Objective To investigate the effects of caffeine on cerebral cortical activity in preterm infants. Methods The preterm infants with 28-34 week gestational age and without asphyxia at birth were recruited as the subjects from January to September 2016. The infants who received conventional caffeine citrate were assigned to the caffeine group, while the infants with the same postmenstrual age did not receive any drugs that excite respiratory center were assigned to the control group. In the caffeine group, after the use of caffeine citrate stopped, the amplitude integration electroencephalogram (aEEG) recording were performed at 33, 34, 35 weeks of postmenstrual age. All the aEEG recordings were continuously monitored for at least 4 hours. The aEEG images were assessed by Burdjalov scoring system, and the interburst intervals were calculated. The effects of caffeine on preterm infants' cerebral cortical activity in early life were analyzed. Results In a total of 49 preterm infants recruited, 21 were in caffeine group and 28 in control group, and the ratio of male and female was 1.45:1. At the same postmenstrual age, the total score and individual scores of aEEG assessed by Burdjalov scoring system were not significantly different between caffeine group and control group. However, the length of interburst interval was significantly shorter in caffeine group than that in control group (P<0.05). All the recruited preterm infants had no seizure-like activity when the aEEG was monitored. Conclusion The use of caffeine citrate has effects on EEG activity in early life of preterm infants, which may accelerate the brain maturation of preterm infants

Five min coronary artery occlusion followed by reperfusion in rats could produce arrhythmias which were rapid in onset & of short duration. The incidences of VT & VF being 100% & 72% respectively. Quinidine & dauricine reduced the incidence & severity of VT significantly; and abolished VF. Tetrandrine could reduce the incidence of VF significantly, but it had no significant effect on the incidence of VT.

Objective·To discusses the high risk factors and therapy strategies for ovarian hyperstimulation syndrome (OHSS). Methods·Seventy-seven cases with moderate and severe OHSS were collected to be retrospectively analyzed in Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine from January 2010 to December 2016. Results·Compared with non-pregnant patients, pregnant patients were more likely to have severe OHSS (P<0.05). Embryo transfer patients who underwent ovulation induction and oocyte retrieval became severe OHSS much more easily and had a much longer hospital stay than oocyte retrieval patients (P<0.05). Pumping ascites and pleural effusion or not has no effect on the length of hospital stay and the usage of low molecular dextran for patients with severe OHSS. Conclusion·The risk of OHSS should be evaluated to determine whether or not to carry out a fresh embryo transfer in patients who underwent ovulation induction and oocyte retrieval. For OHSS patients who have undergone embryo transfer or pregnancy, more attention should be paid to the progress of the disease, and individualized treatment is required.

Objective　To study the histologic source, clinical features and treatment methods of leiomyoma of the vagina. Methods　From January of 1988 to January of 1999, 25 patients with leiomyoma of the vagina were retrospectively analyzed. Results　The clinical features of leiomyoma of the vagina were slow in growth and solitary in number. Leiomyoma of the vagina can be recurrence and sarcomatous change. The symptoms of leiomyoma of the vagina depended on the size and location of the leiomyoma. Treatment consisted of surgical excision by vagina. Conclusions　Leiomyoma of the vagina is a rare condition. Whenever such a tumor is detected, it has to be removed immediately to prevent further growing and sarcomatous change in the future.

Objective To investigate the clinical application of mizoribine (MZR) in minimizing virus infection risk in renal transplant patients. Methods Four transplantation centers in Beijing participated in this clinical trial, and 112 primary cadaveric renal allograft recipients were enrolled. MZR in combination with CsA and corticosteroids was used for the prevention of acute rejection (AR). The biochemical data were observed and the infections of 7 different viruses were monitored and recorded. Results All patients were followed up for 12-20 months (average 15. 5 months). The patient/graft survival rate was 96% and the morbidity of AR was 11.6%. All ARs were converted. The major side effect was hyperuricimia, which could be controlled without withdrawal of MZR. The morbidity of CMV infection was 11.6% and no CMV diseases occurred. Only one case experienced adenovirus infection. Conclusions MZR is a safe and effective immunosuppressants. Hyperuricimia should be controlled after operation. The morbidity of virus infections was relatively lowered.

