In this report,We performed HLA-A、—B and DR antigens typing and detected antibodies to U_1RNP ploypeptide antigen by Immunblotting in 37 patients with MCTD.The results showed that (1)there were no significant differences between the MCTD patients and normal controls in the frequencies of HLA—A,—B antigens.(2)there were significant differences between patients fulfilling sharp's criteria and normal controls in the frequencies of DR4 and R5 (60.9%,RR=4.7,Pc0.05).(3)the frequencies of DR4 and R5 in MCTD patients with myositis were increasedcompared with these without myositis(P0.05).

Circular RNAs (circRNAs) produced from back-splicing of exons of pre-mRNAs are widely expressed, but current understanding of their functions is limited. These RNAs are stable in general and are thought to have unique structural conformations distinct from their linear RNA cognates. Here, we show that endogenous circRNAs tend to form 16-26 bp imperfect RNA duplexes and act as inhibitors of double-stranded RNA (dsRNA)-activated protein kinase (PKR) related to innate immunity. Upon poly (I:C) stimulation or viral infection, circRNAs are globally degraded by RNase L, a process required for PKR activation in early cellular innate immune responses. Augmented PKR phosphorylation and circRNA reduction are found in peripheral blood mononuclear cells (PBMCs) derived from patients with autoimmune disease systemic lupus erythematosus (SLE). Importantly, overexpression of the dsRNA-containing circRNA in PBMCs or T cells derived from SLE can alleviate the aberrant PKR activation cascade, thus providing a connection between circRNAs and SLE.

Objective To investigate the perinatal outcomes of isolated single umbilical artery (ISUA) in full-term birth. Methods We performed a retrospective study of 82 252 pregnant women (aged<35 years;singleton; full-term live birth; no known chromosomal/structural anomalies) who delivered between January 1, 2011 and January 1, 2012 in 39 hospitals in 14 cities in China. There were 273 cases with ISUA as study group and 1 092 cases with a three-vessel cord selected in a 1∶4 ratio as control group. Perinatal outcomes including delivery modes (vaginal delivery or emergency cesarean section for fetal reasons), birth weight and height, placental weight, umbilical cord length, Apgar scores at 1 min, and rate of neonatal asphyxia were analyzed retrospectively. Data were analyzed using the Chi-square test, two independent samples t-test or rank sum test. Results The incidence of ISUA was 0.3%(273/82 252). There was no difference between the two groups with regard to maternal age, parity, gravidity, smoking status, gestational age at birth, or rate of complications during pregnancy (gestational diabetes mellitus or pregnancy-induced hypertension) (all P>0.05). The birth weight in ISUA group and control group was (3 259±463) and (3 344±411) g (t=3.689), birth hight was (48.6±2.7) and (49.7±1.9) cm (t=8.368), placental weight was (508±72) and (543±153) g (t=3.114), umbilical cord length was (52.6±8.1) and (53.7±7.5) cm (t=1.983), and Apgar scores at 1 min were 9.0 (8.0-10.0) and 10.0 (9.0-10.0) (Z=11.831), respectively; the values in the ISUA group were lower than those in control group (all P < 0.05). No significant differences were observed in the rate of vaginal delivery and emergeny cesarean section for fetal reasons between the ISUA group and control group [52.8%(144/273) and 49.9%(545/1 092),χ2=0.704;19.4%(25/273) and 15.7% (86/1 092), χ2=1.162; both P>0.05]. Conclusions ISUA does not increase emergency cesarean delivery rates for the fetal reasons, but the fetal growth and development may fall behind those with a three-vessel umbilical cord. Monitoring during pregnancy and delivery should be intensified for fetuses with ISUA.

