Objective To investigate delivery mode of uterine scar pregnancy and analyze the safety of vagi-nal delivery.Methods 210 delivery women with scar uterus after cesarean section and 85 delivery women with non -scar uterus vaginal delivery of maternal selection were collected.According to the different ways of delivery,the preg-nant women in the scar group were divided into A group (72 cases)and B group (138 cases).Delivery outcome, maternal complications and average hospitalization time between the two groups were compared.Results 72 cases of maternal vaginal delivery in scar A group was successful and smooth vaginal delivery in 64 cases,and success rate was 88.89%(64 /72).8 patients maternal modified cesarean section production,accounted for 11.11%(8 /72),including 3 cases of persistent occiput posterior position,2 cases of social factors give up vaginal delivery,2 cases fetal distress, 1 case for incomplete rupture of uterus.138 cases delivery women in scar B group successfully obtained the cesarean section.100 cases of delivery women in non scar group,91 cases successfully got vaginal delivery,and the success rate was 91.00% (91 /100).Another 9 cases of delivery women were replaced with caesarean birth[9.00%(9 /100)],of which 3 cases of fetal distress,2 cases for fetal macrosomia,2 cases of persistent occiput transverse position,2 cases as social factors give up of vaginal delivery.Scar in group A maternal average hospitalization time was significantly shor-ter than scar in group B,and mean postpartum hemorrhage was significantly increased than scar in group B,and the differences were statistically significant (t =15.87,26.32,all P <0.05).There were no significant differences in the incidence of postpartum hemorrhage and neonatal asphyxia between the two groups (χ2 =0.24,1.05,all P >0.05). The maternal average hospitalization time,mean postpartum hemorrhage,postpartum hemorrhage and incidence rate of neonatal asphyxia between scar group A and non scar group had no significant differences (χ2 =0.88,1.30,1.03, 0.00,all P >0.05).Conclusion When choosing vaginal delivery in scar uterus again pregnancy,we should strictly grasp cesarean section pregnancy after vaginal delivery of the indications.Under strict monitoring,the safety of vaginal delivery was high.It was worth of clinical promotion.

Objective With the CT analysis of vascular lesions which caused abdominal pain,to improve the radiologist’s understanding of this disease,and to reduce the rate of misdiagnosis.Methods The CT data of 69 cases with vascular lesions which caused abdominal pain were analysis retrospective.Results In the vascular lesions causing abdominal pain,the occlusions of the superior mesenteric artery and vein were the most common,a total of 30 patients (43%),and the most common cause of occlusion was thrombosis (27%);There were the abdominal aorta dissection (Ⅰ+Ⅲ type+limitation)in 1 5 cases,abdominal aorta and/or iliac artery vein multiple ulcers in 9 cases (13%);Type B intramural hematoma in 6 cases (8%);Simply superior mesenteric artery dissection in 5 cases;Other less common splenic arterial thrombotic occlusion in 2 cases,pure splenic artery occlusion in 1 case and renal artery dissection in 1 case.7 cases were missed lesions,the main reason for radiologists to focus placed in the abdominal cavity prone to abdominal pain caused by solid organ or cavity organ,while ignoring the observation in the scanning range of the abdominal aorta and its main branches of the artery,lack of knowledge and experience of the lesions,and therefore not to see the consciousness or habits.Conclusion Vascular causes is an important reason causing abdominal pain.In patients with abdominal pain who underwent CT examination,if the cause of the gut and other abdominal organs can be exclused,the possibility of vascular etiology should be considered,and we should carefully observe intraabdominal artery and vein to exclude the possibility of this disease.

ObjectiveTo investigate the value of urinary BNP for diagnosis of chronic heart failure (CHF). MethodsThe levels of Urinary BNP and plasma BNP were measured by microparticle enzyme immunoassay (MEIA) in 83 patients with CHF and 30 control subjects. The heart function was classified according totheNYHAcriteria. Leftventricularejectionfractions(LVEF)weremeasuredby echocardiology. ResultsThe level of urinary BNP in patients with CHF was[90. 0(38. 3 -209. 5 )]ng/L and the level of plasma BNP was[680. 0 ( 289. 7 - 1543.5)]ng/L, both of them were much higher than those in healthy subjects,[17. 0 ( 13.0 - 33. 0)]ng/L and[84. 5 ( 56. 0 - 158.0 )]ng/L, respectively (P＜0. 01 ). The concentrations of urinary BNP increased gradually with more severe symptoms ( NYHA cl ass Ⅰ -ⅣV ). The level of urinary BNP was positively correlated with NYHA class ( r = 0. 742, P ＜ 0. 01 )and the level of plasma BNP (r =0. 842,P ＜0. 01 ) while negatively related with LVEF (r = -0. 801 ,P ＜0. 01 ). The level of urinary BNP in patients with LVEF ＜ 40％ was[143.0 ( 85. 0 - 258.0)]ng/L , which was much higher than that in patients with LVEF≥40％ ,[31.5( 17.3 -38. 8)]ng/L, (P ＜0. 01 ). At a decision threshold of 36. 5 ng/L, the urine BNP assay demonstrated a clinical sensitivity and specificity of 84％ and 80％ ,respectively. In this study,the area under the curve(AUC) was 0. 905. ConclusionUrinary BNP is a new candidate marker for the diagnosis of CHF,it provides a similar accuracy with plasma BNP.