ObjectiveTo evaluate clinical-pathological features, diagnosis and therapy of gestational trophoblastic tumor (GTT) misdiagnosed as ectopic pregnancy. MethodsFrom 1999 to 2003, a total of 13 patients with GTT misdiagnosed as ectopic pregnancy were retrospectively analyzed. ResultsThe main symptoms were amenorrhea, abdominal pain, irregular vaginal bleeding. Serum beta-human chorionic gonadotrop in(hCG) was measured in 10 patients. Eight had hCG values above 10 000 IU/L; 3 had hCG values above 50 000 IU/L. The lesions of GTT misdiagnosed as ectopic pregnancy were fallopian tube, horn of uterus, peritoneal cavity, greater omentum, recto-uterine pouch. According to standards of the International Federation of Gynecology and Obstetrics(FIGO) the 13 patients were categorized as 6 of stage Ⅰ, 2 of stage Ⅱ, 3 of stage Ⅲ and 5 of stage Ⅳ. Histologically they included 10 cases of choriocarcinoma and 3 of invasise mole. All patients were treated by complete surgical resection combined with subsequent adjuvant chemotherapy. ConclusionsMisdiagnosis leads to delay in therapy with resultant increased morbidity of GTT.Analysis on serial hCG is helpful to differential diagnosis between ectopic pregnancy and GTT.

Objective To explore pre-thrombosis state in patients with cor pulmonale and the efficacy of anticoagulant treatment with low molecular heparin(LME). Methods 54 patients with cor pulmonale were divided into LMH treatment group and routine treatment group, each group containing 27 patients. The concentrations of Von Willlebrand factor (VWF),prethrombin F 1+2 fragment(F 1+2 ),Fibrinogen(Fg),granule membrane protein(GMP-140)and D-dimer fragment(DD)were measured before and after treatment. Results The concentrations of WF,F 1+2 ,Fg,GMP-140 and DD in the patients with cor pulmonale were significantly higher than those in the controls. In LMH treatment group, the above indices and PaCO 2 markedly decreased and PaO 2 obviously increased, while in routine treatment group, PaCO 2 and PaO 2 slightly improved, and no change was observed in coagulation indices. Conclusion Early detection and diagnosis of pre-thrombosis state in patients with cor pulmonale and immediate treatment with LMH can be beneficial to the prognosis of these patients in acute stage.

Objective:To investigate the gene polymorphism distribution of tumor necrosis factor-beta(TNF?) with SLE patient and different race in Chinese Han population of Jiangsu province.Methods:DNA samples were extraced from 168 EDTA-blood of unrelated healthy individuals and 66 SLE patients.TNF? alleles were typed using polymerase chain reaction-restrication fragment length polymorphism(PCR-RFLP). Results:The alleles frequencies of TNF? was higher significantly in Chinese Han population than in the White race;the gene frequencies of the TNF?*2 was higher significantly in SLE patients than in the normal controls(SLE patients 67.4%,normal controls 55.1%,P

