Objective To compare the neonatal outcomes of different gestational age at which elective cesarean sections at term were performed. Methods All the cases of cesarean section registered in Peking Union Medical College Hospital from September 2002 to November 2009 were collected. Women with viable singleton pregnancies delivered before the onset of labor and without recognized indications for cesarean section after 37 weeks at term were included and their general information and outcomes were compared with one-way ANOVA. All the maternal data and neonatal adverse events were compared with Cochran-Armitage test among different gestational weeks, including respiratory complications (respiratory distress syndrome or transient tachypnea of the newborn), infections, admission to the neonatal intensive care unit (NICU), and hospitalization in NICU＞5 d. Results Of 8122 primary cesarean sections and 594 repeat cesarean sections at term, 4565 and 409 cases were performed electively as the primary or repeat cesarean section. Among the 4565 women underwent primary elective cesarean sections, 2194 (48.1%) were before 39 gestational weeks,and 1828 (40.0%) at 39-39+6 weeks. While, among the 409 repeat elective cesareans sections, these figures were 275 (67.2%) and 120 (29.3%), respectively. No fetal or neonatal death occurred during perinatal period. Compared with births at 39-39+6 weeks, births at 37-37+6 weeks or 38-38+6 weeks were associated with increased risk of the neonatal adverse events. For the primary cesarean section cases, the odds ratio (OR) for births at 37-37+6 weeks and 38-38+6 weeks was 1.4 (95% CI: 0.9-2.0) and 1.1 (95% CI: 0.9-1.4), respectively. For the repeat cesarean section cases, OR for births at 37-37+6 weeks and 38-38+6 weeks was 2.5 (95% CI: 1.1-5.8) and 1.3 (95% CI: 0.6-2.7) respectively. Conclusions Elective cesarean section before 39 weeks of gestation is popular and associated with adverse neonatal outcomes. Elective cesarean section performed after 39-39+6 gestational weeks might decrease the risk of adverse neonatal outcomes.

Objective:The clinical features,maternal and fetal outcomes and management of pregnant women with uterine malformation during the pednatal period were investigated.Methods:99 pregnant patients with uterine malformation as research group and 100 pregnant patients without uterine malformation as control group were recruited in Peking Union Medical College hospital from January 1 st in 2000 to September 30th in 2008.A retrospective study was done to compare the clinical features,matemal and fetal outcomes in these two groups.Clinical management of pregnancy with uterine malformation.Results:In the research group,the incidence of caesarean section,threatened abortion,preterm rupture of membrane,abnormal presentation,and placenta accrete were higher than those in the control group.The average fetal weight was smaller than that of control group.There were no significant differences in postpartum hemorrhage and perinatal child death in these two groups.Conclusions:Patients with uterine malformations more likely undergo C-section.Postpartum hemorrhage and other pregnant complications should be paid more attention.

Objective To investigate whether damaged human amniotic epithelial cells(HAEC)could be repaired on the matrix of formulated fibrin clot in vitro and the effects of epidermal growth factor(EGF),basic fibroblast growth factor(bFGF)and transforming growth factor ?_1(TGF-?_1)on the proliferation of HAEC. Methods Ring drill was used to drill the HAEC layer on culture sheets to make quantified models of damaged HAEC, on which the lacks were then covered with fibrin clot. Subsequently, EGF (EGF group), bFGF(bFGF group) and TGF-?_1 (TGF-?_1 group) of different concentration were added into the sheets respectively. After the predesigned culturing time, the growing and transiting conditions of HAEC were observed under inverted microscope after Giemsa stain. Also, the proliferating conditions of HAEC were detected by using 5-bromodeoxyuridine(BrdU). Results In all groups, HAEC could transit toward damaged area on fibrin clot and grow there. Higher transiting speed and larger cell numbers were observed in the EGF and bFGF groups followed by the control group, while the TGF-?_1 group showed the relatively poorer results. Proliferating rates of HAEC were 17.8%, 28.0%, 35.3%, 51.6%, 34.1%, 34.2% and 26.0% respectively by EGF of different cultured concentration (1.0ng/ml, 5.0ng/ml, 10.0ng/ml, 20.0ng/ml, 40.0ng/ml, 80.0ng/ml and 160.0ng/ml). Proliferating rates of HAEC were 18.0%, 35.7%, 43.0%, 52.7%, 67.4%, 43.6% and 30.5% respectively by bFGF of different cultured concentration (1.0ng/ml, 5.0ng/ml, 10.0ng/ml, 20.0 ng/ml, 40.0 ng/ml, 80.0 ng/ml and 160.0ng/ml). Compared with the control group, EGF groups (EGF concentration ranging from 10ng/ml to 80ng/ml) and bFGF groups (bFGF concentration ranging from 5ng/ml to 80ng/ml ) showed better proliferating effects of HAEC(P

