Objective To explore the change of Doppler velocity waveforms in the fetal main pulmonary artery in patients with early onset severe preeclampsia and to assess its value in fetal lung maturity.Methods A prospective study was conducted to analyze fetal main pulmonary artery velocity waveforms parameters including acceleration time(AT),ejection time(ET),acceleration time/ejection time (AT/ET),peak systolic velocity (PSV) in 30 cases of pregnant women with early onset severe preeclampsia.According to neonatal outcome,these cases were divided into respiratory distress syndrome (RDS) group (18 cases) and non-RDS group (12 cases).Each group was compared with 54 cases and 36 cases that were normal and had corresponding gestational age separately.Doppler parameters were compared between these two groups and their corresponding normal control groups.Results Gestational age at sonographic examination,gestational age at delivery and birth weight of neonates in RDS group were significantly lower than those in non-RDS group(all P ＜0.001).The value of AT,ET,AT/ET,PSV were lower in RDS group than those in gestational age-matched control group(all P ＜0.05),while there were no significant difference between non-RDS group and gestational age-matched control group(all P ＞ 0.05).Conclusions Doppler ultrasound monitoring fetal main pulmonary artery velocity waveforms to evaluate fetal lung maturity in patients with early onset severe preeclampsia has clinical application value.

ObjectiveTo investigate the effect of both conservative and surgical treatment on cervical spinal cord injury without fracture and dislocation.MethodsResultsAll patients had some recovery after both surgical and conservative treatment(P<0.05),but the patients after surgical treatment had a better outcome than those after conservative treatment(P<0.01).ConclusionThe effect of early surgical treatment on cervical spinal cord injury without fracture and dislocation is superior to conservative.

Objective To observe the changes of abdominal oxygen saturation in very low birth weight infants (VLBWI)with feeding intolerance (FI)within 1 4 days after birth monitored by near infrared spectroscopy (NIRS).Methods VLBWI fitting entry criteria were enrolled into this study.NIRS monitoring was carried out to detect cerebral oxygen saturation (ScO2 )and abdominal oxygen saturation (SsO2 ).Data were analyzed between FI infants and feeding tolerance (FT)infants.FI was defined as follows:gastric residual of more than 50% of the previous feeding volume;emesis or abdominal distention or both;decrease,delay or discontinuation of enteral feedings. Results 93 VLBWI were enrolled.52 cases(55.91 %)presented with FI,including 29 cases(31 .1 9%)of gastric residual increasing and 23 cases(24.73%)of emesis with or without abdominal distention within 1 4 days after birth. The levels of SsO2 and SsO2 /ScO2 showed no differences in infants with FT and with FI within 24h after birth (P >0.05).The change rates of the median of SsO2 and SsO2 /ScO2 in FT infants were similar during 1 4 days (P >0.05).While both the change rates of SsO2 and SsO2 /ScO2 were markedly decreased 1 day before and the day of FI (P <0.01 ).The decreasing degree of SsO2 was similar between infants with gastric residual increasing and infants with emesis with or without abdominal distention[(1 6.2 ±5.1 )vs (1 7.4 ±3.6)%,t =0.733,P =0.476]. Conclusion Abdominal oxygen saturation measured by NIRS may be a useful method for infants adjusting the feeding plan.

Objective: To study the influence of Centipede Acidic Protein(CAP) on the proliferation and collagen synthesis of cultured neonatal rat cardiac fibroblasts(CFb) induced by angiotensinⅡ(AngⅡ),and to explore the mechanisms of CAP on cardiac fibrosis.Methods: Neonatal rat cardiac fibroblasts were treated with AngⅡ to produce fibrosis model.The effects of CAP on proliferation of CFb were observed by MTT colorimetric assay,synthesis of collagen was observed by the hydroxyproline concentration.The NO contents were measured by Nitric acid reductase method.The c-myc expression was examined by semi-quantitative RT-PCR analysis.Results: Compared with that of control group,the proliferation,collagen synthesis and the levels of c-myc mRNA expression of CFb in the model group increased,while the NO contents decreased obviously(P

BACKGROUND:Glial scar and cavity formation fol owing spinal cord injury inhibits axonal entrance, so limited axonal regeneration, less secretion of neurotrophic factor and inhibitors in the microenvironment of axonal growth are considered as major impediments for impacting functional recovery of patients with spinal cord injury.
OBJECTIVE:To analyze literatures home and abroad related to the biological characters of astrocytes and glial scar hyperplasia after spinal cord injury, and to provide a theoretical basis for the mechanism underlying glial scar formation fol owing spinal cord injury.
METHODS:PubMed and Wanfang databases were retrieved using the keywords“astrocytes, reactive astrogliosis, glial scar, spinal cord injury”in English and Chinese, respectively. Final y 62 literatures were selected for overview.
RESULTS AND CONCLUSION:Currently, studies concerning the biological characters of astrocytes, reactive astrogliosis and glial scar formation fol owing spinal cord injury have achieved some progresses. Studies mainly focus on the sole impediment for spinal cord injury, and treatment also aims at inhibiting single factor, but interactions among factors have not been confimed. In addition, the regulatary mechanisms of specific intracel ular and extracel ular signal molecule in the astrocytes, and effective control and interference of glial scar formation fol owing spinal cord injury stil need in-depth study.

