Objective:To estimate the organ doses and effective doses to different-age children during cardiovascular interventional radiological procedures under some specific exposure conditions, and explore the main influencing factors on the doses.Methods:Based on the paediatric reference computational phantoms recommended in the ICRP Publication 143, several specific exposure models of cardiovascular intervention were built, and the Monte Carlocook MCNPX 2.7.0, was used to calculate the organ doses and effective doses for 1-, 5-, 10- and 15-year-old children. To validate the simulation result , an experiment was implemented by putting the thermoluminescent dosimeters in a 5-y old phantom (ATOM 705-D) manufactured by the CIRS Inc. in the USA.Results:Both the height and weight of the reference children for 1-, 5- and 10-year-old provided for by Chinese national standards are nearly in consistency with those recommended by ICRP, and even for the 15-year-old, the maximum relative deviations of the height and weight are only -1.9% and -5.7%, respectively. Under the exposure condition where the focal spot to image receptor distance (SID) was 90 cm, the length of square field of view (FOV) was 30 cm with a dose area product (DAP) of 45 Gy·cm 2, the relative deviations between simulated and measured doses to main organs/tissues within the irradiation filed were within ±6.7%. Under the same exposure conditions, the younger the children, the larger the organ doses and effective doses, and the effective doses could vary by a factor of about 5 among the 4 age groups. The conversion coefficient between the organ dose and the value of DAP was not only closely related to the age of children, but also affected by the FOV. Conclusions:In combination with the paediatric reference computational phantoms and the exposure models of cardiovascular intervention, the Monte Carlo method can be used to calculate the doses to children undergoing cardiovascular interventional radiological procedures. The information on the values of DAP and FOV as well as the directions of projection are needed for more accurate estimation of the exposure doses.

Objective To explore the relationship between periodontal disease and preeclampsia and the effects of periodontal treatment on preeclampsia.Methods China National Knowledge Infrastructure,Chinese Biomedical Literature Database,WANGFANG DATA,China Dissertation Full-Text Database,China Proceedings of Conference Full-Text Database,Cochrane Library,PubMed,EMbase,Elsevier,Springer,and Science Direct OnSite were extracted from inception till September 30,2014.The case-control,cohort and randomized controlled trials about the association of matemal periodontal disease and preeclampsia were searched according to the inclusion and exclusion criteria.RevMan5.1 and Stata12.0 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 Twenty studies (15 case-control and 5 cohort) involving 8 775 women assessed the association between periodontal disease and preeclampsia.A positive association was found (OR=2.48,95％CI:1.76-3.48,P ＜ 0.01).Meta-analysis of the case-control studies showed more than twice in the odds of preeclampsia with the presence of periodontal disease (OR=2.75,95％CI:1.93-3.92,P ＜ 0.01).Meta-analysis of cohort studies did not reveal any significant differences (OR=1.84,95％CI:0.91-3.74,P ＞ 0.05).Four randomized controlled trials with 3 712 women evaluated the effect of periodontal treatment on preeclampsia,and meta-analysis showed no relative risk reduction in preeclampsia with periodontal treatment (RR=1.04,95％CI:0.84-1.30,P ＞ 0.05).Conclusions Periodontal disease appears to be a possible risk factor for preeclampsia,but treatment during pregnancy does not prevent preeclampsia.High-quality prospective studies are needed to confirm the relationship between periodontal disease and preeclampsia.

