Objective:To evaluate the seven existing vaginal birth after cesarean (VBAC)screening tools and to identify additional factors that may predict VBAC or failed trial of labor in China.Methods:In the study,53 patients with 1 previous cesarean delivery who then delivered between January 1,2007 and Novenber 31,2014 were recruited.The average age of the patients was (32.1 ±3.5 )years,the average gestational age was (38.0 ±2.3)weeks.There was no significant difference of the successful group and the failed group in the maternal /neonatal mortality and morbidity,also in the incidence of the postpartum hemorrhage and the postpartum infection.The probability of VBAC was calculated for each participant using 7 prediction models created by Weinstein,Flamm,Grobman,Gonen,Troyer,Smith and Torri.The data were analyzed using t test,rank-sum test,and receiver operating curve analysis. Results:44 trial of labor patients had a vaginal birth after cesarean delivery,and the successful rate was 83%.The scores between the successful group and the failed group had significant difference when eva-luated by Weinstein and Grobman scoring models only.After recalculating the successful rate of VBAC in different score levels according to the references,there was significant difference between the rates of dif-ferent score levels when evaluated by the Weinstein model.The successful rates of different score levels were higher compared to the references (<50%)when evaluated by the Troyer (70%),Gonen (60%),Torri (85.7%)models.The area under the receiver operating characteristic curve of Weinstein prediction model (0.746)and Flamm prediction model (0.723)were more than 0.7,and there was no significant difference between the seven models.Conclusion:Among the seven scoring models,the Weinstein model is more applicable to the population of our country,but a new model more applying to Chinese women still needs to be created.

Objective To discuss the potential relationship between endometrial serous carcinoma (ESC) and tubal epithelial lesions by pathologic examination of fallopian tubes with ESC. Methods A total of 30 cases of typical ESC were reexamined and chosen by the pathologist. In each case, bilateral fallopian tubes were submitted to examination of pathologic morphology and immunostaining for p53, annexin Ⅳ(ANX-Ⅳ), human epidermal growth factor receptor 2(HER2)/neu, and high-mobility group protein A2 (HMGA2). Results Fallopian tubal epithelial lesions were found in 15 cases, including 9 cases tubal serous carcinoma, 2 cases serous tubal intraepithelial carcinoma (STIC) and 2 cases epithelial hyperplasia. Both sides of tubal serous carcinoma and STIC were found in 1 case. The results showed the positive expression for p53 in 26(87%)out of 30 endometrial malignant specimens tissues and 9(30%)tubal tissues samples (P>0.05). Twenty-five(83%)endometrial malignant specimens tissues and 6(20%)tubal tissues samples showed the positive expression of ANX-Ⅳ. Twenty-one(70%)endometrial malignant tissues and 7(23%) tubal tissues showed the positive expression of HER2/neu. Twenty-five(83%) endometrial malignant tissues and 6(20%)tubal tissues showed the positive expression of HMGA2. While, there were significant differences among the expression of three proteins between endometrium and the fallopian tube site (all P<0.05). Conclusions STIC may be associated with the occurrence of ESC. The expression of p53 was positively correlated between the fallopian tube and the endometrium. ANX-Ⅳ,HER2/neu and HMGA2 were extensively expressed in ESC.

Objective To investigate the changes of CA125 between primary cytoreductive surgery and interval debulking surgery for prediction the rate of optimal interval cytoreductive surgery and prediction the recurrence and the prognosis in patients with epithelial ovarian cancer.Methods A total of 39 cases with suboptimal primary cytoreductive surgery admitted from Jan.1996 to Jan.2009 were retrospectively analyzed.The median age of patients was 56 years( range:41 -68 years).Based on the changes in CA125level between primary cytoreductive surgery and interval debulking surgery,all cases were divided into four groups,group A (CA125 reduced to normal after primary cytoreductive surgery,n=6),group B (CA125reduced to normal after 1 - 2 cycles of chemotherapy,n =11 ),group C ( CA125 reduced to normal after 3 -4 cycles of chemotherapy,n =14),and group D ( CA125 did not reduced to normal after the chemotherapy,n =8 ), and all received platinum-based chemotherapy.The response to chemotherapy evaluated by pathological examination versus CA125 level,and recurrence and prognoses were also analyzed.Results ( 1 )The rate of optimal interval cytoreductive surgery in group A,B,C and D were 6/6,8/11,9/14 and 2/8respectively,in which there were statistically different between group A or B and group D (P ＜0.05).(2)The clinical benefit rates evaluated by the pathological examination in group A,B,C and D were 4/6,4/11,5/14 and 0,respectively and there were statistically different between group A and group D (P =0.030).( 3 ) There was significant difference in the recurrence rate between group A and group D (3/6 vs.8/8,P =0.024),while there were not significant differences between group B or C and group D ( all P ＞ 0.05 ).The rate of drug-resistant recurrence in group A,B,C and D were 1/6,3/11,5/14 and 7/8,respectively,in which there were significant differences between group A,B or C and group D ( all P ＜ 0.05 ). ( 4 ) The median progression-free survival (PFS) for patients in group A,B,C and D were 32,10,18 and 3 months,respectively,in which there were significant differences in the PFS between group A,B or C and group D (P =0.012,P =0.003,P =0.032 ).The median overall survival (OS) were 44,45,44 and 16 months,respectively.There were significant differences in the OS between group A,B or C and group D ( P =0.022,P =0.004,P =0.000 ).Conclusion The change of CA125 between primary cytoreductive surgery and interval debulking surgery may be predict the recurrence type and the prognosis in patients with epithelial ovarian cancer.

