.22±1.89,D-dimer(g/L):0.35±0.17 vs. 0.72±0.25,whole blood high shear viscosity (mPa · s):5.54±2.26 vs. 6.73±2.48,whole blood low shear viscosity(mPa · s):8.56±2.12 vs . 11.76±3.45,plasma viscosity(mPa · s):1.35±0.24 vs. 1.82±0.50,WBC(×109/L):10.75±5.53 vs. 14.34±8.66,PaO2/FiO2(mmHg, 1 mmHg=0.133 kPa):288.52±85.34 vs. 216.34±97.72, MAP(mmHg):99.52±20.85 vs. 90.73±21.86, Lac (mmol/L):2.72±1.08 vs. 4.46±2.87, ALT (U/L):89.73±22.45 vs. 125.23±77.48, SCr (μmol/L):110.19±35.26 vs. 140.23±68.96,APACHEⅡscore:13.29±3.74 vs. 18.45±3.52,all P<0.05〕;in the control group,the activated partial thromboplastin time(APTT)after treatment was decreased significantly(s:40.76±9.89 vs. 42.39±12.47),while in the observation group,increased(57.50±7.12 vs. 41.74±13.62). Compared with the control group,the length of stay in ICU was shortered(days:4.1±1.5 vs. 4.6±2.3,P<0.05),the incidence of MODS (22.8% vs. 46.7%,P<0.05)and mortality(6.5% vs. 14.1%,P<0.05)were reduced significantly in observation group. No serious complications occurred in two groups. Conclusion Anti-coagulant used for early intervention can control the disease progress and prevent the patients with severe disease from further deterioration,thus it may reduce the incidence of secondary MODS and mortality,shorten the duration of hospitalization in ICU and save the cost.

To determine immune responses and immunopathology in ICOSL knockout (ICOSL KO) mice infected with Schistosoma japonicum,ICOSL- KO mice and wild-type C57BL/6J mice were used as experimental models for Schistosoma japonicum infection.The splenic lymphocytes were isolated from the mice the day before infection (0 week) as well as 4,7,12,16 and 20 weeks post infection,and stimulated with SEA for 72 hours in culture.The concentrations of Th1 cytokines (IFN-γand IL- 12) and Th2 cytokines (IL- 4,IL-10 and IL-13) in the culture supernatants were measured by sandwich ELISA.The levels of SEA-specific IgG antibody and its subtypes (IgG1 and IgG2a) were measured in mouse sera by ELISA.Pathological changes of hepatic granuloma in mice were determined by hematoxylin and eosin (H&E) staining.After the infection,the levels of Th1 cytokines,IFN- γ and IL 12,in ICOSL- KO mice were higher than those in wild-type C57BL/6J mice.However,the levels of Th2 cytokines (IL- 4,IL- 10 and IL- 13) were significantly decreased in ICOSL-KO mice compared to those in wild-type C57BL/6J mice.The levels of SEA-specific IgG antibody and its subtypes (IgG1 and IgG2a) in the sera of ICOSL- KO mice were also significantly lower than those of wild -type C57BL/6J mice.Moreover,the Th2 differentiation index was lower in ICOSL- KO mice than in wild-type C57BL/6J mice at 4,7,12,16 and 20 weeks post-infection.Similarly,the ratio of IgG1/IgG2a in ICOSL-KO mice was significantly lower than that in wild- type C57BL/6J mice at 7,12 and 16 weeks post- infection.Furthermore,throughout the course of disease progression,the volume of hepatic egg granuloma in ICOSL- KO mice was significantly smaller than that in wild-type C57BL/6J mice.In conclusions,there is a substantially down-regulated Th2 immune response in ICOSL- KO mice infected with Schistosoma japonicum,thus results in an attenuated hepatic lesion caused by egg granulomas.The findings indicate that the ICOS ICOSL co-stimulatory pathway plays an important role in the hepatic egg granuloma formation of schistosomiasis.

