Objectives To summarize and analyze the characteristics ofspina bifida occulta in prenatal ultrasound scan in order to improve the accuracy of diagnosis.Methods Sixteen singleton pregnant women with fetal spina bifida occulta who were diagnosed in the Ultrasonography Department of Dalian Maternal and Child Health Hospital from January 2014 to April 2015,were enrolled in this study.Diagnosis was made based upon the abnormalities found in the spinal column of fetus during routine ultrasound scan,followed by a close examination on the fetal spinal column and the position of conus medullaris by using multiple scan.Descriptive analysis was used to summarize the characteristics of spina bifida occulta in ultrasonic images.Results Among the 16 cases,12 had subcutaneous mass (nine cases had follicle-like anechoic mass and three cases had masses with strong echoes).The other four cases without subcutaneous mass manifested signs of disappeared physiological curvatures or disordered arrangement of spinal column,angulation deformity or scoliosis,or asymmetry in ossification centers of spinal column on both sides of lesions and lowered position of conus medullaris.Lemon shaped head and banana shaped cerebellum were seen in one case,while the other 15 cases were found no cerebral abnormalities.Eight cases had tethered cord (the position of conus medullaris was lower than the second lumber vertebra),six cases had unclear position of conus medullaris and the other two were normal.Diagnoses for all of the 16 cases were confirmed by MRI after delivery or autopsy or neonatal operation.Conclusions Abnormalities such as subcutaneous mass and tethered cord observed in prenatal ultrasound scan are significant indicators for suspected closed spinal dysraphism and further multiple scan is required to confirm the diagnosis.

Objective To generate of human induced pluripotent stem cells from umbilical cord matrix cells(UMC).Methods Sox2 and Klf4 and Oct4 and c-Myc were transfected into UMC cells with retrovirus,and thcn UMC cells was reprogrammed to iPS cells.Gene expression was confirmed with RT -PCR and the integration was confirmed with cell karyotype.iPS cells were further validatcd with cell alkaline phosphatase detection and immunofluorescence staining,differentiating into teratomas in vivo and embryoid bodies in vitro.Results iPS cells were similar to embryonic stem cells (ES).The expression of Nanog,Oct4,Rex1 and Sox2 in iPS cells were higher than UMC cells,and Sox2,Klf4,Oct4,c-Myc silenced in iPS cells.Exogenous genes were inserted into the nucleus of iPS cells,which was confirmed by 1％ agarose gel electrophoresis.iPS ccll karyotype was normal,alkaline phosphatase activity increased,ES cell-specific proteins,including SSEA3,SSEA4,TRA-1-60,TRA-1-81 and Nanog,were expressed.iPS cells were differentiated into a teratoma in vivo and embryoid bodies in vitro.Conclusions iPS cells were similar to ES cells,which had pluripotency.

Objective To investigate the risk factors and outcomes of acute kidney injury (AKI) in patients after intra--coronary stent implantation.Methods A retrospective and case control study was done with data analysis in 325 patients who underwent intra-coronary stent implantation from January 2010 to March 2011.The patients were divided into two groups as per the criteria of AKI identified on the 7th day after implantation of stent.The variables to be studied included:(1) age,gender,hypertension,diabetes,cerebrovascular disease,left ventricular insufficiency,peripheral angiopathy,creatinine,urea nitrogen,estimated glomerular filtration rate,hyperuricemia,proteinuria,emergency operation,hydration,and medication (ACEI/ARB,statins) before operation; (2) dose of contrast media,operation time,hypotension during intra-operative period; and (3) postoperative:hypotension.The variables were analyzed with the process of One-way ANOVA and multivariate Logistical regression analysis.Consequently,the independent risk factors of AKI in patients after intra-coronary stent implantation could be found.Further,the prognosis of AKI patients was analyzed.Results Of the 325 patients,51 (15.7％) developed AKI.Compared the normal group,hospital stay (P ＜ 0.01 ) and in-hospital mortality (P ＜ 0.05) increased significantly in the AKI group.Monofactorial analysis showed that age,pre-operative laboratory and clinical data including left ventricular insufficiency,peripheral angiopathy,creatinine,urea nitrogen,estimated glomerular filtration rate, hyperuricemia, proteinuria, hydration and emergency operation, and intraoperative information such as operation time and hypotension,and postoperative hypotension in AKI patients group were significantly different in comparison with control group ( P ＜ 0.05 ). Multivariate logistic regression analysis revealed that elderly age (OR =0.253),pre-operative proteinuria (OR =5.351 ),preoperative left ventricular insufficiency ( OR =8.704),eGFR ≤ 60 ml/ ( min · 1.73 m2 ) ( OR =6.677 ),prolonged operation time ( OR =1.017),intra-operative hypotension ( OR =25.245 ) were independent risk factors of AKI ( P ＜ 0.05 ).Conclusions AKI is a common complication and associated with increase in mortality after intra-coronary stent implantation.Increase in age,pre-operative proteinuria,pre-operative left ventricular insufficiency,pre-operative low estimated glomerular filtration rate,prolonged operation time,intra-operative hypotension are the independently risk factors associated with AKI.

