Objective To compare the fetal and maternal outcomes of labor undergoing epidural block anesthesia with and without using hand-and-knee position in the second stage of labor.Methods A total of 1,158 subjects were included in the study.There were 560 subjects in the study group and 598 cases in the control group.All the subjects were divided into study and control group according to the randomized numbers.Both groups underwent epidural block anesthesia and used the same labor way in stage I and stage 3.In the study group,the hand-and-knee position was used for 15～30 minutes combined with uterine contractions and the delivery was done in the lithotomy position.In the control group,the gradidea took the semi-recumbent position with bent knees and bed elevated 40°,combined with uterine contractions until the delivery was done in the lithotomy position.The labor time of stage1,stage2,stage3 and all abor,labor way,perinaueum,complications and newborns were compared.Results The average time of the second stage labor and all labor in the observation group were significantly shorter than those of the control group (P＜0.05).The labor ways in the observation group was better than that of the control group (P＜0.05).The incidence of postpartum urinary retention in the observation group was significantly lower than that of the control group (P＜0.05).The differences of labor time for stage 1,stage2,perinaueum,blood loss rate,newboms' s tomor and neonatal asphyxia between two groups were not statistically significant (P＞0.05).Conclusions Under continuous epidural block anesthesia,the use of the hands-and-knees position in the second stage of labor can reduce the incidence of operative delivery,shorten the labor process,and reduce maternal complications.The method is worthy of promotion.

Objective To investigate the clinical and biochemical metabolic features of 12 patients with systemic primary carnitine deficiency(CDSP) and to identify the SLC22A5 gene mutation types of the disease. Method The clinical and biochemical data were collected by retrospective analysis. DNA direct sequencing and multiplex ligation dependent probe amplification(MLPA)were applied for SLC22A5 gene analysis. Result Among 12 patients with CDSP, 3 cases had evident infection factors, 6 cases with convulsions, 5 cases manifested liver hypertrophy, 8 cases with hyperammonemia, and 9 cases showed myocardial damage. All CDSP patients were detected biallelic pathogenic mutation in SLC22A5 gene by direct sequencing. The gene types include IVS2+1G>T, c.3G>T(p.Met1Ile), c.760C>T(p.Arg254X), c.1400C>G(p.Ser467Cys), c.844dupc(p.Arg282fs), c.338G>A(p.Cys113Tyr), c.51C>G(p.Phe17Leu), c.659A>T(p.Glu220Val), and c.1365dupC(p.Thr456fs). c.659A>T(p.Glu220Val) and c.1365dupC(p.Thr456fs)are novel mutations. One female patient was maternal CDSP, her child had abnormal newborn screening. The allele frequency of c.760C>T(p.Arg254X) and c.1400C>G(p.Ser467Cys) were 37.5%(9/24)and 29.2%(7/24)respectively. The MLPA test results of all patients were negative. Conclusion The clinical manifestations are complex and various in patients with CDSP. Point and small InDel(insertions/deletions)mutation constitute the major alteration in SLC22A5 gene. c.1400C>G(p.Ser467Cys) might be another prevalence mutation type in Chinese CDSP patient.

NOD/SCID (non-obese diabetic/severe combined immunodeficient) mice are immune deficient mice which are made by backcross of severe combined immunodeficient mice with non-obese diabetic mice strains. NOD/SCID mice are both innate immune deficiencies and lack of T and B lymphocytes. Various tumor cells can be implanted in this kind of mice, the rejection and graft-versus-host disease (GVHD) occur fewer. Therefore, NOD/SCID mice gradually become a useful tool for the study on Experimental Hematology. This paper comprehensively reviews the biological characteristics of NOD/SCID mice, the establishment of human leukemia model, stem cell transplantation, drug research, deficiency and improvement of NOD/SCID mice in application for study.
Animals ; Disease Models, Animal ; Hematology ; methods ; Leukemia ; Mice ; Mice, Inbred NOD ; Mice, SCID ; Models, Animal ; Research ; trends

This study was aimed to investigate the effect of polypeptide extract from scorpion venom (PESV) on PI3K, p-Akt signal protein regulating K562 cell apoptosis and its mechanism. The K562 cells were cultured with PESV for different time, the cell growth curve was determined by MTT method, the levels of PI3K and p-Akt proteins were detected by Western blot. The results showed that as compared with control group, the apoptosis rate of K562 cells treated with PESV increased, the levels of PI3K and p-Akt expression decreased. It is concluded that the PESV inhibits the proliferation and promotes the apoptosis of K562 cells probably through suppressing the expression of PI3K and p-Akt signal proteins.
Apoptosis ; drug effects ; Cell Proliferation ; drug effects ; Humans ; K562 Cells ; Phosphatidylinositol 3-Kinases ; metabolism ; Proto-Oncogene Proteins c-akt ; metabolism ; Scorpion Venoms ; pharmacology ; Signal Transduction ; drug effects