BACKGROUND:Knee joint function limitation often occurs after internal fixation of complex femoral condyle fractures, but the mechanism and its influencing factors are also unclear.
OBJECTIVE:To screen and analyze the relevant factors of knee joint function limitation after internal fixation of complex femoral condyle fractures.
METHODS:We retrospectively summarized postoperative fol ow-up data of 6 and 12 months from 121 patients with complex femoral condyle fractures. Knee joint function recovery was evaluated according to Merchan criteria. A multiple stepwise regression analysis was carried out in terms of gender, age, causes, concomitant injuries, skin and soft tissue injury, fracture type, fixed method, operation time, postoperative plaster fixed situation, healing of postoperative incision, bone healing and postoperative functional exercises, to summarize the relevant influencing factors for knee joint function limitation.
RESULTS AND CONCLUSION:Whether the knee joint function after internal fixation was limited acted as the dependent variable Y, and factors with statistical significance of the single factor analysis served as the independent variable X. We used the multiple stepwise regression analysis for multiple factors analysis. Results showed that the gender of patients (X1), with or without concomitant injuries (X3), soft tissue damage (X4) and operation time (X6), a total of four factors, could not be introduced into the model, suggesting that these four factors had no significant correlation with postoperative knee joint function limitation. Another eight factors could be introduced into the factor analysis model, showing that the cause of injury (X2), fracture type (X5), the choice of internal fixation (X7), with or without bone graft (X8), with or without postoperative plaster cast (X9), postoperative knee joint functional exercise or not (X10) and postoperative wound healing (X11), the degree of postoperative bone healing (X12) are closely related to postoperative knee joint function limitation in complex femoral condyles fractures.

Objective To discuss protein marks expressed differentially in placenta of Down's syndrome by means of proteomics. Methods We collected placenta of 18 patients(from March 2009 to December 2009 at Beijing Obstetrics and Gynecology Hospital), and divided them into two groups, one was 10 patients with fetal Down's syndrome, the other was normal pregnancies (normal chromosome) with other diseases. We separated proteins expressed in placentas of two groups by two-dimensional difference gel electrophoresis (2D-DIGE), and then analyzed the differential protein spots by software Decyder 6. 5, then,spots differentially expressed by 1.5 fold or more were analyzed by matrix assisted laser desorption ionizationtime of flight-mass spectrometry (MALDI-TOF-MS). In the end, the differential expressional levels of partially identified proteins were validated by western blot analysis. Results (1) Differential proteins of two groups protein spots of placentas separated by 2D-DIGE were analyzed by software Decyder 6. 5 (these colored lights scattered in the image were protein spots), a total of 56 spots out of 352 were differentially expressed (P<0. 05) in two groups. We analyzed 17 protein spots(12 protein spots were over-expressed and 5 protein spots were down-expressed) differentially expressed by 1.5 fold or more by MALDI-TOF-MS.(2) Protein matching after searching protein database, 17 protein spots turn out to be 10 proteins. Four kinds [superoxide dismutase 1 (SOD1), peroxiredoxin 6 (PRDX6), heat shock protein 27 (HSP27),endoplasmic reticulum protein 29 (ERP29)] of them were validated by western blot analysis, the group of fetal Down's syndrome were 0.74 ±0. 12,0.29 ±0. 10,0.53 ±0. 16,0.20 ±0. 09,the group of normal pregnancies were 0. 51 ±0. 08,0. 34 ± 0. 16,0. 18 ± 0. 07,0. 35 ± 0. 09, the results confirmed the observed changes in proteomics. Conclusions Compared with normal pregnancies, there were differential proteins expressed in placenta of Down's syndrome. This approach might provide new screening markers in use for prediction of Down's syndrome, however, further study should be done to make these 4 proteins (SOD1,HSP27, ERP29, PRDX6) be new screening markers.

