Objective To discuss the diagnosis, treatment and following up of the cervical lesions(CIN～cervical carcinoma Ia 1) during pregnancy. Methods Fifteen pregnant women with cervical lesions were reviewed from Jan 1998～Oct 2003 in our hospital. Results Among the fifteen cases, 11 were diagnosed as CIN～ cervical carcinoma Ia 1 based on biopsy results under copolscopy. Ten of the 11 cases had copolscopy repeated every 8 weeks and delivered at term. The left one woman terminated the pregnancy in the first trimester due to carcinoma in situ (CIS) invasion to glands. Among those 10 cases who progressed to term, four were stable during pregnancy (CINⅡ,CINⅢ,CIS and cervical carcinoma Ia1, one for each) and had the same pathology postpartum as antepartum; three had CIN I during pregnancy but changed to inflammation postpartum;one had CIS involved in glands prepartumly while CINⅡ～Ⅲ postpartumly; one had CINⅢ prepartumly and progressed to CIS involved in glands confirmed after conization postpartumly. One woman was missing after delivery. Conclusions Cervical lesions (CIN～Ia 1) less likely get worse during pregnancy. Conservative management is possible if regular cytology, copolscopy and bioposy when necessary are available. Re examination is necessary within two months after birth. Routine examination for women who have no pap smear within the last one year period would be helpful in detecting cervical lesions during pregnancy.

Objective To compare the efficacy and safety of liquid nitrogen cryotherapy combined with acyclovir and mecobalamin in the treatment of herpes zoster in elderly patients.Methods 520 elderly patients with herpes zoster were randomly divided into two groups,experimental group and control group (n=260,each).Patients in experimental group were treated with liquid nitrogen cryotherapy,using liquid nitrogen cotton swab to graze the skin lesions 2-3 times per day for successive 5 days,combined with acyclovir and mecobalamin.Patients in control group were treated with acyclovir and mecobalamin.New blisters and dry skin and crust were observed and compared between the two groups on the 5th,14th,30th day after treatment.The skin lesion situation and reaction times for pain complete remission,vesicular scab,postherpetic neuralgia (PHN) were recorded and analyzed.Results The effective rate was 93.9％ (244/260) in the experimental group versus 84.2％ (219/260) in the control group (x2 =12.32,P＜ 0.05).The reaction times for vesicular scab,pain complete remission and subside were shorter in experimental group than in control group [(2.63 ±0.78)d vs.(4.75±1.39)d,(8.17±1.68)d vs.(11.25±2.23)d,(9.24±2.53)d vs.(12.78±3.13)d,all P＜0.01].There was no significant difference in new blister time between the experimental group and the control group [(1.85±0.62) d vs.(1.79±0.83)d,P＞0.05].Postherpetic neuralgia incidence was lower in experimental group than in control group [6.9％ (18/260) vs.18.1％ (47/260),x2 =14.79,P＜0.01].Conclusions Treatment with liquid nitrogen cryotherapy combined with acyclovir and mecobalamin can shorten the reaction times of vesicular scab,and pain complete remission and subside,and reduce postherpetic neuralgia as compared to acyclovir and mecobalamin treatment in elderly patients with herpes zoster.

Objective To evaluate the effect of ALD on podocyte apoptosis and the possible roles of Akt in ALD-induced apoptosis. Methods The cultured rat podocytes were incubated with increasing concentrations of ALD (10-9~10-5 mol/L) for variable time periods. Apoptosis was evaluated by cell nucleus staining and flow cytometry. RT-PCR was used to examine the expression of mineralocorticoid receptor (MR)and 11 Beta-hydroxysteroid dehydrogenase type 2 (11?-HSD2) mRNA in podocyte. Activation of Akt/PKB was evaluated by performing Akt kinase assay. Results ALD induced podocyte apoptosis in a dose- and time-dependent manner. The proapoptotic effect was attenuated by the presence of spironolactone (10-7mol/L). The expression of MR and 11P-HSD2 mRNA was demonstrated in the podocytes by RT-PCR. ALD also inhibited the activity of Akt in a dose-dependent manner, but the inhibitory effect was significantly ameliorated by the presence of spironolactone. The activity of Akt was negatively correlated with podocyte apoptosis. Conclusion ALD induces apoptosis in rat podocytes through the signaling mechanism by which Akt is inhibited.

