Objective To detect the normal value of the fetal middle cerebral artery peak systolic velocity (MCA-PSV) with Doppler ultrasonography, and to investigate the association between MCA-PSV and fetal anemia. Methods Doppler ultrasonography was performed in 535 normal pregnant women from the 14th to the 40th week of gestation. MCA-PSV was measured, and the standard value of the normal fetal MCA-PSV was established. Fetuses with abnormal high MCA-PSV were assessed with a standard of MCA-PSV＞mean vale of gestational weeks+2 standard deviation or 1.5 multiples of mean value of gestational weeks. Results The value of normal fetal MCA-PSV correlated well with the gestational weeks (linear regression equation was: MCA-PSV＝-9.955+1.561×weeks; r＝0.795, P<0.0001). Using 1.5 multiples of the mean of different gestational weeks to diagnose the moderate and severe fetal anemia, 7 fetuses were screened out of 209 of obstetric ultrasonography; 4 of them had MCA-PSV＞1.5 multiples of mean value of gestational weeks and were proved with induced labor. Conclusion The value of 1.5 multiples of mean value of gestational weeks of fetal MCA-PSV in prenatal ultrasonography might be an important clue for the diagnosis of fetal anemia.

BACKGROUND:The tensile and stress-relaxation mechanical properties of sciatic nerve injury after repaired with autologous nerve and poly(lactic acid-glycolic acid) (PLGA) scaffold are rarely reported. OBJECTIVE:To analyze the tensile and stress relaxation characteristics of sciatic nerve injury after the transplantation of autologous nerve and PLGA scaffold. METHODS:Sixty sciatic nerves were extracted from the fresh cadavers dead within 24 hours, processed into 35 mm samples, and were then randomly divided into three groups. The nerve samples in control group received no intervention;the nerves in artificial and autologous groups were modeled into 20 mm defects, followed by repaired with PLGA scaffold and autologous nerve, respectively. Afterwards, the tension and stress-relaxation tests were performed in each group. RESULTS AND CONCLUSION:The stress in each group descended fast at the first 600 seconds, then descended slowly and was closed to the horizontal level until 7200 seconds, and the stress-relaxation curves in each group were in logarithmic decrease. The order of the elastic limit load, elastic limit stress, maximum load, maximum stress, elastic limit strain and maximum strain during tension was as follows:control group>artificial group>autologous group (P<0.05). Our results indicate that the PLGA scaffold holds good tension and stress-relaxation properties, which meets the mechanical requirements of the biomaterials used for sciatic nerve repair.

The government and general public has paid unprecedented attention to the public health after the outbreak of SARS in 2003. Based on the first and the second round of Three-year Action Plan for Public Health System Construction, the public health system in Shanghai has been gradually improved. The city's public health security has been increasingly consolidated and people's main health status and indicators have been constantly improved. Nowadays, the third round of Three-year Action Plan will be started. This paper will review the development of public health system in Shanghai in recent ten years, analyze the possible problems and challenges in the future and put forward the development direction and strategy of the system.

Objective To explore the expression change of death associated protein kinase(DAPK)and therapeutic time window for traumatic brain injury in rats.Method The traumatic brain injury models of rats were achieved by free drop impact model.The adult rats were randomly divided into normal control,sham-operation and TBI groups.Samples of"TBI group were acquired at the time point of2h,8h,24h,48h and 72h after brain injury.Pathological changes of injured neurons were demonstrated by H-E staining,the expression of DAPK mRNA W8.8 detected by RT-PCR,relative quantitation of neuron apoptosis Wa$detected by TUNEL.Results At the Sh after brain injury,the expression of DAPK increased evidently and neuron apeptosis Wag detected.The expression of DAPK and quantitation of neuron apeptosis reached peal[at the 24h after injury.Conclusion These obaervatiorm showed that the expression of DAPK in the cerebral tissues reached peak at the 24h after injury.The optimum therapeutic time window wag 24h after injury.

Objective To explore the efficacy and safety of modified vaginal paravaginal repair (VPVR) in treatment of symptomatic paravaginal defect cystocele(PDCC). Methods This study was an observational case series of 52 consecutive women in Beijing hospital from January 2007 to August 2009, with symptomatic paravaginal defect cystocele. Among them, 6 patients had anterior wall colporrhaphy. Preoperative and postoperative pelvic evaluations were performed with the POP-Q system. All the cases underwent vaginal approach to paravaginal repair, 49 cases underwent vaginal hysterectomy simultaneously. Patients were followed up for 1 to 24 months. Criteria for objective cure were defined as the anterior vaginal walls at grade 0 and firmly apposing to the lateral pelvic sidewalls.Results Of the 52 patients, 30 had grade Ⅱ , 17 had grade Ⅲ, and 5 had grade Ⅳ paravaginal defect cystocele. In all patients the VPVR was performed successfully. No complication happened during and after operation. The average operation time was (65 ±18) min (45-110 min) and estimated blood loss was (95 ± 27) ml (50-200 ml). Patients were followed up postoperatively for 3 to 24months, with a mean of (10. 1±3.1) months. The PDCC recurred in 6 cases, 5 patients had grade Ⅰcystocele and 1 had grade Ⅲ cystocele. Conclusions The vaginal approach to the correction of paravaginal defect cystocele is highly effective in our population.

