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 investigate the prenatal diagnosis and prenatal genetic conselling of pseudomosaic trisomy 20. Methods One case of pseudomosaic trisomy 20 was analyzed and relative literatures were reviewed. Results A 31-year-old gravid 1, para 0 woman underwent amniocentesis at 18 weeks of gestation due to high risk of trisomy 21 during maternal serum screening in September, 2012. Interphase fluorescence in situ hybridization (FISH) of amniocytes with probes GLP13/GLP21/CSP18/CSPX/CSPY showed a normal result, while cytogenetic analysis of cultured amniocytes revealed a karyotype of 47,XY,+20[7]/46,XY[9]. The level of trisomy in the cultured amniocytes was 7/16. Cordocentesis revealed a karyotype of 46,XY in cultured cord blood cells. Interphase FISH analysis was performed using the probes D20Z1 (20p11.1-q11.1) and D20S1157/20QTEL14 (20 per/qter). Each probe showed two signals in all uncultured amniocytes. The prenatal ultrasound findings were unremarkable. The mosaicism was considered to be pseudomosaicism. After genetic counseling, the parents selected to continue the pregnancy. A healthy male baby was delivered at 39 weeks of gestation. Postnatal cytogenetic analysis revealed a karyotype of 46,XY in peripheral blood lymphocytes. Interphase FISH analysis of the uncultured buccal cast-off cells using the probes D20Z1 and D20S1157/20QTEL14 showed normal results in 100%cells. There was no phenotypic abnormality at the age of seven months. Conclusions When mosaic trisomy 20 is identified in amniocytes, further evaluation and genetic counseling are required. Interphase FISH of the uncultured amniocytes with a chromosome-specific probe is a useful tool for confirmation of the prenatal diagnosis of mosaicism. Genetic analysis of multiple tissues is required postnatally.

Objective:To study the qualitative identification and quantitative analysis of Paeoniae radix Rubra in Fufang Fuqing lotion. Methods:TLC was used to identify Paeoniae radix Rubra. The content of paeoniflorinl was determined by HPLC. The mobile phase was acetonitrile-0. 01% phosphonic acid (13 ∶87), and the detection wavelength was 230 nm,the flow rate was 1. 0ml·min-1, the column temperature was 40℃,and the sample size was 10μl. Results:The results of TLC showed that the relevant spots were clear without any interference from the negative sample. The calibration curve of paeoniflorinl was linear within the range of 0. 070-4. 500 μg (r=1. 000 0). The average recovery was 98. 36% with RSD of 2. 73%(n=6). Conclusion:The methods are accurate and quick in the qualitative identification and quantitative assay of the preparation, which can be used for the quality control of Fufang Fuqing lo-tion.

Objective:To analyse the property of voltage-dependent potassium 〔K(v)〕 channel in healthy people′s peripheral lymphocyte so as to contribute the control for property alteration under some pathological condition,and to try to find the new subset of this channel.Methods:Patch-clamp whole cell recording technique was used.Results:In the recorded 39 cells,activated voltage of the channels was -40.3±2.5 Mv.No inactivation phenomenon appeared under repeated stimulation.The closing time of the channels was 116.3+8.2 ms under the repolarization,and the current could be inhibited by 10 mmol/L TEA.Conclusion:There might be only one type of K(v) channel in human peripheral blood lymphocytes,and its properties quite resumble the type of n K(v) channel in mice.

Objective To determine plasma resistin level in patients with traumatic brain injury (TBI) and evaluate its correlations with outcome and inflammatory reaction. Methods Fiftyfour patients with moderate TBI, 71 patients with severe TBI and 40 healthy controls were enrolled in this study. Plasma samples were obtained from the healthy controls on physical examination and from the TBI patients on admission. Enzyme-linked immunosorbent assay ( ELISA) was used to determine the plasma resistin concentrations. Results Twenty patients (37.0% ) and 53 patients (74.6% ) with moderate and severe TBI suffered from an unfavorable outcome (defined as GOS score for 1-3 points) three months after TBI respectively. Plasma resistin levels in the patients with moderate and severe TBI were substantially higher than that in the healthy controls ((21. 9 ± 8. 4) ng/ml and (29. 2 ± 9. 6) ng/ml vs (9. 3 ± 2.6) ng/ml, both P ＜0. 01] by using covariance analysis. By using the multivariate linear regression analysis, plasma C-reactive protein level (t =2.212,P =0.035; t =2. 274,P =0. 014) and GCS scores (t =3. 120,P =0.007; t=3.986,P=0.003) were associated with the plasma resistin levels. Logistic regression analysis selected plasma resistin level as an independent predictor for 3-month unfavorable outcome of the patients with moderate and severe TBI (odds ratio = 1. 124, 95% CI = 1. 040-1. 221, P = 0.011; odds ratio = 1. 145, 95% CI = 1. 044-1. 232, P = 0. 009). A receiver operating characteristic curve identified cutoff levels of plasma resistin (22.4 ng/ml and 30.5 ng/ml) that predicted 3-month unfavorable outcome of moderate and severe TBI patients with the high sensitivity (70. 0% and 79. 2% ) and specificity (70.6% and 72.2% ) ( area under curve = 0.719, 95% CI = 0.642-0.829, P = 0.000;area under curve =0.735, 95% CI =0. 671-0. 893, P = 0.000). Conclusions Plasma resistin level is increased after TBI and may be involved in inflammatory response of brain injury. Clinical detection of this indicator can help early determine the prognosis of the TBI patients.

