Objective　To investigate the dynamic changes of psychological states and the results of delivery in pregnant women,simultaneously,study the effective way to reduce the rate of cesarean section.Methods　Through applying the self-compiled test paper,the self-evaluating state table(SCL-90)and the table of overall feeling of happiness,we assessed the psychological states of 89 pregnant women.The results were recorded at 35 and 38 weeks of gestation and 72 hours postpartum.Results　48 delivered vaginally(53.93%).4 were managed by cesarean section(46.07%),including 12 non-indicated cesarean section(29.27%).The mark of anxiety,terror and depression factors increased in the group of non-indicated cesarean section before and after dilivery compared with the group of vaginal delivery and indicated cesarean section.There was remarkable difference(P＜0.01).The value of overall feeling of happiness in the group of non-indicated cesarean section was less than that in the group of vaginal delivery.The difference was extremely significant(P＜0.001).The rdevant analysis showed that the feeling of happiness,the desire of labor and educational level were related negatively to the level of symptom during pregnancy(P＜0.01).The mode of delivery was related positively to the psychological state of pregnant women(P＜0.01).Conclusion　Non-indicated cesarean section is mainly interrelated to anxiety,terror and depression that proceed gradually during pregnancy and delivery.So it is suggested that the aimed psychological education be beneficial to decrease the rate of cesarean section.

Objective:To provide imaging evidence for the treatment of anterior disc displacement without reduction by the injection of sodium hyaluronate into temporomandibular joint (TMJ).Methods:40 patients with anterior disc displacement without reduction were injected 3 times with sodium hyaluronate into the TMJ.Patient's TMJ and clinical symptoms were examined 3,9 and 12 months after treatment.The clinical parameters of Fricton's Craniomandibular Index(Fricton index),maximal mouth opening(MMO),pain intensity of a visual analog scale(VAS) and CBCT radiographic data of 48 TMJs from 40 patients were analysed.Results:The CBCT images showed that at 9 and 12 months follow-up the surface of the condylus became smooth,the density of the cortical bone and the adjacent subcortical bone increased and osteophyte in condylar head decreased(P =0.026,P =0.001).As for disc displacement without osteoarthritts,9 months after treatment condylus were moved forward(P =0.038).VAS and Fricton index were reduced(P ＜0.05),MMO was increased (P ＜ 0.05).3-12 months after treatment,there was no statistical difference of Fricton index (P ＞ 0.05).Conclusion:Injection of sodium hyaluronate into TMJ can remodel the condylar bone surface but cant make condyle back to the middle of acetabulum.

Objective To explore the expression and change of ski-interacting protein (SKIP) in rats after spinal cord injury. Methods A total of 60 adult female Sprague-Dawley rats were randomly divided into sham group (n=30) and spinal cord injury (SCI) group (n=30), each group was further divided into five time points including one day, three days, five days, seven days, and 14 days with six rats in each time points. The model was established at T10 with modified Allen's technique, and the sham group only bit the lamina of rats. The hindlimbs behavior was assessed with Basso-Beattie-Bresnahan (BBB) score at each time point. The pathological changes of spinal cord neurons were detected with Nissl staining. The expression of SKIP were observed with immunofluorescence staining. Results The BBB scores were signif-icantly lower in each time point in SCI group than in the sham group (t>48.267, P<0.001). Compared with the sham group, Nissl bodies in the cytoplasm of spinal cord neurons began to disintegrate, coalesce and irregularly distribute, the neurons began to degenerate and die on the fifth day, and the damage deteriorated on the 14th day. Immunofluorescence staining showed that SKIP expression was mainly expressed in the gray matter of the spinal cord and little expressed in the white matter. The expression of SKIP gradually increased after SCI, and reached a peak on the fifth day (t=-17.035, P<0.001) and decreased significantly on the 14th day (t=3.853, P<0.05). Conclusion SKIP may be a new signaling molecule, which play an important role in neuronal apoptosis after SCI.

