Objective To investigate clinical predictors in early pregnancy for adverse pregnancy outcomes in women complicated with chronic nephropathy. Methods One hundred and eighty-four pregnancies complicated with chronic nephropathy who delivered between January, 2005 and January, 2014 in Peking University First Hospital were retrospectively analyzed. Two hundred pregnant women without chronic nephropathy were selected as the control group. Pregnancy outcomes were compared between the two groups. Relationships between clinical predictors in early pregnancy [age, history of kidney disease, drugs used before pregnancy (in three months), results of renal biopsy, blood pressure, serum creatinine, urea nitrogen, 24 h urinary protein, estimated glomerular filtration rate, stage of chronic nephropathy] and adverse pregnancy outcomes [maternal mortality;pregnancy complicated by severe preeclampsia;renal function decline, early preterm birth, very low birth weight infants, fetal loss after 20 weeks of pregnancy] were assessed by logistic regression analysis. T-test, Chi-square test and multivariate regressions were used for statistical analysis. Results There were 174 and 197 livebirths in the study and the control groups, respectively. The most popular type of chronic nephropathy in pregnant women was IgA nephropathy (38.6%, 71/184). Compared with the control group, the risk of premature labor [9.8%(17/174) vs 3.0%(6/197), χ2=7.184], low birth weight infants[18.4%(32/174) vs 7.1%(14/197),χ2=9.813], very low birth weight infants [5.7%(10/174) vs 1.5%(3/197),χ2=4.536], fetal loss after 20 weeks of pregnancy [5.7%(10/184) vs 1.5%(3/200), χ2=4.536] and severe preeclampsia [17.9%(33/184) vs 1.5%(3/200), χ2=33.544] increased significantly in the study group (all P < 0.05). Twenty-four-hour urinary protein content (OR=1.84, 95%CI: 1.36-2.50, P=0.001) and mean arterial pressure (OR=1.04, 95%CI: 1.00-1.07, P=0.027) in early pregnancy were risk factors for adverse pregnancy outcomes. The risk of renal function decline increased significantly in patients with higher stages of chronic nephropathy in early pregnancy (OR=6.50, 95%CI: 3.34-8.21, P<0.01). Mother complicated by preeclampsia during pregnancy was an independent risk factor (OR=11.10, 95%CI: 4.48-27.20, P<0.01). Compared with women whose 24 h urinary protein content less than 1g in early pregnancy (122 livebirths within 126 cases), the risk of premature labor [17.3%(9/52) vs 6.6%(8/122), χ2=4.780], increased significantly in women whose 24 h urinary protein content were more than or equal to 1 g in early pregnancy (52 livebirths within 58 cases) (P<0.05). Conclusions Elevated urinary protein level and mean arterial pressure in early pregnancy were risk factors of adverse pregnancy outcomes. The risk of renal function decline increased in patients with higher stages of chronic nephropathy in early pregnancy. Mother complicated by preeclampsia during pregnancy was an independent risk factor for poor prognosis of the fetus.

Aortic Coarctation ; complications ; Ductus Arteriosus, Patent ; complications ; Humans ; Infant ; Pulmonary Artery ; abnormalities

Objective To analyze the clinical effect of nutritional support for postoperative patients with esophageal cancer with fat emulsion and amino acids (17) and glucose (11%) injection (Calvin injection). Methods A total of 68 patients with esophageal cancer treated in the chest surgery in our hospital from December 2014 to December 2016 were selected and randomly divided into two groups with 34 cases in each group. All patients were treated with surgery for esophageal cancer. The patients in the study group were treated with Calvin injection after operation while patients in the control group were treated with conventional fluid replacement therapy. Subjective comprehensive assessment (SGA) was used to assess the nutritional status of the patients and the weight, serum total protein (TSP), serum albumin (Alb), transferrin (TF) content, urea nitrogen content in on one week, malnutrition improvement and complications of the patients in two groups were recorded and compared. Results The weight of the patients with esophageal cancer in the two groups after operation was decreased, and the weight loss of the patients in the study group was lower than that of the control group and the difference was statistically significant (P<0.01). The decrease degree of TSP, Alb and TF in the study group was lower than that in the control group, and the difference was statistically significant (P<0.05). The negative nitrogen balance of the two groups was improved, and the improvement of the negative nitrogen balance in the study group was better than that in the control group, and the difference was statistically significant (P<0.01). The postoperative malnutrition in the patients with esophageal cancer was improved. The improvement degree of malnutrition in the study group was better than that in the control group, and the difference was statistically significant (P<0.05). The incidence of complications in the study group was lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion Compared with the traditional method of postoperative fluid replacement, Calvin injection can improve the recovery of the body function of the patients with esophageal cancer after operation, improve the patient's negative nitrogen balance and nutritional status, reduce the incidence of complications, and improve the clinical prognosis. This treatment is safer and more effective and it is worth popularizing in clinical practice.

