Anti-müllerian hormone (AMH) is mainly produced by the granulose cells of the developing preantral and antral follicles in women and a reliable marker of the reproductive function of women.The mean terminal t1/2 of AMH is calculated as (27.6 ± 0.8) h.Serum concentration of AMH declines by 5.6％ per year and several reproductive and lifestyle factors are associated with age-specific AMH levels.AMH can be applied to predict the precise age of the menopause and is a marker of ovarian reserve in women of 25 year old and older.Iu the field of assisted reproductive technologies,AMH is beneficial in the individualization of stimulation protocols at controlled ovarian hyperstimulation and may be positively associated with clinical pregnancy rates,live-birth rates and twin gestation after assisted reproduction.The researches of AMH may be helpful in the studies of mechanism of polycystic ovary syndrome (PCOS).AMH measurement may be included as a diagnostic criterion of PCOS and a useful predictive marker for the efficiency of the treatment of PCOS.AMH has been also shown to inhibit tumor growth in vitro and in vivo and can be used as a tumor marker in granulosa cell tumors.By using AMH,ovarian reserve damages caused by different kinds of diseases and treatments,including rheumatoid arthritis,laparoscopic surgeries of endometriomas,chemotherapy of female cancers have been studied.Some researchers have begun to pay attention to the potential relationship between AMH and the function of human brain.In the future,the applications of AMH maybe probably do significant contributions to make ideal and individualized treatment programs in more and more related fields.

Objective To establish D-dimer normal reference range in pregnant and postpartum women in Zhejiang Han population.Methods Plasma samples were collected from 669 healthy pregnant women, 578 healthy postpartum women, 8 venous thrombosis or DIC patients and 80 healthy non-pregnant women in Women′s Hospital, School of Medicine, Zhejiang University from March 2009 to August 2010.According to different gestational week, postpartum days and delivery pattern, the healthy pregnant and postpartum women were stratified into 3 groups: (1) ≤13 weeks (n=120), 14-20 weeks (n=120), 21-27 weeks (n=145), 28-34 weeks (n=147), ≥35 weeks (n=137);(2) The first day after vaginal delivery (n=163), the second day after vaginal delivery (n=121);(3) The first day after cesarean sections (n=166), the second day after cesarean sections (n=128). These groups were further stratified based on age: ＜30 years old and ≥30 years old.All blood samples were drawn in citrate sodium anticoagulated blood.D-dimer concentration was determined by STA-R Evolution coagulation analyzer.Since D-dimer concentration showed non-normal distribution, the normal values (one-tailed) were established by using (P95) percentile method.The results of 8 patients were used to validate the established normal values.Results In the group of ＜30 years old, the D-dimer values[M(P25-P75)]in group of ≤13 weeks, 14-20 weeks, 21-27 weeks, 28-34 weeks, ≥35 weeks and healthy non-pregnant women were 0.25(0.17-0.37), 0.51(0.38-0.75), 0.75(0.57-1.10), 1.14(0.80-1.48), 1.60(1.14-1.89) and 0.20(0.10-0.28) mg/L, respectively, which showed statistical difference(H=239.24, P＜0.05).In the group of ≥30 years old, the D-dimer values of the above different groups were 0.28(0.14-0.38), 0.50(0.36-0.65), 0.83(0.59-1.41), 0.93(0.68-1.37), 1.47(1.22-1.84) and 0.17(0.12-0.25) mg/L, respectively, which also showed statistical difference(H=127.75, P＜0.05).In the group of ＜30 years old, the D-dimer values were 2.45(1.51-3.77), 1.30(0.97-1.96), 2.68(1.52-3.74) and 1.55(1.10-2.10) on the first and second day after vaginal delivery and cesarean section, respectively, which showed statistical difference (H=64.85,P＜0.05).In the group of ≥30 years old, the corresponding values were 2.20(1.33-3.54), 1.33(1.02-2.14), 2.27(1.66-3.17) and 1.62(1.26-2.69), respectively, which also showed statistical difference(H=18.64, P＜0.05).D-dimer normal values were established based on different gestational week, postpartum days and delivery pattern.The normal values of ≤13 weeks, 14-20 weeks, 21-27 weeks, 28-34 weeks and ≥35 weeks were ≤0.64 mg/L, ≤1.54 mg/L, ≤2.60 mg/L, ≤3.01 mg/L and ≤3.19 mg/L, respectively. The normal values of 1st day after vaginal delivery, 2nd day after vaginal delivery,1st day after cesarean sections and 2nd day after cesarean sections were ≤7.83 mg/L, ≤3.29 mg/L, ≤9.95 mg/L and ≤3.80 mg/L.All 8 patients showed positive results with the above normal values.Conclusion D-dimer normal values in pregnant and postpartum women in Zhejiang Han population are established, which can improve the application values of D-dimer in the pregnant and postpartum population.