In subclinical diabetic nephropathy with glomerular hyperfiltration,the renal size parameters are increased significantly,and this change sets in as early as before the appearance of microalbuminuria.The average kidney length discriminator value for glomerular hyperfiltration by receiver operating characteristic (ROC) curve analysis is 10.53 cm,with the best sensitivity,higher specificity and total coincidence rate,and can be a clinical indicator for screening early diabetic nephropathy with glomerular hyperfiltration.

Objective: To investigate the clinical effect of microsurgical operation combined with liquid nitrogen cryotherapy on squamous cell carcinoma in elderly patients. Methods: Forty-six patients with squamous cell carcinoma visiting dermatology department of our hospital from January 2011 to July 2014 were enrolled.They were randomizely divided into two groups: the control group(n=23)receiving a microsurgical treatment and the observation group(n=23)receiving liquid nitrogen cryotherapy as add-on to a microsurgical operation.All patients were followed up for 1-3 years.Clinical efficacy, 1-year recurrence rate, 1-year transfer rate and the survival rate were compared between the two groups. Results: The total effective rate was higher in the observation group than in the control group(91.3% vs.82.6%, P<0.05). The 1-year recurrence rate and 1-year transfer rate were lower in the observation group than in the control group(13.4% vs.17.4%, 4.3% vs.8.7%, P<0.05). Conclusions The surgery combined with liquid nitrogen cryotherapy for cutaneous squamous cell carcinoma can significantly reduce the recurrence rate and transfer rate after operation and prolong the survival time, which is worthy of further research and promotion.

Objective To investigate prenatal diagnosis and prognosis of fetus with hyperechogenic kidney.Methods Clinical data of 65 cases prenatally diagnosed with fetal hyperechogenic kidney in Peking University First Hospital between July,2009 and May,2015 were retrospectively analyzed.Results of fetal ultrasound screening and pregnancy outcomes were analyzed and Growth and development status of those babies were followed up until December,2015.Independent-sample-t,Chi-square or Fisher's exact test was applied for statistical analysis.Results Among the 65 cases,including 48(73.8％) bilateral and 17 (26.2％) unilateral,34 cases (52.3％) were diagnosed as non-isolated and 31 cases (47.7％) as isolated fetal hyperechogenic kidney.The primary associated malformations with non-isolated fetal hyperechogenic kidney included cardiac abnormality (14 cases,41.2％),urinary system abnormality (12 cases,35.2％),skeletal system abnormality (nine cases,26.5％),central nervous system abnormality (eight cases,23.5％) and Meckel-Gruber sydrome (one case,2.9％).Amniotic volume,the size and numbers of affected kidney between non-isolated and isolated groups showed no significant differences (all P＞0.05).Twenty out of the 65 cases (30.8％) received fetal karyotyping and one received non-invasive prenatal testing,and no abnormality was detected.Three cases received cord blood array comparative genomic hybridization with negative results.Pathogenic genes were found in two cases who received targeted exome capture with high throughput sequencing,including a TTC21B mutation in cord blood in one case and a HNF1β deletion mutation in peripheral blood after birth in the other.There were 23 (35.4％) terminations of pregnancy and 42 (64.6％) live births among which three died after birth.The rate of live birth was significantly higher in the isolated group than in the non-isolated group[87.1％(27/31) vs 44.1％(15/34),x2=13.101,P＜0.01].Of the fifteen live births in the non-isolated group,there were fourteen survived symptomfree except that one lost to follow-up.Of the 27 live births in the isolated group,follow up study revealed 23 symptom-free survivors,one lost,two neonatal deaths (one died of volvulus neonatorum,and the other due to unknown causes) and one death of renal and liver function failures at the age of two-and-a-half.ConclusionsFetal hyperechogenic kidney is an important prenatal ultrasound marker for congenital renal anomalies,and the prognosis of non-isolated fetal hyperechogenic kidney is poor.The current rate of abnormal karyotype in fetus with hyperechogenic kidney is very low.However,the rate of prenatal genes screening should be encouraged.

