Objective To dynamically observe the plasma levels of MFG-E8 in mice with obstructive jaundice and the expression of MFG-E8 mRNA and protein in liver,spleen,lymph nodes and thymus,and to investigate their significance in obstructive jaun-dice.Methods The mice models of obstructive jaundice were established and divided into the sham operation group and the common bile duct ligation group.Western blot was adopted to detect plasma MFG-E8 protein expression in obstructive jaundice mice on 3,7, 14 d;the MFG-E8 mRNA expression changes in liver,spleen,lymph nodes and thymus tissue were detected by RT-PCR;the MFG-E8 protein expression in the above organizations was detected by Western blot.Results Plasma MFG-E8 protein levels at each time point in the obstructive jaundice mice were significantly lower than those in the control group (P<0.05);MFG-E8 mRNA expres-sion in liver,spleen,lymph nodes and thymus tissue was significantly decreased (P<0.05),meanwhile the MFG-E8 protein levels in liver,spleen,lymph nodes and thymus tissue were significantly decreased (P<0.05).Conclusion the expression of MFG-E8 in obstructive jaundice immune tissue is significantly decreased,which may have a significant impact on the clearance of apoptotic cells in obstructive jaundice.

Objective To observe the protection effect of adrenomedullin(AM)and adrenomedullin binding protein-1 (AMBP-1) on the intestinal mucosal barrier after obstructive jaundice.Methods 24 male Sprague-Dawley rats were randomly divided into the Sham group,obstructive jaundice control group(Vehicle)and AM/AMBP-1 treatment group(n=8).Obstructive jaundice was in-duced in adult rats(180-220 g)by common bile duct ligation(CBDL).On 6 d after CBDL,the rats were administered through fem-oral vein with AM/AMBP-1(24/80μg/kg).Blood and tissue samples were collected at 24 h after administered AM/AMBP-1 for various measurements.The intestinal permeability of all rats was measured by fluorescein isothiocyanate-dextran(FITC-D).Serum concentration of TNF-αwas measured by enzyme-linked immunosorbent assay.The apoptosis of intestinal cells was detected by ter-minal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL).The expression of cleaved caspase-3 was measured by Western blot.The inj ury condition in the small intestinal mucosa was assessed by the Chiu′s scoring under microscope.Results Compared with the Sham group,the permeability of intestinal mucosa in the Vehicle group was increased (P<0.05)and serum TNF-αlevel was increased obviously (P<0.05).The expression of cleaved caspase-3 protein,the apoptosis index(AI)and the Chiu′s score were increased in the Vehicle control group(P<0.05).Compared with the Vehicle control group,the permeability of intestinal mucosa was significantly improved (P<0.05),serum TNF-αwas decreased in the AM/AMBP-1 group(P<0.05).The expression of cleaved caspase-3,the AI index and Chiu′s score were significantly decreased in the AM/AMBP-1 group(P<0.05). Conclusion AM and AMBP-1 can significantly improve the high permeability state of the intestinal mucosa in obstructive jaundice rat,reduce the apoptosis of the small intestinal tissue,alleviate the systemic inflammatory reaction and have the protective effect on the intestinal mucosal barrier.

Objectives:To construct rGA antisense eukaryotic expression vector. Methods:Using molecular cloning technology, we subcloned rGA cDNA in its antisense orientations of the pcDNA 3.0 vector. Results:Cutting with Eco RⅠ and Hin D Ⅲ,antisense recombinant plasmid produce 2 bands. One was 0.28 kb fragment, the other was 5.5 kb fragment which corresponded to theoretical calculation. Conclusions:We succeeded in constructing rGA antisense eukaryotic expression vector.