Objective To explore the association between maternal age and perinatal outcomes.Methods Totally,3 151 women with advanced maternal age and 6 098 women younger than 35 years old who delivered in Beijing Obstetrics and Gynecology Hospital in 2016 were recruited.Their clinic characteristics and perinatal outcomes were collected to divide into 3 groups based on delivery age,Group 1 (aged 35-39 years,2 683 cases),Group 2 (aged ≥40 years,366 cases) and the control group (aged＜35 years,6 098 cases).The association between maternal age and adverse perinatal outcomes were analyzed,including hypertensive disorder complicating pregnancy,gestational diabetes mellitus (GDM),preterm birth and postpartum hemorrhage.Results The rate of cesarean section history (27.39％,33.61％,5.53％) or previous myomectomy history (2.80％,5.46％,0.72％) were compared between the advanced maternal age groups and the control group,and the differences were statistically significant (P＜0.05).The percentage of prepregnancy overweight and obesity (29.67％,27.05％,18.47％),complicated with myoma (14.83％,19.95％,5.64％) were compared among the three groups,and the differences were statistically significant (P＜ 0.05).The percentage of pregnancy through assisted reproductive technology (9.84％,15.03％,3.12％) also had statistically significant differences (P＜0.05).The incidence of fetal chromosomal abnormalities (1.23％,3.01％,0.36％) and fetal malformations (1.94％,4.37％,0.48％) increased with the maternal age,with statistically significant differences (P＜0.01).The mobidity of hypertensive disorders (9.84％,13.11％,9.23％),pregestational diabetes mellitus (1.83％,2.19％,0.72％),gestational diabetes mellitus (22.70％,28.42％,14.87％),premature rupture of membranes (25.57％,19.40％,31.42％),placenta previa (2.05％,2.46％,0.92％),preterm birth(8.35％,11.20％,5.51％),postpartum hemorrhage (25.11％,18.31％,20.27％)and forceps delivery (5.42％,2.33％,5.71％) were compared,and the differences were statistically significant (P＜0.05).The cesarean section rate in primipara (45.42％,75.74％,21.33％) and multipara (51.46％,61.54％,30.95％) had statistically significant difference (P＜0.05).The proportion of macrosomia (10.80％,8.85％,7.96％) and neonates transferred into neonatal ICU (9.63％,11.48％,5.21％) in term neonates had statistically significant difference (P＜0.05).Conclusions Women with advanced maternal age increase after new family planning policy put into effect,so do the risk of adverse perinatal outcomes.Attention and interventions should be made to cope with the occurrence of adverse perinatal outcomes.

Objective To investigate the antimicrobial resistance mechanisms and genetic homogeny of Salmonella from community acquired infections in Shenzhen,China.Methods Ninety-three of Salmonella were isolated from 2002 to 2007 at Shenzhen People's Hospital,China.PCR and DNA sequencing were used to investigate the mutation in QRDR of the gyrA,gyrB,parC and parE.Plasmid mediated quinolone resistance genes including qnr and aac(6')-Ib-cr,β-lactamase genes including blaTEM,blaSHV,blaOXA, blaCTX-M, and class 1 integron were detected. All isolates were typed by PFGE. Results S. enterica typhi and S. enterica paratyphi A were susceptible to ampicillin, chloramphenicol, trimethoprim/sulfamethoxazole, ceftriaxone and ciprofloxacin, with the susceptible rate of 96%-100%. Fifty-two percent (13/25) of S. enterica typhi and 95% (61/64) of S. enterica paratyphi A were resistant to nalidixic acid. Twenty-four percent (6/25) of nalidixic acid-resistant S. enterica typhi and 94% (60/64) of nalidixic acid-resistant S. enterica paratyphi A showed decreased susceptibility to ciprofloxacin (MIC of 0. 125-1 μg/ml).All nalidixic acid-resistant (susceptible to ciprofloxacin ) Salmonella (NARS) isolates had a single substitution in the QRDR of GyrA, and 91% (68/75) of these isolates carried the substitution Ser83Phe in GyrA. Two mutations in the QRDR of GyrA were detected in both of two ciprnfloxacin-resistant Salmonella,with the additional one mutation in the QRDR of parC. Plasmid mediated quinolone resistance genes including qnr and aac(6')-lb-cr were not detected in any isolate. The blaCTX-M-14 gene was detected in a ceftriaxoneresistant isolate of S. enterica paratyphi A, with ISEcpl located on the upstream of it. Three muhidrugresistant strains of Salmonella all carried one 1 900 bp classⅠ integron gene cassette dhfrⅫ-orfF-aadA2,with the additional one β-lactamase gene of blaTEM-1, or blaOXA-30. Twenty-two distinct PFGE patterns were observed among twenty-five S. enterica typhi. The PFGE patterns of sixty-four S. enterica paratyphi A showed limited genetic diversity (average similarity of 91% ). Ninety investigated inpatients were infected in the community. Six patients infected by S. enterica paratyphi A had a travel history before infection. Conclusions Nalidixic acid-resistant S. enterica typhi and S. enterica paratyphi A are highly prevalent in Shenzhen,China. The mutation in the QRDR of GyrA is the prevalent mechanism responsible for the resistance to nalidixic acid in Slmonella. The great genetic similarity among S. enterica paratyphi A isolates indicates endemic disease from the presence of a single clone over 6-year period.