Objective To understand the whole situation of neonatal resuscitation in high risk deliveries.Methods Totally,3 420 neonates born from high risk pregnant mothers in Tianjin Central Obstetrics and Gynecology Hospital from September 2013 to November 2014 were recruited and divided into four groups according the needs of resuscitation,including no resuscitation group (Group A),initial resuscitation group (Group B),initial resuscitation plus bag-and-mask or T-piece ventilation (positive pressure ventilation group,Group C),tracheal intubation and/or external chest compression and/or epinephrine administation (tracheal intubation group,Group D).Variance analysis,Chi-square test and Logistic regression analysis were applied to compare the differences of clinical conditions among these groups and to analyze risk factors of tracheal intubation requirement for extensive resuscitation.Results Among the 3 420 newborns,2 360(69.0％) were assigned to Group A,565 (16.5％) to Group B,408 (11.9％) to Group C and 87 (2.5％) to Group D.Statistical differences were shown in the gestational age [(35.5 ± 4.1),(33.0 ± 4.3) and (32.1 ± 4.8) weeks],birth weight [(2 593.8 ± 663.6),(2 063.3 ± 973.9) and (1 839.0 ± 977.9) g],and the incidence of multiple births [66(11.7％),65(15.9％) and 23(26.4％)],abruptio placentae [15(2.7％),35(8.6％) and 9(10.3％)],umbilical cord prolapse [0(0.0％),2(0.5％),and 10(11.5％)],abnormal fetal heart rate in labor [28(5.0％),45(11.0％) and 46(52.9％)],prolonged labor [36(6.4％),35(8.6％),and 20(23.0％)],meconium stained liquor [32(5.7％),0(0.0％),and 8(9.2％)],and congenital anomaly [8(1.4％),12(2.9％) and 7(8.0％)] among Group B,C and D (F or x2=233.188,105.050,14.535,19.934,91.434,149.366,26.525,28.602 and 13.765,all P ≤ 0.05).Multiple regression analysis revealed that gestational age ≤ 28 weeks (OR=1.290,95％ CI:1.167-1.425),abnormal fetal heart rate in labor (OR=1.350,95％CI:1.184-6.862) and meconium stained liquor (OR=1.397,95％CI:1.051-6.825) were independent risk factors for endotracheal intubation requirement (all P ≤ 0.05).Conclusions More newborns born from high risk mothers may need resuscitation,especially for those in small gestational age,with abnormal fetal heart rate during labor and meconium-stained liquor,thus close monitoring and management are necessary.

Objective To establish a stable and real-time monitorable nude mouse model of orthotopic glioma xenograft.Methods U251 glioma cell line was infected by a lentiviral vector containing green fluorescent protein (GFP) and luciferase (Luc) gene.Cells stably expressing fluorescence of GFP and Luc were sorted by flow cytometry.CCK-8 test and Transwell tumor invasion and migration assay were used to compare the biological features between the cells stably expressing GFP-Luc fluorescence and cells without fluorescence.Then the cells were implanted intracranially in the right caudate nucleus of athymic Balb/c nude mice to establish the tumor model.The growth of intracerebral tumor was monitored over time by a bioluminescence imaging (BLI) system.Hematoxylin-eosin (HE) staining was used to evaluate the histopathological features and tumorigenicity of the transplanted glioma cells in the brain of nude mice.Results U251 glioma cell line with stably expressing GFP-Luc fluorescence and the corresponding orthotopic xenograft model were successfully established.There was no statistically significant difference in the proliferation,invasion and migration abilities between the cells with stably expressing GFP-Luc fluorescence and the control cells.This model showed a high tumor formation rate and stable tumor growth,and takes a moderate time to establish this model.Conclusions Compared with the traditional glioma cells,GFP-Luc-transfected human glioma cells are more feasible for the studies of glioma in vivo.The tumor growth and pathological characteristics in this U251-GFP-Luc glioma model are similar to human glioma,and the growth of this tumor can be real-time monitored.It can be used as an ideal animal model for experimental studies of glioma.