Objective To explore the probable function of peptidyl arginine deiminase 4 (PAD4) in rheumatoid arthritis(RA).Methods Real-time quantitative polymerase chain reaction (PCR) was used to determine the expression of PAD4 mRNA in peripheral blood mononucleated cells (PBMCs) from 60 RA patients and 40 healthy individuals.Asymmetric di-methylation of histone H3R17,symmetric di-methylation and mono-methylation of H4R3 were semi-quantified by Western blotting in 12 patients with osteoarthritis (OA),26 patients with RA and 10 healthy controls.Results PAD4 mRNA in RA was significantly higher than that in healthy controls [34.6 (16.7,70.8) vs 20.6 (11.1,51.8),P ＜ 0.05].The level of histone H3R17 asymmetric di-methylation in RA was significantly higher than that of OA or control groups(71.34 ±25.65 vs 37.18 ± 18.62 vs 50.67 ± 13.99,P ＜0.01),which was positively related to Tender joint count and Swollen joint count in 28 joints (r =0.418,P =0.034 ; r =0.402,P =0.042).The level of histone H4R3 symmetric di-methylation was similar in RA,OA and control groups (75.02 ± 20.35 vs 57.92 ± 22.77 vs 68.37 ± 17.57,P ＞ 0.05).The level of histone H4R3 mono-methylation in RA patients was significantly lower than that of OA patients and healthy individuals (11.24 ±7.81 vs 32.77 ±30.77 vs 51.20 ±47.14,P ＜ 0.05).The level of histone H4R3 mono-methylation in RA patients was negatively correlated to PAD4 (r =-0.643,P ＜ 0.01).The level of histone H3R17 asymmetric di-methylation and H4R3 symmetric di-methylation was not associated with PAD4 level in RA group (r =-0.185,P =0.377; r =0.198,P =0.344).Conclusions The level of histone H3R17 asymmetric di-methylation is significantly higher and the level of histone H4R3 mono-methylation is significantly lower in RA patients comparing with OA and control groups.Abnormality of histone methylation may be one of the mechanisms for the development of RA.PAD4 probably plays an important role in rheumatoid arthritis by influencing histone methylation.

OBJECTIVETo improve the X-ray diagnosis of cervical spondylosis of vertebral artery type (VCS).

METHODSA blinded design research. The X-ray signs both 60 patients with VCS and 60 patients with cervical spondylotic radiculopathy were collected from January 2011 to November 2012. There were 36 males and 84 females, aged from 25 to 65 years old with an average of (48.4 ± 12.3) years old. Cervical curvature, atlanto-occipital joint angle, atlanto-axial joint angle, C2/C3 joint angle and lower cervical instability condition and segmental distribution were measured and recorded by X-rays. These data were analyzed and compared between the two groups after unblended. Combined with clinical manifestations,the X-ray imaging features of VCS were further analyzed.

RESULTSThere was significant difference in cervical curvature between two groups in anteflexion X-ray films (P < 0.05). There was significant difference in extension degree of atlanto-occipital joint angle between two groups (P < 0.01). There was significant difference in atlanto-axial joint angle between two groups in lateral X-ray films (P< 0.05). There was significant.difference in anteflexion degree of atlanto-axial joint angle between two groups (P < 0.05). There was no significant difference in C2/C3 joint angle between two groups. There was no significant difference in the lower cervical instability condition and segmental distribution between two groups. In VCS group, the mild and moderate dizziness was main symptom, flexion and extension activities of neck was most common cause in the dizziness; and always accompanied with headache; tenderness mostly concentrated in the upper cervical area.

CONCLUSIONBoth X-ray signs and clinical manifestations can prompt the abnormalities of the upper cervical structure or function in patients with VCS. Anteflexion activities of neck observed by functional position of X-ray films should be emphasized in diagnosis of VCS.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Radiculopathy ; diagnostic imaging ; Radiography ; Spondylosis ; diagnostic imaging ; Vertebral Artery ; X-Rays

OBJECTIVETo approach the correlation of upper airway and surrounding tissues with body mass index (BMI) of non-apnea aged males.

METHODSThirty-one non-apnea aged from 70 years to 84 years males (all were inspected by polysomnography and apnea hyponea index < 10 times/hour) had magnetic resonance imaging scanned. In images of MRI, the upper airway was divided into four sections, including nasopharynx, velopharynx, glossopharynx and laryn-gopharynx. The sizes, forms and surrounding tissues were measured and correlation analysis of duality vaniable about upper airway and surrounding tissues with BMI were carried out.