Objective To evaluate the efficiency, safety and complications of transcatheter closure of atrial septal defect (ASD) using Amplatzer and sideris occluder under the guidance of transthoracic echocardiography and fluoroscopy. Methods Fourteen patients of ASD, 6 male and 8 female, age ranged from 2.6 to 43 years old, were treated by transcatheter closure of ASD with Sideris or Amplatzer occluders. All cases were guided by thansthoracic echocardiography and fluoroscopy. Results The diameter of ASD (balloon stretched diameter) was 14-34 mm (24.16 ? 5.16)mm. The Amplatzer devices were used in 9 cases, all of them were successfully occluded with satisfactory results. Of 5 patients treated by Sideris buttoned devices, 4 had success procedure and one failed, in which unbuttoning occurred and retrieval of the device was performed by emergency surgery. Conclusion Transcatheter closure of ASD is a simple and convenient method with a high success rate and reliable curative effect. The indication of Amplatzer method is much wider and the instant success rate after the procedure is much higher than those of Sideris device. Thansthoracic echocardiography plays a key role for guiding transcatheter closure of ASD in this study.

Objective To investigate the prognostic value of the changes in serum CA125 level during chemotherapy post-surgery in patients with advaneed epithelial ovarian carcinoma.Methods A retrospective analysis was conducted on 142 patients with stage Ⅲ-Ⅳ epithelial ovarian carcinoma who had primary treatment in the Cancer Center of the Sun Yat-sen University during January 1998 to December 2003.The changes in CA125 levels during chemotherapy post-surgery in patients were analyzed.The survival outcomes of patients with various levels of CA125 were studied using Kaplan-Meier method.Multivariate Cox regression model Wag used to aggess the correlations between survival and the change in CA125 level during chemotherapy and other prognostic factors.Results The 3-year overall survival(OS)was 64%,71%,and 64%respectively in patients with different pretreatment CA125 levels(≤500,>500-1500 and>1500 kU/L;P>0.05).The CA125 level was normalized(0-35 kU/L)in 77(54.2%)patients after three cycles of postoperative chemotherapy.It revealed significant differences in 3-year OS(84%vs.42%)and 5-year OS(56%vs.15%)between the patients with normalized and elevated CA125 levels(n=48)after three cycles of chemothempy(P<0.01).Multivariate analysis showed that residual tumor size>1 cm(P<0.01)and elevated CA125 after three-cycle postoperative chemotherapies(P<0.01)were two independent factors related to survival.In the subgroup of optimal cytoreduction(residual tumor size≤1 cm),the 3-year and 5-year OS rate were 88%and 64%for patients with normalized CA125 level after three cycles of chemotherapy respectively,while only 52%and 18%for patients with elevated CA125 level(P<0.01).Similarly,even in the suboptimal cytoreduction group,the 3-year and 5-year OS were also significantly increased for patients with normalized CA125 level after three cycles of chemotherapy post-surgery,as compared with patients with elevated CA125 level(74%vs.33%in 3-year OS,32%vs.13%in 5-year OS;P<0.01).Conclusions CA125 level after three cycles of chemotherapy post-surgery is an independent predictor of survival for advanced ovarian carcinoma.Whatever the patients undergo,optimal or suboptimal cytoreduction,ifthe CA125 becomes normalized after three cycles of chemotherapy,they would have more favorable prognosis than those with elevated CA125 after three cycles of chemotherapy.

Objective To develop a PCR-based method of detecting plankton 16S rDNA for the i dentification of death by drowning. Methods Fifteen Sprague-Dawley rats were divided randomly into three groups: the death by drowning group, the group of submerging after death and the control group. After sacrificing by different ways, the brain, liver, kidney and lung of rats were taken out respectively and DNA were extracted from the tissues of these organs and were amplified subsequently by specific primers selected from the third and fourth variable regions of plankton 16S rDNA. Results The specific amplification products were detected from all 5 samples of lung tissue ( 100% ) , 4 samples from liver and kidney tissues (80% ) , and 3 samples from brain tissue (75% ) in the group of death by drowning. No amplification product was detected in all samples of the control group and the amplification product was detected only in 1 sample of lung (20% ) in the group of submerging after death. Conclusion The PCR-based method of detecting plankton 16S rDNA for the identification of death by drowning is certainly feasible.