Objective To analyze the epidemic trend of hepatitis B virus (HBV) in 18 minority nationalities in Yunnan Province from 2009 to 2018, so as to explore the ethnic differences in the incidence of HBV in Yunnan Province. Methods Based on the reported incidence data of hepatitis B in China's disease prevention and control information system from 2009 to 2018, descriptive epidemiology method was used to describe and analyze the incidence of hepatitis B in different ethnic groups, and K-means clustering method was used to explore and analyze the annual average incidence of hepatitis B in different ethnic groups. Results From 2009 to 2018, the average incidence of hepatitis B in Yunnan Province was 44.26/100 000, which was much lower than the overall level of China every year; the average incidence of hepatitis B in ethnic groups was 41.27/100 000, slightly lower than the overall level of Yunnan every year. The prevalence of hepatitis B was different in different ethnic groups. The average incidence of Wa was significantly higher than others (95.26/100 000), and Jingpo was the lowest (22.51/100 000). According to the incidence of hepatitis B, different ethnic groups were divided into three categories: high incidence ethnic group, middle incidence ethnic group and low incidence ethnic group. Conclusion There are ethnic differences in the incidence of hepatitis B in Yunnan Province. The incidence of hepatitis B in some ethnic groups is higher than that in the whole country all the year round, which is the key population in the prevention and control of hepatitis B.

Objective To achieve detailed genomic characterization and investigate the antibiotic-resistant mechanisms of plasmid pA1137 carrying the aminoglycoside resistance gene aacC2.Methods Antibiotic-resistant genes were deter-mined by PCR.Conjugation experiments were performed to verify the transferability of plasmid pA 1137.The minimum in-hibitory concentration(MIC)values of bacterial strains were tested with microdilution method.The genetic background, mobile elements and antibiotic resistance mechanisms of pA 1137 were determined using a whole genome sequencing meth-od.Results Both carbapenem-resistant gene blaIMP-8and aminoglycoside-resistant genes aacC2 and aacA4 were carried by A1137 isolated from Enterobacter cloacae(ECL).aacC2 was located in plasmid pA1137 while the other two resistant genes were observed in chromosomes.Plasmid pA1137 was an IncFⅡplasmid,whose total length was 68.97 kb,and GenBank accession number was MF190369.Plasmid pA1137 contained multiple replicons and intact conjugative transfer regions,so it could be transferred into ECL through conjugation experiments and confer corresponding antibiotic resistance to the transconjugant A1137-EC600.Conclusion IncFⅡ plasmid pA1137 has a single accessory region, the first reported Tn5403-based aacC2-tmrB-related region,which can cause stable inheritance and mediate the resistance to aminoglycoside antibiotics in ECL A1137.

OBJECTIVETo understand the use of lipidemia related assistant examinations and lipid-lowering agents, the clinical ability among physicians in district and community hospitals in Beijing, and to evaluate the capability of dislipidemia diagnosis and treatment in these hospitals.

METHODSA survey was carried out in 42 hospitals in Chaoyang and Haidian district, including 9 district level hospitals, and the rest were at the community level. Questionnaire survey and in-depth interview were used to collect information from the leaders of related departments in those hospitals. A total number of 632 physicians in those hospitals were investigated, using a close book examination.

RESULTS100% of the hospitals could perform TC and TG tests; 87.5% and 72.5% of the hospitals had medications as statins and bile acid, respectively; 100% of the hospitals could test ALT and 40.0% of the hospitals could test CK. The correct rates of selecting treatment strategy and determining the appropriate treatment goals were 53.7% and 17.6%, respectively.

CONCLUSIONThe hardware condition of community hospitals seem to have satisfied the implicit requirements of dyslipidemia evaluation and treatment but it was essential to improve the knowledge and ability among physicians in community hospitals.

China ; Data Collection ; Dyslipidemias ; diagnosis ; therapy ; Hospitals, Community ; statistics & numerical data ; Humans ; Practice Patterns, Physicians'

OBJECTIVETo analyze the influence of knowledge about hypertension and clinical competence among physicians in district and community hospitals on management of hypertensives.

METHODSQuestionnaire investigation was used in 9 district and community hospitals in Chaoyang and Haidian district, including 181 physicians and 204 patients with hypertension.

