Objective To develop a gas chromatography-mass spectrometric method(GC/MS) for simultaneous determination of environmental estrogens including 4-nonylphenol,bishphenol A,diethylstilbestrol and 17?-ethinylestradiol and endogenic estrogens including 17?-estradiol,17?-estradiol,estriol and estrone in mutton. Methods Mutton samples were extracted using a mixture of acetonitrile-ethyl acetate(3∶2,V/V) and cleaned up by florisil cartridge. Derived with pentafluoropropionic anhydride(PFPA) ,the derivatives were determined by GC-MS. Results The linear range of determination was 0.2-5.0 ?g/kg. The intraday relative standard deviations of the peak area were 1.25%—5.85% and the detection limits ranged from 0.024 to 1.40 ?g/kg,and the rates of recovery ranged from 71.5%—111.0% except for 17?-ethinylestradiol( 55.4%) . Conclusion This method is simple,rapid,accurate and applicable to the determination of trace environmental estrogens in mutton

Objective To investigate the changing trend of eclampsia in our hospital during 30 years. Methods We retrospectively analysed 98 cases of eclampsia from 1971 to 2000. Results The incidence of eclampsia fell from 0.3% in the 1970s to 0.1% in the 1990s (P0.05). Conclusions The incidence of eclampsia has fallen significantly during 30 years. The composition of eclampsia has changed significantly, antepartum eclampsia decreased and postpartum eclampsia increased. The perinatal mortality has fallen. The death ratio of women with eclampsia hasn't fallen.

Objective To explore the clinical expression of P53, Livin and PARP in the epithelial ovarian cancer and its correlation with the chemotherapy resistance and clinical prognosis.Methods 74 specimen of epithelial ovarian cancer confirmed from January 2009 to June 2011 in our gynecology department were selected.During the follow-up visit, the subjects were divided into chemotherapy sensitivity group and chemotherapy resistance group according to the recurrence cases, the clinical expression and survival rate for two groups were compared, the influence factors of survival time were analyzed.Results The positive rate of P53, Livin and PARP for chemotherapy sensitivity group was 47.1%, 56.9%and 52.9%;the positive rate for chemotherapy resistance group was 73.9%, 95.7% and 95.7%,the diyforences were significant(P<0.05).After 1, 3 and 5 years of treatment, the survival rate for chemotherapy sensitivity group was 100.0%, 82.4% and 66.7%,The survival rate for chemotherapy resistance group was 87.0%, 26.1% and 8.7%,the diyforences were significant(P<0.05).Based on the Cox regression model, the influence factors of the patient's age, pathological differentiation degree, clinical staging and chemotherapy sensitivity were introduced.It was known that the patient's survival time was greatly influenced by clinical staging and chemotherapy sensitivity (P<0.05).Conclusion For patients with epithelial ovarian cancer, the expression of P53, Livin and PARP is correlated with chemotherapy resistance.Therefore, the clinical effect is predictable, for patients with higher expression, the personalized therapy can improve the patient's prognosis.

Objective To investigate clinical significance of counting follicles classification by three-dimensional imaging with sonography based automated volume calculation(SonoAVC)in the diagnosis of polycystic ovary syndrome(PCOS).Methods Eighty cases with PCOS were counted classified follicles and determined ovarian volume by three-dimensional(3D)imaging with SonoAVC method matched with 60 infertile women with fallopian tube or male factors as control.Main clinical.biological and other ultrasonographic markers were assessed during the early follicular phase,and the relationship between the follicle number range per ovary or the volume per ovary and the major hormonal features of PCOS was studied.Results Three-dimensional ultrasound imaging with SonoAVC methed provides a new path for objective quantitative assessment of follicle count.ovarian volume,total follicle numbers.The volume of (11 ±8)ml,total numbers of 27 ±14 follicle and number of22 ±19 follicle with diameter of≥2-＜6 mm in PCOS patients were significantly higher than(6 ±4)ml in ovarian volume.6 ±4 in total follicles and 2 ±3 in follicle with diameter of≥2-＜6 mm in controls(P＜0.05).while follicles were similar for the≥6-≤9mm range(P＞0.05).Total follicle numbers and follicles≥2-＜6 mm had significantly positive relationships with ovarian volume ( r= 0. 600, 0. 618, P＜0. 01 ) and level of testosterones ( r= 0. 364,0. 291, P＜0.05), follicles ≥2-＜6 mm also had significantly positive relationships with total follicle number (r=0. 916,P＜0. 01 ). The follicles within the ≥6 - ≤9 mm range was significantly and negatively related to ovarian volume and total follicle numbers ( r = - 0. 618, - 0. 263, all P = 0. 001 ), but no significantly related to the major hormonal features of PCOS. The ovarian volume was significantly positively related with luteinizing hormone ( LH)/follicle stimulating hormone (FSH) ratio ( r= 0. 282, P = 0. 010)but negatively related to FSH level (r = - 0. 226, P = 0. 042). Conclusions Ovarian volume, total follicle numbers and follicles ≥2 - ＜6 mm in PCOS patients were significantly higher than those in controls. The larger ovarian volume might produce more total follicle and follicles ≥ 2 - ＜6 mm. The higher level of testosterone might produce more total follicle probably, which mainly result in more follicles ≥2 -＜6 mm.These morphologically ultrasonographic characteristics could reflect pathophysiological changes in PCOS. Obviously, it has important clinical significance to count follicles in patients with PCOS by the threedimensional ultrasound imaging with SonoAVC method.

