Objective To investigate the clinical values of multiple ultrasound soft markers in screening for fetal chromosomal abnormality during first-trimester.Methods Two thousand seven hundred and eighty-nine nulliparas in Department of Obstetrics,the First Affiliated Hospital of Jinan University during early pregnancy (11-13+6 gestational weeks) were selected for this study.Fetalnuchal translucency (NT),facial angle (FA),ductus venosus (DV),fetal heart rate (FHR),tricuspid reverse (TR),nasal bone (NB) and fetal structures were scanned and measured.Risk calculation software (Astraia) was used to calculate the chromosomal abnormal risk (cut-off line:＞1/300) based on ultrasound records.The chorionic villi or amniotic fluid of high risk patients was collected with informed consent for karyotype analysis (prenatal diagnosis).All patients were followed up until six months after delivery.Chi-square test or Fisher exact test was used to compare the difference.Results One hundred and seven cases were high-risk of trisomy 21 among which 96 cases accepted invasive prenatal diagnosis.Sixteen chromosomal anomaly and six trisomy 21 cases were diagnosed out the 96 fetuses.Among 2789 cases,four were high-risk of trisomy 21 according to ultrasound screening.Six cases were diagnosed as trisomy 21.The false positive rate of ultrasound screening was 3.6％(101/2783).There were 196 cases whose NT ≥2.5 mm,in which 66 cases were high risk of chromosomal abnormality,and 16 fetal chromosomal abnormalities were diagnosed after chorionic villus sampling.The invasive procedure rate was 2.3％ (66/2789).Totally,186 pregnant women were older than 35 years,among which 32 cases were high risk.There was no significantly difference on the of rate fetal chromosomal abnormality between the groups of age≥ 35 pregnant women and the general population (P=0.055).But 29.9％ (32/107) high risk cases were detected in the group of age≥35.Five of thirteen fetal malformations cases were associated with abnormal karyotype.Conclusions Multiple ultrasound soft markers screening during early pregnancy could increase the diagnosis rate of chromosomal abnormality and decrease the false positive rate,false negative rate and invasive procedure rate.Early ultrasound screening might be effective in not only identifying chromosomal abnormality,but also diagnosing severe structure deformity of fetus.

Objective To study the effects of enriched rehabilitative training on the expression of microtu-bule associated protein 2 (MAP-2) and synaptophysin (SYN), and to explore its relationship with brain plasticity. Methods Seventy-seven male Wistar rats weighing 160 to 200 g were randomly divided into an ischemia + enriched rehabilitation group (IE, n=36), an ischemia + standard rehabilitation group(IS, n=8), a sham ischemia + en-riched rehabilitation group (SE, n=21) and a sham ischemia + standard rehabilitation group (SS, n=12). Rats in the ischemia groups had their middle cerebral artery sutured for two hours before reperfusion, while those in the sham groups had a similar operation without occlusion. The enriched groups were given enriched rehabilitative train-ing, while the standard groups were left without any training. Behavioral tests, including the acrobatic performance, were administered once daily 2 days after operation, and SP staining of MAP2 and SYN were used to observe the func-tional recovery and brain plasticity changes among the groups at 1,7, 14, 21 and 28 days after the operations. Re-sults Acrobatic performance times reduced gradually. Bederson scores were significantly better in the IE than in the IS group by the 28th day after the operation). There was no significant difference between IE and IS groups in a foot fault test). The expression of MAP-2 and SYN around the infarct and in the hippocampus decreased significantly at first), then recovered gradually. The expression of MAP-2 and SYN in the IE group was significantly higher than that in the IS group at various time points of observation). Conclusion Enriched rehabilitative training can improve functional recovery and the expression of MAP-2 and SYN after brain ischemia, and the functional enhancement may attribute to the brain plasticity.

Objective To assess the change of left ventricular wall motion at ventricular pacing(VP)by using global circumferential strain (GCS) and segmental circumferential strain of speckle tracking imaging(STI). Methods Seven adult pigs were sedated,followed by median sternotomy and opening of the pericardium. Temporary pacing leads were placed on the right ventricular (RV) epicardium and LV epicardium for RV or LV pacing. A LV short axis view at the mid-level LV was acquired at sinus and VP rhythm. Analysis of circumferential strain by STI was performed offline. The onset of QRS wave was used to characterize the beginning of the cardiac cycle, and the ratio of beginning systolic time, end systolic time and total systolic time to cardiac cycle dyssynchrony was analyzed at sinus and VP rhythm. Results Compared with sinus rhythm,in VP rhythm all of the ratio of the beginning systolic time,end systolic time and total systolic time to cardiac cycle were increased (all P ＜0.05), and the construction of six segments were dyssynchrony,even segmental paradoxical movement. At VP ≥130 beats/min,both LV global and LV segments sometimes showed irregular motion while the EKG remained normal, which included: ( 1 ) multiple construction and diastole in one heart cycle; (2) A large variability of construction amplitude in several consecutive cardiac cycles. Conclusions VP can lead to several kinds of disturbance of left ventricular wall motion, including delay and lengthening of LV systole, dyssynchrony, and irregularity of systole and diastole.