OBJECTIVE To provide gists for educations about AIDS control through finding out the knowledge among medical staff at a low infected area.METHODS The questionnaires including 30 questions of 5 kinds were analyzed.RESULTS The awareness rate of total knowledge among medical staff was 64.94%.The positive rate about common knowledge was upon 88%.But the rate about comprehensive knowledge such as diagnosis standard,therapy way,disinfection measure,career defending,law function,and so on was law.The correct answers on 17 questions among nurses were higher than doctors(P

Objective To observe the effect of magnesium valproate sustained release tablets on children with epilepsy and its effects on cognitive function.Methods Magnesium valproate sustained release tablets were conducted on 38 cases.Close attention was paid to both the degree of paroxysm control and side effects during treatment while periodic examinations on liver function and blood routine were also conducted.The intelligence and P300 of children with epileptics were respectively measured before and after 6-month treatment.Forty children of control group was set up.Results Eighteen cases were totally under controlled(47.4%),11 obviously effect(28.9%),6 effect(15.8%).The total effective rate in total was 92.1%.Obvious differencees in intelligence between children with epileptics and control group before and after 6-month treatment were observed(all P0.05).Conclusions Magnesium valproate sustained release tablets is a new type of broad-spectrum anti-epileptic drug,which has an obvious effect on treatment of children with epileptic without any obvious adverse reaction.It imposes little influence on children′s cognitive function.

OBJECTIVE On the basis of the different shapes of upper airway(UA)obstruction and collapse characteristic of obstructive sleep apnea hypopnea syndrome(OSAHS), the effect of modified uvulopalatopharyngoplasty(UPPP)combined with coblation in OSAHS operations on patients with AHI≥20,which could be done selectively to patients with various or multiple UA obstructive sites, was explored. METHODS 30 patients of OSAHS were diagnosed and analysed by polysomnography(PSG)to have AHIs≥20. Based on the shapes of their UAs classified according to the degree of the shortened lateral and radial vectors,the UPPP was modified in two ways: either the lateral vector or the radial vector was amplified, or both could be amplified with coblation. All patients were analyzed by questionnaires(PSG)Muller's maneuver and oral cavity measurement pre-and 6 months post-operation. RESULTS 86.7 % of the patients showed a decrease of at least 25 % in AHI . Velopalatal insufficiency never occurred. CONCLUSION The modified-UPPP combined with coblation can be used selectively on patients based on their UA shapes.

Chemoimmunotherapy has attracted much attention as an emerging therapy pattern for the treatment of cancers. Exploring effective drug combination schemes and reasonable delivery methods remained the key issue in current research. Herein, we designed sorafenib (SF) and anti-Tim-3 monoclonal antibody (Tim-3 mAb) co-loaded MMP2-responsive mesoporous silica nanoparticles (ST-MSNs) for combined chemoimmunotherapy of hepatocellular carcinoma (HCC). The shell of ST-MSNs was fabricated by Tim-3 mAb through matrix metalloproteinase 2 (MMP2) sensitive peptides as "gatekeepers" to prevent drug release during the blood circulation. In tumor microenvironment, the high levels of MMP2 caused the responsive shedding of Tim-3 mAb, leading to the triggerred release of SF and Tim-3 mAb. Then, SF could be delivered to tumor cells and Tim-3 mAb could be delivered to T cells, respectively. In vivo tumor inhibition study results demonstrated that ST-MSNs can significantly enhance synergistic antitumor activity compared with sequential administration of free SF solution and Tim-3 mAb solution. Meanwhile, the expression of antitumor cytokines IFN-γ, IL-12 and the percentage of CD3⁺CD4⁺ cells, CD3⁺CD8⁺ cells in tumors were upregulated after the administration of ST-MSNs, demonstrating good immunomodulatory ability. In addition, within the dosage range, the ST-MSNs had low cytotoxicity and hemolysis, and no obvious tissue toxicity was observed. All animal experiments were performed in line with national regulations and approved by the Animal Experiments Ethical Committee of Shandong University. In conclusion, this study provided a promising drug combination of chemoimmunotherapy with good application prospects for clinical HCC treatment, and exhibited a potential drug carrier for clinical chemoimmunotherapy.