BACKGROUND: Insulin resistance (IR) is associated with type 2 diabetes mellitus and its macrovascular complications. Euglycemic agent (rosiglitazone and metformin) can ameliorate IR, but its influences on other cardiovascular risk factors, including blood lipid, blood pressure and body mass need to be further studied.OBJECTIVE: To observe the effects of rosiglitazone and metformin on the blood glucose, blood lipid, blood pressure and body mass of patients with type 2 diabetes mellitus complicated by blood lipid disturbance.DESIGN: A clinical observation.SETTING: Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University.PARTICIPANTS: Forty-two patients with type 2 diabetes mellitus complicated by dyslipideamia, who received treatment in the Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University between June and September 2006 were recruited in this study. The involved patients, 27 male and 15 female, averaged (58±2)years ranging from 30 to 70 years old. Inclusive criteria:①Type 2 diabetes mellitus all met the diagnostic criteria of American Diabetes Association (2006).② Diagnostic criteria of blood lipid disturbance : total cholesterol(TC)＞ 4.68 mmol/L, triglyceride (TG) ＞ 1.7 mmol/L, low density lipoprotein cholesterol (LDL-C) ＞ 2.68 mmol/L, high density lipoprotein cholesterol (HDL-C) ＜ 0.9 mmol/L (female), ＜ 1.0 mmol/L (male). Informed consents were obtained from all the patients.METHODS：①Drug treatment：Dudng the 12-week treatment,all the patients received 0．75 g metformin(Lot No．051110 and 051214,0.25 g，lablel,Jiangsu Hengrui Medicine Co.，Ltd)and 4 mg rosiglitazone (Lot No．0511101,2 mg／tablet，Jiangsu Hengrui Medicine Co.，Ltd) daily．②Physical and laboratory measurements：Body mass index，blood pressure were taken，and blood lipid profile(TC,TG,C-LDL and C-HDL)，fasting and postprandial blood glucose were measured by colodmetdc method before,8 and 12 weeks after treatment．MAIN OUTCOME MEASURES：①Fasting and postprandial blood glucose level change．②Blood lipid，blood pressure and body mass index change．RESULTS：Forty-two patients with type 2 diabetes mellitus complicated by dyslipideamia were recruited，and three dropped out the experiment，one patient suffered from severe watery stool,one patient from severe abdominal distention,one patient from urinary tract infection, and the other thirty-nine patients completed the observation in the final analysis．Compared with pretraatment data,fasting and postprandial blood glucose levels 12 weeks after treatment were decreased(P＜0．01),TC increased(P＜0．05)，LDL-C decreased(P＜0．01)，HDL-C increased(P＜0．01),blood pressure did not change(P＞0．05) and body mass index increased(P＜0．01)．CONCLUSION：Combinatin of rosiglitazone and metformin significantly decreases blood glucose，decreases LDL-C,increases TC，HDL-C,body mass index,and has no obvious effects on TG and blood pressure．It is safe and bearable for type 2 diabetes mellitus patients with dyslipideamia．

Objective To inve stigate in vestigate the effects of splenectomy on the expression of the PTEN gene in liver fibrosis of rats induced by biliary tract obstruction.Methods The liver fibrosis model was induced by bile duct ligation.Rats were randomly divided into 3 groups.Group A had bile duct ligation + splenectomy (BDL + SPL,45 rats),group B had bile duct ligation + spleen sham operation (BDL + SSP,45 rats),and group C had sham bile duct ligation + spleen sham operation (SBDL + SSP,45 rats).Liver tissue samples from each group were taken in weeks 1,3,and 5.HE and Sirius staining displayed the degree of liver fibrosis.Western-blot,real-time PCR,and immunohistochemistry SP measured the expression of α-smooth muscle actin (α-SMA) together with the expression of PTEN mRNA and PTEN protein.The relevance was also tested in this study.Results As time increased,liver fibrosis gradually occurred in group A and B,and the degree of liver fibrosis was more serious in group B than in group A.The expression volume of PTEN mRNA and PTEN protein in group A was higher than that in group B (P ＜ 0.05),while the expression volume of α-SMA was the opposite (P ＜ 0.05).The expression volume of PTEN mRNA and PTEN protein were negatively correlated to α-SMA (r =-0.86,P ＜ 0.05).Conclusion In the rat liver fibrosis model,splenectomy up-regulated the expression of the PTEN gene and reduced the secretion of α-SMA,thereby delaying the progression of liver fibrosis.