Objective To investigate the clinical significance of universal newborn hearing screening for deaf‐ness predisposing genes in newborns .Methods A total of 965 newborns at Subei Hospital in Yangzhou were taken blood samples at heel and received for deafness predisposing genes screening .The most common deafness genes were detected by gene sequencing ,including mt12SrRNA c .1555A > G ,c .1494C > T ,GJB2 35delG ,167delT ,176_191del16 ,235delC ,299_300delAT ,SLC26A4 281C> T ,589G>A ,IVS7 -2A>G ,1174A> T ,1226G> A ,1229C> T ,IVS15+5G> A ,1975G>C ,2027T > A ,2162C> T ,2168A> G ,GJB3538C> T ,547G> A .At the same time ,all infants received hearing screening .Otoacoustic emission(OAE) was used as the first step screening ,and OAE combined with auto-auditory brainstem response(AABR) detection were used as the second step screening . Results Fifty -three cases (5 .49% ) had partial gene mutation ,one case of 12SrRNA gene mutation ,33 cases of GJB2 gene mutation ,18 cases of SCL26A4 gene mutation ,one case of GJB3 gene mutation .Of 965 cases ,28 cases failed to pass hearing screening while 18 cases did not pass rescreening .There were 10 cases taking audiological di‐agnosis at the age of three months .Six cases were confirmed with hearing loss .There were 905 cases passed thehearing screening and genetic screening ,11 failed born hearing and gene screening .Conclusion That the newborn gene screening was added into the hearing screening can be helpful to find out the deafness predisposing genes and drug -induced or late-onset hearing loss .

Objective To study the imaging characteristics of vesical leukoplakia under the cys-toscope imaging system. Methods The characteristics of vesical leukoplakia were observed under the cystoscope imaging system in 556 cases. After anti-infection treatment to these patients, the chan-ges of the characteristic under the cystoseope imaging system were re-observed and compared before and after treatment. SPSS 11.0 software package x2 teat for statistical analysis was used. Results Under the cystoscope imaging system, there were four different imaging manifestations in the 556 pa-tients. These were, from mild to severe, congestive type in 42 cases, spots type in 56 cases, thin macular type in 399 cases and thick macular type in 59 cases. One type could transform to another af-ter anti-infection treatment. When reexamination by the cystoscope, 131 cases got improved, 304 cases had no changes and 121 cases were aggravated. Statistical analysis showed the transformation among the 4 types had significant difference (x2 = 130.92, v=6, P<0.001). From congestive type to spots type, thin macular type and thick macular type, after anti-infection treatment, the ratio of improved cases decreased gradually, however the ratio of aggravated cases and cases without changes increased gradually. Conclusion Vesical leukoplakia could be classified into 4 types initially: congestive type,spots type, thin macular type, thick macular type. The different clinical treatments should be provid-ed.

Objective To find out the current situation of brucellosis infection and exposure status of family members of sheep farmers in the western pastoral areas of Jilin Province,and to provide a reference for control of human brucellosis spreading among family members.Methods On November 2012,Qianguo County was randomly selected using a multi-stage sampling method,and two townships,Chaganhua and Wulantala,were randomly selected in the county; half of the villages were selected from each township; all family members of the sheep farmers in these villages were investigated about their demographic characteristics (sex,age,education),high-risk behavior and information about brucellosis infection by using a questionnaire survey.Based on the principle of informed consent,respondents venous blood samples were collected.Brucellosis was confirmed with serum agglutination test (SAT).The effects of gender,age,education and other demographic data,high-risk behavior and high-risk behavior protection on the prevalence of brucellosis were studied.Results Out of the 403 copies of qualified questionnaires collected,84 people were found infected with brucellosis,and the infection rate was 20.84％ (84/403).Men infection [24.78％ (57/230)] was higher than that of women [15.61％ (27/173),x2 =5.038,P ＜ 0.05].The rates of eight kinds of high-risk behaviors were:helping feeding 86.85％ (350/403),cleaning sheepfold 80.40％ (324/403),holding lamp 71.71％ (289/403),delivering sheep 61.54％ (248/403),vaccinating sheep 53.85％ (217/403),apoblema 47.39％ (191/403),milking 22.08％ (89/403) and slaughtering sheep 14.89％ (60/403).The highest risk behavior was vaccinating sheep[24.40％(53/217)],and the lowest was milking [16.90％ (15/89)].The highest rate of basic protection was delivering a sheep [31.85％ (79/248)],the next was apoblema[27.23％ (52/191)],and the lowest was slaughtering sheep [8.33％ (5/60)].There was no statistical significant difference between brucellosis infection and the eight kinds of high-risk behaviors as well as the basic protective behaviors.Conclusions The prevalence of brucellosis infection among sheep farmers' family members is higher than others.Brucellosis infection-related contact manner is ubiquitous and the level of basic protection is low.We should carry out targeted health education on sheep farming household members to improve their level of protection,so as to reduce the risk of brucellosis infection.

