We report the management and maternal and neonatal outcomes of four cases of delayed interval delivery after cervical cerclage in twin pregnancies, who hospitalized in Shanghai First Maternity and Infant Hospital from year 2017 to 2018. Four patients with dichorionic diamniotic twin pregnancies all presented with gradually weakened uterine contractions after spontaneous vaginal delivery of twin 1. After informed consent, the patients received cervical cerclage at 2 to 3 days after delivery when the maternal and fetal conditions were stable, to delay delivery of twin 2. The gestational weeks at delivery of twin 1 were 25 +4, 23 +1, 27 +1, and 23 weeks, which were noted for 30 +1, 32 +6, 31 +4, and 24 weeks for twin 2, respectively. Delayed delivery intervals were 32, 69, 31 and 7 d. Three of the four twin 2 survived, with Apgar score ≥ 8 at 1 minute and birth weight of 1 390, 2 290 and 1 620 g. During a 2-year follow-up, no developmental abnormalities were observed in the children, and no serious maternal complications were found, including severe infection, bleeding or cervical laceration.

Objective To explore the relationship between different blood glucose levels and new carotid artery plaques.Methods A total of 5 440 participants met the inclusion criteria were selected stratified randomly from the 101,510 serving and retired workers of Tangshan Kailuan Company who participated the health examination from 2006 to 2007.The follow-up health examination were respectively preformed from 2010 to 2011 and from 2012 to 2013 which included carotid ultrasound for these 5 440 participants.The 5 440 participants were divided into three groups (ideal blood glucose group,impaired fasting glucose group and diabetic group) according to their fasting glucose levels in 2010-2011 examination.Multivariate Logistic regression analysis was used to analyze the risk factors of new carotid artery plaques.Results Among 5 440 subjects,participants whose FPG,ultrasound data incomplete and ultrasound detection of carotid plaques during the 2010-2011 health examination were excluded,then 3 084 participants were included in this study,among them,175 participants who did not participate the 2012-2013 health examination and 561 participants whose carotid plaque ultrasound data incomplete were excluded.Thus,a total of 2 348 participants were included in the present analysis.The total detection of new carotid artery plaque rate was 15.0％ (352/2 348) after 2 years of follow-up.The detection of new carotid artery plaque rate in normal glucose group(n =1724),impaired fasting glucose group(n=464) and diabetic group(n=160) were 14.2％(245/1 724),14.9％(69/464) and 23.8％(38/160),respectively.The diabetic group was higher than that of the ideal blood glucose group and the impaired fasting glucose group,the difference was statistically significant(P＜0.05).Impaired fasting glucose group and diabetic group had an increased risk of new carotid artery plaque compared with those in ideal glucose group(OR =0.924,95％CI 0.691-1.235 and OR =1.733,95％CI 1.107-2.713,respectively),the difference was statistically significant(P＜0.05).After adjusted for the other risk factors,with the risk-adjusted ratio (OR =1.117,95％CI 0.824-1.513 and OR =1.393,95％CI 0.872-2.226).Conclusion The detection of new carotid artery plaque increase in the diabetic group.However,after adjustment for other risk factors associate with emerging danger of new carotid artery plaque is no significant difference.This requires more long-term follow-up study of a large sample to be further confirmed.

The brain pharmacokinetics of hyperoside and 1 , 5-dicaffeoylquinic acid and the effects of acanthopanax senticosus leaves on neurotransmitters in cerebral ischemic rat brain were investigated. In the study, acute incompleteness cerebral ischemia model was developed by ligating the bilateral common carotid arteries of rats. The differences of brain pharmacokinetics of hyperoside and 1,5-dicaffeoylquinic acid between control and cerebral ischemic rats were determined by online microdialysis coupled with MS/MS method. At the same time, the contents of glutamic acid (Glu), aspartic acid (Asp), γ-aminobutyric acid (GABA), serotonin (5-HT) , dopamine ( DA) , and acetylcholine( Ach) in rat hippocampus among different groups were determined simultaneously in MRM mode. ACE 5 C18-AR column was used for separation. Results showed that the online analytical method had excellent linearity (R2>0. 99). The accuracy and precision could meet the analysis requirement. Besides, the hyperoside and 1,5-dicaffeoylquinic acid penetrated the blood-brain barrier successfully and metabolized quickly, but the absorption reduced and elimination became faster in cerebral ischemic rats; the contents of Glu, Asp, GABA and DA in brain issue of cerebral ischemic rats decreased significantly ( p<0 . 01 ) and the level of Ach increased remarkably ( p<0 . 05 ) after a preventive medication with the extract of acanthopanax senticosus leaves for one week.

