Objective To observe the anaesthetic effect of sulfentanil combined with bupivacaine for subarachnoid block on cesarean section patients and the influence on the patient and fetus.Methods Eighty patients who were scheduled for elective cesarean section under subarachnoid block,were distributed into two groups:bupivacaine with no sulfenlanil(group B)and bupivacaine with sulfentanil(group BS).Detected SBP,DBP,MAP,HR,SpO2 before and after anesthesia.The time of drug onset,motor recovery and pain recovery were recorded,the effect of muscle relaxation was evaluated,and the drag reaction,neonatal Apgar score and anesthesia complication were recorded.Results There was no significant difference in the time of drug onset and motor recovery,muscle relaxation,neonatal Apgar score between the two groups.MAP was lower after 3-10 min of anesthesia than before anesthesia,but there was no significant difference after 30-120 min of anesthesia in the two groups.The rate of drag reaction was 27.5% in group B,but no case in group BS.The time of pain recovery was longer in group BS than that in group B(P＜0.01).The rate of temporary itch of skin after operation was 17.5% in group BS.Conclusion The addition of sulfentanil to hyperbaric bupivacaine provides adequate anesthesia for cesarean section and good postoperative analgesia.

Objective: To study the effect of nicotine on alkaline phosphatase (ALP) activity of human dental papilla mesenchymal cells in vitro. Methods: Human dental papilla mesenchymal cells were cultured in the presence of nicotine at various concentrations, ALP level of the cells was meseased at different time with an enzyme dynamical method and was expressed as A value at 410 um. Results: After 3day-exposure of the cells to nicotine(g/L) at 0, 0.05, 0.1, 0.2 and 0.4 the A values(per 10 5cells) were 0.64 ? 0.15, 0.61?0.03, 0.47 ? 0.05, 0.44 ? 0.06 and 0.39? 0.03; after 5-day-exposure those were 0.55 ? 0.12, 0.42?0.16, 0.29? 0.10, 0.19 ? 0. 4 and 0.10?0.02; after 7 day exposure those were 0.40? 0.12, 0.31 ? 0.10, 0.26? 0.06, 0.13? 0.02 and 0.09? 0.02, respectively. Conclusion: Nicotine inhibited the alkaline activity of human dental papilla mesenchymal cells in a dose and time dependant manner. Nicotine may play a role on the differentiation of the cells.