Objective To document peritoneal tuberculosis mimicking ovarian malignancy in elderly post-menopausal women and to review pertinent literature.Methods The records of 3 women with peritoneal tuberculosis who were managed at Beijing Hospital from January 2003 to September 2009 were reviewed.Results Three patients with peritoneal tuberculosis mimicking ovarian malignancy all presented with the classical symptoms of advanced-stage ovarian carcinoma,including ascites,abdominopelvic masses,elevated serum CA125,bloating and progressive emaciation.Two patients received laparotomy revealing peritoneal tuberculosis but no malignancy.All the patients were treated with anti-tuberculosis chemotherapy.Conclusions Medical awareness of peritoneal tuberculosis is still lacking and many women with this disease are initially thought to have ovarian malignancy and undergo unnecessary extended surgery.Laparoscopy including biopsies seems to be a sufficient and safe method to provide diagnosis of peritoneal tuberculosis.If laparoscopy is not feasible,laparotomy should be performed.Ascites and high level of CA125 do not necessarily indicate that the clinical picture is malignant in post-menopausal women.

Objective:Investigate whether adenosine disodium triphosphate for injection can reduce the systemic inflammatory response which induced by cardiopulmonary bypass.Methods:Forty-seven patients scheduled for cardiac surgery over 30 min following CPB were randomly divided into two groups. In treated group(n=23),adenosine disodium triphosphate for injection(2 mmol/L) was added into the prime during CPB, but in control group(n=24), no adenosine disodium triphosphate for injection was added. Blood samples were drawn from the radial artery at the following time points:(1)before CPB;(2)30 min after aortic clamping;(3)30 min after aortic declamping;(4) 12 h after aortic declamping;(5)24 h after aortic declamping.Enzyme-linked immunosorbent assays(ELISA) were used to measure the concentration of tumor necrosis factor-?(TNF-?), interleukin-6(IL-6), in plasma,CK-MB in plasma level were measured too.Results:The concentration of TNF-??IL-6?CK-MB levels in plasma level of two groups showed no difference before CPB. They all had increased by 30 min after aortic clamping(P

Objective:To investigate L-type calcium channels of human mesenchymal stem cells(hMSCs) cultured in vitro.Methods:hMSCs were isolated,cultured by Percoll gradient centrifugation,adherence to plastic flask and monoclonal culture.Immunophenotypes of hMSCs were detected by immunofluorescence and flow cytometry techniques.Whole cell patch-clamp technique was used to observe the change of L-type calcium channels of human mesenchymal stem cells(hMSCs).Results:High homogenous hMSCs had been isolated and cultured in vitro.hMSCs had unique immunophenotypes and they were positive for CD44,CD29,c-kit but negative for CD34,CD31,CD54.Calcium currents could be found in 40 percent of hMSCs,peak currents of calcium(I Ca-Peak ) were (102.67?19.06)pA from +20 mV to +30 mV.The currents could be inhibited by Cd~ 2+ (20 ?mol/L).Conclusion:Undifferentiated hMSCs express less L-type calcium channes,regulation of the chanels might contribute to directional differentiation.