20 adult healthy rats were used for microelectropheretic delivery of horseradish peroxidase (HRP). The diameter of the tip of the glass electrode was around 20～50?. It was inserted into nucleus raphe magnus, 20% HRP was delivered microelectrophoretically(5 ?A for 30 min; 10 ?A for 10 min). In eight rats the microelectrode was withdrawn immediately after the delivery and in the rest it was removed 10～20 minutes after delivery. Afterward the animals were allowed to survive for 40 hrs before decapitation, except 2 for 20 and 2 for 60 hrs. The brains were dissected out for cryostat sections and DAB reaction for peroxidase.The tip of the electrode was located in the nucleus raphe magnus, at the level of nucleus facialis. The diameter of the brain tissues occupied by HRP at the points of microelectophoretic delivery was 0.2～0.4mm and the maximum reached 0.6～0.7mm. The exogenous HRP granules were not visible in the cases with electrodes withdrawn immeditely after delivery and in the survivors of 60 hrs. In most cases the electrodes were left inside for more than 10 minutes after the delivery. The exogenous HRP granules were large, coarse, brown, steroscopic and distributed evenly in the perikaryon of some neurons in several levels of the brain. Those in the axon and dentrite were distributed just like strings of pearls. There were much more neurons with exogenous HRP positive granules dispersed in the reticular formation of the medula oblongata, most of them were polydendritic. Small and fusiformed HRP-positive cells are observed occasionally in the gray substance of subventriculum, reticular formation pontis and ventrolateral side of locus coeruleus. Weaker reactions were found in a few cells in the periaquaductous gray substance of the midbrain, nucleus raphe centro-superior, substantia nigra pars compacta and in the area around the nucleus supraopticus. Besides no HRP-positive cells were discovered in thalamus and subcortex structure.There were two types of cells with HRP positive granules around some blood vessels in reticular formation and subventricular gray substance: One was a small protoplasmic astrocyte with broad cytoplasma, small nucleus, and thick, short and irregular processes and another kind was polydendritic neurons filling with brown positive granules in perikarya and cytoprocesses, in the latter, the HRP positive granules were arranged as strips of pearls.

50 ms (PNN 50 ) and the high frequency (HF) in patients with EH were decreased, While the ratio between low frequency and high frequency (LF/HF) were increased. After the treatment of irbesartan, the values of SDNN, RMSSD, PNN 50 , and HF were increased, and the LF/HF was decreased significantly. CONCLUSION: Irbersartan can increase the lowed HRV in patients with EH, which improves the cardiovascular automatic function.

OBJECTIVE To investigate ESBLs-producing Escherichia coli and Klebsiella pneumoniae and their antibiotic resistance changing at the same area in different period.METHODS Using Bio-Merieux ATB susceptibility test panels microdilution broth method to detect the antibiotic resistance of E.coli and K.pneumoniae,in addition to the use of phenotypic confirmatory test to detect the ESBLs.RESULTS The ESBLs-producing rate of E.coli and K.pneumoniae during 1999-2001 compared with 2003-2005,was elevated more than double.To imipenem,cefoxitin,piperacillin/tazobactam,and amikacin,the resistant rate was relatively lower,but to other ?-lactams,aminoglycosides,quinolones and sulfonamides,the resistant rate increased significantly in both periods compared,the differences were significant(P

Objective To investigate the feasibility of using low Kv,low iodine contrast Agent concentration (dual low)CT scan techniques in Coronary CTA (CCTA).Methods Seventy-six patients undergoing CCTA were divided into Group A and Group B , randomly.Group A (38 patients)was the dual-low group,which was scanned with tube voltage of 100 kVp,and injected with iso-osmolarity contrast agent visipaque 270 (270 mg I/mL),with iterative reconstruction technique (ASIR 40%).Group B (38 pa-tients)was scanned with 120 kVp,and low osmolarity contrast agent omnipaque 350 (350 mg I/mL)and FBP reconstruction,The images are assessed double-blindly by two experienced radiologists.Five ROIs were placed onto the ascending root of aorta (AO), left main artery(LM),left anterior descending (LAD),left circumflex artery(LCX),right coronary artery (RCA),and the image qualities are evaluated objectively using CT values,noise,signal noise ratio (SNR),contrast noise ratio (CNR),and compared sta-tistically using Paired t-test.The radiation dosages,such as CTDIvol,DLP and ED were also recorded and compared with Paired t-test.Results CTDIvol,DLP and ED of Group A (dual low)decreased 35.7%,38.6% and 38.6% respectively compared with Group B,the iodine intake decreased 22.9%.While the image qualities of the two groups were not significantly different,all images are good enough for diagnosis,with Group A slightly better than Group B in radiologists’scores.Conclusion Voltage 100 kVp, combined with low contrast agent concentration of 270 mg I/mL can fully satisfy the diagnostics need in CCTA,and significantly lower both the radiation dosage and iodine intake.