ObjectiveTo investigate the change of cervical length (CL) during uncomplicated pregnancy by transvaginal ultrasound and its correlated factors.MethodsData of five hundred and ninety-five normal singleton pregnant women who received vaginal ultrasound examination on CL in their 11-13+6gestational weeks ( Ⅰstage),20-24 gestational weeks ( Ⅱ stage),28-32 gestational weeks (Ⅲ stage) and ≥36 gestational weeks (Ⅳ stage) were collected and retrospectively analyzed.Related factors were recorded at the same time.Repeated measurement data analysis of variance,t-test and Spearman correlation analysis were applied for statistical analysis.Results(1) The mean values of CL at Ⅰ,Ⅱ,Ⅲ and Ⅳ stage were (38.85±3.11) mm,(38.92±4.10) mm,(36.43±4.69) mm and (30.63±6.11) mm,respectively.There were statistical differences between the CL of any two stages (P＜0.01),except for that between Ⅰ and Ⅱ stage.The median values of CL change rates were:Ⅱ-Ⅰ stage0.00％; Ⅲ-Ⅰ stage -5.36％; Ⅳ-Ⅰ stage -20.00％.(2) The CL of pregnant women who were older than 35 was longer than that of those younger than 35 at any stage [ Ⅰ stage:(39.36±3.18) mm　vs (38.77±3.10) mm;Ⅱ stage:(39.89±4.61) mm vs (38.88±4.00) mm;Ⅲ stage:(37.29±4.79) mm vs (36.31 ±4.67) mm;Ⅳ stage:(32.25± 5.95) mm vs (30.38±6.10) mm],while significant difference was found only at Ⅳ stage (t=-2.56,P=0.01).The CL of multiparas was longer than that of primiparas [ Ⅰ stage:(38.95±2.59) mm vs (38.76±3.14) mm;Ⅱ stage:(39.54±3.62) mm vs (38.82±4.11) mm;Ⅲ stage:(37.37±4.21) mm vs (36.34±4.70) mm;Ⅳ stage:(31.77±6.05) mm vs (30.59±6.11) mm],while there was no statistical significance within any stage ( P＞ 0.05). ConclusionsCervix shortens gradually after 28 gestational weeks.Sequential measurement of CL during routine ultrasonic inspection might be helpful in predicting preterm labor.

Objective To study the value of cervical length(CL) by transvaginal sonography in the mid-trimester and late-trimester for the prediction of preterm delivery.Methods The CL was measured by transvaginal sonography for 5277 pregnant women between 22-24 weeks and 28-32 weeks gestation,who were prenatal cared and delivered at the First Hospital of Peking University from June 2008 to November 2009.The pregnancy outcomes were followed,and the relationship between CL and preterm delivery and preterm premature rupture of membrane was studied.Results ( 1 ) The incidence of preterm delivery was 5.4％ (289/5370) total,among of them the incidence of therapeutic preterm delivery was 1.7％ (93/5370),spontaneously preterm delivery was 1.2％ (62/5370),and preterm premature rupture of membrane was 2.5 ％ (134/5370).There are 4 cases (4/5370) who occured late abortion.(2) Excluding the 93 women who had therapeutic preterm delivery,the mean CL of 22-24 weeks was ( 38.8±4.0) mm.The relative risk for preterm delivery when the CL＜30 mm was 5.2,when CL＜25 mm,the relative risk was 11.1,and when CL ＜15 mm the relative risk for preterm delivery was 13.8.The average CL during 28-32 weeks of gestation was ( 34.6±4.8) mm,was significantly shorter than that of 22-24 weeks ( P＜0.05 ).During this period the relative risk for preterm delivery when the CL＜30 mm was 6.9,when CL＜25 mm,the relative risk was 11.1,and when CL＜15 mm the relative risk for preterm delivery was 20.0.(3) A CL＜30 mm as the cutoff value for predicting preterm delivery during 22-24 weeks of gestation has only a 3％ sensitivity and 19％ positive predictive value,but had a 99％ specificity and 96％ negative predictive value.The sensitivity,positive predictive value,specificity and negative predictive value for a CL ＜ 30 mm as the cut-off value for predicting preterm delivery during 28-32 weeks of gestation was 33％,21％,95 ％ and 97 ％ respectively.(4) The total number of preterm premature rupture of membrane pregnant women was 134 (2.5％ ),who had a mean CL of (38.4 ±4.7) mm during 22-24 weeks of gestation,was similar with the women without preterm premature rupture of membrane ( PPROM),but during 28-32 weeks of gestation the women who occured PPROM had a mean cervical length of ( 30.6 ± 8.1 ) mm,and was significantly shorter than that of women without PPROM ( 34.7 + 4.6 ) mm.Conclusions ( 1 ) CL in 28-32 weeks of gestation issignificantly shorter than that of in the mid-gestation,but more than 90％ of women has a CL≥30 mm.(2)The shorter the CL is,the greater the relative risk of preterm delivery.According to different CL for clinical consulting objective relative risk could be provide.(3) The CL during 28-32 weeks of gestation can also predict preterm delivery,the sensitivity is obviously better than that of 22-24 weeks of gestation.(4) The CL during 28-32 weeks of gestation is valuable for predicting of PPROM.