Objective To evaluate the safety and clinical efficacy of CT-guided 125I seeds interstitial implantation in treating the refractory liver cancers that show poor response to commonly used therapies. Methods A total of 40 patients with refractory clinically or pathologically-proved liver cancer were enrolled in this study, the diseases included primary liver cancer (n = 27, with coexisting portal vein cancerous thrombus in 2) and metastatic liver cancer (n = 13). CT-guided 125I seeds interstitial implantation was performed in all patients. Preoperative plan of seeds implantation protocol was formulated by using the treatment plan system (TPS); the 125I seed activity was 0.6 -0.8 mCi and the peripheral matching dose (MPD) was 100 -140 Gy. The procedure of 125I seeds interstitial implantation was performed under local anesthesia in all patients. By using percutaneous trans-hepatic puncturing and single-or multiple-needle technique, the 125I seeds were implanted along a line parallel to the long axis of the tumor and/or tumorous thrombus with an interval of 0.5 -1.0 cm. The short-term efficacy was evaluated by modified response evaluation criteria in solid tumors (mRECIST), and the median time to tumor progression (mTTP) and the median overall survival time (mOS) were calculated by Kaplan and Meier method. Results The technical success rate was 100%. The diameter of the tumor was 1.5 -12.0 cm (mean 4.0 cm), and a total of 1 748 125I seeds were implanted in 40 patients (mean 44 seeds per patient). The short-term effective rate was 37.5%(n = 15), including complete remission in 8 cases and partial remission in 7 cases, the stable disease was seen in 15 cases (37.5%), and the disease control rate was 75%. The mTTP was 7.0 months (95%CI:4.524-9.476 months), while mOS was 10 months (95%CI: 6.901 -13.099 months). The procedure-related adverse reactions included small amount of subcapsular hemorrhage (n =2, 5%), intrahepatic migration of 125I seeds (n=2, 5%), pain at liver area (n=1, 2.5%); and no special treatment was needed in these patients. One patient developed high fever with chills 3 hours after the procedure, which was relieved after symptomatic and antipyretic treatment. Conclusion For the treatment of refractory liver cancers, CT-guided 125I seeds permanent interstitial implantation, used as a remedial therapy, is safe and effective. This technique is worth popularizing in clinical practice.

Objective To compare the quality of life ( QOL) in different family life cycle residents and analyze its influencing factors. Methods Based on the stratified cluster sampling,517 married residents from three communities of Dongguan city were chosen to be investigated by a questionnaire on the general status and the MOS health survey (SF-36).The One-Way ANOVA and Multiple Regression Analysis were used to analyze the data. Result There were significant differences on the seven domains of the SF-36 ex-cept of physical pain in different family life cycle residents (P<0.05) . The scores of different domains at the retirement or senior years were the lowest ( ranging from 37.10-59.81) ,and the scores of different domains at the child-bearing period were highest (ranging from 37.10-59.81). The results of Multiple Linear Stepwise Regression showed that the QOL of different family life cycle residents were influenced by some factors. The influencing factors on PCS at the child-bearing period were income (β=1.51) and life events (β=-6.13), while that at the period of families with adolescents were economic income (β=1.81) and age (β=-0.65);that at the period of empty nest were economic income (β=-3.64) and age (β=-0.65);and that at the re-tirement or senior years were unhealthy living habit (β=-15.06),age (β=-0.56) and income (β=3.06). The influencing factors on MCS at the child-bearing period was medical insurance (β=5.86),while that at the period of families with adolescents were medical insurance (β=6.28),education (β=2.32),life events (β=-4.68) and occupation (β=-5.53);that at the period of the empty nest were age (β=-0.61) ,gender (β=-10.35) and chronic disease (β=-8.35);that at the retirement or senior years were age (β=-0.27) , economic income (β=2.55) and unhealthy living habit (β=-6.95) . Conclusion The influencing factors of QOL for different family cycle residents are not conformity with each other. It suggested that in order to im-prove the QOL of residents, the community health service including health education and health promotion should be based on different family life cycle.

