Objective:To test the effects of roxithromycin(RM) on TNF? and IL-6 release from periodontal ligment fibroblasts(PDLCs) stimulated with lipopolysaccharide(LPS).Methods:PDLCs of passage 4~8 were cultured with RM at 2,20 and 200 ?g/ml respectively with 10 ?g/ml of LPS.The control cells were cultured with culture medium only.The cultures were continued for 3,6,12 and 24 hours respectively.ELISA method was used to measure TNF-? and IL-6 released into the culture medium from PDLCs in the different groups.Results:LPS increased both TNF-? and IL-6 release from PDLCs at all the time points(P

Background and purpose: Docetaxel/cisplatin are widely used in chemo-naive patients with advanced non-small cell lung cancer(NSCLC),but the standard 3-weeks'project of docetaxel caused significant toxicity.We performed this study to compare the effect and toxicity of modified and standard 3-weeks'docetaxel/cisplatin as first line chemotherapy for advanced NSCLC.Methods:68 patients with stage ⅢB or Ⅳ NSCLC(proven by histology or cytology) were randomly divided into two groups,modified(A) and standard(B) chemotherapy.Group A: docetaxel 75 mg/m2,divided into 2 days,ivgtt d1 and d 8,cisplatin 25 mg/(m2?d),ivgtt d 1-d 3,q3w;Group B: docetaxel 75 mg/m2,ivgtt d 1,cisplatin was administered as Group A,q3w.The effect and toxicity were assessed after two cycles and one-year survival was followed up.Results:There was no CR in both groups.10 PR,20 SD,4 PD were found in group A,the overall response rate is 29%;whereas 11 PR,20 SD,3 PD were found in group B,the overall response rate is 32%.The one-year survival rate were 38% and 35% in group A and B,respectively.There were no significant difference about the overall response rate(P=0.793) and one-year survival rate(P=0.801) between group A and B.The rates of grade Ⅲ/Ⅳ neutropenia were 18% and 47% in group A and B respectively.The difference was statistically significant(P=0.010).Conclusions:In comparison with the standard 3-weeks'docetaxel/ cisplatin chemotherapy,the modified one has similar response rate but lower hematologic toxicity,and thus it was well tolerated.

Objective To clarify malaria infection and the incidence in first Chinese medical team of United Nation peacekeeping mission in Democratic Republic of Congo and evaluate the effect of prevention measures so that provide reference for studying on malaria prevention and the precautionary measures for the follow-up personnel in Africa. Methods 43 cases (male 30, female 13) were observed between Apr. and Dec. 2003 when they were deployed in D.R.of Congo. Eliminating mosquito was used to decrease the density, including the usage of driving mosquito machine, killing mosquito lamp and chlorine cyanogens chrysanthemum ester, ”Prevent malaria-3”and COTECXIN as the precautionary medicines. Plasmodiums in blood were checked periodically. The cases with positive result of blood test and without clinical symptom was considered as infection, otherwise as disease with symptom appeared. Results The density of mosquito in house decreased. 3 cases (male 2, female 1) suffering from malaria, the incidence was 6.98%. Plasmodium was found in 39 individuals (male 26, female 13), the infection rate was 90.70%. The incidence was the lowest compared with contingents from other countries. Conclusion It was effective that these measures taken by reducing mosquito density and ”Prevent malaria-3”and COTECXIN usage in Chinese medical team during peacekeeping mission .