Objective To study the perinatal outcomes of pregnant women when their total stage of labor over 24 hours after the application of new partogram.Methods A retrospective case-control study was conducted on 3 991 pregnant women who received routine prenatal care and intrapartum management according to new partogram and delivered at full-term with alive babies at Beijing Obstetrics and Gynecology Hospital from October 1,2014 to January 31,2015.Among these 3 991 women,85 delivered after 24-hours' labor and all were nulliparas,while five of the 85 converted to cesarean section (CS group) and 80 delivered vaginally (study group).Another 160 primigravidas were randomly selected from those vaginal deliveries with the total stage of labor less than 24 h as control group.The general conditions,maternal and fetal perinatal outcomes were compared between the study and control group and between the study and CS group.The duration of labor was compared among different groups of women in the study group.Independent sample t-test,Rank-sum test,Chi-square test or Fisher's exact test were applied for statistics.Results The durations of first stage,second stage,third stage and total stage of labor were all longer in the study group than in the control [25.7(23.8-26.8) vs 10.4(5.9-13.9) h,1.4(0.6-1.8) vs 0.8(0.4-1.0) h,0.14(0.08-0.17) vs 0.11(0.07-0.13) h,27.2(24.9-26.8) vs 10.4(5.9 14.0) h,Z=12.525,4.359,3.528 and 12.588,all P＜0.01].The proportions of intrapartum interventions and application of labor analgesia were both higher in the study group than in the control [97.5％(78/80) vs 32.5％(52/160),42.5％(34/80) vs 11.9％(19/160),x2=90.764 and 29.071,both P＜0.01].Higher incidences of intrapartum fever [18.8％(15/80) vs 5.6％(9/160),x2=10.208],episiotomy [50.0％(40/80) vs 25.6％(41/160),22=14.172],assisted vaginal delivery [26.3％(21/80) vs 10.0％(16/160),x2=10.800],postpartum hemorrhage [32.5％(26/80) vs 8.1％(13/160),x2=23.284],and cervical laceration [15.0％(12/80) vs 3.1％(5/160),~=11.427] were shown in the study group than in the control (all P＜0.01).There was no statistically significant difference was found in the rate of fetal distress,neonatal asphyxia and neonatal intensive care unit (NICU) admission between the study and control group (all P＞0.05) except for newborns' birth weight [(3 542±388) vs (3 431 ±368) g,t=2.162,P=0.032].However,the incidences of postpartum hemorrhage,intrapartum fever and neonatal admission to NICU were comparable between the study (n=20) and CS group (both P＞0.05).Within the study group,the durations of second stage of labor in women with postpartum hemorrhage,assisted vaginal delivery and episiotomy were significantly longer than those without [1.8(0.9-3.1) vs 1.2(0.5-1.5) h,2.0(0.8-3.4) vs 1.2(0.5-1.6) h,1.7(0.6-2.6) vs 1.1(0.5-1.5) h,Z=2.168,2.756 and 1.891,all P＜0.05].Conclusions After the application of new partogram,vaginal delivery remains possible for pregnant women whose total stage of labor over 24 hours without increase of neonatal morbidity.However,the incidences of postpartum hemorrhage,episiotomy and assisted vaginal delivery may rise up.

Objective To describe the anxiety of caregivers and condition management of preschool asthma children ,and analyze the relation?ship between anxiety and disease management. Methods A total of 208 caregivers of asthma children from two hospitals in Shanghai were select?ed using convenient sampling,and surveyed by self?rating anxiety scale(SAS),condition management ability scale and condition management diffi?culty scale. Results The score of SAS were negatively correlated with the condition management ability and positively correlated with the condi?tion management difficulty. Hierarchical regression analysis showed that the model explained 26.6%amount and 35.1%amount of variation respec?tively. Conclusion The anxiety of caregiver of children with asthma may affect the disease management. Future interventions should be strength?ened on the caregivers'psychological problems,so as to improve disease management and control asthma more effectively.

Training of war trauma rescue personnel under modern war time is the key point for strengthening the war preparation and satisfying the logistic supply. In the present paper,the training model of war field surgeon in Russian was firstly introduced,and then by combining the status of war rescue of our army,the strategies suitable for the training of field war surgeon in our army were put forward.