Objective To investigate the efficacy and safety of CT-guided radiofrequency ablation (RFA) in treating lung tumors. Methods A total of 33 patients with lung cancer (35 lesions in total), who were admitted to authors’ hospital during the period from May 2007 to August 2013 to receive treatment, were enrolled in this study. RFA was carried out in all patients. After RFA the patients were followed up regularly (once every 3 months) to evaluate the therapeutic efficacy and the adverse reaction. The deadline for the following-up was November 2013, or to the time when tumor progression occurred. Results Of the total 34 lesions in 32 patients who had received RFA and had complete follow-up data, the one-year local control rate was 85.3%. The average one-year progression-free survival rate was 75.0%, among them 15 cases with primary lung cancer had a mean one-year progression-free survival rate of 80.0% and 17 cases with metastatic lung cancer had a mean one-year progression-free survival rate of 70.6%. The overall median progression-free survival (PFS) was(18.0±1.3) months. No obvious correlation existed between PFS and age, sex, tumor size, pathological type, clinical stage (P<0.05). The main adverse reactions of RFA were pain, hydrothorax and pneumothorax; no serious life-threatening complications occurred. Conclusion RFA is a safe, effective and minimally-invasive treatment for lung cancer, regardless of early stage or late stage of the tumor.

Objective To investigate the influencing factors of low birth weight infants (LBWI) in China in order to provide evidence for lowering the incidence of LBWI and improving the perinatal outcomes.Methods Clinical data were obtained from 14 different provinces, municipalities or autonomous regions in Northeastern, Northwestern, Northern, Central, Eastern, Southern and Southwestern of China, covering 39 hospitals of different levels.A total of 112 441 newborns were collected from January 1 to December 31 in 2011.After exclusion of those cases with incomplete information, miscarriage before 28 weeks of gestation, induction due to fetal malformation or intrauterine fetal death, 103 678 cases were restrospectively analyzed.Questionnaires were filled out and all data were recorded in computer network databases.Clinical data included maternal age, education background, height, weight, parity, histories of abnormal pregancy and comorbidities and complication.Independent sample t-test, Chi-square test, unvariate and ultivariate unconditional Logistics regression analysis were performed.Results The incidence of LBWI in mainland China was 7.21％ (7 474/103 678), 61.43％ (5 260/8 562) for preterm babies, and 2.33％ (2 214/95 116) for full-term babies.Univariate analysis showed that LBWI were associated with maternal age, education background, height, pregestational body mass index (BMI), weight gain during pregnancy, cord length, smoking, parity, histories of abnormal pregancy, gestational diabetes mellitus (GDM), preterm birth, hypertensive disorders in pregnancy, anemia, premature rupture of membranes and abnormal amniotic fluid volume.The following unconditional binary logistic regression analysis for those factors with P ＜ 0.3 in unvariate analysis showed that preterm birth (OR=46.246, 95％CI: 41.484-51.555), hypertensive disorders during pregnancy (OR=5.031, 95％CI: 4.325-5.853), histories of intrauterine fetal death ≥ 1 times (OR=2.446, 95％CI: 1.479-4.044), oligohydramnios (OR=2.068, 95％CI:1.659-2.578), pregestational BMI ＜ 18.5 (OR=1.637, 95％CI: 1.415-1.893), spontaneous abortion ≥ 1 times (OR=1.362, 95％CI: 1.043-1.777), age ≤ 20 (OR=1.332, 95％CI: 1.046 1.695), anemia (OR=1.230, 95％CI: 1.017-1.488) and premature rupture of membranes (OR=1.154, 95％CI:1.016-1.311) were risk factors for LBWI.The higher the maternal education level, weight gain, BMI and height, the lower the LBWI incidence.The risk factors of LBWI in premature small for gestational age (SGA) infants were hypertensive disorders during pregnancy and histories of intrauterine fetal death ≥ 1 times.The higher the maternal height and weight gain during pregnancy, the lower the incidence of LBWI in premature SGA infants.Conclusions The main influencing factors for LBWI are preterm birth and hypertensive disorders during pregnancy.In addition, LBWI is also associated with socioeconomic and genetic factors.