Objective To measure and analyze Varian Clinac 21EX accelerator induced radioactivity,and to provide specific recommendations and ways of radiation protection for radiotherapy technicians.Methods To simulate the working environment of radiotherapy technician,and to detect induced radioactivity variation of Varian Clinac 21EX accelerator that induced by 15 MV X-rays under different conditions of beam field area,dose,time,distance and by high energy electron beam (12,16,20 MeV)at the different time.Results The induced radioactivity level was not influenced by different beam field area,and was increased with increasing dose (r =0.930,P ＜ 0.05),decreased with time increase (r =-0.84,P ＜ 0.05),decreased with distance increase(r =-0.975,P ＜ 0.05).The induced radioactivity attenuation levels of the different doses at the same time are different,and have the common characteristic that the induced radioactivity attenuation rate is faster in the initial times.The induced radioactivity levels of high energy electron beams were significantly lower than those of high-energy X-rays.Conclusions During radiotherapy positioning,it is necessary to take measures to protect against the induced radioactivity when high-energy rays with energy greater than 10 MeV will be used.The radiotherapy technician should take the different time and energy interval steps for the different ray type and energy and dose in order to meet the radiation protection principle of optimization.

ObjectiveGeneration of human induced pluripotent stem cells from human skin fibroblasts.MethodsSox2, Klf4, Oct4, c-Myc were transfected into HSF cells with retrovirus, and then HSF cells was reprogrammed to iPS cells.Detecting cells endogenous and exogenous gene, analyzing karyotype,cells alkaline phosphatase staining and immunofluorescence staining, differentiating into teratomas in vivo and embryoid bodies in vitro were performed.ResultsiPS cell morphology was similar to embryonic stem cells (ES).The expression of Nanog, Oct4, Rex1, Sox2 in iPS cells were higher than HSF cells, and Sox2, Klf4, Oct4, c-Myc were silenced for the iPS cells.Exogenous genes were inserted into the nucleus of iPS cells, which was confirmed by 1％ agarose gel electrophoresis.iPS cell karyotype was normal, alkaline phosphatase activity increased, ES cell-specific protein expressed.iPS cells were differentiated into a teratoma in vivo and embryoid bodies in vitro.ConclusionsiPS cells were similar to ES cells, which have pluripotency.

Objectives To summarize the characteristics,differential diagnosis and management of incomplete 17 alpha-hydroxylase/17,20-1yase deficiency(17 OHD)of Chinese patients.Methods Six cases of incomplete 17 OHD from Peking Union Medical College Hospital were studied retrospectively through analyzing their clinical data,and the molecular pathogenic mechanism was discussed after literature review.Results Four cases of 46,XX incomplete 17 OHD were reported.The clinical characteristics included female phenotype,various degrees of breast development and absent or sparse axillary/pubic hair, oligomenorrhea or secondary amenorrhea,recurrent luteinized ovarian cysts,hypogonadism with persistent hyperprogesteronemia or high serum 17 alpha-hydroxyprogesterone level,with or without hypokalemic hypertension.There were also 2 cases of 46,XY incomplete 17 OHD,in which ambiguous genitalia were present besides hypokalemic hypertension.Conclusions Incomplete 17 OHD is a very rare form of congenital enzymatic deficiencies of steroid synthesis,which should be included in the differential diagnosis when there are menstrual disorders,sexual infantilism,recurrent ovarian cysts or ambiguous genitalia.Under such circumstances,hyperprogesteronemia offers a valuable clue for further investigation.