Post-stroke cognitive impairment(PSCI),refers to a range of clinical syndromes of cognitive impairment caused by stroke.Although its specific pathogenesis is still unclear,many studies have confirmed that endoplasmic reticulum-mitochondria interaction has become a key hub for intracellular signal transduction and substance metabolism,and its regulation of various biological processes,such as Ca2+ balance,lipid metabolism,mitochondrial dynamics,autophagy,and neuroinflammation,is closely related to the development of PSCI.There-fore,in this paper,we will review the various functions of endoplasmic reticulum-mitochondrial interactions and explore their specific roles in PSCI,in order to discover new therapeutic targets and provide new theoretical basis and references for the development of PSCI-targeted drugs in the future.

BACKGROUND:Articular chondrocytes with the ability of autocrine and paracrine can provide the growth factors and microenvironment for synovial mesenchymal stem cels differentiating into the chondrocyte. The
three-dimensional scaffold could provide space for cels adhesion, proliferation and differentiation.
OBJECTIVE: To study the ability of chondrogenesis by co-culturing synovial mesenchymal stem cels and chondrocytes under the three-dimensional condition.
METHODS:The synovial membrane and articular cartilage were harvested from rat knee joint. The synovial
mesenchymal stem cels and chondrocytes were obtained through the method of enzyme digestion. The passage 3 synovial mesenchymal stem cels and passage 2 chondrocytes were co-cultured in the chitosan/I colagen
composite scaffolds at the ratio of 1:2. Then, the cels/scaffold composite was harvested to be examined
morphologicaly, histologicaly and immunohistochemicaly after being cultured 21 days. The confocal laser was also employed to detect the cels distribution in the scaffold.
RESULTS AND CONCLUSION: After being cultured 72 hours, it could be observed from the cels/scaffold composite examined through the scanning electron microscope that the cels adhered on the surface of the
scaffold and extracelular matrix surrounding the cels was seen on the scaffold. After being cultured 21 days, it could be found through the confocal laser scanning that the cels were wel-distributed on the scaffold, and cels decreased gradualy. Type II colagen was positive in the extracelular matrix immunohistochamicaly. It
suggested from this study that the synovial mesenchymal stem cels could be co-cultured with chondrocytes in the chitosan/I colagen composite scaffolds and have the ability of chondrogenesis differentiation.

BACKGROUND:Compared with other sources of mesenchymal stem cells, synovial-derived mesenchymal stem cells have significant characteristics of chondrogenesis and cloning. Therefore, synovial-derived mesenchymal stem cells are one of the most promising seed cells in cartilage tissue engineering.
OBJECTIVE:To isolate and culture synovial-derived mesenchymal stem cells of Sprague-Dawley rats, identify the multipotential differentiation and the potential ability of chondrogenic differentiation in three-dimensional culture condition.
METHODS:The synovium tissue was harvested from Sprague-Dawley rats. The synovial-derived mesenchymal stem cells were isolated with typeⅠcol agen enzyme digestion method and cultured in vitro. The passage 3 cells were detected with giemsa staining, the cellcycle, adipogenic and osteogenic differentiation were determined. The passage 3 cells were centrifuged as pel ets and cultured in the chondriogenic medium for 21 days. And the pel ets were examined by toluidine blue staining, typeⅡcol agen immunohistochemical staining and RT-PCR.
RESULTS AND CONCLUSION:The mesenchymal stem cells isolated from the synovium tissue of rats have the characteristics of mesenchymal stem cells, and exhibit fibroblast-like morphology after cultured in vitro. The multilineage differentiation potentials were also revealed. After the cellwere cultured in chondrogenic medium for 21 days, chondroid tissue was found, type II col agen and aggrecan could be detected positively by toluidine blue staining, typeⅡcol agen immunohistochemical staining, and expressed by RT-PCR examination. Therefore, synovial mesenchymal stem cells have a chondrogenic differentiation potential.