AIM: To investigate the role of endoplasmic reticulum stress in renal injury caused by hyperlipidemia and the influence effect of simvastatin. METHODS: Thirty male Wistar rats were randomly divided into three groups: rats in control group (n=10) were fed with normal diet; rats in high fat group (n=10) were fed with high fat diet; animals in simvastatin+high fat group (n=10) were fed with high fat diet and were received simvastatin 10 mg·kg~(-1)·d~(-1) by gastric irrigation. After 18 weeks, the quantitative urine protein in 24 h, the serum cholesterol and triglycerides levels were tested. The pathological changes of renal tissue were observed under optic microscope. The expressions of GRP78 and p-JNK in renal tissues were examined by immunohistochemistry. The apoptotic cells in the kidney were detected by TUNEL staining. The mRNA expressions of GRP78 and CHOP were examined by RT-PCR. RESULTS: The quantitative urine protein in 24 h, the serum lipid, the expressions of GRP78 and p-JNK proteins, the mRNA expressions of GRP78 and CHOP as well as the apoptotic cells in renal tissues were increased in high fat group (P<0.01).The quantitative urine protein in 24 h, the serum lipid, the expression of GRP78 and p-JNK proteins, the mRNA expressions of GRP78 and CHOP as well as the apoptotic cells in renal tissues were remarkably reduced in simvastatin+high fat group than those in high fat group (P<0.05). CONCLUSION: The endoplasmic reticulum stress is engaged in the renal injury caused by hyperlipidemia. The simvastatin play a role in renal protection by inhibiting the endoplasmic reticulum stress in the kidney.

SUMMARY Hemophilia A is aninherited bleeding disorder, lack of coagulation factorⅧ( FⅧ) , and if combined with intracranial malignant tumor, the operation risk is very high. Department of Pediatric Sur-gery in Peking University First Hospital used coagulation factor replacement therapy, succeeded in the operation of 2 cases of intracranial malignant tumor with hemophilia A in children, with no abnormal bleeding events. The establishment of the multi subject cooperation group before operation, good preoper-ative preparation, enough alternative factors, and close postoperative monitoring, are the key to the suc-cessful treatment.

Objective To retrospectively analyze the clinical characteristics ,pathological features and aetiology of pulmonary carcinoid tumourlets .Methods The clinical data of 10 patients with pulmonary carcinoid tumourlets in the West China Hospital of Sichuan University from April 1976 to October 2013 were collected for conducting the retrospective analysis and combining the lite‐raute review .Results Of the total 10 patients ,3 cases were male and 7 cases are female .9 cases were accompanied by bronchiecta‐sis ,1 case was complicated with lung adenocarcinoma .The clinical manifestations were lack of specificity ,which were dominated by repeated cough ,expectoration ,dyspnea and hemoptysis .The microscopic pathological examination suggested that there were differ‐ent degrees of inflammation reaction or fibrous tissue hyperplasia .All patients had no carcinoid syndrome ,lymph node and distant metastasis .10 cases received the surgical treatment .6 cases were pulmonary hypoplasia ,in which 1 case was carcinoid tumourlets complicating pulmonary sequestration .The postoperative follow up lasted for 5 - 80 months .8 cases had no recurrence and 2 cases were loss of follow up .Conclusion For the middle‐aged women patients with bronchiectasis and poor therapeutic effect ,complica‐ting carcinoid tumourlets should be vigilant ,active surgery combined with the pathologic examination is a suitable clinical decision .