RESULTS(1) The hospitals involved were divided into two groups according to our evaluation on the knowledge of hypertension and clinical competence of physicians. Four hospitals were graded as high-score group and 5 hospitals as low-score group. (2) There was no significant difference on physicians' evaluation between district and community hospitals. There was higher proportion of hypertensives with instructed physical exercises, reducing salt ingestion, psychological balance and weight reduction in district hospitals than those in community ones. (3) The proportion of hypertensives who were examined with funduscopy, ambulatory pressure and instructed with physical exercises, reducing salt ingestion and weight reduction in high-score group was obviously higher than that in low-score group. The control rates of blood pressure, on the days of examination during lastest check-up or the past three months, were significantly higher in high-score group than in low-score group (P < 0.05).

CONCLUSIONKnowledge of hypertension and clinical management competence among physicians in district and community hospitals did influence the management of hypertension and education of physicians and thus should be increased.

Clinical Competence ; standards ; Delivery of Health Care ; standards ; Directive Counseling ; standards ; Education, Medical ; standards ; Hospitals, Community ; classification ; standards ; Humans ; Hypertension ; diagnosis ; therapy ; Patient Care ; standards ; Physicians ; standards

OBJECTIVETo evaluate the antitumor activity of a novel class of 4, 8-Disubstituted-8, 9-dihydropyrazine[2, 3-g]quinazoline-7(6H)-ketones in vitro, and to screen potential anticancer compounds for further study.

METHODSSeventeen compounds of 4, 8-Disubstituted-8, 9-dihydropyrazine[2, 3-g]quinazoline-7(6H)-ketones were synthesized with solid-phase method for biological evaluation of EGFR tyrosine kinase. MTT method was used to evaluate the cytotoxic activity in vitro against three human cancer cell lines (human lung carcinoma cell line A549, human leukemia cell lines K562 and human gastric carcinoma cell line SGC7901).

RESULTSCompound 7-13 and 7-14 showed potent antitumor activities against A549 cells, with IC(50) values of 8.10 and 8.12 mol/L, respectively. Eight compounds showed proliferative inhibition effect on K562 cells, especially 7-2, 7-13 and 7-17, with IC(50) values of 2.22,0.57 and 7.20 mol/L,respectively.And compound 7-13 and 7-3 showed potent antitumor activity against SGC7901 cells, with IC(50) values of 4.20 and 9.71 mol/L, respectively.

CONCLUSIONThe synthesized compounds 4, 8-Disubstituted-8, 9-dihydropyrazine[2, 3-g] quinazoline-7(6H)-ketones show inhibition effects on human cancer cell lines in vitro. Compound 7-13 has anticancer activity in all three cancer cell lines, which might be used as a potential antitumor drug for further study.

Antineoplastic Agents ; chemical synthesis ; chemistry ; pharmacology ; Cell Line, Tumor ; Drug Screening Assays, Antitumor ; Humans ; K562 Cells ; Lung Neoplasms ; pathology ; Molecular Structure ; Pyrazines ; chemical synthesis ; chemistry ; pharmacology ; Quinazolines ; chemical synthesis ; chemistry ; pharmacology ; Receptor, Epidermal Growth Factor ; antagonists & inhibitors ; Stomach Neoplasms ; pathology ; Structure-Activity Relationship

OBJECTIVETo review our experience in surgical management of proximal anterior cerebral artery (A1) aneurysms in 23 patients.

METHODSBetween January, 2004 and December, 2014, 23 patients (1.6%) with A1 aneurysms diagnosed by CTA or DSA were treated surgically. The "3H" therapy was adopted for postoperative prevention of cerebrovascular spasm. All the patients were followed up and examined with cerebrovascular CTA at 6, 12, 48 and 60 months after the operation with their Glasgow Outcome Scale score recorded.

RESULTSThe patients consisted of 15 men and 8 women with an age range of 16 to 72 years (mean 51.3 years). The average diameter of the aneurysms was 5.8 mm, ranging from 3.2 to 9.7 mm. Twenty-two saccular aneurysms were found in these patients; 21 patients presented with SAH and two had vascular malformation. All the A1 aneurysms were managed through the pterional approach, and the mean postoperative Glasgow Outcome Scale score was 4.8.

CONCLUSIONThorough analysis of the angiographic data is essential for the diagnosis and treatment of A1 aneurysms. Preservation of the perforators and prevention of aneurysm rupture are critical during the surgery. Full exposure of the Sylvian fissure and temporary occlusion of the parent artery ensures safe and effective dissection of A1 aneurysms.