Background TLR-4 is a natural immunity receptors in immunity,and it plays an important role in the repair of central nervous system damage.But its effect in glaucoma optic nerve injury is unclear.Objective This study was to investigate the expression of TLR-4 in retina with high intraocular pressure(IOP)in genetic and Drotein level and therefore explore the mechanism of TLR-4 on retinal ganglion cells(RGCs)injury. Methods Chronic ocular hypertension models were established in the right eyes of 150 clean purebred Sprague-Dawley rats by cauterizing the 3 sallow sclera veins.IOP was measured before and after 2 h,1 day,3,7,14,28,56 days after operation by PEN Ⅱ TONO-type pen tonometer.The expression of TLR-4 protein in rat retina was detected by immunohistochemistry and Western blot,and expression of TLR-4 mRNA was assayed by real time-PCR.This experimental procedure foliowed the Statement of Association for Research in Vision and Ophthalmology. Results The IOP was elevated in various time points after operation in experimental group,showing significant differences in comparison with control group(P<0.01).The immunohistochemistry revealed that the expression of TLR-4 protein in rat retina with chronic hypertension in 2 h,1 day,3,7,14,28,56 days after operation with the high A298 values in comparison with control eyes(P<0.05-0.01).Increased levels of TLR-4 mRNA in rat retinas were detected by RTPCR in high IOP eyes compared with control eyes in all time points after operation,presenting statistically significant differences between two groups(P<0.05-0.01).Western blot detection displayed the high expression of TLR-4 in retina in high IOP eyes early after operation with statistically significant results between model group and control group (P<0.05-0. 01). Conclusion TLR-4 is up-regulated in rat retina with chronic high IOP,suggesting that TLR-4 plays an immunoregulatory effect in glaucomatous eye.

To study the oxidative alkaline-degradation products of PQS (Panax quinquefolium saponin), two compounds were isolated from the crude product of oxidative alkaline-degradation by silica gel column chromatography, Sephadex LH-20 column chromatography and recrystallized methods. On the basis of spectroscopic analysis, their structures were established as (12R, 20S, 24R)-20, 24; 12, 24-diepoxy-24-deisopropyl-dammarane-3beta-ol (1) and (20S, 24R)-20, 24-epoxydammarane-3beta3, 12beta, 25-triol (2). Compounds 1 and 2, dammarane type triterpene with cyclization at the side chain, were obtained for the first time from alkaline-degradation products of total ginsenosides of Panax quinquefolium L., compound 1 is a new compound.
Cyclization ; Oxidation-Reduction ; Panax ; chemistry ; Sapogenins ; chemistry ; Saponins ; chemistry ; Steroids ; chemistry ; Triterpenes ; chemistry

Objective:To understand the utilization of clinical services provided through hospital-at-home to the elderly in Xuzhou City, and analyze patient satisfaction.Methods:The stratified cluster sampling method was used to select community elderly people aged 60 and above in Xuzhou city to conduct a face-to-face questionnaire survey.Descriptive analysis was used to examine the utilization and evaluation of home-based clinical services for the elderly.Multiple linear regression analysis was used to analyze associated factors for the satisfaction of the elderly in this care setting.Results:A total of 203 elderly people who had received this type of services were investigated.The overall satisfaction of the elderly in Xuzhou City with home-based clinical services was 79.3%(161/203), and the average satisfaction score of the comprehensive evaluation was(4.11±1.03)points.Age( β=-0.011), marital status( β=0.164), informed consent for service( β=0.162), doctors' bed-side services( β=0.146), service fee( β=0.346), and the home hospital bed assembling process( β=0.257)were the influencing factors for satisfaction with family hospital bed services, according to the patients involved in the comprehensive evaluation(all P<0.05). Conclusions:The utilization and evaluation with clinical services by elderly people in the hospital-at-home setting in downtown Xuzhou is relatively good, with relatively high satisfaction.Comprehensive measures should be taken in response to factors related to satisfaction to promote sustainable development of clinical services through hospital-at-home in China.

To establish the water dynamics model for drying process of Angelicae Sinensis Radix, the Weibull distribution model was applied to study the moisture ratio variation curves, and compared the drying rate and drying activation energy with the drying methods of temperature controllable air drying, infrared drying under different temperatures (50, 60, 70 degrees C). The Weibull distribution model could well describe the drying curves, for the moisture ratio vs. drying time profiled of the model showed high correlation (R2 = 0. 994-0. 999). The result proved that the drying process of Angelicae Sinensis Radix belonged to falling-rate drying period. For the drying process, the scale parameter (a) was related to the drying temperature, and decreased as the temperature increases. The shape parameter (β) for the same drying method, drying temperature had little impact on the shape parameter. The moisture diffusion coefficient increase along with temperature increasing from 0.425 x 10(-9) m2 x s(-1) to 2.260 x 10(-9) m2 x s(-1). The activation energy for moisture diffusion was 68.82, 29.60 kJ x mol(-1) by temperature controllable air drying and infrared drying, respectively. Therefore, the Weibull distribution model can be used to predict the moisture removal of Angelicae Sinensis Radix in the drying process, which is great significance for the drying process of prediction, control and process optimization. The results provide the technical basis for the use of modern drying technology for industrial drying of Angelicae Sinensis Radix.
Angelica sinensis ; chemistry ; Desiccation ; methods ; Models, Theoretical ; Water