Objective To evaluate left ventricular systolic function by real-time three-dimension speckle tracking imaging (RT3D-STI) in coronary artery diseases (CHD) patients,to determine the clinical value of RT3D-STI in CHD.Methods 34 control subjects and 55 patients with CHD by coronary angiography were involved.Left ventricular global longitudinal strain (GLS),left ventricular global circumferential strain (GCS),left ventricular global radial strain (GRS),left ventricular global area strain (GAS) and left ventricular ejection fraction (LVEF),etc,was acquired by RT3D-STI,respectively.The parameters by RT3D-STI to diagnose CHD were analyzed.Results Compared with control group,GLS,GCS,GRS and GAS were significantly decreased in CHD group (P ＜ 0.05).The area under receiver operating characteristics (AUC) curve of GLS to diagnose CHD was 91.6％.The cutoff value,the sensitivity and Youden index of GLS were-12.5,90.3 ％ and 0.612,respectiuely.The cutoff value,the sensitivity and Youden index of GAS were-23.0,95.8％ and 0.539,respectiuely.GLS,GAS correlated well with LVEF in CHD group (r =-0.860,r =-0.926).Conclusions GLS is the most sensitivity and GAS is the most specificity in the all of strain parameters.RT3D-STI can early show the changes of left ventricular global systolic function in patients with CHD.

Three pSIREN-siRNA plasmids were constructed using a pSIREN-RetroQ vector to silence the expression of muhidrug resistance-associated protein (MRP1) gene, and subsequently characterized by restriction endonuclease digestion and DNA sequencing. A truncated MRP1 and a full-length MRP1 were cloned into pEGFP-N2 and PeDNA3.1 respectively as pEGFP-MRP1T and pcDNA-MRP1. The plasmid pEGFP-MRP1T was co-transferred with each of the three pSIREN-siRNAs into HEK293 cells for MRP1T-GFP targeted silencing, and pSIREN-siRNA1 was used as the negative control, pSIREN-siRNA2 and pSIREN-siRNA3 appeared to be more effective to silence MRP1T-GFP compared to pSIREN-siRNA1 as shown by fluorescence microscopy. For the silencing of full-length MRP1 expression, HEK293 ceils were co-transferred with pcDNA-MRP1 and either of the three pSIREN-siRNAs, then subjected for Western blot analysis and MTT assays, pSIREN-siRNA2 and pSIREN-siRNA3 were able to inhibit the expression of 190 kD MRP1, but not pSIREN-siRNA1. The MDR of MRP1-transfected HEK293 ceils was abolished with pSIREN-siRNA2 or pSIREN-siRNA3 transfections. RNA secondary structure predictions demonstrated that the mRNA local free energy (△G) of the siRNA1 targeted sequence was lower, as the GC content and Tm value of siRNA1 were higher than those of siRNA2 and siRNA3. These data suggest that the local structure siRNAs and target mRNA may influence the silencing efficiency of MRP1 expression.

Objective To explore the function of specialized training course in training singleport laparoscopic skills.Methods The specialized training course for single-port laparoscopy included cutting rubber bands into‘Z’shape,cutting‘petaloid’folded slips and peeling oranges.Twelve residents were enrolled into traditional laparoscopy training for one week and then randomized into two groups:6 trainees performed the specialized training course for 2 h daily and the others as the control group continued to practice the traditional course for 2 h daily.One week later,the trainees were tested on performing porcine single-port laparoscopic nephrectomy.Operation time and performance was compared.T test were performed using SAS 9.1.3 statistics software,and a P＜0.05 was considered to be statistical significance.Results Operation time of the specialized group was decreased significantly(59.2±17.3)min vs.(87.0±25.5)min,P=0.049,and the total global rating scale score increased significantly(26.3±2.2 vs 18.2±2.8,P=0.000 17).Conclusion The specialized course is beneficial to the training of single-port laparoscopic skills.