Objective To explore the impact of 2009 International Federation of Gynecology and Obstetrics(FIGO)staging system alteration for stage Ⅰ endometrioid adenocarcinoma on its' prognosis assessing.Methods A retrospective study was carried out on 244 cases with endometrial carcinoma admitted in Peking University People's Hospital from Jan.1995 to Feb.2008.Results(1)All 244 patients were divided into FIGO 2009 Ⅰ a group(n =200)and FIGO 2009 Ⅰ b group(n =44)according to FIGO 2009 staging system,while they were divided into FIGO 1988 Ⅰ a group(n =34),FIGO 1988 Ⅰ b group(n =156)and FIGO 1988 Ⅰ c group(n =29).The others 25 cases were stage Ⅱ a(n =16)and stage Ⅲa with merely positive abdominal cytology(n =9)according to FIGO 1988 staging system.(2)The higher percentage of low-grade in FIGO 1988 Ⅰ a group than that in FIGO 2009 Ⅰ a group(P =0.003).Compared with FIGO 2009 Ⅰ a group,the age of the patients,surgery extent,the percentage of lymph node excision and received chemotherapy and radiotherapy,there were no difference in FIGO 1988 Ⅰ a and Ⅰ b group,respectively(P ＞ 0.05).There were 5.9％(2/34)and 6.7％(10/150)found relapse among FIGO 1988 Ⅰ a group and FIGO 1988 Ⅰ b group,and there were 2.9％(1/34)and 2.7％(4/150)for the two groups died of carcinoma.Compared with FIGO 2009 Ⅰ a group,there were not significant difference[7.5％(13/200)vs.3.0％(6/200);P ＞0.05].The 5 years and 10 years progression-free survival(PFS)of FIGO 1988 Ⅰ a group and Ⅰ b group were(97.0 ±3.0)％,(90.9 ±6.5)％ and(95.3 ±2.1)％,(90.2 ± 3.6)％,respectively,in which there were not significant difference compared with that in FIGO 2009 Ⅰ a group[(96.1 ±1.6)％,(89.6±3.2)％ ; P＞0.05].The 5 years and 10 years overall survival(OS)in FIGO 1988 Ⅰ a group and Ⅰ b group were 100％,(93.8 ±6.0)％ and(96.9 ± 1.8)％,(95.2 ±2.5)％,respectively,in which there were did not significant difference with that in FIGO 2009 Ⅰ a group [(97.9 ± 1.2)％,(93.4 ± 2.8)％ ; P ＞ 0.05].(3)There were not significant difference between FIGO 1988 Ⅰ c group and FIGO 2009 Ⅰ b group(P ＞0.05)for the age of the patients,grade,surgery extent,lymph node excision,the percentage of received chemotherapy and radiotherapy.Between FIGO 1988 Ⅰ c group and FIGO 2009 Ⅰ b group,there were 3.4％(1/29)and 6.8％(3/44)cases found relapse,respectively.And there were 0 and 2.3％(1/44)cases died of carcinoma in the two groups,in which there were not differ much either(P ＞ O.05).The 5 years and 10 years PFS in FIGO 1988 Ⅰ c group were all 100％,while they were 100％ and(90.9 ±6.2)％ in FIGO 2009 Ⅰ b group.The 5 years and 10 years OS in FIGO 1988 Ⅰ c group were all 100％,but were 100％ and(95.0 ±4.9)％ in FIGO 2009 Ⅰ b group,in which they all did not significantly differ much(P ＞ 0.05).(4)The patients in FIGO 2009 Ⅰ a group were younger than those in FIGO 2009 Ⅰ b group(P ＜ 0.01).The percentage of low grade in FIGO 2009 Ⅰ a group were higher than that in FIGO 2009 Ⅰ b group(P =0.029).The percentages of received chemotherapy and radiotherapy in FIGO 2009 Ⅰ a group were lower than that in FIGO 2009 Ⅰ b group remarkably(P ＜ 0.01).But there were not significant difference in the uterine excision extent and the percentage of lymph node excision between the two groups(P ＞ 0.05).There were not significantly differ in the relapse rates and the death rates between the FIGO 2009 Ⅰ a group and FIGO 2009 Ⅰ b group(P ＞0.05).There were also not significant difference in PFS and OS between the two groups(P ＞0.05).Conclusions There were not significant difference in the prognosis between FIGO 2009 stage Ⅰ a and FIGO 1988 stage Ⅰ a and Ⅰ b.There were also not significant difference in the prognosis between FIGO 2009 stage Ⅰ a and FIGO 2009 stage Ⅰ b,which may be due to received more chemotherapy and radiotherapy in FIGO 2009 stage Ⅰ b patients.