Objective To compare the curative effect between minimal invasive internal fixation with Mast Quadrant and tra -ditional open internal fixation for treating thoracolumbar fractures .Methods A total of 46 cases suffered thoracolumbar fractures were randomly divided into the minimally invasive group (MQ) and the traditional open group (TO) ,the patients in MQ group re-ceived minimally invasive pedicle internal fixation under Mast Quadrant minimal invasive channel ;the patients in TO group received pedicle internal fixation under traditional open channel .Perioperative related indicators ,imaging indicators and improvements of low back pain were recorded and statistically compared respectively .Results The different of the volume of blood loss ,operation time and length of incision and postoperative volume of drainage between the two groups were statistically significant (P < 0 .05) ,the different of the volume of hospital duration ,postoperative VAS score between the two groups were statistically significant (P <0 .05) .The different of the volume of flange height in injured vertebral fanterior ,Cobb Angle between preoperative and postopera-tive were statistically significant (P< 0 .05) .And comparison between groups had no statistical significance (P> 0 .05) .Conclusion Compared with traditional open operation ,minimally invasive pedicle internal fixation under Mast Quadrant minimal invasive chan-nel has the advantage of more simple operation ,less intraoperative bleeding and postoperative pain less invasive ,fast recovery and short hospitalization stay .

Objective To research the important of prenatal diagnosis and effect of intervention to fetal hydrothorax. Methods The cases of fetal hydrothorax (n=5) were obtained from the Shengjing Hospital,China Medical University between December 2014 and May 2015. All pregnancies were uncomplicated, excluded congenital organic and chromosomal abnormalities during prenatal diagnosis and with a 37 average gestational weeks. The case 1, 2, 4 were unilateral hydrothorax and the case 3, 5 were bilateral. We performed an antenatal thracocentesis to case 1, 2, 3. In case1, the hydrothorax increased rapidly after 5 days, and the patient underwent a cesarean section and ex utero intrapartum treatment (EXIT);in case 2, the fetal heart rate was decreased to 40-50 bpm suddenly during thracocentesis, and we performed an emergent cesarean section and EXIT for the patient; in case 3, the patient underwent thracocentesis and a meanwhile cesarean section and EXIT procedure. We performed a conservative management to case 4, 5, the hydrothorax resolved spontaneously during the pregnancy and after birth, both patients underwent cesarean section. Results All fetuses were survived, the neonates of case 1, 2 and 3 underwent assited mechanical ventilation, thoracic close drainage, then discharged after hydrothorax resolved and feeding tolerance;in case 4, there was no respiratory distress and hospital treatment;in case 5, the neonate underwent assited mechanical ventilation and conservative management, the hydrothorax has resolved gradually. Conclusions The prenatal diagnosis and antenatal intervention (thracocentesis) may play an important role in fetal hydrothorax treatment. In clinical, we should choose different plan according to the gestation weeks and classification of hydrothorax of the patient.

Objective To explore the correlation between thyroid peroxidase antibody (TPOAb) and outcomes during pregnancy and the effects of treatment on outcomes. Methods PubMed, Cochrane Library, Science Direct, Embase, Chinese Biomedicine, and Wanfangdata had been searched. Case-control and cohort studies about TPOAb and pregnancy outcomes were searched according to the inclusion and exclusion criteria. Fifty studies were finally recruited (all of cohort-studies, 10 for English and 5 for Chinese). Review Manager 5.3 were used to test the heterogeneity of the results among the different studies and amalgamate the effect size using fixed or random effect models. Results Meta-analysis showed TPOAb (+)with normal thyroid function increase the risks of miscarriage,and premature delivery, OR calculated were 2.02(95%CI:1.13-3.62, P=0.001)and 1.39(95%CI:1.11-1.76, P=0.005), while showed no relative risk to hypertensive disease,placental abruption in pregnancy and fetal growth restriction, OR calculated were 1.29(95%CI:1.00-1.67, P=0.080),0.42(95%CI:0.12-1.43, P=0.210)and 1.61(95%CI:0.23-11.12, P=0.100). TPOAb(+)with normal thyroid function increase miscarriage in in vitro fertilization and embryo transfer (IVF-ET), OR calculated were 2.14(95%CI:1.43-3.21, P=0.000). Levothyroxine (LT4) for patients of TPOAb(+)with normal thyroid dysfunction decrease adverse obstetric outcomes, OR calculated were 0.43(95%CI:0.22-0.85, P=0.020). Conclusions TPOAb(+)with normal thyroid function increase the risks of miscarriage,and premature delivery. TPOAb(+) with normal thyroid function increase miscarriage in IVF-ET. LT4 for patients of TPOAb(+)with normal thyroid dysfunction decrease adverse obstetric outcomes.