Objective To summarize our experiences of applying totally implantable venous access ports ( TIVAP) in chemotherapy for young children with malignant tumors.Methods Between December 2011 and May 2015, 50 young children with malignant tumors were implanted with TIVAP in Anhui Provincial Children's Hospital for chemotherapy.A retrospective review was conducted with their clinical records, focusing on success rate, clinical effect, and complications of TIVAP.Results The technical success rate was 100%with no intrao-perative complication such as puncture-related injury.In one case the device had to be adjusted through reopera-tion due to malposition of catheter tip.The port was removed in one case after 1 year due to infection.15 patients had the ports removed after the completion of chemotherapy.5 patients died due to the relapse and metastasis of tumor.29 patients are still using the port with no complications.Conclusion TIVAP is a safe device in young children, ensuring reliable vascular access for chemotherapy and improving patients'quality of life.

05). Conclusion The maternal serum level of ADAM 12 in the first-trimester is a potential marker for aneupolyhaploid screening and early fetal loss prediction, and is suggested to be tested at 9-12 gestational weeks as part of prenatal screening.

ObjectiveTo discuss the interaction of pregnancy and myasthenia gravis(MG) and the management of pregnancy with MG.MethodsSeven cases of pregnancy with MG in Peking Union Medical College Hospital were analyzed retrospectively,with respect to the therapy of MG,pregnancy complications and outcomes.Results Totally 38 683 pregnant women were admitted to Peking Union Medical College Hospital between Oct.1983 and Oct.2010.Among them there were 9 patients suffered from MG,with the incidence of 0.023％.Two pregnancies were terminated because of personal reasons,and seven continued.( 1 ) Onset of MG:in the 7 cases,6 were diagnosed before conception,with the mean course of 5.9 years.The other one occurred in the third trimester.(2) Management:all the cases were under close surveillance during pregnancy.Four women took thymectomy before conception,and one of them kept taking medication after surgery. In those who received thymectomy,3 cases remained stable and 1 case worsened during prenancy.The latter one took medication at 33 weeks,and continued to full term.MG exacerbated in the other three women who had not undergone thymectomy before conception.Among them, one woman complicated with systemic lupus erythematosus and lupus nephritis delivered the baby at 31 weeks.(3) Delivery and neonatal outcomes:cesarean deliveries were performed in 5 cases and the other two underwent vaginal deliveries.All the newborns were admitted to neonatal intensive care unit for surveillance.There were three smaller than gestational week (SGA) infants.No MG was observed in newborns.ConclusionsPatients with MG should have an overall evaluation before conception.The course of MG during pregnancy is unpredictable.They may get a promising outcome under the control of a multidisciplinary team including obstetricians and neurologists.Newborns should be carefully monitored for sings of transitory MG in the department of pediatrics.

Objective To calculate the incidence of chromosomal abnormalities at second trimester in women who were 35 or older at their expected date of birth.Methods The amniocentesis and karyotyping results in Peking Union Medical College Hospital from January 1st,2001 to June 30th,2011 were retrospectively analyzed.The only indication for amniocentesis in these group of woman was advanced maternal age.A total of 6584 cases Were included in this study and were divided into two groups according to maternal age,ie.35-39 and ≥40 year old group.The incidences of fetal 47,+ 21,47,+ 18 and sex aneuploidies were calculated and compared between two groups by Chi-square test.Results Altogether,121 cases were diagnosed to be abnormal chromosome,and the overall incidence was 18.38‰ (121/6584).The abnormal karyotypes included 111 cases of aneuploidies (mosaicism included) and 10 cases of structural abnormalities.The aneuploidies included 59 cases of 47,+21 (8.96‰,59/6584),25 cases of 47,+18 (3.80‰,25/6584),2 cases of 47,+13 (0.30‰,2/6584) and 25 cases of sex aneuploidies (3.80‰,25/6584).Fetal 47,+21 was the most frequent chromosomal abnormality,accounting for 53.15％ (59/111) of all aneuploidies.The incidence of fetal 47,+21 was significantly higher in ≥40 year-old group than that of 35-39 year old group[13.99‰(16/1144) vs 7.90‰(43/5440),x2=3.937,P=0.047].There were no statistical differences of the incidences of fetal 47,+ 18 and sex aneuploidies between the two groups.Conclusions The main fetal chromosomal abnormalities in women aged 35 and older are the aneuploidies of chromosome 21,18,13 and sex chromosomes.The incidence of fetal 47,+21 is significantly increased in the women aged 40 years and older.So prenatal screening should be provided first to women at 35-39 years of age and amniocentesis should be the first choice of prenatal diagnosis for women over 40 years old.