Fas-associated death domain (FADD) is a signal connection protein in Fas/FasL apoptotic path which might play a key role on apoptosis by transferring apoptotic signal. To reveal the intracellular signal transduction molecules involved in the procedure of follicular development in bovine ovary, we cloned FADD gene in bovine ovary tissue with RT-PCR, deleted the termination codon in its cDNA and directionally cloned the amplified FADD gene into eukaryotic expression vector pAcGFP-N1 including AcGFP, successfully constructed the fusion protein recombinant plasmid. After identifying by restrictive enzyme Bgl II/EcoR I and sequencing, transfected pAcGFP-bFADD into CHO-K1 cell mediated by Lipofectamine 2000, observed the expression of AcGFP and detected the transcription and expression of FADD by RT-PCR and Western blotting. The results showed that the cattle FADD was successfully cloned, the pAcGFP-bFADD fusion protein recombinant plasmid was successfully constructed by introducing Bgl II, EcoR I cloning site at two ends of FADD open reading frame and inserting a Kozak sequence before start codon. AcGFP expression was detected as early as 24 h after transfection. The percentage of AcGFP positive cells reached about 65% after 24 h. A 654 bp transcription was amplified by RT-PCR, and 51.4 kD target protein was detected by Western blotting. Construction of pAcGFP-bFADD recombinant plasmid should be helpful for further understanding the mechanism of regulation of FADD on bovine oocytes formation and development.
Animals ; Base Sequence ; CHO Cells ; Cattle ; Cloning, Molecular ; Cricetinae ; Cricetulus ; DNA, Complementary ; genetics ; Fas-Associated Death Domain Protein ; biosynthesis ; genetics ; Female ; Genetic Vectors ; genetics ; Green Fluorescent Proteins ; biosynthesis ; genetics ; Molecular Sequence Data ; Oocytes ; cytology ; Open Reading Frames ; Ovary ; metabolism ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; Transfection

Objective To investigate proteolipid protein 1 (PLP1) mutations in six pedigrees with Pelizaeus-Merzbacher disease (PMD),and to provide prenatal consulting and prenatal diagnosis.Methods Subjects were six probands with PMD admitted in Department of Pediatrics,Peking University First Hospital from July 2006 to November 2011 and their family members.Genomic DNA sarnples were extracted from peripheral bloods of probands and their family members.Multiplex ligation-dependent probe amplification (MLPA) technique was used to detect PLP1 duplication mutation.Direct DNA sequencing was used to detect point mutation.Genetic diagnosis were based on PLP1 mutation genotype from probands.Prenatal diagnosis of nine fetuses were performed from seven PLP1 mutation female carriers by fetuses' DNA extracted from amniocytes or villus cells.Results PLP1 duplications were found in probands 1-4 (P1-4) whose mothers and the aunt of proband 1 (P1) were PLP1 duplications carriers.The two cases of point mutation,c.96C＞G(p.F32L) and c.623G＞T (p.G208V),were found in proband 5 (P5) and proband 6 (P6).Hcterozygous changes of the same mutations were found in P5' and P6' mothers with normal phenotypes.Seven female PLP1 mutation carriers were pregnant again.Prenatal diagnosis of PLP1 for nine fetuses presented one PLP1 duplication,one point mutation,one PLP1 duplication carrier,and six wildtypes.A segmental crossing over of X chromosome was detected in one male fetus of PLP1 wildtype.Conclusions PLP1 mutation analysis could help to diagnose PMD pedigree and to identify female PLP1 mutation carrier in the family.The following prenatal diagnosis and proper genetic counseling are very important to prevent PMD child from being delivered.