RESULTS(1) The volume of nasopharynx had negative correlation with body mass(P < 0.05). (2) The min anterior-posterior diameter of velopharynx had positive correlation with body mass and BMI. The max value of anterior-posterior diameter/transverse diameter of velopharynx had positive correlation with body mass. The mi value of distance of fatpads had negative correlation with body mass and BMI. The min and average value of distance of ascending ramus had positive correlation with body mass and BMI. The mn value of distance of fatpads/distance of ascending ramus had negative correlation with body mass and BMI. The transverse diameter/lateral velopharyngeal wall of velopharynx had positive correlation with BMI. All of above results had statistic significance (P < 0.05). (3)The volume of soft palate, tongue and fatpads had no correlation with body mass and BMI (P > 0.05).

CONCLUSIONThe forms of sectional areas of velopharynx are subjected to body mass, and with the increasing of body mass they tend to round. In non-apnea aged males, the distance of fatpads and ascending rami have intimate relationship with body mass and BMI. The volume of soft palate, tongue, tatpads and velopharyngeal walls has little things with hody mass and BMI.

Apnea ; Body Mass Index ; Humans ; Magnetic Resonance Imaging ; Male ; Palate, Soft ; Polysomnography ; Sleep Apnea, Obstructive ; Tongue

OBJECTIVETo describe the morphology of upper airway in non-apnea males aged seventy years or over.

METHODSThirty-one non-apnea males aged 70 years or over [diagnosed by whole-night polysomnography (PSG), apnea and hypopnea index (AHI) < 10 per hour] had been taken magnetic resonance imaging (MRI) scanning.

RESULTSThe narrowest point of upper airway was at velopharynx. The mean and the minimum section areas were (190.9 +/- 67.1) mm(2) and (112.1 +/- 47.7) mm(2), respectively. Each sagittal/transverse ratio was between 0.22 and 0.89. It showed an ellipse-like cross-section of upper airway, while velopharynx was the most "slender" segment (sagittal/transverse-caliber was 0.22 - 0.71). The min/max section area of upper airway was between 0.38 and 0.62. It demonstrated that each airway segment was a "cone-like" form, while the velopharynx was the steepest segment.

CONCLUSIONSIn the non-apnea elderly males aged seventy years or over, the velopharynx was most likely to collapse.

Aged ; Aged, 80 and over ; Humans ; Magnetic Resonance Imaging ; Male ; Palate, Soft ; anatomy & histology ; Pharynx ; anatomy & histology ; Polysomnography ; Sleep Apnea, Obstructive ; Surveys and Questionnaires ; Tongue ; anatomy & histology

Objective To explore the expression and the changes of ski with time in the injured spinal cord in rats. Methods Sixty adult female Sprague-Dawley rats were randomly divided into sham group (n=30) and injury group (n=30), each group were further divided into 1 week, 2 weeks, 4 weeks, 8 weeks and 12 weeks subgroups, with 6 rats in each subgroup. Spinal cord injury at T10 was established with modi-fied Allen's technique (10 g × 25 mm) in the injury group. The hindlimbs behavior of rats was rated with Basso-Beattie-Bresnahan (BBB) scores 1 day, 3 days, 1 week, 2 weeks, 4 weeks, 8 weeks and 12 weeks after spinal cord injury. Three rats in each subgroup were stained with HE staining to observe the pathological changes of the spinal cord and the formation of cavity. The other 3 rats were analyzed with im-munofluorescence staining of ski and semi quantitative analysis. Results The BBB scores of each time point were less in the injury group than in the sham group (P<0.05). Necrosis was the major pathological change in the injury groups 1 and 2 weeks after injury;cystic cavity completely formed 4 weeks after injury, with dense scar tissue around it;there was no significant change in the cavity and scar 8 and 12 weeks after injury, however, the adjacent spinal cord was obviously thinner. Ski expressed little in the normal spinal cord, and expressed more and more after injury, peaked at 8 weeks and decreased then. Ski was mainly observed in white matter in the sham group and 12 weeks injury subgroup, which was in gray matter 2, 4 and 8 weeks after injury. Ski was highly expressed around the cavity in injury center and formed high expression band. Conclusion Ski expresses after spinal cord injury in rats, that may be associated with the activation and prolif-eration of astrocytes and the formation of glial scar.