Objective To investigate the molecular mechanism of the glucocorticoid?induced osteoblasts apoptosis,and to develop the effective intervention measures. Methods The MC3T3?E1 cells were treated with different concentrations of dexamethasone for 24 hours,then the apoptosis rate was detected with TUNEL analysis,the intracellular expression of Bim and Bax were determined by Westen blot. In addition,MC3T3?E1 cells were randomly divided into Bim?siRNA group,negative control siRNA group and control group. Twenty?four hours after transfection,10-4mmol/L dexamethasone was added to each group of cells for another 24 hours administration. The apoptosis rate was analyzed using the TUNEL,the mito?chondrial transmembrane electric potential was detected by flow cytometry after JC?1 staining,the expression of Bax,Bcl?2 in mitochondrial and Cyt?C,AIF in cytosolic were determined by Western blot. Results The rate of osteoblast apoptosis and Bim expression in cells were both significantly in?creased with the dosage of dexamethasone,there was no significant difference between the groups in the expression of Bax;the rate of osteoblast apop?tosis after the expression of silence Bim was significantly lower than the negative control siRNA group and control group,the expression of Bax and Cyt?C,AIF in cytosolic were significantly reduced,and the mitochondrial transmembrane electric potential was increased. Conclusion Bim is the key molecules in hormone?induced apoptosis of osteoblasts ,the expression of silence Bim can inhibit dexamethasone induced osteoblasts apoptosis through the mitochondrial pathway.

Objective To investigate the diagnostic value of hysteroscopy in patients with abnormal uterine bleeding.Methods The clinical data of 547 cases of abnormal uterine bleeding were analyzed retrospectively.The diagnostic curettage was conducted after hysteroscopy,the specimens were examined by histopathology,the detection result of hysteroscopy and histopathological were compared.Results The sensitivity of hysteroscopy in diagnosed abnormal uterine cavity lesions was 95.83％ (161/168),the specificity was 97.63％ (370/379),the false positive rate was 2.37％ (9/379),the false negative rate was 4.17％ (7/168),the positive predictive value was 94.71％ (161/170),the negative predictive value was 98.14％ (370/377),the Jorden index was 0.934.Hysteroscopy diagnosis showed that the endometrial polyps was 54 cases,the pathological diagnosis coincidence rate was 79.63％ (43/54);93 cases of simple hyperplasia,the pathological diagnosis coincidence rate was 90.32％ (84/93);16 cases of atypical hyperplasia,the pathological diagnosis coincidence rate was 87.50％ (14/16);4 cases of differentiated endometrial adenocarcinoma,the pathological diagnosis coincidence rate was 100.00％ (4/4);2 cases of uterine papillary serous carcinoma,the pathological diagnosis coincidence rate was 100.00％ (2/2);1 case of transitional cell carcinoma of endometrium,the pathological diagnosis coincidence rate was 100.00％ (1/1).Conclusion Hysteroscopy can visually observe the morphology of cervical canal and uterine cavity,the diagnostic rate of endometrial polyps,simple hyperplasia,atypical hyperplasia and endometrial carcinoma are higher,so it has important clinical value in the diagnosis of abnormal uterine bleeding.