Objective To investigate the left ventricular remodeling (LVR) patterns and its relationships with cardiovascular risk factors in patients with obstructive sleep apnea syndrome (OSAS).Methods 148 patients with habitual snoring were diagnosed OSAS by polysomnography with AHI≥5 /h and blood pressure was monitored at same time.The clinical characteristics were collected and echocardiography was done next morning.LVR patterns was categorized as normal geometry (NG),concentric remodeling (CR),eccentric hypertrophy (EH) and concentric hypertrophy (CH) on the basis of RWT ＞0.42 and LVMI ＞46.7 g/m2.7 (female) or 49.2 g/m2.7 (male).Multinomial logistic regression was used to analysis the correlation of cardiovascular risk factors and LVR patterns.Results ①Of 148 OSAS patients,there were 115 (77.7％) with abnormal LVR,NG 33 (22.3％),CR 35 (23.6％),EH 37 (25％)and CH 43 (29.1 ％).②General clinical characteristics:Compared with NG group,BMI and waistline were increased in EH group (P ＜0.05 or P ＜0.01) ; Age,BMI,waistline,hypertension,dSBP and nSBP were increased in CH group (P ＜0.05 or P ＜0.01).Compared with CR group,male,age,BMI and waistline were increased in EH group (P ＜0.05 or P ＜0.01).Male,age,BMI,waistline,hypertension,nSBP and TG were increased in CH group (P ＜ 0.05 or P ＜ 0.01); Compared with EH group,the prevalence of hypertension was increased in CH group (P ＜0.05); Compared with EH group,the prevalence of hypertension was increased in CH group (P＜0.05).③Polysomnography parameters:Compared with NG group,AHI and ODI were increased in CR group (P＜0.05 or P＜0.01).AHI,ODI and T90 were increased,while Mean SaO2 and Lowest SaO2 were decreased in CH group (P ＜0.05 or P ＜ 0.01);Compared with CR group,AHI was decreased in EH group (P ＜0.05).Mean SaO2 was decreased,but T90 was increased in CH group (P＜0.05 or P ＜0.01); Compared with EH group,Lowest SaO2 was decreased in CH group (P＜0.05).④Blood pressure:Compared with NG group,4:00 SBP and 6:00 SBP were increased in CH group (P＜0.05) ;Compared with CR group,22:00 SBP was increased in CH group (P ＜0.05).⑤ In multinomial logistic regression analysis,after adjusting the confounding factors,CR was associated with AHI [odds ratio (OR) 1.035,P =0.024.EH was associated with Age (OR 1.094,P =0.016),BMI (OR 1.397,P =0.011) and 4:00 SBP (OR 1.124,P =0.026).CH was associated with Age (OR 1.084,P =0.028).Conclusions OSAS could cause result in LVR and the prevalence of four patterns were similar..Age and AHI were significant determinants of CH and CR respectively.Age,BMI and 4:00 SBP were significant determinants of EH.

Objective To detect changes of regional grey matter and white matter volume in patients of neuromyelitis optica (NMO) by voxel-based morphometry (VBM),and investigate its relationship with clinical variables.Methods Conventional magnetic resonance imaging (MRI) and structural threedimensional MRI were obtained from 20 NMO and 20 sex-and age-matched healthy volunteers.The comparison of grey matter and white matter volume between the two groups was analyzed by VBM tools of statistical parametric mapping (SPM) 5.Pearson correlational analysis was used to assess correlations between regional volume decrease and disease duration and expanded disability status scale (EDSS) scores in NMO patients.Results Compared with normal controls,NMO patients had grey matter atrophy in several cortical regions,such as right inferior frontal gyrus (cluster size 514),left superior temporal gyrus (282),right middle temporal gyvus (229) and right insula (211) (t =3.58-5.11,AlphaSim corrected,P ＜0.05).White matter atrophy was found in several subcortical regions in NMO patients,such as right precentral and postcentral gyrus (cluster size 457,110),left middle frontal gyrus (285),and right inferior parietal lobule (231) (t =2.90-4.25,AlphaSim corrected,P ＜ 0.05).Grey matter and white matter volume loss were not significantly correlated with clinical duration or EDSS score in NMO.Conclusion By means of VBM,regional atrophy of grey matter and white matter is found in NMO patients,which may provide evidence for brain structural abnormality in NMO.

Objective To study the changes of plasma endotoxin and procalcitonin in patients with esophagogastric varices and provide a theoretical basis for prophylactic antibiotics after endoscopic treatment. Methods Fifty cases of patients with esophageal and gastric varices accepted the endoscopic treatment.The patients were divided into antibiotic group (32 cases)and non-antibiotic group (18 cases).The plasma endotoxin and procalcitonin were measured before and on the first day and 7th day after endoscopic treatment.Results The plasma levels of endotoxin and procalcitonin were not significantly different on the first and 7th day after endoscopic treatment compared with preoperative levels in antibiotic group.But in non-antibiotic group,the levels significantly increased on 7th day after endoscopic treatment compared with preoperative levels (P <0.05).And in patients of Child-Pugh A grade,the level of plasma procalcitonin significantly increased on 7th day after endoscopic treatment compared with preoperative levels (P <0.01), but the procalcitonin was not significantly different on the first and 7th day after operation.And in patients of Child-Pugh B and C grades,the levels of plasma endotoxin and procalcitonin significantly increased on the 7th day(P <0.01).Conclusion The levels of plasma endotoxin and procalcitonin in non-antibiotic group increase after endoscopic treatment,which suggests the risk of infection.Prophylactic antibiotics after endo-scopic treatment should be considered for the patients of Child-Pugh B and C grades.