Objective To establish appropriate correction models of serum marker α -fetoprotein (AFP) multiple of the median (MOM) for prenatal screening on patients with neural tube defect (NTD) at the second trimester to replace the foreign data currendy used in Beijing with a higher sensitivity.Methods A sample of 5815 mid-gestation pregnant women with normal pregnancy outcome were selected including 5557 cases of age ＜ 35 years and 258 cases of age ≥35 years.The regression relationship between AFP median and gestational age was builded by exponential model and the regression relationship between MOM and weight was builded by power model in age ＜ 35 years.The regression relationship between AFP median and gestational age was builded by S model and the regression relation ship between MOM and weight was builded by quadratic model in age ≥35 years.The normal reference values in two age sections were estimated approximately by percentiles method.Results Corrected AFP MOM values with mean value (age ＜ 35 years:1.001; age ≥35 years:1.113) and median value (age ＜ 35 years:0.934;age ≥35 years:0.990) obtained by regression analysis were more close to 1.00 than the data from the software[mean value(age ＜ 35 years:1.164; age ≥35 years:1.254) and median value (age ＜35 years:1.093; age ≥35 years:1.149)].There were significant differences (age ＜35 years:t =65.120,P =0.000;age ≥35 years:t =9.812,P =0.000).Conclusion Correction model for maternal serum marker is more applicable for Beijing population at the second-trimester prenatal screening.

Antibodies, Viral ; blood ; China ; epidemiology ; Humans ; Yellow Fever ; epidemiology ; Yellow fever virus ; immunology

Objective To evaluate the physiological and anatomic basis,indications,surgical skills, prevention of ureter injury and clinic outcomes of using high uterosacral ligament suspension(HUS)for correction of advanced uterine prolapse by the vaginal route.Methods Fifty women with advanced uterine prolapse underwent transvaginal HUS after vaginal hysterectomy with reconstruction of pubocervical and rectovaginal fascia to correct their uterine prolapse between June 2003 and September 2007.The average age of the women was 60.1 years.The mean follow-up period was 24 months(range 4-51 months).The degree of pelvic organ prolapse preoperatively and anatomic outcomes postoperatively were assessed with pelvic organ prolapse quantification system(POP-Q).Results The remnants of the uterosacral ligaments were clearly identified and palpated posterior and medial to the ischial spines by traction with a 24 cm long Allis clamp and used for successful vaginal vault suspension and reconstruction in all 50 consecutive advanced uterine prolapse patients.The ureter injury was avoided by complete knowledge of the ureter's course from the cervix/apex toward its insertion in the sacral region and how far outside of the uterosacral ligament,by uteri palpation and by suturing purposefully placed"deep"dorsally and posteriorly toward the sacrum,as well as by cystoscopy examination of the spillage of urine from both ureters.Mean POP-Q point C improved from 1.5 to-7.5 cm with a median follow-up of 24 months.If the successful HUS was defined as point C≤stage I prolapse,both the objective and subjective cure rates were as high as 100% with a maximum follow-up of 51 months.None of the 50 patients had repeat operation for recurrence of prolapse.There was no major intra-or postoperative complications,such as ureter and other pelvic organ injury.Conclusion HUS with fascial reconstruction seems to be a safe,minimal traumatic,tolerable and highly successful procedure for vaginal repair of advanced uterine prolapse.Because of the use of native tissue as suspension site HUS is more physiologic and cost effective.

A laboratory-scale experiment was carried out to assess the influence of temperature fluctuation on thermophilic anaerobic digestion of municipal organic solid waste (MOSW). Heating failure was simulated by decreasing temperature suddenly from 55 degrees C to 20 degrees C suddenly; 2 h time is needed for temperature decrease and recovery. Under the conditions of 8.0 g/(L.d) and 15 d respectively for MOSW load and retention time, following results were noted: (1) biogas production almost stopped and VFA (volatile fatty acid) accumulated rapidly, accompanied by pH decrease; (2) with low temperature (20 degrees C) duration of 1, 5, 12 and 24 h, it took 3, 11, 56 and 72 h for the thermophilic anaerobic digestion system to reproduce methane after temperature fluctuation; (3) the longer the low temperature interval lasted, the more the methanogenic bacteria would decay; hydrolysis, acidification and methanogenesis were all influenced by temperature fluctuation; (4) the thermophilic microorganisms were highly resilient to temperature fluctuation.
Archaea ; cytology ; physiology ; Bacteria, Anaerobic ; cytology ; physiology ; Biodegradation, Environmental ; Cell Survival ; Cities ; Fatty Acids, Volatile ; metabolism ; Hydrogen-Ion Concentration ; Methane ; metabolism ; Refuse Disposal ; methods ; Sewage ; microbiology ; Temperature

