Objective To explore the clinical significance of prenatal ultrasonic diagnosis of fetal nephrohydrosis and its prognosis.Methods Prenatal ultrasanography was performed on 9526 women at more than 20 weeks gestation,and 162 women whose anteroposterior diameter of the renal pelvis was≥8 mm were included in this study.The grade of fetal nephrohydrosis was classified according to Grignon grading method.The changes in fetal nephrohydrosis were observed regularly until delivery.Results(1)The incidence of fetal encephalic fluid and Grignon grade:there were 162 fetuses with fetal nephrohydrosis among 9526 fetuses,with an incidence of 1.7%.The numbers of fetuses with Grades 1 to 5 were 71,59,7,3 and 22,respectively.(2)The distribution in gestafional weeks of fetal nephrohydrosis:generally,fetal nephrohydrosis was first diagnosed at(33±5)weeks,and the maximum degree of nephrohydrosis was observed at(36±3)weeks.One hundred and ten fetuses with nephrohydrosis recovered during the process of gestation,at about(37±4)weeks.(3)Poor terminations of pregnancy:there were 40(25%)fetuses with poor terminations among totally 162 cases.Among these 40 fetuses,3(27%)were first diagnosed at 20 to 24 weeks within 11 fetuses,6(24%)were first diagnosed at 25 to 28 weeks within 20 fetuses,14(26%)were first diagnosed at 29 to 32 weeks within 53 fetuses,11(23%)were first diagnosed at 33 to 36 weeks within 48 fetuses,and 6(20%)were first diagnosed at 37 to 40 weeks within 30 fetuses,The results demonstrate that high grade of fetal nephrohydrosis according to Grignon grading method indicates a poorer prognosis of the fetus.(4)Follow-up results:there were 122(75%,122/162)live and healthy neonates in total,including 110 neonates whose nephrohydrosis recovered prior to birth and 12 neonates whose nephrohydrosis recovered within 1 week after birth.These neonates all developed well without any urinary sequela within the first 2 years.There were also 20(12%,20/162)hydronephrotic neonates who were still diagnosed as nephrohydrosis within 1 week after birth,including 11 fetuses graded below Grignon grade 3,whose nephrohydrosis recovered 3 to 12 months after birth and who developed well without any urinary symptoms.Conclusions The study demonstrates that hydronephrotic fetuses who are diagnosed at earlier gestational weeka and with higher grading have poore prognosis.The Grignon grading method can be used in the prenatal evaluation of fetal nephrohydrosis to predict the prognosis of the fetus.

Objective To investigate whether scores of epworth sleepiness scale (ESS) assessing daytime sleepiness were associated with sleep apnea syndrome(SAS)combined with cerebral vascular disease and ESS could be used to predict cerebral vascular disease occurrence.Methods A group of 62 SAS combined with transient ischemic attack(TIA), a group of 53 SAS with combined hypertension and the other group of 61 SAS combined without other diseases were monitored by polysomnography(PSG), daytime sleepiness of these SAS patients were assessed by ESS at the same time. Results Compared to SAS combined without other diseases, those SAS combined with TIA and hypertension patients had significant higher scores of ESS,apnea/hypopnea index (AHI) and micro-arousal index(MAI)(all P

Objective To analyze the changing process and development trend of deaths (mortality)in patients with viral hepatitis after the use of the Internet-based National Notifiable Infectious Disease Reporting System.Methods Descriptive statistical and moving average methods were employed to analyze the infectious disease reports released by the Chinese government during 1992-2013,and the changing process and development trend of deaths (mortality)in patients with viral hepatitis in China over the past 10 years were investigated.Re-sults The annual deaths (mortality)in patients with viral hepatitis showed a decreasing trend.The deaths (mortality)from hepatitis B showed a slight declining trend,accounting for a great proportion (over 70%)of the deaths (mortality)from viral hepatitis;the deaths (mortality)from hepatitis C had shown a slight downward trend since 2007;the deaths (mortality)from hepatitis A and unclassified hepati-tis decreased to different extents;the deaths (mortality)from hepatitis E remained at a relatively low level.Conclusion The treatment of viral hepatitis has been gradually improved in China and the public awareness of viral hepatitis keeps increasing.However,much attention still needs to be given to the prevention and treatment of viral hepatitis,especially hepatitis B and C,by the government.

OBJECTIVE To apply a low temperature hydrogen peroxide gas plasma sterilization for the heat intolerant orthopedic instruments.METHODS A comparison of the sterilizing effects of the orthopedic(instruments) was made among the low temperature hydrogen peroxide gas plasma sterilization,the ethylene oxide sterilization and the 2% glutaraldehyte(GTA).RESULTS Twelve hours were spent in the sterilization to the undurable(orthopedic) instruments when the ethylene oxide was used,and 10h were needed using the 2%GTA.but,55 min were enough using the low temperature hydrogen peroxide gas plasma.CONCLUSIONS The low temperature(hydrogen) peroxide gas plasma sterilization is applicable to rapidly sterilizing the heat undurable orthopedic(instruments) characteristically with the high effects,quick speed and convenient.

Objective To investigate the relationship between Hepatitis B patients with different viral loads and immunoglob-ulin A,G,M and complement C3,C4.Methods Firstly,followed by real-time fluorescence quantitative PCR detection 210 cases of hepatitis B patients with HBV-DNA levels,according to 10n copies/ml different viral load detection results,it was divided into 102 ~108 copies/ml of the experimental groups.Then the experimental groups and control group were simulta-neously detected in immunoglobulin A,G,M and complement C3,C4.Analysed the correlation between HBV loads and im-munoglobulin A,G,M and complement C3,C4.Results When the viral loads of hepatitis B patients were 105 ~108 copies/ml,the testing results of IgA,IgG and IgM were both increasing (U =12.43,10.96,6.42,P <0.01),while C3 and C4 were both decreasing (U =8.37,6.0,P <0.01).When the viral loads of hepatitis B patients were 102 ~ 104 copies/ml,only IgA and IgM were increasing (U =2.36,2.04,P <0.05),the other testing results had no statistical significance.Between the test of 7 experimental groups compared with each other,only 104 group and 105 group had significantly changed (IgA and IgM were increasing,C4 was decreasing,U =2.39,2.46,2.09,P <0.05,IgG was increasing,U = 3.25,P <0.01),but between other low viral loads or high viral loads were not significantly differences.Conclusion The different viral loads of hepatitis B patients could cause the different changes of immunoglobulin A,G,M and complement C3,C4,especially in the 4 groups from 105 to 108 copies/ml.Followed by increasing in viral loads,there were immunoglobulin A,G,M increasing and comple-ment C3,C4 decreasing,and also serious impaction on the immune function of organism.There was a positive correlation be-tween viral loads in vivo and immune damages,correlation coefficient (γ =0.967,P <0.01).When the viral loads from 104 to 105 copies/ml,the testing results had changed significantly.It suggest that should control viral loads under 104 copies/ml in the hepatitis B antiviral treatment,so the effect of immune function damage will be the minimum.

Objective To explore the dynamic changes of D-dimers during pregnancy and early puerperium (within 3 days postpartum). Methods A retrospective study was performed among 8 367 healthy women who had term singleton delivery in Women′s Hospital, School of Medicine, Zhejiang University from January 2007 to December 2014. D-dimers concentrations during pregnancy and early puerprium of all the cases were collected. Data of 21 065 D-dimers tests were assigned to 5 groups according to the time of sampling, including early pregnancy (≤12 gestation weeks), middle pregnancy (12-28 gestation weeks), late pregnancy (>28 gestation weeks), 1 postpartum (within 48 hours postpartum) and 2 postpartum (48-72 hours postpartum). The D-dimers concentrations in different groups were compared. The effect of delivery mode on D-dimers of early pureperium was analyzed. The correlation between D-dimers and the thromboembolic disease was also explored. In this study, Student′s t-test and Wilcoxon rank sum test were used for statistical analysis. D-dimers concentration≤0.5 mg/L was used as the normal range. Results (1) D-dimers concentrations during pregnancy were higher than the non-pregnant women (P<0.01), but there was no statistical difference between early pregnancy and late pregnancy (P=0.820). D-dimers concentration in the 1 postpartum group was higher than that of early pregnancy group or late pregnancy group (P<0.01). But in the 2 postpartum group, it was lower than early pregnancy, late pregnancy and 1 postpartum groups. (2)D-dimers in cesarean section cases was significantly higher than in vaginal delivery cases in each period of pregnancy and early pueprium.(3)The 95%CI of D-dimers in early pregnancy, late pregnancy, 48 hours after vaginal delivery, 48-72 hours after vaginal delivery, ≤48 hours after cesarean section, 48-72 hours after cesarean section were 0.58-8.28, 0.47-11.52, 1.04-9.59, 0.87-5.22, 1.07-11.58 and 1.00-6.23 mg/L, respectively.(4)In 6 cases with thromboembolic disease, D-dimers was 6.89-19.89 mg/L, with the mean value of 13.66 mg/L. It was significantly higher than normal range. In 3 cases, all after cesarean section, with lower extremity vein thrombosis within 48 hours postpartum, the D-dimers concentrations, 9.77, 8.65 and 6.89 mg/L respectively, were in the 95%CI of the study population after cesarean section. Conclusions D-dimers concentration of 0.5 mg/L is not suitable for venous thromboembolism screening during pregnancy. D-dimers concentration in pregnancy and early puerprium is higher than non-pregnancy. It increases in the very early period postpartum and decreases with time. D-dimers should not be a routine screening test to exclude thromboembolic disease in pregnant women without high risk factors and clinical manifestation of thromboembolic disease.

Objective To study the effctiveness and safety of arsenic trioxide(As2O3)combined with Homoharringtoninum in the chronic myelocytic leukmia-chonic phase(CML-CP).Methods Seven patients were treated with As2O3 10mg per day for 2~3 week and with Homoharringtoninum 3~4mg per day for 1~2.Results All patients were clinic remission,of which there were 4 complete remission who were all initial therapy,and 3 partial remission,2 of who were initial therapy and 1 was resume threapy.4 patients of CR were treated with second strengthen therapy and continued hematologic CR.The main side effects were grade 3 hematologic toxicity and light liver damage,and no significant nausea,emesis,diarrhea or mucositis.Conclusion As2O3 combined with Homoharringtonium in the CML-CP is a safe and effctive regimen.

Objective To evaluate the significance of platelet activation and the expression of inter-leukin (IL)-1β in patients with RA. Methods The activation of platelets and the expression of IL-1β in pla-telets in 50 RA patients(22 high-active, 28 mediate/low active ) and 30 normal controls were determined us-ing flow cytometry. Meanwhile, inflammatory indicators such as erythrocyte sedimentation(ESR), C-reactive protein (CRP) and DAS28 were also recorded. T test and correlation analysis were performed. Results The platelet activation in RA group(19.2±4.8) was higher than the control group(9.0±2.9)(t=10.5, P=0.001). The expression of IL-1β in platelets in RA group(41±11) was higher than control group(21±8)(t=9.01, P =0.000) .The platelet activation in high-active RA group(22 ±4) was higher than mediate/low active RA group(17 ±4)(t =3.96,P =0.001). The expression of IL-1β in platelets in high-active RA group(45 ±10) was higher than mediate/low active RA group (38 ±10)(t =2.329,P =0.024). The expression of IL-1β in platelets in RA group was positively correlated with the level of ESR、CRP and DAS28 (r value and P value were 0.576, 0.578, 0.618 and 0.000, 0.000, 0.000 respectively). Conclusion The platelets of patients with RA are activated and may suggest that IL-1β, which may associate with disease activity. Our research suggest that platelet may play a role in the inflammatory process of RA by secreting IL-1β.

Objective To evaluate the role of calpain in sevoflurane anesthesia-induced apoptosis in hippocampal neurons of aged rats.Methods Fifty-four healthy female Sprague-Dawley rats,aged 18 months,weighing 450-550 g,were randomly divided into 3 groups (n=12 each) using a random number table:control group (group C),sevoflurane group (Sev group) and calpain inhibitor M DL28170 group (group M).In group C,the rats inhaled 50％ O2-50％N2 for 3 h.In Sev group,the rats inhaled 3％ sevoflurane for 3 h.In group M,MDL28170 10 mg/kg was injected via the tail vein,30 min later 3％ sevoflurane was inhaled for 3 h,and MDL28170 was simultaneously infused at 3.33 mg · kg 1 · h-1 via the tail vein.Nine rats in each group were selected,and cognitive function was assessed by using Morris water maze test at 30 min before anesthesia and 1-5 days after anesthesia.The escape latency and frequency of crossing the original platform were recorded.After the end of Morris water maze test performed at 30 min before anesthesia and 1-5 days after anesthesia,3 rats in each group were sacrificed,and hippocampal tissues were obtained for detection of cell apoptosis (by flow cytometry) and intracellular [Ca2+] i.Apoptotic rate was calculated.Results Compared with group C,the escape latency was significantly prolonged,and the frequency of crossing the original platform was decreased,and the apoptotic rate and intracellular [Ca2+]i were increased at 1 day after anesthesia in Sev and M groups.Compared with group Sev,the escape latency was significantly shortened,the frequency of crossing the original platform was increased,and the apoptotic rate was decreased at 1 day after anesthesia,and no significant change was found in intracellular [Ca2+]i in group M.Conclusion Calpain activation is involved in sevoflurane anesthesia-induced apoptosis in hippocampal neurons of aged rats.

BACKGROUND:It is important to establish an ideal mouse model of severe aplastic anemia for investigating the mechanism and finding new therapies for aplastic anemia. OBJECTIVE:To establish a severe aplastic anemia mouse model by using recombinant human interferon-γand busulfan. METHODS:Sixty healthy Kunming female mice were randomly divided into two groups:model group (n=50) and control group (n=10). The model group was given recombinant human interferon-γat a dose of 1×104 U/d by intraperitoneal injection and busulfan at a dose of 18 mg/(kg·d) through stomach feeding for 7 days. The same volume of physiological saline was given to control group. Multi-parameters, including general condition, body weight, blood cellcount, morphology and biopsy of bone marrow were analyzed in two groups. RESULTS AND CONCLUSION:At day 7 after treatment, the weight, white blood cellcount, hemoglobin, blood platelet, reticulocyte count in model group were significantly lower than control group (P<0.05). Bone marrow smears and biopsy of model group showed marked reduction of bone marrow proliferation and increases of percentages of non-hematopoietic cellclusters and adipose tissue. The oil drop and fat vacuole were apparently seen in the model group. Severe aplastic anemia mouse model can be established by using recombinant human interferon-γand busulfan successful y, which is economic, stable and easy to operate.