Objective To research the relationship between the expression of PAI-1 and the clinical characteristics of the endometrial carcinoma.Methods We detected the level of the serum PAI-1 by ELISA in the patients with endometrial carcinoma,the patients with endometrial hyperplasia and the patients with normal endometrium.The expression of PAI-1 in endometrial carcinoma and normal endometrial tissues was observed by immunohistochemistry.Results The concentration of serum PAI-1 in patients with endometrial carcinoma was 18.64 ± 6.22 μtg/L,significantly higher than those of patients with endometrial hyperplasia (6.94 ± 2.87) μg/L and patients with normal endometrium (6.68 ± 2.13)μg/L (P=0.00).The expression rate of PAI-1 was 68.2％ (15/22) in endometrial carcinoma tissue,and 8.3％ (2/24) in normal endometrial tissue (P=0.00).Compared with the early endometrial carcinoma,the expression rate of PAI-1 in the advanced endometrial carcinoma was significantly higher (6/6 w 9/16,P=0.03).Conclusions The expression level of PAI-1 may be related to the stage of the endometrial carcinoma.

Objective To analyze the clinical outcome and impact factors of twin-to-twin transfusion syndrome (TTTS) with anterior placenta treated by fetoscopic selective laser coagulation of placental vessels(SLCPV). Methods Ten cases of TTTS with anterior placenta and 8 cases with posterior placenta were treated by SLCPV in Shengjing Hospital from July 2011 to April 2014. Clinical data were analyzed retrospectively. Some cases were at Quintero stageⅡor higher stage, others were at Quintero stageⅠbut with cardiovascular score≥5 according to the scoring system of Children′s Hospital of Philadelphia. The anterior placenta cases were treated by curve fetoscopy and the posterior placenta cases were treated by straight fetoscopy. Results (1) Of all the 18 cases, the mean gestational age at SLCPV was 24.1 weeks (17+5 to 27+4 weeks). There were 2 cases at Quintero stageⅠ, 4 at stageⅡand 12 at stageⅢ. The mean gestational age of anterior placenta cases at SLCPV was 25.2 weeks (22 to 27+4 weeks), with 2 cases at Quintero stageⅠ, 2 cases at stage Ⅱ and 6 at stage Ⅲ;5 cases had preterm prelabour rupture of the membranes (PPROM)and 1 case had maternal intestinal obstruction after the operation;the average operation time was 40 minutes. Of the posterior placenta cases, the mean gestational age at SLCPV was 22.7 weeks (17+5 to 27+4 weeks);2 cases were at Quintero stageⅡand 6 cases at stageⅢ. PPROM happened in one case;one case had maternal enterobacter cloacae septicemia;the average operation time was 28 minutes. All the 18 cases could tolerate the operations. There was no intraoperative complication. (2) One anterior placenta case had maternal intestinal obstruction and miscarriage; and one posterior placenta case had enterobacter cloacae septicemia. Karyotype analyses of the all the twins were normal. (3) 17 cases delivered already, including all the 10 anterior placenta cases and 7 posterior placenta cases. One infant had corpus callosum agenesis, but its co-twin was normal. The average gestational age at delivery for anterior placenta cases was 32.6 weeks (24 to 37+1 weeks), an was 28.2 weeks (25+6 to 36+2 weeks) for posterior placenta cases. The fetuses survival rate was 13/17 (one case was still in pregnancy) for at least one twin, and 10/17 for both twins. Both twins survival rates were 5/10, 5/7 for anterior placenta cases and posterior placenta cases, respectively. At least one twin survival rates were 8/10, 5/7 for the two groups respectively. Conclusion SLCPV is suitable for the treatment of TTTS, no matter the placenta is on the anterior wall or posterior wall. The treatment had good outcomes, but more PPROM happened in the anterior placenta cases, which may be associated with operation time and the range of operation.