Objective To evaluate the compliance on hand-hygiene and related factors among healthcare providers working at secondary and tertiary hospitals in Chengdu.Methods On-site observations regarding hand-hygiene compliance and facilities were conducted in 6 hospitals in Chengdu.Doctors and nurses were asked and recorded about their knowledge regarding hand hygiene.Results Of 1535 activities where hand-hygiene was deemed necessary,under observating healthcare providers would perform hand-hygiene procedures 17.8％ of the time (12.8％ of the time before touching a patient,21.0％ of the time before touching objects around a patient,27.3％ of the time after touching a patient,and 31.5％ of the time after removing gloves).Only 2.2％ of the treating rooms were equipped with foot-operated or automatic faucets; of these only 24.5％ had soap or alcohol-based hand-sanitizer,and 6.3％ had paper towel or other hand-drying equipments.92.8％ of the healthcare providers knew of the six-step method on hand-washing.More than 90.0％ of the healthcare providers knew that both palm and back of the hands as well as the front and back of the fingers should be washed.However,only 22.8％ knew that the hand-washing procedure should last ≥15 seconds.Rates on hand hygiene among chief or more senior physicians (14.6％),attending physicians (9.2％) and junior doctors (15.6％),nurses in chief (25.0％),senior nurses (26.3％) and junior nurses (20.5％) showed no significant differences (P＞0.05).Similarly,scores on related knowledge between chief or senior physicians (12.4 ± 3.2),attending physicians (13.6 ± 3.3) and junior doctors ( 13.4 ± 2.9),nurses in charge ( 15.2 ± 2.0),senior nurses ( 14.8 ± 2.1 ) and junior nurses (14.3 ± 2.6) also showed no significant differences (P＞0.05).Rate on hand hygiene among nurses (22.7％) was significantly higher than that of the doctors ( 13.6％ ).Rate of hand hygiene among 50-59 years old healthcare providers (7.4％) was significantly lower than those of all the other age groups ( 17.1％-25.0％ ) ; rate of female health care providers ( 19.5％ ) was significantly higher than that of males ( 13.8％ ).Similarly,the nurse' s knowledge score ( 14.7 ± 2.3) was significantly higher than that of the doctors ( 13.2 ± 3.1 ).Among 50-59 years old healthcare providers,the rate was ( 12.2 ± 3.8) significantly lower than that of 20-29 ( 14.0 ± 2.6),30-39 ( 14.3 ± 2.9) and 40-49 year olds ( 13.8 ± 2.7).Again,the knowledge score of females ( 14.5 ± 2.5 ) was significantly higher than that of males (12.7 ± 3.2) (P＜0.05).Conclusion The high-level knowledge on hand-hygiene among healthcare providers in this area did not translate into good practices.Also,most of the hospitals had poor hand-hygiene equipments.We recommend that training and periodic monitoring be conducted,and hand-hygiene equipment be improved to facilitate hand-hygiene practices among healthcare providers.

OBJECTIVETo investigate the renal protective effects of sulodexide and its anti-oxidative stress mechanism in diabetic rats.

METHODThirty male SD rats were randomized into 3 equal groups, namely the control group, diabetic group, and sulodexide treatment group. Twelve weeks after establishment of rat diabetic models and administration of sulodexide, the rats were sacrificed for measurement of the urine volume, body mass, kidney mass/body weight ratio, plasma glucose, and glycosylated hemoglobin (HbA1c). Malondialdehyde (MDA) levels and superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-PX) activities in the renal tissue or serum were tested. Electron microscopy was performed to observe the pathological changes in the kidneys.