Objective To explore the long term effects of gestational diabetes mellitus (GDM)on offsprings of affected women.Methods One hundred and twenty-four singleton pregnant women with GDM,who delivered in Department of Obstetrics and Gynecology,Peking University First Hospital from June 14,2006 to December 31,2007,were enrolled as the study group.Ninety-eight singleton pregnant women with normal glucose metabolism who delivered at the corresponding period were enrolled as the control group.The follow-up study was performed from November 6,2010 to January 31,2011 on their offsprings.Anthropometry indexes,including height,weight,waist circumference,systolic and diastolic blood pressure (DBP),triceps skin fold (TSF) and sub-scapular skin fold (SSF) were measured.According to the development standard of children less than five years old issued by World Health Organization in 2006,there were six detailed evaluation indicators including length/height for age z-score (HAZ),weight for age z-score (WAZ),weight for length/ height z score (WHZ),body mass index (BMI) for age z-score (BAZ),triceps skin folds for agez-score (TSFZ) and sub-scapular skin folds for age z-score (SSFZ).Chi-square,t-test or variance analysis were applied.Results (1) No statistical difference on age,birth weight,sex,height,weight,BMI,waist circumference,blood pressure,TSF and SSF was found between offsprings of study and control group (P＞0.05).(2) Offsprings in both groups were further divided into macrosomia and non-microsomia subgroups,i.e.GDM macrosomic subgroup (n =15),GDM nonmacrosomic subgroup (n=109),control macrosomia subgroup (n=6) and control non-macrosomia subgroup (n=92).Significant difference was shown amont the four subgroups in weight [(19.8±3.9),(17.0±1.9),(17.7±1.7)and (17.2±1.7) kg,F=6.238,P＜0.001],BMI (17.6±2.6,16.0±1.2,16.6±1.1 and 16.2±1.1,F=5.901,P＜0.001),waist circumference [(53.6±5.3),(49.9±2.7),(50.9±3.3) and (50.4±0.9) cm,F=5.307,P＜0.001],WHZ (1.40±1.44,0.45±0.81,0.88±0.75 and 0,60±0.87,F=5.269,P=0.002),HAZ (1.22±0.78,0.47±0.82,0.98±0.74 and 0.50±1.00,F=3.668,P=0.013),WAZ (1.68±1.23,0.58±0.79,1.15±0.85and 0.71±0.93,F=7.361,P＜0.001) and BAZ (1.41±1.52,0.42±0.84,0.81±0.76 and 0.60±0.90,F=5.210,P =0.002).While comparing between each two subgroups,there was statistical difference between GDM macrosomia subgroup and GDM non macrosomia subgroup,and between GDM marosomia subgroup and control non-macrosomia group.(3) While comparing GDM macrosomia and GDM non-macrosomia subgroup with control group [weight (17.2±2.5) kg,BMI (16.2± 1.4),waist circumference (50.5 ± 3.6) cm,DBP (55.2 ± 6.9)mm Hg,SSF(6.1 ± 1.8) mm,WHZ (0.62±0.87),HAZ (0.53±0.99),WAZ (0.73±0.92),BAZ(0.61±0.89)],the weight (F=9.283,P＜0.001),BMI (F=8.707,P＜0.001),waist circumference (F=7.934,P＜0.001),DBP(F=3.123,P=0.046),SSF (F=3.499,P=0.032),WHZ (F=7.639,P＜0.001),HAZ(F=4.709,P=0.010),WAZ (F=10.302,P＜0.001) and BAZ (F=7.689,P＜0.001) was higher in GDM group than the control group.(4) The proportions of overweight and obesity were higher in GDM macrosomia subgroup than in GDM non-macrosomia and control groups [overweight:9/15 vs24.8％ (27/109) and 24.5％ (24/98),x2 =8.870,P=0.012; obesity:5/15 vs 7.3％(8/109) and 9.2％(9/98),x2=10.083,P=0.006].If all subjects were divided into macrosomia and non-macrosomia group,then the proportion of overweight and obesity was higher in the former group [overweight:52.4％ (11/21) vs24.4％(49/201),x2=7.560,P=0.006; obesity:28.6％ (6/21)vs 7.9％(16/201),x2 =9.047,P=0.003].Conclusions GDM may have long term adverse effect on the development of offsprings at three-four-year-old with higher incidence of obesity or high diastolic blood pressure in macrosomic babies of GDM mothers than in non macrosomic babies of GDM mothers or babies of non GDM mothers.

Objective:To investigate the protective effect of intratracheal transplantation of different dose of human umbilical cord mesenchymal stem cells (MSCs) in rats with acute lung injury induced by severe burns.Methods:Seventy-five male Wistar rats were randomly divided into five groups:Sham(group A),Saline group(group B) and different doses of hUMSCs transplantation groups(C,D and E).The dosage ofhUMSCs was 1 × 105,5 × 105 and 1 × 106 respectively.Rats inflicted by 50 ％TBSA Ⅲ degree scalding employed as the model.After modeling,rats in group B and transplantation groups were immediately fluid resuscitated.Transplantation groups were intratracheally administered different dose hUCMSCs (0.2 mL),and group B were given normal saline in the same dose intratracheally.The lung tissue samples were collected on day 1,day 3 and day 7 after administration.HE staining was used to observe the pathological changes of lung tissue.MPO and CD68 immunohistochemical staining were used to observe the positive expression of neutrophils and macrophages in lung tissue.Results:Lung pathology showed that alveolar cavity was clear,alveolar structure integrity,occasionally a small amount of inflammatory cells of group A at each time point.At 1 day after scald,group B and the transplantation group (group C,D,E)the alveolar septum was thickened,and there was visible pulmonary capillary hyperemia,as well as a large amount of inflammatory cell infiltrations in the pulmonary capillaries and alveolar space.At 3 day,group B and the transplantation group alveolar structural damage,pulmonary hemorrhage and inflammatory cell infiltrations were better than those in 1 day.Compared with group B,the alveolar structure was clear and the septum was thinner,but there was no significant difference between the transplantation groups.On the 7 day after scald,the lung injury in the transplanted group was significantly less than group B,and the recovery of the injured lung tissue in E group was the most obvious.The number of the MPO positive cells increased significantly on the first day after scald (P ＜0.05) compared with group A,but there was no significant difference between the two groups.Compared with B group,the number of positive cells in transplantation group was significantly reduced at 3 and 7 day after scald,(P＜0.05),and the number of positive cells in group E was significantly lower than other groups (P＜0.05).CD68 staining showed a significant increase in positive cells in each group on day 1 (P＞ 0.05).The number of positive cells decreased in 3 day after transplantation (P＜0.05),but there was no significant difference between the transplantation groups.The number of positive cells in transplantation group was significantly lower than group B (P＜0.05) after 7 day.Compared with group C and D,there was significant difference in group E (P＜0.05).Conclusions:Intratracheal transplantation of different dose hUCMSCs have protective on severe burns induced acute lung injury models;the protection mechanisms may be that the hUCMSCs transplantation can inhibit the invasion of the inflammatory cells in lung tissues,and the optimal dosage is 1 × 106.