Objective To study the efficacy and safety of CO2 laser microsurgery for early glottis carcinoma.Methods The data of 96 cases of early glottic laryngeal carcinoma treated with CO2 laser microsurgery were retrospectively analyzed.Surgical specimens were conventionally embedded with paraffin and serially sectioned.Sections were stained by using hematoxylin-eosin for pathologic examination.The local control rate was observed after operation.Results Among the 96 specimens,88 surgical margins were negative and 8 were positive.10 patients (10.4 ％) recurrenced followed up for 3 years.The recurrence rates of Tis,T1a,T1b and T2 were 0 (0/10),4.1％ (2/48),25.0 ％ (4/16) and 18.1％ (4/22),respectively,with significant differences among groups (X2 =6.105,P ＜ 0.05).All of 8 cases with positive margin and 2 cases with negative margin were recurrened.The recurrent rate of patients with involvement of the anterior commissure was 30.0 ％ (6/20),which was higher than that of patients with no tumor invasion [5.3 ％ (4/76)] (X2 =9.624,P ＜ 0.01).Conclusions The safe edges can be obtained by CO2 laser microsurgery for early stage of glottis carcinoma,which have advantages in local control rate,vocal function of the larynx and curative effect.

Studies have found that depression is closely related to the hyperactivity of the hypothalamo–pituitary–adrenal (HPA) axis, which is manifested in increases in HPA axis-related hormones CRH, ACTH and CORT contents. Traditional Chinese medical acupuncture can down-regulate HPA axis levels to produce a marked antidepressant effect. However, at present there is no HPA axis mechanism analysis of the antidepressant effect of acupuncture. From two aspects: the relationship between depression and HPA axis, and clinical and animal mechanism studies of the antidepressant effect of acupuncture by regulating the HPA axis, an analysis has been made to provide a more powerful scientific basis and the idea of further in-depth study for clinical acupuncture treatment of depression.

Objective To evaluate the significance of electronic gastroscopy examination combined with miR-21 in the diagnosis of gastric carcinoma.Methods 96 gastroscopy cases in Guangzhou General Hospital of Guangzhou Military Command were adopted from June,2011 to December,2012.The patients received gastric endoscopy examination,and the diseased tissue samples were taken out at the same time.To calculate the diagnosis rate and missed rate with gastroscopy,by comparing the gastroscopy diagnosis with the pathology diagnosis.To evaluate the expression level of miR-21 of the tissue by applying quantitative real time PCR.Results The diagnosis rates of gastric cancer,gastric ulcer,chronic superficial gastritis,gastroesophageal reflux gastritis,chronic atrophic gastritis under gastroscopy were 28.12 ％ (27/96),30.21％ (29/96),18.75 ％ (18/96),10.42 ％ (10/96),12.50 ％ (12/96).The diagnosis rate of gastric cancer was 100.00 ％ and the missed diagnosis rate was 6.90 ％ (2/29),the relative transcript level of miR-21 in the gastric cancer group was 54.41±6.66,which was obviously higher than the gastric ulcer group and the other groups (P ＜ 0.01).Conclusions Electronic gastroscopy is a clinically practical examination method in screening gastric cancer cases,evaluating the expression level of miR-21 in the diseased tissue under gastroscopy can enhance the accuracy of screening gastric cancer.Combining the two methods is useful in the diagnosis of gastric cancer.

Objective:To explore the protective effect of vagus nerve stimulation (VNS) on the prognosis of rats suffering from cardiac arrest/cardiopulmonary resuscitation (CA/CPR) under different treatment timings.Methods:The method of percutaneous epicardial electrical stimulation was used to establish CA model of rat. Fifty-three male SD rats were randomly (random number) divided into the sham group ( n=5), CPR group ( n=12), PRE group ( n=12), POST5 group ( n=12) and POST30 group ( n=12). The sham group did not experience CA/CPR. VNS treatment was started at 30 min before CA (PRE group, n=12), 5 min after recovery of spontaneous circulation (ROSC) (POST5 group, n=12), and 30 min after ROSC (POST30 group, n=12) in different VNS-treated group, respectively. The electrical stimulation was applied to the vagus nerve for 30 min with a unified parameter. The neurological deficit scores at 24, 48, and 72 h after ROSC were recorded, and the survival rate in each group was observed. TUNEL staining was used to detect the apoptosis of cortical area and the expression of α7 nicotinic acetylcholine receptor (α7nAChR) in brain tissue was measured by immunofluorescence at 72 h after ROSC. Variables were compared with one-way analysis of variance, and survival for Kaplan-Meier curves were tested with the log-rank test. A P value less than 0.05 was considered statistically significant. Results:Compared with the CPR group (survival rate 33.33%), both pre-treatment (survival rate 75%) and post-treatment of VNS (POST5 group survival rate 75% and POST30 group survival rate 83.33%) significantly improved the 72 h survival rate after CPR ( P<0.05), mitigated neurological deficits after ROSC, reduced the positive rate of apoptosis neurons, and up-regulated the expression of α7nAChR in cerebral cortex. There was no significant difference among the VNS-treated groups (all P>0.05). Conclusions:Both pre-treatment and post-treatment of VNS can play a protective role in rats after CA/CPR, which may be related to the activation of α7nAChR-mediated anti-inflammatory and anti-apoptosis effects.