RESULTSThe urine volume, renal mass/body mass ratio, serum glucose, HbA1C, and serum and renal MDA levels all significantly increased in the diabetic rats in comparison with the normal controls (P<0.05). But the body weight and activities of SOD, CAT, and GSH-PX in the renal tissue in the normal control group were significantly higher than those in the diabetic and sulodexide group. After 12 weeks of sulodexide treatment, SOD, CAT, and GSH-PX activities in the renal tissue of rats were significantly increased in comparison with those in the diabetic rats (P<0.05). Electron microscopy showed obvious irregular thickening of the glomerular capillary basement membrane in the diabetic group with vacuolization in the mitochondria in the epithelial cells, and such pathological changes were significantly alleviated in the sulodexide treatment group.

CONCLUSIONSSulodexide can effectively lower the urinary albumin excretion rate, improve the ultrastructural renal pathologies and prevent glomerular basement membrane thickening in diabetic rats, probably in association with the reduction of the MDA levels and enhancement of SOD, CAT, and GSH-PX activities.

Animals ; Antioxidants ; pharmacology ; therapeutic use ; Body Weight ; drug effects ; Catalase ; metabolism ; Diabetes Mellitus ; drug therapy ; metabolism ; pathology ; Glutathione Peroxidase ; metabolism ; Glycosaminoglycans ; pharmacology ; therapeutic use ; Kidney ; drug effects ; metabolism ; pathology ; Male ; Malondialdehyde ; metabolism ; Organ Size ; drug effects ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism

OBJECTIVETo acquire cDNA sequence of lecithin-cholesterol acyltransferase (LCAT) from tree shrew and analyze the sequence structure.

METHODSThe first strand cDNA was acquired by reverse transcription using mRNA from tree shrew liver as template. By the method of SMART RACE PCR, tree shrew LCAT cDNA was acquired and deduced its amino acids sequence. The sequence and structure of tree shrew LCAT cDNA and amino acid were analyzed and predicted by the molecular software.

RESULTSTree shrew LCAT cDNA is composed of 1,340 bp, including 2 bp 5' untranslated region (5' UTR), 1,320 bp open reading frame (ORF) which encodes protein precursor of 440 amino acids (24 amino acids signal peptide and 416 amino acids mature peptide), and 18 bp 3' untranslated region (3'UTR). The stop codon is TAA and there is a poly (A) signal sequence AATAAA and a 25 bp poly (A) tail. Tree shrew LCAT cDNA sequence has been accepted by GenBank as a new gene, accession number AF272861 and its homology with human and baboon was 90% and 89%, respectively.

CONCLUSIONThe sequence of LCAT cDNA in tree shrew has high identity with that of human and other experimental animal species.

Amino Acid Sequence ; Animals ; Base Sequence ; DNA, Complementary ; genetics ; Liver ; enzymology ; Molecular Sequence Data ; Open Reading Frames ; genetics ; Phosphatidylcholine-Sterol O-Acyltransferase ; chemistry ; genetics ; Sequence Analysis, Protein ; Tupaiidae

BACKGROUNDSteroid 11beta-hydroxylase deficiency (11beta-OHD), an autosomal recessive inherited disease, accounts for 5% - 8% of congenital adrenal hyperplasia. It was scarcely reported in China. This article reports two Chinese girls with 11beta-OHD.

METHODSThe two patients were sisters and presented with hypertrichosis, skin pigmentation, laryngeal prominence and virilization of external genitalia. The patients were followed up for their clinical symptoms and signs, hormone profile, and adrenal image. The genomic deoxyribonucleic acids of the patients and their parents were isolated. 11beta-hydroxylase gene (CYP11B1) was amplified by polymerase chain reaction and directly sequenced.

RESULTSHormone tests showed that serum cortisol was in the low limit of normal range, whereas the concentrations of adrenocorticotropic hormone, testosterone and progesterone were much higher than those of normal adult females. There were obvious adrenal hyperplasia and advance of bone age. After 11 months of treatment with dexamethasone, the skin pigment became regressed; the breast, uterus and ovary gradually developed and normal menstrual cycle started while the manifestations of virilization did not change. A single point mutation of CYP11B1 (R454C, GGC --> TGC) in all the members of this family was detected. The sisters were homozygous and their parents were heterozygous.

CONCLUSIONSThe clinical manifestation of 11beta-OHD is complicated. The manifestation of virilization could not regress after treatment with dexamethasone. The novel missense mutation of CYP11B1 (R454C, GGC --> TGC) is the pathogenesis of 11beta-OHD at least in some Chinese patients.