Objective To evaluate the relative efficacy of different dosages of Calf Pulmonary Surfactant (Calsurf) administration in premature infants with established respiratory distress syndrome (NRDS).Methods Four neonatal intensive care units in Jiangsu province were enrolled.Premature infants,birth weight ＜ 2 500 g,with NRDS,received 70 mg/kg (61 cases)or 100 mg/kg (69 cases)Calsurf.Clinical and respiratory parameters were recorded.The primary outcome measures were blood gas analysis of 1 h,12 h and 36 h after administration,the need for oxygenation and ventilatory requirements and the adverse events of NRDS.Results Arterial oxygen tension[pa (O2)] results in a significant improvement(80.27-±36.81) mmHg,(73.03 ±24.94) mmHg and (72.35 ± 24.72) mmHg at 1 h,12 h and 24 h in higher dose group(P ＜ 0.05),(67.95 ± 23.79) mmHg,(72.35 ± 24.72) mmHg in 24 h,as compared with the lower dose group at the same time [(67.07 ± 19.94) mmHg,(62.93 ± 21.71) mmHg,(67.95 ±-23.79) mmHg] (P ＞ 0.05).Inspired oxygen (FiO2) and pa (O2) decreased after administration in two groups and the duration of FiO2 decline lasted to 48 h (all P ＜ 0.05).The oxygen index (OI) was improved after Calsurf administration,especially in the infants who received 100 mg/kg of Calsurf with 6.1 ± 2.8,5.6 ± 3.3,5.5 ± 3.5,5.8 ± 4.5,5.3 ± 3.1 in 1 h,12 h,24 h,36 h,48 h,respectively(P ＜ 0.01).The arterial-to-alveolar oxygen tension ratio (a/APO2) of 100 mg/kg group was reduced significantly in 1 h,12 h,24 h,36 h,48 h with 0.39 ±0.22,0.42 ±0.20,0.45 ± 0.22,0.44 ± 0.22,0.46 ± 0.21 as compared with 0.27 ± 0.18 which was at the time point before administration (P ＜ 0.01).Although not statistically significant,the mean time of duration of mechanical ventilation and oxygen inhalation of higher dose group were decreased as compared to the lower dose group [(94.54 ± 113.44) h vs (109.27 ± 124.87) h (P＞0.05) and (259.10 ±280.45) vs (372.31 ±398.08) h(P ＞0.05)].There were no significant differences in the rates of other adverse events such as pneumonia,pneumothorax,intracranial hemorrhage,patent ductus arteriosus (PDA),pneumorrhagia,necrotizing enterocolitis,septicemia between two groups (P ＞ 0.05).Conclusions Calsurf given to preterm infants with NRDS at a dose of 100 mg/kg resulted in a higher Pa (O2),a/APO2,better OI and lower FiO2 as compared with those receiving 70 mg/kg.The need for mechanical ventilation and oxygen supplement were reduced with higher-dose administration.Large dose of Calsurf did not increase the risk of complications as mentioned above.

Immunotherapy which has been in practice for more than 20 years proves effective for the treatment of metastatic renal cell carcinoma (mRCC). Anti-angiogenesis-targeted therapy has recently been identified as a promising therapeutic strategy for mRCC. This study was aimed to evaluate the effectiveness of vascular endothelial growth factor (VEGF) pathway-targeted therapy for mRCC by comparing its effectiveness with that of immunotherapy. The electronic databases were searched. Randomized controlled trials (RCTs) on comparison of VEGF inhibiting drugs (sorafenib, sunitinib and bevacizumab) with interferon (IFN) or placebo for mRCC treatment were included. Data were pooled to meta-analyze. A total of 7 RCTs with 3451 patients were involved. The results showed that anti-VEGF agents improved progression-free survival (PFS) and offered substantial clinical benefits to patients with mRCC. Among them, sunitinib had a higher overall response rate (ORR) than IFN (47% versus 12%, P<0.000001). Bevacizumab plus IFN produced a superior PFS [risk ratio (RR): 0.86, 95% confidence interval (CI): 0.76-0.97; P=0.01] and ORR (RR: 2.19; 95% CI: 1.72-2.78; P<0.00001) in patients with mRCC over IFN, but it yielded an increase by 31% in the risk of serious toxic effects (RR: 1.31; 95% CI: 1.20-1.43; P<0.00001) as compared with IFN. The overall survival (OS) was extended by sorafenib (17.8 months) and sunitinib (26.4 months) as compared with IFN (13 months). It was concluded that compared with IFN therapy, VEGF pathway-targeted therapies improved PFS and achieved significant therapeutic benefits in mRCC. However, the risk to benefit ratio of these agents needs to be further evaluated.