Objective To study the protective effects of tBHQ on type 2 diabetic rats retina and its related mechanism.Methods Sixty SD rats were divided into normal control group (NC group),model group (diabetes mellitus,DM group) and tBHQ group.After feeding with high fat and high sugar diets for 4 weeks,the rats in model group were induced by intraperitoneal injection of STZ for the model of type 2 diabetes mellitus.1％ tBHQ were added into the high fat and high sugar feed 1 week later after successfully modeled in the tBHQ group.Fasting plasma glucose (FPG) and fasting serum insulin (FINs) were detected at 4 and 12 weeks after modeled.Immunohistochemical method and real-time fluorescent quantitative PCR (qRT-PCR) were respectively used to detect the distributions and relative expression levels of nuclear factor erythroid 2-related factor 2 (Nrf2),heme oxygenase 1 (HO-1),B-cell lymPhoma 2 (Bcl-2) and vascular endothelial growth factor (VEGF) in retinas of the rats.Results FPG levels totally comparative differences were statistically significant between each group (F =78.531,P =0.000).The level of FPG in DM and tBHQ group were obviously higher than that in NC group,the 12 weeks was higher than 4 weeks in DM group,and the 12 weeks was lower than 4 weeks in tBHQ group (all P ＜ 0.05).Totally comparative differences in the level of FINs were statistically significant (F=22.480,P =0.000),NC group was lower than DM and tBHQ group,12 weeks was higher than 4 weeks (all P ＜ 0.05).Immunohistochemical detection showed that each factor in each group were expressed in the retina of rat,and the relative expressions of Nrf2,HO-1,Bcl-2 and VEGF protein in retina have totally statistically differences in different time points after modeled (all P ＜0.05).The expressions of each factor in DM group were more than those in the NC group.The Nrf2,HO-1 and Bcl-2 in tBHQ group were more than those in the DM group,but the VEGF was lower.At 12 weeks,the expressions of VEGF and Nrf2 in DM group were more than those at 4 weeks,but the HO-1 was lower;the Nrf2,HO-1 and Bcl-2 in tBHQ group were more than those at 4 weeks (all P ＜ 0.05).PCR tests revealed that the relative expressions of Nrf2,HO-1,Bcl-2 and VEGF mRNA in retina have totally statistically differences in different time points after modeled(all P ＜ 0.05).The expressions of each factor in DM group were more than those in the NC group.The Nrf2,HO-1 and Bcl-2 mRNA in tBHQ group were more than those in the DM group,but the VEGF mRNA was lower.At 12 weeks,VEGF mRNA in DM group and Nrf2,HO-1,Bcl-2 in tBHQ group were more than those at 4 weeks (all P ＜ 0.05).Conclusion tBHQ maybe have protection for islet function on diabetic rat,and can induce the expressions of Nrf2,HO-1,Bcl-2 in retina of diabetic rats and reduce the expression of VEGF,inhibit the oxidative stress of retinal tissue damage,reduce cell apoptosis and inhibit the proliferation of retinal blood vessels.tBHQ may protect the retina of diabetic rats through the Nrf2/HO-1/VEGF and Nrf2/Bcl-2 way.

BackgroundLimbal stem cell deficiency usually leads to blindness, and traditional therapy is limited. Recent research demonstrated that bone mesenchymal stem cells ( BMSCs ) and human amniotic epithelial cells(AECs) could differentiate into many kinds of cells including corneal epithelial cells, but the outcome and effect of these cells on corneal stem cell deficiency are still unclear. ObjectiveThis study aimed to observe and compare the effects of rabbit BMSCs and human AECs transplantation for rabbit limbal stem cell deficiency. Methods Eighteen clean New Zealand rabbits were randomly divided into the amniotic stroma(AS) group, rabbit BMSCs group and human AECs group with 6 rabbits for each group. Limbal stem cell deficiency models were established by putting a piece of filter paper that had been soaked in a NaOH solution at the corneal center. Rabbit BMSCs were isolated and purified by density gradient centrifugation combined with the attachment culture method, and human AECs were collected by a sequential trypsin digestion technique,and the third generation rabbit BMSCs and the first generation human AECs were identified with RT-PCR. After that,cells were inoculated onto the denuded AS and grafted to the corneal surface of the experimental animals. Twenty-eight days after cell transplantation, the therapeutic effects were evaluated based on the corneal neovascularization and opacity scores. Corneal histopathological examination and immunohistochemistry were performed to evaluate and compare the effectiveness among AS,rabbit BMSCs and human AECs on corneal stem cell deficiency. The procedure complied with the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission. ResultsThe third generation of rabbit BMSCs grew well after 12 hours, and the first generation of human AECs formed a membrane-like monolayer after 48 hours of incubation on AS. Immunohistochemistry staining showed that, 28 days after transplantation, the surface cells of the cornea were positive for cytokeratin 3 in both the rabbit BMSCs group and human AECs group.Compared with the AS group,the corneal neovascularization and opacity grades were significantly decreased in the rabbit BMSCs group( Z=-2. 983, P =0. 003 ; Z =-2. 844, P =0. 004 ) and human AECs group ( Z =-2. 817, P =0. 005 ; Z =-2.041, P =0. 041 ). Histopathological analysis exhibited that stratified corneal epithelial-like cells formed on the corneal stroms 28 days after grafting and no signs of goblet cells and neovascularization were found. Less inflammatory cells and regular collagen fiber could be seen in the rabbit BMSCs group and human AECs group. In addition,clinical observation also revealed that the corneas were much clearer in the rabbit BMSCs group than the human A ECs group( Z =-2. 091 , P=0. 037 ), but the corneal neovascularization score was similar between them (Z = -0. 267,P=-0. 789). ConclusionsRabbit BMSCs and human AECs can differentiate into corneal epithelial-like cells onthedamagedcornealsurfaceandfurtherdemonstrateremarkableinhibitoryeffectsoncornealneovascularization and inflammatory cells. The more dominant and prominent effect is the role played by rabbit BMSCsin the improvement of corneal transparency.