Objective:To detect the expression of upstream stimulatory factor 1(USF1) and its tempo-spatial distribution during mice teeth development. Methods: Total protein was extracted from P1 and P11 d mice first molar teeth germ, and Western blot for USF1 was undertaken. Paraffin sections of first molar teeth germs from E13, 16, 19, P1, 5, 8, 11, 21 d and 6-month-old adult mice were prepared respectively and immunohistochemical staining was carried out. Results: Western blot analysis identified one Mr 43 000 protein from P11 d mice teeth germs, but none from P1d mice. Immunohistochemically, evidently positive staining for USF1 in mice teeth germs began from P5 d, and extended to P11 d, which was mainly confined to the cytoplasm of secreting ameloblasts and odontoblasts, but no staining in bud, cap and early bell stages of tooth germ. However, after tooth eruption on P21 d, USF1 became negative again, although it was still positive in the adjacent muscles, and the same result was observed in adult mice tooth. Conclusion: USF1 is expressed in tooth germ, which localizes solely in secreting ameloblasts and odontoblasts, and its expression was quite dynamic during mice tooth development.

Objective:To investigate the relationship between vulnerability of mouse coronary artery plaque and downstream myocardial perfusion and myocardial strain.Methods:Thirteen ApoE knockout mice with stable coronary plaques (stable plaque group)and 13 ApoE knockout mice with vulnerable coronary plaques(vulnerable plaque group) were selected as the experimental group, and 15 sex- and age-matched C57BL/6 mice with the same genetic background as ApoE mice were chosed as the control group. Myocardial contrast echocardiography (MCE) was carried out to quantify regional myocardial perfusion at rest and during adenosine stress using a Vevo 2100 system (Visual sonics). Replenishment curves of myocardial contrast were obtained, and rates of signal rise (β) and plateau intensity (A) were recorded. MBF was estimated by the product of A and β. Speckle tracking imaging combined with adenosine stress test was used to evaluate the longitudinal strain of left ventricular myocardium in mice. The vulnerability of the plaque was assessed by histopathology in serial tissue sections of proximal and middle left coronary artery according to the previously reported method.Results:There were no significant differences in body weight, heart rate, left ventricular end diastolic volume, left ventricular end systolic volume, left ventricular mass and ejection fraction among the three groups( P>0.05). The levels of serum triglyceride, total cholesterol, high density lipoprotein and low density lipoprotein in stable plaque group and vulnerable plaque group were significantly increased when compared with those in control group (all P<0.05). The pathological results showed that the coronary luminal stenosis rates in the stable plaque group and the vulnerable plaque group were (74.3±4.9)% and (75.5±7.1)% respectively, with no significant difference between the two groups( P>0.05). MBF of the middle anterior septum and left ventricular posterior wall in the experimental groups were significantly decreased when compared with that in the control group both in the resting status and during adenosine stress(all P<0.05). There were no significant differences in the MCE parameters between the stable plaque group and the vulnerable plaque group at rest( P>0.05). However, during adenosine stress, MBF of the vulnerable plaque group was decreased more significantly than that of the stable plaque group ( P<0.05). Compared with the control group, the values of longitudinal strain of the left ventricle in both experimental groups were decreased during resting status, without statistical significance (all P>0.05), but decreased significantly during adenosine stress and with more decrease in the vulnerable plaque group (all P<0.05). Conclusions:For the same degree of coronary artery stenosis in mice, the coronary artery vulnerable plaque group has less downstream myocardial perfusion and myocardial strain than the stable plaque group during adenosine stress. That is, the plaque vulnerability can affect the downstream myocardial perfusion and myocardial strain in the mouse model.

This paper presents some ideas and practices to realize the homogeneity quality management process within the Beijing Children Hospital Group,the largest specialized medical group in the country.This research aims at providing references and thoughts on homogeneity quality management for trans-regional medical unions in the country.