To evaluate the effectiveness and safety of transvaginal cervical cerclage and to investigate the influencing factors in prognosis. Methods The medical records of 85 cases who underwent transvaginal cervical cerclage in Peking Union Medical College Hospital from January, 1985 to September, 2011 were reviewed. Patients with a typical history of recurrent preterm birth/second trimester miscarriage, or for whom the 8.0 mm Hegar uterine dilator could be pushed through the internal cervical os without resistance during the non-pregnancy period were included in the elective cerclage group (n=69) and those diagnosed as cervical insufficiency during pregnancy were included in the emergency cerclage group (n=16). The numbers of premature birth/second trimester miscarriage, gestational age at cerclage, gestational age at delivery and its influencing factors were compared between the two groups. T test, rank sum test and Fisher's exact test were used for statistical analysis. Results All patients underwent cerclage between 13+3 and 26+6 weeks of gestation without major complications, such as rupture of membrane, placental abruption or bladder injury. Patients in the elective cerclage group underwent the procedure significantly earlier than those in the emergency cerclage group [16.6(15.4, 18.3)vs 22.7(19.5, 24.6)weeks, Z=-5.140, P<0.05]. Nine cases had lost to follow-up. Among the remaining 76 cases, the rate of infection after surgery was 18.4%(14/76);the rate of abortion was 17.1%(13/76); and the rate of live birth was 82.9%(63/76). The live birth rate of the emergency group was lower than that of the elective cerclage group [9/15 vs 88.5%(54/61), Fisher's exact test, P<0.05]. Apparent infection after surgery was observed more frequently in the emergency group than that in the elective cerclage group [6/15 vs 13.1% (8/61), Fisher's exact test, P<0.05]. Uterine malformation, infection after surgery and latent infection befor surgery were unfavorable factors associated with miscarriage and early preterm labor. Conclusions Transvaginal cervical cerclage is a safe and effective treatment for cervical insufficiency. Elective cervical cerclage is superior to emergent cerclage. Emphasis should be placed on the monitoring and treatment of perioperative infection. Cervical cerclage should be undertaken with caution in patients with uterine malformation.

Cultivating clinical comprehensive ability is one of the core and main purposes for surgical clinical education.According to the characteristics in clinical teaching of hepatobiliary surgery,we combined basic theory with clinical practice and discussed on the problems of how to improve medical students' clinical comprehensive abilities including clinical operational ability,logical thinking ability,scientific research innovative ability and the doctor-patient communication ability and how to cultivate medical ethics and professional competence from aspects of basic clinical skills training,translational medicine concept,etc.

Objective To construct the recombinant plasmid carrying antisense GA cDNA, and evaluate the effect of antisense GA gene on the biological characteristics of colon cancer cells. Methods The recombinant plasmid pcDNA3.0/GA containing antisense GA gene was constructed by gene recombination technique. The recombinant plasmid was transfected into colon cancer cells by lipofectamine. The effect of antisene GA gene on the biological characteristics of colon cancer cell line DH52 was evaluated by MTT and electron microscopy. Results The recombinant plasmid pcDNA3.0/GA was successfully constructed. The growth rate of colon cancer cells decreased, and microstructure of the cells appeared typical apoptotic changes after transfection. Conclusion Antisense GA gene could inhibit the growth of colon cancer cells possibly by suppressing GA gene expression and decreasing GA activity in the colon cancer cells.

AIM:To put forward three-level design(Box-Behnken design)for fitting response surfaces to optimize the extraction technology of total flavonoids from Hypericum ascyron L.METHODS:Four factors,including temperature,reflux time,concentration of ethanol,ratio of solvent to raw material were used to examine the yield of total flavonoids.Prediction was carried out through comparing the observed and predicted values.RESULTS:The results suggested that ethanol concentration and extraction temperature were two statistically significant factors.The optimum conditions of extraction process consisted of the ratio(mL:g)of solvent to material(13.3:1),ethanol concentration(53.2%),extraction temperature(78.7℃)and extraction time(2.3h).Regression coefficient of binomial fitting complex model was as high as 0.984 6.Bias between observed and predicted values was-4.01%.CONCLUSION:Box-Behnken design is success in optimizing the extaction in close agreement with the predicted values of the mathematic model.