Objective To discuss the clinical features and treatment measures on patients with medium volume of supratentorial hypertensive cerebral hemorrhage in the elderly.Methods The clinical data of 57 patients with medium volume of supratentorial hypertensive cerebral hemorrhage aged ≥ 70 years were analyzed retrospectively.Results All of 57 patients,15 cases accepted medical treatment,42 cases were treated with minimally invasive operation for 1-26 (4.6 ± 6.5) h after onset.Three cases died in hospital,7 cases were transferred or gave up,6 cases lived as plant,8 cases were severely maimed,11 cases were moderately maimed,22 cases [38.6％(22/57)] recovered favorably.The main clinical characteristics of elderly patients:long history of hypertension,blood pressure fluctuation; atypical symptoms of increased intracranial pressure; more complications such as arrhythmia and pulmonary infection; most of family members of patients were pessimistic to treatment.Conclusions All factors should be thought over about the treatment of elderly patients with medium volume of hypertensive cerebral hemorrhage.Individual treatment is reasonable.Do not emphasize on early operation,minimally invasive operation can be helpful for patients.

Objective To discuss the methods and outcomes of twin reversed arterial perfusion sequence in different stage. Methods From August 2012 to December 2013, 11 cases were diagnosed with twin reversed arterial perfusion sequence (TRAP) by 3d color Doppler ultrasound in the Maternal ang Fetal Medicine Center ,Affiliated Shengjing Hospital, China Medical University, including 3 cases in stageⅠa, 7 in stageⅡa and 1 case in stageⅡb. We performed expected therapy to 3 cases in stageⅠa and 4 cases in stageⅡa [1 case (case 9) in stageⅡa developed to stageⅡb and was terminated by emergency cesarean section], radio frequency ablation (RFA) selective reduction to 3 cases in stage Ⅱa, emergency cesarean section to 1 case in stageⅡb. All cases except case 1,4 took cesarean section to terminate pregnancy and would be followed up on the aspect of infant′s growth. Results (1) 3 cases in stageⅠa were monitored by sequential ultrasound examination, all donors grew normally, in which 2 acardias arised spontaneous cessation of flow and were implemented of cesarean section after the normal period of gestation; 1 case suffered premature rupture of membrane and experienced the natural childbirth at 34 gestation weeks plus 5 days. The survived average labor weight was 2 923 g. (2) In the 7 stage Ⅱa cases, 3 cases were implemented of RFA selective reduction, 2 cases survived and the average labor gestation was 35 weeks plus 1 day and average labor weight was 2 050 g;in 3 expected therapy cases, 1 case suffered premature rupture of membrane at 34 gestation weeks plus 5 days and experienced cesarean section; 1 case was observed for 3 weeks and the donor was stillborn; 1 case progressed to stage Ⅱb and experienced cesarean section at 34 gestation weeks plus 5 days;and 1 case was lost of follow up. (3) For 2 cases of stageⅡb cases, one was progressed from stage Ⅱa during expected therapy; the other one had been already in stage Ⅱb since visiting and experimented an emergency cesarean section, but the neonate died of heart failure two days after labor. (4) 7 survived neonates were followed up, all had a normal condition compared to kids of the same age, except one suffering a congenital heart disease, patent ductus arteriosus and atrial septal defect and whose weight (6 kg at 7 months) was lighter. Conclusions We should make the diagnosis of TRAP as early as soon and choose appropriate therapy according to the stage. According to our research, cases in stage Ⅰa can undergo an expected therapy under a sequential ultrasound examination;cases in stageⅡa can undergo a RFA selective reduction to improve the prognosis of the donor, which can make a good perinatal outcome.