Objective To explore the effect of Sunset Abelmoschus on podocyte injury in adriamycin-induced nephropathy rats.Methods Fifty male SD rats were randomly divided into five groups:sham operation group (n=10),model group (n=10),Sunset Abelmoschus low dose group (0.5 g·kg-1· d-1 n=10),middle dose group (1.0 g· kg-1· d-1,n=10) and high dose group (2.0 g· kg-1· d-1,n=10).Unilateral nephrectomy combined repeated adriamycin injection were performed to establish adriamycininduced nephropathy models.The rats were administered with the corresponding dose of Sunset Abelmoschus during the experiment period.Urinary protein,urinary N-acetyl glucose aminotransferase (NAG),serum albumin,serum creatinine and blood lipid were measured before operation and 2,4,6,8 weeks after operation.The rats were sacrificed on week 8 for the renal histological examination,including light microscope and electron microscope.Expression of nephrin was examined by immunofluorescence assays.Results As compared to model group,urinary protein and NAG significantly decreases in Sunset Abelmoschus groups in each time point,especially in high dose group (P＜0.01),meanwhile the serum albumin increased and the disturbance of lipid metabolism was improved in Sunset Abelmoschus groups (P＜0.05).Compared with sham group,Scr increased significantly in model group and Sunset Abelmoschus groups at the 4th week.At the 8th week,Scr in high dose group was lower than that in model group (P＜0.05),and the ratio of glomerular globe sclerosis and segmental sclerosis,tubulointerstitial damage reduced in Sunset Abelmoschus groups,especially in high dose group.The podocyte damage and the extent of foot process fusion were improved in Sunset Abelmoschus groups compared with model group.Expression of nephrin increased in Sunset Abelmoschus groups than that in model group.Conclusion Sunset Abelmoschus can ameliorate proteinuria and renal tissue damage of adriamycin-induced nephropathy rats,whose mechanism may be associated with the improvement of podocyte injury.

Objective The study aimed to explore the growth status of children under 3 years of age in Nankai district of Tianjin city,provide reference evidence for children's health care work of the local area.Methods Convenience sampling was used to collect physical examination records of children under 3 years old from Wangdingdi hospital in Nankai district of Tianjin city.The records of 2 880 children' physical examination data were collected.Results The median scores of weight for height (WHZ) of children of 6,9,12,18 months old were 0.74 (0.01,1.49),0.73 (0.08,1.38),0.58 (0.11,1.27),0.54 (0.14,1.22),while children of 3,24,36 months old were 0.29 (0.45,1.03),0.17 (0.61,0.95),0.22 (0.36,0.80),the difference between them had statistical significance,x2=21.71,P＜0.05.The median scores of height for age (HAZ) of children of 3,6,9,12,16 months old were 1.05 (0.33,1.76),1.09 (0.32,1.85),1.22 (0.41,2.02),1.00 (0.20,1.79),1.09 (0.19,1.99),while children of 18,24 months old were 0.79 (0.06,1.51),0.86 (0.15,1.56),the difference between them had statistical significance,x2=27.83,P＜0.05.The median scores of weight for age (WAZ) of children of 3,12,18,24,36 months old were 0.88 (0.29,1.46),0.96 (0.31,1.61),0.85(0.19,1.51),0.64 (0.04,1.23),0.91 (0.28,1.54),while children of 6,9 months old were 1.10 (0.43,1.76),1.09 (0.43,1.74),the difference between them had statistical significance,x2=36.95,P＜0.05.The prevalence of stunting,wasting and overweight were 0.3％ (10/2 880),0.8％ (22/2 880) and 9.3％ (267/2 880).The physical condition between premature and full term infants and post-mature infants had statistical significance,t=140.23,100.64,P＜0.05.Conclusions The growth and development status of children in Tianjin Nankai district under 3 years old was generally good,and there was no significant difference between boys and girls,however,overweight has been the most serious problem at present.Compared with full-term and post-mature infants,the physical condition of premature newborn was lower.