[Objective] To disuse the traumatic mechanism,clinical feature and treatment of the occult osteochondral avulsion of the posterior ankle joint.[Method]The data of 6 patients had been reviewed.From 2003.9 to 2006.6,6 patients had been treated,including 4 male and 2 female,with the average ages of 31.7 years(27~38 years).They all had injury history of their ankle but no fracture or dislocation had been found in X-ray film immediatey after the trauma.Four of them had been treated by plastic cast fixation of their ankle for 3 weeks,2 received treatment without fixation,but all the patients suffered pain and tenderness in the medial-posterior or the lateral-posterior of the ankle with leg or/and food radiation.The symptoms were persistent even when they were rest.The diagnosis of osteochondrl avulsion fracture had not been made until they were admitted in 4 mouth to 1 year after the injury.The fractured bone debris were showed by X-ray film and CT scan.All patients had been treated by operation of ablating the fractured fragment.[Result]All symptoms in the ankle had disappeared 2~3 days after the operation and no recurrence during 6 mouth to 2 years follow up.[Conclusion]It shoud be attaching importance to the occult osteochondral avulsion in early time after ankle injury,and when the diagnosis is made,operation is the appropriate treatment.

Objective To investigate the correlation between carotid artery intima media thickness (IMT) and cerebrovascular hemodynamic analysis (CVA) and the diagnostic value in ischemic stroke.Methods Using colour Doppler IMT,IMT/D ratio and CVA were performed in 120 patients with hyperacute and acute ischemic stroke as compared with the health controls.Results IMT and IMT/D ratio were higher in patients with ischemic stroke than the health aduts. Vmean and Qmean in ischemic stroke hyperacute group were lower, and R,DR were higher obvious in hyperacute group than that of acute group. IMT and IMT/D ratio were negatively correlation with Vmean and Qmean and positively correlation with R and Zc.Conclusion The measurement of carotid artery IMT and CVA have clinical significance in early diagnosis of ischemic stroke.

OBJECTIVE:To evaluate the economic effectiveness of three angiotension-converting enzyme inhibitor(ACEI) in treating patients with essential hypertension.METHODS:186 patients with essential hypertension were randomly divided into three groups receiving enalapril,fosinopril and perindopril respectively.The results were evaluated with pharmacoeconomic analysis.RESULTS:In treatment of hypertension,enalapril was minimal in cost.CONCLUSION:Therapeutic effect will be improved and cost decreased when pharmacoeconomic cost-effectiveness analysis is used.

AIM: There has been accumulating evidence demonstrating that activators for peroxisome proliferator-activated receptor ? (PPAR?) have antiinflammatory, antiatherogenic, and vasodilatory actions. We investigated the effect of PPAR? activator, fenofibrate, on trombin-induced endothelin-1 (ET-1) expression in cultured vascular endothelial cells. METHODS: Bovine aortic endothelial cells (BAECs) were treated with the PPAR? activator, fenofibrate. The ET-1 concentrations were evaluated by radioimmunoassay. Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the ET-1 mRNA expression. RESULTS: Thrombin(10U/L) induced ET-1 release in BAECs [(22.4?4.7) nmol/g protein vs control (13.2?1.6) nmol/g protein, P

