Objective To investigate the effects of duration of active phase on delivery mode and pregnancy outcome.Methods Data of 417 women with abnormal active phase identified from 1744 term-birth,singleton,cephalic presentation primiparas who had tried vaginal delivery in Peking University First Hospital from January 1,2009 to December 31,2009 were retrospectively studied.Effects of different durations of protracted active phase on pregnancy outcomes were compared between women with vaginal delivery or cesarean section by Chi square test.Results The incidence of protracted active phase was 23.9％ (417/1744); and the incidence of prolonged active phase was 2.9％ (50/1744).There were 205 cases of cesarean section and 212 cases of vaginal deliveries.The incidence of neonates hospitalization in Department of Pediatrics in vaginal delivery group with active phase ≥6 h was higher than that of those with active phase ＜6 h [20.6％ (26/126) vs 8.1％ (7/86),x2 =6.07,P＜0.05].The incidence of intrauterine infection in cesarean section group with active phase ＜6 h were higher than that of those with active phase ≥6 h [22.7％ (30/132) vs 6.8％(5/73),x2 =8.37,P＜0.01].In vaginal group with protracted active phase before 6 cm of cervical dilation,the incidences of postpartum hemorrhage (4.8％,9/186),maternal complications (3.8％,7/186) and neonates hospitalization (15.6％,29/186) were similar with those after 6 cm of cervical dilation [6.2％ (1/16),x2=0.12; 0.0％ (0/16),x2=0.01 and 12.5％ (2/16),x2=0.00; all P＞0.05] respectively.In cesarean delivery group with cervical dilation ≥6 cm,the incidence of neonates hospitalization was higher than that of those with cervical dilation ＜6 cm [60.0％ (6/10) vs 19.9％ (34/171),x2 =8.83,P＜0.05].There were no difference in maternal age,gestational age,body mass index at delivery,volume of postpartum hemorrhage and neonatal birth weight between women with cesarean section whose protracted active phase ≥4 h or ＜4 h when cervical dilation at 3 cm (P＞ 0.05 respectively).The incidence of neonates hospitalization was low in women whose indication of cesarean section was protracted active phase (11.2％,9/80),while it was high when protracted active phase complicated with intrauterine infection (42.1％,16/38).Conclusions Protracted active phase with cervical dilation less than 6 cm might not need active management if neither the mother nor the fetus is compromised.The infants born vaginally should be closely monitored if the active phase is over 6 h.

Carcinoembryonic Antigen ; analysis ; Humans ; Luminescence

BACKGROUND:The tourniquet is usualy fuly used or bilateraly used in partial time during bilateral total knee arthroplasty. However, very few people try to use it on one side and on the other side in partial time.
OBJECTIVE:To investigate the effective strategy of using a tourniquet in simultaneous bilateral total knee arthroplasty.
METHODS:80 patients (160 knees) with severe osteoarthritis who underwent simultaneous bilateral total knee arthroplasty in the Department of Orthopedics, Chinese PLA Medical School from January to December 2013 were divided into two groups according to the different tourniquet strategies. In test group (n=40), left knees did not receive tourniquet, and right knees received tourniquet in partial time. In control group (n=40), al knees received tourniquet in the whole time. The perioperative and postoperative blood loss, 3-day postoperative thigh sweling rate and pain visual analog scale, 3-week and 1-year postoperative Knee Society Score were recorded in both groups.
RESULTS AND CONCLUSION:There were no statisticaly significant differences between two groups in perioperative total blood loss (P > 0.05). However, postoperative blood loss in test group was less than that in control group (P < 0.05). The visual analog scale scores were significantly lower in the test group than in the control group at 3 days after surgery (P < 0.05). Visual analog scale scores on the left side were lower than on the right side in the test group at 3 days post surgery (P < 0.05). Bilateral thigh sweling rate was significantly lower in the test group than in the control group at 3 days after surgery (P < 0.05). The thigh sweling rate was lower on the left side than on the right side in the test group at 3 days after surgery (P < 0.05). Knee Society Score was higher in the test group than in the control group in the early stage, and no significant difference in long-term Knee Society Score was detected (P > 0.05). These findings verify that taking the strategy that the first knee without tourniquet and the second knee with part time tourniquet technique in simultaneous bilateral total knee arthroplasty wil aleviate pain and sweling after operation and promote early functional rehabilitation without increasing the perioperative total blood loss.

Objective To investigate the expression of beclin1 and LC3 in non small cell lung cancer and explore their clinical significance. Methods Immunohistochemistry was applied to confirm expression of Beclin1 and LC3 in 66 samples of NSCC and 52 samples of adjacent tissues. Clinical pathological features were analyzed. Results Beclin1 and LC3 expression were lower in cancer tissues than that in adjacent cancer tissues ,and the dif-ference was statistically significant(46.9%vs 75%,53%vs 80.7%,P<0.05). The expression of Beclin1 and LC3 was down-regulated with TNM staging rising and tissue differentiation decreasing. With tumor enlarging ,Beclin1 down-regulated,and the difference is statistically significant(P<0.05). Expression of Beclin1 was positively cor-related with LC3 expression(r=0.31,P<0.05). Conclusion The down-regulation of autophagy-related protein Beclinl and LC3 might be involved in the genesis and development of non small lung cancer.