Objective To modify the existing preparation instrument for medical patch material to realize its scale and automatic production.Methods The instrument had its shaking table improved and a cylindrical processing system added with comprehensive analysis on raw materials and kinds of process flows.A spreading and fixation mechanism for animal materials was placed in the cylindrical processing system,which had the holes for liquid inlet and outlet respectively on its top and bottom.The cylindrical processing system was fixed to the base of the shaking table.Results The instrument enhanced preparation efficiency significantly,and had the raw material utilization rate increased by 20％,product qualification rate raised by 35％,preparation cycle reduced by 33％ and total cost saved by 40％.Conclusion The instrument behaves well in adaptability to multi animals,preparation process,inter-assay difference,raw material utilization rate,product qualification rate and cost reduction,which is of great significance to promote the clinical application of medical biological patch.

OBJECTIVETo test the diagnostic accuracy of qualitative and semi-quantitative evaluations on root resorption associated with orthodontic force (RRAOF) using orthopantomogram (OPG) and periapical film, through comparing with assessments with cone beam computed tomography (CBCT), which is considered as the gold standard.

METHODSBefore and after treatment, OPG, periapical film, CBCT images of 121 upper anterior teeth in 32 orthodontic patients were obtained. Blind evaluation of RRAOF was performed according to Levander and Malmgren's method by three trained radiographers through examining three kinds of images of these teeth. The diagnostic accuracy of qualitative and semi-quantitative evaluations on RRAOF using OPG and periapical films were test through comparing with assessments with CBCT, which was considered as the gold standard.

RESULTSTo the same sample, the RRAOF qualitative and semi-quantitative diagnostic classification results of OPG and periapical films compared with CBCT were significant differences (P<0.05). The sensitivity of periapical films and OPG was 71.6% and 78.4%. The specificity of periapical films and OPG was 25.5% and 51.1%. The accuracy of periapical films and OPG was 53.7% and 67.8%, respectively.

CONCLUSIONPeriapical films and OPG for evaluating RRAOF have a poor diagnostic accuracy.

Objective To study the changes of plasma cystatin C level (PcyC),and evaluate the effects of the joint use of atorvastatin and probucol on PcyC and severity of coronary lesion in patients with borderline lesion of coronary artery.Methods One hundred and thirty consecutive patients with borderline coronary lesion assessed by quantitative coronary angiography were enrolled into borderline coronary lesion group (BCL),and another 136 subjects without coronary lesion were enrolled as controls (CTR).And in the meantime,the subjects in BCL group were randomized (closed envelope method) into routine treatment subgroup ( RTT,n =60),and combined treatment subgroup in which patients were treated with atorvastatin 20 mg plus probucol 1.0 g daily in addition to routine medication ( CBT,n =70) for 6 months.There were no statistical differences in basic clinical features between two subgroups.PcyC,high-sensitive C-reactive protein (hs-CRP),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol ( HDL-C ) and triglycerides (TG) were determined.Of them,104 patients in BCL group rechecked by coronary angiography.Comparison of biomarkers carried out between two groups by using a number of independent-sample t-test and analysis of variance.For enumeration data,chi-square test was used to compare mean values of biomarkers between groups. P ＜ 0.05 was considered statistically significant.Results PcyC levels were significantly higher in BCL group than those in CTR group ( P ＜ 0.05 ).Compared with RTT subgroup,levels of PcyC,TC,LDL-C,TG and hs-CRP were more significantly decreased in CBT subgroup (P ＜ 0.05,P ＜ 0.01 ).Moreover,there was a trend of slight decrease in the mean percent of stenosis (MPS) of coronary artery with borderline lesion in RTT subgroup treated for 6 months,whereas more marked decrease in the MPS of coronary artery with borderline coronary lesion in CBT subgroup treated for 6 months ( P ＞ 0.05 ; P ＜ 0.05 ).Conclusions Cystatin C plays an important role in the pathogenesis of coronary artery,and PcyC is associated with severity of coronary lesion,the combination of atorvastatin and probucol decreases the PcyC level,and it may be the treatment of choice for borderline lesion of coronary artery.