In constructing the system of medical functional teaching and enhancing the quality and ability of students,we adjust the content and method of teaching in practice,and try to find students'problems in study through questionnaire survey and promote teaching reform and disciplines construction.

Objective To analyze the perinatal outcomes of those women experienced hypoglycemia during 75 g oral glucose tolerance test(OGTT).Methods A retrospective study was conducted in 774.pregnant women who underwent OGTT and delivered in our institution from January 2005 to January 2006.The distribution of glucose levels of the fasting,1 h,2 h and 3 h of the OGTT was analyzed.Plasma glucose level below the 5th percentile and above the 1h percentile was defined as hypoglycemia and those below the 1th percentile as exceeding hypoglycemia.Perinatal outcomes including birth weight,birth height,obstetric complications,the incidence of small for gestational age (SGA)were compared between women with hypoglycemia or exceeding hypoglycemia. Results The birth weight in exceeding hypoglycemia group of fasting glucose was significantly lower than that of the others [(2817±764)g vs(3439±487)g,t=3.344,P＜0.01]and the incidence of SGA in this group was also higher(3/7 vs 3.4%,x2=22.78,P＜0.01);the proportion of babies with birth weight＜3000 g in the same group was higher than the others(5/7 vs 14.73%,P＜0.01).The newhorns height was significantly shorter in the hypoglycemia group at 2 h than the normal glycemic group [(49.03±1.68)cm vs(49.48±1.65)cm,P＜0.05].Conclusions The plasma glucose 1evel is associated with the newborns'birth weight and height.Women with hypoglycemia during OGTT are more likely to have babies with lower birth weight and height.

In recent years,studies have shown that galactose - deficient IgA1(Gd - IgA1)antibodies are im-portant in the pathogenesis of IgA nephropathy(IgAN). Serum levels of Gd - IgA1 antibodies are associated with levels of proteinuria and renal histological grading. Measuring the antibodies has guidance value in the diagnosis of IgAN,for its sensitivity and specificity can be up to 88% - 89% and 89% - 92% respectively. In addition,the antibodies play an important role in clinical prognosis,and it may provide a new direction for treatment in IgAN. Now,its role in prognosis of IgAN was reviewed.

OBJECTIVETo explore therapeutic effects of minor external fixator for open comminuted phalangeal fractures with non-transarticular.

METHODSFrom January 2013 to December 2014,13 patients with open comminuted phalangeal fractures were treated by minor external fixator with non-transarticular, including 9 males and 4 females aged from 18 to 56 years old with an average of 35 years old. According to Gustilo classification, 8 cases were type II, and 5 cases were type III. The time from injury to operation ranged from 2 to 7 h averaged 5 h. Seven patients were diagnosed as phalangeal fracture, 6 patients were involved with joint surface of phalangeal, which 1 case combined with inherent nerve damage and 1 case combined with soft tissue defect repaired at stage II. The patients were fixed by plaster for 2 weeks and removal external fixtor from 6 to 8 weeks after operation and received functional exercise.

RESULTSAll patients were followed up from 3 to 12 months with an average of 7 months. One case occurred metacarpophalangeal joints stiffness. No screw breakage, inflammation occurred. Skin soft tissue recovered well and obtained bone healing, the average time of bone healing was (4.6 ± 1.0) weeks. According to TAM scoring system used by Hand Surery Association of Chinese Medical Association, 7 cases got excellent results, 4 good, 1 moderate and 1 poor.

CONCLUSIONMinor external fixator for open comminuted phalangeal fractures with non-transarticular has advantages of simple operation, good stability, and could adjust at the later stage, less damage for soft tissue periosteum, low inflammatory rate, earlier functional exercise. It is worth to be popularized and applied.

Adolescent ; Adult ; External Fixators ; Female ; Finger Phalanges ; injuries ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged