ObjectiveTo investigate the influence of transverse and longitudinal lower segment caesarean section on the outcome of newborn, postpartum haemorrhage and ratio of complications in placenta previa. MethodsPlacenta previa with lower segment transverse caesarean section( 117 cases) were taken as control group, meanwhile, the lower segment with longitudinal section (142 cases ) as experimental group. Their operational complications, amount of bleeding during and after operation and outcome of the perinatal period were analysed.Results No significant difference in age, parities, gestational weeks, the types of the placenta praevia and the locus of placenta between the two groups were found( P>0.05), while there were significant difference in the amount of bleeding during and after operation, the need of using gauze ribbon to stop bleeding, section splitting and rate of hysterectomy after caesarean section(P<0.01). ConelusionLower segment longitudinal caesarean section in placenta praevia not only shows less bleeding during operation and lower rate of postpartum haemorrhage, but also avoids using gauzes to stop bleeding and causes lower rate of hysterectomy after caesarean section, so it can be the first choice when determining the style of section in placenta praevia.

Objective To compare the clinical effect of small bone flap craniotony and skull drill drainage in treatment of hypertensive cerebral hemorrhage.Methods Ninety -eight patients with hypertensive cerebral hemorrhage were classified into group A and group B by random number table with 49 cases in each.Group A was used small bone flap craniotony,and group B was used skull drill drainage.The clinical effects between two groups were compared.Results The short-term total effective rate in group A was 83.7％(41/49 ),which was significantly higher than that in group B with 65.3％(32/49 )(P ＜ 0.05 ).The long-term good rate in group A was 55.1％(27/49),which was significantly higher than that in group B with 26.5％ (13/49) (P ＜ 0.05 ).Conclusion Both the short-term and long-term effective rate of small bone flap craniotony for hypertensive cerebral hemorrhage are better than skull drill drainage.

Objective: To identify Rehmanniae Radiuxand its closely related species using the ITS2 barcode and to guarantee the quality and clinical curative effect of this medical material. Method: The sequences has been ana-lyzed and assembled using corresponding software. The Kimura 2-Parameter (K2P) distances were calculated and NJ (neighbor-joining) tree was established based on the K2P methods to identify the Rehmanniae Radix. Results:The length of the ITS2 sequence of Rehmanniae Radix was 231 bp. The average intra-specific genetic distances of Rehmanniae Radix were 0.0004. The average inter-specific genetic distances between Rehmanniae Radix and its closely related species were 0.0312. The minimum inter-specific divergence is larger than the maximum intra-specific divergence. The Rehmanniae Radix can be identified using the NJ trees method. Conclusions: The ITS2 sequence can be used as DNA barcode to identify Rehmanniae Radix and its closely related species, which will lay the foundation for the clinical medication safety of Rehmanniae Radix.

Objective · To investigate the effects of insulin on high glucose-cultured humanmononuclear cell line THP-1 and macrophage phenotype transformation in diabetic wounds. Methods · THP-1 cells were cultured with normal (5.6 mmol/L) and high (25 mmol/L) glucose, respectively,stimulated with PMA for differentiation, and induced to M1 macrophages with LPS. After treated with insulin for 6 h, expression changes of M1 type macrophage markers inducible nitric oxide synthase (iNOS), tumor necrosis factor α (TNF-α), and interleukin-1β (IL-1β), as well as M2 type macrophage markers arginase1 (Arg1) and IL-10 were detected using real-time PCR andWestern blotting. High fat diet feeding plus multiple intraperitoneal injections of low dose streptozotocin (STZ) were used to induce type II diabetes rat model. After blood glucose level has been stable for five weeks, two fullthickness skin wounds with the diameter of 1cm were made on the back of DM rats. Wounds were randomly assigned to being treated with insulin (0.2 U insulin /20 μL saline) or saline (20 μL saline) using the random number table. Characteristics of macrophagephenotypes were observed 3, 7, and 25days after wounds were made. Normal rats (n=3) served as controls. Results · After being cultured with high glucose, the mRNA levels of M1 markers iNOS and TNF-α were up-regulated in LPS-induced THP-1 cells, while the mRNA levels of M2 markers Arg1 and IL-10 were down-regulated.Afterbeing treated with insulin for 6 h, mRNA levels of iNOS and TNF-α weredown-regulated, protein levels of iNOS, IL-1β were down-regulated too, while mRNAand protein levels of Arg1 and IL-10 were up-regulated. In addition, the expression level of phosphorylated NF-κB-p65 was significantly increased after high glucose culture and was significantly decreased after insulin intervention. Compared to normal rat skin wounds, the expression of iNOS in macrophages was significantly increased in wounds of diabetic rats. The expression of iNOS in macrophages was high in saline treated wounds 3 and 7 days after the wounds were made and the expression of Arg1 was low 25 days after the wounds were made. In insulin treated wounds, the expression of iNOS started to decrease on day 7 after the wounds were made and the expression of Arg1 was significantly higher than that in saline treated wounds on day 25 after the wounds were made. Conclusion · Insulin can induce macrophage phenotype transformation from M1 to M2 under high glucose condition and the mechanism may be associated with the phosphorylation of NF-κB-p65.

Objective:To investigate the immunomodulatory effect of Astragalus Saponin on macrophages and explore the mechanisms of its immunomodulation.Methods:By adding different concentrations of AS into cultured mice peritoneal macrophages,the influence of AS on synthesis of nitro oxide(NO)was observed by NO Kit(enzymic method).MTT assay was used to determine the cytotoxicity of macrophages induced by AS.The morphological changes of the macrophages were identified by Transmission Electron Microscope.LSCM and specificity fluorescent probe Fluo-3/AM were applied to observe the change of Ca2+ in the macrophages induced by AS.Results:AS could significantly increase NO synthesis,enhance the capacity of mice peritoneal macrophages for cytotoxicity to carcinoma cells.The surface projections of the macrophages were exhibited multiplicating,thickening and extenting via Transmission Electron Microscope.Augmented intracellular Ca2+ in the macrophage was observed by LSCM.Conclusion:AS can enhance the immune functions of macrophages,the increase of intracellular Ca2+ be one of the mechanisms of its immunomodulatory effects.

AIM:To investigate the immunomodulatory effect of astragalus saponin(AS)on macrophages and explore the mechanism of its immunomodulation.METHODS:By adding different concentrations of AS into cultured mouse peritoneal macrophages in vitro,the influence of AS on the synthesis of nitro oxide(NO)was detected by NO kit(enzymatic method).MTT assay was used to determine the cytotoxicity of macrophages induced by AS.The morphological changes of macrophages were observed under transmission electron microscope.LSCM and specificity fluorescent probe Fluo-3/AM were applied to observe the change of Ca2+ in macrophages induced by AS.RESULTS:AS significantly increased NO synthesis,enhanced the effects of mouse peritoneal macrophages on killing carcinoma cells.Cell surface projection exhibited multiplication,becoming thickening and growth longer via transmission electron microscope.Increase in intracellular Ca2+ in macrophages was also observed.CONCLUSION:AS enhances the immune function of macrophages by increasing NO synthesis and enhancing cytotoxicity.The increased intracellular Ca2+ may be the mechanism of immunomodulatory effect of AS.

Objective To investigate the prevalence and features of thyroid nodules in middle and aged patients with type 2 diabetes mellitus(T2DM). Methods High-resolution ultrasonography was used to detect thyroid nodules in 132 cases middle and aged patients with type 2 diabetes and 89 patients without diabetes.The nodule features and its relationships with related indicators in diabetic patients were analyzed. Results The prevalence of thyroid nodules in middle and aged patients with type 2 diabetes was higher than that without diabetes (67.4％ vs. 53.9％,P＜0.05),and most occurred in 50 to 59 age group (66.7％ vs. 42.9％) without dependence on changes in thyroid functions and volumes.In diabetes group,the prevalence of thyroid nodules were 59.5％ in male and 81.3％ in female (P＜0.05),no obvious difference was observed in the size and number of thyroid nodules between male and female,multiple nodules and micronodule (＜ 1.0 cm) had the higher incidences in both sexes.The prevalence of thyroid nodules was increased with aging,but not with diabetes duration and glycosylated hemoglobin (HbAlc) level (x2 =0.797,P=0.372; x2 =1.078,P =0.229). Conclusions It is common that thyroid nodules combined with diabetes in middle and aged patients,thyroid ultrasound screening and regular following-up of patients aged ≥50 years have important clinical significance.

Objective To investigate the necessity of low-intensity anticoagulation standard in patients after heart valve replacement and the rationality of INR in our hospital.Methods 681 eligible candidates were anticoagulated under the current guidelines for postoperative anticoagulation therapy in our hospital(AVR 1.5-2.0,MVR 2.0-2.5,DVR 2.0-2.5,TVR 2.5-3.0).We monitored the patient 's PT regularly and analyzed the occurrence of anticoagulation-related complications,such as bleeding,thrombosis and embolism.Results 602 cases completed the follow-up.During the period of follow-up,66 patients had bleeding tendencies,the incidence of bleeding complications was 10.96％ (66/602).1 1 patients had embolism complications,the incidence of thrombotic complications was 1.83 ％ (11/602).The average of INR was 2.24± 0.68,the mean oral Warfarin dose was(3.12± 1.14) mg/d.Conclusion Our study suggest that the effect of low-intensity anticoagulation after heart valve replacement is reliable.Further more,the current anticoagulation standards of our hospital meet the requirements of postoperative clinical anticoagulant after heart valve replacement in our region.

Objective To observethe clinical efficacy of comprehensive acupuncture treatment in treating primary open-angle glaucoma, and to objectively evaluate the therapeutic efficacy.Method Twenty-eight patients (53 eyes) who received acupuncture treatment were recruited. By adopting a self-control design, the changes of intraocular tension, mean defect (MD) of vision field, mean sensitivity (MS), vision, and score of Quality of Life Scale for Patients with Visual Impairment (QLSPVI) were observed after 3-month acupuncture treatment.ResultThe intraocular tension of the 28 patients declined obviously after the treatment (P<0.01); MD, MS and vision didn't show significant improvements after the treatment (P>0.05); the QLSPVI score dropped significantly after the treatment (P<0.01);the total effective rate was 86.8%; the therapeutic efficacy wasn't correlated with age, disease duration, and treatment duration (P>0.05).Conclusion Acupuncture treatment can effectively reduce the intraocular tension, control the deterioration of MD and MS, maintain the level of vision, and enhance the quality of life of patients with primary open-angle glaucoma; with the same disease duration, the longer the treatment, the better the therapeutic efficacy.

Objective: Reveal the global expression profile of serum exosomal proteins of Crouzon syndrome patients. Methods: We isolated microvesicles from serum of Crouzon children with a C342Y mutation in FGFR2 by ultracentrifugation, which were further characterized by electron microscopy and immunoblotting. The protein profiling in normal subjects and Crouzon patients was systematically compared by iTRAQ proteomic analysis. Results: The result demonstrated that microvesicles were between 30—100 nm in diameter, round shape with cup-like concavity and expressed exosomal marker tumor susceptibility gene (TSG) 101 and flotillin (Flot) 1. We identified a total number of 62 proteins, among which 22 proteins overlap with ExoCarta database and were different between the Crouzon patient and the normal subject. The Ingenuity Pathway Analysis showed that the functions of these proteins are mostly involved in Developmental Disorder, Hereditary Disorder, Skeletal and Muscular Disorders, which are all related to the clinical manifestations of Crouzon syndrome. In addition, the proteins were focused on the network of "Organismal Injury and Abnormalities, Hematological System Development and Function, Cell-To-Cell Signaling and Interaction" . The central protein FN1 was presented as the key protein in the network. Conclusions Our data demonstrated that serum exosomes harbor informative proteins and FN1 was selected as a potential candidate for its role in promoting osteoblast adhesion, proliferation and mineralization.