Objective To investigate regional ventricular long-axis velocity and adjacent intraventricular flow velocity using dual-pulse wave(PW) Doppler echocardiography synchronously,and to analyze the coupling relationship between regional ventricular long-axis strain and adjacent intraventricular pressure gradients in normal cases using dual-PW Doppler echocardiography.Methods Eighty-six normal subjects aged 19～66 years [mean age (37.49 ± 11.97)years] underwent routine echocardiography and dualPW Doppler echocardiographic exam.Total 18 segments were sampled using dual-PW Doppler (PW/TDI mode) images at basal,mid and apical levels on three standard apical views,and electrocardiogram was recorded simultaneously.Peak early diastolic velocity (emax),peak late diastolic velocity (amax),peak early mitral diastolic inflow velocity (Emax),regional peak early diastolic velocity (Em),regional peak late diastolic velocity (Am) and regional peak early diastolic inflow velocity (E) were measured simultaneously in the same one cardiac cycle.Myocardial variations of left ventricular segments were observed.Em,Am and E of different levels from different ventricular wall were analyzed.The co-relationship between regional ventricular long-axis strain and adjacent intraventricular pressure gradients were calculated and analyzed.Results ①Regional myocardial velocity and regional peak early diastolic inflow velocity in normal subjects declined from basal to apical segments gradually at the same ventricular wall (P ＜ 0.01).② Emax was correlated with emax(r =0.418,P ＜0.001),and E was correlated with Em (posterior septum,r =0.610,P ＜0.001 ；anterior wall,r =0.499,P ＜0.001).③There was a medium correlation between normal longaxis strain in segments and adjacent intraventricular pressure gradients (the global,r =0.412,P ＜0.001 ；posterior septum,r =0.319,P ＜0.005).Conclusions The acquirement of E and Em by dual-PW Doppler showed downtrend of segmental wall movement and regional blood flow from basal segment to apex.Emax is correlated with e E is correlated with Em,and long-axis strain at segments is correlated with adjacent intraventricular pressure gradients partly.Dual-PW Doppler might provide a potential method for the more precise evaluation of left ventricular fluid-solid coupling during diastole.

Objective To explore how to elevate the efficiency of fetal heart screening.Methods Volume data of 83 normal fetuses ranging between 20 to 24 gestational weeks were acquired by spatiotemporal image correlation (STIC) with the apical four-chamber view(4CV).Tomographic ultrasound imaging (TUI) was then used to present the different views of fetal hearts,and were compared with those aquired by 2-dimensional (2D) ultrasound.Results All the 83 volume datasets were obtained by STIC.(1) Qualification ratio of short axis view of the aorta (SAV) by TUI was higher than that of 2D (94.0％ vs 84.3％,x2 =5.57,P=0.042).While,in the other 8 planes,the qualification ration by STIC were higher than that of 2D,however no significant difference was found (P＞0.05).(2) In 4CV,5-chamber view (5CV),left ventricular outflow tract view (LVOT),right ventricular outflow tract view (RVOT) and SAV,STIC showed excellent consistency with 2D (Kappa =0.79,0.90,0.92,0.93 and 0.77,respectively).And in long axis view of the aortic arch (LAV-AoA),long axis view of the duct (LAV-DA),superior and inferior vena cava (SVC+IVC) and short axis view of the ventricle (SVV),STIC showed good agreement with 2D (Kappa=0.72,0.67,0.74 and 0.70,respectively).(3) Image collecting time of T2D,TSTIC,TTUI and TSTIC+TUI were (5.80±1.58) min,(0.85±0.18) min,(2.57±1.32) min and (3.29±1.13) min,respectively.There were significant difference between TSTIC and T2D(t=3.500,P=0.000) and between TSTIC+TUI and TTUI (t=2.877,P=0.001).Conclusion The technique of STIC-TUI used in this study can display the standard planes of fetal heart conveniently,clearly and in shorter time.It is helpful for improving the quality and efficiency of fetal heart screening.

Objective To detect left atrial (LA) function and left ventricular (LV)-LA coupling using vector flow mapping (VFM) and two-dimensional tissue tracking (2DTT) echocardiography in patients with diabetes.Methods A total of 51 patients with type 2 diabetes (DM group) and 38 healthy volunteers (control group) were studied.LA and LV strain were assessed by 2DTT.The energy loss (EL) of LA and LV during ventricular systole (ELs),early diastole (ELed),and atrial contraction (ELac) were measured by VFM.Results LVEL in DM group was significantly increased compared to that in control group (P<0.05).LAELs and LAELed in control group were higher than those in DM group (P<0.05);while LAELac decreased in control group (P<0.05).Multivariate regression analysis identified E and LVELed as independent predictors of LAELed;Peak torsion,LA peak systolic strain and LVELac were independent predictors of LAELac.Conclusions The reservoir and conduit function of LA are impaired in patients with DM,while the pump function increases as a compensation.Abnormal LA-LV coupling also appears in patients with DM.