Objective To compare dose distribution in gamma knife radiotherapy plan, conformal radiotherapy(CRT)plan and intensity modulated radiotherapy(MRT)plan for patients with small mass in lung, and evaluate their characters. Methods Fourteen patients with small mass in lung participated in the study. Gamma knife radiotherapy plan(plan 1), CRT plan(plan 2)and IMRT plan(plan 3)were made for each mass. The planning target volume(PTV)and the dose include 95% PTV were consistent.Conformal index(CI), homogeneity index(HI), lung V5 ,V10 ,V20 ,V30 and the max dose of esophagus and spinal cord were analyzed. Paired samples t-test was used for comparison between each two plans. Results The CI of the plan 1,2 and 3 were 0. 58,0. 46 and 0. 63, respectively. CI of the plan 1 ＞ that of the plan 2 (t= -3.95,P =0.000),plan 3 ＞ plan 2(t = -6.01 ,P =0.000),plan 1 =plan 3(t =1.64,P =0.116);HI of the plan 1,2 and 3 were 1.66,1.10 and 1.07 respectively. HI of the plan 1 ＞ plan 2 ,plan 1 ＞ plan 3(t= -20.52,21.41 respectively, both P=0. 000),plan 2 = plan 3(t= -1.08,P=0.294). The wholelung V5 ,V10 ,V20 and V30 were 10.0% ,5.6% ,2. 4% and 1.2%, respectively, in plan 1 ;20. 2% ,13. 4%,6. 9% ,3.0%, respectively, in plan 3; and 26. 5%, 18. 0%, 11.4% and 4. 6%, respectively, in plan 2.The V5, V10, V20 and V 30 of the plan 1 ＜ in plan 2(t = 9. 68,8. 41,5. 45,5. 14, all P = 0. 000), the V5,V10,V20 and V30 of the plan 1 ＜ in plan 3(t=7.58,8.95,6. 15,4.78, respectively, all P=0.000),the V5 ,V10, V20andV30 oftheplan2 ＞ inplan3(t =9. 71,5. 91,4. 13,3.91, respectively, allP =0.000).The max dose of esophagus in plan 1 ,2 and 3 were 24.93 ± 21.54, 31.90 ± 18. 75, 29. 19 ± 23.09 Gy,respectively, plan 1 ＜ plan 2(t = -2. 71 ,P=0.013),plan 1 = plan 3(t = - 1.49,P =0. 152),plan 2 =plan 3(t = 1.35, P = 0. 193). The max dose of spinal cord in plan 1,2 and 3 were 12.07 ± 10. 67,17.70 ±11.35 and 8.92 :± 10. 04 Gy, respectively, plan 2 ＞ plan 1 ＞plan 3(t = -2. 38,2. 29,4. 83,P=0. 1027,0.033,0.000);All three plans of each mass meet the needs that the max dose of the esophagus≤60 Gy and the max dose of spinal cord ≤40 Gy. Conclusions The dose of the normal lung was lower, but the HI and the max dose of spinal cord were higher in Gamma knife radiotherapy plan than those in the CRT and the IMRT plan of the small mass in lung.

OBJECTIVEExplore the hygienic status of indoor environment in railway air-conditioned passenger trains.

METHODSWe carried out a hygienic investigation of various air-conditioned passenger trains on total 10 railway lines in Shanghai, Chengtu, Kunming, Harbin, Urumchi and Guangzhou railway bureaus for two years between July, 1997 and Oct., 1999. The monitoring was conducted on difference train cars at different time, different railway status. The control groups were selected in the same condition.

RESULTSThe results of temperature and wind speed in air-conditioned trains both meet with the national standards GB 9673-1996 in summer and winter. The humidity in summer exceeded the national standards. Of different railways the status, the noise in four different cars except dining cars exceeded the national standards. The results of shock demonstrated that all measure up to the standards of ISO 2631/1-85. As to indoor air quality, the concentration of CO in air-conditioned trains in difference seasons(summer, autumn, winter) all met with the national standards, the ratio was 100%. In summer, the concentrations of CO2 in hard seat cars and soft berth car exceeded the national standard with a statistic significance(P < 0.01). In winter, the concentrations of CO2 in soft berth and hard berth cars both exceeded the same standard. The results of inhalable particulate matter(IP) and total count of bacteria all satisfied the standards, meanwhile the natural lighting and artificial illumination in air-conditioned train cars all were superior to that in ordinary trains.

CONCLUSIONHumidity in summer and noise in dining car exceeded the standards, the concentration of CO2 in different cars in summer and winter exceeded the standards in some degrees.

Air Conditioning ; Air Pollution, Indoor ; Carbon Dioxide ; analysis ; Environmental Monitoring ; Humidity ; Motor Vehicles ; standards ; Particulate Matter ; analysis ; Seasons