Child ; Chromosome Duplication ; genetics ; Craniofacial Abnormalities ; diagnosis ; genetics ; Facies ; Genetic Diseases, X-Linked ; diagnosis ; genetics ; Humans ; Intellectual Disability ; diagnosis ; genetics ; Male ; Methyl-CpG-Binding Protein 2 ; genetics ; Oligonucleotide Array Sequence Analysis ; Polymorphism, Single Nucleotide ; Sex Chromosome Disorders ; diagnosis ; genetics

Objective To investigate the tolerated dose of the optic nerves and chiasm in patients with locally advanced nasopharyngeal carcinoma(NPC)treated with intensity-modulated radiotherapy (IMRT). Methods A retrospective analysis was performed on dose characteristics and the incidence of radiation optic neuropathy in 108 patients with locally advanced NPC treated with IMRT at D 2>55 Gy in the optic nerves and chiasm in our hospital between May 2009 and December 2013. The Common Terminology Criteria for Adverse Events(CTCAE)Version 3.0 grading criteria were used for evaluating adverse reactions of the optic nerves and optic chiasm.A logistic regression analysis was performed to assess the risk factors for the development of radiation-induced optic neuropathy(RION). Results No patient had severe RION (grade 3-5),although 7 of the 108 patients had mild optic nerve disorder(grade 1-2). No patient-or treatment-related factors were found to be associated with the development of RION(P>0.05). With a median follow-up of 46 months(range,13-91 months),the 3-year estimated overall survival,local recurrence-free survival,and distant metastasis-free survival rates were 90.0%,94.5%,and 86.4%, respectively. Conclusions The dose constraint of<55 Gy derived for optic nerves and chiasm from conventional radiotherapy does not seem to apply to IMRT. For advanced NPC patients treated with IMRT, the dose constraints of optic nerves and chiasm might be relaxed in order to improve target coverage.

In 1930s, Wolf created the first partogram. In 1950s, Friedman proposed the classical model of partogram that has been applied in clinical labor assessment ever since. Over the past ten years, Zhang has made great improvement in this field. Here, we reviewed the three different stages in partogram research (the first proposed stage, Friedman's classical stage and Zhang's stage) in terms of its background, demographic characteristics and clinical application. Moreover, this article also emphasized the necessity of partogram research and discussed the prospects for future research and clinical application based on the recent progress in China.

Objective To analyze National Center for Clinical Laboratories external quality assessment(EQA)of blood cell morphology,and to summarize the cell system,morphological types and frequency of EQA.Methods EXCEL software was used to analyze retrospectively 506 pictures from National Center for Clinical Laboratories 51 times EQA of blood cell morphology from 1999 to 2016,then the type and frequency were summarized.Results Among the 506 pictures in National Center for Clinical Laboratories EQA from 1999 to 2016,380 pictures came from peripheral blood,125 pictures came from bone marrow,and the ratio was 3:1.The remaining one came from cerebrospinal fluid cells.In results of 51 times EQA,there were 135 kinds of cell morphology,including 37.78% morphology once only.In blood cell types,mononuclear had the highest frequency(28 times),then atypical lymphocyte appeared 25 times.Conclusion It is necessary for each laboratory to learn the content of blood cell morphology,and master proficiently cell morphology characteristics,especially the basic cells in blood smear for the improvement of diagnosis accuracy.