The effect of gelatin on anaero-cultivation of Bifidobacterium adolescent is and stabilization of its living cell in dried preparation was investigared. It was shown that the well-distributed mixture of gelatin and medium could have a cushioning effect on pH reduction resulting from acid-production while incubating, and the dried mixture comprising living cell of bifidobacterium adolescentis was prepared, in which the stability and viability of cell come from cultures of gelatin mixture was increased compared with that without gelatin mixture. It was shown that oxygen toxicity to anaerobic cell was well reduced because of cell immobilization by the gel mixure after drying with saccharide substance , and then fermentable dynamics in 50L fermentor was tested as well as the relationship of growth kinetics, pH, dissolved oxygen rate, and content of soluble solids.

AIM:To investigate the role of p38 MAPK/ATF-2 pathway in C-relative protein ( CRP)-induced endothelial cell activation.METHODS:Human coronary artery endothelial cells ( HCAEC) were cultured and were used between passages 3 and 7.CRP served as a stimulus for endothelial cell activation.Western blotting was performed to de-termine the expression and phosphorylation of eNOS, p38 and ATF2.ELISA was carried out to detect the levels of ICAM-1, VCAM-1 and MCP-1 released from HCAEC.Pharmacological p38 inhibitors SB203580 and SB202190 were used to de-termine the effect of p38/ATF-2 pathway.RESULTS:CRP reduced the p-eNOS level in a concentration-dependent man-ner and induced the release of ICAM-1, VCAM-1 and MCP-1.The p38/ATF-2 pathway was activated by CRP treatment. SB203580 and SB202190 partially rescued p-eNOS level and suppressed the secretion of ICAM-1, VCAM-1 and MCP-1. CONCLUSION:p38MAPK/ATF-2 pathway participates in CRP-induced endothelial activation.

Objective To analyze the features of quality management of maternal serum prenatal screening for Down syndrome in the second trimester and investigate the methods to establish and improve quality control system.Methods Prenatal screening and clinical data were collected for statistical analysis from 17 prenatal screening centers in Zhejiang Province from 2011 to 2012.The impacts of maternal age , weight, gestational age , specimen collection , the median values of serum markers selection and different analysis software on prenatal screening results for Down syndrome were analyzed respectively .Results Totally 417 347 and 463 846 prenatal screening cases were collected in 2011 and 2012 respectively.The maternal age of the entire province presented as a Gaussian distribution.The age distributions of different screening institutions were inconsistent , while maternal weight distributions were similar.The approach to determine gestational age was significantly different among screening institutions.Median MoM of the samples from the blood collection points was different from those of the main screening center.Median MoM-freeβ-hCG was positive bias , particularly the specimens from the blood collection points.After strengthening the control of temperature and time during samples transportation , Median MoM-free β-hCG of specimens from blood collection points became nearly equal to those of main screening center .Use of local median made the median MoM value closer to 1.0 in the centers with positive or negtive bias of the markers , which had little effect in detection rate and decreased the false positive rate and screening positive rate.Six more positive cases were detected by the Lifecycle software instead of 2T software in 213 followed-up positive cases, which means the Lifecycle software can improve the detection rate.Conclusions The impact of maternal age, weight, gestational age, specimen collection and other factors on screening performance should be taken into consideration when it evaluates the screening quality of different laboratory .The use of local medians is necessary in prenatal screening.Optimization of screening analysis software can reduce false negative rate.

Histone methyltransferase SMYD3 (SET and MYND domain containing 3) is a protein which has the function of histone methylation found in recent years,it has an important role in transcriptional regulation.The research shows that SMYD3 inhibit apoptosis and promote cell proliferation,invasion and metastasis.More and more data shows SMYD3 highly expressed in liver cancer and is low in normal tissues which is even undetectable.SMYD3 level was significantly associated with prognosis,and gene silencing experiments in SMYD3 tumor cell growth was inhibited.Therefor,SMYD3 is closely related with the development and prognosis of HCC occurrence,which suggests that people can suppress the expression SMYD3 to block tumor cell growth,migration and improve prognosis to provide new goals and direction for the future of cancer treatment.