=3) in spinal fluid. The intra and inter-day relative standard deviation of analysis were less than 3.0 % (n = 5). The recovery of lidocaine was between 98.3 % - 102.7 % . Lidocaine assay was carried out in a medical case by using the method established. Conclusion Spinal fluid is suitable for assay lidocain in forensic toxicological analysis and other medical studies by using the HPLC method which is sensitive, rapid and accurate.

Objectives To investigate the distribution of uridine diphosphate-glucuronosyltransferase 1A1 (UGT1A1) gene promoter polymorphism and its relation to the toxicities caused by irinotecan in Chinese patients with cervical cancer and ovarian cancer.Methods Sixty-four blood samples were taken from the patients with ovarian cancer and cervical cancer.The DNA was extracted and amplified with PCR.Then,the sequences of UGT1A1 gene promoter were detected by capillary electrophoresis allele fragment analysis (size-based analysis) methods.The relationship between UGT1A1 gene promoter polymorphism and the toxicity caused by irinotecan was analyzed.Results In all the patients,TA 6/6 was the most common genotype of UGT1A1 gene promoter (44 cases),accounting for 69％ (44/64),followed by genotype of TA 6/7 ( 17 cases,27％,17/64),while genotype TA 7/7 was rare (3 cases,5％,3/64).The genotypes of UGT1A1 gene promoter was an independent factor for the occurrence of delayed diarrhea (P =0.040,OR =4.228,95％ CI:1.065 - 16.785 ) but not for neutropenia ( P =0.068,OR =3.659,95％ CI:0.911 - 14.700).The patients with both genotype TA 6/7 and TA 7/7 presented much higher risk of delayed diarrhea and neutropenia than those with TA 6/6 ( all P =0.001 ).Conclusions UGT1 A1 gene promoter polymorphism may be a significant influencing factor for delayed diarrhea.The patients with both genotype TA 6/7 and TA 7/7 could present much higher risk for delayed diarrhea than those with TA 6/6,while genotype TA 6/6 may be the most common UGT1A1 promoter type in Chinese patients with cervical or ovarian cancer.

Objective:To investigate the Prostaglandin E2(PG-E2),Leukotrienes B4(LT-B4)、Platelet activating factor(PAF) and vascular endothelial growth factor (VEGF) levels in the model of UC rats serum,and the changes after the Mesalazine,clostridium, and montmorillonite powder treatment intervention ,in order to understand the significance of the four inflammatory factors in UC rats and the interference effect of the above three drugs on the four inflammatory cytokines .Methods:100 rats were randomly divided into normal group(A),model group(B),Mesalazine group(C),clostridium group(D)and montmorillonite group(E),The levels of the plasma PG-E2,LT-B4,PAF and VEGF were measured by ELISA .The different changes of the four cytokines were compared in the different groups.Results:①The scores of DAI and the levels of the plasma PGE2,LTB4,PAF and VEGF in the B,C,D and E group were higher than ones in A group(P<0.05).②Compared B group,the scores of DAI and the levels of plasma PGE2,LT-B4,PAF and VEGF in B,C,D and E group were lower ( P<0.05 ) .③Compared the efficacy among mesalazine , clostridium and montmorillonite powdergot treating UC , mesalazine and montmorillonite powder got the best results ( P<0.05 ) .The efficacy between mesalazine and montmorillonite was similar.Conclusion:①The PGE2,LT-B4,PAF and VEGF are very active higher in the blood of rats with UC and have a positive correlation with inflammation .②Mesalazine, clostridium and montmorillonite powder may renovate the damage of inflammatory tissues of rats with UC , and relieve the symptoms of inflammation , and also shorten the duration of inflammation by reducing exudation of proinflammatory cytokines PGE 2,LTB4,PAF and VEGF.

OBJECTIVE:To provide reference for further implementation and improvement ofTwo Tax Billmedicines distri-bution reform. METHODS:Literature review and field investigation were used to systematically sort out,summarize and analyze the effect ofTwo Tax Billmedicines distribution reform and potential problems. Corresponding policy suggestions were proposed. RESULTS & CONCLUSIONS:TheTwo Tax Billmedicines distribution reform boosted the integration and re-combination of medicines distribution system,and effectively rectify the medicines distribution system. However,this study found no evidence of its effect on reducing the high medicines prices. We suggest that,the implementation ofTwo Tax Billmedicines distribution re-form should firstly ensure the stable supply of medicines,especially the availability of essential medicines in rural remote areas, and those medicines with high risk of shortage. It is also suggested to strengthen the audit of tax receipts;establish long-term mecha-nism to promote on-time payment to suppliers by hospitals;break down local protection;set up efficient multi-ministerial coordina-tion mechanism.