Object To define suitable gathering season of Ginkgo biloba L. leaves. Methods The content of total flavonoids and total terpene lactones in G. biloba leaves were determined by HPLC DAD and HPLC ELSD. Results The content of total flavonoids and total terpene lactones in G. biloba were distinct in different ages of tree and collecting seasons. Conclusion The content of total flavonoids and total terpene lactones in G. biloba are the highest in 2 3 ages of tree. The total flavonoid is the highest in May and total terpene lactone is the highest in September.

Objective To investigate the survival and recurrence data after treatment in neuroendocrine carcinoma of the uterine cervix(NECUC)with stageⅠb-Ⅱa, and to analyse its prognostic factors. Methods Thirty-two cases of primary NECUC in early-stage disease treated from Jan. 2005 to Dec. 2013 at Cancer Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences were reviewed, and their data of clinicopathologic characteristics were collected and analysed. The median age was 37 years (range, 23-57 years). The distribution by International Federation of Gynecology and Obstetrics (FIGO) clinical stage:19 cases stageⅠb1, 10 cases stageⅠb2, 1 case stageⅡa1, 2 cases stageⅡa2. Pathologic types: 22 cases of small cell carcinoma, 1 case of atypical carcinoid, 9 cases of mixed carcinoma. The diameter of cervical tumor:12 cases≥4 cm, 20 cases<4 cm. All patients underwent radical hysterectomy and pelvic ± para-aortic lymphadenectomy, and 15 cases of them were preserved unilateral or bilateral ovaries. Pathologic examination showed that 25 cases with cervical deep stromal invasion thickness ≥1/2, 21 cases with lymph-vascular space invasion (LVSI), and 18 cases with pelvic and (or) para-aortic lymph nodes involvement. Ten cases were performed neoadjuvant chemotherapy (range,1-3 cycles), all patients received postoperative chemotherapy (range,3-6 cycles), and 15 patients were treated with radiotherapy after surgery. The follow-up data were updated on Jul. 2014. The median follow-up time was 18 months (range, 7-71 months). A retrospective analysis was conducted to analyse the survival and recurrence data,and to explore the prognostic factors of NECUC. Results Thirteen patients died during the follow-up period. The cumulative progression-free survival (PFS) of 2 and 5 years were respectively 54.2%and 38.1%, and the estimated median PFS was 29 months. The cumulative overall survival (OS) of 2 and 5 years were respectively 56.1%and 44.9%, and the estimated median OS was 31 months. Fourteen cases had recurrence, and the median recurrence time was 9 months (range, 3-30 months). Recurrent or metastatic sites:2 cases in pelvis, 4 cases in liver, 3 cases in lung, 3 cases in adrenal glands, 3 cases in bones, 2 cases in brain, 1 case in pancreas, 1 case in lymph nodes of para-aorta and neck, and 3 cases had metastasis in two or more organs. Thirteen cases with recurrence died of disease, and another one is alive with disease. The univariate analysis showed that lesion size of the cervix and FIGO stage were significant prognostic factors (P<0.01), while age, tumor components, deep invasion in cervical stromal, LVSI, pelvic and (or) para-aortic lymph nodes involvement, neoadjuvant chemotherapy, adjuvant radiotherapy and preserving ovaries were not significantly associated with prognosis(all P>0.05). Conclusion The prognosis of NECUC in early-stage is poor and the lesion size of the cervix and FIGO stage are prognostic factors.

ObjectiveTo identify the early predictors of refractory epilepsy (RE). MethodsAll 173 epileptic patients with correct diagnosis and reasonable treatment were enrolled. The 106 patients were classified as drug non-responsive epilepsy (DNR-EP). The remaining 63 patients were classified as drugresponsive epilepsy (DR-EP). With multiple logistic regression, the clinical characteristics between the two groups were compared to identify the early predictors of RE. ResultsMultiple logistic regression analysis demonstrated that more than 10 seizures before treatment (OR =4. 46, 95％ CI 1.60-12. 40, P =0. 004),mental retardation at early time ( OR =19. 87, 95％ CI 3. 60-109. 78, P =0. 001 ) and abnormal electroencephalogram(EEG) with epileptiform wave after treatment ( OR =7.57, 95％ CI 2. 54-22. 56,P ＜0. 01 ) were independent predictors of RE.Response to initial therapy was a protective factor of RE (OR=0.05, 95％ CI 0.018-0. 139, P＜0.01). ConclusionPatients who have many seizures before treatment, mental retardation at the early time, epileptiform abnormality in EEG after treatment and who are resistant to initial therapy are likely to develop into refractory epilepsy.