BACKGROUND: Promoting immunological function of patients with chronic obstructive pulmonary disease (COPD) can control development of COPD.OBJECTIVE: To investigate the effect of bufei yishen granule on pulmonary ventilation function and immunological function of COPD patients and compare with placebo.DESIGN: A randomized grouping comparison and placebo controlled study.SETTING: Respiration Department of the First Affiliated Hospital of Henan Traditional Chinese Medical.PARTICIPANTS: A total of 62 COPD patients selected from Department of Respiration of the First Affiliated Hospital of Henan College of Traditional Chinese Medicine from January 1999 to October 2004,were randomly divided into two groups :Observation group and control group with 31 in each group.METHODS: Patients in observation group were treated with bufei yishen granule consisting of ginseng, mongolian milkvetch root, largehead atractylodes rhizome, divaricate saposhnikovia root, dwarf lilyturf tuber, Chinese magnoliavine fruit, malytea scurfpea fruit, medicinal evodia fruit, Chinese cster pillar fungus, Chinese eaglewood wood, scorpion, almond, thunberg fritillary bulb, szechwan lovge rhizome, etc., produced by Pharmaceutic Department of the First Affiliated Hospital of Henan College of Traditional Chinese Medicine. Each granule of 1 g contained an equivalent of 5.78 g raw drugs. Three times a day with 10 g for each; and patients in control group were treated with placebo consisting of hawthorn fruit and malt. The dosage and medication were the same as those in observation group. Both therapies were respectively administered in a treatment course of two months. Before and after the therapy course,the followed indexes were measured.① Assay of immunological function: The levels of IgG, IgA and IgM from blood serum were detected with simple agar diffusion.② Assay of Ag level in nucleolus organizer region (Ag-NORs): The ratios non-histone staining acidity non-histone vs core area (IS%) was calculated by staining the activating lymphocytes of the blood by silver staining technique with microscope image analysis technique. ③ Assay of pulmonary function: The pulmonary function was measured by Sensor Medics Ros System in all of the people with the levels of forced expiratory volume in first second (FEV1.0), mean maximu expiratory flow (MMEF), peak expiratory flow (PEF), once after and before treatment. The examination was repeated three times in order to obtain the peak number. The difference of the three examinations was within ±5%.MAIN OUTCOME MEASURES: Comparison of T lympholeukocyte subpopulation and pulmonary ventilation function in the patients before and after 1 course.RFSULTS: Data of totally 62 patients was entered the final analysis without any loss.① Comparison of pulmonary ventilation function of patients in the two groups before and after 1 course: FEV1.0, MMEF, PEF,and ratio of FEV1.0 and forced vital capacity (FEV1%) in observation group were significant higher than those before treatment (t=2.12-3.41,P ＜ 0.05-0.01), thoseindexes in observation group were higher than those in control group (t=2.54-3.17, P ＜ 0.05-0.01). ② Changes of T lymphocyte subgroups of patients in the two groups before and after 1 course:The levels of CD3+, CD4+, CD4+/CD8+ in observation group after 1 course were high.er than those before treatment (t=2.71-13.20, P ＜ 0.01), but the level of CD8+ was decreased as compared with that before treatment (t =8.63, P ＜ 0.01). The levels of CD3+, CD4+, CD4+/CD8+ in observation group were higher than those in control group (t=2.85-11.84, P ＜ 0.01), but the level of CD8+ was decreased as compared with that in control group (t =5.83, P ＜ 0.01).CONCLUSION: The bufei yishen granule can obviously improve the pulmonary ventilation function and immunological function of COPD patients,and its intervention is superior to that of placebo.

Background:Esophageal cancer is a digestive system malignant tumor with high incidence in China. Early diagnosis and treatment are the keys to increase the survival rate of patients with esophageal cancer. Now,applying magnifying endoscopy combined with narrow-band imaging(ME-NBI)for diagnosis of early esophageal cancer has become the hot research spot. Aims:To evaluate the diagnostic value of ME-NBI for early esophageal cancer and its invasive depth. Methods:Consecutive patients with early esophageal cancer or precancerous lesion undergoing conventional white light endoscopy with biopsy and ME-NBI from June 2013 to November 2015 at the Ren Ji Hospital,School of Medicine, Shanghai Jiao Tong University were collected retrospectively. The findings of ME-NBI and biopsy pathology of conventional white light endoscopy were comparatively analyzed. The accuracy of ME-NBI in diagnosis of invasive depth of early esophageal cancer was evaluated. Results:A total of 49 patients were enrolled. The overall agreement of ME-NBI findings with endoscopic surgical pathology(gold standard)as well as the sensitivity and negative predictive value of ME-NBI for differentiating early esophageal cancer and precancerous lesion were significantly higher than those of biopsy pathology under conventional white light endoscopy[91. 8%(45 / 49)vs. 24. 5%(12 / 49);100%(45 / 45)vs. 17. 8%(8 / 45);100%(3 / 3)vs. 9. 8%(4 / 41),P all < 0. 05]. Total accuracy of ME-NBI for diagnosing the invasive depth of early esophageal cancer was 77. 8%(35 / 45). Conclusions:ME-NBI has good diagnostic value for early esophageal cancer and its depth of invasion. It can be used as an effective modality for clinical diagnosis of early esophageal cancer.