Objective To compare the short-term safety and efficacy of radiofrequency ablation (RFA) and microwave ablation (MWA) for treatment of large benign thyroid nodules.Methods A total of 34 patients with large benign thyroid nodules were studied retrospectively,including 13 patients treated with ultrasound-guided RFA and 21 patients treated with MWA between Jun.,2016 and Feb.,2017 in Zhongshan Hospital.The thyroid function parameters,serum antibodies,complications and thyroid nodules volume reduction rate(VRR) were compared between the two groups during the follow-up.Results There were no statistically significant differences(P＞0.05)among those patients before and after treatment in serum free triiodothyronine (fT3),free thyroxine (fT4),thyroid stimulating hormone (TSH),anti-thyroglobulin antibodies (TG-Ab) levels,and thyroid peroxidase antibodies (TPO-Ab).One patient in the MWA group had mild hoarseness after ablation and another patient in the RFA group had intraoperative hemorrhage for about 10 mL.There were no other complications such as neck scar,postoperative infection,skin burns,tracheal and esophageal injury.One day after the ablation,all nodules were showed hypoecho and contrast-enhanced ultrasound proved there was no blood supply.One month after treatment,no statistically significant difference was found in VRR between two groups (23.8％ vs.22.6％,P =0.127).Conclusions RFA and MWA are safe and effective treatments for large benign thyroid nodules,and no significant difference was observed in short-term follow-up.

Objective To explore the short-term and long-term efficacy of laparoscopic versus open liver resection(LLR)in the treatment of hepatocellular carcinoma(HCC). Methods The perioperative and follow-up data ofLLR(n = 43)and OLR(n = 73)for the treatment of HCC at the same period were analyzed respectively. Results There were no significant differences in the age,gender,Child-Pugh classification,liver cirrhosis, AFP,and hepatic virus affection between the 2 groups. 1 case in the LLR group was converted for the open surgery and another one case in the OLR group died in the perioperative time. However ,compared with OLR group ,the intraoperative blood loss of LLR group(P < 0.05)was larger and the mean operative time(P < 0.05)was longer. The liver function indicators of the regular hepatectomy subgroup were recovered more quickly(P<0.05),but the indicators of remaining subgroups were not significantly different. The postoperative ambulation time (P < 0.05), the postoperative eating time(P < 0.05),the postoperative hospital stay(P < 0.05)were all shorter. The VAS score was lower(P<0.05). There was no difference in the incidence and distribution of complications and the inci-dence of severe complications between the two groups(all P>0.05). The first and third year disease-free survival rates were 82.2%,53.8%for LLR and 91.5%,75.9%for OLR,respectively(χ2=0.55,P=0.46). The first and third 5 year overall survival rates were 94.2%,79.3%for LLR and 94.9%,47.3%for OLR,respectively(χ2=1.06, P=0.30). Conclusion LLR for HCC treatment is a safe and effective way with the advantages of minimal opera-tive trauma,quick recovery and significant short-term efficacy.

Objective To provide the experimental basis for the further research of the interacting proteins with Stathmin ,the Stathmin gene Pichia pastoris expression system was constructed ,the expressed Stathmin product was purified and identified .Meth‐ods Stathmin gene was amplified from tumor cell line of SKBR3 by PCR method and cloned into the yeast expression vector pPIC3 .5K .The recombinant vector pPIC3 .5K‐Stathmin was constructed and transformed into Pichia pastoris GS115 .The positive clones were screened by YPD medium containing Geneticin 600 μg/mL .Expression was induced with 0 .5% methanol and expres‐sion products were identified by SDS‐PAGE and Western Blotting .Results DNA sequencing result showed that the gene fragment was consistent with Stathmin gene sequence .pPIC3 .5K‐Stathmin was selected from YPD culture medium containing Geneticin ,and the positive clones were identified by PCR .SDS‐PAGE showed that a 37 × 103 protein band could be seen on the PAGE gel after Coomassie Blue staining ,which was further confirmed and identified as Stathmin protein by Western Blotting .Conclusion Stathmin yeast expression vector is successfully constructed and expressed in Pichia pastoris ,which laid the foundation for the study of inter‐acting proteins with Stathmin ,and for the preparation of the biological treatment drugs of Stahtmin target .

Adolescent ; Child ; Child, Preschool ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Intercellular Adhesion Molecule-1 ; blood ; Male ; Purpura, Schoenlein-Henoch ; blood ; Vascular Endothelial Growth Factor A ; blood

Objective To gain the virus like particles (VLPs) based on Trop2 targets ,which provided the basis for further in vi‐vo induced experiments and anti‐tumor vaccine studies .Methods Using molecular cloning method to constract eukaryotic expres‐sion vector of pCAGGs/Trop2 and baculovirus expression vector of pFastbac1/Trop2 ,expression product of pCAGGs/Trop2 in HeLa cells were intended to be to be anchored to the cell membrane by the methods of Immunohistochemistry ;pFastbac1/Trop2 were transformed into E .coliDH10bac isolates to gain recombinant bacmids ,which were transfected into insect cells to express re‐combinant baculovirus with Gag rBV ,then sucrose density gradient centrifugation ,Western Blot and electron microscope were per‐formed to purify and identify the Trop2 VLPs .Results Building recombinant bacmids which were transfected into insect cells to express recombinant baculovirus with Gag rBV ,gained the recombinant Virus like Particles .Conclusion Trop2 VLPs was success‐fully prepared ,which laid the foundation for the subsequent induction of humoral and cellular immune response .

Lactose was shown to no less competent than Isopropyl-?-D-thiogalactoside (IPTG) in inducing the expression of the ENHANCIN coding gene from Helicoverpa armigera granulosis virus in Eswcherichia coli BL21 (DE3) regulated by a T7 promoter, since the lactose induction could lead to an ENHANCIN band no smaller than the one in IPTG induction on the SDS-PAGE gel. This would decrease the cost of the large-scale ENHANCIN production. The lactose concentration was optimized at 2.2% - 2.5% (w/v) . Different treatments on the lactose sterilization showed that lactose steam- sterilized in 116. 5℃ for 15min could lead to the ENHANCIN production. The convenience and the relatively low cost in its" operation could further decrease the cost of the ENHANCIN production.