Adrenal Hyperplasia, Congenital ; diagnosis ; drug therapy ; genetics ; Child ; Dexamethasone ; therapeutic use ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Male ; Mutation, Missense ; genetics ; Steroid 11-beta-Hydroxylase ; genetics

OBJECTIVETo investigate the survival benefit of cytoreductive surgery in gastric cancer patients with peritoneal metastasis.

METHODSClinicopathological data of 151 advanced gastric adenocarcinoma patients with extensive peritoneal metastasis who were identified by surgical exploration between May 2008 and April 2015 in Xijing Hospital of Digestive Diseases were analyzed retrospectively. Of all the patients, 32 cases were treated by cytoreductive surgery with local radical tumor resection and regional lymph node cleaning, combined with fluorouracil-based adjuvant chemotherapy after surgery (cytoreductive surgery combined with chemotherapy group); 39 caseswere only treated by cytoreductive surgery group(cytoreductive surgery group);23 caseswere treated bysurgical exploration combined with fluorouracil-based adjuvant chemotherapy after surgery(surgical exploration combined with chemotherapy group) and 57 cases were only treated bysurgical exploration (surgical exploration group). The overall survival of four groups were analyzed and compared.

RESULTSAmong the 151 patients, 148 (98.0%) patients were followed up. The median follow up time was 7.2 months (range 1.4-61.2). The median survival of cytoreductive surgery combined with chemotherapy group, cytoreductive surgery group, surgical exploration combined with chemotherapy group and surgical exploration group was 11.9(95% CI: 8.8-15.1) months, 7.1(95% CI: 3.2-11.1) months, 8.2(95% CI:4.6-11.8) and 5.4(95% CI:4.4-6.4) months, respectively(P < 0.01).

CONCLUSIONSCytoreductive surgery can prolong the survival of gastric adenocarcinoma patients with extensive peritoneal metastasis. Cytoreductive surgery combined with chemotherapy may provide more benefit for patients, and can be used as a choice of treatment in these patients.

Adenocarcinoma ; Antineoplastic Combined Chemotherapy Protocols ; Chemotherapy, Adjuvant ; Cytoreduction Surgical Procedures ; Humans ; Lymph Nodes ; Peritoneal Neoplasms ; secondary ; Retrospective Studies ; Stomach Neoplasms

OBJECTIVETo summarize our experience in adult-to-infant living donor liver transplantation (A-ILDLT) and to analyze the efficacy and complications of A-ILDLT.

METHODSThe clinical data, surgical strategies and complications of 28 adult donors and infantile recipients who underwent A-ILDLT from April 2006 to December 2009 were retrospectively analyzed. These 28 patients (14 boys and 14 girls) aged from 80 days to 11.5 months with body weights of 3.08 to 10.3 kg at the time of operation . They suffered from biliary atresia with decompensated cirrhosis. The living donors were 15 mothers, 9 fathers, 3 grandma and 1 elder brother with ABO compatible with the infantile recipients. 27 Donor organs were the left lateral lobe grafts (segment II, III) and 1 graft was segment II. All patients were followed up for 5 to 24 months.

RESULTSThese grafts were orthotopically transplanted into the infantile recipients. The average length of stay was 9.3 days for the donor group without any complications. Postoperative immunosuppression included prednisone, Cyclosporin and mycophenolate mofetil (MMF). A total of 24 postoperative complications occurred in 20 recipients, including 5 vascular complications, 4 bleeding, 7 pneumonia, 2 bowel obstruction, 4 intestinal perforation and 3 rejection. Three recipients died of hepatic arterial thrombosis (HAT). The perioperative mortality rate of recipients was 10.7% (3/28) and the survival rate was 89.3% in peroperative period. One died of stricture of hepatic vein and 1 of accidental asphyxia during follow-up term. At present, 23 cases are still alive.

CONCLUSIONA-ILDLT has become an effective method to infants with end-stage liver disease. The postoperative vascular complication is the predominant cause of death.

Female ; Humans ; Infant ; Liver Diseases ; surgery ; Liver Transplantation ; methods ; Living Donors ; Male ; Retrospective Studies ; Treatment Outcome