Objective To investigate the influence of acute hypervolemic hemodilution(HHD)on pharmacokinetics of propofol.Methods Sixteen ASA Ⅰ or Ⅱ patients aged 20-55 yrs undergoing elective surgery under general anesthesia combined with epidural analgesia were randomly allocated into 2 groups(n=8 each);Ⅰ control group and Ⅱ HHD group.The patients were premedicated with intramuscular phenobarbital 0.1 g and scopolamine 0.3 mg.Right internal jugular vein was cannulated for CVP monitoring and blood sampling.Radial artery was cannulated for BP monitoring.All patients in both groups received lactated Ringer's solution(0.7 ml?kg~(-1)? number of hours of fasting before operation)before induction of general anesthesia.In HHD group 4% gelofusine 20 ml?kg~(-1) was infused at the rate of 20 ml?kg~(-1)?h~(-1).Anesthesia was induced with midazolam 0.04 mg?kg~(-1),fentanyl 4 ?g?kg~(-1) and propofol 1.5 mg?kg~(-1).Tracheal intubation was facilitated by succinylcholine 2 mg?kg~(-1).Anesthesia was maintained with isoflurane,fentanyl,vecuronium and epidural analgesia.ECG,BP, SpO_2,P_(ET)CO_2 and CVP were continuously monitored.Blood samples were taken at 1,2,4,6,10,15,30,45, 60,75,90,120,150,180,240,300 and 360 min after propofol was given Ⅳ for determination of plasma concentration of propofol(HPLC).Pharmacokinetic data were analyzed by 3P97 pharmacokinetic software.Results The two groups were comparable with respect to demographic data.Blood propofol concentrations were significantly lower in HHD group than in control group at 1,2,4,6,10 min after propofol injection(P＜0.01), thereafter there was no significant difference in plasma propofol concentration between the two groups(P＞0.05). The pharmacokinetic profile of propofol was well described by a standard three-compartment model.In HHD group V_C was significantly increased,K_(10) and Cl were significantly decreased and T_(1/2?) was significantly prolonged as compared with control group.Conclusion Acute HHD increases V_C,prolongs the T_(1/2?) and decreases K_(10) and Cl, suggesting that the effect of propofol may be potentiated by acute HHD.

Objective:To evaluate the immunogenicity of recombinant factor H binding protein(fHBP) by detecting serum antibody titer and serum bactericidal antibody test (SBA).Methods:fHBP sequence was selected and synthesized, connected to plasmid pET43.1a, transformed to Escherichia coli BL21(DE3), and expressed two recombinant fHBP proteins, included two subfamilies, fHBPA and fHBPB. After purification, the recombinant fHBP proteins were immunized to rabbits and mice. The immune antiserum titer and the bactericidal titer to epidemic strains of meningococcal bacteria group B were measured by ELISA and SBA respectively. Results:The antiserum titer of fHBP immunized rabbits was greater than 2.0×10 6, and that of immunized mice was not less than 1.0×10 6. fHBP immunized rabbit serum had bactericidal titer more than 1∶128 to 41 strains A subfamily and 20 strains B subfamily in the SBA against 69 endemic strains, and there was no cross-protection between the subfamily bacteria. The bactericidal titers of mouse serum immunized fHBPA to strains A subfamily such as Nm210902 Nm211009、Nm450522 were 1∶1 024, 1∶608、1∶861, to Nm510703、Nm311304、Nm431002 were 1∶234、1∶861、1∶430 respectively, and mouse serum immunized fHBP B to strains B subfamily Nm311302、Nm311304、Nm431002 were 1∶876、1∶274、1∶1858, all of three strains were positive in bactericidal titers. Conclusions:the titer of fHBP antiserum was higher than 1.0×10 6, the bactericidal titer was no less than 1∶128 to 61 epidemic strains, and it has a 94.2% protective effect on 69 meningococcal epidemic strains group B.