Objective To evaluate the maternal and fetal outcomes of pregnant women with lupus nephritis (LN) and the risk factors.Methods Ninety-three patients with 97 pregnancies from January 1st,1990 to December 31st,2012 in Peking Union Medical College Hospital were evaluated retrospectively.Objects of study were divided into three groups:stable lupus before pregnancy (stable group,52 cases),active lupus before pregnancy (active group,26 cases),and newly diagnosed LN during pregnancy (19 cases).Adverse maternal outcomes included exacerbated disease during pregnancy,preeclampsia,increased proteinuria and impaired renal function during pregnancy or postpartum,maternal death,thrombocytopenia and hypocomplementemia.Adverse fetal or neonatal outcomes included therapeutically termination of pregnancy,fetal loss,neonatal death,preterm labor,small gestational age and asphyxia.Statistical analysis was performed by Chi-square test or Fisher's exact test.A binary logistic regression model was used to evaluate the risk factors for adverse maternal and fetal outcomes.Results (1) Adverse maternal outcomes:There was no significant difference between exacerbated cases during pregnancies in stable group and that in active group [53.8 ％ (28/52) vs 61.5 ％ (16/26),x2 =0.417,P＞0.05].After deleting abortions before 20 weeks of gestation (5 cases in stable group and 4 cases in active group),there was no significant difference between preeclampsia incidence in stable group and that in active group [36.2％ (17/47) vs 59.1％ (13/22),x2 =3.204,P＞0.05].In nineteen newly diagnosed LN women,eighteen cases were over 20 weeks of gestation,during which preeclampsia incidence was 6/18.(2) Adverse fetal or neonatal outcomes:Therapeutically termination of pregnancy rate was higher in active group than that in stable group[42.3％(10/26) vs 7.7％(4/52),Fisher's exact test,P＜0.01].After deleting patients who required termination of pregnancy (three cases in stable group) and therapeutically termination of pregnancy (four cases in stable group and ten cases in active group),the rate of fetal loss and neonatal death was higher in active group than that in stable group [5/16 vs 6.7％(3/45),Fisher's exact test,P＜0.05].The rate of adverse fetal or neonatal outcomes was higher in active group than that in stable group [92.3％(24/26) vs50％(26/52),x2=13.483,P＜0.001].Among the nineteen newly diagnosed LN cases during pregnancy,the numbers of therapeutically termination of pregnancy and fetal loss were five and three cases respectively; among eleven live birth cases,two newborns died from severe asphyxia,and nine cases were preterm birth.(3) Binary logistic regression analysis showed that the independent risk factors for exacerbated lupus during pregnancy were hypocomplementemia (OR =0.300,95％ CI:0.104-0.863) and thrombocytopenia (OR =0.054,95％CI∶0.007-0.439).The independent risk factors for preeclampsia in LN pregnant women were thrombocytopenia (OR=0.151,95％CI:0.046-0.499) and LN recurrence or first diagnosed during pregnancy (OR=0.135,95％CI:0.027-0.679).The independent risk factors for adverse fetal or neonatal outcomes were preeclampsia (OR=0.134,95％CI:0.028-0.637) and lupus active during pregnancy (OR =0.026,95 ％ CI:0.005-0.138).Conclusions Active lupus before pregnancy is associated with poor maternal and fetal outcomes in lupus nephritis pregnancy.All pregnancies with LN should be planned,preferably after more than six months of quiescent disease.Blood pressure,renal function,proteinuria and level of platelet and serum complements should be closely monitored.

Objective To evaluate the clinical significance of thyroid stimulating hormone (TSH) and thyroid autoantibodies (anti-TGAb and anti-TPOAb) in cord blood of infants of mothers complicated with hypothyroidism and the influencing factors of neonatal thyroid function. Methods Clinical data of 67 singleton pregnant women complicated with hypothyroidism in Peking Union Medical College Hospital were analyzed retrospectively. Thyroid function and its autoantibody levels in maternal, cord blood and neonatal serum at 5-7 d after birth were compared. Umbilical TSH level and its affecting factors were also investigated. The results of TSH was expressed as median (25th-75th percentile). Results (1) Umbilical TSH levels were elevated in 9. 0% (6/67) of all infants born to mothers complicated with hypothyroidism. (2) No correlation was found in TSH levels between cord blood and venous blood in neonates 5-7 d after birth. Umbilical TSH levels were significantly higher in infants born vaginally than in those born abdominally [10. 20(6. 10-12. 80) mU/L vs 5. 86(4.02-7.74) mU/L,P=0.001]. Higher umbilical TSH levels were also detected in those complicated with fetal distress and preterm birth compared with those withoutere [fetal distress: (10. 36(6. 61-13. 37) mU/L and 6. 89(4. 18-9. 70) mU/L, P = 0. 046; preterm birth: 8. 90(7. 60-10. 33) mU/L and 6.84(4.17-9. 80) mU/L,P=0. 046,0. 049)]. (3) The anti-TGAb levels in cord blood were positively correlated with that in neonatal serum at 5-7 d after birth (r=0. 960, P = 0. 000), and the same was true for anti-TGPOAb levels (r= 0. 975, P = 0. 000). Maternal thyroid autoantibody levels (anti-TGAb and anti-TPOAb) had significant effect on umbilical antibody levels (P = 0. 003 and 0. 000, respectively), but not on the neonatal TSH levels (P>0. 05). Conclusions Umbilical TSH levels are affected by many delivery factors which may limit its prediction role on congenital hypothyroidism. However, there is an increased risk of elevated umbilical TSH, anti-TGAb and anti-TPOAb levels among these patients which may increase the risk of congenital hypothyroidism. Further follow up of these infants is warranted.

Humans ; MicroRNAs ; Non-alcoholic Fatty Liver Disease